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Sample records for aids mortality rates

  1. Trends in under-5 mortality rates and the HIV/AIDS epidemic.

    PubMed Central

    Adetunji, J.

    2000-01-01

    INTRODUCTION: The prevalence of human immunodeficiency virus (HIV) among adults and mortality rates among under-5-year-olds have increased or stagnated in many countries. The objective of this study was to investigate whether there is a link between under-5 mortality trends and the prevalence of HIV among adults and, if so, to assess the magnitude of the effect of adult HIV prevalence on under-5 mortality rates. METHOD: Data from Demographic and Health Surveys were used to establish the trends in under-5 mortality rates for 25 countries for which there are data for at least two points in time. Countries were ranked according to the most recent adult HIV prevalence data and grouped in three categories: those with very high HIV prevalence (> or = 5%); those with moderately high prevalence (1-4.9%); and those with low prevalence (< 1%). A mathematical model was fitted to obtain an estimate of the contribution of HIV/AIDS to the level of under-5 mortality in each country. RESULTS: Under-5 mortality rates showed an increase in most countries with high adult HIV prevalence, but a decrease in almost every country with moderately high or low prevalence. The estimated contribution of adult HIV prevalence to the observed level of under-5 mortality was highest (up to 61%) in Zimbabwe (where HIV prevalence was highest) and tended to decrease with the level of HIV prevalence. DISCUSSION: The contribution of HIV/AIDS to childhood mortality therefore appears to be most noticeable in settings where the epidemic is most severe. PMID:11100615

  2. Mortality rates decline in Malaysia.

    PubMed

    1991-11-01

    Experiencing remarkable decreases in mortality rates over the past 3 decades, Malaysia currently has one of the lowest mortality rates among developing countries, a rate that compares favorably with those of developed countries. Between 1957 and 1989, the crude death rate dropped from 12.4/1000 population to 4.6. Over the same period, Malaysia recorded even greater decreases in the infant mortality rate, from 75.5/1000 births to 15.2. The Maternal mortality rate also declined from 1.48 in 1970 to 0.24 in 1988. The data indicates that mortality rates vary from state to state, and that rural areas have a higher mortality than urban areas. According to a study by the National Population and Family Development Board, the use of maternal and child health services has played an important role in reducing neonatal, perinatal, infant, child, and maternal mortality rates. Nearly all women in Malaysia receive antenatal services. While the country has achieved great gains on mortality rates, programs focusing on specific age and socioeconomic groups could lead to even greater reductions. The Minister for National Unity and Social Development, Dato Napsiah Omar, has called for the development of programs designed to improve the population's quality of life.

  3. Mortality rates decline in Malaysia.

    PubMed

    1991-11-01

    Experiencing remarkable decreases in mortality rates over the past 3 decades, Malaysia currently has one of the lowest mortality rates among developing countries, a rate that compares favorably with those of developed countries. Between 1957 and 1989, the crude death rate dropped from 12.4/1000 population to 4.6. Over the same period, Malaysia recorded even greater decreases in the infant mortality rate, from 75.5/1000 births to 15.2. The Maternal mortality rate also declined from 1.48 in 1970 to 0.24 in 1988. The data indicates that mortality rates vary from state to state, and that rural areas have a higher mortality than urban areas. According to a study by the National Population and Family Development Board, the use of maternal and child health services has played an important role in reducing neonatal, perinatal, infant, child, and maternal mortality rates. Nearly all women in Malaysia receive antenatal services. While the country has achieved great gains on mortality rates, programs focusing on specific age and socioeconomic groups could lead to even greater reductions. The Minister for National Unity and Social Development, Dato Napsiah Omar, has called for the development of programs designed to improve the population's quality of life. PMID:12284509

  4. Examining non-AIDS mortality among people who inject drugs

    PubMed Central

    Mathers, Bradley M.; Degenhardt, Louisa

    2014-01-01

    Objective: To systematically review and analyse data from cohorts of people who inject drugs (PWID) to improve existing estimates of non-AIDS mortality used to calculate mortality among PWID in the Spectrum Estimates and Projection Package. Design: Systematic review and meta-analysis. Methods: We conducted an update of an earlier systematic review of mortality among PWID, searching specifically for studies providing data on non-AIDS-related deaths. Random-effects meta-analyses were performed to derive pooled estimates of non-AIDS crude mortality rates across cohorts disaggregated by sex, HIV status and periods in and out of opioid substitution therapy (OST). Within each cohort, ratios of non-AIDS CMRs were calculated and then pooled across studies for the following paired sub-groups: HIV-negative versus HIV-positive PWID; male versus female PWID; periods in OST versus out of OST. For each analysis, pooled estimates by country income group and by geographic region were also calculated. Results: Thirty-seven eligible studies from high-income countries and five from low and middle-income countries were found. Non-AIDS mortality was significantly higher in low and middle-income countries [2.74 per 100 person-years; 95% confidence interval (CI) 1.76–3.72] than in high-income countries (1.56 per 100 person-years; 95% CI 1.38–1.74). Non-AIDS CMRs were 1.34 times greater among men than women (95% CI 1.14–1.57; N = 19 studies); 1.50 times greater among HIV-positive than HIV-negative PWID (95% CI 1.15, 1.96; N = 16 studies); and more than three times greater during periods out of OST than for periods on OST (N = 7 studies). Conclusions: A comprehensive response to injecting drug must include efforts to reduce the high levels of non-AIDS mortality among PWID. Due to limitations of currently available data, including substantial heterogeneity between studies, estimates of non-AIDS mortality specific to geographic regions, country income level, or the

  5. Mortality among People Living with HIV and AIDS in China: Implications for Enhancing Linkage

    PubMed Central

    Li, Meng; Tang, Weiming; Bu, Kai; Mahapatra, Tanmay; Zhang, Xiayan; Feng, Yibing; Chen, Fangfang; Guo, Wei; Wang, Liyan; Ding, Zhengwei; Qin, Qianqian; Liu, Shiliang; Tucker, Joseph D.; Wang, Lu; Wang, Ning

    2016-01-01

    To assess the patterns and predictors of AIDS-related mortality and identify its correlates among adult people living with HIV/AIDS (PLWHA) in China, a retrospective record-based cohort study was conducted among 18 years or older PLWHA, who had at least one follow up reported to the national database between January-1989 and June-2012. Cumulative Incidence Function was used to calculate AIDS-related mortality rate. Gray’s test was used to determine the variation in cumulative incidence across strata. The Fine and Gray model was used to measure the burden of cumulative incidence of AIDS-related mortality and strength of its association with potential correlates. Among 375,629 patients, 107,634 died during study period, of which 54,759 (50.87%) deaths were AIDS-related. Cumulative mortality rates of AIDS-related death at one, two, five, 10 and 15 years post-diagnosis were 5.7%, 8.2%, 14.3%, 22.9% and 30.9%, respectively. Among PLWHA, male gender, ethnic minority and having AIDS were associated with significantly higher mortality. Further, homosexual transmission, being on ART and increasing CD4-testing frequency were associated with lower mortality. To reduce mortality among PLWHA, efficient interventions targeting males, ethnic minority, heterosexually infected and AIDS patients should be combined with immunologic monitoring, enhancement of coverage of HIV-testing and ART. PMID:27324204

  6. The Economic Consequences of AIDS mortality in South Africa

    PubMed Central

    Bärnighausen, Till; Case, Anne; Menendez, Alicia

    2014-01-01

    We quantify the impact of adult deaths on household economic wellbeing, using a large longitudinal dataset spanning more than a decade. Verbal autopsies allow us to distinguish AIDS mortality from that due to other causes. The timing of the lower socioeconomic status observed for households with AIDS deaths suggests that the socioeconomic gradient in AIDS mortality is being driven primarily by poor households being at higher risk for AIDS, rather than AIDS impoverishing the households. Following a death, households that experienced an AIDS death are observed being poorer still. However, the additional socioeconomic loss following an AIDS death is very similar to the loss observed from sudden death. Funeral expenses can explain some of the impoverishing effects of death in the household. In contrast, the loss of an employed member cannot. To date, antiretroviral therapy has not changed the socioeconomic status gradient observed in AIDS deaths. PMID:25411517

  7. HIV-induced immunodeficiency and mortality from AIDS-defining and non-AIDS-defining malignancies

    PubMed Central

    2009-01-01

    Objective To evaluate deaths from AIDS-defining malignancies (ADM) and non-AIDS-defining malignancies (nADM) in the D:A:D Study and to investigate the relationship between these deaths and immunodeficiency. Design Observational cohort study. Methods Patients (23 437) were followed prospectively for 104 921 person-years. We used Poisson regression models to identify factors independently associated with deaths from ADM and nADM. Analyses of factors associated with mortality due to nADM were repeated after excluding nADM known to be associated with a specific risk factor. Results Three hundred five patients died due to a malignancy, 298 prior to the cutoff for this analysis (ADM: n=110; nADM: n=188). The mortality rate due to ADM decreased from 20.1/1000 person-years of follow-up [95% confidence interval (CI) 14.4, 25.9] when the most recent CD4 cell count was <50 cells/μl to 0.1 (0.03, 0.3)/1000 person-years of follow-up when the CD4 cell count was more than 500 cells/μl; the mortality rate from nADM decreased from 6.0 (95% CI 3.3, 10.1) to 0.6 (0.4, 0.8) per 1000 person-years of follow-up between these two CD4 cell count strata. In multivariable regression analyses, a two-fold higher latest CD4 cell count was associated with a halving of the risk of ADM mortality. Other predictors of an increased risk of ADM mortality were homosexual risk group, older age, a previous (non-malignancy) AIDS diagnosis and earlier calendar years. Predictors of an increased risk of nADM mortality included lower CD4 cell count, older age, current/ex-smoking status, longer cumulative exposure to combination antiretroviral therapy, active hepatitis B infection and earlier calendar year. Conclusion The severity of immunosuppression is predictive of death from both ADM and nADM in HIV-infected populations. PMID:18832878

  8. 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. PMID:22352149

  9. 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.

  10. Infectious Disease Mortality Rates, Thailand, 1958–2009

    PubMed Central

    McCarron, Margaret; Lertiendumrong, Jongkol; Olsen, Sonja J.; Bundhamcharoen, Kanitta

    2012-01-01

    To better define infectious diseases of concern in Thailand, trends in the mortality rate during 1958–2009 were analyzed by using data from public health statistics reports. From 1958 to the mid-1990s, the rate of infectious disease–associated deaths declined 5-fold (from 163.4 deaths/100,000 population in 1958 to 29.5/100,000 in 1997). This average annual reduction of 3.2 deaths/100,000 population was largely attributed to declines in deaths related to malaria, tuberculosis, pneumonia, and gastrointestinal infections. However, during 1998–2003, the mortality rate increased (peak of 70.0 deaths/100,000 population in 2003), coinciding with increases in mortality rate from AIDS, tuberculosis, and pneumonia. During 2004–2009, the rate declined to 41.0 deaths/100,000 population, coinciding with a decrease in AIDS-related deaths. The emergence of AIDS and the increase in tuberculosis- and pneumonia-related deaths in the late twentieth century emphasize the need to direct resources and efforts to the control of emerging and re-emerging infectious diseases. PMID:23092558

  11. Rate of bacterial mortality in aquatic environments

    SciTech Connect

    Servais, P.; Billen, G.; Rego, J.V.

    1985-06-01

    A method is proposed which provides a minimum estimate of the rate of bacterial mortality in growing natural populations of planktonic bacteria. This estimate is given by the rate of decrease of radioactivity from the DNA of a (/sup 3/H)thymidine-labeled natural assemblage of bacteria after all added thymidine has been exhausted from the medium. Results obtained from river water, estuarine water, and seawater show overall bacterial mortality rates in the range 0.010 to 0.030 h/sup -1/, in good agreement with the range of growth rates measured in the same environments. Use of selective filtration through Nuclepore filters (pore size, 2 ..mu..m) allowed us to determine the contribution of microzooplankton grazing to overall bacterial mortality. Grazing rates estimated by this method ranged from 0 to 0.02 h/sup -1/.

  12. Liver cancer mortality rate model in Thailand

    NASA Astrophysics Data System (ADS)

    Sriwattanapongse, Wattanavadee; Prasitwattanaseree, Sukon

    2013-09-01

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

  13. InterVA versus Spectrum: how comparable are they in estimating AIDS mortality patterns in Nairobi's informal settlements?

    PubMed Central

    Oti, Samuel Oji; Wamukoya, Marilyn; Mahy, Mary; Kyobutungi, Catherine

    2013-01-01

    Background The Spectrum computer package is used to generate national AIDS mortality estimates in settings where vital registration systems are lacking. Similarly, InterVA-4 (the latest version of the InterVA programme) is used to estimate cause-of-mortality data in countries where cause-specific mortality data are not available. Objective This study aims to compare trends in adult AIDS-related mortality estimated by Spectrum with trends from the InterVA-4 programme applied to data from a Health and Demographic Surveillance System (HDSS) in Nairobi, Kenya. Design A Spectrum model was generated for the city of Nairobi based on HIV prevalence data for Nairobi and national antiretroviral therapy coverage, underlying mortality, and migration assumptions. We then used data, generated through verbal autopsies, on 1,799 deaths that occurred in the HDSS area from 2003 to 2010 among adults aged 15–59. These data were then entered into InterVA-4 to estimate causes of death using probabilistic modelling. Estimates of AIDS-related mortality rates and all-cause mortality rates from Spectrum and InterVA-4 were compared and presented as annualised trends. Results Spectrum estimated that HIV prevalence in Nairobi was 7%, while the HDSS site measured 12% in 2010. Despite this difference, Spectrum estimated higher levels of AIDS-related mortality. Between 2003 and 2010, the proportion of AIDS-related mortality in Nairobi decreased from 63 to 40% according to Spectrum and from 25 to 16% according to InterVA. The net AIDS-related mortality in Spectrum was closer to the combined mortality rates when AIDS and tuberculosis (TB) deaths were included for InterVA-4. Conclusion Overall trends in AIDS-related deaths from both methods were similar, although the values were closer when TB deaths were included in InterVA. InterVA-4 might not accurately differentiate between TB and AIDS deaths. PMID:24160914

  14. Excess mortality in patients with AIDS in the era of highly active antiretroviral therapy: Temporal changes and risk factors

    PubMed Central

    Puhan, Milo A.; Van Natta, Mark L.; Palella, Frank J.; Addessi, Adrienne; Meinert, Curtis

    2010-01-01

    Background Excess mortality has declined among HIV infected patients but without evidence of a decline in patients with AIDS. We assessed temporal changes in excess mortality and elucidated risk factors for excess mortality in patients with AIDS diagnosed in the era of highly active antiretroviral therapy (HAART). Methods We included 1,188 patients of the Longitudinal Study of Ocular Complications in AIDS who were between 25-64 years old at enrollment and diagnosed with AIDS after 1995. We calculated excess mortality as the age-, year- and sex-adjusted difference in mortality rates between patients with AIDS and persons in the US general population, between 1999 and 2007, and used a relative survival model to identify risk factors for excess mortality. Results There were an average of 50 excess deaths (95% CI 44-57) per 1,000 person years between 1999 and 2007. Excess mortality almost halved with an annual decline of 8.0% per year (3.0-12.7 p=0.002) but remained high at 36 excess deaths per 1,000 person years in 2007. Viral load >400 vs. ≤400 copies/mL (risk ratio 3.4 [2.3-5.0]), CD4+ count <200 vs. ≥200 cells/μL (2.7 [1.9-3.9]) and cytomegalovirus retinitis (1.6 [1.2-2.1]) were the strongest risk factors for excess mortality. Conclusions Excess mortality among patients with AIDS was nearly halved in the HAART era and most strongly linked to stage of HIV disease. These results reflect the continuing improvements in AIDS management but also highlight that excess mortality remains about five times higher in patients with AIDS than in patients with HIV-infection but no AIDS. PMID:20825306

  15. Does cosmic weather affect infant mortality rate?

    PubMed

    Shamir, Lior

    2010-01-01

    In this article, the author proposes to consider a link between infant mortality rate (IMR) and galactic cosmic radiation (CR) density. The periodical increase in solar activity increases the effect of the magnetic field of the sun, and therefore weakens galactic cosmic rays hitting the Earth's surface. As a result, embryos in their early stages of development may be less exposed to high-energy ionizing cosmic rays when the solar activity peaks. In the study discussed here, cosmic ray density data were correlated with the U.S. infant mortality rate in the following year. Statistical analysis shows that in the past 30 years, Pearson correlation between the change in galactic CR flux and IMR decrease in the following year was -0.36 (p < .05). PMID:20687328

  16. Female breast cancer mortality rates in Turkey.

    PubMed

    Dogan, Nurhan; Toprak, Dilek

    2014-01-01

    The main objective of this study was to analyze the mortality trends of female breast cancer in Turkey between the years 1987-2008. The rates per 100,000 age-standardized to the European standard population were assessed and time trends presented using joinpoint regression analysis. Average annual percent change (AAPC), anual percent change (APC) and 95% confidence interval (CI) was calculated. Nearly 23,000 breast cancer deaths occurred in Turkey during the period 1987-2008, with the average annual age-standardized mortality rate (ASR) being 11.9 per 100,000 women. In the last five years, significant increases were observed in all age groups, but there was no significant change over the age of 65. In this period, the biggest significant increase was in the 45-54 age group (AAPC=4.3, 95%CI=2.6 to 6.0). PMID:25292030

  17. Regional Differences in AIDS and Non-AIDS Related Mortality in HIV-Positive Individuals across Europe and Argentina: The EuroSIDA Study

    PubMed Central

    Reekie, Joanne; Kowalska, Justyna D.; Karpov, Igor; Rockstroh, Jurgen; Karlsson, Anders; Rakhmanova, Aza; Horban, Andrzej; Kirk, Ole; Lundgren, Jens D.; Mocroft, Amanda

    2012-01-01

    Background Differences in access to care and treatment have been reported in Eastern Europe, a region with one of the fastest growing HIV epidemics, compared to the rest of Europe. This analysis aimed to establish whether there are regional differences in the mortality rate of HIV-positive individuals across Europe, and Argentina. Methods 13,310 individuals under follow-up were included in the analysis. Poisson regression investigated factors associated with the risk of death. Findings During 82,212 person years of follow-up (PYFU) 1,147 individuals died (mortality rate 14.0 per 1,000 PYFU (95% confidence interval [CI] 13.1–14.8). Significant differences between regions were seen in the rate of all-cause, AIDS and non-AIDS related mortality (global p<0.0001 for all three endpoints). Compared to South Europe, after adjusting for baseline demographics, laboratory measurements and treatment, a higher rate of AIDS related mortality was observed in East Europe (IRR 2.90, 95%CI 1.97–4.28, p<.0001), and a higher rate of non-AIDS related mortality in North Europe (IRR 1.51, 95%CI 1.24–1.82, p<.0001). The differences observed in North Europe decreased over calendar-time, in 2009–2011, the higher rate of non-AIDS related mortality was no longer significantly different to South Europe (IRR 1.07, 95%CI 0.66–1.75, p = 0.77). However, in 2009–2011, there remained a higher rate of AIDS-related mortality (IRR 2.41, 95%CI 1.11–5.25, p = 0.02) in East Europe compared to South Europe in adjusted analysis. Interpretations There are significant differences in the rate of all-cause mortality among HIV-positive individuals across different regions of Europe and Argentina. Individuals in Eastern Europe had an increased risk of mortality from AIDS related causes and individuals in North Europe had the highest rate of non-AIDS related mortality. These findings are important for understanding and reviewing HIV treatment strategies and policies across the European region

  18. Size-dependent mortality rate profiles.

    PubMed

    Roa-Ureta, Ruben H

    2016-08-01

    Knowledge of mortality rates is crucial to the understanding of population dynamics in populations of free-living fish and invertebrates in marine and freshwater environments, and consequently to sustainable resource management. There is a well developed theory of population dynamics based on age distributions that allow direct estimation of mortality rates. However, for most cases the aging of individuals is difficult or age distributions are not available for other reasons. The body size distribution is a widely available alternative although the theory underlying the formation of its shape is more complicated than in the case of age distributions. A solid theory of the time evolution of a population structured by any physiological variable has been developed in 1960s and 1970s by adapting the Hamilton-Jacobi formulation of classical mechanics, and equations to estimate the body size-distributed mortality profile have been derived for simple cases. Here I extend those results with regards to the size-distributed mortality profile to complex cases of non-stationary populations, individuals growing according to a generalised growth model and seasonally patterned recruitment pulses. I apply resulting methods to two cases in the marine environment, a benthic crustacean population that was growing during the period of observation and whose individuals grow with negative acceleration, and a sea urchin coastal population that is undergoing a stable cycle of two equilibrium points in population size whose individuals grow with varying acceleration that switches sign along the size range. The extension is very general and substantially widens the applicability of the theory. PMID:27164999

  19. Exploring Thailand's mortality transition with the aid of life tables.

    PubMed

    Carmichael, Gordon A

    2011-01-01

    The project Thai Health-Risk Transition: A National Cohort Study seeks to better understand the health implications of modernisation and globalisation forces impacting on Thailand. As part of its "look-back" component this paper seeks, using available life tables, to document the country's post-war mortality transition. The onset of transition through mass campaigns of the late 1940s and 1950s is first discussed before attention turns to the life tables. They are predictably far from flawless, but careful analysis does permit trends that have seen around 30 years added to life expectancy to be traced, and age patterns of improved survivorship and their relation to initiatives to improve health to be examined. The broad benefits generated by mass campaigns, ongoing improvements in infant and early childhood mortality, and a phased impact of the expansion of primary health care in rural areas on adult survival prospects after the mid-1970s are demonstrated. The paper also investigates the consequences for mortality of a motorcycle-focused rapid increase in road fatalities in the late 1980s and early 1990s and the HIV/AIDS epidemic that developed after 1984. PMID:21847831

  20. Exploring Thailand's mortality transition with the aid of life tables

    PubMed Central

    Carmichael, Gordon A

    2011-01-01

    The project Thai Health-Risk Transition: A National Cohort Study seeks to better understand the health implications of modernisation and globalisation forces impacting on Thailand. As part of its ‘look-back’ component this paper seeks, using available life tables, to document the country's post-war mortality transition. The onset of transition through mass campaigns of the late 1940s and 1950s is first discussed before attention turns to the life tables. They are predictably far from flawless, but careful analysis does permit trends that have seen around 30 years added to life expectancy to be traced, and age patterns of improved survivorship and their relation to initiatives to improve health to be examined. The broad benefits generated by mass campaigns, ongoing improvements in infant and early childhood mortality, and a phased impact of the expansion of primary health care in rural areas on adult survival prospects after the mid-1970s are demonstrated. The paper also investigates the consequences for mortality of a motorcycle-focused rapid increase in road fatalities in the late 1980s and early 1990s and the HIV/AIDS epidemic that developed after 1984. PMID:21847831

  1. Exploring Thailand's mortality transition with the aid of life tables.

    PubMed

    Carmichael, Gordon A

    2011-01-01

    The project Thai Health-Risk Transition: A National Cohort Study seeks to better understand the health implications of modernisation and globalisation forces impacting on Thailand. As part of its "look-back" component this paper seeks, using available life tables, to document the country's post-war mortality transition. The onset of transition through mass campaigns of the late 1940s and 1950s is first discussed before attention turns to the life tables. They are predictably far from flawless, but careful analysis does permit trends that have seen around 30 years added to life expectancy to be traced, and age patterns of improved survivorship and their relation to initiatives to improve health to be examined. The broad benefits generated by mass campaigns, ongoing improvements in infant and early childhood mortality, and a phased impact of the expansion of primary health care in rural areas on adult survival prospects after the mid-1970s are demonstrated. The paper also investigates the consequences for mortality of a motorcycle-focused rapid increase in road fatalities in the late 1980s and early 1990s and the HIV/AIDS epidemic that developed after 1984.

  2. MORBIDITY AND MORTALITY DUE TO AIDS: A STUDY OF BURDEN OF DISEASE AT A MUNICIPAL LEVEL

    PubMed Central

    SILVA, Jane DA; RAMOS, Victoria; SILVA, Helena Caetano Gonçalves DA; TRAEBERT, Jefferson

    2015-01-01

    Introduction: The purpose of measuring the burden of disease involves aggregating morbidity and mortality components into a single indicator, the disability-adjusted life year (DALY), to measure how much and how people live and suffer the impact of a disease. Objective: To estimate the global burden of disease due to AIDS in a municipality of southern Brazil. Methods: An ecological study was conducted in 2009 to examine the incidence and AIDS-related deaths among the population residing in the city of Tubarao, Santa Catarina State, Brazil. Data from the Mortality Information System in the National Health System was used to calculate the years of life lost (YLL) due to premature mortality. The calculation was based on the difference between a standardized life expectancy and age at death, with a discount rate of 3% per year. Data from the Information System for Notifiable Diseases were used to calculate the years lived with disability (YLD). The DALY was estimated by the sum of YLL and YLD. Indicator rates were estimated per 100,000 inhabitants, distributed by age and gender. Results: A total of 131 records were examined, and a 572.5 DALYs were estimated, which generated a rate of 593.1 DALYs/100,000 inhabitants. The rate among men amounted to 780.7 DALYs/100,000, whereas among women the rate was 417.1 DALYs/100,000. The most affected age groups were 30-44 years for men and 60-69 years for women. Conclusion: The burden of disease due to AIDS in the city of Tubarao was relatively high when considering the global trend. The mortality component accounted for more than 90% of the burden of disease. PMID:26603227

  3. Variations of Radon Risk with Changing Mortality Rates

    SciTech Connect

    Chen Jing

    2008-08-07

    This study examines the variation of radon risks with changing mortality rates. The Canadian age-specific mortality rates averaged over five year periods from 1986 to 1990 and from 1996 to 2000 were used in the risk calculations. Because of the synergistic interaction between smoking and radon, the risk of radon induced lung cancer for Canadian men decreased with the declining lung cancer mortality rates while for Canadian women the radon risks increased with the rising lung cancer mortality rates.

  4. Variations of Radon Risk with Changing Mortality Rates

    NASA Astrophysics Data System (ADS)

    Chen, Jing

    2008-08-01

    This study examines the variation of radon risks with changing mortality rates. The Canadian age-specific mortality rates averaged over five year periods from 1986 to 1990 and from 1996 to 2000 were used in the risk calculations. Because of the synergistic interaction between smoking and radon, the risk of radon induced lung cancer for Canadian men decreased with the declining lung cancer mortality rates while for Canadian women the radon risks increased with the rising lung cancer mortality rates

  5. Recurrent pneumonia mortality risk in a HIV/AIDS Puerto Rican cohort.

    PubMed

    Mayor, A M; Gomez, M A; Rios, E; Hunter, R F

    2003-12-01

    Recurrent pneumonia (RP) within 12 months is one of the AIDS diagnosis criteria. To gain knowledge of RP infection in HIV-infected patients, we studied 145 RP cases detected in a cohort of 2,996 HIV patients in Puerto Rico between Jan. 1992-Dec. 2001. The RP prevalence was 4.8%; 77.2% were males and 62.1% were injecting drug users (IDU). At the time of RP diagnosis, the mean CD4+ T cell count was 93.8 cells/mm3, 59.3% were in antiretroviral treatment, 13% had received the pneumococcal vaccine and 84.8% had another AIDS related condition. Over 37% received two or more antiretroviral medications. The death rate in the first year after the RP diagnosis was 63.4%. A Cox proportional hazard analysis showed that CD4+ T cells <200/mm3 (p<0.05), history of toxoplasmosis (p<0.01), wasting syndrome (p<0.01), esophageal candidiasis (p<0.05) and lower number of antiretroviral medications (p<0.05) increased their mortality risk. The studied patients had a highly compromised immune system and a very low pneumococcal vaccination percent at the time of RP diagnosis. Low CD4+ T cells significantly increased the hazard and mortality risk of the cases studied. Antecedents of antiretroviral therapy in these patients ensure a better outcome with lower mortality. Efforts to increase the vaccination rate should reduce the RP incidence in our HIV-infected population.

  6. Mortality Rates in a Genetically Heterogeneous Population of Caenorhabditis elegans

    NASA Astrophysics Data System (ADS)

    Brooks, Anne; Lithgow, Gordon J.; Johnson, Thomas E.

    1994-02-01

    Age-specific mortality rates in isogenic populations of the nematode Caenorhabditis elegans increase exponentially throughout life. In genetically heterogeneous populations, age-specific mortality increases exponentially until about 17 days and then remains constant until the last death occurs at about 60 days. This period of constant age-specific mortality results from genetic heterogeneity. Subpopulations differ in mean life-span, but they all exhibit near exponential, albeit different, rates of increase in age-specific mortality. Thus, much of the observed heterogeneity in mortality rates later in life could result from genetic heterogeneity and not from an inherent effect of aging.

  7. Ubiquitous burden: the contribution of migration to AIDS and Tuberculosis mortality in rural South Africa

    PubMed Central

    Bocquier, Philipe; Collinson, Mark A.; Clark, Samuel J.; Gerritsen, Annette A.M.; Kahn, Kathleen; TollMan, Stephen M.

    2014-01-01

    The paper aims to estimate the extent to which migrants are contributing to AIDS or tuberculosis (TB) mortality among rural sub-district populations. The Agincourt (South Africa) health and socio-demographic surveillance system provided comprehensive data on vital and migration events between 1994 and 2006. AIDS and TB cause-deleted life expectancy, and crude death rates by gender, migration status and period were computed. The annualised crude death rate almost tripled from 5·39 [95% CI 5·13–5·65] to 15·10 [95% CI 14·62–15·59] per 1000 over the years 1994–2006. The contribution of AIDS and TB in returned migrants to the increase in crude death rate was 78·7% [95% CI 77·4–80·1] for males and 44·4% [95% CI 43·2–46·1] for females. So, in a typical South African setting dependent on labour migration for rural livelihoods, the contribution of returned migrants, many infected with AIDS and TB, to the burden of disease is high. PMID:25574071

  8. Estimating cause-specific mortality rates using recovered carcasses.

    PubMed

    Joly, Damien O; Heisey, Dennis M; Samuel, Michael D; Ribic, Christine A; Thomas, Nancy J; Wright, Scott D; Wright, Irene E

    2009-01-01

    Stranding networks, in which carcasses are recovered and sent to diagnostic laboratories for necropsy and determination of cause of death, have been developed to monitor the health of marine mammal and bird populations. These programs typically accumulate comprehensive, long-term datasets on causes of death that can be used to identify important sources of mortality or changes in mortality patterns that lead to management actions. However, the utility of these data in determining cause-specific mortality rates has not been explored. We present a maximum likelihood-based approach that partitions total mortality rate, estimated by independent sources, into cause-specific mortality rates. We also demonstrate how variance estimates are derived for these rates. We present examples of the method using mortality data for California sea otters (Enhydra lutris nereis) and Florida manatees (Trichechus manatus latirostris). PMID:19204341

  9. Infant, neonatal and perinatal mortality rates in Singapore.

    PubMed

    Tan, K L

    1982-07-01

    Infant, neonatal and perinatal mortality rates are reliable indices of the health status and delivery of health care in a country. These rates have been declining in Singapore since World War II, and presently have become comparable to those of many developing countries. The pattern has also changed; postneonatal mortality has fallen markedly, resulting in neonatal mortality accounting for 75% of infant mortality, and first week mortality for 85% of neonatal mortality. Perinatal mortality rates have also declined over the years, due mainly to a decline in the first week mortality rates though a slight fall in stillbirth rates has also occurred. Further improvements can be expected in the perinatal and neonatal mortality rates. As neonatal intensive care improves, the prognosis of the very small and feeble infants will be brighter even though the efforts required might be very much greater. Such a challenge will prove to be very exciting and stimulating, and be an impetus to the raising of neonatal intensive care to a much higher level.

  10. Engineering Aid 1 & C. Rate Training Manual.

    ERIC Educational Resources Information Center

    Naval Education and Training Command, Pensacola, FL.

    The manual is written primarily to aid in the training of personnel to meet the professional qualifications of the engineering aid, first class and chief. In chapter one, the trainee becomes familiar with the rewards and responsibilities of an engineering aid. Chapter two deals with principles of SEABEE administration, the organization and…

  11. Prediction of mortality rates in the presence of missing values

    NASA Astrophysics Data System (ADS)

    Tan, Chon Sern; Pooi, Ah Hin

    2015-12-01

    A time series model based on multivariate power-normal distribution has been applied in the past literature on the United States (US) mortality data from the years 1933 to 2000 to forecast the future age-specific mortality rates of the years 2001 to 2010. In this paper, we show that the method based on multivariate power-normal distribution can still be used for an incomplete US mortality dataset that contains some missing values. The prediction intervals based on this incomplete training data are found to still have good ability of covering the observed future mortality rates although the interval lengths may become wider for long-range prediction.

  12. United States counties with low black male mortality rates

    PubMed Central

    Levine, Robert; Rust, George; Aliyu, Muktar; Pisu, Maria; Zoorob, Roger; Goldzweig, Irwin; Juarez, Paul; Husaini, Baqar; Hennekens, Charles H.

    2013-01-01

    OBJECTIVE In the United States, young and middle-aged black men have significantly higher total mortality than any other racial or ethnic group. We describe the characteristics of US counties with low non–Hispanic Black or African American male mortality (ages 25-64 years, 1999-2007). METHODS Information was accessed through public data, the US Census, the US Compressed Mortality File, and the Native American Graves Repatriation Act military database. RESULTS Of 1307 counties with black mortality rates classified as reliable by the National Center for Health Statistics (at least 20 deaths), 66 recorded lower mortality among black men than corresponding US whites. Most notable, 97% of the 66 counties were home to or adjacent a military installation versus 37% of comparable US counties (P .001). Blacks in these counties had less poverty, higher percentages of elderly civilian veterans, and higher per capita income. Within these counties, national black:white disparities in mortality were eliminated for ischemic heart disease, accidents, diseases of the liver, chronic lower respiratory diseases, and mental disorder from psychoactive substance use. Application of age-, race-, ethnicity-, gender-, and urbanization-specific mortality rates from counties with relatively low mortality would reduce the black:white mortality rate ratio for black men aged 25 to 64 years from 1.67 to 1.20 nationally and to 1.00 in areas outside large central metropolitan areas. CONCLUSIONS These descriptive data demonstrate a small number of communities with low mortality rates among young and middle-aged black/African American men. Their characteristics may provide clinical and public health insights to reduce these higher mortality rates in the US population. Analytic epidemiologic studies are necessary to test these hypotheses. PMID:23260504

  13. All-cause mortality in the cohorts of the Spanish AIDS Research Network (RIS) compared with the general population: 1997–2010

    PubMed Central

    2013-01-01

    Background Combination antiretroviral therapy (cART) has produced significant changes in mortality of HIV-infected persons. Our objective was to estimate mortality rates, standardized mortality ratios and excess mortality rates of cohorts of the AIDS Research Network (RIS) (CoRIS-MD and CoRIS) compared to the general population. Methods We analysed data of CoRIS-MD and CoRIS cohorts from 1997 to 2010. We calculated: (i) all-cause mortality rates, (ii) standardized mortality ratio (SMR) and (iii) excess mortality rates for both cohort for 100 person-years (py) of follow-up, comparing all-cause mortality with that of the general population of similar age and gender. Results Between 1997 and 2010, 8,214 HIV positive subjects were included, 2,453 (29.9%) in CoRIS-MD and 5,761 (70.1%) in CoRIS and 294 deaths were registered. All-cause mortality rate was 1.02 (95% CI 0.91-1.15) per 100 py, SMR was 6.8 (95% CI 5.9-7.9) and excess mortality rate was 0.8 (95% CI 0.7-0.9) per 100 py. Mortality was higher in patients with AIDS, hepatitis C virus (HCV) co-infection, and those from CoRIS-MD cohort (1997–2003). Conclusion Mortality among HIV-positive persons remains higher than that of the general population of similar age and sex, with significant differences depending on the history of AIDS or HCV coinfection. PMID:23961924

  14. Subjective ratings of noise-reduction hearing aids.

    PubMed

    Kuk, F K; Tyler, R S; Mims, L

    1990-01-01

    The effectiveness of seven commercially available noise-reduction hearing aids was evaluated using subjective ratings of continuous discourse. Subjective scales of listening comfort, speech quality, speech understanding, noise interference, and overall liking were used. Fifteen experienced hearing-aid users participated. Two hearing aids that used amplitude compression (Audiotone A-54 and Telex 363C), two hearing aids that used the Zeta Noise Blocker (two versions of a Maico SP147), and three hearing aids that proportionally attenuated the low-frequencies (Rion HB-69AS, Richards ASE-B, and Siemens 283 ASP) were evaluated. None of the noise-reduction hearing aids significantly altered group performance on any subjective scale. Individually, however, subjects responded differently to different noise-reduction hearing aids, indicating that some noise-reduction hearing aids may help some hearing-impaired individuals.

  15. Why have ovarian cancer mortality rates declined? Part I. Incidence.

    PubMed

    Sopik, Victoria; Iqbal, Javaid; Rosen, Barry; Narod, Steven A

    2015-09-01

    The age-adjusted mortality rate from ovarian cancer in the United States has declined over the past several decades. The decline in mortality might be the consequence of a reduced number of cases (incidence) or a reduction in the proportion of patients who die from their cancer (case-fatality). In part I of this three-part series, we examine rates of ovarian cancer incidence and mortality from the Surveillance Epidemiology and End Results (SEER) registry database and we explore to what extent the observed decline in mortality can be explained by a downward shift in the stage distribution of ovarian cancer (i.e. due to early detection) or by fewer cases of ovarian cancer (i.e. due to a change in risk factors). The proportion of localized ovarian cancers did not increase, suggesting that a stage-shift did not contribute to the decline in mortality. The observed decline in mortality paralleled a decline in incidence. The trends in ovarian cancer incidence coincided with temporal changes in the exposure of women from different birth cohorts to various reproductive risk factors, in particular, to changes in the use of the oral contraceptive pill and to declining parity. Based on recent changes in risk factor propensity, we predict that the trend of the declining age-adjusted incidence rate of ovarian cancer in the United States will reverse and rates will increase in coming years. PMID:26080287

  16. Ecological integrity of streams related to human cancer mortality rates.

    PubMed

    Hitt, Nathaniel P; Hendryx, Michael

    2010-08-01

    Assessments of ecological integrity have become commonplace for biological conservation, but their role for public health analysis remains largely unexplored. We tested the prediction that the ecological integrity of streams would provide an indicator of human cancer mortality rates in West Virginia, USA. We characterized ecological integrity using an index of benthic macroinvertebrate community structure (West Virginia Stream Condition Index, SCI) and quantified human cancer mortality rates using county-level data from the Centers for Disease Control and Prevention. Regression and spatial analyses revealed significant associations between ecological integrity and public health. SCI was negatively related to age-adjusted total cancer mortality per 100,000 people. Respiratory, digestive, urinary, and breast cancer rates increased with ecological disintegrity, but genital and oral cancer rates did not. Smoking, poverty, and urbanization were significantly related to total cancer mortality, but did not explain the observed relationships between ecological integrity and cancer. Coal mining was significantly associated with ecological disintegrity and higher cancer mortality. Spatial analyses also revealed cancer clusters that corresponded to areas of high coal mining intensity. Our results demonstrated significant relationships between ecological integrity and human cancer mortality in West Virginia, and suggested important effects of coal mining on ecological communities and public health. Assessments of ecological integrity therefore may contribute not only to monitoring goals for aquatic life, but also may provide valuable insights for human health and safety.

  17. Remarkable rates of lightning strike mortality in Malawi.

    PubMed

    Mulder, Monique Borgerhoff; Msalu, Lameck; Caro, Tim; Salerno, Jonathan

    2012-01-01

    Livingstone's second mission site on the shore of Lake Malawi suffers very high rates of consequential lightning strikes. Comprehensive interviewing of victims and their relatives in seven Traditional Authorities in Nkhata Bay District, Malawi revealed that the annual rate of consequential strikes was 419/million, more than six times higher than that in other developing countries; the rate of deaths from lightning was 84/million/year, 5.4 times greater than the highest ever recorded. These remarkable figures reveal that lightning constitutes a significant stochastic source of mortality with potential life history consequences, but it should not deflect attention away from the more prominent causes of mortality in this rural area.

  18. Improving estimates of tree mortality probability using potential growth rate

    USGS Publications Warehouse

    Das, Adrian J.; Stephenson, Nathan L.

    2015-01-01

    Tree growth rate is frequently used to estimate mortality probability. Yet, growth metrics can vary in form, and the justification for using one over another is rarely clear. We tested whether a growth index (GI) that scales the realized diameter growth rate against the potential diameter growth rate (PDGR) would give better estimates of mortality probability than other measures. We also tested whether PDGR, being a function of tree size, might better correlate with the baseline mortality probability than direct measurements of size such as diameter or basal area. Using a long-term dataset from the Sierra Nevada, California, U.S.A., as well as existing species-specific estimates of PDGR, we developed growth–mortality models for four common species. For three of the four species, models that included GI, PDGR, or a combination of GI and PDGR were substantially better than models without them. For the fourth species, the models including GI and PDGR performed roughly as well as a model that included only the diameter growth rate. Our results suggest that using PDGR can improve our ability to estimate tree survival probability. However, in the absence of PDGR estimates, the diameter growth rate was the best empirical predictor of mortality, in contrast to assumptions often made in the literature.

  19. Increased cardiovascular disease mortality rates in traumatic lower limb amputees.

    PubMed

    Modan, M; Peles, E; Halkin, H; Nitzan, H; Azaria, M; Gitel, S; Dolfin, D; Modan, B

    1998-11-15

    We evaluated the 24-year mortality rates of male traumatic lower limb amputees (n = 201) of the Israeli army, wounded between 1948 and 1974 compared with a cohort sample representing the general population (n = 1,832). Mortality rates were significantly higher (21.9% vs 12.1%, p <0.001) in amputees than in controls. Cardiovascular disease (CVD) mortality was the main cause for this difference. The prevalence of selected risk factors for CVD was determined in 101 surviving amputees (aged 50 to 65 years) and a sample of the controls (n = 96) matched by age and ethnic origin. Amputees had higher plasma insulin levels (during fasting and in response to oral glucose loading) and increased blood coagulation activity. No differences were found in rates of current symptoms of ischemic heart disease or of cerebrovascular disease, obesity, hypertension, altered plasma lipoprotein profile, impaired physical activity, smoking, or nutritional habits. Traumatic lower limb amputees had increased mortality rates due to CVD. Surviving amputees had hyperinsulinemia, increased coagulability, and increased sympathetic and parasympathetic responses (described previously). These established CVD risk factors may explain the excess mortality due to CVD in traumatic amputees.

  20. Mortality Rates during Cholera Epidemic, Haiti, 2010-2011.

    PubMed

    Luquero, Francisco J; Rondy, Marc; Boncy, Jacques; Munger, André; Mekaoui, Helmi; Rymshaw, Ellen; Page, Anne-Laure; Toure, Brahima; Degail, Marie Amelie; Nicolas, Sarala; Grandesso, Francesco; Ginsbourger, Maud; Polonsky, Jonathan; Alberti, Kathryn P; Terzian, Mego; Olson, David; Porten, Klaudia; Ciglenecki, Iza

    2016-03-01

    The 2010 cholera epidemic in Haiti was one of the largest cholera epidemics ever recorded. To estimate the magnitude of the death toll during the first wave of the epidemic, we retrospectively conducted surveys at 4 sites in the northern part of Haiti. Overall, 70,903 participants were included; at all sites, the crude mortality rates (19.1-35.4 deaths/1,000 person-years) were higher than the expected baseline mortality rate for Haiti (9 deaths/1,000 person-years). This finding represents an excess of 3,406 deaths (2.9-fold increase) for the 4.4% of the Haiti population covered by these surveys, suggesting a substantially higher cholera mortality rate than previously reported.

  1. Mortality Rates during Cholera Epidemic, Haiti, 2010–2011

    PubMed Central

    Rondy, Marc; Boncy, Jacques; Munger, André; Mekaoui, Helmi; Rymshaw, Ellen; Page, Anne-Laure; Toure, Brahima; Degail, Marie Amelie; Nicolas, Sarala; Grandesso, Francesco; Ginsbourger, Maud; Polonsky, Jonathan; Alberti, Kathryn P.; Terzian, Mego; Olson, David; Porten, Klaudia; Ciglenecki, Iza

    2016-01-01

    The 2010 cholera epidemic in Haiti was one of the largest cholera epidemics ever recorded. To estimate the magnitude of the death toll during the first wave of the epidemic, we retrospectively conducted surveys at 4 sites in the northern part of Haiti. Overall, 70,903 participants were included; at all sites, the crude mortality rates (19.1–35.4 deaths/1,000 person-years) were higher than the expected baseline mortality rate for Haiti (9 deaths/1,000 person-years). This finding represents an excess of 3,406 deaths (2.9-fold increase) for the 4.4% of the Haiti population covered by these surveys, suggesting a substantially higher cholera mortality rate than previously reported. PMID:26886511

  2. Infant mortality, the birth rate, and development in Egypt.

    PubMed

    Field, J O; Ropes, G

    1980-07-01

    This paper is a product of the Massachusetts Institute of Technology-Cairo University Health Care Delivery Systems Project which has examined the delivery of health services in Egypt in relation to malnutrition, early childhood mortality, and fertility. Egypt's economic progress since the 1952 Revolution has had only limited effect on high mortality among preschool children, infants and a high rate of population growth. This paper uses governorate data and simple analytical methods. 10% of Egyptian children die in the 1st year of life; subsequent mortality is also extensive in the preschool age children. The crude birthrate remains in the high 30s and overall population growth continues unabated. Early childhood mortality reflects the interplay of malnutrition and infection and population growth is caused by the fact that children, especially males, are considered economic assets. High fertility is a reflection of high mortality to a significant degree. 4 dimensions of development in Egypt are: 1) an urban cluster, 2) poverty, 3) the incidence of women in the paid labor force, 4) development in the rural sector, and 5) population density. Agricultural income increases as women enter the paid labor force and agricultural productivity is weakly related to the practice of women working for pay. Infant mortality in Egypt varies with and is most influenced by population pressures on the land, including urban crowdedness and by the proportion of households living below the poverty line. Female employment adds to family income and affects infant mortality indirectly. Policy implications are: 1) the government must deal with the density factor, 2) it must pursue a development strategy that stimulates productivity and raises the resource base of society, and 3) the government must address infant mortality along with malnutrition and morbidity. The author concludes that: 1) variation in the birth rate is less than variation in the infant mortality rate, 2) mortality and

  3. Benchmarking clinical practice in surgery: looking beyond traditional mortality rates.

    PubMed

    Castro, Ricardo A S; Oliveira, Pedro N; Silva Portela, Conceição; Camanho, Ana S; Queiroz e Melo, João

    2015-12-01

    This paper proposes two new measures to assess performance of surgical practice based on observed mortality: reliability, measured as the area under the ROC curve and a living score, the sum of individual risk among surviving patients, divided by the total number of patients. A Monte Carlo simulation of surgeons' practice was used for conceptual validation and an analysis of a real-world hospital department was used for managerial validation. We modelled surgical practice as a bivariate distribution function of risk and final state. We sampled 250 distributions, varying the maximum risk each surgeon faced, the distribution of risk among dead patients, the mortality rate and the number of surgeries performed yearly. We applied the measures developed to a Portuguese cardiothoracic department. We found that the joint use of the reliability and living score measures overcomes the limitations of risk adjusted mortality rates, as it enables a different valuation of deaths, according to their risk levels. Reliability favours surgeons with casualties, predominantly, in high values of risk and penalizes surgeons with deaths in relatively low levels of risk. The living score is positively influenced by the maximum risk for which a surgeon yields surviving patients. These measures enable a deeper understanding of surgical practice and, as risk adjusted mortality rates, they rely only on mortality and risk scores data. The case study revealed that the performance of the department analysed could be improved with enhanced policies of risk management, involving the assignment of surgeries based on surgeon's reliability and living score.

  4. AIDS mortality in a tertiary health institution: A four-year review.

    PubMed Central

    Sani, Mahmoud U.; Mohammed, Aminu Z.; Adamu, Bappa; Yusuf, Shehu M.; Samaila, Adamu A.; Borodo, Musa M.

    2006-01-01

    Africa contains 70% of adults and 80% of children living with AIDS in the world and has buried 75% of the 21.8 million worldwide who have died of AIDS since the epidemic began. Nigeria, the most populous country in Africa, has 5.8% of her adult population having HIV infection at the end of 2003. We reviewed the causes of death among AIDS patients in Aminu Kano Teaching Hospital Kano, Nigeria over four years. Four-hundred-fifty-five (9.9%) of the 4,574 adult medical admissions were due to HIV/AIDS-related diagnosis. HIV/AIDS admissions increased progressively from 45 cases in 2001 to 174 in 2004. HIV/AIDS caused 176 deaths over the period giving an HIV-related mortality of 38.7%. This also showed a gradual increase from 24 deaths in 2001 to 61 deaths in 2004. The most common causes of death were tuberculosis (33.4%), septicemia (23.8%), advanced HIV disease (9.1%), meningitis (7.4%), other pulmonary infections (5.1%) and Kaposi's sarcoma (4.5%). The present dismal situation of patients living with HIV/AIDS calls for enhanced strategies to decrease the mortality trend observed. With the introduction of affordable highly active antiretroviral therapy (HAART) in several centers in Nigeria, it is hoped that infected patients can be made to live longer. PMID:16775907

  5. Mortality trends: toward a new definition of AIDS?

    PubMed

    Highleyman, Liz

    2005-01-01

    HIV disease today looks very different than it did two decades ago when the first cases were described--at least in developed countries where highly active antiretroviral therapy (HAART) is widely available. Most HIV positive people receiving treatment no longer succumb to opportunistic illnesses (OIs) that take advantage of their ravaged immune systems. Instead, people with HIV now live longer and die from a wide variety of other causes. In other words, a growing number of positive people will die with HIV, but not of HIV. In the HAART era, HIV positive people and their health-care providers must now think about the cumulative impact of chronic HIV infection and the longterm side effects of treatment. In addition, as effective antiretroviral therapy extends the lives of people with HIV, they become prone to conditions that normally occur with greater frequency as people age (such as heart disease, diabetes, and osteoporosis) and progressive conditions that may take decades to cause significant illness or death (such as chronic viral hepatitis). Given the shifts in the types of conditions now seen in people with HIV, it may be time to rethink the definition of AIDS. PMID:15828120

  6. Fiscal decentralisation and infant mortality rate: the Colombian case.

    PubMed

    Soto, Victoria Eugenia; Farfan, Maria Isabel; Lorant, Vincent

    2012-05-01

    There is a paucity of research analysing the influence of fiscal decentralisation on health outcomes. Colombia is an interesting case study, as health expenditure there has been decentralising since 1993, leading to an improvement in health care insurance. However, it is unclear whether fiscal decentralisation has improved population health. We assess the effect of fiscal decentralisation of health expenditure on infant mortality rates in Colombia. Infant mortality rates for 1080 municipalities over a 10-year period (1998-2007) were related to fiscal decentralisation by using an unbalanced fixed-effect regression model with robust errors. Fiscal decentralisation was measured as the locally controlled health expenditure as a proportion of total health expenditure. We also evaluated the effect of transfers from central government and municipal institutional capacity. In addition, we compared the effect of fiscal decentralisation at different levels of municipal poverty. Fiscal decentralisation decreased infant mortality rates (the elasticity was equal to -0.06). However, this effect was stronger in non-poor municipalities (-0.12) than poor ones (-0.081). We conclude that decentralising the fiscal allocation of responsibilities to municipalities decreased infant mortality rates. However, this improved health outcome effect depended greatly on the socio-economic conditions of the localities. The policy instrument used by the Health Minister to evaluate municipal institutional capacity in the health sector needs to be revised. PMID:22417812

  7. Estimating cancer mortality rates from SEER incidence and survival data.

    PubMed Central

    Chu, K C; Horm, J W; Smart, C R

    1990-01-01

    A method to estimate site-specific cancer mortality rates using Surveillance, Epidemiology, and End Results (SEER) Program incidence and survival data is proposed, calculated, and validated. This measure, the life table-derived mortality rate (LTM), is the sum of the product of the probability of being alive at the beginning of an interval times the probability of dying of the cancer of interest during the interval times the annual age-adjusted incidence rate for each year that data have been collected. When the LTM is compared to death certificate mortality rates (DCM) for organ sites with no known misclassification problems, the LTM was within 10 percent of the death certificate rates for 13 of 14 organ sites. In the sites that have problems with the death certificate rates, there were major disagreements between the LTM and DCM. The LTM was systematically lower than the DCM for sites if there was overreporting on the death certificates, and the LTM was higher than the DCM for sites if there was underreporting. The limitations and applications of the LTM are detailed. PMID:2106703

  8. Suicide mortality rates in Louisiana, 1999-2010.

    PubMed

    Straif-Bourgeois, Susanne; Ratard, Raoult

    2012-01-01

    This report is a descriptive study on suicide deaths in Louisiana occurring in the years 1999 to 2010. Mortality data was collected from death certificates from this 12-year period to describe suicide mortality by year, race, sex, age group, and methods of suicide. Data were also compared to national data. Rates and methods used to commit suicide vary greatly according to sex, race, and age. The highest rates were observed in white males, followed by black males, white females, and black females. Older white males had the highest suicide rates. The influence of age was modulated by the sex and race categories. Firearm was the most common method used in all four categories. Other less common methods were hanging/strangulation/suffocation (HSS) and drugs/alcohol. Although no parish-level data were systematically analyzed, a comparison of suicide rates post-Katrina versus pre-Katrina was done for Orleans Parish, the rest of the Greater New Orleans area, and a comparison group. It appears that rates observed among whites, particularly males, were higher after Katrina. Data based on mortality do not give a comprehensive picture of the burden of suicide, and their interpretation should be done with caution. PMID:23362593

  9. Suicide mortality rates in Louisiana, 1999-2010.

    PubMed

    Straif-Bourgeois, Susanne; Ratard, Raoult

    2012-01-01

    This report is a descriptive study on suicide deaths in Louisiana occurring in the years 1999 to 2010. Mortality data was collected from death certificates from this 12-year period to describe suicide mortality by year, race, sex, age group, and methods of suicide. Data were also compared to national data. Rates and methods used to commit suicide vary greatly according to sex, race, and age. The highest rates were observed in white males, followed by black males, white females, and black females. Older white males had the highest suicide rates. The influence of age was modulated by the sex and race categories. Firearm was the most common method used in all four categories. Other less common methods were hanging/strangulation/suffocation (HSS) and drugs/alcohol. Although no parish-level data were systematically analyzed, a comparison of suicide rates post-Katrina versus pre-Katrina was done for Orleans Parish, the rest of the Greater New Orleans area, and a comparison group. It appears that rates observed among whites, particularly males, were higher after Katrina. Data based on mortality do not give a comprehensive picture of the burden of suicide, and their interpretation should be done with caution.

  10. Self-rated health and mortality in people with diabetes.

    PubMed Central

    Dasbach, E J; Klein, R; Klein, B E; Moss, S E

    1994-01-01

    OBJECTIVES. This study examined whether self-rated health is an independent and significant predictor of mortality in people with diabetes, using data collected in the Wisconsin Epidemiologic Study of Diabetic Retinopathy. METHODS. Participants were asked to rate their health in comparison with others their age. A proportional hazards model was used to regress survival time on self-rated health and a number of covariates measuring physical health. RESULTS. People with younger onset diabetes (n = 891) who rated their health relative to their peers as "worse" or "don't know" were no more likely to die than those rating their health as "the same" or "better" when physical health status was controlled. In contrast, those with older onset diabetes (n = 987) who rated their health as "worse" or "don't know" were almost twice as likely to die as those rating their health as "the same" or "better" when physical health status was controlled. CONCLUSIONS. Self-rated health is a significant predictor of mortality in people with older onset diabetes but not in those with younger onset diabetes when physical health status is controlled. PMID:7977916

  11. Engineering Aid 3 & 2, Vol. 2. Rate Training Manual.

    ERIC Educational Resources Information Center

    Bernal, Benito C., Jr.

    Designed for individual study and not formal classroom instruction, this rate training manual provides subject matter that relates directly to the occupational qualifications of the Engineering Aid (EA) rating. This volume contains 10 chapters which deal with: (1) wood and light frame structures (examining the uses, kinds, sizes, and grades of…

  12. Dynamics of self-rated health and selective mortality

    PubMed Central

    2011-01-01

    Self-rated health status (SRHS) is one of the most frequently used health measures in empirical health economics. This article analyzes the first seven waves of the Health and Retirement Study (HRS) and finds that (1) all available lags have decreasing but significant predictive power for current SRHS and (2) SRHS and future mortality are strongly related which leads to a specific selection problem known as survivorship bias. A parsimonious joint model with an autocorrelated latent health component in both the SRHS and the mortality equation is suggested. It is better able to capture the empirical facts than commonly used models including random effects and/or state dependence and better able to correct the survivorship bias than commonly used strategies such as inverse probability weighting. PMID:21423875

  13. The case of the elusive infant mortality rate.

    PubMed

    Hartford, R B

    1984-05-01

    The layperson's concern focuses on 4 criteria for comparabiltiy of infant mortality data: appropriateness of unit of analysis, whether or not the population measured is a certain minimum size or conforms to some social or demographic standard; completeness, i.e., the extent to which all relevant are counted; coverage -- the extent to which all population segements or subgroups are included in the registration system within a country; and uniformity of measurement, that is, use of standard definitions and measurement procedures. A year ago Carl Haub's article, "Where Does the U.S. Stand in Infant Mortality," ranked the US 19th in a comparison with 30 other countries. Following UN practice, Haub excluded countries reporting less than 50 infant deaths, whose rates might be easily skewed. Completeness of registration was not a problem in highly industrialized nations with highly developed medical care and statistics recording systems. In recent years coverage has been essentially comprehensive. It is with the uniformity of measurement that complications arise -- in discriminating between a fetal death and an infant death. The UN standard lists 4 life signs for an infant, any one of which constitutes a live birth. Other countries have had a shorter list of admissible signs. Still other countries have excluded infants dying within 24 hours of birth or set viability criteria for including newly born in the infant category. Yet, the statistics in many cases have become standardized. Regarding the objection that the US with its large mixed population cannot be compared with small European countries, 10 states of the US with the lowest infant mortality rates in 1980 are examined. They are: New Hampshire (9.2); Wyoming (9.8); Vermont (9.9); Minnesota (10.0); Colorado (10.1); Wisconsin (10.3); Hawaii (10.3); Kansas (10.4); Utah (10.4); and Massachustetts (10.5). The populations of most of these states are small and homogeneous. If these states were to be inserted into Haub

  14. [Mortality from the HIV/AIDS in the Instituto Mexicano del Seguro Social].

    PubMed

    Vázquez-Martínez, José Luis; Mercadillo-Pérez, María Guadalupe; Celis-Quintal, Juan Germán

    2011-01-01

    Mortality is an indicator that allow us to evaluate HIV infection control programs. From the middle of the last decade, mortality presents a tendency to decrease in the population covered by the Instituto Mexicano del Seguro Social). In relation to gender and age group the most affected are men between 25 to 44 years of age with mortality rates ranging from 30 to 12 by 100,000 men (1995 to 2009 respectively). In 2009, at least half of the Delegaciones (administrative units by State) present larger mortality rates than the institutional average, particularly Campeche with 14.9 by 100,000 men. It is clear that introduction of control measures against the disease from infected people represents a modification in the course of the illness in the population covered by IMSS.

  15. Disentangling Effects of Vector Birth Rate, Mortality Rate, and Abundance on Spread of Plant Pathogens.

    PubMed

    Sisterson, Mark S; Stenger, Drake C

    2016-04-01

    Models on the spread of insect-transmitted plant pathogens often fix vector population size by assuming that deaths are offset by births. Although such mathematical simplifications are often justified, deemphasizing parameters that govern vector population size is problematic, as reproductive biology and mortality schedules of vectors of plant pathogens receive little empirical attention. Here, the importance of explicitly including parameters for vector birth and death rates was evaluated by comparing results from models with fixed vector population size with models with logistic vector population growth. In fixed vector population size models, increasing vector mortality decreased percentage of inoculative vectors, but had no effect on vector population size, as deaths were offset by births. In models with logistic vector population growth, increasing vector mortality decreased percentage of inoculative vectors and decreased vector population size. Consequently, vector mortality had a greater effect on pathogen spread in models with logistic vector population growth than in models with fixed vector population size. Further, in models with logistic vector population growth, magnitude of vector birth rate determined time required for vector populations to reach large size, thereby determining when pathogen spread occurred quickly. Assumptions regarding timing of vector mortality within a time step also affected model outcome. A greater emphasis of vector entomologists on studying reproductive biology and mortality schedules of insect species that transmit plant pathogens will facilitate identification of conditions associated with rapid growth of vector populations and could lead to development of novel control strategies.

  16. Immunization coverage and infant mortality rate in developing countries.

    PubMed

    Shimouchi, A; Ozasa, K; Hayashi, K

    1994-01-01

    We examined whether immunization coverage (IMC) is one of the predictors of infant mortality rate (IMR), as a single indicator representing the availability of primary health care (PHC) services in developing countries. Multiple regression analysis showed that partial correlation coefficients for IMR with immunization coverage (-0.224), logarithm of per capita GNP (-0.294), total fertility rate (0.269), and adult literacy rate (-0.325) were all statistically significant (p < 0.001) in 97 developing countries which make up more than 97% of the population in all the developing countries of the world. Multiple correlation coefficients of IMR with these four variables in 97 countries was 0.921. Thus, more than 80% of variation of IMR in developing countries were explained by the variation of the four variables. The study also showed that IMC was well correlated (simple correlation) with the four indicators of the availability of primary health care services; access to local care (0.730), care of pregnant women (0.603), delivery care (0.666), and infant care (0.553), all of which were statistically significant (p < 0.001) in the 48 developing countries which make up 42% of the population of all developing countries. Multiple correlation coefficients of these four variables was 0.787. About 60% of the variation of IMC will be explained by the variation of the four variables. Thus we conclude that immunization coverage is one of the main predictors of the infant mortality rate. It represents one of the health intervention components which can be used as a proxy indicator of the availability of PHC service in developing countries.

  17. Refocusing the lens: epidemiologic transition theory, mortality differentials, and the AIDS pandemic.

    PubMed

    Gaylin, D S; Kates, J

    1997-03-01

    The epidemiologic transition theory presented first by Omran [Omram. A. R. (1971) The epidemiologic transition: a theory of the epidemiology of population change, Mildbank Quarterly 49(4), 509-538] was designed to explain global trends in the dynamic relationship between epidemiological phenomena and demographic change. This paper argues that universalizing this theory only partially serves to explain mortality declines over the last century and eclipses key epidemiologic differences between population subgroups based on socioeconomic status, race, and sex. This paper examines morbidity and mortality differentials between population subgroups and demonstrates important inconsistencies with the optimistic trends implied by the epidemiologic transition theory, an argument further developed using the HIV/AIDS pandemic as a case study. The paper argues that these differences should be brought from margins to center to present a more complex and comprehensive picture of how population subgroups experience epidemiologic transitions differently. PMID:9032829

  18. Strategies to reduce infant mortality rate in India.

    PubMed

    Ghai, O P

    1985-01-01

    As a systems approach is needed to develop strategies to reduce the infant mortality rate (IMR), it is appropriate to analyze the present situation in India, reasons for low IMR in some Indian states vis-a-vis others, the status in some neighboring countries, and the cost effectiveness of various available technological interventions and their organizational constraints. A 1981 survey revealed 1) a low IMR for the state of Kerala, one which was comparable with Western nations, despite the fact that nearly half of the population in Kerala lived below the poverty line; 2) a very high IMR for the state of Uttar Pradesh, even though the number of people living below the poverty line was not significantly by different from the state of Kerala; and a moderate IMR reduction in the state of Punjab, even though only 15% of the population was below the poverty line. Favorable factors for low IMR appear to be a high female literacy rate, good medical and educational facilities close to the place of residence, and an excellent transportation and communication system. To significantly reduce IMR in a short period of time, it is necessary to adopt certain immediate measures. Nearly 55% of infant deaths occur in the 1st month of life, and these generally are not amenable to general measures and technological interventions. The problem is difficult, but a solution can be found by reaching a broad consensus among professionals and administrators. The major recommendations of a seminar on the Strategies for Reducing infant Mortality in India, held during January 1984, were: provide antenatal care to 100% of pregnant women; work for early registration of pregnancy and identification of high risk pregnancies; immunize 100% of pregnant women with tetanus toxoid; make available intrapartum care for all pregnant women; delineate anticipated job requirements, duties, and functions of village level health workers; make presterilized packaged delivery kits available to all female health

  19. Variable Impact on Mortality of AIDS-Defining Events Diagnosed during Combination Antiretroviral Therapy: Not All AIDS-Defining Conditions Are Created Equal

    PubMed Central

    2011-01-01

    Background The extent to which mortality differs following individual acquired immunodeficiency syndrome (AIDS)–defining events (ADEs) has not been assessed among patients initiating combination antiretroviral therapy. Methods We analyzed data from 31,620 patients with no prior ADEs who started combination antiretroviral therapy. Cox proportional hazards models were used to estimate mortality hazard ratios for each ADE that occurred in >50 patients, after stratification by cohort and adjustment for sex, HIV transmission group, number of anti-retroviral drugs initiated, regimen, age, date of starting combination antiretroviral therapy, and CD4+ cell count and HIV RNA load at initiation of combination antiretroviral therapy. ADEs that occurred in <50 patients were grouped together to form a “rare ADEs” category. Results During a median follow-up period of 43 months (interquartile range, 19–70 months), 2880 ADEs were diagnosed in 2262 patients; 1146 patients died. The most common ADEs were esophageal candidiasis (in 360 patients), Pneumocystis jiroveci pneumonia (320 patients), and Kaposi sarcoma (308 patients). The greatest mortality hazard ratio was associated with non-Hodgkin’s lymphoma (hazard ratio, 17.59; 95% confidence interval, 13.84–22.35) and progressive multifocal leukoencephalopathy (hazard ratio, 10.0; 95% confidence interval, 6.70–14.92). Three groups of ADEs were identified on the basis of the ranked hazard ratios with bootstrapped confidence intervals: severe (non-Hodgkin’s lymphoma and progressive multifocal leukoencephalopathy [hazard ratio, 7.26; 95% confidence interval, 5.55–9.48]), moderate (cryptococcosis, cerebral toxoplasmosis, AIDS dementia complex, disseminated Mycobacterium avium complex, and rare ADEs [hazard ratio, 2.35; 95% confidence interval, 1.76–3.13]), and mild (all other ADEs [hazard ratio, 1.47; 95% confidence interval, 1.08–2.00]). Conclusions In the combination antiretroviral therapy era, mortality rates

  20. Suicide mortality among people accessing highly active antiretroviral therapy for HIV/AIDS in British Columbia: a retrospective analysis

    PubMed Central

    Gurm, Jasmine; Samji, Hasina; Nophal, Adriana; Ding, Erin; Strehlau, Verena; Zhu, Julia; Montaner, Julio S.G.; Hogg, Robert S.

    2015-01-01

    Background Suicide rates have been reported at elevated levels among people living with HIV/AIDS. We sought to characterize longitudinal suicide rates among people living with HIV/AIDS who are accessing free highly active antiretroviral treatment (HAART) in British Columbia and evaluate the sociodemographic, clinical and behavioural factors associated with suicide in this population. Methods Retrospective analysis of all patients in the HAART Observational Medical Evaluation and Research (HOMER) cohort who were 19 years of age and older who started treatment between August 1996 and June 2012. The primary outcome variable was death due to suicide. Data on deaths were obtained monthly through a linkage with the British Columbia Ministry of Health Vital Statistics Agency. Logistic regression and Cox proportional hazards models were used to identify factors independently associated with suicide mortality. Results A total of 993 deaths among 5229 patients accessing treatment were recorded, of which 82 (8.2%) were caused by suicide. Death from suicide peaked at 961 deaths per 100 000 person-years in 1998 and declined to 2.81 deaths per 100 000 person-years in 2010. Cox regression analysis showed that a history of injection drug use (adjusted hazard ratio [AHR] = 3.95, 95% confidence interval [CI] 1.99–7.86) or having no experience with an AIDS-defining illness (AHR = 4.45, 95% CI 1.62–12.25) were factors independently associated with suicide. This model showed a 51% reduction (AHR = 0.49, 95% CI 0.45–0.54) in the suicide rate per calendar year. Interpretation Deaths from suicide declined substantially over time, and factors other than progression of HIV disease, such as injection drug use, may be important targets for intervention to reduce suicide risk. PMID:26389091

  1. AIDS web sites face censorship under new rating schemes.

    PubMed

    1997-08-22

    The American Civil Liberties Union (ACLU) issued a position paper regarding the software industry's proposed rating standards that will block and rate information judged unsuitable for minors. Following the U.S. Supreme Court's overturning of the Communications Decency Act, a ruling that maintains a high level of free speech protection over the Internet, the software industry began examining mechanisms to rate online content. Legislators are considering criminal penalties for those who misrate a web page. These moves are seen as damaging to HIV/AIDS prevention and safe sex information web sites that utilize jargon, street language, and explicit diagrams to teach safe sex practices to a wide audience. It is noted that related ratings and censorships do not apply to print material.

  2. Differences between Older Men and Women in the Self-Rated Health-Mortality Relationship

    ERIC Educational Resources Information Center

    Bath, Peter A.

    2003-01-01

    Purpose: The aims of this study were to examine differences between older men and women: (a) in the ability of self-rated health to predict mortality, (b) in the effect of different follow-up periods on the self-rated health mortality relationship, and (c) in the relative importance of self-rated health and self-rated change in health in…

  3. Effects of type of ownership of skilled nursing facilities on residents' mortality rates in Illinois.

    PubMed

    Bell, R; Krivich, M

    1990-01-01

    The effect of ownership on the quality and cost of care in skilled nursing facilities (SNFs) was examined using unadjusted and adjusted mortality rates for such facilities in Illinois for the 1986-87 reporting year. Results indicated that when using unadjusted mortality rates, for-profit facilities had much lower rates than either government-owned or nonprofit SNFs. When mortality rates were adjusted, using available measures of intervening variables, differences by type of ownership disappeared. The higher percentage of discharges to general hospitals exhibited by for-profit facilities, compared with other types of facility ownership, appears to have the strongest effect on SNF mortality rates. PMID:2120730

  4. Causes and rates of mortality of swift foxes in western Kansas

    USGS Publications Warehouse

    Sovada, M.A.; Roy, C.C.; Bright, J.B.; Gillis, J.R.

    1998-01-01

    Knowledge of mortality factors is important for developing strategies to conserve the swift fox (Vulpes velox), a species being considered for listing under the Endangered Species Act, but available information about swift fox mortality is inadequate. We used radiotelemetry techniques to examine the magnitude and causes of mortality of swift fox populations in 2 study areas in western Kansas. One study area was predominantly cropland, the other rangeland. Mortality rates, calculated using Kaplan-Meier estimation techniques in a staggered entry design, were 0.55 ?? 0.08 (5 ?? SE) for adult and 0.67 ?? 0.08 for juvenile swift foxes. We did not detect differences between study areas in mortality rates for adults or juveniles. Predation by coyotes (Canis latrans) was the major cause of mortality for adult and juvenile swift foxes in both study areas, and vehicle collision was an important mortality factor for juveniles in the cropland study area. No mortality was attributed to starvation or disease.

  5. Causes and implications of the correlation between forest productivity and tree mortality rates

    USGS Publications Warehouse

    Stephenson, Nathan L.; van Mantgem, Philip J.; Bunn, Andrew G.; Bruner, Howard; Harmon, Mark E.; O'Connell, Kari B.; Urban, Dean L.; Franklin, Jerry F.

    2011-01-01

    For only one of these four mechanisms, competition, can high mortality rates be considered to be a relatively direct consequence of high NPP. The remaining mechanisms force us to adopt a different view of causality, in which tree growth rates and probability of mortality can vary with at least a degree of independence along productivity gradients. In many cases, rather than being a direct cause of high mortality rates, NPP may remain high in spite of high mortality rates. The independent influence of plant enemies and other factors helps explain why forest biomass can show little correlation, or even negative correlation, with forest NPP.

  6. Widespread increase of tree mortality rates in the Western United States

    USGS Publications Warehouse

    van Mantgem, P.J.; Stephenson, N.L.; Byrne, J.C.; Daniels, L.D.; Franklin, J.F.; Fule, P.Z.; Harmon, M.E.; Larson, A.J.; Smith, Joseph M.; Taylor, A.H.; Veblen, T.T.

    2009-01-01

    Persistent changes in tree mortality rates can alter forest structure, composition, and ecosystem services such as carbon sequestration. Our analyses of longitudinal data from unmanaged old forests in the western United States showed that background (noncatastrophic) mortality rates have increased rapidly in recent decades, with doubling periods ranging from 17 to 29 years among regions. Increases were also pervasive across elevations, tree sizes, dominant genera, and past fire histories. Forest density and basal area declined slightly, which suggests that increasing mortality was not caused by endogenous increases in competition. Because mortality increased in small trees, the overall increase in mortality rates cannot be attributed solely to aging of large trees. Regional warming and consequent increases in water deficits are likely contributors to the increases in tree mortality rates.

