How the 2008 stock market crash and seasons affect total and cardiac deaths in Los Angeles County.

PubMed

Schwartz, Bryan Glen; Pezzullo, John Christopher; McDonald, Scott Andrew; Poole, William Kenneth; Kloner, Robert Alan

2012-05-15

Various stressors trigger cardiac death. The objective was to investigate a possible relation between a stock market crash and cardiac death in a large population within the United States. We obtained daily stock market data (Dow Jones Industrial Average Index), death certificate data for daily deaths in Los Angeles County (LA), and annual LA population estimates for 2005 through 2008. The 4 years death rate curves (2005 through 2008) were averaged into a single curve to illustrate annual trends. Data were "deseasonalized" by subtracting from the daily observed value the average value for that day of year. There was marked seasonal variation in total and cardiac death rates. Even in the mild LA climate, death rates were higher in winter versus summer including total death (+17%), circulatory death (+24%), coronary heart disease death (+28%), and myocardial infarction death (+38%) rates (p <0.0001 for each). Absolute coronary heart disease death rates have decreased since 1985. After accounting for seasonal variation, the large stock market crash in October 2008 did not affect death rates in LA. Death rates remained at or below seasonal averages during the stock market crash. In conclusion, after correcting for seasonal variation, the stock market crash in October 2008 was not associated with an increase in total or cardiac death in LA. Annual coronary heart disease death rates continue to decrease. However, seasonal variation (specifically winter) remains a trigger for death and coronary heart disease death even in LA where winters are mild. Copyright © 2012 Elsevier Inc. All rights reserved.

Physician-reported practices on continuous deep sedation until death: A descriptive and comparative study.

PubMed

Papavasiliou, Evangelia Evie; Chambaere, Kenneth; Deliens, Luc; Brearley, Sarah; Payne, Sheila; Rietjens, Judith; Vander Stichele, Robert; Van den Block, Lieve

2014-06-01

Research on continuous deep sedation until death has focused on estimating prevalence and describing clinical practice across care settings. However, evidence on sedation practices by physician specialty is scarce. To compare and contrast physician-reported practices on continuous deep sedation until death between general practitioners and medical specialists. A secondary analysis drawing upon data from a large-scale, population-based, retrospective survey among physicians in Flanders, Belgium in 2007. Symptom prevalence and characteristics of sedation (drugs used, artificial nutrition and hydration administered, intentions, and decision-making) were measured. Response rate was 58.4%. The frequency of continuous deep sedation until death among all deaths was 11.3% for general practitioners and 18.4% for medical specialists. General practitioners reported significantly higher rates of severity and mean intensity of pain, delirium, dyspnea, and nausea in the last 24 h of life for sedated patients and a higher number of severe symptoms than medical specialists. No differences were found between groups in the drugs used, except in propofol, reported only by medical specialists (in 15.8% of all cases). Artificial nutrition and hydration was withheld or withdrawn in 97.2% of general practitioner and 36.2% of medical specialist cases. Explicit life-shortening intentions were reported by both groups (for 3%-4% of all cases). Continuous deep sedation until death was initiated without consent or request of either the patient or the family in 27.9% (medical specialists) and 4.7% (general practitioners) of the cases reported. Considerable variation, often largely deviating from professional guidelines, was observed in physician-reported performance and decision-making, highlighting the importance of providing clearer guidance on the specific needs of the context in which continuous deep sedation until death is to be performed. © The Author(s) 2014.

5 CFR 843.504 - Rate of annuity.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 5 Administrative Personnel 2 2012-01-01 2012-01-01 false Rate of annuity. 843.504 Section 843.504 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES RETIREMENT SYSTEM-DEATH BENEFITS AND EMPLOYEE REFUNDS Insurable Interest Annuities § 843.504 Rate...

5 CFR 843.504 - Rate of annuity.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Rate of annuity. 843.504 Section 843.504 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES RETIREMENT SYSTEM-DEATH BENEFITS AND EMPLOYEE REFUNDS Insurable Interest Annuities § 843.504 Rate...

5 CFR 843.504 - Rate of annuity.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 5 Administrative Personnel 2 2014-01-01 2014-01-01 false Rate of annuity. 843.504 Section 843.504 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES RETIREMENT SYSTEM-DEATH BENEFITS AND EMPLOYEE REFUNDS Insurable Interest Annuities § 843.504 Rate...

5 CFR 843.504 - Rate of annuity.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 5 Administrative Personnel 2 2013-01-01 2013-01-01 false Rate of annuity. 843.504 Section 843.504 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES RETIREMENT SYSTEM-DEATH BENEFITS AND EMPLOYEE REFUNDS Insurable Interest Annuities § 843.504 Rate...

5 CFR 843.504 - Rate of annuity.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 5 Administrative Personnel 2 2011-01-01 2011-01-01 false Rate of annuity. 843.504 Section 843.504 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES RETIREMENT SYSTEM-DEATH BENEFITS AND EMPLOYEE REFUNDS Insurable Interest Annuities § 843.504 Rate...

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

Code of Federal Regulations, 2010 CFR

2010-01-01

... beginning on the day after the death of the separated employee. (ii) The rate of the adjusted annuity equals... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Annuity based on death of a separated... SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES RETIREMENT SYSTEM-DEATH BENEFITS AND EMPLOYEE REFUNDS...

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

Code of Federal Regulations, 2012 CFR

2012-01-01

... beginning on the day after the death of the separated employee. (ii) The rate of the adjusted annuity equals... 5 Administrative Personnel 2 2012-01-01 2012-01-01 false Annuity based on death of a separated... SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES RETIREMENT SYSTEM-DEATH BENEFITS AND EMPLOYEE REFUNDS...

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

Code of Federal Regulations, 2011 CFR

2011-01-01

... beginning on the day after the death of the separated employee. (ii) The rate of the adjusted annuity equals... 5 Administrative Personnel 2 2011-01-01 2011-01-01 false Annuity based on death of a separated... SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES RETIREMENT SYSTEM-DEATH BENEFITS AND EMPLOYEE REFUNDS...

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

Code of Federal Regulations, 2014 CFR

2014-01-01

... beginning on the day after the death of the separated employee. (ii) The rate of the adjusted annuity equals... 5 Administrative Personnel 2 2014-01-01 2014-01-01 false Annuity based on death of a separated... SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES RETIREMENT SYSTEM-DEATH BENEFITS AND EMPLOYEE REFUNDS...

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

Code of Federal Regulations, 2013 CFR

2013-01-01

... beginning on the day after the death of the separated employee. (ii) The rate of the adjusted annuity equals... 5 Administrative Personnel 2 2013-01-01 2013-01-01 false Annuity based on death of a separated... SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES RETIREMENT SYSTEM-DEATH BENEFITS AND EMPLOYEE REFUNDS...

Young, Black, and Sentenced To Die: Black Males and the Death Penalty.

ERIC Educational Resources Information Center

Joseph, Janice

1996-01-01

Explores the death penalty as imposed on young black males in the United States and examines the disparity in death penalty rates for homicides with black offenders and white victims. States continue to impose the death penalty rather than viewing youth violence as a failure of the social system. (SLD)

Report to the Nation shows cancer death rates dropping

Cancer.gov

The Annual Report to the Nation on the Status of Cancer, 1975–2009, shows that overall cancer death rates continued to decline in the United States among both men and women, among all major racial and ethnic groups, and for all of the most common cancer s

Inaccuracies in oral cavity-pharynx cancer coded as the underlying cause of death on U.S. death certificates, and trends in mortality rates (1999-2010).

PubMed

Polednak, Anthony P

2014-08-01

To enhance surveillance of mortality from oral cavity-pharynx cancer (OCPC) by considering inaccuracies in the cancer site coded as the underlying cause of death on death certificates vs. cancer site in a population-based cancer registry (as the gold standard). A database was used for 9 population-based cancer registries of the Surveillance, Epidemiology and End Results (SEER) Program, including deaths in 1999-2010 for patients diagnosed in 1973-2010. Numbers of deaths and death rates for OCPC in the SEER population were modified for apparent inaccuracies in the cancer site coded as the underlying cause of death. For age groups <65 years, deaths from OCPC were underestimated by 22-35% by using unmodified (vs. modified) numbers, but temporal declines in death rates were still evident in the SEER population and were similar to declines using routine mortality data for the entire U.S. population. Deaths were underestimated by about 70-80% using underlying cause for tonsillar cancers, strongly associated with human papillomavirus (HPV) infection, but a lack of decline in death rates was still evident. Routine mortality statistics based on underlying cause of death underestimate OCPC deaths but demonstrate trends in OCPC death rates that require continued surveillance in view of increasing incidence rates for HPV-related OCPC. Copyright © 2014 Elsevier Ltd. All rights reserved.

Therapeutic milestone: stroke declines from the second to the third leading organ- and disease-specific cause of death in the United States.

PubMed

Towfighi, Amytis; Ovbiagele, Bruce; Saver, Jeffrey L

2010-03-01

Stroke mortality rates declined for much of the second half of the 20th century, but recent trends and their relation to other organ- and disease-specific causes of death have not been characterized. Using the National Center for Health Statistics mortality data, leading organ- and disease-specific causes of death were assessed for the most recent 10-year period (1996 to 2005) in the United States with a specific focus on stroke deaths. Age-adjusted stroke death rates declined by 25.4%; as a result, lung cancer (which only declined by 9.2%) surpassed stroke as the second leading cause of death in 2003. Despite a 31.9% decline in age-adjusted ischemic heart disease death rates, it remains the leading cause of death. Stroke is now the fifth leading cause of death in men and the fourth leading cause of death in whites but remains the second leading cause of death in women and blacks. With stroke death rates decreasing substantially in the United States from 1996 to 2005, stroke moved from the second to the third leading organ- and disease-specific cause of death. Women and blacks may warrant attention for targeted stroke prevention and treatment because they continue to have disproportionately high stroke death rates.

Michael Jackson, Bin Laden and I: functions of positive and negative, public and private flashbulb memories.

PubMed

Demiray, Burcu; Freund, Alexandra M

2015-01-01

This study examined the perceived psychosocial functions of flashbulb memories: It compared positive and negative public flashbulb memories (positive: Bin Laden's death, negative: Michael Jackson's death) with private ones (positive: pregnancy, negative: death of a loved one). A sample of n = 389 young and n = 176 middle-aged adults answered canonical category questions used to identify flashbulb memories and rated the personal significance, the psychological temporal distance, and the functions of each memory (i.e., self-continuity, social-boding, directive functions). Hierarchical regressions showed that, in general, private memories were rated more functional than public memories. Positive and negative private memories were comparable in self-continuity and directionality, but the positive private memory more strongly served social functions. In line with the positivity bias in autobiographical memory, positive flashbulb memories felt psychologically closer than negative ones. Finally, middle-aged adults rated their memories as less functional regarding self-continuity and social-bonding than young adults. Results are discussed regarding the tripartite model of autobiographical memory functions.

Heart Disease Death Rates Among Blacks and Whites Aged ≥35 Years - United States, 1968-2015.

PubMed

Van Dyke, Miriam; Greer, Sophia; Odom, Erika; Schieb, Linda; Vaughan, Adam; Kramer, Michael; Casper, Michele

2018-03-30

Heart disease is the leading cause of death in the United States. In 2015, heart disease accounted for approximately 630,000 deaths, representing one in four deaths in the United States. Although heart disease death rates decreased 68% for the total population from 1968 to 2015, marked disparities in decreases exist by race and state. 1968-2015. The National Vital Statistics System (NVSS) data on deaths in the United States were abstracted for heart disease using diagnosis codes from the eighth, ninth, and tenth revisions of the International Classification of Diseases (ICD-8, ICD-9, and ICD-10) for 1968-2015. Population estimates were obtained from NVSS files. National and state-specific heart disease death rates for the total population and by race for adults aged ≥35 years were calculated for 1968-2015. National and state-specific black-white heart disease mortality ratios also were calculated. Death rates were age standardized to the 2000 U.S. standard population. Joinpoint regression was used to perform time trend analyses. From 1968 to 2015, heart disease death rates decreased for the total U.S. population among adults aged ≥35 years, from 1,034.5 to 327.2 per 100,000 population, respectively, with variations in the magnitude of decreases by race and state. Rates decreased for the total population an average of 2.4% per year, with greater average decreases among whites (2.4% per year) than blacks (2.2% per year). At the national level, heart disease death rates for blacks and whites were similar at the start of the study period (1968) but began to diverge in the late 1970s, when rates for blacks plateaued while rates for whites continued to decrease. Heart disease death rates among blacks remained higher than among whites for the remainder of the study period. Nationwide, the black-white ratio of heart disease death rates increased from 1.04 in 1968 to 1.21 in 2015, with large increases occurring during the 1970s and 1980s followed by small but steady increases until approximately 2005. Since 2005, modest decreases have occurred in the black-white ratio of heart disease death rates at the national level. The majority of states had increases in black-white mortality ratios from 1968 to 2015. The number of states with black-white mortality ratios >1 increased from 16 (40%) to 27 (67.5%). Although heart disease death rates decreased both for blacks and whites from 1968 to 2015, substantial differences in decreases were found by race and state. At the national level and in most states, blacks experienced smaller decreases in heart disease death rates than whites for the majority of the period. Overall, the black-white disparity in heart disease death rates increased from 1968 to 2005, with a modest decrease from 2005 to 2015. Since 1968, substantial increases have occurred in black-white disparities of heart disease death rates in the United States at the national level and in many states. These increases appear to be due to faster decreases in heart disease death rates for whites than blacks, particularly from the late 1970s until the mid-2000s. Despite modest decreases in black-white disparities at the national level since 2005, in 2015, heart disease death rates were 21% higher among blacks than among whites. This study demonstrates the use of NVSS data to conduct surveillance of heart disease death rates by race and of black-white disparities in heart disease death rates. Continued surveillance of temporal trends in heart disease death rates by race can provide valuable information to policy makers and public health practitioners working to reduce heart disease death rates both for blacks and whites and disparities between blacks and whites.

Heart Disease Death Rates Among Blacks and Whites Aged ≥35 Years — United States, 1968–2015

PubMed Central

Van Dyke, Miriam; Greer, Sophia; Odom, Erika; Schieb, Linda; Vaughan, Adam; Kramer, Michael; Casper, Michele

2018-01-01

Problem/Condition Heart disease is the leading cause of death in the United States. In 2015, heart disease accounted for approximately 630,000 deaths, representing one in four deaths in the United States. Although heart disease death rates decreased 68% for the total population from 1968 to 2015, marked disparities in decreases exist by race and state. Period Covered 1968–2015. Description of System The National Vital Statistics System (NVSS) data on deaths in the United States were abstracted for heart disease using diagnosis codes from the eighth, ninth, and tenth revisions of the International Classification of Diseases (ICD-8, ICD-9, and ICD-10) for 1968–2015. Population estimates were obtained from NVSS files. National and state-specific heart disease death rates for the total population and by race for adults aged ≥35 years were calculated for 1968–2015. National and state-specific black-white heart disease mortality ratios also were calculated. Death rates were age standardized to the 2000 U.S. standard population. Joinpoint regression was used to perform time trend analyses. Results From 1968 to 2015, heart disease death rates decreased for the total U.S. population among adults aged ≥35 years, from 1,034.5 to 327.2 per 100,000 population, respectively, with variations in the magnitude of decreases by race and state. Rates decreased for the total population an average of 2.4% per year, with greater average decreases among whites (2.4% per year) than blacks (2.2% per year). At the national level, heart disease death rates for blacks and whites were similar at the start of the study period (1968) but began to diverge in the late 1970s, when rates for blacks plateaued while rates for whites continued to decrease. Heart disease death rates among blacks remained higher than among whites for the remainder of the study period. Nationwide, the black-white ratio of heart disease death rates increased from 1.04 in 1968 to 1.21 in 2015, with large increases occurring during the 1970s and 1980s followed by small but steady increases until approximately 2005. Since 2005, modest decreases have occurred in the black-white ratio of heart disease death rates at the national level. The majority of states had increases in black-white mortality ratios from 1968 to 2015. The number of states with black-white mortality ratios >1 increased from 16 (40%) to 27 (67.5%). Interpretation Although heart disease death rates decreased both for blacks and whites from 1968 to 2015, substantial differences in decreases were found by race and state. At the national level and in most states, blacks experienced smaller decreases in heart disease death rates than whites for the majority of the period. Overall, the black-white disparity in heart disease death rates increased from 1968 to 2005, with a modest decrease from 2005 to 2015. Public Health Action Since 1968, substantial increases have occurred in black-white disparities of heart disease death rates in the United States at the national level and in many states. These increases appear to be due to faster decreases in heart disease death rates for whites than blacks, particularly from the late 1970s until the mid-2000s. Despite modest decreases in black-white disparities at the national level since 2005, in 2015, heart disease death rates were 21% higher among blacks than among whites. This study demonstrates the use of NVSS data to conduct surveillance of heart disease death rates by race and of black-white disparities in heart disease death rates. Continued surveillance of temporal trends in heart disease death rates by race can provide valuable information to policy makers and public health practitioners working to reduce heart disease death rates both for blacks and whites and disparities between blacks and whites. PMID:29596406

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

PubMed Central

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

2014-01-01

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

Abortion-Related Mortality in the United States 1998–2010

PubMed Central

Zane, Suzanne; Creanga, Andreea A.; Berg, Cynthia J.; Pazol, Karen; Suchdev, Danielle B.; Jamieson, Denise J.; Callaghan, William M.

2015-01-01

OBJECTIVE To examine characteristics and causes of legal induced abortion–related deaths in the United States between 1998 and 2010. METHODS Abortion-related deaths were identified through the national Pregnancy Mortality Surveillance System with enhanced case-finding. We calculated the abortion mortality rate by race, maternal age, and gestational age and the distribution of causes of death by gestational age and procedure. RESULTS During the period from 1998–2010, of approximately 16.1 million abortion procedures, 108 women died, for a mortality rate of 0.7 deaths per 100,000 procedures overall, 0.4 deaths for non-Hispanic white women, 0.5 deaths for Hispanic women, and 1.1 deaths for black women. The mortality rate increased with gestational age, from 0.3 to 6.7 deaths for procedures performed at 8 weeks or less and at 18 weeks or greater, respectively. A majority of abortion-related deaths at 13 weeks of gestation or less were associated with anesthesia complications and infection, whereas a majority of abortion-related deaths at more than 13 weeks of gestation were associated with infection and hemorrhage. In 20 of the 108 cases, the abortion was performed as a result of a severe medical condition where continuation of the pregnancy threatened the woman’s life. CONCLUSION Deaths associated with legal induced abortion continue to be rare events—less than 1 per 100,000 procedures. Primary prevention of unintended pregnancy, including those in women with serious pre-existing medical conditions, and increased access to abortion services at early gestational ages may help to further decrease abortion-related mortality in the United States. PMID:26241413

What has contributed to the change in life expectancy in Italy between 1980 and 1992?

PubMed

Ngongo, K N; Nante, N; Chenet, L; McKee, M

1999-07-01

Life expectancy at birth in southern Europe is known to be greater than expected in comparison with levels of economic development. This has been attributed to the 'Mediterranean diet'. There are, however, concerns that this comparative advantage is being lost. This paper examines the factors underlying changing life expectancy in Italy since 1980. The subjects of this analysis are obtained from data on all deaths in Italy between 1980 and 1992. Change in age specific death rates is calculated from selected causes and, using the method developed by Pollard, the contribution of deaths from different causes and at different ages to changing life expectancy at birth is estimated. Between 1980 and 1992, life expectancy at birth increased by 2.70 years for men and 2.75 years for women. Death rates have fallen among children and those over 40. In contrast, death rates have increased among men aged between 20 and 39 and have increased very slightly among women aged 25-29. Falling death rates from ischaemic heart disease are continuing to contribute to increasing life expectancy. Death rates from lung and breast cancer are rising among women but are compensated for by falling death rates from other cancers. Among men, falling death rates from cancer at younger ages are being offset by increases at older ages. The rising death rate among younger men is almost entirely due to AIDS, with accidents also making a small contribution. Life expectancy in Italy has improved throughout the 1980s, largely driven by falling death rates from cardiovascular diseases. Here are, however, some worrying trends, most notably the rising death rate among young men, due almost entirely to AIDS. The changing pattern of mortality has some similarities with Spain, another Mediterranean country, but there are also important differences.

The U.S. health production function: evidence from 2001 to 2009.

PubMed

Tseng, Hui-Kuan; Olsen, Reed

2016-03-01

This study estimates the impact of the 2007 financial crisis upon U.S. health as measured by age adjusted death rates. OLS regression results suggest that the average death rate was lower in the post-crisis period than the pre-crisis period. The majority of the average decline in the death rate was a result of the time period and not a result of changes in the values of the underlying explanatory variables. We continue to find this result even adding state fixed effects. Contrary to other research, we find that the unemployment rate has no statistically significant impact on death rates either for the U.S. as a whole or for any states individually. Rather, the impact of the financial crisis is felt via year fixed effects that increased over time during the post-crisis period.

Trends in death rates among U.S. adults with and without diabetes between 1997 and 2006: findings from the National Health Interview Survey.

PubMed

Gregg, Edward W; Cheng, Yiling J; Saydah, Sharon; Cowie, Catherine; Garfield, Sanford; Geiss, Linda; Barker, Lawrence

2012-06-01

To determine whether all-cause and cardiovascular disease (CVD) death rates declined between 1997 and 2006, a period of continued advances in treatment approaches and risk factor control, among U.S. adults with and without diabetes. We compared 3-year death rates of four consecutive nationally representative samples (1997-1998, 1999-2000, 2001-2002, and 2003-2004) of U.S. adults aged 18 years and older using data from the National Health Interview Surveys linked to National Death Index. Among diabetic adults, the CVD death rate declined by 40% (95% CI 23-54) and all-cause mortality declined by 23% (10-35) between the earliest and latest samples. There was no difference in the rates of decline in mortality between diabetic men and women. The excess CVD mortality rate associated with diabetes (i.e., compared with nondiabetic adults) decreased by 60% (from 5.8 to 2.3 CVD deaths per 1,000) while the excess all-cause mortality rate declined by 44% (from 10.8 to 6.1 deaths per 1,000). Death rates among both U.S. men and women with diabetes declined substantially between 1997 and 2006, reducing the absolute difference between adults with and without diabetes. These encouraging findings, however, suggest that diabetes prevalence is likely to rise in the future if diabetes incidence is not curtailed.

Changes in mortality rates and humanitarian conditions in Darfur, Sudan 2003-2007.

PubMed

Garfield, Richard; Polonsky, Jonny

2010-01-01

The Darfur region of Sudan has been an intense focus of humanitarian concern since rebellions began there early in 2003. In 2004, the US Secretary of State declared that conflict in Darfur represented genocide. Since 2003, many sample surveys and various mortality estimates for Darfur have been made. Nonetheless, confusion and controversy surrounding mortality levels and trends have continued. For this project, results were reviewed from the highest quality field surveys on mortality in Darfur conducted between 2003 and 2008. Trend analysis demonstrated a dramatic decline in mortality over time in Darfur. By 2005, mortality levels had fallen below emergency levels and have continued to decline. Deaths directly due violence have declined as a proportion of all of the deaths in Darfur. Declining mortality in Darfur was not associated with other proximate improvements in well-being, such as improved nutrition. Without large-scale, humanitarian intervention, continuing high rates of mortality due to violence likely would have occurred. If mortality had continued at the high rate documented in 2004, by January 2009, there would have been 330,000 additional deaths. With the humanitarian assistance provided through the United Nations and non-governmental organizations, these people are alive today. A focus on excess deaths among noncombatants may draw attention away from other needs, such as establishing better security, improving service delivery to the displaced, and advocating for internally displaced persons to be reached today and to re-establish their lives and livelihoods tomorrow.

A cluster of unexplained deaths in a nursing home in Florida.

PubMed Central

Sacks, J J; Herndon, J L; Lieb, S H; Sorhage, F E; McCaig, L F; Withum, D G

1988-01-01

In the two-week period November 13-27, 1984, 12 patients died in a 54-bed nursing home in Florida; based on previous mortality patterns, 2.5 deaths would have been expected for the whole month. There was no similar increase in deaths in November 1984 and no comparable monthly death rate for any of 69 nursing homes in the same county from 1976-84. Comparison of the 12 deaths in November with 28 deaths that occurred during the previous 10 months and with 31 surviving patients who were continuously present in the nursing home between November 12-28, 1984 revealed that the patients who died in November were more likely to have had onset of the terminal event during the night shift, had a recent visitor, and had an admitting diagnosis of organic brain syndrome. The abrupt increase in the death rate for November 1984 was not associated with a measurable change in population characteristics, an outbreak of infectious disease, or changes in procedures or the environment. Reviews of employee schedules revealed a consistent and strong association between the duty times of two nurses and the onsets of the terminal episode and the times of patient deaths. Continuing epidemiologic surveillance of adverse outcomes in nursing homes is recommended. PMID:3381956

Meeting the Healthy People 2020 Objectives to Reduce Cancer Mortality.

PubMed

Weir, Hannah K; Thompson, Trevor D; Soman, Ashwini; Møller, Bjorn; Leadbetter, Steven; White, Mary C

2015-07-02

Healthy People 2020 (HP2020) calls for a 10% to 15% reduction in death rates from 2007 to 2020 for selected cancers. Trends in death rates can be used to predict progress toward meeting HP2020 targets. We used mortality data from 1975 through 2009 and population estimates and projections to predict deaths for all cancers and the top 23 cancers among men and women by race. We apportioned changes in deaths from population risk and population growth and aging. From 1975 to 2009, the number of cancer deaths increased among white and black Americans primarily because of an aging white population and a growing black population. Overall, age-standardized cancer death rates (risk) declined in all groups. From 2007 to 2020, rates are predicted to continue to decrease while counts of deaths are predicted to increase among men (15%) and stabilize among women (increase <10%). Declining death rates are predicted to meet HP2020 targets for cancers of the female breast, lung and bronchus, cervix and uterus, colon and rectum, oral cavity and pharynx, and prostate, but not for melanoma. Cancer deaths among women overall are predicted to increase by less than 10%, because of, in part, declines in breast, cervical, and colorectal cancer deaths among white women. Increased efforts to promote cancer prevention and improve survival are needed to counter the impact of a growing and aging population on the cancer burden and to meet melanoma target death rates.

Meeting the Healthy People 2020 Objectives to Reduce Cancer Mortality

PubMed Central

Thompson, Trevor D.; Soman, Ashwini; Møller, Bjorn; Leadbetter, Steven; White, Mary C.

2015-01-01

Introduction Healthy People 2020 (HP2020) calls for a 10% to 15% reduction in death rates from 2007 to 2020 for selected cancers. Trends in death rates can be used to predict progress toward meeting HP2020 targets. Methods We used mortality data from 1975 through 2009 and population estimates and projections to predict deaths for all cancers and the top 23 cancers among men and women by race. We apportioned changes in deaths from population risk and population growth and aging. Results From 1975 to 2009, the number of cancer deaths increased among white and black Americans primarily because of an aging white population and a growing black population. Overall, age-standardized cancer death rates (risk) declined in all groups. From 2007 to 2020, rates are predicted to continue to decrease while counts of deaths are predicted to increase among men (15%) and stabilize among women (increase <10%). Declining death rates are predicted to meet HP2020 targets for cancers of the female breast, lung and bronchus, cervix and uterus, colon and rectum, oral cavity and pharynx, and prostate, but not for melanoma. Conclusion Cancer deaths among women overall are predicted to increase by less than 10%, because of, in part, declines in breast, cervical, and colorectal cancer deaths among white women. Increased efforts to promote cancer prevention and improve survival are needed to counter the impact of a growing and aging population on the cancer burden and to meet melanoma target death rates. PMID:26133647

Traffic crash statistics report, 2003

DOT National Transportation Integrated Search

2004-01-01

In 2003, the number of miles driven on Florida's highways increased by 7 billion; however, the mileage death rate decreased from 1.8 deaths per hundred million miles driven in 2002, to 1.7 in 2003. Florida continued to see improvements in traffic saf...

Increases in Drug and Opioid-Involved Overdose Deaths - United States, 2010-2015.

PubMed

Rudd, Rose A; Seth, Puja; David, Felicita; Scholl, Lawrence

2016-12-30

The U.S. opioid epidemic is continuing, and drug overdose deaths nearly tripled during 1999-2014. Among 47,055 drug overdose deaths that occurred in 2014 in the United States, 28,647 (60.9%) involved an opioid (1). Illicit opioids are contributing to the increase in opioid overdose deaths (2,3). In an effort to target prevention strategies to address the rapidly changing epidemic, CDC examined overall drug overdose death rates during 2010-2015 and opioid overdose death rates during 2014-2015 by subcategories (natural/semisynthetic opioids, methadone, heroin, and synthetic opioids other than methadone).* Rates were stratified by demographics, region, and by 28 states with high quality reporting on death certificates of specific drugs involved in overdose deaths. During 2015, drug overdoses accounted for 52,404 U.S. deaths, including 33,091 (63.1%) that involved an opioid. There has been progress in preventing methadone deaths, and death rates declined by 9.1%. However, rates of deaths involving other opioids, specifically heroin and synthetic opioids other than methadone (likely driven primarily by illicitly manufactured fentanyl) (2,3), increased sharply overall and across many states. A multifaceted, collaborative public health and law enforcement approach is urgently needed. Response efforts include implementing the CDC Guideline for Prescribing Opioids for Chronic Pain (4), improving access to and use of prescription drug monitoring programs, enhancing naloxone distribution and other harm reduction approaches, increasing opioid use disorder treatment capacity, improving linkage into treatment, and supporting law enforcement strategies to reduce the illicit opioid supply.

5 CFR 843.503 - Commencing and terminating dates.

Code of Federal Regulations, 2014 CFR

2014-01-01

... REGULATIONS (CONTINUED) FEDERAL EMPLOYEES RETIREMENT SYSTEM-DEATH BENEFITS AND EMPLOYEE REFUNDS Insurable... basis, one-thirtieth of the monthly rate constituting the daily rate. An annuity does not accrue for the...

5 CFR 843.503 - Commencing and terminating dates.

Code of Federal Regulations, 2013 CFR

2013-01-01

... REGULATIONS (CONTINUED) FEDERAL EMPLOYEES RETIREMENT SYSTEM-DEATH BENEFITS AND EMPLOYEE REFUNDS Insurable... basis, one-thirtieth of the monthly rate constituting the daily rate. An annuity does not accrue for the...

5 CFR 843.503 - Commencing and terminating dates.

Code of Federal Regulations, 2011 CFR

2011-01-01

... REGULATIONS (CONTINUED) FEDERAL EMPLOYEES RETIREMENT SYSTEM-DEATH BENEFITS AND EMPLOYEE REFUNDS Insurable... basis, one-thirtieth of the monthly rate constituting the daily rate. An annuity does not accrue for the...

5 CFR 843.503 - Commencing and terminating dates.

Code of Federal Regulations, 2010 CFR

2010-01-01

... REGULATIONS (CONTINUED) FEDERAL EMPLOYEES RETIREMENT SYSTEM-DEATH BENEFITS AND EMPLOYEE REFUNDS Insurable... basis, one-thirtieth of the monthly rate constituting the daily rate. An annuity does not accrue for the...

5 CFR 843.503 - Commencing and terminating dates.

Code of Federal Regulations, 2012 CFR

2012-01-01

... REGULATIONS (CONTINUED) FEDERAL EMPLOYEES RETIREMENT SYSTEM-DEATH BENEFITS AND EMPLOYEE REFUNDS Insurable... basis, one-thirtieth of the monthly rate constituting the daily rate. An annuity does not accrue for the...

Annual report to the nation on the status of cancer, 1975-2007, featuring tumors of the brain and other nervous system.

PubMed

Kohler, Betsy A; Ward, Elizabeth; McCarthy, Bridget J; Schymura, Maria J; Ries, Lynn A G; Eheman, Christie; Jemal, Ahmedin; Anderson, Robert N; Ajani, Umed A; Edwards, Brenda K

2011-05-04

The American Cancer Society, the Centers for Disease Control and Prevention (CDC), the National Cancer Institute, and the North American Association of Central Cancer Registries (NAACCR) collaborate annually to provide updated information on cancer occurrence and trends in the United States. This year's report highlights brain and other nervous system (ONS) tumors, including nonmalignant brain tumors, which became reportable on a national level in 2004. Cancer incidence data were obtained from the National Cancer Institute, CDC, and NAACCR, and information on deaths was obtained from the CDC's National Center for Health Statistics. The annual percentage changes in age-standardized incidence and death rates (2000 US population standard) for all cancers combined and for the top 15 cancers for men and for women were estimated by joinpoint analysis of long-term (1992-2007 for incidence; 1975-2007 for mortality) trends and short-term fixed interval (1998-2007) trends. Analyses of malignant neuroepithelial brain and ONS tumors were based on data from 1980-2007; data on nonmalignant tumors were available for 2004-2007. All statistical tests were two-sided. Overall cancer incidence rates decreased by approximately 1% per year; the decrease was statistically significant (P < .05) in women, but not in men, because of a recent increase in prostate cancer incidence. The death rates continued to decrease for both sexes. Childhood cancer incidence rates continued to increase, whereas death rates continued to decrease. Lung cancer death rates decreased in women for the first time during 2003-2007, more than a decade after decreasing in men. During 2004-2007, more than 213 500 primary brain and ONS tumors were diagnosed, and 35.8% were malignant. From 1987-2007, the incidence of neuroepithelial malignant brain and ONS tumors decreased by 0.4% per year in men and women combined. The decrease in cancer incidence and mortality reflects progress in cancer prevention, early detection, and treatment. However, major challenges remain, including increasing incidence rates and continued low survival for some cancers. Malignant and nonmalignant brain tumors demonstrate differing patterns of occurrence by sex, age, and race, and exhibit considerable biologic diversity. Inclusion of nonmalignant brain tumors in cancer registries provides a fuller assessment of disease burden and medical resource needs associated with these unique tumors.

Pulmonary Hypertension Surveillance

PubMed Central

Schieb, Linda J.; Ayala, Carma; Talwalkar, Anjali; Levant, Shaleah

2014-01-01

Pulmonary hypertension (PH) is an uncommon but progressive condition, and much of what we know about it comes from specialized disease registries. With expanding research into the diagnosis and treatment of PH, it is important to provide updated surveillance on the impact of this disease on hospitalizations and mortality. This study, which builds on previous PH surveillance of mortality and hospitalization, analyzed mortality data from the National Vital Statistics System and data from the National Hospital Discharge Survey between 2001 and 2010. PH deaths were identified using International Classification of Diseases, Tenth Revision codes I27.0, I27.2, I27.8, or I27.9 as any contributing cause of death on the death certificate. Hospital discharges associated with PH were identified using International Classification of Diseases, Ninth Revision, Clinical Modification codes 416.0, 416.8, or 416.9 as one of up to seven listed medical diagnoses. The decline in death rates associated with PH among men from 1980 to 2005 has reversed and now shows a significant increasing trend. Similarly, the death rates for women with PH have continued to increase significantly during the past decade. PH-associated mortality rates for those aged 85 years and older have accelerated compared with rates for younger age groups. There have been significant declines in PH-associated mortality rates for those with pulmonary embolism and emphysema. Rates of hospitalization for PH have increased significantly for both men and women during the past decade; for those aged 85 years and older, hospitalization rates have nearly doubled. Continued surveillance helps us understand and address the evolving trends in hospitalization and mortality associated with PH and PH-associated conditions, especially regarding sex, age, and race/ethnicity disparities. PMID:24700091

Mortality in well controlled HIV in the continuous antiretroviral therapy arms of the SMART and ESPRIT trials compared with the general population.

PubMed

Rodger, Alison J; Lodwick, Rebecca; Schechter, Mauro; Deeks, Steven; Amin, Janaki; Gilson, Richard; Paredes, Roger; Bakowska, Elzbieta; Engsig, Frederik N; Phillips, Andrew

2013-03-27

Due to the success of antiretroviral therapy (ART), it is relevant to ask whether death rates in optimally treated HIV are higher than the general population. The objective was to compare mortality rates in well controlled HIV-infected adults in the SMART and ESPRIT clinical trials with the general population. Non-IDUs aged 20-70 years from the continuous ART control arms of ESPRIT and SMART were included if the person had both low HIV plasma viral loads (≤400 copies/ml SMART, ≤500 copies/ml ESPRIT) and high CD4(+) T-cell counts (≥350 cells/μl) at any time in the past 6 months. Standardized mortality ratios (SMRs) were calculated by comparing death rates with the Human Mortality Database. Three thousand, two hundred and eighty individuals [665 (20%) women], median age 43 years, contributed 12,357 person-years of follow-up. Sixty-two deaths occurred during follow up. Commonest cause of death was cardiovascular disease (CVD) or sudden death (19, 31%), followed by non-AIDS malignancy (12, 19%). Only two deaths (3%) were AIDS-related. Mortality rate was increased compared with the general population with a CD4(+) cell count between 350 and 499 cells/μl [SMR 1.77, 95% confidence interval (CI) 1.17-2.55]. No evidence for increased mortality was seen with CD4(+) cell counts greater than 500 cells/μl (SMR 1.00, 95% CI 0.69-1.40). In HIV-infected individuals on ART, with a recent undetectable viral load, who maintained or had recovery of CD4(+) cell counts to at least 500 cells/μl, we identified no evidence for a raised risk of death compared with the general population.

The Parkinson's disease death rate: carbidopa and vitamin B6.

PubMed

Hinz, Marty; Stein, Alvin; Cole, Ted

2014-01-01

The only indication for carbidopa and benserazide is the management of L-3,4-dihydroxyphenylalanine (L-dopa)-induced nausea. Both drugs irreversibly bind to and permanently deactivate pyridoxal 5'-phosphate (PLP), the active form of vitamin B6, and PLP-dependent enzymes. PLP is required for the function of over 300 enzymes and proteins. Virtually every major system in the body is impacted directly or indirectly by PLP. The administration of carbidopa and benserazide potentially induces a nutritional catastrophe. During the first 15 years of prescribing L-dopa, a decreasing Parkinson's disease death rate was observed. Then, in 1976, 1 year after US Food and Drug Administration approved the original L-dopa/carbidopa combination drug, the Parkinson's disease death rate started increasing. This trend has continued to the present, for 38 years and counting. The previous literature documents this increasing death rate, but no hypothesis has been offered concerning this trend. Carbidopa is postulated to contribute to the increasing Parkinson's disease death rate and to the classification of Parkinson's as a progressive neurodegenerative disease. It may contribute to L-dopa tachyphylaxis.

The Parkinson’s disease death rate: carbidopa and vitamin B6

PubMed Central

Hinz, Marty; Stein, Alvin; Cole, Ted

2014-01-01

The only indication for carbidopa and benserazide is the management of L-3,4-dihydroxyphenylalanine (L-dopa)-induced nausea. Both drugs irreversibly bind to and permanently deactivate pyridoxal 5′-phosphate (PLP), the active form of vitamin B6, and PLP-dependent enzymes. PLP is required for the function of over 300 enzymes and proteins. Virtually every major system in the body is impacted directly or indirectly by PLP. The administration of carbidopa and benserazide potentially induces a nutritional catastrophe. During the first 15 years of prescribing L-dopa, a decreasing Parkinson’s disease death rate was observed. Then, in 1976, 1 year after US Food and Drug Administration approved the original L-dopa/carbidopa combination drug, the Parkinson’s disease death rate started increasing. This trend has continued to the present, for 38 years and counting. The previous literature documents this increasing death rate, but no hypothesis has been offered concerning this trend. Carbidopa is postulated to contribute to the increasing Parkinson’s disease death rate and to the classification of Parkinson’s as a progressive neurodegenerative disease. It may contribute to L-dopa tachyphylaxis. PMID:25364278

Annual report to the nation on the status of cancer, 1975-2000, featuring the uses of surveillance data for cancer prevention and control.

PubMed

Weir, Hannah K; Thun, Michael J; Hankey, Benjamin F; Ries, Lynn A G; Howe, Holly L; Wingo, Phyllis A; Jemal, Ahmedin; Ward, Elizabeth; Anderson, Robert N; Edwards, Brenda K

2003-09-03

The American Cancer Society, the Centers for Disease Control and Prevention (CDC), the National Cancer Institute (NCI), and the North American Association of Central Cancer Registries (NAACCR) collaborate annually to update cancer rates and trends in the United States. This report updates statistics on lung, female breast, prostate, and colorectal cancers and highlights the uses of selected surveillance data to assist development of state-based cancer control plans. Age-adjusted incidence rates from 1996 through 2000 are from state and metropolitan area cancer registries that met NAACCR criteria for highest quality. Death rates are based on underlying cause-of-death data. Long-term trends and rates for major racial and ethnic populations are based on NCI and CDC data. Incidence trends from 1975 through 2000 were adjusted for reporting delays. State-specific screening and risk factor survey data are from the CDC and other federal and private organizations. Cancer incidence rates for all cancer sites combined increased from the mid-1970s through 1992 and then decreased from 1992 through 1995. Observed incidence rates for all cancers combined were essentially stable from 1995 through 2000, whereas the delay-adjusted trend showed an increase that had borderline statistical significance (P =.05). Increases in the incidence rates of breast cancer in women and prostate cancer in men offset a long-term decrease in lung cancer in men. Death rates for all cancer sites combined decreased beginning in 1994 and stabilized from 1998 through 2000, resulting in part from recent revisions in cause-of-death codes. Death rates among men continued to decline throughout the 1990s, whereas trends in death rates among women were essentially unchanged from 1998 through 2000. Analysis of state data for the leading cancers revealed mixed progress in achieving national objectives for improving cancer screening, risk factor reduction, and decreases in mortality. Overall cancer incidence and death rates began to stabilize in the mid- to late 1990s. The recent increase in the delay-adjusted trend will require monitoring with additional years of data. Further reduction in the burden of cancer is possible but will require the continuation of strong federal, state, local, and private partnerships to increase dissemination of evidence-based cancer control programs to all segments of the population.

Increases in Drug and Opioid Overdose Deaths--United States, 2000-2014.

PubMed

Rudd, Rose A; Aleshire, Noah; Zibbell, Jon E; Gladden, R Matthew

2016-01-01

The United States is experiencing an epidemic of drug overdose (poisoning) deaths. Since 2000, the rate of deaths from drug overdoses has increased 137%, including a 200% increase in the rate of overdose deaths involving opioids (opioid pain relievers and heroin). CDC analyzed recent multiple cause-of-death mortality data to examine current trends and characteristics of drug overdose deaths, including the types of opioids associated with drug overdose deaths. During 2014, a total of 47,055 drug overdose deaths occurred in the United States, representing a 1-year increase of 6.5%, from 13.8 per 100,000 persons in 2013 to 14.7 per 100,000 persons in 2014. The rate of drug overdose deaths increased significantly for both sexes, persons aged 25-44 years and ≥55 years, non-Hispanic whites and non-Hispanic blacks, and in the Northeastern, Midwestern, and Southern regions of the United States. Rates of opioid overdose deaths also increased significantly, from 7.9 per 100,000 in 2013 to 9.0 per 100,000 in 2014, a 14% increase. Historically, CDC has programmatically characterized all opioid pain reliever deaths (natural and semisynthetic opioids, methadone, and other synthetic opioids) as "prescription" opioid overdoses (1). Between 2013 and 2014, the age-adjusted rate of death involving methadone remained unchanged; however, the age-adjusted rate of death involving natural and semisynthetic opioid pain relievers, heroin, and synthetic opioids, other than methadone (e.g., fentanyl) increased 9%, 26%, and 80%, respectively. The sharp increase in deaths involving synthetic opioids, other than methadone, in 2014 coincided with law enforcement reports of increased availability of illicitly manufactured fentanyl, a synthetic opioid; however, illicitly manufactured fentanyl cannot be distinguished from prescription fentanyl in death certificate data. These findings indicate that the opioid overdose epidemic is worsening. There is a need for continued action to prevent opioid abuse, dependence, and death, improve treatment capacity for opioid use disorders, and reduce the supply of illicit opioids, particularly heroin and illicit fentanyl.

Breast cancer statistics, 2011.

PubMed

DeSantis, Carol; Siegel, Rebecca; Bandi, Priti; Jemal, Ahmedin

2011-01-01

In this article, the American Cancer Society provides an overview of female breast cancer statistics in the United States, including trends in incidence, mortality, survival, and screening. Approximately 230,480 new cases of invasive breast cancer and 39,520 breast cancer deaths are expected to occur among US women in 2011. Breast cancer incidence rates were stable among all racial/ethnic groups from 2004 to 2008. Breast cancer death rates have been declining since the early 1990s for all women except American Indians/Alaska Natives, among whom rates have remained stable. Disparities in breast cancer death rates are evident by state, socioeconomic status, and race/ethnicity. While significant declines in mortality rates were observed for 36 states and the District of Columbia over the past 10 years, rates for 14 states remained level. Analyses by county-level poverty rates showed that the decrease in mortality rates began later and was slower among women residing in poor areas. As a result, the highest breast cancer death rates shifted from the affluent areas to the poor areas in the early 1990s. Screening rates continue to be lower in poor women compared with non-poor women, despite much progress in increasing mammography utilization. In 2008, 51.4% of poor women had undergone a screening mammogram in the past 2 years compared with 72.8% of non-poor women. Encouraging patients aged 40 years and older to have annual mammography and a clinical breast examination is the single most important step that clinicians can take to reduce suffering and death from breast cancer. Clinicians should also ensure that patients at high risk of breast cancer are identified and offered appropriate screening and follow-up. Continued progress in the control of breast cancer will require sustained and increased efforts to provide high-quality screening, diagnosis, and treatment to all segments of the population. Copyright © 2011 American Cancer Society, Inc.

Compression of Morbidity and Mortality: New Perspectives1

PubMed Central

Stallard, Eric

2017-01-01

Compression of morbidity is a reduction over time in the total lifetime days of chronic disability, reflecting a balance between (1) morbidity incidence rates and (2) case-continuance rates—generated by case-fatality and case-recovery rates. Chronic disability includes limitations in activities of daily living and cognitive impairment, which can be covered by long-term care insurance. Morbidity improvement can lead to a compression of morbidity if the reductions in age-specific prevalence rates are sufficiently large to overcome the increases in lifetime disability due to concurrent mortality improvements and progressively higher disability prevalence rates with increasing age. Compression of mortality is a reduction over time in the variance of age at death. Such reductions are generally accompanied by increases in the mean age at death; otherwise, for the variances to decrease, the death rates above the mean age at death would need to increase, and this has rarely been the case. Mortality improvement is a reduction over time in the age-specific death rates and a corresponding increase in the cumulative survival probabilities and age-specific residual life expectancies. Mortality improvement does not necessarily imply concurrent compression of mortality. This paper reviews these concepts, describes how they are related, shows how they apply to changes in mortality over the past century and to changes in morbidity over the past 30 years, and discusses their implications for future changes in the United States. The major findings of the empirical analyses are the substantial slowdowns in the degree of mortality compression over the past half century and the unexpectedly large degree of morbidity compression that occurred over the morbidity/disability study period 1984–2004; evidence from other published sources suggests that morbidity compression may be continuing. PMID:28740358

Cancer mortality in a cohort of continuous glass filament workers.

PubMed

Pira, Enrico; Manzari, Marco; Gallus, Silvano; Negri, Eva; Bosetti, Cristina; Romano, Canzio; McLaughlin, Joseph K; Boffetta, Paolo; La Vecchia, Carlo

2009-02-01

To examine cancer mortality in continuous glass filament workers. A cohort of 936 continuous glass filament workers employed in a plant from northern Italy since January 1976 was followed-up through December 2003, for a total of 19,987 man-years. Overall, 144 deaths were observed compared with 160.8 expected based on regional death rates (standardized mortality ratio [SMR] = 0.90, 95% CI = 0.76 to 1.05). There were 53 deaths from all cancers (SMR = 1.01, 95% CI = 0.75 to 1.32), and 21 from lung cancer (SMR = 1.23, 95% CI = 0.76 to 1.89). There was no consistent relation with risk for age at first employment, time since first or last employment, or duration of employment for any of the causes considered. Although limited in size, this study provides no evidence that continuous glass filament workers experience a significant increased risk of cancer, including respiratory cancer.

12 CFR 330.3 - General principles.

Code of Federal Regulations, 2013 CFR

2013-01-01

... the rate of earnings. (j) Continuation of insurance coverage following the death of a deposit owner... depository institution. The exchange rates to be used for such conversions are the 12 PM rates (the “noon buying rates for cable transfers”) quoted for major currencies by the Federal Reserve Bank of New York on...

12 CFR 330.3 - General principles.

Code of Federal Regulations, 2011 CFR

2011-01-01

... the rate of earnings. (j) Continuation of insurance coverage following the death of a deposit owner... depository institution. The exchange rates to be used for such conversions are the 12 PM rates (the “noon buying rates for cable transfers”) quoted for major currencies by the Federal Reserve Bank of New York on...

12 CFR 330.3 - General principles.

Code of Federal Regulations, 2012 CFR

2012-01-01

... the rate of earnings. (j) Continuation of insurance coverage following the death of a deposit owner... depository institution. The exchange rates to be used for such conversions are the 12 PM rates (the “noon buying rates for cable transfers”) quoted for major currencies by the Federal Reserve Bank of New York on...

12 CFR 330.3 - General principles.

Code of Federal Regulations, 2010 CFR

2010-01-01

... the rate of earnings. (j) Continuation of insurance coverage following the death of a deposit owner... depository institution. The exchange rates to be used for such conversions are the 12 PM rates (the “noon buying rates for cable transfers”) quoted for major currencies by the Federal Reserve Bank of New York on...

Drug-related death following release from prison: a brief review of the literature with recommendations for practice.

PubMed

Leach, D; Oliver, P

2011-12-01

Mortality from drug-related death is a significant contributor to the loss of life of young people in the UK. Despite attention, the high death rate from this cause continues to persist. One of the most frequently cited factors involved in drug-related death (DRD) is release from prison. This review aims to examine the published literature with a view to quantifying the risk associated with recent prison release and identifying risk factors and prevention strategies. Most deaths following release from prison are caused by overdose, usually from opioid use. The risk of death is greatest within the first week of release but, when compared with the general population, continues to be elevated for several weeks. Relative risk estimates suggest that those released from prison are up to 40 times more likely to die than similar individuals from the general population. Other than gender and an association with poor mental health, there is little in the way of robust risk factors for post-release death that could be identified from the literature. In-prison pharmacological maintenance treatment with methadone and buprenorphine has been shown to reduce the rate of heroin use, in the period immediately following release, in a small number of randomised controlled trials. It is widely recognised that continuity of care, of any form, is critical in avoiding DRDs. For problem drug users, packages of education, including information on the associated risks, treatments, and recognition of DRD after release from prison, are seen as a basic minimum requirement of the prison services. However, special protocols may be required for those drug-using prisoners who have a possibility of being released at short notice.

Predictive implications of Gompertz's law

NASA Astrophysics Data System (ADS)

Richmond, Peter; Roehner, Bertrand M.

2016-04-01

Gompertz's law tells us that for humans above the age of 35 the death rate increases exponentially with a doubling time of about 10 years. Here, we show that the same law continues to hold up to age 106. At that age the death rate is about 50%. Beyond 106 there is so far no convincing statistical evidence available because the number of survivors are too small even in large nations. However, assuming that Gompertz's law continues to hold beyond 106, we conclude that the mortality rate becomes equal to 1 at age 120 (meaning that there are 1000 deaths in a population of one thousand). In other words, the upper bound of human life is near 120. The existence of this fixed-point has interesting implications. It allows us to predict the form of the relationship between death rates at age 35 and the doubling time of Gompertz's law. In order to test this prediction, we first carry out a transversal analysis for a sample of countries comprising both industrialized and developing nations. As further confirmation, we also develop a longitudinal analysis using historical data over a time period of almost two centuries. Another prediction arising from this fixed-point model, is that, above a given population threshold, the lifespan of the oldest persons is independent of the size of their national community. This prediction is also supported by empirical evidence.

Annual Report to the Nation on the Status of Cancer, 1975–2007, Featuring Tumors of the Brain and Other Nervous System

PubMed Central

Ward, Elizabeth; McCarthy, Bridget J.; Schymura, Maria J.; Eheman, Christie; Jemal, Ahmedin; Anderson, Robert N.; Ajani, Umed A.; Edwards, Brenda K.

2011-01-01

Background The American Cancer Society, the Centers for Disease Control and Prevention (CDC), the National Cancer Institute, and the North American Association of Central Cancer Registries (NAACCR) collaborate annually to provide updated information on cancer occurrence and trends in the United States. This year’s report highlights brain and other nervous system (ONS) tumors, including nonmalignant brain tumors, which became reportable on a national level in 2004. Methods Cancer incidence data were obtained from the National Cancer Institute, CDC, and NAACCR, and information on deaths was obtained from the CDC’s National Center for Health Statistics. The annual percentage changes in age-standardized incidence and death rates (2000 US population standard) for all cancers combined and for the top 15 cancers for men and for women were estimated by joinpoint analysis of long-term (1992–2007 for incidence; 1975–2007 for mortality) trends and short-term fixed interval (1998–2007) trends. Analyses of malignant neuroepithelial brain and ONS tumors were based on data from 1980–2007; data on nonmalignant tumors were available for 2004–2007. All statistical tests were two-sided. Results Overall cancer incidence rates decreased by approximately 1% per year; the decrease was statistically significant (P < .05) in women, but not in men, because of a recent increase in prostate cancer incidence. The death rates continued to decrease for both sexes. Childhood cancer incidence rates continued to increase, whereas death rates continued to decrease. Lung cancer death rates decreased in women for the first time during 2003–2007, more than a decade after decreasing in men. During 2004–2007, more than 213 500 primary brain and ONS tumors were diagnosed, and 35.8% were malignant. From 1987–2007, the incidence of neuroepithelial malignant brain and ONS tumors decreased by 0.4% per year in men and women combined. Conclusions The decrease in cancer incidence and mortality reflects progress in cancer prevention, early detection, and treatment. However, major challenges remain, including increasing incidence rates and continued low survival for some cancers. Malignant and nonmalignant brain tumors demonstrate differing patterns of occurrence by sex, age, and race, and exhibit considerable biologic diversity. Inclusion of nonmalignant brain tumors in cancer registries provides a fuller assessment of disease burden and medical resource needs associated with these unique tumors. PMID:21454908

A midpoint assessment of the American Cancer Society challenge goal to halve the U.S. cancer mortality rates between the years 1990 and 2015.

PubMed

Byers, Tim; Barrera, Ermilo; Fontham, Elizabeth T H; Newman, Lisa A; Runowicz, Carolyn D; Sener, Stephen F; Thun, Michael J; Winborn, Sara; Wender, Richard C

2006-07-15

The American Cancer Society has challenged the U.S. to reduce cancer mortality rates 50% over the 25 years from 1990 to 2015. The current report is an analysis and commentary on progress toward that goal through 2002, the midpoint of the challenge period. Cancer mortality rates were examined from 1990 through 2002, and projections to the Year 2015 were made. Cancer deaths that were prevented or deferred by the declining death rates were expressed as the difference between the observed and projected numbers of deaths and the numbers that would have been observed over that period had the 1990 death rates persisted. Since 1990, cancer mortality rates have been declining in the U.S. by approximately 1% per year. Trends especially have been favorable for cancers of the breast, prostate, and colorectum and for lung cancer among men. Should this rate of decline continue over the coming decade, death rates from cancer will be approximately 23% lower in the Year 2015 than they were in 1990, and approximately 1.8 million deaths from cancer will have been prevented or deferred. At this midpoint of the 25-year challenge period, it appears that fully reaching the goal will require substantial breakthroughs in cancer early detection and/or in cancer therapy. Between now and 2015, however, many more cancer deaths can be averted by concerted action to control tobacco and obesity, by redoubling efforts in mammography and colorectal screening, and by enacting policies to close gaps in access to cancer detection and treatment services.

A comparison of continuous- and discrete- time three-state models for rodent tumorigenicity experiments.

PubMed Central

Lindsey, J C; Ryan, L M

1994-01-01

The three-state illness-death model provides a useful way to characterize data from a rodent tumorigenicity experiment. Most parametrizations proposed recently in the literature assume discrete time for the death process and either discrete or continuous time for the tumor onset process. We compare these approaches with a third alternative that uses a piecewise continuous model on the hazards for tumor onset and death. All three models assume proportional hazards to characterize tumor lethality and the effect of dose on tumor onset and death rate. All of the models can easily be fitted using an Expectation Maximization (EM) algorithm. The piecewise continuous model is particularly appealing in this context because the complete data likelihood corresponds to a standard piecewise exponential model with tumor presence as a time-varying covariate. It can be shown analytically that differences between the parameter estimates given by each model are explained by varying assumptions about when tumor onsets, deaths, and sacrifices occur within intervals. The mixed-time model is seen to be an extension of the grouped data proportional hazards model [Mutat. Res. 24:267-278 (1981)]. We argue that the continuous-time model is preferable to the discrete- and mixed-time models because it gives reasonable estimates with relatively few intervals while still making full use of the available information. Data from the ED01 experiment illustrate the results. PMID:8187731

5 CFR 843.409 - Rates of annuities.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Rates of annuities. 843.409 Section 843... (CONTINUED) FEDERAL EMPLOYEES RETIREMENT SYSTEM-DEATH BENEFITS AND EMPLOYEE REFUNDS Child Annuities § 843.409 Rates of annuities. (a) For each month, the amount of annuity payable to each surviving child under this...

5 CFR 843.409 - Rates of annuities.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 5 Administrative Personnel 2 2012-01-01 2012-01-01 false Rates of annuities. 843.409 Section 843... (CONTINUED) FEDERAL EMPLOYEES RETIREMENT SYSTEM-DEATH BENEFITS AND EMPLOYEE REFUNDS Child Annuities § 843.409 Rates of annuities. (a) For each month, the amount of annuity payable to each surviving child under this...

5 CFR 843.409 - Rates of annuities.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 5 Administrative Personnel 2 2013-01-01 2013-01-01 false Rates of annuities. 843.409 Section 843... (CONTINUED) FEDERAL EMPLOYEES RETIREMENT SYSTEM-DEATH BENEFITS AND EMPLOYEE REFUNDS Child Annuities § 843.409 Rates of annuities. (a) For each month, the amount of annuity payable to each surviving child under this...

5 CFR 843.409 - Rates of annuities.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 5 Administrative Personnel 2 2014-01-01 2014-01-01 false Rates of annuities. 843.409 Section 843... (CONTINUED) FEDERAL EMPLOYEES RETIREMENT SYSTEM-DEATH BENEFITS AND EMPLOYEE REFUNDS Child Annuities § 843.409 Rates of annuities. (a) For each month, the amount of annuity payable to each surviving child under this...

5 CFR 843.409 - Rates of annuities.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 5 Administrative Personnel 2 2011-01-01 2011-01-01 false Rates of annuities. 843.409 Section 843... (CONTINUED) FEDERAL EMPLOYEES RETIREMENT SYSTEM-DEATH BENEFITS AND EMPLOYEE REFUNDS Child Annuities § 843.409 Rates of annuities. (a) For each month, the amount of annuity payable to each surviving child under this...

Declining mortality from smoking in the United States.

PubMed

Rodu, Brad; Cole, Philip

2007-07-01

The proportion of Americans who smoke cigarettes has declined 50% since 1965. The effect on mortality of this considerable reduction has received little attention and is described in this study. U.S. national data were used to enumerate current, former, and never-smokers aged 35 years or older in 1987 and 2002. Mortality rate ratios were used to estimate smoking-attributable deaths among these groups, and corresponding age-adjusted smoking-attributable mortality rates (SAMRs) were calculated. There were 402,000 deaths attributable to smoking in 1987 and 322,000 in 2002. The SAMR for men aged 35 years or more was 556 deaths per 100,000 person-years in 1987, accounting for 24% of all male deaths. By 2002 the SAMR declined 41% to 329 and accounted for only 17% of deaths. The SAMR for women in 1987 was 175, accounting for 12% of deaths. By 2002 the SAMR among women had declined 30% to 122, representing 9% of deaths. The U.S. mortality rate attributable to smoking declined about 35% between 1987 and 2002. The impact of smoking on American society will diminish even further in the foreseeable future as smoking prevalence continues its decline among men and women.

Increasing lung cancer death rates among young women in southern and midwestern States.

PubMed

Jemal, Ahmedin; Ma, Jiemin; Rosenberg, Philip S; Siegel, Rebecca; Anderson, William F

2012-08-01

Previous studies reported that declines in age-specific lung cancer death rates among women in the United States abruptly slowed in women younger than age 50 years (ie, women born after the 1950s). However, in view of substantial geographic differences in antitobacco measures and sociodemographic factors that affect smoking prevalence, it is unknown whether this change in the trend was similar across all states. We examined female age-specific lung cancer death rates (1973 through 2007) by year of death and birth in each state by using age-period-cohort models. Cohort relative risks adjusted for age and period effects were used to compare the lung cancer death rate for a given birth cohort to a referent birth cohort (ie, the 1933 cohort herein). Age-specific lung cancer death rates declined continuously in white women in California, but the rates declined less quickly or even increased in the remaining states among women younger than age 50 years and women born after the 1950s, especially in several southern and midwestern states. For example, in some southern states (eg, Alabama), lung cancer death rates among women born in the 1960s were approximately double those of women born in the 1930s. The unfavorable lung cancer trend in white women born after circa 1950 in southern and midwestern states underscores the need for additional interventions to promote smoking cessation in these high-risk populations, which could lead to more favorable future mortality trends for lung cancer and other smoking-related diseases.

Increasing Lung Cancer Death Rates Among Young Women in Southern and Midwestern States

PubMed Central

Jemal, Ahmedin; Ma, Jiemin; Rosenberg, Philip S.; Siegel, Rebecca; Anderson, William F.