  7. Child Mortality Estimation: Consistency of Under-Five Mortality Rate Estimates Using Full Birth Histories and Summary Birth Histories

    PubMed Central

    Silva, Romesh

    2012-01-01

    Background Given the lack of complete vital registration data in most developing countries, for many countries it is not possible to accurately estimate under-five mortality rates from vital registration systems. Heavy reliance is often placed on direct and indirect methods for analyzing data collected from birth histories to estimate under-five mortality rates. Yet few systematic comparisons of these methods have been undertaken. This paper investigates whether analysts should use both direct and indirect estimates from full birth histories, and under what circumstances indirect estimates derived from summary birth histories should be used. Methods and Findings Usings Demographic and Health Surveys data from West Africa, East Africa, Latin America, and South/Southeast Asia, I quantify the differences between direct and indirect estimates of under-five mortality rates, analyze data quality issues, note the relative effects of these issues, and test whether these issues explain the observed differences. I find that indirect estimates are generally consistent with direct estimates, after adjustment for fertility change and birth transference, but don't add substantial additional insight beyond direct estimates. However, choice of direct or indirect method was found to be important in terms of both the adjustment for data errors and the assumptions made about fertility. Conclusions Although adjusted indirect estimates are generally consistent with adjusted direct estimates, some notable inconsistencies were observed for countries that had experienced either a political or economic crisis or stalled health transition in their recent past. This result suggests that when a population has experienced a smooth mortality decline or only short periods of excess mortality, both adjusted methods perform equally well. However, the observed inconsistencies identified suggest that the indirect method is particularly prone to bias resulting from violations of its strong

  8. Measures to reduce the infant mortality rate in Tanzania.

    PubMed

    Karungula, J

    1992-05-01

    Tanzanian health problems reflect those in other developing countries where the standard of living is low and housing and sanitation are inadequate. The major cause of infant mortality can be attributed to preventable diseases such as gastroenteritis, acute respiratory infections and malnutrition. In spite of the fact that various efforts have been made to extend primary health care coverage, particularly in rural areas, the scarcity of economic resources impedes the implementation of many health programmes. However, only by maintaining primary health care as a major part of the country's development strategy can the needs of both rural and urban people be met.

  9. The effects of differential unemployment rate increases of occupation groups on changes in mortality.

    PubMed Central

    Martikainen, P T; Valkonen, T

    1998-01-01

    OBJECTIVES: This study estimated the effects of changes in unemployment rates of occupation groups on changes in mortality in a period of increasing unemployment. METHODS: Census records for all 20- to 64-year-old economically active Finnish men in 1985 were linked to information on unemployment and deaths in 1987 through 1993. RESULTS: Change in mortality was similar in occupation groups in which unemployment rates increased at a different pace. These relationships were similar for all age groups and for mortality from diseases as well as accidents and violence. CONCLUSIONS: Unemployment does not seem to cause mortality in the short term. Excess mortality rates among unemployed individuals observed in previous studies may have been due in part to selection. PMID:9842389

  10. Women Chemists Mortality Study Finds High Suicide Rate.

    ERIC Educational Resources Information Center

    Chemical and Engineering News, 1984

    1984-01-01

    A study of white women members (N=347) of the American Chemical Society who died between 1925 and 1979 finds five times the expected rate of suicide, a higher risk for some forms of cancer, and a lower rate of heart disease. These and other findings are discussed. (JN)

  11. Occupational injury mortality rates in the United States: changes from 1980 to 1989.

    PubMed Central

    Stout, N A; Jenkins, E L; Pizatella, T J

    1996-01-01

    Changes in occupational injury mortality rates over the 1980s were examined through analysis of the National Traumatic Occupational Fatalities surveillance system. The US occupational injury mortality rate decreased 37% over the decade, with decreases seen in nearly every demographic and employment sector. Greater declines were among men, Blacks, and younger workers, as well as among agricultural, trade, and service workers. Electrocutions, machine-related incidents, and homicides showed the greatest decreases. Changes in occupational mortality rates by demography, industry, and cause of death indicate the areas in which the most progress has been made and those that are prime targets for prevention efforts. PMID:8561247

  12. Self rated health and mortality: a long term prospective study in eastern Finland

    PubMed Central

    Heistaro, S; Jousilahti, P; Lahelma, E; Vartiainen, E; Puska, P

    2001-01-01

    STUDY OBJECTIVE—To assess the relation between self rated health and mortality over a period of 23 years, taking into account medical history, cardiovascular risk factors, and education at the beginning of the follow up.
DESIGN—A cohort of random population samples. The baseline studies included a self administered questionnaire and a health examination. Mortality data were collected from the national mortality register using personal identification numbers.
SETTING—The provinces of North Karelia and Kuopio in eastern Finland.
PARTICIPANTS—Random samples of working age people (n=21 302) from the population register.
MAIN RESULTS—For self rated health, the age adjusted poor to good relative risk for all cause mortality was 2.36 (95% confidence intervals 2.10, 2.64) for men and 1.90 (1.63, 2.22) for women, and for cardiovascular mortality 2.29 (1.96, 2.68) for men and 2.34 (1.84, 2.96) for women. Adjusted for selected potentially fatal diseases from the subjects' medical histories, cardiovascular disease risk factors, and education, the corresponding relative risks for all cause mortality were 1.66 (1.47, 1.88) for men and 1.50 (1.26, 1.78) for women, and for cardiovascular mortality 1.54 (1.29, 1.82) for men and 1.63 (1.26, 2.10) for women. The association between self rated health and mortality attributable to external causes was fairly strong.
CONCLUSIONS—Poor self rated health is a strong predictor of mortality, and the association is only partly explained by medical history, cardiovascular disease risk factors, and education.


Keywords: self rated health; mortality; Finland PMID:11238576

  13. Captive Reptile Mortality Rates in the Home and Implications for the Wildlife Trade.

    PubMed

    Robinson, Janine E; St John, Freya A V; Griffiths, Richard A; Roberts, David L

    2015-01-01

    The trade in wildlife and keeping of exotic pets is subject to varying levels of national and international regulation and is a topic often attracting controversy. Reptiles are popular exotic pets and comprise a substantial component of the live animal trade. High mortality of traded animals raises welfare concerns, and also has implications for conservation if collection from the wild is required to meet demand. Mortality of reptiles can occur at any stage of the trade chain from collector to consumer. However, there is limited information on mortality rates of reptiles across trade chains, particularly amongst final consumers in the home. We investigated mortality rates of reptiles amongst consumers using a specialised technique for asking sensitive questions, additive Randomised Response Technique (aRRT), as well as direct questioning (DQ). Overall, 3.6% of snakes, chelonians and lizards died within one year of acquisition. Boas and pythons had the lowest reported mortality rates of 1.9% and chameleons had the highest at 28.2%. More than 97% of snakes, 87% of lizards and 69% of chelonians acquired by respondents over five years were reported to be captive bred and results suggest that mortality rates may be lowest for captive bred individuals. Estimates of mortality from aRRT and DQ did not differ significantly which is in line with our findings that respondents did not find questions about reptile mortality to be sensitive. This research suggests that captive reptile mortality in the home is rather low, and identifies those taxa where further effort could be made to reduce mortality rates.

  14. Captive Reptile Mortality Rates in the Home and Implications for the Wildlife Trade

    PubMed Central

    Robinson, Janine E.; St. John, Freya A. V.; Griffiths, Richard A.; Roberts, David L.

    2015-01-01

    The trade in wildlife and keeping of exotic pets is subject to varying levels of national and international regulation and is a topic often attracting controversy. Reptiles are popular exotic pets and comprise a substantial component of the live animal trade. High mortality of traded animals raises welfare concerns, and also has implications for conservation if collection from the wild is required to meet demand. Mortality of reptiles can occur at any stage of the trade chain from collector to consumer. However, there is limited information on mortality rates of reptiles across trade chains, particularly amongst final consumers in the home. We investigated mortality rates of reptiles amongst consumers using a specialised technique for asking sensitive questions, additive Randomised Response Technique (aRRT), as well as direct questioning (DQ). Overall, 3.6% of snakes, chelonians and lizards died within one year of acquisition. Boas and pythons had the lowest reported mortality rates of 1.9% and chameleons had the highest at 28.2%. More than 97% of snakes, 87% of lizards and 69% of chelonians acquired by respondents over five years were reported to be captive bred and results suggest that mortality rates may be lowest for captive bred individuals. Estimates of mortality from aRRT and DQ did not differ significantly which is in line with our findings that respondents did not find questions about reptile mortality to be sensitive. This research suggests that captive reptile mortality in the home is rather low, and identifies those taxa where further effort could be made to reduce mortality rates. PMID:26556237

  15. Categorizing Fetal Heart Rate Variability with and without Visual Aids

    PubMed Central

    Ashdown, Amanda J.; Scerbo, Mark W.; Belfore, Lee A.; Davis, Stephen S.; Abuhamad, Alfred Z.

    2016-01-01

    Objective This study examined the ability of clinicians to correctly categorize images of fetal heart rate (FHR) variability with and without the use of exemplars. Study Design A sample of 33 labor and delivery clinicians inspected static FHR images and categorized them into one of four categories defined by the National Institute of Child Health and Human Development (NICHD) based on the amount of variability within absent, minimal, moderate, or marked ranges. Participants took part in three conditions: two in which they used exemplars representing FHR variability near the center or near the boundaries of each range, and a third control condition with no exemplars. The data gathered from clinicians were compared with those from a previous study using novices. Results Clinicians correctly categorized more images when the FHR variability fell near the center rather than the boundaries of each range, F (1,32) = 71.69, p < 0.001, partial η2 = 0.69. They also correctly categorized more images when exemplars were available, F (2,64) = 5.44, p = 0.007, partial η2 = 0.15. Compared with the novices, the clinicians were more accurate and quicker in their category judgments, but this difference was limited to the condition without exemplars. Conclusion The results suggest that categorizing FHR variability is more difficult when the examples fall near the boundaries of each NICHD-defined range. Thus, clinicians could benefit from training with visual aids to improve judgments about FHR variability and potentially enhance safety in labor and delivery. PMID:27722031

  16. Rate of ESRD Exceeds Mortality among African Americans with Hypertensive Nephrosclerosis

    PubMed Central

    Wang, Xuelei; Wright, Jackson T.; Appel, Lawrence J.; Greene, Tom; Norris, Keith; Lewis, Julia

    2010-01-01

    In several studies, patients with CKD seemed to be at greater risk for dying from cardiovascular disease (CVD) than reaching ESRD. The purpose of this study was to compare incident ESRD rates with rates of total mortality, CVD death, and a CVD composite (CVD mortality and CVD hospitalization) among participants who had hypertensive nephrosclerosis and were enrolled in the African American Study of Kidney Disease and Hypertension (AASK). The study period included the AASK trial phase (1996 through 2001) and a subsequent cohort phase (2002 through 2007). The AASK enrolled 1094 participants. Of the 764 participants who completed the trial phase without an event, 691 (90%) enrolled in the cohort phase. During 11 years of follow-up, there were 59 CVD-related deaths and 118 non–CVD-related deaths. The rate of ESRD (3.9/100 patient-years) was significantly higher than the rates of total mortality (2.2/100 patient-years), CVD mortality (0.8/100 patient-years), and the CVD composite (3.2/100 patient-years). The incidence rate ratio of ESRD to CVD mortality was 5.0. The rate of ESRD consistently exceeded the various mortality rates across most of the subgroups defined by age, gender, income, education, previous CVD, baseline urine protein excretion, and baseline estimated GFR. In conclusion, AASK participants were more likely to reach ESRD than to die. PMID:20651163

  17. Mortality rates in a female cohort following asbestos exposure in Germany.

    PubMed

    Rösler, J A; Woitowitz, H J; Lange, H J; Woitowitz, R H; Ulm, K; Rödelsperger, K

    1994-08-01

    A cohort study was conducted of 616 German female workers with a history of exposure to asbestos. Standardized proportionate mortality analysis was done except for mesothelioma, for which proportionate mortality was computed based on best evident cause of death. Mortality from lung cancer was increased three times over expected value. Death rates due to mesothelioma were 340 times higher than in the general population. Female mortality rates surpassed those observed in men twofold for lung cancer and fourfold for mesothelioma. In comparison with published data from international cohort studies, the observed mortality for mesothelioma in our female cohort appeared higher than that previously reported. German women with a history of asbestos exposure are considered a high-risk group for developing mesothelioma and lung cancer. They should be a target group for intervention strategies (eg, chemoprevention, smoking cessation, early cancer detection).

  18. Understanding Racial and Ethnic Disparities in U.S. Infant Mortality Rates

    MedlinePlus

    ... specific infant mortality rates, by race and Hispanic origin of mother: United States, 2007 Gestational age (weeks) ... ethnic groups is higher than in other developed countries, all U.S. racial and ethnic groups might benefit ...

  19. Hypomagnesemia is a risk factor for nonrecovery of renal function and mortality in AIDS patients with acute kidney injury.

    PubMed

    Santos, M S Biagioni; Seguro, A C; Andrade, L

    2010-03-01

    The objective of the present study was to determine the prevalence of electrolyte disturbances in AIDS patients developing acute kidney injury in the hospital setting, as well as to determine whether such disturbances constitute a risk factor for nephrotoxic and ischemic injury. A prospective, observational cohort study was carried out. Hospitalized AIDS patients were evaluated for age; gender; coinfection with hepatitis; diabetes mellitus; hypertension; time since HIV seroconversion; CD4 count; HIV viral load; proteinuria; serum levels of creatinine, urea, sodium, potassium and magnesium; antiretroviral use; nephrotoxic drug use; sepsis; intensive care unit (ICU) admission, and the need for dialysis. Each of these characteristics was correlated with the development of acute kidney injury, with recovery of renal function and with survival. Fifty-four patients developed acute kidney injury: 72% were males, 59% had been HIV-infected for >5 years, 72% had CD4 counts <200 cells/mm(3), 87% developed electrolyte disturbances, 33% recovered renal function, and 56% survived. ICU admission, dialysis, sepsis and hypomagnesemia were all significantly associated with nonrecovery of renal function and with mortality. Nonrecovery of renal function was significantly associated with hypomagnesemia, as was mortality in the multivariate analysis. The risks for nonrecovery of renal function and for death were 6.94 and 6.92 times greater, respectively, for patients with hypomagnesemia. In hospitalized AIDS patients, hypomagnesemia is a risk factor for nonrecovery of renal function and for in-hospital mortality. To determine whether hypomagnesemia is a determinant or simply a marker of critical illness, further studies involving magnesium supplementation in AIDS patients are warranted.

  20. Patterns, trends and sex differences in HIV/AIDS reported mortality in Latin American countries: 1996-2007

    PubMed Central

    2011-01-01

    Background International cohort studies have shown that antiretroviral treatment (ART) has improved survival of HIV-infected individuals. National population based studies of HIV mortality exist in industrialized settings but few have been presented from developing countries. Our objective was to investigate on a population basis, the regional situation regarding HIV mortality and trends in Latin America (LA) in the context of adoption of public ART policies and gender differences. Methods Cause of death data from vital statistics registries from 1996 to 2007 with "good" or "average" quality of mortality data were examined. Standardized mortality rates and Poisson regression models by country were developed and differences among countries assessed to identify patterns of HIV mortality over time occurring in Latin America. Results Standardized HIV mortality following the adoption of public ART policies was highest in Panama and El Salvador and lowest in Chile. During the study period, three overall patterns were identified in HIV mortality trends- following the adoption of the free ART public policies; a remarkable decrement, a remarkable increment and a slight increment. HIV mortality was consistently higher in males compared to females. Mean age of death attributable to HIV increased in the majority of countries over the study period. Conclusions Vital statistics registries provide valuable information on HIV mortality in LA. While the introduction of national policies for free ART provision has coincided with declines in population-level HIV mortality and increasing age of death in some countries, in others HIV mortality has increased. Barriers to effective ART implementation and uptake in the context of free ART public provision policies should be further investigated. PMID:21801402

  1. [Survey of suicidal mortality rate in several districts of Sichuan province].

    PubMed

    Hu, Z; Liu, X; Huo, K; Zhang, W

    1992-09-01

    A survey of the suicidal mortality rates in two cities and six districts in Sichuan province was carried out from 1980 to 1988 by the authors. The average suicidal mortality rate (ASMR) in these districts from 1980 to 1988 was 15.5/10(5), and the population and suicidal mortality rate positively correlated, r = 0.53. The ASMR in the male was 14.9/10(5), in the female 17.1/10(5), in the urban area 9.4/10(5), in the rural area 21/10(5), and the ASMR in the urban area was higher than that in the rural area (P < 0.05). The peak age of suicidal mortality was around twenty years. PMID:1304550

  2. [Survey of suicidal mortality rate in several districts of Sichuan province].

    PubMed

    Hu, Z; Liu, X; Huo, K; Zhang, W

    1992-09-01

    A survey of the suicidal mortality rates in two cities and six districts in Sichuan province was carried out from 1980 to 1988 by the authors. The average suicidal mortality rate (ASMR) in these districts from 1980 to 1988 was 15.5/10(5), and the population and suicidal mortality rate positively correlated, r = 0.53. The ASMR in the male was 14.9/10(5), in the female 17.1/10(5), in the urban area 9.4/10(5), in the rural area 21/10(5), and the ASMR in the urban area was higher than that in the rural area (P < 0.05). The peak age of suicidal mortality was around twenty years.

  3. Mortality rate in children born to mothers and fathers with celiac disease: a nationwide cohort study.

    PubMed

    Zugna, Daniela; Richiardi, Lorenzo; Stephansson, Olof; Cnattingius, Sven; Ludvigsson, Jonas F

    2013-06-15

    Celiac disease (CD) is associated with increased mortality rate and adverse pregnancy outcome, but little is known about offspring mortality rate. In this nationwide retrospective cohort study, we identified persons whose biopsy-verified CD was diagnosed in Sweden in 1969-2008. We compared mortality rates in children born to mothers with and without CD (n = 16,121 vs. n = 61,782) and children born to fathers with and without CD (n = 9,289 vs. n = 32,984). Median age of offspring at end of follow-up was 28.7 (range, 16.7-39.7) years. We also examined mortality rates in children born to mothers with undiagnosed CD (later CD diagnosis; n = 12,919) and diagnosed CD (n = 3,202) to determine if intrauterine exposures associated with CD could affect offspring mortality rate. We estimated hazard ratios for death by using Cox regression. Death rates were independent of maternal CD (60 deaths per 100,000 person-years in children of mothers with CD, vs. 54 in controls) and paternal CD (53 deaths per 100,000 person-years in children of fathers with CD, vs. 53 in controls). Corresponding adjusted hazard ratios were 1.09 (95% confidence interval: 0.95, 1.26) for maternal CD and 1.02 (95% confidence interval: 0.85, 1.23) for paternal CD. Death rates were similar in children born to mothers with undiagnosed CD and in children whose mothers had diagnosed CD during pregnancy. Parental CD does not seem to influence mortality rate in offspring, which suggests that neither genetic influences of CD nor intrauterine conditions have adverse effects on offspring mortality rate.

  4. Declining effect of latitude on melanoma mortality rates in the United States. A preliminary study.

    PubMed

    Lee, J A

    1997-09-01

    The gradient of mortality from melanoma of the skin with latitude among US whites was estimated from the slopes of semilogarithmic models fitted to the state-specific mortality rates and the latitudes of the states' capital cities. The upward gradient of mortality from north to south for malignant melanoma of the skin has been decreasing since 1950-1959, when data first became available, through 1960-1969, 1970-1979, and 1988-1992. By the early years of the 21st century, rates of melanoma mortality in the contiguous United States are expected to be unaffected by latitude. For the country as a whole, melanoma mortality rates have been rising for many years. This rise has become progressively slower, such that national rates have been projected to stabilize in the near future. While increasing geographic mobility has probably played a role in reducing the latitude effect, melanoma mortality rates may have reached levels at which increased exposure of US whites to sunlight has little incremental effect.

  5. Increased mortality rate and suicide in Swedish former elite male athletes in power sports.

    PubMed

    Lindqvist, A-S; Moberg, T; Ehrnborg, C; Eriksson, B O; Fahlke, C; Rosén, T

    2014-12-01

    Physical training has been shown to reduce mortality in normal subjects, and athletes have a healthier lifestyle after their active career as compared with normal subjects. Since the 1950s, the use of anabolic androgenic steroids (AAS) has been frequent, especially in power sports. The aim of the present study was to investigate mortality, including causes of death, in former Swedish male elite athletes, active 1960-1979, in wrestling, powerlifting, Olympic lifting, and the throwing events in track and field when the suspicion of former AAS use was high. Results indicate that, during the age period of 20-50 years, there was an excess mortality of around 45%. However, when analyzing the total study period, the mortality was not increased. Mortality from suicide was increased 2-4 times among the former athletes during the period of 30-50 years of age compared with the general population of men. Mortality rate from malignancy was lower among the athletes. As the use of AAS was marked between 1960 and 1979 and was not doping-listed until 1975, it seems probable that the effect of AAS use might play a part in the observed increased mortality and suicide rate. The otherwise healthy lifestyle among the athletes might explain the low malignancy rates. PMID:24033718

  6. Increased mortality rate and suicide in Swedish former elite male athletes in power sports.

    PubMed

    Lindqvist, A-S; Moberg, T; Ehrnborg, C; Eriksson, B O; Fahlke, C; Rosén, T

    2014-12-01

    Physical training has been shown to reduce mortality in normal subjects, and athletes have a healthier lifestyle after their active career as compared with normal subjects. Since the 1950s, the use of anabolic androgenic steroids (AAS) has been frequent, especially in power sports. The aim of the present study was to investigate mortality, including causes of death, in former Swedish male elite athletes, active 1960-1979, in wrestling, powerlifting, Olympic lifting, and the throwing events in track and field when the suspicion of former AAS use was high. Results indicate that, during the age period of 20-50 years, there was an excess mortality of around 45%. However, when analyzing the total study period, the mortality was not increased. Mortality from suicide was increased 2-4 times among the former athletes during the period of 30-50 years of age compared with the general population of men. Mortality rate from malignancy was lower among the athletes. As the use of AAS was marked between 1960 and 1979 and was not doping-listed until 1975, it seems probable that the effect of AAS use might play a part in the observed increased mortality and suicide rate. The otherwise healthy lifestyle among the athletes might explain the low malignancy rates.

  7. A comparison of determinants of infant mortality rate (IMR) between countries with high and low IMR.

    PubMed

    Megawangi, R; Barnett, J B

    1993-06-01

    Weighted least squares regressions and pooled regression models were used to examine the determinants of infant mortality in developing countries. Data were obtained from the UNICEF's "State of the World's Children, 1987" for 87 countries with data on gross national product, percentage of literate females, percentage of low birth weight infants, daily caloric supply per capita as a percentage of the daily requirement, percentage of population with access to drinking water, total fertility rate, and the population to nurses ratio. Data was unavailable on breast feeding practices and government expenditures on health. Weighted procedures were used because of heteroscadascity problems: total fertility rate was associated with the variance in the error term. The results of pooled data showed that the female literacy rate had the strongest impact on infant mortality, followed by access to clean water and the number of population per nursing person. The impact of female literacy was still strong in high infant mortality countries when controls for gross national product were included. Puzzling findings were the negative sign of low birth weight and the insignificant effect of the total fertility rate. The suggestion was that low birth weight may be expressed already in the level of education and availability of health programs. Fertility's lack of wide variations may explain the insignificant effect. Findings showed that infant mortality was 22.19% higher in countries with gross national product under $500. In low infant mortality countries, none of the environmental variables significantly explained infant mortality. Low birth weight increased its impact on infant mortality among these countries but was still not significant. The findings suggested that infant mortality was most affected by low birth weight and amount of population per nurse in more affluent countries. Environmental factors were more important in explaining high levels of infant mortality in less

  8. Mortality rates by occupation in Korea: a nationwide, 13-year follow-up study

    PubMed Central

    Lee, Hye-Eun; Kim, Hyoung-Ryoul; Chung, Yun Kyung; Kang, Seong-Kyu; Kim, Eun-A

    2016-01-01

    Objective The present study sought to identify inequalities in cause-specific mortality across different occupational groups in Korea. Methods The cohort included Korean workers enrolled in the national employment insurance programme between 1995 and 2000. Mortality was determined by matching death between 1995 and 2008 according to a nationwide registry of the Korea National Statistical Office. The cohort was divided into nine occupational groups according to the Korean Standard Occupational Classification (KSOC). Age-standardised mortality rates of each subcohort were calculated. Results The highest age-standardised mortality rate was identified in KSOC 6 (agricultural, forestry and fishery workers; male (M): 563.0 per 100 000, female (F): 206.0 per 100 000), followed by KSOC 9 (elementary occupations; M: 499.0, F: 163.4) and KSOC 8 (plant, machine operators and assemblers; M: 380.3, F: 157.8). The lowest rate occurred in KSOC 2 (professionals and related workers; M: 209.1, F: 93.3). Differences in mortality rates between KSOC 2 and KSOC 9 (M: 289.9, F: 70.1) and the rate ratio of KSCO9 to KSCO2 (M: 2.39, F: 1.75) were higher in men. The most prominent mortality rate difference was observed in external causes of death (M: 96.9, F: 21.6) and liver disease in men (38.3 per 100 000). Mental disease showed the highest rate ratio (M: 6.31, F: 13.00). Conclusions Substantial differences in mortality rates by occupation were identified. Main causes of death were injury, suicide and male liver disease. Development of policies to support occupations linked with a lower socioeconomic position should be prioritised. PMID:26920855

  9. 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.

  10. Calculating the Rate of Senescence From Mortality Data: An Analysis of Data From the ERA-EDTA Registry.

    PubMed

    Koopman, Jacob J E; Rozing, Maarten P; Kramer, Anneke; Abad, José M; Finne, Patrik; Heaf, James G; Hoitsma, Andries J; De Meester, Johan M J; Palsson, Runolfur; Postorino, Maurizio; Ravani, Pietro; Wanner, Christoph; Jager, Kitty J; van Bodegom, David; Westendorp, Rudi G J

    2016-04-01

    The rate of senescence can be inferred from the acceleration by which mortality rates increase over age. Such a senescence rate is generally estimated from parameters of a mathematical model fitted to these mortality rates. However, such models have limitations and underlying assumptions. Notably, they do not fit mortality rates at young and old ages. Therefore, we developed a method to calculate senescence rates from the acceleration of mortality directly without modeling the mortality rates. We applied the different methods to age group-specific mortality data from the European Renal Association-European Dialysis and Transplant Association Registry, including patients with end-stage renal disease on dialysis, who are known to suffer from increased senescence rates (n = 302,455), and patients with a functioning kidney transplant (n = 74,490). From age 20 to 70, senescence rates were comparable when calculated with or without a model. However, when using non-modeled mortality rates, senescence rates were yielded at young and old ages that remained concealed when using modeled mortality rates. At young ages senescence rates were negative, while senescence rates declined at old ages. In conclusion, the rate of senescence can be calculated directly from non-modeled mortality rates, overcoming the disadvantages of an indirect estimation based on modeled mortality rates.

  11. Growth rate predicts mortality of Abies concolor in both burned and unburned stands

    USGS Publications Warehouse

    van Mantgem, Phillip J.; Stephenson, Nathan L.; Mutch, Linda S.; Johnson, Veronica G.; Esperanza, Annie M.; Parsons, David J.

    2003-01-01

    Tree mortality is often the result of both long-term and short-term stress. Growth rate, an indicator of long-term stress, is often used to estimate probability of death in unburned stands. In contrast, probability of death in burned stands is modeled as a function of short-term disturbance severity. We sought to narrow this conceptual gap by determining (i) whether growth rate, in addition to crown scorch, is a predictor of mortality in burned stands and (ii) whether a single, simple model could predict tree death in both burned and unburned stands. Observations of 2622 unburned and 688 burned Abies concolor (Gord. & Glend.) Lindl. (white fir) in the Sierra Nevada of California, U.S.A., indicated that growth rate was a significant predictor of mortality in the unburned stands, while both crown scorch and radial growth were significant predictors of mortality in the burned stands. Applying the burned stand model to unburned stands resulted in an overestimation of the unburned stand mortality rate. While failing to create a general model of tree death for A. concolor, our findings underscore the idea that similar processes may affect mortality in disturbed and undisturbed stands.

  12. Fetal alcohol spectrum disorders: a population based study of premature mortality rates in the mothers.

    PubMed

    Li, Qing; Fisher, Wayne W; Peng, Chun-Zi; Williams, Andrew D; Burd, Larry

    2012-08-01

    Fetal alcohol spectrum disorders (FASD) are associated with an increase in risk for mortality for people with an FASD and their siblings. In this study we examine mortality rates of birth mothers of children with FASD, using a retrospective case control methodology. We utilized the North Dakota FASD Registry to locate birth certificates for children with FASD which we used to identify birth mothers. We then searched for mothers' death certificates. We then compared the mortality rates of the birth mothers with an age matched control group comprised of all North Dakota women who were born and died in the same year as the birth mother. The birth mothers of children with FASD had a mortality rate of 15/304 = 4.93%; (95% CI 2.44-7.43%). The mortality rate for control mothers born in same years as the FASD mothers was 126/114,714 = 0.11% (95% CI 0.09-0.13%). Mothers of children with an FASD had a 44.82 fold increase in mortality risk and 87% of the deaths occurred in women under the age of 50. Three causes of death (cancer, injuries, and alcohol related disease) accounted for 67% of the deaths in the mothers of children with FASD. A diagnosis of FASD is an important risk marker for premature death in the mothers of children diagnosed with an FASD. These women should be encouraged to enter substance abuse treatment.

  13. 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.

  14. Geographic disparity in chronic obstructive pulmonary disease (COPD) mortality rates among the Taiwan population.

    PubMed

    Chan, Ta-Chien; Chiang, Po-Huang; Su, Ming-Daw; Wang, Hsuan-Wen; Liu, Michael Shi-yung

    2014-01-01

    Chronic obstructive pulmonary disease (COPD) causes a high disease burden among the elderly worldwide. In Taiwan, the long-term temporal trend of COPD mortality is declining, but the geographical disparity of the disease is not yet known. Nationwide COPD age-adjusted mortality at the township level during 1999-2007 is used for elucidating the geographical distribution of the disease. With an ordinary least squares (OLS) model and geographically weighted regression (GWR), the ecologic risk factors such as smoking rate, area deprivation index, tuberculosis exposure, percentage of aborigines, density of health care facilities, air pollution and altitude are all considered in both models to evaluate their effects on mortality. Global and local Moran's I are used for examining their spatial autocorrelation and identifying clusters. During the study period, the COPD age-adjusted mortality rates in males declined from 26.83 to 19.67 per 100,000 population, and those in females declined from 8.98 to 5.70 per 100,000 population. Overall, males' COPD mortality rate was around three times higher than females'. In the results of GWR, the median coefficients of smoking rate, the percentage of aborigines, PM10 and the altitude are positively correlated with COPD mortality in males and females. The median value of density of health care facilities is negatively correlated with COPD mortality. The overall adjusted R-squares are about 20% higher in the GWR model than in the OLS model. The local Moran's I of the GWR's residuals reflected the consistent high-high cluster in southern Taiwan. The findings indicate that geographical disparities in COPD mortality exist. Future epidemiological investigation is required to understand the specific risk factors within the clustering areas.

  15. Geographic Disparity in Chronic Obstructive Pulmonary Disease (COPD) Mortality Rates among the Taiwan Population

    PubMed Central

    Chan, Ta-Chien; Chiang, Po-Huang; Su, Ming-Daw; Wang, Hsuan-Wen; Liu, Michael Shi-yung

    2014-01-01

    Chronic obstructive pulmonary disease (COPD) causes a high disease burden among the elderly worldwide. In Taiwan, the long-term temporal trend of COPD mortality is declining, but the geographical disparity of the disease is not yet known. Nationwide COPD age-adjusted mortality at the township level during 1999–2007 is used for elucidating the geographical distribution of the disease. With an ordinary least squares (OLS) model and geographically weighted regression (GWR), the ecologic risk factors such as smoking rate, area deprivation index, tuberculosis exposure, percentage of aborigines, density of health care facilities, air pollution and altitude are all considered in both models to evaluate their effects on mortality. Global and local Moran’s I are used for examining their spatial autocorrelation and identifying clusters. During the study period, the COPD age-adjusted mortality rates in males declined from 26.83 to 19.67 per 100,000 population, and those in females declined from 8.98 to 5.70 per 100,000 population. Overall, males’ COPD mortality rate was around three times higher than females’. In the results of GWR, the median coefficients of smoking rate, the percentage of aborigines, PM10 and the altitude are positively correlated with COPD mortality in males and females. The median value of density of health care facilities is negatively correlated with COPD mortality. The overall adjusted R-squares are about 20% higher in the GWR model than in the OLS model. The local Moran’s I of the GWR’s residuals reflected the consistent high-high cluster in southern Taiwan. The findings indicate that geographical disparities in COPD mortality exist. Future epidemiological investigation is required to understand the specific risk factors within the clustering areas. PMID:24845852

  16. Fishing mortality rates of giant clams (Family Tridacnidae) from the Sulu Archipelago and Southern Palawan, Philippines

    NASA Astrophysics Data System (ADS)

    Villanoy, Cesar L.; Juinio, Antoinette R.; Meñez, Lambert Anthony

    1988-05-01

    Average size frequency distributions of Tridacna squamosa, T. gigas, Hippopus hippopus and H. porcellanus harvested from the Sulu Archipelago and Southern Palawan areas from 1978 1985 were derived from export records and a warehouse inventory of giant clam shells. Average species mortality rates ( Z) were estimated and were used to approximate average fishing mortality rates ( F) over the period 1978 1985. Crude estimates of exploitation rates ( F/Z) indicate that populations of these species are already overexploited. These findings have serious implications in view of the fact that the Sulu Archipelago and Southern Palawan are thought to be the last strongholds of giant clams in Philippine waters.

  17. Judging hospitals by severity-adjusted mortality rates: the influence of the severity-adjustment method.

    PubMed Central

    Iezzoni, L I; Ash, A S; Shwartz, M; Daley, J; Hughes, J S; Mackiernan, Y D

    1996-01-01

    OBJECTIVES: This research examined whether judgments about a hospital's risk-adjusted mortality performance are affected by the severity-adjustment method. METHODS: Data came from 100 acute care hospitals nationwide and 11880 adults admitted in 1991 for acute myocardial infarction. Ten severity measures were used in separate multivariable logistic models predicting in-hospital death. Observed-to-expected death rates and z scores were calculated with each severity measure for each hospital. RESULTS: Unadjusted mortality rates for the 100 hospitals ranged from 4.8% to 26.4%. For 32 hospitals, observed mortality rates differed significantly from expected rates for 1 or more, but not for all 10, severity measures. Agreement between pairs of severity measures on whether hospitals were flagged as statistical mortality outliers ranged from fair to good. Severity measures based on medical records frequently disagreed with measures based on discharge abstracts. CONCLUSIONS: Although the 10 severity measures agreed about relative hospital performance more often than would be expected by chance, assessments of individual hospital mortality rates varied by different severity-adjustment methods. PMID:8876505

  18. The effect of anatomical factors on mortality rates after endovascular aneurysm repair

    PubMed Central

    Derih, Ay; Burak, Erdolu; Gunduz, Yumun; Yumun, Aydin; Ahmet, Demir; Hakan, Ozkan; Osman, Tiryakioglu; Kamuran, Erkoc

    2016-01-01

    Summary Objective The objective of this study was to investigate the effect of anatomical characteristics on mortality rates after endovascular aneurysm repair (EVAR). Methods We investigated 56 EVAR procedures for infrarenal aortic aneurysms performed between January 2010 and December 2013, and the data were supplemented with a prospective review. The patients were divided into two groups according to the diameter of the aneurysm. Group I (n = 30): patients with aneurysm diameters less than 6 cm, group II (n = 26): patients with aneurysm diameters larger than 6 cm. The pre-operative anatomical data of the aneurysms were noted and the groups were compared with regard to postoperative results. Results There were no correlations between diameter of aneurysm (p > 0.05), aneurysm neck angle (p > 0.05) and mortality rate. The long-term mortality rate was found to be high in patients in whom an endoleak occurred. Conclusion We found that aneurysm diameter did not have an effect on postoperative mortality rates. An increased EuroSCORE value and the development of endoleaks had an effect on long-term mortality rates. PMID:26207946

  19. In Sickness but Not in Health: Self-Ratings, Identity, and Mortality

    ERIC Educational Resources Information Center

    Idler, Ellen; Leventhal, Howard; McLaughlin, Julie; Leventhal, Elaine

    2004-01-01

    Self-rated health as a predictor of mortality has been studied primarily in large, representative populations, with relatively little progress toward understanding the information processing that individuals use to arrive at these ratings. With subsamples of National Health and Nutrition Examination Survey (NHANES) Epidemiologic Follow-up Study…

  20. Differential Neonatal and Postneonatal Infant Mortality Rates across US Counties: The Role of Socioeconomic Conditions and Rurality

    ERIC Educational Resources Information Center

    Sparks, P. Johnelle; McLaughlin, Diane K.; Stokes, C. Shannon

    2009-01-01

    Purpose: To examine differences in correlates of neonatal and postneonatal infant mortality rates, across counties, by degree of rurality. Methods: Neonatal and postneonatal mortality rates were calculated from the 1998 to 2002 Compressed Mortality Files from the National Center for Health Statistics. Bivariate analyses assessed the relationship…

  1. Trends in corrected lung cancer mortality rates in Brazil and regions

    PubMed Central

    Malta, Deborah Carvalho; de Abreu, Daisy Maria Xavier; de Moura, Lenildo; Lana, Gustavo C; Azevedo, Gulnar; França, Elisabeth

    2016-01-01

    ABSTRACT OBJECTIVE To describe the trend in cancer mortality rates in Brazil and regions before and after correction for underreporting of deaths and redistribution of ill-defined and nonspecific causes. METHODS The study used data of deaths from lung cancer among the population aged from 30 to 69 years, notified to the Mortality Information System between 1996 and 2011, corrected for underreporting of deaths, non-registered sex and age , and causes with ill-defined or garbage codes according to sex, age, and region. Standardized rates were calculated by age for raw and corrected data. An analysis of time trend in lung cancer mortality was carried out using the regression model with autoregressive errors. RESULTS Lung cancer in Brazil presented higher rates among men compared to women, and the South region showed the highest death risk in 1996 and 2011. Mortality showed a trend of reduction for males and increase for women. CONCLUSIONS Lung cancer in Brazil presented different distribution patterns according to sex, with higher rates among men and a reduction in the mortality trend for men and increase for women. PMID:27355467

  2. Early mortality rate of atomic bomb survivors based on House Reconstruction Survey.

    PubMed

    Mori, H; Nakamura, T; Mine, M; Kondo, H; Okumura, Y; Hoel, D G

    1994-02-01

    This paper studies the mortality rate experienced by over 23,000 A-bomb survivors in Nagasaki between September 1945 and 1950 when the RERF-ABCC initiated the follow-up of the large LSS cohort. The study is based on the data of the 10-year House Reconstruction Survey. As expected, these data show an increasing mortality rate with increasing proximity to the hypocenter of the bomb. What was not anticipated was a higher mortality rate in the 1400-1699 m band than in the closer distance interval of 1200-1399 m. This suggests a possible selective survival among A-bomb survivors. Whether this affects the cancer risk estimates has not as yet been determined.

  3. Which is the best deprivation predictor of foetal and infant mortality rates?

    PubMed

    Joyce, R; Webb, R; Peacock, J L; Stirland, H

    2000-01-01

    This study investigates which, if any, population-based indicator of deprivation best predicts foetal and infant mortality rates in England. For the year 1995, the deprivation levels of 364 English Local Authorities were compared; using the three commonly used indicators, Jarman score, Townsend score and percentage unemployed. The predictive value of these for stillbirth, neonatal and infant mortality rates was then calculated. The three deprivation indicators were highly inter-correlated (r=0.866-0.924). For each mortality rate, the correlation with deprivation did not differ significantly for the three indicators of deprivation. We conclude, when comparing these outcomes in different areas of England, that any of the three deprivation indicators may be used to adjust for deprivation. PMID:10787021

  4. Coal flow aids reduce coke plant operating costs and improve production rates

    SciTech Connect

    Bedard, R.A.; Bradacs, D.J.; Kluck, R.W.; Roe, D.C.; Ventresca, B.P.

    2005-06-01

    Chemical coal flow aids can provide many benefits to coke plants, including improved production rates, reduced maintenance and lower cleaning costs. This article discusses the mechanisms by which coal flow aids function and analyzes several successful case histories. 2 refs., 10 figs., 1 tab.

  5. Canadian suicide mortality rates: first-generation immigrants versus Canadian-born.

    PubMed

    Strachan, J; Johansen, H; Nair, C; Nargundkar, M

    1990-01-01

    This article examines suicide mortality rates and trends in Canada for first-generation immigrants and the Canadian-born population. Data are analyzed by age, sex and country of birth. Since 1950, suicide rates worldwide for both men and women have been increasing. In North America and most of Europe, suicide has been one of the major causes of death for many years. In Canada, suicide rates are also rising. However, this increase is due entirely to a rise in the rate for men; the rate for women has remained relatively stable. Several differences are apparent between the rates for the Canadian-born population and those for first-generation immigrants. For example, three times as many Canadian-born men as women commit suicide. For first-generation immigrants, the ratio is two to one. Suicide mortality rates for the Canadian-born are higher than those for first-generation immigrants in every age group except for the 65 and over groups. Canadian born males have higher ASMR than first generation immigrant males. The rates for women show that first-generation immigrant women have higher suicide mortality rates than their Canadian-born counterparts, and that the highest rate for all women is for immigrants born in Asia. PMID:1713798

  6. Canadian suicide mortality rates: first-generation immigrants versus Canadian-born.

    PubMed

    Strachan, J; Johansen, H; Nair, C; Nargundkar, M

    1990-01-01

    This article examines suicide mortality rates and trends in Canada for first-generation immigrants and the Canadian-born population. Data are analyzed by age, sex and country of birth. Since 1950, suicide rates worldwide for both men and women have been increasing. In North America and most of Europe, suicide has been one of the major causes of death for many years. In Canada, suicide rates are also rising. However, this increase is due entirely to a rise in the rate for men; the rate for women has remained relatively stable. Several differences are apparent between the rates for the Canadian-born population and those for first-generation immigrants. For example, three times as many Canadian-born men as women commit suicide. For first-generation immigrants, the ratio is two to one. Suicide mortality rates for the Canadian-born are higher than those for first-generation immigrants in every age group except for the 65 and over groups. Canadian born males have higher ASMR than first generation immigrant males. The rates for women show that first-generation immigrant women have higher suicide mortality rates than their Canadian-born counterparts, and that the highest rate for all women is for immigrants born in Asia.

  7. Do metropolitan HIV epidemic histories and programs for people who inject drugs and men who have sex with men predict AIDS incidence and mortality among heterosexuals?

    PubMed Central

    Friedman, Samuel R.; West, Brooke S.; Tempalski, Barbara; Morton, Cory M.; Cleland, Charles M.; Des Jarlais, Don C.; Hall, H. Irene; Cooper, Hannah LF.

    2014-01-01

    Purpose We focus on a little-researched issue—how HIV epidemics and programs in key populations in metropolitan areas affect epidemics in other key populations. We consider: 1) How are earlier epidemics among people who inject drugs (PWID) and men who have sex with men (MSM) related to later AIDS incidence and mortality among heterosexuals?; 2) Were prevention programs targeting PWID or MSM associated with lower AIDS incidence and mortality among heterosexuals?; and 3) Was the size of the potential bridge population of non-injecting drug users (NIDUs) in a metropolitan area associated with later AIDS incidence and mortality among heterosexuals? Methods Using data for 96 large US metropolitan areas, Poisson regression assessed associations of population prevalences of HIV-infected PWID and MSM (1992); NIDU population prevalence (1992–1994); drug use treatment coverage for PWID (1993); HIV counseling and testing coverage for MSM and for PWID (1992); and syringe exchange presence (2000) with CDC data on AIDS incidence and mortality among heterosexuals in 2006 – 2008, with appropriate socioeconomic controls. Results Population density of HIV+ PWID and of NIDUs were positively related, and prevention programs for PWID negatively related, to later AIDS incidence among heterosexuals and later mortality among heterosexuals living with AIDS. HIV+ MSM population density and prevention programs for MSM were not associated with these outcomes. Conclusions Efforts to reduce HIV transmission among PWID and NIDUs may reduce AIDS and AIDS-related mortality among heterosexuals. More research is needed at metropolitan area, network and individual levels into HIV bridging across key populations and how interventions in one key population affect HIV epidemics in other key populations. PMID:24529517

  8. Hypothetical ratings of coronary angiography appropriateness: are they associated with actual angiographic findings, mortality, and revascularisation rate? The ACRE study

    PubMed Central

    Hemingway, H; Crook, A; Banerjee, S; Dawson, J; Feder, G; Magee, P; Wood, A; Philpott, S; Timmis, A

    2001-01-01

    OBJECTIVE—To determine whether ratings of coronary angiography appropriateness derived by an expert panel on hypothetical patients are associated with actual angiographic findings, mortality, and subsequent revascularisation in the ACRE (appropriateness of coronary revascularisation) study.
DESIGN—Population based, prospective study. The ACRE expert panel rated hypothetical clinical indications as inappropriate, uncertain, or appropriate before recruitment of a cohort of real patients.
SETTING—Royal Hospitals Trust, London, UK.
PARTICIPANTS—3631 consecutive patients undergoing coronary angiography (no exclusion criteria).
MAIN OUTCOME MEASURES—Angiographic findings, mortality (n = 226 deaths), and revascularisation (n = 1556 procedures) over 2.5 years of follow up.
RESULTS—The indications for coronary angiography were rated appropriate in 2253 (62%) patients. 166 (5%) coronary angiograms were performed for indications rated inappropriate, largely for asymptomatic or atypical chest pain presentations. The remaining 1212 (33%) angiograms were rated uncertain, of which 47% were in patients with mild angina and no exercise ECG or in patients with unstable angina controlled by inpatient management. Three vessel disease was more likely among appropriate cases and normal coronaries were more likely among inappropriate cases (p < 0.001). Mortality and revascularisation rates were highest among patients with an appropriate indication, intermediate in those with an uncertain indication, and lowest in the inappropriate group (log rank p = 0.018 and p < 0.0001, respectively).
CONCLUSION—The ACRE ratings of appropriateness for angiography predicted angiographic findings, mortality, and revascularisation rates. These findings support the clinical usefulness of expert panel methods in defining criteria for performing coronary angiography.


Keywords: coronary artery disease; coronary angiography; coronary artery bypass graft

  9. Does expressed acceptance reflect genuine attitudes? A bogus pipeline study of the effects of mortality salience on acceptance of a person with AIDS.

    PubMed

    Grover, Kristin W; Miller, Carol T

    2012-01-01

    The present study examined whether expressed acceptance of a person with AIDS reflects genuine acceptance or a desire to appear to be accepting. Theory and research on the effects of mortality salience on acceptance of stigmatized people provided the framework for investigating this question. After writing about death or another aversive topic, participants indicated their acceptance of a target with AIDS while connected to physiological equipment that they believed could detect lies (bogus pipeline) or was simply measuring physiological responses to participation in the study. As predicted, participants in the mortality salience/bogus pipeline condition indicated significantly less acceptance of the target with AIDS than participants in the other three conditions, suggesting that acceptance of a person with AIDS is at least partially a result of wanting to appear to be accepting, without necessarily genuinely accepting someone with AIDS.

  10. A model study with light-dependent mortality rates of copepod stages

    NASA Astrophysics Data System (ADS)

    Neumann, Thomas; Kremp, Christine

    2005-06-01

    This paper is based on an advanced ecosystem model of the Baltic Sea (ERGOM [ J. Mar. Sys. 25 (3-4) (2005) 405]), but with an increased resolution of the zooplankton stage variable [ J. Plankton Res. 23 (2001) 1217; ICES Marine Science 219 (2003) 208]. The model copepods are represented by five stages: eggs, an aggregated variable of nauplii, two aggregated groups of copepodites and adults. The transfer among the stages, i.e., hatching, molting and reproduction, is controlled by food availability and temperature. As usual, the model food web is truncated at the level of zooplankton. The study explores the effects of different parametrization of zooplankton mortality and looks in particular on light-dependent rates. The light climate may serve a proxy for the effects of visual feeding of fish larvae and fish. Different choices of the mortality parameters can result in remarkable differences in abundances and biomass of the model zooplankton and in the timing of its development. It is found that the different choices of mortality affect the development of populations in several ways: Relative small initial differences of abundances at the beginning of the spring bloom are important for the development of the model populations. Higher mortality rates are less important at food rich conditions than at scarce resources. At low phytoplankton levels, the individual development of the copepods through the stages can be faster for elevated mortality rates because then less animals have to share the available food.

  11. Comparison of Turkish and US haemodialysis patient mortality rates: an observational cohort study

    PubMed Central

    Asci, Gulay; Marcelli, Daniele; Celtik, Aygul; Grassmann, Aileen; Gunestepe, Kutay; Yaprak, Mustafa; Tamer, Abdulkerim Furkan; Turan, Mehmet Nuri; Sever, Mehmet Sukru; Ok, Ercan

    2016-01-01

    Background There are significant differences between countries in the mortality rates of haemodialysis (HD) patients. The extent of these differences and possible contributing factors are worthy of investigation. Methods As of March 2009, all patients undergoing HD or haemodiafiltration for >3 months (n = 4041) in the Turkish clinics of the NephroCare network were enrolled. Data were prospectively collected for 2 years through the European Clinical Dialysis Database. Mean age ± standard deviation was 58.7 ± 14.7 years, 45.9% were female and 22.9% were diabetic. Comparison with US data was performed by applying an indirect standardization technique, using specific mortality rates for patients on HD by age, gender, race and primary diagnosis as provided by the 2012 US Renal Data System Annual Data Report as reference. Results The crude mortality rate in Turkey was 95.1 per 1000 patient-years. Compared with the US reference population, the annual mortality rate for Turkey was significantly lower, irrespective of gender, age and diabetes. After adjustments for age, gender and diabetes, the mortality risk in the Turkish cohort was 50% lower than US whites [95% confidence interval (CI) 0.46–0.54, P < 0.001], 44% lower than US African-Americans (95% CI 0.52–0.61, P < 0.001) and 20% lower than Asian-Americans (95% CI 0.74–0.86, P < 0.05). Conclusions The annual mortality rate of prevalent HD patients was found to be significantly lower in the studied Turkish cohort compared with that published by the US Renal Data System Annual Data Report. Differences in practice patterns may contribute to the divergence. PMID:27274836

  12. Brazil's conditional cash transfer program associated with declines in infant mortality rates.

    PubMed

    Shei, Amie

    2013-07-01

    Conditional cash transfer programs are innovative social safety-net programs that aim to relieve poverty. They provide a regular source of income to poor families and are "conditional" in that they require poor families to invest in the health and education of their children through greater use of educational and preventive health services. Brazil's Bolsa Família conditional cash transfer program, created in 2003, is the world's largest program of its kind. During the first five years of the program, it was associated with a significant 9.3 percent reduction in overall infant mortality rates, with greater declines in postneonatal mortality rates than in mortality rates at an earlier age and in municipalities with many users of Brazil's Family Health Program than in those with lower use rates. There were also larger effects in municipalities with higher infant mortality rates at baseline. Programs like Bolsa Família can improve child health and reduce long-standing health inequalities. Policy makers should review the adequacy of basic health services to ensure that the services can respond to the increased demand created by such programs. Programs should also target vulnerable groups at greatest risk and include careful monitoring and evaluation. PMID:23836744

  13. High Basal Metabolic Rate Is a Risk Factor for Mortality: The Baltimore Longitudinal Study of Aging

    PubMed Central

    Ruggiero, Carmelinda; Metter, E. Jeffrey; Melenovsky, Vojtech; Cherubini, Antonio; Najjar, Samer S.; Ble, Alessandro; Senin, Umberto; Longo, Dan L.; Ferrucci, Luigi

    2016-01-01

    Background Despite longstanding controversies from animal studies on the relationship between basal metabolic rate (BMR) and longevity, whether BMR is a risk factor for mortality has never been tested in humans. We evaluate the longitudinal changes in BMR and the relationship between BMR and mortality in the Baltimore Longitudinal Study of Aging (BLSA) participants. Methods BMR and medical information were collected at the study entry and approximately every 2 years in 1227 participants (972 men) over a 40-year follow-up. BMR, expressed as kcal/m2/h, was estimated from the basal O2 consumption and CO2 production measured by open-circuit method. Data on all-cause and specific-cause mortality were also obtained. Result BMR declined with age at a rate that accelerated at older ages. Independent of age, participants who died had a higher BMR compared to those who survived. BMR was a significant risk factor for mortality independent of secular trends in mortality and other well-recognized risk factors for mortality, such as age, body mass index, smoking, white blood cell count, and diabetes. BMR was nonlinearly associated with mortality. The lowest mortality rate was found in the BMR range 31.3–33.9 kcal/m2/h. Participants with BMR in the range 33.9–36.4 kcal/m2/h and above the threshold of 36.4 kcal/m2/h experienced 28% (hazard ratio: 1.28; 95% confidence interval, 1.02–1.61) and 53% (hazard ratio: 1.53; 95% confidence interval, 1.19–1.96) higher mortality risk compared to participants with BMR 31.3–33.9 kcal/m2/h. Conclusion We confirm previous findings of an age-related decline of BMR. In our study, a blunted age-related decline in BMR was associated with higher mortality, suggesting that such condition reflects poor health status. PMID:18693224

  14. Under-five mortality and maternal HIV status in Tanzania: analysis of trends between 2003 and 2012 using AIDS Indicator Survey data

    PubMed Central

    Arunda, Malachi Ochieng; Choudhry, Vikas; Ekman, Björn; Asamoah, Benedict Oppong

    2016-01-01

    Background Mortality among children under five remains a significant health challenge across sub-Saharan Africa. HIV/AIDS is one of the leading contributors to the relatively slow decline in under-five mortality in this region. In Tanzania, HIV prevalence among under-five children is high and 90% of all infections are due to mother-to-child transmission. Objectives The study aimed to examine the association between maternal HIV-positive status and under-five mortality in Tanzania. It also aimed to estimate the proportions and trends of under-five mortality attributable to maternal HIV/AIDS in Tanzania between 2003 and 2012. Design Binomial logistic regression was used to analyze cross-sectional survey data from the Tanzania AIDS Indicator Surveys to examine the association between maternal HIV positivity and under-five mortality between 2003 and 2012. Results After controlling for confounders, the adjusted odds ratios were 1.5 (95% CI 1.1–1.9) in 2003–2004, 4.6 (95% CI 2.7–7.8) in 2007–2008, and 2.4 (95% CI 1.2–4.6) in 2011–2012. The maternal HIV-attributable mortality risk percent of under-five children was 3.7 percent in 2003–2004, 11.3 percent in 2007–2008 and 5.6% in 2011–2012. Conclusion Maternal HIV positivity is associated with under-five mortality in Tanzania, making maternal HIV serostatus a relevant determinant of whether a child will survive up to five years of age or not. The impact of maternal HIV/AIDS attributable mortality risk has a significant contribution to the overall under-five mortality in Tanzania. The continued monitoring of HIV and mortality trends is important for policy development and design of interventions. PMID:27329937

  15. Partitioning loss rates of early juvenile blue crabs from seagrass habitats into mortality and emigration

    USGS Publications Warehouse

    Etherington, L.L.; Eggleston, D.B.; Stockhausen, W.T.

    2003-01-01

    Determining how post-settlement processes modify patterns of settlement is vital in understanding the spatial and temporal patterns of recruitment variability of species with open populations. Generally, either single components of post-settlement loss (mortality or emigration) are examined at a time, or else the total loss is examined without discrimination of mortality and emigration components. The role of mortality in the loss of early juvenile blue crabs, Callinectes sapidus, has been addressed in a few studies; however, the relative contribution of emigration has received little attention. We conducted mark-recapture experiments to examine the relative contribution of mortality and emigration to total loss rates of early juvenile blue crabs from seagrass habitats. Loss was partitioned into emigration and mortality components using a modified version of Jackson's (1939) square-within-a-square method. The field experiments assessed the effects of two size classes of early instars (J1-J2, J3-J5), two densities of juveniles (low: 16 m-2, high: 64 m-2), and time of day (day, night) on loss rates. In general, total loss rates of experimental juveniles and colonization rates by unmarked juveniles were extremely high (range = 10-57 crabs m-2/6 h and 17-51 crabs m-2/6 h, for loss and colonization, respectively). Total loss rates were higher at night than during the day, suggesting that juveniles (or potentially their predators) exhibit increased nocturnal activity. While colonization rates did not differ by time of day, J3-J5 juveniles demonstrated higher rates of colonization than J1-J2 crabs. Overall, there was high variability in both mortality and emigration, particularly for emigration. Average probabilities of mortality across all treatment combinations ranged from 0.25-0.67/6 h, while probabilities of emigration ranged from 0.29-0.72/6 h. Although mean mortality rates were greater than emigration rates in most treatments, the proportion of experimental trials

  16. A Hierarchical Distance Sampling Approach to Estimating Mortality Rates from Opportunistic Carcass Surveillance Data

    PubMed Central

    Bellan, Steve E.; Gimenez, Olivier; Choquet, Rémi; Getz, Wayne M.

    2012-01-01

    Summary Distance sampling is widely used to estimate the abundance or density of wildlife populations. Methods to estimate wildlife mortality rates have developed largely independently from distance sampling, despite the conceptual similarities between estimation of cumulative mortality and the population density of living animals. Conventional distance sampling analyses rely on the assumption that animals are distributed uniformly with respect to transects and thus require randomized placement of transects during survey design. Because mortality events are rare, however, it is often not possible to obtain precise estimates in this way without infeasible levels of effort. A great deal of wildlife data, including mortality data, is available via road-based surveys. Interpreting these data in a distance sampling framework requires accounting for the non-uniformity sampling. Additionally, analyses of opportunistic mortality data must account for the decline in carcass detectability through time. We develop several extensions to distance sampling theory to address these problems.We build mortality estimators in a hierarchical framework that integrates animal movement data, surveillance effort data, and motion-sensor camera trap data, respectively, to relax the uniformity assumption, account for spatiotemporal variation in surveillance effort, and explicitly model carcass detection and disappearance as competing ongoing processes.Analysis of simulated data showed that our estimators were unbiased and that their confidence intervals had good coverage.We also illustrate our approach on opportunistic carcass surveillance data acquired in 2010 during an anthrax outbreak in the plains zebra of Etosha National Park, Namibia.The methods developed here will allow researchers and managers to infer mortality rates from opportunistic surveillance data. PMID:24224079

  17. Factors Influencing The Six-Month Mortality Rate In Patients With A Hip Fracture

    PubMed Central

    Ristic, Branko; Rancic, Nemanja; Bukumiric, Zoran; Zeljko, Stepanovic; Ignjatovic-Ristic, Dragana

    2016-01-01

    Abstract Background There are several potential risk factors in patients with a hip fracture for a higher rate of mortality that include: comorbid disorders, poor general health, age, male gender, poor mobility prior to injury, type of fracture, poor cognitive status, place of residence. The aim of this study was to assess the influence of potential risk factors for six-month mortality in hip fracture patients. Methods The study included all patients with a hip fracture older than 65 who had been admitted to the Clinic for orthopaedic surgery during one year. One hundred and ninety-two patients were included in the study. Results Six months after admission due to a hip fracture, 48 patients had died (6-month mortality rate was 25%). The deceased were statistically older than the patients who had survived. Univariate regression analysis indicated that six variables had a significant effect on hip fracture patients’ survival: age, mobility prior to the fracture, poor cognitive status, activity of daily living, comorbidities and the place where they had fallen. Multivariate regression modelling showed that the following factors were independently associated with mortality at 6 months post fracture: poor cognitive status, poor mobility prior to the fracture, comorbid disease. Conclusion Poor cognitive status appeared to be the strongest mortality predictor. The employment of brief tests for cognitive status evaluation would enable orthopaedists to have good criteria for the choice of treatment for each patient screened. PMID:27284379

  18. Pollution Sources and Mortality Rates across Rural-Urban Areas in the United States

    ERIC Educational Resources Information Center

    Hendryx, Michael; Fedorko, Evan; Halverson, Joel

    2010-01-01

    Purpose: To conduct an assessment of rural environmental pollution sources and associated population mortality rates. Methods: The design is a secondary analysis of county-level data from the Environmental Protection Agency (EPA), Department of Agriculture, National Land Cover Dataset, Energy Information Administration, Centers for Disease Control…

  19. Estimating the out-of-hospital mortality rate using patient discharge data.

    PubMed

    Farsi, Mehdi; Ridder, Geert

    2006-09-01

    This paper explores the hospital quality measures based on routine administrative data such as patient discharge records. Most of the measures used in the literature are based on in-hospital mortality risks rather than post-discharge events. The in-hospital outcomes are sensitive to the hospital's discharge policy, thus could bias the quality estimates. This study aims at identifying out-of-hospital mortality risks and disentangling discharge and re-hospitalization rates from mortality rates using patient discharge data. It is shown that these objectives can be achieved without post-discharge death records. This is an example of the use of public use administrative data for estimating empirical relations when key dependent variables are not available. Using data on the lengths of hospitalizations and out-of-hospital spells, the mortality rates before and after discharge are estimated for a sample of heart-attack patients hospitalized in California between 1992 and 1998. The results suggest that the quality assessments that ignore the variation of discharge rates among hospitals could be misleading.

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

    ERIC Educational Resources Information Center

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

    2011-01-01

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

  1. A Needs Assessment of Health Issues Related to Maternal Mortality Rates in Afghanistan: A Pilot Study.

    PubMed

    Naim, Ali; Feldman, Robert; Sawyer, Robin

    2015-01-01

    Maternal death rates in Afghanistan were among the highest in the world during the reign of the Taliban. Although these figures have improved, current rates are still alarming. The aim of this pilot study was to develop a needs assessment of the major health issues related to the high maternal mortality rates in Afghanistan. In-depth interviews were conducted with managerial midwives, clinical midwives, and mothers. Results of the interviews indicate that the improvement in the maternal mortality rate may be attributed to the increase in the involvement of midwives in the birthing process. However, barriers to decreasing maternal mortality still exist. These include transportation, access to care, and sociocultural factors such as the influence of the husband and mother-in-law in preventing access to midwives. Therefore, any programs to decrease maternal mortality need to address infrastructure issues (making health care more accessible) and sociocultural factors (including husbands and mother-in-laws in maternal health education). However, it should be noted that these findings are based on a small pilot study to help develop a larger scale need assessment.

  2. Estimating mortality rates of adult fish from entrainment through the propellers of river towboats

    USGS Publications Warehouse

    Gutreuter, S.; Dettmers, J.M.; Wahl, David H.

    2003-01-01

    We developed a method to estimate mortality rates of adult fish caused by entrainment through the propellers of commercial towboats operating in river channels. The method combines trawling while following towboats (to recover a fraction of the kills) and application of a hydrodynamic model of diffusion (to estimate the fraction of the total kills collected in the trawls). The sampling problem is unusual and required quantifying relatively rare events. We first examined key statistical properties of the entrainment mortality rate estimators using Monte Carlo simulation, which demonstrated that a design-based estimator and a new ad hoc estimator are both unbiased and converge to the true value as the sample size becomes large. Next, we estimated the entrainment mortality rates of adult fishes in Pool 26 of the Mississippi River and the Alton Pool of the Illinois River, where we observed kills that we attributed to entrainment. Our estimates of entrainment mortality rates were 2.52 fish/km of towboat travel (80% confidence interval, 1.00-6.09 fish/km) for gizzard shad Dorosoma cepedianum, 0.13 fish/km (0.00-0.41) for skipjack herring Alosa chrysochloris, and 0.53 fish/km (0.00-1.33) for both shovelnose sturgeon Scaphirhynchus platorynchus and smallmouth buffalo Ictiobus bubalus. Our approach applies more broadly to commercial vessels operating in confined channels, including other large rivers and intracoastal waterways.

  3. Rates of perinatal mortality and low birth weight among 3367 consecutive births in south of Beirut.

    PubMed

    Bittar, Z

    1998-01-01

    3367 consecutive births were reviewed prospectively. Population belongs mainly to a community with relatively underprivileged living conditions. Perinatal mortality was found at a rate of 22.4/1000 B. Early neonatal mortality formed 6.66/1000 B and stillbirth formed 15.83/1000 B. Low birth weight rate was 5.43% of live birth. Analysis of our findings suggests the need to improve follow-up during gestation to avoid complications resulting in macerated stillbirths, and to review the routine of follow-up and care in the immediate period before delivery, during delivery, in the immediate post partum period including resuscitation procedures, and care in the ICN. The aim is to prevent and appropriately treat intrauterine asphyxia, fetal distress, obstetric complications, and in the post partum period to appropriately resuscitate the newborn and improve ICN procedures. These measures are expected to reduce fresh stillbirth and early neonatal mortality and consequently infant mortality. Lowering rate of low birth weight is of less urgent nature in this population as it is relatively not high, but because a larger portion of early neonatal mortality is among low birth weight infants, with weights below 2000 gms, improving ICN care provided to these neonates is expected to sharply reduce neonatal mortality. In Lebanon we have a growing number of ICN units with wide variability of the quality of medical supervision and facilities. Insufficient number of neonatologists and nurses who are specialized in neonatal intensive care is leaving the chance for sick neonates to be attended by general pediatricians and insufficiently trained nurses. Our medical schools are called to encourage pediatricians to specialize in neonatal intensive care and to create more opportunities for this specialty to meet the national requirement. It is suggested, too, to subject ICN units in Lebanon to standardized requirements concerning attendance and facilities before obtaining official recognition

  4. Rest/Activity Rhythms and Mortality Rates in Older Men: MrOS Sleep Study

    PubMed Central

    Paudel, Misti L.; Taylor, Brent C.; Ancoli-Israel, Sonia; Blackwell, Terri; Stone, Katie L.; Tranah, Greg; Redline, Susan; Cummings, Steven R; Ensrud, Kristine E.

    2010-01-01

    Background An association between increased risk of mortality and disruptions in rest/activity circadian rhythms (RAR) has been shown among adults with dementia and with metastatic colorectal cancer. However the association among a more general population of older adults has not been studied. Methods Study population consisted of 2964 men aged 67 and older enrolled in the Outcomes of Sleep Disorders in Older Men (MrOS Sleep) Study. Rest/activity patterns were measured with wrist actigraphy. RAR parameters were computed and expressed as quintiles, and included acrophase (time of peak activity level), amplitude (peak-to-nadir difference), mesor (middle of the peak), pseudo F-value (overall circadian rhythmicity), beta (steepness) and alpha (peak-to-trough width). Results After adjustment for multiple potential confounders, men in the lowest quintile of pseudo F-value had a 57% higher mortality rate (Hazard ratio [HR]=1.57, 95%CI, 1.03–2.39) compared with men in the highest quintile. This association was even stronger with increased risk of cardiovascular disease-related mortality (CVD) (HR=2.32, 95%CI, 1.04–5.22). Additionally, men in the lowest quintile of acrophase had a 2.8-fold higher rate of CVD-related mortality (HR=2.84, 95%CI, 1.29–6.24). There was no evidence of independent associations with amplitude, mesor, alpha, beta and risk of mortality. Conclusions Older men with less robust RAR and earlier acrophase timing, have modestly higher all-cause and CVD-related mortality rates. Further research should examine potential biological mechanisms underlying this association. PMID:20370475

  5. Rest/activity rhythms and mortality rates in older men: MrOS Sleep Study.

    PubMed

    Paudel, Misti L; Taylor, Brent C; Ancoli-Israel, Sonia; Blackwell, Terri; Stone, Katie L; Tranah, Greg; Redline, Susan; Cummings, Steven R; Ensrud, Kristine E

    2010-01-01

    An association between increased risk of mortality and disruptions in rest/activity circadian rhythms (RAR) has been shown among adults with dementia and with metastatic colorectal cancer. However, the association among a more general population of older adults has not been studied. Our study population consisted of 2964 men aged > or = 67 yrs of age enrolled in the Outcomes of Sleep Disorders in Older Men (MrOS Sleep) Study. Rest/activity patterns were measured with wrist actigraphy. RAR parameters were computed and expressed as quintiles, and included acrophase (time of peak activity level), amplitude (peak-to-nadir difference), mesor (middle of the peak), pseudo F-value (overall circadian rhythmicity), beta (steepness), and alpha (peak-to-trough width). After adjustment for multiple potential confounders, men in the lowest quintile of pseudo F-value had a 57% higher mortality rate (hazard ratio [HR] = 1.57, 95% CI, 1.03-2.39) than men in the highest quintile. This association was even stronger with increased risk of cardiovascular disease-related mortality (CVD) (HR = 2.32, 95% CI, 1.04-5.22). Additionally, men in the lowest quintile of acrophase had a 2.8-fold higher rate of CVD-related mortality (HR = 2.84, 95% CI, 1.29-6.24). There was no evidence of independent associations with amplitude, mesor, alpha, beta, and mortality risk. Older men with less robust RAR and earlier acrophase timing have modestly higher all-cause and CVD-related mortality rates. Further research should examine potential biological mechanisms underlying this association. PMID:20370475

  6. Aid to determining freeway metering rates and detecting loop errors

    SciTech Connect

    Nihan, N.L.

    1997-11-01

    A recent freeway congestion prediction study for the Washington Department of Transportation (WSDOT) found that the sum of storage rates over time, SumSR(t), for a freeway section was a better variable for determining the best upstream ramp metering rates than the storage rate for time interval t, SR(t), which is the current WSDOT criterion. (Use of the SumSR(t) variable for this purpose requires that the summation be started during a period of low density flows.) Another finding was that the SumSR(t) variable was a better detector of loop chattering errors than WSDOT`s current criterion, which misses chattering errors that occur at normal traffic volume levels. Since calculation of SumSR(t) is easily incorporated in the current WSDOT ramp metering algorithm, the writer recommends its use in future WSDOT freeway metering schemes.

  7. Wind Speed and Mortality Rate of a Marine Fish, the Northern Anchovy (Engraulis mordax).

    PubMed

    Peterman, R M; Bradford, M J

    1987-01-16

    Large variability in recruitment of marine fishes creates challenging management problems. In northern anchovy (Engraulis mordax), there is a significant linear relation between larval mortality rate and the frequency of calm, low wind speed periods during the spawning season, possibly because calm winds permit maintenance of concentrated patches of larval food. Neither cannibalism on larvae nor offshore transport contributed significantly to interannual variation in early larval mortality. These results are consistent with the hypothesis that wind-driven turbulent mixing affects variability in survival of young fish larvae. However, abundance of recruits does not necessarily reflect abundance of larvae surviving through this early stage. PMID:17750387

  8. Associations of Various Health-Ratings with Geriatric Giants, Mortality and Life Satisfaction in Older People

    PubMed Central

    Lindenberg, Jolanda; Gussekloo, Jacobijn; Slaets, Joris P. J.; Westendorp, Rudi G. J.

    2016-01-01

    Self-rated health is routinely used in research and practise among general populations. Older people, however, seem to change their health perceptions. To accurately understand these changed perceptions we therefore need to study the correlates of older people’s self-ratings. We examined self-rated, nurse-rated and physician-rated health’s association with common disabilities in older people (the geriatric giants), mortality hazard and life satisfaction. For this, we used an age-representative population of 501 participant aged 85 from a middle-sized city in the Netherlands: the Leiden 85-plus Study. Participants with severe cognitive dysfunction were excluded. Participants themselves provided health ratings, as well as a visiting physician and a research nurse. Visual acuity, hearing loss, mobility, stability, urinal and faecal incontinence, cognitive function and mood (depressive symptoms) were included as geriatric giants. Participants provided a score for life satisfaction and were followed up for vital status. Concordance of self-rated health with physician-rated (k = .3 [.0]) and nurse-rated health (k = .2 [.0]) was low. All three ratings were associated with the geriatric giants except for hearing loss (all p < 0.001). Associations were equal in strength, except for depressive symptoms, which showed a stronger association with self-rated health (.8 [.1] versus .4 [.1]). Self-rated health predicted mortality less well than the other ratings. Self-rated health related stronger to life satisfaction than physician’s and nurse’s ratings. We conclude that professionals’ health ratings are more reflective of physical health whereas self-rated health reflects more the older person’s mental health, but all three health ratings are useful in research. PMID:27658060

  9. Disparities in Cervical Cancer Mortality Rates as Determined by the Longitudinal Hyperbolastic Mixed-Effects Type II Model

    PubMed Central

    Tabatabai, Mohammad A.; Kengwoung-Keumo, Jean-Jacques; Eby, Wayne M.; Bae, Sejong; Guemmegne, Juliette T.; Manne, Upender; Fouad, Mona; Partridge, Edward E.; Singh, Karan P.

    2014-01-01

    Background The main purpose of this study was to model and analyze the dynamics of cervical cancer mortality rates for African American (Black) and White women residing in 13 states located in the eastern half of the United States of America from 1975 through 2010. Methods The cervical cancer mortality rates of the Surveillance, Epidemiology, and End Results (SEER) were used to model and analyze the dynamics of cervical cancer mortality. A longitudinal hyperbolastic mixed-effects type II model was used to model the cervical cancer mortality data and SAS PROC NLMIXED and Mathematica were utilized to perform the computations. Results Despite decreasing trends in cervical cancer mortality rates for both races, racial disparities in mortality rates still exist. In all 13 states, Black women had higher mortality rates at all times. The degree of disparities and pace of decline in mortality rates over time differed among these states. Determining the paces of decline over 36 years showed that Tennessee had the most rapid decline in cervical cancer mortality for Black women, and Mississippi had the most rapid decline for White Women. In contrast, slow declines in cervical cancer mortality were noted for Black women in Florida and for White women in Maryland. Conclusions In all 13 states, cervical cancer mortality rates for both racial groups have fallen. Disparities in the pace of decline in mortality rates in these states may be due to differences in the rates of screening for cervical cancers. Of note, the gap in cervical cancer mortality rates between Black women and White women is narrowing. PMID:25226583

  10. A PC-aided optical foetal heart rate detection system.

    PubMed

    Oweis, Rami J; As'ad, Hala; Aldarawsheh, Amany; Al-Khdeirat, Rawan; Lwissy, Kaldoun

    2014-01-01

    Safe monitoring of foetal heart rate is a valuable tool for the healthy evolution and wellbeing of both foetus and mother. This paper presents a non-invasive optical technique that allows for foetal heart rate detection using a photovoltaic infrared (IR) detector placed on the mother's abdomen. The system presented here consists of a photoplethysmography (PPG) circuit, abdomen circuit and a personal computer equipped with MATLAB. A near IR beam having a wavelength of 880 nm is transmitted through the mother's abdomen and foetal tissue. The received abdominal signal that conveys information pertaining to the mother and foetal heart rate is sensed by a low noise photodetector. The PC receives the signal through the National Instrumentation Data Acquisition Card (NIDAQ). After synchronous detection of the abdominal and finger PPG signals, the designed MATLAB-based software saves, analyses and extracts information related to the foetal heart rate. Extraction is carried out using recursive least squares adaptive filtration. Measurements on eight pregnant women with gestational periods ranging from 35-39 weeks were performed using the proposed system and CTG. Results show a correlation coefficient of 0.978 and a correlation confidence interval between 88-99.6%. The t test results in a p value of 0.034, which is less than 0.05. Low power, low cost, high signal-to-noise ratio, reduction of ambient light effect and ease of use are the main characteristics of the proposed system. PMID:24195701

  11. Socio-demographic factors intensifying male mating competition exacerbate male mortality rates.

    PubMed

    Kruger, Daniel J

    2010-05-07

    Sex differences in mortality rates stem from a complex set of genetic, physiological, psychological, and social causes whose influences and interconnections are best understood in an integrative evolutionary life history framework. Although there are multiple levels of mechanisms contributing to sex based disparities in mortality rates, the intensity of male mating competition in a population may have a crucial role in shaping the level of excess male mortality. The degree of variation and skew in male reproductive success may shape the intensity of male mating competition, leading to riskier behavioral and physiological strategies. This study examines three socio-demographic factors related to variation in human male reproductive success; polygyny, economic inequality, and the population ratio of reproductively viable men to women across nations with available data. The degrees of economic inequality and polygyny explained unique portions in the sex difference in mortality rates, these predictors accounted for 53% of the variance. The population ratio of reproductively viable men to women did not explain any additional variance. These results demonstrate the association between social conditions and health outcomes in modern nations, as well as the power of an evolutionary life history framework for understanding important social issues.

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

    PubMed

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

    2013-01-01

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

  13. Health Human Capital in Sub-Saharan Africa: Conflicting Evidence from Infant Mortality Rates and Adult Heights

    PubMed Central

    Akachi, Yoko; Canning, David

    2011-01-01

    We investigate trends in cohort infant mortality rates and adult heights in 39 developing countries since 1960. In most regions of the world improved nutrition, and reduced childhood exposure to disease, have lead to improvements in both infant mortality and adult stature. In Sub-Saharan Africa, however, despite declining infant mortality rates, adult heights have not increased. We argue that in Sub-Saharan Africa the decline in infant mortality may have been due to interventions that prevent infant deaths rather than improved nutrition and childhood morbidity. Despite declining infant mortality, Sub-Saharan Africa may not be experiencing increases in health human capital. PMID:20634153

  14. Prescription of enoxaparin is associated with decreasing pulmonary embolism mortality rate in Germany.

    PubMed

    Pütter, Carolin; von Beckerath, Olga; Sobik, Hanna Maria; Reinecke, Holger; Stausberg, Jürgen; Kröger, Knut

    2015-11-01

    We analysed time trends in the pulmonary embolism (PE) mortality rates in Germany from 2004 and assessed for an association between the use of anticoagulants and PE caused mortality. We extracted age-specific number of deaths due to PE (ICD-10 I26) from 2004 to 2011 as available from the WHO mortality databases. In addition we derived defined daily dosage (DDD) of prescribed anticoagulants and the low molecular heparin Enoxaparin for the years 2004-2011 from the statutory health insurance-drug-information system reports. Age-standardized PE mortality per 100,000 decreased from 5.9283 in year 2004 to 4.4876 in 2011 (-24.3 %). Amounts of prescribed anticoagulants increased in this period from 271,810.7 × 1000 DDD to 416,611.8 × 1000 DDD (+53.3 %), that of Enoxaparin increased from 27,071.1 × 1000 DDD in 2004 97,276.5 × 1000 DDD in 2011. The PE mortality is negatively correlated with anticoagulants (-0.9463, p = 0.0004) as well as with enoxaparin (-0.9740, p < 0.0001) and of DDD of Enoxaparin per 1000 insured (-0.9682, p < 0.0001). In univariate linear regression model, anticoagulants, Enoxaparin and Enoxaparin per 1000 insured all reach significance (p = 0.0004, p = 4.31 × 10(-5) and p = 0.0001 respectively). Multiple regression models show that Enoxaparin has the most robust effect. Including the time trend in the model does not alter the results. Our study shows that increasing number of prescribed Enoxaparin in an outpatient setting might be one determinant of decreasing PE mortality rate in Germany since 2004.

  15. An ecological analysis of PM2.5 concentrations and lung cancer mortality rates in China

    PubMed Central

    Fu, Jingying; Jiang, Dong; Lin, Gang; Liu, Kun; Wang, Qiao

    2015-01-01

    Objective To explore the association between Particulate Matter (PM)2.5 (particles with an aerodynamic diameter less than 2.5 µm) and lung cancer mortality rates and to estimate the potential risk of lung cancer mortality related to exposure to high PM2.5 concentrations. Design Geographically weighted regression was performed to evaluate the relation between PM2.5 concentrations and lung cancer mortality for males, females and for both sexes combined, in 2008, based on newly available long-term data. Lung cancer fatalities from long-term exposure to PM2.5 were calculated according to studies by Pope III et al and the WHO air quality guidelines (AQGs). Setting 31 provinces in China. Results PM2.5 was associated with the lung cancer mortality of males, females and both sexes combined, in China, although there were exceptions in several regions, for males and females. The number of lung cancer fatalities calculated by the WHO AQGs ranged from 531 036 to 532 004, whereas the number calculated by the American Cancer Society (ACS) reached 614 860 after long-term (approximately 3–4 years) exposure to PM2.5 concentrations since 2008. Conclusions There is a positive correlation between PM2.5 and lung cancer mortality rate, and the relationship between them varies across the entire country of China. The number of lung cancer fatalities estimated by ACS was closer to the actual data than those of the WHO AQGs. Therefore, the ACS estimate of increased risk of lung cancer mortality from long-term exposure to PM2.5 might be more applicable for evaluating lung cancer fatalities in China than the WHO estimate. PMID:26603253

  16. Rate of Contrast Extravasation on CT Angiography Predicts Hematoma Expansion and Mortality in Primary Intracerebral Hemorrhage

    PubMed Central

    Brouwers, H. Bart; Battey, Thomas W.K.; Musial, Hayley H.; Ciura, Viesha A.; Falcone, Guido J.; Ayres, Alison M.; Vashkevich, Anastasia; Schwab, Kristin; Viswanathan, Anand; Anderson, Christopher D.; Greenberg, Steven M.; Pomerantz, Stuart R.; Ortiz, Claudia J.; Goldstein, Joshua N.; Gonzalez, R. Gilberto; Rosand, Jonathan; Romero, Javier M.

    2015-01-01

    Background and Purpose In primary intracerebral hemorrhage (ICH), the presence of contrast extravasation following CT angiography (CTA), termed the ‘spot sign’, predicts hematoma expansion and mortality. Since the biological underpinnings of the spot sign are not fully understood, we investigated whether the rate of contrast extravasation - which may reflect the rate of bleeding - predicts expansion and mortality beyond the simple presence of the spot sign. Methods Consecutive ICH patients with first-pass CTA followed by a 90-second delayed post-contrast CT (delayed CTA) were included. CTAs were reviewed for spot sign presence by two blinded readers. Spot sign volumes on first-pass and delayed CTA and ICH volumes were measured using semi-automated software. Extravasation rates were calculated and tested for association with hematoma expansion and mortality using uni- and multivariable logistic regression. Results 162 patients were included, 48 (30%) of whom had ≥1 spot sign. Median spot sign volume was 0.04mL on first-pass CTA and 0.4mL on delayed CTA. Median extravasation rate was 0.23mL/min overall, and 0.30mL/min among expanders versus 0.07mL/min in non-expanders. Extravasation rates were also significantly higher in patients who died in hospital: 0.27mL/min versus 0.04mL/min. In multivariable analysis, the extravasation rate was independently associated with in-hospital mortality (OR1.09 [95%CI 1.04–1.18], p=0.004), 90-day mortality (OR1.15 [95%CI 1.08–1.27], p=0.0004), and hematoma expansion (OR1.03 [95%CI 1.01–1.08], p=0.047). Conclusions Contrast extravasation rate, or spot sign growth, further refines the ability to predict hematoma expansion and mortality. Our results support the hypothesis that the spot sign directly measures active bleeding in acute ICH. PMID:26243220

  17. Temporal dynamics of outcrossing and host mortality rates in host-pathogen experimental coevolution.

    PubMed

    Morran, Levi T; Parrish, Raymond C; Gelarden, Ian A; Lively, Curtis M

    2013-07-01

    Cross-fertilization is predicted to facilitate the short-term response and the long-term persistence of host populations engaged in antagonistic coevolutionary interactions. Consistent with this idea, our previous work has shown that coevolving bacterial pathogens (Serratia marcescens) can drive obligately selfing hosts (Caenorhabditis elegans) to extinction, whereas the obligately outcrossing and partially outcrossing populations persisted. We focused the present study on the partially outcrossing (mixed mating) and obligately outcrossing hosts, and analyzed the changes in the host resistance/avoidance (and pathogen infectivity) over time. We found that host mortality rates increased in the mixed mating populations over the first 10 generations of coevolution when outcrossing rates were initially low. However, mortality rates decreased after elevated outcrossing rates evolved during the experiment. In contrast, host mortality rates decreased in the obligately outcrossing populations during the first 10 generations of coevolution, and remained low throughout the experiment. Therefore, predominant selfing reduced the ability of the hosts to respond to coevolving pathogens compared to outcrossing hosts. Thus, we found that host-pathogen coevolution can generate rapid evolutionary change, and that host mating system can influence the outcome of coevolution at a fine temporal scale.

  18. The Influence of a Crosshair Visual Aid on Observer Detection of Simulated Fetal Heart Rate Signals.

    PubMed

    Kennedy, Rebecca A; Scerbo, Mark W; Anderson-Montoya, Brittany L; Belfore, Lee A; Abuhamad, Alfred Z; Davis, Stephen S

    2016-03-01

    Objective To determine whether a visual aid overlaid on fetal heart rate (FHR) tracings increases detection of critical signals relative to images with no visual aid. Study Design In an experimental study, 21 undergraduate students viewed 240 images of simulated FHR tracings twice, once with the visual aids and once without aids. Performance was examined for images containing three different types of FHR signals (early deceleration, late deceleration, and acceleration) and four different FHR signal-to-noise ratios corresponding to FHR variability types (absent, minimal, moderate, and marked) identified by the National Institute of Child Health and Human Development (2008). Performance was analyzed using repeated-measures analyses of variance. Results The presence of the visual aid significantly improved correct detections of signals overall and decreased false alarms for the marked variability condition. Conclusion The results of the study provide evidence that the presence of a visual aid was useful in helping novices identify FHR signals in simulated maternal-fetal heart rate images. Further, the visual aid was most useful for conditions in which the signal is most difficult to detect (when FHR variability is highest).

  19. The Influence of a Crosshair Visual Aid on Observer Detection of Simulated Fetal Heart Rate Signals.

    PubMed

    Kennedy, Rebecca A; Scerbo, Mark W; Anderson-Montoya, Brittany L; Belfore, Lee A; Abuhamad, Alfred Z; Davis, Stephen S

    2016-03-01

    Objective To determine whether a visual aid overlaid on fetal heart rate (FHR) tracings increases detection of critical signals relative to images with no visual aid. Study Design In an experimental study, 21 undergraduate students viewed 240 images of simulated FHR tracings twice, once with the visual aids and once without aids. Performance was examined for images containing three different types of FHR signals (early deceleration, late deceleration, and acceleration) and four different FHR signal-to-noise ratios corresponding to FHR variability types (absent, minimal, moderate, and marked) identified by the National Institute of Child Health and Human Development (2008). Performance was analyzed using repeated-measures analyses of variance. Results The presence of the visual aid significantly improved correct detections of signals overall and decreased false alarms for the marked variability condition. Conclusion The results of the study provide evidence that the presence of a visual aid was useful in helping novices identify FHR signals in simulated maternal-fetal heart rate images. Further, the visual aid was most useful for conditions in which the signal is most difficult to detect (when FHR variability is highest). PMID:26989564

  20. Survival rates, mortality causes, and habitats of Pennsylvania white-tailed deer fawns

    USGS Publications Warehouse

    Vreeland, J.K.; Diefenbach, D.R.; Wallingford, B.D.

    2004-01-01

    Estimates of survival and cause-specific mortality of white-tailed deer (Odocoileus virginianus) fawns are important to population management. We quantified cause-specific mortality, survival rates, and habitat characteristics related to fawn survival in a forested landscape and an agricultural landscape in central Pennsylvania. We captured and radiocollared neonatal (0.05). Predation accounted for 46.2% (95% Cl = 37.6-56.7%) of 106 mortalities through 34 weeks. We attributed 32.7% (95% Cl = 21.9-48.6%) and 36.7% (95% Cl = 25.5-52.9%) of 49 predation events to black bears (Ursus americanus) and coyotes (Canis latrans], respectively. Natural causes, excluding predation, accounted for 27.4% (95% Cl = 20.1-37.3) of mortalities. Fawn survival in Pennsylvania was comparable to reported survival in forested and agricultural regions in northern portions of the white-tailed deer range. We have no evidence to suggest that the fawn survival rates we observed were preventing population growth. Because white-tailed deer are habitat generalists, home-range-scale habitat characteristics may be unrelated to fawn survival; therefore, future studies should consider landscape-related characteristics on fawn survival.

  1. Mortality Prediction with a Single General Self-Rated Health Question

    PubMed Central

    DeSalvo, Karen B; Bloser, Nicole; Reynolds, Kristi; He, Jiang; Muntner, Paul

    2006-01-01

    objective Health planners and policy makers are increasingly asking for a feasible method to identify vulnerable persons with the greatest health needs. We conducted a systematic review of the association between a single item assessing general self-rated health (GSRH) and mortality. Data Sources Systematic MEDLINE and EMBASE database searches for studies published from January 1966 to September 2003. Review Methods Two investigators independently searched English language prospective, community-based cohort studies that reported (1) all-cause mortality, (2) a question assessing GSRH; and (3) an adjusted relative risk or equivalent. The investigators searched the citations to determine inclusion eligibility and abstracted data by following a standarized protocol. Of the 163 relevant studies identified, 22 cohorts met the inclusion criteria. Using a random effects model, compared with persons reporting “excellent” health status, the relative risk (95% confidence interval) for all-cause mortality was 1.23 [1.09, 1.39], 1.44 [1.21, 1.71], and 1.92 [1.64, 2.25] for those reporting “good,”“fair,” and “poor” health status, respectively. This relationship was robust in sensitivity analyses, limited to studies that adjusted for co-morbid illness, functional status, cognitive status, and depression, and across subgroups defined by gender and country of origin. Conclusions Persons with “poor” self-rated health had a 2-fold higher mortality risk compared with persons with “excellent” self-rated health. Subjects' responses to a simple, single-item GSRH question maintained a strong association with mortality even after adjustment for key covariates such as functional status, depression, and co-morbidity. PMID:16336622

  2. Apparent climatically induced increase of tree mortality rates in a temperate forest

    USGS Publications Warehouse

    van Mantgem, P.J.; Stephenson, N.L.

    2007-01-01

    We provide a first detailed analysis of long-term, annual-resolution demographic trends in a temperate forest. After tracking the fates of 21 338 trees in a network of old-growth forest plots in the Sierra Nevada of California, we found that mortality rate, but not the recruitment rate, increased significantly over the 22 years of measurement (1983-2004). Mortality rates increased in both of two dominant taxonomic groups (Abies and Pinus) and in different forest types (different elevational zones). The increase in overall mortality rate resulted from an increase in tree deaths attributed to stress and biotic causes, and coincided with a temperature-driven increase in an index of drought. Our findings suggest that these forests (and by implication, other water-limited forests) may be sensitive to temperature-driven drought stress, and may be poised for die-back if future climates continue to feature rising temperatures without compensating increases in precipitation. ?? 2007 Blackwell Publishing Ltd/CNRS.

  3. Engineering Aid 3 & 2, Vol. 1. Rate Training Manual and Nonresident Career Course.

    ERIC Educational Resources Information Center

    Naval Education and Training Command, Washington, DC.

    Designed for individual study and not formal classroom instruction, this rate training manual provides subject matter that relates directly to the occupational qualifications of the Engineering Aid (EA) rating. This eight-chapter volume focuses on administrative matters, mathematics, and basic drafting. Chapter 1 discusses the scope of the EA…

  4. Resting heart rate as a prognostic factor for mortality in patients with breast cancer.

    PubMed

    Lee, Dong Hoon; Park, Seho; Lim, Sung Mook; Lee, Mi Kyung; Giovannucci, Edward L; Kim, Joo Heung; Kim, Seung Il; Jeon, Justin Y

    2016-09-01

    Although elevated resting heart rate (RHR) has been shown to be associated with mortality in the general population and patients with certain diseases, no study has examined this association in patients with breast cancer. A total of 4786 patients with stage I-III breast cancer were retrospectively selected from the Severance hospital breast cancer registry in Seoul, Korea. RHR was measured at baseline and the mean follow-up time for all patients was 5.0 ± 2.5 years. Hazard ratios (HRs) with 95 % confidence intervals (CIs) were calculated using Cox regression models. After adjustment for prognostic factors, patients in the highest quintile of RHR (≥85 beat per minute (bpm)) had a significantly higher risk of all-cause mortality (HR: 1.57; 95 %CI 1.05-2.35), breast cancer-specific mortality (HR: 1.69; 95 %CI 1.07-2.68), and cancer recurrence (HR: 1.49; 95 %CI 0.99-2.25), compared to those in the lowest quintile (≤67 bpm). Moreover, every 10 bpm increase in RHR was associated with 15, 22, and 6 % increased risk of all-cause mortality, breast cancer-specific mortality, and cancer recurrence, respectively. However, the association between RHR and cancer recurrence was not statistically significant (p = 0.26). Elevated RHR was associated with an increased risk of mortality in patients with breast cancer. The findings from this study suggest that RHR may be used as a prognostic factor for patients with breast cancer in clinical settings. PMID:27544225

  5. Comparison of mortality and rates of cerebral palsy in two populations of very low birthweight infants.

    PubMed Central

    Ens-Dokkum, M H; Johnson, A; Schreuder, A M; Veen, S; Wilkinson, A R; Brand, R; Ruys, J H; Verloove-Vanhorick, S P

    1994-01-01

    Comparisons of mortality and rates of cerebral palsy in different populations can be confusing. This is illustrated by comparing two populations of very low birthweight infants born in the 1980s, one from the Netherlands, the other from the UK (Oxford region). Although a number of biases were controlled for while comparing two large geographically defined populations, by assessing the survivors at similar ages and describing their health status in a standard way, some problems in interpretation of outcome remained. Differences in registration practice of live births at early gestational ages, as well as differences in withholding or withdrawing treatment, which occurred in about half of the cases of neonatal death in the Netherlands and in about one third of those in the Oxford region, may have influenced the incidence of registered live births, neonatal mortality, and the rate of cerebral palsy. PMID:8154921

  6. The Very High Premature Mortality Rate among Active Professional Wrestlers Is Primarily Due to Cardiovascular Disease

    PubMed Central

    Herman, Christopher W.; Conlon, Anna S. C.; Rubenfire, Melvyn; Burghardt, Andrew R.; McGregor, Stephen J.

    2014-01-01

    Purpose Recently, much media attention has been given to the premature deaths in professional wrestlers. Since no formal studies exist that have statistically examined the probability of premature mortality in professional wrestlers, we determined survival estimates for active wresters over the past quarter century to establish the factors contributing to the premature mortality of these individuals. Methods Data including cause of death was obtained from public records and wrestling publications in wrestlers who were active between January 1, 1985 and December 31, 2011. 557 males were considered consistently active wrestlers during this time period. 2007 published mortality rates from the Center for Disease Control were used to compare the general population to the wrestlers by age, BMI, time period, and cause of death. Survival estimates and Cox hazard regression models were fit to determine incident premature deaths and factors associated with lower survival. Cumulative incidence function (CIF) estimates given years wrestled was obtained using a competing risks model for cause of death. Results The mortality for all wrestlers over the 26-year study period was.007 deaths/total person-years or 708 per 100,000 per year, and 16% of deaths occurred below age 50 years. Among wrestlers, the leading cause of deaths based on CIF was cardiovascular-related (38%). For cardiovascular-related deaths, drug overdose-related deaths and cancer deaths, wrestler mortality rates were respectively 15.1, 122.7 and 6.4 times greater than those of males in the general population. Survival estimates from hazard models indicated that BMI is significantly associated with the hazard of death from total time wrestling (p<0.0001). Conclusion Professional wrestlers are more likely to die prematurely from cardiovascular disease compared to the general population and morbidly obese wrestlers are especially at risk. Results from this study may be useful for professional wrestlers, as well as

  7. Ejection Fraction and Mortality Rate of Patients with Isolated Acute Inferior Myocardial Infarction Reperfused by Streptokinase

    PubMed Central

    Beiraghdar, Mozhdeh; Reza Torknezhad, Mohammad; Torkan, Ali

    2011-01-01

    BACKGROUND This study aimed to evaluate the effects of streptokinase on left ventricular ejection fraction and mortality rate of patients with inferior acute myocardial infarction (AMI) without right ventricular myocardial infarction (RVMI). METHODS Fifty five consecutive patients with the diagnosis of inferior AMI without RVMI in the coronary care unit (CCU) of Shariati Hospital in Isfahan were selected for this study. Patients who had a history and/or electrocardiogram (ECG) evidence of previous myocardial infarction, evidence of bundle branch block, historical or clinical findings of valvular or other non-coronary heart diseases or heart failure were excluded. Participants were divided into two groups. Group one (n=28) had no contraindication for taking thrombolytic therapy and group two (n=27) had at least one contraindication for this treatment. Patients in group one took 1,000,000 units streptokinase for one hour. Three days later, LVEF of all participants was measured by an experienced cardiologist using 2-dimentiona1 echocardiography. Patients were followed up until four weeks to assess the mortality rate. RESULTS One death in the first 24 hours was reported in group one. However, no death was reported in any group until four weeks after discharge. There was no significant difference in mortality rate during the first 24 hours and four weeks after discharge between the two groups. Mean LVEF in the two groups did not show any significant difference (P=0.21). CONCLUSION Probably streptokinase has no effects on one-month mortality rate and LVEF in patients with inferior AMI without RVMI. Therefore, streptokinase side effects must be taken into consideration when being administered for this group of patients. PMID:22577446

  8. Linking leaf veins to growth and mortality rates: an example from a subtropical tree community.

    PubMed

    Iida, Yoshiko; Sun, I-Fang; Price, Charles A; Chen, Chien-Teh; Chen, Zueng-Sang; Chiang, Jyh-Min; Huang, Chun-Lin; Swenson, Nathan G

    2016-09-01

    A fundamental goal in ecology is to link variation in species function to performance, but functional trait-performance investigations have had mixed success. This indicates that less commonly measured functional traits may more clearly elucidate trait-performance relationships. Despite the potential importance of leaf vein traits, which are expected to be related to resource delivery rates and photosynthetic capacity, there are few studies, which examine associations between these traits and demographic performance in communities. Here, we examined the associations between species traits including leaf venation traits and demographic rates (Relative Growth Rate, RGR and mortality) as well as the spatial distributions of traits along soil environment for 54 co-occurring species in a subtropical forest. Size-related changes in demographic rates were estimated using a hierarchical Bayesian approach. Next, Kendall's rank correlations were quantified between traits and estimated demographic rates at a given size and between traits and species-average soil environment. Species with denser venation, smaller areoles, less succulent, or thinner leaves showed higher RGR for a wide range of size classes. Species with leaves of denser veins, larger area, cheaper construction costs or thinner, or low-density wood were associated with high mortality rates only in small size classes. Lastly, contrary to our expectations, acquisitive traits were not related to resource-rich edaphic conditions. This study shows that leaf vein traits are weakly, but significantly related to tree demographic performance together with other species traits. Because leaf traits associated with an acquisitive strategy such as denser venation, less succulence, and thinner leaves showed higher growth rate, but similar leaf traits were not associated with mortality, different pathways may shape species growth and survival. This study suggests that we are still not measuring some of key traits related to

  9. Disentangling effects of vector birth rate, mortality rate, and abundance on spread of a plant pathogen

    Technology Transfer Automated Retrieval System (TEKTRAN)

    For insect-transmitted plant pathogens, rates of pathogen spread are a function of vector abundance. While vector abundance is recognized to be important, parameters that govern vector population size receive little attention. For example, epidemiological models often fix vector population size by a...

  10. Unexpected reduction of mortality rates from melanoma in males living in central Italy.

    PubMed

    Crocetti, E; Carli, Paolo

    2003-04-01

    A registry-based study has been carried out in central Italy to investigate cutaneous melanoma incidence and mortality trends. The incidence of invasive (1492 cases analysed) and in situ (224 cases) cutaneous melanomas increased significantly from 1985 to 1997, in both genders. The increase of invasive tumours was mainly due to 'thin' (rates. From 1985 to 1999, we evidenced a statistically significant decrease in mortality among males, the estimated annual percent change (EAPC) was -3.3%/year (P<=0.012), but this was not observed among females (EAPC=0.2, P=0.896). The stage at diagnosis was worse for males than females at the beginning of the analysed period, therefore the former had more possibilities for improvement than females. This may partially explain this finding since mortality rates among females were also quite low during the late 1980s. However, the stable incidence rates of the thick forms of melanoma make this finding largely unexpected, and difficult to understand assuming that in the last decade no 'clear-cut' improvements in survival have been documented as a result of new treatments in advanced melanomas.

  11. Prevalence and mortality rate of peste des petitis ruminant (PPR): possible association with abortion in goat.

    PubMed

    Abubakar, Muhammad; Ali, Qurban; Khan, Haider A

    2008-06-01

    Present study was designed to investigate the prevalence and mortality (%) caused by Peste des Petitis Ruminant (PPR) and its possible association with abortion in goat flocks at different areas of Pakistan. A total of 140 animals were samples in the population of 650 which was having 185 deaths (Mortality rate = 28 %) from three different regions of the country. There were 58 abortions in the 140 pregnant goats of above said population One hundred & ten (110) serum samples from diseased, recovered and apparently healthy animals were tested for the presence of PPR antibodies by competitive ELISA (c ELISA). Eighty-four (84) animals were positive for PPR antibodies whereas in apparently healthy adult goats in the same flock, no PPR antibodies were detected. Twenty-four (24) tissue samples collected from the dead animals and six samples from aborted fetus were tested for the presence of PPR antigen by Immuno-capture ELISA (Ic ELISA). Nineteen (19) out of thirty (30) organ samples mainly from lung, spleen, lymph node were found positive for PPR antigen but negative from lungs of aborted fetus. There was a high rate of abortions (28-45%) in each of the outbreak and it was highest in the outbreak of Golra Sharif, Islamabad (No. = 21 in total population of 100). As the serum samples from the aborted dams were found positive for PPR antibodies so the study provides the possible association of mortality and prevalence of PPR disease with high rate of abortions in goat.

  12. Exacerbation rate, health status and mortality in COPD – a review of potential interventions

    PubMed Central

    Seemungal, Terence AR; Hurst, John R; Wedzicha, Jadwiga A

    2009-01-01

    COPD is prevalent in Western society and its incidence is rising in the developing world. Acute exacerbations of COPD, about 50% of which are unreported, lead to deterioration in quality of life and contribute significantly to disease burden. Quality of life deteriorates with time; thus, most of the health burden occurs in more severe disease. COPD severity and frequent and more severe exacerbations are all related to an increased risk of mortality. Inhaled corticosteroids (ICS) have similar effects on quality of life but ICS/long-acting bronchodilator combinations and the long-acting antimuscarinic tiotropium all improve health status and exacerbation rates and are likely to have an effect on mortality but perhaps only with prolonged use. Erythromycin has been shown to decrease the rate of COPD exacerbations. Pulmonary rehabilitation and regular physical activity are indicated in all severities of COPD and improve quality of life. Noninvasive ventilation is associated with improved quality of life. Long-term oxygen therapy improves mortality but only in hypoxic COPD patients. The choice of an inhaler device is a key component of COPD therapy and this requires more attention from physicians than perhaps we are aware of. Disease management programs, characterized as they are by patient centeredness, improve quality of life and decrease hospitalization rates. Most outcomes in COPD can be modified by interventions and these are well tolerated and have acceptable safety profiles. PMID:19554195

  13. Chemical characterization of indoor air of homes from communes in Xuan Wei, China, with high lung cancer mortality rates

    EPA Science Inventory

    In a rural county, Xuan Wei, China, the lung cancer mortality rate is among China's highest, especially in women. This mortality rate is more associated with indoor air burning of smoky coal, as opposed to smokeless coal or wood, for cooking and heating under unvented conditions....

  14. Cause-specific mortality rates in sub-Saharan Africa and Bangladesh.

    PubMed Central

    Adjuik, Martin; Smith, Tom; Clark, Sam; Todd, Jim; Garrib, Anu; Kinfu, Yohannes; Kahn, Kathy; Mola, Mitiki; Ashraf, Ali; Masanja, Honorati; Adazu, Kubaje; Adazu, Ubaje; Sacarlal, Jahit; Alam, Nurul; Marra, Adama; Gbangou, Adjima; Mwageni, Eleuther; Binka, Fred

    2006-01-01

    OBJECTIVE: To provide internationally comparable data on the frequencies of different causes of death. METHODS: We analysed verbal autopsies obtained during 1999 -2002 from 12 demographic surveillance sites in sub-Saharan Africa and Bangladesh to find cause-specific and age-specific mortality rates. The cause-of-death codes used by the sites were harmonized to conform to the ICD-10 system, and summarized with the classification system of the Global Burden of Disease 2000 (Version 2). FINDINGS: Causes of death in the African sites differ strongly from those in Bangladesh, where there is some evidence of a health transition from communicable to noncommunicable diseases, and little malaria. HIV dominates in causes of mortality in the South African sites, which contrast with those in highly malaria endemic sites elsewhere in sub-Saharan Africa (even in neighbouring Mozambique). The contributions of measles and diarrhoeal diseases to mortality in sub-Saharan Africa are lower than has been previously suggested, while malaria is of relatively greater importance. CONCLUSION: The different patterns of mortality we identified may be a result of recent changes in the availability and effectiveness of health interventions against childhood cluster diseases. PMID:16583076

  15. Reducing high maternal mortality rates in western China: a novel approach.

    PubMed

    Gyaltsen Gongque Jianzan, Kunchok; Gyal Li Xianjia, Lhusham; Gipson, Jessica D; Kyi Cai Rangji, Tsering; Pebley, Anne R

    2014-11-01

    Among the Millennium Development Goals, maternal mortality reduction has proven especially difficult to achieve. Unlike many countries, China is on track to meeting these goals on a national level, through a programme of institutionalizing deliveries. Nonetheless, in rural, disadvantaged, and ethnically diverse areas of western China, maternal mortality rates remain high. To reduce maternal mortality in western China, we developed and implemented a three-level approach as part of a collaboration between a regional university, a non-profit organization, and local health authorities. Through formative research, we identified seven barriers to hospital delivery in a rural Tibetan county of Qinghai Province: (1) difficulty in travel to hospitals; (2) hospitals lack accommodation for accompanying families; (3) the cost of hospital delivery; (4) language and cultural barriers; (5) little confidence in western medicine; (6) discrepancy in views of childbirth; and (7) few trained community birth attendants. We implemented a three-level intervention: (a) an innovative Tibetan birth centre, (b) a community midwife programme, and (c) peer education of women. The programme appears to be reaching a broad cross-section of rural women. Multilevel, locally-tailored approaches may be essential to reduce maternal mortality in rural areas of western China and other countries with substantial regional, socioeconomic, and ethnic diversity. PMID:25555773

  16. Reducing high maternal mortality rates in western China: a novel approach.

    PubMed

    Gyaltsen Gongque Jianzan, Kunchok; Gyal Li Xianjia, Lhusham; Gipson, Jessica D; Kyi Cai Rangji, Tsering; Pebley, Anne R

    2014-11-01

    Among the Millennium Development Goals, maternal mortality reduction has proven especially difficult to achieve. Unlike many countries, China is on track to meeting these goals on a national level, through a programme of institutionalizing deliveries. Nonetheless, in rural, disadvantaged, and ethnically diverse areas of western China, maternal mortality rates remain high. To reduce maternal mortality in western China, we developed and implemented a three-level approach as part of a collaboration between a regional university, a non-profit organization, and local health authorities. Through formative research, we identified seven barriers to hospital delivery in a rural Tibetan county of Qinghai Province: (1) difficulty in travel to hospitals; (2) hospitals lack accommodation for accompanying families; (3) the cost of hospital delivery; (4) language and cultural barriers; (5) little confidence in western medicine; (6) discrepancy in views of childbirth; and (7) few trained community birth attendants. We implemented a three-level intervention: (a) an innovative Tibetan birth centre, (b) a community midwife programme, and (c) peer education of women. The programme appears to be reaching a broad cross-section of rural women. Multilevel, locally-tailored approaches may be essential to reduce maternal mortality in rural areas of western China and other countries with substantial regional, socioeconomic, and ethnic diversity.

  17. Reducing high maternal mortality rates in western China: a novel approach

    PubMed Central

    Gyaltsen, Kunchok; Jianzan, Gongque; Gyal, Lhusham; Xianjia, Li; Gipson, Jessica D; Kyi, Tsering; Rangji, Cai; Pebley, Anne R

    2015-01-01

    Among the Millennium Development Goals, maternal mortality reduction has proven especially difficult to achieve. Unlike many countries, China is on track to meeting these goals on a national level, through a programme of institutionalizing deliveries. Nonetheless, in rural, disadvantaged, and ethnically diverse areas of western China, maternal mortality rates remain high. To reduce maternal mortality in western China, we developed and implemented a three-level approach as part of a collaboration between a regional university, a non-profit organization, and local health authorities. Through formative research, we identified seven barriers to hospital delivery in a rural Tibetan county of Qinghai Province: (1) difficulty in travel to hospitals; (2) hospitals lack accommodation for accompanying families; (3) the cost of hospital delivery; (4) language and cultural barriers; (5) little confidence in western medicine; (6) discrepancy in views of childbirth; and (7) few trained community birth attendants. We implemented a three-level intervention: (a) an innovative Tibetan birth centre, (b) a community midwife programme, and (c) peer education of women. The programme appears to be reaching a broad cross-section of rural women. Multilevel, locally-tailored approaches may be essential to reduce maternal mortality in rural areas of western China and other countries with substantial regional, socioeconomic, and ethnic diversity. PMID:25555773

  18. Stochastic variation in sex ratios in infant mortality rates due to small samples in provisioned Japanese macaque (Macaca fuscata) populations.

    PubMed

    Kurita, Hiroyuki

    2010-01-01

    Sex differences in infant mortality in provisioned Japanese macaque populations were examined using 10 data sets from five populations. The results indicate that there was no available data set in which a sex difference in infant mortality was statistically significant. To examine whether the observed sex ratios in infant mortality rates could be the product of stochastic variation in small samples, a correlation between sample size and the magnitude of sex ratios in infant mortality rates was also examined. Notably, the magnitude of sex ratios in infant mortality rates declined significantly as sample sizes increased. These results suggest that previously reported marked sex ratios in infant mortality could be the product of stochastic variation in small samples.

  19. Geomagnetic storms link to the mortality rate in the Smolyan region for the period 1988--2009

    NASA Astrophysics Data System (ADS)

    Simeonova, Siyka G. 1; Georgieva, Radostina C. 2; Dimitrova, Boryana H. 2; Slavcheva, Radka G. 2; Kerimova, Bojena P. 2; Georgiev, Tsvetan B. 34

    We present correlations and trends of 10 parameters of annual mortality rate (1 to common mortality rate, 5 to cardiovascular reasons and 4 to "accidental" reasons (car accidents, suicides, infections)) with respect to 6 parameters of annual solar and geomagnetic activity (Wolf index, number of geomagnetic storms, duration of the storms, amplitude of the storms). During the period of observation, characterized by a 3-4-fold decrease of the mean geomagnetic activity (in terms of the number and the duration of the storms) and with a strong variations of the amplitude of the storms (about an almost constant mean values for the period), there is a 1.3-fold decrease in the urban population, a 1.5-fold increase of the common mortality rate, a 1.8-fold increase of the cardiovascular mortality rate and a 1.1-fold decrease of the "accidental" mortality rates. During the years 2003-2005 we observe about 2-fold temporary increase in the storm amplitudes. During the years 2007-2008, characterized by extremely low geomagnetic activity, we observe a surprising temporary increase of the common and the cardiovascular mortality rates 1.1 and 1.3-fold, respectively (Figures 1-4). We point out 3 main results. (1) The available data shows notable increase in the mortality rates while there is generally a decrease of the solar or geomagnetic activity during the studied period (Figures 5-9). We explain this anti-correlation with the domination of the increasing mortality rates as an effect of the advance in the mean age of the population (due to immigration of young people and decrease of new-borns), hiding an eventual display of the solar and geomagnetic influence on the mortality rates. Using this data we can not reveal influence of the long-time (10-20 years) change of the average solar and geomagnetic activity on the mortality rate. (2) Excluding the unusual years 2007 and 2008, we establish that with respect to the years with low geomagnetic activity (1993, 1995, 1996, 1999), in

  20. Mortality rate estimation for eelgrass Zostera marina (Potamogetonaceae) using projections from Leslie matrices.

    PubMed

    Flores Uzeta, Olga; Solana Arellano, Elena; Echavarría Heras, Héctor

    2008-09-01

    The main goal of this study is to provide estimations of mean mortality rate of vegetative shoots of the seagrass Zostera marina in a meadow near Ensenada Baja California, using a technique that minimizes destructive sampling. Using cohorts and Leslie matrices, three life tables were constructed, each representing a season within the period of monthly sampling (April 1999 to April 2000). Ages for the cohorts were established in terms of Plastochrone Interval (PI). The matrices were projected through time to estimate the mean total number of individuals at time t, n(t) as well as mortality. We found no statistical differences between observed and predicted mean values for these variables (t = -0.11, p = 0.92 for n(t) and t = 0.69, p = 0.5 for mean rate of mortality). We found high correlation coefficient values between observed and projected values for monthly number of individuals (r = 0.70, p = 0.007) and monthly mortality rates (r = 0.81, p = 0.001). If at a certain time t a sudden environmental change occurs, and as long as the perturbation does not provoke the killing of all the individuals of a given age i for 0 < or = i < or = x - 1, there will be a prevailing number of individuals of age or stage x at a time t+1. This nondestructive technique reduces the number of field visits and samples needed for the demographic analysis of Z. marina, and therefore decreases the disturbance caused by researches to the ecosystem. PMID:19419024

  1. Mortality rate estimation for eelgrass Zostera marina (Potamogetonaceae) using projections from Leslie matrices.

    PubMed

    Flores Uzeta, Olga; Solana Arellano, Elena; Echavarría Heras, Héctor

    2008-09-01

    The main goal of this study is to provide estimations of mean mortality rate of vegetative shoots of the seagrass Zostera marina in a meadow near Ensenada Baja California, using a technique that minimizes destructive sampling. Using cohorts and Leslie matrices, three life tables were constructed, each representing a season within the period of monthly sampling (April 1999 to April 2000). Ages for the cohorts were established in terms of Plastochrone Interval (PI). The matrices were projected through time to estimate the mean total number of individuals at time t, n(t) as well as mortality. We found no statistical differences between observed and predicted mean values for these variables (t = -0.11, p = 0.92 for n(t) and t = 0.69, p = 0.5 for mean rate of mortality). We found high correlation coefficient values between observed and projected values for monthly number of individuals (r = 0.70, p = 0.007) and monthly mortality rates (r = 0.81, p = 0.001). If at a certain time t a sudden environmental change occurs, and as long as the perturbation does not provoke the killing of all the individuals of a given age i for 0 < or = i < or = x - 1, there will be a prevailing number of individuals of age or stage x at a time t+1. This nondestructive technique reduces the number of field visits and samples needed for the demographic analysis of Z. marina, and therefore decreases the disturbance caused by researches to the ecosystem.

  2. CURB-65 score predicted mortality in community-acquired pneumonia better than IDSA/ATS minor criteria in a low-mortality-rate setting.

    PubMed

    Guo, Q; Li, H-Y; Zhou, Y-P; Li, M; Chen, X-K; Liu, H; Peng, H-L; Yu, H-Q; Chen, X; Liu, N; Liang, L-H; Zhao, Q-Z; Jiang, M

    2012-12-01

    The CURB-65 scoring system performs well at identifying patients with pneumonia who have a low risk of death. Whether it predicts mortality in community-acquired pneumonia (CAP) better than the 2007 Infectious Disease Society of America (IDSA)/American Thoracic Society (ATS) minor criteria in low-mortality-rate settings is not clear. The purpose of this study was to determine the hypothesis.A total of 1,230 adult inpatients admitted to our hospital from 2005 to 2009 for CAP were reviewed retrospectively.The hospital mortality was 1.3 %. Percentage mortality increased significantly with CURB-65 score and the increasing number of IDSA/ATS minor criteria present. The number of CURB-65 criteria or IDSA/ATS minor criteria present had significant increased odds ratios for mortality of 7.547 and 2.711, respectively. The sensitivities of a CURB-65 score of ≥ 3 and the presence of ≥ 3 minor criteria in predicting mortality was 25 % and 37.5 %, which increased to 75 % and 62.5 %, while the cut-off values reduced to ≥ 2 criteria, respectively. The area under the receiver operating characteristic curve for CURB-65 was greater than the corresponding area for IDSA/ATS minor criteria in predicting hospital mortality (0.915 vs. 0.805, p = 0.0091).CURB-65 score predicted hospital mortality better than IDSA/ATS minor criteria, and a CURB-65 score of ≥ 2 or the presence of ≥ 2 minor criteria might be more valuable cut-off values for "severe" CAP in a low-mortality-rate setting.

  3. Gender Differences in the Self-Rated Health-Mortality Association: Is It Poor Self-Rated Health that Predicts Mortality or Excellent Self-Rated Health that Predicts Survival?

    ERIC Educational Resources Information Center

    Benyamini, Yael; Blumstein, Tzvia; Lusky, Ayala; Modan, Baruch

    2003-01-01

    Purpose: This study investigates gender differences in the association between self-rated health (SRH) and mortality. This association has been well-documented, but findings regarding gender differences are inconsistent. The specific objectives were (a) to examine these differences in a short and a long time frame, (b) to examine these differences…

  4. Dispensing Rates of Four Common Hearing Aid Product Features: Associations With Variations in Practice Among Audiologists

    PubMed Central

    Johnson, Earl E.; Ricketts, Todd A.

    2010-01-01

    The purpose of the study was to develop and examine a list of potential variables that may account for variability in the dispensing rates of four common hearing aid features. A total of 29 potential variables were identified and placed into the following categories: (1) characteristics of the audiologist, (2) characteristics of the hearing aids dispensed by the audiologist, (3) characteristics of the audiologist's patient population, and (4) evidence-based practice grades of recommendation for each feature. The potentially associative variables then were examined using regression analyses from the responses of 257 audiologists to a dispensing practice survey. There was a direct relation between price and level of hearing aid technology with the frequency of dispensing product features. There was also a direct relation between the belief by the audiologist that a feature might benefit patients and the frequency of dispensing that feature. In general, the results suggested that personal differences among audiologists and the hearing aids audiologists choose to dispense are related more strongly to dispensing rates of product features than to differences in characteristics of the patient population served by audiologists. An additional finding indicated that evidence-based practice recommendations were inversely related to dispensing rates of product features. This finding, however, may not be the result of dispensing trends as much as hearing aid manufacturing trends. PMID:20457726

  5. Effect of marital status on death rates. Part 2: Transient mortality spikes

    NASA Astrophysics Data System (ADS)

    Richmond, Peter; Roehner, Bertrand M.

    2016-05-01

    We examine what happens in a population when it experiences an abrupt change in surrounding conditions. Several cases of such "abrupt transitions" for both physical and living social systems are analyzed from which it can be seen that all share a common pattern. First, a steep rising death rate followed by a much slower relaxation process during which the death rate decreases as a power law. This leads us to propose a general principle which can be summarized as follows: "Any abrupt change in living conditions generates a mortality spike which acts as a kind of selection process". This we term the Transient Shock conjecture. It provides a qualitative model which leads to testable predictions. For example, marriage certainly brings about a major change in personal and social conditions and according to our conjecture one would expect a mortality spike in the months following marriage. At first sight this may seem an unlikely proposition but we demonstrate (by three different methods) that even here the existence of mortality spikes is supported by solid empirical evidence.

  6. Enrollee health status under Medicare risk contracts: an analysis of mortality rates.

    PubMed Central

    Riley, G; Lubitz, J; Rabey, E

    1991-01-01

    Previous studies comparing the health status of Medicare beneficiaries enrolled under HMO risk contracts to that of Medicare beneficiaries in fee-for-service (FFS) have generally focused on demonstration projects conducted before 1985. This study examines mortality rates in 1987 for approximately 1 million aged Medicare beneficiaries enrolled in 108 HMOs. We estimated adjusted mortality ratios (AMR) for each HMO and across all HMOs, by dividing the actual number of deaths among HMO enrollees by the "expected" number of deaths. The expected number of deaths was based on death rates among local FFS populations, adjusting for age, sex, Medicaid buy-in status, and institutional status. The AMR for all HMO enrollees pooled together was 0.80. For persons newly enrolled in 1987, the AMR was 0.69; in general, AMRs were higher for beneficiaries who had been enrolled for longer periods of time. Among individual HMOs, none exhibited an AMR substantially above 1.00. Regression analysis indicated lower AMRs for staff model HMOs than for either IPA or group models. Low mortality among Medicare HMO enrollees is consistent with favorable selection or with improvements in the health status of enrollees due to better access or quality of care in HMOs. In either case, health status differences between HMO enrollees and FFS beneficiaries have implications for the appropriateness of Medicare's Adjusted Average Per Capita Cost (AAPCC) payment formula for HMOs. PMID:2061054

  7. Mortality rates in the Federal Republic of Germany following previous occupational exposure to asbestos dust.

    PubMed

    Woitowitz, H J; Lange, H J; Beierl, L; Rathgeb, M; Schmidt, K; Ulm, K; Giesen, T; Woitowitz, R H; Pache, L; Rödelsperger, K

    1986-01-01

    In 1972, a procedure was introduced by the Industrial Injuries Insurance Institutes (Berufsgenossenschaften) of the Federal Republic of Germany, which is to be used by the special occupational health service for employees exposed to asbestos dust. Since 1 January 1972, occupational health examinations are performed when exposure to asbestos dust has been of at least 3 years' duration. On 1 January 1977, a prospective cohort study was started with employees formerly exposed to asbestos dust whilst working for companies manufacturing or using asbestos. Data on these persons are collected in the Central Register of Employees Exposed to Asbestos Dust of the Industrial Injuries Insurance Institutes. A total of 3,070 male and female employees in whom asbestos exposure terminated after 1 January 1972 formed subcohort I of the study. For comparison, 665 persons whose exposure terminated before 1 January 1972 served as subcohort II. In addition to several other inclusion criteria, each individual's permission was required before personal data could be evaluated. Of the subjects in the two subcohorts, 185 and 71, respectively, had died by 31 December 1982. Tumours were more frequently than this cause of death is expected in the general population. In addition to a high incidence of mesothelioma, the standard mortality rate was especially increased for lung cancer. The proportional mortality rates of about 40% for tumours of all sites (with about 17% lung cancer and 8% mesothelioma) especially in subcohort II, seemed to be comparable to the international figures for epidemiological mortality.

  8. The health of nations in a global context: trade, global stratification, and infant mortality rates.

    PubMed

    Moore, Spencer; Teixeira, Ana C; Shiell, Alan

    2006-07-01

    Despite the call for a better understanding of macro-level factors that affect population health, social epidemiological research has tended to focus almost exclusively on national-level factors, such as Gross Domestic Product per capita (GDP/c) or levels of social cohesion. Using a world-systems framework to examine cross-national variations in infant mortality, this paper seeks to emphasize the effects of global trade on national-level population health. Rather than viewing national-level health indicators as autonomous from broader global contexts, the study uses network analysis methods to examine the effects of international trade on infant mortality rates. Network data for countries were derived from international data on the trade of capital-intensive commodities in 2000. Using automorphic equivalence to measure the degree to which actors in a network perform similar roles, countries were assigned into one of six world-system blocks, each with its own pattern of trade. These blocks were dummy-coded and tested using ordinary least squares (OLS) regression. A key finding from this analysis is that after controlling for national-level factors, the two blocks with the lowest density in capital-intensive exchange, i.e., the periphery, are significantly and positively associated with national-level infant mortality rates. Results show the effects of peripherality and stratification on population health, and highlight the influence of broader macro-level factors such as trade and globalization on national health.

  9. Infant Stool Color Card Screening Helps Reduce the Hospitalization Rate and Mortality of Biliary Atresia

    PubMed Central

    Lee, Min; Chen, Solomon Chih-Cheng; Yang, Hsin-Yi; Huang, Jui-Hua; Yeung, Chun-Yan; Lee, Hung-Chang

    2016-01-01

    Abstract Biliary atresia (BA) is a significant liver disease in children. Since 2004, Taiwan has implemented a national screening program that uses an infant stool color card (SCC) for the early detection of BA. The purpose of this study was to examine the outcomes of BA cases before and after the launch of this screening program. The objectives of this study were to evaluate the rates of hospitalization, liver transplantation (LT), and mortality of BA cases before and after the program, and to examine the association between the hospitalization rate and survival outcomes. This was a population-based cohort study. BA cases born during 1997 to 2010 were identified from the Taiwan National Health Insurance Research Database. Sex, birth date, hospitalization date, LT, and death data were collected and analyzed. The hospitalization rate by 2 years of age (Hosp/2yr) was calculated to evaluate its association with the outcomes of LT or death. Among 513 total BA cases, 457 (89%) underwent the Kasai procedure. Of these, the Hosp/2yr was significantly reduced from 6.0 to 6.9/case in the earlier cohort (1997–2004) to 4.9 to 5.3/case in the later cohort (2005–2010). This hospitalization rate reduction was followed by a reduction in mortality from 26.2% to 15.9% after 2006. The Cox proportional hazards model showed a significant increase in the risk for both LT (hazard ratio [HR] = 1.14, 95% confidence interval [CI] = 1.10–1.18) and death (HR = 1.05, 95% CI = 1.01–1.08) for each additional hospitalization. A multivariate logistic regression model found that cases with a Hosp/2yr >6 times had a significantly higher risk for both LT (adjusted odds ratio [aOR] = 4.35, 95% CI = 2.82–6.73) and death (aOR = 1.75, 95% CI = 1.17–2.62). The hospitalization and mortality rates of BA cases in Taiwan were significantly and coincidentally reduced after the launch of the SCC screening program. There was a significant association between the

  10. Estimated Glomerular Filtration Rate and Mortality among Patients with Coronary Heart Disease

    PubMed Central

    Ding, Ding; Xia, Min; Li, Dan; Yang, Yunou; Li, Qing; Liu, Jiaxing; Chen, Xuechen; Hu, Gang; Ling, Wenhua

    2016-01-01

    Objective The association between estimated glomerular filtration rate (eGFR) and the risk of mortality among patients with coronary heart disease (CHD) is complex and still unclear. The aim of this study was to evaluate the effect of eGFR on the risk prediction of all-cause and cardiovascular disease (CVD) mortality with a long follow-up period among patients with CHD in China. Methods We conducted a prospective cohort study of 3276 Chinese patients with CHD. Cox proportional hazards regression models were used to estimate the association of different levels of eGFR with the risks of mortality. Results During a mean follow-up period of 4.9 years, 293 deaths were identified. The multivariable-adjusted hazard ratios associated with different levels of eGFR (≥90 [reference group], 60–89, 30–59, 15–29 ml/min per 1.73m2) at baseline were 1.00, 1.28 (95% confidence interval [CI], 0.87–1.88), 1.96 (95% CI, 1.31–2.94), and 3.91 (95% CI, 2.15–7.13) (P <0.001) for all-cause mortality, and 1.00, 1.26 (95% CI, 0.78–2.04), 1.94 (95% CI, 1.17–3.20), and 3.77 (95% CI, 1.80–7.89) (P <0.001) for CVD mortality, respectively. After excluding subjects who died during the first 2 years of follow-up (n = 113), the graded associations of eGFR with the risks of all-cause and CVD morality were still present. The addition of eGFR to a model including traditional cardiovascular risk factors resulted in significant improvement in the prediction of all-cause and CVD mortality. Conclusions Reduced eGFR (< 60 ml/min per 1.73 m2) at baseline is associated with increased risks of all-cause and CVD mortality among Chinese patients with CHD. PMID:27537335

  11. Socio-demographic and spatial aspects of male mortality from HIV-AIDS related diseases in New South Wales, Australia, 1990-1994.

    PubMed

    Burnley, I H

    1999-09-01

    During 1990-1994, a very high proportion of males aged under 40 who died from HIV-AIDs related diseases in New South Wales were never married. However, a significant minority of men aged 40-64 who died had been married at some stage in their lives and in the cities of Newcastle, Wollongong and in higher income areas of Sydney this proportion approached 40%. AIDS related mortality was over-represented in professional, managerial, paraprofessional and service occupations even though educational levels were higher in these groups and, thus, presumably knowledge about risk behaviour and preventative behaviour. AIDS related mortality was also elevated among men with no stated occupation. Thus, with males, AIDS was in part a disease of affluence, even though the highest proportions of those dying resided in lower income areas, where marginalised persons may also be at risk. The proportion of deaths to men over age 40 was markedly higher than that in Australia in the 1980s. Elevated mortality with the New Zealand and the Americas birthplace groups may reflect overseas travel and exposure to risk in overseas countries, of persons domiciled in Australia. There was a very strong spatial pattern of AIDS-related mortality in the inner and eastern suburbs in Sydney and there is limited evidence of persons having migrated back to places of origin to be cared for by families. The impact on total mortality under age 65 in these localised areas was considerable. Prevention strategies should include the sensitive targeting of bisexual men, men generally having sex with men and those who are both gay and members of the drug sub-culture.

  12. Prediction of Hospital Acute Myocardial Infarction and Heart Failure 30-Day Mortality Rates Using Publicly Reported Performance Measures

    PubMed Central

    Aaronson, David S.; Bardach, Naomi S.; Lin, Grace A.; Chattopadhyay, Arpita; Goldman, L. Elizabeth; Dudley, R. Adams

    2014-01-01

    Objective To identify an approach to summarizing publicly reported hospital performance data for acute myocardial infarction (AMI) or heart failure (HF) that best predicts current year hospital mortality rates. Setting A total of 1,868 U.S. hospitals reporting process and outcome measures for AMI and HF to the Centers for Medicare and Medicaid Services (CMS) from July 2005 to June 2006 (Year 0) and July 2006 to June 2007 (Year 1). Design Observational cohort study measuring the percentage variation in Year 1 hospital 30-day risk-adjusted mortality rate explained by denominator-based weighted composite scores summarizing hospital Year 0 performance. Data Collection Data were prospectively collected from hospitalcompare.gov. Results Percentage variation in Year 1 mortality was best explained by mortality rate alone in Year 0 over other composites including process performance. If only Year 0 mortality rates were reported, and consumers using hospitals in the highest decile of mortality instead chose hospitals in the lowest decile of mortality rate, the number of deaths at 30 days that potentially could have been avoided was 1.31 per 100 patients for AMI and 2.12 for HF (p < .001). Conclusion Public reports focused on 30-day risk-adjusted mortality rate may more directly address policymakers’ goals of facilitating consumer identification of hospitals with better outcomes. PMID:22093186

  13. Maternal and neonatal morbidity and mortality rate in caesarean section and vaginal delivery

    PubMed Central

    Ghahiri, Ataollah; Khosravi, Mehrnoush

    2015-01-01

    Background: The cesarean section is one of the most common procedures to prevent health-threatening risks to the mother and infant. Increasing rate of cesarean section attracted the attention of professionals and the overall objective of this study was to determine the frequency of maternal and neonatal morbidity and mortality rates in the two methods of delivery. Materials and Methods: In a comparative cohort study, 300 cases undergoing caesarean section and 300 cases with vaginal delivery were selected in two main hospitals of Isfahan, Iran during 2013 and 2014. Demographic characteristics and factors related to mortality and morbidity of mothers and infants were studied. Mothers were also recruited 6 weeks after delivery to ask for complications. Mothers and infants mortality and morbidity were studied and analyzed by SPSS 22 software. Results: Follow-up of deliveries up to 1-month after delivery suggested 2 cases of infant death (7%) in vaginal delivery group, while no case of infant death was reported in cesarean delivery group (P = 0.5). Incidence of fever was observed in first 10 days after delivery in 7 cases in the vaginal delivery group and 11 cases in the cesarean delivery group (2.3% vs. 3.7%, P = 0.4). Conclusion: Despite all the benefits of vaginal delivery compared with cesarean section, in many cases, especially in emergency cesarean section delivery can substantially reduce the maternal and neonatal mortality and morbidity. It is recommended to assess the complications of each method in all pregnant women about to give birth, and then decide on the method of delivery. PMID:26605232

  14. Concordance of effects of medical interventions on hospital admission and readmission rates with effects on mortality

    PubMed Central

    Hemkens, Lars G.; Contopoulos-Ioannidis, Despina G.; Ioannidis, John P.A.

    2013-01-01

    Background: Many clinical trials examine a composite outcome of admission to hospital and death, or infer a relationship between hospital admission and survival benefit. This assumes concordance of the outcomes “hospital admission” and “death.” However, whether the effects of a treatment on hospital admissions and readmissions correlate to its effect on serious outcomes such as death is unknown. We aimed to assess the correlation and concordance of effects of medical interventions on admission rates and mortality. Methods: We searched the Cochrane Database of Systematic Reviews from its inception to January 2012 (issue 1, 2012) for systematic reviews of treatment comparisons that included meta-analyses for both admission and mortality outcomes. For each meta-analysis, we synthesized treatment effects on admissions and death, from respective randomized trials reporting those outcomes, using random-effects models. We then measured the concordance of directions of effect sizes and the correlation of summary estimates for the 2 outcomes. Results: We identified 61 meta-analyses including 398 trials reporting mortality and 182 trials reporting admission rates; 125 trials reported both outcomes. In 27.9% of comparisons, the point estimates of treatment effects for the 2 outcomes were in opposite directions; in 8.2% of trials, the 95% confidence intervals did not overlap. We found no significant correlation between effect sizes for admission and death (Pearson r = 0.07, p = 0.6). Our results were similar when we limited our analysis to trials reporting both outcomes. Interpretation: In this metaepidemiological study, admission and mortality outcomes did not correlate, and discordances occurred in about one-third of the treatment comparisons included in our analyses. Both outcomes convey useful information and should be reported separately, but extrapolating the benefits of admission to survival is unreliable and should be avoided. PMID:24144601

  15. 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

  16. Survival rates and risk factors for mortality in systemic lupus erythematosus patients in a Chinese center.

    PubMed

    Wu, Ge; Jia, Xiaoyuan; Gao, Dan; Zhao, Zhanzheng

    2014-07-01

    This paper aims to study the survival and risk factors affecting the long-term prognosis of Chinese patients with systemic lupus erythematosus (SLE). We collected clinical data of 1,072 SLE patients at the time of diagnosis. The Kaplan-Meier method was used to estimate the survival rate, and the Cox proportional hazard regression model for the risk factors affecting prognosis. Of the original 1,072 recruited SLE patients, 665 (570 females and 95 males) were successfully followed up. Mean follow-up was 5.47 ± 4.62 years. Mean age of onset was 29.4 ± 13.4 years. Eighty-one patients did not survive during follow-up; infection, followed by cardiovascular disease, renal failure and SLE disease activity were the leading causes of death. The 5- and 10-year survival rates were 91.2 and 79.6 %, respectively. Moreover, the 5-year survival rates of female and male patients were 92.6 and 81.6 % respectively, and the 10-year survival rates were 80.8 and 62.3 %, respectively. Univariate analyses indicated that male gender, older age of onset, hypertension, increased blood creatinine levels, and high-density lipoprotein cholesterol at the time of diagnosis of SLE were risk factors for all-cause mortality. After adjusting for potential confounders by multivariate analysis, male gender, older age of onset, and high SLEDAI scores at the time of diagnosis were independent risk factors for all-cause mortality in SLE patients. The long-term survival of Chinese SLE patients is comparable to that of other countries. Older age of onset, high disease activity, and decline in renal function are independent risk factors for mortality in patients with SLE.

  17. Resources, mortality, and disease ecology: Importance of positive feedbacks between host growth rate and pathogen dynamics

    PubMed Central

    Smith, Val H.; Holt, Robert D.; Smith, Marilyn S.; Niu, Yafen; Barfield, Michael

    2016-01-01

    Resource theory and metabolic scaling theory suggest that the dynamics of a pathogen within a host should strongly depend upon the rate of host cell metabolism. Once an infection occurs, key ecological interactions occur on or within the host organism that determine whether the pathogen dies out, persists as a chronic infection, or grows to densities that lead to host death. We hypothesize that, in general, conditions favoring rapid host growth rates should amplify the replication and proliferation of both fungal and viral pathogens. If a host population experiences an increase in mortality, to persist it must have a higher growth rate, per host, often reflecting greater resource availability per capita. We hypothesize that this could indirectly foster the pathogen, which also benefits from increased within-host resource turnover. We first bring together in a short review a number of key prior studies which illustrate resource effects on viral and fungal pathogen dynamics. We then report new results from a semi-continuous cell culture experiment with SHIV, demonstrating that higher mortality rates indeed can promote viral proliferation. We develop a simple model that illustrates dynamical consequences of these resource effects, including interesting effects such as alternative stable states and oscillatory dynamics. Our paper contributes to a growing body of literature at the interface of ecology and infectious disease epidemiology, emphasizing that host abundances alone do not drive community dynamics: the physiological state and resource content of infected hosts also strongly influence host-pathogen interactions. PMID:27642269

  18. The Association between Financial Aid Availability and the College Dropout Rates in Colombia

    ERIC Educational Resources Information Center

    Melguizo, Tatiana; Torres, Fabio Sanchez; Jaime, Haider

    2011-01-01

    The main objective of this study is to estimate the association between financial aid and college dropout rates of postsecondary students in Colombia. We use a unique dataset from the Colombian Ministry of Education that includes all enrolled college students in the country between 1998 and 2008. Logistic regression is used to identify the…

  19. Long-term effects of wealth on mortality and self-rated health status.

    PubMed

    Hajat, Anjum; Kaufman, Jay S; Rose, Kathryn M; Siddiqi, Arjumand; Thomas, James C

    2011-01-15

    Epidemiologic studies seldom include wealth as a component of socioeconomic status. The authors investigated the associations between wealth and 2 broad outcome measures: mortality and self-rated general health status. Data from the longitudinal Panel Study of Income Dynamics, collected in a US population between 1984 and 2005, were used to fit marginal structural models and to estimate relative and absolute measures of effect. Wealth was specified as a 6-category variable: those with ≤0 wealth and quintiles of positive wealth. There were a 16%-44% higher risk and 6-18 excess cases of poor/fair health (per 1,000 persons) among the less wealthy relative to the wealthiest quintile. Less wealthy men, women, and whites had higher risk of poor/fair health relative to their wealthy counterparts. The overall wealth-mortality association revealed a 62% increased risk and 4 excess deaths (per 1,000 persons) among the least wealthy. Less wealthy women had between a 24% and a 90% higher risk of death, and the least wealthy men had 6 excess deaths compared with the wealthiest quintile. Overall, there was a strong inverse association between wealth and poor health status and between wealth and mortality.

  20. Mortality, Rehospitalisation and Violent Crime in Forensic Psychiatric Patients Discharged from Hospital: Rates and Risk Factors

    PubMed Central

    Fazel, Seena; Wolf, Achim; Fimińska, Zuzanna; Larsson, Henrik

    2016-01-01

    Objectives To determine rates and risk factors for adverse outcomes in patients discharged from forensic psychiatric services. Method We conducted a historical cohort study of all 6,520 psychiatric patients discharged from forensic psychiatric hospitals between 1973 and 2009 in Sweden. We calculated hazard ratios for mortality, rehospitalisation, and violent crime using Cox regression to investigate the effect of different psychiatric diagnoses and two comorbidities (personality or substance use disorder) on outcomes. Results Over mean follow-up of 15.6 years, 30% of patients died (n = 1,949) after discharge with an average age at death of 52 years. Over two-thirds were rehospitalised (n = 4,472, 69%), and 40% violently offended after discharge (n = 2,613) with a mean time to violent crime of 4.2 years. The association between psychiatric diagnosis and outcome varied—substance use disorder as a primary diagnosis was associated with highest risk of mortality and rehospitalisation, and personality disorder was linked with the highest risk of violent offending. Furthermore comorbid substance use disorder typically increased risk of adverse outcomes. Conclusion Violent offending, premature mortality and rehospitalisation are prevalent in patients discharged from forensic psychiatric hospitals. Individualised treatment plans for such patients should take into account primary and comorbid psychiatric diagnoses. PMID:27196309

  1. The Effects of Parental Involvement Laws and the AIDS Epidemic on the Pregnancy and Abortion Rates of Minors.

    ERIC Educational Resources Information Center

    Altman-Palm, Nancy; Tremblay, Carol Horton

    1998-01-01

    Explores the effects of legislation requiring parental consent for a minor's abortion and the risk of acquiring AIDS on adolescent pregnancy and abortion rates. Finds lower pregnancy and abortion rates for women 15-17 in states with parental involvement legislation, while abortion doubles and pregnancy rates decline with the incidence of AIDS.…

  2. Trends in amenable mortality rate in the Mongolian population, 2007-2014.

    PubMed

    Surenjav, Enkhjin; Sovd, Tugsdelger; Yoshida, Yoshitoku; Yamamoto, Eiko; Reyer, Joshua A; Hamajima, Nobuyuki

    2016-02-01

    Amenable mortality (AM) is an indicator of medical care quality. This study aimed to assess the trend and magnitude of AM in Mongolia, with the purpose of providing evidence for decisions on resource allocation. This is the first study on AM trends in Mongolia. Retrospective analysis was done on mortality statistics for the period 2007-2014. Causes of death were coded according to the 10th revision of the International Classification of Diseases (ICD-10). Nolte & McKee's classification of AM was used for the estimation of amenable mortality rates (AMRs) in Mongolia. During the study period, a total of 130,402 deaths were registered in Mongolia, of which 44,800 (34.4%) deaths were classified as being amenable. The age-standardized AMR per 100,000 population was highest in 2007 (226.6), and declined continuously until the level of 169.2 in 2014. The rate remained consistently higher in males than in females. Cerebrovascular diseases, ischemic heart diseases, perinatal deaths, influenza/pneumonia/asthma and tuberculosis were the leading causes of AM in the past eight years in Mongolia. The AMR was higher in remote western provinces with harsh weather conditions, high poverty rates, lack of human resources for health, and poor infrastructure. In addition, the provinces where Mongolia's ethnic minorities live tended to have a higher AMR. The government of Mongolia needs to critically look at the regional differences in AM in order to allocate health resources, including human resources, effectively. Further studies are needed to look into the causes of regional disparities in AM, individual-level risk factors to amenable deaths, and validity of death coding in health sector. PMID:27019528

  3. Trends in amenable mortality rate in the Mongolian population, 2007–2014

    PubMed Central

    Surenjav, Enkhjin; Sovd, Tugsdelger; Yoshida, Yoshitoku; Yamamoto, Eiko; Reyer, Joshua A.; Hamajima, Nobuyuki

    2016-01-01

    ABSTRACT Amenable mortality (AM) is an indicator of medical care quality. This study aimed to assess the trend and magnitude of AM in Mongolia, with the purpose of providing evidence for decisions on resource allocation. This is the first study on AM trends in Mongolia. Retrospective analysis was done on mortality statistics for the period 2007–2014. Causes of death were coded according to the 10th revision of the International Classification of Diseases (ICD-10). Nolte & McKee’s classification of AM was used for the estimation of amenable mortality rates (AMRs) in Mongolia. During the study period, a total of 130,402 deaths were registered in Mongolia, of which 44,800 (34.4%) deaths were classified as being amenable. The age-standardized AMR per 100,000 population was highest in 2007 (226.6), and declined continuously until the level of 169.2 in 2014. The rate remained consistently higher in males than in females. Cerebrovascular diseases, ischemic heart diseases, perinatal deaths, influenza/pneumonia/asthma and tuberculosis were the leading causes of AM in the past eight years in Mongolia. The AMR was higher in remote western provinces with harsh weather conditions, high poverty rates, lack of human resources for health, and poor infrastructure. In addition, the provinces where Mongolia’s ethnic minorities live tended to have a higher AMR. The government of Mongolia needs to critically look at the regional differences in AM in order to allocate health resources, including human resources, effectively. Further studies are needed to look into the causes of regional disparities in AM, individual-level risk factors to amenable deaths, and validity of death coding in health sector. PMID:27019528

  4. Decreasing mortality and morbidity rates after the institution of a statewide burn program.

    PubMed

    Clark, D E; Katz, M S; Campbell, S M

    1992-01-01

    During the late 1970s, a statewide system for burn treatment and prevention was developed in Maine; it was assumed that such a system would reduce mortality and morbidity rates. To examine the effect of this intervention and the validity of its underlying hypothesis, data for the period from 1973 to 1988 were collected from burn unit registries inside and outside of the state and from hospital discharge abstracts, death certificates, and published sources. In Maine, the annual number of deaths per million persons that resulted from fire- and burn-related injuries declined from 41 in the years 1973-1980 to 25 in the years 1981-1988, which is a significantly greater decrease than for the United States as a whole (p less than 0.001). This decrease could not be explained by changes in the age or urban and rural distribution of the population. The annual number of hospital admissions for treatment of burns (per million persons) in Maine decreased from 401 to 301 over the same period, and patients with more complicated burns were increasingly referred to more specialized centers within and outside of the state. Since a state system was instituted, hospital mortality rates, when grouped by age and burn area, were not significantly different from those reported by the most prominent burn unit in New England. The population-based methods of data collection and linkage that were developed for this investigation may be useful for other studies of injury epidemiology. A statewide burn program appears to have contributed to a reduction in mortality and morbidity rates, primarily through preventive efforts. PMID:1587928

  5. Resting heart rate and all-cause and cardiovascular mortality in the general population: a meta-analysis

    PubMed Central

    Zhang, Dongfeng; Shen, Xiaoli; Qi, Xin

    2016-01-01

    Background: Data on resting heart rate and risk of all-cause and cardiovascular mortality are inconsistent; the magnitude of associations between resting heart rate and risk of all-cause and cardiovascular mortality varies across studies. We performed a meta-analysis of prospective cohort studies to quantitatively evaluate the associations in the general population. Methods: We searched PubMed, Embase and MEDLINE from inception to Jan. 1, 2015. We used a random-effects model to combine study-specific relative risks and 95% confidence intervals (CIs). We used restricted cubic spline functions to assess the dose–response relation. Results: A total of 46 studies were included in the meta-analysis, involving 1 246 203 patients and 78 349 deaths for all-cause mortality, and 848 320 patients and 25 800 deaths for cardiovascular mortality. The relative risk with 10 beats/min increment of resting heart rate was 1.09 (95% CI 1.07–1.12) for all-cause mortality and 1.08 (95% CI 1.06–1.10) for cardiovascular mortality. Compared with the lowest category, patients with a resting heart rate of 60–80 beats/min had a relative risk of 1.12 (95% CI 1.07–1.17) for all-cause mortality and 1.08 (95% CI 0.99–1.17) for cardiovascular mortality, and those with a resting heart rate of greater than 80 beats/min had a relative risk of 1.45 (95% CI 1.34–1.57) for all-cause mortality and 1.33 (95% CI 1.19–1.47) for cardiovascular mortality. Overall, the results did not differ after adjustment for traditional risk factors for cardiovascular disease. Compared with 45 beats/min, the risk of all-cause mortality increased significantly with increasing resting heart rate in a linear relation, but a significantly increased risk of cardiovascular mortality was observed at 90 beats/min. Substantial heterogeneity and publication bias were detected. Interpretation: Higher resting heart rate was independently associated with increased risks of all-cause and cardiovascular mortality. This

  6. Enterotomy and Mortality Rates of Laparoscopic Incisional and Ventral Hernia Repair: a Review of the Literature

    PubMed Central

    Elieson, Melvin Joseph; Corder, James M.