2012-01-01

Purpose Previous studies reported that declines in age-specific lung cancer death rates among women in the United States abruptly slowed in women younger than age 50 years (ie, women born after the 1950s). However, in view of substantial geographic differences in antitobacco measures and sociodemographic factors that affect smoking prevalence, it is unknown whether this change in the trend was similar across all states. Methods We examined female age-specific lung cancer death rates (1973 through 2007) by year of death and birth in each state by using age-period-cohort models. Cohort relative risks adjusted for age and period effects were used to compare the lung cancer death rate for a given birth cohort to a referent birth cohort (ie, the 1933 cohort herein). Results Age-specific lung cancer death rates declined continuously in white women in California, but the rates declined less quickly or even increased in the remaining states among women younger than age 50 years and women born after the 1950s, especially in several southern and midwestern states. For example, in some southern states (eg, Alabama), lung cancer death rates among women born in the 1960s were approximately double those of women born in the 1930s. Conclusion The unfavorable lung cancer trend in white women born after circa 1950 in southern and midwestern states underscores the need for additional interventions to promote smoking cessation in these high-risk populations, which could lead to more favorable future mortality trends for lung cancer and other smoking-related diseases. PMID:22734032

The Birthday-Deathday Effect: Fact or Artifact?

ERIC Educational Resources Information Center

Wood, John B.

1987-01-01

Birthday-deathday relationship has been called an artifact due to continuous depletion of population with age. The increased death rate with age, however, cancels this effect at ages 75 to 84. There remains a 33 percentexcess of deaths from heart disease among married persons aged 75 and older in the three-day period centered at the birthday.…

Recent trends in cutaneous melanoma incidence and death rates in the United States, 1992-2006.

PubMed

Jemal, Ahmedin; Saraiya, Mona; Patel, Pragna; Cherala, Sai S; Barnholtz-Sloan, Jill; Kim, Julian; Wiggins, Charles L; Wingo, Phyllis A

2011-11-01

Increasing cutaneous melanoma incidence rates in the United States have been attributed to heightened detection of thin (≤ 1-mm) lesions. We sought to describe melanoma incidence and mortality trends in the 12 cancer registries covered by the Surveillance, Epidemiology, and End Results program and to estimate the contribution of thin lesions to melanoma mortality. We used joinpoint analysis of Surveillance, Epidemiology, and End Results incidence and mortality data from 1992 to 2006. During 1992 through 2006, melanoma incidence rates among non-Hispanic whites increased for all ages and tumor thicknesses. Death rates increased for older (>65 years) but not younger persons. Between 1998 to 1999 and 2004 to 2005, melanoma death rates associated with thin lesions increased and accounted for about 30% of the total melanoma deaths. Availability of long-term incidence data for 14% of the US population was a limitation. The continued increases in melanoma death rates for older persons and for thin lesions suggest that the increases may partly reflect increased ultraviolet radiation exposure. The substantial contribution of thin lesions to melanoma mortality underscores the importance of standard wide excision techniques and the need for molecular characterization of the lesions for aggressive forms. Copyright © 2011 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

Leading causes of death and all-cause mortality in American Indians and Alaska Natives.

PubMed

Espey, David K; Jim, Melissa A; Cobb, Nathaniel; Bartholomew, Michael; Becker, Tom; Haverkamp, Don; Plescia, Marcus

2014-06-01

We present regional patterns and trends in all-cause mortality and leading causes of death in American Indians and Alaska Natives (AI/ANs). US National Death Index records were linked with Indian Health Service (IHS) registration records to identify AI/AN deaths misclassified as non-AI/AN. We analyzed temporal trends for 1990 to 2009 and comparisons between non-Hispanic AI/AN and non-Hispanic White persons by geographic region for 1999 to 2009. Results focus on IHS Contract Health Service Delivery Area counties in which less race misclassification occurs. From 1990 to 2009 AI/AN persons did not experience the significant decreases in all-cause mortality seen for Whites. For 1999 to 2009 the all-cause death rate in CHSDA counties for AI/AN persons was 46% more than that for Whites. Death rates for AI/AN persons varied as much as 50% among regions. Except for heart disease and cancer, subsequent ranking of specific causes of death differed considerably between AI/AN and White persons. AI/AN populations continue to experience much higher death rates than Whites. Patterns of mortality are strongly influenced by the high incidence of diabetes, smoking prevalence, problem drinking, and social determinants. Much of the observed excess mortality can be addressed through known public health interventions.

Estimating benefits of past, current, and future reductions in smoking rates using a comprehensive model with competing causes of death.

PubMed

van Meijgaard, Jeroen; Fielding, Jonathan E

2012-01-01

Despite years of declining smoking prevalence, tobacco use is still the leading preventable contributor to illness and death in the United States, and the effect of past tobacco-use control efforts has not fully translated into improvements in health outcomes. The objective of this study was to use a life course model with multiple competing causes of death to elucidate the ongoing benefits of tobacco-use control efforts on US death rates. We used a continuous-time life course simulation model for the US population. We modeled smoking initiation and cessation and 20 leading causes of death as competing risks over the life span, with the risk of death for each cause dependent on past and current smoking status. Risk parameters were estimated using data from the National Health Interview Survey that were linked to follow-up mortality data. Up to 14% (9% for men, 14% for women) of the total gain in life expectancy since 1960 was due to tobacco-use control efforts. Past efforts are expected to further increase life expectancy by 0.9 years for women and 1.3 years for men. Additional reduction in smoking prevalence may eventually yield an average 3.4-year increase in life expectancy in the United States. Coronary heart disease is expected to increase as a share of total deaths. A dynamic individual-level model with multiple causes of death supports assessment of the delayed benefits of improved tobacco-use control efforts. We show that past smoking reduction efforts will translate into further increases in life expectancy in the coming years. Smoking will remain a major contributor to preventable illness and death, worthy of continued interventions.

Tuberculosis mortality trends in cuba, 1998 to 2007.

PubMed

González, Edilberto; Risco, Grisel E; Borroto, Susana; Perna, Abel; Armas, Luisa

2009-01-01

Introduction Tuberculosis (TB) is a major cause of illness and death throughout the world. The World Health Organization's Global Plan to Stop TB 2006-2015 proposes that countries cut TB mortality by half compared to 1990 rates. In Cuba, TB mortality declined steadily throughout the 20th century, particularly after 1960. Objective Describe TB mortality distribution and trends in Cuba from January 1998 to December 2007 by infection site, sex, age and province, and determine progress towards the WHO's 2015 target for TB mortality reduction. Methods A time series ecological study was conducted. Death certificates stating TB as cause of death were obtained from the Ministry of Public Health's National Statistics Division, and population data by age group, sex, and province were obtained from the National Statistics Bureau. Crude and specific death rate trends and variation were analyzed. Results TB mortality declined from 0.4 per 100,000 population in 1998 to 0.2 (under half the 1990 rate) in 2007. Clinical forms of the disease, both pulmonary and extrapulmonary, also declined. The highest mortality rates were found in males and in the group aged ≥ 65 years. Rates were also highest in the capital, Havana, with extreme values of 0.73 and 0.39 per 100,000 population at the beginning and end of the period, respectively. Conclusions Deaths from TB declined steadily compared to total deaths and deaths caused by infectious diseases. The Global Plan to Stop TB target was met well ahead of 2015. If this trend continues, TB is likely to become an exceptional cause of death in Cuba.

'Visitation by God': rationalizing death in the Victorian asylum.

PubMed

Smith, Cathy

2012-03-01

This article argues that death from insanity raised serious questions for the medical profession and for those who promoted the public asylum movement in the nineteenth century. While the medical emphasis on the somatic origins of insanity was increasingly accepted, limited observable signs of disease in the brain at post-mortem made it difficult to explain cause of death. This posed problems for a growing county asylum movement which was justified on the basis that insanity was a treatable disease and thus mortality rates would naturally decline. As asylum populations continued to grow and mortality rates remained little changed, statistics on lunacy ultimately became not the predicted measure of success but instead clear evidence of failure.

Mortality of San Joaquin kit fox (Vulpes velox macrotis) at Camp Roberts Army National Guard Training Site, California

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

Standley, W.G.; Berry, W.H.; O'Farrell, T.P.

1992-09-01

Sources and rates of mortality of a San Joaquin kit fox population (Vulpes velox macrotis) were investigated at Camp Roberts Army National Guard Training Site, California, from November 1988 through September 1991. National Guard-authorized activities, including military training, caused the death of three of the 94 (3%) kit foxes radiocollared, and do not appear to jeopardize the continued existence of the population. Predation by larger carnivores, primarily coyotes (Canis latrans), caused the death of 75% of the 32 radiocollared kit foxes recovered dead for which a cause of death could be determined; vehicle impacts, disease (rabies), poisoning, and shooting weremore » each responsible for the deaths of 6.3%. Adult annual mortality rate was 0.47 and the juvenile mortality rate was 0.80, and both rates are similar to rates reported for kit foxes in other locations. There was no significant difference between male and female mortality rates in either age class. The proportions of dead kit foxes recovered in different habitat types were similar to the availability of the habitat types within the distribution of kit fox on the installation.« less

Forecasting state-level premature deaths from alcohol, drugs, and suicides using Google Trends data.

PubMed

Parker, Jason; Cuthbertson, Courtney; Loveridge, Scott; Skidmore, Mark; Dyar, Will

2017-04-15

Vital statistics on the number of, alcohol-induced death (AICD) drug-induced death (DICD), and suicides at the local-level are only available after a substantial lag of up to two years after the events occur. We (1) investigate how well Google Trends search data explain variation in state-level rates in the US, and (2) use this method to forecast these rates of death for 2015 as official data are not yet available. We tested the degree to which Google Trends data on 27 terms can be fit to CDC data using L 1 -regularization on AICD, DICD, and suicide. Using Google Trends data, we forecast 2015 AICD, DICD, and suicide rates. L 1 -regularization fit the pre-2015 data much better than the alternative model using state-level unemployment and income variables. Google Trends data account for substantial variation in growth of state-level rates of death: 30.9% for AICD, 23.9% for DICD, and 21.8% for suicide rates. Every state except Hawaii is forecasted to increase in all three of these rates in 2015. The model predicts state, not local or individual behavior, and is dependent on continued availability of Google Trends data. The method predicts state-level AICD, DICD, and suicide rates better than the alternative model. The study findings suggest that this methodology can be developed into a public health surveillance system for behavioral health-related causes of death. State-level predictions could be used to inform state interventions aimed at reducing AICD, DICD, and suicide. Copyright © 2017. Published by Elsevier B.V.

Leading Causes of Death and All-Cause Mortality in American Indians and Alaska Natives

PubMed Central

Jim, Melissa A.; Cobb, Nathaniel; Bartholomew, Michael; Becker, Tom; Haverkamp, Don; Plescia, Marcus

2014-01-01

Objectives. We present regional patterns and trends in all-cause mortality and leading causes of death in American Indians and Alaska Natives (AI/ANs). Methods. US National Death Index records were linked with Indian Health Service (IHS) registration records to identify AI/AN deaths misclassified as non-AI/AN. We analyzed temporal trends for 1990 to 2009 and comparisons between non-Hispanic AI/AN and non-Hispanic White persons by geographic region for 1999 to 2009. Results focus on IHS Contract Health Service Delivery Area counties in which less race misclassification occurs. Results. From 1990 to 2009 AI/AN persons did not experience the significant decreases in all-cause mortality seen for Whites. For 1999 to 2009 the all-cause death rate in CHSDA counties for AI/AN persons was 46% more than that for Whites. Death rates for AI/AN persons varied as much as 50% among regions. Except for heart disease and cancer, subsequent ranking of specific causes of death differed considerably between AI/AN and White persons. Conclusions. AI/AN populations continue to experience much higher death rates than Whites. Patterns of mortality are strongly influenced by the high incidence of diabetes, smoking prevalence, problem drinking, and social determinants. Much of the observed excess mortality can be addressed through known public health interventions. PMID:24754554

Rapid population growth.

PubMed

1972-01-01

At the current rate of population growth, world population by 2000 is expected to reach 7 billion or more, with developing countries accounting for some 5.4 billion, and economically advanced nations accounting for 1.6 billion. 'Population explosion' is the result of falling mortality rates and continuing high birth rates. Many European countries, and Japan, have already completed what is termed as demographic transition, that is, birth rates have fallen to below 20 births per 1000 population, death rates to 10/1000 population, and annual growth rates are 1% or less; annual growth rates for less developed countries ranged from 2 to 3.5%. Less developed countries can be divided into 3 groups: 1) countries with both high birth and death rates; 2) countries with high birth rates and low death rates; and 3) countries with intermediate and declining birth rates and low death rates. Rapid population growth has serious economic consequences. It encourages inequities in income distribution; it limits rate of growth of gross national product by holding down level of savings and capital investments; it exerts pressure on agricultural production and land; and it creates unemployment problems. In addition, the quality of education for increasing number of chidren is adversely affected, as high proportions of children reduce the amount that can be spent for the education of each child out of the educational budget; the cost and adequacy of health and welfare services are affected in a similar way. Other serious consequences of rapid population growth are maternal death and illness, and physical and mental retardation of children of very poor families. It is very urgent that over a billion births be prevented in the next 30 years to reduce annual population growth rate from the current 2% to 1% per year.

A mobile phone based alarm system for supervising vital parameters in free moving rats.

PubMed

Kellermann, Kristine; Kreuzer, Matthias; Omerovich, Adem; Hoetzinger, Franziska; Kochs, Eberhard F; Jungwirth, Bettina

2012-02-23

Study protocols involving experimental animals often require the monitoring of different parameters not only in anesthetized, but also in free moving animals. Most animal research involves small rodents, in which continuously monitoring parameters such as temperature and heart rate is very stressful for the awake animals or simply not possible. Aim of the underlying study was to monitor heart rate, temperature and activity and to assess inflammation in the heart, lungs, liver and kidney in the early postoperative phase after experimental cardiopulmonary bypass involving 45 min of deep hypothermic circulatory arrest in rats. Besides continuous monitoring of heart rate, temperature and behavioural activity, the main focus was on avoiding uncontrolled death of an animal in the early postoperative phase in order to harvest relevant organs before autolysis would render them unsuitable for the assessment of inflammation. We therefore set up a telemetry-based system (Data Science International, DSI™) that continuously monitored the rat's temperature, heart rate and activity in their cages. The data collection using telemetry was combined with an analysis software (Microsoft excel™), a webmail application (GMX) and a text message-service. Whenever an animal's heart rate dropped below the pre-defined threshold of 150 beats per minute (bpm), a notification in the form of a text message was automatically sent to the experimenter's mobile phone. With a positive predictive value of 93.1% and a negative predictive value of 90.5%, the designed surveillance and alarm system proved a reliable and inexpensive tool to avoid uncontrolled death in order to minimize suffering and harvest relevant organs before autolysis would set in. This combination of a telemetry-based system and software tools provided us with a reliable notification system of imminent death. The system's high positive predictive value helped to avoid uncontrolled death and facilitated timely organ harvesting. Additionally we were able to markedly reduce the drop out rate of experimental animals, and therefore the total number of animals used in our study. This system can be easily adapted to different study designs and prove a helpful tool to relieve stress and more importantly help to reduce animal numbers.

US-funded measurements of cervical cancer death rates in India: scientific and ethical concerns.

PubMed

Suba, Eric J

2014-01-01

Since 1998, randomised trials in India funded by the US National Cancer Institute (NCI) and the Bill and Melinda Gates Foundation have compared cervical cancer death rates among 224,929 women offered cervical screening to those among 138,624 women offered no screening whatsoever. To date, at least 254 women in unscreened control groups have died of cervical cancer. The United States Office for Human Research Protections (OHRP) determined that the subjects in the studies were not given adequate information for the purpose of providing informed consent. The determinations of the OHRP contradict assurances given by other American medical and bioethical leaders. CONCERNS: Defective scientific design required inadequate informed consent. US-funded measurements of death rates may have needlessly delayed development of indispensable, life-saving public health infrastructure. US-funded measurements of incidence and death rates proved to be scientifically irreproducible and unreliable. Predictably, nothing was learned from these measurements that was not already known. Statistical bias embedded in measurement of death rates yielded the absurd conclusion that Papanicolaou screening does not prevent cervical cancer, leading to a marketing campaign for a proprietary human papillomavirus (HPV) screening test unaffordable for the women among whom death rates had been measured. Inexplicably, measurements of death rates among unscreened women were continued even after the mortality benefit of screening had been confirmed. Quality management of NCI fundedvisual screening (VIA) in Mumbai failed catastrophically, with unsettling implications for VIA conducted by those with less expertise. High-quality screening must be provided to all surviving unscreened women without further delay. US-based global health organisations should institutionalise a commitment to “improving health outcomes as rapidly as possible among as many people as possible.” Those who suffered avoidable harm and death, as well as their families, should be promptly and fairly compensated. As another critic of these unfortunate studies concluded, “You can’t let people die to show something you already know.”

Prediction of trauma-specific death rates of pedestrians of Fars Province, Iran.

PubMed

Akbari, Maryam; Tabrizi, Reza; Heydari, Seyed Taghi; Sekhavati, Eghbal; Moosazadeh, Mahmood; Lankarani, Kamran Bagheri

2015-09-01

Pedestrians are the most vulnerable group to accidents among road users. Due to the well-known concerns and complications of accidents involving pedestrians, the aim of this study was to identify the rate of such accidents for five-year period. We analyzed all fatalities among pedestrians caused by traffic accidents during years of 2009-2013 in Fars Province in Iran. The study was a cross-sectional study in which logistic regression analysis was used to predict the death rate among pedestrians. Sensitivity analysis using the Monte Carlo method was used to increase the accuracy of the results. Then, we predicted the death rates for the years 2014-2018 predicted and compared the results with the actual data from the previous five-year period (2009-2013). During 2009-2013, 1723 out of 8689 (20.3%) of the people killed in traffic accidents were pedestrians. The death rate for male pedestrians in 2011 was estimated to be 10.86 per 100,000 (with an uncertainty interval of 95% giving a range of 9.85-12.05 per 100,000). Compared to the data for 2006, this represented a decrease of 20% (with a mean decrease of 4% per year). Based on these data, the death date in 2018n was projected to be 8.08 per 100,000 (with an uncertainty interval of 95% giving a range of 7.26-8.87). Similar data and analysis for women indicated that the reduction in the rate of fatalities has been smaller than that for men in recent years, i.e., 2.2% versus 4%. Although great progress has been made in reducing traffic accidents, to date, the death rate is still high among pedestrians. It is essential to continue to find ways to reduce traffic accidents and the pedestrians' deaths associated with them, especially among the elderly, who make up a disproportionate fraction of the deaths.

Widening of Socioeconomic Inequalities in U.S. Death Rates, 1993–2001

PubMed Central

Jemal, Ahmedin; Ward, Elizabeth; Anderson, Robert N.; Murray, Taylor; Thun, Michael J.

2008-01-01

Background Socioeconomic inequalities in death rates from all causes combined widened from 1960 until 1990 in the U.S., largely because cardiovascular death rates decreased more slowly in lower than in higher socioeconomic groups. However, no studies have examined trends in inequalities using recent US national data. Methodology/Principal Findings We calculated annual age-standardized death rates from 1993–2001 for 25–64 year old non-Hispanic whites and blacks by level of education for all causes and for the seven most common causes of death using death certificate information from 43 states and Washington, D.C. Regression analysis was used to estimate annual percent change. The inequalities in all cause death rates between Americans with less than high school education and college graduates increased rapidly from 1993 to 2001 due to both significant decreases in mortality from all causes, heart disease, cancer, stroke, and other conditions in the most educated and lack of change or increases among the least educated. For white women, the all cause death rate increased significantly by 3.2 percent per year in the least educated and by 0.7 percent per year in high school graduates. The rate ratio (RR) comparing the least versus most educated increased from 2.9 (95% CI, 2.8–3.1) in 1993 to 4.4 (4.1–4.6) in 2001 among white men, from 2.1 (1.8–2.5) to 3.4 (2.9–3–9) in black men, and from 2.6 (2.4–2.7) to 3.8 (3.6–4.0) in white women. Conclusion Socioeconomic inequalities in mortality are increasing rapidly due to continued progress by educated white and black men and white women, and stable or worsening trends among the least educated. PMID:18478119

Prediction of trauma-specific death rates of pedestrians of Fars Province, Iran

PubMed Central

Akbari, Maryam; Tabrizi, Reza; Heydari, Seyed Taghi; Sekhavati, Eghbal; Moosazadeh, Mahmood; Lankarani, Kamran Bagheri

2015-01-01

Introduction: Pedestrians are the most vulnerable group to accidents among road users. Due to the well-known concerns and complications of accidents involving pedestrians, the aim of this study was to identify the rate of such accidents for five-year period. Methods: We analyzed all fatalities among pedestrians caused by traffic accidents during years of 2009–2013 in Fars Province in Iran. The study was a cross-sectional study in which logistic regression analysis was used to predict the death rate among pedestrians. Sensitivity analysis using the Monte Carlo method was used to increase the accuracy of the results. Then, we predicted the death rates for the years 2014–2018 predicted and compared the results with the actual data from the previous five-year period (2009–2013). Results: During 2009–2013, 1723 out of 8689 (20.3%) of the people killed in traffic accidents were pedestrians. The death rate for male pedestrians in 2011 was estimated to be 10.86 per 100,000 (with an uncertainty interval of 95% giving a range of 9.85–12.05 per 100,000). Compared to the data for 2006, this represented a decrease of 20% (with a mean decrease of 4% per year). Based on these data, the death date in 2018n was projected to be 8.08 per 100,000 (with an uncertainty interval of 95% giving a range of 7.26–8.87). Similar data and analysis for women indicated that the reduction in the rate of fatalities has been smaller than that for men in recent years, i.e., 2.2% versus 4%. Conclusion: Although great progress has been made in reducing traffic accidents, to date, the death rate is still high among pedestrians. It is essential to continue to find ways to reduce traffic accidents and the pedestrians’ deaths associated with them, especially among the elderly, who make up a disproportionate fraction of the deaths. PMID:26435824

Overdose Deaths Involving Opioids, Cocaine, and Psychostimulants - United States, 2015-2016.

PubMed

Seth, Puja; Scholl, Lawrence; Rudd, Rose A; Bacon, Sarah

2018-03-30

During 1999‒2015, 568,699 persons died from drug overdoses in the United States.* Drug overdose deaths in the United States increased 11.4% from 2014 to 2015 resulting in 52,404 deaths in 2015, including 33,091 (63.1%) that involved an opioid. The largest rate increases from 2014 to 2015 occurred among deaths involving synthetic opioids other than methadone (synthetic opioids) (72.2%) (1). Because of demographic and geographic variations in overdose deaths involving different drugs (2,3), † CDC examined age-adjusted death rates for overdoses involving all opioids, opioid subcategories (i.e., prescription opioids, heroin, and synthetic opioids), § cocaine, and psychostimulants with abuse potential (psychostimulants) by demographics, urbanization levels, and in 31 states and the District of Columbia (DC). There were 63,632 drug overdose deaths in 2016; 42,249 (66.4%) involved an opioid. ¶ From 2015 to 2016, deaths increased across all drug categories examined. The largest overall rate increases occurred among deaths involving cocaine (52.4%) and synthetic opioids (100%), likely driven by illicitly manufactured fentanyl (IMF) (2,3). Increases were observed across demographics, urbanization levels, and states and DC. The opioid overdose epidemic in the United States continues to worsen. A multifaceted approach, with faster and more comprehensive surveillance, is needed to track emerging threats to prevent and respond to the overdose epidemic through naloxone availability, safe prescribing practices, harm-reduction services, linkage into treatment, and more collaboration between public health and public safety agencies.

Trends in Unintentional Fall-Related Traumatic Brain Injury Death Rates in Older Adults in the United States, 1980-2010: A Joinpoint Analysis.

PubMed

Sung, Kuan-Chin; Liang, Fu-Wen; Cheng, Tain-Junn; Lu, Tsung-Hsueh; Kawachi, Ichiro

2015-07-15

Unintentional fall-related traumatic brain injury (TBI) death rate is high in older adults in the United States, but little is known regarding trends of these death rates. We sought to examine unintentional fall-related TBI death rates by age and sex in older adults from 1980 through 2010 in the United States. We used multiple-cause mortality data from 1980 through 2010 (31 years of data) to identify fall-related TBI deaths. Using a joinpoint regression program, we determined the joinpoints (years at which trends change significantly) and annual percentage changes (APCs) in mortality trends. The fall-related TBI death rates (deaths per 100,000 population) in older adults ages 65-74, 75-84, and 85 years and above were 2.7, 9.2, and 21.5 for females and 8.5, 18.2, and 40.8 for males, respectively, in 1980. The rate was about the same in 1992, yet increased markedly to 5.9, 23.4, and 68.9 for females and 11.6, 41.2, and 112.4 for males, respectively, in 2010. For males all 65 years years of age and above, we found the first joinpoint in 1992, when the APC for 1980 through 1992, -0.8%, changed to 6.2% for 1992-2005. The second joinpoint occurred in 2005, when the APC decreased to 3.7% for 2005-2010. For all females 65 years of age and above, the first joinpoint was in 1993 when the APC for 1980 through 1993, -0.2%, changed to 7.6% from 1993 to 2005. The second joinpoint occurred in 2005 when the APC decreased to 3.8% for 2005-2010. This descriptive epidemiological study suggests increasing fall-related TBI death rates from 1992 to 2005 and then a slowdown of increasing trends between 2005 and 2010. Continued monitoring of fall-related TBI death rate trends is needed to determine the burden of this public health problem among older adults in the United States.

[The short-term effects of air pollution on mortality: the results of the EMECAM project in the municipality of Madrid, 1992-1995. Estudio Multicéntrico Español sobre la Relación entre la Contaminación Atmosférica y la Mortalidad].

PubMed

Galán Labaca, I; Aránguez Ruiz, E; Gandarillas Grande, A; Ordóñez Iriarte, J M; Aragonés Sanz, N

1999-01-01

Despite the changes which have taken place in the sources of emissions, the levels of particles, SO2 and CO continue to be high in the municipality of Madrid. Apart from this, photochemical pollutants, such as NO2 and O3 are taking on growing importance due to the increased number of cars and trucks on the road and the major degrees of sunlight in this city. The objective of this article is to set out the short-term relationship between the major pollutants and the daily death rate in the city of Madrid for the 1992-1995 period, using the standardized procedure of the EMECAM Projects (Spanish Multicenter Study of Air Pollution and Death Rate). The daily fluctuations in the death rate for all causes except external ones for all ages and for those individuals over age 69, in addition to those of the circulatory system and respiratory apparatus are related to the daily fluctuations in particles (PM10), SO2, NO2, CO and O3, by means of autoregressive Poisson regression models. The seasonality, tendency, temperature, relative humidity, flu, day of the week, holidays and events out of the ordinary are controlled. Statistically significant positive relationships were found to exist between SO2 and all of the death rate series analyzed, between CO and the death rate of individuals over age 69, as well as with cardiovascular and respiratory deaths and of the particles to the death rate as the result of cardiovascular disease. A statistically significant relationship was also found to exist between NO2 and the cardiovascular death rate. These impact are immediate, that is to say, they occur with the pollutants of the same day. No significant positive relationships were found to exist for O3. These findings suggest that, for a broad spectrum of major pollutants, the current levels of air pollution in Madrid are related to a rise in the death rate.

An updated study of taconite miners and millers exposed to silica and non-asbestiform amphiboles.

PubMed

Cooper, W C; Wong, O; Trent, L S; Harris, F

1992-12-01

This is the second update of a study of 3,444 taconite miners and millers who were first exposed to taconite, with associated exposures to silica and nonasbestiform amphiboles, in the period 1947 through 1958. Previous analyses of deaths through 1977, and again through 1983, showed no significant excess deaths from any specific causes. The present study continues the follow-up through 1988, adding 14,748 person-years of observation and 261 death certificates for analysis. The population, reduced to 3,431 because of the detection of 13 earlier duplications, has now been observed for 101,055 person-years, with 1,058 deaths and 1,039 death certificates. Death certificates were obtained for 98.2% of those known to be dead. The total number of deaths was significantly fewer than expected. Based on US rates, the standardized mortality ratio (SMR) was 83 (ie, 83% of expected). Based on Minnesota death rates, it was 91. With both US and Minnesota death rates, the SMRs for malignant neoplasms, cancer of the respiratory tract, cancer of the digestive system, heart disease, nonmalignant respiratory disease, and cirrhosis of the liver were all below 100. Slightly elevated SMRs were found for cancer of the colon, cancer of the kidney, and lymphopoietic cancer. These elevations were not statistically significant. Separate analyses were made of total deaths, lung cancer deaths, and kidney cancer deaths in men who had worked with taconite for time periods of less than 1 year, 1-5 years, 5-10 years, and over 10 years, during observation periods less than 10 years, 10-20 years, and over 20 years.(ABSTRACT TRUNCATED AT 250 WORDS)

Admission white blood cell count predicts short-term clinical outcomes in patients with uncomplicated Stanford type B acute aortic dissection.

PubMed

Chen, Zhao-Ran; Huang, Bi; Lu, Hai-Song; Zhao, Zhen-Hua; Hui, Ru-Tai; Yang, Yan-Min; Fan, Xiao-Han

2017-01-01

Inflammation has been shown to be related with acute aortic dissection (AAD). The present study aimed to evaluate the association of white blood cell counts (WBCc) on admission with both in-hospital and long-term all-cause mortality in patients with uncomplicated Stanford type B AAD. From 2008 to 2010, a total of 377 consecutive patients with uncomplicated type B AAD were enrolled and then followed up. Clinical data and WBCc on admission were collected. The primary end points were in-hospital death and long-term all-cause death. The in-hospital death rate was 4.2%, and the long-term all-cause mortality rate was 6.9% during a median follow-up of 18.9 months. WBCc on admission was identified as a risk factor for in-hospital death by univariate Cox regression analysis as both a continuous variable and a categorical variable using a cut off of 11.0 × 10 9 cell/L (all P < 0.05). After adjusting for age, sex and other risk factors, elevated admission WBCc was still a significant predictor for in-hospital death as both a continuous variable [hazard ratio (HR): 1.052, 95% CI: 1.024-1.336, P = 0.002] and a categorical variable using a cut off of 11.0 × 10 9 cell/L (HR: 2.056, 95% CI: 1.673-5.253, P = 0.034). No relationship was observed between WBCc on admission and long-term all-cause death. Our results indicate that elevated WBCc upon admission might be used as a predictor for increased risk of in-hospital death in uncomplicated type B AAD. There might be no predictive value of WBCc for the long-term survival of type B AAD.

Cross-National Trends in Mortality Rates among the Elderly.

ERIC Educational Resources Information Center

Myers, GeorgeC.

1978-01-01

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

High rates of homicide in a rural South African population (2000-2008): findings from a population-based cohort study.

PubMed

Otieno, George; Marinda, Edmore; Bärnighausen, Till; Tanser, Frank

2015-01-01

South Africa has continued to receive increasing attention due to unprecedented high levels of violence. Homicide-related violence accounts for a significant proportion of unnatural deaths and contributes significantly to loss of years of expected life. We investigated levels and factors associated with homicide-related deaths and identify communities with excessively high homicide risk in a typical rural South African population. Data drawn from verbal autopsies conducted on all deaths recorded during annual demographic and health surveillance in KwaZulu Natal, South Africa were used to derive the cumulative probability of death from homicide over a nine-year period (2000-2008). Weibull regression methods were used to investigate factors associated with homicide deaths. A Kulldorff spatial scan statistic was used to identify spatial clusters of homicide-related deaths. With 536 homicide-related deaths, and a median seven years of follow-up, the study found an overall homicide incidence rate of 66 deaths per 100, 000 person-years of observation (PYOs) (95 % CI 60-72) for the period under study. Death related to the use of firearms was the leading reported method of homicide (65 %) and most deaths occurred over weekends (43 %). Homicides are the second-most common cause of death in men aged 25-34 after HIV-related deaths (including TB) in this community, at 210 deaths per 100,000 PYOs, and was highest among 55-64 year old women, at 78 deaths per 100,000 PYOs. Residency status, age, socioeconomic status, and highest education level attained independently predicted the risk of homicide death. The spatial distribution of homicide deaths was not homogenous and the study identified two clear geographical clusters with significantly elevated homicide risk. The high rates of homicide observed in this typical rural South African population - particularly among men - underscore the need for urgent interventions to reduce this tragic and theoretically preventable loss of life in this population and similar South African settings.

Quantifying policy options for reducing future coronary heart disease mortality in England: a modelling study.

PubMed

Scholes, Shaun; Bajekal, Madhavi; Norman, Paul; O'Flaherty, Martin; Hawkins, Nathaniel; Kivimäki, Mika; Capewell, Simon; Raine, Rosalind

2013-01-01

To estimate the number of coronary heart disease (CHD) deaths potentially preventable in England in 2020 comparing four risk factor change scenarios. Using 2007 as baseline, the IMPACTSEC model was extended to estimate the potential number of CHD deaths preventable in England in 2020 by age, gender and Index of Multiple Deprivation 2007 quintiles given four risk factor change scenarios: (a) assuming recent trends will continue; (b) assuming optimal but feasible levels already achieved elsewhere; (c) an intermediate point, halfway between current and optimal levels; and (d) assuming plateauing or worsening levels, the worst case scenario. These four scenarios were compared to the baseline scenario with both risk factors and CHD mortality rates remaining at 2007 levels. This would result in approximately 97,000 CHD deaths in 2020. Assuming recent trends will continue would avert approximately 22,640 deaths (95% uncertainty interval: 20,390-24,980). There would be some 39,720 (37,120-41,900) fewer deaths in 2020 with optimal risk factor levels and 22,330 fewer (19,850-24,300) in the intermediate scenario. In the worst case scenario, 16,170 additional deaths (13,880-18,420) would occur. If optimal risk factor levels were achieved, the gap in CHD rates between the most and least deprived areas would halve with falls in systolic blood pressure, physical inactivity and total cholesterol providing the largest contributions to mortality gains. CHD mortality reductions of up to 45%, accompanied by significant reductions in area deprivation mortality disparities, would be possible by implementing optimal preventive policies.

Quantifying Policy Options for Reducing Future Coronary Heart Disease Mortality in England: A Modelling Study

PubMed Central

Scholes, Shaun; Bajekal, Madhavi; Norman, Paul; O’Flaherty, Martin; Hawkins, Nathaniel; Kivimäki, Mika; Capewell, Simon; Raine, Rosalind

2013-01-01

Aims To estimate the number of coronary heart disease (CHD) deaths potentially preventable in England in 2020 comparing four risk factor change scenarios. Methods and Results Using 2007 as baseline, the IMPACTSEC model was extended to estimate the potential number of CHD deaths preventable in England in 2020 by age, gender and Index of Multiple Deprivation 2007 quintiles given four risk factor change scenarios: (a) assuming recent trends will continue; (b) assuming optimal but feasible levels already achieved elsewhere; (c) an intermediate point, halfway between current and optimal levels; and (d) assuming plateauing or worsening levels, the worst case scenario. These four scenarios were compared to the baseline scenario with both risk factors and CHD mortality rates remaining at 2007 levels. This would result in approximately 97,000 CHD deaths in 2020. Assuming recent trends will continue would avert approximately 22,640 deaths (95% uncertainty interval: 20,390-24,980). There would be some 39,720 (37,120-41,900) fewer deaths in 2020 with optimal risk factor levels and 22,330 fewer (19,850-24,300) in the intermediate scenario. In the worst case scenario, 16,170 additional deaths (13,880-18,420) would occur. If optimal risk factor levels were achieved, the gap in CHD rates between the most and least deprived areas would halve with falls in systolic blood pressure, physical inactivity and total cholesterol providing the largest contributions to mortality gains. Conclusions CHD mortality reductions of up to 45%, accompanied by significant reductions in area deprivation mortality disparities, would be possible by implementing optimal preventive policies. PMID:23936122

The Validity of Race and Hispanic-origin Reporting on Death Certificates in the United States: An Update.

PubMed

Arias, Elizabeth; Heron, Melonie; Hakes, Jahn

2016-08-01

Objectives This report presents the findings of an updated study of the validity of race and Hispanic-origin reporting on death certificates in the United States, and its impact on race- and Hispanic origin-specific death rates. Methods The latest version of the National Longitudinal Mortality Study (NLMS) was used to evaluate the classification of race and Hispanic origin on death certificates for deaths occurring in 1999–2011 to decedents in NLMS. To evaluate change over time, these results were compared with those of a study based on an earlier version of NLMS that evaluated the quality of race and ethnicity classification on death certificates for 1979–1989 and 1990–1998. NLMS consists of a series of annual Current Population Survey files (1973 and 1978–2011) and a sample of the 1980 decennial census linked to death certificates for 1979–2011. Pooled 2009–2011 vital statistics mortality data and 2010 decennial census population data were used to estimate and compare observed and corrected race- and Hispanic origin-specific death rates. Results Race and ethnicity reporting on death certificates continued to be highly accurate for both white and black populations during the 1999–2011 period. Misclassification remained high at 40% for the American Indian or Alaska Native (AIAN) population. It improved, from 5% to 3%, for the Hispanic population, and from 7% to 3% for the Asian or Pacific Islander (API) population. Decedent characteristics such as place of residence and nativity affected the quality of reporting on the death certificate. Effects of misclassification on death rates were large for the AIAN population but not significant for the Hispanic or API populations.

Cancer statistics for African Americans, 2016: Progress and opportunities in reducing racial disparities.

PubMed

DeSantis, Carol E; Siegel, Rebecca L; Sauer, Ann Goding; Miller, Kimberly D; Fedewa, Stacey A; Alcaraz, Kassandra I; Jemal, Ahmedin

2016-07-01

In this article, the American Cancer Society provides the estimated number of new cancer cases and deaths for blacks in the United States and the most recent data on cancer incidence, mortality, survival, screening, and risk factors for cancer. Incidence data are from the National Cancer Institute, the Centers for Disease Control and Prevention, and the North American Association of Central Cancer Registries, and mortality data are from the National Center for Health Statistics. Approximately 189,910 new cases of cancer and 69,410 cancer deaths will occur among blacks in 2016. Although blacks continue to have higher cancer death rates than whites, the disparity has narrowed for all cancers combined in men and women and for lung and prostate cancers in men. In contrast, the racial gap in death rates has widened for breast cancer in women and remained level for colorectal cancer in men. The reduction in overall cancer death rates since the early 1990s translates to the avoidance of more than 300,000 deaths among blacks. In men, incidence rates from 2003 to 2012 decreased for all cancers combined (by 2.0% per year) as well as for the top 3 cancer sites (prostate, lung, and colorectal). In women, overall rates during the corresponding time period remained unchanged, reflecting increasing trends in breast cancer combined with decreasing trends in lung and colorectal cancer rates. Five-year relative survival is lower for blacks than whites for most cancers at each stage of diagnosis. The extent to which these disparities reflect unequal access to health care versus other factors remains an active area of research. Progress in reducing cancer death rates could be accelerated by ensuring equitable access to prevention, early detection, and high-quality treatment. CA Cancer J Clin 2016;66:290-308. © 2016 American Cancer Society. © 2016 American Cancer Society, Inc.

Causes of death among females-investigating beyond maternal causes: a community-based longitudinal study.

PubMed

Melaku, Yohannes Adama; Weldearegawi, Berhe; Aregay, Alemseged; Tesfay, Fisaha Haile; Abreha, Loko; Abera, Semaw Ferede; Bezabih, Afework Mulugeta

2014-09-10

In developing countries, investigating mortality levels and causes of death among all age female population despite the childhood and maternal related deaths is important to design appropriate and tailored interventions and to improve survival of female residents. Under Kilite-Awlealo Health and Demographic Surveillance System, we investigated mortality rates and causes of death in a cohort of female population from 1st of January 2010 to 31st of December 2012. At the baseline, 33,688 females were involved for the prospective follow-up study. Households under the study were updated every six months by fulltime surveillance data collectors to identify vital events, including deaths. Verbal Autopsy (VA) data were collected by separate trained data collectors for all identified deaths in the surveillance site. Trained physicians assigned underlining causes of death using the 10th edition of International Classification of Diseases (ICD). We assessed overall, age- and cause-specific mortality rates per 1000 person-years. Causes of death among all deceased females and by age groups were ranked based on cause specific mortality rates. Analysis was performed using Stata Version 11.1. During the follow-up period, 105,793.9 person-years of observation were generated, and 398 female deaths were recorded. This gave an overall mortality rate of 3.76 (95% confidence interval (CI): 3.41, 4.15) per 1,000 person-years. The top three broad causes of death were infectious and parasitic diseases (1.40 deaths per 1000 person-years), non-communicable diseases (0.98 deaths per 1000 person-years) and external causes (0.36 per 1000 person-years). Most deaths among reproductive age female were caused by Human Deficiency Virus/Acquired Immune Deficiency Virus (HIV/AIDS) and tuberculosis (0.14 per 1000 person-years for each cause). Pregnancy and childbirth related causes were responsible for few deaths among women of reproductive age--3 out of 73 deaths (4.1%) or 5.34 deaths per 1,000 person-years. Communicable diseases are continued to be the leading causes of death among all age females. HIV/AIDS and tuberculosis were major causes of death among women of reproductive age. Together with existing efforts to prevent pregnancy and childbirth related deaths, public health and curative interventions on other causes, particularly on HIV/AIDS and tuberculosis, should be strengthened.

Estimation for general birth-death processes

PubMed Central

Crawford, Forrest W.; Minin, Vladimir N.; Suchard, Marc A.

2013-01-01

Birth-death processes (BDPs) are continuous-time Markov chains that track the number of “particles” in a system over time. While widely used in population biology, genetics and ecology, statistical inference of the instantaneous particle birth and death rates remains largely limited to restrictive linear BDPs in which per-particle birth and death rates are constant. Researchers often observe the number of particles at discrete times, necessitating data augmentation procedures such as expectation-maximization (EM) to find maximum likelihood estimates. For BDPs on finite state-spaces, there are powerful matrix methods for computing the conditional expectations needed for the E-step of the EM algorithm. For BDPs on infinite state-spaces, closed-form solutions for the E-step are available for some linear models, but most previous work has resorted to time-consuming simulation. Remarkably, we show that the E-step conditional expectations can be expressed as convolutions of computable transition probabilities for any general BDP with arbitrary rates. This important observation, along with a convenient continued fraction representation of the Laplace transforms of the transition probabilities, allows for novel and efficient computation of the conditional expectations for all BDPs, eliminating the need for truncation of the state-space or costly simulation. We use this insight to derive EM algorithms that yield maximum likelihood estimation for general BDPs characterized by various rate models, including generalized linear models. We show that our Laplace convolution technique outperforms competing methods when they are available and demonstrate a technique to accelerate EM algorithm convergence. We validate our approach using synthetic data and then apply our methods to cancer cell growth and estimation of mutation parameters in microsatellite evolution. PMID:25328261

Estimation for general birth-death processes.

PubMed

Crawford, Forrest W; Minin, Vladimir N; Suchard, Marc A

2014-04-01

Birth-death processes (BDPs) are continuous-time Markov chains that track the number of "particles" in a system over time. While widely used in population biology, genetics and ecology, statistical inference of the instantaneous particle birth and death rates remains largely limited to restrictive linear BDPs in which per-particle birth and death rates are constant. Researchers often observe the number of particles at discrete times, necessitating data augmentation procedures such as expectation-maximization (EM) to find maximum likelihood estimates. For BDPs on finite state-spaces, there are powerful matrix methods for computing the conditional expectations needed for the E-step of the EM algorithm. For BDPs on infinite state-spaces, closed-form solutions for the E-step are available for some linear models, but most previous work has resorted to time-consuming simulation. Remarkably, we show that the E-step conditional expectations can be expressed as convolutions of computable transition probabilities for any general BDP with arbitrary rates. This important observation, along with a convenient continued fraction representation of the Laplace transforms of the transition probabilities, allows for novel and efficient computation of the conditional expectations for all BDPs, eliminating the need for truncation of the state-space or costly simulation. We use this insight to derive EM algorithms that yield maximum likelihood estimation for general BDPs characterized by various rate models, including generalized linear models. We show that our Laplace convolution technique outperforms competing methods when they are available and demonstrate a technique to accelerate EM algorithm convergence. We validate our approach using synthetic data and then apply our methods to cancer cell growth and estimation of mutation parameters in microsatellite evolution.

Mortality among Hispanic drug users in Puerto Rico.

PubMed

Robles, Rafaela R; Matos, Tomás D; Colón, Héctor M; Sahai, Hardeo; Reyes, Juan C; Marrero, C Amalia; Calderón, José M

2003-12-01

This paper assesses mortality rate for a cohort of drug users in Puerto Rico compared with that of the Island's general population, examining causes of death and estimating relative risk of death. Date and cause of death were obtained from death certificates during 1998. Vital status was confirmed through contact with subjects, family, and friends. HIV/AIDS was the major cause of death (47.7%), followed by homicide (14.6%), and accidental poisoning (6.3%). Females had higher relative risk of death than males in all age categories. Not living with a sex partner and not receiving drug treatment were related to higher mortality due to HIV/AIDS. Drug injection was the only variable explaining relative risk of death due to overdose. Puerto Rico needs to continue developing programs to prevent HIV/AIDS among drug users. Special attention should be given to young women, who appear to be in greatest need of programs to prevent early mortality.

Suicide and accidental deaths in children and adolescents in England and Wales, 2001-2010.

PubMed

Windfuhr, Kirsten; While, David; Hunt, Isabelle M; Shaw, Jenny; Appleby, Louis; Kapur, Nav

2013-12-01

To investigate the impact of narrative verdicts on suicide statistics among 10-19-year-olds; to identify the number and rate of suicide and accidental deaths, particularly in 10-14-year-olds. National cohort study. England and Wales. Mid-year population estimates from the Office for National Statistics (ONS) were used to calculate rates per 100,000 population for suicide (undetermined and suicide verdicts) and accidental deaths (poisoning, hanging) for those aged 10-14 and 15-19. Trends in rates over time (2001-2010) were investigated using Poisson regression. Interaction tests were carried out to determine differences in trends between the two time periods (2001-2005 and 2006-2010). There were 1523 suicides (2.25/100,000). Suicide rates were highest in those aged 15-19 years (4.04/100,000) and in males (3.14/100,000). Between 2001 and 2010, rates significantly decreased among those aged 15-19 years (incidence rate-ratio (IRR): 0.95; 95% CI 0.93 to 0.97), with no change in rates of accidental deaths (IRR: 1.01, 95% CI 0.95 to 1.07). However, there was a significant interaction between the two time periods for accidental poisonings (2001-2005: IRR: 0.79 (95% CI 0.69 to 0.91); 2006-2010: IRR: 1.01 (95% CI 0.89 to 1.15), interaction p=0.012) and accidental hangings (2001-2005: IRR: 0.93 (95% CI 0.76 to 1.14); 2006-2010: IRR: 1.25 (95% CI 1.04 to 1.49), interaction=0.01) Undetermined deaths significantly decreased among females aged 15-19 yeras (IRR: 0.93; 95% CI 0.88 to 0.98). There were no significant trends among 10-14-year-olds. Rates of suicide are higher among older adolescents and males. There was a significant fall in suicide rates in males aged 15-19 years that was not accounted for by changes in rates of accidental death. The absence of a significant trend in suicide or accidental deaths in those aged 10-14 years may have been the result of small numbers. However, monitoring should continue to identify longitudinal trends in all young people.

Long-term effects of continuing adjuvant tamoxifen to 10 years versus stopping at 5 years after diagnosis of oestrogen receptor-positive breast cancer: ATLAS, a randomised trial.

PubMed

Davies, Christina; Pan, Hongchao; Godwin, Jon; Gray, Richard; Arriagada, Rodrigo; Raina, Vinod; Abraham, Mirta; Medeiros Alencar, Victor Hugo; Badran, Atef; Bonfill, Xavier; Bradbury, Joan; Clarke, Michael; Collins, Rory; Davis, Susan R; Delmestri, Antonella; Forbes, John F; Haddad, Peiman; Hou, Ming-Feng; Inbar, Moshe; Khaled, Hussein; Kielanowska, Joanna; Kwan, Wing-Hong; Mathew, Beela S; Mittra, Indraneel; Müller, Bettina; Nicolucci, Antonio; Peralta, Octavio; Pernas, Fany; Petruzelka, Lubos; Pienkowski, Tadeusz; Radhika, Ramachandran; Rajan, Balakrishnan; Rubach, Maryna T; Tort, Sera; Urrútia, Gerard; Valentini, Miriam; Wang, Yaochen; Peto, Richard

2013-03-09

For women with oestrogen receptor (ER)-positive early breast cancer, treatment with tamoxifen for 5 years substantially reduces the breast cancer mortality rate throughout the first 15 years after diagnosis. We aimed to assess the further effects of continuing tamoxifen to 10 years instead of stopping at 5 years. In the worldwide Adjuvant Tamoxifen: Longer Against Shorter (ATLAS) trial, 12,894 women with early breast cancer who had completed 5 years of treatment with tamoxifen were randomly allocated to continue tamoxifen to 10 years or stop at 5 years (open control). Allocation (1:1) was by central computer, using minimisation. After entry (between 1996 and 2005), yearly follow-up forms recorded any recurrence, second cancer, hospital admission, or death. We report effects on breast cancer outcomes among the 6846 women with ER-positive disease, and side-effects among all women (with positive, negative, or unknown ER status). Long-term follow-up still continues. This study is registered, number ISRCTN19652633. Among women with ER-positive disease, allocation to continue tamoxifen reduced the risk of breast cancer recurrence (617 recurrences in 3428 women allocated to continue vs 711 in 3418 controls, p=0·002), reduced breast cancer mortality (331 deaths vs 397 deaths, p=0·01), and reduced overall mortality (639 deaths vs 722 deaths, p=0·01). The reductions in adverse breast cancer outcomes appeared to be less extreme before than after year 10 (recurrence rate ratio [RR] 0·90 [95% CI 0·79–1·02] during years 5–9 and 0·75 [0·62–0·90] in later years; breast cancer mortality RR 0·97 [0·79–1·18] during years 5–9 and 0·71 [0·58–0·88] in later years). The cumulative risk of recurrence during years 5–14 was 21·4% for women allocated to continue versus 25·1% for controls; breast cancer mortality during years 5–14 was 12·2% for women allocated to continue versus 15·0% for controls (absolute mortality reduction 2·8%). Treatment allocation seemed to have no effect on breast cancer outcome among 1248 women with ER-negative disease, and an intermediate effect among 4800 women with unknown ER status. Among all 12,894 women, mortality without recurrence from causes other than breast cancer was little affected (691 deaths without recurrence in 6454 women allocated to continue versus 679 deaths in 6440 controls; RR 0·99 [0·89–1·10]; p=0·84). For the incidence (hospitalisation or death) rates of specific diseases, RRs were as follows: pulmonary embolus 1·87 (95% CI 1·13–3·07, p=0·01 [including 0·2% mortality in both treatment groups]), stroke 1·06 (0·83–1·36), ischaemic heart disease 0·76 (0·60–0·95, p=0·02), and endometrial cancer 1·74 (1·30–2·34, p=0·0002). The cumulative risk of endometrial cancer during years 5–14 was 3·1% (mortality 0·4%) for women allocated to continue versus 1·6% (mortality 0·2%) for controls (absolute mortality increase 0·2%). For women with ER-positive disease, continuing tamoxifen to 10 years rather than stopping at 5 years produces a further reduction in recurrence and mortality, particularly after year 10. These results, taken together with results from previous trials of 5 years of tamoxifen treatment versus none, suggest that 10 years of tamoxifen treatment can approximately halve breast cancer mortality during the second decade after diagnosis. Cancer Research UK, UK Medical Research Council, AstraZeneca UK, US Army, EU-Biomed.

Long-term effects of continuing adjuvant tamoxifen to 10 years versus stopping at 5 years after diagnosis of oestrogen receptor-positive breast cancer: ATLAS, a randomised trial

PubMed Central

Davies, Christina; Pan, Hongchao; Godwin, Jon; Gray, Richard; Arriagada, Rodrigo; Raina, Vinod; Abraham, Mirta; Alencar, Victor Hugo Medeiros; Badran, Atef; Bonfill, Xavier; Bradbury, Joan; Clarke, Michael; Collins, Rory; Davis, Susan R; Delmestri, Antonella; Forbes, John F; Haddad, Peiman; Hou, Ming-Feng; Inbar, Moshe; Khaled, Hussein; Kielanowska, Joanna; Kwan, Wing-Hong; Mathew, Beela S; Müller, Bettina; Nicolucci, Antonio; Peralta, Octavio; Pernas, Fany; Petruzelka, Lubos; Pienkowski, Tadeusz; Rajan, Balakrishnan; Rubach, Maryna T; Tort, Sera; Urrútia, Gerard; Valentini, Miriam; Wang, Yaochen; Peto, Richard

2013-01-01

Summary Background For women with oestrogen receptor (ER)-positive early breast cancer, treatment with tamoxifen for 5 years substantially reduces the breast cancer mortality rate throughout the first 15 years after diagnosis. We aimed to assess the further effects of continuing tamoxifen to 10 years instead of stopping at 5 years. Methods In the worldwide Adjuvant Tamoxifen: Longer Against Shorter (ATLAS) trial, 12 894 women with early breast cancer who had completed 5 years of treatment with tamoxifen were randomly allocated to continue tamoxifen to 10 years or stop at 5 years (open control). Allocation (1:1) was by central computer, using minimisation. After entry (between 1996 and 2005), yearly follow-up forms recorded any recurrence, second cancer, hospital admission, or death. We report effects on breast cancer outcomes among the 6846 women with ER-positive disease, and side-effects among all women (with positive, negative, or unknown ER status). Long-term follow-up still continues. This study is registered, number ISRCTN19652633. Findings Among women with ER-positive disease, allocation to continue tamoxifen reduced the risk of breast cancer recurrence (617 recurrences in 3428 women allocated to continue vs 711 in 3418 controls, p=0·002), reduced breast cancer mortality (331 deaths vs 397 deaths, p=0·01), and reduced overall mortality (639 deaths vs 722 deaths, p=0·01). The reductions in adverse breast cancer outcomes appeared to be less extreme before than after year 10 (recurrence rate ratio [RR] 0·90 [95% CI 0·79–1·02] during years 5–9 and 0·75 [0·62–0·90] in later years; breast cancer mortality RR 0·97 [0·79–1·18] during years 5–9 and 0·71 [0·58–0·88] in later years). The cumulative risk of recurrence during years 5–14 was 21·4% for women allocated to continue versus 25·1% for controls; breast cancer mortality during years 5–14 was 12·2% for women allocated to continue versus 15·0% for controls (absolute mortality reduction 2·8%). Treatment allocation seemed to have no effect on breast cancer outcome among 1248 women with ER-negative disease, and an intermediate effect among 4800 women with unknown ER status. Among all 12 894 women, mortality without recurrence from causes other than breast cancer was little affected (691 deaths without recurrence in 6454 women allocated to continue versus 679 deaths in 6440 controls; RR 0·99 [0·89–1·10]; p=0·84). For the incidence (hospitalisation or death) rates of specific diseases, RRs were as follows: pulmonary embolus 1·87 (95% CI 1·13–3·07, p=0·01 [including 0·2% mortality in both treatment groups]), stroke 1·06 (0·83–1·36), ischaemic heart disease 0·76 (0·60–0·95, p=0·02), and endometrial cancer 1·74 (1·30–2·34, p=0·0002). The cumulative risk of endometrial cancer during years 5–14 was 3·1% (mortality 0·4%) for women allocated to continue versus 1·6% (mortality 0·2%) for controls (absolute mortality increase 0·2%). Interpretation For women with ER-positive disease, continuing tamoxifen to 10 years rather than stopping at 5 years produces a further reduction in recurrence and mortality, particularly after year 10. These results, taken together with results from previous trials of 5 years of tamoxifen treatment versus none, suggest that 10 years of tamoxifen treatment can approximately halve breast cancer mortality during the second decade after diagnosis. Funding Cancer Research UK, UK Medical Research Council, AstraZeneca UK, US Army, EU-Biomed. PMID:23219286

Controlled population-based comparative study of USA and international adult [55-74] neurological deaths 1989-2014.

PubMed

Pritchard, C; Rosenorn-Lanng, E; Silk, A; Hansen, L

2017-12-01

A population-based controlled study to determine whether adult (55-74 years) neurological disease deaths are continuing to rise and are there significant differences between America and the twenty developed countries 1989-91 and 2012-14. Total Neurological Deaths (TND) rates contrasted against control Cancer and Circulatory Disease Deaths (CDD) extrapolated from WHO data. Confidence intervals compare USA and the other countries over the period. The Over-75's TND and population increases are examined as a context for the 55-74 outcomes. Male neurological deaths rose >10% in eleven countries, the other countries average rose 20% the USA 43% over the period. Female neurological deaths rose >10% in ten counties, averaging 14%, the USA up 68%. USA male and female neurological deaths increased significantly more than twelve and seventeen countries, respectively. USA over-75s population increased by 49%, other countries 56%. Other countries TND up 187% the USA rose fourfold. Male and female cancer and CDD fell in every country averaging 26% and 21%, respectively, and 64% and 67% for CDD. Male neurological rates rose significantly more than Cancer and CCD in every country; Female neurological deaths rose significantly more than cancer in 17 countries and every country for CDD. There was no significant correlation between increases in neurological deaths and decreases in control mortalities. There are substantial increases in neurological deaths in most countries, significantly so in America. Rises in the 55-74 and over-75's rates are not primarily due to demographic changes and are a matter of concern warranting further investigation. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Death and Dialysis After Transcatheter Aortic Valve Replacement: An Analysis of the STS/ACC TVT Registry.

PubMed

Hansen, James W; Foy, Andrew; Yadav, Pradeep; Gilchrist, Ian C; Kozak, Mark; Stebbins, Amanda; Matsouaka, Roland; Vemulapalli, Sreekanth; Wang, Alice; Wang, Dee Dee; Eng, Marvin H; Greenbaum, Adam B; O'Neill, William O

2017-10-23

The authors sought to elucidate the true incidence of renal replacement therapy (RRT) after transcatheter aortic valve replacement (TAVR). There is a wide discrepancy in the reported rate of RRT after TAVR (1.4% to 40%). The true incidence of RRT after TAVR is unknown. The STS/ACC TVT (Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy) registry was linked to the Centers for Medicare & Medicaid database to identify all patients that underwent TAVR from November 2011 through September 2015 and their outcomes. The authors compared rates of death, new RRT, and a composite of both as a function of pre-procedure glomerular filtration rate (GFR), both in stages of chronic kidney disease (CKD), as well as on a continuous scale. Pre-procedure GFR is associated with the risk of death and new RRT after TAVR when GFR is <60 ml/min/m 2 , and increases significantly when GFR falls below 30 ml/min/m 2 . Incremental increases in GFR of 5 ml/min/m 2 were statistically significant (unadjusted hazard ratio: 0.71; p < 0.001) at 30 days, and continued to be significant at 1 year when pre-procedure GFR was <60 ml/min/m 2 . One in 3 CKD stage 4 patients will be dead within 1 year, with 14.6% (roughly 1 in 6) requiring dialysis. In CKD stage 5, more than one-third of patients will require RRT within 30 days; nearly two-thirds will require RRT at 1 year. In both unadjusted and adjusted analysis, pre-procedural GFR was associated with the outcomes of death and new RRT. Increasing CKD stage leads to an increased risk of death and/or RRT. Continuous analysis showed significant differences in outcomes in all levels of CKD when GFR was <60 ml/min/m 2 . Pre-procedure GFR should be considered when selecting CKD patients for TAVR. Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

42 CFR 23.31 - May loan payments be postponed or waived?

Code of Federal Regulations, 2011 CFR

2011-10-01

..., interest will continue to accrue at the rate specified in the promissory note until the loan is repaid in... shall be cancelled upon the death or total and permanent disability of the borrower, as determined by...

Patterns and trends in accidental poisoning death rates in the US, 1979-2014.

PubMed

Buchanich, Jeanine M; Balmert, Lauren C; Pringle, Janice L; Williams, Karl E; Burke, Donald S; Marsh, Gary M

2016-08-01

The purpose of this study was to examine US accidental poisoning death rates by demographic and geographic factors from 1979 to 2014, including High Intensity Drug Trafficking Areas. Crude and age-adjusted death rates were formed for age group, race, sex, and county for accidental poisonings (ICD 9th revision: E850-E869; ICD 10th revision: X40-X49) from 1979 to 2014 using the Mortality and Population Data System housed at the University of Pittsburgh. Rate ratios were calculated comparing rates from 2014 to 1979, overall, by sex, age group, race, and county. Joinpoint regression detected changes in trends and calculated the average annual percentage change (AAPC) as a summary measure of trend. Drug poisoning mortality rates have risen an average of 6% per year since 1979. Increases are occurring in all ages 15+, and in all race-sex groups. HIDTA counties with the highest mortality rates were in Appalachia and New Mexico. Many of the HIDTA border counties had lower rates of mortality. The drug poisoning mortality epidemic is continuing to grow. While HIDTA resources are appropriately targeted at many areas in the US most affected, rates are also rapidly rising in some non-HIDTA areas. Copyright © 2016 Elsevier Inc. All rights reserved.

Mortality among young injection drug users in San Francisco: a 10-year follow-up of the UFO study.

PubMed

Evans, Jennifer L; Tsui, Judith I; Hahn, Judith A; Davidson, Peter J; Lum, Paula J; Page, Kimberly

2012-02-15

This study examined associations between mortality and demographic and risk characteristics among young injection drug users in San Francisco, California, and compared the mortality rate with that of the population. A total of 644 young (<30 years) injection drug users completed a baseline interview and were enrolled in a prospective cohort study, known as the UFO ("U Find Out") Study, from November 1997 to December 2007. Using the National Death Index, the authors identified 38 deaths over 4,167 person-years of follow-up, yielding a mortality rate of 9.1 (95% confidence interval: 6.6, 12.5) per 1,000 person-years. This mortality rate was 10 times that of the general population. The leading causes of death were overdose (57.9%), self-inflicted injury (13.2%), trauma/accidents (10.5%), and injection drug user-related medical conditions (13.1%). Mortality incidence was significantly higher among those who reported injecting heroin most days in the past month (adjusted hazard ratio = 5.8, 95% confidence interval: 1.4, 24.3). The leading cause of death in this group was overdose, and primary use of heroin was the only significant risk factor for death observed in the study. These findings highlight the continued need for public health interventions that address the risk of overdose in this population in order to reduce premature deaths.