    2007-01-01

    Laparoscopic incisional and ventral hernia (LVIH) repair is becoming more popular throughout the world. Although individual series have presented their own information, few data have been collected to identify the risk of the most serious complication, enterotomy. A literature review has identified this to occur in 1.78% of patients who undergo this procedure. Large bowel injury represents only 8.3% of these injuries. Eighty-two percent of the time, these injuries will be recognized and repaired. In the majority of published series in which this occurred, the hernia repair was completed with a laparoscopically placed prosthesis, as only 43% were converted to the open procedure. Complications related to this approach are infrequent. The mortality rate of this operation was noted to be 0.05%. However, if an enterotomy occurred, it increased to 2.8%. A recognized enterotomy was associated with a mortality rate of 1.7%, but an unrecognized enterotomy had a rate of 7.7%. Careful technique and close inspection of the intestine at the completion of the adhesiolysis and the herniorrhaphy is recommended. If the hernia repair proceeds as planned following repair of enterotomy, continuation of antibiotics and the placement of an antimicrobial impregnated prosthesis are recommended. More study is necessary before firm recommendations can be made, as the majority of these events are most likely unreported. Safety concerns may require postponement of the hernia repair if an enterotomy occurs. PMID:18237502

  7. Evaluation of a mark-recapture method for estimating mortality and migration rates of stratified populations

    USGS Publications Warehouse

    Dorazio, R.M.; Rago, P.J.

    1991-01-01

    We simulated mark–recapture experiments to evaluate a method for estimating fishing mortality and migration rates of populations stratified at release and recovery. When fish released in two or more strata were recovered from different recapture strata in nearly the same proportions, conditional recapture probabilities were estimated outside the [0, 1] interval. The maximum likelihood estimates tended to be biased and imprecise when the patterns of recaptures produced extremely "flat" likelihood surfaces. Absence of bias was not guaranteed, however, in experiments where recapture rates could be estimated within the [0, 1] interval. Inadequate numbers of tag releases and recoveries also produced biased estimates, although the bias was easily detected by the high sampling variability of the estimates. A stratified tag–recapture experiment with sockeye salmon (Oncorhynchus nerka) was used to demonstrate procedures for analyzing data that produce biased estimates of recapture probabilities. An estimator was derived to examine the sensitivity of recapture rate estimates to assumed differences in natural and tagging mortality, tag loss, and incomplete reporting of tag recoveries.

  8. 29 CFR Appendix A to Part 4022 - Lump Sum Mortality Rates

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 29 Labor 9 2012-07-01 2012-07-01 false Lump Sum Mortality Rates A Appendix A to Part 4022 Labor....001351 20 0.001311 21 0.001267 22 0.001219 23 0.001167 24 0.001149 25 0.001129 26 0.001107 27 0.001083 28....143179 88 0.155147 89 0.168208 90 0.182461 91 0.198030 92 0.215035 93 0.232983 94 0.252545 95 0.273878...

  9. 29 CFR Appendix A to Part 4022 - Lump Sum Mortality Rates

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 9 2010-07-01 2010-07-01 false Lump Sum Mortality Rates A Appendix A to Part 4022 Labor....001351 20 0.001311 21 0.001267 22 0.001219 23 0.001167 24 0.001149 25 0.001129 26 0.001107 27 0.001083 28....143179 88 0.155147 89 0.168208 90 0.182461 91 0.198030 92 0.215035 93 0.232983 94 0.252545 95 0.273878...

  10. 29 CFR Appendix A to Part 4022 - Lump Sum Mortality Rates

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 29 Labor 9 2013-07-01 2013-07-01 false Lump Sum Mortality Rates A Appendix A to Part 4022 Labor....001351 20 0.001311 21 0.001267 22 0.001219 23 0.001167 24 0.001149 25 0.001129 26 0.001107 27 0.001083 28....143179 88 0.155147 89 0.168208 90 0.182461 91 0.198030 92 0.215035 93 0.232983 94 0.252545 95 0.273878...

  11. Selection of mortality rates and spatial structure in a host-disease model

    NASA Astrophysics Data System (ADS)

    Socolar, Joshua E. S.; Richards, Shane; Wilson, William

    2000-03-01

    A simple model of population dynamics with evolving hosts and rapidly spreading, fatal diseases is introduced. The model is of interest to ecologists for two reasons: (1) it demonstrates a novel kin selection mechanism that limits evolution towards greater longevity; and (2) spatial organization plays a crucial role in this mechanism. For statistical physicists, the model poses the challenge of accounting for the average mortality rate after many generations. An appropriate mean-field theory has been formulated for a 1-dimensional system, but the problem takes on a very different character in 2D, where numerical results indicate that the system evolves to a critical state.

  12. Postnatal growth rates covary weakly with embryonic development rates and do not explain adult mortality probability among songbirds on four continents

    USGS Publications Warehouse

    Martin, Thomas E.; Oteyza, Juan C.; Mitchell, Adam E.; Potticary, Ahva L.; Lloyd, P.

    2016-01-01

    Growth and development rates may result from genetic programming of intrinsic processes that yield correlated rates between life stages. These intrinsic rates are thought to affect adult mortality probability and longevity. However, if proximate extrinsic factors (e.g., temperature, food) influence development rates differently between stages and yield low covariance between stages, then development rates may not explain adult mortality probability. We examined these issues based on study of 90 songbird species on four continents to capture the diverse life-history strategies observed across geographic space. The length of the embryonic period explained little variation (ca. 13%) in nestling periods and growth rates among species. This low covariance suggests that the relative importance of intrinsic and extrinsic influences on growth and development rates differs between stages. Consequently, nestling period durations and nestling growth rates were not related to annual adult mortality probability among diverse songbird species within or among sites. The absence of a clear effect of faster growth on adult mortality when examined in an evolutionary framework across species may indicate that species that evolve faster growth also evolve physiological mechanisms for ameliorating costs on adult mortality. Instead, adult mortality rates of species in the wild may be determined more strongly by extrinsic environmental causes.

  13. Postnatal growth rates covary weakly with embryonic development rates and do not explain adult mortality probability among songbirds on four continents.

    PubMed

    Martin, Thomas E; Oteyza, Juan C; Mitchell, Adam E; Potticary, Ahva L; Lloyd, Penn

    2015-03-01

    Growth and development rates may result from genetic programming of intrinsic processes that yield correlated rates between life stages. These intrinsic rates are thought to affect adult mortality probability and longevity. However, if proximate extrinsic factors (e.g., temperature, food) influence development rates differently between stages and yield low covariance between stages, then development rates may not explain adult mortality probability. We examined these issues based on study of 90 songbird species on four continents to capture the diverse life-history strategies observed across geographic space. The length of the embryonic period explained little variation (ca. 13%) in nestling periods and growth rates among species. This low covariance suggests that the relative importance of intrinsic and extrinsic influences on growth and development rates differs between stages. Consequently, nestling period durations and nestling growth rates were not related to annual adult mortality probability among diverse songbird species within or among sites. The absence of a clear effect of faster growth on adult mortality when examined in an evolutionary framework across species may indicate that species that evolve faster growth also evolve physiological mechanisms for ameliorating costs on adult mortality. Instead, adult mortality rates of species in the wild may be determined more strongly by extrinsic environmental causes.

  14. Modeling Atmospheric Emissions and Calculating Mortality Rates Associated with High Volume Hydraulic Fracturing Transportation

    NASA Astrophysics Data System (ADS)

    Mathews, Alyssa

    Emissions from the combustion of fossil fuels are a growing pollution concern throughout the global community, as they have been linked to numerous health issues. The freight transportation sector is a large source of these emissions and is expected to continue growing as globalization persists. Within the US, the expanding development of the natural gas industry is helping to support many industries and leading to increased transportation. The process of High Volume Hydraulic Fracturing (HVHF) is one of the newer advanced extraction techniques that is increasing natural gas and oil reserves dramatically within the US, however the technique is very resource intensive. HVHF requires large volumes of water and sand per well, which is primarily transported by trucks in rural areas. Trucks are also used to transport waste away from HVHF well sites. This study focused on the emissions generated from the transportation of HVHF materials to remote well sites, dispersion, and subsequent health impacts. The Geospatial Intermodal Freight Transport (GIFT) model was used in this analysis within ArcGIS to identify roadways with high volume traffic and emissions. High traffic road segments were used as emissions sources to determine the atmospheric dispersion of particulate matter using AERMOD, an EPA model that calculates geographic dispersion and concentrations of pollutants. Output from AERMOD was overlaid with census data to determine which communities may be impacted by increased emissions from HVHF transport. The anticipated number of mortalities within the impacted communities was calculated, and mortality rates from these additional emissions were computed to be 1 in 10 million people for a simulated truck fleet meeting stricter 2007 emission standards, representing a best case scenario. Mortality rates due to increased truck emissions from average, in-use vehicles, which represent a mixed age truck fleet, are expected to be higher (1 death per 341,000 people annually).

  15. 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

  16. Uneven futures of human lifespans: reckonings from Gompertz mortality rates, climate change, and air pollution.

    PubMed

    Finch, Caleb E; Beltrán-Sánchez, Hiram; Crimmins, Eileen M

    2014-01-01

    The past 200 years have enabled remarkable increases in human lifespans through improvements in the living environment that have nearly eliminated infections as a cause of death through improved hygiene, public health, medicine, and nutrition. We argue that the limit to lifespan may be approaching. Since 1997, no one has exceeded Jeanne Calment's record of 122.5 years, despite an exponential increase of centenarians. Moreover, the background mortality may be approaching a lower limit. We calculate from Gompertz coefficients that further increases in longevity to approach a life expectancy of 100 years in 21st century cohorts would require 50% slower mortality rate accelerations, which would be a fundamental change in the rate of human aging. Looking into the 21st century, we see further challenges to health and longevity from the continued burning of fossil fuels that contribute to air pollution as well as global warming. Besides increased heat waves to which elderly are vulnerable, global warming is anticipated to increase ozone levels and facilitate the spread of pathogens. We anticipate continuing socioeconomic disparities in life expectancy.

  17. Uneven Futures of Human Lifespans: Reckonings from Gompertz Mortality Rates, Climate Change, and Air Pollution

    PubMed Central

    Finch, Caleb E; Beltrán-Sánchez, Hiram; Crimmins, Eileen M

    2014-01-01

    The past 200 years have enabled remarkable increases in human lifespans thru improvements of the living environment that have nearly eliminated infections as a cause of death through improved hygiene- public health, medicine, and nutrition. We argue that the limit to lifespan may be approaching. Since 1997, no one has exceeded Jean Calment's record of 122.5 years, despite an exponential increase of centenarians. Moreover, the background mortality may be approaching a lower limit. We calculate from Gompertz coefficients that further increases in longevity to approach a life expectancy of 100 years in 21st C cohorts would require 50% slower mortality rate accelerations, which would be a fundamental change in the rate of human aging. Looking into the 21st C, we see further challenges to health and longevity from the continued burning of fossil fuels that contribute to air pollution, as well as global warming. Besides increased heat waves to which elderly are vulnerable, global warming is anticipated to increase ozone levels and to favor the spread of pathogens. We anticipate continuing socio-economic disparities of life expectancy. PMID:24401556

  18. Uneven futures of human lifespans: reckonings from Gompertz mortality rates, climate change, and air pollution.

    PubMed

    Finch, Caleb E; Beltrán-Sánchez, Hiram; Crimmins, Eileen M

    2014-01-01

    The past 200 years have enabled remarkable increases in human lifespans through improvements in the living environment that have nearly eliminated infections as a cause of death through improved hygiene, public health, medicine, and nutrition. We argue that the limit to lifespan may be approaching. Since 1997, no one has exceeded Jeanne Calment's record of 122.5 years, despite an exponential increase of centenarians. Moreover, the background mortality may be approaching a lower limit. We calculate from Gompertz coefficients that further increases in longevity to approach a life expectancy of 100 years in 21st century cohorts would require 50% slower mortality rate accelerations, which would be a fundamental change in the rate of human aging. Looking into the 21st century, we see further challenges to health and longevity from the continued burning of fossil fuels that contribute to air pollution as well as global warming. Besides increased heat waves to which elderly are vulnerable, global warming is anticipated to increase ozone levels and facilitate the spread of pathogens. We anticipate continuing socioeconomic disparities in life expectancy. PMID:24401556

  19. The relation of ambulatory heart rate with all-cause mortality among middle-aged men: a prospective cohort study.

    PubMed

    Korshøj, Mette; Lidegaard, Mark; Kittel, France; Van Herck, Koen; De Backer, Guy; De Bacquer, Dirk; Holtermann, Andreas; Clays, Els

    2015-01-01

    The aim of this study was to investigate the association between average 24-hour ambulatory heart rate and all-cause mortality, while adjusting for resting clinical heart rate, cardiorespiratory fitness, occupational and leisure time physical activity as well as classical risk factors. A group of 439 middle-aged male workers free of baseline coronary heart disease from the Belgian Physical Fitness Study was included in the analysis. Data were collected by questionnaires and clinical examinations from 1976 to 1978. All-cause mortality was collected from the national mortality registration with a mean follow-up period of 16.5 years, with a total of 48 events. After adjustment for all before mentioned confounders in a Cox proportional hazards regression analysis, a significant increased risk for all-cause mortality was found among the tertile of workers with highest average ambulatory heart rate compared to the tertile with lowest ambulatory heart rate (Hazard ratio = 3.21, 95% confidence interval: 1.22-8.44). No significant independent association was found between resting clinic heart rate and all-cause mortality. The study indicates that average 24-hour ambulatory heart rate is a strong predictor of all-cause mortality independent from resting clinic heart rate, cardiorespiratory fitness, occupational and leisure time physical activity and other classical risk factors among healthy middle-aged workers.

  20. Brain cancer mortality rates increase with Toxoplasma gondii seroprevalence in France

    USGS Publications Warehouse

    Vittecoq, Marion; Elguero, Eric; Lafferty, Kevin D.; Roche, Benjamin; Brodeur, Jacques; Gauthier-Clerc, Michel; Missé, Dorothée; Thomas, Frédéric

    2012-01-01

    The incidence of adult brain cancer was previously shown to be higher in countries where the parasite Toxoplasma gondii is common, suggesting that this brain protozoan could potentially increase the risk of tumor formation. Using countries as replicates has, however, several potential confounding factors, particularly because detection rates vary with country wealth. Using an independent dataset entirely within France, we further establish the significance of the association between T. gondii and brain cancer and find additional demographic resolution. In adult age classes 55 years and older, regional mortality rates due to brain cancer correlated positively with the local seroprevalence of T. gondii. This effect was particularly strong for men. While this novel evidence of a significant statistical association between T. gondii infection and brain cancer does not demonstrate causation, these results suggest that investigations at the scale of the individual are merited.

  1. Ambulatory heart rate range predicts mode-specific mortality and hospitalisation in chronic heart failure

    PubMed Central

    Cubbon, Richard M; Ruff, Naomi; Groves, David; Eleuteri, Antonio; Denby, Christine; Kearney, Lorraine; Ali, Noman; Walker, Andrew M N; Jamil, Haqeel; Gierula, John; Gale, Chris P; Batin, Phillip D; Nolan, James; Shah, Ajay M; Fox, Keith A A; Sapsford, Robert J; Witte, Klaus K; Kearney, Mark T

    2016-01-01

    Objective We aimed to define the prognostic value of the heart rate range during a 24 h period in patients with chronic heart failure (CHF). Methods Prospective observational cohort study of 791 patients with CHF associated with left ventricular systolic dysfunction. Mode-specific mortality and hospitalisation were linked with ambulatory heart rate range (AHRR; calculated as maximum minus minimum heart rate using 24 h Holter monitor data, including paced and non-sinus complexes) in univariate and multivariate analyses. Findings were then corroborated in a validation cohort of 408 patients with CHF with preserved or reduced left ventricular ejection fraction. Results After a mean 4.1 years of follow-up, increasing AHRR was associated with reduced risk of all-cause, sudden, non-cardiovascular and progressive heart failure death in univariate analyses. After accounting for characteristics that differed between groups above and below median AHRR using multivariate analysis, AHRR remained strongly associated with all-cause mortality (HR 0.991/bpm increase in AHRR (95% CI 0.999 to 0.982); p=0.046). AHRR was not associated with the risk of any non-elective hospitalisation, but was associated with heart-failure-related hospitalisation. AHRR was modestly associated with the SD of normal-to-normal beats (R2=0.2; p<0.001) and with peak exercise-test heart rate (R2=0.33; p<0.001). Analysis of the validation cohort revealed AHRR to be associated with all-cause and mode-specific death as described in the derivation cohort. Conclusions AHRR is a novel and readily available prognosticator in patients with CHF, which may reflect autonomic tone and exercise capacity. PMID:26674986

  2. Testosterone Deficiency Increases Hospital Readmission and Mortality Rates in Male Patients with Heart Failure

    PubMed Central

    dos Santos, Marcelo Rodrigues; Sayegh, Ana Luiza Carrari; Groehs, Raphaela Vilar Ramalho; Fonseca, Guilherme; Trombetta, Ivani Credidio; Barretto, Antônio Carlos Pereira; Arap, Marco Antônio; Negrão, Carlos Eduardo; Middlekauff, Holly R.; Alves, Maria-Janieire de Nazaré Nunes

    2015-01-01

    Background Testosterone deficiency in patients with heart failure (HF) is associated with decreased exercise capacity and mortality; however, its impact on hospital readmission rate is uncertain. Furthermore, the relationship between testosterone deficiency and sympathetic activation is unknown. Objective We investigated the role of testosterone level on hospital readmission and mortality rates as well as sympathetic nerve activity in patients with HF. Methods Total testosterone (TT) and free testosterone (FT) were measured in 110 hospitalized male patients with a left ventricular ejection fraction < 45% and New York Heart Association classification IV. The patients were placed into low testosterone (LT; n = 66) and normal testosterone (NT; n = 44) groups. Hypogonadism was defined as TT < 300 ng/dL and FT < 131 pmol/L. Muscle sympathetic nerve activity (MSNA) was recorded by microneurography in a subpopulation of 27 patients. Results Length of hospital stay was longer in the LT group compared to in the NT group (37 ± 4 vs. 25 ± 4 days; p = 0.008). Similarly, the cumulative hazard of readmission within 1 year was greater in the LT group compared to in the NT group (44% vs. 22%, p = 0.001). In the single-predictor analysis, TT (hazard ratio [HR], 2.77; 95% confidence interval [CI], 1.58–4.85; p = 0.02) predicted hospital readmission within 90 days. In addition, TT (HR, 4.65; 95% CI, 2.67–8.10; p = 0.009) and readmission within 90 days (HR, 3.27; 95% CI, 1.23–8.69; p = 0.02) predicted increased mortality. Neurohumoral activation, as estimated by MSNA, was significantly higher in the LT group compared to in the NT group (65 ± 3 vs. 51 ± 4 bursts/100 heart beats; p < 0.001). Conclusion These results support the concept that LT is an independent risk factor for hospital readmission within 90 days and increased mortality in patients with HF. Furthermore, increased MSNA was observed in patients with LT. PMID:26200897

  3. Impacts of land use on spatial distribution of mortality rates of cancers caused by naturally occurring asbestos.

    PubMed

    Wei, Binggan; Jia, Xianjie; Ye, Bixiong; Yu, Jiangping; Zhang, Biao; Zhang, Xiuwu; Lu, Rongan; Dong, Tingrong; Yang, Linsheng

    2012-09-01

    This study investigated the spatial distributions of mortality rates of six cancers: mesothelioma, lung cancer, intestinal cancer, nasopharyngeal and laryngeal cancer, liver cancer, and stomach cancer in Dayao using Geographic Information Systems. Relationships between the mortality rates of the six cancers and land use patterns were investigated by Pearson Correlation Coefficients. The results indicated that the mortality rates of nasopharyngeal and laryngeal cancer, lung cancer, intestinal cancer, and mesothelioma were significantly associated with outcropped asbestos. Both the proportions of farmland and urban area were positively related to the mortality rates of nasopharyngeal and laryngeal cancer, lung cancer, intestinal cancer, and mesothelioma, and significant negative correlations were found between the proportion of forestland and nasopharyngeal and laryngeal cancer and intestinal cancer. It can be concluded that naturally occurring asbestos may significantly elevate the mortality rates of nasopharyngeal and laryngeal cancer, intestinal cancer, lung cancer, and mesothelioma. Moreover, higher proportions of farmland, urban area, and lower proportions of forested land may elevate the mortality rate of the four cancers.

  4. Rate-constrained source separation for speech enhancement in wireless-communicated binaural hearing aids

    NASA Astrophysics Data System (ADS)

    Ayllón, David; Gil-Pita, Roberto; Rosa-Zurera, Manuel

    2013-12-01

    A recent trend in hearing aids is the connection of the left and right devices to collaborate between them. Binaural systems can provide natural binaural hearing and support the improvement of speech intelligibility in noise, but they require data transmission between both devices, which increases the power consumption. This paper presents a novel sound source separation algorithm for binaural speech enhancement based on supervised machine learning and time-frequency masking. The system is designed considering the power restrictions in hearing aids, constraining both the computational cost of the algorithm and the transmission bit rate. The transmission schema is optimized using a tailored evolutionary algorithm that assigns a different number of bits to each frequency band. The proposed algorithm requires less than 10% of the available computational resources for signal processing and obtains good separation performance using bit rates lower than 64 kbps.

  5. Effects of local extrinsic mortality rate, crime and sex ratio on preventable death in Northern Ireland

    PubMed Central

    Uggla, Caroline; Mace, Ruth

    2015-01-01

    Background and objectives: Individual investment in health varies greatly within populations and results in significant differences in the risk of preventable death. Life history theory predicts that individuals should alter their investment in health (somatic maintenance) in response to ecological cues that shift the perceived fitness payoffs to such investments. However, previous research has failed to isolate the effects of different ecological factors on preventable death, and has often relied on macro-level data without individual controls. Here, we test some key predictions concerning the local ecology—that higher extrinsic mortality rate (EMR), crime rate and mate-scarcity (male/female-biased sex ratio) at the ward-level—will be associated with a higher risk of preventable death. Methodology: We use census-based data from Northern Ireland (n = 927 150) on preventable death during an 8.7-year period from the 2001 Census and run Cox regressions for (i) accident/suicide or alcohol-related death and (ii) deaths from preventable diseases, for men and women separately, controlling for a wide range of individual variables. Results: We find evidence of ward-level EMR and crime rate being positively associated with preventable death among men, particularly men with low socioeconomic position. There was a tentative relationship between male-biased sex ratio and preventable death among women, but not among men. Conclusion and implications: Both behaviours that might lead to ‘risky’ death and health neglect might be adaptive responses to local ecologies. Efforts to reduce crime might be as effective as those to reduce extrinsic mortality, and both could have positive effects on various health behaviours. PMID:26338679

  6. Declines in stillbirth and neonatal mortality rates in Europe between 2004 and 2010: results from the Euro-Peristat project

    PubMed Central

    Zeitlin, Jennifer; Mortensen, Laust; Cuttini, Marina; Lack, Nicholas; Nijhuis, Jan; Haidinger, Gerald; Blondel, Béatrice; Hindori-Mohangoo, Ashna D

    2016-01-01

    Background Stillbirth and neonatal mortality rates declined in Europe between 2004 and 2010. We hypothesised that declines might be greater for countries with higher mortality in 2004 and disproportionally affect very preterm infants at highest risk. Methods Data about live births, stillbirths and neonatal deaths by gestational age (GA) were collected using a common protocol by the Euro-Peristat project in 2004 and 2010. We analysed stillbirths at ≥28 weeks GA in 22 countries and live births ≥24 weeks GA for neonatal mortality in 18 countries. Per cent changes over time were assessed by calculating risk ratios (RR) for stillbirth, neonatal mortality and preterm birth rates in 2010 vs 2004. We used meta-analysis techniques to derive pooled RR using random-effects models overall, by GA subgroups and by mortality level in 2004. Results Between 2004 and 2010, stillbirths declined by 17% (95% CI 10% to 23%), with a range from 1% to 39% by country. Neonatal mortality declined by 29% (95% CI 23% to 35%) with a range from 9% to 67%. Preterm birth rates did not change: 0% (95% CI −3% to 3%). Mortality declines were of a similar magnitude at all GA; mortality levels in 2004 were not associated with RRs. Conclusions Stillbirths and neonatal deaths declined at all gestational ages in countries with both high and low levels of mortality in 2004. These results raise questions about how low-mortality countries achieve continued declines and highlight the importance of improving care across the GA spectrum. PMID:26719590

  7. Exogenous heat shock protein 70 mediates sepsis manifestations and decreases the mortality rate in rats

    PubMed Central

    Kustanova, Gul'sara A.; Murashev, Arcady N.; Karpov, Vadim L.; Margulis, Boris A.; Guzhova, Irina V.; Prokhorenko, Izabella R.; Grachev, Sergei V.; Evgen'ev, Michael B.

    2006-01-01

    Mammalian responses to bacterial lipopolysaccharide (LPS) from the outer membrane of Gram-negative bacteria can lead to an uncontrolled inflammatory reaction that can be deadly for the host. We checked whether heat shock protein 70 (Hsp70) protein is able to protect animals from the deleterious effects of bacterial LPS by monitoring the effect of exogenous Hsp70 injections before and after LPS administration. Our research with rats demonstrates for the first time that administration of exogeneous Hsp70 before and after LPS challenges can reduce mortality rates and modify several parameters of hemostasis and hemodynamics. Hsp70 isolated from bovine muscles showed significant protective effects against the impaired coagulation and fibrinolytic systems caused by LPS, and reduced the mortality caused by Escherichia coli and Salmonella typhimurium LPS injections significantly. Characteristically, Hsp70 preparations used in the experiments result in different effects when administered before and after an LPS challenge, and the effects of Hsp70 injections also differ significantly depending on the origin of the LPS (E coli vs S typhimurium). Based on our data, mammalian Hsp70 appears to be an attractive target in therapeutic strategies designed to stimulate endogenous protective mechanisms against many deleterious consequences of septic shock by accelerating the functional recovery of susceptible organs in humans. PMID:17009601

  8. Determining the Independent Risk Factors and Mortality Rate of Nosocomial Infections in Pediatric Patients

    PubMed Central

    Aktar, Fesih; Tekin, Recep; Güneş, Ali; Ülgen, Cevat; Tan, İlhan; Ertuğrul, Sabahattin; Köşker, Muhammet; Balık, Hasan; Karabel, Duran; Yolbaş, Ilyas

    2016-01-01

    The objective of this study was to determine the rate, independent risk factors, and outcomes of healthcare-associated infections in pediatric patients. This study was performed between 2011 and 2014 in pediatric clinic and intensive care unit. 86 patients and 86 control subjects were included in the study. Of 86 patients with nosocomial infections (NIs), there were 100 NIs episodes and 90 culture growths. The median age was 32.0 months. The median duration of hospital stay of the patients was 30.0 days. The most frequent pathogens were Coagulase-negative Staphylococcus, Acinetobacter spp., Klebsiella spp., and Candida spp. Unconsciousness, prolonged hospitalization, transfusion, mechanical ventilation, use of central venous catheter, enteral feeding via a nasogastric tube, urinary catheter, and receiving carbapenems and glycopeptides were found to be significantly higher in NIs patients. Multivariate logistic regression analysis showed prolonged hospitalization, neutropenia, and use of central venous catheter and carbapenems as the independent risk factors for NIs. In the univariate analysis, unconsciousness, mechanical ventilation, enteral feeding, use of enteral feeding via a nasogastric tube, H2 receptor blockers, and port and urinary catheter were significantly associated with mortality. In the multiple logistic regression analysis, only mechanical ventilation was found as an independent predictor of mortality in patients with NIs. PMID:26981536

  9. Mortality rates among employees potentially exposed to chrysotile asbestos at two automotive parts factories.

    PubMed

    Finkelstein, M M

    1989-07-15

    A study of the mortality rates among 1657 employees at two Ontario automotive parts factories that manufactured friction materials containing chrysotile asbestos was initiated in response to the workers' concerns about the effects of asbestos on their health. A total of 1194 men and 258 women had had their first potential exposure at least 10 years before the end of the study period; 563 of the men and 138 of the women had had such an exposure at least 20 years before the end of the study period. A significantly increased rate of death from laryngeal cancer and an elevated rate of death from lung cancer were observed in a cohort analysis. One or two deaths might have been due to pleural mesothelioma. There was no increase in the rate of death from gastrointestinal cancer or from nonmalignant respiratory disease. Case-control analysis showed no association between the risk of laryngeal or lung cancer and the total duration of employment (a surrogate for the extent of ambient exposure to asbestos or other workplace toxic substances) or employment in departments where asbestos had been used. An association between risk of death and occupational exposure is uncertain. PMID:2545323

  10. Mortality rates among employees potentially exposed to chrysotile asbestos at two automotive parts factories.

    PubMed Central

    Finkelstein, M M

    1989-01-01

    A study of the mortality rates among 1657 employees at two Ontario automotive parts factories that manufactured friction materials containing chrysotile asbestos was initiated in response to the workers' concerns about the effects of asbestos on their health. A total of 1194 men and 258 women had had their first potential exposure at least 10 years before the end of the study period; 563 of the men and 138 of the women had had such an exposure at least 20 years before the end of the study period. A significantly increased rate of death from laryngeal cancer and an elevated rate of death from lung cancer were observed in a cohort analysis. One or two deaths might have been due to pleural mesothelioma. There was no increase in the rate of death from gastrointestinal cancer or from nonmalignant respiratory disease. Case-control analysis showed no association between the risk of laryngeal or lung cancer and the total duration of employment (a surrogate for the extent of ambient exposure to asbestos or other workplace toxic substances) or employment in departments where asbestos had been used. An association between risk of death and occupational exposure is uncertain. PMID:2545323

  11. Is the United States Maternal Mortality Rate Increasing? Disentangling trends from measurement issues Short title: U.S. Maternal Mortality Trends

    PubMed Central

    Declercq, Eugene; Cabral, Howard; Morton, Christine

    2016-01-01

    Background A pregnancy question was added to the U.S. standard death certificate in 2003 to improve ascertainment of maternal deaths. The delayed adoption of this question among states led to data incompatibilities, and impeded accurate trend analysis. Our objectives were to develop methods for trend analysis, and to provide an overview of U.S. maternal mortality trends from 2000–2014. Methods This observational study analyzed vital statistics maternal mortality data from all U.S. states in relation to the format and year-of-adoption of the pregnancy question. Correction factors were developed to adjust data from before the standard pregnancy question was adopted, to promote accurate trend analysis. Joinpoint regression was used to analyze trends for groups of states with similar pregnancy questions. Results The estimated maternal mortality rate (per 100,000 live births) for 48 states and Washington D.C. (excluding California and Texas, analyzed separately) increased by 26.6%, from 18.8 in 2000 to 23.8 in 2014. California showed a declining trend, while Texas had a sudden increase in 2011–2012. Analysis of the measurement change suggests that U.S. rates in the early 2000s were higher than previously reported. Discussion Despite the United Nations Millennium Development Goal for a 75% reduction in maternal mortality by 2015, the estimated maternal mortality rate for 48 states and Washington D.C. increased from 2000–2014, while the international trend was in the opposite direction. There is a need to redouble efforts to prevent maternal deaths and improve maternity care for the 4 million U.S. women giving birth each year. PMID:27500333

  12. High mortality rates occur in copper deficient rats exposed to a normally nonlethal endotoxin treatment

    SciTech Connect

    DiSilvestro, R.; Joseph, E.; Yang, F.L. )

    1991-03-15

    Endotoxin hepatotoxicity is proposed to occur by processes which could be retarded by 3 copper enzymes: ceruloplasmin, Cu-Zn superoxide dismutase (SOD), and extracellular (EC) SOD. Weanling rats fed low copper for 40 days showed low activity levels of these enzymes, and a very high mortality rate 20 h after endotoxin injection. No rats fed adequate copper died from this treatment. In addition, serum transaminase activities, indicators of liver damage, were elevated by 3 h to a greater extent in the deficient rats than in the adequates. The high susceptibility to endotoxemia in the deficient rats was not associated with low hepatic glutathione, high liver malondialedhyde, nor restricted metallothionein induction 3 h after endotoxin injection. Endotoxin reduced serum EC SOD activities in adequate and deficient rats, but final values were lower in the latter. Studies on roles of specific copper enzymes in resistance to endotoxemia are currently underway.

  13. Case fatality ratio and mortality rate trends of community-onset Staphylococcus aureus bacteraemia.

    PubMed

    Tom, S; Galbraith, J C; Valiquette, L; Jacobsson, G; Collignon, P; Schønheyder, H C; Søgaard, M; Kennedy, K J; Knudsen, J D; Ostergaard, C; Lyytikäinen, O; Laupland, K B

    2014-10-01

    Lethal outcomes can be expressed as a case fatality ratio (CFR) or as a mortality rate per 100 000 population per year (MR). Population surveillance for community-onset methicillin-sensitive (MSSA) and methicillin-resistant (MRSA) Staphylococcus aureus bacteraemia was conducted in Canada, Australia, Sweden and Denmark to evaluate 30-day CFR and MR trends between 2000 and 2008. The CFR was 20.3% (MSSA 20.2%, MRSA 22.3%) and MR was 3.4 (MSSA 3.1, MRSA 0.3) per 100 000 per year. Although MSSA CFR was stable the MSSA MR increased; MRSA CFR decreased while its MR remained low during the study. Community-onset S. aureus bacteraemia, particularly MSSA, is associated with major disease burden. This study highlights complementary information provided by evaluating both CFR and MR.

  14. Longitudinal Changes in Vascular Risk Markers and Mortality Rates among a Latino Population with Hypertension

    PubMed Central

    Pflederer, Matthew C.; Long, Carlin S.; Beaty, Brenda; Havranek, Edward P.; Mehler, Philip S.; Keniston, Angela

    2016-01-01

    Vascular markers such as pulse-wave velocity and carotid intima-media thickness (CIMT) might improve the prediction of incident cardiovascular disease beyond traditional risk factors. These vascular markers have not been well characterized in minority populations and might be more useful than inflammatory biomarkers. We conducted a prospective, longitudinal cohort study among hypertensive patients in an urban safety-net hospital. We evaluated inflammatory biomarkers, arterial pulse-wave velocity, and carotid intima-media thickness at baseline, 1 year, and 2 years. The primary outcome variable was CIMT. Generalized linear mixed-effects models were used to evaluate associations between CIMT and predictive variables accounting for the correlation of multiple measurements within subjects over time. For our secondary outcome, we used administrative and National Death Index data to determine all-cause death, and univariate relationships were evaluated. Among 175 subjects, 117 were Latino (67%) and 117 were female (67%). Pulse-wave velocity and CIMT regressed over time (both P <0.001) and were highly correlated (P <0.001). Only pulse-wave velocity (P=0.002) and total cholesterol (P=0.03) were associated with CIMT in time-varying covariate analysis. At a median follow-up period of 80 months, 17 of 175 subjects had died (10%). Higher baseline CIMT and pulse-wave velocity were associated with increased mortality rates (both P <0.01). No serum inflammatory marker was significantly correlated with longitudinal changes in CIMT or death. In conclusion, both arterial stiffness and preclinical carotid atherosclerosis were associated with increased mortality rates and might be useful risk-stratification markers among this minority population. PMID:27127427

  15. Longitudinal Changes in Vascular Risk Markers and Mortality Rates among a Latino Population with Hypertension.

    PubMed

    Pflederer, Matthew C; Long, Carlin S; Beaty, Brenda; Havranek, Edward P; Mehler, Philip S; Keniston, Angela; Krantz, Mori J

    2016-04-01

    Vascular markers such as pulse-wave velocity and carotid intima-media thickness (CIMT) might improve the prediction of incident cardiovascular disease beyond traditional risk factors. These vascular markers have not been well characterized in minority populations and might be more useful than inflammatory biomarkers. We conducted a prospective, longitudinal cohort study among hypertensive patients in an urban safety-net hospital. We evaluated inflammatory biomarkers, arterial pulse-wave velocity, and carotid intima-media thickness at baseline, 1 year, and 2 years. The primary outcome variable was CIMT. Generalized linear mixed-effects models were used to evaluate associations between CIMT and predictive variables accounting for the correlation of multiple measurements within subjects over time. For our secondary outcome, we used administrative and National Death Index data to determine all-cause death, and univariate relationships were evaluated. Among 175 subjects, 117 were Latino (67%) and 117 were female (67%). Pulse-wave velocity and CIMT regressed over time (both P <0.001) and were highly correlated (P <0.001). Only pulse-wave velocity (P=0.002) and total cholesterol (P=0.03) were associated with CIMT in time-varying covariate analysis. At a median follow-up period of 80 months, 17 of 175 subjects had died (10%). Higher baseline CIMT and pulse-wave velocity were associated with increased mortality rates (both P <0.01). No serum inflammatory marker was significantly correlated with longitudinal changes in CIMT or death. In conclusion, both arterial stiffness and preclinical carotid atherosclerosis were associated with increased mortality rates and might be useful risk-stratification markers among this minority population.

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

    PubMed Central

    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. PMID:27730182

  17. Mortality rates of 0-group plaice ( Platessa platessa L.), dab ( Limanda limanda L.) and turbot ( Scophthalmus maximus L.) in European waters . III. Density dependence of mortality rates of 0-group plaice and some demographic implications

    NASA Astrophysics Data System (ADS)

    Beverton, R. J. H.; Iles, T. C.

    This last of our three linked contributions on the dynamics of North Sea plaice is concerned with the detection and measurement from demographic data of the density-dependence of mortality rate during the early demersal phase of the life history. A mathematical expression is developed for the survival trajectory of a cohort subject to an instantaneous relative mortality rate which is a linear function of the algorithm of its density. This is used to analyse three independent data sets; a. pairs of densities at or soon after settlement in the Wadden Sea, b. estimates of seasonal mortality rates (M̊ d -1) and initial density of 0-group plaice cohorts derived by linear regression and c. autumn estimates 0- and 1-group fish from the ICES Young Fish Surveys. After correcting for various sources of bias, these each gave statistically significant estimates of the density-dependent mortality coefficient μ2 of 0.015, 0.0044 and 0.0010 per day, respectively. The same theoretical treatment of density-dependent mortality is used to develop an equation predicting the progressive 'damping' of the extremes of inter-year-class variation with age. The above three estimates of the density-dependent mortality coefficient μ2 applied in sequence provide more than sufficient 'damping' to explain the very low variability of recruitment and long-term stability which is characteristic of the North Sea plaice stock.

  18. [Epidemiological analysis of the dynamics and structure of population mortality rate from malignant neoplasms in the city of Tomsk].

    PubMed

    Meshkov, N A

    2014-01-01

    There was revealed the tendency of reduction of cancer mortality in the city of Tomsk. Average indices of the time series of total mortality (absolute growth and growth rate) in 1998-2003 outstripped the similar indices in 2004-2010 respectively 5.3 times and 1.6 times over. Mortality from cancer neoplasmas on localization decreased by 2 orders of magnitude. Mortality from cancer of the trachea, bronchus and lung in the structure of total oncomortality is on the 1st place, on the 2nd--the death rate from cancer of the stomach, on the 3rd place in 1998-2003, mortality rate of colorectal cancer in 2004-2010. There was found the relationship of mortality of cancer of separate localizations with industrial emissions (leukemia), motor vehicles (cancer of the lips, mouth, pharynx, and colon) and stationary sources (cancer of the urinary organs). The air pollution with formaldehyde and particulate matter were established to affect the death rate for cancer of lips, mouth and throat, and other digestive organs and larynx.

  19. Consumer preferences for hearing aid attributes: a comparison of rating and conjoint analysis methods.

    PubMed

    Bridges, John F P; Lataille, Angela T; Buttorff, Christine; White, Sharon; Niparko, John K

    2012-03-01

    Low utilization of hearing aids has drawn increased attention to the study of consumer preferences using both simple ratings (e.g., Likert scale) and conjoint analyses, but these two approaches often produce inconsistent results. The study aims to directly compare Likert scales and conjoint analysis in identifying important attributes associated with hearing aids among those with hearing loss. Seven attributes of hearing aids were identified through qualitative research: performance in quiet settings, comfort, feedback, frequency of battery replacement, purchase price, water and sweat resistance, and performance in noisy settings. The preferences of 75 outpatients with hearing loss were measured with both a 5-point Likert scale and with 8 paired-comparison conjoint tasks (the latter being analyzed using OLS [ordinary least squares] and logistic regression). Results were compared by examining implied willingness-to-pay and Pearson's Rho. A total of 56 respondents (75%) provided complete responses. Two thirds of respondents were male, most had sensorineural hearing loss, and most were older than 50; 44% of respondents had never used a hearing aid. Both methods identified improved performance in noisy settings as the most valued attribute. Respondents were twice as likely to buy a hearing aid with better functionality in noisy environments (p < .001), and willingness to pay for this attribute ranged from US$2674 on the Likert to US$9000 in the conjoint analysis. The authors find a high level of concordance between the methods-a result that is in stark contrast with previous research. The authors conclude that their result stems from constraining the levels on the Likert scale.

  20. Consumer preferences for hearing aid attributes: a comparison of rating and conjoint analysis methods.

    PubMed

    Bridges, John F P; Lataille, Angela T; Buttorff, Christine; White, Sharon; Niparko, John K

    2012-03-01

    Low utilization of hearing aids has drawn increased attention to the study of consumer preferences using both simple ratings (e.g., Likert scale) and conjoint analyses, but these two approaches often produce inconsistent results. The study aims to directly compare Likert scales and conjoint analysis in identifying important attributes associated with hearing aids among those with hearing loss. Seven attributes of hearing aids were identified through qualitative research: performance in quiet settings, comfort, feedback, frequency of battery replacement, purchase price, water and sweat resistance, and performance in noisy settings. The preferences of 75 outpatients with hearing loss were measured with both a 5-point Likert scale and with 8 paired-comparison conjoint tasks (the latter being analyzed using OLS [ordinary least squares] and logistic regression). Results were compared by examining implied willingness-to-pay and Pearson's Rho. A total of 56 respondents (75%) provided complete responses. Two thirds of respondents were male, most had sensorineural hearing loss, and most were older than 50; 44% of respondents had never used a hearing aid. Both methods identified improved performance in noisy settings as the most valued attribute. Respondents were twice as likely to buy a hearing aid with better functionality in noisy environments (p < .001), and willingness to pay for this attribute ranged from US$2674 on the Likert to US$9000 in the conjoint analysis. The authors find a high level of concordance between the methods-a result that is in stark contrast with previous research. The authors conclude that their result stems from constraining the levels on the Likert scale. PMID:22514094

  1. Digoxin Use to Control Ventricular Rate in Patients with Atrial Fibrillation and Heart Failure Is Not Associated with Increased Mortality

    PubMed Central

    Dominic, Paari

    2015-01-01

    Introduction. Digoxin is used to control ventricular rate in atrial fibrillation (AF). There is conflicting evidence regarding safety of digoxin. We aimed to evaluate the risk of mortality with digoxin use in patients with AF using meta-analyses. Methods. PubMed was searched for studies comparing outcomes of patients with AF taking digoxin versus no digoxin, with or without heart failure (HF). Studies were excluded if they reported only a point estimate of mortality, duplicated patient populations, and/or did not report adjusted hazard ratios (HR). The primary endpoint was all-cause mortality. Adjusted HRs were combined using generic inverse variance and log hazard ratios. A multivariate metaregression model was used to explore heterogeneity in studies. Results. Twelve studies with 321,944 patients were included in the meta-analysis. In all AF patients, irrespective of heart failure status, digoxin is associated with increased all-cause mortality (HR [1.23], 95% confidence interval [CI] 1.16–1.31). However, digoxin is not associated with increased mortality in patients with AF and HF (HR [1.08], 95% CI 0.99–1.18). In AF patients without HF digoxin is associated with increased all-cause mortality (HR [1.38], 95% CI 1.12–1.71). Conclusion. In patients with AF and HF, digoxin use is not associated with an increased risk of all-cause mortality when used for rate control. PMID:26788401

  2. Mortality rates between treated post-traumatic stress disorder Israeli male veterans compared to non-diagnosed veterans.

    PubMed

    Zohar, Joseph; Fostick, Leah

    2014-01-01

    The literature suggests that post-traumatic stress disorder (PTSD) is associated with increased mortality. However, to date, mortality rates amongst veterans diagnosed with post-traumatic stress disorder have not been reported for Israeli veterans, who bear a different profile than veterans from other countries. This study aims to evaluate age-adjusted mortality rates amongst Israeli Defense Forces veterans with and without PTSD diagnosis. The study was carried out in a paired sample design with 2457 male veterans with treated PTSD and 2457 matched male veterans without a PTSD diagnosis. Data on PTSD and non-PTSD veterans was collected from the Rehabilitation Division of the Israeli Ministry of Defense (MOD) and the Israeli Defense Forces' (IDF) special unit for treatment of combat stress reaction. Mortality data were collected from the Ministry of the Interior (MOI) computerized database. Comparison of mortality rates between PTSD and non-PTSD veterans was done using paired observations survival analysis by applying a proportional hazards regression model. Overall no statistically significant difference in mortality rates was found between veterans with treated PTSD and veterans without PTSD. These findings hold even when excluding veterans who died in battle and including non-PTSD veterans who died before their matched PTSD veteran was diagnosed. However, among pairs with similar military jobs PTSD group had significantly less mortality. The results of this large national cohort suggest that treated PTSD is not associated with increased mortality. We submit that the lack of this association represents the "net" pathophysiology of PTSD due to the unique characteristics of the sample.

  3. EVALUATION OF THE MORTALITY RATE ONE YEAR AFTER HIP FRACTURE AND FACTORS RELATING TO DIMINISHED SURVIVAL AMONG ELDERLY PEOPLE

    PubMed Central

    Ricci, Guilherme; Longaray, Maurício Portal; Gonçalves, Ramiro Zilles; Neto, Ary da Silva Ungaretti; Manente, Marislei; Barbosa, Luíza Barbosa Horta

    2015-01-01

    Objective: To evaluate the mortality rate after one year and correlated preoperative factors, among patients with hip fractures. Methods: We prospectively studied 202 out of a total of 376 patients with a diagnosis of hip fracture who were admitted to the Hospital Cristo Redentor, between October 2007 and March 2009. The database with the epidemiological analysis was set up during their hospitalization, and follow–up data were obtained preferentially by phone. Results: The overall mortality rate after one year of follow-up was 28.7% or 58 deaths, among which 11 (5.45%) occurred during hospitalization. Fractures were more prevalent among women (71.3%) and rare among blacks (5%). Among the comorbidities, dementia and depression showed a statistically significant reduction in survival (p = 0.018 and 0.007, respectively). Conclusion: The mortality rate after one year of follow-up was 28.7%. Dementia and depression increased this rate. PMID:27042638

  4. Mortality rates of 0-group plaice ( pleuronectes platessa L.) dab ( limanda limanda L.) and turbot ( scophthalmus maximus L.) in European waters . II. Comparison of mortality rates and construction of life table for 0-group plaice

    NASA Astrophysics Data System (ADS)

    Beverton, R. J. H.; Iles, T. C.

    This paper collates and compares the available published and unpublished estimates of mortality rates of demersal 0-group plaice, dab and turbot on their nursery grounds of the North Sea and adjacent coastal waters. Seasonal and spatial variations account for some but not all of the observed differences. The consolidated phase mortality rates throughout the first year from hatching onwards are then checked against independent data of the total egg-production and numbers of age 1 recruits for the 1986, 1987 and 1988 year-classes of plaice. From this analysis a revised life-table for the first year of life of North Sea plaice is constructed. The mortality rate of dab from mid-summer to the end of the first year is well correlated with that of plaice in the same location at the same time, suggesting that the main causes of mortality during this phase of the life-history are the same in both species. The only available estimate of the mortality rate of demersal 0-group turbot is within the upper part of the range for plaice. The demographic implications of these findings are examined and significant gaps identified in the present knowledge of the quantitative early life-history of these species.

  5. Quality Indicators but Not Admission Volumes of Neonatal Intensive Care Units Are Effective in Reducing Mortality Rates of Preterm Infants

    PubMed Central

    Rochow, Niels; Lee, Sauyoung; Schünemann, Holger; Fusch, Christoph

    2016-01-01

    Aim To investigate how two different strategies to form larger neonatal intensive care units (NICU) impact neonatal mortality rates. Methods Cross-sectional study modeling admission volumes and mortality rates of 177,086 VLBW infants aggregated into 862 NICUs. Cumulative 3-year data was abstracted from Vermont Oxford Network. The model simulated a reduction in number of NICUs by stepwise exclusion using either admission volume (VOL) or quality (QUAL) cut-offs. After randomly redirecting infants of excluded to remaining NICUs resulting system mortality rates were calculated with and without adjusting for effects of experience levels (EL) using published data to reflect effects of different team-to-patient exposure. Results The quality-based strategy is more effective in reducing mortality; while VOL alone was not able to reduce system mortality, QUAL already achieved a 5% improvement after reducing 8% of NICUs and redirecting 6% of infants. Including “EL”, a 5% improvement of mortality was achieved by reducing 77% (VOL) vs. 7% (QUAL) of NICUs and redirecting 54% (VOL) vs. 5% (QUAL) of VLBW infants, respectively. Conclusion While a critical number of admissions is needed to maintain skills this study emphasizes the importance of including quality parameters to restructure neonatal care. The findings can be generalized to other medical fields. PMID:27508499

  6. Ozone and daily mortality rate in 21 cities of East Asia: how does season modify the association?

    PubMed

    Chen, Renjie; Cai, Jing; Meng, Xia; Kim, Ho; Honda, Yasushi; Guo, Yue Leon; Samoli, Evangelia; Yang, Xin; Kan, Haidong

    2014-10-01

    Previous studies in East Asia have revealed that the short-term associations between tropospheric ozone and daily mortality rate were strongest in winter, which is opposite to the findings in North America and Western Europe. Therefore, we investigated the season-varying association between ozone and daily mortality rate in 21 cities of East Asia from 1979 to 2010. Time-series Poisson regression models were used to analyze the association between ozone and daily nonaccidental mortality rate in each city, testing for different temperature lags. The best-fitting model was obtained after adjustment for temperature in the previous 2 weeks. Bayesian hierarchical models were applied to pool the city-specific estimates. An interquartile-range increase of the moving average concentrations of same-day and previous-day ozone was associated with an increase of 1.44% (95% posterior interval (PI): 1.08%, 1.80%) in daily total mortality rate after adjustment for temperature in the previous 2 weeks. The corresponding increases were 0.62% (95% PI: 0.08%, 1.16%) in winter, 1.46% (95% PI: 0.89%, 2.03%) in spring, 1.60% (95% PI: 1.03%, 2.17%) in summer, and 1.12% (95% PI: 0.73%, 1.51%) in fall. We found significant associations between short-term exposure to ozone and higher mortality rate in East Asia that varied considerably from season to season with a significant trough in winter.

  7. Agricultural adjuvants: acute mortality and effects on population growth rate of Daphnia pulex after chronic exposure.

    PubMed

    Stark, John D; Walthall, William K

    2003-12-01

    Acute and chronic toxicity of eight agricultural adjuvants (Bond, Kinetic, Plyac, R-11, Silwet L-77, Sylgard 309, X-77, and WaterMaxx) to Daphnia pulex were evaluated with 48-h acute lethal concentration estimates (LC50) and a 10-d population growth-rate measurement, the instantaneous rate of increase (r1). Based on LC50, the order of toxicity was R-11 > X-77 = Sylgard 309 = Silwet L-77 > Kinetic > Bond > Plyac > WaterMaxx; all LC50 estimates were higher than the expected environmental concentration (EEC) of 0.79 mg/L, indicating that none of these adjuvants should cause high levels of mortality in wild D. pulex populations. Extinction, defined as negative population growth rate, occurred after exposure to 0.9 mg/L R-11, 13 mg/L X-77, 25 mg/L Kinetic, 28 mg/L Silwet, 18 mg/L Sylgard, 450 mg/L Bond, 610 mg/L Plyac, and 1,600 mg/L WaterMaxx. Concentrations that caused extinction were substantially below the acute LC50 for R-11, Kinetic, Plyac, X-77, and Bond. The no-observable-effects concentration (NOEC) and lowest-observable-effects concentration (LOEC) for the number of offspring per surviving female after exposure to R-11 were 0.5 and 0.75 mg/L, respectively. The NOEC and LOEC for population size after exposure to R-11 were (1.25 and 0.5 mg/L, respectively. Both of these values were lower than the EEC, indicating that R-11 does have the potential to cause damage to D. pulex populations after application at recommended field rates. The wide range of concentrations causing extinction makes it difficult to generalize about the potential impacts that agricultural adjuvants might have on aquatic ecosystems. Therefore, additional studies that examine effects on other nontarget organisms and determine residues in aquatic ecosystems may be warranted.

  8. Salivary Immunoglobulin A Secretion Rate Is Negatively Associated with Cancer Mortality: The West of Scotland Twenty-07 Study.

    PubMed

    Phillips, Anna C; Carroll, Douglas; Drayson, Mark T; Der, Geoff

    2015-01-01

    Immunoglobulins are essential for combating infectious disease although very high levels can indicate underlying pathology. The present study examined associations between secretory immunoglobulin A (sIgA) in saliva and mortality rates in the general population. Participants were 639 adults from the eldest cohort of the West of Scotland Twenty-07 Study aged 63 years at the time of saliva sampling in 1995. From unstimulated 2-minute saliva samples, saliva volume and S-IgA concentration were measured, and S-IgA secretion rate determined as their product. Mortality data were tracked for 19 years. Cox proportional hazard models were applied to compute hazard ratios (HR) for all-cause mortality from sIgA secretion rate. Associations were adjusted for gender, assay batch, household occupational group, smoking, medication usage, and self-reported health. There was a negative association between log sIgA secretion rate and all-cause mortality, HR = 0.81, 95%CI = 0.73-0.91, p < .001. Further analysis of specific causes of mortality revealed that the all-cause association was due to an underlying association with cancer mortality and in particular with cancers other than lung cancer. The HR for non-lung cancer was 0.68 (95%CI = 0.54 to 0.85) implying a 32% reduction in mortality risk per standard deviation rise in log sIgA secretion rate. Effects were stronger for men than women. For deaths from respiratory diseases, sIgA secretion had a non-linear relationship with mortality risk whereby only the very lowest levels of secretion were associated with elevated risk. SIgA concentration revealed a similar but weaker pattern of association. In the present study, higher secretion rates of sIgA were associated with a decreased risk of death from cancer, specifically non-lung cancer, as well as from respiratory disease. Thus, it appears that sIgA plays a protective role among older adults, and could serve as a marker of mortality risk, specifically cancer mortality. PMID:26699127

  9. Salivary Immunoglobulin A Secretion Rate Is Negatively Associated with Cancer Mortality: The West of Scotland Twenty-07 Study

    PubMed Central

    Carroll, Douglas; Drayson, Mark T.

    2015-01-01

    Immunoglobulins are essential for combating infectious disease although very high levels can indicate underlying pathology. The present study examined associations between secretory immunoglobulin A (sIgA) in saliva and mortality rates in the general population. Participants were 639 adults from the eldest cohort of the West of Scotland Twenty-07 Study aged 63 years at the time of saliva sampling in 1995. From unstimulated 2-minute saliva samples, saliva volume and S-IgA concentration were measured, and S-IgA secretion rate determined as their product. Mortality data were tracked for 19 years. Cox proportional hazard models were applied to compute hazard ratios (HR) for all-cause mortality from sIgA secretion rate. Associations were adjusted for gender, assay batch, household occupational group, smoking, medication usage, and self-reported health. There was a negative association between log sIgA secretion rate and all-cause mortality, HR = 0.81, 95%CI = 0.73–0.91, p < .001. Further analysis of specific causes of mortality revealed that the all-cause association was due to an underlying association with cancer mortality and in particular with cancers other than lung cancer. The HR for non-lung cancer was 0.68 (95%CI = 0.54 to 0.85) implying a 32% reduction in mortality risk per standard deviation rise in log sIgA secretion rate. Effects were stronger for men than women. For deaths from respiratory diseases, sIgA secretion had a non-linear relationship with mortality risk whereby only the very lowest levels of secretion were associated with elevated risk. SIgA concentration revealed a similar but weaker pattern of association. In the present study, higher secretion rates of sIgA were associated with a decreased risk of death from cancer, specifically non-lung cancer, as well as from respiratory disease. Thus, it appears that sIgA plays a protective role among older adults, and could serve as a marker of mortality risk, specifically cancer mortality. PMID:26699127

  10. Delayed Effects of Obese and Overweight Population Conditions on All-Cause Adult Mortality Rate in the USA

    PubMed Central

    Okunade, Albert A.; Rubin, Rose M.; Okunade, Adeyinka K.

    2016-01-01

    Currently, there are few studies separating the linkage of pathological obese and overweight body mass indices (BMIs) to the all-cause mortality rate in adults. Consequently, this paper, using annual Behavioral Risk Factor Surveillance System data of the 50 US states and the District of Columbia, estimates empirical regression models linking the US adult overweight (25 ≤ BMI < 30) and obesity (BMI ≥ 30) rates to the all-cause deaths rate. The biochemistry of multi-period cumulative adiposity (saturated fatty acid) from unexpended caloric intakes (net energy storage) provides the natural theoretical foundation for tracing unhealthy BMI to all-cause mortality. Cross-sectional and panel data regression models are separately estimated for the delayed effects of obese and overweight BMIs on the all-cause mortality rate. Controlling for the independent effects of economic, socio-demographic, and other factors on the all-cause mortality rate, our findings confirm that the estimated panel data models are more appropriate. The panel data regression results reveal that the obesity-mortality link strengthens significantly after multiple years in the condition. The faster mortality response to obesity detected here is conjectured to arise from the significantly more obese. Compared with past studies postulating a static (rather than delayed) effects, the statistically significant lagged effects of adult population BMI pathology in this study are novel and insightful. And, as expected, these lagged effects are more severe in the obese than overweight population segment. Public health policy implications of this social science study findings agree with those of the clinical sciences literature advocating timely lifestyle modification interventions (e.g., smoking cessation) to slow premature mortality linked with unhealthy BMIs. PMID:27734013

  11. Hospitalization Rates and Post-Operative Mortality for Abdominal Aortic Aneurysm in Italy over the Period 2000–2011

    PubMed Central

    Sensi, Luigi; Tedesco, Dario; Mimmi, Stefano; Rucci, Paola; Pisano, Emilio; Pedrini, Luciano; McDonald, Kathryn M.; Fantini, Maria Pia

    2013-01-01

    Background Recent studies have reported declines in incidence, prevalence and mortality for abdominal aortic aneurysms (AAAs) in various countries, but evidence from Mediterranean countries is lacking. The aim of this study is to examine the trend of hospitalization and post-operative mortality rates for AAAs in Italy during the period 2000–2011, taking into account the introduction of endovascular aneurysm repair (EVAR) in 1990s. Methods This retrospective cohort study was carried out in Emilia-Romagna, an Italian region with 4.5 million inhabitants. A total of 19,673 patients hospitalized for AAAs between 2000 and 2011, were identified from the hospital discharge records (HDR) database. Hospitalization rates, percentage of OSR and EVAR and 30-day mortality rates were calculated for unruptured (uAAAs) and ruptured AAAs (rAAAs). Results Adjusted hospitalization rates decreased on average by 2.9% per year for uAAAs and 3.2% for rAAAs (p<0.001). The temporal trend of 30-day mortality rates remained stable for both groups. The percentage of EVAR for uAAAs increased significantly from 2006 to 2011 (42.7 versus 60.9% respectively, mean change of 3.9% per year, p<0.001). No significant difference in mortality was found between OSR and EVAR for uAAAs and rAAAs. Conclusions The incidence and trend of hospitalization rates for rAAAs and uAAAs decreased significantly in the last decade, while 30-day mortality rates in operated patients remained stable. OSR continued to be the most common surgery in rAAAs, although the gap between OSR and EVAR recently declined. The EVAR technique became the preferred surgery for uAAAs since 2008. PMID:24386294

  12. Heart Rate-Corrected QT Interval Helps Predict Mortality after Intentional Organophosphate Poisoning

    PubMed Central

    Liu, Shou-Hsuan; Lin, Ja-Liang; Weng, Cheng-Hao; Yang, Huang-Yu; Hsu, Ching-Wei; Chen, Kuan-Hsing; Huang, Wen-Hung; Yen, Tzung-Hai

    2012-01-01

    Introduction In this study, we investigated the outcomes for patients with intentional organophosphate poisoning. Previous reports indicate that in contrast to normal heart rate-corrected QT intervals (QTc), QTc prolongation might be indicative of a poor prognosis for patients exposed to organophosphates. Methods We analyzed the records of 118 patients who were referred to Chang Gung Memorial Hospital for management of organophosphate poisoning between 2000 and 2011. Patients were grouped according to their initial QTc interval, i.e., normal (<0.44 s) or prolonged (>0.44 s). Demographic, clinical, laboratory, and mortality data were obtained for analysis. Results The incidence of hypotension in patients with prolonged QTc intervals was higher than that in the patients with normal QTc intervals (P = 0.019). By the end of the study, 18 of 118 (15.2%) patients had died, including 3 of 75 (4.0%) patients with normal QTc intervals and 15 of 43 (34.9%) patients with prolonged QTc intervals. Using multivariate-Cox-regression analysis, we found that hypotension (OR = 10.930, 95% CI = 2.961–40.345, P = 0.000), respiratory failure (OR = 4.867, 95% CI = 1.062–22.301, P = 0.042), coma (OR = 3.482, 95% CI = 1.184–10.238, P = 0.023), and QTc prolongation (OR = 7.459, 95% CI = 2.053–27.099, P = 0.002) were significant risk factors for mortality. Furthermore, it was revealed that non-survivors not only had longer QTc interval (503.00±41.56 versus 432.71±51.21 ms, P = 0.002), but also suffered higher incidences of hypotension (83.3 versus 12.0%, P = 0.000), shortness of breath (64 versus 94.4%, P = 0.010), bronchorrhea (55 versus 94.4%, P = 0.002), bronchospasm (50.0 versus 94.4%, P = 0.000), respiratory failure (94.4 versus 43.0%, P = 0.000) and coma (66.7 versus 11.0%, P = 0.000) than survivors. Finally, Kaplan-Meier analysis demonstrated that cumulative mortality was higher among patients

  13. 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.

  14. 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

  15. [Growth, mortality and exploitation rate of Priacanthus arenatus (Perciformes: Priacanthidae), in the trawl fisheries of northeast Venezuela].

    PubMed

    Toledo, J; Mendoza, J; Marcano, L

    2000-12-01

    We analyzed growth, mortality and exploitation rate of Priacanhus arenatus, captured by the shrimp trawling fishery (1989-1996), in northeastern Venezuela. The growth coefficient (K) and the asymptotic length (L8) were estimated by length-frequency data using the Battacharya method and other routines of the FISAT program. Total mortality (Z) and exploitation (E) rates were obtained by length-converted catch curve analysis, based on length-frequency data, and the Berverton and Holt's yield per recruit model, respectively. The mean growth parameters L and K were estimated as 474.7 mm and 0.69 year(-1), respectively. Mean total mortality was 4.03 and the exploitation rate range was 0.70-0.80. Results indicated that the population is overexploited. PMID:15272462

  16. Differential mortality and transplantation rates among Asians and Pacific Islanders with ESRD.

    PubMed

    Hall, Yoshio N; Sugihara, Jared G; Go, Alan S; Chertow, Glenn M

    2005-12-01

    Few studies in patients with ESRD have examined outcomes in Asian or Pacific Islander subgroups compared with white individuals. The objective of this study was to assess ethnic disparities in mortality and kidney transplantation among a multiethnic cohort of incident dialysis patients. A total of 24,963 patients who initiated dialysis within the TransPacific Renal Network (Network 17) between April 1, 1995, and September 30, 2001, were studied to ascertain death and kidney transplantation through September 30, 2002. Overall, 12,902 deaths and 2258 kidney transplantations were observed during 59,075 person-years of follow-up. Mortality on dialysis among Asians and Pacific Islanders (except Chamorros) was lower than that of white individuals after controlling for differences in sociodemographic characteristics, comorbid conditions, and other risk factors for death (adjusted hazard ratio [95% confidence interval] versus white individuals: Japanese 0.64 [0.57 to 0.72], Chinese 0.64 [0.52 to 0.78], Filipino 0.64 [0.57 to 0.72], Native Hawaiian 0.84 [0.72 to 0.96], Samoan 0.62 [0.48 to 0.82], and Chamorro 0.96 [0.84 to 1.20]). In contrast, Asians and Pacific Islanders were much less likely to undergo kidney transplantation (adjusted rate ratio [95% confidence interval] versus white individuals: Japanese 0.34 [0.24 to 0.46], Chinese 0.54 [0.30 to 0.88], Filipino 0.32 [0.26 to 0.47], Native Hawaiian 0.17 [0.10 to 0.30], Samoan 0.17 [0.07 to 0.38], and Chamorro 0.04 [0.01 to 0.14]). Despite wide variations in primary cause of ESRD, clinical characteristics, and body size at dialysis initiation, Asians and Pacific Islanders experience better survival but substantially lower transplantation rates compared with white individuals. Strategies that are aimed at improving access to transplantation in Asian and Pacific Islander communities may further enhance survival among Asians and Pacific Islanders with ESRD.

  17. Vector Observation-Aided/Attitude-Rate Estimation Using Global Positioning System Signals

    NASA Technical Reports Server (NTRS)

    Oshman, Yaakov; Markley, F. Landis

    1997-01-01

    A sequential filtering algorithm is presented for attitude and attitude-rate estimation from Global Positioning System (GPS) differential carrier phase measurements. A third-order, minimal-parameter method for solving the attitude matrix kinematic equation is used to parameterize the filter's state, which renders the resulting estimator computationally efficient. Borrowing from tracking theory concepts, the angular acceleration is modeled as an exponentially autocorrelated stochastic process, thus avoiding the use of the uncertain spacecraft dynamic model. The new formulation facilitates the use of aiding vector observations in a unified filtering algorithm, which can enhance the method's robustness and accuracy. Numerical examples are used to demonstrate the performance of the method.

  18. Variation in bird-window collision mortality and scavenging rates within an urban landscape

    EPA Science Inventory

    Annual avian mortality from collisions with windows and buildings is estimated to range from a million to a billion birds in the United States alone. However, estimates of mortality based on carcass counts suffer from bias due to imperfect detection and carcass scavenging. We stu...

  19. Maternal use of cigarettes, pipes, and smokeless tobacco associated with higher infant mortality rates in Cambodia.

    PubMed

    Singh, Pramil N; Eng, Carlin; Yel, Daravuth; Kheam, They; Job, Jayakaran S; Kanal, Koum

    2013-09-01

    In the Western Pacific Region, rural women use loose tobacco in betel quid chewing and pipe smoking. We examined the relation between maternal use of tobacco and infant mortality (IM) in a national sample of 24 296 birth outcomes in adult women (n = 6013) in Cambodia. We found that (1) age-adjusted odds of IM were higher for maternal use of any tobacco (odds ratio [OR] = 1.69; 95% confidence interval [CI] = 1.27-2.26); (2) age-adjusted odds of IM were higher for cigarette use (OR = 2.54; 95% CI = 1.54- 4.1), use of pipes (OR = 3.09; [95% CI = 1.86-5.11]), and betel quid chewing (OR = 1.55; 95% CI = 1.10-2.17); and (3) these associations remained after multivariable adjustment for environmental tobacco smoke, malnutrition, ethnicity, religion, marital status, education, income, occupation, and urban/rural dwelling. In addition to finding the established association with cigarettes, we also found that maternal use of smokeless tobacco and pipes was associated with higher rates of infant death in Cambodia.

  20. High Neonatal Mortality Rates in Rural India: What Options to Explore?

    PubMed Central

    Upadhyay, Ravi Prakash; Chinnakali, Palanivel; Odukoya, Oluwakemi; Yadav, Kapil; Sinha, Smita; Rizwan, S. A.; Daral, Shailaja; Chellaiyan, Vinoth G.; Silan, Vijay

    2012-01-01

    The neonatal mortality rate in India is amongst the highest in the world and skewed towards rural areas. Nonavailability of trained manpower along with poor healthcare infrastructure is one of the major hurdles in ensuring quality neonatal care. We reviewed case studies and relevant literature from low and middle income countries and documented alternative strategies that have proved to be favourable in improving neonatal health. The authors reiterate the fact that recruiting and retaining trained manpower in rural areas by all means is essential to improve the quality of neonatal care services. Besides this, other strategies such as training of local rural healthcare providers and traditional midwives, promoting home-based newborn care, and creating community awareness and mobilization also hold enough potential to influence the neonatal health positively and efforts should be made to implement them on a larger scale. More research is demanded for innovations such as “m-health” and public-private partnerships as they have been shown to offer potential in terms of improving the standards of care. The above proposed strategy is likely to reduce morbidity among neonatal survivors as well. PMID:23213561

  1. Development of more erratic heart rate patterns is associated with mortality post-myocardial infarction.

    PubMed

    Stein, Phyllis K; Le, QuyChi; Domitrovich, Peter P

    2008-01-01

    Cardiac patients often have sinus arrhythmia of nonrespiratory origin (erratic sinus rhythm [ESR]). ESR was quantified using hourly Poincaré and power spectral heart rate variability plots from normal-to-normal interbeat intervals and hourly values of the short-term fractal scaling exponent and correlations of normal-to-normal intervals in n = 60 nonsurvivors and n = 66 randomly selected survivors in the Cardiac Arrhythmia Suppression Trial. Hours were coded (ABN) as normal (0), borderline (0.5), or ESR (1). t Tests compared ABN for n = 2413 paired hours at baseline and on therapy. ABN was higher in nonsurvivors (0.38 +/- 0.44 vs 0.28 +/- 0.40, baseline, and 0.51 +/- 0.45 vs 0.34 +/- 0.43, on therapy, P < .001). Increased ABN with treatment were greater in nonsurvivors. Normal hours at baseline (relative risk = 0.77; 095% confidence interval, 0.62-0.96, P = .018) and on treatment (relative risk = 0.47; 95% confidence interval, 0.39-0.58) were significantly associated with decreased mortality compared with ESR. Quantification of ESR may identify more vulnerable patients or help monitor the effects of pharmacologic treatment.

  2. Prediction of hospital mortality by changes in the estimated glomerular filtration rate (eGFR).

    PubMed

    Berzan, E; Mellotte, G; Silke, B

    2015-03-01

    Deterioration of physiological or laboratory variables may provide important prognostic information. We have studied whether a change in estimated glomerular filtration rate (eGFR) value calculated using the (Modification of Diet in Renal Disease (MDRD) formula) over the hospital admission, would have predictive value. An analysis was performed on all emergency medical hospital episodes (N = 61964) admitted between 1 January 2002 and 31 December 2011. A stepwise logistic regression model examined the relationship between mortality and change in renal function from admission to discharge. The fully adjusted Odds Ratios (OR) for 5 classes of GFR deterioration showed a stepwise increased risk of 30-day death with OR's of 1.42 (95% CI: 1.20, 1.68), 1.59 (1.27, 1.99), 2.71 (2.24, 3.27), 5.56 (4.54, 6.81) and 11.9 (9.0, 15.6) respectively. The change in eGFR during a clinical episode, following an emergency medical admission, powerfully predicts the outcome. PMID:25876302

  3. An Ecological Study of the Determinants of Differences in 2009 Pandemic Influenza Mortality Rates between Countries in Europe

    PubMed Central

    Nikolopoulos, Georgios; Bagos, Pantelis; Lytras, Theodoros; Bonovas, Stefanos

    2011-01-01

    Background Pandemic A (H1N1) 2009 mortality rates varied widely from one country to another. Our aim was to identify potential socioeconomic determinants of pandemic mortality and explain between-country variation. Methodology Based on data from a total of 30 European countries, we applied random-effects Poisson regression models to study the relationship between pandemic mortality rates (May 2009 to May 2010) and a set of representative environmental, health care-associated, economic and demographic country-level parameters. The study was completed by June 2010. Principal Findings Most regression approaches indicated a consistent, statistically significant inverse association between pandemic influenza-related mortality and per capita government expenditure on health. The findings were similar in univariable [coefficient: –0.00028, 95% Confidence Interval (CI): –0.00046, –0.00010, p = 0.002] and multivariable analyses (including all covariates, coefficient: –0.00107, 95% CI: –0.00196, –0.00018, p = 0.018). The estimate was barely insignificant when the multivariable model included only significant covariates from the univariate step (coefficient: –0.00046, 95% CI: –0.00095, 0.00003, p = 0.063). Conclusions Our findings imply a significant inverse association between public spending on health and pandemic influenza mortality. In an attempt to interpret the estimated coefficient (–0.00028) for the per capita government expenditure on health, we observed that a rise of 100 international dollars was associated with a reduction in the pandemic influenza mortality rate by approximately 2.8%. However, further work needs to be done to unravel the mechanisms by which reduced government spending on health may have affected the 2009 pandemic influenza mortality. PMID:21589928

  4. Mortality of the elderly is still exceedingly high at diagnosis of AIDS despite favourable outcomes after highly active antiretroviral therapy in Recife, Brazil.

    PubMed

    Lacerda, H R; Kitner, D

    2008-07-01

    This study aimed to compare the outcome of an elderly group of AIDS patients with that of a younger group and their features at the time of the diagnosis of AIDS. We evaluated 58 patients aged >60 years and 114 aged 20-39 years, followed for 35.3 months. There was an obvious delay in diagnosing the elderly as they had more AIDS-defining diseases at diagnosis and their most frequent opportunistic infection was pulmonary tuberculosis. Mortality at the time of the diagnosis of AIDS was four times higher in the elderly (24.1% versus 6.1%, P < 0.001). However, when comparing only those submitted to highly active antiretroviral therapy, there was a similar frequency of favourable outcomes; 76.9% in the elderly against 83.1% in the young (P = 0.455). Mean CD4 lymphocyte was 438 cells/mm(3) at the end of follow up in the young when compared with 442 cells/mm(3) in the elderly (P = 0.945). The types of antiretroviral schema and the number of antivirals per patient were similar in both groups.

  5. Does higher income inequality adversely influence infant mortality rates? Reconciling descriptive patterns and recent research findings.

    PubMed

    Siddiqi, Arjumand; Jones, Marcella K; Erwin, Paul Campbell

    2015-04-01

    As the struggle continues to explain the relatively high rates of infant mortality (IMR) exhibited in the United States, a renewed emphasis is being placed on the role of possible 'contextual' determinants. Cross-sectional and short time-series studies have found that higher income inequality is associated with higher IMR at the state level. Yet, descriptively, the longer-term trends in income inequality and in IMR seem to call such results into question. To assess whether, over the period 1990-2007, state-level income inequality is associated with state-level IMR; to examine whether the overall effect of income inequality on IMR over this period varies by state; to test whether the association between income inequality and IMR varies across this time period. IMR data--number of deaths per 1000 live births in a given state and year--were obtained from the U.S. Centers for Disease Control Wonder database. Income inequality was measured using the Gini coefficient, which varies from zero (complete equality) to 100 (complete inequality). Covariates included state-level poverty rate, median income, and proportion of high school graduates. Fixed and random effects regressions were conducted to test hypotheses. Fixed effects models suggested that, overall, during the period 1990-2007, income inequality was inversely associated with IMR (β = -0.07, SE (0.01)). Random effects models suggested that when the relationship was allowed to vary at the state-level, it remained inverse (β = -0.05, SE (0.01)). However, an interaction between income inequality and time suggested that, as time increased, the effect of income inequality had an increasingly positive association with total IMR (β = 0.009, SE (0.002)). The influence of state income inequality on IMR is dependent on time, which may proxy for time-dependent aspects of societal context.

  6. When to Initiate Combined Antiretroviral Therapy to Reduce Mortality and AIDS-Defining Illness in HIV-Infected Persons in Developed Countries

    PubMed Central

    2012-01-01

    Background Most clinical guidelines recommend that AIDS-free, HIV-infected persons with CD4 cell counts below 0.350 × 109 cells/L initiate combined antiretroviral therapy (cART), but the optimal CD4 cell count at which cART should be initiated remains a matter of debate. Objective To identify the optimal CD4 cell count at which cART should be initiated. Design Prospective observational data from the HIV-CAUSAL Collaboration and dynamic marginal structural models were used to compare cART initiation strategies for CD4 thresholds between 0.200 and 0.500 × 109 cells/L. Setting HIV clinics in Europe and the Veterans Health Administration system in the United States. Patients 20 971 HIV-infected, therapy-naive persons with baseline CD4 cell counts at or above 0.500 × 109 cells/L and no previous AIDS-defining illnesses, of whom 8392 had a CD4 cell count that decreased into the range of 0.200 to 0.499 × 109 cells/L and were included in the analysis. Measurements Hazard ratios and survival proportions for all-cause mortality and a combined end point of AIDS-defining illness or death. Results Compared with initiating cART at the CD4 cell count threshold of 0.500 × 109 cells/L, the mortality hazard ratio was 1.01 (95% CI, 0.84 to 1.22) for the 0.350 threshold and 1.20 (CI, 0.97 to 1.48) for the 0.200 threshold. The corresponding hazard ratios were 1.38 (CI, 1.23 to 1.56) and 1.90 (CI, 1.67 to 2.15), respectively, for the combined end point of AIDS-defining illness or death. Limitations CD4 cell count at cART initiation was not randomized. Residual confounding may exist. Conclusion Initiation of cART at a threshold CD4 count of 0.500 × 109 cells/L increases AIDS-free survival. However, mortality did not vary substantially with the use of CD4 thresholds between 0.300 and 0.500 ×109 cells/L. Primary Funding Source National Institutes of Health. PMID:21502648

  7. An Estimation of Mortality Risks among People Living with HIV in Karnataka State, India: Learnings from an Intensive HIV/AIDS Care and Support Programme

    PubMed Central

    Prakash, Ravi; Isac, Shajy; Washington, Reynold; Halli, Shiva S.

    2016-01-01

    Background In Indian context, limited attempts have been made to estimate the mortality risks among people living with HIV (PLHIV). We estimated the rates of mortality among PLHIV covered under an integrated HIV-prevention cum care and support programme implemented in Karnataka state, India, and attempted to identify the key programme components associated with the higher likelihood of their survival. Methods Retrospective programme data of 55,801 PLHIV registered with the Samastha programme implemented in Karnataka state during 2006–11 was used. Kaplan-Meier survival methods were used to estimate the ten years expected survival probabilities and Cox-proportional hazard model was used to examine the factors associated with risk of mortality among PLHIV. We also calculated mortality rates (per 1000 person-year) across selected demographic and clinical parameters. Results Of the total PLHIV registered with the programme, about nine percent died within the 5-years of programme period with an overall death rate of 38 per 1000 person-years. The mortality rate was higher among males, aged 18 and above, among illiterates, and those residing in rural areas. While the presence of co-infections such as Tuberculosis leads to higher mortality rate, adherence to ART was significantly associated with reduction in overall death rate. Cox proportional hazard model revealed that increase in CD4 cell counts and exposure to intensive care and support programme for at least two years can bring significant reduction in risk of death among PLHIV [(hazard ratio: 0.234; CI: 0.211–0.260) & (hazard ratio: 0.062; CI: 0.054–0.071), respectively] even after adjusting the effect of other socio-demographic, economic and health related confounders. Conclusion Study confirms that while residing in rural areas and presence of co-infection significantly increases the mortality risk among PLHIV, adherence to ART and improvement in CD4 counts led to significant reduction in their mortality risk

  8. Trends in Mortality Rate from Cardiovascular Disease in Brazil, 1980-2012

    PubMed Central

    Mansur, Antonio de Padua; Favarato, Desidério

    2016-01-01

    Background Studies have questioned the downward trend in mortality from cardiovascular diseases (CVD) in Brazil in recent years. Objective to analyze recent trends in mortality from ischemic heart disease (IHD) and stroke in the Brazilian population. Methods Mortality and population data were obtained from the Brazilian Institute of Geography and Statistics and the Ministry of Health. Risk of death was adjusted by the direct method, using as reference the world population of 2000. We analyzed trends in mortality from CVD, IHD and stroke in women and men in the periods of 1980-2006 and 2007-2012. Results there was a decrease in CVD mortality and stroke in women and men for both periods (p < 0.001). Annual mortality variations for periods 1980-2006 and 2007-2012 were, respectively: CVD (total): -1.5% and -0.8%; CVD men: -1.4% and -0.6%; CVD women: -1.7% and -1.0%; DIC (men): -1.1% and 0.1%; stroke (men): -1.7% and -1.4%; DIC (women): -1.5% and 0.4%; stroke (women): -2.0% and -1.9%. From 1980 to 2006, there was a decrease in IHD mortality in men and women (p < 0.001), but from 2007 to 2012, changes in IHD mortality were not significant in men [y = 151 + 0.04 (R2 = 0.02; p = 0.779)] and women [y = 88-0.54 (R2 = 0.24; p = 0.320). Conclusion Trend in mortality from IHD stopped falling in Brazil from 2007 to 2012. PMID:27223642

  9. 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.

  10. Decline in hospital mortality rate after the use of the World Health Organization protocol for management of severe malnutrition.

    PubMed

    Falbo, Ana Rodrigues; Alves, João Guilherme Bezerra; Batista Filho, Malaquias; de Fátima Costa Caminha, Maria; Cabral-Filho, José Eulálio

    2009-04-01

    We studied the implementation of the World Health Organization protocol for the treatment of malnourished children at the largest maternal and infant hospital in the northeast of Brazil. The implementation of the protocol resulted in a reduction in the mortality rate from 38.0% to 16.2%.

  11. Association of soil arsenic and nickel exposure with cancer mortality rates, a town-scale ecological study in Suzhou, China.

    PubMed

    Chen, Kai; Liao, Qi Lin; Ma, Zong Wei; Jin, Yang; Hua, Ming; Bi, Jun; Huang, Lei

    2015-04-01

    Heavy metals and arsenic are well-known carcinogens. However, few studies have examined whether soil heavy metals and arsenic concentrations associate with cancer in the general population. In this ecological study, we aimed to evaluate the association of heavy metals and arsenic in soil with cancer mortality rates during 2005-2010 in Suzhou, China, after controlling for education and smoking prevalence. In 2005, a total of 1683 soil samples with a sampling density of one sample every 4 km(2) were analyzed. Generalized linear model with a quasi-Poisson regression was applied to evaluate the association between town-scale cancer mortality rates and soil heavy metal concentrations. Results showed that soil arsenic exposure had a significant relationship with colon, gastric, kidney, lung, and nasopharyngeal cancer mortality rates and soil nickel exposure was significantly associated with liver and lung cancer. The associations of soil arsenic and nickel exposure with colon, gastric, kidney, and liver cancer in male were higher than those in female. The observed associations of soil arsenic and nickel with cancer mortality rates were less sensitive to alternative exposure metrics. Our findings would contribute to the understanding of the carcinogenic effect of soil arsenic and nickel exposure in general population. PMID:25410308

  12. The Relationship between Toxics Release Inventory Discharges and Mortality Rates in Rural and Urban Areas of the United States

    ERIC Educational Resources Information Center

    Hendryx, Michael; Fedorko, Evan

    2011-01-01

    Background: Potential environmental exposures from chemical manufacturing or industrial sites have not been well studied for rural populations. The current study examines whether chemical releases from facilities monitored through the Toxics Release Inventory (TRI) program are associated with population mortality rates for both rural and urban…

  13. Association of soil arsenic and nickel exposure with cancer mortality rates, a town-scale ecological study in Suzhou, China.

    PubMed

    Chen, Kai; Liao, Qi Lin; Ma, Zong Wei; Jin, Yang; Hua, Ming; Bi, Jun; Huang, Lei

    2015-04-01

    Heavy metals and arsenic are well-known carcinogens. However, few studies have examined whether soil heavy metals and arsenic concentrations associate with cancer in the general population. In this ecological study, we aimed to evaluate the association of heavy metals and arsenic in soil with cancer mortality rates during 2005-2010 in Suzhou, China, after controlling for education and smoking prevalence. In 2005, a total of 1683 soil samples with a sampling density of one sample every 4 km(2) were analyzed. Generalized linear model with a quasi-Poisson regression was applied to evaluate the association between town-scale cancer mortality rates and soil heavy metal concentrations. Results showed that soil arsenic exposure had a significant relationship with colon, gastric, kidney, lung, and nasopharyngeal cancer mortality rates and soil nickel exposure was significantly associated with liver and lung cancer. The associations of soil arsenic and nickel exposure with colon, gastric, kidney, and liver cancer in male were higher than those in female. The observed associations of soil arsenic and nickel with cancer mortality rates were less sensitive to alternative exposure metrics. Our findings would contribute to the understanding of the carcinogenic effect of soil arsenic and nickel exposure in general population.

  14. A Study of the Gender-Specific Mortality Rates in Korea and Japan for the Formation of Health Promotion Policy

    ERIC Educational Resources Information Center

    Nam, Eun-Woo; Song, Yea-Li-A

    2007-01-01

    Objective: This study attempts to provide fundamental information to help with the development of health policy and health services by looking at the trends of the gender-specific mortality rates in Korea and Japan. Design: The death statistics of Korea and Japan over the 21-year period from 1983 to 2003 are analyzed. Setting: We used the death…

  15. Misery Loves Company? A Meta-Regression Examining Aggregate Unemployment Rates and the Unemployment-Mortality Association

    PubMed Central

    Roelfs, David J.; Shor, Eran; Blank, Aharon; Schwartz, Joseph E.

    2015-01-01

    PURPOSE Individual-level unemployment has been consistently linked to poor health and higher mortality, but some scholars have suggested that the negative effect of job loss may be lower during times and in places where aggregate unemployment rates are high. We review three logics associated with this moderation hypothesis: health selection, social isolation, and unemployment stigma. We then test whether aggregate unemployment rates moderate the individual-level association between unemployment and all-cause mortality. METHODS We use 6 meta-regression models (each utilizing a different measure of the aggregate unemployment rate) based on 62 relative all-cause mortality risk estimates from 36 studies (from 15 nations). RESULTS We find that the magnitude of the individual-level unemployment-mortality association is approximately the same during periods of high and low aggregate-level unemployment. Model coefficients (exponentiated) were 1.01 for the crude unemployment rate (p = 0.27), 0.94 for the change in unemployment rate from the previous year (p = 0.46), 1.01 for the deviation of the unemployment rate from the 5-year running average (p = 0.87), 1.01 for the deviation of the unemployment rate from the 10-year running average (p = 0.73), 1.01 for the deviation of the unemployment rate from the overall average (measured as a continuous variable; p = 0.61), and showed no variation across unemployment levels when the deviation of the unemployment rate from the overall average was measured categorically. Heterogeneity between studies was significant (p < .001), supporting the use of the random effects model. CONCLUSIONS We found no strong evidence to suggest that unemployment experiences change when macro-economic conditions change. Efforts to ameliorate the negative social and economic consequences of unemployment should continue to focus on the individual and should be maintained regardless of periodic changes in macro-economic conditions. PMID:25795225

  16. Social life factors affecting the mortality, longevity, and birth rate of total Japanese population: effects of rapid industrialization and urbanization.

    PubMed

    Araki, S; Uchida, E; Murata, K

    1990-12-01

    To expand upon the findings that lower mortality was found in Japanese urban areas in contrast to the Western model where in the US and Britain the risk of death was higher in metropolitan areas and conurbations, 22 social life indicators are examined among 46 prefectures in Japan in terms of their effect on age specific mortality, life expectancy, and age adjusted marriage, divorce, and birth rates. The effects of these factors on age adjusted mortality for 8 major working and nonworking male populations, where also analyzed. The 22 social life factors were selected from among 227 indicators in the system of Statistical Indicators on Life. Factor analysis was used to classify the indicators into 8 groups of factors for 1970 and 7 for 1975. Factors 1-3 for both years were rural or urban residence, low income and unemployment, and prefectural age distribution. The 4th for 1970 was home help for the elderly and for 1975, social mobility. The social life indicators were classified form 1 to 8 as rural residence in 1970 and 1975, urban residence, low income, high employment, old age, young age, social mobility, and home help for the elderly which moved from 8th place in 1970 to 1st in 1975. Between 1960-75, rapid urbanization took place with the proportion of farmers, fishermen, and workers declining from 43% in 1960 to 19% in 1975. The results of stepwise regression analysis indicate a positive relationship of urban residence with mortality of men and women except school-aged and middle-aged women, and the working populations, as well as life expectancy at birth for males and females and ages 20 and 40 years for males. Rural residence was positively associated with the male marriage rate, whereas the marriage rate for females was affected by industrialization and urbanization. High employment and social mobility were positively related to the female marriage rate. Low income was positively related to the divorce rate for males and females. Rural residence and high

  17. Income inequality, mortality, and self rated health: meta-analysis of multilevel studies

    PubMed Central

    Sembajwe, Grace; Kawachi, Ichiro; van Dam, Rob M; Subramanian, S V; Yamagata, Zentaro

    2009-01-01

    Objective To provide quantitative evaluations on the association between income inequality and health. Design Random effects meta-analyses, calculating the overall relative risk for subsequent mortality among prospective cohort studies and the overall odds ratio for poor self rated health among cross sectional studies. Data sources PubMed, the ISI Web of Science, and the National Bureau for Economic Research database. Review methods Peer reviewed papers with multilevel data. Results The meta-analysis included 59 509 857 subjects in nine cohort studies and 1 280 211 subjects in 19 cross sectional studies. The overall cohort relative risk and cross sectional odds ratio (95% confidence intervals) per 0.05 unit increase in Gini coefficient, a measure of income inequality, was 1.08 (1.06 to 1.10) and 1.04 (1.02 to 1.06), respectively. Meta-regressions showed stronger associations between income inequality and the health outcomes among studies with higher Gini (≥0.3), conducted with data after 1990, with longer duration of follow-up (>7 years), and incorporating time lags between income inequality and outcomes. By contrast, analyses accounting for unmeasured regional characteristics showed a weaker association between income inequality and health. Conclusions The results suggest a modest adverse effect of income inequality on health, although the population impact might be larger if the association is truly causal. The results also support the threshold effect hypothesis, which posits the existence of a threshold of income inequality beyond which adverse impacts on health begin to emerge. The findings need to be interpreted with caution given the heterogeneity between studies, as well as the attenuation of the risk estimates in analyses that attempted to control for the unmeasured characteristics of areas with high levels of income inequality. PMID:19903981

  18. Design and implementation of a bluetooth-based band-aid pulse rate sensor

    NASA Astrophysics Data System (ADS)

    Kumar, Prashanth S.; Oh, Sechang; Rai, Pratyush; Kwon, Hyeokjun; Banerjee, Nilanjan; Varadan, Vijay K.

    2011-04-01

    Remote patient monitoring systems capable of collecting vital patient data such as blood pressure readings, Electrocardiograph (ECG) waveforms, and heart rate can obviate the need for repeated visits to the hospital. Moreover, such systems that continuously monitor the human physiology can provide valuable data to prognosticate the onset of critical health problems. The key to such remote health diagnostics is the design of minimally intrusive, low cost sensors that do not impede a patient's quotidian life but at the same time collect reliable noise free data. To this end, in this paper, we design and implement a Bluetooth-based wireless sensor system with a disposable sensor element and a reusable wireless component that can be worn as a "band-aid". The sensor is a piezoelectric polymer film placed on the wrist in proximity to the radial artery. The band-aid sized sensor allows non-intrusive monitoring of the pulsatile flow of blood in the artery. The sensor, using the Bluetooth module, can communicate with any Bluetooth enabled computer, mobile phone, or PDA. The data collected from the patient can be remotely viewed and analyzed by a physician.

  19. Girl child marriage and its association with national rates of HIV, maternal health, and infant mortality across 97 countries.

    PubMed

    Raj, Anita; Boehmer, Ulrike

    2013-04-01

    This study was designed to assess associations between national rates of girl child marriage and national rates of HIV and maternal and child health (MCH) concerns, using national indicator data from 2009 United Nations reports. Current analyses were limited to the N = 97 nations (of 188 nations) for which girl child marriage data were available. Regression analyses adjusted for development and world region demonstrate that nations with higher rates of girl child marriage are significantly more likely to contend with higher rates of maternal and infant mortality and nonutilization of maternal health services, but not HIV.

  20. Associated influence of hypertension and heart rate greater than 80 beats per minute on mortality rate in patients with anterior wall STEMI

    PubMed Central

    Davidovic, Goran; Iric-Cupic, Violeta; Milanov, Srdjan

    2013-01-01

    Acute myocardial infarction as a form of coronary heart disease is characterized by permanent damage/loss of anatomical and functional cardiac tissue. Diagnosis of STEMI includes data on anginal pain and persistent ST-segment elavation. According to the numerous epidemiological studies, arterial blood pressure and heart rate are offten increased especially during the first hours of pain due to domination of sympathetic response. We wanted to investigate the associated influence of heart rate greater than 80 beats per minute and hypertension on the mortality in patients with anterior wall STEMI. Research included 140 patients treated in Coronary Unit, Clinical Center Kragujevac form January 2001 to June 2006. Heart rate was calculated as the mean value of baseline and heart rate in the first 30 minutes after admission, recorded on monitor and electrocardiogram. Data for history of hypertension were collected and blood pressure levels were measured in a lying position after 5 minutes of rest, and classified according to the VII JNC recommendations as confirmation of hypertension. Collected data were analyzed in SPSS 13.0 for Windows. Heart rate greater than 80 bpm influences the hospital mortality. Systolic blood pressure levels were higher in the survivors, while for the diastolic there was no difference. History of hypertension was singled out as a significant predictor of mortality without difference between the respondents with heart rate greater and lower than 80 bpm in the survivors and fatal. Increased heart rate and hypertension at admission are significant predictors of mortality in patients with anterior wall STEMI. PMID:23724155

  1. Experimental warming and precipitation interactively modulate the mortality rate and timing of spring emergence of a gallmaking Tephritid fly

    PubMed Central

    Xi, Xinqiang; Li, Dongbo; Peng, Youhong; Eisenhauer, Nico; Sun, Shucun

    2016-01-01

    Global climate change is mostly characterized by temperature increase and fluctuating precipitation events, which may affect the spring phenology and mortality rate of insects. However, the interaction effect of temperature and precipitation on species performance has rarely been examined. Here we studied the response of the gall-making Tephritid fly Urophora stylata (Diptera: Tephritidae) to artificial warming, changes in precipitation, and the presence of galls. Our results revealed a significant interaction effect of warming, precipitation, and galls on the life-history traits of the focal species. Specifically, when the galls were intact, warming had no effect on the phenology and increased the mortality of the fly under decreased precipitation, but it significantly advanced the timing of adult emergence and had no effect on the mortality under increased precipitation. When galls were removed, warming significantly advanced the timing of emergence and increased fly mortality, but precipitation showed no effect on the phenology and mortality. In addition, gall removal significantly increased adult fresh mass for both females and males. Our results indicate that the effect of elevated temperature on the performance of species may depend on other environmental conditions, such as variations in precipitation, and species traits like the formation of galls. PMID:27578601

  2. Experimental warming and precipitation interactively modulate the mortality rate and timing of spring emergence of a gallmaking Tephritid fly.

    PubMed

    Xi, Xinqiang; Li, Dongbo; Peng, Youhong; Eisenhauer, Nico; Sun, Shucun

    2016-01-01

    Global climate change is mostly characterized by temperature increase and fluctuating precipitation events, which may affect the spring phenology and mortality rate of insects. However, the interaction effect of temperature and precipitation on species performance has rarely been examined. Here we studied the response of the gall-making Tephritid fly Urophora stylata (Diptera: Tephritidae) to artificial warming, changes in precipitation, and the presence of galls. Our results revealed a significant interaction effect of warming, precipitation, and galls on the life-history traits of the focal species. Specifically, when the galls were intact, warming had no effect on the phenology and increased the mortality of the fly under decreased precipitation, but it significantly advanced the timing of adult emergence and had no effect on the mortality under increased precipitation. When galls were removed, warming significantly advanced the timing of emergence and increased fly mortality, but precipitation showed no effect on the phenology and mortality. In addition, gall removal significantly increased adult fresh mass for both females and males. Our results indicate that the effect of elevated temperature on the performance of species may depend on other environmental conditions, such as variations in precipitation, and species traits like the formation of galls. PMID:27578601

  3. Experimental warming and precipitation interactively modulate the mortality rate and timing of spring emergence of a gallmaking Tephritid fly.

    PubMed

    Xi, Xinqiang; Li, Dongbo; Peng, Youhong; Eisenhauer, Nico; Sun, Shucun

    2016-08-31

    Global climate change is mostly characterized by temperature increase and fluctuating precipitation events, which may affect the spring phenology and mortality rate of insects. However, the interaction effect of temperature and precipitation on species performance has rarely been examined. Here we studied the response of the gall-making Tephritid fly Urophora stylata (Diptera: Tephritidae) to artificial warming, changes in precipitation, and the presence of galls. Our results revealed a significant interaction effect of warming, precipitation, and galls on the life-history traits of the focal species. Specifically, when the galls were intact, warming had no effect on the phenology and increased the mortality of the fly under decreased precipitation, but it significantly advanced the timing of adult emergence and had no effect on the mortality under increased precipitation. When galls were removed, warming significantly advanced the timing of emergence and increased fly mortality, but precipitation showed no effect on the phenology and mortality. In addition, gall removal significantly increased adult fresh mass for both females and males. Our results indicate that the effect of elevated temperature on the performance of species may depend on other environmental conditions, such as variations in precipitation, and species traits like the formation of galls.

  4. Mortality rates of males who commit parricide or other violent offense against a parent.

    PubMed

    Liettu, Anu; Mikkola, Liisa; Säävälä, Hannu; Räsänen, Pirkko; Joukamaa, Matti; Hakko, Helinä

    2010-01-01

    Clinical information on parricidal offenders has accumulated in recent decades. The purpose of this study was to examine and compare the mortality of matricidal and patricidal offenders in detail by using a comprehensive national data set with follow-up ranging from 3 to 24 years. The sample included forensic psychiatric examination statements and mortality data of 99 matricidal, 113 patricidal, and 111 control male violent offenders evaluated in a forensic psychiatric examination from 1973 to 2004 in Finland. The Standardized Mortality Ratio among parricidal offenders 25 to 49 years of age was increased compared with that of the general population. One-third of deaths among parricidal offenders were attributable to suicide. The matricidal males who committed suicide had a significantly shorter survival time after the offense than did the patricidal and control offenders who died by suicide. The results of the present study are compared with the previous study findings on parricidal offenders and offenders in general.

  5. A combined telemetry - tag return approach to estimate fishing and natural mortality rates of an estuarine fish

    USGS Publications Warehouse

    Bacheler, N.M.; Buckel, J.A.; Hightower, J.E.; Paramore, L.M.; Pollock, K.H.

    2009-01-01

    A joint analysis of tag return and telemetry data should improve estimates of mortality rates for exploited fishes; however, the combined approach has thus far only been tested in terrestrial systems. We tagged subadult red drum (Sciaenops ocellatus) with conventional tags and ultrasonic transmitters over 3 years in coastal North Carolina, USA, to test the efficacy of the combined telemetry - tag return approach. There was a strong seasonal pattern to monthly fishing mortality rate (F) estimates from both conventional and telemetry tags; highest F values occurred in fall months and lowest levels occurred during winter. Although monthly F values were similar in pattern and magnitude between conventional tagging and telemetry, information on F in the combined model came primarily from conventional tags. The estimated natural mortality rate (M) in the combined model was low (estimated annual rate ?? standard error: 0.04 ?? 0.04) and was based primarily upon the telemetry approach. Using high-reward tagging, we estimated different tag reporting rates for state agency and university tagging programs. The combined telemetry - tag return approach can be an effective approach for estimating F and M as long as several key assumptions of the model are met.

  6. Neonatal and Infant Mortality in Korea, Japan, and the U.S.: Effect of Birth Weight Distribution and Birth Weight-Specific Mortality Rates

    PubMed Central

    2016-01-01

    Difference in crude neonatal and infant mortality rates (NMR and IMR) among different countries is due to the differences in its two determinants: birth weight distribution (BWD) and birth weight-specific mortality rates (BW-SMRs). We aimed to determine impact of BWD and BW-SMRs on differences in crude NMR and IMR among Korea, Japan, and the U.S. Our study used the live birth data of the period 2009 through 2010. Crude NMR/IMR are the lowest in Japan, 1.1/2.1, compared to 1.8/3.2, in Korea, and 4.1/6.2, in the U.S., respectively. Japanese had the best BW-SMRs of all birth weight groups compared to the Koreans and the U.S. The U.S. BWD was unfavorable with very low birth weight (< 1,500 g) rate of 1.4%, compared to 0.6% in Korea, and 0.8% in Japan. If Koreans and Japanese had the same BWD as in the U.S., their crude NMR/IMR would be 3.9/6.1 for the Koreans and 1.5/2.5 for the Japanese. If both Koreans and Japanese had the same BW-SMRs as in the U.S., the crude NMR/IMR would be 2.0/3.8 for the Koreans and 2.7/5.0 for the Japanese. In conclusion, compared to the U.S., lower crude NMR or IMR in Japan is mainly attributable to its better BW-SMRs. Koreans had lower crude NMR and IMR, primarily from its favorable BWD. Comparing crude NMR or IMR among different countries should include further exploration of its two determinants, BW-SMRs reflecting medical care, and BWD reflecting socio-demographic conditions. PMID:27510390

  7. A single measure of cancer burden combining incidence with mortality rates for worldwide application.

    PubMed

    Kim, Jeong Lim; Cho, Kyoung-Hee; Park, Eun-Cheol; Cho, Woo Hyun

    2014-01-01

    We attempted to develop an indicator combining incidence and mortality (summary indicator of cancer burden, SMCB) and to compare the magnitudes of cancer burden by world region. The SMCB was used to measure the size of cancer burden summarizing the incidence and mortality. The incidence and mortality were divided in equivalent forms and were split. The criteria dividing the size of cancer burden were used as the maximum incidence and mortality by men and women according to the world database, and the value corresponding to 10% of each maximum was set as the cut-off value. In SMCB, the size of cancer burden was highest for men with lung cancer (SMCB=18) and for women with breast cancer (SMCB=14) in MDR (more developed regions) compared to the size of burden in LDR (lower developed regions) (lung, SMCB=11, breast, SMCB=8). For men, the size of cancer burden by region was highest in EURO (SMCB=18, lung), followed by WPRO (SMCB=16, lung), PAHO (SMCB=14, prostate), AFRO (SMCB=8, prostate) and SEARO (SMCB=7, lung). Moreover, for women, the size of cancer burden was greatest in EURO (SMCB=14, breast), followed by PAHO (SMCB=13, breast), AFRO (SMCB=11, cervix uteri), EMRO (SMCB=9, breast) or SEARO (SMCB=8, cervix uteri) and WPRO (SMCB=7, lung). The summary indicator will help to provide a priority setting for reducing cancer burden in health policy.

  8. Why do child mortality rates fall? An analysis of the Nicaraguan experience.

    PubMed Central

    Sandiford, P; Morales, P; Gorter, A; Coyle, E; Smith, G D

    1991-01-01

    A comprehensive review of available sources of mortality data was undertaken to document the changes that have occurred in infant mortality in Nicaragua over the last three decades. It was found that a rapid fall in infant mortality commenced in the early 1970s and has continued steadily since. Trends in several different factors which might have led to this breakthrough were examined including: income, nutrition, breastfeeding practices, maternal education, immunizations, access to health services, provision of water supplies and sanitation, and anti-malarial programs. Of these, improved access to health services appears to have been the most important factor. At a time when the number of hospital beds per capita was dropping, increasing numbers of health care professionals, particularly nurses, were becoming available to staff primary health care facilities built in the 1960s. These were provided at least partly in response to the growing political turmoil enveloping the nation at that time. Certain Nicaraguan cultural attributes may have added to the impact of the reforms. Efforts in the field of public health made since the 1979 insurrection appear to have maintained the decline in child mortality. PMID:1983913

  9. Indirectly estimated absolute lung cancer mortality rates by smoking status and histological type based on a systematic review

    PubMed Central

    2013-01-01

    Background National smoking-specific lung cancer mortality rates are unavailable, and studies presenting estimates are limited, particularly by histology. This hinders interpretation. We attempted to rectify this by deriving estimates indirectly, combining data from national rates and epidemiological studies. Methods We estimated study-specific absolute mortality rates and variances by histology and smoking habit (never/ever/current/former) based on relative risk estimates derived from studies published in the 20th century, coupled with WHO mortality data for age 70–74 for the relevant country and period. Studies with populations grossly unrepresentative nationally were excluded. 70–74 was chosen based on analyses of large cohort studies presenting rates by smoking and age. Variations by sex, period and region were assessed by meta-analysis and meta-regression. Results 148 studies provided estimates (Europe 59, America 54, China 22, other Asia 13), 54 providing estimates by histology (squamous cell carcinoma, adenocarcinoma). For all smoking habits and lung cancer types, mortality rates were higher in males, the excess less evident for never smokers. Never smoker rates were clearly highest in China, and showed some increasing time trend, particularly for adenocarcinoma. Ever smoker rates were higher in parts of Europe and America than in China, with the time trend very clear, especially for adenocarcinoma. Variations by time trend and continent were clear for current smokers (rates being higher in Europe and America than Asia), but less clear for former smokers. Models involving continent and trend explained much variability, but non-linearity was sometimes seen (with rates lower in 1991–99 than 1981–90), and there was regional variation within continent (with rates in Europe often high in UK and low in Scandinavia, and higher in North than South America). Conclusions The indirect method may be questioned, because of variations in definition of smoking and

  10. Esophageal cancer epidemiology in blacks and whites: racial and gender disparities in incidence, mortality, survival rates and histology.

    PubMed Central

    Baquet, Claudia R.; Commiskey, Patricia; Mack, Kelly; Meltzer, Stephen; Mishra, Shiraz I.

    2005-01-01

    BACKGROUND: Esophageal cancer rate disparities are pronounced for blacks and whites. This study presents black-white esophageal cancer incidence, mortality, relative survival rates, histology and trends for two five-year time periods--1991-1995 and 1996-2000--and for the time period 1991-2000. METHODS: The study used data from the National Cancer Institute's population-based Surveillance Epidemiology End Results (SEER) program with submission dates 1991-2000. Age-adjusted incidence, mortality, relative survival rates and histology for esophageal carcinoma were calculated for nine SEER cancer registries for 1991-2000. Rates were analyzed by race and gender for changes over specified time periods. RESULTS: Esophageal cancer age-adjusted incidence of blacks was about twice that of whites (8.63 vs. 4.39/100,000, p < 0.05). Age-adjusted mortality for blacks, although showing a declining trend, was nearly twice that of whites (7.79 vs. 3.96, p < 0.05). Although survival was poor for all groups, it was significantly poorer in blacks than in whites. Squamous cell carcinoma was more commonly diagnosed in blacks and white females, whereas adenocarcinoma was more common among white males (p < 0.001). CONCLUSIONS: Racial disparities in esophageal cancer incidence, mortality, survival and histology exist. Survival rates from this disease have not significantly improved over the decade. These data support the need for advances in prevention, early detection biomarker research and research on new, more effective treatment modalities for this disease. Images Figure 1 PMID:16334494

  11. A simple risk stratification model that predicts 1-year postoperative mortality rate in patients with solid-organ cancer

    PubMed Central

    Chou, Wen-Chi; Wang, Frank; Cheng, Yu-Fan; Chen, Miao-Fen; Lu, Chang-Hsien; Wang, Cheng-Hsu; Lin, Yung-Chang; Yeh, Ta-Sen

    2015-01-01

    This study aimed to construct a scoring system developed exclusively from the preoperative data that predicts 1-year postoperative mortality in patients with solid cancers. A total of 20,632 patients who had a curative resection for solid-organ cancers between 2007 and 2012 at Chang Gung Memorial Hospital Linkou Medical Center were included in the derivation cohort. Multivariate logistic regression analysis was performed to develop a risk model that predicts 1-year postoperative mortality. Patients were then stratified into four risk groups (low-, intermediate-, high-, and very high-risk) according to the total score (0–43) form mortality risk analysis. An independent cohort of 16,656 patients who underwent curative cancer surgeries at three other hospitals during the same study period (validation cohort) was enrolled to verify the risk model. Age, gender, cancer site, history of previous cancer, tumor stage, Charlson comorbidity index, American Society of Anesthesiologist score, admission type, and Eastern Cooperative Oncology Group performance status were independently predictive of 1-year postoperative mortality. The 1-year postoperative mortality rates were 0.5%, 3.8%, 14.6%, and 33.8%, respectively, among the four risk groups in the derivation cohort (c-statistic, 0.80), compared with 0.9%, 4.2%, 14.6%, and 32.6%, respectively, in the validation cohort (c-statistic, 0.78). The risk stratification model also demonstrated good discrimination of long-term survival outcome of the four-tier risk groups (P < 0.01 for both cohorts). The risk stratification model not only predicts 1-year postoperative mortality but also differentiates long-term survival outcome between the risk groups. PMID:26311149

  12. A simple risk stratification model that predicts 1-year postoperative mortality rate in patients with solid-organ cancer.

    PubMed

    Chou, Wen-Chi; Wang, Frank; Cheng, Yu-Fan; Chen, Miao-Fen; Lu, Chang-Hsien; Wang, Cheng-Hsu; Lin, Yung-Chang; Yeh, Ta-Sen

    2015-11-01

    This study aimed to construct a scoring system developed exclusively from the preoperative data that predicts 1-year postoperative mortality in patients with solid cancers. A total of 20,632 patients who had a curative resection for solid-organ cancers between 2007 and 2012 at Chang Gung Memorial Hospital Linkou Medical Center were included in the derivation cohort. Multivariate logistic regression analysis was performed to develop a risk model that predicts 1-year postoperative mortality. Patients were then stratified into four risk groups (low-, intermediate-, high-, and very high-risk) according to the total score (0-43) form mortality risk analysis. An independent cohort of 16,656 patients who underwent curative cancer surgeries at three other hospitals during the same study period (validation cohort) was enrolled to verify the risk model. Age, gender, cancer site, history of previous cancer, tumor stage, Charlson comorbidity index, American Society of Anesthesiologist score, admission type, and Eastern Cooperative Oncology Group performance status were independently predictive of 1-year postoperative mortality. The 1-year postoperative mortality rates were 0.5%, 3.8%, 14.6%, and 33.8%, respectively, among the four risk groups in the derivation cohort (c-statistic, 0.80), compared with 0.9%, 4.2%, 14.6%, and 32.6%, respectively, in the validation cohort (c-statistic, 0.78). The risk stratification model also demonstrated good discrimination of long-term survival outcome of the four-tier risk groups (P < 0.01 for both cohorts). The risk stratification model not only predicts 1-year postoperative mortality but also differentiates long-term survival outcome between the risk groups.

  13. 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

  14. Decadal-scale rates of reef erosion following El Niño-related mass coral mortality.

    PubMed

    Roff, George; Zhao, Jian-Xin; Mumby, Peter J

    2015-12-01

    As the frequency and intensity of coral mortality events increase under climate change, understanding how declines in coral cover may affect the bioerosion of reef frameworks is of increasing importance. Here, we explore decadal-scale rates of bioerosion of the framework building coral Orbicella annularis by grazing parrotfish following the 1997/1998 El Niño-related mass mortality event at Long Cay, Belize. Using high-precision U-Th dating and CT scan analysis, we quantified in situ rates of external bioerosion over a 13-year period (1998-2011). Based upon the error-weighted average U-Th age of dead O. annularis skeletons, we estimate the average external bioerosion between 1998 and 2011 as 0.92 ± 0.55 cm depth. Empirical observations of herbivore foraging, and a nonlinear numerical response of parrotfish to an increase in food availability, were used to create a model of external bioerosion at Long Cay. Model estimates of external bioerosion were in close agreement with U-Th estimates (0.85 ± 0.09 cm). The model was then used to quantify how rates of external bioerosion changed across a gradient of coral mortality (i.e., from few corals experiencing mortality following coral bleaching to complete mortality). Our results indicate that external bioerosion is remarkably robust to declines in coral cover, with no significant relationship predicted between the rate of external bioerosion and the proportion of O. annularis that died in the 1998 bleaching event. The outcome was robust because the reduction in grazing intensity that follows coral mortality was compensated for by a positive numerical response of parrotfish to an increase in food availability. Our model estimates further indicate that for an O. annularis-dominated reef to maintain a positive state of reef accretion, a necessity for sustained ecosystem function, live cover of O. annularis must not drop below a ~5-10% threshold of cover.

  15. Decadal-scale rates of reef erosion following El Niño-related mass coral mortality.

    PubMed

    Roff, George; Zhao, Jian-Xin; Mumby, Peter J

    2015-12-01

    As the frequency and intensity of coral mortality events increase under climate change, understanding how declines in coral cover may affect the bioerosion of reef frameworks is of increasing importance. Here, we explore decadal-scale rates of bioerosion of the framework building coral Orbicella annularis by grazing parrotfish following the 1997/1998 El Niño-related mass mortality event at Long Cay, Belize. Using high-precision U-Th dating and CT scan analysis, we quantified in situ rates of external bioerosion over a 13-year period (1998-2011). Based upon the error-weighted average U-Th age of dead O. annularis skeletons, we estimate the average external bioerosion between 1998 and 2011 as 0.92 ± 0.55 cm depth. Empirical observations of herbivore foraging, and a nonlinear numerical response of parrotfish to an increase in food availability, were used to create a model of external bioerosion at Long Cay. Model estimates of external bioerosion were in close agreement with U-Th estimates (0.85 ± 0.09 cm). The model was then used to quantify how rates of external bioerosion changed across a gradient of coral mortality (i.e., from few corals experiencing mortality following coral bleaching to complete mortality). Our results indicate that external bioerosion is remarkably robust to declines in coral cover, with no significant relationship predicted between the rate of external bioerosion and the proportion of O. annularis that died in the 1998 bleaching event. The outcome was robust because the reduction in grazing intensity that follows coral mortality was compensated for by a positive numerical response of parrotfish to an increase in food availability. Our model estimates further indicate that for an O. annularis-dominated reef to maintain a positive state of reef accretion, a necessity for sustained ecosystem function, live cover of O. annularis must not drop below a ~5-10% threshold of cover. PMID:26113199

  16. Dampening effects of long-term experimental drought on growth and mortality rates of a Holm oak forest.

    PubMed

    Barbeta, Adrià; Ogaya, Romà; Peñuelas, Josep

    2013-10-01

    Forests respond to increasing intensities and frequencies of drought by reducing growth and with higher tree mortality rates. Little is known, however, about the long-term consequences of generally drier conditions and more frequent extreme droughts. A Holm oak forest was exposed to experimental rainfall manipulation for 13 years to study the effect of increasing drought on growth and mortality of the dominant species Quercus ilex, Phillyrea latifolia, and Arbutus unedo. The drought treatment reduced stem growth of A. unedo (-66.5%) and Q. ilex (-17.5%), whereas P. latifolia remained unaffected. Higher stem mortality rates were noticeable in Q. ilex (+42.3%), but not in the other two species. Stem growth was a function of the drought index of early spring in the three species. Stem mortality rates depended on the drought index of winter and spring for Q. ilex and in spring and summer for P. latifolia, but showed no relation to climate in A. unedo. Following a long and intense drought (2005-2006), stem growth of Q. ilex and P. latifolia increased, whereas it decreased in A. unedo. Q. ilex also enhanced its survival after this period. Furthermore, the effect of drought treatment on stem growth in Q. ilex and A. unedo was attenuated as the study progressed. These results highlight the different vulnerabilities of Mediterranean species to more frequent and intense droughts, which may lead to partial species substitution and changes in forest structure and thus in carbon uptake. The response to drought, however, changed over time. Decreased intra- and interspecific competition after extreme events with high mortality, together with probable morphological and physiological acclimation to drought during the study period, may, at least in the short term, buffer forests against drier conditions. The long-term effects of drought consequently deserve more attention, because the ecosystemic responses are unlikely to be stable over time.Nontechnical summaryIn this study, we

  17. Dampening effects of long-term experimental drought on growth and mortality rates of a Holm oak forest.

    PubMed

    Barbeta, Adrià; Ogaya, Romà; Peñuelas, Josep

    2013-10-01

    Forests respond to increasing intensities and frequencies of drought by reducing growth and with higher tree mortality rates. Little is known, however, about the long-term consequences of generally drier conditions and more frequent extreme droughts. A Holm oak forest was exposed to experimental rainfall manipulation for 13 years to study the effect of increasing drought on growth and mortality of the dominant species Quercus ilex, Phillyrea latifolia, and Arbutus unedo. The drought treatment reduced stem growth of A. unedo (-66.5%) and Q. ilex (-17.5%), whereas P. latifolia remained unaffected. Higher stem mortality rates were noticeable in Q. ilex (+42.3%), but not in the other two species. Stem growth was a function of the drought index of early spring in the three species. Stem mortality rates depended on the drought index of winter and spring for Q. ilex and in spring and summer for P. latifolia, but showed no relation to climate in A. unedo. Following a long and intense drought (2005-2006), stem growth of Q. ilex and P. latifolia increased, whereas it decreased in A. unedo. Q. ilex also enhanced its survival after this period. Furthermore, the effect of drought treatment on stem growth in Q. ilex and A. unedo was attenuated as the study progressed. These results highlight the different vulnerabilities of Mediterranean species to more frequent and intense droughts, which may lead to partial species substitution and changes in forest structure and thus in carbon uptake. The response to drought, however, changed over time. Decreased intra- and interspecific competition after extreme events with high mortality, together with probable morphological and physiological acclimation to drought during the study period, may, at least in the short term, buffer forests against drier conditions. The long-term effects of drought consequently deserve more attention, because the ecosystemic responses are unlikely to be stable over time.Nontechnical summaryIn this study, we

  18. Chemical characterization of indoor air of homes from communes in Xuan Wei, China, with high lung cancer mortality rate

    NASA Astrophysics Data System (ADS)

    Chuang, J. C.; Cao, S. R.; Xian, Y. L.; Harris, D. B.; Mumford, J. L.

    In a rural county, Xuan Wei, China, the lung cancer mortality rate is among China's highest, especially in women. This mortality rate is more associated with indoor air burning of smoky coal, as opposed to smokeless coal or wood, for cooking and heating under unvented conditions. Homes using different fuels from communes with high and low lung cancer mortality rates were sampled for particulate matter (< 10 μm) and semivolatile organics. The fine particles obtained from homes using smoky coal contained highest concentrations of organic matter (> 70%), including PAH, followed by homes using wood and smokeless coal. The major components present in the smoky coal filter samples were PAH and alkylated PAH. The smokeless coal filter samples exhibited profiles which were similar to the smoky coal samples except that some sulfur compounds were found. The estimated concentration levels of PAH in the smokeless coal samples were about one to two orders of magnitude lower than those of the smoky coal samples. In addition to PAH, aliphatic compounds and fatty acids were the major components found in the wood samples. Selected sample extracts from homes using smoky coal were fractionated into four fractions, and the results showed that the PAH and polar fractions have high mutagenic activity. Chemical characterization of the PAH fraction indicated that concentrations of some alkylated PAH were higher than those of their parent compounds. Chemical characterization of the polar fractions showed that nitrogen heterocyclic compounds are present.

  19. [Mortality rates by causes of deaths in the area aggregated by dyeing factories in Kyoto (author's transl)].

    PubMed

    Sugita, M; Yoshida, O; Miyakawa, M; Okada, Y; Oshiro, K; Yamaguchi, N; Tsuchiya, K

    1980-01-01

    In 1971 and 1973, Yoshida, et al. reported a higher relative risk of urinary bladder cancer among the workers of dyeing factories in Kyoto city. In order to confirm this, death certificates in Kyoto city from 1969 to 1972 were retrospectively investigated. Kyoto city was devided into three areas, that is, areas with high, medium and low clusterings of dyeing factories, and the differences of the mortality rates of all causes of deaths among these three areas were examined. As a result of this study, a statistically significant difference of the mortality rate of bladder cancer could not be found for males. But, the relative risk of bladder cancer in the areas with high and medium clusterings of dyeing factories compared to the area with low was found to be 1.45. Therefore, the relationship between dyeing work and bladder cancer could not necessarily be denied. It is, thus, necessary to carry out a prospective study, by which a more precise result can be obtained. In addition, our study revealed a significantly high mortality rate of skin cancer among the areas with high and medium clusterings of dyeing factories for males, observing a relative risk of 3.88. The observed association between skin cancer and dyeing work should be further studied.

  20. Mortality rates associated with crown health for eastern forest tree species.

    PubMed

    Morin, Randall S; Randolph, KaDonna C; Steinman, Jim

    2015-03-01

    The condition of tree crowns is an important indicator of tree and forest health. Crown conditions have been evaluated during inventories of the US Forest Service Forest Inventory and Analysis (FIA) program since 1999. In this study, remeasured data from 55,013 trees on 2616 FIA plots in the eastern USA were used to assess the probability of survival among various tree species using the suite of FIA crown condition variables. Logistic regression procedures were employed to develop models for predicting tree survival. Results of the regression analyses indicated that crown dieback was the most important crown condition variable for predicting tree survival for all species combined and for many of the 15 individual species in the study. The logistic models were generally successful in representing recent tree mortality responses to multiyear infestations of beech bark disease and hemlock woolly adelgid. Although our models are only applicable to trees growing in a forest setting, the utility of models that predict impending tree mortality goes beyond forest inventory or traditional forestry growth and yield models and includes any application where managers need to assess tree health or predict tree mortality including urban forest, recreation, wildlife, and pest management.

  1. Heart Rate Variability Change Before and After Hemodialysis is Associated with Overall and Cardiovascular Mortality in Hemodialysis

    PubMed Central

    Chen, Szu-Chia; Huang, Jiun-Chi; Tsai, Yi-Chun; Hsiu-Chin Mai, R. N.; Jui-Hsin Chen, R. N.; Kuo, Po-Lin; Chang, Jer-Ming; Hwang, Shang-Jyh; Chen, Hung-Chun

    2016-01-01

    Low heart rate variability (HRV) has been recognized to correlate with adverse cardiovascular (CV) outcomes in hemodialysis (HD) patients. It has been reported that HRV might be improved after HD, but whether the improved HRV after HD predicts a better CV prognosis remains to be determined. This study examined the ability of the change in HRV before and after HD in predicting overall and CV mortality in HD patients. This study enrolled 182 patients under maintenance HD. HRV was examined to assess changes before and after HD. The change in HRV (ΔHRV) was defined as post-HD HRV minus pre-HD HRV. During a median follow-up period of 35.2 months, 29 deaths (15.9%) were recorded. Multivariate analysis showed that decreased ΔLF% was associated with increased overall (hazard ratios [HR], 0.978; 95% confidence interval [CI], 0.961–0.996; p = 0.019) and CV mortality (HR, 0.941; 95% CI, 0.914–0.970; p < 0.001), respectively. Moreover, adding ΔLF% to a clinical model provided an additional benefit in the prediction of overall (p = 0.002) and CV mortality (p < 0.001). HRV change before and after HD (ΔHRV) is an useful clinical marker, and it is stronger than HRV before HD in predicting overall and CV mortality. PMID:26854202

  2. Standard First Aid Training Course. Naval Education and Training Command Rate Training Manual.

    ERIC Educational Resources Information Center

    Naval Education and Training Command, Washington, DC.

    This first aid manual is designed to serve as basic first aid instructional materials for all nonmedical naval personnel. Chapters are included on the following topics: basic life support, hemorrhage, shock, wounds, injuries, drug abuse, poisoning, common medical emergencies, NBC (nuclear, biological, chemical) agent casualties, and rescue and…

  3. Here Today, Gone Tomorrow? Investigating Rates and Patterns of Financial Aid Renewal among College Freshmen

    ERIC Educational Resources Information Center

    Bird, Kelli; Castleman, Benjamin L.

    2016-01-01

    College affordability continues to be a top concern among prospective students, their families, and policy makers. Prior work has demonstrated that a significant share of prospective students forgo financial aid because they did not complete the Free Application for Federal Student Aid (FAFSA); recent federal policy efforts have focused on…

  4. The effects of dosage and the routes of administrations of streptozotocin and alloxan on induction rate of type1 diabetes mellitus and mortality rate in rats

    PubMed Central

    Mostafavinia, Ataroalsadat; Amini, Abdodlah; Ghorishi, Seyed Kamran; Pouriran, Ramin

    2016-01-01

    The approach and novelty of this scientific work was to formulate the appropriate Streptozotocin (STZ) and Alloxan dosage in different routes of administration to imply minimum mortality rate and high incidence of diabetes mellitus (DM) in the rat experiment model. Rats were randomly divided into STZ, Alloxan and control groups. 1-Alloxan group was divided into two subgroups: intraperitoneal (ip) subgroups which received a single dose of, 140, 120, 100 and 80 mg/kg; and the subcutaneous (sc) subgroups which received a single dose of, 120, 110, 100, 90, and 80 mg/kg. 2-STZ group was divided into four subgroups of ip route. The ip subgroup which received intraperitoneally a single dose of, 30, 35, 40 and 50 mg/kg. 3-The control group: This group received solo distilled water. The injection day was considered as the day zero. Blood glucose levels and mortality rate were recorded. Subsequently, 30 days after, the logistic regression modeling was used to evaluate the effect of the explanatory variables, the dose levels, and route approaches, on the probability of DM incidence, and mortality. According to the statistical logistic analysis for Alloxan, it is concluded that the minimum dosage needed to induce DM was 120 mg/kg by sc method (probability 0.712). In addition, the logistic analysis for STZ showed that the optimal dose-level for STZ was 40 mg/kg with ip with approximate induction of DM probability 0.764. Based on the data, male Wistar rats in which received a single dosage of Alloxan by sc injection at dose of 120 mg/kg showed the most desirable result of induction of type I DM; furthermore, those in which received STZ by ip injection at the dose of 40 mg/kg developed a persistent and optimal DM state characterized by high rate of DM induction and low- level of mortality. PMID:27729932

  5. Elevated Erythrocyte Sedimentation Rate Is Predictive of Interstitial Lung Disease and Mortality in Dermatomyositis: a Korean Retrospective Cohort Study

    PubMed Central

    2016-01-01

    Interstitial lung disease (ILD) is a major cause of death in patients with dermatomyositis (DM). This study was aimed to examine the utility of the erythrocyte sedimentation rate (ESR) as a predictor of ILD and prognostic marker of mortality in patients with DM. One hundred-and-fourteen patients with DM were examined, including 28 with clinically amyopathic DM (CADM). A diagnosis of ILD was made based on high resolution computed tomography (HRCT) scans. The association between elevated ESR and pulmonary impairment and mortality was then examined. ILD was diagnosed in 53 (46.5%) of 114 DM patients. Cancer was diagnosed in 2 (3.8%) of 53 DM patients with ILD and in 24 (92.3%) of those without ILD (P < 0.001). The median ESR (50.0 mm/hour) in patients with ILD was significantly higher than that in patients without ILD (29.0 mm/hour; P < 0.001). ESR was inversely correlated with forced vital capacity (Spearman ρ = - 0.303; P = 0.007) and carbon monoxide diffusing capacity (ρ = - 0.319; P = 0.006). DM patients with baseline ESR ≥ 30 mm/hour had significantly higher mortality than those with ESR < 30 mm/hour (P = 0.002, log-rank test). Patients with a persistently high ESR despite immunosuppressive therapy was associated with higher mortality than those with a normalized ESR (P = 0.039, log-rank test). Elevated ESR is associated with increased mortality in patients with DM due to respiratory failure. Thus, monitoring ESR should be an integral part of the clinical care of DM patients. PMID:26955239

  6. Fine Root Mortality Rates in a Temperate Forest: Estimates using Radiocarbon Data and Numerical Modeling

    SciTech Connect

    Riley, William J.; Gaudinski, Julia B.; Torn, Margaret S.; JoslinJr., John D.; Hanson, Paul J

    2009-01-01

    Carbon (C) fluxes through roots are the most uncertain of all C exchanges between the atmosphere, plants, and soil. Yet the three dominant methods to characterize root C fluxes (minirhizotron, sequential coring, and isotopes) yield significantly different estimates of temperate forest root mortality turnover times. We contend that these discrepancies result from limitations in interpreting these very distinct types of observations. In this study we used a whole-ecosystem 14C label to develop, parameterize, and test a model (Radix1.0) of fine-root mortality and decomposition. Radix simulates two live roots pools (one with structural and non-structural C components), two dead root pools, non-normally distributed root mortality turnover times, a stored C pool, seasonal growth and respiration patterns, a best-fit to measurements approach to estimate model parameters, and Monte Carlo uncertainty analysis. We applied Radix at a temperate forest in Oak Ridge Tennessee using 14C measurements from two root size classes (<0.5 mm and 0.5−2.0 mm) and three soil depth increments (O horizon, 0−15, and 30−60 cm). Predicted root lifetimes were 0.1-0.9 y and 11-14 y for fast and slow live root pools respectively, and 0.1-4 y and 11-14 y for fast and slow dead root pool decomposition turnover times, respectively. We estimated that C fluxes through fine roots <2 mm diameter are ~40, 220, and 90 g C m-2 y 1 in the O horizon, 0−15 cm, and 30−60 cm depth intervals, respectively. We conclude that accurate characterization of C flows through fine roots required a model with two live fine-root pools, two dead fine-root pools, and root respiration. Further, root turnover times on the order of a decade imply different response times in biomass and growth than are currently predicted by models with a single annual turnover pool.

  7. The incidence rate and mortality of malignant brain tumors after 10 years of intensive cell phone use in Taiwan.

    PubMed

    Hsu, Min-Huei; Syed-Abdul, Shabbir; Scholl, Jeremiah; Jian, Wen-Shan; Lee, Peisan; Iqbal, Usman; Li, Yu-Chuan

    2013-11-01

    The issue of whether cell phone usage can contribute toward the development of brain tumors has recently been reignited with the International Agency for Research on Cancer classifying radiofrequency electromagnetic fields as 'possibly' carcinogenic to humans in a WHO report. To our knowledge, this is the largest study reporting on the incidence and mortality of malignant brain tumors after long-term use of the cell phone by more than 23 million users. A population-based study was carried out the numbers of cell phone users were collected from the official statistics provided by the National Communication Commission. According to National Cancer Registry, there were 4 incidences and 4 deaths due to malignant neoplasms in Taiwan during the period 2000-2009. The 10 years of observational data show that the intensive user rate of cell phones has had no significant effect on the incidence rate or on the mortality of malignant brain tumors in Taiwan. In conclusion, we do not detect any correlation between the morbidity/mortality of malignant brain tumors and cell phone use in Taiwan. We thus urge international agencies to publish only confirmatory reports with more applicable conclusions in public. This will help spare the public from unnecessary worries.

  8. Multi-scale heart rate dynamics detected by phase-rectified signal averaging predicts mortality after acute myocardial infarction

    PubMed Central

    Kisohara, Masaya; Stein, Phyllis K.; Yoshida, Yutaka; Suzuki, Mari; Iizuka, Narushi; Carney, Robert M.; Watkins, Lana L.; Freedland, Kenneth E.; Blumenthal, James A.; Hayano, Junichiro

    2013-01-01

    Aims Acceleration and deceleration capacity (AC and DC) for beat-to-beat short-term heart rate dynamics are powerful predictors of mortality after acute myocardial infarction (AMI). We examined if AC and DC for minute-order long-term heart rate dynamics also have independent predictive value. Methods and results We studied 24-hr Holter electrcardiograms in 708 post-AMI patients who were followed up for up to 30 months thereafter. Acceleration capacity and DC was calculated with the time scales of T (window size defining heart rate) and s (wavelet scale) from 1 to 500 s and compared their prognostic values with conventional measures (ACconv and DCconv) that were calculated with (T,s) = [1,2 (beat)]. During the follow-up, 47 patients died. Both increased ACconv and decreased DCconv predicted mortality (C statistic, 0.792 and 0.797). Concordantly, sharp peaks of C statistics were observed at (T,s) = [2,7 (sec)] for both increased AC and decreased DC (0.762 and 0.768), but there were larger peaks of C statistics at around [30,60 (sec)] for both (0.783 and 0.796). The C statistic was greater for DC than AC at (30,60) (P = 0.0012). Deceleration capacity at (30,60) was a significant predictor even after adjusted for ACconv (P = 0.020) and DCconv (P = 0.028), but the predictive power of AC at (30,60) was no longer significant. Conclusion A decrease in DC for minute-order long-term heart rate dynamics is a strong predictor for post-AMI mortality and the predictive power is independent of ACconv and DCconv for beat-to-beat short-term heart rate dynamics. PMID:23248218

  9. What is self-rated health and why does it predict mortality? Towards a unified conceptual model.

    PubMed

    Jylhä, Marja

    2009-08-01

    The association of self-rated health with mortality is well established but poorly understood. This paper provides new insights into self-rated health that help integrate information from different disciplines, both social and biological, into one unified conceptual framework. It proposes, first, a model describing the health assessment process to show how self-rated health can reflect the states of the human body and mind. Here, an analytic distinction is made between the different types of information on which people base their health assessments and the contextual frameworks in which this information is evaluated and summarized. The model helps us understand why self-ratings of health may be modified by age or culture, but still be a valid measure of health status. Second, based on the proposed model, the paper examines the association of self-rated health with mortality. The key question is, what do people know and how do they know what they know that makes self-rated health such an inclusive and universal predictor of the most absolute biological event, death. The focus is on the social and biological pathways that mediate information from the human organism to individual consciousness, thus incorporating that information into self-ratings of health. A unique source of information is provided by the bodily sensations that are directly available only to the individual him- or herself. According to recent findings in human biology, these sensations may reflect important physiological dysregulations, such as inflammatory processes. Third, the paper discusses the advantages and limitations of self-rated health as a measure of health in research and clinical practice. Future research should investigate both the logics that govern people's reasoning about their health and the physiological processes that underlie bodily feelings and sensations. Self-rated health lies at the cross-roads of culture and biology, therefore a collaborative effort between different

  10. Tag return models allowing for harvest and catch and release: Evidence of environmental and management impacts on striped bass fishing and natural mortality rates

    USGS Publications Warehouse

    Jiang, H.; Pollock, K.H.; Brownie, C.; Hoenig, J.M.; Latour, R.J.; Wells, B.K.; Hightower, J.E.

    2007-01-01

    Catch-and-release fisheries have become very important in the management of overexploited recreational fish stocks. Tag return studies, where the tag is removed regardless of fish disposition, have been used to assess the effectiveness of restoration efforts for these fisheries. We extend the instantaneous rate formulation of tag return models to allow for catch and release as well as harvest. The key point of our methods is that, given an estimate of the tag reporting rate, the fishing mortality rate (F) is separated into two components: the mortality on harvested fish and the "mortality" on tags (because the lags are removed) of fish released alive. The total fishing mortality rate for untagged fish is the sum of the Fs due to harvest and hooking mortality suffered by fish released alive. Natural mortality rates can also be estimated. Both age-independent models and age-dependent models are constructed, and the age-dependent models are illustrated by application to data from a study of striped bass Morone saxatilis in Chesapeake Bay from 1991 to 2003 by the Maryland Department of Natural Resources. By fitting models of the natural mortality rate with limited age and year dependence, we demonstrate an overall decrease in natural mortality rates as fish age and provide evidence of an increase in natural mortality beginning in the late 1990s, when an outbreak of the disease mycobacteriosis is thought to have begun. Our results indicate that fishing mortality is age dependent; selectivity increases up to age 6, when fish appear to be fully recruited to the fishery. There is also evidence of an increase in fishing mortality since 1995, when regulations were relaxed. ?? Copyright by the American Fisheries Society 2007.

  11. Restructuring fundamental predator-prey models by recognising prey-dependent conversion efficiency and mortality rates.

    PubMed

    Li, Jiqiu; Montagnes, David J S

    2015-05-01

    Incorporating protozoa into population models (from simple predator-prey explorations to complex food web simulations) is of conceptual, ecological, and economic importance. From theoretical and empirical perspectives, we expose unappreciated complexity in the traditional predator-prey model structure and provide a parsimonious solution, especially for protistologists. We focus on how prey abundance alters two key components of models: predator conversion efficiency (e, the proportion of prey converted to predator, before mortality loss) and predator mortality (δ, the portion of the population lost though death). Using a well-established model system (Paramecium and Didinium), we collect data to parameterize a range of existing and novel population models that differ in the functional forms of e and δ. We then compare model simulations to an empirically obtained time-series of predator-prey population dynamics. The analysis indicates that prey-dependent e and δ should be considered when structuring population models and that both prey and predator biomass also vary with prey abundance. Both of these impact the ability of the model to predict population dynamics and, therefore, should be included in theoretical model evaluations and assessment of ecosystem dynamics associated with biomass flux. PMID:25819465

  12. Restructuring fundamental predator-prey models by recognising prey-dependent conversion efficiency and mortality rates.

    PubMed

    Li, Jiqiu; Montagnes, David J S

    2015-05-01

    Incorporating protozoa into population models (from simple predator-prey explorations to complex food web simulations) is of conceptual, ecological, and economic importance. From theoretical and empirical perspectives, we expose unappreciated complexity in the traditional predator-prey model structure and provide a parsimonious solution, especially for protistologists. We focus on how prey abundance alters two key components of models: predator conversion efficiency (e, the proportion of prey converted to predator, before mortality loss) and predator mortality (δ, the portion of the population lost though death). Using a well-established model system (Paramecium and Didinium), we collect data to parameterize a range of existing and novel population models that differ in the functional forms of e and δ. We then compare model simulations to an empirically obtained time-series of predator-prey population dynamics. The analysis indicates that prey-dependent e and δ should be considered when structuring population models and that both prey and predator biomass also vary with prey abundance. Both of these impact the ability of the model to predict population dynamics and, therefore, should be included in theoretical model evaluations and assessment of ecosystem dynamics associated with biomass flux.

  13. Assessing and mapping spatial associations among oral cancer mortality rates, concentrations of heavy metals in soil, and land use types based on multiple scale data.

    PubMed

    Lin, Wei-Chih; Lin, Yu-Pin; Wang, Yung-Chieh; Chang, Tsun-Kuo; Chiang, Li-Chi

    2014-02-21

    In this study, a deconvolution procedure was used to create a variogram of oral cancer (OC) rates. Based on the variogram, area-to-point (ATP) Poisson kriging and p-field simulation were used to downscale and simulate, respectively, the OC rate data for Taiwan from the district scale to a 1 km × 1 km grid scale. Local cluster analysis (LCA) of OC mortality rates was then performed to identify OC mortality rate hot spots based on the downscaled and the p-field-simulated OC mortality maps. The relationship between OC mortality and land use was studied by overlapping the maps of the downscaled OC mortality, the LCA results, and the land uses. One thousand simulations were performed to quantify local and spatial uncertainties in the LCA to identify OC mortality hot spots. The scatter plots and Spearman's rank correlation yielded the relationship between OC mortality and concentrations of the seven metals in the 1 km cell grid. The correlation analysis results for the 1 km scale revealed a weak correlation between OC mortality rate and concentrations of the seven studied heavy metals in soil. Accordingly, the heavy metal concentrations in soil are not major determinants of OC mortality rates at the 1 km scale at which soils were sampled. The LCA statistical results for local indicator of spatial association (LISA) revealed that the sites with high probability of high-high (high value surrounded by high values) OC mortality at the 1 km grid scale were clustered in southern, eastern, and mid-western Taiwan. The number of such sites was also significantly higher on agricultural land and in urban regions than on land with other uses. The proposed approach can be used to downscale and evaluate uncertainty in mortality data from a coarse scale to a fine scale at which useful additional information can be obtained for assessing and managing land use and risk.

  14. Assessing and Mapping Spatial Associations among Oral Cancer Mortality Rates, Concentrations of Heavy Metals in Soil, and Land Use Types Based on Multiple Scale Data

    PubMed Central

    Lin, Wei-Chih; Lin, Yu-Pin; Wang, Yung-Chieh; Chang, Tsun-Kuo; Chiang, Li-Chi

    2014-01-01

    In this study, a deconvolution procedure was used to create a variogram of oral cancer (OC) rates. Based on the variogram, area-to-point (ATP) Poisson kriging and p-field simulation were used to downscale and simulate, respectively, the OC rate data for Taiwan from the district scale to a 1 km × 1 km grid scale. Local cluster analysis (LCA) of OC mortality rates was then performed to identify OC mortality rate hot spots based on the downscaled and the p-field-simulated OC mortality maps. The relationship between OC mortality and land use was studied by overlapping the maps of the downscaled OC mortality, the LCA results, and the land uses. One thousand simulations were performed to quantify local and spatial uncertainties in the LCA to identify OC mortality hot spots. The scatter plots and Spearman’s rank correlation yielded the relationship between OC mortality and concentrations of the seven metals in the 1 km cell grid. The correlation analysis results for the 1 km scale revealed a weak correlation between OC mortality rate and concentrations of the seven studied heavy metals in soil. Accordingly, the heavy metal concentrations in soil are not major determinants of OC mortality rates at the 1 km scale at which soils were sampled. The LCA statistical results for local indicator of spatial association (LISA) revealed that the sites with high probability of high-high (high value surrounded by high values) OC mortality at the 1 km grid scale were clustered in southern, eastern, and mid-western Taiwan. The number of such sites was also significantly higher on agricultural land and in urban regions than on land with other uses. The proposed approach can be used to downscale and evaluate uncertainty in mortality data from a coarse scale to a fine scale at which useful additional information can be obtained for assessing and managing land use and risk. PMID:24566045

  15. Association of electronic fetal monitoring during labor with cesarean section rate and with neonatal morbidity and mortality.

    PubMed Central

    McCusker, J; Harris, D R; Hosmer, D W

    1988-01-01

    Data from the 1980 National Natality Survey by the National Center for Health Statistics were used to assess the relation of electronic fetal monitoring (EFM) during labor with cesarean section rates and neonatal morbidity and mortality. In univariate analyses, EFM was associated with higher cesarean section rates, lower five-minute Apgar scores, and a higher rate of respiratory distress. Logistic regression analysis controlling for other risk factors for poor neonatal outcome indicated that the association of EFM with higher cesarean section rates persisted (odds ratio 1.45, 95% CI 1.16, 1.81), except in certain pregnancies at very high risk for cesarean section. EFM was associated with an Apgar score less than 6 at five minutes only if delivery was by cesarean section. EFM was not found to be independently associated with respiratory distress. Neither univariate nor multivariate analyses found an association of EFM with neonatal mortality. These results suggest that EFM may identify hypoxic infants, who are frequently delivered by cesarean section. The lack of association of EFM with beneficial neonatal outcomes is consistent either with lack of effect of EFM or with uncontrolled selection bias. PMID:3407813

  16. Mortality, Recurrence, and Dependency Rates Are Higher after Acute Ischemic Stroke in Elderly Patients with Diabetes Compared to Younger Patients.

    PubMed

    Long, Xue; Lou, Yongzhong; Gu, Hongfei; Guo, Xiaofei; Wang, Tao; Zhu, Yanxia; Zhao, Wenjuan; Ning, Xianjia; Li, Bin; Wang, Jinghua; An, Zhongping

    2016-01-01

    Stroke has a greater effect on the elderly than on younger patients. However, the long-term outcomes associated with stroke among elderly patients with diabetes are unknown. We aimed to assess the differences in long-term outcomes between young and elderly stroke patients with diabetes. A total of 3,615 acute ischemic stroke patients with diabetes were recruited for this study between 2006 and 2014. Outcomes at 12 and 36 months after stroke (including mortality, recurrence, and dependency) were compared between younger (age <75 years) and elderly (age ≥75 years) patients. The elderly group included 692 patients (19.1%) overall. Elderly patients were more likely than younger patients to have a Trial of Org 10172 in Acute Stroke Treatment classification of stroke due to cardioembolism, moderate and severe stroke, and atrial fibrillation, but less likely to have hypertension and dyslipidemia, current smokers, and alcohol consumers. Mortality, dependency, and recurrence rates at 12 months after stroke were 19.0, 48.5, and 20.9% in the elderly group and 7.4, 30.9, and 15.4% in the younger group, respectively (all P < 0.05). Corresponding rates at 36 months after stroke were 35.4, 78.7, and 53.8% in the elderly group and 13.7, 61.7, and 43.0% in the younger group, respectively (all P < 0.001). The mortality, dependency, and recurrence rates at 12 and 36 months after stroke were significantly higher in the elderly group than in the younger group after adjusting for stroke subtypes, stroke severity, and risk factors. Odds ratios (95% confidence interval) at 12 and 36 months after stroke were 2.18 (1.64-2.89) and 3.10 (2.35-4.08), respectively, for mortality, all P < 0.001; 1.81 (1.49-2.20) and 2.04 (1.57-2.34), respectively, for dependency, all P < 0.001; and 1.37 (1.06-1.76) and 1.40 (1.07-1.85), respectively, for recurrence, P = 0.016. The findings from this study suggest that management and secondary prevention should be emphasized in elderly patients with diabetes in

  17. Mortality, Recurrence, and Dependency Rates Are Higher after Acute Ischemic Stroke in Elderly Patients with Diabetes Compared to Younger Patients

    PubMed Central

    Long, Xue; Lou, Yongzhong; Gu, Hongfei; Guo, Xiaofei; Wang, Tao; Zhu, Yanxia; Zhao, Wenjuan; Ning, Xianjia; Li, Bin; Wang, Jinghua; An, Zhongping

    2016-01-01

    Stroke has a greater effect on the elderly than on younger patients. However, the long-term outcomes associated with stroke among elderly patients with diabetes are unknown. We aimed to assess the differences in long-term outcomes between young and elderly stroke patients with diabetes. A total of 3,615 acute ischemic stroke patients with diabetes were recruited for this study between 2006 and 2014. Outcomes at 12 and 36 months after stroke (including mortality, recurrence, and dependency) were compared between younger (age <75 years) and elderly (age ≥75 years) patients. The elderly group included 692 patients (19.1%) overall. Elderly patients were more likely than younger patients to have a Trial of Org 10172 in Acute Stroke Treatment classification of stroke due to cardioembolism, moderate and severe stroke, and atrial fibrillation, but less likely to have hypertension and dyslipidemia, current smokers, and alcohol consumers. Mortality, dependency, and recurrence rates at 12 months after stroke were 19.0, 48.5, and 20.9% in the elderly group and 7.4, 30.9, and 15.4% in the younger group, respectively (all P < 0.05). Corresponding rates at 36 months after stroke were 35.4, 78.7, and 53.8% in the elderly group and 13.7, 61.7, and 43.0% in the younger group, respectively (all P < 0.001). The mortality, dependency, and recurrence rates at 12 and 36 months after stroke were significantly higher in the elderly group than in the younger group after adjusting for stroke subtypes, stroke severity, and risk factors. Odds ratios (95% confidence interval) at 12 and 36 months after stroke were 2.18 (1.64–2.89) and 3.10 (2.35–4.08), respectively, for mortality, all P < 0.001; 1.81 (1.49–2.20) and 2.04 (1.57–2.34), respectively, for dependency, all P < 0.001; and 1.37 (1.06–1.76) and 1.40 (1.07–1.85), respectively, for recurrence, P = 0.016. The findings from this study suggest that management and secondary prevention should be emphasized in elderly patients with

  18. Mortality, Recurrence, and Dependency Rates Are Higher after Acute Ischemic Stroke in Elderly Patients with Diabetes Compared to Younger Patients.