Mortality Among Young Injection Drug Users in San Francisco: A 10-Year Follow-up of the UFO Study

PubMed Central

Evans, Jennifer L.; Tsui, Judith I.; Hahn, Judith A.; Davidson, Peter J.; Lum, Paula J.; Page, Kimberly

2012-01-01

This study examined associations between mortality and demographic and risk characteristics among young injection drug users in San Francisco, California, and compared the mortality rate with that of the population. A total of 644 young (<30 years) injection drug users completed a baseline interview and were enrolled in a prospective cohort study, known as the UFO (“U Find Out”) Study, from November 1997 to December 2007. Using the National Death Index, the authors identified 38 deaths over 4,167 person-years of follow-up, yielding a mortality rate of 9.1 (95% confidence interval: 6.6, 12.5) per 1,000 person-years. This mortality rate was 10 times that of the general population. The leading causes of death were overdose (57.9%), self-inflicted injury (13.2%), trauma/accidents (10.5%), and injection drug user-related medical conditions (13.1%). Mortality incidence was significantly higher among those who reported injecting heroin most days in the past month (adjusted hazard ratio = 5.8, 95% confidence interval: 1.4, 24.3). The leading cause of death in this group was overdose, and primary use of heroin was the only significant risk factor for death observed in the study. These findings highlight the continued need for public health interventions that address the risk of overdose in this population in order to reduce premature deaths. PMID:22227793

Mortality trends in northern sea otters (Enhydra lutris kenyoni) collected from the coasts of Washington and Oregon (2002–15)

USGS Publications Warehouse

White, C. LeAnn; Lankau, Emily W.; Lynch, Deanna; Knowles, Susan N.; Schuler, Krysten L.; Dubey, Jitender P.; Shearn-Bochsler, Valerie I.; Isidoro Ayza, Marcos; Thomas, Nancy J.

2018-01-01

During 2002−15 we examined the causes of mortality in a population of northern sea otters (Enhydra lutris kenyoni). Beachcast sea otters were collected primarily from the coast of Washington. Although there are no permanent sea otter residents in Oregon, several beachcast otters were collected from the Oregon coast. Infectious diseases were the primary cause of death (56%) for otters we examined. Sarcocystosis was the leading infectious cause of death (54%) and was observed throughout the study period. Some infectious diseases, such as morbilliviral encephalitis and leptospirosis, were documented for a limited number of years and then not detected again despite continued testing for these pathogens in necropsied animals. Trauma was the second most common cause of death (14%) during the study period. The continued stable growth of the Washington population of otters suggests they are able to tolerate current mortality rates.

Predicting and analyzing the trend of traffic accidents deaths in Iran in 2014 and 2015.

PubMed

Mehmandar, Mohammadreza; Soori, Hamid; Mehrabi, Yadolah

2016-01-01

Predicting the trend in traffic accidents deaths and its analysis can be a useful tool for planning and policy-making, conducting interventions appropriate with death trend, and taking the necessary actions required for controlling and preventing future occurrences. Predicting and analyzing the trend of traffic accidents deaths in Iran in 2014 and 2015. It was a cross-sectional study. All the information related to fatal traffic accidents available in the database of Iran Legal Medicine Organization from 2004 to the end of 2013 were used to determine the change points (multi-variable time series analysis). Using autoregressive integrated moving average (ARIMA) model, traffic accidents death rates were predicted for 2014 and 2015, and a comparison was made between this rate and the predicted value in order to determine the efficiency of the model. From the results, the actual death rate in 2014 was almost similar to that recorded for this year, while in 2015 there was a decrease compared with the previous year (2014) for all the months. A maximum value of 41% was also predicted for the months of January and February, 2015. From the prediction and analysis of the death trends, proper application and continuous use of the intervention conducted in the previous years for road safety improvement, motor vehicle safety improvement, particularly training and culture-fostering interventions, as well as approval and execution of deterrent regulations for changing the organizational behaviors, can significantly decrease the loss caused by traffic accidents.

Implantable Cardioverter-Defibrillators in Patients With a Continuous-Flow Left Ventricular Assist Device: An Analysis of the INTERMACS Registry.

PubMed

Clerkin, Kevin J; Topkara, Veli K; Demmer, Ryan T; Dizon, Jose M; Yuzefpolskaya, Melana; Fried, Justin A; Mai, Xingchen; Mancini, Donna M; Takeda, Koji; Takayama, Hiroo; Naka, Yoshifumi; Colombo, Paolo C; Garan, A Reshad

2017-12-01

This study sought to determine if the presence of implantable cardioverter-defibrillators (ICD) provided a mortality benefit during continuous-flow left ventricular assist device (LVAD) support. An ICD decreases mortality in selected patients with advanced heart failure and have been associated with reduced mortality in patients with pulsatile LVAD. However, it is unclear whether that benefit extends to patients with a contemporary continuous-flow LVAD. Propensity score matching was used to generate a cohort of patients with similar baseline characteristics. The primary outcome was freedom from death during LVAD support. Secondary endpoints included freedom from unexpected death, likelihood of transplantation and recovery, and adverse events. Among 16,384 eligible patients in the Interagency Registry for Mechanically Assisted Circulatory Support registry, 2,209 patients with an ICD and 2,209 patients without one had similar propensity scores and were included. The presence of an ICD was associated with an increased mortality risk (hazard ratio: 1.20; 95% confidence interval [CI]: 1.04 to 1.39; p = 0.013) and an increased risk of unexpected death during device support (HR: 1.33; 95% CI: 1.03 to 1.71; p = 0.03). Patients with an ICD were more likely to undergo transplantation (HR: 1.16; 95% CI: 0.99 to 1.35; p = 0.06) and less likely to have LVAD explant for recovery (HR: 0.53, 95% CI: 0.29 to 0.98; p = 0.04). Patients with an ICD had a higher rate of treated ventricular arrhythmias (rate ratio: 1.27; 95% CI: 1.10 to 1.48; p = 0.001) and rehospitalization (rate ratio: 1.08; 95% CI: 1.04 to 1.12; p < 0.0001), but rates of hemorrhagic stroke were similar (rate ratio: 1.01; 95% CI: 0.81 to 1.26; p = 0.98). Among patients with a continuous flow LVAD, the presence of an ICD was not associated with reduced mortality. Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Should apparently uncomplicated monochorionic twins be delivered electively at 32 weeks?

PubMed

Domingues, Ana Patrícia; Fonseca, Etelvina; Vasco, Elsa; Moura, Paulo

2009-11-01

We aimed to estimate the optimal time of delivery and investigated the residual risk of fetal death after viability in otherwise uncomplicated monochorionic diamniotic twin pregnancies. A database of 576 completed multiple pregnancies that were managed in our tertiary referral fetal medicine department between 1996 and 2007 was reviewed and the uncomplicated 111 monochorionic and the 290 dichorionic diamniotic twin pregnancies delivered after 24 weeks were selected. The rate of fetal death was derived for two-week periods starting at 24 weeks' gestation and the prospective risk of fetal death was calculated by determining the number of intrauterine fetal deaths that occurred within the two-week block divided by the number of continuing uncomplicated monochorionic twin pregnancies during that same time period. The unexpected single intrauterine deaths rate was 2.7% versus 2.8% in previously uncomplicated monochorionic and dichorionic diamniotic pregnancies, respectively. The prospective risk of unexpected stillbirth after 32 weeks of gestation was 1.3% for monochorionic and 0.8% for dichorionic pregnancies. In otherwise apparently uncomplicated monochorionic diamniotic pregnancies this prospective risk of fetal death after 32 weeks of gestation is lower than reported and similar to that of dichorionic pregnancies, so does not sustain the theory of elective preterm delivery.

OPTN/SRTR 2016 Annual Data Report: Lung.

PubMed

Valapour, M; Lehr, C J; Skeans, M A; Smith, J M; Carrico, R; Uccellini, K; Lehman, R; Robinson, A; Israni, A K; Snyder, J J; Kasiske, B L

2018-01-01

In 2016, 2692 candidates aged 12 years or older were added to the lung transplant waiting list; 2345 transplants were performed, the largest number of any prior year. The median waiting time for listed candidates in 2016 was 2.5 months, and waiting times were shortest for group D candidates. The transplant rate increased to 191.9 transplants per 100 waitlist years in 2016, with a slight decrease in waitlist mortality to 15.1 deaths per 100 waitlist years. Short-term survival continued to improve, with a 6-month death rate of 6.6% and a 1-year death rate of 10.8% among recipients in 2015 compared with 8.0% and 13.3%, respectively, among recipients in 2014. Long-term survival rates remained unchanged; 55.6% of recipients were alive at 5 years. In 2016, 23 new candidates aged 0-11 years were added to the waiting list and 16 lung transplants were performed. Incidence of posttransplant mortality for lung transplant recipients aged 0-11 years who underwent transplant in 2014-2015 was 13.8% at 6 months and 19.6% at 1 year. Changes in waitlist and transplant demographic features continued to evolve following implementation of the revised lung allocation score in 2015. Some early trends that may be attributable to the revised LAS are shorter waiting times, stabilization of the number of group D candidates listed for transplant, and convergence of LAS with lower prevalence of extremely high scores.  .

[Chile: mortality between 1 and 4 years of age. Trends and causes].

PubMed

Taucher, E

1981-08-01

The great decline in infant mortality in Chile in the last 2 decades provokes interest in the current situation in child mortality (for children 1-4 years of age). For the present analysis, central death rates and probabilities of dying are used, calculated with Greville's method from birth and death data. Mortality trends of the group between 1961-78, sex differentials, and causes of death are studied. The findings indicate that mortality in this age group has declined dramatically during the period of analysis, mainly due to the decrease in mortality from respiratory diseases, diarrhea, and diseases avoidable through vaccination. To attain the future approach of the Chilean rate to that of more developed countries, the reduction of mortality from respiratory diseases and diarrhea should continue together with the achievement of substantial reduction in mortality from violence and accidents. This, the primary cause of death in children, ages 1-4, has not varied during the period under study. (author's)

Cervical cancer incidence and mortality among American Indian and Alaska Native women, 1999-2009.

PubMed

Watson, Meg; Benard, Vicki; Thomas, Cheryll; Brayboy, Annie; Paisano, Roberta; Becker, Thomas

2014-06-01

We analyzed cervical cancer incidence and mortality data in American Indian and Alaska Native (AI/AN) women compared with women of other races. We improved identification of AI/AN race, cervical cancer incidence, and mortality data using Indian Health Service (IHS) patient records; our analyses focused on residents of IHS Contract Health Service Delivery Area (CHSDA) counties. Age-adjusted incidence and death rates were calculated for AI/AN and White women from 1999 to 2009. AI/AN women in CHSDA counties had a death rate from cervical cancer of 4.2, which was nearly twice the rate in White women (2.0; rate ratio [RR] = 2.11). AI/AN women also had higher incidence rates of cervical cancer compared with White women (11.0 vs 7.1; RR = 1.55) and were more often diagnosed with later-stage disease (RR = 1.84 for regional stage and RR = 1.74 for distant stage). Death rates decreased for AI/AN women from 1990 to 1993 (-25.8%/year) and remained stable thereafter. Although rates decreased over time, AI/AN women had disproportionately higher cervical cancer incidence and mortality. The persistently higher rates among AI/AN women compared with White women require continued improvements in identifying and treating cervical cancer and precancerous lesions.

Vital Signs: Racial Disparities in Age-Specific Mortality Among Blacks or African Americans - United States, 1999-2015.

PubMed

Cunningham, Timothy J; Croft, Janet B; Liu, Yong; Lu, Hua; Eke, Paul I; Giles, Wayne H

2017-05-05

Although the overall life expectancy at birth has increased for both blacks and whites and the gap between these populations has narrowed, disparities in life expectancy and the leading causes of death for blacks compared with whites in the United States remain substantial. Understanding how factors that influence these disparities vary across the life span might enhance the targeting of appropriate interventions. Trends during 1999-2015 in mortality rates for the leading causes of death were examined by black and white race and age group. Multiple 2014 and 2015 national data sources were analyzed to compare blacks with whites in selected age groups by sociodemographic characteristics, self-reported health behaviors, health-related quality of life indicators, use of health services, and chronic conditions. During 1999-2015, age-adjusted death rates decreased significantly in both populations, with rates declining more sharply among blacks for most leading causes of death. Thus, the disparity gap in all-cause mortality rates narrowed from 33% in 1999 to 16% in 2015. However, during 2015, blacks still had higher death rates than whites for all-cause mortality in all groups aged <65 years. Compared with whites, blacks in age groups <65 years had higher levels of some self-reported risk factors and chronic diseases and mortality from cardiovascular diseases and cancer, diseases that are most common among persons aged ≥65 years. To continue to reduce the gap in health disparities, these findings suggest an ongoing need for universal and targeted interventions that address the leading causes of deaths among blacks (especially cardiovascular disease and cancer and their risk factors) across the life span and create equal opportunities for health.

Changing Trends in Complications and Mortality Rates Among US Youth and Young Adults With HIV Infection in the Era of Combination Antiretroviral Therapy

PubMed Central

Mirani, Gayatri; Williams, Paige L.; Chernoff, Miriam; Abzug, Mark J.; Levin, Myron J.; Seage, George R.; Oleske, James M.; Purswani, Murli U.; Hazra, Rohan; Traite, Shirley; Zimmer, Bonnie; Van Dyke, Russell B.

2015-01-01

Background. Combination antiretroviral therapy (cART) has resulted in a dramatic decrease in human immunodeficiency virus (HIV)–related opportunistic infections and deaths in US youth, but both continue to occur. Methods. We estimated the incidence of complications and deaths in IMPAACT P1074, a long-term US-based prospective multicenter cohort study conducted from April 2008 to June 2014. Incidence rates of selected diagnoses and trends over time were compared with those from a previous observational cohort study, P219C (2004–2007). Causes of death and relevant demographic and clinical features were reviewed. Results. Among 1201 HIV-infected youth in P1074 (87% perinatally infected; mean [standard deviation] age at last chart review, 20.9 [5.4] years), psychiatric and neurodevelopmental disorders, asthma, pneumonia, and genital tract infections were among the most common comorbid conditions. Compared with findings in P219C, conditions with significantly increased incidence included substance or alcohol abuse, latent tuberculosis, diabetes mellitus, atypical mycobacterial infections, vitamin D deficiency or metabolic bone disorders, anxiety disorders, and fractures; the incidence of pneumonia decreased significantly. Twenty-eight deaths occurred, yielding a standardized mortality rate 31.5 times that of the US population. Those who died were older, less likely to be receiving cART, and had lower CD4 cell counts and higher viral loads. Most deaths (86%) were due to HIV-related medical conditions. Conclusions. Opportunistic infections and deaths are less common among HIV-infected youth in the US in the cART era, but the mortality rate remains elevated. Deaths were associated with poor HIV control and older age. Emerging complications, such as psychiatric, inflammatory, metabolic, and genital tract diseases, need to be addressed. PMID:26270680

Trends in underlying causes of death in people with HIV from 1999 to 2011 (D:A:D): a multicohort collaboration.

PubMed

Smith, Colette J; Ryom, Lene; Weber, Rainer; Morlat, Philippe; Pradier, Christian; Reiss, Peter; Kowalska, Justyna D; de Wit, Stephane; Law, Matthew; el Sadr, Wafaa; Kirk, Ole; Friis-Moller, Nina; Monforte, Antonella d'Arminio; Phillips, Andrew N; Sabin, Caroline A; Lundgren, Jens D

2014-07-19

With the advent of effective antiretroviral treatment, the life expectancy for people with HIV is now approaching that seen in the general population. Consequently, the relative importance of other traditionally non-AIDS-related morbidities has increased. We investigated trends over time in all-cause mortality and for specific causes of death in people with HIV from 1999 to 2011. Individuals from the Data collection on Adverse events of anti-HIV Drugs (D:A:D) study were followed up from March, 1999, until death, loss to follow-up, or Feb 1, 2011, whichever occurred first. The D:A:D study is a collaboration of 11 cohort studies following HIV-1-positive individuals receiving care at 212 clinics in Europe, USA, and Australia. All fatal events were centrally validated at the D:A:D coordinating centre using coding causes of death in HIV (CoDe) methodology. We calculated relative rates using Poisson regression. 3909 of the 49,731 D:A:D study participants died during the 308,719 person-years of follow-up (crude incidence mortality rate, 12.7 per 1000 person-years [95% CI 12.3-13.1]). Leading underlying causes were: AIDS-related (1123 [29%] deaths), non-AIDS-defining cancers (590 [15%] deaths), liver disease (515 [13%] deaths), and cardiovascular disease (436 [11%] deaths). Rates of all-cause death per 1000 person-years decreased from 17.5 in 1999-2000 to 9.1 in 2009-11; we saw similar decreases in death rates per 1000 person-years over the same period for AIDS-related deaths (5.9 to 2.0), deaths from liver disease (2.7 to 0.9), and cardiovascular disease deaths (1.8 to 0.9). However, non-AIDS cancers increased slightly from 1.6 per 1000 person-years in 1999-2000 to 2.1 in 2009-11 (p=0.58). After adjustment for factors that changed over time, including CD4 cell count, we detected no decreases in AIDS-related death rates (relative rate for 2009-11 vs 1999-2000: 0.92 [0.70-1.22]). However, all-cause (0.72 [0.61-0.83]), liver disease (0.48 [0.32-0.74]), and cardiovascular disease (0.33 [0.20-0.53) death rates still decreased over time. The percentage of all deaths that were AIDS-related (87/256 [34%] in 1999-2000 and 141/627 [22%] in 2009-11) and liver-related (40/256 [16%] in 1999-2000 and 64/627 [10%] in 2009-11) decreased over time, whereas non-AIDS cancers increased (24/256 [9%] in 1999-2000 to 142/627 [23%] in 2009-11). Recent reductions in rates of AIDS-related deaths are linked with continued improvement in CD4 cell count. We hypothesise that the substantially reduced rates of liver disease and cardiovascular disease deaths over time could be explained by improved use of non-HIV-specific preventive interventions. Non-AIDS cancer is now the leading non-AIDS cause and without any evidence of improvement. Oversight Committee for the Evaluation of Metabolic Complications of HAART, with representatives from academia, patient community, US Food and Drug Administration, European Medicines Agency and consortium of AbbVie, Boehringer Ingelheim, Bristol-Myers Squibb, Gilead Sciences, ViiV Healthcare, Merck, Pfizer, F Hoffmann-La Roche, and Janssen Pharmaceuticals. Copyright © 2014 Elsevier Ltd. All rights reserved.

Use of verbal autopsy to determine mortality patterns in an urban slum in Kolkata, India.

PubMed

Kanungo, Suman; Tsuzuki, Ataru; Deen, Jacqueline L; Lopez, Anna Lena; Rajendran, Krisnan; Manna, Byomkesh; Sur, Dipika; Kim, Deok Ryun; Gupta, Vinay Kumar; Ochiai, R Leon; Ali, Mohammad; von Seidlein, Lorenz; Bhattacharya, Sujit K; Clemens, John D

2010-09-01

To define mortality patterns in an urban slum in Kolkata, India, in the context of a cholera and typhoid fever project. In a well-defined population that was under surveillance for 18 months, we followed a dynamic cohort of 63 788 residents whose households were visited monthly by community health workers to identify deaths. Trained physicians performed verbal autopsies and experienced senior physicians assigned the primary cause of death according to the International classification of diseases, 10th edition. We tabulated causes of death in accordance with Global Burden of Disease 2000 categories and assessed overall and cause-specific mortality rates per age group and gender. During 87 921 person-years of follow-up, we recorded 544 deaths. This gave an overall mortality rate of 6.2 per 1000 person-years. We assigned a cause to 89% (482/544) of the deaths. The leading causes of death, in descending order, were cardiovascular diseases (especially among adults aged over 40 years), cancer, respiratory ailments and digestive disorders. Most deaths in children under 5 years of age were caused by tuberculosis, respiratory infections and diarrhoeal diseases. Although the most common causes of death in children were infectious, non-communicable diseases were predominant among adults. There is a need for continuing interventions against infectious diseases in addition to new and innovative strategies to combat non-infectious conditions.

[Mortality by homicides in Colombia, 1998-2012].

PubMed

Chaparro-Narváez, Pablo; Cotes-Cantillo, Karol; León-Quevedo, Willian; Castañeda-Orjuela, Carlos

2016-12-01

Homicide is a universal indicator of social violence with large public health consequences. To describe mortality by homicides and to analyze its trends and geographic distribution in Colombia between 1998 and 2012. We conducted a descriptive study of deaths by homicide in Colombia between 1998 and 2012 using official mortality databases and the population projections of the Departamento Administrativo Nacional de Estadística, DANE. We calculated age- and sex-specific mortality rates, and we analyzed the geographical distribution of mean-adjusted homicide mortality rates at municipal level. Between 1998 and 2012, 331,470 homicides were reported in Colombia. The mean crude rate was 51.5 per 100,000 inhabitants: 95.9 in men and 8.2 in women. Since 2003, a decrease in the number of deaths and rates was observed; 91.9% of the victims were men and the highest mortality rates were reported in the 20-29 years old group. The most frequently involved mechanism was the firearm: Eight of 10 homicides in men, and seven of 10 homicides in women. Out of 1,122 municipalities, 186 were in the highest quintile, accumulating 50.1% of all deaths. In Colombia, homicides have been one of the leading causes of death with a trend towards reduction since 2002. Its geographical distribution has been heterogeneous. To continue addressing this public health issue we must recur to multidisciplinary analytical methodologies for a better understanding of the phenomenon.

Comparative study and evaluation of scram use, recidivism rates, and characteristics : traffic tech.

DOT National Transportation Integrated Search

2015-04-01

Impaired driving continues to cause hundreds of thousands of alcohol-related crashes each year, many resulting in serious injury or death. Many offenders are repeat offenders despite sanctions and court processes that attempt to dissuade offenders fr...

Annual Report to the Nation: Overall cancer mortality declines

Cancer.gov

The 2018 Annual Report to the Nation on the Status of Cancer finds overall cancer death rates continue to decline and cancer incidence dropped in men and remained stable in women. A companion study reports on recent changes in prostate cancer trends.

A pediatric death audit in a large referral hospital in Malawi.

PubMed

Fitzgerald, Elizabeth; Mlotha-Mitole, Rachel; Ciccone, Emily J; Tilly, Alyssa E; Montijo, Jennie M; Lang, Hans-Joerg; Eckerle, Michelle

2018-02-21

Death audits have been used to describe pediatric mortality in under-resourced settings, where record keeping is often a challenge. This information provides the cornerstone for the foundation of quality improvement initiatives. Malawi, located in sub-Saharan Africa, currently has an Under-5 mortality rate of 64/1000. Kamuzu Central Hospital, in the capital city Lilongwe, is a busy government referral hospital, which admits up to 3000 children per month. A study published in 2013 reported mortality rates as high as 9%. This is the first known audit of pediatric death files conducted at this hospital. A retrospective chart review on all pediatric deaths that occurred at Kamuzu Central Hospital (excluding deaths in the neonatal nursery) during a 13-month period was done using a standardized death audit form. A descriptive analysis was completed, including patient demographics, HIV and nutritional status, and cause of death. Modifiable factors were identified that may have contributed to mortality, including a lack of vital sign collection, poor documentation, and delays in the procurement or results of tests, studies, and specialist review. Seven hundred forty three total pediatric deaths were recorded and 700 deceased patient files were reviewed. The mortality rate by month ranged from a low of 2.2% to a high of 4.4%. Forty-four percent of deaths occurred within the first 24 h of admission, and 59% occurred within the first 48 h. The most common causes of death were malaria, malnutrition, HIV-related illnesses, and sepsis. The mortality rate for this pediatric referral center has dramatically decreased in the 6 years since the last published mortality data, but remains high. Areas identified for continued development include improved record keeping, improved patient assessment and monitoring, and more timely and reliable provision of testing and treatment. This study demonstrates that in low-resource settings, where reliable record keeping is often difficult, death audits are useful tools to describe the sickest patient population and determine factors possibly contributing to mortality that may be amenable to quality improvement interventions.

Heart rate is a prognostic risk factor for myocardial infarction: a post hoc analysis in the PERFORM (Prevention of cerebrovascular and cardiovascular Events of ischemic origin with teRutroban in patients with a history oF ischemic strOke or tRansient ischeMic attack) study population.

PubMed

Fox, Kim; Bousser, Marie-Germaine; Amarenco, Pierre; Chamorro, Angel; Fisher, Marc; Ford, Ian; Hennerici, Michael G; Mattle, Heinrich P; Rothwell, Peter M

2013-10-09

Elevated resting heart rate is known to be detrimental to morbidity and mortality in cardiovascular disease, though its effect in patients with ischemic stroke is unclear. We analyzed the effect of baseline resting heart rate on myocardial infarction (MI) in patients with a recent noncardioembolic cerebral ischemic event participating in PERFORM. We compared fatal or nonfatal MI using adjusted Cox proportional hazards models for PERFORM patients with baseline heart rate <70 bpm (n=8178) or ≥70 bpm (n=10,802). In addition, heart rate was analyzed as a continuous variable. Other cerebrovascular and cardiovascular outcomes were also explored. Heart rate ≥70 bpm was associated with increased relative risk for fatal or nonfatal MI (HR 1.32, 95% CI 1.03-1.69, P=0.029). For every 5-bpm increase in heart rate, there was an increase in relative risk for fatal and nonfatal MI (11.3%, P=0.0002). Heart rate ≥70 bpm was also associated with increased relative risk for a composite of fatal or nonfatal ischemic stroke, fatal or nonfatal MI, or other vascular death (excluding hemorrhagic death) (P<0001); vascular death (P<0001); all-cause mortality (P<0001); and fatal or nonfatal stroke (P=0.04). For every 5-bpm increase in heart rate, there were increases in relative risk for fatal or nonfatal ischemic stroke, fatal or nonfatal MI, or other vascular death (4.7%, P<0.0001), vascular death (11.0%, P<0.0001), all-cause mortality (8.0%, P<0.0001), and fatal and nonfatal stroke (2.4%, P=0.057). Elevated heart rate ≥70 bpm places patients with a noncardioembolic cerebral ischemic event at increased risk for MI. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

European cancer mortality predictions for the year 2018 with focus on colorectal cancer.

PubMed

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

2018-04-01

We projected cancer mortality statistics for 2018 for the European Union (EU) and its six more populous countries, using the most recent available data. We focused on colorectal cancer. We obtained cancer death certification data from stomach, colorectum, pancreas, lung, breast, uterus, ovary, prostate, bladder, leukaemia, and total cancers from the World Health Organisation database and projected population data from Eurostat. We derived figures for France, Germany, Italy, Poland, Spain, the UK, and the EU in 1970-2012. We predicted death numbers by age group and age-standardized (world population) rates for 2018 through joinpoint regression models. EU total cancer mortality rates are predicted to decline by 10.3% in men between 2012 and 2018, reaching a predicted rate of 128.9/100 000, and by 5.0% in women with a rate of 83.6. The predicted total number of cancer deaths is 1 382 000 when compared with 1 333 362 in 2012 (+3.6%). We confirmed a further fall in male lung cancer, but an unfavourable trend in females, with a rate of 14.7/100 000 for 2018 (13.9 in 2012, +5.8%) and 94 500 expected deaths, higher than the rate of 13.7 and 92 700 deaths from breast cancer. Colorectal cancer predicted rates are 15.8/100 000 men (-6.7%) and 9.2 in women (-7.5%); declines are expected in all age groups. Pancreatic cancer is stable in men, but in women it rose +2.8% since 2012. Ovarian, uterine and bladder cancer rates are predicted to decline further. In 2018 alone, about 392 300 cancer deaths were avoided compared with peak rates in the late 1980s. We predicted continuing falls in mortality rates from major cancer sites in the EU and its major countries to 2018. Exceptions are pancreatic cancer and lung cancer in women. Improved treatment and-above age 50 years-organized screening may account for recent favourable colorectal cancer trends.

Leading causes of child mortality in Brazil, in 1990 and 2015: estimates from the Global Burden of Disease study.

PubMed

França, Elisabeth Barboza; Lansky, Sônia; Rego, Maria Albertina Santiago; Malta, Deborah Carvalho; França, Julia Santiago; Teixeira, Renato; Porto, Denise; Almeida, Marcia Furquim de; Souza, Maria de Fatima Marinho de; Szwarcwald, Célia Landman; Mooney, Meghan; Naghavi, Mohsen; Vasconcelos, Ana Maria Nogales

2017-05-01

To analyze under-5 mortality rates and leading causes in Brazil and states in 1990 and 2015, using the Global Burden of Disease Study (GBD) 2015 estimates. The main sources of data for all-causes under-5 mortality and live births estimates were the mortality information system, surveys, and censuses. Proportions and rates per 1,000 live births (LB) were calculated for total deaths and leading causes. Estimates of under-5 deaths in Brazil were 191,505 in 1990, and 51,226 in 2015, 90% of which were infant deaths. The rates per 1,000 LB showed a reduction of 67.6% from 1990 to 2015, achieving the proposed target established by the Millennium Development Goals (MDGs). The reduction generally was more than 60% in states, with a faster reduction in the poorest Northeast region. The ratio of the highest and lowest rates in the states decreased from 4.9 in 1990 to 2.3 in 2015, indicating a reduction in socioeconomic regional disparities. Although prematurity showed a 72% reduction, it still remains as the leading cause of death (COD), followed by diarrheal diseases in 1990, and congenital anomalies, birth asphyxia and septicemia neonatal in 2015. Under-5 mortality has decreased over the past 25 years, with reduction of regional disparities. However, pregnancy and childbirth-related causes remain as major causes of death, together with congenital anomalies. Intersectoral and specific public health policies must be continued to improve living conditions and health care in order to achieve further reduction of under-5 mortality rates in Brazil.

Mortality experience of Tsimane Amerindians of Bolivia: regional variation and temporal trends.

PubMed

Gurven, Michael; Kaplan, Hillard; Supa, Alfredo Zelada

2007-01-01

This paper examines regional and temporal trends in mortality patterns among the Tsimane, a population of small-scale forager-horticulturalists in lowland Bolivia. We compare age-specific mortality in remote forest and riverine regions with that in more acculturated villages and examine mortality changes among all age groups over the past 50 years. Discrete-time logistic regression is used to examine impacts of region, period, sex, and age on mortality hazard. Villages in the remote forest and riverine regions show 2-4 times higher mortality rates from infancy until middle adulthood than in the acculturated region. While there was little change in mortality for most of the life course over the period 1950-1989, overall life expectancy at birth improved by 10 years from 45 to 53 after 1990. In both periods, over half of all deaths were due to infectious disease, especially respiratory and gastrointestinal infections. Accidents and violence accounted for a quarter of all deaths. Unlike typical patterns described by epidemiologic transition theory, we find a much larger period reduction of death rates during middle and late adulthood than during infancy or childhood. In the remote villages, infant death rates changed little, whereas death rates among older adults decreased sharply. We hypothesize that this pattern is due to a combination of differential access to medical interventions, a continued lack of public health infrastructure and Tsimane cultural beliefs concerning sickness and dying. Copyright 2007 Wiley-Liss, Inc.

Preventable causes of death in Wisconsin, 2004.

PubMed

Vila, Peter M; Booske, Bridget C; Wegner, Mark V; Remington, Patrick L

2007-10-01

While heart disease, cancer, and injuries are leading proximate causes of death, research has demonstrated that about half of all deaths in the United States are actually due to preventable causes, including tobacco use, poor diet, and physical inactivity. Using state vital statistics data and findings from national studies, we report on the trends in the preventable causes of death in Wisconsin from 1992 to 2004. The leading proximate causes of death in Wisconsin were obtained from Wisconsin Interactive Statistics on Health (WISH) data derived from individual death certificates. Information on the preventable causes of death was either obtained from the underlying cause information on the death certificate or from peer-reviewed epidemiologic studies. While the overall age-adjusted death rate declined from 837 to 744 per 100,000 from 1992 to 2004, the top 10 causes of death remain largely unchanged. Nearly half of the deaths in Wisconsin in 2004 resulted from 11 preventable causes, similar to the findings in 1992. Epidemiologic research demonstrates that nearly half of all deaths in Wisconsin are due to preventable causes. Programs and policies must continue to address these preventable causes of disease if Wisconsin is to meet its goal of promoting and protecting population health.

Contemporary outcomes for carotid endarterectomy at a large community-based academic health center.

PubMed

Long, Graham W; Nuthakki, Vijay; Bove, Paul G; Brown, O William; Shanley, Charles J; Bendick, Phillip J; Rimar, Steven; Kitzmiller, John; Zelenock, Gerald B

2007-05-01

The North American Symptomatic Carotid Endarterectomy Trial (NASCET) and Asymptomatic Carotid Atherosclerosis Study (ACAS) demonstrated the efficacy of carotid endarterectomy (CEA), but these studies were published 15 and 11 years ago, respectively. We hypothesized that present clinical results of CEA have improved compared with those reported by NASCET/ACAS. Every patient having CEA from January 1999 through December 2003 was reviewed as part of a continuous quality-assurance program. Patient demographics and risk factors were recorded; high-risk patients were identified using inclusion criteria for high-risk carotid stent trials. Primary end points recorded were all neurologic events, deaths, and myocardial infarctions (MIs). Outcomes were reported individually or as combined neurologic events and deaths (traditional NASCET/ACAS methodology) and, similar to recent carotid stent trials, individually, combined, and as a composite that included MI. A total of 1,927 CEAs were performed, 1,140 in men (59%) and 787 in women (41%). The average age was 72 +/- 9 years; 21% of patients were age 80 or older. Symptomatic patients accounted for 717 procedures (37%). Perioperative neurologic event, death, and MI occurred in 1.0%, 0.5%, and 1.3% of patients, respectively. The combined neurologic event and death rate was 1.3% (symptomatic = 1.8%, asymptomatic = 1.1%). High-risk patients comprised 54% of the cohort; the neurologic event and death rate for this group was 1.6%. The composite end point including MI was 3.4%. Severe coronary artery disease and prior ipsilateral CEA significantly correlated with a higher incidence of primary end point complications. In contemporary practice, the perioperative neurologic event rate is significantly less than reported in NASCET/ACAS. Perioperative death and MI rates were similar to those seen in NASCET/ACAS. Neurologic events and death rates were not different between high- and low-risk groups. These data may serve as a guide for the modern vascular specialist weighing open and endovascular options for treatment of carotid artery occlusive disease in both high- and low-risk patients.

Predicting and analyzing the trend of traffic accidents deaths in Iran in 2014 and 2015

PubMed Central

Mehmandar, Mohammadreza; Soori, Hamid; Mehrabi, Yadolah

2016-01-01

Background: Predicting the trend in traffic accidents deaths and its analysis can be a useful tool for planning and policy-making, conducting interventions appropriate with death trend, and taking the necessary actions required for controlling and preventing future occurrences. Objective: Predicting and analyzing the trend of traffic accidents deaths in Iran in 2014 and 2015. Settings and Design: It was a cross-sectional study. Materials and Methods: All the information related to fatal traffic accidents available in the database of Iran Legal Medicine Organization from 2004 to the end of 2013 were used to determine the change points (multi-variable time series analysis). Using autoregressive integrated moving average (ARIMA) model, traffic accidents death rates were predicted for 2014 and 2015, and a comparison was made between this rate and the predicted value in order to determine the efficiency of the model. Results: From the results, the actual death rate in 2014 was almost similar to that recorded for this year, while in 2015 there was a decrease compared with the previous year (2014) for all the months. A maximum value of 41% was also predicted for the months of January and February, 2015. Conclusion: From the prediction and analysis of the death trends, proper application and continuous use of the intervention conducted in the previous years for road safety improvement, motor vehicle safety improvement, particularly training and culture-fostering interventions, as well as approval and execution of deterrent regulations for changing the organizational behaviors, can significantly decrease the loss caused by traffic accidents. PMID:27308255

Cancer statistics, 2018.

PubMed

Siegel, Rebecca L; Miller, Kimberly D; Jemal, Ahmedin

2018-01-01

Each year, the American Cancer Society estimates the numbers of new cancer cases and deaths that will occur in the United States and compiles the most recent data on cancer incidence, mortality, and survival. Incidence data, available through 2014, were collected by the Surveillance, Epidemiology, and End Results Program; the National Program of Cancer Registries; and the North American Association of Central Cancer Registries. Mortality data, available through 2015, were collected by the National Center for Health Statistics. In 2018, 1,735,350 new cancer cases and 609,640 cancer deaths are projected to occur in the United States. Over the past decade of data, the cancer incidence rate (2005-2014) was stable in women and declined by approximately 2% annually in men, while the cancer death rate (2006-2015) declined by about 1.5% annually in both men and women. The combined cancer death rate dropped continuously from 1991 to 2015 by a total of 26%, translating to approximately 2,378,600 fewer cancer deaths than would have been expected if death rates had remained at their peak. Of the 10 leading causes of death, only cancer declined from 2014 to 2015. In 2015, the cancer death rate was 14% higher in non-Hispanic blacks (NHBs) than non-Hispanic whites (NHWs) overall (death rate ratio [DRR], 1.14; 95% confidence interval [95% CI], 1.13-1.15), but the racial disparity was much larger for individuals aged <65 years (DRR, 1.31; 95% CI, 1.29-1.32) compared with those aged ≥65 years (DRR, 1.07; 95% CI, 1.06-1.09) and varied substantially by state. For example, the cancer death rate was lower in NHBs than NHWs in Massachusetts for all ages and in New York for individuals aged ≥65 years, whereas for those aged <65 years, it was 3 times higher in NHBs in the District of Columbia (DRR, 2.89; 95% CI, 2.16-3.91) and about 50% higher in Wisconsin (DRR, 1.78; 95% CI, 1.56-2.02), Kansas (DRR, 1.51; 95% CI, 1.25-1.81), Louisiana (DRR, 1.49; 95% CI, 1.38-1.60), Illinois (DRR, 1.48; 95% CI, 1.39-1.57), and California (DRR, 1.45; 95% CI, 1.38-1.54). Larger racial inequalities in young and middle-aged adults probably partly reflect less access to high-quality health care. CA Cancer J Clin 2018;68:7-30. © 2018 American Cancer Society. © 2018 American Cancer Society.

Annual Report to the Nation, 1975-2012

Cancer.gov

The Report to the Nation on the Status of Cancer (1975-2012) shows that death rates continued to decline for all cancers combined, as well as for most cancer sites for men and women, as well as for most cancer sites for men and women.

Englerin A Delivers One-Two Punch to Kidney Cancer Cells | Center for Cancer Research

Cancer.gov

While overall cancer death rates continue to decline in the U.S., mortality rates for certain cancer sites, including the kidney, are on the rise. New treatments are needed to reverse this trend and one potentially rich source is natural products, compounds derived from living organisms. John Beutler, Ph.D., and his colleagues, in CCR’s Molecular Targets Laboratory located at

Is Brazil going to achieve the road traffic deaths target? An analysis about the sustainable development goals.

PubMed

Blumenberg, Cauane; Martins, Rafaela C; Calu Costa, Janaína; Ricardo, Luiza I C

2017-09-07

To describe the temporal relationship between the road traffic mortality rate and gross domestic product (GDP) per capita in Brazil, and make an annual prediction of the evolution of both indicators until 2020, the end of the Sustainable Development Goals (SDGs) monitoring period. Brazilian road traffic mortality rate official data were described from 2000 to 2015, while the GDP per capita official data were described from 2000 to 2013. GDP per capita and traffic mortality rate predictions were performed until 2020 using fractional polynomial analysis. Correlations were assessed using Pearson's correlation coefficient. From 2000 to 2015, there were over 446 000 road crashes fatal victims in Brazil. The road traffic mortality rate was positively related to the Brazilian GDP per capita, with a strong correlation (r=0.89; p<0.001) from 2000 to 2013 and a mild correlation (r=0.55; p<0.001) considering the whole period (2000-2020). The predictions show a reduction on the road traffic mortality rates in Brazil; however, if this same reduction pace continues, we estimate that the country will reach 12.4 road crash deaths per 100 000 inhabitants in 2020, a reduction of only 13.4% compared with 2015. If the same mortality reduction pace continues in Brazil, the country will not reach the proposed SDG, which is to reduce by half the number of deaths per 100 000 inhabitants. In addition, an intertwined conciliation between economical growth, sustainable development and public policies is needed in order to meet such an overwhelming goal. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

[Trends in the mortality of liver cancer in Qidong, China: an analysis of fifty years].

PubMed

Chen, Jian-guo; Zhu, Jian; Zhang, Yong-hui; Chen, Yong-sheng; Ding, Lu-lu; Lu, Jian-hua; Zhu, Yuan-rong

2012-07-01

To describe and analyze the charecteristics and trends of liver cancer mortality during the past fifty years in Qidong, China. Retrospective mortality survey was conducted to get the data on liver cancer death in the period of 1958-1971, and the data from 1972 to 2007 were obtained from the records of cancer registration in Qidong. The crude mortality rate (CR) of liver cancer, and age-standardized rate by Chinese population (CASR) and by world population (WASR) were calculated and analyzed. The total percent changes (PC) and annual percent changes (APC) were used for evaluating the increasing trends of the mortality. The sex-specific rate, age-specific rate, truncated rate of the age group 35 - 64, cumulative rate of the age group 0-74, cumulative risk, period-rate, and the rate for age-birth cohort were compared. The natural death rate in Qidong residents for the past five-decade period experienced a wave interval of 8.62‰ in 1958 down to 5.37‰ in 1979, and up to 7.75‰ in 2007. The mortality rate for all-site cancers was increased from 56.69 per 100, 000 to 234.97 per 100, 000. The mortality rate of liver cancer, being 20.45 per 100, 100 in 1958 was increased to 49.04 per 100, 000 in 1972, and up to 69.29 per 100, 000 in 2007. According to the registration data of 1972 - 2007, the death from liver cancer was accounted for 34.88% of all deaths due to cancers, with a CR of 58.86 per 100, 000, CASR of 38.36 per 100, 000, and WASR, 49.37 Per 100, 000 in Qidong. The truncated rate for the age group 35 - 64 was 117.08 per 100, 000, and the cumulative rate for the age group 0-74 and the cumulative risk were 5.15% and 5.02%, respectively. The CRs for males was 90.52 per 100, 000 and for females was 27.93 per 100, 000, with a sex ratio of 3.24:1. For the period of 1972 - 2007, the PC for CR was 49.71%, and APC was +1.41%, showing an increasing variation tendency. The APCs for CASR and WASR, however, were decreasing, with a percentage of -1.11%, and -0.84%, respectively. The age-specific mortality rates by period showed a decreasing trend for those under age of 44. Moreover, age-birth cohort analysis showed a more rapid lowering mortality in the age groups 35-, 30-, 25-, and 15-, that is, those born after 1950's. Liver cancer remains the leading death cause due to cancers in Qidong, with a continuing higher crude mortality rate. Yet the age-standardized mortality rate has presented a declining posture. The liver cancer mortality in young people in Qidong demonstrates a continuously falling trend. The campaign for the control of liver cancer in Qidong has achieved initial success.

Annual Report to the Nation on the Status of Cancer, 1975–2009, Featuring the Burden and Trends in Human Papillomavirus (HPV)–Associated Cancers and HPV Vaccination Coverage Levels

PubMed Central

2013-01-01

Background The American Cancer Society (ACS), the Centers for Disease Control and Prevention (CDC), the National Cancer Institute (NCI), and the North American Association of Central Cancer Registries (NAACCR) collaborate annually to provide updates on cancer incidence and death rates and trends in these outcomes for the United States. This year’s report includes incidence trends for human papillomavirus (HPV)–associated cancers and HPV vaccination (recommended for adolescents aged 11–12 years). Methods Data on cancer incidence were obtained from the CDC, NCI, and NAACCR, and data on mortality were obtained from the CDC. Long- (1975/1992–2009) and short-term (2000–2009) trends in age-standardized incidence and death rates for all cancers combined and for the leading cancers among men and among women were examined by joinpoint analysis. Prevalence of HPV vaccination coverage during 2008 and 2010 and of Papanicolaou (Pap) testing during 2010 were obtained from national surveys. Results Death rates continued to decline for all cancers combined for men and women of all major racial and ethnic groups and for most major cancer sites; rates for both sexes combined decreased by 1.5% per year from 2000 to 2009. Overall incidence rates decreased in men but stabilized in women. Incidence rates increased for two HPV-associated cancers (oropharynx, anus) and some cancers not associated with HPV (eg, liver, kidney, thyroid). Nationally, 32.0% (95% confidence interval [CI] = 30.3% to 33.6%) of girls aged 13 to 17 years in 2010 had received three doses of the HPV vaccine, and coverage was statistically significantly lower among the uninsured (14.1%, 95% CI = 9.4% to 20.6%) and in some Southern states (eg, 20.0% in Alabama [95% CI = 13.9% to 27.9%] and Mississippi [95% CI = 13.8% to 28.2%]), where cervical cancer rates were highest and recent Pap testing prevalence was the lowest. Conclusions The overall trends in declining cancer death rates continue. However, increases in incidence rates for some HPV-associated cancers and low vaccination coverage among adolescents underscore the need for additional prevention efforts for HPV-associated cancers, including efforts to increase vaccination coverage. PMID:23297039

Annual Report to the Nation on the Status of Cancer, 1975-2009, featuring the burden and trends in human papillomavirus(HPV)-associated cancers and HPV vaccination coverage levels.

PubMed

Jemal, Ahmedin; Simard, Edgar P; Dorell, Christina; Noone, Anne-Michelle; Markowitz, Lauri E; Kohler, Betsy; Eheman, Christie; Saraiya, Mona; Bandi, Priti; Saslow, Debbie; Cronin, Kathleen A; Watson, Meg; Schiffman, Mark; Henley, S Jane; Schymura, Maria J; Anderson, Robert N; Yankey, David; Edwards, Brenda K

2013-02-06

The American Cancer Society (ACS), the Centers for Disease Control and Prevention (CDC), the National Cancer Institute (NCI), and the North American Association of Central Cancer Registries (NAACCR) collaborate annually to provide updates on cancer incidence and death rates and trends in these outcomes for the United States. This year's report includes incidence trends for human papillomavirus (HPV)-associated cancers and HPV vaccination (recommended for adolescents aged 11-12 years). Data on cancer incidence were obtained from the CDC, NCI, and NAACCR, and data on mortality were obtained from the CDC. Long- (1975/1992-2009) and short-term (2000-2009) trends in age-standardized incidence and death rates for all cancers combined and for the leading cancers among men and among women were examined by joinpoint analysis. Prevalence of HPV vaccination coverage during 2008 and 2010 and of Papanicolaou (Pap) testing during 2010 were obtained from national surveys. Death rates continued to decline for all cancers combined for men and women of all major racial and ethnic groups and for most major cancer sites; rates for both sexes combined decreased by 1.5% per year from 2000 to 2009. Overall incidence rates decreased in men but stabilized in women. Incidence rates increased for two HPV-associated cancers (oropharynx, anus) and some cancers not associated with HPV (eg, liver, kidney, thyroid). Nationally, 32.0% (95% confidence interval [CI] = 30.3% to 33.6%) of girls aged 13 to 17 years in 2010 had received three doses of the HPV vaccine, and coverage was statistically significantly lower among the uninsured (14.1%, 95% CI = 9.4% to 20.6%) and in some Southern states (eg, 20.0% in Alabama [95% CI = 13.9% to 27.9%] and Mississippi [95% CI = 13.8% to 28.2%]), where cervical cancer rates were highest and recent Pap testing prevalence was the lowest. The overall trends in declining cancer death rates continue. However, increases in incidence rates for some HPV-associated cancers and low vaccination coverage among adolescents underscore the need for additional prevention efforts for HPV-associated cancers, including efforts to increase vaccination coverage.

Quantifying Options for Reducing Coronary Heart Disease Mortality By 2020

PubMed Central

Huffman, Mark D.; Lloyd-Jones, Donald M.; Ning, Hongyan; Labarthe, Darwin R.; Castillo, Maria Guzman; O’Flaherty, Martin; Ford, Earl S.; Capewell, Simon

2013-01-01

Introduction The AHA 2020 Strategic Impact Goal proposes a 20% improvement in cardiovascular health of all Americans. We aimed to estimate the potential reduction in coronary heart disease (CHD) deaths. Methods and Results We used data on 40,373 CVD-free adults from NHANES (1988–2010). We quantified recent trends for six metrics (total cholesterol [TC]; systolic blood pressure [SBP]; physical inactivity; smoking; diabetes; obesity) and generated linear projections to 2020. We projected the expected number of CHD deaths in 2020 if 2006 age- and sex-specific CHD death rates remained constant, which would result in approximately 480,000 CHD deaths in 2020 (12% increase). We used the previously validated IMPACT CHD model to project numbers of CHD deaths in 2020 under two different scenarios. A) Assuming a 20% improvement in each CVH metric, we project 365,000 CHD deaths in 2020, (range 327,000–403,000) a 24% decrease reflecting modest reductions in TC (−41,000), SBP (−36,000), physical inactivity (−12,000), smoking (−10,000), diabetes (−10,000), and obesity (−5,000). B) Assuming that recent risk factor trends continue to 2020, we project 335,000 CHD deaths (range 274,000–386,000), a 30% decrease reflecting improvements in TC, SBP, smoking and physical activity (~167,000 fewer deaths), offset by increases in diabetes and BMI (~24,000 more deaths). Conclusions Two contrasting scenarios of change in CVH metrics could prevent 24–30% of the CHD deaths expected in 2020, though with differing impacts by age. Unfavorable continuing trends in obesity and diabetes would have substantial adverse effects. This analysis demonstrates the utility of modelling to inform health policy. PMID:23661723

Quantifying options for reducing coronary heart disease mortality by 2020.

PubMed

Huffman, Mark D; Lloyd-Jones, Donald M; Ning, Hongyan; Labarthe, Darwin R; Guzman Castillo, Maria; O'Flaherty, Martin; Ford, Earl S; Capewell, Simon

2013-06-25

The American Heart Association (AHA) 2020 Strategic Impact Goal proposes a 20% improvement in cardiovascular health of all Americans. We aimed to estimate the potential reduction in coronary heart disease (CHD) deaths. We used data on 40 373 adults free of cardiovascular disease from the National Health and Nutrition Examination Survey (NHANES; 1988-2010). We quantified recent trends for 6 metrics (total cholesterol, systolic blood pressure, physical inactivity, smoking, diabetes mellitus, and obesity) and generated linear projections to 2020. We projected the expected number of CHD deaths in 2020 if 2006 age- and sex-specific CHD death rates remained constant, which would result in ≈480 000 CHD deaths in 2020 (12% increase). We used the previously validated IMPACT CHD model to project numbers of CHD deaths in 2020 under 2 different scenarios: (1) Assuming a 20% improvement in each cardiovascular health metric, we project 365 000 CHD deaths in 2020 (range 327 000-403 000) a 24% decrease reflecting modest reductions in total cholesterol (-41 000), systolic blood pressure (-36 000), physical inactivity (-12 000), smoking (-10 000), diabetes mellitus (-10 000), and obesity (-5000); (2) Assuming that recent risk factor trends continue to 2020, we project 335 000 CHD deaths (range 274 000-386 000), a 30% decrease reflecting improvements in total cholesterol, systolic blood pressure, smoking, and physical activity (≈167 000 fewer deaths), offset by increases in diabetes mellitus and body mass index (≈24 000 more deaths). Two contrasting scenarios of change in cardiovascular health metrics could prevent 24% to 30% of the CHD deaths expected in 2020, though with differing effects by age. Unfavorable continuing trends in obesity and diabetes mellitus would have substantial adverse effects. This analysis demonstrates the utility of modelling to inform health policy.

Insulation workers in Belfast. A further study of mortality due to asbestos exposure (1940-75).

PubMed Central

Elmes, P C; Simpson, M J

1977-01-01

A follow-up study of 162 men already working as insulators (laggers) in 1940 has been extended from 1965 to 1975. By the end of 1975 there were 40 survivors when 108 had been expected. Until 1965 there had been an overall excess of deaths; these were due to asbestosis with or without tuberculosis and to alimentary cancer, as well as to bronchial carcinoma and mesothelioma. From 1965 onwards the overall death rate among survivors is not so excessive but there is still a marked excess of deaths from bronchial cancer and mesothelioma. The continued risk of death attributable to malignancy after asbestosis had ceased to contribute directly, does not appear to be caused by any changes which occurred before 1940 in the conditions at work. PMID:911687

Cervical Cancer Incidence and Mortality Among American Indian and Alaska Native Women, 1999–2009

PubMed Central

Benard, Vicki; Thomas, Cheryll; Brayboy, Annie; Paisano, Roberta; Becker, Thomas

2014-01-01

Objectives. We analyzed cervical cancer incidence and mortality data in American Indian and Alaska Native (AI/AN) women compared with women of other races. Methods. We improved identification of AI/AN race, cervical cancer incidence, and mortality data using Indian Health Service (IHS) patient records; our analyses focused on residents of IHS Contract Health Service Delivery Area (CHSDA) counties. Age-adjusted incidence and death rates were calculated for AI/AN and White women from 1999 to 2009. Results. AI/AN women in CHSDA counties had a death rate from cervical cancer of 4.2, which was nearly twice the rate in White women (2.0; rate ratio [RR] = 2.11). AI/AN women also had higher incidence rates of cervical cancer compared with White women (11.0 vs 7.1; RR = 1.55) and were more often diagnosed with later-stage disease (RR = 1.84 for regional stage and RR = 1.74 for distant stage). Death rates decreased for AI/AN women from 1990 to 1993 (−25.8%/year) and remained stable thereafter. Conclusions. Although rates decreased over time, AI/AN women had disproportionately higher cervical cancer incidence and mortality. The persistently higher rates among AI/AN women compared with White women require continued improvements in identifying and treating cervical cancer and precancerous lesions. PMID:24754650

Cost-effectiveness analysis of 30-month vs 12-month dual antiplatelet therapy with clopidogrel and aspirin after drug-eluting stents in patients with acute coronary syndrome.

PubMed

Jiang, Minghuan; You, Joyce H S

2017-10-01

Continuation of dual antiplatelet therapy (DAPT) beyond 1 year reduces late stent thrombosis and ischemic events after drug-eluting stents (DES) but increases risk of bleeding. We hypothesized that extending DAPT from 12 months to 30 months in patients with acute coronary syndrome (ACS) after DES is cost-effective. A lifelong decision-analytic model was designed to simulate 2 antiplatelet strategies in event-free ACS patients who had completed 12-month DAPT after DES: aspirin monotherapy (75-162 mg daily) and continuation of DAPT (clopidogrel 75 mg daily plus aspirin 75-162 mg daily) for 18 months. Clinical event rates, direct medical costs, and quality-adjusted life-years (QALYs) gained were the primary outcomes from the US healthcare provider perspective. Base-case results showed DAPT continuation gained higher QALYs (8.1769 vs 8.1582 QALYs) at lower cost (USD42 982 vs USD44 063). One-way sensitivity analysis found that base-case QALYs were sensitive to odds ratio (OR) of cardiovascular death with DAPT continuation and base-case cost was sensitive to OR of nonfatal stroke with DAPT continuation. DAPT continuation remained cost-effective when the ORs of nonfatal stroke and cardiovascular death were below 1.241 and 1.188, respectively. In probabilistic sensitivity analysis, DAPT continuation was the preferred strategy in 74.75% of 10 000 Monte Carlo simulations at willingness-to-pay threshold of 50 000 USD/QALYs. Continuation of DAPT appears to be cost-effective in ACS patients who were event-free for 12-month DAPT after DES. The cost-effectiveness of DAPT for 30 months was highly subject to the OR of nonfatal stroke and OR of death with DAPT continuation. © 2017 Wiley Periodicals, Inc.

Study of colorectal mortality in the Andalusian population.

PubMed

Cayuela, A; Rodríguez-Domínguez, S; Garzón-Benavides, M; Pizarro-Moreno, A; Giráldez-Gallego, A; Cordero-Fernández, C

2011-06-01

to provide up-to-date information and to analyze recent changes in colorectal cancer mortality trends in Andalusia during the period of 1980-2008 using joinpoint regression models. age- and sex-specific colorectal cancer deaths were taken from the official vital statistics published by the Instituto de Estadística de Andalucía for the years 1980 to 2008. We computed age-specific rates for each 5-year age group and calendar year and age-standardized mortality rates per 100,000 men and women. A joinpoint regression analysis was used for trend analysis of standardized rates. Joinpoint regression analysis was used to identify the years when a significant change in the linear slope of the temporal trend occurred. The best fitting points (the "join-points") are chosen where the rate significantly changes. mortality from colorectal cancer in Andalusia during the period studied has increased, from 277 deaths in 1980 to 1,227 in 2008 in men, and from 333 to 805 deaths in women. Adjusted overall colorectal cancer mortality rates increased from 7.7 to 17.0 deaths per 100,000 person-years in men and from 6.6 to 9.0 per 100,000 person-years in women Changes in mortality did not evolve similarly for men and women. Age-specific CRC mortality rates are lower in women than in men, which imply that women reach comparable levels of colorectal cancer mortality at higher ages than men. sex differences for colorectal cancer mortality have been widening in the last decade in Andalusia. In spite of the decreasing trends in age-adjusted mortality rates in women, incidence rates and the absolute numbers of deaths are still increasing, largely because of the aging of the population. Consequently, colorectal cancer still has a large impact on health care services, and this impact will continue to increase for many more years.

Influence of changing travel patterns on child death rates from injury: trend analysis.

PubMed Central

DiGuiseppi, C.; Roberts, I.; Li, L.

1997-01-01

OBJECTIVES: To examine trends in child mortality from unintentional injury between 1985 and 1992 and to find how changes in modes of travel contributed to these trends. DESIGN: Poisson regression modelling using data from death certificates, censuses, and national travel surveys. SETTING: England and Wales. SUBJECTS: Resident children aged 0-14. MAIN OUTCOME MEASURES: Deaths from unintentional injury and poisoning. RESULTS: Child deaths from injury declined by 34% (95% confidence interval 28% to 40%) per 100,000 population between 1985 and 1992. Substantial decreases in each of the leading causes of death from injury contributed to this overall decline. On average, children walked and cycled less distance and travelled substantially more miles by car in 1992 compared with 1985. Deaths from road traffic accidents declined for pedestrians by 24% per mile walked and for cyclists by 20% per mile cycled, substantially less than the declines per 100,000 population of 37% and 38% respectively. In contrast, deaths of occupants of motor vehicles declined by 42% per mile travelled by car compared with a 21% decline per 100,000 population. CONCLUSIONS: If trends in child mortality from injury continue the government's target to reduce the rate by 33% by the year 2005 will be achieved. A substantial proportion of the decline in pedestrian traffic and pedal cycling deaths, however, seems to have been achieved at the expense of children's walking and cycling activities. Changes in travel patterns may exact a considerable price in terms of future health problems. PMID:9116546

Temporal Changes in Mortality Related to Extreme Temperatures for 15 Cities in Northeast Asia: Adaptation to Heat and Maladaptation to Cold.

PubMed

Chung, Yeonseung; Noh, Heesang; Honda, Yasushi; Hashizume, Masahiro; Bell, Michelle L; Guo, Yue-Liang Leon; Kim, Ho

2017-05-15

Understanding how the temperature-mortality association worldwide changes over time is crucial to addressing questions of human adaptation under climate change. Previous studies investigated the temporal changes in the association over a few discrete time frames or assumed a linear change. Also, most studies focused on attenuation of heat-related mortality and studied the United States or Europe. This research examined continuous temporal changes (potentially nonlinear) in mortality related to extreme temperature (both heat and cold) for 15 cities in Northeast Asia (1972-2009). We used a generalized linear model with splines to simultaneously capture 2 types of nonlinearity: nonlinear association between temperature and mortality and nonlinear change over time in the association. We combined city-specific results to generate country-specific results using Bayesian hierarchical modeling. Cold-related mortality remained roughly constant over decades and slightly increased in the late 2000s, with a larger increase for cardiorespiratory deaths than for deaths from other causes. Heat-related mortality rates have decreased continuously over time, with more substantial decrease in earlier decades, for older populations and for cardiorespiratory deaths. Our findings suggest that future assessment of health effects of climate change should account for the continuous changes in temperature-related health risk and variations by factors such as age, cause of death, and location. © Crown copyright 2017.

Pleural cancer mortality in Spain: time-trends and updating of predictions up to 2020.

PubMed

López-Abente, Gonzalo; García-Gómez, Montserrat; Menéndez-Navarro, Alfredo; Fernández-Navarro, Pablo; Ramis, Rebeca; García-Pérez, Javier; Cervantes, Marta; Ferreras, Eva; Jiménez-Muñoz, María; Pastor-Barriuso, Roberto

2013-11-06

A total of 2,514,346 metric tons (Mt) of asbestos were imported into Spain from 1906 until the ban on asbestos in 2002. Our objective was to study pleural cancer mortality trends as an indicator of mesothelioma mortality and update mortality predictions for the periods 2011-2015 and 2016-2020 in Spain. Log-linear Poisson models were fitted to study the effect of age, period of death and birth cohort (APC) on mortality trends. Change points in cohort- and period-effect curvatures were assessed using segmented regression. Fractional power-link APC models were used to predict mortality until 2020. In addition, an alternative model based on national asbestos consumption figures was also used to perform long-term predictions. Pleural cancer deaths increased across the study period, rising from 491 in 1976-1980 to 1,249 in 2006-2010. Predictions for the five-year period 2016-2020 indicated a total of 1,319 pleural cancer deaths (264 deaths/year). Forecasts up to 2020 indicated that this increase would continue, though the age-adjusted rates showed a levelling-off in male mortality from 2001 to 2005, corresponding to the lower risk in post-1960 generations. Among women, rates were lower and the mortality trend was also different, indicating that occupational exposure was possibly the single factor having most influence on pleural cancer mortality. The cancer mortality-related consequences of human exposure to asbestos are set to persist and remain in evidence until the last surviving members of the exposed cohorts have disappeared. It can thus be assumed that occupationally-related deaths due to pleural mesothelioma will continue to occur in Spain until at least 2040.

[Death by homicide in Colombia and Mexico: magnitude and trends, 2000-2011].