    PubMed

    Long, Xue; Lou, Yongzhong; Gu, Hongfei; Guo, Xiaofei; Wang, Tao; Zhu, Yanxia; Zhao, Wenjuan; Ning, Xianjia; Li, Bin; Wang, Jinghua; An, Zhongping

    2016-01-01

    Stroke has a greater effect on the elderly than on younger patients. However, the long-term outcomes associated with stroke among elderly patients with diabetes are unknown. We aimed to assess the differences in long-term outcomes between young and elderly stroke patients with diabetes. A total of 3,615 acute ischemic stroke patients with diabetes were recruited for this study between 2006 and 2014. Outcomes at 12 and 36 months after stroke (including mortality, recurrence, and dependency) were compared between younger (age <75 years) and elderly (age ≥75 years) patients. The elderly group included 692 patients (19.1%) overall. Elderly patients were more likely than younger patients to have a Trial of Org 10172 in Acute Stroke Treatment classification of stroke due to cardioembolism, moderate and severe stroke, and atrial fibrillation, but less likely to have hypertension and dyslipidemia, current smokers, and alcohol consumers. Mortality, dependency, and recurrence rates at 12 months after stroke were 19.0, 48.5, and 20.9% in the elderly group and 7.4, 30.9, and 15.4% in the younger group, respectively (all P < 0.05). Corresponding rates at 36 months after stroke were 35.4, 78.7, and 53.8% in the elderly group and 13.7, 61.7, and 43.0% in the younger group, respectively (all P < 0.001). The mortality, dependency, and recurrence rates at 12 and 36 months after stroke were significantly higher in the elderly group than in the younger group after adjusting for stroke subtypes, stroke severity, and risk factors. Odds ratios (95% confidence interval) at 12 and 36 months after stroke were 2.18 (1.64-2.89) and 3.10 (2.35-4.08), respectively, for mortality, all P < 0.001; 1.81 (1.49-2.20) and 2.04 (1.57-2.34), respectively, for dependency, all P < 0.001; and 1.37 (1.06-1.76) and 1.40 (1.07-1.85), respectively, for recurrence, P = 0.016. The findings from this study suggest that management and secondary prevention should be emphasized in elderly patients with diabetes in

  19. Disparities in rates of inpatient mortality and adverse events: race/ethnicity and language as independent contributors.

    PubMed

    Hines, Anika L; Andrews, Roxanne M; Moy, Ernest; Barrett, Marguerite; Coffey, Rosanna M

    2014-12-01

    Patients with limited English proficiency have known limitations accessing health care, but differences in hospital outcomes once access is obtained are unknown.We investigate inpatient mortality rates and obstetric trauma for self-reported speakers of English, Spanish, and languages of Asia and the Pacific Islands (API) and compare quality of care by language with patterns by race/ethnicity. Data were from the United States Agency for Healthcare Research and Quality, Healthcare Cost and Utilization Project,2009 State Inpatient Databases for California. There were 3,757,218 records. Speaking a non-English principal language and having a non-White race/ethnicity did not place patients at higher risk for inpatient mortality; the exception was significantly higher stroke mortality for Japanese-speaking patients. Patients who spoke API languages or had API race/ethnicity had higher risk for obstetric trauma than English-speaking White patients.Spanish-speaking Hispanic patients had more obstetric trauma than English-speaking Hispanic patients. The influence of language on obstetric trauma and the potential effects of interpretation services on inpatient care are discussed. The broader context of policy implications for collection and reporting of language data is also presented. Results from other countries with and without English as a primary language are needed for the broadest interpretation and generalization of outcomes.

  20. Prostate cancer in South Africa: pathology based national cancer registry data (1986-2006) and mortality rates (1997-2009).

    PubMed

    Babb, Chantal; Urban, Margaret; Kielkowski, Danuta; Kellett, Patricia

    2014-01-01

    Prostate cancer is one of the most common male cancers globally; however little is known about prostate cancer in Africa. Incidence data for prostate cancer in South Africa (SA) from the pathology based National Cancer Registry (1986-2006) and data on mortality (1997-2009) from Statistics SA were analysed. World standard population denominators were used to calculate age specific incidence and mortality rates (ASIR and ASMR) using the direct method. Prostate cancer was the most common male cancer in all SA population groups (excluding basal cell carcinoma). There are large disparities in the ASIR between black, white, coloured, and Asian/Indian populations: 19, 65, 46, and 19 per 100 000, respectively, and ASMR was 11, 7, 52, and 6 per 100 000, respectively. Prostate cancer was the second leading cause of cancer death, accounting for around 13% of male deaths from a cancer. The average age at diagnosis was 68 years and 74 years at death. For SA the ASIR increased from 16.8 in 1986 to 30.8 in 2006, while the ASMR increased from 12.3 in 1997 to 16.7 in 2009. There has been a steady increase of incidence and mortality from prostate cancer in SA. PMID:24955252

  1. Disparities in Rates of Inpatient Mortality and Adverse Events: Race/Ethnicity and Language as Independent Contributors

    PubMed Central

    Hines, Anika L.; Andrews, Roxanne M.; Moy, Ernest; Barrett, Marguerite L.; Coffey, Rosanna M.

    2014-01-01

    Patients with limited English proficiency have known limitations accessing health care, but differences in hospital outcomes once access is obtained are unknown. We investigate inpatient mortality rates and obstetric trauma for self-reported speakers of English, Spanish, and languages of Asia and the Pacific Islands (API) and compare quality of care by language with patterns by race/ethnicity. Data were from the United States Agency for Healthcare Research and Quality, Healthcare Cost and Utilization Project, 2009 State Inpatient Databases for California. There were 3,757,218 records. Speaking a non-English principal language and having a non-White race/ethnicity did not place patients at higher risk for inpatient mortality; the exception was significantly higher stroke mortality for Japanese-speaking patients. Patients who spoke API languages or had API race/ethnicity had higher risk for obstetric trauma than English-speaking White patients. Spanish-speaking Hispanic patients had more obstetric trauma than English-speaking Hispanic patients. The influence of language on obstetric trauma and the potential effects of interpretation services on inpatient care are discussed. The broader context of policy implications for collection and reporting of language data is also presented. Results from other countries with and without English as a primary language are needed for the broadest interpretation and generalization of outcomes. PMID:25514153

  2. Desiccation as a mitigation tool to manage biofouling risks: trials on temperate taxa to elucidate factors influencing mortality rates.

    PubMed

    Hopkins, Grant A; Prince, Madeleine; Cahill, Patrick L; Fletcher, Lauren M; Atalah, Javier

    2016-01-01

    The desiccation tolerance of biofouling taxa (adults and early life-stages) was determined under both controlled and 'realistic' field conditions. Adults of the ascidian Ciona spp. died within 24 h. Mortality in the adult blue mussel Mytilus galloprovincialis occurred within 11 d under controlled conditions, compared with 7 d when held outside. The Pacific oyster Crassostrea gigas was the most desiccation-tolerant taxon tested (up to 34 d under controlled conditions). Biofouling orientated to direct sunlight showed faster mortality rates for all the taxa tested. Mortality in Mytilus juveniles took up to 24 h, compared with 8 h for Ciona, with greater survival at the higher temperature (18.5°C) and humidity (~95% RH) treatment combination. This study demonstrated that desiccation can be an effective mitigation method for a broad range of fouling taxa, especially their early life-stages. Further work is necessary to assess risks from other high-risk species such as algae and cyst forming species. PMID:26691450

  3. Disparities in rates of inpatient mortality and adverse events: race/ethnicity and language as independent contributors.

    PubMed

    Hines, Anika L; Andrews, Roxanne M; Moy, Ernest; Barrett, Marguerite L; Coffey, Rosanna M

    2014-01-01

    Patients with limited English proficiency have known limitations accessing health care, but differences in hospital outcomes once access is obtained are unknown. We investigate inpatient mortality rates and obstetric trauma for self-reported speakers of English, Spanish, and languages of Asia and the Pacific Islands (API) and compare quality of care by language with patterns by race/ethnicity. Data were from the United States Agency for Healthcare Research and Quality, Healthcare Cost and Utilization Project, 2009 State Inpatient Databases for California. There were 3,757,218 records. Speaking a non-English principal language and having a non-White race/ethnicity did not place patients at higher risk for inpatient mortality; the exception was significantly higher stroke mortality for Japanese-speaking patients. Patients who spoke API languages or had API race/ethnicity had higher risk for obstetric trauma than English-speaking White patients. Spanish-speaking Hispanic patients had more obstetric trauma than English-speaking Hispanic patients. The influence of language on obstetric trauma and the potential effects of interpretation services on inpatient care are discussed. The broader context of policy implications for collection and reporting of language data is also presented. Results from other countries with and without English as a primary language are needed for the broadest interpretation and generalization of outcomes.

  4. Desiccation as a mitigation tool to manage biofouling risks: trials on temperate taxa to elucidate factors influencing mortality rates.

    PubMed

    Hopkins, Grant A; Prince, Madeleine; Cahill, Patrick L; Fletcher, Lauren M; Atalah, Javier

    2016-01-01

    The desiccation tolerance of biofouling taxa (adults and early life-stages) was determined under both controlled and 'realistic' field conditions. Adults of the ascidian Ciona spp. died within 24 h. Mortality in the adult blue mussel Mytilus galloprovincialis occurred within 11 d under controlled conditions, compared with 7 d when held outside. The Pacific oyster Crassostrea gigas was the most desiccation-tolerant taxon tested (up to 34 d under controlled conditions). Biofouling orientated to direct sunlight showed faster mortality rates for all the taxa tested. Mortality in Mytilus juveniles took up to 24 h, compared with 8 h for Ciona, with greater survival at the higher temperature (18.5°C) and humidity (~95% RH) treatment combination. This study demonstrated that desiccation can be an effective mitigation method for a broad range of fouling taxa, especially their early life-stages. Further work is necessary to assess risks from other high-risk species such as algae and cyst forming species.

  5. Prostate Cancer in South Africa: Pathology Based National Cancer Registry Data (1986–2006) and Mortality Rates (1997–2009)

    PubMed Central

    Babb, Chantal; Urban, Margaret; Kielkowski, Danuta; Kellett, Patricia

    2014-01-01

    Prostate cancer is one of the most common male cancers globally; however little is known about prostate cancer in Africa. Incidence data for prostate cancer in South Africa (SA) from the pathology based National Cancer Registry (1986–2006) and data on mortality (1997–2009) from Statistics SA were analysed. World standard population denominators were used to calculate age specific incidence and mortality rates (ASIR and ASMR) using the direct method. Prostate cancer was the most common male cancer in all SA population groups (excluding basal cell carcinoma). There are large disparities in the ASIR between black, white, coloured, and Asian/Indian populations: 19, 65, 46, and 19 per 100 000, respectively, and ASMR was 11, 7, 52, and 6 per 100 000, respectively. Prostate cancer was the second leading cause of cancer death, accounting for around 13% of male deaths from a cancer. The average age at diagnosis was 68 years and 74 years at death. For SA the ASIR increased from 16.8 in 1986 to 30.8 in 2006, while the ASMR increased from 12.3 in 1997 to 16.7 in 2009. There has been a steady increase of incidence and mortality from prostate cancer in SA. PMID:24955252

  6. Prostate cancer in South Africa: pathology based national cancer registry data (1986-2006) and mortality rates (1997-2009).

    PubMed

    Babb, Chantal; Urban, Margaret; Kielkowski, Danuta; Kellett, Patricia

    2014-01-01

    Prostate cancer is one of the most common male cancers globally; however little is known about prostate cancer in Africa. Incidence data for prostate cancer in South Africa (SA) from the pathology based National Cancer Registry (1986-2006) and data on mortality (1997-2009) from Statistics SA were analysed. World standard population denominators were used to calculate age specific incidence and mortality rates (ASIR and ASMR) using the direct method. Prostate cancer was the most common male cancer in all SA population groups (excluding basal cell carcinoma). There are large disparities in the ASIR between black, white, coloured, and Asian/Indian populations: 19, 65, 46, and 19 per 100 000, respectively, and ASMR was 11, 7, 52, and 6 per 100 000, respectively. Prostate cancer was the second leading cause of cancer death, accounting for around 13% of male deaths from a cancer. The average age at diagnosis was 68 years and 74 years at death. For SA the ASIR increased from 16.8 in 1986 to 30.8 in 2006, while the ASMR increased from 12.3 in 1997 to 16.7 in 2009. There has been a steady increase of incidence and mortality from prostate cancer in SA.

  7. Trends in the Attack Rates, Incidence, and Mortality of Stroke during 1986–2012: Data of Kaunas (Lithuania) Stroke Registry

    PubMed Central

    Radisauskas, Ricardas; Malinauskiene, Vilija; Milinaviciene, Egle; Kranciukaite-Butylkiniene, Daina; Tamosiunas, Abdonas; Bernotiene, Gailute; Luksiene, Dalia; Milasauskiene, Zemyna; Sopagiene, Diana; Rastenyte, Daiva

    2016-01-01

    Background There is a lack of reliable epidemiological data on longitudinal trends in stroke attack rates, incidence, and mortality in the countries of the Baltic region. Aims The aim of the present study was to explore the longitudinal trends of stroke in middle-aged urban population of Lithuania during the period of 1986 through 2012. Methods All stroke events in the studied population were ascertained and validated according to the standardized criteria outlined by the WHO MONICA Project. The study included all patients in Kaunas (Lithuania) city aged 25 to 64 years who experienced a stroke between 1986 and 2012. Estimates of time-trends of the annual percentage change in stroke attack rates, incidence of stroke, and mortality from this condition were made by applying the Joinpoint regression analysis. Results During the study period, 9,992 stroke events were registered. The overall proportion of recurrent events was 25.7%. Overall, 18.9% of the events (20.0% in men, and 17.4% in women) were fatal within 28 days. During the period of 1986 to 2012, a flat trend in the incidence of stroke was observed among both male and female middle-aged inhabitants of Kaunas city, while attack rates were increasing due to the increase in recurrent strokes. Both mortality and 28-day case fatality of stroke declined significantly over the study period in both sexes. Conclusions An increase both in the incidence and recurrence of stroke among middle-aged men residing in Kaunas city and in the recurrence of stroke among women denotes the inefficiency of measures applied both for primary and secondary prevention of stroke in Lithuania. The revision of current prevention strategies and the introduction of new ones are of paramount importance in order to fight the epidemic of stroke. PMID:27124412

  8. Trends in Pneumonia Mortality Rates and Hospitalizations by Organism, United States, 2002–20111

    PubMed Central

    Wuerth, Brandon A.; Bonnewell, John P.; Wiemken, Timothy L.

    2016-01-01

    Because the epidemiology of pneumonia is changing, we performed an updated, population-based analysis of hospitalization and case-fatality rates for pneumonia patients in the United States. From 2002 to 2011, hospitalization rates decreased significantly for pneumonia caused by pneumococcus and Haemophilus influenzae but increased significantly for Pseudomonas spp., Staphylococcus aureus, and influenza virus. PMID:27532154

  9. Association of resting heart rate and hypertension stages on all-cause and cardiovascular mortality among elderly Koreans: the Kangwha Cohort Study

    PubMed Central

    Ryu, Mikyung; Bayasgalan, Gombojav; Kimm, Heejin; Nam, Chung Mo; Ohrr, Heechoul

    2016-01-01

    Background Elevated resting heart rate and hypertension independently increase the risk of mortality. However, their combined effect on mortality in stages of hypertension according to updated clinical guidelines among elderly population is unclear. Methods We followed a cohort of 6100 residents (2600 males and 3500 females) of Kangwha County, Korea, ranging from 55 to 99 year-olds as of March 1985, for all-cause and cardiovascular mortality for 20.8 years until December 31, 2005. Mortality data were collected through telephone calls and visits (to 1991), and were confirmed by death record matching with the National Statistical Office (1992−2005). Hazard ratios were calculated for all-cause and cardiovascular mortality by resting heart rate and hypertension defined by Eighth Joint National Committee criteria using the Cox proportional hazard model after controlling for confounding factors. Results The hazard ratios associated with resting heart rate > 80 beats/min were higher in hypertensive men compared with normotensives with heart rate of 61–79 beats/min, with hazard ratios values of 1.43 (95% CI: 1.00−1.92) on all-cause mortality for prehypertension, 3.01 (95% CI: 1.07–8.28) on cardiovascular mortality for prehypertension, and 8.34 (95% CI: 2.52−28.19) for stage 2 hypertension. Increased risk (HR: 3.54, 95% CI: 1.16–9.21) was observed among those with both a resting heart rate ≥ 80 beats/min and prehypertension on cardiovascular mortality in women. Conclusions Individuals with coexisting elevated resting heart rate and hypertension, even in prehypertension, have a greater risk for all-cause and cardiovascular mortality compared to those with elevated resting heart rate or hypertension alone. These findings suggest that elevated resting heart rate should not be regarded as a less serious risk factor in elderly hypertensive patients. PMID:27605937

  10. Fine-root mortality rates in a temperate forest: Estimates using radiocarbon data and numerical modeling

    SciTech Connect

    Riley, W.J.; Gaudinski, J.B.; Torn, M.S.; Joslin, J.D.; Hanson, P.J.

    2009-09-01

    We used an inadvertent whole-ecosystem {sup 14}C label at a temperate forest in Oak Ridge, Tennessee, USA to develop a model (Radix1.0) of fine-root dynamics. Radix simulates two live-root pools, two dead-root pools, non-normally distributed root mortality turnover times, a stored carbon (C) pool, and seasonal growth and respiration patterns. We applied Radix to analyze measurements from two root size classes (< 0.5 and 0.5-2.0 mm diameter) and three soil-depth increments (O horizon, 0-15 cm and 30-60 cm). Predicted live-root turnover times were < 1 yr and 10 yr for short- and long-lived pools, respectively. Dead-root pools had decomposition turnover times of 2 yr and 10 yr. Realistic characterization of C flows through fine roots requires a model with two live fine-root populations, two dead fine-root pools, and root respiration. These are the first fine-root turnover time estimates that take into account respiration, storage, seasonal growth patterns, and non-normal turnover time distributions. The presence of a root population with decadal turnover times implies a lower amount of belowground net primary production used to grow fine-root tissue than is currently predicted by models with a single annual turnover pool.

  11. Brugada syndrome in a family with a high mortality rate: a case report

    PubMed Central

    2013-01-01

    Introduction Brugada syndrome is a hereditary arrhythmia characterized by a specific electrocardiographic pattern and an increased risk of sudden cardiac death, with an apparent absence of structural abnormalities or ischemic heart disease. To date, mutations in the sodium channel, voltage-gated, type V, alpha subunit gene and glycerol-3-phosphate dehydrogenase 1-like gene are estimated to account for approximately 28% of Brugada syndrome probands. Case presentation We report the case of a 32-year-old mixed-race Brazilian man who is sodium channel, voltage-gated, type V, alpha subunit gene and glycerol-3-phosphate dehydrogenase 1-like gene mutation-negative with a type 1 Brugada electrocardiographic pattern and a history of high family mortality, including five sudden deaths among relatives of whom four were first-degree relatives. Conclusion To the best of our knowledge, this is the first case of a patient who has Brugada syndrome and a history of sudden death in four first-degree family members. This case report reinforces the evidence that genetic studies are of limited use while determining risk but remain helpful for diagnosis, and that diagnosis via electrocardiography is of great importance in preventing adverse events and stratifying risk. Although there are several technologically advanced diagnostic tools, they might not be accessible in small towns and hospitals; however, a basic diagnostic tool like electrocardiography is easily accessible. PMID:23506330

  12. Incidence of AIDS-Defining Opportunistic Infections and Mortality during Antiretroviral Therapy in a Cohort of Adult HIV-Infected Individuals in Hanoi, 2007-2014

    PubMed Central

    Tanuma, Junko; Lee, Kyu Ha; Haneuse, Sebastien; Matsumoto, Shoko; Nguyen, Dung Thi; Nguyen, Dung Thi Hoai; Do, Cuong Duy; Pham, Thuy Thanh; Nguyen, Kinh Van; Oka, Shinichi

    2016-01-01

    Background Although the prognosis for HIV-infected individuals has improved after antiretroviral therapy (ART) scale-up, limited data exist on the incidence of AIDS-defining opportunistic infections (ADIs) and mortality during ART in resource-limited settings. Methods HIV-infected adults in two large hospitals in urban Hanoi were enrolled to the prospective cohort, from October 2007 through December 2013. Those who started ART less than one year before enrollment were assigned to the survival analysis. Data on ART history and ADIs were collected retrospectively at enrollment and followed-up prospectively until April 2014. Results Of 2,070 cohort participants, 1,197 were eligible for analysis and provided 3,446 person-years (PYs) of being on ART. Overall, 161 ADIs episodes were noted at a median of 3.20 months after ART initiation (range 0.03–75.8) with an incidence 46.7/1,000 PYs (95% confidence interval [CI] 39.8–54.5). The most common ADI was tuberculosis with an incidence of 29.9/1,000 PYs. Mortality after ART initiation was 8.68/1,000 PYs and 45% (19/45) died of AIDS-related illnesses. Age over 50 years at ART initiation was significantly associated with shorter survival after controlling for baseline CD4 count, but neither having injection drug use (IDU) history nor previous ADIs were associated with poor survival. Semi-competing risks analysis in 951 patients without ADIs history prior to ART showed those who developed ADIs after starting ART were at higher risk of death in the first six months than after six months. Conclusion ADIs were not rare in spite of being on effective ART. Age over 50 years, but not IDU history, was associated with shorter survival in the cohort. This study provides in-depth data on the prognosis of patients on ART in Vietnam during the first decade of ART scale-up. PMID:26939050

  13. The Effect of Application Rate of GF-120 (Spinosad) and Malathion on the Mortality of Apis mellifera (Hymenoptera: Apidae) Foragers.

    PubMed

    Cabrera-Marín, Nina Vanessa; Liedo, Pablo; Sánchez, Daniel

    2016-04-01

    Beneficial organisms like the honey bee, Apis mellifera L. (Hymenoptera: Apidae), are heavily affected by pest control practices that incorporate insecticides. Safer alternatives as the spinosad-based formulation GF-120 have been developed to overcome this issue. Though both the low concentration of spinosad and the ultra-low-volume application rate of GF-120 are supposed to have a low acute toxicity in honey bee foragers, to our knowledge such claims have not been explicitly proven. We thus carried out a series of experiments to assess the effect of GF-120, malathion, and Spintor (spinosad) on honey bee foragers when applied at two concentrations (80 and 1,500 ppm) and two application rates (low density rate [LDR]—80 drops of 5 mm diameter per square meter; high density rate [HDR]—thousands of 200 -µm-diameter droplets per square meter). Interestingly, the three pesticides caused low mortality on foragers when applied at LDR-80, LDR-1,500, or HDR-80. However, HDR-1,500 caused a very high mortality. Based upon these results, we developed a computer program to estimate the average number of foragers that are exposed at LDR and HDR. We found that more foragers receive a lethal dose when exposed at HDR than at the other rates. Our results support the hypothesis that the impact of GF-120 and malathion upon honey bees is minimal when applied at LDR and that computer simulation can help greatly in understanding the effects of pesticides upon nontarget species. PMID:26739308

  14. Do deficits in cardiac care influence high mortality rates in schizophrenia? A systematic review and pooled analysis

    PubMed Central

    Mitchell, Alex J; Lord, Oliver

    2010-01-01

    We have previously documented inequalities in the quality of medical care provided to those with mental ill health but the implications for mortality are unclear. We aimed to test whether disparities in medical treatment of cardiovascular conditions, specifically receipt of medical procedures and receipt of prescribed medication, are linked with elevated rates of mortality in people with schizophrenia and severe mental illness. We undertook a systematic review of studies that examined medical procedures and a pooled analysis of prescribed medication in those with and without comorbid mental illness, focusing on those which recruited individuals with schizophrenia and measured mortality as an outcome. From 17 studies of treatment adequacy in cardiovascular conditions, eight examined cardiac procedures and nine examined adequacy of prescribed cardiac medication. Six of eight studies examining the adequacy of cardiac procedures found lower than average provision of medical care and two studies found no difference. Meta-analytic pooling of nine medication studies showed lower than average rates of prescribing evident for the following individual classes of medication; angiotensin converting enzyme inhibitors (n = 6, aOR = 0.779, 95% CI = 0.638–0.950, p = 0.0137), beta-blockers (n = 9, aOR = 0.844, 95% CI = 0.690–1.03, p = 0.1036) and statins (n = 5, aOR = 0.604, 95% CI = 0.408–0.89, p = 0.0117). No inequality was evident for aspirin (n = 7, aOR = 0.986, 95% CI = 0.7955–1.02, p = 0.382). Interestingly higher than expected prescribing was found for older non-statin cholesterol-lowering agents (n = 4, aOR = 1.55, 95% CI = 1.04–2.32, p = 0.0312). A search for outcomes in this sample revealed ten studies linking poor quality of care and possible effects on mortality in specialist settings. In half of the studies there was significantly higher mortality in those with mental ill health

  15. A trait-based trade-off between growth and mortality: evidence from 15 tropical tree species using size-specific relative growth rates.

    PubMed

    Philipson, Christopher D; Dent, Daisy H; O'Brien, Michael J; Chamagne, Juliette; Dzulkifli, Dzaeman; Nilus, Reuben; Philips, Sam; Reynolds, Glen; Saner, Philippe; Hector, Andy

    2014-09-01

    A life-history trade-off between low mortality in the dark and rapid growth in the light is one of the most widely accepted mechanisms underlying plant ecological strategies in tropical forests. Differences in plant functional traits are thought to underlie these distinct ecological strategies; however, very few studies have shown relationships between functional traits and demographic rates within a functional group. We present 8 years of growth and mortality data from saplings of 15 species of Dipterocarpaceae planted into logged-over forest in Malaysian Borneo, and the relationships between these demographic rates and four key functional traits: wood density, specific leaf area (SLA), seed mass, and leaf C:N ratio. Species-specific differences in growth rates were separated from seedling size effects by fitting nonlinear mixed-effects models, to repeated measurements taken on individuals at multiple time points. Mortality data were analyzed using binary logistic regressions in a mixed-effects models framework. Growth increased and mortality decreased with increasing light availability. Species differed in both their growth and mortality rates, yet there was little evidence for a statistical interaction between species and light for either response. There was a positive relationship between growth rate and the predicted probability of mortality regardless of light environment, suggesting that this relationship may be driven by a general trade-off between traits that maximize growth and traits that minimize mortality, rather than through differential species responses to light. Our results indicate that wood density is an important trait that indicates both the ability of species to grow and resistance to mortality, but no other trait was correlated with either growth or mortality. Therefore, the growth mortality trade-off among species of dipterocarp appears to be general in being independent of species crossovers in performance in different light environments.

  16. A trait-based trade-off between growth and mortality: evidence from 15 tropical tree species using size-specific relative growth rates

    PubMed Central

    Philipson, Christopher D; Dent, Daisy H; O’Brien, Michael J; Chamagne, Juliette; Dzulkifli, Dzaeman; Nilus, Reuben; Philips, Sam; Reynolds, Glen; Saner, Philippe; Hector, Andy

    2014-01-01

    A life-history trade-off between low mortality in the dark and rapid growth in the light is one of the most widely accepted mechanisms underlying plant ecological strategies in tropical forests. Differences in plant functional traits are thought to underlie these distinct ecological strategies; however, very few studies have shown relationships between functional traits and demographic rates within a functional group. We present 8 years of growth and mortality data from saplings of 15 species of Dipterocarpaceae planted into logged-over forest in Malaysian Borneo, and the relationships between these demographic rates and four key functional traits: wood density, specific leaf area (SLA), seed mass, and leaf C:N ratio. Species-specific differences in growth rates were separated from seedling size effects by fitting nonlinear mixed-effects models, to repeated measurements taken on individuals at multiple time points. Mortality data were analyzed using binary logistic regressions in a mixed-effects models framework. Growth increased and mortality decreased with increasing light availability. Species differed in both their growth and mortality rates, yet there was little evidence for a statistical interaction between species and light for either response. There was a positive relationship between growth rate and the predicted probability of mortality regardless of light environment, suggesting that this relationship may be driven by a general trade-off between traits that maximize growth and traits that minimize mortality, rather than through differential species responses to light. Our results indicate that wood density is an important trait that indicates both the ability of species to grow and resistance to mortality, but no other trait was correlated with either growth or mortality. Therefore, the growth mortality trade-off among species of dipterocarp appears to be general in being independent of species crossovers in performance in different light environments

  17. High Emergency Lung Transplantation: dramatic decrease of waiting list death rate without relevant higher post-transplant mortality.

    PubMed

    Roux, Antoine; Beaumont-Azuar, Laurence; Hamid, Abdul Monem; De Miranda, Sandra; Grenet, Dominique; Briend, Guillaume; Bonnette, Pierre; Puyo, Philippe; Parquin, François; Devaquet, Jerome; Trebbia, Gregoire; Cuquemelle, Elise; Douvry, Benoit; Picard, Clément; Le Guen, Morgan; Chapelier, Alain; Stern, Marc; Sage, Edouard

    2015-09-01

    Many candidates for lung transplantation (LT) die on the waiting list, raising the question of graft availability and strategy for organ allocation. We report the experience of the new organ allocation program, "High Emergency Lung Transplantation" (HELT), since its implementation in our center in 2007. Retrospective analysis of 201 lung transplant patients, of whom 37 received HELT from 1st July 2007 to 31th May 2012. HELT candidates had a higher impairment grade on respiratory status and higher Lung Allocation Score (LAS). HELT patients had increased incidence of perioperative complications (e.g., perioperative bleeding) and extracorporeal circulatory assistance (75% vs. 36.6%, P = 0.0005). No significant difference was observed between HELT and non-HELT patients in mechanical ventilation duration (15.5 days vs. 11 days, P = 0.27), intensive care unit length of stay (15 days vs. 10 days, P = 0.22) or survival rate at 12 (81% vs. 80%), and 24 months post-LT (72.9% vs. 75.0%). Lastly, mortality on the waiting list was spectacularly reduced from 19% to 2% when compared to the non-HELT 2004-2007 group. Despite a more severe clinical status of patients on the waiting list, HELT provided similar results to conventional LT. These results were associated with a dramatic reduction in the mortality rate of patients on the waiting list.

  18. Factors associated with declining under-five mortality rates from 2000 to 2013: an ecological analysis of 46 African countries

    PubMed Central

    Kipp, Aaron M; Blevins, Meridith; Haley, Connie A; Mwinga, Kasonde; Habimana, Phanuel; Shepherd, Bryan E; Aliyu, Muktar H; Ketsela, Tigest; Vermund, Sten H

    2016-01-01

    Objective Inadequate overall progress has been made towards the 4th Millennium Development Goal of reducing under-five mortality rates by two-thirds between 1990 and 2015. Progress has been variable across African countries. We examined health, economic and social factors potentially associated with reductions in under-five mortality (U5M) from 2000 to 2013. Setting Ecological analysis using publicly available data from the 46 nations within the WHO African Region. Outcome measures We assessed the annual rate of change (ARC) of 70 different factors and their association with the annual rate of reduction (ARR) of U5M rates using robust linear regression models. Results Most factors improved over the study period for most countries, with the largest increases seen for economic or technological development and external financing factors. The median (IQR) U5M ARR was 3.6% (2.8 to 5.1%). Only 4 of 70 factors demonstrated a strong and significant association with U5M ARRs, adjusting for potential confounders. Higher ARRs were associated with more rapidly increasing coverage of seeking treatment for acute respiratory infection (β=0.22 (ie, a 1% increase in the ARC was associated with a 0.22% increase in ARR); 90% CI 0.09 to 0.35; p=0.01), increasing health expenditure relative to gross domestic product (β=0.26; 95% CI 0.11 to 0.41; p=0.02), increasing fertility rate (β=0.54; 95% CI 0.07 to 1.02; p=0.07) and decreasing maternal mortality ratio (β=−0.47; 95% CI −0.69 to −0.24; p<0.01). The majority of factors showed no association or raised validity concerns due to missing data from a large number of countries. Conclusions Improvements in sociodemographic, maternal health and governance and financing factors were more likely associated with U5M ARR. These underscore the essential role of contextual factors facilitating child health interventions and services. Surveillance of these factors could help monitor which countries need additional support in reducing U5M

  19. Trends in mortality rates from coronary heart disease in Belgrade (Serbia) during the period 1990–2010: a joinpoint regression analysis

    PubMed Central

    2013-01-01

    Background Coronary heart disease (CHD) causes an estimated 7 million deaths worldwide each year. In the last few decades, mortality from CHD has been decreasing in many countries. The aim of this study was to analyze the trends of mortality from CHD and myocardial infarction (MI) in the population of Belgrade during the period 1990–2010. Methods Mortality data for CHD and MI were obtained from the Municipal Institute of Statistics in Belgrade and used to calculate age- and sex-specific and age-adjusted mortality rates. Joinpoint regression analysis was used to estimate annual percent changes (APCs) in mortality and to identify points in time where significant changes in trend occur. Results Trends in CHD mortality rates showed significant decline in men during the period studied (APC -0.5%, no joinpoints detected), but no significant change among women (APC +0.4%, no joinpoints detected). While we observed significant declines in CHD mortality in men aged 35–44, 55–64 and 65–74 and women aged 55–64, there was a significant increase in mortality in men aged ≥85 and women aged 75–84 and ≥85. Trends in MI mortality rates showed similar patterns in both genders, with a significant decline from the mid-1990s. Significant decline in MI mortality was observed in almost all age groups, except the two oldest (75–84 and ≥85) in women population. Conclusions Given that CHD and MI mortality trends showed different patterns during the period studied, especially in women, our results imply that further observation of trend is needed. PMID:24320937

  20. Adolescent Inpatient Psychiatric Admission Rates and Subsequent One-Year Mortality in England: 1998-2004

    ERIC Educational Resources Information Center

    James, Anthony; Clacey, Joe; Seagroatt, Valerie; Goldacre, Michael

    2010-01-01

    Background: Adolescence is a time of very rapid change not only in physical but also psychological development. During the teenage years there is a reported rise in the prevalence of psychiatric disorders. The aim of this study was to investigate age- and sex-specific National Health Service (NHS) hospital inpatient admission rates for psychiatric…

  1. Nuclear cardiology and CVD in the developing world: Are we applying our scarce resources appropriately? Why is our mortality rate so high?

    PubMed

    Vitola, João V

    2016-10-01

    While mortality rates from cardiovascular diseases have progressively decreased in developed nations, this has not been observed to the same extent in the developing world. Nuclear Cardiology utilization remains low or non-existent for most of those living in the low-to-middle-income countries. How much of the decline in mortality observed in the developed world has to do with advanced cardiac imaging? Are we applying our scarce resources appropriately for myocardial perfusion imaging? Are myocardial revascularizations being guided by appropriate use criteria? Is more imaging necessary to reduce the mortality rates further in the developing world?

  2. Measurement of a drowning incidence rate combining direct observation of an exposed population with mortality statistics.

    PubMed

    Morgan, Damian; Ozanne-Smith, Joan

    2015-01-01

    Drowning risk factors may be identified by comparing drowning incidence rates for comparable at-risk populations but precise methods are lacking. To address this knowledge gap, an ecological study extrapolated crude time-duration exposure to water for a specified at-risk sample of surf bathers to estimate the bather population for all wave-dominated beaches in Victoria, Australia, over a four-year summer season period. An incidence rate was calculated using surf bather drowning deaths frequencies matched for time and location. For the sample, 47,341 hours of surf bathing were estimated from 177,528 bathing episodes. Generalising these results to Victoria, the crude drowning deaths incidence rate in the summer season was 0.41 per 1,000,000 person-hours of surf bathing (95% CI 0.37-0.45). Further application of the method, particularly in open water settings, may be used to identify candidate drowning risk factors to advance drowning prevention strategies.

  3. Estimation of fine-root production using rates of diameter-dependent root mortality, decomposition and thickening in forests.

    PubMed

    Van Do, Tran; Osawa, Akira; Sato, Tamotsu

    2016-04-01

    Current studies indicate that fine roots of different diameter classes show different rates of decomposition. This study developed a new method to estimate fine-root production by considering the difference in the production of fine roots of two size classes, fine roots thinner than 1 mm and those between 1 and 2 mm, and their corresponding rates of decomposition. A litter bag experiment was used to estimate the decomposition rates, while the sequential soil core technique was used to identify mass values of live roots and dead roots at a given period of observation. The continuous inflow method was applied to estimate the amount of root decomposition, mortality and production with a framework of two diameter classes of fine roots and for quantification of the amount of mass transfer from the thicker fine-root class to the coarser root category (>2 mm). The results indicated that the estimate of fine-root production was greater when two size classes of fine roots were distinguished. Using a framework of two size classes developed in this study resulted in 21.3% higher fine-root production than a method that did not recognize fine-root size classes or mass transfer to the category of coarse roots. In addition, using shorter collection intervals led to higher production estimates than longer intervals. The production estimate with a 1-month interval was 21.4% higher than that with a 6-month interval. We consider that the use of the sequential soil core technique with continuous inflow estimate method by differentiating size classes of fine roots is likely to minimize the underestimation of the parameters of fine-root dynamics by accounting for decomposition and mortality of fine roots more appropriately.

  4. Spectrum of Opportunistic Infections and Risk Factors for In-Hospital Mortality of Admitted AIDS Patients in Shanghai

    PubMed Central

    Luo, Bin; Sun, Jianjun; Cai, Rentian; Shen, Yinzhong; Liu, Li; Wang, Jiangrong; Zhang, Renfang; Shen, Jiayin; Lu, Hongzhou

    2016-01-01

    Abstract To investigate the frequency and the spectrum of major opportunistic infections (OIs), evaluate the major clinical factors associated with each specific OI, and identify the risk factors for in-hospital death among HIV patients in East China. A retrospective cohort study was made including all the HIV-infected patients who were admitted for the first time to the Shanghai Public Health Clinical Center during June 1, 2013 to June 1, 2015. The demographic and clinical data were collected. Comparison of continuous variables was analyzed by one-way ANOVA and rank sum test. Person χ2 test and Fisher exact test were applied to analyze the categorical variables. A Cox proportional hazards regression model was used to determine the risk for the occurrence of in-hospital death. In total, 920 patients were enrolled with age of 41.59 ± 13.36 years and 91% male. Median CD4 was 34 (IQR, 13–94) cells/μL. Among these patients, 94.7% acquired OIs while the rest developed malignancies. Pneumocystis pneumonia and bacterial coinfection (42.1%) was found to be the most common OIs, followed by tuberculosis (31.4%), CMV (20.9%), Cryptococcosis (9.0%), and MAC infection (5.2%). Of the above 5 major OIs, CMV-infected patients had the lowest median CD4 cell count 22.50 (IQR, 7.50–82.00) while the patients with tuberculosis infection had the highest count 61.00 (IQR, 27.00–176.00). In-hospital death rate was 4.2 per 100 person-years among these patients. Of note, admitted patients with 2 types of OIs (2.20, 95% CI 1.39–3.48) and those patients who were 40-year old or older (1.75, 95% CI 1.10–2.78) had a higher risk of such death. Pneumocystis pneumonia and tuberculosis were still the leading causes for the admission of HIV-infected patients in East China, and these patients tended to have very low CD4 cell counts. It is believed that expanding the HIV screening test and pushing the infected ones get ART earlier is required for generating a more successful HIV management

  5. Spectrum of Opportunistic Infections and Risk Factors for In-Hospital Mortality of Admitted AIDS Patients in Shanghai.

    PubMed

    Luo, Bin; Sun, Jianjun; Cai, Rentian; Shen, Yinzhong; Liu, Li; Wang, Jiangrong; Zhang, Renfang; Shen, Jiayin; Lu, Hongzhou

    2016-05-01

    To investigate the frequency and the spectrum of major opportunistic infections (OIs), evaluate the major clinical factors associated with each specific OI, and identify the risk factors for in-hospital death among HIV patients in East China.A retrospective cohort study was made including all the HIV-infected patients who were admitted for the first time to the Shanghai Public Health Clinical Center during June 1, 2013 to June 1, 2015. The demographic and clinical data were collected. Comparison of continuous variables was analyzed by one-way ANOVA and rank sum test. Person χ test and Fisher exact test were applied to analyze the categorical variables. A Cox proportional hazards regression model was used to determine the risk for the occurrence of in-hospital death.In total, 920 patients were enrolled with age of 41.59 ± 13.36 years and 91% male. Median CD4 was 34 (IQR, 13-94) cells/μL. Among these patients, 94.7% acquired OIs while the rest developed malignancies. Pneumocystis pneumonia and bacterial coinfection (42.1%) was found to be the most common OIs, followed by tuberculosis (31.4%), CMV (20.9%), Cryptococcosis (9.0%), and MAC infection (5.2%). Of the above 5 major OIs, CMV-infected patients had the lowest median CD4 cell count 22.50 (IQR, 7.50-82.00) while the patients with tuberculosis infection had the highest count 61.00 (IQR, 27.00-176.00). In-hospital death rate was 4.2 per 100 person-years among these patients. Of note, admitted patients with 2 types of OIs (2.20, 95% CI 1.39-3.48) and those patients who were 40-year old or older (1.75, 95% CI 1.10-2.78) had a higher risk of such death.Pneumocystis pneumonia and tuberculosis were still the leading causes for the admission of HIV-infected patients in East China, and these patients tended to have very low CD4 cell counts. It is believed that expanding the HIV screening test and pushing the infected ones get ART earlier is required for generating a more successful HIV management strategy.

  6. Changes in Post-Operative Complication and Mortality Rates after Lung Cancer Resection in the 20-Year Period 1995-2014.

    PubMed

    Sawada, Shigeki; Suehisa, Hiroshi; Ueno, Tsuyoshi; Yamashita, Motohiro

    2016-06-01

    We reviewed post-operative complication and mortality rates from 1995 through 2014 and evaluated the changes in those rates across that 20-year period. Two thousand and three hundred sixteen patients with lung cancer underwent resection at our institution between 1995 and 2014. This timespan was divided into four 5-year periods. Each patient's age, Charlson comorbidity index score, and extent of surgery in each 5-year period were summarized, and the changes in these factors over the 20-year span were evaluated. The complication and mortality rates were calculated for each 5-year period, and the changes in those rates over the 20-years were evaluated. The number of patients with higher Charlson comorbidity index scores increased during the 20-year period. Of the 455 patients who developed complications, 97 developed life-threating complications. There were 16 post-operative deaths and 23 in-hospital deaths. There were no significant changes in the complication rate or mortality rate during the 20-year period. Both rates were significantly correlated with the extent of resection. Although the number of patients with comorbidities increased in the 20-year period, the post-operative complication and mortality rates, as well as in-hospital mortality, did not change significantly.

  7. A 6-year comparative economic evaluation of healthcare costs and mortality rates of Dutch patients from conventional and CAM GPs

    PubMed Central

    Baars, Erik W; Kooreman, Peter

    2014-01-01

    Objectives To compare healthcare costs and mortality rates of Dutch patients with a conventional (CON) general practitioner (GP) and patients with a GP who has additionally completed training in complementary and alternative medicine (CAM). Design Comparative economic evaluation. Setting Database from the Dutch insurance company Agis. Participants 1 521 773 patients (98.8%) from a CON practice and 18 862 patients (1.2%) from a CAM practice. Main outcome measures Annual information on five types of healthcare costs for the years 2006–2011: care by GP, hospital care, pharmaceutical care, paramedic care and care covered by supplementary insurance. Healthcare costs in the last year of life. Mortality rates. Results The mean annual compulsory and supplementary healthcare costs of CON patients are respectively €1821 (95% CI 1813 to 1828) and €75.3 (95% CI 75.1 to 75.5). Compulsory healthcare costs of CAM patients are €225 (95% CI 169 to 281; p<0.001; 12.4%) lower and result mainly from lower hospital care costs (€165; 95% CI 118 to 212; p<0.001) and lower pharmaceutical care costs (€58; 95% CI 41 to 75; p<0.001), especially in the age categories 25–49 and 50–74 years. The costs in the last year of life of patients with CAM, GPs are €1161 (95% CI −138 to 2461; p<0.1) lower. This difference is entirely due to lower hospital costs (€1250; 95% CI 19 to 2481; p<0.05). The mean annual supplementary costs of CAM patients are €33 (95% CI 30 to 37; p<0.001; 44%) higher. CAM patients do not have lower or higher mortality rates than CON patients. Conclusions Dutch patients whose GP additionally completed training in CAM on average have €192 (10.1%) lower annual total compulsory and supplementary healthcare costs and do not live longer or shorter than CON patients. PMID:25164536

  8. 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.

  9. Impact of Starting an Emergency Medicine Residency Program on Overall Mortality Rate in a Regional Trauma Center

    PubMed Central

    McLaughlin, Thomas; Blow, Osbert; Herrick, John; Richman, Peter

    2016-01-01

    Background CHRISTUS Spohn Hospital Corpus Christi - Memorial began an Emergency Medicine Residency Program in March 2007. During each of the three years of their residency, residents are required to complete a trauma surgery rotation. These emergency medicine residents are the only residents participating on this rotation as there is no surgical residency. The Department of Acute Care Surgery, Trauma and Surgical Critical Care analyzed the impact of the residents on trauma patient care outcomes with the hypothesis that there were no differences. Methods Data including length of stay in the hospital, length of stay in the intensive care unit, time spent in the emergency department (ED), morbidities and mortalities were compiled from the trauma registry for patients from the year before the residents began (March 1, 2006 to February 28, 2007) and compared with patients from the first year the residents began their trauma rotations (March 1, 2007 to February 29, 2008). T-tests and Mann-Whitney U tests were used to compare continuous variables and a Chi-square test was used to analyze the categorical variable (mortality). Linear and logistic regression analyses were also performed in order to adjust for potential confounding factors. Results Trauma patient admission rates were 1,316 before and 1,391 after the residents began. No statistically significant differences were found among all of the outcome variables during the two time periods except for time spent in the ED (P = 0.00), which increased during the year the residents began (236.83 ± 4.53 minutes in 2006 compared to 297.40 ± 5.55 minutes in 2007). Linear and logistic regression analyses confirmed these results with the exception of a statistically significant decrease in mortality with the residents on the trauma service (2.8% in 2006 and 2.1% in 2007, P = 0.00) after adjustment for multiple confounding factors. Conclusion The addition of emergency medicine residents to the trauma care service did increase

  10. Age effects in monetary valuation of reduced mortality risks: the relevance of age-specific hazard rates.

    PubMed

    Leiter, Andrea M

    2011-08-01

    This paper highlights the relevance of age-specific hazard rates in explaining the age variation in "value of statistical life" (VSL) figures. The analysis-which refers to a stated preference framework-contributes to the ongoing discussion of whether benefits resulting from reduced mortality risk should be valued differently depending on the age of the beneficiaries. By focussing on a life-threatening environmental phenomenon I show that the consideration of the individual's age-specific hazard rate is important. If a particular risk affects all individuals regardless of their age so that their hazard rate is age-independent, VSL is rather constant for people at different age; if hazard rate varies with age, VSL estimates are sensitive to age. The results provide an explanation for the mixed outcomes in empirical studies and illustrate in which cases an adjustment to age may or may not be justified. Efficient provision of live-saving measures requires that such differences to be taken into account.

  11. [Light pollution increases morbidity and mortality rate from different causes in male rats].

    PubMed

    Bukalev, A V; Vinogradova, I A; Zabezhinskiĭ, M A; Semenchenko, A V; Anisimov, V N

    2012-01-01

    The influence of different light regimes (constant light--LL; constant darkness--DD; standard light regime--LD, 12 hours light 12 hours darkness; natural lightening of the North-West of Russia--NL) on the dynamics of life's morbidity rate, spontaneous tumorigenesis and frequency of some kinds of non-tumor pathology revealed at the post-mortem examination of male rats was studied. It was found out that the maintenance of animals at LL and NL conditions led to the increase of the number of infectious diseases, substantially faster development of spontaneous tumors and the increase of non-tumor diseases in comparison with the animals kept at LD (standard light) regime. Light deprivation (DD) led to substantial reduction of development of new growth, of non-tumor and infectious diseases in comparison with the similar parameters in standard light regime.

  12. Phycocyanobilin accelerates liver regeneration and reduces mortality rate in carbon tetrachloride-induced liver injury mice

    PubMed Central

    Liu, Jie; Zhang, Qing-Yu; Yu, Li-Ming; Liu, Bin; Li, Ming-Yi; Zhu, Run-Zhi

    2015-01-01

    AIM: To investigate the hepatoprotective effects of phycocyanobilin (PCB) in reducing hepatic injury and accelerating hepatocyte proliferation following carbon tetrachloride (CCl4) treatment. METHODS: C57BL/6 mice were orally administered PCB 100 mg/kg for 4 d after CCl4 injection, and then the serum and liver tissue of the mice were collected at days 1, 2, 3, 5 and 7 after CCl4 treatment. A series of evaluations were performed to identify the curative effects on liver injury and recovery. Aspartate aminotransferase (AST), alanine aminotransferase (ALT), albumin and superoxide dismutase (SOD) were detected to indirectly assess the anti-inflammatory effects of PCB. Meanwhile, we detected the expressions of hepatocyte growth factor, transforming growth factor alpha (TGF-α), TGF-β, tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6), the factors which are associated with inflammation and liver regeneration. The protein expressions of proliferating cell nuclear antigen (PCNA), TNF-α and cytochrome C were detected by western blot. Furthermore, the survival rates were analyzed of mice which were administered a lethal dose of CCl4 (2.6 mg/kg) with or without PCB. RESULTS: In our research, PCB showed a strongly anti-inflammatory effect on CCl4-induced liver injury in mice. The ALT was significantly decreased after CCl4 treatment from day 1 (P < 0.01) and the AST was significantly decreased from day 2 (P < 0.001). Both albumin and liver SOD were increased from day 2 (P < 0.001 and P < 0.01), but serum SOD levels did not show a significant increase (P > 0.05). PCB protected the structure of liver from the injury by CCl4. TUNEL assay showed that PCB dramatically reduced the number of apoptotic cells after CCl4 treatment compared to the control (101.0 ± 25.4 vs 25.7 ± 6.4, P < 0.01). The result of western blotting showed that PCB could increase PCNA expression, decrease TNF-α and cytochrome C expression. Furthermore, data shows that PCB could improve the

  13. Chemical exposure of embryos during the preimplantation stages of pregnancy: mortality rate and intrauterine development.

    PubMed

    Fabro, S; McLachlan, J A; Dames, N M

    1984-04-01

    Exposure of CD-1 mouse embryos at the eight- to 16-cell stage for 1 hour to methylmethanesulfonate (MMS; 0.25, 0.5, and 1.0 mM) produced DNA breakage and interfered with embryonic development in a dose-related manner. MMS-exposed blastocysts were transferred to oviducts of untreated recipient female mice, and the conceptuses were allowed to develop to term. MMS exposure resulted in an increased intrauterine death rate, although the number of implantation sites was not decreased. Surviving MMS-treated offspring showed intrauterine growth retardation, but there was no increase in the incidence of gross abnormalities. Intrauterine growth retardation, without an increase in gross abnormalities, was also observed in the offspring of pregnant New Zealand White rabbits dosed during the preimplantation stages of pregnancy with an "environmental cocktail" composed of ethanol, nicotine, caffeine, sodium salicylate, and dichloro-diphenyl-trichloro-ethane (DDT). When the compounds were tested individually, nicotine and DDT were the only two that produced intrauterine growth retardation. DDT-treated 8-day rabbit conceptuses were smaller than controls and showed abnormal persistence of preimplantation proteins in the yolk sac fluid. These results suggest that exposure to chemicals during the preimplantation stages of pregnancy may result in a cessation of growth and development before implantation or during later intrauterine development. Damage can be repaired but it may result in offspring that show intrauterine growth retardation without gross abnormalities. PMID:6711631

  14. [Differences between neonatal mortality and stillbirth rates in Brazil: a study based on the Unified Health System (SIH/SUS) Hospital Information System].

    PubMed

    de Andrade Schramm, J M; Szwarcwald, C L

    2000-01-01

    The main objective of this article is to estimate stillbirth and neonatal mortality rates in Brazilian States based upon the country's Hospital Information System. Analysis of 1995 data reveals contrasting rates between the various regions of the country. In order to elucidate the States' different rates, we focused on the association between indicators of coverage, utilization, and access to the Unified Health System (SUS). The results for the neonatal period mostly showed higher early neonatal mortality rates when compared to late neonatal mortality rates, higher neonatal mortality rates in the States comprising the South and Southeast regions, less variable rates between those States, and extremely low rates in some States of the North, Central-West, and Northeast regions. The limited supply of SUS services and low access to same are relevant constraints on health care for the population in the North and Northeast. Aspects related to quality of childbirth and neonatal care are also reflected in the rates studied. The findings suggest that spatial and temporal monitoring of these rates could provide analytical support for organizing the Maternal and Child Health Program. PMID:11175526

  15. Not just smoking and high-tech medicine: socioeconomic inequities in US mortality rates, overall and by race/ethnicity, 1960–2006

    PubMed Central

    Krieger, Nancy; Chen, Jarvis T.; Kosheleva, Anna; Waterman, Pamela D.

    2011-01-01

    Recent research on the post-1980 widening of US socioeconomic mortality inequalities has emphasized the contribution of smoking and high-tech medicine, with some studies treating the growing inequalities as effectively inevitable. No studies, however, have analyzed long-term trends in US mortality rates and inequities unrelated to smoking or due to lack of basic medical care, even as a handful have shown that US socioeconomic inequalities in overall mortality shrank between the mid-1960s and 1980. We accordingly analyzed US mortality data for 1960–2006, stratified by county income quintile and race/ethnicity, for mortality unrelated to smoking and preventable by 1960s standards of medical care. Key findings were that relative and absolute socioeconomic inequalities in US mortality unrelated to smoking and preventable by 1960s medical care standards shrank between the 1960s and 1980 and then increased and stagnated, with absolute rates on par with several leading causes of death, and with the burden worst for US populations of color. None of these findings can be attributed to trends in smoking-related deaths and access to high-tech medicine, and they also demonstrate that socioeconomic inequities in mortality can shrink and need not inevitably rise. PMID:22611656

  16. Paying for Default: Change over Time in the Share of Federal Financial Aid Sent to Institutions with High Student Loan Default Rates

    ERIC Educational Resources Information Center

    Jaquette, Ozan; Hillman, Nicholas W.

    2015-01-01

    Both federal spending on financial aid and student loan default rates have increased over the past decade. These trends have intensified policymakers' concerns that some postsecondary institutions-- particularly in the for-profit sector--maximize revenue derived from federal financial aid without helping students to graduate or find employment.…

  17. Incidence and mortality rates in breast, corpus uteri, and ovarian cancers in Poland (1980–2013): an analysis of population-based data in relation to socioeconomic changes

    PubMed Central

    Banas, Tomasz; Juszczyk, Grzegorz; Pitynski, Kazimierz; Nieweglowska, Dorota; Ludwin, Artur; Czerw, Aleksandra

    2016-01-01

    Objectives This study aimed to analyze incidence and mortality trends in breast cancer (BC), corpus uteri cancer (CUC), and ovarian cancer (OC) in Poland in the context of sociodemographic changes. Materials and methods Incidence and mortality data (1980–2013) were retrieved from the Polish National Cancer Registry, while socioeconomic data (1960–2013) were obtained from the World Bank. Age-standardized incidence and mortality rates were calculated by direct standardization, and join-point regression was performed to describe trends using the average annual percentage change (AAPC). Results A significant decrease in birth and fertility rates and a large increase in gross domestic product were observed together with a decrease in the total mortality rate among women, as well as an increase in life expectancy for women. A large, significant increase in BC incidence was observed (AAPC1980–1990 2.14, AAPC1990–1996 4.71, AAPC1996–2013 2.21), with a small but significant decrease in mortality after a slight increase (AAPC1980–1994 0.52, AAPC1994–2013 −0.66). During the period 1980–2013, a significant increase in CUC incidence (AAPC1980–1994 3.7, AAPC1994–2013 1.93) was observed, with an initial mortality-rate reduction followed by a significant increase (AAPC1980–2006 −1.12, AAPC2006–2013 3.74). After the initial increase of both OC incidence and mortality from 1994, the incidence rate decreased significantly (AAPC1980–1994 2.98, AAPC1994–2013 −0.49), as did the mortality rate (AAPC1980–1994 0.52, AAPC1994–2013 −0.66). Conclusion After 1994, a decrease in OC incidence was found, while the incidence of BC and CUC continued to increase. A reduction in mortality rate was observed for BC and OC predominantly at the end of the study period, while for CUC, after a long decreasing mortality trend, a significant increase was observed.

  18. Incidence and mortality rates in breast, corpus uteri, and ovarian cancers in Poland (1980–2013): an analysis of population-based data in relation to socioeconomic changes

    PubMed Central

    Banas, Tomasz; Juszczyk, Grzegorz; Pitynski, Kazimierz; Nieweglowska, Dorota; Ludwin, Artur; Czerw, Aleksandra

    2016-01-01

    Objectives This study aimed to analyze incidence and mortality trends in breast cancer (BC), corpus uteri cancer (CUC), and ovarian cancer (OC) in Poland in the context of sociodemographic changes. Materials and methods Incidence and mortality data (1980–2013) were retrieved from the Polish National Cancer Registry, while socioeconomic data (1960–2013) were obtained from the World Bank. Age-standardized incidence and mortality rates were calculated by direct standardization, and join-point regression was performed to describe trends using the average annual percentage change (AAPC). Results A significant decrease in birth and fertility rates and a large increase in gross domestic product were observed together with a decrease in the total mortality rate among women, as well as an increase in life expectancy for women. A large, significant increase in BC incidence was observed (AAPC1980–1990 2.14, AAPC1990–1996 4.71, AAPC1996–2013 2.21), with a small but significant decrease in mortality after a slight increase (AAPC1980–1994 0.52, AAPC1994–2013 −0.66). During the period 1980–2013, a significant increase in CUC incidence (AAPC1980–1994 3.7, AAPC1994–2013 1.93) was observed, with an initial mortality-rate reduction followed by a significant increase (AAPC1980–2006 −1.12, AAPC2006–2013 3.74). After the initial increase of both OC incidence and mortality from 1994, the incidence rate decreased significantly (AAPC1980–1994 2.98, AAPC1994–2013 −0.49), as did the mortality rate (AAPC1980–1994 0.52, AAPC1994–2013 −0.66). Conclusion After 1994, a decrease in OC incidence was found, while the incidence of BC and CUC continued to increase. A reduction in mortality rate was observed for BC and OC predominantly at the end of the study period, while for CUC, after a long decreasing mortality trend, a significant increase was observed. PMID:27660470

  19. Estimating natural mortality rates and simulating fishing scenarios for Gulf of Mexico red grouper (Epinephelus morio) using the ecosystem model OSMOSE-WFS

    NASA Astrophysics Data System (ADS)

    Grüss, Arnaud; Schirripa, Michael J.; Chagaris, David; Velez, Laure; Shin, Yunne-Jai; Verley, Philippe; Oliveros-Ramos, Ricardo; Ainsworth, Cameron H.

    2016-02-01

    The ecosystem model OSMOSE-WFS was employed to evaluate natural mortality rates and fishing scenarios for Gulf of Mexico (GOM) red grouper (Epinephelus morio). OSMOSE-WFS represents major high trophic level (HTL) groups of species of the West Florida Shelf, is forced by the biomass of plankton and benthos groups, and has a monthly time step. The present application of the model uses a recently developed 'stochastic mortality algorithm' to resolve the mortality processes of HTL groups. OSMOSE-WFS predictions suggest that the natural mortality rate of juveniles of GOM red grouper is high and essentially due to predation, while the bulk of the natural mortality of adult red grouper results from causes not represented in OSMOSE-WFS such as, presumably, red tides. These results were communicated to GOM red grouper stock assessments. Moreover, OSMOSE-WFS indicate that altering the fishing mortality of GOM red grouper may have no global impact on the biomass of the major prey of red grouper, due to the high complexity and high redundancy of the modeled system. By contrast, altering the fishing mortality of GOM red grouper may have a large impact on the biomass of its major competitors. Increasing the fishing mortality of red grouper would increase the biomass of major competitors, due to reduced competition for food. Conversely, decreasing the fishing mortality of red grouper would diminish the biomass of major competitors, due to increased predation pressure on the juveniles of the major competitors by red grouper. The fishing scenarios that we evaluated may have slightly different impacts in the real world, due to some discrepancies between the diets of red grouper and its major competitors predicted by OSMOSE-WFS and the observed ones. Modifications in OSMOSE-WFS are suggested to reduce these discrepancies.

  20. Lower mortality rates at cardiac specialty hospitals traceable to healthier patients and to doctors' performing more procedures.

    PubMed

    O'Neill, Liam; Hartz, Arthur J

    2012-04-01

    Physician-owned cardiac specialty hospitals advertise that they have outstanding physicians and results. To test this assertion, we examined who gets referred to these hospitals, as well as whether different results occur when specialty physicians split their caseloads among specialty and general hospitals in the same markets. Using data on 210,135 patients who underwent percutaneous coronary interventions in Texas during 2004-07, we found that the risk-adjusted in-hospital mortality rate for patients treated at specialty hospitals was significantly below the rate for all hospitals in the state (0.68 percent versus 1.50 percent). However, the rate was significantly higher when physicians who owned cardiac specialty hospitals treated patients in general hospitals (2.27 percent versus 1.50 percent). In addition, several patient characteristics were associated with a lower likelihood of being admitted to a cardiac hospital for cardiac care, such as being African American or Hispanic and having Medicaid or no health insurance. After adjustment for patient severity and number of procedures performed, the overall outcomes for cardiologists who owned specialty hospitals were not significantly different from the "average outcomes" obtained at noncardiac hospitals. In contrast to previous studies, patient outcomes were found to be highly dependent on the type of hospital where the procedure was performed. To remove a potential source of bias and achieve a more balanced comparison, the quality statistics reported by physician-owned cardiac hospitals should be adjusted to incorporate the high rates of poor outcomes for the many procedures done by their cardiologists at nearby noncardiac hospitals. PMID:22492898

  1. Gender differences in the predictive role of self-rated health on short-term risk of mortality among older adults

    PubMed Central

    Assari, Shervin

    2016-01-01

    Objectives: Despite the well-established association between self-rated health and mortality, research findings have been inconsistent regarding how men and women differ on this link. Using a national sample in the United States, this study compared American male and female older adults for the predictive role of baseline self-rated health on the short-term risk of mortality. Methods: This longitudinal study followed 1500 older adults (573 men (38.2%) and 927 women (61.8%)) aged 66 years or older for 3 years from 2001 to 2004. The main predictor of interest was self-rated health, which was measured using a single item in 2001. The outcome was the risk of all-cause mortality during the 3-year follow-up period. Demographic factors (race and age), socio-economic factors (education and marital status), and health behaviors (smoking and drinking) were covariates. Gender was the focal moderator. We ran logistic regression models in the pooled sample and also stratified by gender, with self-rated health treated as either nominal variables, poor compared to other levels (i.e. fair, good, or excellent) or excellent compared to other levels (i.e. good, fair, or poor), or an ordinal variable. Results: In the pooled sample, baseline self-rated health predicted mortality risk, regardless of how the variable was treated. We found a significant interaction between gender and poor self-rated health, indicating a stronger effect of poor self-rated health on mortality risk for men compared to women. Gender did not interact with excellent self-rated health on mortality. Conclusion: Perceived poor self-rated health better reflects risk of mortality over a short period of time for older men compared to older women. Clinicians may need to take poor self-rated health of older men very seriously. Future research should test whether the differential predictive validity of self-rated health based on gender is due to a different meaning of poor self-rated health for older men and women

  2. Gender differences in the predictive role of self-rated health on short-term risk of mortality among older adults

    PubMed Central

    Assari, Shervin

    2016-01-01

    Objectives: Despite the well-established association between self-rated health and mortality, research findings have been inconsistent regarding how men and women differ on this link. Using a national sample in the United States, this study compared American male and female older adults for the predictive role of baseline self-rated health on the short-term risk of mortality. Methods: This longitudinal study followed 1500 older adults (573 men (38.2%) and 927 women (61.8%)) aged 66 years or older for 3 years from 2001 to 2004. The main predictor of interest was self-rated health, which was measured using a single item in 2001. The outcome was the risk of all-cause mortality during the 3-year follow-up period. Demographic factors (race and age), socio-economic factors (education and marital status), and health behaviors (smoking and drinking) were covariates. Gender was the focal moderator. We ran logistic regression models in the pooled sample and also stratified by gender, with self-rated health treated as either nominal variables, poor compared to other levels (i.e. fair, good, or excellent) or excellent compared to other levels (i.e. good, fair, or poor), or an ordinal variable. Results: In the pooled sample, baseline self-rated health predicted mortality risk, regardless of how the variable was treated. We found a significant interaction between gender and poor self-rated health, indicating a stronger effect of poor self-rated health on mortality risk for men compared to women. Gender did not interact with excellent self-rated health on mortality. Conclusion: Perceived poor self-rated health better reflects risk of mortality over a short period of time for older men compared to older women. Clinicians may need to take poor self-rated health of older men very seriously. Future research should test whether the differential predictive validity of self-rated health based on gender is due to a different meaning of poor self-rated health for older men and women

  3. Cause-Specific Mortality in HIV-Positive Patients Who Survived Ten Years after Starting Antiretroviral Therapy

    PubMed Central

    May, Margaret T.; Vehreschild, Janne; Obel, Niels; Gill, Michael John; Crane, Heidi; Boesecke, Christoph; Samji, Hasina; Grabar, Sophie; Cazanave, Charles; Cavassini, Matthias; Shepherd, Leah; d’Arminio Monforte, Antonella; Smit, Colette; Saag, Michael; Lampe, Fiona; Hernando, Vicky; Montero, Marta; Zangerle, Robert; Justice, Amy C.; Sterling, Timothy; Miro, Jose; Ingle, Suzanne; Sterne, Jonathan A. C.

    2016-01-01

    Objectives To estimate mortality rates and prognostic factors in HIV-positive patients who started combination antiretroviral therapy between 1996–1999 and survived for more than ten years. Methods We used data from 18 European and North American HIV cohort studies contributing to the Antiretroviral Therapy Cohort Collaboration. We followed up patients from ten years after start of combination antiretroviral therapy. We estimated overall and cause-specific mortality rate ratios for age, sex, transmission through injection drug use, AIDS, CD4 count and HIV-1 RNA. Results During 50,593 person years 656/13,011 (5%) patients died. Older age, male sex, injecting drug use transmission, AIDS, and low CD4 count and detectable viral replication ten years after starting combination antiretroviral therapy were associated with higher subsequent mortality. CD4 count at ART start did not predict mortality in models adjusted for patient characteristics ten years after start of antiretroviral therapy. The most frequent causes of death (among 340 classified) were non-AIDS cancer, AIDS, cardiovascular, and liver-related disease. Older age was strongly associated with cardiovascular mortality, injecting drug use transmission with non-AIDS infection and liver-related mortality, and low CD4 and detectable viral replication ten years after starting antiretroviral therapy with AIDS mortality. Five-year mortality risk was <5% in 60% of all patients, and in 30% of those aged over 60 years. Conclusions Viral replication, lower CD4 count, prior AIDS, and transmission via injecting drug use continue to predict higher all-cause and AIDS-related mortality in patients treated with combination antiretroviral therapy for over a decade. Deaths from AIDS and non-AIDS infection are less frequent than deaths from other non-AIDS causes. PMID:27525413

  4. [Significance of trends in infant mortality rates in the municipality of São Paulo, SP (Brazil) in the last 30 years (1950-1979)].

    PubMed

    Monteiro, C A

    1982-02-01

    The possible correlations between infant mortality statistics and those statistics related to the real value of the legal minimum salary and those on the extent of the public water supply system for the city of Sao Paulo, Brazil over the last 3 decades were studied with a view to determining the relationship between the historical trends in infant mortality rates and in the quality of life. The abovementioned factors, salary and water supply, are taken as factors of lesser and greater relevance for the overall picture of the living conditions among this population. The mortality decline in the 1950s and the increase in the 1960s were found significantly related to the trends in the real value of the legal minimum salary. However, the trend in mortality in the 1970s, with a notable fall from 1974, was found to be specifically related to the trends in water supply extension. One might conclude that during the 1950-79 period the implications relating to the quality of life to be drawn from infant mortality trends are diverse. It would seem erroneous to affirm that the reversal in high mortality from 1974 might signify an identical reversal of the deterioration of living conditions which led to the increase of mortality in the preceding period. (author's modified)

  5. Recanalization and Mortality Rates of Thrombectomy With Stent-Retrievers in Octogenarian Patients with Acute Ischemic Stroke

    SciTech Connect

    Parrilla, G.; Carreón, E.; Zamarro, J.; Espinosa de Rueda, M.; García-Villalba, B.; Marín, F.; Hernández-Fernández, F.; Morales, A.; Fernández-Vivas, M.; Núñez, R.; Moreno, A.

    2015-04-15

    BackgroundOur objective was to evaluate the effect of treatment with stent-retrievers in octogenarians suffering an acute ischemic stroke.MethodsA total of 150 consecutive patients with acute stroke who were treated with stent-retrievers between April 2010 and June 2012 were retrospectively reviewed. Patients were divided into those <80 years old (n = 116) and those ≥80 (n = 34). Baseline characteristics, procedure data, and endpoints (postprocedural NIHSS, death, and mRS at 3 months) were compared.ResultsHigh blood pressure, atrial fibrillation, and anticoagulation were more frequent in octogenarians (p = 0.01, 0.003, and 0.04 respectively). There were no differences between both groups regarding previous intravenous thrombolysis (32.4 vs. 48.3 %, p = 0.1), preprocedural NIHSS (18.1 vs. 16.8, p = 0.3), procedure time (74.5 (40–114) min vs. 63 (38–92) min, p = 0.2), revascularization time (380.5 (298–526.3) min vs. 350 (296.3–452.8), p = 0.3), TICI ≥ 2B (88.2 vs. 93.9 %, p = 0.1), and symptomatic haemorrhage (5.9 vs. 2.6 %, p = 0.3). Discharge NIHSS was higher in octogenarians (9.7 vs. 6.5, p = 0.03). Death and 3-month mRS ≥3 were more frequent in octogenarians (35.3 vs. 17.2 %, p = 0.02 and 73.5 vs. 37.1 %, p = 0.02). ICA-involvement and prolonged revascularization involved higher mortality (66.7 vs. 27.6 %, p = 0.03) and worse mRS (50 vs. 24.4 %, p = 0.06) in octogenarians.ConclusionsIn our series, treatment with stent-retrievers in octogenarians with acute ischemic stroke achieved good rates of recanalization but with a high mortality rate. ICA involvement and revascularization times beyond 6 hours associated to a worse prognosis. These data might be of value in the design of prospective studies evaluating the clinical efficacy of the endovascular treatments in octogenarians.

  6. Inclusion of non-viable neonates in the birth record and its impact on infant mortality rates in Shelby County, Tennessee, USA

    PubMed Central

    Williams, Bryan L.; Magsumbol, Melina S.

    2010-01-01

    Rates of infant death are one of the most common indicators of a population's overall health status. Infant mortality rates (IMRs) are used to make broad inferences about the quality of health care, effects of health policies and even environmental quality. The purpose of our study was threefold: i) to examine the characteristics of births in the area in relation to gestational age and birthweight; ii) to estimate infant mortality using variable gestational age and/or birthweight criteria for live birth, and iii) to calculate proportional mortality ratios for each cause of death using variable gestational age and/or birthweight criteria for live birth. We conducted a retrospective analysis of all Shelby County resident-linked birth and infant death certificates during the years 1999 to 2004. Descriptive test statistics were used to examine infant mortality rates in relation to specific maternal and infant risk factors. Through careful examination of 1999–2004 resident-linked birth and infant death data sets, we observed a disproportionate number of non-viable live births (≤20 weeks gestation or ≤350 grams) in Shelby County. Issuance of birth certificates to these non-viable neonates is a factor that contributes to an inflated IMR. Our study demonstrates the complexity and the appropriateness of comparing infant mortality rates in smaller geographic units, given the unique characteristics of live births in Shelby County. The disproportionate number of pre-viable infants born in Shelby County greatly obfuscates neonatal mortality and de-emphasizes the importance of post-neonatal mortality. PMID:21589834

  7. Evaluation of annual survival and mortality rates and longevity of bottlenose dolphins (Tursiops truncatus) at the United States Navy Marine Mammal Program from 2004 through 2013.

    PubMed

    Venn-Watson, Stephanie K; Jensen, Eric D; Smith, Cynthia R; Xitco, Mark; Ridgway, Sam H

    2015-04-15

    Objective-To evaluate annual survival and mortality rates and the longevity of a managed population of bottlenose dolphins (Tursiops truncatus). Design-Retrospective cohort study. Animals-103 bottlenose dolphins at the US Navy Marine Mammal Program (MMP). Procedures-Population age structures, annual survival and crude mortality rates, and median age at death for dolphins > 30 days old were determined from 2004 through 2013. Results-During 2004 through 2013, the annual survival rates for MMP dolphins ranged from 0.98 to 1.0, and the annual crude mortality rates ranged from 0% to 5%, with a mean of 2.7%. The median age at death was 30.1 years from 2004 through 2008 and increased to 32 years from 2009 through 2013. The maximum age for a dolphin in the study was 52 years. Conclusions and Clinical Relevance-Results indicated that the annual mortality rates were low and survival rates were high for dolphins in the MMP from 2004 through 2013 and that the median age at death for MMP dolphins during that time was over 10 years greater than that reported in free-ranging dolphins. These findings were likely attributable to the continually improving care and husbandry of managed dolphin populations.