PubMed

Dávila-Cervantes, Claudio Alberto; Pardo-Montaño, Ana Melisa

2014-07-01

To quantify the magnitude and explain the trends and impact of death by homicide in Colombia and Mexico between 2000 and 2011 at the national level and by sex. Data were obtained from national homicide statistics (Departamento Administrativo Nacional de Estadística [DANE], Colombia; and Instituto Nacional de Estadística y Geografía [INEGI], Mexico). Standardized death rates and years of life lost (YLL) were calculated (the latter assuming zero mortality) in people 15–49 years old. In Colombia, between 2000 and 2002, deaths by homicide increased from 71.3 to 76.7 per 100 000 (7.5%); by 2011 this figure had fallen to 36.1. YLL in the same period increased to 0.58 years overall, reducing temporary life expectancy by one year in men and 0.1 years in women. Between 2002 and 2011, YLL was 0.45 years in both sexes: 0.83 in men and 0.07 in women. This decline occurred mainly in persons over 45 years of age. In Mexico, between 2000 and 2007, homicide rates fell from 10.8 to 8.2 per 100,000 and YLL dropped by 24%. Between 2008 and 2011, mortality and YLL increased significantly in both sexes (191.2% and 164.5%, respectively), reducing life expectancy by 0.39 years in men and 0.04 years in women. It was corroborated that there has been a decline in deaths by homicide in Colombia and a significant rise in Mexico after a period of continuous reduction. Numerous actions should be taken to continue reducing homicides in Colombia and to reverse the current trend in Mexico.

REDUCE CHILD MORTALITY AS A MILLENNIUM DEVELOPMENI GOAL IN ROMANIA.

PubMed

Duma, Olga-Odetta; Roşu, Solange Tamara; Petrariu, F D; Manole, M; Constantin, Brânduşa

2016-01-01

To assess the efforts made in Romania towards achieving the Goal 4 from MDGs--Reduce Child Mortality. A descriptive study about the deaths among Romanian children under five, between 2002 and 2015, from the perspective of the MDGs. To help track progress toward this commitment, following specific targets and indicators were developed: Target 1-Halve the mortality rate in children aged 1-4 years between 2002-2015; Target 2--Reduce infant mortality by 40% between 2002 and 2015; Target 3--Eliminate measles by 2007. The comparison allows establish the status (achieved or not) for each target. From 2002, the under-five mortality rate recorded a continuous descendent trend till now (20.8 to 10.3 under five deaths per 1000 inhabitants in 2013). The infant mortality rates declined from 17.3 to 8.5 deaths per 1,000 live births (2002-2013). Eliminating measles by 2007--was achieved one year later, because of the measles epidemic in 2005 and 2006. High vaccination rates have been maintained, with the proportion of children 1 year old vaccinated against measles reaching and being maintained at between 94-98%. Substantial progress has been made in Romania, in achieving the Millennium Development Goal no. 4. All the three targets were achieved. However, infant mortality still remains above the average of European Union (4 infant deaths per 1,000 live-births).

Likelihood-based inference for discretely observed birth-death-shift processes, with applications to evolution of mobile genetic elements.

PubMed

Xu, Jason; Guttorp, Peter; Kato-Maeda, Midori; Minin, Vladimir N

2015-12-01

Continuous-time birth-death-shift (BDS) processes are frequently used in stochastic modeling, with many applications in ecology and epidemiology. In particular, such processes can model evolutionary dynamics of transposable elements-important genetic markers in molecular epidemiology. Estimation of the effects of individual covariates on the birth, death, and shift rates of the process can be accomplished by analyzing patient data, but inferring these rates in a discretely and unevenly observed setting presents computational challenges. We propose a multi-type branching process approximation to BDS processes and develop a corresponding expectation maximization algorithm, where we use spectral techniques to reduce calculation of expected sufficient statistics to low-dimensional integration. These techniques yield an efficient and robust optimization routine for inferring the rates of the BDS process, and apply broadly to multi-type branching processes whose rates can depend on many covariates. After rigorously testing our methodology in simulation studies, we apply our method to study intrapatient time evolution of IS6110 transposable element, a genetic marker frequently used during estimation of epidemiological clusters of Mycobacterium tuberculosis infections. © 2015, The International Biometric Society.

Annual Report to the Nation on the Status of Cancer, 1975–2006, Featuring Colorectal Trends and Impact of Interventions (Risk Factors, Screening, and Treatment) to Reduce Future Rates

PubMed Central

Edwards, Brenda K.; Ward, Elizabeth; Kohler, Betsy A.; Eheman, Christie; Zauber, Ann G.; Anderson, Robert N.; Jemal, Ahmedin; Schymura, Maria J.; Lansdorp-Vogelaar, Iris; Seeff, Laura C.; van Ballegooijen, Marjolein; Goede, S. Luuk; Ries, Lynn A. G.

2009-01-01

Background The American Cancer Society (ACS), the Centers for Disease Control and Prevention (CDC), the National Cancer Institute (NCI), and the North American Association of Central Cancer Registries (NAACCR) collaborate annually to provide updated information about cancer occurrence and trends in the United States (U.S.). This year’s report includes trends in colorectal cancer (CRC) incidence and death rates and highlights use of microsimulation modeling as a tool for interpreting past trends and projecting future trends to assist in cancer control planning and policy decisions. Methods Information on invasive cancers was obtained from the NCI, CDC, and NAACCR, and information on deaths from the CDC’s National Center for Health Statistics. Annual percentage changes in the age-standardized incidence and death rates (2000 U.S. population standard) for all cancers combined and for the top 15 cancers were estimated by joinpoint analysis of long-term (1975–2006) trends and short-term fixed interval (1997–2006) trends. All statistical tests were two-sided. Results Both incidence and death rates from all cancers combined significantly declined (P < .05) in the most recent time period for men and women overall and for most racial and ethnic populations. These decreases were driven largely by declines in both incidence and death rates for the 3 most common cancers in men (i.e., lung and prostate cancers and CRC) and for two of the 3 leading cancers in women (i.e., breast cancer and CRC). The long-term trends for lung cancer mortality in women showed smaller and smaller increases until 2003 when there was a change to a non-significant decline. Microsimulation modeling shows that declines in CRC death rates are consistent with a relatively large contribution from screening and with a smaller but demonstrable impact of risk factor reductions and improved treatments. These declines are projected to continue if risk factor modification, screening, and treatment remain at current rates, but could be further accelerated with favorable trends in risk factors and higher utilization of screening and optimal treatment. Conclusions Although the decrease in overall cancer incidence and death rates is encouraging, rising incidence and mortality for some cancers are of concern. PMID:19998273

Mortality risks in alcoholism and effects of abstinence and addiction treatment.

PubMed

Miller, N S

1999-06-01

The mortality rate from alcoholism and related comorbidities is high. Studies show multiple causes of premature death from alcoholism. Several studies showed that abstinence had a positive effective on the overall survival of alcoholics. Alcoholics who abstained from alcohol, particularly continuously, showed reduced mortality rates and increased years of longevity than alcoholics who relapsed to alcohol consumption. The sources of the findings tend to be derived from treatment populations, in which abstinence is expected to occur in higher rates than in the general population.

Causes of death from the randomized CoreValve US Pivotal High-Risk Trial.

PubMed

Gaudiani, Vincent; Deeb, G Michael; Popma, Jeffrey J; Adams, David H; Gleason, Thomas G; Conte, John V; Zorn, George L; Hermiller, James B; Chetcuti, Stan; Mumtaz, Mubashir; Yakubov, Steven J; Kleiman, Neal S; Huang, Jian; Reardon, Michael J

2017-06-01

Explore causes and timing of death from the CoreValve US Pivotal High-Risk Trial. An independent clinical events committee adjudicated causes of death, followed by post hoc hierarchical classification. Baseline characteristics, early outcomes, and causes of death were evaluated for 3 time periods (selected based on threshold of surgical 30-day mortality and on the differences in the continuous hazard between the 2 groups): early (0-30 days), recovery (31-120 days), and late (121-365 days). Differences in the rate of death were evident only during the recovery period (31-120 days), whereas 15 patients undergoing transcatheter aortic valve replacement (TAVR) (4.0%) and 27 surgical aortic valve replacement (SAVR) patients (7.9%) died (P = .025). This mortality difference was largely driven by higher rates of technical failure, surgical complications, and lack of recovery following surgery. From 0 to 30 days, the causes of death were more technical failures in the TAVR group and lack of recovery in the SAVR group. Mortality in the late period (121-365 days) in both arms was most commonly ascribed to other circumstances, comprising death from medical complications from comorbid disease. Mortality at 1 year in the CoreValve US Pivotal High-Risk Trial favored TAVR over SAVR. The major contributor was that more SAVR patients died during the recovery period (31-121 days), likely affected by the overall influence of physical stress associated with surgery. Similar rates of technical failure and complications were observed between the 2 groups. This suggests that early TAVR results can improve with technical refinements and that high-risk surgical patients will benefit from reducing complications. Copyright © 2017 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

Outcomes in African Americans and whites after percutaneous coronary intervention.

PubMed

Chen, Michael S; Bhatt, Deepak L; Chew, Derek P; Moliterno, David J; Ellis, Stephen G; Topol, Eric J

2005-09-01

We aimed to determine whether African Americans and whites have different outcomes after percutaneous coronary intervention (PCI). We prospectively selected 8832 patients (707 African Americans) for long-term follow-up after PCI at our institution from 1992 to 2002. The primary outcome studied was death or myocardial infarction at 1 year. Propensity adjustment was performed to account for baseline differences between African Americans and whites. African Americans had higher rates of diabetes and less prior revascularization. Percutaneous coronary interventions in African Americans were more often urgent. Stent use was similar. Procedural success rates were similar, as were periprocedural and 30-day composite rates of death or myocardial infarction. In 1-year unadjusted outcomes, African Americans had a higher rate of death or myocardial infarction (18.0% vs 14.5%; hazard ratio (HR) = 1.25; 95% confidence interval (CI): 1.04 to 1.50; P = 0.017), but the difference was no longer significant after propensity adjustment (HR = 1.18; 95% CI: 0.98 to 1.43, P = 0.087). African Americans had a higher risk for periprocedural bleeding that persisted after propensity adjustment (adjusted odds ratio = 1.45; 95% CI: 1.14 to 1.84, P = 0.002). After PCI, African Americans have similar short-term rates of death or myocardial infarction when compared with whites but have a nonsignificant trend toward worse long-term outcomes. Our findings, when interpreted in the context of reportedly lower revascularization rates among African Americans, suggest that continued efforts to optimize the appropriate use of coronary revascularization among African Americans are warranted.

Changing Trends in Complications and Mortality Rates Among US Youth and Young Adults With HIV Infection in the Era of Combination Antiretroviral Therapy.

PubMed

Mirani, Gayatri; Williams, Paige L; Chernoff, Miriam; Abzug, Mark J; Levin, Myron J; Seage, George R; Oleske, James M; Purswani, Murli U; Hazra, Rohan; Traite, Shirley; Zimmer, Bonnie; Van Dyke, Russell B

2015-12-15

Combination antiretroviral therapy (cART) has resulted in a dramatic decrease in human immunodeficiency virus (HIV)-related opportunistic infections and deaths in US youth, but both continue to occur. We estimated the incidence of complications and deaths in IMPAACT P1074, a long-term US-based prospective multicenter cohort study conducted from April 2008 to June 2014. Incidence rates of selected diagnoses and trends over time were compared with those from a previous observational cohort study, P219C (2004-2007). Causes of death and relevant demographic and clinical features were reviewed. Among 1201 HIV-infected youth in P1074 (87% perinatally infected; mean [standard deviation] age at last chart review, 20.9 [5.4] years), psychiatric and neurodevelopmental disorders, asthma, pneumonia, and genital tract infections were among the most common comorbid conditions. Compared with findings in P219C, conditions with significantly increased incidence included substance or alcohol abuse, latent tuberculosis, diabetes mellitus, atypical mycobacterial infections, vitamin D deficiency or metabolic bone disorders, anxiety disorders, and fractures; the incidence of pneumonia decreased significantly. Twenty-eight deaths occurred, yielding a standardized mortality rate 31.5 times that of the US population. Those who died were older, less likely to be receiving cART, and had lower CD4 cell counts and higher viral loads. Most deaths (86%) were due to HIV-related medical conditions. Opportunistic infections and deaths are less common among HIV-infected youth in the US in the cART era, but the mortality rate remains elevated. Deaths were associated with poor HIV control and older age. Emerging complications, such as psychiatric, inflammatory, metabolic, and genital tract diseases, need to be addressed. © The Author 2015. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Acute changes in community violence and increases in hospital visits and deaths from stress-responsive diseases.

PubMed

Ahern, Jennifer; Matthay, Ellicott C; Goin, Dana E; Farkas, Kriszta; Rudolph, Kara E

2018-06-06

Community violence may affect a broad range of health outcomes through physiologic stress responses and changes in health behaviors among residents. However, existing research on the health impacts of community violence suffers from problems with bias. We examined the relations of acute changes in community violence with hospital visits and deaths due to stress-responsive diseases (mental, respiratory, and cardiac conditions) in statewide data from California 2005-2013. The community violence exposure was measured as both binary spikes and continuous acute changes. We applied a combined fixed-effects and time-series design that separates the effects of violence from those of community- and individual-level confounders more effectively than past research. Temporal patterning was removed from community violence rates and disease rates in each place using a Kalman smoother, resulting in residual rates. We used linear regression with place fixed-effects to examine within-place associations of acute changes in community violence with residual rates of each outcome, controlling for local time-varying covariates. We found acute increases in hospital visits and deaths due to anxiety disorders (0.31 per 100,000; 95% Confidence Interval (CI) 0.02,0.59), substance use (0.47 per 100,000; 95%CI 0.14,0.80), asthma (0.56 per 100,000; 95%CI 0.16,0.95), and fatal acute myocardial infarction (0.09 per 100,000; 95%CI 0.00,0.18) co-occurring with violence spikes. The pattern of findings was similar for the exposure of continuous acute violence changes. Although the associations were small, the identified increases in stress-responsive conditions suggest the possibility of health impacts of acute changes in community violence.

Health Effects of Overweight and Obesity in 195 Countries over 25 Years.

PubMed

Afshin, Ashkan; Forouzanfar, Mohammad H; Reitsma, Marissa B; Sur, Patrick; Estep, Kara; Lee, Alex; Marczak, Laurie; Mokdad, Ali H; Moradi-Lakeh, Maziar; Naghavi, Mohsen; Salama, Joseph S; Vos, Theo; Abate, Kalkidan H; Abbafati, Cristiana; Ahmed, Muktar B; Al-Aly, Ziyad; Alkerwi, Ala’a; Al-Raddadi, Rajaa; Amare, Azmeraw T; Amberbir, Alemayehu; Amegah, Adeladza K; Amini, Erfan; Amrock, Stephen M; Anjana, Ranjit M; Ärnlöv, Johan; Asayesh, Hamid; Banerjee, Amitava; Barac, Aleksandra; Baye, Estifanos; Bennett, Derrick A; Beyene, Addisu S; Biadgilign, Sibhatu; Biryukov, Stan; Bjertness, Espen; Boneya, Dube J; Campos-Nonato, Ismael; Carrero, Juan J; Cecilio, Pedro; Cercy, Kelly; Ciobanu, Liliana G; Cornaby, Leslie; Damtew, Solomon A; Dandona, Lalit; Dandona, Rakhi; Dharmaratne, Samath D; Duncan, Bruce B; Eshrati, Babak; Esteghamati, Alireza; Feigin, Valery L; Fernandes, João C; Fürst, Thomas; Gebrehiwot, Tsegaye T; Gold, Audra; Gona, Philimon N; Goto, Atsushi; Habtewold, Tesfa D; Hadush, Kokeb T; Hafezi-Nejad, Nima; Hay, Simon I; Horino, Masako; Islami, Farhad; Kamal, Ritul; Kasaeian, Amir; Katikireddi, Srinivasa V; Kengne, Andre P; Kesavachandran, Chandrasekharan N; Khader, Yousef S; Khang, Young-Ho; Khubchandani, Jagdish; Kim, Daniel; Kim, Yun J; Kinfu, Yohannes; Kosen, Soewarta; Ku, Tiffany; Defo, Barthelemy Kuate; Kumar, G Anil; Larson, Heidi J; Leinsalu, Mall; Liang, Xiaofeng; Lim, Stephen S; Liu, Patrick; Lopez, Alan D; Lozano, Rafael; Majeed, Azeem; Malekzadeh, Reza; Malta, Deborah C; Mazidi, Mohsen; McAlinden, Colm; McGarvey, Stephen T; Mengistu, Desalegn T; Mensah, George A; Mensink, Gert B M; Mezgebe, Haftay B; Mirrakhimov, Erkin M; Mueller, Ulrich O; Noubiap, Jean J; Obermeyer, Carla M; Ogbo, Felix A; Owolabi, Mayowa O; Patton, George C; Pourmalek, Farshad; Qorbani, Mostafa; Rafay, Anwar; Rai, Rajesh K; Ranabhat, Chhabi L; Reinig, Nikolas; Safiri, Saeid; Salomon, Joshua A; Sanabria, Juan R; Santos, Itamar S; Sartorius, Benn; Sawhney, Monika; Schmidhuber, Josef; Schutte, Aletta E; Schmidt, Maria I; Sepanlou, Sadaf G; Shamsizadeh, Moretza; Sheikhbahaei, Sara; Shin, Min-Jeong; Shiri, Rahman; Shiue, Ivy; Roba, Hirbo S; Silva, Diego A S; Silverberg, Jonathan I; Singh, Jasvinder A; Stranges, Saverio; Swaminathan, Soumya; Tabarés-Seisdedos, Rafael; Tadese, Fentaw; Tedla, Bemnet A; Tegegne, Balewgizie S; Terkawi, Abdullah S; Thakur, J S; Tonelli, Marcello; Topor-Madry, Roman; Tyrovolas, Stefanos; Ukwaja, Kingsley N; Uthman, Olalekan A; Vaezghasemi, Masoud; Vasankari, Tommi; Vlassov, Vasiliy V; Vollset, Stein E; Weiderpass, Elisabete; Werdecker, Andrea; Wesana, Joshua; Westerman, Ronny; Yano, Yuichiro; Yonemoto, Naohiro; Yonga, Gerald; Zaidi, Zoubida; Zenebe, Zerihun M; Zipkin, Ben; Murray, Christopher J L

2017-07-06

Although the rising pandemic of obesity has received major attention in many countries, the effects of this attention on trends and the disease burden of obesity remain uncertain. We analyzed data from 68.5 million persons to assess the trends in the prevalence of overweight and obesity among children and adults between 1980 and 2015. Using the Global Burden of Disease study data and methods, we also quantified the burden of disease related to high body-mass index (BMI), according to age, sex, cause, and BMI in 195 countries between 1990 and 2015. In 2015, a total of 107.7 million children and 603.7 million adults were obese. Since 1980, the prevalence of obesity has doubled in more than 70 countries and has continuously increased in most other countries. Although the prevalence of obesity among children has been lower than that among adults, the rate of increase in childhood obesity in many countries has been greater than the rate of increase in adult obesity. High BMI accounted for 4.0 million deaths globally, nearly 40% of which occurred in persons who were not obese. More than two thirds of deaths related to high BMI were due to cardiovascular disease. The disease burden related to high BMI has increased since 1990; however, the rate of this increase has been attenuated owing to decreases in underlying rates of death from cardiovascular disease. The rapid increase in the prevalence and disease burden of elevated BMI highlights the need for continued focus on surveillance of BMI and identification, implementation, and evaluation of evidence-based interventions to address this problem. (Funded by the Bill and Melinda Gates Foundation.).

Annual Report to the Nation on the Status of Cancer, 1975-2012, featuring the increasing incidence of liver cancer.

PubMed

Ryerson, A Blythe; Eheman, Christie R; Altekruse, Sean F; Ward, John W; Jemal, Ahmedin; Sherman, Recinda L; Henley, S Jane; Holtzman, Deborah; Lake, Andrew; Noone, Anne-Michelle; Anderson, Robert N; Ma, Jiemin; Ly, Kathleen N; Cronin, Kathleen A; Penberthy, Lynne; Kohler, Betsy A

2016-05-01

Annual updates on cancer occurrence and trends in the United States are provided through an ongoing collaboration among the American Cancer Society (ACS), the Centers for Disease Control and Prevention (CDC), the National Cancer Institute (NCI), and the North American Association of Central Cancer Registries (NAACCR). This annual report highlights the increasing burden of liver and intrahepatic bile duct (liver) cancers. Cancer incidence data were obtained from the CDC, NCI, and NAACCR; data about cancer deaths were obtained from the CDC's National Center for Health Statistics (NCHS). Annual percent changes in incidence and death rates (age-adjusted to the 2000 US Standard Population) for all cancers combined and for the leading cancers among men and women were estimated by joinpoint analysis of long-term trends (incidence for 1992-2012 and mortality for 1975-2012) and short-term trends (2008-2012). In-depth analysis of liver cancer incidence included an age-period-cohort analysis and an incidence-based estimation of person-years of life lost because of the disease. By using NCHS multiple causes of death data, hepatitis C virus (HCV) and liver cancer-associated death rates were examined from 1999 through 2013. Among men and women of all major racial and ethnic groups, death rates continued to decline for all cancers combined and for most cancer sites; the overall cancer death rate (for both sexes combined) decreased by 1.5% per year from 2003 to 2012. Overall, incidence rates decreased among men and remained stable among women from 2003 to 2012. Among both men and women, deaths from liver cancer increased at the highest rate of all cancer sites, and liver cancer incidence rates increased sharply, second only to thyroid cancer. Men had more than twice the incidence rate of liver cancer than women, and rates increased with age for both sexes. Among non-Hispanic (NH) white, NH black, and Hispanic men and women, liver cancer incidence rates were higher for persons born after the 1938 to 1947 birth cohort. In contrast, there was a minimal birth cohort effect for NH Asian and Pacific Islanders (APIs). NH black men and Hispanic men had the lowest median age at death (60 and 62 years, respectively) and the highest average person-years of life lost per death (21 and 20 years, respectively) from liver cancer. HCV and liver cancer-associated death rates were highest among decedents who were born during 1945 through 1965. Overall, cancer incidence and mortality declined among men; and, although cancer incidence was stable among women, mortality declined. The burden of liver cancer is growing and is not equally distributed throughout the population. Efforts to vaccinate populations that are vulnerable to hepatitis B virus (HBV) infection and to identify and treat those living with HCV or HBV infection, metabolic conditions, alcoholic liver disease, or other causes of cirrhosis can be effective in reducing the incidence and mortality of liver cancer. Cancer 2016;122:1312-1337. © 2016 American Cancer Society. © 2016 American Cancer Society.

Annual Report to the Nation on the Status of Cancer, 1975–2012, Featuring the Increasing Incidence of Liver Cancer

PubMed Central

Ryerson, A. Blythe; Eheman, Christie R.; Altekruse, Sean F.; Ward, John W.; Jemal, Ahmedin; Sherman, Recinda L.; Henley, S. Jane; Holtzman, Deborah; Lake, Andrew; Noone, Anne-Michelle; Anderson, Robert N.; Ma, Jiemin; Ly, Kathleen N.; Cronin, Kathleen A.; Penberthy, Lynne; Kohler, Betsy A.

2016-01-01

BACKGROUND Annual updates on cancer occurrence and trends in the United States are provided through an ongoing collaboration among the American Cancer Society (ACS), the Centers for Disease Control and Prevention (CDC), the National Cancer Institute (NCI), and the North American Association of Central Cancer Registries (NAACCR). This annual report highlights the increasing burden of liver and intrahepatic bile duct (liver) cancers. METHODS Cancer incidence data were obtained from the CDC, NCI, and NAACCR; data about cancer deaths were obtained from the CDC’s National Center for Health Statistics (NCHS). Annual percent changes in incidence and death rates (age-adjusted to the 2000 US Standard Population) for all cancers combined and for the leading cancers among men and women were estimated by joinpoint analysis of long-term trends (incidence for 1992–2012 and mortality for 1975–2012) and short-term trends (2008–2012). In-depth analysis of liver cancer incidence included an age-period-cohort analysis and an incidence-based estimation of person-years of life lost because of the disease. By using NCHS multiple causes of death data, hepatitis C virus (HCV) and liver cancer-associated death rates were examined from 1999 through 2013. RESULTS Among men and women of all major racial and ethnic groups, death rates continued to decline for all cancers combined and for most cancer sites; the overall cancer death rate (for both sexes combined) decreased by 1.5% per year from 2003 to 2012. Overall, incidence rates decreased among men and remained stable among women from 2003 to 2012. Among both men and women, deaths from liver cancer increased at the highest rate of all cancer sites, and liver cancer incidence rates increased sharply, second only to thyroid cancer. Men had more than twice the incidence rate of liver cancer than women, and rates increased with age for both sexes. Among non-Hispanic (NH) white, NH black, and Hispanic men and women, liver cancer incidence rates were higher for persons born after the 1938 to 1947 birth cohort. In contrast, there was a minimal birth cohort effect for NH Asian and Pacific Islanders (APIs). NH black men and Hispanic men had the lowest median age at death (60 and 62 years, respectively) and the highest average person-years of life lost per death (21 and 20 years, respectively) from liver cancer. HCV and liver cancer-associated death rates were highest among decedents who were born during 1945 through 1965. CONCLUSIONS Overall, cancer incidence and mortality declined among men; and, although cancer incidence was stable among women, mortality declined. The burden of liver cancer is growing and is not equally distributed throughout the population. Efforts to vaccinate populations that are vulnerable to hepatitis B virus (HBV) infection and to identify and treat those living with HCV or HBV infection, metabolic conditions, alcoholic liver disease, or other causes of cirrhosis can be effective in reducing the incidence and mortality of liver cancer. PMID:26959385

[Estimation of the excess death associated with influenza pandemics and epidemics in Japan after world war II: relation with pandemics and the vaccination system].

PubMed

Ohmi, Kenichi; Marui, Eiji

2011-10-01

To estimate the excess death associated with influenza pandemics and epidemics in Japan after World War II, and to reexamine the relationship between the excess death and the vaccination system in Japan. Using the Japanese national vital statistics data for 1952-2009, we specified months with influenza epidemics, monthly mortality rates and the seasonal index for 1952-74 and for 1975-2009. Then we calculated excess deaths of each month from the observed number of deaths and the 95% range of expected deaths. Lastly we calculated age-adjusted excess death rates using the 1985 model population of Japan. The total number of excess deaths for 1952-2009 was 687,279 (95% range, 384,149-970,468), 12,058 (95% range, 6,739-17,026) per year. The total number of excess deaths in 6 pandemic years of 1957-58, 58-59, 1968-69, 69-70, 77-78 and 78-79, was 95,904, while that in 51 'non-pandemic' years was 591,376, 6.17 fold larger than pandemic years. The average number of excess deaths for pandemic years was 23,976, nearly equal to that for 'non-pandemic' years, 23,655. At the beginning of pandemics, 1957-58, 1968-69, 1969-70, the proportion of those aged <65 years in excess deaths rose compared with 'non-pandemic' years. In the 1970s and 1980s, when the vaccination program for schoolchildren was mandatory in Japan on the basis of the "Fukumi thesis", age-adjusted average excess mortality rates were relatively low, with an average of 6.17 per hundred thousand. In the 1990s, when group vaccination was discontinued, age-adjusted excess mortality rose up to 9.42, only to drop again to 2.04 when influenza vaccination was made available to the elderly in the 2000s, suggesting that the vaccination of Japanese children prevented excess deaths from influenza pandemics and epidemics. Moreover, in the age group under 65, average excess mortality rates were low in the 1970s and 1980s rather than in the 2000s, which shows that the "Social Defensive" schoolchildren vaccination program in the 1970s and 1980s was more effective than the "Individual Defensive" vaccination program in the 2000s. Excess deaths were observed continually, and not limited to pandemic years. We must not slight public health interventions for 'non-pandemic' influenza as well as pandemic influenza. We should also re-examine the importance of "Social Defenses", including preventative vaccination, for public health policy.

Differences in Poisoning Mortality in the United States, 2003–2007: Epidemiology of Poisoning Deaths Classified as Unintentional, Suicide or Homicide

PubMed Central

Muazzam, Sana; Swahn, Monica H.; Alamgir, Hasanat; Nasrullah, Muazzam

2012-01-01

Introduction Poisoning, specifically unintentional poisoning, is a major public health problem in the United States (U.S.). Published literature that presents epidemiology of all forms of poisoning mortalities (i.e., unintentional, suicide, homicide) together is limited. This report presents data and summarizes the evidence on poisoning mortality by demographic and geographic characteristics to describe the burden of poisoning mortality and the differences among sub-populations in the U.S. for a 5-year period. Methods Using mortality data from the Center for Disease Control and Prevention's Web-based Injury Statistics Query and Reporting System, we presented the age-specific and age-adjusted unintentional and intentional (suicide, homicide) poisoning mortality rates by sex, age, race, and state of residence for the most recent years (2003–2007) of available data. Annual percentage changes in deaths and rates were calculated, and linear regression using natural log were used for time-trend analysis. Results There were 121,367 (rate=8.18 per 100,000) unintentional poisoning deaths. Overall, the unintentional poisoning mortality rate increased by 46.9%, from 6.7 per 100,000 in 2003 to 9.8 per100.000 in 2007, with the highest mortality rate among those aged 40–59 (rate=15.36), males (rate=11.02) and whites (rate=8.68). New Mexico (rate=18.2) had the highest rate. Unintentional poisoning mortality rate increased significantly among both sexes, and all racial groups except blacks (p<0.05 time-related trend for rate). Among a total of 29,469 (rate=1.97) suicidal poisoning deaths, the rate increased by 9.9%, from 1.9 per 100,000 in 2003 to 2.1 per 100,000 in 2007, with the highest rate among those aged 40–59 (rate=3.92), males (rate=2.20) and whites (rate=2.24). Nevada (rate=3.9) had the highest rate. Mortality rate increased significantly among females and whites only (p<0.05 time-related trend for rate). There were 463 (rate=0.03) homicidal poisoning deaths and the rate remained the same during 2003–2007. The highest rates were among aged 0–19 (rate=0.05), males (rate=0.04) and blacks (rate=0.06). Conclusion Prevention efforts for poisoning mortalities, especially unintentional poisoning, should be developed, implemented and strengthened. Differences exist in poisoning mortality by age, sex, location, and these findings underscore the urgency of addressing this public health burden as this epidemic continues to grow in the U.S. PMID:22900120

Is council tax valuation band a predictor of mortality?

PubMed Central

Beale, Norman R; Taylor, Gordon J; Straker-Cook, Dawn MK

2002-01-01

Background All current UK indices of socio-economic status have inherent problems, especially those used to govern resource allocation to the health sphere. The search for improved markers continues: this study proposes and tests the possibility that Council Tax Valuation Band (CTVB) might match requirements. Presentation of the hypothesis To determine if there is an association between CTVB of final residence and mortality risk using the death registers of a UK general practice. Testing the hypothesis Standardised death rates and odds ratios (ORs) for groups defined by CTVB of dwelling (A – H) were calculated using one in four denominator samples from the practice lists. Analyses were repeated three times – between number of deaths and CTVB of residence of deceased 1992 – 1994 inclusive, 1995 – 1997 inc., 1998 – 2000 inc. In 856 deaths there were consistent and significant differences in death rates between CTVBs: above average for bands A and B residents; below average for other band residents. There were significantly higher ORs for A, B residents who were female and who died prematurely (before average group life expectancy). Implications of the hypothesis CTVB of final residence appears to be a proxy marker of mortality risk and could be a valuable indicator of health needs resource at household level. It is worthy of further exploration. PMID:12207828

Fatal occupational injuries among electric power company workers.

PubMed

Loomis, D; Dufort, V; Kleckner, R C; Savitz, D A

1999-03-01

Surveillance data suggest high rates of electrocutions and fatal falls among workers in electric utility companies, who may be exposed to electric current, heights, flammable agents, and frequent motor vehicle travel. To characterize the occurrence of fatal injuries among electric utility workers, we studied workers in five electric power companies in the United States. A cohort of 127,129 men hired between 1950 and 1986 was followed through 1988. Injuries at work were identified through manual review of death certificates. The occurrence of occupational injuries was analyzed with directly adjusted rates and Poisson regression. The overall rate of fatal occupational injuries was 13.20 per 100,000 person-years (n = 192), with 76% due to electric current, homicide, and falls from heights. Deaths were concentrated in a few groups with elevated injury rates, notably linemen (rate ratio (RR) 3.33), electricians (RR 2.79), and painters (RR 3.27). Occupations requiring daily work on elevations or frequent, direct contact with energized electrical equipment experienced markedly higher rates of fatal injury from falls and electrocutions with rate ratios of 21.8 (95% confidence interval (CI) 11.4-41.5) and 16.7 (95% CI 6.6-42.6), respectively, independent of worker age and seniority. Although fatal injury rates in this industry have declined in recent decades, significant numbers of deaths still occur. Based on the premise that all injuries are preventable, a need for continued vigilance and efforts at prevention is indicated.

Deaths of Detainees in the Custody of US Forces in Iraq and Afghanistan From 2002 to 2005

PubMed Central

Allen, Scott A.; Rich, Josiah D.; Bux, Robert C.; Farbenblum, Bassina; Berns, Matthew; Rubenstein, Leonard

2006-01-01

In light of the large number of detainees who continue to be taken and held in US custody in settings with limited judicial or public oversight, deaths of detainees warrant scrutiny. We have undertaken the task of reviewing all known detainee deaths between 2002 and early 2005 based on reports available in the public domain. Using documents obtained from the Department of Defense through a Freedom of Information Act request, combined with a review of anecdotal published press accounts, 112 cases of death of detainees in United States custody (105 in Iraq, 7 in Afghanistan) during the period from 2002 to early 2005 were identified. Homicide accounted for the largest number of deaths (43) followed by enemy mortar attacks against the detention facility (36). Deaths attributed to natural causes numbered 20. Nine were listed as unknown cause of death, and 4 were reported as accidental or natural. A clustering of 8 deaths ascribed to natural causes in Iraq in August 2003 raises questions about the adequacy and availability of medical care, as well as other conditions of confinement that may have had an impact on the mortality rate. PMID:17415327

Using community-based reporting of vital events to monitor child mortality: Lessons from rural Ghana.

PubMed

Helleringer, Stephane; Arhinful, Daniel; Abuaku, Benjamin; Humes, Michael; Wilson, Emily; Marsh, Andrew; Clermont, Adrienne; Black, Robert E; Bryce, Jennifer; Amouzou, Agbessi

2018-01-01

Reducing neonatal and child mortality is a key component of the health-related sustainable development goal (SDG), but most low and middle income countries lack data to monitor child mortality on an annual basis. We tested a mortality monitoring system based on the continuous recording of pregnancies, births and deaths by trained community-based volunteers (CBV). This project was implemented in 96 clusters located in three districts of the Northern Region of Ghana. Community-based volunteers (CBVs) were selected from these clusters and were trained in recording all pregnancies, births, and deaths among children under 5 in their catchment areas. Data collection lasted from January 2012 through September 2013. All CBVs transmitted tallies of recorded births and deaths to the Ghana Birth and deaths registry each month, except in one of the study districts (approximately 80% reporting). Some events were reported only several months after they had occurred. We assessed the completeness and accuracy of CBV data by comparing them to retrospective full pregnancy histories (FPH) collected during a census of the same clusters conducted in October-December 2013. We conducted all analyses separately by district, as well as for the combined sample of all districts. During the 21-month implementation period, the CBVs reported a total of 2,819 births and 137 under-five deaths. Among the latter, there were 84 infant deaths (55 neonatal deaths and 29 post-neonatal deaths). Comparison of the CBV data with FPH data suggested that CBVs significantly under-estimated child mortality: the estimated under-5 mortality rate according to CBV data was only 2/3 of the rate estimated from FPH data (95% Confidence Interval for the ratio of the two rates = 51.7 to 81.4). The discrepancies between the CBV and FPH estimates of infant and neonatal mortality were more limited, but varied significantly across districts. In northern Ghana, a community-based data collection systems relying on volunteers did not yield accurate estimates of child mortality rates. Additional implementation research is needed to improve the timeliness, completeness and accuracy of such systems. Enhancing pregnancy monitoring, in particular, may be an essential step to improve the measurement of neonatal mortality.

Occupational fatalities in the United States commercial fishing industry, 2000-2009.

PubMed

Lincoln, Jennifer M; Lucas, Devin L

2010-10-01

The occupational fatality rate among commercial fishermen decreased in the United States during 1992-2008; however, commercial fishing continues to be one of the most dangerous occupations in the United States, with an average annual fatality rate of 129 deaths per 100,000 fishermen in 2008. By contrast, the average annual occupational fatality rate among all US workers during the same period was four deaths per 100,000 workers. During the 1990s, numerous safety interventions were developed for Alaska fisheries that resulted in a significant decline in the state's commercial fishing fatality rate. In 2007, the National Institute for Occupational Safety and Health (NIOSH) expanded surveillance of commercial fishing fatalities to the rest of the United States. The purpose of this report is to identify the hazards and risk factors for all causes of occupational mortality in the US commercial fishing industry, and to explore how those hazards and risk factors differ among fisheries and locations. During 2000-2009, 504 commercial fishing fatalities occurred in the United States. Most (261, 52%) occurred following a vessel disaster (defined as a sinking, capsizing, or other event in which the crew was forced to abandon ship) or a fall overboard (155, 31%). Fatalities occurred in Alaska (133, 26%), Northeast (124, 25%), Gulf of Mexico (116, 23%), West Coast (83, 16%), and the Mid- and South Atlantic (41, 8%) regions. Fatalities occurred most commonly while fishing for shellfish (226, 47%), groundfish (144, 30%) and pelagic fish (97, 20%). Average annual fatality rates were calculated for selected fisheries. The Northeast multispecies groundfish fleet had the highest average annual fatality rate (600 deaths per 100,000 full-time equivalent [FTE] fishermen) followed by the Atlantic scallop fleet (425 deaths per 100,000 FTE fishermen) and the West Coast Dungeness crab fleet (310 deaths per 100,000 FTE fishermen). To reduce fatalities among fishermen at greatest risk, additional prevention measures tailored to specific high-risk fisheries should be considered.

HIV/AIDS-related mortality in Africa and Asia: evidence from INDEPTH health and demographic surveillance system sites.

PubMed

Streatfield, P Kim; Khan, Wasif A; Bhuiya, Abbas; Hanifi, Syed M A; Alam, Nurul; Millogo, Ourohiré; Sié, Ali; Zabré, Pascal; Rossier, Clementine; Soura, Abdramane B; Bonfoh, Bassirou; Kone, Siaka; Ngoran, Eliezer K; Utzinger, Juerg; Abera, Semaw F; Melaku, Yohannes A; Weldearegawi, Berhe; Gomez, Pierre; Jasseh, Momodou; Ansah, Patrick; Azongo, Daniel; Kondayire, Felix; Oduro, Abraham; Amu, Alberta; Gyapong, Margaret; Kwarteng, Odette; Kant, Shashi; Pandav, Chandrakant S; Rai, Sanjay K; Juvekar, Sanjay; Muralidharan, Veena; Wahab, Abdul; Wilopo, Siswanto; Bauni, Evasius; Mochamah, George; Ndila, Carolyne; Williams, Thomas N; Khagayi, Sammy; Laserson, Kayla F; Nyaguara, Amek; Van Eijk, Anna M; Ezeh, Alex; Kyobutungi, Catherine; Wamukoya, Marylene; Chihana, Menard; Crampin, Amelia; Price, Alison; Delaunay, Valérie; Diallo, Aldiouma; Douillot, Laetitia; Sokhna, Cheikh; Gómez-Olivé, F Xavier; Mee, Paul; Tollman, Stephen M; Herbst, Kobus; Mossong, Joël; Chuc, Nguyen T K; Arthur, Samuelina S; Sankoh, Osman A; Byass, Peter

2014-01-01

As the HIV/AIDS pandemic has evolved over recent decades, Africa has been the most affected region, even though a large proportion of HIV/AIDS deaths have not been documented at the individual level. Systematic application of verbal autopsy (VA) methods in defined populations provides an opportunity to assess the mortality burden of the pandemic from individual data. To present standardised comparisons of HIV/AIDS-related mortality at sites across Africa and Asia, including closely related causes of death such as pulmonary tuberculosis (PTB) and pneumonia. Deaths related to HIV/AIDS were extracted from individual demographic and VA data from 22 INDEPTH sites across Africa and Asia. VA data were standardised to WHO 2012 standard causes of death assigned using the InterVA-4 model. Between-site comparisons of mortality rates were standardised using the INDEPTH 2013 standard population. The dataset covered a total of 10,773 deaths attributed to HIV/AIDS, observed over 12,204,043 person-years. HIV/AIDS-related mortality fractions and mortality rates varied widely across Africa and Asia, with highest burdens in eastern and southern Africa, and lowest burdens in Asia. There was evidence of rapidly declining rates at the sites with the heaviest burdens. HIV/AIDS mortality was also strongly related to PTB mortality. On a country basis, there were strong similarities between HIV/AIDS mortality rates at INDEPTH sites and those derived from modelled estimates. Measuring HIV/AIDS-related mortality continues to be a challenging issue, all the more so as anti-retroviral treatment programmes alleviate mortality risks. The congruence between these results and other estimates adds plausibility to both approaches. These data, covering some of the highest mortality observed during the pandemic, will be an important baseline for understanding the future decline of HIV/AIDS.

South African child deaths 1990–2011: have HIV services reversed the trend enough to meet Millennium Development Goal 4?

PubMed Central

Kerber, Kate J.; Lawn, Joy E.; Johnson, Leigh F.; Mahy, Mary; Dorrington, Rob E.; Phillips, Heston; Bradshaw, Debbie; Nannan, Nadine; Msemburi, William; Oestergaard, Mikkel Z.; Walker, Neff P.; Sanders, David; Jackson, Debra

2013-01-01

Objective: To analyse trends in under-five mortality rate in South Africa (1990–2011), particularly the contribution of AIDS deaths. Methods: Three nationally used models for estimating AIDS deaths in children were systematically reviewed. The model outputs were compared with under-five mortality rate estimates for South Africa from two global estimation models. All estimates were compared with available empirical data. Results: Differences between the models resulted in varying point estimates for under-five mortality but the trends were similar, with mortality increasing to a peak around 2005. The three models showing the contribution of AIDS suggest a maximum of 37–39% of child deaths were due to AIDS in 2004–2005 which has since declined. Although the rate of progress from 1990 is not the 4.4% needed to meet Millennium Development Goal 4 for child survival, South Africa's average annual rate of under-five mortality decline between 2006 and 2011 was between 6.3 and 10.2%. Conclusion: In 2005, South Africa was one of only four countries globally with an under-five mortality rate higher than the 1990 Millennium Development Goal baseline. Over the past 5 years, the country has achieved a rate of child mortality reduction exceeded by only three other countries. This rapid turnaround is likely due to scale-up of prevention of mother-to-child transmission of HIV, and to a lesser degree, the expanded roll-out of antiretroviral therapy. Emphasis on these programmes must continue, but failure to address other aspects of care including integrated high-quality maternal and neonatal care means that the decline in child mortality could stall. PMID:23863402

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.

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

Influence of simulated microgravity on the longevity of insect-cell culture

NASA Technical Reports Server (NTRS)

Cowger, N. L.; O'Connor, K. C.; Bivins, J. E.

1997-01-01

Simulated microgravity within the NASA High Aspect Rotating-Wall Vessel (HARV) provides a quiescent environment to culture fragile insect cells. In this vessel, the duration of stationary and death phase for cultures of Spodoptera frugiperda cells was greatly extended over that achieved in shaker-flask controls. For both HARV and control cultures, S. frugiperda cells grew to concentrations in excess of 1 x 10(7) viable cells ml-1 with viabilities greater than 90%. In the HARV, stationary phase was maintained 9-15 days in contrast to 4-5 days in the shaker flask. Furthermore, the rate of cell death was reduced in the HARV by a factor of 20-90 relative to the control culture and was characterized with a death rate constant of 0.01-0.02 day-1. Beginning in the stationary phase and continuing in the death phase, there was a significant decrease in population size in the HARV versus an increase in the shaker flask. This phenomenon could represent cell adaptation to simulated microgravity and/or a change in the ratio of apoptotic to necrotic cells. Differences observed in this research between the HARV and its control were attributed to a reduction in hydrodynamic forces in the microgravity vessel.

Time since death and decomposition of the human body: variables and observations in case and experimental field studies.

PubMed

Mann, R W; Bass, W M; Meadows, L

1990-01-01

Much of the difficulty in determining the time since death stems from the lack of systematic observation and research on the decomposition rate of the human body. Continuing studies conducted at the University of Tennessee, Knoxville, provide useful information on the impact of carrion insect activity, ambient temperature, rainfall, clothing, burial and depth, carnivores, bodily trauma, body weight, and the surface with which the body is in contact. This paper reports findings and observations accumulated during eight years of research and case studies that may clarify some of the questions concerning bodily decay.

Demographic trends in suicide in the UK and Ireland 1980-2010.

PubMed

Murphy, O C; Kelleher, C; Malone, K M

2015-03-01

Ireland has the 17th highest suicide rate in the EU and the 4th highest among 15-24-year-old males (WHO 2012). Suicide is the leading cause of death in this age group; death by hanging accounted for 69 % of suicides in 2010. This study examines youth suicide rates from 1980 to 2010 in Ireland and compares them to the rates in Northern Ireland, Scotland, England and Wales. Irish data were obtained from the Central Statistics Office and their annual reports on Vital Statistics. Northern Irish data were obtained from the Northern Ireland Statistics and Research Agency website; Scottish data were from the General Register Office for Scotland and English/Welsh data from the Office for National Statistics website. There has been a threefold increase in young male suicide in Ireland over the past three decades (8.9-29.7 per 100,000). In contrast, there has been approximately a threefold reduction in deaths by road traffic accidents in young men in the same period (42.7-16.2 per 100,000). Suicide rates in young men are similar in Scotland and Northern Ireland for the same period but are 50 % lower in England and Wales. Despite the rates of hanging as a method of suicide increasing in all jurisdictions, the overall rate in England and Wales has continued to decline. The suicide rate in Ireland remains very high and strategies to address this are urgently required. Our study indicates that national suicide prevention strategies can be effective.

Delayed Referral Results in Missed Opportunities for Organ Donation After Circulatory Death.

PubMed

Krmpotic, Kristina; Payne, Clare; Isenor, Cynthia; Dhanani, Sonny

2017-06-01

Rates of organ donation and transplantation have steadily increased in the United States and Canada over the past decade, largely attributable to a notable increase in donation after circulatory death. However, the number of patients awaiting solid organ transplantation continues to remain much higher than the number of organs transplanted each year. The objective of this study was to determine the potential to increase donation rates further by identifying gaps in the well-established donation after circulatory death process in Ontario. Retrospective cohort study. Provincial organ procurement organization. Patients who died in designated donation hospitals within the province of Ontario, Canada between April 1, 2013, and March 31, 2015. None. Of 1,407 patient deaths following planned withdrawal of life-sustaining therapy, 54.0% (n = 760) were medically suitable for donation after circulatory death. In 438 cases where next of kin was approached, consent rates reached 47.5%. A total of 119 patients became actual organ donors. Only 66.2% (n = 503) of suitable patients were appropriately referred, resulting in 251 missed potential donors whose next of kin could not be approached regarding organ donation because referral occurred after initiation of withdrawal of life-sustaining therapy or not at all. The number of medically suitable patients who die within 2 hours of planned withdrawal of life-sustaining therapy is nearly six times higher than the number of actual organ donors, with the greatest loss of potential due to delayed referral until at the time of or after planned withdrawal of life-sustaining therapy. Intensive care teams are not meeting their ethical responsibility to recognize impending death and appropriately refer potential organ donors to the local organ procurement organization. In cases where patients had previously registered their consent decision, they were denied a healthcare right.

Peri-operative Adverse Outcomes in Patients with Atrial Fibrillation Taking Warfarin or Edoxaban: Analysis of the ENGAGE AF-TIMI 48 Trial.

PubMed

Douketis, James D; Murphy, Sabina A; Antman, Elliott M; Grip, Laura T; Mercuri, Michele F; Ruff, Christian T; Weitz, Jeffrey I; Braunwald, Eugene; Giugliano, Robert P

2018-06-01

 Peri-operative management of anticoagulated patients with atrial fibrillation (AF) is challenging. To gain information on the peri-operative management of edoxaban, we compared outcomes in patients on warfarin or edoxaban enrolled in ENGAGE AF-TIMI 48 who underwent a surgery or invasive procedure.  Data from patients undergoing their first surgery/procedure were analysed and results compared by anticoagulant (warfarin vs. higher- or lower-dose edoxaban regimen [HDER and LDER, respectively]). Patients were classified by procedural management: anticoagulant interrupted (last dose 4-10 days pre-procedure) or anticoagulant continued (last dose ≤ 3 days pre-procedure). Stroke/systemic embolism (SSE), major bleeding (MB), MB or clinically relevant non-MB (CRNMB) and death were assessed from 7 days pre- until 30 days post-procedure. The chi-square test was used to compare outcomes across treatment groups.  A total of 7,193 patients (34%) underwent surgery/procedure: 3,116 had anticoagulant interrupted, 4,077 had anticoagulant continued. Among patients on warfarin, HDER and LDER who had anticoagulant interrupted, rates of SSE were 0.6, 0.5 and 0.9% ( p  = 0.53), rates of MB were 1.0, 1.2 and 1.1% ( p  = 0.94) and rates of MB or CRNMB were 3.9, 4.2 and 3.6% ( p  = 0.78); among patients on warfarin, HDER and LDER who had anticoagulant continued, rates of SSE were 1.1, 0.7 and 0.9% ( p  = 0.51), rates of MB were 3.6, 2.6 and 2.4% ( p  = 0.13) and rates of MB or CRNMB were 8.5, 7.9 and 6.6% ( p  = 0.17).  In patients requiring surgery/procedure in ENGAGE AF-TIMI 48, peri-operative rates of SSE, MB and death were not significantly different in patients who received edoxaban or warfarin. Schattauer GmbH Stuttgart.

Adjusted hospital death rates: a potential screen for quality of medical care.

PubMed

Dubois, R W; Brook, R H; Rogers, W H

1987-09-01

Increased economic pressure on hospitals has accelerated the need to develop a screening tool for identifying hospitals that potentially provide poor quality care. Based upon data from 93 hospitals and 205,000 admissions, we used a multiple regression model to adjust the hospitals crude death rate. The adjustment process used age, origin of patient from the emergency department or nursing home, and a hospital case mix index based on DRGs (diagnostic related groups). Before adjustment, hospital death rates ranged from 0.3 to 5.8 per 100 admissions. After adjustment, hospital death ratios ranged from 0.36 to 1.36 per 100 (actual death rate divided by predicted death rate). Eleven hospitals (12 per cent) were identified where the actual death rate exceeded the predicted death rate by more than two standard deviations. In nine hospitals (10 per cent), the predicted death rate exceeded the actual death rate by a similar statistical margin. The 11 hospitals with higher than predicted death rates may provide inadequate quality of care or have uniquely ill patient populations. The adjusted death rate model needs to be validated and generalized before it can be used routinely to screen hospitals. However, the remaining large differences in observed versus predicted death rates lead us to believe that important differences in hospital performance may exist.

Self-Rated Health Changes and Oldest-Old Mortality

PubMed Central

2014-01-01

Objectives. This study explores how 2 measures of self-rated health (SRH) change are related to mortality among oldest-old adults. In doing so, it also considers how associations between SRH and mortality may depend on prior SRH. Method. Data come from the Asset and Health Dynamics survey—the oldest-old portion of the Health and Retirement Study—and follow 6,233 individuals across 13 years. I use parametric hazard models to examine relationships between death and 2 measures of short-term SRH change—a computed measure comparing SRH at time t–1 and t, and a respondent-provided retrospectively reported change. Results. Respondents who demonstrate or report any SRH change between survey waves died at a greater rate than those with consistent SRH. After controlling for morbidity, individual characteristics, and SRH, those who changed SRH categories between survey waves and those who retrospectively reported an improvement in health continue to have a greater risk of death, when compared with those with no change. Discussion. These findings suggest that the well-established associations between SRH status and mortality may understate the risk of death for oldest-old individuals with recent subjective health improvements. PMID:24589929

Selected cancers with increasing mortality rates by educational attainment in 26 states in the United States, 1993-2007.

PubMed

Jemal, Ahmedin; Simard, Edgar P; Xu, Jiaquan; Ma, Jiemin; Anderson, Robert N

2013-03-01

Mortality rates continue to increase for liver, esophagus, and pancreatic cancers in non-Hispanic whites and for liver cancer in non-Hispanic blacks. However, the extent to which trends vary by socioeconomic status (SES) is unknown. We calculated age-standardized death rates for liver, esophagus, and pancreas cancers for non-Hispanic whites and non-Hispanic blacks aged 25-64 years by sex and level of education (≤12, 13-15, and ≥16 years, as a SES proxy) during 1993-2007 using mortality data from 26 states with consistent education information on death certificates. Temporal trends were evaluated using log-linear regression, and rate ratios (RRs) with 95 % confidence intervals (CIs) compared death rates in persons with ≤12 versus ≥16 years of education. Generally, death rates increased for cancers of the liver, esophagus, and pancreas in non-Hispanic whites and non-Hispanic blacks (liver cancer only) with ≤12 and 13-15 years of education, with steeper increases in the least educated group. In contrast, rates remained stable in persons with ≥16 years of education. During 1993-2007, the RR (rates in ≤12 versus ≥16 years of education) increased for all three cancers, particularly for liver cancer among men which increased from 1.76 (95 % CI, 1.38-2.25) to 3.23 (95 % CI, 2.78-3.75) in non-Hispanic whites and from 1.28 (95 % CI, 0.71-2.30) to 3.64 (95 % CI, 2.44-5.44) in non-Hispanic blacks. The recent increase in mortality rates for liver, esophagus, and pancreatic cancers in non-Hispanic whites and for liver cancer in non-Hispanic blacks reflects increases among those with lower education levels.

Contesting the Equivalency of Continuous Sedation until Death and Physician-assisted Suicide/Euthanasia: A Commentary on LiPuma.

PubMed

Raho, Joseph A; Miccinesi, Guido

2015-10-01

Patients who are imminently dying sometimes experience symptoms refractory to traditional palliative interventions, and in rare cases, continuous sedation is offered. Samuel H. LiPuma, in a recent article in this Journal, argues that continuous sedation until death is equivalent to physician-assisted suicide/euthanasia based on a higher brain neocortical definition of death. We contest his position that continuous sedation involves killing and offer four objections to the equivalency thesis. First, sedation practices are proportional in a way that physician-assisted suicide/euthanasia is not. Second, continuous sedation may not entirely abolish consciousness. Third, LiPuma's particular version of higher brain neocortical death relies on an implausibly weak construal of irreversibility--a position that is especially problematic in the case of continuous sedation. Finally, we explain why continuous sedation until death is not functionally equivalent to neocortical death and, hence, physician-assisted suicide/euthanasia. Concluding remarks review the differences between these two end-of-life practices. © The Author 2015. Published by Oxford University Press, on behalf of the Journal of Medicine and Philosophy Inc. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Fatal occupational injuries in the North Carolina construction industry, 1978-1994.

PubMed

Jackson, Seronda A; Loomis, Dana

2002-01-01

Occupational injury is a major public health problem and the cause of high rates of fatalities. The construction industry is one of the leading industries for on-the-job fatalities. The North Carolina Medical Examiner's system was used to identify all fatal unintentional injuries that occurred on the job in the state's construction industry between 1978 and 1994. The populations at risk were estimated from the 1980 and 1990 U.S. censuses. There were 525 identified deaths. All except two decedents were male, and the majority were Caucasian (79.2%). The mean age of decedents was 39 years. Death rates were higher among older workers. The crude fatality rate for the overall study period was 15.4 per 100,000 worker-years, with higher rates found among African-Americans (22.9) than among Caucasians (14.5). Occupations within the industry with the highest rates were laborers (49.5), truck drivers (43.2), operating engineers (37.2), roofers (32.8), and electricians (29.0). Falls (26.7%), electrocutions (20.4%), and motor vehicle accidents (18.9%) were found to be the leading causes of death. These findings suggest a need for continued attention to the hazards of heights and electric currents and a need for occupational safety standards for motor vehicles. This study also suggests that the hazards facing construction laborers require further investigation.

Are Global and Regional Improvements in Life Expectancy and in Child, Adult and Senior Survival Slowing?

PubMed Central

Hum, Ryan J.; Verguet, Stéphane; Cheng, Yu-Ling; McGahan, Anita M.; Jha, Prabhat

2015-01-01

Improvements in life expectancy have been considerable over the past hundred years. Forecasters have taken to applying historical trends under an assumption of continuing improvements in life expectancy in the future. A linear mixed effects model was used to estimate the trends in global and regional rates of improvements in life expectancy, child, adult, and senior survival, in 166 countries between 1950 and 2010. Global improvements in life expectancy, including both child and adult survival rates, decelerated significantly over the study period. Overall life expectancy gains were estimated to have declined from 5.9 to 4.0 months per year for a mean deceleration of -0.07 months/year2; annual child survival gains declined from 4.4 to 1.6 deaths averted per 1000 for a mean deceleration of -0.06 deaths/1000/year2; adult survival gains were estimated to decline from 4.8 to 3.7 deaths averted per 1000 per year for a mean deceleration of -0.08 deaths/1000/year2. Senior survival gains however increased from 2.4 to 4.2 deaths averted per 1000 per year for an acceleration of 0.03 deaths/1000/year2. Regional variation in the four measures was substantial. The rates of global improvements in life expectancy, child survival, and adult survival have declined since 1950 despite an increase in the rate of improvements among seniors. We postulate that low-cost innovation, related to the last half-century progress in health–primarily devoted to children and middle age, is reaping diminishing returns on its investments. Trends are uneven across regions and measures, which may be due in part to the state of epidemiological transition between countries and regions and disparities in the diffusion of innovation, accessible only in high-income countries where life expectancy is already highest. PMID:25992949

Preventing commercial fishing deaths in Alaska

PubMed Central

Lincoln, J. M.; Conway, G. A.

1999-01-01

OBJECTIVES: To evaluate the effectiveness of the United States Commercial Fishing Industry Vessel Safety Act of 1988 in reducing the high occupational death rate (200/100,000/year in 1991-2) among Alaska's commercial fishermen. METHODS: Comprehensive surveillance of deaths in commercial fishing was established by our office during 1991 and 1992 for Alaska. Demographic data and data on risk factors and incidents were compiled and analysed for trend. RESULTS: During 1991-8, there was a significant (p < 0.001) decrease in deaths in Alaska related to commercial fishing. Although drownings from fishermen falling overboard and events related to crab fishing vessels (often conducted far offshore and in winter) have continued to occur, marked progress (significant downward trend, p < 0.001) has been made in saving the lives of people involved in vessels capsizing and sinking. CONCLUSIONS: Specific measures tailored to prevent drowning associated with vessels capsizing and sinking in Alaska's commercial fishing industry have been successful. However, these events continue to occur, and place fishermen and rescue personnel at substantial risk. Additional strategies must be identified to reduce the frequency of vessels capsizing and sinking, to enable parallel improvements in the mortality among crab fishermen, and to prevent fishermen falling overboard and drownings associated with them.   PMID:10658549

Motor vehicle and fall related deaths among older Americans 1990-98: sex, race, and ethnic disparities.

PubMed

Stevens, J A; Dellinger, A M

2002-12-01

To examine differences in motor vehicle and fall related death rates among older adults by sex, race, and ethnicity. Annual mortality tapes for 1990-98 provided demographic data including race and ethnicity, date, and cause of death. Trend analyses were conducted using Poisson regression. From 1990-98, overall motor vehicle related death rates remained stable while death rates from unintentional falls increased. Motor vehicle and fall related death rates were higher among men. Motor vehicle related death rates were higher among people of color while fall related death rates were higher among whites. Among whites, fall death rates increased significantly during the study period, with an annual relative increase of 3.6% for men and 3.2% for women. The risk of death from motor vehicle and fall related injuries among older adults differed by sex, race and ethnicity, results obscured by simple age and sex specific death rates. This study found important patterns and disparities in these death rates by race and ethnicity useful for identifying high risk groups and guiding prevention strategies.

Surveillance for Violent Deaths - National Violent Death Reporting System, 17 States, 2013.

PubMed

Lyons, Bridget H; Fowler, Katherine A; Jack, Shane P D; Betz, Carter J; Blair, Janet M

2016-08-19

In 2013, more than 57,000 persons died in the United States as a result of violence-related injuries. This report summarizes data from CDC's National Violent Death Reporting System (NVDRS) regarding violent deaths from 17 U.S. states for 2013. Results are reported by sex, age group, race/ethnicity, marital status, location of injury, method of injury, circumstances of injury, and other selected characteristics. 2013. NVDRS collects data from participating states regarding violent deaths obtained from death certificates, coroner/medical examiner reports, law enforcement reports, and secondary sources (e.g., child fatality review team data, supplemental homicide reports, hospital data, and crime laboratory data). This report includes data from 17 states that collected statewide data for 2013 (Alaska, Colorado, Georgia, Kentucky, Maryland, Massachusetts, North Carolina, New Jersey, New Mexico, Ohio, Oklahoma, Oregon, Rhode Island, South Carolina, Utah, Virginia, and Wisconsin). NVDRS collates documents for each death and links deaths that are related (e.g., multiple homicides, a homicide followed by a suicide, or multiple suicides) from a single incident. For 2013, a total of 18,765 fatal incidents involving 19,251 deaths were captured by NVDRS in the 17 states included in this report. The majority (66.2%) of deaths were suicides, followed by homicides (23.2%), deaths of undetermined intent (8.8%), deaths involving legal intervention (1.2%) (i.e., deaths caused by law enforcement and other persons with legal authority to use deadly force, excluding legal executions), and unintentional firearm deaths (<1%). (The term legal intervention is a classification incorporated into the International Classification of Diseases, Tenth Revision [ICD-10] and does not denote the lawfulness or legality of the circumstances surrounding a death caused by law enforcement.) Suicides occurred at higher rates among males, non-Hispanic whites, American Indian/Alaska Natives, persons aged 45-64 years, and males aged ≥75 years. Suicides were preceded primarily by a mental health, intimate partner, or physical health problem or a crisis during the previous or upcoming 2 weeks. Homicide rates were higher among males and persons aged 15-44 years; rates were highest among non-Hispanic black males. Homicides primarily were precipitated by arguments and interpersonal conflicts, occurrence in conjunction with another crime, or were related to intimate partner violence (particularly for females). A known relationship between a homicide victim and a suspected perpetrator was most likely either that of an acquaintance or friend or an intimate partner. Legal intervention death rates were highest among males and persons aged 20-24 years and 30-34 years; rates were highest among non-Hispanic black males. Precipitating factors for the majority of legal intervention deaths were another crime, a mental health problem, or a recent crisis. Deaths of undetermined intent occurred at the highest rates among males and persons aged <1 year and 45-54 years. Substance abuse and mental or physical health problems were the most common circumstances preceding deaths of undetermined intent. Unintentional firearm death rates were higher among males, non-Hispanic whites, and persons aged persons aged 15-19 and 55-64 years; these deaths were most often precipitated by a person unintentionally pulling the trigger while playing with a firearm or while hunting. This report provides a detailed summary of data from NVDRS for 2013. The results indicate that violent deaths resulting from self-inflicted or interpersonal violence disproportionately affected persons aged <65 years, males, and certain minority populations. For homicides and suicides, intimate partner problems, interpersonal conflicts, mental health problems, and recent crises were primary precipitating factors. NVDRS data are used to monitor the occurrence of violence-related fatal injuries and assist public health authorities in the development, implementation, and evaluation of programs and policies to reduce and prevent violent deaths. For example, Utah Violent Death Reporting System (VDRS) data were used to develop policies that support children of intimate partner homicide victims, Colorado VDRS data to develop a web-based suicide prevention program targeting middle-aged men, and Rhode Island VDRS data to help guide suicide prevention efforts at workplaces. The continued development and expansion of NVDRS to include all U.S. states, territories, and the District of Columbia are essential to public health efforts to reduce the impact of violence.

Mortality and causes of death in children referred to a tertiary epilepsy center.

PubMed

Grønborg, Sabine; Uldall, Peter

2014-01-01

Patients with epilepsy, including children, have an increased mortality rate when compared to the general population. Only few studies on causes of mortality in childhood epilepsy exist and pediatric SUDEP rate is under continuous discussion. To describe general mortality, incidence of sudden unexpected death in epilepsy (SUDEP), causes of death and age distribution in a pediatric epilepsy patient population. The study retrospectively examined the mortality and causes of death in 1974 patients with childhood-onset epilepsy at a tertiary epilepsy center in Denmark over a period of 9 years. Cases of death were identified through their unique civil registration number. Information from death certificates, autopsy reports and medical notes were collected. 2.2% (n = 43) of the patient cohort died during the study period. This includes 9 patients with SUDEP (8 SUDEP cases per 10,000 patient years). 9 patients died in the course of neurodegenerative disease and 28 children died of various causes. Epilepsy was considered drug resistant in more than 95% of the deceased patients, 90% were diagnosed with intellectual disability. Mortality of patients that underwent dietary epilepsy treatment was slightly higher than in the general cohort. There were no epilepsy-related deaths due to drowning. This study confirms that SUDEP must not be disregarded in the pediatric age group. The vast majority of SUDEP cases in this study displays numerous risk factors similar to those described in adult epilepsy patients. Including SUDEP, only 30% of the mortality was directly seizure related. Copyright © 2013 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

Socioeconomic factors affecting infant sleep-related deaths in St. Louis.

PubMed

Hogan, Cathy

2014-01-01

Though the Back to Sleep Campaign that began in 1994 caused an overall decrease in sudden infant death syndrome (SIDS) rates, racial disparity has continued to increase in St. Louis. Though researchers have analyzed and described various sociodemographic characteristics of SIDS and infant deaths by unintentional suffocation in St. Louis, they have not simultaneously controlled for contributory risk factors to racial disparity such as race, poverty, maternal education, and number of children born to each mother (parity). To determine whether there is a relationship between maternal socioeconomic factors and sleep-related infant death. This quantitative case-control study used secondary data collected by the Missouri Department of Health and Senior Services between 2005 and 2009. The sample includes matched birth/death certificates and living birth certificates of infants who were born/died within time frame. Descriptive analysis, Chi-square, and logistic regression. The controls were birth records of infants who lived more than 1 year. Chi-square and logistic regression analyses confirmed that race and poverty have significant relationships with infant sleep-related deaths. The social significance of this study is that the results may lead to population-specific modifications of prevention messages that will reduce infant sleep-related deaths. © 2013 Wiley Periodicals, Inc.

[Time analysis of mortality from cerebrovascular diseases in Andalucia (1975-1999)].

PubMed

Cayuela-Domínguez, A; Rodríguez-Domínguez, S; Iglesias-Bonilla, P; Mir-Rivera, P; Martínez-Fernández, E

In previous publications we analysed the tendency of mortality from cerebrovascular diseases (CVD) in Andalusia over the period 1975-1992, and we observed a marked decrease in the mortality rates in both sexes. AIMS. To describe the evolution of mortality from CVD in Andalusia throughout the period 1975-1999. Deaths from CVD over the period 1975 1999 were obtained from the Instituto Andaluz de Estadística. We employed the direct method of standardisation of rates (world standard population). The rates were subjected to logarithmic transformations and the regression lines were adjusted. A considerable decrease was found in the rates: 3.9% in males and 4.0% in females. The drop in truncated rates (35 64 years old) was greater in women ( 5.9%) than in men ( 4.3%). Our work shows a marked and continuous decrease in mortality from CVD in Andalusia (1975-1999). In accordance with the process of aging of the population, the magnitude of CVD measured in terms of deaths, invalidity and health costs still represents a great challenge for preventative and health care policies.

Songs of Despair: A Case Study of Adolescent Suicide.

ERIC Educational Resources Information Center

Sapp, Allen D.

This report outlines the extent of the problem of adolescent suicide in the United States, noting that suicide is the third leading cause of death among adolescents in this country and that the rate of suicide by adolescents is expected to continue to increase in the future. It examines one adolescent suicide, using the case study method, to…

Polio, Disability, and American Public Schooling: A Historiographical Exploration

ERIC Educational Resources Information Center

Altenbaugh, Richard J.

2004-01-01

Poliomyelitis, a virus that quickly attacks the central nervous system, struck the United States in 1916 with devastating results. Twenty-six states reported some 27,000 cases, claiming 6,000 deaths. The morbidity rate continued to climb during the next four decades until 1955 with the introduction of the Salk vaccine. It proved to be especially…

Continuity of care by a midwife team versus routine care during pregnancy and birth: a randomised trial.

PubMed

Rowley, M J; Hensley, M J; Brinsmead, M W; Wlodarczyk, J H

1995-09-18

To compare continuity of care from a midwife team with routine care from a variety of doctors and midwives. A stratified, randomised controlled trial. 814 women attending the antenatal clinic of a tertiary referral, university hospital. Women were randomly allocated to team care from a team of six midwives, or routine care from a variety of doctors and midwives. Antenatal, intrapartum and neonatal events; maternal satisfaction; and cost of treatment. 405 women were randomly allocated to team care and 409 to routine care; they delivered 385 and 386 babies, respectively. Team care women were more likely to attend antenatal classes (OR, 1.73; 95% CI, 1.23-2.42); less likely to use pethidine during labour (OR, 0.32; 95% CI, 0.22-0.46); and more likely to labour and deliver without intervention (OR, 1.73; 95% CI, 1.28-2.34). Babies of team care mothers received less neonatal resuscitation (OR, 0.59; 95% CI, 0.41-0.86), although there was no difference in Apgar scores at five minutes (OR, 0.86; 95% CI, 0.29-2.57). The stillbirth and neonatal death rate was the same for both groups of mothers with a singleton pregnancy (three deaths), but there were three deaths (birthweights of 600 g, 660 g, 1340 g) in twin pregnancies in the group receiving team care. Team care was rated better than routine care for all measures of maternal satisfaction. Team care meant a cost reduction of 4.5%. Continuity of care provided by a small team of midwives resulted in a more satisfying birth experience at less cost than routine care and fewer adverse maternal and neonatal outcomes. Although a much larger study would be required to provide adequate power to detect rare outcomes, our study found that continuity of care by a midwife team was as safe as routine care.

Using National Inpatient Death Rates as a Benchmark to Identify Hospitals with Inaccurate Cause of Death Reporting - Missouri, 2009-2012.

PubMed

Lloyd, Jennifer; Jahanpour, Ehsan; Angell, Brian; Ward, Craig; Hunter, Andy; Baysinger, Cherri; Turabelidze, George

2017-01-13

Reporting causes of death accurately is essential to public health and hospital-based programs; however, some U.S. studies have identified substantial inaccuracies in cause of death reporting. Using CDC's national inpatient hospital death rates as a benchmark, the Missouri Department of Health and Senior Services (DHSS) analyzed inpatient death rates reported by hospitals with high inpatient death rates in St. Louis and Kansas City metro areas. Among the selected hospitals with high inpatient death rates, 45.8% of death certificates indicated an underlying cause of death that was inconsistent with CDC's Guidelines for Death Certificate completion. Selected hospitals with high inpatient death rates were more likely to overreport heart disease and renal disease, and underreport cancer as an underlying cause of death. Based on these findings, the Missouri DHSS initiated a new web-based training module for death certificate completion based on the CDC guidelines in an effort to improve accuracy in cause of death reporting.

26 CFR 1.101-2 - Employees' death benefits.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 26 Internal Revenue 2 2013-04-01 2013-04-01 false Employees' death benefits. 1.101-2 Section 1.101... (CONTINUED) INCOME TAXES (CONTINUED) Items Specifically Excluded from Gross Income § 1.101-2 Employees' death... employer and by reason of the death of the employee shall be excluded from the gross income of the...

26 CFR 1.101-2 - Employees' death benefits.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 26 Internal Revenue 2 2014-04-01 2014-04-01 false Employees' death benefits. 1.101-2 Section 1.101... (CONTINUED) INCOME TAXES (CONTINUED) Items Specifically Excluded from Gross Income § 1.101-2 Employees' death... employer and by reason of the death of the employee shall be excluded from the gross income of the...

26 CFR 1.101-2 - Employees' death benefits.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 26 Internal Revenue 2 2011-04-01 2011-04-01 false Employees' death benefits. 1.101-2 Section 1.101... (CONTINUED) INCOME TAXES (CONTINUED) Items Specifically Excluded from Gross Income § 1.101-2 Employees' death... employer and by reason of the death of the employee shall be excluded from the gross income of the...

26 CFR 1.101-2 - Employees' death benefits.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 26 Internal Revenue 2 2012-04-01 2012-04-01 false Employees' death benefits. 1.101-2 Section 1.101... (CONTINUED) INCOME TAXES (CONTINUED) Items Specifically Excluded from Gross Income § 1.101-2 Employees' death... employer and by reason of the death of the employee shall be excluded from the gross income of the...

Widening Educational Disparities in Premature Death Rates in Twenty Six States in the United States, 1993–2007

PubMed Central

Ma, Jiemin; Xu, Jiaquan; Anderson, Robert N.; Jemal, Ahmedin

2012-01-01

Background Eliminating socioeconomic disparities in health is an overarching goal of the U.S. Healthy People decennial initiatives. We present recent trends in mortality by education among working-aged populations. Methods and Findings Age-standardized death rates and their average annual percent change for all-cause and five major causes (cancer, heart disease, stroke, diabetes, and accidents) were calculated from 1993 through 2007 for individuals aged 25–64 years by educational attainment as a marker of socioeconomic status, using national vital registration data for 26 states with consistent educational information on the death certificates. Rate ratios and rate differences were used to assess disparities (≤12 versus ≥16 years of education) for 1993 through 2007. From 1993 through 2007, relative educational disparities in all-cause mortality continued to increase among working-aged men and women in the U.S., due to larger decreases of mortality rates among the most educated coupled with smaller decreases or even worsening trends in the less educated. For example, the rate ratios of all-cause mortality increased from 2.5 (95% confidence interval (CI), 2.4–2.6) in 1993 to 3.6 (95% CI, 3.5–3.7) in 2007 in men and from 1.9 (95% CI, 1.8–2.0) to 3.0 (95% CI, 2.9–3.1) in women. Generally, the rate differences (per 100,000 persons) of all-cause mortality increased from 415.5 (95% CI, 399.1–431.9) in 1993 to 472.7 (95% CI, 460.2–485.2) in 2007 in men and from 165.4 (95% CI, 154.5–176.2) to 256.2 (95% CI, 248.3–264.2) in women. Disparity patterns varied largely across the five specific causes considered in this study, with the largest increases of relative disparities for accidents, especially in women. Conclusions Relative educational differentials in mortality continued to widen among men and women despite emphasis on reducing disparities in the U.S. Healthy People decennial initiatives. PMID:22911814

Comparison of Short- and Long-Term Cardiac Mortality in Early Versus Late Stent Thrombosis (from Pooled PROTECT Trials).

PubMed

Secemsky, Eric A; Matteau, Alexis; Yeh, Robert W; Steg, Philippe Gabriel; Camenzind, Edoardo; Wijns, William; McFadden, Eugene; Mauri, Laura

2015-06-15

Studies have indicated varying mortality risks with timing of stent thrombosis (ST), but few have been adequately powered with prospective late follow-up. PROTECT randomized 8,709 subjects to either Endeavor zotarolimus-eluting or Cypher sirolimus-eluting stents. PROTECT Continued Access enrolled 1,018 patients treated with Endeavor zotarolimus-eluting stents. Subjects completed at least 4 and 3 years of follow-up, respectively. ARC-defined definite and probable ST events were stratified by time from index procedure: early (≤30 days), late (>30 and ≤360 days), and very late (>360 days). Rates of death and myocardial infarction were analyzed by ST timing. Median follow-up was 4.1 years. There were 184 ST events (1.9%): 61 early, 27 late, and 96 very late. Patient and procedural characteristics were similar between timing groups. There was no difference in dual-antiplatelet therapy use at discharge (97%) or 1 year (84%). Cardiac death in patients with ST at 4 years occurred in 32.1% compared with 2.5% in patients without ST (p <0.001). Combined rates of cardiac death and myocardial infarction did not differ according to ST timing, yet early ST was more commonly associated with cardiac death at 4 years than later ST (50.8% for early vs 18.5% for late vs 24.0% for very late; p <0.001). The relation between ST timing and outcomes did not differ between stent types. In conclusion, in prospective data, cardiac death was more common after early ST than later ST. Although ST remains infrequent, continued efforts to determine how to reduce ST, particularly within the first 30 days, are warranted. (The PROTECT trial is registered with ClinicalTrials.gov, number NCT00476957.). Copyright © 2015 Elsevier Inc. All rights reserved.

Increased Respiratory Disease Mortality at a Microwave Popcorn Production Facility with Worker Risk of Bronchiolitis Obliterans

PubMed Central

Halldin, Cara N.; Suarthana, Eva; Fedan, Kathleen B.; Lo, Yi-Chun; Turabelidze, George; Kreiss, Kathleen

2013-01-01

Background Bronchiolitis obliterans, an irreversible lung disease, was first associated with inhalation of butter flavorings (diacetyl) in workers at a microwave popcorn company. Excess rates of lung-function abnormalities were related to cumulative diacetyl exposure. Because information on potential excess mortality would support development of permissible exposure limits for diacetyl, we investigated respiratory-associated mortality during 2000–2011 among current and former workers at this company who had exposure to flavorings and participated in cross-sectional surveys conducted between 2000–2003. Methods We ascertained workers' vital status through a Social Security Administration search. Causes of death were abstracted from death certificates. Because bronchiolitis obliterans is not coded in the International Classification of Disease 10th revision (ICD-10), we identified respiratory mortality decedents with ICD-10 codes J40–J44 which encompass bronchitis (J40), simple and mucopurulent chronic bronchitis (J41), unspecified chronic bronchitis (J42), emphysema (J43), and other chronic obstructive pulmonary disease (COPD) (J44). We calculated expected number of deaths and standardized mortality ratios (SMRs) with 95% confidence intervals (CI) to determine if workers exposed to diacetyl experienced greater respiratory mortality than expected. Results We identified 15 deaths among 511 workers. Based on U.S. population estimates, 17.39 deaths were expected among these workers (SMR = 0.86; CI:0.48-1.42). Causes of death were available for 14 decedents. Four deaths among production and flavor mixing workers were documented to have a multiple cause of ‘other COPD’ (J44), while 0.98 ‘other COPD’-associated deaths were expected (SMR = 4.10; CI:1.12–10.49). Three of the 4 ‘other COPD’-associated deaths occurred among former workers and workers employed before the company implemented interventions reducing diacetyl exposure in 2001. Conclusion Workers at the microwave popcorn company experienced normal rates of all-cause mortality but higher rates of COPD-associated mortality, especially workers employed before the company reduced diacetyl exposure. The demonstrated excess in COPD-associated mortality suggests continued efforts to lower flavoring exposure are prudent. PMID:23469109

Increased respiratory disease mortality at a microwave popcorn production facility with worker risk of bronchiolitis obliterans.

PubMed

Halldin, Cara N; Suarthana, Eva; Fedan, Kathleen B; Lo, Yi-Chun; Turabelidze, George; Kreiss, Kathleen

2013-01-01

Bronchiolitis obliterans, an irreversible lung disease, was first associated with inhalation of butter flavorings (diacetyl) in workers at a microwave popcorn company. Excess rates of lung-function abnormalities were related to cumulative diacetyl exposure. Because information on potential excess mortality would support development of permissible exposure limits for diacetyl, we investigated respiratory-associated mortality during 2000-2011 among current and former workers at this company who had exposure to flavorings and participated in cross-sectional surveys conducted between 2000-2003. We ascertained workers' vital status through a Social Security Administration search. Causes of death were abstracted from death certificates. Because bronchiolitis obliterans is not coded in the International Classification of Disease 10(th) revision (ICD-10), we identified respiratory mortality decedents with ICD-10 codes J40-J44 which encompass bronchitis (J40), simple and mucopurulent chronic bronchitis (J41), unspecified chronic bronchitis (J42), emphysema (J43), and other chronic obstructive pulmonary disease (COPD) (J44). We calculated expected number of deaths and standardized mortality ratios (SMRs) with 95% confidence intervals (CI) to determine if workers exposed to diacetyl experienced greater respiratory mortality than expected. We identified 15 deaths among 511 workers. Based on U.S. population estimates, 17.39 deaths were expected among these workers (SMR = 0.86; CI:0.48-1.42). Causes of death were available for 14 decedents. Four deaths among production and flavor mixing workers were documented to have a multiple cause of 'other COPD' (J44), while 0.98 'other COPD'-associated deaths were expected (SMR = 4.10; CI:1.12-10.49). Three of the 4 'other COPD'-associated deaths occurred among former workers and workers employed before the company implemented interventions reducing diacetyl exposure in 2001. Workers at the microwave popcorn company experienced normal rates of all-cause mortality but higher rates of COPD-associated mortality, especially workers employed before the company reduced diacetyl exposure. The demonstrated excess in COPD-associated mortality suggests continued efforts to lower flavoring exposure are prudent.

National Cancer Center Singapore: the way forward.

PubMed

Teo, Melissa; Soo, Khee Chee

2016-02-01

Cancer is the leading cause of death in Singapore, comprising almost 30% of annual deaths. The incidence and prevalence continue to rise, resulting in Singapore having the highest age-standardized rate of cancer in southeast Asia. A review of national health policies in 1992 resulted in the creation of a National Cancer Centre Singapore (NCCS) in 1999. The current NCCS, with its three pillars of clinical service, research and education, manages about 70% of all new cancer cases in the countries public healthcare system. As it outgrows its current outfit and looks to the new NCCS building in 2020, the goal must be for strategic planning to attract and retain the best minds and heart in the field of cancer if it were to continue to be successful in achieving its vision and mission. This article chronicles the NCCS's history and details the foundation of its strategic plans.

The Changing Demographic Profile of the United States

DTIC Science & Technology

2006-05-05

3 Figure 3. Crude and Age-adjusted Death Rates : United States, 1950-2003...21 Appendix Table A. U.S. Population Growth Rates, Birth Rates, Death Rates , and Net Immigration Rates...P o p u la tio n Birth Rates Growth Rates Death Rates Net Immigration Rates Figure 2. Population Growth, Birth, Death, and Net Immigration Rates

Heart Disease and Cancer Deaths - Trends and Projections in the United States, 1969-2020.

PubMed

Weir, Hannah K; Anderson, Robert N; Coleman King, Sallyann M; Soman, Ashwini; Thompson, Trevor D; Hong, Yuling; Moller, Bjorn; Leadbetter, Steven

2016-11-17

Heart disease and cancer are the first and second leading causes of death in the United States. Age-standardized death rates (risk) have declined since the 1960s for heart disease and for cancer since the 1990s, whereas the overall number of heart disease deaths declined and cancer deaths increased. We analyzed mortality data to evaluate and project the effect of risk reduction, population growth, and aging on the number of heart disease and cancer deaths to the year 2020. We used mortality data, population estimates, and population projections to estimate and predict heart disease and cancer deaths from 1969 through 2020 and to apportion changes in deaths resulting from population risk, growth, and aging. We predicted that from 1969 through 2020, the number of heart disease deaths would decrease 21.3% among men (-73.9% risk, 17.9% growth, 34.7% aging) and 13.4% among women (-73.3% risk, 17.1% growth, 42.8% aging) while the number of cancer deaths would increase 91.1% among men (-33.5% risk, 45.6% growth, 79.0% aging) and 101.1% among women (-23.8% risk, 48.8% growth, 76.0% aging). We predicted that cancer would become the leading cause of death around 2016, although sex-specific crossover years varied. Risk of death declined more steeply for heart disease than cancer, offset the increase in heart disease deaths, and partially offset the increase in cancer deaths resulting from demographic changes over the past 4 decades. If current trends continue, cancer will become the leading cause of death by 2020.

Congenital heart disease infant death rates decrease as gestational age advances from 34 to 40 weeks.

PubMed

Cnota, James F; Gupta, Resmi; Michelfelder, Erik C; Ittenbach, Richard F

2011-11-01

To describe congenital heart disease death rates in infants born between 34 and 40 weeks, estimate the relationship between gestational age and congenital heart disease infant death rates, and compare congenital heart disease death rates across 1- and 2-week intervals in gestational age. The 2000 to 2003 national linked birth/infant death cohort datasets were obtained. Congenital heart disease deaths were identified by using International Statistical Classification of Diseases, 10th Revision codes. Proportional death rates were calculated by using congenital heart disease deaths and all live births. The relationship between congenital heart disease death rates and gestational age was determined. Death rates were compared across intervals. A total of 14.9 million records were analyzed. Congenital heart disease deaths occurred in 4736 infants (0.04%) born between 34 and 40 weeks. There was a significant, negative linear relationship between congenital heart disease death rate and gestational age (R(2) = 0.97). Comparisons across 1-week intervals varied (P = .02-.23). All 2-week intervals were statistically significant (P < .01). Congenital heart disease death rates decrease as gestational age approaches 40 weeks. These results should be considered before elective delivery for the sole indication of prenatally diagnosed congenital heart disease. Copyright © 2011 Mosby, Inc. All rights reserved.

Aging and Death Education.

ERIC Educational Resources Information Center

Pinder, Margaret M.; Hayslip, Bert, Jr.

1980-01-01

The elderly death rate is somewhat higher than the death rate in general. Numbers of schools with gerontological curricula and frequency of death education courses are positively related to elderly death rates. The contention that elderly deaths have less social impact is not supported. (JAC)

Temperature-based death time estimation with only partially known environmental conditions.

PubMed

Mall, Gita; Eckl, Mona; Sinicina, Inga; Peschel, Oliver; Hubig, Michael

2005-07-01

The temperature-oriented death time determination is based on mathematical model curves of postmortem rectal cooling. All mathematical models require knowledge of the environmental conditions. In medico-legal practice homicide is sometimes not immediately suspected at the death scene but afterwards during external examination of the body. The environmental temperature at the death scene remains unknown or can only be roughly reconstructed. In such cases the question arises whether it is possible to estimate the time since death from rectal temperature data alone recorded over a longer time span. The present study theoretically deduces formulae which are independent of the initial and environmental temperatures and thus proves that the information needed for death time estimation is contained in the rectal temperature data. Since the environmental temperature at the death scene may differ from that during the temperature recording, an additional factor has to be used. This is that the body core is thermally well isolated from the environment and that the rectal temperature decrease after a sudden change of environmental temperature will continue for some time at a rate similar to that before the sudden change. The present study further provides a curve-fitting procedure for such scenarios. The procedure was tested in rectal cooling data of from 35 corpses using the most commonly applied model of Henssge. In all cases the time of death was exactly known. After admission to the medico-legal institute the bodies were kept at a constant environmental temperature for 12-36 h and the rectal temperatures were recorded continuously. The curve-fitting procedure led to valid estimates of the time since death in all experiments despite the unknown environmental conditions before admission to the institute. The estimation bias was investigated statistically. The 95% confidence intervals amounted to +/-4 h, which seems reasonable compared to the 95% confidence intervals of the Henssge model with known environmental temperature. The presented method may be of use for determining the time since death even in cases in which the environmental temperature and rectal temperature at the death scene have unintentionally not been recorded.

Getting comfortable with death & near-death experiences. Near-death experiences: an essay in medicine & philosophy.

PubMed

Moody, Raymond A

2013-01-01

Near-death experiences are an ancient and very common phenomenon that spans from ancient philosophy, religion and healing to the most modern clinical practice of medicine. Probably we are not much closer to an ultimate explanation of NDEs than were early thinkers like Plato and Democritus. Puzzling cases of near-death experiences continue to come to light and the ancient debate about what they mean continues unabated.

Temporal trend analysis of avoidable mortality in Taiwan, 1971-2008: overall progress, with areas for further medical or public health investment

PubMed Central

2013-01-01

Background Avoidable mortality (AM), or “unnecessary untimely death,” is considered an indicator of health care quality. We investigated trends in the age-standardized mortality rates (ASMRs) and associated standard expected years of life lost (SEYLL) for deaths amenable to medical care or public health measures in Taiwan from 1971-2008, with an emphasis on identifying areas where additional medical or public health investment may help reduce the burden of AM. Methods Taiwan’s ASMRs per 100,000 for AM and other causes of death were calculated using data from the National Death Certificate Registry in five-year bins from 1971 to 2008. SEYLL rates per 100,000 were calculated annually from 1971 to 2008 using the same data source. Results ASMR for almost all AM and other causes of death declined dramatically from 1971 to 2008 except for lung cancer (16.6% and 7.4% increase among men and women, respectively) and breast cancer (109.8% increase among women). In the same period, SEYLL due to lung cancer increased from 269.2 to 555.7 for men and 249.7 to 342.5 for women. For women, SEYLL due to breast cancer increased from 263.5 in 1971 to 659.3 in 2008. There were gender-specific differences in the reduction (or increase) in AM rates, with women showing larger rates of reduction or smaller rates of increase. Among men, AM fell by 65.9% from 1971-1975 to 2006-2008, and deaths from other causes increased by 15.6%. Among women, AM and deaths from other causes fell by 80.8% and 59.8% respectively. SEYLL decreased, respectively among males and females, from 23,147.3 and 24,081.1 in 1971 to 11,261.8 and 5,929.6 in 2008. Conclusion From 1971 to 2008, Taiwan experienced a dramatic reduction in most AM and corresponding SEYLL except for lung cancer (for both males and females) and breast cancer (for females). Additional effort should be devoted to public health measures to combat the rising prevalence of smoking in Taiwan, which may be responsible for the increasing AM from lung cancer. If AM in breast cancer continues unabated in the future, greater policy emphasis on the early detection and treatment of breast cancer may also be warranted. PMID:23742049

Temporal trend analysis of avoidable mortality in Taiwan, 1971-2008: overall progress, with areas for further medical or public health investment.

PubMed

Chen, Brian K; Yang, Chun-Yuh

2013-06-06

Avoidable mortality (AM), or "unnecessary untimely death," is considered an indicator of health care quality. We investigated trends in the age-standardized mortality rates (ASMRs) and associated standard expected years of life lost (SEYLL) for deaths amenable to medical care or public health measures in Taiwan from 1971-2008, with an emphasis on identifying areas where additional medical or public health investment may help reduce the burden of AM. Taiwan's ASMRs per 100,000 for AM and other causes of death were calculated using data from the National Death Certificate Registry in five-year bins from 1971 to 2008. SEYLL rates per 100,000 were calculated annually from 1971 to 2008 using the same data source. ASMR for almost all AM and other causes of death declined dramatically from 1971 to 2008 except for lung cancer (16.6% and 7.4% increase among men and women, respectively) and breast cancer (109.8% increase among women). In the same period, SEYLL due to lung cancer increased from 269.2 to 555.7 for men and 249.7 to 342.5 for women. For women, SEYLL due to breast cancer increased from 263.5 in 1971 to 659.3 in 2008. There were gender-specific differences in the reduction (or increase) in AM rates, with women showing larger rates of reduction or smaller rates of increase. Among men, AM fell by 65.9% from 1971-1975 to 2006-2008, and deaths from other causes increased by 15.6%. Among women, AM and deaths from other causes fell by 80.8% and 59.8% respectively. SEYLL decreased, respectively among males and females, from 23,147.3 and 24,081.1 in 1971 to 11,261.8 and 5,929.6 in 2008. From 1971 to 2008, Taiwan experienced a dramatic reduction in most AM and corresponding SEYLL except for lung cancer (for both males and females) and breast cancer (for females). Additional effort should be devoted to public health measures to combat the rising prevalence of smoking in Taiwan, which may be responsible for the increasing AM from lung cancer. If AM in breast cancer continues unabated in the future, greater policy emphasis on the early detection and treatment of breast cancer may also be warranted.

QuickStats: Death Rates for Motor Vehicle Traffic Injury,* Suicide,† and Homicide§ Among Children and Adolescents aged 10-14 Years - United States, 1999-2014.

PubMed

2016-11-04

In 1999, the mortality rate for children and adolescents aged 10-14 years for deaths from motor vehicle traffic injury (4.5 per 100,000) was about four times higher than the rate for deaths for suicide and homicide (both at 1.2). From 1999 to 2014, the death rate for motor vehicle traffic injury declined 58%, to 1.9 in 2014 (384 deaths). From 1999 to 2007, the death rate for suicide fluctuated and then doubled from 2007 (0.9) to 2014 (2.1, 425 deaths). The death rate for homicide gradually declined to 0.8 in 2014. In 2013 and 2014, the differences between death rates for motor vehicle traffic injury and suicide were not statistically significant.

Long-Term Adaptive Servo-Ventilator Treatment Prevents Cardiac Death and Improves Clinical Outcome.

PubMed

Imamura, Teruhiko; Kinugawa, Koichiro; Nitta, Daisuke; Komuro, Issei

2016-01-01

Adaptive servo-ventilation (ASV) is a recently developed, noninvasive therapeutic tool for the treatment of heart failure (HF). However, the efficacy of ASV therapy in patients with advanced HF remains uncertain, especially as regards its contribution to freedom from cardiac replacement therapy. A total of 85 patients with advanced HF (New York Heart Association [NYHA] class IV 71%, inotrope infusion-dependent 34%) refractory to guideline-directed medical therapy, received ASV therapy, irrespective of sleep-disordered breathing, at our institute between 2008 and 2014. Among these 85 patients, 46 continued ASV therapy for > 1 month (continued group), whereas 39 discontinued the therapy after < 1 month because of intolerance (discontinued group). There were no significant differences in baseline variables between the two groups. Heart rate indicating sympathetic activity, left ventricular (LV) reverse remodeling assessed by LV diastolic diameter, LV ejection fraction, and the grades of mitral and tricuspid regurgitations, HF severity assessed by NYHA class and plasma level of B-type natriuretic peptide, and end-organ dysfunction, improved significantly at 6 months following the initiation of ASV therapy (P < 0.05 for all). All-cause mortality and cardiac death rate were significantly lower during 2-year follow up in the continued group (P < 0.05 for both). In conclusion, ASV is a novel therapeutic tool prior to cardiac replacement therapy in patients with advanced HF and may prolong the period until cardiac replacement therapy becomes necessary.

Structured Modeling and Analysis of Stochastic Epidemics with Immigration and Demographic Effects

PubMed Central

Baumann, Hendrik; Sandmann, Werner

2016-01-01

Stochastic epidemics with open populations of variable population sizes are considered where due to immigration and demographic effects the epidemic does not eventually die out forever. The underlying stochastic processes are ergodic multi-dimensional continuous-time Markov chains that possess unique equilibrium probability distributions. Modeling these epidemics as level-dependent quasi-birth-and-death processes enables efficient computations of the equilibrium distributions by matrix-analytic methods. Numerical examples for specific parameter sets are provided, which demonstrates that this approach is particularly well-suited for studying the impact of varying rates for immigration, births, deaths, infection, recovery from infection, and loss of immunity. PMID:27010993

Structured Modeling and Analysis of Stochastic Epidemics with Immigration and Demographic Effects.

PubMed

Baumann, Hendrik; Sandmann, Werner

2016-01-01

Stochastic epidemics with open populations of variable population sizes are considered where due to immigration and demographic effects the epidemic does not eventually die out forever. The underlying stochastic processes are ergodic multi-dimensional continuous-time Markov chains that possess unique equilibrium probability distributions. Modeling these epidemics as level-dependent quasi-birth-and-death processes enables efficient computations of the equilibrium distributions by matrix-analytic methods. Numerical examples for specific parameter sets are provided, which demonstrates that this approach is particularly well-suited for studying the impact of varying rates for immigration, births, deaths, infection, recovery from infection, and loss of immunity.

Surveillance for violent deaths--National Violent Death Reporting System, 16 states, 2005.

PubMed

Karch, Debra L; Lubell, Keri M; Friday, Jennifer; Patel, Nimesh; Williams, Dionne D

2008-04-11

An estimated 50,000 persons die annually in the United States as a result of violence-related injuries. This report summarizes data from CDC's National Violent Death Reporting System (NVDRS) regarding violent deaths from 16 U.S. states for 2005. Results are reported by sex, age group, race/ethnicity, marital status, location of injury, method of injury, circumstances of injury, and other selected characteristics. 2005. NVDRS collects data regarding violent deaths obtained from death certificates, coroner/medical examiner reports, and law enforcement reports. NVDRS began operation in 2003 with seven states (Alaska, Maryland, Massachusetts, New Jersey, Oregon, South Carolina, and Virginia) participating; six states (Colorado, Georgia, North Carolina, Oklahoma, Rhode Island, and Wisconsin) joined in 2004 and four (California, Kentucky, New Mexico, and Utah) in 2005, for a total of 17 states. This report includes data from 16 states; data from California are not included in this report because NVDRS has been implemented only in a limited number of California cities and counties rather than statewide as in other states. For 2005, a total of 15,495 fatal incidents involving 15,962 violent deaths occurred in the 16 NVDRS states included in this report. The majority (56.1%) of deaths were suicides, followed by homicides and deaths involving legal interventions (29.6%), violent deaths of undetermined intent (13.3%), and unintentional firearm deaths (0.7%). Fatal injury rates varied by sex, race/ethnicity, age group, and method of injury. Rates were substantially higher for males than for females and for American Indians/Alaska Natives (AI/ANs) and blacks than for whites and Hispanics. Rates were highest for persons aged 20-24 years. For method of injury, the three highest rates were reported for firearms, poisonings, and hanging/strangulation/suffocation. Suicides occurred at higher rates among males, AI/ANs, whites, and older persons and most often involved the use of firearms in the home. Suicides were precipitated primarily by mental illness, intimate partner or physical health problems, or a crisis during the previous 2 weeks. Homicides occurred at higher rates among males and young adult blacks and most often involved the use of firearms in the home or on a street/highway. Homicides were precipitated primarily by an argument over something other than money or property or in conjunction with another crime. Similar variation was reported among the other manners of death and special situations or populations highlighted in this report. This report provides the first detailed summary of data concerning violent deaths collected by NVDRS. The results indicate that deaths resulting from self-inflicted or interpersonal violence occur to a varying extent among males and females of every age group and racial/ethnic population. Key factors affecting rates of violent fatal injuries include sex, age group, method of injury, location of injury, and precipitating circumstances (e.g., mental health and substance abuse). Because additional information might be reported subsequently as participating states update their findings, the data provided in this report are preliminary. Accurate, timely, and comprehensive surveillance data are necessary for the occurrence of violent deaths in the United States to be understood better and ultimately prevented. NVDRS data can be used to track the occurrence of violence-related fatal injuries and assist public health authorities in the development, implementation, and evaluation of programs and policies to reduce and prevent violent deaths and injuries at the national, state, and local levels. The continued development and expansion of NVDRS is essential to CDC's efforts to reduce the personal, familial, and societal costs of violence. Further efforts are needed to increase the number of states using NVDRS, with an ultimate goal of full national representation.

Neurodevelopmental Outcomes of Extremely Low Birth Weight Infants Ventilated With Continuous Positive Airway Pressure vs. Mechanical Ventilation

PubMed Central

Thomas, Cameron W.; Meinzen-Derr, Jareen; Hoath, Steven B.; Narendran, Vivek

2012-01-01

OBJECTIVE To compare continuous positive airway pressure (CPAP) vs. traditional mechanical ventilation (MV) at 24 h of age as predictors of neurodevelopmental (ND) outcomes in extremely low birth weight (ELBW) infants at 18-22 mo corrected gestational age (CGA). METHODS Infants ≤ 1000g birth weight born from January 2000 through December 2006 at two hospitals at the Cincinnati site of the National Institute of Child Health and Human Development Neonatal Research Network were evaluated comparing CPAP (N = 198) vs. MV (N = 109). Primary outcomes included the Bayley Score of Infant Development Version II (BSID-II), presence of deafness, blindness, cerebral palsy, bronchopulmonary dysplasia and death. RESULTS Ventilatory groups were similar in gender, rates of preterm prolonged rupture of membranes, antepartum hemorrhage, use of antenatal antibiotics, steroids, and tocolytics. Infants receiving CPAP weighed more, were older, were more likely to be non-Caucasian and from a singleton pregnancy. Infants receiving CPAP had better BSID-II scores, and lower rates of BPD and death. CONCLUSIONS After adjusting for acuity differences, ventilatory strategy at 24 h of age independently predicts long-term neurodevelopmental outcome in ELBW infants. PMID:21853318

Effects of tobacco control policies on smoking prevalence and tobacco-attributable deaths in Mexico: the SimSmoke model.

PubMed

Reynales-Shigematsu, Luz Myriam; Fleischer, Nancy L; Thrasher, James F; Zhang, Yian; Meza, Rafael; Cummings, K Michael; Levy, David T

2015-10-01

To examine how policies adopted in Mexico in response to the Framework Convention on Tobacco Control affected smoking prevalence and smoking-attributable deaths. The SimSmoke simulation model of tobacco control policy is applied to Mexico. This discrete time, first-order Markov model uses data on population size, smoking rates and tobacco control policy for Mexico. It assesses, individually and jointly, the effects of seven types of policies: cigarette taxes, smoke-free air laws, mass media campaigns, advertising bans, warning labels, cessation treatment, and youth tobacco access policies. The Mexico SimSmoke model estimates that smoking rates have been reduced by about 30% as a result of policies implemented since 2002, and that the number of smoking-attributable deaths will have been reduced by about 826 000 by 2053. Increases in cigarette prices are responsible for over 60% of the reductions, but health warnings, smoke-free air laws, marketing restrictions and cessation treatments also play important roles. Mexico has shown steady progress towards reducing smoking prevalence in a short period of time, as have other Latin American countries, such as Brazil, Panama and Uruguay. Tobacco control policies play an important role in continued efforts to reduce tobacco use and associated deaths in Mexico.

Relation between myocardial infarction, depression, hostility, and death.

PubMed

Kaufmann, M W; Fitzgibbons, J P; Sussman, E J; Reed, J F; Einfalt, J M; Rodgers, J K; Fricchione, G L

1999-09-01

To examine the independent impact of major depression and hostility on mortality rate at 6 months and 12 months after discharge from the hospital in patients with a myocardial infarction. Three hundred thirty-one patients were prospectively evaluated for depression with a modified version of the National Institute of Mental Health Diagnostic Interview Schedule for major depressive episode. The Cook Medley Hostility Scale data were analyzed by chi(2) procedures for nominal and categoric data, and Student t test was used for continuous data types. Depression was a significant predictor of death at 12 months (P =. 04) but not at 6 months (P =.08). Hostility was not found to be a predictor of death at 6 months or 12 months. Major depression in patients hospitalized after myocardial infarction is a significant univariable predictor of death at 12 months, although it was not a statistically significant predictor after adjusting for other variables. Hostility is not a predictor of death. Prospective studies are needed to determine the impact of aggressive treatment of depression on post-myocardial infarction survival.

Deaths from injury in children and employment status in family: analysis of trends in class specific death rates.

PubMed

Edwards, Phil; Roberts, Ian; Green, Judith; Lutchmun, Suzanne

2006-07-15

To examine socioeconomic inequalities in rates of death from injury in children in England and Wales. Analysis of rates of death from injury in children by the eight class version of the National Statistics Socio-Economic Classification (NS-SEC) and by the registrar general's social classification. England and Wales during periods of four years around the 1981, 1991, and 2001 censuses. Children aged 0-15 years. Death rates from injury and poisoning. Rates of death from injury in children fell from 11.1 deaths (95% confidence interval 10.8 to 11.5 deaths) per 100,000 children per year around the 1981 census to 4.0 deaths (3.8 to 4.2 deaths) per 100,000 children per year around the 2001 census. Socioeconomic inequalities remain: the death rate from all external causes for children of parents classified as never having worked or as long term unemployed (NS-SEC 8) was 13.1 (10.3 to 16.5) times that for children in NS-SEC 1(higher managerial/professional occupations). For deaths as pedestrians the rate in NS-SEC 8 was 20.6 (10.6 to 39.9) times higher than in NS-SEC 1; for deaths as cyclists it was 27.5 (6.4 to 118.2) times higher; for deaths due to fires it was 37.7 (11.6 to 121.9) times higher; and for deaths of undetermined intent it was 32.6 (15.8 to 67.2) times higher. Overall rates of death from injury and poisoning in children have fallen in England and Wales over the past 20 years, except for rates in children in families in which no adult is in paid employment. Serious inequalities in injury death rates remain, particularly for pedestrians, cyclists, house fires, and deaths of undetermined intent.

Continuous versus bolus intermittent loop diuretic infusion in acutely decompensated heart failure: a prospective randomized trial

PubMed Central

2014-01-01

Introduction Intravenous loop diuretics are a cornerstone of therapy in acutely decompensated heart failure (ADHF). We sought to determine if there are any differences in clinical outcomes between intravenous bolus and continuous infusion of loop diuretics. Methods Subjects with ADHF within 12 hours of hospital admission were randomly assigned to continuous infusion or twice daily bolus therapy with furosemide. There were three co-primary endpoints assessed from admission to discharge: the mean paired changes in serum creatinine, estimated glomerular filtration rate (eGFR), and reduction in B-type natriuretic peptide (BNP). Secondary endpoints included the rate of acute kidney injury (AKI), change in body weight and six months follow-up evaluation after discharge. Results A total of 43 received a continuous infusion and 39 were assigned to bolus treatment. At discharge, the mean change in serum creatinine was higher (+0.8 ± 0.4 versus -0.8 ± 0.3 mg/dl P <0.01), and eGFR was lower (-9 ± 7 versus +5 ± 6 ml/min/1.73 m2P <0.05) in the continuous arm. There was no significant difference in the degree of weight loss (-4.1 ± 1.9 versus -3.5 ± 2.4 kg P = 0.23). The continuous infusion arm had a greater reduction in BNP over the hospital course, (-576 ± 655 versus -181 ± 527 pg/ml P = 0.02). The rates of AKI were comparable (22% and 15% P = 0.3) between the two groups. There was more frequent use of hypertonic saline solutions for hyponatremia (33% versus 18% P <0.01), intravenous dopamine infusions (35% versus 23% P = 0.02), and the hospital length of stay was longer in the continuous infusion group (14. 3 ± 5 versus 11.5 ± 4 days, P <0.03). At 6 months there were higher rates of re-admission or death in the continuous infusion group, 58% versus 23%, (P = 0.001) and this mode of treatment independently associated with this outcome after adjusting for baseline and intermediate variables (adjusted hazard ratio = 2.57, 95% confidence interval, 1.01 to 6.58 P = 0.04). Conclusions In the setting of ADHF, continuous infusion of loop diuretics resulted in greater reductions in BNP from admission to discharge. However, this appeared to occur at the consequence of worsened renal filtration function, use of additional treatment, and higher rates of rehospitalization or death at six months. Trial registration ClinicalTrials.gov NCT01441245. Registered 23 September 2011. PMID:24974232

Vital signs: melanoma incidence and mortality trends and projections - United States, 1982-2030.

PubMed

Guy, Gery P; Thomas, Cheryll C; Thompson, Trevor; Watson, Meg; Massetti, Greta M; Richardson, Lisa C

2015-06-05

Melanoma incidence rates have continued to increase in the United States, and risk behaviors remain high. Melanoma is responsible for the most skin cancer deaths, with about 9,000 persons dying from it each year. CDC analyzed current (2011) melanoma incidence and mortality data, and projected melanoma incidence, mortality, and the cost of treating newly diagnosed melanomas through 2030. Finally, CDC estimated the potential melanoma cases and costs averted through 2030 if a comprehensive skin cancer prevention program was implemented in the United States. In 2011, the melanoma incidence rate was 19.7 per 100,000, and the death rate was 2.7 per 100,000. Incidence rates are projected to increase for white males and females through 2019. Death rates are projected to remain stable. The annual cost of treating newly diagnosed melanomas was estimated to increase from $457 million in 2011 to $1.6 billion in 2030. Implementation of a comprehensive skin cancer prevention program was estimated to avert 230,000 melanoma cases and $2.7 billion in initial year treatment costs from 2020 through 2030. If additional prevention efforts are not undertaken, the number of melanoma cases is projected to increase over the next 15 years, with accompanying increases in health care costs. Much of this morbidity, mortality, and health care cost can be prevented. Substantial reductions in melanoma incidence, mortality, and cost can be achieved if evidence-based comprehensive interventions that reduce ultraviolet (UV) radiation exposure and increase sun protection are fully implemented and sustained.

A Nationwide Survey About Palliative Sedation Involving Japanese Palliative Care Specialists: Intentions and Key Factors Used to Determine Sedation as Proportionally Appropriate.

PubMed

Hamano, Jun; Morita, Tatsuya; Ikenaga, Masayuki; Abo, Hirofumi; Kizawa, Yoshiyuki; Tunetou, Satoru

2018-03-01

Although there has long been debate about physicians' intentions and what physicians consider to be proportionally appropriate when performing palliative sedation, few large studies have been performed. To identify physicians' intentions when starting continuous deep sedation and to clarify what factors determine whether physicians regard sedation as proportionally appropriate in relation to expected survival, the patients' wishes, and refractoriness. A nationwide questionnaire survey of Japanese palliative care specialists was performed from August to December 2016. We defined continuous deep sedation as the continuous use of sedatives to relieve intolerable and refractory symptoms with the loss of consciousness until death. Of the 695 palliative care specialists enrolled, 440 were analyzed (response rate, 69%). A total of 95% and 87% of the physicians reported that they explicitly intended to perform symptom palliation and decrease consciousness levels, respectively. Moreover, 38% answered that they explicitly intended to maintain unconsciousness until death, and 11% reported that they intended to shorten survival to some extent. The respondents considered that continuous deep sedation is more appropriate when the predicted survival is shorter, the patients' wishes are consistent and clear, and confidence in the refractoriness of symptoms is higher. Japanese palliative care specialists explicitly intend to control symptoms and reduce the level of consciousness when performing continuous deep sedation, but there are differences in their intentions with regard to maintaining unconsciousness until death. Predicted survival, patients' wishes, and confidence in refractoriness are associated with physicians' judgment that sedation is proportionally appropriate. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

Associations and Trends in Cause-Specific Rates of Death Among Persons Reported with HIV Infection, 23 U.S. Jurisdictions, Through 2011.

PubMed

Adih, William K; Selik, Richard M; Hall, H Irene; Babu, Aruna Surendera; Song, Ruiguang

2016-01-01

Published death rates for persons with HIV have not distinguished deaths due to HIV from deaths due to other causes. Cause-specific death rates would allow better assessment of care needs. Using data reported to the US national HIV surveillance system, we examined a) associations between selected decedent characteristics and causes of death during 2007-2011, b) trends in rates of death due to underlying causes among persons with AIDS during 1990-2011, and among all persons with diagnosed HIV infection (with or without AIDS) during 2000-2011. During 2007-2011, non-HIV-attributable causes of death with the highest rates per 1,000 person-years were heart disease (2.0), non-AIDS cancers other than lung cancer (1.4), and accidents (0.8). During 1990-2011, among persons with AIDS, the annual rate of death due to HIV-attributable causes decreased by 89% (from 122.0 to 13.2), and the rate due to non-HIV-attributable-causes decreased by 57% (from 20.0 to 8.6), while the percentage of deaths caused by non-HIV-attributable causes increased from 11% to 43%. During 2000-2011, among persons with HIV infection, the rate of death due to HIV-attributable causes decreased by 69% (from 26.4 to 8.3), and the rate due to non-HIV-attributable causes decreased by 28% (from 10.5 to 7.6), while the percentage of deaths caused by non-HIV-attributable causes increased from 25% to 48%. Among HIV-infected persons, as rates of death due to HIV-attributable causes decreased, rates due to non-HIV-attributable causes also decreased, but the percentages of deaths due to non-HIV-attributable causes, such as heart disease and non-AIDS cancers increased.

Self-rated health changes and oldest-old mortality.

PubMed

Vogelsang, Eric M

2014-07-01

This study explores how 2 measures of self-rated health (SRH) change are related to mortality among oldest-old adults. In doing so, it also considers how associations between SRH and mortality may depend on prior SRH. Data come from the Asset and Health Dynamics survey--the oldest-old portion of the Health and Retirement Study-and follow 6,233 individuals across 13 years. I use parametric hazard models to examine relationships between death and 2 measures of short-term SRH change--a computed measure comparing SRH at time t-1 and t, and a respondent-provided retrospectively reported change. Respondents who demonstrate or report any SRH change between survey waves died at a greater rate than those with consistent SRH. After controlling for morbidity, individual characteristics, and SRH, those who changed SRH categories between survey waves and those who retrospectively reported an improvement in health continue to have a greater risk of death, when compared with those with no change. These findings suggest that the well-established associations between SRH status and mortality may understate the risk of death for oldest-old individuals with recent subjective health improvements. © The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

The Effects of Vehicle Redesign on the Risk of Driver Death.

PubMed

Farmer, Charles M; Lund, Adrian K

2015-01-01

This study updates a 2006 report that estimated the historical effects of vehicle design changes on driver fatality rates in the United States, separate from the effects of environmental and driver behavior changes during the same period. In addition to extending the period covered by 8 years, this study estimated the effect of design changes by model year and vehicle type. Driver death rates for consecutive model years of vehicle models without design changes were used to estimate the vehicle aging effect and the death rates that would have been expected if the entire fleet had remained unchanged from the 1985 calendar year. These calendar year estimates are taken to be the combined effect of road environment and motorist behavioral changes, with the difference between them and the actual calendar year driver fatality rates reflecting the effect of changes in vehicle design and distribution of vehicle types. The effects of vehicle design changes by model year were estimated for cars, SUVs, and pickups by computing driver death rates for model years 1984-2009 during each of their first 3 full calendar years of exposure and comparing with the expected rates if there had been no design changes. As reported in the 2006 study, had there been no changes in the vehicle fleet, driver death risk would have declined during calendar years 1985-1993 and then slowly increased from 1993 to 2004. The updated results indicate that the gradual increase would have continued through 2006, after which driver fatality rates again would have declined through 2012. Overall, it is estimated that there were 7,700 fewer driver deaths in 2012 than there would have been had vehicle designs not changed. Cars were the first vehicle type whose design safety generally exceeded that of the 1984 model year (starting in model year 1996), followed by SUVs (1998 models) and pickups (2002 models). By the 2009 model year, car driver fatality risk had declined 51% from its high in 1994, pickup driver fatality risk had declined 61% from its high in 1988, and SUV risk had declined 79% from its high in 1988. The risk of driver death in 2009 model passenger vehicles was 8% lower than that in 2008 models and about half that in 1984 models. Changes in vehicles, whether from government regulations and consumer testing that led to advanced safety designs or from other factors such as consumer demand for different sizes and types of vehicles, have been key contributors to the decline in U.S. motor vehicle occupant crash death rates since the mid-1990s. Since the early 1990s, environmental and behavioral risk factors have not shown similar improvement, until the recession of 2007, even though there are many empirically proven countermeasures that have been inadequately applied.

Annual Report to the Nation on the Status of Cancer, 1975–2014, Featuring Survival

PubMed Central

Ward, Elizabeth M.; Johnson, Christopher J.; Cronin, Kathleen A.; Ma, Jiemin; Ryerson, A. Blythe; Mariotto, Angela; Lake, Andrew J.; Wilson, Reda; Sherman, Recinda L.; Anderson, Robert N.; Henley, S. Jane; Kohler, Betsy A.; Penberthy, Lynne; Feuer, Eric J.; Weir, Hannah K.

2017-01-01

Abstract Background: The American Cancer Society (ACS), the Centers for Disease Control and Prevention (CDC), the National Cancer Institute (NCI), and the North American Association of Central Cancer Registries (NAACCR) collaborate to provide annual updates on cancer occurrence and trends in the United States. This Annual Report highlights survival rates. Methods: Data were from the CDC- and NCI-funded population-based cancer registry programs and compiled by NAACCR. Trends in age-standardized incidence and death rates for all cancers combined and for the leading cancer types by sex were estimated by joinpoint analysis and expressed as annual percent change. We used relative survival ratios and adjusted relative risk of death after a diagnosis of cancer (hazard ratios [HRs]) using Cox regression model to examine changes or differences in survival over time and by sociodemographic factors. Results: Overall cancer death rates from 2010 to 2014 decreased by 1.8% (95% confidence interval [CI] = –1.8 to –1.8) per year in men, by 1.4% (95% CI = –1.4 to –1.3) per year in women, and by 1.6% (95% CI = –2.0 to –1.3) per year in children. Death rates decreased for 11 of the 16 most common cancer types in men and for 13 of the 18 most common cancer types in women, including lung, colorectal, female breast, and prostate, whereas death rates increased for liver (men and women), pancreas (men), brain (men), and uterine cancers. In contrast, overall incidence rates from 2009 to 2013 decreased by 2.3% (95% CI = –3.1 to –1.4) per year in men but stabilized in women. For several but not all cancer types, survival statistically significantly improved over time for both early and late-stage diseases. Between 1975 and 1977, and 2006 and 2012, for example, five-year relative survival for distant-stage disease statistically significantly increased from 18.7% (95% CI = 16.9% to 20.6%) to 33.6% (95% CI = 32.2% to 35.0%) for female breast cancer but not for liver cancer (from 1.1%, 95% CI = 0.3% to 2.9%, to 2.3%, 95% CI = 1.6% to 3.2%). Survival varied by race/ethnicity and state. For example, the adjusted relative risk of death for all cancers combined was 33% (HR = 1.33, 95% CI = 1.32 to 1.34) higher in non-Hispanic blacks and 51% (HR = 1.51, 95% CI = 1.46 to 1.56) higher in non-Hispanic American Indian/Alaska Native compared with non-Hispanic whites. Conclusions: Cancer death rates continue to decrease in the United States. However, progress in reducing death rates and improving survival is limited for several cancer types, underscoring the need for intensified efforts to discover new strategies for prevention, early detection, and treatment and to apply proven preventive measures broadly and equitably. PMID:28376154

Late Mortality Among 5-Year Survivors of Childhood Cancer: A Summary From the Childhood Cancer Survivor Study

PubMed Central

Armstrong, Gregory T.; Liu, Qi; Yasui, Yutaka; Neglia, Joseph P.; Leisenring, Wendy; Robison, Leslie L.; Mertens, Ann C.

2009-01-01

The Childhood Cancer Survivor Study (CCSS) has assembled the largest cohort to date for assessment of late mortality. Vital status and cause of death of all patients eligible for participation in CCSS was determined using the National Death Index and death certificates to characterize the mortality experience of 20,483 survivors, representing 337,334 person-years of observation. A total of 2,821 deaths have occurred as of December 31, 2002. The overall cumulative mortality is 18.1% (95% CI, 17.3 to 18.9) at 30 years from diagnosis. With time, while all-cause mortality rates have been stable, the pattern of late death is changing. Mortality attributable to recurrence or progression of primary disease is decreasing, with increases in rates of mortality attributable to subsequent neoplasms (standardized mortality ratios [SMR], 15.2; 95% CI, 13.9 to 16.6), cardiac death (SMR, 7.0; 95% CI, 5.9 to 8.2), and pulmonary death (SMR, 8.8; 95% CI, 6.8 to 11.2) largely due to treatment-related causes. In addition, the CCSS has identified specific treatment-related risk factors for late mortality. Radiotherapy (relative risk [RR], 2.9; 95% CI, 2.1 to 4.2), alkylating agents (RR, 2.2; 95% CI, 1.6 to 3.0), and epipodophyllotoxins (RR, 2.3; 95% CI, 1.2 to 4.5) increase the risk of death due to subsequent malignancy. Cardiac radiation exposure (RR, 3.3; 95% CI, 2.0 to 5.5) and high dose of anthracycline exposure (RR, 3.1; 95% CI, 1.6 to 5.8) are associated with late cardiac death. By continued longitudinal follow-up of the cohort and expansion of the cohort to include patients diagnosed between 1987 and 1999, the CCSS will remain a primary resource for assessment of late mortality of survivors of childhood cancers. PMID:19332714

Estimated reductions in hospitalizations and deaths from childhood diarrhea following implementation of rotavirus vaccination in Africa.

PubMed

Shah, Minesh P; Tate, Jacqueline E; Mwenda, Jason M; Steele, A Duncan; Parashar, Umesh D

2017-10-01

Rotavirus is the leading cause of hospitalizations and deaths from diarrhea. 33 African countries had introduced rotavirus vaccines by 2016. We estimate reductions in rotavirus hospitalizations and deaths for countries using rotavirus vaccination in national immunization programs and the potential of vaccine introduction across the continent. Areas covered: Regional rotavirus burden data were reviewed to calculate hospitalization rates, and applied to under-5 population to estimate baseline hospitalizations. Rotavirus mortality was based on 2013 WHO estimates. Regional pre-licensure vaccine efficacy and post-introduction vaccine effectiveness studies were used to estimate summary effectiveness, and vaccine coverage was applied to calculate prevented hospitalizations and deaths. Uncertainties around input parameters were propagated using boot-strapping simulations. In 29 African countries that introduced rotavirus vaccination prior to end 2014, 134,714 (IQR 112,321-154,654) hospitalizations and 20,986 (IQR 18,924-22,822) deaths were prevented in 2016. If all African countries had introduced rotavirus vaccines at benchmark immunization coverage, 273,619 (47%) (IQR 227,260-318,102) hospitalizations and 47,741 (39%) (IQR 42,822-52,462) deaths would have been prevented. Expert commentary: Rotavirus vaccination has substantially reduced hospitalizations and deaths in Africa; further reductions are anticipated as additional countries implement vaccination. These estimates bolster wider introduction and continued support of rotavirus vaccination programs.

Annual Report to the Nation on the Status of Cancer, 1975-2010, Featuring Prevalence of Comorbidity and Impact on Survival among Persons with Lung, Colorectal, Breast or Prostate Cancer

PubMed Central

Edwards, Brenda K.; Noone, Anne-Michelle; Mariotto, Angela B.; Simard, Edgar P.; Boscoe, Francis P.; Henley, S. Jane; Jemal, Ahmedin; Cho, Hyunsoon; Anderson, Robert N.; Kohler, Betsy A.; Eheman, Christie R.; Ward, Elizabeth M.

2014-01-01

Background The American Cancer Society (ACS), the Centers for Disease Control and Prevention (CDC), the National Cancer Institute (NCI), and the North American Association of Central Cancer Registries (NAACCR) collaborate annually to provide updates on cancer incidence and death rates and trends in these outcomes for the U.S. This year’s report includes the prevalence of comorbidity at time of first cancer diagnosis among patients with lung, colorectal, breast or prostate cancer and the survival among cancer patients based on comorbidity level. Methods Data on cancer incidence were obtained from NCI, CDC, and NAACCR, and on mortality from CDC. Long- (1975/92-2010) and short- (2001-2010) term trends in age-standardized incidence and death rates for all cancers combined and for the leading cancers among men and among women were examined by joinpoint analysis. Through linkage with Medicare claims, the prevalence of comorbidity among cancer patients diagnosed between 1992 through 2005 residing in 11 Surveillance, Epidemiology, and End Results (SEER) areas were estimated and compared to those among a 5% random sample of cancer-free Medicare beneficiaries. Among cancer patients, survival and the probabilities of dying of their cancer and of other causes by comorbidity level, age, and stage were calculated. Results Death rates continued to decline for all cancers combined for men and women of all major racial and ethnic groups and for most major cancer sites; rates for both sexes combined decreased by 1.5% per year from 2001 through 2010. Overall incidence rates decreased in men and stabilized in women. The prevalence of comorbidity was similar among cancer-free Medicare beneficiaries (31.8%), breast cancer patients (32.2%), and prostate cancer patients (30.5%), highest among lung cancer patients (52.8%), and intermediate among colorectal cancer patients (40.7%). Among all cancer patients and especially for patients diagnosed with local and regional disease, age and comorbidity level were important influences on the probability of dying of other causes and consequently on overall survival. For patients diagnosed with distant disease, the probability of dying of cancer was much higher than the probability of dying of other causes, and age and comorbidity had a smaller effect on overall survival. Conclusions Cancer death rates in the U.S. continue to decline. Estimates of survival that include the probability of dying of cancer and other causes stratified by comorbidity level, age and stage can provide important information to facilitate treatment decisions. PMID:24343171

Declining death rates from hyperglycemic crisis among adults with diabetes, U.S., 1985-2002.