  8. Mortality and F1 progeny of the lesser grain borer, Rhyzopertha dominica (F), on wheat treated with diatomaceous earth: effects of rate, exposure period and relative humidity.

    PubMed

    Ferizli, Ahmet G; Beris, Gulay

    2005-11-01

    A series of experiments at 25 (+/-1) degrees C were conducted in which different application rates of diatomaceous earth (DE) formulation Protect-It at two levels of relative humidity, 40 and 55%, and at three exposure periods were evaluated for control of Rhyzopertha dominica (F). Test insects were placed in vials containing 40 g of soft winter wheat mixed with 0.25, 0.50, 1.00, 1.50 and 2.00 g DE kg(-1). At all rates except 0.25 g kg(-1), mortality was significantly different from that in the control at the relevant exposure period. After each exposure interval, dead and live insects were counted and removed, and the vial containing wheat was then returned to the appropriate humidity chamber for 8 weeks until F(1) adults emerged. F(1) progeny production was significantly different from the control group at all rates. Mortalities for 1, 2 and 3 weeks exposure were found to be 47 (+/-5)%. Despite the fact that mortality increased with increasing rate, total mortality was not achieved even at the highest rate of DE. F(1) progeny production decreased with increasing rate for both RH conditions, and containment of population for both RH conditions was achieved at 1.00 g DE kg(-1). For each exposure period, F(1) progeny production of R dominica decreased with increasing rate of DE, and population suppression was achieved at 1.00 g DE kg(-1) for all exposure intervals. In summary, Protect-It resulted in reduced F(1) adult progeny and containment of population was achieved at 1.00 g DE kg(-1) at which rate mortality was 77%.

  9. Low protein catabolic rate and serum albumin correlate with increased mortality and abdominal complications in peritoneal dialysis patients.

    PubMed

    Germain, M; Harlow, P; Mulhern, J; Lipkowitz, G; Braden, G

    1992-01-01

    We retrospectively reviewed 167 consecutive peritoneal dialysis patients with regard to serum albumin (Alb), mortality and abdominal complications. In addition, 25 patients were studied with serial measurements of urea kinetics. The patients were divided into four groups based on their dialysis index (DI) and normalized protein catabolic rate (NPCR) (Table I). 12/167 patients were identified with abdominal catastrophes. Before these complications occurred, the M Alb in this group was 2.67 + 0.24 (compared to age, sex and disease matched controls of 3.55 + .11 P < .05). Six of these patients died from abdominal complications. In the 26 patients with serial urea kinetic studies, 4/11 patients in group IV died (low NPCR and low DI) (P < .05 compared to Group I, II or III). We conclude that urea kinetic modeling is predictive of outcome in those patients with presumed poor nutrition and inadequate dialysis and that abdominal catastrophes are more common in those patients with poor nutrition. Prospective interventional studies should be designed in an attempt to improve the poor outcome in this group of patients.

  10. The logic of comparative life history studies for estimating key parameters, with a focus on natural mortality rate

    USGS Publications Warehouse

    Hoenig, John M; Then, Amy Y.-H.; Babcock, Elizabeth A.; Hall, Norman G.; Hewitt, David A.; Hesp, Sybrand A.

    2016-01-01

    There are a number of key parameters in population dynamics that are difficult to estimate, such as natural mortality rate, intrinsic rate of population growth, and stock-recruitment relationships. Often, these parameters of a stock are, or can be, estimated indirectly on the basis of comparative life history studies. That is, the relationship between a difficult to estimate parameter and life history correlates is examined over a wide variety of species in order to develop predictive equations. The form of these equations may be derived from life history theory or simply be suggested by exploratory data analysis. Similarly, population characteristics such as potential yield can be estimated by making use of a relationship between the population parameter and bio-chemico–physical characteristics of the ecosystem. Surprisingly, little work has been done to evaluate how well these indirect estimators work and, in fact, there is little guidance on how to conduct comparative life history studies and how to evaluate them. We consider five issues arising in such studies: (i) the parameters of interest may be ill-defined idealizations of the real world, (ii) true values of the parameters are not known for any species, (iii) selecting data based on the quality of the estimates can introduce a host of problems, (iv) the estimates that are available for comparison constitute a non-random sample of species from an ill-defined population of species of interest, and (v) the hierarchical nature of the data (e.g. stocks within species within genera within families, etc., with multiple observations at each level) warrants consideration. We discuss how these issues can be handled and how they shape the kinds of questions that can be asked of a database of life history studies.

  11. The effect of excess fluid balance on the mortality rate of surgical patients: a multicenter prospective study

    PubMed Central

    2013-01-01

    Introduction In some studies including small populations of patients undergoing specific surgery, an intraoperative liberal infusion of fluids was associated with increasing morbidity when compared to restrictive strategies. Therefore, to evaluate the role of excessive fluid infusion in a general population with high-risk surgery is very important. The aim of this study was to evaluate the impact of intraoperative fluid balance on the postoperative organ dysfunction, infection and mortality rate. Methods We conducted a prospective cohort study during one year in four ICUs from three tertiary hospitals, which included patients aged 18 years or more who required postoperative ICU after undergoing major surgery. Patients who underwent palliative surgery and whose fluid balance could change in outcome were excluded. The calculation of fluid balance was based on preoperative fasting, insensible losses from surgeries and urine output minus fluid replacement intraoperatively. Results The study included 479 patients. Mean age was 61.2 ± 17.0 years and 8.8% of patients died at the hospital during the study. The median duration of surgery was 4.0 (3.2 to 5.5) h and the value of the Simplified Acute Physiology Score (SAPS) 3 score was 41.8 ± 14.5. Comparing survivors and non-survivors, the intraoperative fluid balance from non-survivors was higher (1,950 (1,400 to 3,400) mL vs. 1,400 (1,000 to 1,600) mL, P <0.001). Patients with fluid balance above 2,000 mL intraoperatively had a longer ICU stay (4.0 (3.0 to 8.0) vs. 3.0 (2.0 to 6.0), P <0.001) and higher incidence of infectious (41.9% vs. 25.9%, P = 0.001), neurological (46.2% vs. 13.2%, P <0.001), cardiovascular (63.2% vs. 39.6%, P <0.001) and respiratory complications (34.3% vs. 11.6%, P <0.001). In multivariate analysis, the fluid balance was an independent factor for death (OR per 100 mL = 1.024; P = 0.006; 95% CI 1.007 to 1.041). Conclusions Patients with excessive intraoperative fluid balance have more ICU

  12. Does absorption of ultraviolet B by stratospheric ozone and urban aerosols influence colon and breast cancer mortality rates? Contributions from NASA and NOAA data

    NASA Astrophysics Data System (ADS)

    Gorham, Edward D.; Garland, Frank C.; Mohr, Sharif B.; Grant, William B.; Garland, Cedric F.

    2005-08-01

    Although most ultraviolet B (UVB) radiation is absorbed by stratospheric ozone, dense anthropogenic sulfate aerosols in the troposphere may further attenuate UVB in some regions. Mortality rates from colon and breast cancer tend to be much higher in areas with low levels of UVB radiation. These high rates may be due in part to inadequate cutaneous photosynthesis of vitamin D. Satellite data on atmospheric aerosols, stratospheric ozone, and cloud cover were obtained from the National Aeronautics and Space Administration (NASA) and the National Oceanic and Atmospheric Administration (NOAA). These data were combined with age-adjusted mortality rates from 175 countries reporting to the World Health Organization. Regression was used to assess the relationship of stratospheric ozone thickness, aerosol optical depth, cloud cover, solar UVB irradiance at the top of the atmosphere, average skin exposure, and a dietary factor with colon and breast cancer mortality rates. Solar UVB irradiance at the top of the atmosphere, total cloud cover, and atmospheric aerosols had the strongest associations with mortality rates, apart from a strong influence of diet. Since 95% of circulating vitamin D is derived from current or stored products of photosynthesis, which may be nonexistent or minimal much of the year above 37°N or below 37°S, attenuation of UVB by atmospheric aerosols and clouds may have a greater than expected adverse effect on human health.

  13. The effects of strong shock waves on mortality rates and percentages of pulmonary lesions in rats as a function of the number of exposures

    NASA Technical Reports Server (NTRS)

    Vassout, P.; Parmentier, G.

    1978-01-01

    The results of the study reveal that with regard to the pulmonary lesions, twice the number of exposures is compensated for by quartering the overpressure of the wave crest. With regard to the mortality rates, it reveals that halving the overpressure of the wave crest is offset by a 20-fold increase in the number of exposures.

  14. Are Gender Differences in the Relationship between Self-Rated Health and Mortality Enduring? Results from Three Birth Cohorts in Melton Mowbray, United Kingdom

    ERIC Educational Resources Information Center

    Spiers, Nicola; Jagger, Carol; Clarke, Michael; Arthur, Antony

    2003-01-01

    Purpose: The purpose of this study was to assess whether there is an enduring gender difference in the ability of self-rated health to predict mortality and investigate whether self-reported physical health problems account for this difference. Design and Methods: Cox models for 4-year survival were fitted to data from successive cohorts aged…

  15. 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

  16. Evaluating the predictive performance of empirical estimators of natural mortality rate using information on over 200 fish species

    USGS Publications Warehouse

    Then, Amy Y.; Hoenig, John M; Hall, Norman G.; Hewitt, David A.

    2015-01-01

    Many methods have been developed in the last 70 years to predict the natural mortality rate, M, of a stock based on empirical evidence from comparative life history studies. These indirect or empirical methods are used in most stock assessments to (i) obtain estimates of M in the absence of direct information, (ii) check on the reasonableness of a direct estimate of M, (iii) examine the range of plausible M estimates for the stock under consideration, and (iv) define prior distributions for Bayesian analyses. The two most cited empirical methods have appeared in the literature over 2500 times to date. Despite the importance of these methods, there is no consensus in the literature on how well these methods work in terms of prediction error or how their performance may be ranked. We evaluate estimators based on various combinations of maximum age (tmax), growth parameters, and water temperature by seeing how well they reproduce >200 independent, direct estimates of M. We use tenfold cross-validation to estimate the prediction error of the estimators and to rank their performance. With updated and carefully reviewed data, we conclude that a tmax-based estimator performs the best among all estimators evaluated. The tmax-based estimators in turn perform better than the Alverson–Carney method based on tmax and the von Bertalanffy K coefficient, Pauly's method based on growth parameters and water temperature and methods based just on K. It is possible to combine two independent methods by computing a weighted mean but the improvement over the tmax-based methods is slight. Based on cross-validation prediction error, model residual patterns, model parsimony, and biological considerations, we recommend the use of a tmax-based estimator (M=4.899t−0.916max, prediction error = 0.32) when possible and a growth-based method (M=4.118K0.73L−0.33∞ , prediction error = 0.6) otherwise.

  17. Mortality rates at 10 years are higher in diabetic than in non-diabetic patients with chronic lower extremity peripheral arterial disease

    PubMed Central

    Mueller, Thomas; Hinterreiter, Franz; Poelz, Werner; Haltmayer, Meinhard; Dieplinger, Benjamin

    2016-01-01

    Patients with lower extremity peripheral artery disease (PAD) have a substantially increased risk for mortality as compared to healthy individuals. We aimed to evaluate the risk for all-cause mortality in PAD patients and in healthy controls during a 10-year follow-up period. Our hypothesis was that the mortality rates at 10 years would differ in diabetic and non-diabetic PAD patients. Our study group consisted of 331 consecutive patients with symptomatic PAD <75 years of age admitted to a tertiary care hospital, including 216 patients without diabetes and 115 with diabetes. Control subjects without atherosclerotic disease were matched to the patients in a 1:1 design by sex, age, and diabetes mellitus status. The outcome measure was all-cause mortality at 10 years. Mortality rates at 10 years were 29% in non-diabetic PAD patients versus 14% in age- and sex-matched non-diabetic controls (risk ratio (RR), 2.31; 95% confidence interval (CI), 1.54–3.47; p<0.001), and 58% in diabetic PAD patients versus 19% in age- and sex-matched diabetic controls (RR, 4.06; 95% CI, 2.67–6.18; p<0.001). Further, PAD patients with diabetes had a significantly increased risk for death within 10 years than did the non-diabetic PAD patients (RR, 2.51; 95% CI, 1.72–3.66; p<0.001). Diabetes was independently associated with outcome, and was the strongest predictor of death in multivariate Cox proportional hazards regression. We conclude that mortality rates at 10 years differ in PAD patients <75 years old with and without diabetes. Our findings suggest that future studies should apply distinct risk assessment strategies in the two PAD subgroups. PMID:27067137

  18. The Acceptability of Psychosocial Support Interventions for Children Orphaned by HIV/AIDS: An Evaluation of Teacher Ratings

    ERIC Educational Resources Information Center

    Chitiyo, Morgan; Changara, Darlington; Chitiyo, George

    2010-01-01

    The AIDS epidemic has created many orphans around the globe. A majority of these orphans live in sub-Saharan Africa. Children orphaned by HIV/AIDS face many daunting challenges in their struggle to cope with life. The issues they face due to the loss of their parent(s) include poverty, the stigma associated with HIV/AIDS and stress. This study…

  19. Association of Age, Systolic Blood Pressure, and Heart Rate with Adult Morbidity and Mortality after Urgent Care Visits

    PubMed Central

    Hart, James; Woodruff, Michael; Joy, Elizabeth; Dalto, Joseph; Snow, Gregory; Srivastava, Rajendu; Isaacson, Brad; Allen, Todd

    2016-01-01

    Introduction Little data exists to help urgent care (UC) clinicians predict morbidity and mortality risk. Age, systolic blood pressure (SBP), and heart rate (HR) are easily obtainable and have been used in other settings to predict short-term risk of deterioration. We hypothesized that there is a relationship between advancing age, SBP, HR, and short-term health outcomes in the UC setting. Methods We collected retrospective data from 28 UC clinics and 22 hospitals in the Intermountain Healthcare system between years 2008–2013. Adult patients (≥18 years) were included if they had a unique UC visit and HR or SBP data. Three endpoints following UC visit were assessed: emergency department (ED) visit within three days, hospitalization within three days, and death within seven days. We analyzed associations between age, SBP, HR and endpoints using local regression with a binomial likelihood. Five age groups were chosen from previously published national surveys. Vital sign (VS) distributions were determined for each age group, and the central tendency was compared against previously published norms (90–120mmHg for SBP and 60–100bpm for HR.) Results A total of 1,720,207 encounters (714,339 unique patients) met the inclusion criteria; 51,446 encounters (2.99%) had ED visit within three days; 12,397 (0.72%) experienced hospitalization within three days; 302 (0.02%) died within seven days of UC visit. Heart rate and SBP combined with advanced age predicted the probability of ED visit (p<0.0001) and hospitalization (p<0.0001) following UC visit. Significant associations between advancing age and death (p<0.0001), and VS and death (p<0.0001) were observed. Odds ratios of risk were highest for elderly patients with lower SBP or higher HR. Observed distributions of SBP were higher than published normal ranges for all age groups. Conclusion Among adults seeking care in the UC, associations between HR and SBP and likelihood of ED visits and hospitalization were more

  20. Association of Age, Systolic Blood Pressure, and Heart Rate with Adult Morbidity and Mortality after Urgent Care Visits

    PubMed Central

    Hart, James; Woodruff, Michael; Joy, Elizabeth; Dalto, Joseph; Snow, Gregory; Srivastava, Rajendu; Isaacson, Brad; Allen, Todd

    2016-01-01

    Introduction Little data exists to help urgent care (UC) clinicians predict morbidity and mortality risk. Age, systolic blood pressure (SBP), and heart rate (HR) are easily obtainable and have been used in other settings to predict short-term risk of deterioration. We hypothesized that there is a relationship between advancing age, SBP, HR, and short-term health outcomes in the UC setting. Methods We collected retrospective data from 28 UC clinics and 22 hospitals in the Intermountain Healthcare system between years 2008–2013. Adult patients (≥18 years) were included if they had a unique UC visit and HR or SBP data. Three endpoints following UC visit were assessed: emergency department (ED) visit within three days, hospitalization within three days, and death within seven days. We analyzed associations between age, SBP, HR and endpoints using local regression with a binomial likelihood. Five age groups were chosen from previously published national surveys. Vital sign (VS) distributions were determined for each age group, and the central tendency was compared against previously published norms (90–120mmHg for SBP and 60–100bpm for HR.) Results A total of 1,720,207 encounters (714,339 unique patients) met the inclusion criteria; 51,446 encounters (2.99%) had ED visit within three days; 12,397 (0.72%) experienced hospitalization within three days; 302 (0.02%) died within seven days of UC visit. Heart rate and SBP combined with advanced age predicted the probability of ED visit (p<0.0001) and hospitalization (p<0.0001) following UC visit. Significant associations between advancing age and death (p<0.0001), and VS and death (p<0.0001) were observed. Odds ratios of risk were highest for elderly patients with lower SBP or higher HR. Observed distributions of SBP were higher than published normal ranges for all age groups. Conclusion Among adults seeking care in the UC, associations between HR and SBP and likelihood of ED visits and hospitalization were more

  1. Rising HIV infection rates in Ho Chi Minh City herald emerging AIDS epidemic in Vietnam.

    PubMed

    Lindan, C P; Lieu, T X; Giang, L T; Lap, V D; Thuc, N V; Thinh, T; Lurie, P; Mandel, J S

    1997-09-01

    An analysis of annual sentinel surveillance data from Viet Nam indicates that Ho Chi Minh City is at the forefront of a new HIV epidemic. Since 1990, data on HIV cases have been collected from prenatal clinics, blood banks, centers for the treatment of sexually transmitted diseases (STDs) and tuberculosis, and rehabilitation centers for injecting drug users and commercial sex workers. The first HIV case in Viet Nam was reported in 1990 in Ho Chi Minh City. By the end of 1996, a cumulative total of 4961 HIV cases had been documented in Viet Nam, 2774 of which were in Ho Chi Minh City. In Ho Chi Minh City, 86.5% of cumulative HIV infections involved men. The distribution of total HIV cases by group has been: injecting drug users, 86.0%; tuberculosis patients, 3.3%; sex workers, 2.5%; STD patients, 2.5%; and pregnant women, 0.6%. By 1996, 42 of Viet Nam's 53 provinces had reported HIV cases and infection rates are rising dramatically in border areas near China and Cambodia. The pattern documented in this analysis resembles that observed in Thailand a decade ago: rapidly rising HIV rates among injecting drug users and infection already established among sex workers, without dissemination to the general population. The necessary infrastructure and resources for control of the epidemic are far more limited in Viet Nam than Thailand, however. Recommended, to prevent the further spread of HIV in Viet Nam, are educational activities targeted at injecting drug users and sex workers outside of rehabilitation centers, the availability of condoms and sterile needles, establishment of anonymous testing sites, control of STDs, and the coordination of programs within southeast Asia.

  2. Rising HIV infection rates in Ho Chi Minh City herald emerging AIDS epidemic in Vietnam.

    PubMed

    Lindan, C P; Lieu, T X; Giang, L T; Lap, V D; Thuc, N V; Thinh, T; Lurie, P; Mandel, J S

    1997-09-01

    An analysis of annual sentinel surveillance data from Viet Nam indicates that Ho Chi Minh City is at the forefront of a new HIV epidemic. Since 1990, data on HIV cases have been collected from prenatal clinics, blood banks, centers for the treatment of sexually transmitted diseases (STDs) and tuberculosis, and rehabilitation centers for injecting drug users and commercial sex workers. The first HIV case in Viet Nam was reported in 1990 in Ho Chi Minh City. By the end of 1996, a cumulative total of 4961 HIV cases had been documented in Viet Nam, 2774 of which were in Ho Chi Minh City. In Ho Chi Minh City, 86.5% of cumulative HIV infections involved men. The distribution of total HIV cases by group has been: injecting drug users, 86.0%; tuberculosis patients, 3.3%; sex workers, 2.5%; STD patients, 2.5%; and pregnant women, 0.6%. By 1996, 42 of Viet Nam's 53 provinces had reported HIV cases and infection rates are rising dramatically in border areas near China and Cambodia. The pattern documented in this analysis resembles that observed in Thailand a decade ago: rapidly rising HIV rates among injecting drug users and infection already established among sex workers, without dissemination to the general population. The necessary infrastructure and resources for control of the epidemic are far more limited in Viet Nam than Thailand, however. Recommended, to prevent the further spread of HIV in Viet Nam, are educational activities targeted at injecting drug users and sex workers outside of rehabilitation centers, the availability of condoms and sterile needles, establishment of anonymous testing sites, control of STDs, and the coordination of programs within southeast Asia. PMID:9376101

  3. Development of a strain rate dependent material model of human cortical bone for computer-aided reconstruction of injury mechanisms.

    PubMed

    Asgharpour, Zahra; Zioupos, Peter; Graw, Matthias; Peldschus, Steffen

    2014-03-01

    Computer-aided methods such as finite-element simulation offer a great potential in the forensic reconstruction of injury mechanisms. Numerous studies have been performed on understanding and analysing the mechanical properties of bone and the mechanism of its fracture. Determination of the mechanical properties of bones is made on the same basis used for other structural materials. The mechanical behaviour of bones is affected by the mechanical properties of the bone material, the geometry, the loading direction and mode and of course the loading rate. Strain rate dependency of mechanical properties of cortical bone has been well demonstrated in literature studies, but as many of these were performed on animal bones and at non-physiological strain rates it is questionable how these will apply in the human situations. High strain-rates dominate in a lot of forensic applications in automotive crashes and assault scenarios. There is an overwhelming need to a model which can describe the complex behaviour of bone at lower strain rates as well as higher ones. Some attempts have been made to model the viscoelastic and viscoplastic properties of the bone at high strain rates using constitutive mathematical models with little demonstrated success. The main objective of the present study is to model the rate dependent behaviour of the bones based on experimental data. An isotropic material model of human cortical bone with strain rate dependency effects is implemented using the LS-DYNA material library. We employed a human finite element model called THUMS (Total Human Model for Safety), developed by Toyota R&D Labs and the Wayne State University, USA. The finite element model of the human femur is extracted from the THUMS model. Different methods have been employed to develop a strain rate dependent material model for the femur bone. Results of one the recent experimental studies on human femur have been employed to obtain the numerical model for cortical femur. A

  4. Development of a strain rate dependent material model of human cortical bone for computer-aided reconstruction of injury mechanisms.

    PubMed

    Asgharpour, Zahra; Zioupos, Peter; Graw, Matthias; Peldschus, Steffen

    2014-03-01

    Computer-aided methods such as finite-element simulation offer a great potential in the forensic reconstruction of injury mechanisms. Numerous studies have been performed on understanding and analysing the mechanical properties of bone and the mechanism of its fracture. Determination of the mechanical properties of bones is made on the same basis used for other structural materials. The mechanical behaviour of bones is affected by the mechanical properties of the bone material, the geometry, the loading direction and mode and of course the loading rate. Strain rate dependency of mechanical properties of cortical bone has been well demonstrated in literature studies, but as many of these were performed on animal bones and at non-physiological strain rates it is questionable how these will apply in the human situations. High strain-rates dominate in a lot of forensic applications in automotive crashes and assault scenarios. There is an overwhelming need to a model which can describe the complex behaviour of bone at lower strain rates as well as higher ones. Some attempts have been made to model the viscoelastic and viscoplastic properties of the bone at high strain rates using constitutive mathematical models with little demonstrated success. The main objective of the present study is to model the rate dependent behaviour of the bones based on experimental data. An isotropic material model of human cortical bone with strain rate dependency effects is implemented using the LS-DYNA material library. We employed a human finite element model called THUMS (Total Human Model for Safety), developed by Toyota R&D Labs and the Wayne State University, USA. The finite element model of the human femur is extracted from the THUMS model. Different methods have been employed to develop a strain rate dependent material model for the femur bone. Results of one the recent experimental studies on human femur have been employed to obtain the numerical model for cortical femur. A

  5. Improving size, lymph node metastatic rate, breast conservation, and mortality of invasive breast cancer in Rhode Island women, a well-screened population.

    PubMed

    Coburn, Natalie G; Cady, Blake; Fulton, John P; Law, Calvin; Chung, Maureen A

    2012-10-01

    The beneficial impact of screening mammography on breast cancer outcome continues to be debated as demonstrated by guidelines published by the United States Preventive Services Task Force. A previous report from Rhode Island, which has a very high rate of mammographic screening, demonstrated significant improvements in invasive breast cancer presentation and mortality through 2001. This report updates data through 2008 to determine whether previous favorable trends continued. Rhode Island Cancer Registry data regarding invasive breast cancer presentation and mortality in 17,522 female residents diagnosed between 1987 and 2008, inclusive, were analyzed for demographic and pathological factors. Data were analyzed by four time periods: 1987-1992, 1993-1998, 1999-2003, and 2004-2008 and overall. Statistically significant improvements occurred over the four successive time periods, in mean cancer size (23.7, 20.9, 19.6, and 19.3 mm, p < 0.0001), pathologic grade (Grade I: 12, 15, 19, and 17 %; Grade III 57, 41, 36, and 35 %, p < 0.0001), breast conserving surgery (38, 56, 67, and 71 %, p < 0.0001) and mortality (37.3, 31.4, 25.1, and 22.6 per 100,000/year, p < 0.0001). The results showed that high screening rates favorably impacted presentation of and mortality from invasive breast cancer in Rhode Island. From 1987 to 2008, there has been a 39 % decline in breast cancer mortality considering 5 year periods (37.3 vs. 22.6 deaths per 100,000) and 41 % comparing the period from 1990 to 2008, which may exceed the goal of 50 % mortality reduction by 2015 established by the American Cancer Society.

  6. Association between self-rated health and mortality: 10 years follow-up to the Pró-Saúde cohort study

    PubMed Central

    2012-01-01

    Background The association between self-rated health (SRH) and mortality is well documented in the literature, but studies on the subject among young adults in Latin America are rare, as are those evaluating this association using repeated SRH measures, beyond the baseline measurement. This study aims to evaluate the association between SRH evaluated at three data collection stages and mortality. Methods Cox regression models were used to examine the association between SRH (Very good, Good, Fair/Poor) varying over time and mortality, over a 10 year period, in a cohort of non-faculty civil servants at a public university in Rio de Janeiro, Brazil (Pró-Saúde Study, n = 4009, men = 44.4%). Results About 40% of the population changed their self-rating over the course of follow-up. After adjustment for self-reported physician-diagnosed chronic diseases and other covariates, men who reported “Fair/Poor” SRH showed relative hazard of death of 2.13 (CI95% 1.03-4.40) and women, 3.43 (CI95% 1.23-9.59), as compared with those who reported “Very good” SRH. Conclusions In a population of young adults, our findings reinforce the role of SRH as a predictor of mortality, even controlling for objective measures of health. PMID:22905737

  7. Contribution of exposure, risk of crash and fatality to explain age- and sex-related differences in traffic-related cyclist mortality rates.

    PubMed

    Martínez-Ruiz, Virginia; Jiménez-Mejías, Eladio; Amezcua-Prieto, Carmen; Olmedo-Requena, Rocío; Luna-del-Castillo, Juan de Dios; Lardelli-Claret, Pablo

    2015-03-01

    This study was designed to quantify the percent contribution of exposure, risk of collision and fatality rate to the association of age and sex with the mortality rates among cyclists in Spain, and to track the changes in these contributions with time. Data were analyzed for 50,042 cyclists involved in road crashes in Spain from 1993 to 2011, and also for a subset of 13,119 non-infractor cyclists involved in collisions with a vehicle whose driver committed an infraction (used as a proxy sample of all cyclists on the road). We used decomposition and quasi-induced exposure methods to obtain the percent contributions of these three components to the mortality rate ratios for each age and sex group compared to males aged 25-34 years. Death rates increased with age, and the main component of this increase was fatality (around 70%). Among younger cyclists, however, the main component of increased death rates was risk of a collision. Males had higher death rates than females in every age group: this rate increased from 6.4 in the 5-14 year old group to 18.8 in the 65-79 year old group. Exposure, the main component of this increase, ranged between 70% and 90% in all age categories, although the fatality component also contributed to this increase. The contributions of exposure, risk of crash and fatality to cyclist death rates were strongly associated with age and sex. Young male cyclists were a high-risk group because all three components tended to increase their mortality rate. PMID:25658669

  8. Sources and rates of mortality of the San Joaquin kit fox, Naval Petroleum Reserve No. 1, Kern County, California, 1980-1986. [Vulpes macrotis mutica

    SciTech Connect

    Berry, W.H.; Scrivner, J.H.; O'Farrell, T.P.; Harris, C.E.; Kato, T.T.; McCue, P.M.

    1987-03-01

    Sources and rates of mortality of the San Joaquin kit fox (Vulpes macrotis mutica) were studied from 1980 to 1986. Of 270 foxes radiocollared, 225 were recovered dead. Of the 225 recovered dead 53.8% (121) were killed by predators, 10.7% (24) were killed by vehicles, 4.4% (10) died from causes other than predation, and 31.1% (70) died from unknown causes. Contingency-table analysis was used to assess the relationship between cause of death and sex, age class (juvenile and adult), habitat type (undeveloped and developed), and year of death (1980-1986). More adults in undeveloped habitat were killed by vehicles than were juveniles; more female juveniles in developed habitat were killed by vehicles than female adults; more juveniles were killed by vehicles in developed habitat than in undeveloped habitat; and more adults in developed habitat were killed by predators in later years of the study than in early years. Over 90% of the foxes collared as juveniles were recovered in their first or second year. Fourteen mortality rates based on age class and year of death were estimated using maximum-likelihood estimation. Mortality rates were higher for juvenile foxes (x-bar = 0.74) than for adult foxes (x-bar = 0.52). For foxes collared as juveniles, there was no significant difference in survival between the two habitat types or between the sexes. Mortality of adults increased between 1980 and 1986. Because coyote predation was a major cause of kit fox mortality the coyote control program implemented in 1985 should be continued and its effectiveness should be evaluated by continued monitoring of kit fox, coyote, and prey populations.

  9. Efficiency of Intergeneric Recombinants Between Bacillus Thuringiensis and Bacillus Subtilis for Increasing Mortality Rate in Cotten Leaf Worm

    NASA Astrophysics Data System (ADS)

    AlOtaibi, Saad Aied

    2012-12-01

    In this study , two strains of Bacillus belonging to two serotypes and four of their transconjugants were screened with respect to their toxicity against lepidopterous cotton pest. . Bacterial transconjugants isolated from conjugation between both strains were evaluated for their transconjugant efficiency caused mortality in Spodoptera littoralis larvae . Two groups of bioinsecticides ; crystals , crystals and spores have been isolated from Bacillusstrains and their transconjugants . Insecticidal crystal protein ( ICP ) was specific for lepidopteran insects because of the toxin sufficient both for insect specificity and toxicity . The toxicities of these two groups against larvae of Spodoptera littoralis was expressed as transconjugant efficiency , which related to the mean number of larvae died expressed as mortality percentage . The results showed transconjugant efficiency in reducing the mean number of Spodoptera littoralis larvae feeding on leaves of Ricinus communis sprayed with bioinsecticides of Bt transconjugants. Most values of positive transconjugant efficiency related to increasing mortality percentage are due to toxicological effects appeared in response to the treatments with crystals + endospores than that of crystals alone .This indicated that crystals + endospores was more effective for increasing mortality percentage than that resulted by crystals . Higher positive transconjugant efficiency in relation to the mid parents and better parent was appeared at 168 h of treatment . The results indicated that recombinant Bacillus thuringiensis are important control agents for lepidopteran pests , as well as , susceptibility decreased with larval development . The results also suggested a potential for the deployment of these recominant entomopathogens in the management of Spodoptera. littoralis larvae .

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

    ERIC Educational Resources Information Center

    McCarron, Mary; Carroll, Rachael; Kelly, Caraiosa; McCallion, Philip

    2015-01-01

    Background:Historically, there has been higher and earlier mortality among people with intellectual disability as compared to the general population, but there have also been methodological problems and differences in the available studies. Method: Data were drawn from the 2012 National Intellectual Disability Database and the Census in Ireland. A…

  11. Determination of florfenicol dose rate in feed for control of mortality in nile tilapia Oreochromis nilotica infected with streptococcus iniae

    Technology Transfer Automated Retrieval System (TEKTRAN)

    A dose titration study was conducted to determine the dosage of florfenicol (FFC) in feed to control Streptococcus iniae-associated mortality in Nile tilapia Oreochromis niloticus. Six tanks were assigned to each of five treatments: (1) not challenged with S. iniae and fed unmedicated feed; (2) chal...

  12. Average County-Level IQ Predicts County-Level Disadvantage and Several County-Level Mortality Risk Rates

    ERIC Educational Resources Information Center

    Barnes, J. C.; Beaver, Kevin M.; Boutwell, Brian B.

    2013-01-01

    Research utilizing individual-level data has reported a link between intelligence (IQ) scores and health problems, including early mortality risk. A growing body of evidence has found similar associations at higher levels of aggregation such as the state- and national-level. At the same time, individual-level research has suggested the…

  13. Lung cancer mortality between 1950 and 1987 after exposure to fractionated moderate-dose-rate ionizing radiation in the Canadian fluoroscopy cohort study and a comparison with lung cancer mortality in the atomic bomb survivors study

    SciTech Connect

    Howe, G.R.

    1995-06-01

    Current lung cancer risk estimates after exposure to low-linear energy transfer radiation such as X rays are based on studies of people exposed to such radiation at high dose rates, for example the atomic bomb survivors. Radiobiology and animal experiments suggest that risks from exposure at low to moderate dose rates, for example medical diagnostic procedures, may be overestimated by such risk models, but data for humans to examine this issue are limited. In this paper we report on lung cancer mortality between 1950 and 1987 in a cohort of 64,172 Canadian tuberculosis patients, of whom 39% were exposed to highly fractionated multiple chest fluoroscopies leading to a mean lung radiation dose of 1.02 Sv received at moderate dose rates. These data have been used to estimate the excess relative risk per sievert of lung cancer mortality, and this is compared directly to estimates derived from 75,991 atomic bomb survivors. Based on 1,178 lung cancer deaths in the fluoroscopy study, there was no evidence of any positive association between risk and dose, with the relative risk at 1 Sv being 1.00 (95% confidence interval 0.94, 1.07), which contrasts with that based on the atomic bomb survivors, 1.60 (1.27, 1.99). The difference in effect between the two studies almost certainly did not arise by chance (P = 0.0001). This study provides strong support from data for humans for a substantial fractionation/dose-rate effect for low-linear energy transfer radiation and lung cancer risk. This implies that lung cancer risk from exposures to such radiation at present-day dose rates is likely to be lower than would be predicted by current radiation risk models based on studies of high-dose-rate exposures. 25 refs., 8 tabs.

  14. An index of unhealthy lifestyle is associated with coronary heart disease mortality rates for small areas in England after adjustment for deprivation.

    PubMed

    Scarborough, P; Allender, S; Rayner, M; Goldacre, M

    2011-03-01

    Indices of socio-economic deprivation are often used as a proxy for differences in the health behaviours of populations within small areas, but these indices are a measure of the economic environment rather than the health environment. Sets of synthetic estimates of the ward-level prevalence of low fruit and vegetable consumption, obesity, raised blood pressure, raised cholesterol and smoking were combined to develop an index of unhealthy lifestyle. Multi-level regression models showed that this index described about 50% of the large-scale geographic variation in CHD mortality rates in England, and substantially adds to the ability of an index of deprivation to explain geographic variations in CHD mortality rates.

  15. Decision aid on breast cancer screening reduces attendance rate: results of a large-scale, randomized, controlled study by the DECIDEO group.

    PubMed

    Bourmaud, Aurelie; Soler-Michel, Patricia; Oriol, Mathieu; Regnier, Véronique; Tinquaut, Fabien; Nourissat, Alice; Bremond, Alain; Moumjid, Nora; Chauvin, Franck

    2016-03-15

    Controversies regarding the benefits of breast cancer screening programs have led to the promotion of new strategies taking into account individual preferences, such as decision aid. The aim of this study was to assess the impact of a decision aid leaflet on the participation of women invited to participate in a national breast cancer screening program. This Randomized, multicentre, controlled trial. Women aged 50 to 74 years, were randomly assigned to receive either a decision aid or the usual invitation letter. Primary outcome was the participation rate 12 months after the invitation. 16 000 women were randomized and 15 844 included in the modified intention-to-treat analysis. The participation rate in the intervention group was 40.25% (3174/7885 women) compared with 42.13% (3353/7959) in the control group (p = 0.02). Previous attendance for screening (RR = 6.24; [95%IC: 5.75-6.77]; p < 0.0001) and medium household income (RR = 1.05; [95%IC: 1.01-1.09]; p = 0.0074) were independently associated with attendance for screening. This large-scale study demonstrates that the decision aid reduced the participation rate. The decision aid activate the decision making process of women toward non-attendance to screening. These results show the importance of promoting informed patient choices, especially when those choices cannot be anticipated.

  16. Mortality and pituitary disease.

    PubMed

    Stewart, Paul M; Sherlock, Mark

    2012-04-01

    Outcome data from large series confirm increased mortality of patients with pituitary tumours, predominantly due to vascular disease. Control of cortisol secretion and growth hormone (GH) hypersecretion (together with cardiovascular risk factor reduction) is key in the normalisation of mortality rates in patients with Cushing's disease and acromegaly, respectively, though some excess mortality may persist even in "cured" patients.

  17. Nonpharmacological therapies and provision of aids in outpatient dementia networks in Germany: utilization rates and associated factors

    PubMed Central

    Wübbeler, Markus; Thyrian, Jochen René; Michalowsky, Bernhard; Hertel, Johannes; Laporte Uribe, Franziska; Wolf-Ostermann, Karin; Schäfer-Walkmann, Susanne; Hoffmann, Wolfgang

    2015-01-01

    Background Nonpharmacological therapies and the provision of aids are described to be supportive in the treatment of persons with dementia (PWDs). These aim to maintain individuals’ participation in daily activities as long as possible, to slow the progression of their disease, and to support their independent living at home. However, there is a lack of knowledge about the utilization of therapies and aids among community-dwelling PWDs. Objective The aims of the study were a) to describe the utilization of nonpharmacological therapies and aids among community-dwelling PWDs and b) to analyze the factors associated with utilization. Method As part of a cross-sectional study of n=560 caregivers of PWDs in dementia networks throughout Germany, we assessed sociodemographics, clinical variables, and the utilization of nonpharmacological therapies (physiotherapy [PT], occupational therapy [OT]), and aids (sensory, mobility, and others), using face-to-face interviews and questionnaires. Results Approximately every fourth PWD received PT and every seventh PWD received OT. Sensory aids were utilized by 91.1%, personal hygiene aids by 77.2%, mobility aids by 58.6%, and medical aids by 57.7% of the sample. Regression analysis revealed that the utilization of PT and medical aids was associated with comorbidities (odds ratio [OR] 1.17 and OR 1.27, respectively) and that the utilization of OT and sensory aids was associated with age (OR 1.06 and OR 0.95, respectively). Conclusion The utilization of nonpharmacological therapies and aids among community-dwelling people served by dementia networks is more frequent than that reported for people in other settings. This result indicates that PWDs in integrated care models such as dementia networks receive better health care. PMID:26056468

  18. A meta-analysis comparing the effect of PCV2 vaccines on average daily weight gain and mortality rate in pigs from weaning to slaughter.

    PubMed

    Kristensen, Charlotte Sonne; Baadsgaard, Niels Peter; Toft, Nils

    2011-03-01

    The aim of this investigation was, through a meta-analysis, to review the published literature concerning the effect of PCV2 vaccination on the average daily weight gain (ADG) and on the mortality rate in pigs from weaning to slaughter. The review was restricted to studies investigating the effect of vaccines against PCV2 published from 2006 to 2008, identified using computerised literature databases. Only studies that met the following criteria were included: commercial vaccines were used, pigs or pens were assigned randomly to vaccination versus control groups in herds naturally infected with PCV2, and vaccinated and non-vaccinated pigs were housed together. Furthermore, it was a requirement that sample size, age at vaccination, and production period were stated. The levels of ADG and mortality rate had to be comparable to those seen in modern intensive swine production. In total, 107 studies were identified; 70 were excluded because they did not fulfil the inclusion criteria and 13 were identical to results published elsewhere. A significant effect of PCV2 vaccination on ADG was found for pigs in all production phases. The largest increase in ADG was found for finishing pigs (41.5g) and nursery-finishing pigs (33.6g) with only 10.6g increase in the nursery pigs. Mortality rate was significantly reduced for finishing pigs (4.4%) and nursery-finishing pigs (5.4%), but not for nursery pigs (0.25%). Herds negative for PRRS had a significantly larger increase in ADG compared to herds positive for PRRS. The PRRS status had no effect on mortality rate.

  19. Widening social inequalities in mortality: the case of Barcelona, a southern European city.

    PubMed Central

    Borrell, C; Plasència, A; Pasarin, I; Ortún, V

    1997-01-01

    OBJECTIVE: To analyse trends in mortality inequalities in Barcelona between 1983 and 1994 by comparing rates in those electoral wards with a low socioeconomic level and rates in the remaining wards. DESIGN: Mortality trends study. SETTING: The city of Barcelona (Spain). SUBJECTS: The study included all deaths among residents of the two groups of city wards. Details were obtained from death certificates. MAIN OUTCOME MEASURES: Age standardised mortality rates, age standardised rates of years of potential life lost, and age specific mortality rates in relation to cause of death, sex, and year were computed as well as the comparative mortality figure and the ratio of standardised rates of years of potential life lost. RESULTS: Rates of premature mortality increased from 5691.2 years of potential life lost per 100,000 inhabitants aged 1 to 70 years in 1983 to 7606.2 in 1994 in the low socioeconomic level wards, and from 3731.2 to 4236.9 in the other wards, showing an increase in inequalities over the 12 years, mostly due to AIDS and drug overdose as causes of death. Conversely, cerebrovascular disease showed a reduction in inequality over the same period. Overall mortality in the 15-44 age group widened the gap between both groups of wards. CONCLUSION: AIDS and drug overdose are emerging as the causes of death that are contributing to a substantial increase in social inequality in terms of premature mortality, an unreported observation in European urban areas. PMID:9519129

  20. Delayed effects of A-bomb radiation: a review of recent mortality rates and risk estimates for five-year survivors.

    PubMed

    Stewart, A M

    1982-06-01

    A review of published data relating to A-bomb survivors has led to the conclusion that since they were based on the mortality experiences of five year survivors estimates of radiation effects should have been controlled for two opposing forces-namely, selective survival of exceptionally fit individuals during the period of heavy acute mortality and residual disabilities. Both effects were dose-related and beyond question, and the disabilities probably included the effects of incomplete repair of bone marrow damage. Therefore, in addition to differences between high and low dose being largely obliterated, there was probably distortion of cancer effects. The two opposing forces are clearly the reason why the change from the high mortality rates of 1945-6 to the low rates of the 1950s was not accompanied by a change from a position to a negative association with dose, and imperviousness to the residual disabilities is probably the reason why sudden deaths of previously healthy individuals (exemplified by suicides) were an exception to this rule. Finally, impairment of bone marrow function probably accounts for the early epidemic of myeloid leukaemia; the apparent absence of other cancers at this time, and the relatively high dose-related death rates for blood diseases other than leukaemia.

  1. Temperature, Not Fine Particulate Matter (PM2.5), is Causally Associated with Short-Term Acute Daily Mortality Rates: Results from One Hundred United States Cities

    PubMed Central

    Cox, Tony; Popken, Douglas; Ricci, Paolo F

    2013-01-01

    Exposures to fine particulate matter (PM2.5) in air (C) have been suspected of contributing causally to increased acute (e.g., same-day or next-day) human mortality rates (R). We tested this causal hypothesis in 100 United States cities using the publicly available NMMAPS database. Although a significant, approximately linear, statistical C-R association exists in simple statistical models, closer analysis suggests that it is not causal. Surprisingly, conditioning on other variables that have been extensively considered in previous analyses (usually using splines or other smoothers to approximate their effects), such as month of the year and mean daily temperature, suggests that they create strong, nonlinear confounding that explains the statistical association between PM2.5 and mortality rates in this data set. As this finding disagrees with conventional wisdom, we apply several different techniques to examine it. Conditional independence tests for potential causation, non-parametric classification tree analysis, Bayesian Model Averaging (BMA), and Granger-Sims causality testing, show no evidence that PM2.5 concentrations have any causal impact on increasing mortality rates. This apparent absence of a causal C-R relation, despite their statistical association, has potentially important implications for managing and communicating the uncertain health risks associated with, but not necessarily caused by, PM2.5 exposures. PMID:23983662

  2. Ten-years of bariatric surgery in Brazil: in-hospital mortality rates for patients assisted by universal health system or a health maintenance organization

    PubMed Central

    KELLES, Silvana Márcia Bruschi; MACHADO, Carla Jorge; BARRETO, Sandhi Maria

    2014-01-01

    Background Bariatric surgery is an option for sustained weight loss for the morbidly obese patient. In Brazil coexists the Unified Health System (SUS) with universal coverage and from which depend 150 million Brazilians and supplemental health security, predominantly private, with 50 million beneficiaries. Aim To compare access, in-hospital mortality, length of stay and costs for patients undergoing bariatric surgery, assisted in one or another system. Methods Data from DATASUS and IBGE were used for SUS patients' and database from one health plan of southeastern Brazil for the health insurance patients. Results Between 2001 and 2010 there were 24,342 and 4,356 surgeries performed in SUS and in the health insurance company, respectively. The coverage rates for surgeries performed in 2010 were 5.3 and 91/100.000 individuals in SUS and health insurance respectively. The rate of in-hospital mortality in SUS, considering the entire country, was 0.55 %, 0.44 % considering SUS Southeast, and 0.30 % for the health insurance. The costs of surgery in the SUS and in the health insurance trend to equalization over the years. Conclusion Despite differences in access and characteristics that may compromise the outcome of bariatric surgery, patients treated at the Southeast SUS had similar rate of in-hospital mortality compared to the health insurance patients. PMID:25626935

  3. Impact of Janani Suraksha Yojana on institutional delivery rate and maternal morbidity and mortality: an observational study in India.

    PubMed

    Gupta, Sanjeev K; Pal, Dinesh K; Tiwari, Rajesh; Garg, Rajesh; Shrivastava, Ashish K; Sarawagi, Radha; Patil, Rajkumar; Agarwal, Lokesh; Gupta, Prashant; Lahariya, Chandrakant

    2012-12-01

    The Government of India initiated a cash incentive scheme--Janani Suraksha Yojana (JSY)--to promote institutional deliveries with an aim to reduce maternal mortality ratio (MMR). An observational study was conducted in a tertiary-care hospital of Madhya Pradesh, India, before and after implementation of JSY, with a sample of women presenting for institutional delivery. The objectives of this study were to: (i) determine the total number of institutional deliveries before and after implementation of JSY, (ii) determine the MMR, and (iii) compare factors associated with maternal mortality and morbidity. The data were analyzed for two years before implementation of JSY (2003-2005) and compared with two years following implementation of JSY (2005-2007). Overall, institutional deliveries increased by 42.6% after implementation, including those among rural, illiterate and primary-literate persons of lower socioeconomic strata. The main causes of maternal mortality were eclampsia, pre-eclampsia and severe anaemia both before and after implementation of JSY. Anaemia was the most common morbidity factor observed in this study. Among those who had institutional deliveries, there were significant increases in cases of eclampsia, pre-eclampsia, polyhydramnios, oligohydramnios, antepartum haemorrhage (APH), postpartum haemorrhage (PPH), and malaria after implementation of JSY. The scheme appeared to increase institutional delivery by at-risk mothers, which has the potential to reduce maternal morbidity and mortality, improve child survival, and ensure equity in maternal healthcare in India. The lessons from this study and other available sources should be utilized to improve the performance and implementation of JSY scheme in India. PMID:23304913

  4. In Hospital and 3-Month Mortality and Functional Recovery Rate in Patients Treated for Hip Fracture by a Multidisciplinary Team

    PubMed Central

    Rostagno, Carlo; Buzzi, Roberto; Campanacci, Domenico; Boccacini, Alberto; Cartei, Alessandro; Virgili, Gianni; Belardinelli, Andrea; Matarrese, Daniela; Ungar, Andrea; Rafanelli, Martina; Gusinu, Roberto; Marchionni, Niccolò

    2016-01-01

    Objectives Medical comorbidities affect outcome in elderly patients with hip fracture. This study was designed to preliminarily evaluate the usefulness of a hip-fracture unit led by an internal medicine specialist. Methods In-hospital and 3-month outcomes in patients with hip fracture were prospectively evaluated in 121 consecutive patients assessed before and followed after surgery by a multidisciplinary team led by internal medicine specialist; 337 consecutive patients were recalled from ICD-9 discharge records and considered for comparison regarding in-hospital mortality. Results In the intervention period, patients treated within 48 hours were 54% vs. 26% in the historical cohort (P<0.0001). In-hospital mortality remained stable at about 2.3 per 1000 person-days. At 3 months, 10.3% of discharged patients had died, though less than 8% of patients developed postoperative complications (mainly pneumonia and respiratory failure). The presence of more than 2 major comorbidities and the loss of 3 or more BADL were independent predictors of death. 50/105 patients recovered previous functional capacity, but no independent predictor of functional recovery could be identified. Mean length of hospital stay significantly decreased in comparison to the historical cohort (13.6± 4.7 vs 17 ± 5 days, p = 0.0001). Combined end-point of mortality and length of hospitalization < 12 days was significantly lower in study period (27 vs 34%, p <0.0132). Conclusions Identification and stabilization of concomitant clinical problems by internal medicine specialists may safely decrease time to surgery in frail subjects with hip fracture. Moreover, integrated perioperative clinical management may shorten hospital stay with no apparent increase in in-hospital mortality and ultimately improve the outcome. These results are to be confirmed by a larger study presently ongoing at our institution. PMID:27389193

  5. Overall and cause-specific excess mortality in HIV-positive persons compared with the general population

    PubMed Central

    Alejos, Belén; Hernando, Victoria; Iribarren, Jose; Gonzalez-García, Juan; Hernando, Asuncion; Santos, Jesus; Asensi, Victor; Gomez-Berrocal, Ana; del Amo, Julia; Jarrin, Inma

    2016-01-01

    Abstract We aimed to estimate overall and cause-specific excess mortality of HIV-positive patients compared with the general population, and to assess the effect of risk factors. We included patients aged >19 years, recruited from January 1, 2004 to May 31, 2014 in Cohort of the Spanish Network on HIV/AIDS Research. We used generalized linear models with Poisson error structure to model excess mortality rates. In 10,340 patients, 368 deaths occurred. Excess mortality was 0.82 deaths per 100 person-years for all-cause mortality, 0.11 for liver, 0.08 for non-AIDS-defining malignancies (NADMs), 0.08 for non-AIDS infections, and 0.02 for cardiovascular-related causes. Lower CD4 count and higher HIV viral load, lower education, being male, and over 50 years were predictors of overall excess mortality. Short-term (first year follow-up) overall excess hazard ratio (eHR) for subjects with AIDS at entry was 3.71 (95% confidence interval [CI] 2.66, 5.19) and 1.37 (95% CI 0.87, 2.15) for hepatitis C virus (HCV)-coinfected; medium/long-term eHR for AIDS at entry was 0.90 (95% CI 0.58, 1.39) and 3.83 (95% CI 2.37, 6.19) for HCV coinfection. Liver excess mortality was associated with low CD4 counts and HCV coinfection. Patients aged ≥50 years and HCV-coinfected showed higher NADM excess mortality, and HCV-coinfected patients showed increased non-AIDS infections excess mortality. Overall, liver, NADM, non-AIDS infections, and cardiovascular excesses of mortality associated with being HIV-positive were found, and HCV coinfection and immunodeficiency played significant roles. Differential short and medium/long-term effects of AIDS at entry and HCV coinfection were found for overall excess mortality. PMID:27603368

  6. The impact of drug-related deaths on mortality among young adults in Madrid.

    PubMed

    de la Fuente, L; Barrio, G; Vicente, J; Bravo, M J; Santacreu, J

    1995-01-01

    The trend from 1983 to 1990 of drug-related mortality (defined as the sum of deaths from acute drug reactions and the acquired immuno-deficiency syndrome [AIDS] in drug users) among the population 15 to 39 years of age in Madrid, Spain, was studied and compared with mortality from all causes. All of the mortality rates increased from 1983 to 1990: all causes, from 101/100,000 to 148/100,000; acute drug reactions, from 3/100,000 to 15/100,000; and AIDS, from 0 to 20/100,000. Drug-related mortality represented 60% of the increase in the rate from all causes in males and 170% of the increase in females. The increases in drug-related mortality are likely to continue in the future.

  7. The impact of drug-related deaths on mortality among young adults in Madrid.

    PubMed Central

    de la Fuente, L; Barrio, G; Vicente, J; Bravo, M J; Santacreu, J

    1995-01-01

    The trend from 1983 to 1990 of drug-related mortality (defined as the sum of deaths from acute drug reactions and the acquired immuno-deficiency syndrome [AIDS] in drug users) among the population 15 to 39 years of age in Madrid, Spain, was studied and compared with mortality from all causes. All of the mortality rates increased from 1983 to 1990: all causes, from 101/100,000 to 148/100,000; acute drug reactions, from 3/100,000 to 15/100,000; and AIDS, from 0 to 20/100,000. Drug-related mortality represented 60% of the increase in the rate from all causes in males and 170% of the increase in females. The increases in drug-related mortality are likely to continue in the future. PMID:7832243

  8. Comparing UK and 20 Western countries' efficiency in reducing adult (55–74) cancer and total mortality rates 1989–2010: Cause for cautious celebration? A population-based study

    PubMed Central

    Hickish, Tamas; Rosenorn-Lanng, Emily; Wallace, Mark

    2016-01-01

    Objective Every Western nation expends vast sums on health, especially for cancer; thus, the question is how efficient is the UK in reducing adult (55–74) cancer mortality rates and total mortality rates (TMR) compared to the other Western nations in the context of economic-input to health, the percentage of Gross-Domestic-Product-expenditure-on-Health. Design WHO mortality rates for baseline 3 years 1989–1991 and 2008–2010 were analysed, and confidence intervals determine any significant differences between the UK and other countries in reducing the mortalities. Efficiency ratios are calculated by dividing reduced mortality over the period by the average % of national income. Setting Twenty-one similar socio-economic Western countries. Participants The 21 countries’ general population. Main outcome measures Cancer mortality rates, total mortality rates Gross Domestic Product and Efficiency Ratios. Results Economic Input: In 1980, UK national income was 5.6% and the European average was 7.1%. By 2010, UK national income was 9.4% being equal 17th of 21 averaging 7.1% over the period. Europe’s 1980–2010 average of 8.4% yields a UK to Europe ratio of 1:1.18. Clinical output 1989–2010: UK Cancer Mortality Rates was the sixth highest, but equal sixth biggest fall, significantly greater than 14 other countries. UK Total Mortality Rates was the fifth highest but third biggest decline, significantly greater than 17 countries. UK’s cancer Efficiency Ratios is largest at 1:301 and second biggest for Total Mortality Rates at 1.1341; the USA ratios were 1:152 and 1:525, respectively. Conclusions UK reduced mortalities indicate that the NHS achieves proportionally more with relatively less, but UK needs to match European average Gross-Domestic-Product-expenditure-on-Health to meet future challenges. PMID:27293774

  9. Infant Mortality and Asians and Pacific Islanders

    MedlinePlus

    ... Infant Heath & Mortality Infant Mortality and Asians and Pacific Islanders Among Asian/Pacific Islanders, Sudden Infant Death Syndrome (SIDS) is the fourth leading cause of infant mortality. Asian/Pacific Islanders women generally have lower infant mortality rates ...

  10. Clinical profile and factors associated with mortality in hospitalized patients with HIV/AIDS: a retrospective analysis from Tripoli Medical Centre, Libya, 2013.

    PubMed

    Shalaka, N S; Garred, N A; Zeglam, H T; Awasi, S A; Abukathir, L A; Altagdi, M E; Rayes, A A

    2015-10-02

    In Libya, little is known about HIV-related hospitalizations and in-hospital mortality. This was a retrospective analysis of HIV-related hospitalizations at Tripoli Medical Centre in 2013. Of 227 cases analysed, 82.4% were males who were significantly older (40.0 versus 36.5 years), reported injection drug use (58.3% versus 0%) and were hepatitis C virus co-infected (65.8% versus 0%) compared with females. Severe immunosuppression was prevalent (median CD4 count = 42 cell/μL). Candidiasis was the most common diagnosis (26.0%); Pneumocystis pneumonia was the most common respiratory disease (8.8%), while cerebral toxoplasmosis was diagnosed in 8.4% of patients. Current HAART use was independently associated with low risk of in-hospital mortality (OR 0.33), while central nervous system symptoms (OR 4.12), sepsis (OR 6.98) and low total lymphocyte counts (OR 3.60) were associated with increased risk. In this study, late presentation with severe immunosuppression was common, and was associated with significant in-hospital mortality.

  11. Acute large-dose exposure to organophosphates in patients with and without diabetes mellitus: analysis of mortality rate and new-onset diabetes mellitus

    PubMed Central

    2014-01-01

    Background We investigated the mortality rates of patients with and without diabetes mellitus after acute large-dose exposure to organophosphate insecticides. All patients without diabetes mellitus were traced to examine the long-term risk of new-onset diabetes mellitus. Previous reports indicated that organophosphate exposure might increase the risk of new-onset diabetes mellitus. Methods We analyzed the records of 118 patients referred to Chang Gung Memorial Hospital for management of intentional organophosphate poisoning between 2000 and 2011. Patients were stratified by diabetes mellitus status. Demographic, clinical, laboratory and mortality data were analyzed. Results Most patients were middle aged (53.45 ± 16.20 years) and male (65.3%) and were referred to our hospital after a relatively short amount of time had elapsed since poisoning (median 3.0 hours). 18 (15.2%) of 118 patients died, including 15 (13.8%) of 109 patients without diabetes mellitus and 3 (33.3%) of 9 with diabetes mellitus. There was no significant difference in mortality between these groups (P = 0.117). In a multivariate Cox regression model, hypotension (P = 0.000), respiratory failure (P = 0.042), coma (P = 0.023), and corrected QT interval prolongation (P = 0.002) were significant risk factors for mortality. Conversely, diabetes mellitus status was not a significant variable in this model. At routine outpatient follow up a median of 1.25 months post exposure, random blood glucose measurements gave no evidence of new-onset diabetes in patients without pre-existing diabetes. Conclusions Diabetes mellitus status might not increase mortality risk following acute large-dose exposure to organophosphates, and the risk of new-onset diabetes mellitus also might be minimal in the short term. Larger prospective studies with formal testing for diabetes at later times post-exposure are required. PMID:24597539

  12. Relation of resting heart rate to risk for all-cause mortality by gender after considering exercise capacity (the Henry Ford exercise testing project).

    PubMed

    Aladin, Amer I; Whelton, Seamus P; Al-Mallah, Mouaz H; Blaha, Michael J; Keteyian, Steven J; Juraschek, Stephen P; Rubin, Jonathan; Brawner, Clinton A; Michos, Erin D

    2014-12-01

    Whether resting heart rate (RHR) predicts mortality independent of fitness is not well established, particularly among women. We analyzed data from 56,634 subjects (49% women) without known coronary artery disease or atrial fibrillation who underwent a clinically indicated exercise stress test. Baseline RHR was divided into 5 groups with <60 beats/min as reference. The Social Security Death Index was used to ascertain vital status. Cox hazard models were performed to determine the association of RHR with all-cause mortality, major adverse cardiovascular events, myocardial infarction, or revascularization after sequential adjustment for demographics, cardiovascular disease risk factors, medications, and fitness (metabolic equivalents). The mean age was 53 ± 12 years and mean RHR was 73 ± 12 beats/min. More than half of the participants were referred for chest pain; 81% completed an adequate stress test and mean metabolic equivalents achieved was 9.2 ± 3. There were 6,255 deaths over 11.0-year mean follow-up. There was an increased risk of all-cause mortality with increasing RHR (p trend <0.001). Compared with the lowest RHR group, participants with an RHR ≥90 beats/min had a significantly increased risk of mortality even after adjustment for fitness (hazard ratio 1.22, 95% confidence interval 1.10 to 1.35). This relationship remained significant for men, but not significant for women after adjustment for fitness (p interaction <0.001). No significant associations were seen for men or women with major adverse cardiovascular events, myocardial infarction, or revascularization after accounting for fitness. In conclusion, after adjustment for fitness, elevated RHR was an independent risk factor for all-cause mortality in men but not women, suggesting gender differences in the utility of RHR for risk stratification. PMID:25439450

  13. Infant Stool Color Card Screening Helps Reduce the Hospitalization Rate and Mortality of Biliary Atresia: A 14-Year Nationwide Cohort Study in Taiwan.

    PubMed

    Lee, Min; Chen, Solomon Chih-Cheng; Yang, Hsin-Yi; Huang, Jui-Hua; Yeung, Chun-Yan; Lee, Hung-Chang

    2016-03-01

    Biliary atresia (BA) is a significant liver disease in children. Since 2004, Taiwan has implemented a national screening program that uses an infant stool color card (SCC) for the early detection of BA. The purpose of this study was to examine the outcomes of BA cases before and after the launch of this screening program. The objectives of this study were to evaluate the rates of hospitalization, liver transplantation (LT), and mortality of BA cases before and after the program, and to examine the association between the hospitalization rate and survival outcomes.This was a population-based cohort study. BA cases born during 1997 to 2010 were identified from the Taiwan National Health Insurance Research Database. Sex, birth date, hospitalization date, LT, and death data were collected and analyzed. The hospitalization rate by 2 years of age (Hosp/2yr) was calculated to evaluate its association with the outcomes of LT or death.Among 513 total BA cases, 457 (89%) underwent the Kasai procedure. Of these, the Hosp/2yr was significantly reduced from 6.0 to 6.9/case in the earlier cohort (1997-2004) to 4.9 to 5.3/case in the later cohort (2005-2010). This hospitalization rate reduction was followed by a reduction in mortality from 26.2% to 15.9% after 2006. The Cox proportional hazards model showed a significant increase in the risk for both LT (hazard ratio [HR] = 1.14, 95% confidence interval [CI] = 1.10-1.18) and death (HR = 1.05, 95% CI = 1.01-1.08) for each additional hospitalization. A multivariate logistic regression model found that cases with a Hosp/2yr >6 times had a significantly higher risk for both LT (adjusted odds ratio [aOR] = 4.35, 95% CI = 2.82-6.73) and death (aOR = 1.75, 95% CI = 1.17-2.62).The hospitalization and mortality rates of BA cases in Taiwan were significantly and coincidentally reduced after the launch of the SCC screening program. There was a significant association between the hospitalization rate and final

  14. Infant Stool Color Card Screening Helps Reduce the Hospitalization Rate and Mortality of Biliary Atresia: A 14-Year Nationwide Cohort Study in Taiwan.

    PubMed

    Lee, Min; Chen, Solomon Chih-Cheng; Yang, Hsin-Yi; Huang, Jui-Hua; Yeung, Chun-Yan; Lee, Hung-Chang

    2016-03-01

    Biliary atresia (BA) is a significant liver disease in children. Since 2004, Taiwan has implemented a national screening program that uses an infant stool color card (SCC) for the early detection of BA. The purpose of this study was to examine the outcomes of BA cases before and after the launch of this screening program. The objectives of this study were to evaluate the rates of hospitalization, liver transplantation (LT), and mortality of BA cases before and after the program, and to examine the association between the hospitalization rate and survival outcomes.This was a population-based cohort study. BA cases born during 1997 to 2010 were identified from the Taiwan National Health Insurance Research Database. Sex, birth date, hospitalization date, LT, and death data were collected and analyzed. The hospitalization rate by 2 years of age (Hosp/2yr) was calculated to evaluate its association with the outcomes of LT or death.Among 513 total BA cases, 457 (89%) underwent the Kasai procedure. Of these, the Hosp/2yr was significantly reduced from 6.0 to 6.9/case in the earlier cohort (1997-2004) to 4.9 to 5.3/case in the later cohort (2005-2010). This hospitalization rate reduction was followed by a reduction in mortality from 26.2% to 15.9% after 2006. The Cox proportional hazards model showed a significant increase in the risk for both LT (hazard ratio [HR] = 1.14, 95% confidence interval [CI] = 1.10-1.18) and death (HR = 1.05, 95% CI = 1.01-1.08) for each additional hospitalization. A multivariate logistic regression model found that cases with a Hosp/2yr >6 times had a significantly higher risk for both LT (adjusted odds ratio [aOR] = 4.35, 95% CI = 2.82-6.73) and death (aOR = 1.75, 95% CI = 1.17-2.62).The hospitalization and mortality rates of BA cases in Taiwan were significantly and coincidentally reduced after the launch of the SCC screening program. There was a significant association between the hospitalization rate and final

  15. Association between Highly Active Antiretroviral Therapy and Type of Infectious Respiratory Disease and All-Cause In-Hospital Mortality in Patients with HIV/AIDS: A Case Series

    PubMed Central

    Báez-Saldaña, Renata; Villafuerte-García, Adriana; Cruz-Hervert, Pablo; Delgado-Sánchez, Guadalupe; Ferreyra-Reyes, Leticia; Ferreira-Guerrero, Elizabeth; Mongua-Rodríguez, Norma; Montero-Campos, Rogelio; Melchor-Romero, Ada; García-García, Lourdes

    2015-01-01

    Background Respiratory manifestations of HIV disease differ globally due to differences in current availability of effective highly active antiretroviral therapy (HAART) programs and epidemiology of infectious diseases. Objective To describe the association between HAART and discharge diagnosis and all-cause in-hospital mortality among hospitalized patients with infectious respiratory disease and HIV/AIDS. Material and Methods We retrospectively reviewed the records of patients hospitalized at a specialty hospital for respiratory diseases in Mexico City between January 1st, 2010 and December 31st, 2011. We included patients whose discharge diagnosis included HIV or AIDS and at least one infectious respiratory diagnosis. The information source was the clinical chart. We analyzed the association between HAART for 180 days or more and type of respiratory disease using polytomous logistic regression and all-cause hospital mortality by multiple logistic regressions. Results We studied 308 patients, of whom 206 (66.9%) had been diagnosed with HIV infection before admission to the hospital. The CD4+ lymphocyte median count was 68 cells/mm3 [interquartile range (IQR): 30–150]. Seventy-five (24.4%) cases had received HAART for more than 180 days. Pneumocystis jirovecii pneumonia (PJP) (n = 142), tuberculosis (n = 63), and bacterial community-acquired pneumonia (n = 60) were the most frequent discharge diagnoses. Receiving HAART for more than 180 days was associated with a lower probability of PJP [Adjusted odd ratio (aOR): 0.245, 95% Confidence Interval (CI): 0.08–0.8, p = 0.02], adjusted for sociodemographic and clinical covariates. HAART was independently associated with reduced odds (aOR 0.214, 95% CI 0.06–0.75) of all-cause in-hospital mortality, adjusting for HIV diagnosis previous to hospitalization, age, access to social security, low socioeconomic level, CD4 cell count, viral load, and discharge diagnoses. Conclusions HAART for 180 days or more was associated

  16. Non-Pneumatic Anti-Shock Garment (NASG), a First-Aid Device to Decrease Maternal Mortality from Obstetric Hemorrhage: A Cluster Randomized Trial

    PubMed Central

    Miller, Suellen; Bergel, Eduardo F.; El Ayadi, Alison M.; Gibbons, Luz; Butrick, Elizabeth A.; Magwali, Thulani; Mkumba, Gricelia; Kaseba, Christine; Huong, N. T. My; Geissler, Jillian D.; Merialdi, Mario

    2013-01-01

    Background Obstetric hemorrhage is the leading cause of maternal mortality. Using a cluster randomized design, we investigated whether application of the Non-pneumatic Anti-Shock Garment (NASG) before transport to referral hospitals (RHs) from primary health care centers (PHCs) decreased adverse outcomes among women with hypovolemic shock. We hypothesized the NASG group would have a 50% reduction in adverse outcomes. Methods and Findings We randomly assigned 38 PHCs in Zambia and Zimbabwe to standard obstetric hemorrhage/shock protocols or the same protocols plus NASG prior to transport. All women received the NASG at the RH. The primary outcomes were maternal mortality; severe, end-organ failure maternal morbidity; and a composite mortality/morbidity outcome, which we labeled extreme adverse outcome (EAO). We also examined whether the NASG contributed to negative side effects and secondary outcomes. The sample size for statistical power was not reached; of a planned 2400 women, 880 were enrolled, 405 in the intervention group. The intervention was associated with a non-significant 46% reduced odds of mortality (OR 0.54, 95% CI 0.14–2.05, p = 0.37) and 54% reduction in composite EAO (OR 0.46, 95% CI 0.13–1.62, p = 0.22). Women with NASGs recovered from shock significantly faster (HR 1.25, 95% CI 1.02–1.52, p = 0.03). No differences were observed in secondary outcomes or negative effects. The main limitation was small sample size. Conclusions Despite a lack of statistical significance, the 54% reduced odds of EAO and the significantly faster shock recovery suggest there might be treatment benefits from earlier application of the NASG for women experiencing delays obtaining definitive treatment for hypovolemic shock. As there are no other tools for shock management outside of referral facilities, and no safety issues found, consideration of NASGs as a temporizing measure during delays may be warranted. A pragmatic study with rigorous evaluation is

  17. The decline in child mortality: a reappraisal.

    PubMed Central

    Ahmad, O. B.; Lopez, A. D.; Inoue, M.

    2000-01-01

    The present paper examines, describes and documents country-specific trends in under-five mortality rates (i.e., mortality among children under five years of age) in the 1990s. Our analysis updates previous studies by UNICEF, the World Bank and the United Nations. It identifies countries and WHO regions where sustained improvement has occurred and those where setbacks are evident. A consistent series of estimates of under-five mortality rate is provided and an indication is given of historical trends during the period 1950-2000 for both developed and developing countries. It is estimated that 10.5 million children aged 0-4 years died in 1999, about 2.2 million or 17.5% fewer than a decade earlier. On average about 15% of newborn children in Africa are expected to die before reaching their fifth birthday. The corresponding figures for many other parts of the developing world are in the range 3-8% and that for Europe is under 2%. During the 1990s the decline in child mortality decelerated in all the WHO regions except the Western Pacific but there is no widespread evidence of rising child mortality rates. At the country level there are exceptions in southern Africa where the prevalence of HIV is extremely high and in Asia where a few countries are beset by economic difficulties. The slowdown in the rate of decline is of particular concern in Africa and South-East Asia because it is occurring at relatively high levels of mortality, and in countries experiencing severe economic dislocation. As the HIV/AIDS epidemic continues in Africa, particularly southern Africa, and in parts of Asia, further reductions in child mortality become increasingly unlikely until substantial progress in controlling the spread of HIV is achieved. PMID:11100613

  18. Identifying and quantifying misclassified and under-reported AIDS deaths in Brazil: a retrospective analysis from 1985 to 2009

    PubMed Central

    Fazito, Erika; Cuchi, Paloma; Ma Fat, Doris; Ghys, Peter Denis; Pereira, Mauricio G; Vasconcelos, Ana Maria Nogales; Pascom, Ana Roberta Pati

    2012-01-01

    Background A retrospective analysis of deaths registered in the Brazilian Mortality System was conducted to quantify the under-reporting of HIV/AIDS deaths and those misclassified to AIDS-related conditions in the 15–49 years old population in Brazil. Methods Death rates for AIDS-related diseases were calculated by age and sex for 1985–2009. Changes in the age-sex-specific death rates over time were used to identify conditions likely to be misclassified AIDS deaths and to quantify the corresponding number of misclassified deaths. Deaths due to ill-defined causes were redistributed across all other natural causes of death. The resulting total number of AIDS deaths was further adjusted for incompleteness of the mortality reporting system. Results Out of the 28 potential causes of death investigated, five increased in the same distinct age pattern as AIDS: pneumonia, Kaposi's sarcoma, other immunodeficiencies, other septicaemia and toxoplasmosis. 18 490 deaths due to these five causes were recoded to HIV/AIDS from 1985 to 2009. 38 145 deaths due to ill-defined causes were redistributed to AIDS and 15 485 were added to the number of AIDS deaths to correct for completeness of the mortality system in Brazil. Altogether, 72 120 deaths were recoded to AIDS between 1985 and 2009 and added to the reported 194 445 AIDS related deaths in the country, representing 27% misclassification of AIDS deaths in Brazil. Conclusions This study demonstrated that AIDS mortality is underestimated by the official mortality information system in Brazil. Efforts need to be made to reduce misclassification of causes of death in the future and identify ways in which the confidentiality of information regarding cause of death can be maintained. PMID:23172349

  19. The disease profile of poverty: morbidity and mortality in northern Uganda in the context of war, population displacement and HIV/AIDS.