PubMed

Wang, Jing; Williams, Desmond E; Narayan, K M Venkat; Geiss, Linda S

2006-09-01

To examine trends in death rates for hyperglycemic crisis (diabetic ketoacidosis or hyperglycemic hyperosmolar state) among adults with diabetes in the U.S. from 1985 to 2002. Deaths with hyperglycemic crisis as the underlying cause were identified from national mortality data. Death rates were calculated using estimates of adults with diabetes from the National Health Interview Survey as the denominator and age adjusted to the 2000 U.S. population. The trends from 1985 to 2002 were tested using joinpoint regression analysis. Deaths due to hyperglycemic crisis dropped from 2,989 in 1985 to 2,459 in 2002. During the time period, age-adjusted death rates decreased from 42.4 to 23.8 per 100,000 adults with diabetes (4.4% decrease per year, P for trend <0.01). Death rates declined in all age-groups, with the greatest decrease occurring among individuals aged > or =65 years. Age-adjusted death rates fell for all race-sex subgroups, with black men experiencing the smallest decline. About one-fifth of deaths occurred at home or on arrival at the hospital, and the death rates for hyperglycemic crisis occurring at these places declined only modestly over time (2.1% decrease per year, P for trend = 0.049). Overall death rates due to hyperglycemic crisis among adults with diabetes have declined in the U.S. However, scope for further improvement remains, especially to further reduce death rates among black men and to prevent deaths occurring at home.

Walking, cycling and transport safety: an analysis of child road deaths.

PubMed

Sonkin, Beth; Edwards, Phil; Roberts, Ian; Green, Judith

2006-08-01

To examine trends in road death rates for child pedestrians, cyclists and car occupants. Analysis of road traffic injury death rates per 100 000 children and death rates per 10 million passenger miles travelled. England and Wales between 1985 and 2003. Children aged 0-14 years. None. Death rates per 100,000 children and per 10 million child passenger miles for pedestrians, cyclists and car occupants. Death rates per head of population have declined for child pedestrians, cyclists and car occupants but pedestrian death rates remain higher (0.55 deaths/100,000 children; 95% confidence interval [CI] 0.42 to 0.72 deaths) than those for car occupants (0.34 deaths; 95% CI 0.23 to 0.48 deaths) and cyclists (0.16 deaths; 95% CI 0.09 to 0.27 deaths). Since 1985, the average distance children travelled as a car occupant has increased by 70%; the average distance walked has declined by 19%; and the average distance cycled has declined by 58%. Taking into account distance travelled, there are about 50 times more child cyclist deaths (0.55 deaths/10 million passenger miles; 0.32 to 0.89) and nearly 30 times more child pedestrian deaths (0.27 deaths; 0.20 to 0.35) than there are deaths to child car occupants (0.01 deaths; 0.007 to 0.014). In 2003, children from families without access to a vehicle walked twice the distance walked by children in families with access to two or more vehicles. More needs to be done to reduce the traffic injury death rates for child pedestrians and cyclists. This might encourage more walking and cycling and also has the potential to reduce social class gradients in injury mortality.

Heart Disease and Cancer Deaths — Trends and Projections in the United States, 1969–2020

PubMed Central

Anderson, Robert N.; Coleman King, Sallyann M.; Soman, Ashwini; Thompson, Trevor D.; Hong, Yuling; Moller, Bjorn; Leadbetter, Steven

2016-01-01

Introduction Heart disease and cancer are the first and second leading causes of death in the United States. Age-standardized death rates (risk) have declined since the 1960s for heart disease and for cancer since the 1990s, whereas the overall number of heart disease deaths declined and cancer deaths increased. We analyzed mortality data to evaluate and project the effect of risk reduction, population growth, and aging on the number of heart disease and cancer deaths to the year 2020. Methods We used mortality data, population estimates, and population projections to estimate and predict heart disease and cancer deaths from 1969 through 2020 and to apportion changes in deaths resulting from population risk, growth, and aging. Results We predicted that from 1969 through 2020, the number of heart disease deaths would decrease 21.3% among men (–73.9% risk, 17.9% growth, 34.7% aging) and 13.4% among women (–73.3% risk, 17.1% growth, 42.8% aging) while the number of cancer deaths would increase 91.1% among men (–33.5% risk, 45.6% growth, 79.0% aging) and 101.1% among women (–23.8% risk, 48.8% growth, 76.0% aging). We predicted that cancer would become the leading cause of death around 2016, although sex-specific crossover years varied. Conclusion Risk of death declined more steeply for heart disease than cancer, offset the increase in heart disease deaths, and partially offset the increase in cancer deaths resulting from demographic changes over the past 4 decades. If current trends continue, cancer will become the leading cause of death by 2020. PMID:27854420

Mortality among three refinery/petrochemical plant cohorts. II. Retirees.

PubMed

Gamble, J F; Lewis, R J; Jorgensen, G

2000-07-01

This study updates mortality data for 6238 retirees from three refinery/petrochemical plants. Almost 90% of the cohort was deceased. Deaths from all causes (standardized mortality ratio, 104; 95% confidence interval, 102 to 107) and all cancers (standardized mortality ratio, 109; 95% confidence interval, 102 to 116) were elevated. Increased deaths due to kidney cancer, mesothelioma, and the category of other lymphohemopoietic cancers also were observed. The rate of leukemia was not increased. There was little internal or external consistency to support an occupational relationship for kidney cancer, but findings for mesothelioma and other lymphohemopoietic cancers are consistent with reports for other petroleum cohorts. Analyses by age indicated significantly higher all-cause mortality rates among persons retiring before age 65. The results suggest that continued surveillance of mesothelioma and lymphohemopoietic cancer malignancies in younger workers with more contemporary exposures may be warranted. Furthermore, age at retirement should be considered when analyzing occupational cohorts.

[When and where motorcyclists have accidents and die in Belo Horizonte, Minas Gerais State, Brazil].

PubMed

Diniz, Eugênio Paceli Hatem; Pinheiro, Letícia Cavalari; Proietti, Fernando Augusto

2015-12-01

The objective of this study was to analyze traffic accidents involving motorcycles in Belo Horizonte, Minas Gerais State, Brazil, from 2007 to 2011 and to identify clusters of high-risk and hazardous intersections in and around the city. Data were provided by the Military Police Brigade and the Emergency Medical Service (SAMU). Accident severity rates were used to identify critical intersections. Two techniques were used: kernel analysis and scan statistics (continuous Poisson model). High-risk clusters were located in the downtown area and on major thoroughfares. Surprisingly, the highest risk of accidents and death occurred not at intersections, but between them. Hazardous intersections are part of routes used to access regions around Greater Metropolitan Belo Horizonte. Two distinct trends in mortality rates and accidents were identified. Most motorcycle deaths occurred after 7:00 PM. The study concludes that there is an urgent need to improve motorcycle and public transportation routes.

Cardiovascular ischemic event rates in outpatients with symptomatic atherothrombosis or risk factors in the united states: insights from the REACH Registry.

PubMed

Eagle, Kim A; Hirsch, Alan T; Califf, Robert M; Alberts, Mark J; Steg, P Gabriel; Cannon, Christopher P; Brennan, Danielle M; Bhatt, Deepak L

2009-06-01

Atherothrombosis, defined as coronary artery, cerebrovascular, and peripheral arterial disease, is the leading cause of death in the United States. Limited data are available from outpatient populations to describe contemporary cardiovascular ischemic event rates and associated use of risk reduction treatments in patients with clinically manifest, or at risk for, atherothrombosis. The REduction of Atherothrombosis for Continued Health (REACH) Registry is an international, prospective, observational study of patients with either documented atherothrombotic syndromes or 3 or more risk factors designed to fill this knowledge gap. Baseline demographics and 1-year outcomes were evaluated for US patients enrolled in the REACH Registry. Multivariate analytic models were constructed using baseline characteristics to determine independent predictors of 1-year event rates. In the United States, 25,686 patients were enrolled into the registry. Among symptomatic patients (n = 19,069), 19% had disease in >or=1 arterial bed. As of July 2006, 1-year outcomes were available for 93.4% (n = 23,985) of patients. The composite cardiovascular death, nonfatal myocardial infarction, and nonfatal stroke event rate was 4.3% for the overall population and highest in patients with triple bed disease (9.9%). There was a relatively high use of risk reduction medications among symptomatic patients. However, opportunity for improvement remains. Approximately 9% of symptomatic patients were not using any antithrombotic, 7% were not using any antihypertensive agents, and 17% were not taking a lipid-lowering agent, whereas >80% of patients suffered from hypertension or dyslipidemia. US patients with established atherothrombotic disease continue to experience high cardiovascular ischemic event rates; these rates increase in close association with polyvascular disease. Despite the use of risk reduction interventions, ideal secondary prevention of ischemic events has not been achieved.

Cause-specific mortality in Finnish forensic psychiatric patients.

PubMed

Ojansuu, Ilkka; Putkonen, Hanna; Tiihonen, Jari

2018-05-02

To analyze the causes of mortality among patients committed to compulsory forensic psychiatric hospital treatment in Finland during 1980-2009 by categorizing the causes of mortality into somatic diseases, suicides and other unnatural deaths. The causes of mortality were analyzed among 351 patients who died during the follow-up. Standardized mortality ratio (SMR) was calculated as the ratio of observed and expected number of deaths by using the subject-years methods with 95% confidence intervals, assuming a Poisson distribution. The expected number of deaths was calculated on the basis of sex-, age- and calendar-period-specific mortality rates for the Finnish population. The vast majority (249/351) of deaths were due to a somatic disease with SMR of 2.6 (mean age at death 61 years). Fifty nine patients committed suicide with a SMR of 7.1 (mean age at death 40 years). Four patients were homicide victims (mean age at death 40 years) and 32 deaths were accidental (mean age at death 52 years). The combined homicides and accidental deaths resulted in a SMR of 1.7. The results of this study point out that the high risk for suicide should receive attention when the hospital treatment and the outpatient care is being organized for forensic psychiatric patients. In addition, the risk of accidents should be evaluated and it should be assured that the patients receive proper somatic healthcare during the forensic psychiatric treatment and that it continues also in the outpatient setting.

5 CFR 843.304 - Commencing and terminating dates of survivor annuities.

Code of Federal Regulations, 2013 CFR

2013-01-01

... (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES RETIREMENT SYSTEM-DEATH BENEFITS AND... annuities. (a) A current or former spouse annuity under this subpart commences on the day after the death of... 55 or dies. (c) A current spouse annuity under this subpart terminated for reasons other than death...

5 CFR 843.304 - Commencing and terminating dates of survivor annuities.

Code of Federal Regulations, 2011 CFR

2011-01-01

... (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES RETIREMENT SYSTEM-DEATH BENEFITS AND... annuities. (a) A current or former spouse annuity under this subpart commences on the day after the death of... 55 or dies. (c) A current spouse annuity under this subpart terminated for reasons other than death...

5 CFR 843.304 - Commencing and terminating dates of survivor annuities.

Code of Federal Regulations, 2014 CFR

2014-01-01

... (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES RETIREMENT SYSTEM-DEATH BENEFITS AND... annuities. (a) A current or former spouse annuity under this subpart commences on the day after the death of... 55 or dies. (c) A current spouse annuity under this subpart terminated for reasons other than death...

5 CFR 843.304 - Commencing and terminating dates of survivor annuities.

Code of Federal Regulations, 2012 CFR

2012-01-01

... (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES RETIREMENT SYSTEM-DEATH BENEFITS AND... annuities. (a) A current or former spouse annuity under this subpart commences on the day after the death of... 55 or dies. (c) A current spouse annuity under this subpart terminated for reasons other than death...

5 CFR 843.304 - Commencing and terminating dates of survivor annuities.

Code of Federal Regulations, 2010 CFR

2010-01-01

... (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES RETIREMENT SYSTEM-DEATH BENEFITS AND... annuities. (a) A current or former spouse annuity under this subpart commences on the day after the death of... 55 or dies. (c) A current spouse annuity under this subpart terminated for reasons other than death...

Molecular mechanisms of cell death: recommendations of the Nomenclature Committee on Cell Death 2018.

PubMed

Galluzzi, Lorenzo; Vitale, Ilio; Aaronson, Stuart A; Abrams, John M; Adam, Dieter; Agostinis, Patrizia; Alnemri, Emad S; Altucci, Lucia; Amelio, Ivano; Andrews, David W; Annicchiarico-Petruzzelli, Margherita; Antonov, Alexey V; Arama, Eli; Baehrecke, Eric H; Barlev, Nickolai A; Bazan, Nicolas G; Bernassola, Francesca; Bertrand, Mathieu J M; Bianchi, Katiuscia; Blagosklonny, Mikhail V; Blomgren, Klas; Borner, Christoph; Boya, Patricia; Brenner, Catherine; Campanella, Michelangelo; Candi, Eleonora; Carmona-Gutierrez, Didac; Cecconi, Francesco; Chan, Francis K-M; Chandel, Navdeep S; Cheng, Emily H; Chipuk, Jerry E; Cidlowski, John A; Ciechanover, Aaron; Cohen, Gerald M; Conrad, Marcus; Cubillos-Ruiz, Juan R; Czabotar, Peter E; D'Angiolella, Vincenzo; Dawson, Ted M; Dawson, Valina L; De Laurenzi, Vincenzo; De Maria, Ruggero; Debatin, Klaus-Michael; DeBerardinis, Ralph J; Deshmukh, Mohanish; Di Daniele, Nicola; Di Virgilio, Francesco; Dixit, Vishva M; Dixon, Scott J; Duckett, Colin S; Dynlacht, Brian D; El-Deiry, Wafik S; Elrod, John W; Fimia, Gian Maria; Fulda, Simone; García-Sáez, Ana J; Garg, Abhishek D; Garrido, Carmen; Gavathiotis, Evripidis; Golstein, Pierre; Gottlieb, Eyal; Green, Douglas R; Greene, Lloyd A; Gronemeyer, Hinrich; Gross, Atan; Hajnoczky, Gyorgy; Hardwick, J Marie; Harris, Isaac S; Hengartner, Michael O; Hetz, Claudio; Ichijo, Hidenori; Jäättelä, Marja; Joseph, Bertrand; Jost, Philipp J; Juin, Philippe P; Kaiser, William J; Karin, Michael; Kaufmann, Thomas; Kepp, Oliver; Kimchi, Adi; Kitsis, Richard N; Klionsky, Daniel J; Knight, Richard A; Kumar, Sharad; Lee, Sam W; Lemasters, John J; Levine, Beth; Linkermann, Andreas; Lipton, Stuart A; Lockshin, Richard A; López-Otín, Carlos; Lowe, Scott W; Luedde, Tom; Lugli, Enrico; MacFarlane, Marion; Madeo, Frank; Malewicz, Michal; Malorni, Walter; Manic, Gwenola; Marine, Jean-Christophe; Martin, Seamus J; Martinou, Jean-Claude; Medema, Jan Paul; Mehlen, Patrick; Meier, Pascal; Melino, Sonia; Miao, Edward A; Molkentin, Jeffery D; Moll, Ute M; Muñoz-Pinedo, Cristina; Nagata, Shigekazu; Nuñez, Gabriel; Oberst, Andrew; Oren, Moshe; Overholtzer, Michael; Pagano, Michele; Panaretakis, Theocharis; Pasparakis, Manolis; Penninger, Josef M; Pereira, David M; Pervaiz, Shazib; Peter, Marcus E; Piacentini, Mauro; Pinton, Paolo; Prehn, Jochen H M; Puthalakath, Hamsa; Rabinovich, Gabriel A; Rehm, Markus; Rizzuto, Rosario; Rodrigues, Cecilia M P; Rubinsztein, David C; Rudel, Thomas; Ryan, Kevin M; Sayan, Emre; Scorrano, Luca; Shao, Feng; Shi, Yufang; Silke, John; Simon, Hans-Uwe; Sistigu, Antonella; Stockwell, Brent R; Strasser, Andreas; Szabadkai, Gyorgy; Tait, Stephen W G; Tang, Daolin; Tavernarakis, Nektarios; Thorburn, Andrew; Tsujimoto, Yoshihide; Turk, Boris; Vanden Berghe, Tom; Vandenabeele, Peter; Vander Heiden, Matthew G; Villunger, Andreas; Virgin, Herbert W; Vousden, Karen H; Vucic, Domagoj; Wagner, Erwin F; Walczak, Henning; Wallach, David; Wang, Ying; Wells, James A; Wood, Will; Yuan, Junying; Zakeri, Zahra; Zhivotovsky, Boris; Zitvogel, Laurence; Melino, Gerry; Kroemer, Guido

2018-03-01

Over the past decade, the Nomenclature Committee on Cell Death (NCCD) has formulated guidelines for the definition and interpretation of cell death from morphological, biochemical, and functional perspectives. Since the field continues to expand and novel mechanisms that orchestrate multiple cell death pathways are unveiled, we propose an updated classification of cell death subroutines focusing on mechanistic and essential (as opposed to correlative and dispensable) aspects of the process. As we provide molecularly oriented definitions of terms including intrinsic apoptosis, extrinsic apoptosis, mitochondrial permeability transition (MPT)-driven necrosis, necroptosis, ferroptosis, pyroptosis, parthanatos, entotic cell death, NETotic cell death, lysosome-dependent cell death, autophagy-dependent cell death, immunogenic cell death, cellular senescence, and mitotic catastrophe, we discuss the utility of neologisms that refer to highly specialized instances of these processes. The mission of the NCCD is to provide a widely accepted nomenclature on cell death in support of the continued development of the field.

Going up or coming down? The changing phases of the lung cancer epidemic from 1967 to 1999 in the 15 European Union countries.

PubMed

Bray, F; Tyczynski, J E; Parkin, D M

2004-01-01

Lung cancer, the most common cause of cancer death in the European Union (EU), continues to have an enormous impact on the health experience of the men and women living in the constituent countries. Information on the course of the lung cancer epidemic is essential in order to formulate an effective cancer control policy. This paper examines recent trends in lung cancer mortality rates in men and women in each of the 15 countries, comparing cross-sectional rates of death in younger (aged 30-64 years) and older populations (aged 65 years or over), and the age, period of death, and birth cohort influences in the younger age group. The latter analysis establishes the importance of year of birth, related to modifications in the tobacco habit among recently born generations. The stage of evolution of the lung cancer epidemic varies markedly by sex and country in terms of the direction, magnitude, and phase of development of national trends. In males, there is some consistency in the direction of the trends between EU countries, declines are apparent in most countries, at least in younger men, with rates in older men either reaching a plateau, or also falling. In younger persons, a decreasing risk of lung cancer death reflects changes in successive birth cohorts, due to modifications in the smoking habit from generation to generation, although these developments are in very different phases across countries. Portugal is the exception to the male trends; there are increases in mortality in both age groups, with little sign of a slowing down by birth cohort. In women, there are unambiguous upsurges in rates seen in younger and older women in almost all EU countries in recent decades, and little sign that the epidemic has or will soon reach a peak. The exceptions are the United Kingdom (UK) and Ireland, where lung cancer death rates are now declining in younger women and stabilising in older women, reflecting a declining risk in women born since about 1950. It is too early to say whether the observed plateau or decline in rates in women born very recently in several countries is real or random. To ascertain whether recent trends in lung cancer mortality will continue, trends in cigarette consumption should also be evaluated. Where data are available by country, the proportion of adult male smokers has, by and large, fallen steadily in the last five decades. In women, recent smoking trends are downwards in Belgium, Denmark, Sweden and the Netherlands, although in Austria and Spain, large increases in smoking prevalence amongst adults are emerging. Unambiguous public health messages must be effectively conveyed to the inhabitants of the EU if the lung cancer epidemic is to be controlled. It is imperative that anti-tobacco strategies urgently target women living in the EU, in order to halt their rapidly increasing risk of lung cancer, and prevent unnecessary, premature deaths among future generations of women.

Effect of continued treatment with pirfenidone following clinically meaningful declines in forced vital capacity: analysis of data from three phase 3 trials in patients with idiopathic pulmonary fibrosis.

PubMed

Nathan, Steven D; Albera, Carlo; Bradford, Williamson Z; Costabel, Ulrich; du Bois, Roland M; Fagan, Elizabeth A; Fishman, Robert S; Glaspole, Ian; Glassberg, Marilyn K; Glasscock, Kenneth F; King, Talmadge E; Lancaster, Lisa; Lederer, David J; Lin, Zhengning; Pereira, Carlos A; Swigris, Jeffrey J; Valeyre, Dominique; Noble, Paul W; Wells, Athol U

2016-05-01

The assessment of treatment response in idiopathic pulmonary fibrosis (IPF) is complicated by the variable clinical course. We examined the variability in the rate of disease progression and evaluated the effect of continued treatment with pirfenidone in patients who experienced meaningful progression during treatment. The source population included patients enrolled in the ASCEND and CAPACITY trials (N=1247). Pearson's correlation coefficients were used to characterise the relationship between changes in FVC during consecutive 6-month intervals in the placebo population. Outcomes following a ≥10% decline in FVC were evaluated by comparing the proportion of patients in the pirfenidone and placebo groups who experienced a ≥10% decline in FVC or death during the subsequent 6 months. A weak negative correlation was observed between FVC changes during consecutive intervals in the placebo population (coefficient, -0.146, p<0.001), indicating substantial variability. Thirty-four (5.5%) and 68 (10.9%) patients in the pirfenidone and placebo groups, respectively, experienced a ≥10% decline in FVC by month 6. During the subsequent 6 months, fewer patients in the pirfenidone group compared with placebo experienced a ≥10% decline in FVC or death (5.9% vs 27.9%; relative difference, 78.9%). There was one (2.9%) death in the pirfenidone group and 14 (20.6%) deaths in the placebo group (relative difference, 85.7%). Longitudinal FVC data from patients with IPF showed substantial intrasubject variability, underscoring the inability to reliably assess therapeutic response using serial FVC trends. In patients who progressed during treatment, continued treatment with pirfenidone resulted in a lower risk of subsequent FVC decline or death. NCT01366209, NCT00287729, NCT00287716. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Effect of continued treatment with pirfenidone following clinically meaningful declines in forced vital capacity: analysis of data from three phase 3 trials in patients with idiopathic pulmonary fibrosis

PubMed Central

Nathan, Steven D; Albera, Carlo; Bradford, Williamson Z; Costabel, Ulrich; du Bois, Roland M; Fagan, Elizabeth A; Fishman, Robert S; Glaspole, Ian; Glassberg, Marilyn K; King, Talmadge E; Lancaster, Lisa; Lederer, David J; Lin, Zhengning; Pereira, Carlos A; Swigris, Jeffrey J; Valeyre, Dominique; Noble, Paul W; Wells, Athol U

2016-01-01

Background The assessment of treatment response in idiopathic pulmonary fibrosis (IPF) is complicated by the variable clinical course. We examined the variability in the rate of disease progression and evaluated the effect of continued treatment with pirfenidone in patients who experienced meaningful progression during treatment. Methods The source population included patients enrolled in the ASCEND and CAPACITY trials (N=1247). Pearson's correlation coefficients were used to characterise the relationship between changes in FVC during consecutive 6-month intervals in the placebo population. Outcomes following a ≥10% decline in FVC were evaluated by comparing the proportion of patients in the pirfenidone and placebo groups who experienced a ≥10% decline in FVC or death during the subsequent 6 months. Results A weak negative correlation was observed between FVC changes during consecutive intervals in the placebo population (coefficient, −0.146, p<0.001), indicating substantial variability. Thirty-four (5.5%) and 68 (10.9%) patients in the pirfenidone and placebo groups, respectively, experienced a ≥10% decline in FVC by month 6. During the subsequent 6 months, fewer patients in the pirfenidone group compared with placebo experienced a ≥10% decline in FVC or death (5.9% vs 27.9%; relative difference, 78.9%). There was one (2.9%) death in the pirfenidone group and 14 (20.6%) deaths in the placebo group (relative difference, 85.7%). Conclusions Longitudinal FVC data from patients with IPF showed substantial intrasubject variability, underscoring the inability to reliably assess therapeutic response using serial FVC trends. In patients who progressed during treatment, continued treatment with pirfenidone resulted in a lower risk of subsequent FVC decline or death. Trial registration numbers NCT01366209, NCT00287729, NCT00287716. PMID:26968970

Use and misuse of motor-vehicle crash death rates in assessing highway-safety performance.

PubMed

O'Neill, Brian; Kyrychenko, Sergey Y

2006-12-01

The objectives of the article are to assess the extent to which comparisons of motor-vehicle crash death rates can be used to determine the effectiveness of highway-safety policies over time in a country or to compare policy effectiveness across countries. Motor-vehicle crash death rates per mile traveled in the 50 U.S. states from 1980 to 2003 are used to show the influence on these rates of factors independent of highway-safety interventions. Multiple regression models relating state death rates to various measures related to urbanization and demographics are used. The analyses demonstrate strong relationships between state death rates and urbanization and demographics. Almost 60% of the variability among the state death rates can be explained by the independent variables in the multiple regression models. When the death rates for passenger vehicle occupants (i.e., excluding motorcycle, pedestrian, and other deaths) are used in the regression models, almost 70% of the variability in the rates can be explained by urbanization and demographics. The analyses presented in the article demonstrate that motor-vehicle crash death rates are strongly influenced by factors unrelated to highway-safety countermeasures. Overall death rates should not be used as a basis for judging the effectiveness (or ineffectiveness) of specific highway-safety countermeasures or to assess overall highway-safety policies, especially across jurisdictions. There can be no substitute for the use of carefully designed scientific evaluations of highway-safety interventions that use outcome measures directly related to the intervention; e.g., motorcyclist deaths should be used to assess the effectiveness of motorcycle helmet laws. While this may seem obvious, there are numerous examples in the literature of death rates from all crashes being used to assess the effectiveness of interventions aimed at specific subsets of crashes.

Cancer Mortality Following Polychlorinated Biphenyl (PCB) Contamination of a Guam Village

PubMed Central

Badowski, Grazyna; Bordallo, Renata

2011-01-01

Beginning more than 10 years after the release of polychlorinated biphenyl (PCB) contamination in the favored fishing grounds of Merizo village, an increase in the proportional cancer mortality rate was observed among residents of the village. This increased rate continued for approximately 20 years after which it returned to near island-wide Guam levels. Although the temporal association between PCB contamination of the environment of this village and an increase in cancer mortality is intriguing, it does not necessarily demonstrate a cause and effect relationship. Objective To investigate a possible temporal relationship between PCB contamination of the Cocos Lagoon and cancer deaths in the adjoining village of Merizo. Methods Data utilized in the study included deaths recorded by the Guam Cancer Registry (years 2000 to 2007) and data collected from original death certificates (years 1968–1999). To check whether there was a significant difference in the proportion of deaths due to cancer in Merizo compared with the rest of Guam, deaths were grouped in four 10-year periods, 1968–1977, 1978–1987, 1988–1997, and 1998–2007, and the Pearson Chi-Square test was calculated for each period separately Results While the number of new cancer cases recorded in the village of Merizo were insufficient in number to draw a statistically significant conclusion when single year incidence rates were compared to the rest of the island, a proportional mortality study showed a distinct increase for the village of Merizo compared to other villages for the period 1978–1997. Conclusion While it is not possible to conclude with certainty that PCB contamination of the Cocos Lagoon was responsible for the observed increase in the proportion of cancer deaths in Merizo village beginning during the 10-year period 1978–1987, that increase and the subsequent decrease as PCB levels also decreased presents the possibility that these trends may be related. PMID:22235158

Tanzania: Background and Current Conditions

DTIC Science & Technology

2010-07-23

persons with albinism and women persisted. Female genital mutilation (FGM), especially of young girls, continued to be practiced. Trafficking in...35%; Zanzibar /islands over 99% Muslim Literacy: Male, 77.5%; Female , 66.2% (2003) Under-5 Mortality: 165 deaths/1,000 live births HIV/AIDS adult...infection rate: 6.2% (2007) Life Expectancy, years at birth: Male, 50.5 Female , 53.5 (2009 est.) Sources: CIA World Factbook 2010. Tanzania

Pathology of Serially Sacrificed Female B6C3F1 Mice Continuously Exposed to Very Low-Dose-Rate Gamma Rays.

PubMed

Tanaka, I B; Komura, J; Tanaka, S

2017-03-01

We have previously reported on life span shortening as well as increased incidence rates in several neoplasms in B6C3F1 mice that were continuously exposed to 21 mGy/day of gamma rays for 400 days. To clarify whether the life shortening was due to early appearance of neoplasms (shortened latency) or increased promotion/progression, 8-week-old female specific-pathogen-free B6C3F1 mice were gamma-ray irradiated at a low dose rate of 20 mGy/day for 400 days. At 100 days postirradiation, 60-90 mice were sacrificed, and thereafter every 100 days alongside the age-matched nonirradiated controls, for 700 days. Additional groups were allowed to live out their natural life span. Pathological examination was performed on all mice to identify lesions, non-neoplastic and neoplastic, as well as to determine the cause of death. Body weights were significantly increased in irradiated mice from sacrifice days 200-500. Incidence rates for spontaneously occurring non-neoplastic lesions, such as adrenal subcapsular cell hyperplasia, fatty degeneration of the liver, atrophy and tubulostromal hyperplasia of the ovaries, were significantly increased in irradiated mice. Significantly increased incidence rates with no shortening of latency periods were observed in irradiated mice for malignant lymphomas, hepatocellular adenomas/carcinomas, bronchioloalveolar adenomas, harderian gland adenoma/adenocarcinoma. Shortened latencies with significantly increased incidence rates were observed for adrenal subcapsular cell adenomas and ovarian neoplasms (tubulostromal adenoma, granulosa cell tumors) in irradiated mice. Life span shortening in mice exposed to 20 mGy/day was mostly due to malignant lymphomas. Multiple primary neoplasms were significantly increased in mice exposed to 20 mGy/day from sacrifice days 400-700 and in the life span group. Our results confirm that continuous low-dose-rate gamma-ray irradiation of female B6C3F1 mice causes both cancer induction (shortened latency) and promotion/progression (early death), depending on the neoplasm's organ/tissue of origin.

Heart Disease Death Rates in Low Versus High Land Elevation Counties in the U.S.

PubMed

Hart, John

2015-01-01

Previous research on land elevation and cancer death rates in the U.S. revealed lower cancer death rates in higher elevations. The present study further tests the possible effect of land elevation on a diffident health outcome, namely, heart disease death rates. U.S. counties not overlapping in their land elevations according to their lowest and highest elevation points were identified. Using an ecological design, heart disease death rates for two races (black and white) corresponding to lower elevation counties were compared to heart disease death rates in higher land elevation counties using the two-sample t-test and effect size statistics. Death rates in higher land elevation counties for both races were lower compared to the death rates in lower land elevation counties (p < 0.001) with large effect sizes (of > 0.70). Since this is an observational study, no causal inference is claimed, and further research is indicated to verify these findings.

Heart Disease Death Rates in Low Versus High Land Elevation Counties in the U.S

PubMed Central

2015-01-01

Previous research on land elevation and cancer death rates in the U.S. revealed lower cancer death rates in higher elevations. The present study further tests the possible effect of land elevation on a diffident health outcome, namely, heart disease death rates. U.S. counties not overlapping in their land elevations according to their lowest and highest elevation points were identified. Using an ecological design, heart disease death rates for two races (black and white) corresponding to lower elevation counties were compared to heart disease death rates in higher land elevation counties using the two-sample t-test and effect size statistics. Death rates in higher land elevation counties for both races were lower compared to the death rates in lower land elevation counties (p < 0.001) with large effect sizes (of > 0.70). Since this is an observational study, no causal inference is claimed, and further research is indicated to verify these findings. PMID:26674102

Mortality risks in new-onset childhood epilepsy.

PubMed

Berg, Anne T; Nickels, Katherine; Wirrell, Elaine C; Geerts, Ada T; Callenbach, Petra M C; Arts, Willem F; Rios, Christina; Camfield, Peter R; Camfield, Carol S

2013-07-01

Estimate the causes and risk of death, specifically seizure related, in children followed from onset of epilepsy and to contrast the risk of seizure-related death with other common causes of death in the population. Mortality experiences from 4 pediatric cohorts of newly diagnosed patients were combined. Causes of death were classified as seizure related (including sudden unexpected death [SUDEP]), natural causes, nonnatural causes, and unknown. Of 2239 subjects followed up for >30 000 person-years, 79 died. Ten subjects with lethal neurometabolic conditions were ultimately excluded. The overall death rate (per 100 000 person-years) was 228; 743 in complicated epilepsy (with associated neurodisability or underlying brain condition) and 36 in uncomplicated epilepsy. Thirteen deaths were seizure-related (10 SUDEP, 3 other), accounting for 19% of all deaths. Seizure-related death rates were 43 overall, 122 for complicated epilepsy, and 14 for uncomplicated epilepsy. Death rates from other natural causes were 159, 561, and 9, respectively. Of 48 deaths from other natural causes, 37 were due to pneumonia or other respiratory complications. Most excess death in young people with epilepsy is not seizure-related. Mortality is significantly higher compared with the general population in children with complicated epilepsy but not uncomplicated epilepsy. The SUDEP rate was similar to or higher than sudden infant death syndrome rates. In uncomplicated epilepsy, sudden and seizure-related death rates were similar to or higher than rates for other common causes of death in young people (eg, accidents, suicides, homicides). Relating the risk of death in epilepsy to familiar risks may facilitate discussions of seizure-related mortality with patients and families.

Associations and Trends in Cause-Specific Rates of Death Among Persons Reported with HIV Infection, 23 U.S. Jurisdictions, Through 2011

PubMed Central

Adih, William K.; Selik, Richard M.; Hall, H. Irene; Babu, Aruna Surendera; Song, Ruiguang

2016-01-01

Background: Published death rates for persons with HIV have not distinguished deaths due to HIV from deaths due to other causes. Cause-specific death rates would allow better assessment of care needs. Methods: Using data reported to the US national HIV surveillance system, we examined a) associations between selected decedent characteristics and causes of death during 2007-2011, b) trends in rates of death due to underlying causes among persons with AIDS during 1990-2011, and among all persons with diagnosed HIV infection (with or without AIDS) during 2000-2011. Results: During 2007-2011, non-HIV-attributable causes of death with the highest rates per 1,000 person-years were heart disease (2.0), non-AIDS cancers other than lung cancer (1.4), and accidents (0.8). During 1990-2011, among persons with AIDS, the annual rate of death due to HIV-attributable causes decreased by 89% (from 122.0 to 13.2), and the rate due to non-HIV-attributable-causes decreased by 57% (from 20.0 to 8.6), while the percentage of deaths caused by non-HIV-attributable causes increased from 11% to 43%. During 2000-2011, among persons with HIV infection, the rate of death due to HIV-attributable causes decreased by 69% (from 26.4 to 8.3), and the rate due to non-HIV-attributable causes decreased by 28% (from 10.5 to 7.6), while the percentage of deaths caused by non-HIV-attributable causes increased from 25% to 48%. Conclusion: Among HIV-infected persons, as rates of death due to HIV-attributable causes decreased, rates due to non-HIV-attributable causes also decreased, but the percentages of deaths due to non-HIV-attributable causes, such as heart disease and non-AIDS cancers increased. PMID:27708746

On the Methodology of Studying Aging in Humans

DTIC Science & Technology

1961-01-01

prediction of death rates The relation of death rate to age has been extensively studied for over 100 years. As an illustration recent death rates for...log death rates appear to be linear, the simpler Gompertz curve fits closely. While on this subject of the Makeham-Gompertz function, it should be...Makeham-Gompertz curve to 5 year age specific death rates . Each fitting provided estimates of the parameters a, {j, and log c for each of the five year

Perianesthetic and Anesthesia-Related Mortality in a Southeastern United States Population: A Longitudinal Review of a Prospectively Collected Quality Assurance Data Base.

PubMed

Pollard, Richard J; Hopkins, Thomas; Smith, C Tyler; May, Bryan V; Doyle, James; Chambers, C Labron; Clark, Reese; Buhrman, William

2018-05-21

Perianesthetic mortality (death occurring within 48 hours of an anesthetic) continues to vary widely depending on the study population examined. The authors study in a private practice physician group that covers multiple anesthetizing locations in the Southeastern United States. This group has in place a robust quality assurance (QA) database to follow all patients undergoing anesthesia. With this study, we estimate the incidence of anesthesia-related and perianesthetic mortality in this QA database. Following institutional review board approval, data from 2011 to 2016 were obtained from the QA database of a large, community-based anesthesiology group practice. The physician practice covers 233 anesthetizing locations across 20 facilities in 2 US states. All detected cases of perianesthetic death were extracted from the database and compared to the patients' electronic medical record. These cases were further examined by a committee of 3 anesthesiologists to determine whether the death was anesthesia related (a perioperative death solely attributable to either the anesthesia provider or anesthetic technique), anesthetic contributory (a perioperative death in which anesthesia role could not be entirely excluded), or not due to anesthesia. A total of 785,467 anesthesia procedures were examined from the study period. A total of 592 cases of perianesthetic deaths were detected, giving an overall death rate of 75.37 in 100,000 cases (95% CI, 69.5-81.7). Mortality judged to be anesthesia related was found in 4 cases, giving a mortality rate of 0.509 in 100,000 (95% CI, 0.198-1.31). Mortality judged to be anesthesia contributory were found in 18 cases, giving a mortality of 2.29 in 100,000 patients (95% CI, 1.45-3.7). A total of 570 cases were judged to be nonanesthesia related, giving an incidence of 72.6 per 100,000 anesthetics (95% CI, 69.3-75.7). In a large, comprehensive database representing the full range of anesthesia practices and locations in the Southeastern United States, the rate of perianesthestic death was 0.509 in 100,000 (95% CI, 0.198-1.31). Future in-depth analysis of the epidemiology of perianesthetic deaths will be reported in later studies.

Stats of the States

MedlinePlus

... rates for fatal drug poisonings. Death Rates from Firearm Injuries: United States, 2013 - The latest state-based age-adjusted death rates for firearm-related fatalities. Death Rates from Homicide: United States, ...

Leading Causes of Death in Nonmetropolitan and Metropolitan Areas— United States, 1999–2014

PubMed Central

Garcia, Macarena C.; Bastian, Brigham; Rossen, Lauren M.; Ingram, Deborah D.; Faul, Mark; Massetti, Greta M.; Thomas, Cheryll C.; Hong, Yuling; Yoon, Paula W.; Iademarco, Michael F.

2017-01-01

Problem/Condition Higher rates of death in nonmetropolitan areas (often referred to as rural areas) compared with metropolitan areas have been described but not systematically assessed. Period Covered 1999–2014 Description of System Mortality data for U.S. residents from the National Vital Statistics System were used to calculate age-adjusted death rates and potentially excess deaths for nonmetropolitan and metropolitan areas for the five leading causes of death. Age-adjusted death rates included all ages and were adjusted to the 2000 U.S. standard population by the direct method. Potentially excess deaths are defined as deaths among persons aged <80 years that exceed the numbers that would be expected if the death rates of states with the lowest rates (i.e., benchmark states) occurred across all states. (Benchmark states were the three states with the lowest rates for each cause during 2008–2010.) Potentially excess deaths were calculated separately for nonmetropolitan and metropolitan areas. Data are presented for the United States and the 10 U.S. Department of Health and Human Services public health regions. Results Across the United States, nonmetropolitan areas experienced higher age-adjusted death rates than metropolitan areas. The percentages of potentially excess deaths among persons aged <80 years from the five leading causes were higher in nonmetropolitan areas than in metropolitan areas. For example, approximately half of deaths from unintentional injury and chronic lower respiratory disease in nonmetropolitan areas were potentially excess deaths, compared with 39.2% and 30.9%, respectively, in metropolitan areas. Potentially excess deaths also differed among and within public health regions; within regions, nonmetropolitan areas tended to have higher percentages of potentially excess deaths than metropolitan areas. Interpretation Compared with metropolitan areas, nonmetropolitan areas have higher age-adjusted death rates and greater percentages of potentially excess deaths from the five leading causes of death, nationally and across public health regions. Public Health Action Routine tracking of potentially excess deaths in nonmetropolitan areas might help public health departments identify emerging health problems, monitor known problems, and focus interventions to reduce preventable deaths in these areas. PMID:28081058

Leading Causes of Death in Nonmetropolitan and Metropolitan Areas- United States, 1999-2014.

PubMed

Moy, Ernest; Garcia, Macarena C; Bastian, Brigham; Rossen, Lauren M; Ingram, Deborah D; Faul, Mark; Massetti, Greta M; Thomas, Cheryll C; Hong, Yuling; Yoon, Paula W; Iademarco, Michael F

2017-01-13

Higher rates of death in nonmetropolitan areas (often referred to as rural areas) compared with metropolitan areas have been described but not systematically assessed. 1999-2014 DESCRIPTION OF SYSTEM: Mortality data for U.S. residents from the National Vital Statistics System were used to calculate age-adjusted death rates and potentially excess deaths for nonmetropolitan and metropolitan areas for the five leading causes of death. Age-adjusted death rates included all ages and were adjusted to the 2000 U.S. standard population by the direct method. Potentially excess deaths are defined as deaths among persons aged <80 years that exceed the numbers that would be expected if the death rates of states with the lowest rates (i.e., benchmark states) occurred across all states. (Benchmark states were the three states with the lowest rates for each cause during 2008-2010.) Potentially excess deaths were calculated separately for nonmetropolitan and metropolitan areas. Data are presented for the United States and the 10 U.S. Department of Health and Human Services public health regions. Across the United States, nonmetropolitan areas experienced higher age-adjusted death rates than metropolitan areas. The percentages of potentially excess deaths among persons aged <80 years from the five leading causes were higher in nonmetropolitan areas than in metropolitan areas. For example, approximately half of deaths from unintentional injury and chronic lower respiratory disease in nonmetropolitan areas were potentially excess deaths, compared with 39.2% and 30.9%, respectively, in metropolitan areas. Potentially excess deaths also differed among and within public health regions; within regions, nonmetropolitan areas tended to have higher percentages of potentially excess deaths than metropolitan areas. Compared with metropolitan areas, nonmetropolitan areas have higher age-adjusted death rates and greater percentages of potentially excess deaths from the five leading causes of death, nationally and across public health regions. Routine tracking of potentially excess deaths in nonmetropolitan areas might help public health departments identify emerging health problems, monitor known problems, and focus interventions to reduce preventable deaths in these areas.

Can dead bacterial cells be defined and are genes expressed after cell death?

PubMed

Trevors, J T

2012-07-01

There is a paucity of knowledge on gene expression in dead bacterial cells. Why would this knowledge be useful? The cells are dead. However, the time duration of gene expression following cell death is often unknown, and possibly in the order of minutes. In addition, it is a challenge to determine if bacterial cells are dead, or viable but non-culturable (VBNC), and what is an agreed upon correct definition of dead bacteria. Cells in the bacterial population or community may die at different rates or times and this complicates both the viability and gene expression analysis. In this article, the definition of dead bacterial cells is discussed and its significance in continued gene expression in cells following death. The definition of living and dead has implications for possible, completely, synthetic bacterial cells that may be capable of growth and division. Copyright © 2012 Elsevier B.V. All rights reserved.

Delayed Effects of Proton Irradiation in Macaca Mulatta. II. Mortality (15-Year Report).

DTIC Science & Technology

1983-01-01

Fig. 9) had significantly (p=.lO) earlier deaths in the combined sexes and the females. In these cases, death rates increased at -2 and -6 years post...while significance occurred in only the combined sexes (p<.lO). All 32-MeV males are alive. This fact increases the ability to detect higher death rates in...where the 55-MeV death rate exceeded the 32-MeV death rate after 4 years. Figures 12 and 13 indicate higher death rates in 138- and 400-MeV males (p<.lO

Child mortality inequalities across Rwanda districts: a geoadditive continuous-time survival analysis.

PubMed

Niragire, François; Achia, Thomas N O; Lyambabaje, Alexandre; Ntaganira, Joseph

2017-05-11

Child survival programmes are efficient when they target the most significant and area-specific factors. This study aimed to assess the key determinants and spatial variation of child mortality at the district level in Rwanda. Data from the 2010 Rwanda Demographic and Health Survey were analysed for 8817 live births that occurred during five years preceding the survey. Out of the children born, 433 had died before survey interviews were carried out. A full Bayesian geo-additive continuous-time hazard model enabled us to maximise data utilisation and hence improve the accuracy of our estimates. The results showed substantial district- level spatial variation in childhood mortality in Rwanda. District-specific spatial characteristics were particularly associated with higher death hazards in two districts: Musanze and Nyabihu. The model estimates showed that there were lower death rates among children from households of medium and high economic status compared to those from low-economic status households. Factors, such as four antenatal care visits, delivery at a health facility, prolonged breastfeeding and mothers younger than 31 years were associated with lower child death rates. Long preceding birth intervals were also associated with fewer hazards. For these reasons, programmes aimed at reducing child mortality gaps between districts in Rwanda should target maternal factors and take into consideration district-specific spatial characteristics. Further, child survival gains require strengthening or scaling-up of existing programmes pertaining to access to, and utilisation of maternal and child health care services as well as reduction of the household gap in the economic status.

Identifying palliative care issues in inpatients dying following stroke.

PubMed

Ntlholang, O; Walsh, S; Bradley, D; Harbison, J

2016-08-01

Stroke leads to high mortality and morbidity but often there is a conflict between need for palliative care and avoidance of 'therapeutic nihilism'. We aimed to elicit the palliative care needs of stroke patients at the end of their lives in our unit with a low overall mortality rate (1 month: 8.8 %, inpatient: 12.9 %). We identified consecutive stroke patients who died over 2 years. Their clinical records were used for data collection. Of 54 deaths, 33 (61.1 %) were females, mean (SD) age at death was 79.3 ± 12.9 years. 41 (75.9 %) died after first stroke, 9 (16.7 %) were inpatient strokes, 7 (13.0 %) thrombolysed and 7 (13.0 %) had strokes as treatment complication. There were clear statements recorded in 26 (48.1 %) that patients were dying and death was thought to be due primarily to extent of brain injury in 24 (44.4 %). Palliative needs identified included dyspnoea 21 (38.9 %), pain 17 (31.5 %), respiratory secretions 17 (31.5 %), agitation 14 (25.9 %) and psychological distress 1 (1.9 %). Symptoms were due to premorbid diseases in 6 (11.1 %). Palliative care expertise were sought in 13 (24.1 %) and continuous subcutaneous infusion was used in 18 (33.3 %) to control symptoms. 4 (7.4 %) subjects underwent cardiac arrest calls and 9 (16.7 %) deaths occurred in ICU/HDU. The median Stroke-Death interval was 20 days (range 0-389). Do Not Attempt Resuscitation (DNAR) orders were in place in 86.8 % of patients. The median DNAR-Death interval was 7 days (range 0-311) with 7-day DNAR-Death rate of 53.2 % and 30-day of 78.7 % of the total deaths. Dyspnoea, pain and respiratory secretions were identified as the main palliative care needs.

Season of death and birth predict patterns of mortality in Burkina Faso.

PubMed

Kynast-Wolf, Gisela; Hammer, Gaël P; Müller, Olaf; Kouyaté, Bocar; Becher, Heiko

2006-04-01

Mortality in developing countries has multiple causes. Some of these causes are linked to climatic conditions that differ over the year. Data on season-specific mortality are sparse. We analysed longitudinal data from a population of approximately 35,000 individuals in Burkina Faso. During the observation period 1993-2001, a total number of 4,098 deaths were recorded. The effect of season on mortality was investigated separately by age group as (i) date of death and (ii) date of birth. For (i), age-specific death rates by month of death were calculated. The relative effect of each month was assessed using the floating relative risk method and modelled continuously. For (ii), age-specific death rates by month of birth were calculated and the mean date of birth among deaths and survivors was compared. Overall mortality was found to be consistently higher during the dry season (November to May). The pattern was seen in all age groups except in infants where a peak was seen around the end of the rainy season. In infants we found a strong association between high mortality and being born during the time period September to February. No effect was seen for the other age groups. The observed excess mortality in young children at or around the end of the rainy season can be explained by the effects of infectious diseases and, in particular, malaria during this time period. In contrast, the excess mortality seen in older children and adults during the early dry season remains largely unexplained although specific infectious diseases such as meningitis and pneumonia are possible main causes. The association between high infant mortality and being born at around the end of the rainy season is probably explained by most of the malaria deaths in areas of high transmission intensity occurring in the second half of infancy.

20 CFR 10.410 - Who is entitled to compensation in case of death, and what are the rates of compensation payable...

Code of Federal Regulations, 2010 CFR

2010-04-01

... death, and what are the rates of compensation payable in death cases? 10.410 Section 10.410 Employees... Related Benefits Compensation for Death § 10.410 Who is entitled to compensation in case of death, and what are the rates of compensation payable in death cases? (a) If there is no child entitled to...

20 CFR 10.410 - Who is entitled to compensation in case of death, and what are the rates of compensation payable...

Code of Federal Regulations, 2011 CFR

2011-04-01

... death, and what are the rates of compensation payable in death cases? 10.410 Section 10.410 Employees... Related Benefits Compensation for Death § 10.410 Who is entitled to compensation in case of death, and what are the rates of compensation payable in death cases? (a) If there is no child entitled to...

Continuous-time system identification of a smoking cessation intervention

NASA Astrophysics Data System (ADS)

Timms, Kevin P.; Rivera, Daniel E.; Collins, Linda M.; Piper, Megan E.

2014-07-01

Cigarette smoking is a major global public health issue and the leading cause of preventable death in the United States. Toward a goal of designing better smoking cessation treatments, system identification techniques are applied to intervention data to describe smoking cessation as a process of behaviour change. System identification problems that draw from two modelling paradigms in quantitative psychology (statistical mediation and self-regulation) are considered, consisting of a series of continuous-time estimation problems. A continuous-time dynamic modelling approach is employed to describe the response of craving and smoking rates during a quit attempt, as captured in data from a smoking cessation clinical trial. The use of continuous-time models provide benefits of parsimony, ease of interpretation, and the opportunity to work with uneven or missing data.

Judged Lethality

DTIC Science & Technology

1980-12-01

Biases in Judged Death Rates Relative to Median Error Ratio in Each Group, Experiment 1 12 Table 5: Direction of Secondary Bias, Experiment 1 14 Table 6...translated into death rates per 100,000 individuals afflicted. The death rate group estimated these rates directly. For the number died group, which was... rates . The four columns differ markedly in the magnitude of the death rates they include. These differences provide an ordering of the response modes by

[Statistics of causes of death and analysis of risk factors in a surgical intensive care unit].

PubMed

Jianhua, Yao; Xingxing, Shi; Fen, Wang; Xijing, Zhang

2015-11-01

To summarize the causes of death and to analyze the risk factors in a surgical intensive care unit (SICU). The relevant information of patients died in the SICU of Xijing Hospital of Fourth Military Medical University in past 15 years (from December 1999 to February 2015) was retrospectively analyzed. The gender, age, reason and date of hospitalization, date of transfer SICU, past medical history, whether or not admitted directly from emergency department or transferred from other department, operated or not, date of death, the main cause of death, acute physiology and chronic health evaluation II (APACHE II) score, the history of undergoing mechanical ventilation, continuous renal replacement therapy (CRRT), or antifungal therapy, as well as the ratio of the patients with body temperature higher than 39 °C, white blood cell (WBC) count higher than 10 x 10⁹/L, platelet (PLT) count below 100 x 10⁹/L, albumin (Alb) below 35 g/L of two periods, namely from December 1999 to July 2007 (the first period), and from August 2007 to February 2015 (the second period) were compared. The above parameters were compared with those of 201 survivors in SICU, and the risk factors leading to death were analyzed by logistic regression. From December 1999 to February 2015, 4 317 patients were taken care of in the SICU. Among them, the number of death was 186, and the mortality rate was 4.3%. In the first time period (from December 1999 to July 2007), the total number of patients was 1 356, and the number of death were 109 (the mortality rate was 8.0%). In the second period, i.e. from August 2007 to February 2015, the number of SICU patients was 2,961, and 77 died (the mortality rate was 2.6%). The difference of mortality rate between the two periods was statistically significant (χ² = 66.707, P = 0.001 ). The death rate of patients transferred directly from emergency department in the first period was 79.8% (87/109), and it was lower in the second period (51.9%, 40/77, χ² = 16.181, P = 0.001 ). The death rate of the patients with blood A1b below 35 g/L in the second period (59.7%, 46/77) was higher than that of the first period (41.3%, 45/109, χ² = 6.151, P = 0.017). The top three causes of death from December 1999 to February 2015 were sepsis (38.2%), trauma (16.7%), and operation for cancer (14.0%). In the first period, the top three causes of death were sepsis (35.8%), trauma (22.0%), and operation for cancer (13.8%). In the second period, the top three causes of death were sepsis (41.6%), damage of the central nervous system (16.9%), and operation for cancer (14.3%). Top three reasons for SICU admission were trauma (29.03%), abdominal pain (20.97%) and other reasons (18.82%). Top three departments from which the patients were transferred were the emergency department (19.35%), orthopedics department (17.20%), and hepatobiliary department (16.13%). Logistic regression analysis showed that age [odds ratio (OR) = 2.025, 95% confidence interval (95% CI) = 1.500-2.734, P = 0.000], mechanical ventilation (OR = 3.514, 95% CI = 1.701-7.259, P = 0.001), CRR T (OR = 5.604, 95% CI = 3.003-10.459, P = 0.000 ), body temperature higher than 39 °C (OR = 1.992, 95%CI = 1.052-3.771, P = 0.034) were the risk factors of death in SICU patients. Sepsis and severe trauma are the leading causes of death in severe SICU patients, to whom with risk factors of death enough attention should be given.

Causes and Disparities in Death Rates Among Urban American Indian and Alaska Native Populations, 1999-2009.

PubMed

Jacobs-Wingo, Jasmine L; Espey, David K; Groom, Amy V; Phillips, Leslie E; Haverkamp, Donald S; Stanley, Sandte L

2016-05-01

To characterize the leading causes of death for the urban American Indian/Alaska Native (AI/AN) population and compare with urban White and rural AI/AN populations. We linked Indian Health Service patient registration records with the National Death Index to reduce racial misclassification in death certificate data. We calculated age-adjusted urban AI/AN death rates for the period 1999-2009 and compared those with corresponding urban White and rural AI/AN death rates. The top-5 leading causes of death among urban AI/AN persons were heart disease, cancer, unintentional injury, diabetes, and chronic liver disease and cirrhosis. Compared with urban White persons, urban AI/AN persons experienced significantly higher death rates for all top-5 leading causes. The largest disparities were for diabetes and chronic liver disease and cirrhosis. In general, urban and rural AI/AN persons had the same leading causes of death, although urban AI/AN persons had lower death rates for most conditions. Urban AI/AN persons experience significant disparities in death rates compared with their White counterparts. Public health and clinical interventions should target urban AI/AN persons to address behaviors and conditions contributing to health disparities.

The 20-year effort to reduce access to mammography screening: historical facts dispute a commentary in Cancer.

PubMed

Kopans, Daniel B; Webb, Matthew L; Cady, Blake

2014-09-15

Mammography screening fulfills all requirements for an effective screening test. It detects many cancers earlier when they are at a smaller size and earlier stage, and it has been demonstrated that this reduces breast cancer deaths in randomized controlled trials. When screening is introduced into the population, the death rate from breast cancer declines. Nevertheless, scientifically unsupported arguments that appear in the medical literature are passed on to the public and continue to confuse women and physicians regarding the value of screening. Methodologically flawed challenges to mammography have been almost continuous since the 1990s. And, as each challenge has been invalidated, a new, specious challenge has been raised. The authors of this report address the long history of misinformation that has developed in the effort to reduce access to screening, and they address the issues raised by commentators concerning their recent publication in this journal. © 2014 American Cancer Society.

Service Use at the End of Life in Medicare Advantage versus Traditional Medicare

PubMed Central

Stevenson, David G.; Ayanian, John Z.; Zaslavsky, Alan M.; Newhouse, Joseph P.; Landon, Bruce E.

2013-01-01

Background Relative to traditional fee-for-service Medicare, managed care plans caring for Medicare beneficiaries may be better positioned to promote recommended services and discourage burdensome procedures with little clinical value at the end of life. Objective To compare end-of-life service use for enrollees in Medicare Advantage health maintenance organizations (MA-HMO) relative to similar individuals enrolled in traditional Medicare (TM). Research Design, Subjects, Measures For a national cohort of Medicare decedents continuously enrolled in MA-HMOs or TM in their year of death, 2003-2009, we obtained hospice enrollment information and individual-level Healthcare Effectiveness Data and Information Set (HEDIS®) utilization measures for MA-HMO decedents for up to one year prior to death. We developed comparable claims-based measures for TM decedents matched on age, sex, race, and location. Results Hospice use in the year preceding death was higher among MA than TM decedents in 2003 (38% vs. 29%), but the gap narrowed over the study period (46% vs. 40% in 2009). Relative to TM, MA decedents had significantly lower rates of inpatient admissions (5-14% lower), inpatient days (18-29%), and emergency department visits (42-54%). MA decedents initially had lower rates of ambulatory surgery and procedures that converged with TM rates by 2009 and had modestly lower rates of physician visits initially that surpassed TM rates by 2007. Conclusions Relative to comparable TM decedents in the same local areas, MA-HMO decedents more frequently enrolled in hospice and used fewer inpatient and emergency department services, demonstrating that MA plans provide less end-of-life care in hospital settings. PMID:23969590

Time to change focus? Transitioning from higher neonatal to higher stillbirth mortality in São Paulo State, Brazil.

PubMed

Andrews, Kathryn; Bourroul, Maria Lúcia Moraes; Fink, Günther; Grisi, Sandra; Scoleze Ferrer, Ana Paula; Diniz, Edna Maria de Albuquerque; Brentani, Alexandra

2017-01-01

Differential trends in mortality suggest that stillbirths may dominate neonatal mortality in the medium to long run. Brazil has made major efforts to improve data collection on health indicators at granular geographic levels, and provides an ideal environment to test this hypothesis. Our goals were to examine levels and trends in stillbirths and neonatal deaths and the extent to which the mortality burden caused by stillbirths dominates neonatal mortality at the municipality- and state-level. We used data from the Brazilian Ministry of Health's repository on births, fetal, and neonatal deaths (2010-2014) to calculate stillbirth and neonatal mortality rates for São Paulo state's 645 municipalities. At the state level, 7.9 per 1000 pregnancies ended in stillbirth (fetal death >22 weeks gestation or fetal weight >500g), but this varied from 0.0 to 28.4 per 1000 across municipalities. 7.9 per 1000 live births also died within the first 28 days. 42% of municipalities had a higher stillbirth rate than neonatal mortality rate, and in 61% of areas with low neonatal mortality (<8.0 per 1000), stillbirth rates exceeded neonatal mortality rates. This analysis suggests large variability and inequality in mortality outcomes at the sub-national level. The results also imply that stillbirth mortality may exceed neonatal mortality in Brazil and similar settings in the next few decades, which suggests a need for a shift in policy. This work further underscores the importance of continued research into causes and prevention of stillbirth.

Time to change focus? Transitioning from higher neonatal to higher stillbirth mortality in São Paulo State, Brazil

PubMed Central

Bourroul, Maria Lúcia Moraes; Fink, Günther; Grisi, Sandra; Scoleze Ferrer, Ana Paula; Diniz, Edna Maria de Albuquerque; Brentani, Alexandra

2017-01-01

Background Differential trends in mortality suggest that stillbirths may dominate neonatal mortality in the medium to long run. Brazil has made major efforts to improve data collection on health indicators at granular geographic levels, and provides an ideal environment to test this hypothesis. Our goals were to examine levels and trends in stillbirths and neonatal deaths and the extent to which the mortality burden caused by stillbirths dominates neonatal mortality at the municipality- and state-level. Methods We used data from the Brazilian Ministry of Health’s repository on births, fetal, and neonatal deaths (2010–2014) to calculate stillbirth and neonatal mortality rates for São Paulo state’s 645 municipalities. Results At the state level, 7.9 per 1000 pregnancies ended in stillbirth (fetal death >22 weeks gestation or fetal weight >500g), but this varied from 0.0 to 28.4 per 1000 across municipalities. 7.9 per 1000 live births also died within the first 28 days. 42% of municipalities had a higher stillbirth rate than neonatal mortality rate, and in 61% of areas with low neonatal mortality (<8.0 per 1000), stillbirth rates exceeded neonatal mortality rates. Conclusions This analysis suggests large variability and inequality in mortality outcomes at the sub-national level. The results also imply that stillbirth mortality may exceed neonatal mortality in Brazil and similar settings in the next few decades, which suggests a need for a shift in policy. This work further underscores the importance of continued research into causes and prevention of stillbirth. PMID:29272295

Trends in Continuous Deep Sedation until Death between 2007 and 2013: A Repeated Nationwide Survey

PubMed Central

Cohen, Joachim; Rietjens, Judith

2016-01-01

Background Continuous deep sedation until death is a highly debated medical practice, particularly regarding its potential to hasten death and its proper use in end-of-life care. A thorough analysis of important trends in this practice is needed to identify potentially problematic developments. This study aims to examine trends in the prevalence and practice characteristics of continuous deep sedation until death in Flanders, Belgium between 2007 and 2013, and to study variation on physicians’ degree of palliative training. Methods Population-based death certificate study in 2007 and 2013 in Flanders, Belgium. Reporting physicians received questionnaires about medical practices preceding the patient’s death. Patient characteristics, clinical characteristics (drugs used, duration, artificial nutrition/hydration, intention and consent), and palliative care training of attending physician were recorded. We posed the following question regarding continuous deep sedation: ‘Was the patient continuously and deeply sedated or kept in a coma until death by the use of one or more drugs’. Results After the initial rise of continuous deep sedation to 14.5% in 2007 (95%CI 13.1%-15.9%), its use decreased to 12.0% in 2013 (95%CI 10.9%-13.2%). Compared with 2007, in 2013 opioids were less often used as sole drug and the decision to use continuous deep sedation was more often preceded by patient request. Compared to non-experts, palliative care experts more often used benzodiazepines and less often opioids, withheld artificial nutrition/hydration more often and performed sedation more often after a request from or with the consent of the patient or family. Conclusion Worldwide, this study is the first to show a decrease in the prevalence of continuous deep sedation. Despite positive changes in performance and decision-making towards more compliance with due care requirements, there is still room for improvement in the use of recommended drugs and in the involvement of patients and relatives in the decision-making process. PMID:27337064

[Efficacy of glycopyrronium bromide and scopolamine hydrobromide in patients with death rattle: a randomized controlled study].

PubMed

Likar, Rudolf; Rupacher, Ernst; Kager, Hans; Molnar, Mario; Pipam, Wofgang; Sittl, Reinhard

2008-01-01

Death rattle is an extremely distressing symptom for the dying patient and for his environment. The aim of this study was to assess the efficacy of glycopyrronium bromide as compared with scopolamine hydrobromide in alleviating death rattle in terminal cancer patients with cognitive impairment. In a randomized, controlled study design patients were allocated in two groups. Group A received scopolamine hydrobromide in a dose of 0.5 mg intravenously every 6 hours for a period of 12 hours, group B received glycopyrronium bromide 0.4 mg every 6 hours for a period of 12 hours. In addition, standardized sedatives were administered as required and the analgesic therapy continued either orally or, if necessary, subcutaneously or intravenously in equipotent doses. Every 2 hours death rattle was assessed and rated on a scale of 1 to 5 (1 = audible breathing noises, 5 = very severe rattling noises). In addition, restlessness and expressions of pain were assessed and rated on a scale of 1 to 3 (1 = mild, 2 = moderate, 3 = severe). 13 patients were included in the study, 7 patients were allocated to group A and 6 patients to group B. There were no significant differences in demographic data, age, weight and diagnosis distribution between the two groups. Group B demonstrated a significant reduction of death rattle in the first 12 hours (p = 0.029) in comparison to group A. There were no significant differences concerning the side effects (restlessness, expressions of pain) in both groups. Glycopyrronium bromide given in a dose of 0,4 mg every six hours demonstrated a significant reduction of death rattle compared to scopolamine hydrobromide. Concerning side effects (restlessness, expressions of pain) there was no difference between both substances.

RIPK1/RIPK3/MLKL-mediated necroptosis contributes to compression-induced rat nucleus pulposus cells death.

PubMed

Chen, Songfeng; Lv, Xiao; Hu, Binwu; Shao, Zengwu; Wang, Baichuan; Ma, Kaige; Lin, Hui; Cui, Min

2017-05-01

The aim of this study was to systematically investigate the role of necroptosis in compression-induced rat nucleus pulposus (NP) cells death, as well as explore the underlying mechanisms involved. Rat NP cells underwent various periods of exposure to 1.0 MPa pressure. Cell viability and cell death were quantified by using cell counting kit-8 (CCK-8), and Calcein-AM/propidium iodine (PI) staining respectively. Necroptosis-associated target molecules receptor-interacing protein kinase 1 (RIPK1), phosphorylated RIPK1 (pRIPK1), receptor-interacing protein kinase 3 (RIPK3), phosphorylated RIPK3 (pRIPK3) and mixed lineage kinase domain-like (MLKL) were analyzed by Western-blot and RT-PCR. NP cells were also examined for morphological and ultrastructural changes, which can indicate necroptosis. To indirectly establish the presence of necroptosis, the RIPK1 specific inhibitor necrostatin-1 (Nec-1), RIPK3 inhibitor GSK'872, MLKL inhibitor necrosulfonamide (NSA) and small interfering RNA (siRNA) were utilized. The results established necroptosis was taking place in NP cells. The level of necroptosis increased in a time-dependent manner, and this effect was reduced by Nec-1 in vitro. Additionally, NP cells death were significantly attenuated following treatment with Nec-1, GSK'872 or NSA. SiRNA-induced knockdown of RIPK3 or MLKL increased cell survival rate, while knockdown of RIPK1 resulted in a decreased cell survival rate. In summary, RIPK1/RIPK3/MLKL-mediated necroptosis may play an important role in NP cells death induced by continuous mechanical stress. Treatment strategies which aim to regulate necroptosis may prove beneficial, by both reducing NP cells death and slowing IVD degeneration.

A follow-up meeting post death is appreciated by family members of deceased patients.

PubMed

Kock, M; Berntsson, C; Bengtsson, A

2014-08-01

A practice with a follow-up meeting post death (FUMPD) with physician and staff for family members of patients who died in the intensive care unit (ICU) was started as a quality project to improve the support of families in post-ICU bereavement. A quality improvement control was conducted after 4 years. The quality improvement control was made retrospectively as an anonymous non-coded questionnaire. Part A related to the FUMPD. Part B inquired if we could contact the family member again for a research project to evaluate family support post-ICU bereavement. The questionnaires were sent to 84 family members of 56 deceased patients. Part A: 46 out of 84 family members answered and had attended a FUMPD. Ninety-one percent of the family members thought that we should continue to offer FUMPD. Seventy-eight percent were satisfied with their meeting. Eighty percent felt that they understood the cause of death. The majority wanted the meeting to take place within 6 weeks of death. Ninety-one percent rated the physician as important to be present at the meeting. The social worker was rated more important to attend the meeting than the assistant nurse. Ninety-one percent wanted to discuss the cause of death.Part B: 54 out of 84 family members answered. Twenty out of 54 did not want us to contact them again. A routine with a Follow-Up Meeting Post Death with the ICU team for the families of the patients who die in the ICU is appreciated. The presence of the physician is important. © 2014 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

20 CFR 10.410 - Who is entitled to compensation in case of death, and what are the rates of compensation payable...

Code of Federal Regulations, 2013 CFR

2013-04-01

... death, and what are the rates of compensation payable in death cases? 10.410 Section 10.410 Employees... Related Benefits Compensation for Death § 10.410 Who is entitled to compensation in case of death, and what are the rates of compensation payable in death cases? (a) Pursuant to 5 U.S.C. 8133, benefits may...

20 CFR 10.410 - Who is entitled to compensation in case of death, and what are the rates of compensation payable...

Code of Federal Regulations, 2014 CFR

2014-04-01

... death, and what are the rates of compensation payable in death cases? 10.410 Section 10.410 Employees... Related Benefits Compensation for Death § 10.410 Who is entitled to compensation in case of death, and what are the rates of compensation payable in death cases? (a) Pursuant to 5 U.S.C. 8133, benefits may...

20 CFR 10.410 - Who is entitled to compensation in case of death, and what are the rates of compensation payable...

Code of Federal Regulations, 2012 CFR

2012-04-01

... death, and what are the rates of compensation payable in death cases? 10.410 Section 10.410 Employees... Related Benefits Compensation for Death § 10.410 Who is entitled to compensation in case of death, and what are the rates of compensation payable in death cases? (a) Pursuant to 5 U.S.C. 8133, benefits may...

Can deaths in police cells be prevented? Experience from Norway and death rates in other countries.

PubMed

Aasebø, Willy; Orskaug, Gunnar; Erikssen, Jan

2016-01-01

To describe the changes in death rates and causes of deaths in Norwegian police cells during the last 2 decades. To review reports on death rates in police cells that have been published in medical journals and elsewhere, and discuss the difficulties of comparing death rates between countries. Data on deaths in Norwegian police cells were collected retrospectively in 2002 and 2012 for two time periods: 1993-2001 (period 1) and 2003-2012 (period 2). Several databases were searched to find reports on deaths in police cells from as many countries as possible. The death rates in Norwegian police cells reduced significantly from 0.83 deaths per year per million inhabitants (DYM) in period 1 to 0.22 DYM in period 2 (p < 0.05). The most common cause of death in period 1 was alcohol intoxication including intracranial bleeding in persons with high blood alcohol levels, and the number declined from 16 persons in period 1 to 1 person in period 2 (p = 0.032). The median death rate in the surveyed Western countries was 0.44 DYM (range: 0.14-1.46 DYM). The number of deaths in Norwegian police cells reduced by about 75% over a period of approximately 10 years. This is probably mainly due to individuals with severe alcohol intoxication no longer being placed in police cells. However, there remain large methodology difficulties in comparing deaths rates between countries. Copyright © 2015 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

Staphylococcus via an Interaction with the ELR+ CXC Chemokine ENA-78 is Associated with BOS

PubMed Central

Gregson, Aric L; Wang, Xiaoyan; Injean, Patil; Weigt, S Sam; Shino, Michael; Sayah, David; DerHovanessian, Ariss; Lynch, Joseph P; Ross, David J; Saggar, Rajan; Ardehali, Abbas; Li, Gang; Elashoff, Robert; Belperio, John A

2014-01-01

Staphylococcus aureus is the most commonly isolated gram-positive bacterium after lung transplantation and has been associated with poor post-transplant outcomes, but its effect on BOS and death in the context of the allograft inflammatory environment has not been studied. A three-state Cox semi-Markovian model was used to determine the influence of allograft S. aureus and the ELR+ CXC chemokines on the survival rates and cause-specific hazards for movement from lung transplant (State 1) to BOS (State 2), from transplant (State 1) to death (State 3), and from BOS (State 2) to death (State 3). Acute rejection, pseudomonas pneumonia, BALF CXCL5 and its interaction with S. aureus all increased the likelihood of transition from transplant to BOS. Transition to death from transplant was facilitated by pseudomonas infection and single lung transplant. Movement from BOS to death was affected by the interaction between aspergillus, pseudomonas and CXCL5, but not S. aureus. S. aureus isolation had state specific effects after lung transplantation and only in concert with elevated BALF CXCL5 concentrations did it augment the risk of BOS. Pseudomonas and elevated BALF concentrations of CXCL5 continued as significant risk factors for BOS and death after BOS in lung transplantation. PMID:25683785

Emerging tobacco hazards in China: 1. Retrospective proportional mortality study of one million deaths

PubMed Central

Liu, Bo-Qi; Peto, Richard; Chen, Zheng-Ming; Boreham, Jillian; Wu, Ya-Ping; Li, Jun-Yao; Campbell, T Colin; Chen, Jun-Shi

1998-01-01

Objective To assess the hazards at an early phase of the growing epidemic of deaths from tobacco in China. Design Smoking habits before 1980 (obtained from family or other informants) of 0.7 million adults who had died of neoplastic, respiratory, or vascular causes were compared with those of a reference group of 0.2 million who had died of other causes. Setting 24 urban and 74 rural areas of China. Subjects One million people who had died during 1986-8 and whose families could be interviewed. Main outcome measures Tobacco attributable mortality in middle or old age from neoplastic, respiratory, or vascular disease. Results Among male smokers aged 35-69 there was a 51% (SE 2) excess of neoplastic deaths, a 31% (2) excess of respiratory deaths, and a 15% (2) excess of vascular deaths. All three excesses were significant (P<0.0001). Among male smokers aged ⩾70 there was a 39% (3) excess of neoplastic deaths, a 54% (2) excess of respiratory deaths, and a 6% (2) excess of vascular deaths. Fewer women smoked, but those who did had tobacco attributable risks of lung cancer and respiratory disease about the same as men. For both sexes, the lung cancer rates at ages 35-69 were about three times as great in smokers as in non-smokers, but because the rates among non-smokers in different parts of China varied widely the absolute excesses of lung cancer in smokers also varied. Of all deaths attributed to tobacco, 45% were due to chronic obstructive pulmonary disease and 15% to lung cancer; oesophageal cancer, stomach cancer, liver cancer, tuberculosis, stroke, and ischaemic heart disease each caused 5-8%. Tobacco caused about 0.6 million Chinese deaths in 1990 (0.5 million men). This will rise to 0.8 million in 2000 (0.4 million at ages 35-69) or to more if the tobacco attributed fractions increase. Conclusions At current age specific death rates in smokers and non-smokers one in four smokers would be killed by tobacco, but as the epidemic grows this proportion will roughly double. If current smoking uptake rates persist in China (where about two thirds of men but few women become smokers) tobacco will kill about 100 million of the 0.3 billion males now aged 0-29, with half these deaths in middle age and half in old age. Key messagesOf the Chinese deaths now being caused by tobacco, 45% are from chronic lung disease, 15% from lung cancer, and 5-8% from each of oesophageal cancer, stomach cancer, liver cancer, stroke, ischaemic heart disease, and tuberculosisTobacco now causes 13% (and will probably eventually cause about 33%) of deaths in men but only 3% (and perhaps eventually about 1%) of deaths in women as the proportion of young women who smoke has become smallTwo thirds of men now become smokers before age 25; few give up, and about half of those who persist will be killed by tobacco in middle or old ageIf present smoking patterns continue about 100 million of the 0.3 billion Chinese males now aged 0-29 will eventually be killed by tobaccoTobacco caused 0.6 million deaths in 1990 and will cause at least 0.8 million in 2000 (0.7 million in men) and about 3 million a year by the middle of the century on the basis of current smoking patterns PMID:9822393

Killer Whale (Orcinus orca) Deaths in Prince William Sound, Alaska, 1985-1990.

PubMed

Fraker, Mark A

2013-01-01

During 1985-1990, two groups of killer whales in Prince William Sound, Alaska, experienced unusually high rates of mortality, while seven others did not. Those affected were AB pod, part of the southern Alaska population of resident (fish-eating) killer whales, and the AT1 transient (marine mammal-eating) group, a very small, reproductively isolated population that last reproduced in 1984. In 1985-1986, several AB pod members were shot by fishermen defending their catch from depredation, which explains some of the deaths. Understanding the other deaths is complicated by the Exxon Valdez oil spill (March 1989) and uncertainties about the causes and times of the deaths. For AB pod, possible factors involved in the post-spill mortalities are delayed effects of bullet wounds, continued shooting, oil exposure, and consequences of being orphaned. For the AT1 group, possible factors are oil exposure, small population size, old age, and high-contaminant burdens. An analysis of possible effects of inhalation of volatile organic compounds, contact with the oil slick, and ingestion of oil with water or prey did not reveal route(s) of exposure that could explain the mortalities. The cause(s) of the killer whale deaths recorded following the oil spill remain uncertain.

Impact of paracetamol pack size restrictions on poisoning from paracetamol in England and Wales: an observational study.

PubMed

Morgan, Oliver; Griffiths, Clare; Majeed, Azeem

2005-03-01

About 500 drug poisoning deaths involving paracetamol (acetaminophen) occur every year in England and Wales. To reduce the number of deaths, regulations were introduced in 1998 to restrict the sale of paracetamol. In this paper, we evaluate the impact of these regulations. Mortality data for England and Wales were provided by the Office for National Statistics. Deaths were defined as due to compound paracetamol (paracetamol in combination with another analgesic, a low dose opioid or other ingredients) or paracetamol only, with or without alcohol or other drugs. The Department of Health provided data on all hospital admissions with a primary diagnosis of paracetamol poisoning. Mortality rates for paracetamol only were similar for males and females, and decreased from about 4.5 to 2.8 per million between 1997 and 1999 and again from about 3.1 to 2.2 per million between 2001 and 2002. These falls may be attributable to random variation in the rates. Deaths involving compound paracetamol, which were not subject to the 1998 regulations, remained relatively constant over the study period. There was evidence of a decreasing trend in paracetamol only mortality rates and this followed overall trends for other drug poisoning excluding opioids and drugs of misuse. Hospital admissions due to paracetamol poisoning increased from about 27 000 to 33 000 between 1995/1996 and 1997/1998 and then decreased to 25 000 in 2001/2002. There were almost 50 per cent more admissions for females than males, with the highest admission rates amongst females aged 15-24 years old. Between 1993 and 2002, mortality rates and hospital admissions due to paracetamol poisoning declined. However, the contribution of the 1998 regulations to this decline is not clear. Paracetamol poisoning continues to be an important public health issue in England and Wales and represents significant workload for the NHS in England.

Does transport time help explain the high trauma mortality rates in rural areas? New and traditional predictors assessed by new and traditional statistical methods

PubMed Central

Røislien, Jo; Lossius, Hans Morten; Kristiansen, Thomas

2015-01-01

Background Trauma is a leading global cause of death. Trauma mortality rates are higher in rural areas, constituting a challenge for quality and equality in trauma care. The aim of the study was to explore population density and transport time to hospital care as possible predictors of geographical differences in mortality rates, and to what extent choice of statistical method might affect the analytical results and accompanying clinical conclusions. Methods Using data from the Norwegian Cause of Death registry, deaths from external causes 1998–2007 were analysed. Norway consists of 434 municipalities, and municipality population density and travel time to hospital care were entered as predictors of municipality mortality rates in univariate and multiple regression models of increasing model complexity. We fitted linear regression models with continuous and categorised predictors, as well as piecewise linear and generalised additive models (GAMs). Models were compared using Akaike's information criterion (AIC). Results Population density was an independent predictor of trauma mortality rates, while the contribution of transport time to hospital care was highly dependent on choice of statistical model. A multiple GAM or piecewise linear model was superior, and similar, in terms of AIC. However, while transport time was statistically significant in multiple models with piecewise linear or categorised predictors, it was not in GAM or standard linear regression. Conclusions Population density is an independent predictor of trauma mortality rates. The added explanatory value of transport time to hospital care is marginal and model-dependent, highlighting the importance of exploring several statistical models when studying complex associations in observational data. PMID:25972600

Serotonin transporter protects the placental cells against apoptosis in caspase 3-independent pathway.

PubMed

Hadden, Coedy; Fahmi, Tariq; Cooper, Anthonya; Savenka, Alena V; Lupashin, Vladimir V; Roberts, Drucilla J; Maroteaux, Luc; Hauguel-de Mouzon, Sylvie; Kilic, Fusun

2017-12-01

Serotonin (5-HT) and its specific transporter, SERT play important roles in pregnancy. Using placentas dissected from 18d gestational SERT-knock out (KO), peripheral 5-HT (TPH1)-KO, and wild-type (WT) mice, we explored the role of 5-HT and SERT in placental functions in detail. An abnormal thick band of fibrosis and necrosis under the giant cell layer in SERT-KO placentas appeared only moderately in TPH1-KO and minimally present in WT placentas. The majority of the changes were located at the junctional zone of the placentas in SERT. The etiology of these findings was tested with TUNEL assays. The placentas from SERT-KO and TPH1-KO showed 49- and 8-fold increase in TUNEL-positive cells without a concurrent change in the DNA repair or cell proliferation compared to WT placentas. While the proliferation rate in the embryos of TPH1-KO mice was 16-fold lower than the rate in gestational age matched embryos of WT or SERT-KO mice. These findings highlight an important role of continuous 5-HT signaling on trophoblast cell viability. SERT may contribute to protecting trophoblast cells against cell death via terminating the 5-HT signaling which changes cell death ratio in trophoblast as well as proliferation rate in embryos. However, the cell death in SERT-KO placentas is in caspase 3-independent pathway. © 2017 Wiley Periodicals, Inc.

Surveillance of US Death Rates from Chronic Diseases Related to Excessive Alcohol Use.

PubMed

Polednak, Anthony P

2016-01-01

To assess the utility of multiple-cause (MC) death records for surveillance of US mortality rates from chronic causes related to excessive alcohol use. The Alcohol-Related Disease Impact (ARDI) resource produced estimates of the population 'alcohol attributable fraction' (AAF) due to excessive drinking for each alcohol-related (AAF > 0%) cause of death, and used AAFs to estimate numbers of alcohol-related deaths from alcohol-related underlying causes (UC) in adults age 20-64 and 65+ years in 2006-2010. For surveillance, this study used MC death file to identify individual deaths (2006-2010) with an 'alcohol-induced' cause (AAF = 100%) anywhere on the certificate, and to obtain US rates of premature death (ages 15-64 and 65-74 years) for 1999-2012. Using the selected MC records, numbers of deaths from alcohol-related chronic UC (2006-2010) were 81% of ARDI estimates for age 20-64, but only 40% for 65+ years. The MC records identified substantial numbers of deaths from causes (e.g. certain infectious diseases) not included as alcohol-related in ARDI, but included in surveillance of premature death rates for chronic UC. Also, premature death rates for chronic alcohol-induced causes using only the UC (as in routine mortality statistics) were only about half the rates based on MC; all rates increased in recent years but some reached statistical significance only by using MC. Using MC records underestimated total US deaths from alcohol-related chronic causes as the UC, but enhanced surveillance of rates for premature deaths involving chronic causes that may be related to excessive alcohol use. © The Author 2015. Medical Council on Alcohol and Oxford University Press. All rights reserved.

The Epidemic of Despair Among White Americans: Trends in the Leading Causes of Premature Death, 1999–2015

PubMed Central

Gennuso, Keith P.; Ugboaja, Donna C.; Remington, Patrick L.

2017-01-01

Objectives. To evaluate trends in premature death rates by cause of death, age, race, and urbanization level in the United States. Methods. We calculated cause-specific death rates using the Compressed Mortality File, National Center for Health Statistics data for adults aged 25 to 64 years in 2 time periods: 1999 to 2001 and 2013 to 2015. We defined 48 subpopulations by 10-year age groups, race/ethnicity, and county urbanization level (large urban, suburban, small or medium metropolitan, and rural). Results. The age-adjusted premature death rates for all adults declined by 8% between 1999 to 2001 and 2013 to 2015, with decreases in 39 of the 48 subpopulations. Most decreases in death rates were attributable to HIV, cardiovascular disease, and cancer. All 9 subpopulations with increased death rates were non-Hispanic Whites, largely outside large urban areas. Most increases in death rates were attributable to suicide, poisoning, and liver disease. Conclusions. The unfavorable recent trends in premature death rate among non-Hispanic Whites outside large urban areas were primarily caused by self-destructive health behaviors likely related to underlying social and economic factors in these communities. PMID:28817333

A not so happy day after all: excess death rates on birthdays in the U.S.

PubMed

Peña, Pablo A

2015-02-01

This study estimates average excess death rates on and around birthdays, and explores differences between birthdays falling on weekends and birthdays falling on weekdays. Using records from the U.S. Social Security Administration for 25 million people who died during the period from 1998 to 2011, average excess death rates are estimated controlling for seasonality of births and deaths. The average excess death rate on birthdays is 6.7% (p < 0.0001). No evidence is found of dips in average excess death rates in a ±10 day neighborhood around birthdays that could offset the spikes on birthdays. Significant differences are found between age groups and between weekend and weekday birthdays. Younger people have greater average excess death rates on birthdays, reaching up to 25.4% (p < 0.0001) for ages 20-29. Younger people also show the largest differences between average excess death rates on weekend birthdays and weekday birthdays, reaching up to 64.5 percentage points (p = 0.0063) for ages 1-9. Over the 13-year period analyzed, the estimated excess deaths on birthdays are 4590. Copyright © 2014 Elsevier Ltd. All rights reserved.

The Epidemic of Despair Among White Americans: Trends in the Leading Causes of Premature Death, 1999-2015.

PubMed

Stein, Elizabeth M; Gennuso, Keith P; Ugboaja, Donna C; Remington, Patrick L

2017-10-01

To evaluate trends in premature death rates by cause of death, age, race, and urbanization level in the United States. We calculated cause-specific death rates using the Compressed Mortality File, National Center for Health Statistics data for adults aged 25 to 64 years in 2 time periods: 1999 to 2001 and 2013 to 2015. We defined 48 subpopulations by 10-year age groups, race/ethnicity, and county urbanization level (large urban, suburban, small or medium metropolitan, and rural). The age-adjusted premature death rates for all adults declined by 8% between 1999 to 2001 and 2013 to 2015, with decreases in 39 of the 48 subpopulations. Most decreases in death rates were attributable to HIV, cardiovascular disease, and cancer. All 9 subpopulations with increased death rates were non-Hispanic Whites, largely outside large urban areas. Most increases in death rates were attributable to suicide, poisoning, and liver disease. The unfavorable recent trends in premature death rate among non-Hispanic Whites outside large urban areas were primarily caused by self-destructive health behaviors likely related to underlying social and economic factors in these communities.

Fatalities in the Peace Corps: a retrospective study, 1984 to 2003.

PubMed

Nurthen, Nancy M; Jung, Paul

2008-01-01

To determine causes of death for Peace Corps Volunteers (PCV) between 1984 and 2003 and compare them with prior Volunteer death rates and with US death rates. We conducted a retrospective cohort study of all PCV between 1984 and 2003 and compared them to published data for prior years and against US death rates. Of the 66 deaths in our study period, the major causes were unintentional injury, homicide, medical illness, and suicide. Comparisons to US mortality data controlled for age, marital status, and educational attainment found equal or lower death rates among Volunteers. When compared to previous study results from 1961 to 1983, the total number of deaths, as well as the death rate per Volunteer-year, decreased. Deaths from unintentional injury, suicide, and medical illness decreased in number and rate; only homicides increased in number during our study period, but this increase did not reach statistical significance. PCV are exposed to unique risks, but these risks have become significantly less fatal over the past 20 years when compared to prior Peace Corps data and matched US population data.

Deceased Donor Organs: What Can Be Done to Raise Donation Rates Using Evidence From Malaysia?

PubMed

Rasiah, R; Manikam, R; Chandrasekaran, S K; Naghavi, N; Mubarik, S; Mustafa, R; Pushparajan, S

2016-05-01

Organ donation rates have continued to fall seriously short of needs worldwide, with the lowest rates recorded among developing economies. This study seeks to analyze evidence from a developing economy to explore the usefulness of social psychological theory to solve the problem. The study deployed a large survey (n = 10 412) using a convenience sampling procedure targeted at increasing the number of Malaysians registered with the Ministry of Health, Malaysia who are willing to donate organs upon death. Structural equation modeling was deployed to estimate simultaneously the relative influence of cognitive and noncognitive variables on willingness to donate deceased organs. The cognitive factors of donation perception, socioeconomic status and financial incentives, and the noncognitive factors of demography and fear showed a high statistically significant (1%) relationship with willingness to donate organs after death. While financial incentives were significant, cash rewards showed the least impact. Donation perception showed the highest impact, which shows that the development of effective pedagogic programs with simultaneous improvements to the quality of services provided by medical personnel engaged in retrieving and transplanting deceased donor organs can help raise organ donation rates. © Copyright 2015 The American Society of Transplantation and the American Society of Transplant Surgeons.

Potentially preventable deaths from the five leading causes of death--United States, 2008-2010.

PubMed

Yoon, Paula W; Bastian, Brigham; Anderson, Robert N; Collins, Janet L; Jaffe, Harold W

2014-05-02

In 2010, the top five causes of death in the United States were 1) diseases of the heart, 2) cancer, 3) chronic lower respiratory diseases, 4) cerebrovascular diseases (stroke), and 5) unintentional injuries. The rates of death from each cause vary greatly across the 50 states and the District of Columbia (2). An understanding of state differences in death rates for the leading causes might help state health officials establish disease prevention goals, priorities, and strategies. States with lower death rates can be used as benchmarks for setting achievable goals and calculating the number of deaths that might be prevented in states with higher rates. To determine the number of premature annual deaths for the five leading causes of death that potentially could be prevented ("potentially preventable deaths"), CDC analyzed National Vital Statistics System mortality data from 2008-2010. The number of annual potentially preventable deaths per state before age 80 years was determined by comparing the number of expected deaths (based on average death rates for the three states with the lowest rates for each cause) with the number of observed deaths. The results of this analysis indicate that, when considered separately, 91,757 deaths from diseases of the heart, 84,443 from cancer, 28,831 from chronic lower respiratory diseases, 16,973 from cerebrovascular diseases (stroke), and 36,836 from unintentional injuries potentially could be prevented each year. In addition, states in the Southeast had the highest number of potentially preventable deaths for each of the five leading causes. The findings provide disease-specific targets that states can use to measure their progress in preventing the leading causes of deaths in their populations.

Causes and Disparities in Death Rates Among Urban American Indian and Alaska Native Populations, 1999–2009

PubMed Central

Espey, David K.; Groom, Amy V.; Phillips, Leslie E.; Haverkamp, Donald S.; Stanley, Sandte L.

2016-01-01

Objectives. To characterize the leading causes of death for the urban American Indian/Alaska Native (AI/AN) population and compare with urban White and rural AI/AN populations. Methods. We linked Indian Health Service patient registration records with the National Death Index to reduce racial misclassification in death certificate data. We calculated age-adjusted urban AI/AN death rates for the period 1999–2009 and compared those with corresponding urban White and rural AI/AN death rates. Results. The top-5 leading causes of death among urban AI/AN persons were heart disease, cancer, unintentional injury, diabetes, and chronic liver disease and cirrhosis. Compared with urban White persons, urban AI/AN persons experienced significantly higher death rates for all top-5 leading causes. The largest disparities were for diabetes and chronic liver disease and cirrhosis. In general, urban and rural AI/AN persons had the same leading causes of death, although urban AI/AN persons had lower death rates for most conditions. Conclusions. Urban AI/AN persons experience significant disparities in death rates compared with their White counterparts. Public health and clinical interventions should target urban AI/AN persons to address behaviors and conditions contributing to health disparities. PMID:26890168

Unintentional Injury Mortality Among American Indians and Alaska Natives in the United States, 1990–2009

PubMed Central

Pokhrel, Pallavi; Worthington, Anne; Billie, Holly; Sewell, Mack; Bill, Nancy

2014-01-01

Objectives. We describe the burden of unintentional injury (UI) deaths among American Indian and Alaska Native (AI/AN) populations in the United States. Methods. National Death Index records for 1990 to 2009 were linked with Indian Health Service registration records to identify AI/AN deaths misclassified as non-AI/AN deaths. Most analyses were restricted to Contract Health Service Delivery Area counties in 6 geographic regions of the United States. We compared age-adjusted death rates for AI/AN persons with those for Whites; Hispanics were excluded. Results. From 2005 to 2009, the UI death rate for AI/AN people was 2.4 times higher than for Whites. Death rates for the 3 leading causes of UI death—motor vehicle traffic crashes, poisoning, and falls—were 1.4 to 3 times higher among AI/AN persons than among Whites. UI death rates were higher among AI/AN males than among females and highest among AI/AN persons in Alaska, the Northern Plains, and the Southwest. Conclusions. AI/AN persons had consistently higher UI death rates than did Whites. This disparity in overall rates coupled with recent increases in unintentional poisoning deaths requires that injury prevention be a major priority for improving health and preventing death among AI/AN populations. PMID:24754624

Mortality rates and cause-of-death patterns in a vaccinated population.

PubMed

McCarthy, Natalie L; Weintraub, Eric; Vellozzi, Claudia; Duffy, Jonathan; Gee, Julianne; Donahue, James G; Jackson, Michael L; Lee, Grace M; Glanz, Jason; Baxter, Roger; Lugg, Marlene M; Naleway, Allison; Omer, Saad B; Nakasato, Cynthia; Vazquez-Benitez, Gabriela; DeStefano, Frank

2013-07-01

Determining the baseline mortality rate in a vaccinated population is necessary to be able to identify any unusual increases in deaths following vaccine administration. Background rates are particularly useful during mass immunization campaigns and in the evaluation of new vaccines. Provide background mortality rates and describe causes of death following vaccination in the Vaccine Safety Datalink (VSD). Analyses were conducted in 2012. Mortality rates were calculated at 0-1 day, 0-7 days, 0-30 days, and 0-60 days following vaccination for deaths occurring between January 1, 2005, and December 31, 2008. Analyses were stratified by age and gender. Causes of death were examined, and findings were compared to National Center for Health Statistics (NCHS) data. Among 13,033,274 vaccinated people, 15,455 deaths occurred between 0 and 60 days following vaccination. The mortality rate within 60 days of a vaccination visit was 442.5 deaths per 100,000 person-years. Rates were highest in the group aged ≥85 years, and increased from the 0-1-day to the 0-60-day interval following vaccination. Eleven of the 15 leading causes of death in the VSD and NCHS overlap in both systems, and the top four causes of death were the same in both systems. VSD mortality rates demonstrate a healthy vaccinee effect, with rates lowest in the days immediately following vaccination, most apparent in the older age groups. The VSD mortality rate is lower than that in the general U.S. population, and the causes of death are similar. Published by Elsevier Inc. on behalf of American Journal of Preventive Medicine

Surveillance for traumatic brain injury-related deaths--United States, 1997-2007.

PubMed

Coronado, Victor G; Xu, Likang; Basavaraju, Sridhar V; McGuire, Lisa C; Wald, Marlena M; Faul, Mark D; Guzman, Bernardo R; Hemphill, John D

2011-05-06

Traumatic brain injury (TBI) is a leading cause of death and disability in the United States. Approximately 53,000 persons die from TBI-related injuries annually. During 1989-1998, TBI-related death rates decreased 11.4%, from 21.9 to 19.4 per 100,000 population. This report describes the epidemiology and annual rates of TBI-related deaths during 1997-2007. January 1, 1997-December 31, 2007. Data were analyzed from the CDC multiple-cause-of-death public-use data files, which contain death certificate data from all 50 states and the District of Columbia. During 1997-2007, an annual average of 53,014 deaths (18.4 per 100,000 population; range: 17.8-19.3) among U.S. residents were associated with TBIs. During this period, death rates decreased 8.2%, from 19.3 to 17.8 per 100,000 population (p = 0.001). TBI-related death rates decreased significantly among persons aged 0-44 years and increased significantly among those aged ≥75 years. The rate of TBI deaths was three times higher among males (28.8 per 100,000 population) than among females (9.1). Among males, rates were highest among non-Hispanic American Indian/Alaska Natives (41.3 per 100,000 population) and lowest among Hispanics (22.7). Firearm- (34.8%), motor-vehicle- (31.4%), and fall-related TBIs (16.7%) were the leading causes of TBI-related death. Firearm-related death rates were highest among persons aged 15-34 years (8.5 per 100,000 population) and ≥75 years (10.5). Motor vehicle-related death rates were highest among those aged 15-24 years (11.9 per 100,000 population). Fall-related death rates were highest among adults aged ≥75 years (29.8 per 100,000 population). Overall, the rates for all causes except falls decreased. Although the overall rate of TBI-related deaths decreased during 1997-2007, TBI remains a public health problem; approximately 580,000 persons died with TBI-related diagnoses during this reporting period in the United States. Rates of TBI-related deaths were higher among young and older adults and certain minority populations. The leading external causes of this condition were incidents related to firearms, motor vehicle traffic, and falls. Accurate, timely, and comprehensive surveillance data are necessary to better understand and prevent TBI-related deaths in the United States. CDC multiple-cause-of-death public-use data files can be used to monitor the incidence of TBI-related deaths and assist public health practitioners and partners in the development, implementation, and evaluation of programs and policies to reduce and prevent TBI-related deaths in the United States. Rates of TBI-related deaths are higher in certain population groups and are primarily related to specific external causes. Better enforcement of existing seat belt laws, implementation and increased coverage of more stringent helmet laws, and the implementation of existing evidence-based fall-related prevention interventions are examples of interventions that can reduce the incidence of TBI in the United States.

A population-based descriptive study of housefire deaths in North Carolina.

PubMed Central

Patetta, M J; Cole, T B

1990-01-01

We report a population-based study of housefire deaths in North Carolina in 1985 using data obtained from fire investigators and the North Carolina medical examiner system. The crude death rate was 3.2 per 100,000 population; age-specific death rates were highest for ages 75-84 years. Death rates for Whites were one-third as high as death rates for other races. Of those decedents tested for alcohol, 56 percent had blood alcohol levels greater than or equal to 22 mmol/L. Most fatal fires were caused by heating units or cigarettes. PMID:2382752

Patterns of gun deaths across US counties 1999-2013.

PubMed

Kalesan, Bindu; Galea, Sandro

2017-05-01

We examined the socio-demographic distribution of gun deaths across 3143 counties in 50 United States' states to understand the spatial patterns and correlates of high and low gun deaths. We used aggregate counts of gun deaths and population in all counties from 1999 to 2013 from the Centers for Disease Control and Prevention's Wide-ranging Online Data for Epidemiologic Research (WONDER). We characterized four levels of gun violence, as distinct levels of gun death rates of relatively safe, unsafe, violent, and extremely violent counties, based on quartiles of 15-year county-specific gun death rates per 100,000 and used negative binomial regression models allowing clustering by state to calculate incidence rate ratios and 95% confidence intervals (95% CIs). Most states had at least one violent or extremely violent county. Extremely violent gun counties were mostly rural, poor, predominantly minority, had high unemployment rate and homicide rate. Overall, homicide rate was significantly associated with gun deaths (incidence rate ratios = 1.08, 95% CI = 1.06-1.09). In relatively safe counties, this risk was 1.09 (95% CI = 1.05-1.13) and in extremely violent gun counties was 1.03 (95% CI = 1.03-1.04). There are broad differences in gun death rates across the United States representing different levels of gun death rates in each state with distinct socio-demographic profiles. Copyright © 2017 Elsevier Inc. All rights reserved.

Life and death of female gametes during oogenesis and folliculogenesis.

PubMed

Krysko, Dmitri V; Diez-Fraile, Araceli; Criel, Godelieve; Svistunov, Andrei A; Vandenabeele, Peter; D'Herde, Katharina

2008-09-01

The vertebrate ovary is an extremely dynamic organ in which excessive or defective follicles are rapidly and effectively eliminated early in ontogeny and thereafter continuously throughout reproductive life. More than 99% of follicles disappear, primarily due to apoptosis of granulosa cells, and only a minute fraction of the surviving follicles successfully complete the path to ovulation. The balance between signals for cell death and survival determines the destiny of the follicles. An abnormally high rate of cell death followed by atresia can negatively affect fertility and eventually lead irreversibly to premature ovarian failure. In this review we provide a short overview of the role of programmed cell death in prenatal differentiation of the primordial germ cells and in postnatal folliculogenesis. We also discuss the issue of neo-oogenesis. Next, we highlight molecules involved in regulation of granulosa cell apoptosis. We further discuss the potential use of scores for apoptosis in granulosa cells and characteristics of follicular fluid as prognostic markers for predicting the outcome of assisted reproduction. Potential therapeutic strategies for combating premature ovarian failure are also addressed.

Lung cancer death rates fall, helping drive decrease in overall cancer death rates

Cancer.gov

The Annual Report to the Nation on the Status of Cancer, covering the period 1975–2010, showed death rates for lung cancer, which accounts for more than one in four cancer deaths, dropping at a faster pace than in previous years.

Cancer and noncancer mortality in populations living near uranium and vanadium mining and milling operations in Montrose County, Colorado, 1950-2000.

PubMed

Boice, John D; Mumma, Michael T; Blot, William J

2007-06-01

Mining and milling of uranium in Montrose County on the Western Slope of Colorado began in the early 1900s and continued until the early 1980s. To evaluate the possible impact of these activities on the health of communities living on the Colorado Plateau, mortality rates between 1950 and 2000 among Montrose County residents were compared to rates among residents in five similar counties in Colorado. Standardized mortality ratios (SMRs) were computed as the ratio of observed numbers of deaths in Montrose County to the expected numbers of deaths based on mortality rates in the general populations of Colorado and the United States. Relative risks (RRs) were computed as the ratio of the SMRs for Montrose County to the SMRs for the five comparison counties. Between 1950 and 2000, a total of 1,877 cancer deaths occurred in the population residing in Montrose County, compared with 1,903 expected based on general population rates for Colorado (SMR(CO) 0.99). There were 11,837 cancer deaths in the five comparison counties during the same 51-year period compared with 12,135 expected (SMR(CO) 0.98). There was no difference between the total cancer mortality rates in Montrose County and those in the comparison counties (RR = 1.01; 95% CI 0.96-1.06). Except for lung cancer among males (RR = 1.19; 95% CI 1.06-1.33), no statistically significant excesses were seen for any causes of death of a priori interest: cancers of the breast, kidney, liver, bone, or childhood cancer, leukemia, non-Hodgkin lymphoma, renal disease or nonmalignant respiratory disease. Lung cancer among females was decreased (RR = 0.83; 95% CI 0.67-1.02). The absence of elevated mortality rates of cancer in Montrose County over a period of 51 years suggests that the historical milling and mining operations did not adversely affect the health of Montrose County residents. Although descriptive correlation analyses such as this preclude definitive causal inferences, the increased lung cancer mortality seen among males but not females is most likely due to prior occupational exposure to radon and cigarette smoking among underground miners residing in Montrose County, consistent with previous cohort studies of Colorado miners and of residents of the town of Uravan in Montrose County.

Updated Death and Injury Rates of U.S. Military Personnel During the Conflicts in Iraq and Afghanistan

DTIC Science & Technology

2014-12-01

rates.11 Not all of the changes in casualty rates over time were statistically significant. The hostile death rates during the surges in Iraq and...hostile- death rates in each theater and period). However, the declines during the post-surge periods in both theaters were overwhelmingly significant...the more-seriously wounded in Vietnam were less likely to survive. 7 Figure 6. Hostile Death Rates Before, During, and After the Surges in Iraq

Practice Guideline Summary: Sudden Unexpected Death in Epilepsy Incidence Rates and Risk Factors: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology and the American Epilepsy Society

PubMed Central

Harden, Cynthia; Tomson, Torbjörn; Gloss, David; Buchhalter, Jeffrey; Cross, J. Helen; Donner, Elizabeth; French, Jacqueline A.; Gil-Nagel, Anthony; Hesdorffer, Dale C.; Smithson, W. Henry; Spitz, Mark C.; Walczak, Thaddeus S.; Sander, Josemir W.; Ryvlin, Philippe

2017-01-01

Objective: To determine the incidence rates of sudden unexpected death in epilepsy (SUDEP) in different epilepsy populations and address the question of whether risk factors for SUDEP have been identified. Methods: Systematic review of evidence; modified Grading Recommendations Assessment, Development and Evaluation process for developing conclusions; recommendations developed by consensus. Results: Findings for incidence rates based on 12 Class I studies include the following: SUDEP risk in children with epilepsy (aged 0–17 years) is 0.22/1,000 patient-years (95% CI 0.16–0.31) (high confidence in evidence). SUDEP risk increases in adults to 1.2/1,000 patient-years (95% CI 0.64–2.32) (low confidence in evidence). The major risk factor for SUDEP is the occurrence of generalized tonic-clonic seizures (GTCS); the SUDEP risk increases in association with increasing frequency of GTCS occurrence (high confidence in evidence). Recommendations: Level B: Clinicians caring for young children with epilepsy should inform parents/guardians that in 1 year, SUDEP typically affects 1 in 4,500 children; therefore, 4,499 of 4,500 children will not be affected. Clinicians should inform adult patients with epilepsy that SUDEP typically affects 1 in 1,000 adults with epilepsy per year; therefore, annually 999 of 1,000 adults will not be affected. For persons with epilepsy who continue to experience GTCS, clinicians should continue to actively manage epilepsy therapies to reduce seizures and SUDEP risk while incorporating patient preferences and weighing the risks and benefits of any new approach. Clinicians should inform persons with epilepsy that seizure freedom, particularly freedom from GTCS, is strongly associated with decreased SUDEP risk. ABBREVIATIONS AAN: American Academy of Neurology AED: antiepileptic drug GTCS: generalized tonic-clonic seizures SUDEP: sudden unexpected death in epilepsy PMID:28684957

Trauma: a major cause of death among surgical inpatients of a Nigerian tertiary hospital

PubMed Central

Ekeke, Onyeanunam Ngozi; Okonta, Kelechi Emmanuel

2017-01-01

Introduction Trauma presents a significant global health burden. Death resulting from trauma remains high in low income countries despite a steady decrease in developed countries. Analysis of the pattern of death will enable intervention to reduce these deaths from trauma in developing countries. This study aims to present the pattern of trauma-related deaths in the surgical wards of University of Port Harcourt Teaching Hospital (UPTH). Methods This was a retrospective study of all patients who died from trauma during admission into the surgical wards of UPTH from 2007 to 2012. Data on demography and traumatic events leading to death were collected from surgical wards, the emergency unit, and theatre records and analyzed using SPSS version 16.0. Results Trauma accounted for 219 (42.4%) of the 527 mortalities recorded. Most of the deaths (62.6 %) occurred between 20 and 59 years. There were 148 males (67.6 %). The yearly mortality rates were as follows: 2007(12.3 %); 2008 (16.9%); 2009 (9.1%), 2010 (12.8 %), 2011 (23.3%) and 2012 (25.6%). Most of the patients (91.3%) died within 1 month of admission. The major events leading to deaths were burns 105(47.9%), traumatic brain injuries were 63(28.8%), and spinal cord injuries 21(9.6%). The secondary causes of death were mainly septic shock 112(51.1%); Respiratory failure 60(27.4%); and Multiple organ dysfunction 44(20.1%). Conclusion Trauma is a leading cause of mortality in the surgical wards of our hospital. Trauma -related deaths continues to increase over the years. Safe keeping of petroleum products and adherence to traffic rules will reduce these avoidable deaths. PMID:29138652

Cardiovascular Deaths among Alaskan Natives, 1980-86.

ERIC Educational Resources Information Center

Middaugh, John P.

1990-01-01

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

[Eugenic abortion could explain the lower infant mortality in Cuba compared to that in Chile].

PubMed

Donoso S, Enrique; Carvajal C, Jorge A

2012-08-01

Cuba and Chile have the lower infant mortality rates of Latin America. Infant mortality rate in Cuba is similar to that of developed countries. Chilean infant mortality rate is slightly higher than that of Cuba. To investigate if the lower infant mortality rate in Cuba, compared to Chile, could be explained by eugenic abortion, considering that abortion is legal in Cuba but not in Chile. We compared total and congenital abnormalities related infant mortality in Cuba and Chile during 2008, based on vital statistics of both countries. In 2008, infant mortality rates in Chile were significantly higher than those of Cuba (7.8 vs. 4.7 per 1,000 live born respectively, odds ratio (OR) 1.67; 95% confidence intervals (Cl) 1.52-1.83). Congenital abnormalities accounted for 33.8 and 19.2% of infant deaths in Chile and Cuba, respectively. Discarding infant deaths related to congenital abnormalities, infant mortality rate continued to be higher in Chile than in Cuba (5.19 vs. 3.82 per 1000 live born respectively, OR 1.36; 95%CI 1.221.52). Considering that antenatal diagnosis is widely available in both countries, but abortion is legal in Cuba but not in Chile, we conclude that eugenic abortion may partially explain the lower infant mortality rate observed in Cuba compared to that observed in Chile.

Stochastic Games for Continuous-Time Jump Processes Under Finite-Horizon Payoff Criterion

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

Wei, Qingda, E-mail: weiqd@hqu.edu.cn; Chen, Xian, E-mail: chenxian@amss.ac.cn

In this paper we study two-person nonzero-sum games for continuous-time jump processes with the randomized history-dependent strategies under the finite-horizon payoff criterion. The state space is countable, and the transition rates and payoff functions are allowed to be unbounded from above and from below. Under the suitable conditions, we introduce a new topology for the set of all randomized Markov multi-strategies and establish its compactness and metrizability. Then by constructing the approximating sequences of the transition rates and payoff functions, we show that the optimal value function for each player is a unique solution to the corresponding optimality equation andmore » obtain the existence of a randomized Markov Nash equilibrium. Furthermore, we illustrate the applications of our main results with a controlled birth and death system.« less

Neonatal heart rate prediction.

PubMed

Abdel-Rahman, Yumna; Jeremic, Aleksander; Tan, Kenneth

2009-01-01

Technological advances have caused a decrease in the number of infant deaths. Pre-term infants now have a substantially increased chance of survival. One of the mechanisms that is vital to saving the lives of these infants is continuous monitoring and early diagnosis. With continuous monitoring huge amounts of data are collected with so much information embedded in them. By using statistical analysis this information can be extracted and used to aid diagnosis and to understand development. In this study we have a large dataset containing over 180 pre-term infants whose heart rates were recorded over the length of their stay in the Neonatal Intensive Care Unit (NICU). We test two types of models, empirical bayesian and autoregressive moving average. We then attempt to predict future values. The autoregressive moving average model showed better results but required more computation.

Spatial analysis of under-5 mortality and potential risk factors in the Basse Health and Demographic Surveillance System, the Gambia.

PubMed

Quattrochi, John; Jasseh, Momodou; Mackenzie, Grant; Castro, Marcia C

2015-07-01

To describe the spatial pattern in under-5 mortality rates in the Basse Health and Demographic Surveillance System (BHDSS) and to test for associations between under-5 deaths and biodemographic and socio-economic risk factors. Using data on child survival from 2007 to 2011 in the BHDSS, we mapped under-5 mortality by km(2) . We tested for spatial clustering of high or low death rates using Kulldorff's spatial scan statistic. Associations between child death and a variety of biodemographic and socio-economic factors were assessed with Cox proportional hazards models, and deviance residuals from the best-fitting model were tested for spatial clustering. The overall death rate among children under 5 was 0.0195 deaths per child-year. We found two spatial clusters of high death rates and one spatial cluster of low death rates; children in the two high clusters died at a rate of 0.0264 and 0.0292 deaths per child-year, while in the low cluster, the rate was 0.0144 deaths per child-year. We also found that children born to Fula mothers experienced, on average, a higher hazard of death, whereas children born in the households in the upper two quintiles of asset ownership experienced, on average, a lower hazard of death. After accounting for the spatial distribution of biodemographic and socio-economic characteristics, we found no residual spatial pattern in child mortality risk. This study demonstrates that significant inequality in under-5 death rates can occur within a relatively small area (1100 km(2) ). Risks of under-5 mortality were associated with mother's ethnicity and household wealth. If high mortality clusters persist, then equity concerns may require additional public health efforts in those areas. © 2015 John Wiley & Sons Ltd.

Antidepressant poisoning deaths in New Zealand for 2001.

PubMed

Reith, David; Fountain, John; Tilyard, Murray; McDowell, Rebecca

2003-10-24

To compare the rates of death per volume of drug dispensed for antidepressants in New Zealand. Deaths from antidepressant poisonings were identified from the reports of coronial inquiries for New Zealand in 2001. Prescriptions for antidepressant medications were identified from the PharmHouse database from 1 January 2001 to 31 December 2001. The rates of deaths (95% CI) per prescription, tablet/capsule or defined daily dose were calculated for individual antidepressants and classes of antidepressant. There were 200 poisoning deaths recorded in the database for New Zealand in 2001. Antidepressants were involved in 41 deaths, and death was attributed to an antidepressant in 23 cases. There were 5.52 (95% CI 3.85-7.68) deaths per 100 000 prescriptions for tricyclic antidepressants (TCAs) and 2.51 (1.57-3.79) deaths per 100 000 prescriptions for selective serotonin reuptake inhibitors (SSRIs). There was marked variability in rates of death per volume of drug dispensed between individual antidepressants. SSRIs have lower rates of death per volume of drug dispensed than TCAs and there is also variation in these rates within these classes of drugs. Toxicity in overdose should be considered when prescribing antidepressants.

Annual Report to the Nation on the status of cancer, 1975-2010, featuring prevalence of comorbidity and impact on survival among persons with lung, colorectal, breast, or prostate cancer.

PubMed

Edwards, Brenda K; Noone, Anne-Michelle; Mariotto, Angela B; Simard, Edgar P; Boscoe, Francis P; Henley, S Jane; Jemal, Ahmedin; Cho, Hyunsoon; Anderson, Robert N; Kohler, Betsy A; Eheman, Christie R; Ward, Elizabeth M

2014-05-01

The American Cancer Society (ACS), the Centers for Disease Control and Prevention (CDC), the National Cancer Institute (NCI), and the North American Association of Central Cancer Registries (NAACCR) collaborate annually to provide updates on cancer incidence and death rates and trends in these outcomes for the United States. This year's report includes the prevalence of comorbidity at the time of first cancer diagnosis among patients with lung, colorectal, breast, or prostate cancer and survival among cancer patients based on comorbidity level. Data on cancer incidence were obtained from the NCI, the CDC, and the NAACCR; and data on mortality were obtained from the CDC. Long-term (1975/1992-2010) and short-term (2001-2010) trends in age-adjusted incidence and death rates for all cancers combined and for the leading cancers among men and women were examined by joinpoint analysis. Through linkage with Medicare claims, the prevalence of comorbidity among cancer patients who were diagnosed between 1992 through 2005 residing in 11 Surveillance, Epidemiology, and End Results (SEER) areas were estimated and compared with the prevalence in a 5% random sample of cancer-free Medicare beneficiaries. Among cancer patients, survival and the probabilities of dying of their cancer and of other causes by comorbidity level, age, and stage were calculated. Death rates continued to decline for all cancers combined for men and women of all major racial and ethnic groups and for most major cancer sites; rates for both sexes combined decreased by 1.5% per year from 2001 through 2010. Overall incidence rates decreased in men and stabilized in women. The prevalence of comorbidity was similar among cancer-free Medicare beneficiaries (31.8%), breast cancer patients (32.2%), and prostate cancer patients (30.5%); highest among lung cancer patients (52.9%); and intermediate among colorectal cancer patients (40.7%). Among all cancer patients and especially for patients diagnosed with local and regional disease, age and comorbidity level were important influences on the probability of dying of other causes and, consequently, on overall survival. For patients diagnosed with distant disease, the probability of dying of cancer was much higher than the probability of dying of other causes, and age and comorbidity had a smaller effect on overall survival. Cancer death rates in the United States continue to decline. Estimates of survival that include the probability of dying of cancer and other causes stratified by comorbidity level, age, and stage can provide important information to facilitate treatment decisions. © 2013 American Cancer Society.

Pattern of injury mortality by age-group in children aged 0-14 years in Scotland, 2002-2006, and its implications for prevention.

PubMed

Pearson, Janne; Stone, David H

2009-04-07

Knowledge of the epidemiology of injuries in children is essential for the planning, implementation and evaluation of preventive measures but recent epidemiological information on injuries in children both in general and by age-group in Scotland is scarce. This study examines the recent pattern of childhood mortality from injury by age-group in Scotland and considers its implications for prevention. Routine mortality data for the period 2002-2006 were obtained from the General Register Office for Scotland and were analysed in terms of number of deaths, mean annual mortality rates per 100,000 population, leading causes of death, and causes of injury death. Mid-year population estimates were used as the denominator. Chi-square tests were used to determine statistical significance. 186 children aged 0-14 died from an injury in Scotland during 2002-06 (MR 4.3 per 100,000). Injuries were the leading cause of death in 1-14, 5-9 and 10-14 year-olds (causing 25%, 29% and 32% of all deaths respectively). The leading individual causes of injury death (0-14 years) were pedestrian and non-pedestrian road-traffic injuries and assault/homicide but there was variation by age-group. Assault/homicide, fire and suffocation caused most injury deaths in young children; road-traffic injuries in older ones. Collectively, intentional injuries were a bigger threat to the lives of under-15s than any single cause of unintentional injury. The mortality rate from assault/homicide was highest in infants (<1 year) and decreased with increasing age. Children aged 5-9 were significantly less likely to die from an injury than 0-4 or 10-14 year-olds (p < 0.05). Suicide was an important cause of injury mortality in 10-14 year-olds. Injuries continue to be a leading cause of death in childhood in Scotland. Variation in causes of injury death by age-group is important when targeting preventive efforts. In particular, the threats of assault/homicide in infants, fire in 1-4 year-olds, pedestrian injury in 5-14 year-olds, and suicide in 10-14 year-olds need urgent consideration for preventive action.

Violent Death Rates: The US Compared with Other High-income OECD Countries, 2010.

PubMed

Grinshteyn, Erin; Hemenway, David

2016-03-01

Violent death is a serious problem in the United States. Previous research showing US rates of violent death compared with other high-income countries used data that are more than a decade old. We examined 2010 mortality data obtained from the World Health Organization for populous, high-income countries (n = 23). Death rates per 100,000 population were calculated for each country and for the aggregation of all non-US countries overall and by age and sex. Tests of significance were performed using Poisson and negative binomial regressions. US homicide rates were 7.0 times higher than in other high-income countries, driven by a gun homicide rate that was 25.2 times higher. For 15- to 24-year-olds, the gun homicide rate in the United States was 49.0 times higher. Firearm-related suicide rates were 8.0 times higher in the United States, but the overall suicide rates were average. Unintentional firearm deaths were 6.2 times higher in the United States. The overall firearm death rate in the United States from all causes was 10.0 times higher. Ninety percent of women, 91% of children aged 0 to 14 years, 92% of youth aged 15 to 24 years, and 82% of all people killed by firearms were from the United States. The United States has an enormous firearm problem compared with other high-income countries, with higher rates of homicide and firearm-related suicide. Compared with 2003 estimates, the US firearm death rate remains unchanged while firearm death rates in other countries decreased. Thus, the already high relative rates of firearm homicide, firearm suicide, and unintentional firearm death in the United States compared with other high-income countries increased between 2003 and 2010. Copyright © 2016 Elsevier Inc. All rights reserved.

Impact of fetal death reporting requirements on early neonatal and fetal mortality rates and racial disparities.

PubMed

Tyler, Crystal P; Grady, Sue C; Grigorescu, Violanda; Luke, Barbara; Todem, David; Paneth, Nigel

2012-01-01

Racial disparities in infant and neonatal mortality vary substantially across the U.S. with some states experiencing wider disparities than others. Many factors are thought to contribute to these disparities, but state differences in fetal death reporting have received little attention. We examined whether such reporting requirements may explain national variation in neonatal and fetal mortality rates and racial disparities. We used data on non-Hispanic white and non-Hispanic black infants from the U.S. 2000-2002 linked birth/infant death and fetal death records to determine the degree to which state fetal death reporting requirements explain national variation in neonatal and fetal mortality rates and racial disparities. States were grouped depending upon whether they based the lower limit for fetal death reporting on birthweight alone, gestational age alone, both birthweight and gestational age, or required reporting of all fetal deaths. Traditional methods and the fetuses-at-risk approach were used to calculate mortality rates, 95% confidence intervals, and relative and absolute racial disparity measures in these four groups. States with birthweight-alone fetal death thresholds substantially underreported fetal deaths at lower gestations and slightly overreported neonatal deaths at older gestations. This finding was reflected by these states having the highest neonatal mortality rates and disparities, but the lowest fetal mortality rates and disparities. Using birthweight alone as a reporting threshold may promote some shift of fetal deaths to newborn deaths, contributing to racial disparities in neonatal mortality. The adoption of a uniform national threshold for reporting fetal deaths could reduce systematic differences in live birth and fetal death reporting.

Honduras.

PubMed

1985-08-01

This discussion of Honduras covers the following: the history of the country's demographic situation; the government's overall approach to population problems; population data systems and development planning; institutional arrangements for the integration of population within development planning; the goverment's view of the importance of population policy in realizing development objectives; population size, growth, and natural increase; morbidity and mortality; fertility; international migration; and spatial distribution. Between the censuses of 1910-40, Honduras grew at an average annual rate of more than 1.5% per annum. The rate of population growth reached 2% per annum after 1940 and 3% after about 1955. By 1970-75 the rate of natural increase was estimated to be about 3.5% per annum, due to the net effect of a crude birthrate of 49/1000 and a crude death rate of about 14/1000. The rate of natural increase has remained around 3.5% in recent years, although the crude death rate has declined to 44/1000 and the crude death rate to about 10/1000. The government wants to substantially reduce the rate of population growth, primarily by means of modifying fertility and averting large-scale immigration of refugees in the future. It desires to reduce the country's high levels of mortality and to adjust patterns of spatial distribution, primarily to improve agricultural productivity and promote national economic intergration. The government also seeks to decrease the emigration of qualified personnel. In the past several years, the government of Honduras has increased its commitment to formulating and implementing explicit population policies as a means of attaining overall development objcetives. With a population of around 4.1 million inhabitants as of 1983, Honduras has been growing at an average annual rate of 3.4% in recent years. According to UN projections, the population is expected to grow to about 7 million by 2000. The average life expectancy at birth for both sexes was 55.3 years in 1974 and around 60 years as of 1982. The crude death rate was estimated to be 10/1000 during 1980-85; infant mortality declined from 117/1000 live births in 1971-72 to 86/1000 in 1978. Diarrheal disease is the single most important cause of death in Honduras, and mortality from other water-related diseases remains high in comparison with other Central American countries. Malnutrition also is serious. The government considers levels and trends of mortality to be unacceptable and is particularly concerned about the continuing high level of infant mortality. In recent years the crude birthrate averaged around 44/1000; the 1981 Contraceptive Prevalence Survey found the total fertility rate to be about 6.5 births/woman, which represents a 13% decline in the level of fertility between 1971-72 and 1981.

5 CFR 843.303 - Marriage duration requirements.

Code of Federal Regulations, 2010 CFR

2010-01-01

... cause of death for criminal or insurance purposes is conclusive evidence of whether a death is accidental. (3) A death certificate showing the cause of death as accident or homicide is prima facie... REGULATIONS (CONTINUED) FEDERAL EMPLOYEES RETIREMENT SYSTEM-DEATH BENEFITS AND EMPLOYEE REFUNDS Current and...

Analysis of novel stochastic switched SILI epidemic models with continuous and impulsive control

NASA Astrophysics Data System (ADS)

Gao, Shujing; Zhong, Deming; Zhang, Yan

2018-04-01

In this paper, we establish two new stochastic switched epidemic models with continuous and impulsive control. The stochastic perturbations are considered for the natural death rate in each equation of the models. Firstly, a stochastic switched SILI model with continuous control schemes is investigated. By using Lyapunov-Razumikhin method, the sufficient conditions for extinction in mean are established. Our result shows that the disease could be die out theoretically if threshold value R is less than one, regardless of whether the disease-free solutions of the corresponding subsystems are stable or unstable. Then, a stochastic switched SILI model with continuous control schemes and pulse vaccination is studied. The threshold value R is derived. The global attractivity of the model is also obtained. At last, numerical simulations are carried out to support our results.

Exposing misclassified HIV/AIDS deaths in South Africa.

PubMed

Birnbaum, Jeanette Kurian; Murray, Christopher Jl; Lozano, Rafael

2011-04-01

To quantify the deaths from human immunodeficiency virus (HIV) infection or acquired immunodeficiency syndrome (AIDS) that are misattributed to other causes in South Africa's death registration data and to adjust for this bias. Deaths in the World Health Organization's mortality database were distributed among 48 mutually exclusive causes. For each cause, age- and sex-specific global death rates were compared with the average rate among people aged 65-69, 70-74 and 75-79 years to generate "relative" global death rates. Relative rates were also computed for South Africa alone. Differences between global and South African relative death rates were used to identify the causes to which deaths from HIV/AIDS were misattributed in South Africa and quantify the HIV/AIDS deaths misattributed to each. These deaths were then reattributed to HIV/AIDS. In South Africa, deaths from HIV/AIDS are often misclassified as being caused by 14 other conditions. Whereas in 1996-2006 deaths attributed to HIV/AIDS accounted for 2.0-2.5% of all registered deaths in South Africa, our analysis shows that the true cause-specific mortality fraction rose from 19% (uncertainty range: 7-28%) to 48% (uncertainty range: 38-50%) over that period. More than 90% of HIV/AIDS deaths were found to have been misattributed to other causes during 1996-2006. Adjusting for cause of death misclassification, a simple procedure that can be carried out in any country, can improve death registration data and provide empirical estimates of HIV/AIDS deaths that may be useful in assessing estimates from demographic models.