    PubMed

    Accorsi, S; Fabiani, M; Nattabi, B; Corrado, B; Iriso, R; Ayella, E O; Pido, B; Onek, P A; Ogwang, M; Declich, S

    2005-03-01

    The population of Gulu District (northern Uganda) has been severely incapacitated by war, epidemics and social disruption. This study is aimed at describing disease patterns and trends in this area through a retrospective analysis of discharge records for 155205 in-patients of Lacor Hospital in the period 1992-2002. The burden of infectious diseases in childhood is overwhelming, with malaria accounting for the steepest increase in admissions. Admissions for war-related injuries and malnutrition fluctuated with the intensity of the war and the severity of famine. Emerging and re-emerging infections, such as HIV/AIDS, tuberculosis and Ebola, accounted for a heavy disease burden; however, there has been a trend for admissions related to HIV/AIDS and tuberculosis to decrease since the implementation of community-based services. Vulnerable groups (infants, children and women) accounted for 79.8% of admissions. Long-term war, population displacement, the collapse of social structures and the breakdown of the health system place people at a much greater risk of persistent, emerging and re-emerging infectious diseases, malnutrition and war-related injuries, shaping the 'disease profile of poverty'. Most of the disease burden results from infectious diseases of childhood, whose occurrence could be dramatically reduced by low-cost and effective preventive and curative interventions. PMID:15653126

  20. [Infant mortality in Peru].

    PubMed

    Ramos Padilla, M A

    1987-01-01

    Bolivia, Haiti, and Peru have infant mortality levels as high as those of the developed countries a century ago. The decline of general and especially infant mortality experienced in Latin America beginning in the 1940s was uneven throughout the continent. Cuba's infant mortality rate declined by 86% between 1940-80, but Peru's declined by only 48% despite its higher initial level. In 1984, 34% of all deaths in Peru were to children under 1 year and about 21% were to children 1-5 years old. Socioeconomic factors are the major explanation of Peru's poor infant mortality levels. Regional and social disparities in access to housing, food, urban infrastructure, and other vital goods and services are reflected in infant mortality statistics. Infant mortality has declined in both rural and urban areas, but the magnitude of the decline was much greater in urban areas. Between 1960-75, the infant mortality rate declined from 133 to 80/1000 live births in urban areas, but only from 180 to 150/1000 in rural areas. Investment in the infrastructure and services of the cities during the 1950s and 60s was not matched by any significant investment in rural infrastructure. Rural-urban mortality differentials are not as profound in countries which distribute public investment more evenly between rural and urban areas. Cuba's rural infant mortality rate is only 16% greater than its urban rate, while Peru's rural rate is 47% higher. The rural-urban differential in Peru hides a steep gap between the metropolitan zone of Lima-Callao, which has an infant mortality rate of 55/1000, and that of all cities, which have a rate 45% higher. Metropolitan Lima has the highest levels of living in Peru, including the highest incomes and best housing and service infrastructure. A majority of Peru's economic and industrial development has been concentrated in Lima. Peru's infant mortality differentials are also striking at the departmental level. The 5 departments with the highest infant mortality

  1. Association of estimated glomerular filtration rate with all‐cause and cardiovascular mortality: the role of malnutrition–inflammation–cachexia syndrome

    PubMed Central

    Ou, Shuo‐Ming; Chen, Yung‐Tai; Hung, Szu‐Chun; Shih, Chia‐Jen; Lin, Chi‐Hung; Chiang, Chih‐Kang

    2016-01-01

    Abstract Background Previous studies have demonstrated that high estimated glomerular filtration rate (eGFR) is paradoxically associated with an increased risk of mortality, and the association becomes more predominant in older people. However, the role of malnutrition–inflammation–cachexia syndrome (MICS) in the association between eGFR and mortality has never been explored. Methods We conducted a community‐based cohort study using data from the Taipei City Elderly Health Examination Database, collected during the period 2001–10. All participants aged ≥65 years were included and stratified by the absence or presence of MICS, which is defined as the presence of at least one of the following markers: body mass index <22 kg/m2, serum albumin <3.0 mg/dL, or Geriatric Nutritional Risk Index (GNRI) <98. The study endpoints were all‐cause and cardiovascular mortality. Results A total of 131 354 participants were identified and categorized according to the chronic kidney disease stage based on eGFR. Compared with the reference eGFR of 60–89 mL/min/1.73 m2, the overall and cardiovascular mortality risks were markedly high in the groups with eGFR of <30 mL/min/1.73 m2 [overall: adjusted hazard ratio (aHR), 1.86; 95% confidence interval (CI), 1.72–2.00; cardiovascular: aHR, 1.87; 95% CI, 1.60–2.19] and ≥90 mL/min/1.73 m2 (overall: aHR, 1.23; 95% CI, 1.13–1.34; cardiovascular: aHR, 1.28; 95% CI, 1.06–1.54). In the absence of MICS, high eGFR was associated with lower mortality risk (aHR, 0.71; 95% CI, 0.62–0.80), and the U‐shaped relationship disappeared. Subgroup analyses produced consistent results. Conclusions MICS could influence the association observed between high eGFR and mortality in older people, particularly in those with low body mass index, albumin level, GNRI, and very low serum creatinine level. PMID:27493868

  2. Modal analysis of the deep-water solitary scleractinian, Desmophyllum dianthus, on SW Pacific seamounts: inferred recruitment periodicity, growth, and mortality rates

    NASA Astrophysics Data System (ADS)

    Thresher, R. E.; Adkins, J.; Thiagarajan, N.

    2011-12-01

    Little is known about the demography of corals inhabiting deep-sea features due to the logistical difficulties of working at the extreme depths they inhabit. To obtain basic information about growth, mortality, and recruitment dynamics for such a coral, we applied modal analysis to the size frequency distributions of live-caught and sub-fossil specimens of the widely distributed solitary cup coral, Desmophyllum dianthus, collected on SW Pacific seamounts. Comparison of live-caught material collected in 1997 and 2007-2009 indicated modal progression over time and an implied maximum age of approximately 190 years, which is similar to ages determined previously for D. dianthus using radiometric techniques. A log-linear decline in the number of individuals with increasing size further implies a constant adult mortality rate, of 15.1% per annum in 1997 and 9.2% per annum in 2007-2009. The spacing of size modes in the 2007-2009 samples suggests regularly episodic recruitment events, at 22- to 32-year intervals, which may relate to periodic variability in large-scale Southern Ocean circulation. Preliminary analyses of size frequency distributions of the sub-fossil material suggest that the trophodynamics, growth, and adult mortality schedules of D. dianthus in the SW Pacific have remained basically similar throughout the Holocene.

  3. Sexual selection has minimal impact on effective population sizes in species with high rates of random offspring mortality: an empirical demonstration using fitness distributions

    PubMed Central

    Pischedda, Alison; Friberg, Urban; Stewart, Andrew D.; Miller, Paige M.; Rice, William R.

    2015-01-01

    The effective population size (Ne) is a fundamental parameter in population genetics that influences the rate of loss of genetic diversity. Sexual selection has the potential to reduce Ne by causing the sex-specific distributions of individuals that successfully reproduce to diverge. To empirically estimate the effect of sexual selection on Ne, we obtained fitness distributions for males and females from an outbred, laboratory-adapted population of Drosophila melanogaster. We observed strong sexual selection in this population (the variance in male reproductive success was ∼14 times higher than that for females), but found that sexual selection had only a modest effect on Ne, which was 75% of the census size. This occurs because the substantial random offspring mortality in this population diminishes the effects of sexual selection on Ne, a result that necessarily applies to other high fecundity species. The inclusion of this random offspring mortality creates a scaling effect that reduces the variance/mean ratios for male and female reproductive success and causes them to converge. Our results demonstrate that measuring reproductive success without considering offspring mortality can underestimate Ne and overestimate the genetic consequences of sexual selection. Similarly, comparing genetic diversity among different genomic components may fail to detect strong sexual selection. PMID:26374275

  4. Mortality rates at 10 years after metal-on-metal hip resurfacing compared with total hip replacement in England: retrospective cohort analysis of hospital episode statistics

    PubMed Central

    Kendal, Adrian R; Prieto-Alhambra, Daniel; Arden, Nigel K; Judge, Andrew

    2013-01-01

    Objectives To compare 10 year mortality rates among patients undergoing metal-on-metal hip resurfacing and total hip replacement in England. Design Retrospective cohort study. Setting English hospital episode statistics database linked to mortality records from the Office for National Statistics. Population All adults who underwent primary elective hip replacement for osteoarthritis from April 1999 to March 2012. The exposure of interest was prosthesis type: cemented total hip replacement, uncemented total hip replacement, and metal-on-metal hip resurfacing. Confounding variables included age, sex, Charlson comorbidity index, rurality, area deprivation, surgical volume, and year of operation. Main outcome measures All cause mortality. Propensity score matching was used to minimise confounding by indication. Kaplan-Meier plots estimated the probability of survival up to 10 years after surgery. Multilevel Cox regression modelling, stratified on matched sets, described the association between prosthesis type and time to death, accounting for variation across hospital trusts. Results 7437 patients undergoing metal-on-metal hip resurfacing were matched to 22 311 undergoing cemented total hip replacement; 8101 patients undergoing metal-on-metal hip resurfacing were matched to 24 303 undergoing uncemented total hip replacement. 10 year rates of cumulative mortality were 271 (3.6%) for metal-on-metal hip resurfacing versus 1363 (6.1%) for cemented total hip replacement, and 239 (3.0%) for metal-on-metal hip resurfacing versus 999 (4.1%) for uncemented total hip replacement. Patients undergoing metal-on-metal hip resurfacing had an increased survival probability (hazard ratio 0.51 (95% confidence interval 0.45 to 0.59) for cemented hip replacement; 0.55 (0.47 to 0.65) for uncemented hip replacement). There was no evidence for an interaction with age or sex. Conclusions Patients with hip osteoarthritis undergoing metal-on-metal hip resurfacing have reduced mortality in

  5. Observing temporal trends in cardiac rehabilitation from 1996 to 2010 in Ontario: characteristics of referred patients, programme participation and mortality rates

    PubMed Central

    Grace, Sherry L; Oh, Paul I; Marzolini, Susan; Colella, Tracey; Tan, Yongyao; Alter, David A

    2015-01-01

    Objectives We sought to describe temporal trends in the sociodemographic and clinical characteristics of participants referred to cardiac rehabilitation (CR), and its effect on programme participation and all-cause mortality over 14 years. Setting A large CR centre in Toronto, Canada. Participants Consecutive patients between 1996 and 2010. Primary and secondary outcome measures Referrals received were deterministically linked to administrative data, to complement referral form abstraction. Out-of-hospital deaths were identified using vital statistics. Patients were tracked until 2012, and mortality was ascertained. Percentage attendance at prescribed sessions was also assessed. Results There were 29 171 referrals received, of which 28 767 (98.6%) were successfully linked, of whom 22 795 (79.2%) attended an intake assessment. The age of the referred population steadily increased, with more females, less affluent and more single patients referred over time (p<0.001). More patients were referred following percutaneous coronary intervention and less following coronary artery bypass graft surgery (p<0.001). The number of comorbidities decreased (p<0.001). Hypertension increased over time (p<0.001), yet the control of cholesterol steadily improved over time. The proportion of smokers decreased over time (p<0.001). Participation in CR significantly declined, and there were no significant changes in mortality. 3-year mortality rates were less than 5%. Conclusions Characteristics of referred patients tended to reflect broader trends in risk factors and cardiovascular disease burden. Physicians appear to be referring more sociodemographically diverse patients to CR; however, programmes may need to better adapt to engage these patients to fully participate. More complex patients should be referred, using explicit criteria-based referral processes. PMID:26537501

  6. Fractal analysis of heart rate dynamics as a predictor of mortality in patients with depressed left ventricular function after acute myocardial infarction. TRACE Investigators. TRAndolapril Cardiac Evaluation

    NASA Technical Reports Server (NTRS)

    Makikallio, T. H.; Hoiber, S.; Kober, L.; Torp-Pedersen, C.; Peng, C. K.; Goldberger, A. L.; Huikuri, H. V.

    1999-01-01

    A number of new methods have been recently developed to quantify complex heart rate (HR) dynamics based on nonlinear and fractal analysis, but their value in risk stratification has not been evaluated. This study was designed to determine whether selected new dynamic analysis methods of HR variability predict mortality in patients with depressed left ventricular (LV) function after acute myocardial infarction (AMI). Traditional time- and frequency-domain HR variability indexes along with short-term fractal-like correlation properties of RR intervals (exponent alpha) and power-law scaling (exponent beta) were studied in 159 patients with depressed LV function (ejection fraction <35%) after an AMI. By the end of 4-year follow-up, 72 patients (45%) had died and 87 (55%) were still alive. Short-term scaling exponent alpha (1.07 +/- 0.26 vs 0.90 +/- 0.26, p <0.001) and power-law slope beta (-1.35 +/- 0.23 vs -1.44 +/- 0.25, p <0.05) differed between survivors and those who died, but none of the traditional HR variability measures differed between these groups. Among all analyzed variables, reduced scaling exponent alpha (<0.85) was the best univariable predictor of mortality (relative risk 3.17, 95% confidence interval 1.96 to 5.15, p <0.0001), with positive and negative predictive accuracies of 65% and 86%, respectively. In the multivariable Cox proportional hazards analysis, mortality was independently predicted by the reduced exponent alpha (p <0.001) after adjustment for several clinical variables and LV function. A short-term fractal-like scaling exponent was the most powerful HR variability index in predicting mortality in patients with depressed LV function. Reduction in fractal correlation properties implies more random short-term HR dynamics in patients with increased risk of death after AMI.

  7. [Map of infant mortality].

    PubMed

    Ramos, H

    1988-06-01

    The heterogeneous economic development of Peru and its relationship to the developed countries have determined that the advances of medical science and their influence on infant mortality rates have been unevenly distributed in Peru. Around 1986, the average infant mortality rate was 14/1000 live births in Europe, 118/1000 in Africa, 86/1000 in Asia, 10/1000 in North America, and 62/1000 in Latin America. The unequal development achieved in different countries is the main reason for the different infant mortality rates. The infant mortality rate for each of Peru's provinces around 1981 was estimated using a program for personal computers from the Latin American Demographic Center, which applied the Coale and Trussell variant of the Brass method to information from Peru's 1981 census. The national average infant mortality rate in 1981 was 101.0/1000 live births. 84 provinces, 55%, had high or very high infant mortality rates ranging from 101.0 to 184.0/1000. All were located in the highlands or jungle where the level of poverty is significantly greater than the national average. 28 provinces (18%) had infant mortality rates of 48-80/1000, considered low in Peru. They were almost all in the more developed coastal region. The remaining 41 provinces (27%) with medium infant mortality levels of 81-100/1000 live births were mostly the sites of provincial capitals of departments or other centers with some significant economic activity that attracted health, educational, and other investments. PMID:12315514

  8. Response of Argentine ants and red imported fire ants to permethrin-impregnated plastic strips: foraging rates, colonization of potted soil, and differential mortality.

    PubMed

    Costa, Heather S; Greenberg, Les; Klotz, John; Rust, Michael K

    2005-12-01

    This study investigated the effects of the permethrin-impregnated plastic on ant mortality and foraging rates, and tested its potential for preventing ants from colonizing potted soil. Direct exposure to the plastic for as short as 1 min caused significant mortality of both red imported fire ants, Solenopsis invicta Buren, and Argentine ants, Linepithema humile (Mayr); however, red imported fire ants were more susceptible than Argentine ants. Knockdown of virtually all ants initially occurred within 15 min after exposure. However, some moribund ants recovered from the effects within 24 h. For example, after 1 min of direct exposure to the permethrin-impregnated plastic, 70% of Argentine ants and 5% of red imported fire ants recovered from the treatment. In established colonies of Argentine ants, significantly fewer ants foraged for food up posts treated with the plastic compared with untreated posts. In addition, colonies responded to introduction of the treatment by significantly reducing their overall foraging rates, even on untreated posts. When pots filled with moistened soil were introduced into established ant colonies, 82% of Argentine ants and 99% of red imported fire ants moved into the soil. In contrast, when a 1-cm-wide coil of the plastic was placed under the pot, no ants moved into the soil. The potential for use of these materials in nursery production is discussed. PMID:16539136

  9. Overall and cause-specific excess mortality in HIV-positive persons compared with the general population: Role of HCV coinfection.

    PubMed

    Alejos, Belén; Hernando, Victoria; Iribarren, Jose; Gonzalez-García, Juan; Hernando, Asuncion; Santos, Jesus; Asensi, Victor; Gomez-Berrocal, Ana; Del Amo, Julia; Jarrin, Inma

    2016-09-01

    We aimed to estimate overall and cause-specific excess mortality of HIV-positive patients compared with the general population, and to assess the effect of risk factors.We included patients aged >19 years, recruited from January 1, 2004 to May 31, 2014 in Cohort of the Spanish Network on HIV/AIDS Research. We used generalized linear models with Poisson error structure to model excess mortality rates.In 10,340 patients, 368 deaths occurred. Excess mortality was 0.82 deaths per 100 person-years for all-cause mortality, 0.11 for liver, 0.08 for non-AIDS-defining malignancies (NADMs), 0.08 for non-AIDS infections, and 0.02 for cardiovascular-related causes. Lower CD4 count and higher HIV viral load, lower education, being male, and over 50 years were predictors of overall excess mortality. Short-term (first year follow-up) overall excess hazard ratio (eHR) for subjects with AIDS at entry was 3.71 (95% confidence interval [CI] 2.66, 5.19) and 1.37 (95% CI 0.87, 2.15) for hepatitis C virus (HCV)-coinfected; medium/long-term eHR for AIDS at entry was 0.90 (95% CI 0.58, 1.39) and 3.83 (95% CI 2.37, 6.19) for HCV coinfection. Liver excess mortality was associated with low CD4 counts and HCV coinfection. Patients aged ≥50 years and HCV-coinfected showed higher NADM excess mortality, and HCV-coinfected patients showed increased non-AIDS infections excess mortality.Overall, liver, NADM, non-AIDS infections, and cardiovascular excesses of mortality associated with being HIV-positive were found, and HCV coinfection and immunodeficiency played significant roles. Differential short and medium/long-term effects of AIDS at entry and HCV coinfection were found for overall excess mortality.

  10. Effect of supplemental heat on mortality rate, growth performance, and blood biochemical profiles of Ghungroo piglets in Indian sub-tropical climate

    PubMed Central

    Nath, Hemanta; Hazorika, Mousumi; Rajkhowa, Dipjyoti; Datta, Mrinmoy; Haldar, Avijit

    2016-01-01

    Aim: The present study was conducted to explore the effect of supplemental heat on mortality rate, growth performance, and blood biochemical profiles of indigenous Ghungroo piglets in sub-tropical cold and humid climatic conditions of Tripura, a state of the north eastern hill (NEH) region of India. Materials and Methods: The experiment was conducted on 38 indigenous Ghungroo piglets from birth up to 60 days of age. Among the 38 piglets, 19 piglets were provided with supplemental heat ranging between 17.0°C and 21.1°C for the period of the first 30 days and thereafter between 24.1°C and 29.9°C for the next 30 days. The other 19 piglets were exposed to natural environmental minimum temperatures ranging between 7.2°C and 15.0°C during the first 30 days and then between 18.5°C and 25.5°C for the next 30 days. Results: The supplemental heat resulted in 10.6% reduction of piglet mortality from the 2nd till the 7th day of age. These beneficial effects could be related with the lower (p<0.05) plasma glutamate pyruvate transaminase (GPT) and cortisol levels and higher (p<0.05) plasma alkaline phosphatase (AP) concentrations in heat supplemented group compared to control group. Plasma AP, GPT, glucose, triiodothyronine, and luteinizing hormone concentrations decreased (p<0.05) gradually with the advancement of age in both control and supplemental heat treated piglets. Conclusion: Supplemental heat could be beneficial since it is related to a reduction of piglet mortality during the first week of life under farm management system in the sub-tropical climate of NEH region of India. PMID:27182136

  11. Infant Mortality

    MedlinePlus

    ... Infant Mortality Infant Mortality: What is CDC Doing? Sudden Infant Death Syndrome Teen Pregnancy Contraception CDC Contraceptive Guidance for ... and low birth weight Maternal complications of pregnancy Sudden Infant Death Syndrome (SIDS) Injuries (e.g., suffocation). The top ...

  12. War and Children's Mortality.

    ERIC Educational Resources Information Center

    Carlton-Ford, Steve; Houston, Paula; Hamill, Ann

    2000-01-01

    Examines impact of war on young children's mortality in 137 countries. Finds that years recently at war (1990-5) interact with years previously at war (1946-89) to elevate mortality rates. Religious composition interacts with years recently at war to reduce effect. Controlling for women's literacy and access to safe water eliminates effect for…

  13. Effects of low doses and low dose rates of external ionizing radiation: Cancer mortality among nuclear industry workers in three countries

    SciTech Connect

    Cardis, E.; Kato, I.; Lave, C.; Gilbert, E.S.; Fix., J.; Carpenter, L.; Howe, D.; Armstrong, B.K.; Bereal, V.

    1995-05-01

    Studies of the mortality among nuclear industry workforces have been carried out, and nationally combined analyses performed, in the U.S., the UK and Canada. This paper presents the results of internationally combined analyses of mortality data on 95,673 workers (85.4% men) monitored for external exposure to ionizing radiation and employed for 6 months or longer in the nuclear industry of one of the three countries. These analyses were undertaken to obtain a more precise direct assessment of the carcinogenic effects of protracted low-level exposure to external, predominantly {gamma}, radiation. The combination of the data from the various studies increases the power to study associations between radiation dose and mortality from all causes or from all cancers. Mortality from leukemia, excluding chronic lymphocytic leukemia (CLL)-the cause of death most strongly and consistently related to radiation dose in studies of atomic bomb survivors and other populations exposed at high dose rates-was significantly associated with cumulative external radiation dose (one-sided P value = 0.046; 119 deaths). Among the 31 other specific types of cancer studied, a significant association was observed only for multiple myeloma (one-sided P value = 0.037; 44 deaths), and this was attributable primarily to the associations reported previously between this disease and radiation dose in the Hanford (U.S.) and Sellafield (UK) cohorts. The excess relative risk (ERR) estimates for all cancers excluding leukemia, and leukemia excluding CLL, the two main groupings of causes of death for which risk estimates have been derived from studies of atomic bomb survivors, were -0.07 per Sv [90% confidence interval (CI):-0.4,0.3] and 2.18 per Sv (90% CI:0.1,5.7), respectively. These values correspond to a relative risk of 0.99 for all cancers excluding leukemia and 1.22 for leukemia excluding CLL for a cumulative protracted dose of 100 mSv compared to O mSv. 53 refs., 1 fig., 8 tabs.

  14. Effects of pressure reductions in a proposed siphon water lift system at St. Stephen Dam, South Carolina, on mortality rates of juvenile American shad and blueback herring. Technical report

    SciTech Connect

    Nestler, J.M.; Schilt, C.R.; Jones, D.P.

    1998-09-01

    This report presents results of studies to predict the mortality rate of juvenile blueback herring (Alosa aestivalis) and American shad (A. sapidissima) associated with reduced pressure as they pass downstream through a proposed siphon water lift system at St. Stephen Dam, South Carolina. The primary function of the siphon is to increase attracting flow to better guide upstream migrating adult herring of both species into the existing fish lift for upstream passage. The US Army Engineer District, Charleston, wishes to consider the siphon as an alternative bypass route through the dam for downstream migrating juvenile and adult herring. A pressure-reduction testing system that emulates some of the pressure characteristics of the siphon was used to determine the approximate percentage of juvenile fishes that could be reasonably expected to be killed passing through the reduced pressures anticipated for the siphon water lift system. The testing system could duplicate the range of pressure change anticipated for the siphon lift system but could not obtain pressures lower than 4.1 psi, whereas pressures for some design alternatives may approach the theoretical minimum pressure of 0.0 psi. Study results indicate that the mortality rate is probably about 20 percent. Power analysis indicates that mortality rate above 30 percent is unlikely. Conducting additional mortality studies is recommended to refine predicted mortality rates. Measures should be taken to prevent juvenile fish from entering the siphon lift system if excessive mortality rates are observed.

  15. Has the Rate of Reduction in Infant Mortality Increased in India Since the Launch of National Rural Health Mission? Analysis of Time Trends 2000-2009 with Projection to 2015

    PubMed Central

    Narwal, Rajesh; Gram, Lu

    2013-01-01

    Objectives: National Rural Health Mission (NRHM) - India was launched in 2005 to tackle urban-rural health inequalities, especially in maternal and child health. We examined national and state level trends in Infant Mortality Rates (IMR) from 2000 through 2009 to: 1) assess whether the NRHM had increased the average annual reduction rate (AARR) of IMR 2) evaluate state-wise progress towards Millennium Development Goals (MDG4) and estimate required AARRs for ‘off track’ states. Methods: Log-linear regression models were applied to national and state IMR data collated from the Sample Registration System (SRS)-India to estimate average annual reduction rates and compare AAARs before and after introduction of NRHM. The log-linear trend of infant mortality rates was also projected forward to 2015. Results: The infant mortality rate in rural India declined from 74 to 55/1000 live births between 2000 and 2009, with AARR of 3.0% (95% CI=2.6%-3.4%) and the urban-rural gap in infant mortality narrowed (p =0.036). However there was no evidence (p=0.49) that AARR in rural India increased post NRHM (3.4%, 95% CI 2.0-4.7%) compared to pre NRHM (2.8%, 95% CI 2.1%-3.5%). States varied widely in rates of infant mortality reduction. Projections of infant mortality rates suggested that only eight states might be on track to help India achieve MDG4 by 2015. Conclusions and Public Health Implications: Despite a narrowing urban-rural gap and high AARRs in some states, there was no evidence that the rate of reduction in infant mortality has increased in rural India post NRHM introduction. India appears unlikely to achieve child survival-related NRHM and millennium development goals. Government should revisit the child survival related NRHM strategies and ensure equitable access to health services. More robust monitoring and evaluation mechanisms must be inbuilt for following years. PMID:27621967

  16. Comparative study of two anesthesia methods according to postoperative complications and one month mortality rate in the candidates of hip surgery

    PubMed Central

    Heidari, Saied Morteza; Soltani, Hasanali; Hashemi, Saied Jalal; Talakoub, Reihanak; Soleimani, Bahram

    2011-01-01

    BACKGROUND: Surgery for hip fractures can be done under general or neuraxial anesthesia. This study aimed to compare these two methods concerning their postoperative complications, duration of operation, hospitalization and the mortality rate within a period of one month after surgery. METHODS: 400 patients aged more than 30 years old and scheduled for elective operative fixation of fractured hip, randomly enrolled in two equal groups of general (GA) and neuraxial (NA) anesthesia. Hemoglobin level was measured before and 6 hours, 2, 3 and 5 days after the surgery. The intra and postoperative blood loss, duration of surgery, the severity of pain at the time of discharge from recovery and at the 2nd, 3rd and 5th postoperative days were recorded. Statistical analysis was performed using SPSS version 12.0 by Mann-Whitney, chi-square, and t tests. P < 0.05 was considered significant. RESULTS: Both groups were similar regarding age, weight, and gender ratio. There was no significant difference in baseline hemoglobin, duration of surgery, length of hospitalization before surgery and the type of surgery. The mean of intraoperative blood loss and visual analogue score (VAS) in recovery and at the 3rd postoperative day, and also the length of hospitalization after surgery were significantly less in neuraxial anesthesia group. Both groups showed a significant decrease in hemoglobin values on the 2nd and 3rd postoperative days comparing to the baseline (p < 0.001). CONCLUSIONS: The morbidity and mortality rates of patients undergoing hip surgery were similar in both methods of anesthesia, but postoperative pain, blood loss, and duration of hospitalization were more in patients undergoing general anesthesia. PMID:22091252

  17. Relationship between Kidney Dysfunction and Ischemic Stroke Outcomes: Albuminuria, but Not Estimated Glomerular Filtration Rate, Is Associated with the Risk of Further Vascular Events and Mortality after Stroke

    PubMed Central

    Lee, Dong-Geun

    2016-01-01

    Background and Objective Estimated glomerular filtration rate (eGFR) and albuminuria are known to be associated with ischemic stroke outcomes. In this study, we investigated the longitudinal relationships of the two markers with mortality, vascular events and functional outcomes in a stroke cohort. Methods A total of 295 patients with acute ischemic stroke were prospectively recruited in a single center between May 2012 and February 2015. Renal dysfunction was defined as a decreased eGFR (<60 mL/min/1.73 m2) or albuminuria (urine albumin-to-creatinine ratio ≥ 30 mg/g). Good functional outcome at 6 months was defined as a modified Rankin scale score ≤ 2, and the occurrence of major vascular events (stroke, acute coronary syndrome or peripheral artery occlusion) or death was monitored. The associations between renal dysfunction and mortality, major vascular events, and 6-month functional outcome were evaluated by the Cox proportional hazards model and logistic regression analysis. Unadjusted and adjusted hazards ratios (HRs), odds ratios (ORs), and 95% confidence intervals (CIs) were obtained. A Kaplan–Meier survival curve for composite adverse events (major vascular events or death) was also computed according to the presence or absence of albuminuria. Results Albuminuria, not eGFR, was significantly associated with mortality (P = 0.028; HR 2.15; 95% CI 1.09–4.25) and major vascular events (P = 0.044; HR 2.24; 95% CI 1.02–4.94) in the multivariate Cox proportional hazards models adjusting for age, sex, diabetes, hypertension, current smoking, atrial fibrillation, previous stroke, alcohol history, initial National Institutes of Health Stroke Scale (NIHSS) score and eGFR. In addition, albuminuria was negatively associated with 6-month functional outcome in the multivariate logistic regression analysis adjusting for age, sex, diabetes, hypertension, current smoking, atrial fibrillation, previous stroke, alcohol history and eGFR (P = 0.001; OR 0.36; 95% CI 0

  18. Differing first year mortality rates of term births to White, African-American, and Mexican-American US-born and foreign-born mothers.

    PubMed

    Collins, James W; Soskolne, Gayle R; Rankin, Kristin M; Bennett, Amanda C

    2013-12-01

    To determine whether maternal nativity (US-born versus foreign-born) is associated with the first year mortality rates of term births. Stratified and multivariable binomial regression analyses were performed on the 2003-2004 National Center for Health Statistics linked live birth-infant death cohort files. Only term (37-42 weeks) infants with non-Latina White, African-American, and Mexican-American mothers were studied. The infant mortality rate (<365 days, IMR) of births to US-born non-Latina White mothers (n = 3,684,569) exceeded that of births to foreign-born White mothers (n = 226,621): 2.4/1,000 versus 1.3/1,000, respectively; relative risk (RR) = 1.8 [95 % confidence interval (CI) 1.6-2.0]. The IMR of births to US-born African-American mothers (n = 787,452) exceeded that of births to foreign-born African-American mothers (n = 118,246): 4.1/1,000 versus 2.2/1,000, respectively; RR = 1.8 (1.6-2.1). The IMR of births to US-born Mexican-American mothers (n = 338,337) exceeded that of births to Mexican-born mothers (n = 719,837): 2.4/1,000 versus 1.8/1,000, respectively; RR = 1.3 (1.2-1.4). These disparities were not limited to a singular cause of death and were widest among deaths due to Sudden Infant Death Syndrome. In multivariable binomial regression models, the adjusted RR of infant mortality for non-LBW, term births to US-born (compared to foreign-born) for White, African-American, and Mexican-American mothers equaled 1.5 (1.3-1.7), 1.7 (1.5-2.1) and 1.6 (1.4-1.8), respectively. The IMR of term births to White, African-American, and Mexican-American mothers exceeds that of their counterparts with foreign-born mothers independent of traditional individual level risk factors.

  19. When to Monitor CD4 Cell Count and HIV RNA to Reduce Mortality and AIDS-Defining Illness in Virologically Suppressed HIV-Positive Persons on Antiretroviral Therapy in High-Income Countries: A Prospective Observational Study

    PubMed Central

    Caniglia, Ellen C.; Sabin, Caroline; Robins, James M.; Logan, Roger; Cain, Lauren E.; Abgrall, Sophie; Mugavero, Michael J.; Hernandez-Diaz, Sonia; Meyer, Laurence; Seng, Remonie; Drozd, Daniel R.; Seage, George R.; Bonnet, Fabrice; Dabis, Francois; Moore, Richard R.; Reiss, Peter; van Sighem, Ard; Mathews, William C.; del Amo, Julia; Moreno, Santiago; Deeks, Steven G.; Muga, Roberto; Boswell, Stephen L.; Ferrer, Elena; Eron, Joseph J.; Napravnik, Sonia; Jose, Sophie; Phillips, Andrew; Olson, Ashley; Justice, Amy C.; Tate, Janet P.; Bucher, Heiner C.; Egger, Matthias; Touloumi, Giota; Sterne, Jonathan A.; Costagliola, Dominique; Saag, Michael; Hernán, Miguel A.

    2016-01-01

    Objective: To illustrate an approach to compare CD4 cell count and HIV-RNA monitoring strategies in HIV-positive individuals on antiretroviral therapy (ART). Design: Prospective studies of HIV-positive individuals in Europe and the USA in the HIV-CAUSAL Collaboration and The Center for AIDS Research Network of Integrated Clinical Systems. Methods: Antiretroviral-naive individuals who initiated ART and became virologically suppressed within 12 months were followed from the date of suppression. We compared 3 CD4 cell count and HIV-RNA monitoring strategies: once every (1) 3 ± 1 months, (2) 6 ± 1 months, and (3) 9–12 ± 1 months. We used inverse-probability weighted models to compare these strategies with respect to clinical, immunologic, and virologic outcomes. Results: In 39,029 eligible individuals, there were 265 deaths and 690 AIDS-defining illnesses or deaths. Compared with the 3-month strategy, the mortality hazard ratios (95% CIs) were 0.86 (0.42 to 1.78) for the 6 months and 0.82 (0.46 to 1.47) for the 9–12 month strategy. The respective 18-month risk ratios (95% CIs) of virologic failure (RNA >200) were 0.74 (0.46 to 1.19) and 2.35 (1.56 to 3.54) and 18-month mean CD4 differences (95% CIs) were −5.3 (−18.6 to 7.9) and −31.7 (−52.0 to −11.3). The estimates for the 2-year risk of AIDS-defining illness or death were similar across strategies. Conclusions: Our findings suggest that monitoring frequency of virologically suppressed individuals can be decreased from every 3 months to every 6, 9, or 12 months with respect to clinical outcomes. Because effects of different monitoring strategies could take years to materialize, longer follow-up is needed to fully evaluate this question. PMID:26895294

  20. Predictors of Mortality in Staphylococcus aureus Bacteremia

    PubMed Central

    Jensen, Slade O.; Vaska, Vikram L.; Espedido, Björn A.; Paterson, David L.; Gosbell, Iain B.

    2012-01-01

    Summary: Staphylococcus aureus bacteremia (SAB) is an important infection with an incidence rate ranging from 20 to 50 cases/100,000 population per year. Between 10% and 30% of these patients will die from SAB. Comparatively, this accounts for a greater number of deaths than for AIDS, tuberculosis, and viral hepatitis combined. Multiple factors influence outcomes for SAB patients. The most consistent predictor of mortality is age, with older patients being twice as likely to die. Except for the presence of comorbidities, the impacts of other host factors, including gender, ethnicity, socioeconomic status, and immune status, are unclear. Pathogen-host interactions, especially the presence of shock and the source of SAB, are strong predictors of outcomes. Although antibiotic resistance may be associated with increased mortality, questions remain as to whether this reflects pathogen-specific factors or poorer responses to antibiotic therapy, namely, vancomycin. Optimal management relies on starting appropriate antibiotics in a timely fashion, resulting in improved outcomes for certain patient subgroups. The roles of surgery and infectious disease consultations require further study. Although the rate of mortality from SAB is declining, it remains high. Future international collaborative studies are required to tease out the relative contributions of various factors to mortality, which would enable the optimization of SAB management and patient outcomes. PMID:22491776

  1. Study projects demographic impact of AIDS in Africa.

    PubMed

    1994-06-01

    Based on the United Nations study, "AIDS and the Demography of Africa", population growth rates will remain high in African countries south of the Sahara despite high mortality due to acquired immunodeficiency syndrome (AIDS). The Population Division of the UN Department for Economic and Social Information and Policy Analysis (DESIPA) incorporated the demographic impact of AIDS in its biennial population estimates and projections for Benin, Burkina Faso, Burundi, Central African Republic, Congo, Ivory Coast, Kenya, Malawi, Mozambique, Rwanda, United Republic of Tanzania, Uganda, Zaire, Zambia, and Zimbabwe. 9 million additional deaths due to AIDS are projected by 2005; 61% will occur in Uganda, Zaire, Tanzania, and Zambia. From 2000 to 2005, the average life expectancy for the region (51.2 years) will be 6.5 years lower than that without AIDS; that in Uganda (42.9 years) will be 11.1 years less. Mortality is increasing and its hardest impact will be during the prime working and family care years. Socioeconomic effects may include reductions in the size and productivity of the labor force, decreased industrial and agricultural production, and changes in care of children and the elderly. Due to high fertility rates, however, population increases are projected for all 15 countries. Although its nearly 12.4 million years less (4%) than that expected without the effect of AIDS, the total population for the region is projected to be 297.9 million by 2005. The address for obtaining the document discussed is listed with the price.

  2. Neonatal mortality in Meerut district.

    PubMed

    Garg, S K; Mishra, V N; Singh, J V; Bhatnagar, M; Chopra, H; Singh, R B

    1993-09-01

    A study of neonatal mortality in Meerut district revealed an infant mortality rate of 50.1 per 1000 live births. Neonatal mortality accounted for 37.8% of infant mortality with a neonatal mortality rate of 19.0 per 1000 live births. 90.5% of these neonates were delivered at home largely by untrained personnel (57.2%). Only 28.6% of these neonates were treated by qualified doctors and only 30.9% of their mothers were fully immunized against tetanus. At least 2/3rd of neonatal mortality was due to exogenous factors with tetanus neonatorum and septicaemia being the principal causes of mortality each accounting for a mortality rate of 4.7 per 1000 live births. PMID:8112786

  3. [AIDS research and prevention strategies in Thailand].

    PubMed

    Leisch, H

    1997-04-01

    The first case of AIDS was registered in Thailand in 1984; this syndrome was deemed to be mainly a disease affecting homosexuals and foreigners. However, soon thereafter its incidence among prostitutes and intravenous drug users increased. According to 1995 data, the number of AIDS patients was about 20,000 and there were approximately 800,000 HIV-positive people. A 1991 map of the AIDS incidence showed that, after the Bangkok metropolitan area, the province of Chiang Mai in the north exhibited a particularly high rate of infection. According to a medium-range forecast, by the year 2010 there will be close to 2.3 million cumulative HIV infection cases and 1.2 million AIDS cases in Thailand. This corresponds to an infection rate of about 3.2% vs. the present 2%. It is estimated that about 20% of all mortality in the age range of 20-48 years in the year 2000 will be caused by AIDS. In 1995, the prime minister predicted that AIDS would cause a 20% drop of the GDP by 2000. The boom of the economy in the 1980s and the early 1990s led to migration to the cities, where prostitution and drug use are rampant, as well as to the emergence of sex tourism, mainly from Germany (40,000-60,000 Germans traveled to Thailand in 1990). The age-old tradition among married men of seeking out the services of prostitutes, lack of condom use (only 20% of men intend to use it, according to recent studies), and disregard for the AIDS problem among the populace are other factors contributing to the rapid spread of AIDS. UNAIDS has undertaken sex education and other information campaigns to counter the epidemic.

  4. [Maternal mortality and perinatal mortality].

    PubMed

    Boutaleb, Y; Mesbahi, M; Lahlou, D; Aderdour, M

    1982-01-01

    intrapartum mortality without maceration, 114 were caused by retroplacental hematomas, 61 by placenta previa, 74 by uterine rupture, 119 by prolapse of the cord, 51 by fetal malformation, 45 by dystochia, 53 by twin pregnancies, 104 by fetal distress, 44 by obstetrical trauma, 55 by prematurity, and 75 by undetermined causes. In 361 cases of early neonatal mortality, 88 were caused by renovascular syndromes, 24 by diabetes, 13 by Rh incompatibility, 34 by placenta previa, 94 by prematurity, 28 by fetal malformation, 35 by fetal infections, 31 by fetal distress, and 14 by obstetrical trauma. The rates of maternal and perinatal mortality are very high compared to those of European countries. PMID:7201485

  5. Heart rate variables in the Vascular Quality Initiative are not reliable predictors of adverse cardiac outcomes or mortality after major elective vascular surgery

    PubMed Central

    Scali, Salvatore; Bertges, Daniel; Neal, Daniel; Patel, Virendra; Eldrup-Jorgensen, Jens; Cronenwett, Jack; Beck, Adam

    2015-01-01

    Objective Heart rate (HR) parameters are known indicators of cardiovascular complications after cardiac surgery, but there is little evidence of their role in predicting outcome after major vascular surgery. The purpose of this study was to determine whether arrival HR (AHR) and highest intraoperative HR are associated with mortality or major adverse cardiac events (MACEs) after elective vascular surgery in the Vascular Quality Initiative (VQI). Methods Patients undergoing elective lower extremity bypass (LEB), aortofemoral bypass (AFB), and open abdominal aortic aneurysm (AAA) repair in the VQI were analyzed. MACE was defined as any postoperative myocardial infarction, dysrhythmia, or congestive heart failure. Controlled HR was defined as AHR <75 beats/min on operating room arrival. Delta HR (DHR) was defined as highest intraoperative HR – AHR Procedure-specific MACE models were derived for risk stratification, and generalized estimating equations were used to account for clustering of center effects. HR, beta-blocker exposure, cardiac risk, and their interactions were explored to determine association with MACE or 30-day mortality. A Bonferroni correction with P < .004 was used to declare significance. Results There were 13,291 patients reviewed (LEB, n = 8155 [62%]; AFB, n = 2629 [18%]; open AAA, n = 2629 [20%]). Rates of any preoperative beta-blocker exposure were as follows: LEB, 66.5% (n = 5412); AFB, 57% (n = 1342); and open AAA, 74.2% (n = 1949). AHR and DHR outcome association was variable across patients and procedures. AHR <75 beats/min was associated with increased postoperative myocardial infarction risk for LEB patients across all risk strata (odds ratio [OR], 1.4; 95% confidence interval [CI], 1.03–1.9; P = .03), whereas AHR<75 beats/min was associated with decreased dysrhythmia risk (OR, 0.42; 95% CI, 0.28–0.63; P = .0001) and 30-day death (OR, 0.50; 95% CI, 0.33–0.77; P = .001) in patients at moderate and high cardiac risk. These HR

  6. Drowning Mortality and Morbidity Rates in Children and Adolescents 0-19yrs: A Population-Based Study in Queensland, Australia

    PubMed Central

    Wallis, Belinda A.; Watt, Kerrianne; Franklin, Richard C.; Nixon, James W.; Kimble, Roy M.

    2015-01-01

    Objective To redress the lack of Queensland population incidence mortality and morbidity data associated with drowning in those aged 0-19yrs, and to understand survival and patient care. Design, Setting and Participants Retrospective population-based study used data linkage to capture both fatal and non-fatal drowning cases (N = 1299) among children aged 0-19years in Queensland, from 2002-2008 inclusive. Patient data were accessed from pre-hospital, emergency department, hospital admission and death data, and linked manually to collate data across the continuum of care. Main Outcome Measures Incidence rates were calculated separately by age group and gender for events resulting in death, hospital admission, and non-admission. Trends over time were analysed. Results Drowning death to survival ratio was 1:10, and two out of three of those who survived were admitted to hospital. Incidence rates for fatal and non-fatal drowning increased over time, primarily due to an increase in non-fatal drowning. There were non-significant reductions in fatal and admission rates. Rates for non-fatal drowning that did not result in hospitalisation more than doubled over the seven years. Children aged 5-9yrs and 10-14yrs incurred the lowest incidence rates 6.38 and 4.62 (expressed as per 100,000), and the highest rates were among children aged 0-4yrs (all drowning events 43.90; fatal 4.04; non-fatal 39.85–comprising admission 26.69 and non-admission 13.16). Males were over-represented in all age groups except 10-14yrs. Total male drowning events increased 44% over the seven years (P<0.001). Conclusion This state-wide data collection has revealed previously unknown incidence and survival ratios. Increased trends in drowning survival rates may be viewed as both positive and challenging for drowning prevention and the health system. Males are over-represented, and although infants and toddlers did not have increased fatality rates, they had the greatest drowning burden demonstrating

  7. Statin Effects on Exacerbation Rates, Mortality, and Inflammatory Markers in Patients with Chronic Obstructive Pulmonary Disease: A Review of Prospective Studies.

    PubMed

    Howard, Meredith L; Vincent, Ashley H

    2016-05-01

    Chronic obstructive pulmonary disease (COPD) is a debilitating, irreversible disease with currently available therapies targeting symptom control and exacerbation reduction. A need for alternative disease-modifying therapies remains, specifically those that may have antiinflammatory and immunomodulatory properties that impact the pathophysiologic components of COPD. Statin drugs, the current gold standard for the treatment of dyslipidemia and prevention of cardiovascular disease (CVD), contain properties that affect the inflammatory disease processes seen in COPD. Several retrospective studies have demonstrated that statins may have a benefit in the reduction of morbidity and mortality in patients with COPD. This has led to prospective trials evaluating the impact of statins on various COPD-related outcomes. This article reviews the current body of prospective evidence for use of statins in patients with COPD. A search of the PubMed/Medline database of English-language articles was conducted from 1964 through November 2015; references of relevant articles were also reviewed for qualifying studies. Prospective studies of all types relating to statin use in patients with COPD were included if they had COPD- or respiratory-related outcomes; ultimately, eight studies were identified for this review. Statin effects on exacerbation rates, mortality, and inflammatory markers in patients with COPD are discussed. Strong prospective evidence does not currently exist to suggest that statins provide a clinical benefit in patients with COPD who do not have other CVD risk factors. Benefits from statins that have been illustrated are likely explained by their impact on underlying CVD risk factors rather than the COPD disease process. An opportunity exists for unanswered questions to be addressed in future studies. PMID:26990316

  8. Clinical epidemiology of HIV/AIDS in China from 2004-2011.

    PubMed

    Li, Min; Shen, Yinzhong; Jiang, Xiaofei; Li, Qi; Zhou, Xiaoming; Lu, Hongzhou

    2014-02-01

    This study retrospectively analyzed Chinese publicly reported data on Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS). The HIV/AIDS morbidity (1/100,000) and mortality (1/100,000) rates in China continually increased from 0.23 and 0.06 in 2004 to 1.53 and 0.69 in 2011, respectively. The AIDS case fatality rate decreased yearly from 53.57% in 2008 to 45.11% in 2011, and the fatality rate in rural areas (0.25-0.42%) was higher than that in cities (0.13-0.22%). The number of HIV/AIDS patients discharged from city-level hospitals increased from 329 in 2004 to 7,266 in 2011, and this number was higher than the number of similar patients discharged from county-level (rural) hospitals (the number of HIV/AIDS patients increased from 252 in 2004 to 5,957 in 2011). The factors contributing to these trends include: enhanced physician HIV/AIDS education regarding diagnosis, intervention, monitoring, testing, and treatment; improved safety of blood collection and use; and improved management of HIV/AIDS patients. Therefore, HIV/AIDS prevention and control in rural areas of China is the key to reducing HIV transmission and mortality in China. PMID:24647113

  9. The association between price of regular-grade gasoline and injury and mortality rates among occupants involved in motorcycle- and automobile-related motor vehicle collisions.

    PubMed

    Hyatt, Eddie; Griffin, Russell; Rue, Loring W; McGwin, Gerald

    2009-09-01

    Motorcyclists have been reported to be more likely to die in a motor vehicle collision (MVC) than automobile occupants. With the recent increase in the pump price of gasoline, it has been reported that people are switching to motorcycles as main modes of transportation. This study evaluated the association between motor vehicle collision-related injury and mortality rates and increases in gasoline prices for occupants of automobiles and riders of motorcycles. There were an estimated 1,270,512 motorcycle MVC and 238,390,853 automobile MVC involved occupants in the U.S. from 1992 to 2007. Higher gasoline prices were associated with increased motorcycle-related injuries and deaths; however, this association no longer remained after accounting for changes in the number of registered vehicles. The current study observed that, while the number of injuries and fatalities in motorcycle-related MVCs increase with increasing gasoline price, rates remained largely unchanged. This suggests that the observed increase in motorcycle-related injuries and fatalities with increasing gasoline price is more a factor of the number of motorcycles on the road rather than operator characteristics.

  10. [Maternal mortality in Argentina].

    PubMed

    1994-01-01

    In Argentina, as in most countries, complications of pregnancy and delivery are important causes of mortality of fertile-age women. At the 1994 International Conference on Population and Development in Cairo, governments agreed on the objective of promoting maternity without risk in order to reduce maternal mortality. Maternal mortality rates in many developing countries are much higher than the 10/100,000 live births in the most developed countries. Deficiencies in reporting due either to failure to report deaths or errors in the cause of death are a major impediment to study of maternal mortality. Two studies were conducted recently to provide more accurate data on maternal mortality in Argentina. A study carried out during 1987-89 was designed to measure underregistration of maternal mortality in the federal capital in 1985. Data from death registers were paired with the corresponding clinical histories. The true maternal mortality rate was found to be 91/100,000 rather than the official 50. 38% of maternal deaths rather than the previously estimated 57% were found to be due to complications of illegal abortion. The degree of underreporting in the federal capital, which has the highest proportion of hospital deliveries and most developed infrastructure, suggests that the maternal mortality rate is also much higher than official estimates in other parts of Argentina. Official estimates for 1993 showed a maternal mortality rate of 46/100,000, with very significant regional differentials. A study using the indirect sister survival method was conducted in a low income neighborhood of Zarate in 1991. 8041 persons in 1679 households were interviewed. The resulting estimate of 140/100,000 corresponded to the early 1980s.

  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. PMID:23132917

  12. Weighing social and economic determinants related to inequalities in mortality.

    PubMed

    Pasarín, M Isabel; Borrell, Carme; Brugal, M Teresa; Díaz-Quijano, Estela

    2004-09-01

    It is well known that there are social inequalities in health. Following the ecological approach, unemployment has been one of the most used indicators to study social inequalities. The aim of the present study was to investigate the relationships between indicators of extreme poverty and social unrest, along with unemployment, and mortality in Barcelona, during the years 1989 to 1993. A cross-sectional ecological study was carried out using Primary Health Care Areas (PHCAs) as the unit of analysis. The study population consisted of residents in Barcelona City. The indicators studied as dependent variables were the age-standardized mortality rates of the following causes of death: total mortality; lung cancer; bronchitis, emphysema, and asthma; cirrhosis; cerebrovascular disease; ischemic heart disease; breast cancer; traffic accidents; acquired immunodeficiency syndrome (AIDS); and drug overdose. Independent variables were male unemployment rate of the primary health care areas and indicators of extreme poverty and social conflict. A descriptive analysis, a bivariate analysis using Spearman correlation coefficients, and a multivariate analysis fitting Poisson regression models were carried out. For the main results, one group of causes of death was associated only with unemployment: bronchitis, emphysema and asthma, cerebrovascular disease, and ischemic heart disease (both men and women); lung cancer (only among men); total mortality and cirrhosis (only among women). Among men, another group of causes of death was associated with extreme poverty and/or social unrest, as well as unemployment: total mortality, cirrhosis, and drug overdose. AIDS in men was only associated with extreme poverty and social unrest. We concluded that we see different types of relationships between deprivation and mortality. Unemployment has been related to mortality because of pathologies with socially accepted risk factors (tobacco and alcohol). Causes of death with risk factors not

  13. Graduation Rates for Selected Cohorts, 2006-11; Student Financial Aid, Academic Year 2013-14; and Admissions in Postsecondary Institutions, Fall 2014. First Look (Provisional Data). NCES 2015-181

    ERIC Educational Resources Information Center

    Ginder, Scott A.; Kelly-Reid, Janice E.; Mann, Farrah B.

    2015-01-01

    This "First Look" presents findings from the provisional data of the IPEDS winter 2014-15 data collection, which included four survey components: (1) Graduation Rates (GR); (2) 200 Percent Graduation Rates (GR200); (3) Student Financial Aid (SFA); and (4) Admissions (ADM). GR and GR200 present graduation rates for selected cohorts within…

  14. HIV / AIDS

    MedlinePlus

    ... Marketing Share this: Main Content Area Understanding HIV/AIDS AIDS was first reported in the United States in ... and has since become a major worldwide epidemic. AIDS is caused by the human immunodeficiency virus, or ...

  15. Maternal mortality in Sirur.

    PubMed

    Shrotri, A; Pratinidhi, A; Shah, U

    1990-01-01

    The research aim was 1) to determine the incidence of maternal mortality in a rural health center area in Sirur, Maharashtra state, India; 2) to determine the relative risk; and 3) to make suggestions about reducing maternal mortality. The data on deliveries was obtained between 1981 and 1984. Medical care at the Rural Training Center was supervised by the Department of Preventive and Social Medicine, the B.J. Medical College in Pune. Deliveries numbered 5994 singleton births over the four years; 5919 births were live births. 15 mothers died: 14 after delivery and 1 predelivery. The maternal mortality rate was 2.5/1000 live births. The maternal causes of death included 9 direct obstetric causes, 3 from postpartum hemorrhage of anemic women, and 3 from puerperal sepsis of anemic women with prolonged labor. 2 deaths were due to eclampsia, and 1 death was unexplained. There were 5 (33.3%) maternal deaths due to indirect causes (3 from hepatitis and 2 from thrombosis). One woman died of undetermined causes. Maternal jaundice during pregnancy was associated with the highest relative risk of maternal death: 106.4. Other relative risk factors were edema, anemia, and prolonged labor. Attributable risk was highest for anemia, followed by jaundice, edema, and maternal age of over 30 years. Maternal mortality at 30 years and older was 3.9/1000 live births. Teenage maternal mortality was 3.3/1000. Maternal mortality among women 20-29 years old was lowest at 2.1/1000. Maternal mortality for women with a parity of 5 or higher was 3.6/1000. Prima gravida women had a maternal mortality rate of 2.9/1000. Parities between 1 and 4 had a maternal mortality rate of 2.3/1000. The lowest maternal mortality was at parity of 3. Only 1 woman who died had received more than 3 prenatal visits. 11 out of 13 women medically examined prenatally were identified with the following risk factors: jaundice, edema, anemia, young or old maternal age, parity, or poor obstetric history. The local

  16. Mortality in Asia.

    PubMed

    1981-01-01

    Although the general trend in mortality between 1950 and 1975 in South and East Asia has been downward, there is considerable country-to-country variation in the rate of decline. In countries where combined economic, social, and political circumstances resulted in controlling the disease spectrum (e.g., China, Malaysia, Sri Lanka), mortality levels declined to those seen in low-mortality countries. In most of the large countries of the region however, mortality declined at a slower rate, even slowing down considerably in the 1970's while the death rates remained high (e.g., India, Bangladesh, Thailand, Philippines); this slowing down of mortality level is attributed essentially to the poverty-stricken masses of society which were not able to take advantage of social, technological, and health-promoting behavioral changes conducive to mortality decline. Infant mortality levels, although declining since 1950, followed the same dismal pattern of the general mortality level. The rate varies from less than 10/1000 live births (Japan) to more than 140/1000 (Bangladesh, Laos, Nepal). Generally, rural areas exhibited higher infant mortality than urban areas. The level of child mortality declines with increases in the mother's educational level in Bangladesh, India, Indonesia, Sri Lanka, and Thailand. The largest decline in child mortality occurs when at least 1 parent has secondary education. The premature retardation of mortality decline is caused by several factors: economic development, nutrition and food supply, provision and adequacy of health services, and demographic trends. The outlook for the year 2000 for most of Asia's countries will depend heavily on significant population increases. In most countries, particularly in South Asia, population is expected to increase by 75%, much of it in rural areas and among poorer socioeconomic groups. In view of this, Asia's health planners and policymakers will have to develop health policies which will strike a balance

  17. IQ, Skin Color, Crime, HIV/AIDS, and Income in 50 U.S. States

    ERIC Educational Resources Information Center

    Templer, Donald I.; Rushton, J. Philippe

    2011-01-01

    In 50 U.S. states, we found a positive manifold across 11 measures including IQ, skin color, birth rate, infant mortality, life expectancy, HIV/AIDS, violent crime, and state income with the first principal component accounting for 33% of the variance (median factor loading = 0.34). The correlation with a composite of total violent crime was…

  18. Ambulatory ECG-based T-wave alternans and heart rate turbulence can predict cardiac mortality in patients with myocardial infarction with or without diabetes mellitus

    PubMed Central

    2012-01-01

    Background Many patients who survive a myocardial infarction (MI) remain at risk of sudden cardiac death despite revascularization and optimal medical treatment. We used the modified moving average (MMA) method to assess the utility of T-wave alternans (TWA) and heart rate turbulence (HRT) as risk markers in MI patients with or without diabetes mellitus (DM). Methods We prospectively enrolled 248 consecutive patients: 96 with MI (post-MI patients); 77 MI with DM (post-MI + DM patients); 75 controls without cardiovascular disease (group control). Both TWA and HRT were measured on ambulatory electrocardiograms (AECGs). HRT was assessed by two parameters ─ turbulence onset (TO) and turbulence slope (TS). HRT was considered positive when both TO ≥0% and TS ≤2.5 ms/R-R interval were met. The endpoint was cardiac mortality. Results TWA values differed significantly between MI and controls. Post-MI + DM patients had higher TWA values than post-MI patients (58 ± 21 μV VS 52 ± 18 μV, P = 0.029). Impaired HRT--increased TO and decreased TS were observed in MI patients with or without DM. During follow-up of 578 ± 146 days, cardiac death occurred in ten patients and three of them suffered sudden cardiac death (SCD). Multivariate analysis determined that a HRT-positive outcome [HR (95% CI): 5.01, 1.33–18.85; P = 0.017], as well as the combination of abnormal TWA (≥47 μV) and positive HRT had significant association with the endpoint [HR (95% CI): 9.08, 2.21–37.2; P = 0.002)]. Conclusion This study indicates that AECGs-based TWA and HRT can predict cardiac mortality in MI patients with or without DM. Combined analysis TWA and HRT may be a convenient and useful method of identifying patients at high risk for cardiovascular death. PMID:22950360

  19. Oxidative DNA damage measured in human lymphocytes: large differences between sexes and between countries, and correlations with heart disease mortality rates.

    PubMed

    Collins, A R; Gedik, C M; Olmedilla, B; Southon, S; Bellizzi, M

    1998-10-01

    The 'antioxidant hypothesis' proposes that vitamin C, vitamin E, carotenoids, and other antioxidants occurring in fruit and vegetables afford protection against heart disease and cancer by preventing oxidative damage to lipids and to DNA, respectively. To test elements of this hypothesis, we have measured blood levels of dietary antioxidants, and 8-oxodeoxyguanosine (8-oxo-dG) concentrations in lymphocyte DNA, in healthy men and women from five European countries: France, Ireland, The Netherlands, Spain, and the U.K. Volunteers, aged 25 45, all nonsmokers, gave blood samples before and after a 12-wk carotenoid supplementation regime. Vitamin C was measured in plasma and vitamin E and carotenoids were measured in serum by high-performance liquid chromatography (HPLC). 8-oxo-dG was assayed by HPLC (with coulometric detection) in DNA isolated from lymphocytes from the same blood samples. Mean values were calculated for groups of volunteers at each sampling time according to country, sex, and supplementation (between 9 and 24 individual samples contributing to each mean). We found that 8-oxo-dG levels in lymphocyte DNA vary significantly according to sex and country. A low mean 8-oxo-dG concentration is seen in DNA of women from all five countries, and of men from France and Spain. 8-oxo-dG is significantly higher (up to about threefold) in lymphocyte DNA from men in Ireland and the U.K. Oxidative DNA damage is not significantly affected by carotenoid supplementation; nor is there any association with mean baseline levels of antioxidants, which are generally similar in the five countries. The five countries sampled lie on an axis from northern to southern Europe with a steep gradient in terms of premature heart disease. There is a strong association between premature coronary heart disease mortality in men and the mean levels of 8-oxo-dG for the five countries (r = 0.95, P < 0.01). Women have low coronary heart disease mortality rates, which do not correlate with 8-oxo

  20. Bone Anchored Hearing Aid

    PubMed Central

    2002-01-01

    Executive Summary Objective The objective of this health technology policy assessment was to determine the effectiveness and cost-effectiveness of bone-anchored hearing aid (BAHA) in improving the hearing of people with conduction or mixed hearing loss. The Technology The (BAHA) is a bone conduction hearing device that includes a titanium fixture permanently implanted into the mastoid bone of the skull and an external percutaneous sound processor. The sound processor is attached to the fixture by means of a skin penetrating abutment. Because the device bypasses the middle ear and directly stimulates the cochlea, it has been recommended for individuals with conduction hearing loss or discharging middle ear infection. The titanium implant is expected to last a lifetime while the external sound processor is expected to last 5 years. The total initial device cost is approximately $5,300 and the external sound processor costs approximately $3,500. Review of BAHA by the Medical Advisory Secretariat The Medical Advisory Secretariat’s review is a descriptive synthesis of findings from 36 research articles published between January 1990 and May 2002. Summary of Findings No randomized controlled studies were found. The evidence was derived from level 4 case series with relative small sample sizes (ranging from 30-188). The majority of the studies have follow-up periods of eight years or longer. All except one study were based on monaural BAHA implant on the side with the best bone conduction threshold. Safety Level 4 evidence showed that BAHA has been be implanted safely in adults and children with success rates of 90% or higher in most studies. No mortality or life threatening morbidity has been reported. Revision rates for tissue reduction or resiting were generally under 10% for adults but have been reported to be as high as 25% in pediatric studies. Adverse skin reaction around the skin penetration site was the most common complication reported. Most of these

  1. Observational, longitudinal study of delirium in consecutive unselected acute medical admissions: age-specific rates and associated factors, mortality and re-admission

    PubMed Central

    Pendlebury, ST; Lovett, NG; Smith, SC; Dutta, N; Bendon, C; Lloyd-Lavery, A; Mehta, Z; Rothwell, PM

    2015-01-01

    Objectives We aimed to determine age-specific rates of delirium and associated factors in acute medicine, and the impact of delirium on mortality and re-admission on long-term follow-up. Design Observational study. Consecutive patients over two 8-week periods (2010, 2012) were screened for delirium on admission, using the confusion assessment method (CAM), and reviewed daily thereafter. Delirium diagnosis was made using the Diagnostic and Statistical Manual Fourth Edition (DSM IV) criteria. For patients aged ≥65 years, potentially important covariables identified in previous studies were collected with follow-up for death and re-admission until January 2014. Participants 503 consecutive patients (age median=72, range 16–99 years, 236 (48%) male). Setting Acute general medicine. Results Delirium occurred in 101/503 (20%) (71 on admission, 30 during admission, 17 both), with risk increasing from 3% (6/195) at <65 years to 14% (10/74) for 65–74 years and 36% (85/234) at ≥75 years (p<0.0001). Among 308 patients aged >65 years, after adjustment for age, delirium was associated with previous falls (OR=2.47, 95% CI 1.45 to 4.22, p=0.001), prior dementia (2.08, 1.10 to 3.93, p=0.024), dependency (2.58, 1.48 to 4.48, p=0.001), low cognitive score (5.00, 2.50 to 9.99, p<0.0001), dehydration (3.53, 1.91 to 6.53, p<0.0001), severe illness (1.98, 1.17 to 3.38, p=0.011), pressure sore risk (5.56, 2.60 to 11.88, p<0.0001) and infection (4.88, 2.85 to 8.36, p<0.0001). Patients with delirium were more likely to fall (OR=4.55, 1.47 to 14.05, p=0.008), be incontinent of urine (3.76, 2.15 to 6.58, p<0.0001) or faeces (3.49, 1.81–6.73, p=0.0002) and be catheterised (5.08, 2.44 to 10.54, p<0.0001); and delirium was associated with stay >7 days (2.82, 1.68 to 4.75, p<0.0001), death (4.56, 1.71 to 12.17, p=0.003) and an increase in dependency among survivors (2.56, 1.37 to 4.76, p=0.003) with excess mortality still evident at 2-year follow-up. Patients with

  2. The ability of self-rated health to predict mortality among community-dwelling elderly individuals differs according to the specific cause of death: data from the NEDICES Cohort

    PubMed Central

    Fernández-Ruiz, Mario; Guerra-Vales, Juan M.; Trincado, Rocío; Fernández, Rebeca; Medrano, María José; Villarejo, Alberto; Benito-León, Julián; Bermejo-Pareja, Félix

    2013-01-01

    Background The biomedical and psychosocial mechanisms underlying the relationship between self-rated health (SRH) and mortality in elderly individuals remain unclear. Objective To assess the association between different measurements of subjective health (global, age-comparative, and time-comparative SRH) and cause-specific mortality. Methods Neurological Disorders in Central Spain (NEDICES) is a prospective population-based survey of the prevalence and incidence of major age-associated conditions. Data on demographic and health-related variables were collected from 5,278 subjects (≥65 years) at the baseline questionnaire. Thirteen-year mortality and cause of death were obtained from the National Death Registry. Adjusted hazard ratios (aHR) for SRH and all-cause and cause-specific mortality were estimated by Cox proportional hazard models. Results At baseline, 4,958 participants (93.9%) answered the SRH questionnaire. At the end of follow-up 2,468 (49.8%) participants had died (of whom 723 [29.2%] died from cardiovascular diseases, 609 [24.7%] from cancer, and 359 [14.5%] from respiratory diseases). Global SRH predicted independently all-cause mortality (aHR for “poor or very poor” vs. “very good” category: 1.39; 95% confidence interval [CI]: 1.15–1.69). Analysis of cause-specific mortality revealed that global SRH was an independent predictor for death due to respiratory diseases (aHR for “poor or very poor” vs. “very good” category: 2.61; 95% CI: 1.55–4.39), whereas age-comparative SRH exhibited a gradient effect on the risk of death due to stroke. Time-comparative SRH provided small additional predictive value. Conclusions The predictive ability of SRH for mortality largely differs according to the specific cause of death, with the strongest associations found for respiratory disease and stroke mortality. PMID:23615509

  3. Children's speech perception and loudness ratings when fitted with hearing aids using the DSL v.4.1 and the NAL-NL1 prescriptions.

    PubMed

    Scollie, Susan D; Ching, Teresa Y C; Seewald, Richard C; Dillon, Harvey; Britton, Louise; Steinberg, Jane; King, Katrina

    2010-01-01

    This paper reports speech and loudness measures on a group of children in a double-blind cross-over trial comparing the NAL-NL1 and DSL[i/o] prescriptions. Twenty-four children with hearing impairment were fitted with digital WDRC hearing aids at each site (Australia, Canada). Speech recognition was measured for nonsense syllables and for the 50% correct threshold for sentence recognition in noise. Loudness ratings for sentences were made on a 7-point scale. Measures were made at fitting and repeated following 8-week trials. Fitting orders were randomized and counterbalanced. Significant differences in consonant recognition occurred for individual children. On average, scores at the 80 dB SPL presentation level were better with the NAL-NL1 fitting. Loudness ratings differed at baseline but did not differ following home trials. Speech recognition scores revealed a small but significant interaction of prescription with level in quiet but not in noise. Individual children had significant performance differences. Loudness ratings showed significant acclimatization effects for children at both sites.

  4. Oral Administration of Faecalibacterium prausnitzii Decreased the Incidence of Severe Diarrhea and Related Mortality Rate and Increased Weight Gain in Preweaned Dairy Heifers.

    PubMed

    Foditsch, Carla; Pereira, Richard Van Vleck; Ganda, Erika Korzune; Gomez, Marilia Souza; Marques, Eduardo Carvalho; Santin, Thiago; Bicalho, Rodrigo Carvalho

    2015-01-01

    Probiotics are a promising alternative to improve food animal productivity and health. However, scientific evidence that specific microbes can be used to benefit animal health and performance is limited. The objective of this study was to evaluate the effects of administering a live culture of Faecalibacterium prausnitzii to newborn dairy calves on subsequent growth, health, and fecal microbiome. Initially, a safety trial was conducted using 30 newborn bull calves to assess potential adverse effects of the oral and rectal administration of F. prausnitzii to neonatal calves. No adverse reactions, such as increased body temperature or heart and respiratory rates, were observed after the administration of the treatments. All calves survived the experimental period, and there was no difference in fecal consistency score, attitude, appetite or dehydration between the treatment groups. The rectal route was not an efficient practice while the oral route ensures that the full dose is administered to the treated calves. Subsequently, a randomized field trial was completed in a commercial farm with preweaned calves. A total of 554 Holstein heifers were assigned to one of two treatment groups: treated calves (FPTRT) and non-treated calves (control). Treated calves received two oral doses of F. prausnitzii, one at treatment assignment (1st week) and another one week later. The FPTRT group presented significantly lower incidence of severe diarrhea (3.1%) compared with the control group (6.8%). Treated calves also had lower mortality rate associated with severe diarrhea (1.5%) compared to control calves (4.4%). Furthermore, FPTRT calves gained significantly more weight, 4.4 kg over the preweaning period, than controls calves. The relative abundance of F. prausnitzii in the fecal microbiota was significantly higher in the 3rd and 5th weeks of life of FPTRT calves than of the control calves, as revealed by sequencing of the 16S rRNA gene. Our findings showed that oral

  5. Oral Administration of Faecalibacterium prausnitzii Decreased the Incidence of Severe Diarrhea and Related Mortality Rate and Increased Weight Gain in Preweaned Dairy Heifers

    PubMed Central

    Foditsch, Carla; Pereira, Richard Van Vleck; Ganda, Erika Korzune; Gomez, Marilia Souza; Marques, Eduardo Carvalho; Santin, Thiago; Bicalho, Rodrigo Carvalho

    2015-01-01

    Probiotics are a promising alternative to improve food animal productivity and health. However, scientific evidence that specific microbes can be used to benefit animal health and performance is limited. The objective of this study was to evaluate the effects of administering a live culture of Faecalibacterium prausnitzii to newborn dairy calves on subsequent growth, health, and fecal microbiome. Initially, a safety trial was conducted using 30 newborn bull calves to assess potential adverse effects of the oral and rectal administration of F. prausnitzii to neonatal calves. No adverse reactions, such as increased body temperature or heart and respiratory rates, were observed after the administration of the treatments. All calves survived the experimental period, and there was no difference in fecal consistency score, attitude, appetite or dehydration between the treatment groups. The rectal route was not an efficient practice while the oral route ensures that the full dose is administered to the treated calves. Subsequently, a randomized field trial was completed in a commercial farm with preweaned calves. A total of 554 Holstein heifers were assigned to one of two treatment groups: treated calves (FPTRT) and non-treated calves (control). Treated calves received two oral doses of F. prausnitzii, one at treatment assignment (1st week) and another one week later. The FPTRT group presented significantly lower incidence of severe diarrhea (3.1%) compared with the control group (6.8%). Treated calves also had lower mortality rate associated with severe diarrhea (1.5%) compared to control calves (4.4%). Furthermore, FPTRT calves gained significantly more weight, 4.4 kg over the preweaning period, than controls calves. The relative abundance of F. prausnitzii in the fecal microbiota was significantly higher in the 3rd and 5th weeks of life of FPTRT calves than of the control calves, as revealed by sequencing of the 16S rRNA gene. Our findings showed that oral

  6. Oral Administration of Faecalibacterium prausnitzii Decreased the Incidence of Severe Diarrhea and Related Mortality Rate and Increased Weight Gain in Preweaned Dairy Heifers.

    PubMed

    Foditsch, Carla; Pereira, Richard Van Vleck; Ganda, Erika Korzune; Gomez, Marilia Souza; Marques, Eduardo Carvalho; Santin, Thiago; Bicalho, Rodrigo Carvalho

    2015-01-01

    Probiotics are a promising alternative to improve food animal productivity and health. However, scientific evidence that specific microbes can be used to benefit animal health and performance is limited. The objective of this study was to evaluate the effects of administering a live culture of Faecalibacterium prausnitzii to newborn dairy calves on subsequent growth, health, and fecal microbiome. Initially, a safety trial was conducted using 30 newborn bull calves to assess potential adverse effects of the oral and rectal administration of F. prausnitzii to neonatal calves. No adverse reactions, such as increased body temperature or heart and respiratory rates, were observed after the administration of the treatments. All calves survived the experimental period, and there was no difference in fecal consistency score, attitude, appetite or dehydration between the treatment groups. The rectal route was not an efficient practice while the oral route ensures that the full dose is administered to the treated calves. Subsequently, a randomized field trial was completed in a commercial farm with preweaned calves. A total of 554 Holstein heifers were assigned to one of two treatment groups: treated calves (FPTRT) and non-treated calves (control). Treated calves received two oral doses of F. prausnitzii, one at treatment assignment (1st week) and another one week later. The FPTRT group presented significantly lower incidence of severe diarrhea (3.1%) compared with the control group (6.8%). Treated calves also had lower mortality rate associated with severe diarrhea (1.5%) compared to control calves (4.4%). Furthermore, FPTRT calves gained significantly more weight, 4.4 kg over the preweaning period, than controls calves. The relative abundance of F. prausnitzii in the fecal microbiota was significantly higher in the 3rd and 5th weeks of life of FPTRT calves than of the control calves, as revealed by sequencing of the 16S rRNA gene. Our findings showed that oral

  7. 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

  8. The mortality of companies.

    PubMed

    Daepp, Madeleine I G; Hamilton, Marcus J; West, Geoffrey B; Bettencourt, Luís M A

    2015-05-01

    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.

  9. AIDS (image)

    MedlinePlus

    AIDS (acquired immune deficiency syndrome) is caused by HIV (human immunodeficiency virus), and is a syndrome that ... life-threatening illnesses. There is no cure for AIDS, but treatment with antiviral medicine can suppress symptoms. ...

  10. Hearing Aids

    MedlinePlus

    ... more in both quiet and noisy situations. Hearing