Parent & Child Perceptions of Child Health after Sibling Death.

PubMed

Roche, Rosa M; Brooten, Dorothy; Youngblut, JoAnne M

Understanding children's health after a sibling's death and what factors may affect it is important for treatment and clinical care. This study compared children's and their parents' perceptions of children's health and identified relationships of children's age, gender, race/ethnicity, anxiety, and depression and sibling's cause of death to these perceptions at 2 and 4 months after sibling death. 64 children and 48 parents rated the child's health "now" and "now vs before" the sibling's death in an ICU or ER or at home shortly after withdrawal of life-prolonging technology. Children completed the Child Depression Inventory and Spence Children's Anxiety Scale. Sibling cause of death was collected from hospital records. At 2 and 4 months, 45% to 54% of mothers' and 53% to 84% of fathers' ratings of their child's health "now" were higher than their children's ratings. Child health ratings were lower for: children with greater depression; fathers whose children reported greater anxiety; mothers whose child died of a chronic condition. Children's ratings of their health "now vs before" their sibling's death did not differ significantly from mothers' or fathers' ratings at 2 or 4 months. Black fathers were more likely to rate the child's health better "now vs before" the death; there were no significant differences by child gender and cause of death in child's health "now vs before" the death. Children's responses to a sibling's death may not be visually apparent or become known by asking parents. Parents often perceive their children as healthier than children perceive themselves at 2 and 4 months after sibling death, so talking with children separately is important. Children's perceptions of their health may be influenced by depression, fathers' perceptions by children's anxiety, and mother's perceptions by the cause of sibling death.

Global burden of hypoglycaemia-related mortality in 109 countries, from 2000 to 2014: an analysis of death certificates.

PubMed

Zaccardi, Francesco; Dhalwani, Nafeesa N; Webb, David R; Davies, Melanie J; Khunti, Kamlesh

2018-07-01

In the context of increasing prevalence of diabetes in elderly people with multimorbidity, intensive glucose control may increase the risk of severe hypoglycaemia, potentially leading to death. While rising trends of severe hypoglycaemia rates have been reported in some European, North American and Asian countries, the global burden of hypoglycaemia-related mortality is unknown. We aimed to investigate global differences and trends of hypoglycaemia-related mortality. We used the WHO mortality database to extract information on death certificates reporting hypoglycaemia or diabetes as the underlying cause of death, and the United Nations demographic database to obtain data on mid-year population estimates from 2000 to 2014. We calculated crude and age-standardised proportions (defined as number of hypoglycaemia-related deaths divided by total number of deaths from diabetes [i.e. the sum of hypoglycaemia- and diabetes-related deaths]) and rates (hypoglycaemia-related deaths divided by mid-year population) of hypoglycaemia-related mortality and compared estimates across countries and over time. Data for proportions were extracted from 109 countries (31 had data from all years analysed [2000-2014] available). Combining all countries, the age-standardised proportion of hypoglycaemia-related deaths was 4.49 (95% CI 4.44, 4.55) per 1000 total diabetes deaths. Compared with the overall mean, most Central American, South American and (mainly) Caribbean countries reported higher proportions (five more age-standardised hypoglycaemia-related deaths per 1000 total diabetes deaths in Chile, six in Uruguay, 11 in Belize and 22 in Aruba), as well as Japan (11 more age-standardised hypoglycaemia-related deaths per 1000 total diabetes deaths). In comparison, lower proportions were noted in most European countries, the USA, Canada, New Zealand and Australia. For countries with data available for all years analysed, trend analysis showed a 60% increase in hypoglycaemia-related deaths until 2010 and stable trends onwards. Rising trends were most evident for Argentina, Brazil, Chile, the USA and Japan. Data for rates were available for 105 countries (30 had data for all years analysed [2000-2014] available). Combining all countries, the age-standardised hypoglycaemia-related death rate was 0.79 (95% CI 0.77, 0.80) per 1 million person-years. Most Central American, South American and Caribbean countries similarly reported higher rates of hypoglycaemia-related death, whilst virtually all European countries, the USA, Canada, Japan, New Zealand and Australia reported lower rates compared with the overall mean. Age-standardised rates were very low for most countries (lower than five per 1 million person-years in 89.5% of countries), resulting in small absolute differences among countries. As noted with the proportions analysis, trend analysis showed an overall 60% increase in hypoglycaemia-related deaths until 2010 and stable rate trends onwards; rising rates were particularly evident for Brazil, Chile and the USA. Most countries in South America, Central America and the Caribbean showed the highest proportions of diabetes-related deaths attributable to hypoglycaemia and the highest rates of hypoglycaemia-related deaths. Between 2000 and 2014, rising trends were observed in Brazil, Chile and the USA for both rates and proportions of hypoglycaemia-related death, and in Argentina and Japan for proportions only. Further studies are required to unravel the contribution of clinical and socioeconomic factors, difference in diabetes prevalence and heterogeneity of death certification in determining lower rates and proportions of hypoglycaemia-related deaths in high-income countries in Europe, North America and Asia. Data used for these analyses are available at https://doi.org/10.17632/ndp52fbz8r.1.

Risk of cardiac death among cancer survivors in the United States: a SEER database analysis.

PubMed

Abdel-Rahman, Omar

2017-09-01

Population-based data on the risk of cardiac death among cancer survivors are needed. This scenario was evaluated in cancer survivors (>5 years) registered within the Surveillance, Epidemiology and End Results (SEER) database. The SEER database was queried using SEER*Stat to determine the frequency of cardiac death compared to other causes of death; and to determine heart disease-specific and cancer-specific survival rates in survivors of each of the 10 most common cancers in men and women in the SEER database. For cancer-specific survival rate, the highest rates were related to thyroid cancer survivors; while the lowest rates were related to lung cancer survivors. For heart disease-specific survival rate, the highest rates were related to thyroid cancer survivors; while the lowest rates were related to both lung cancer survivors and urinary bladder cancer survivors. The following factors were associated with a higher likelihood of cardiac death: male gender, old age at diagnosis, black race and local treatment with radiotherapy rather than surgery (P < 0.0001 for all parameters). Among cancer survivors (>5 years), cardiac death is a significant cause of death and there is a wide variability among different cancers in the relative importance of cardiac death vs. cancer-related death.

Ethical and legal issues in donation after cardiac death in Italy.

PubMed

Bruzzone, P

2010-05-01

In Italy death of a human being must be declared either after brain death or after 20 minutes of cardiac arrest, certified by continuous electrocardiography (EKG) recording. It is my personal opinion that in such circumstances after cardiac death (DCD) will allow at best only the retrieval of few marginal kidneys and some tissues, and therefore will not be very helpful for our waiting list patients. I suggest instead modifying first the Italian law in order to be able to declare cardiac death after only 5 minutes of cardiac arrest, certified by continuous EKG recording. Copyright (c) 2010 Elsevier Inc. All rights reserved.

Light-induced generation of singlet oxygen by naked gold nanoparticles and its implications to cancer cell phototherapy.

PubMed

Pasparakis, George

2013-12-20

Generation of singlet oxygen by direct irradiation of naked gold nanoparticles is observed using either continuous wave or pulsed laser sources. The underlying mechanism involves plasmon- and hot-electron-mediated reaction pathways and (1) O2 seems to significantly amplify the overall death rates during photothermal treatment of cancer cell lines in vitro. Copyright © 2013 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Trend (1999-2009) in U.S. death rates from myelodysplastic syndromes: utility of multiple causes of death in surveillance.

PubMed

Polednak, Anthony P

2013-10-01

For myelodysplastic syndromes (MDS) (formerly known as preleukemia), a diverse group of myeloid neoplasms usually involving anemia in elderly persons, trends in U.S. death rates apparently have not been reported. Trends in annual age-standardized rates per 100,000 from 1999 to 2009 were examined for MDS using multiple causes vs. underlying cause alone, coded on death certificates for U.S. residents. The death rate (all ages combined) for MDS increased from 1999 to 2009, from 1.62 to 1.84 using underlying cause alone and from 2.89 to 3.27 using multiple causes. Rates using multiple causes were about 80% higher than those based on underlying cause alone. From 2001 to 2004 the rate for MDS using underlying cause alone (but not using multiple causes) declined, accompanied by an increase in the rate for deaths from leukemia as underlying cause with mention of MDS; this trend coincided with the advent of the 2001 World Health Organization's reclassification of certain MDS as leukemia. The MDS rate for age 65+ years increased after 2005, whereas the rate for age 25-64 years was low but declined from 2001 to 2003 and then stabilized. For deaths with MDS coded as other than underlying cause, rates did not decline for deaths from each of the two most common causes (i.e., cardiovascular diseases and leukemia). Evidence for decreases in MDS-related mortality rates was limited; the increase at age 65+ years is consistent with increases in incidence rates reported from cancer registries. Using multiple causes of death vs. only the underlying cause results in substantially higher MDS-related death rates, shows the impact of changes in the classification of myeloid neoplasms and emphasizes the importance of reducing cardiovascular disease mortality in MDS patients. Copyright © 2013 Elsevier Ltd. All rights reserved.

Suicide in the Highlands of Scotland.

PubMed

Stark, C; Matthewson, F; O'Neill, N; Oates, K; Hay, A

2002-01-01

The Highlands have one of the highest suicide rates in Scotland. This paper describes suicide and deliberate self-harm in the Highlands in the last 20 years and explores possible reasons for the differences from the Scottish average. Retrospective analysis of routine data from the SMRI/SMR01 scheme and information on deaths from the Registrar General. Suicide and undetermined deaths were combined in the analysis. Highland and Scotland 1978-98. The high rates in Highland are caused by an excess of male deaths. Highland has had consistently high male suicide rates over the 20 year period compared to Scotland. These differences do not disappear when deaths of non-Highland residents are excluded. By comparison, deliberate self-harm admissions follow a similar pattern to Scotland as a whole. Causes of death differed from Scotland as a whole, with an over-representation of drowning, gases and firearm deaths. Highland suicide rates are elevated compared to Scotland. This is mainly due to an excess of deaths in men up to the age of 74 years, and is not accounted for by deaths of non-residents. Female deaths are not elevated in comparison to the rest of Scotland. Male attempted suicide rates do not differ from Scotland. Lethality of method--drowning, car exhausts and firearms--may contribute to the elevated male death rates.

Traumatic Brain Injury (TBI) Data and Statistics

MedlinePlus

... data.cdc.gov . Emergency Department Visits, Hospitalizations, and Deaths Rates of TBI-related Emergency Department Visits, Hospitalizations, ... related Hospitalizations by Age Group and Injury Mechanism Deaths Rates of TBI-related Deaths by Sex Rates ...

Comparison of Continuing Bonds Reported by Parents and Siblings after a Child's Death from Cancer

ERIC Educational Resources Information Center

Foster, Terrah L.; Gilmer, Mary Jo; Davies, Betty; Dietrich, Mary S.; Barrera, Maru; Fairclough, Diane L.; Vannatta, Kathryn; Gerhardt, Cynthia A.

2011-01-01

Few studies have distinguished similarities and differences between continuing bonds as they appear in various bereaved populations, particularly parent versus sibling cohorts following a child's death. This mixed-method study compared how parents and siblings experienced continuing bonds in 40 families who lost a child to cancer. Thirty-six…

Variations in mortality rates among Canadian neonatal intensive care units

PubMed Central

Sankaran, Koravangattu; Chien, Li-Yin; Walker, Robin; Seshia, Mary; Ohlsson, Arne; Lee, Shoo K.

2002-01-01

Background Most previous reports of variations in mortality rates for infants admitted to neonatal intensive care units (NICUs) have involved small groups of subpopulations, such as infants with very low birth weight. Our aim was to examine the incidence and causes of death and the risk-adjusted variation in mortality rates for a large group of infants of all birth weights admitted to Canadian NICUs. Methods We examined the deaths that occurred among all 19 265 infants admitted to 17 tertiary-level Canadian NICUs from January 1996 to October 1997. We used multivariate analysis to examine the risk factors associated with death and the variations in mortality rates, adjusting for risks in the baseline population, severity of illness on admission and whether the infant was outborn (born at a different hospital from the one where the NICU was located). Results The overall mortality rate was 4% (795 infants died). Forty percent of the deaths (n = 318) occurred within 2 days of NICU admission, 50% (n = 397) within 3 days and 75% (n = 596) within 12 days. The major conditions associated with death were gestational age less than 24 weeks (59 deaths [7%]), gestational age 24–28 weeks (325 deaths [41%]), outborn status (340 deaths [42%]), congenital anomalies (270 deaths [34%]), surgery (141 deaths [18%]), infection (108 deaths [14%]), hypoxic–ischemic encephalopathy (128 deaths [16%]) and small for gestational age (i.e., less than the third percentile) (77 deaths [10%]). There was significant variation in the risk-adjusted mortality rates (range 1.6% to 5.5%) among the 17 NICUs. Interpretation Most NICU deaths occurred within the first few days after admission. Preterm birth, outborn status and congenital anomalies were the conditions most frequently associated with death in the NICU. The significant variation in risk-adjusted mortality rates emphasizes the importance of risk adjustment for valid comparison of NICU outcomes. PMID:11826939

[Death rate by malnutrition in children under the age of five, Colombia].

PubMed

Quiroga, Edwin Fernando

2012-01-01

Much higher mortalities occur in children under five in developing countries with high poverty rates compared with developed countries. Causes of death are related to perinatal conditions, measles, HIV/AIDS, diarrhea, respiratory diseases and others. Throughout the world, malnutrition has been identified as the underlying cause of approximately half of these deaths. Death rate due to malnutrition was described using an adjusted method that takes into account the difficulties of identifying malnutrition as a direct cause of death. A descriptive study included analysis of the International Classification of Diseases (ICD-10) vital statistics from 2003-2007. Death rates were estimated, a method of analysis of multiple causes was applied for infectious diseases, along with calculations of death probabilities. Malnutrition was associated with infectious diseases. The frequency of infectious disease as a direct cause of death was almost seven times higher in cases with the antecedent of malnutrition. When adjusted death rate values were used, the initial value increased nearly five times. The probability of death after the adjustment for inadequate classification increased approximately four times. The Analysis of Multiple Causes Method was established as an effective method in analyzing malnutrition and infectious diesease mortality in Colombia. Malnutrition may be a direct underlying cause of death in one of eight deaths in children <1 year old and one of three deaths in 1-4-year-olds.

Coarsening dynamics in condensing zero-range processes and size-biased birth death chains

NASA Astrophysics Data System (ADS)

Jatuviriyapornchai, Watthanan; Grosskinsky, Stefan

2016-05-01

Zero-range processes with decreasing jump rates are well known to exhibit a condensation transition under certain conditions on the jump rates, and the dynamics of this transition continues to be a subject of current research interest. Starting from homogeneous initial conditions, the time evolution of the condensed phase exhibits an interesting coarsening phenomenon of mass transport between cluster sites characterized by a power law. We revisit the approach in Godrèche (2003 J. Phys. A: Math. Gen. 36 6313) to derive effective single site dynamics which form a nonlinear birth death chain describing the coarsening behavior. We extend these results to a larger class of parameter values, and introduce a size-biased version of the single site process, which provides an effective tool to analyze the dynamics of the condensed phase without finite size effects and is the main novelty of this paper. Our results are based on a few heuristic assumptions and exact computations, and are corroborated by detailed simulation data.

Progress towards malaria control targets in relation to national malaria programme funding

PubMed Central

2013-01-01

Background Malaria control has been dramatically scaled up the past decade, mainly thanks to increasing international donor financing since 2003. This study assessed progress up to 2010 towards global malaria impact targets, in relation to Global Fund, other donor and domestic malaria programme financing over 2003 to 2009. Methods Assessments used domestic malaria financing reported by national programmes, and Global Fund/OECD data on donor financing for 90 endemic low- and middle-income countries, WHO estimates of households owning one or more insecticide-treated mosquito net (ITN) for countries in sub-Saharan Africa, and WHO-estimated malaria case incidence and deaths in countries outside sub-Saharan Africa. Results Global Fund and other donor funding is concentrated in a subset of the highest endemic African countries. Outside Africa, donor funding is concentrated in those countries with highest malaria mortality and case incidence rates over the years 2000 to 2003. ITN coverage in 2010 in Africa, and declines in case and death rates per person at risk over 2004 to 2010 outside Africa, were greatest in countries with highest donor funding per person at risk, and smallest in countries with lowest donor malaria funding per person at risk. Outside Africa, all-source malaria programme funding over 2003 to 2009 per case averted ($56-5,749) or per death averted ($58,000-3,900,000) over 2004 to 2010 tended to be lower (more favourable) in countries with higher donor malaria funding per person at risk. Conclusions Increases in malaria programme funding are associated with accelerated progress towards malaria control targets. Associations between programme funding per person at risk and ITN coverage increases and declines in case and death rates suggest opportunities to maximize the impact of donor funding, by strategic re-allocation to countries with highest continued need. PMID:23317000

Paediatric low speed vehicle run-over fatalities in Queensland.

PubMed

Griffin, Bronwyn; Watt, Kerrianne; Wallis, Belinda; Shields, Linda; Kimble, Roy

2011-02-01

Child pedestrian fatalities associated with motor vehicles reversing or moving at low speed are difficult to identify in surveillance data. This study aims to determine the incidence of fatalities associated with what is thought to be an under-reported and preventable fatal injury mechanism. The term low speed vehicle run-over (LSVRO) incidents encompasses pedestrian fatalities where vehicles run-over a child at low speed. Data were obtained for children aged 0-15 years in the Australian state of Queensland (January 2004-December 2008). There were 15 deaths (12 boys and 3 girls) during 2004-2008 (rate:1.67/100,000). Over half were aged 0 and 1 years of age (n=8; 53.3%, rate: 14.67/100,000), and one quarter were 2 and 3 years of age (n=4, 27%, rate 7.46/100,000). There were no LSVRO deaths recorded among 10-15 year olds. Most (13/15) of the incidents occurred on private property, and only two occurred on a street/road. Almost half of the fatalities were caused by a four wheel drive (4WD) vehicle; large family sedans were involved in four fatalities, and heavy vehicles were involved in three deaths. In 11 of the fatalities, parents were the drivers of the vehicle involved (mothers 5; fathers 6). In nine, the vehicle involved was reversing before it came in contact with the child. Fatalities occurred in each of the Socio-Economic Indexes For Areas (SEIFA) levels. The unique data provided by the child death review team has signalled that LSVRO fatalities are a significant problem in Queensland. The Commission for Children and Young People and Child Guardian (CCYPCG) continue to collect data, which, when combined, will provide outcomes that will act as an impetus for promoting intervention and child advocacy.

Ongoing Impact of HIV Infection on Mortality among Persons who Inject Drugs Despite Free Antiretroviral Therapy

PubMed Central

Lappalainen, Leslie; Hayashi, Kanna; Dong, Huiru; Milloy, M-J; Kerr, Thomas; Wood, Evan

2014-01-01

Aims To determine the impact of HIV infection on mortality over time among persons who inject drugs (PWID) in settings with free HIV/AIDS care. Design and Setting Prospective cohort study of PWID in Vancouver, Canada, recruited between May 1996 and December 2011. We ascertained morality rates and causes of death through a confidential linkage with the provincial vital statistics registry. Participants 2283 individuals were followed for a median of 60.9 months (Interquartile range: 34.4 – 113.1) among whom 622 (27.2%) individuals were HIV-positive at baseline, and 179 (7.8%) seroconverted during follow-up. Measurements The primary and secondary outcomes of interests were all-cause mortality and cause of death, respectively. The main independent variable of interest was HIV serostatus (positive vs. negative). We used Cox proportional hazards regression to determine factors associated with mortality, including socio-demographic variables, drug use behaviors and other risk behaviors. Findings Over the study period, 491 (21.5%) individuals died. In multivariate analyses, HIV infection remained independently associated with all-cause mortality (adjusted hazard ratio = 3.15; 95% CI: 2.59 – 3.82). While all-cause mortality rates declined markedly during the study period (p < 0.001, the independent effect of HIV infection on mortality remained unchanged over time (p = 0.640). Among HIV-positive individuals, significant changes in causes of death from infectious and AIDS-related causes to non-AIDS-related etiologies were observed. Conclusions HIV infection continues to have a persistent impact on mortality rates among persons who inject drugs in settings with free HIV/AIDS care, though causes of death have shifted markedly from infectious and AIDS-related causes to non-AIDS-related etiologies. PMID:25203392

Modeling Conventional Land Combat in a Multi-Agent System Using Generalization of the Different Combat Entities and Combat Operations

DTIC Science & Technology

2001-09-01

Blue and Red Death Rates for Red Lethality = 1 ..........................66 xi Figure 23 Blue and Red Death Rates for Red Lethality = 2...67 Figure 24 Blue and Red Death Rates for Red Lethality = 3 ..........................67 Figure 25 Blue and Red Casualties...vs. Red Lethality....................................68 Figure 26 Blue and Red Death Rates for Blue Training = 100%...................69 Figure

Effect of ethnic origin of mother on fetal outcome.

PubMed Central

Lyon, A J; Clarkson, P; Jeffrey, I; West, G A

1994-01-01

The outcome of 11046 infants, from 20 weeks' gestation, born to mothers of different ethnic origins within one London borough has been analysed. There was no difference in perinatal death rates between the Asian and white infants. Among those with mothers from Africa and the West Indies there were overall significantly more intrauterine deaths (26.8/1000 and 20.0/1000) and neonatal deaths (8.6/1000 and 9.6/1000) than for the white mothers (intrauterine deaths 8.3/1000; neonatal deaths 3.7/1000). At less than 28 weeks', gestation specific death rates were similar in all groups and the overall higher death rates were due to an increase in the proportion of preterm deliveries among the black mothers. From 28 to 36 weeks' gestation, black infants born alive had lower neonatal death rates (7.7/1000) than the white infants (19/1000). The cause of the increased incidence of preterm labour among the black mothers is uncertain, though differences in intrauterine infection rates may be an important factor. PMID:8117126

Female labor force participation and female mortality in Wisconsin 1974-1978.

PubMed

Passannante, M R; Nathanson, C A

1985-01-01

The following research question is addressed in the study: what effect will the entrance of women into the labor force have on female mortality rates for all causes of death combined as well as specific causes relating to occupational stress, behavioral factors and physical hazards associated with occupation? This question is examined through comparisons of age, marital status and occupation-specific death rates for all causes of death combined and for selected causes of death. Death certificates provided by the Wisconsin Bureau of Health Statistics for the years 1974-1978 and population data provided by the 1976 Survey of Income and Education were used to construct death rates. The death rates of the white civilian female population of Wisconsin 16-64 years of age were examined using exploratory data analysis techniques (schematic plots and median polish) and standard errors. In general, the death rates of women in the labor force are substantially lower than those of housewives. These results may indicate that the role of housewife exposes women to health hazards. In addition, the results of this study may suggest some selectivity of healthy women into the labor force or a protective effect of labor force participation. In a limited number of instances, labor force participants' mortality rates exceed those of housewives. In the 60-64 year old population, white-collar workers, specifically, sales workers, managers and professionals, experience significantly higher death rates than housewives. In addition, specific groups of labor force participants experience significantly higher death rates than housewives for accidental deaths (i.e. laborers 16-44 and 45-54), deaths due to heart disease (i.e. laborers 45-54 and sales workers 60-64) and deaths due to malignant neoplasms (i.e. white-collar workers 60-64 years of age). The possibility that these instances indicate the direction of future mortality trends should be considered.

The effectiveness of continuing training for traditional birth attendants on their reproductive health-care knowledge and performance.

PubMed

Chen, Solomon Chih-Cheng; Wang, Jung-Der; Ward, Aimee Lou; Chan, Chang-Chuan; Chen, Pau-Chung; Chiang, Hung-Che; Kolola-Dzimadzi, Rose; Nyasulu, Yohane M Z; Yu, Joseph Kwong-Leung

2011-10-01

to evaluate the effectiveness of continuing training for traditional birth attendants (TBAs) on their reproductive knowledge and performance. Mzuzu Central Hospital in the northern region of Malawi. PARTICIPANTS AND ANALYSIS: a total of 81 TBAs trained during 2004 and 2006 in Mzuzu, Malawi received continuing training courses. Their reproductive knowledge was assessed by a structured questionnaire during 2004 and 2007. A multivariate generalised estimating equation (GEE) model was constructed to determine the associations between their reproductive knowledge scores and age, years of education, time since the last training course, test frequency and number of babies delivered. from July 2004 to June 2007, a total of 1984 pregnant women visited these trained TBAs. A total of 79 (4.0%) mothers were referred to health facilities before the birth due to first-born or difficult pregnancies. No maternal deaths occurred among the remaining mothers. There were 26 deaths among 1905 newborn babies, giving a perinatal mortality rate of 13.6 per 1000 live births. The GEE model demonstrated that knowledge scores of TBAs were significantly higher for TBAs under the age of 45 years, TBAs with more than five years of education, TBAs who had taken a training course within one year, and TBAs with a higher test frequency. continuing training courses are effective to maintain the reproductive knowledge and performance of trained TBAs. It is recommended that continuing training should be offered regularly, at least annually. Copyright © 2010 Elsevier Ltd. All rights reserved.

Trends in suicide from drug overdose in the elderly in England and Wales, 1993-1999.

PubMed

Shah, Rajen; Uren, Zoë; Baker, Allan; Majeed, Azeem

2002-05-01

Drug overdose is a common method of suicide in the elderly. Hence, an understanding of current trends in epidemiology of these deaths is important when considering measures to decrease suicide rates. Analysis of the Office for National Statistics (ONS) database of deaths from overdose and poisoning. Suicide and undetermined deaths from drug overdose between 1993-1999 in the over 65 year olds were studied. Socio-demographic data from the four drug groups most commonly used in overdose were extracted, and age and sex specific mortality rates calculated. Enumeration districts were ranked into five quintiles based on their Carstairs scores, and death rates in each quintile for men and women calculated. There were 1864 deaths from drug overdose during the study period. Suicide and undetermined death rates from drug overdose remained stable between 1993-1999. Drugs most commonly used in overdose were (in order) paracetamol (and related compounds), benzodiazepines, antidepressants, and opiates. Women comprised 62% of deaths. Death rates increased with age, with highest rates in men over 75 (37.7 deaths per million). Benzodiazepines showed the most marked increase with age. Co-proxamol comprised 32% of deaths from paracetamol compounds, and 95% of antidepressant deaths were due to tricyclic antidepressants. There was no association in women between Carstairs area deprivation and suicide rates; in men rates were highest in the most deprived areas. Suicides in the over 65 year olds may be decreased by changes in prescription practice. Paracetamol, co-proxamol, tricyclic antidepressants and benzodiazepines should be prescribed with caution to the elderly with depression or at high risk of depression. Copyright 2002 John Wiley & Sons, Ltd.

38 CFR 3.666 - Incarcerated beneficiaries and fugitive felons-pension.

Code of Federal Regulations, 2013 CFR

2013-07-01

... child is such that death pension would be payable. (3) At the rate payable under the death pension law... the rate of death pension payable if there were no such surviving spouse; or (2) If a child is disqualified, to a surviving spouse or other child or children at the rate of death pension payable if there...

38 CFR 3.666 - Incarcerated beneficiaries and fugitive felons-pension.

Code of Federal Regulations, 2012 CFR

2012-07-01

... child is such that death pension would be payable. (3) At the rate payable under the death pension law... the rate of death pension payable if there were no such surviving spouse; or (2) If a child is disqualified, to a surviving spouse or other child or children at the rate of death pension payable if there...

38 CFR 3.666 - Incarcerated beneficiaries and fugitive felons-pension.

Code of Federal Regulations, 2011 CFR

2011-07-01

... child is such that death pension would be payable. (3) At the rate payable under the death pension law... the rate of death pension payable if there were no such surviving spouse; or (2) If a child is disqualified, to a surviving spouse or other child or children at the rate of death pension payable if there...

38 CFR 3.666 - Incarcerated beneficiaries and fugitive felons-pension.

Code of Federal Regulations, 2010 CFR

2010-07-01

... child is such that death pension would be payable. (3) At the rate payable under the death pension law... the rate of death pension payable if there were no such surviving spouse; or (2) If a child is disqualified, to a surviving spouse or other child or children at the rate of death pension payable if there...

38 CFR 3.666 - Incarcerated beneficiaries and fugitive felons-pension.

Code of Federal Regulations, 2014 CFR

2014-07-01

... child is such that death pension would be payable. (3) At the rate payable under the death pension law... the rate of death pension payable if there were no such surviving spouse; or (2) If a child is disqualified, to a surviving spouse or other child or children at the rate of death pension payable if there...

Exposing misclassified HIV/AIDS deaths in South Africa

PubMed Central

Birnbaum, Jeanette Kurian; Murray, Christopher JL

2011-01-01

Abstract Objective To quantify the deaths from human immunodeficiency virus (HIV) infection or acquired immunodeficiency syndrome (AIDS) that are misattributed to other causes in South Africa’s death registration data and to adjust for this bias. Methods Deaths in the World Health Organization’s mortality database were distributed among 48 mutually exclusive causes. For each cause, age- and sex-specific global death rates were compared with the average rate among people aged 65–69, 70–74 and 75–79 years to generate “relative” global death rates. Relative rates were also computed for South Africa alone. Differences between global and South African relative death rates were used to identify the causes to which deaths from HIV/AIDS were misattributed in South Africa and quantify the HIV/AIDS deaths misattributed to each. These deaths were then reattributed to HIV/AIDS. Findings In South Africa, deaths from HIV/AIDS are often misclassified as being caused by 14 other conditions. Whereas in 1996–2006 deaths attributed to HIV/AIDS accounted for 2.0–2.5% of all registered deaths in South Africa, our analysis shows that the true cause-specific mortality fraction rose from 19% (uncertainty range: 7–28%) to 48% (uncertainty range: 38–50%) over that period. More than 90% of HIV/AIDS deaths were found to have been misattributed to other causes during 1996–2006. Conclusion Adjusting for cause of death misclassification, a simple procedure that can be carried out in any country, can improve death registration data and provide empirical estimates of HIV/AIDS deaths that may be useful in assessing estimates from demographic models. PMID:21479092

Mortality from cystic fibrosis in Europe: 1994-2010.

PubMed

Quintana-Gallego, Esther; Ruiz-Ramos, Miguel; Delgado-Pecellin, Isabel; Calero, Carmen; Soriano, Joan B; Lopez-Campos, Jose Luis

2016-02-01

To date, available mortality trends due to cystic fibrosis (CF) have been limited to the analysis of certain countries in different parts of the world showing that mortality trends have been constantly decreasing. However, no studies have examined Europe as a whole. The present study aims to analyze CF mortality trends by gender within the European Union (EU) and to quantify potential years of life lost (PYLL). Deaths from the 27 EU countries were obtained from the statistical office of the EU from the years 1994-2010. Crude and age-standardized mortality rates (ASR) were estimated for women and men using the standard European population, expressed in deaths per 1,000,000 persons. The PYLL from ages 0 up to 30 years were estimated. Trends were studied by a joinpoint regression analysis. During the study period, 5,130 deaths (2,443 in males and 2,687 in females) were identified. Females had a slightly higher mortality rate than males, with a downward trend observed for both genders. In males, the ASR changed from 1.34 in 1994 to 1.03 in 2010. In females, the ASR changed from 1.42 in 1994 to 0.92 in 2010. The mean age at death and PYLL increased for both genders. The joinpoint analysis did not identify any significant joinpoint for either gender for ASR or PYLL. Our data suggest a continued downward trend of CF mortality throughout the EU, with differences by country and gender. © 2015 Wiley Periodicals, Inc.

Inhibitors of Cytotoxic T Lymphocyte Antigen 4 and Programmed Death 1/Programmed Death 1 Ligand for Metastatic Melanoma, Dual Versus Monotherapy-Summary of Advances and Future Directions for Studying These Drugs.

PubMed

Loo, Kimberly; Daud, Adil I

Immense progress in the field of cancer immunotherapy has garnered several novel and successful treatments for metastatic melanoma. Beginning with therapies targeting cytotoxic T lymphocyte antigen 4 (CTLA-4), objective response rates, overall survival, and long-term survival were significantly increased when compared with glycoprotein 100 vaccine therapies. Expanding the breadth of therapies aimed to "release the breaks" on the active immune system, anti-programmed death 1 (PD-1) and anti-programmed death 1 ligand (PD-L1) therapies further improved overall survival, progression-free survival, and objective tumor response while exhibiting more favorable safety profiles compared with ipilimumab and to chemotherapy agents. Given the power of these agents as monotherapies, a combination approach sought to combine the anti-CTLA agent ipilimumab and anti-PD-1 agent, nivolumab, to form a double-pronged attack and target several mechanisms within the active immune system. Given the promise in elevated response rates and progression-free survival, the future appears promising along the immunotherapy front. Continuing the push for progress, biomarkers to uncover the profile of responders to the various therapies will become vital in the treatment of metastatic melanoma patients. Here, we highlight the advances of CTLA-4 and PD-1/PD-L1 inhibitors in the metastatic melanoma setting and discuss future directions for uncovering the full potential of these therapies.

Suicide and undetermined violent deaths in Malaysia, 1966-1990: evidence for the misclassification of suicide statistics.

PubMed

Maniam, T

1995-01-01

Suicide statistics are generally recognised to be unreliable. This study of the reported rates of suicide in West Malaysia between 1966-1990 shows that the mean crude suicide rate between 1966-1974 was 6.1 per 100,000, but had dropped drastically between 1975-1990 to a mean of 1.6 per 100,000. Three lines of evidence are presented to show that this reduction in the suicide rate is due to a systematic misclassification of medically certified suicides as deaths due to undetermined violent deaths (which refers to violent deaths not known to be accidentally or deliberately inflicted). Firstly, the large drop in reported suicide rates corresponds closely to an increase in the rate of deaths due to undetermined violent deaths. There is a highly positive negative correlation between the two rates (coefficient of correlation, r = -0.9). Secondly, the misclassification appears to be mainly a problem with the medically certified deaths which follow the ICD classification. The mean ratio of uncertified to certified suicides before 1975 was 0.8, but from 1975 onwards the mean was 3.1. This is in contrast to the corresponding ratio for deaths due to all accidents which has remained fairly constant throughout these years. Thirdly, the race and sex differences for the rates of undetermined violent deaths are identical to those of suicide. Taking the misclassification into account the corrected suicide rate for West Malaysia is estimated to be between 8-13 per 100,000 since 1982.

Motor neuron disease mortality and lifetime petrol lead exposure: Evidence from national age-specific and state-level age-standardized death rates in Australia.

PubMed

Zahran, Sammy; Laidlaw, Mark A S; Rowe, Dominic B; Ball, Andrew S; Mielke, Howard W

2017-02-01

The age standardized death rate from motor neuron disease (MND) for persons 40-84 years of age in the Australian States of New South Wales, Victoria, and Queensland increased dramatically from 1958 to 2013. Nationally, age-specific MND death rates also increased over this time period, but the rate of the rise varied considerably by age-group. The historic use of lead (Pb) additives in Australian petrol is a candidate explanation for these trends in MND mortality (International Classification of Disease (ICD)-10 G12.2). Leveraging temporal and spatial variation in petrol lead exposure risk resulting from the slow rise and rapid phase-out of lead as a constituent in gasoline in Australia, we analyze relationships between (1) national age-specific MND death rates in Australia and age-specific lifetime petrol lead exposure, (2) annual between-age dispersions in age-specific MND death rates and age-specific lifetime petrol lead exposure; and (3) state-level age-standardized MND death rates as a function of age-weighted lifetime petrol lead exposure. Other things held equal, we find that a one percent increase in lifetime petrol lead exposure increases the MND death rate by about one-third of one percent in both national age-specific and state-level age-standardized models of MND mortality. Lending support to the supposition that lead exposure is a driver of MND mortality risk, we find that the annual between-age group standard deviation in age-specific MND death rates is strongly correlated with the between-age standard deviation in age-specific lifetime petrol lead exposure. Legacy petrol lead emissions are associated with age-specific MND death rates as well as state-level age-standardized MND death rates in Australia. Results indicate that we are approaching peak lead exposure-attributable MND mortality. Copyright © 2016 Elsevier Inc. All rights reserved.

Racial Differences in Accidental and Violent Deaths Among U.S. Navy Personnel

DTIC Science & Technology

1984-10-01

for accidental injuries than whites; i O bjective The objective of this study was to examine the death rates of black and white enlisted personnel...pre-servIce soclo- cultural factors may play a role in accounting for the high death rates among older black .males. It is suggested, however, that...all deaths of personnel diagnosed as having injuries due to accidents, poisonings and violence (ICDA-8 codes 800.0 -. 999.9). Death rates were

Chronic Radiation Sickness Among Techa Riverside Residents

DTIC Science & Technology

1998-02-01

people with CRS. Consequently, data listed below are considered tentative; they can- 19 1 0.3 not be used to calculate death rates nor to analyze 20...age cohort 0-14 years Death rates for patients with diagnosed CRS were from the control group; the same age cohort is ab- studied by the cohort method...mortality contains age-specific archives of the civil registrars confirmed the deaths. death rates . Copies were made of the death certificates for de- ceased

Effect of aliskiren on postdischarge mortality and heart failure readmissions among patients hospitalized for heart failure: the ASTRONAUT randomized trial.

PubMed

Gheorghiade, Mihai; Böhm, Michael; Greene, Stephen J; Fonarow, Gregg C; Lewis, Eldrin F; Zannad, Faiez; Solomon, Scott D; Baschiera, Fabio; Botha, Jaco; Hua, Tsushung A; Gimpelewicz, Claudio R; Jaumont, Xavier; Lesogor, Anastasia; Maggioni, Aldo P

2013-03-20

Hospitalizations for heart failure (HHF) represent a major health burden, with high rates of early postdischarge rehospitalization and mortality. To investigate whether aliskiren, a direct renin inhibitor, when added to standard therapy, would reduce the rate of cardiovascular (CV) death or HF rehospitalization among HHF patients. International, double-blind, placebo-controlled study that randomized hemodynamically stable HHF patients a median 5 days after admission. Eligible patients were 18 years or older with left ventricular ejection fraction (LVEF) 40% or less, elevated natriuretic peptides (brain natriuretic peptide [BNP] ≥ 400 pg/mL or N -terminal pro-BNP [NT-proBNP] ≥ 1600 pg/mL), and signs and symptoms of fluid overload. Patients were recruited from 316 sites across North and South America, Europe, and Asia between May 2009 and December 2011. The follow-up period ended in July 2012. All patients received 150 mg (increased to 300 mg as tolerated) of aliskiren or placebo daily, in addition to standard therapy. The study drug was continued after discharge for a median 11.3 months. MAIN OUTCOME MEASURES Cardiovascular death or HF rehospitalization at 6 months and 12 months. In total, 1639 patients were randomized, with 1615 patients included in the final efficacy analysis cohort (808 aliskiren, 807 placebo). Mean age was 65 years; mean LVEF, 28%; 41% of patients had diabetes mellitus, mean estimated glomerular filtration rate, 67 mL/min/1.73 m2. At admission and randomization, median NT-proBNP levels were 4239 pg/mL and 2718 pg/mL, respectively. At randomization, patients were receiving diuretics (95.9%), β-blockers (82.5%), angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers (84.2%), and mineralocorticoid receptor antagonists (57.0%). In total, 24.9% of patients receiving aliskiren (77 CV deaths, 153 HF rehospitalizations) and 26.5% of patients receiving placebo (85 CV deaths, 166 HF rehospitalizations) experienced the primary end point at 6 months (hazard ratio [HR], 0.92; 95% CI, 0.76-1.12; P = .41). At 12 months, the event rates were 35.0% for the aliskiren group (126 CV deaths, 212 HF rehospitalizations) and 37.3% for the placebo group (137 CV deaths, 224 HF rehospitalizations; HR, 0.93; 95% CI, 0.79-1.09; P = .36). The rates of hyperkalemia, hypotension, and renal impairment/renal failure were higher in the aliskiren group compared with placebo. Among patients hospitalized for HF with reduced LVEF, initiation of aliskiren in addition to standard therapy did not reduce CV death or HF rehospitalization at 6 months or 12 months after discharge. clinicaltrials.gov Identifier: NCT00894387.

Palliative Sedation in Terminal Cancer Patients Admitted to Hospice or Home Care Programs: Does the Setting Matter? Results From a National Multicenter Observational Study.

PubMed

Caraceni, Augusto; Speranza, Raffaella; Spoldi, Elio; Ambroset, Cristina Sonia; Canestrari, Stefano; Marinari, Mauro; Marzi, Anna Maria; Orsi, Luciano; Piva, Laura; Rocchi, Mirta; Valenti, Danila; Zeppetella, Gianluigi; Zucco, Furio; Raimondi, Alessandra; Matos, Leonor Vasconcelos; Brunelli, Cinzia

2018-03-13

Few studies regarding palliative sedation (PS) have been carried out in home care (HC) setting. A comparison of PS rate and practices between hospice (HS) and HC is also lacking. Comparing HC and HS settings for PS rate, patient clinical characteristics before and during PS, decision-making process, and clinical aspects of PS. About 38 HC/HS services in Italy participated in a multicenter observational longitudinal study. Consecutive adult cancer patients followed till death during a four-month period and undergoing PS were eligible. Symptom control and level of consciousness were registered every eight hours to death. About 4276 patients were screened, 2894 followed till death, and 531 (18%) underwent PS. PS rate was 15% in HC and 21% in HS (P < 0.001). Principal refractory symptoms were delirium (54%) and dyspnea (45%), respectively, more common in HC (P < 0.001) and HS (P = 0.03). Informed consent was not obtained in 72% of patients but achieved by 96% of families. Midazolam was the most used drug (94% HS vs. 75% HC; P < 0.001) mainly by continuous infusion (74% HC vs. 89% HS; P < 0.001). PS duration was less than 48 hours in 67% of patients. Hydration during PS was less frequent in HC (27% vs. 49%; P < 0.001). In the eight hours before death, consciousness level was unrousable to mild physical stimulation in 81% and symptom control complete in 89% of cases. Our results show feasibility of PS in HC and HS and suggest setting differences in rates, indications, and practice of PS, possibly related to patients' selection or care organization. Copyright © 2018 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

Birth/birth-death processes and their computable transition probabilities with biological applications.

PubMed

Ho, Lam Si Tung; Xu, Jason; Crawford, Forrest W; Minin, Vladimir N; Suchard, Marc A

2018-03-01

Birth-death processes track the size of a univariate population, but many biological systems involve interaction between populations, necessitating models for two or more populations simultaneously. A lack of efficient methods for evaluating finite-time transition probabilities of bivariate processes, however, has restricted statistical inference in these models. Researchers rely on computationally expensive methods such as matrix exponentiation or Monte Carlo approximation, restricting likelihood-based inference to small systems, or indirect methods such as approximate Bayesian computation. In this paper, we introduce the birth/birth-death process, a tractable bivariate extension of the birth-death process, where rates are allowed to be nonlinear. We develop an efficient algorithm to calculate its transition probabilities using a continued fraction representation of their Laplace transforms. Next, we identify several exemplary models arising in molecular epidemiology, macro-parasite evolution, and infectious disease modeling that fall within this class, and demonstrate advantages of our proposed method over existing approaches to inference in these models. Notably, the ubiquitous stochastic susceptible-infectious-removed (SIR) model falls within this class, and we emphasize that computable transition probabilities newly enable direct inference of parameters in the SIR model. We also propose a very fast method for approximating the transition probabilities under the SIR model via a novel branching process simplification, and compare it to the continued fraction representation method with application to the 17th century plague in Eyam. Although the two methods produce similar maximum a posteriori estimates, the branching process approximation fails to capture the correlation structure in the joint posterior distribution.

Trends in heroin and pharmaceutical opioid overdose deaths in Australia.

PubMed

Roxburgh, Amanda; Hall, Wayne D; Dobbins, Timothy; Gisev, Natasa; Burns, Lucinda; Pearson, Sallie; Degenhardt, Louisa

2017-10-01

There has been international concern over the rise in fatal pharmaceutical opioid overdose rates, driven by increased opioid analgesic prescribing. The current study aimed to examine trends in opioid overdose deaths by: 1) opioid type (heroin and pharmaceutical opioids); and 2) age, gender, and intent of the death assigned by the coroner. Analysis of data from the National Coronial Information System (NCIS) of opioid overdose deaths occurring between 2001 and 2012. Deaths occurred predominantly (98%) among Australians aged 15-74 years. Approximately two-thirds of the decedents (68%) were male. The heroin overdose death rate remains unchanged over the period; these were more likely to occur among males. Pharmaceutical opioid overdose deaths increased during the study period (from 21.9 per million population in 2001-36.2), and in 2012 they occurred at 2.5 times the incident rate of heroin overdose deaths. Increases in pharmaceutical opioid deaths were largely driven by accidental overdoses. They were more likely to occur among males than females, and highest among Australians aged 45-54 years. Rates of fentanyl deaths in particular showed an increase over the study period (from a very small number at the beginning of the period) but in 2012 rates of morphine deaths were higher than those for oxycodone, fentanyl and tramadol. Given the increase in rates of pharmaceutical opioid overdose deaths, it is imperative to implement strategies to reduce pharmaceutical opioid-related mortality, including more restrictive prescribing practices and increasing access to treatment for opioid dependence. Copyright © 2017 Elsevier B.V. All rights reserved.

Frequency distributions from birth, death, and creation processes.

PubMed

Bartley, David L; Ogden, Trevor; Song, Ruiguang

2002-01-01

The time-dependent frequency distribution of groups of individuals versus group size was investigated within a continuum approximation, assuming a simplified individual growth, death and creation model. The analogy of the system to a physical fluid exhibiting both convection and diffusion was exploited in obtaining various solutions to the distribution equation. A general solution was approximated through the application of a Green's function. More specific exact solutions were also found to be useful. The solutions were continually checked against the continuum approximation through extensive simulation of the discrete system. Over limited ranges of group size, the frequency distributions were shown to closely exhibit a power-law dependence on group size, as found in many realizations of this type of system, ranging from colonies of mutated bacteria to the distribution of surnames in a given population. As an example, the modeled distributions were successfully fit to the distribution of surnames in several countries by adjusting the parameters specifying growth, death and creation rates.

Where there's smoking, there's fire: the effects of smoking policies on the incidence of fires in the USA.

PubMed

Markowitz, Sara

2014-11-01

Fires and burns are among the leading causes of unintentional death in the USA. Most of these deaths occur in residences, and cigarettes are a primary cause. In this paper, I explore the relationship between smoking, cigarette policies, and fires. As smoking rates decline, there are fewer opportunities for fires; however, the magnitude of any reduction is in question. Using a state-level panel, I find that increases in cigarette prices are associated with fewer residential fires and deaths. However, laws regulating indoor smoking are associated with more fires; in particular, restaurant and bar smoking bans are associated with an increase in fires at eating and drinking establishments. This increase is important given the growing popularity of smoking bans in the USA and around the world. As workplaces, schools, and businesses ban smoking and remove ashtrays, smokers who continue to smoke are left without safe options for disposal of cigarettes, leading to more opportunities for fires to start. Copyright © 2013 John Wiley & Sons, Ltd.

Health issues in the Arab American community. Commentary on tobacco: the world's leading cause of cancer.

PubMed

Seffrin, John R

2007-01-01

Cancer incidence is on the rise in many regions of the world, including the Middle East, where incidence rates for both men and women are increasing. Like many regions of the world, increased tobacco use, combined with other factors, is driving cancer incidence in the Middle East. Tobacco, the only consumer product proven to kill more than half of its regular users, will be responsible for 4.9 million deaths worldwide this year alone. That burden is fairly evenly shared by industrialized and developing nations today but, if current trends continue, the cancer burden in the developing world will more than triple in the next 25 years, resulting in a global total of 10 million deaths worldwide each year. Seven million of these deaths will occur in the developing world, in nations least prepared to deal with the financial, social, and political consequences of this global public health tragedy. In the Arab world, lung cancer is already occurring with increasing frequency, particularly among men.

Variability of undetermined manner of death classification in the US.

PubMed

Breiding, M J; Wiersema, B

2006-12-01

To better understand variations in classification of deaths of undetermined intent among states in the National Violent Death Reporting System (NVDRS). Data from the NVDRS and the National Vital Statistics System were used to compare differences among states. Percentages of deaths assigned undetermined intent, rates of deaths of undetermined intent, rates of fatal poisonings broken down by cause of death, composition of poison types within the undetermined-intent classification. Three states within NVDRS (Maryland, Massachusetts, and Rhode Island) evidenced increased numbers of deaths of undetermined intent. These same states exhibited high rates of undetermined death and, more specifically, high rates of undetermined poisoning deaths. Further, these three states evidenced correspondingly lower rates of unintentional poisonings. The types of undetermined poisonings present in these states, but not present in other states, are typically the result of a combination of recreational drugs, alcohol, or prescription drugs. The differing classification among states of many poisoning deaths has implications for the analysis of undetermined deaths within the NVDRS and for the examination of possible/probable suicides contained within the undetermined- or accidental-intent classifications. The NVDRS does not collect information on unintentional poisonings, so in most states data are not collected on these possible/probable suicides. The authors believe this is an opportunity missed to understand the full range of self-harm deaths in the greater detail provided by the NVDRS system. They advocate a broader interpretation of suicide to include the full continuum of deaths resulting from self-harm.

Vital signs: restraint use and motor vehicle occupant death rates among children aged 0-12 years - United States, 2002-2011.

PubMed

Sauber-Schatz, Erin K; West, Bethany A; Bergen, Gwen

2014-02-07

Motor vehicle crashes are a leading cause of death among children in the United States. Age- and size-appropriate child restraint use is the most effective method for reducing these deaths. CDC analyzed 2002–2011 data from the Fatality Analysis Reporting System to determine the number and rate of motor-vehicle occupant deaths, and the proportion of unrestrained child deaths among children aged <1 year, 1–3 years , 4–7 years, 8–12 years, and for all children aged 0–12 years. Age group–specific death rates and proportions of unrestrained child motor vehicle deaths for 2009–2010 were further stratified by race/ethnicity. Motor vehicle occupant death rates for children declined significantly from 2002 to 2011. However, one third (33%) of children who died in 2011 were unrestrained. Compared with white children for 2009–2010, black children had significantly higher death rates, and black and Hispanic children both had significantly higher proportions of unrestrained child deaths. Motor vehicle occupant deaths among children in the United States have declined in the past decade, but more deaths could be prevented if restraints were always used. Effective interventions, including child passenger restraint laws (with child safety seat/ booster seat coverage through at least age 8 years) and child safety seat distribution plus education programs, can increase restraint use and reduce child motor vehicle deaths.

Vital Signs: Restraint Use and Motor Vehicle Occupant Death Rates Among Children Aged 0–12 Years — United States, 2002–2011

PubMed Central

Sauber-Schatz, Erin K.; West, Bethany A.; Bergen, Gwen

2014-01-01

Background Motor vehicle crashes are a leading cause of death among children in the United States. Age- and size-appropriate child restraint use is the most effective method for reducing these deaths. Methods CDC analyzed 2002–2011 data from the Fatality Analysis Reporting System to determine the number and rate of motor-vehicle occupant deaths, and the proportion of unrestrained child deaths among children aged <1 year, 1–3 years, 4–7 years, 8–12 years, and for all children aged 0–12 years. Age group–specific death rates and proportions of unrestrained child motor vehicle deaths for 2009–2010 were further stratified by race/ethnicity. Results Motor vehicle occupant death rates for children declined significantly from 2002 to 2011. However, one third (33%) of children who died in 2011 were unrestrained. Compared with white children for 2009–2010, black children had significantly higher death rates, and black and Hispanic children both had significantly higher proportions of unrestrained child deaths. Conclusions Motor vehicle occupant deaths among children in the United States have declined in the past decade, but more deaths could be prevented if restraints were always used. Implications for Public Health Effective interventions, including child passenger restraint laws (with child safety seat/booster seat coverage through at least age 8 years) and child safety seat distribution plus education programs, can increase restraint use and reduce child motor vehicle deaths. PMID:24500292

Chronic Liver Disease and American Indians/Alaska Natives

MedlinePlus

... www.cdc.gov/nchs/nhis/shs/tables.htm Death Rate Cancer Death Rates per 100,000 – Men (2009-2013) Cancer: ... Counties 4.8 7.8 0.6 Cancer Death Rates per 100,000 – Women (2009-2013) Cancer: ...

Ergodicity bounds for birth-death processes with particularities

NASA Astrophysics Data System (ADS)

Zeifman, Alexander I.; Satin, Yacov; Korotysheva, Anna; Shilova, Galina; Kiseleva, Ksenia; Korolev, Victor Yu.; Bening, Vladimir E.; Shorgin, Sergey Ya.

2016-06-01

We introduce an inhomogeneous birth-death process with birth rates λk(t), death rates µk(t), and possible transitions to/from zero with rates βk(t), rk(t) respectively, and obtain ergodicity bounds for this process.

Quantifying cause-related mortality by weighting multiple causes of death

PubMed Central

Moreno-Betancur, Margarita; Lamarche-Vadel, Agathe; Rey, Grégoire

2016-01-01

Abstract Objective To investigate a new approach to calculating cause-related standardized mortality rates that involves assigning weights to each cause of death reported on death certificates. Methods We derived cause-related standardized mortality rates from death certificate data for France in 2010 using: (i) the classic method, which considered only the underlying cause of death; and (ii) three novel multiple-cause-of-death weighting methods, which assigned weights to multiple causes of death mentioned on death certificates: the first two multiple-cause-of-death methods assigned non-zero weights to all causes mentioned and the third assigned non-zero weights to only the underlying cause and other contributing causes that were not part of the main morbid process. As the sum of the weights for each death certificate was 1, each death had an equal influence on mortality estimates and the total number of deaths was unchanged. Mortality rates derived using the different methods were compared. Findings On average, 3.4 causes per death were listed on each certificate. The standardized mortality rate calculated using the third multiple-cause-of-death weighting method was more than 20% higher than that calculated using the classic method for five disease categories: skin diseases, mental disorders, endocrine and nutritional diseases, blood diseases and genitourinary diseases. Moreover, this method highlighted the mortality burden associated with certain diseases in specific age groups. Conclusion A multiple-cause-of-death weighting approach to calculating cause-related standardized mortality rates from death certificate data identified conditions that contributed more to mortality than indicated by the classic method. This new approach holds promise for identifying underrecognized contributors to mortality. PMID:27994280

Cost of Racial Disparity in Preterm Birth: Evidence from Michigan

PubMed Central

Xu, Xiao; Grigorescu, Violanda; Siefert, Kristine A.; Lori, Jody R.; Ransom, Scott B.

2009-01-01

This study examined the economic costs associated with racial disparity in preterm birth and preterm fetal death in Michigan. Linked 2003 Michigan vital statistics and hospital discharge data were used for data analysis. Thirteen percent of the singleton births among non-Hispanic Blacks were before 37 completed weeks of gestation, compared to only 7.7% among non-Hispanic Whites (risk ratio = 1.66, 95% confidence interval: 1.59-1.72; p<0.0001). One thousand one hundred and eighty four non-Hispanic Black, singleton preterm births and preterm fetal deaths would have been avoided in 2003 had their preterm birth rate been the same as Michigan non-Hispanic Whites. Economic costs associated with these excess Black preterm births and preterm fetal deaths amounted to $329 million (range: $148 million - $598 million) across their lifespan over and above the costs if they were born at term, including costs associated with the initial hospitalization, productivity loss due to perinatal death, and major developmental disabilities. Hence, racial disparity in preterm birth and preterm fetal death has substantial cost implications for society. Improving pregnancy outcomes for African American women and reducing the disparity between Blacks and Whites should continue to be a focus of future research and interventions. PMID:19648701

Killer Whale (Orcinus orca) Deaths in Prince William Sound, Alaska, 1985–1990

PubMed Central

Fraker, Mark A.

2013-01-01

During 1985–1990, two groups of killer whales in Prince William Sound, Alaska, experienced unusually high rates of mortality, while seven others did not. Those affected were AB pod, part of the southern Alaska population of resident (fish-eating) killer whales, and the AT1 transient (marine mammal–eating) group, a very small, reproductively isolated population that last reproduced in 1984. In 1985–1986, several AB pod members were shot by fishermen defending their catch from depredation, which explains some of the deaths. Understanding the other deaths is complicated by the Exxon Valdez oil spill (March 1989) and uncertainties about the causes and times of the deaths. For AB pod, possible factors involved in the post-spill mortalities are delayed effects of bullet wounds, continued shooting, oil exposure, and consequences of being orphaned. For the AT1 group, possible factors are oil exposure, small population size, old age, and high-contaminant burdens. An analysis of possible effects of inhalation of volatile organic compounds, contact with the oil slick, and ingestion of oil with water or prey did not reveal route(s) of exposure that could explain the mortalities. The cause(s) of the killer whale deaths recorded following the oil spill remain uncertain. PMID:23335844

Tobacco Policies in Louisiana: Recommendations for Future Tobacco Control Investment from SimSmoke, a Policy Simulation Model.

PubMed

Levy, David; Fergus, Cristin; Rudov, Lindsey; McCormick-Ricket, Iben; Carton, Thomas

2016-02-01

Despite the presence of tobacco control policies, Louisiana continues to experience a high smoking burden and elevated smoking-attributable deaths. The SimSmoke model provides projections of these health outcomes in the face of existing and expanded (simulated) tobacco control polices. The SimSmoke model utilizes population data, smoking rates, and various tobacco control policy measures from Louisiana to predict smoking prevalence and smoking-attributable deaths. The model begins in 1993 and estimates are projected through 2054. The model is validated against existing Louisiana smoking prevalence data. The most powerful individual policy measure for reducing smoking prevalence is cigarette excise tax. However, a comprehensive cessation treatment policy is predicted to save the most lives. A combination of tobacco control policies provides the greatest reduction in smoking prevalence and smoking-attributable deaths. The existing Louisiana excise tax ranks as one of the lowest in the country and the legislature is against further increases. Alternative policy measures aimed at lowering prevalence and attributable deaths are: cessation treatments, comprehensive smoke-free policies, and limiting youth access. These three policies have a substantial effect on smoking prevalence and attributable deaths and are likely to encounter more favor in the Louisiana legislature than increasing the state excise tax.

Relation of Total and Cardiovascular Death Rates to Climate System, Temperature, Barometric Pressure, and Respiratory Infection.

PubMed

Schwartz, Bryan G; Qualls, Clifford; Kloner, Robert A; Laskey, Warren K

2015-10-15

A distinct seasonal pattern in total and cardiovascular death rates has been reported. The factors contributing to this pattern have not been fully explored. Seven locations (average total population 71,354,000) were selected where data were available including relatively warm, cold, and moderate temperatures. Over the period 2004 to 2009, there were 2,526,123 all-cause deaths, 838,264 circulatory deaths, 255,273 coronary heart disease deaths, and 135,801 ST-elevation myocardial infarction (STEMI) deaths. We used time series and multivariate regression modeling to explore the association between death rates and climatic factors (temperature, dew point, precipitation, barometric pressure), influenza levels, air pollution levels, hours of daylight, and day of week. Average seasonal patterns for all-cause and cardiovascular deaths were very similar across the 7 locations despite differences in climate. After adjusting for multiple covariates and potential confounders, there was a 0.49% increase in all-cause death rate for every 1°C decrease. In general, all-cause, circulatory, coronary heart disease and STEMI death rates increased linearly with decreasing temperatures. The temperature effect varied by location, including temperature's linear slope, cubic fit, positional shift on the temperature axis, and the presence of circulatory death increases in locally hot temperatures. The variable effect of temperature by location suggests that people acclimatize to local temperature cycles. All-cause and circulatory death rates also demonstrated sizable associations with influenza levels, dew point temperature, and barometric pressure. A greater understanding of how climate, temperature, and barometric pressure influence cardiovascular responses would enhance our understanding of circulatory and STEMI deaths. Copyright © 2015 Elsevier Inc. All rights reserved.

Socio-demographic diversity and unexplained variation in death rates among the most deprived parliamentary constituencies in Britain.

PubMed

Tunstall, H; Mitchell, R; Gibbs, J; Platt, S; Dorling, D

2012-06-01

There is considerable unexplained variation in death rates between deprived areas of Britain. This analysis assesses the degree of variation in socio-demographic factors among deprivation deciles and how variables associated with deaths differ among the most deprived areas. Death rates 1996-2001, Carstairs' 2001 deprivation score and indicators, population density, black and minority ethnic group (BME) and population change 1971-2001 were calculated for 641 parliamentary constituencies in Britain. Constituencies were grouped into Carstairs' deciles. We assessed standard errors of all variables by decile and the relationship between death rates and socio-demographic variables with Pearson's correlations and linear regression by decile and for all constituencies combined. Standard errors in death rates and most socio-demographic variables were greatest for the most deprived decile. Death rates among all constituencies were positively correlated with Carstairs' score and indicators, density and BME, but for the most deprived decile, there was no association with Carstairs and a negative correlation with overcrowding, density and BME. For the most deprived decile multivariate models containing population density, BME and change had substantially higher R(2). Understanding variations in death rates between deprived areas requires greater consideration of their socio-demographic diversity including their population density, ethnicity and migration.

Comparison of Cross-Linked Hemoglobin Solution to Lactated Ringers and 5% Albumin in Resuscitation of a Rat Model of escherichia coli Septic Shock

DTIC Science & Technology

1993-08-01

and 0M. in BHI (0). 35 36 7 II I "I -. I 4I I .0 Z 2 L 0 1 2 3 4 5 6 7 Time (hours) Figure 10. Death Rate The Death Rates of 3 septic groups receiving...There were insufficient numbers of animals in each group to make statistical conclusions regarding death rates between groups. 37 38 7 _! 5 S o 2.0 Z 2...0 0 1 2 3 4 5 6 7 Time (hours) Figure 11. Death Rate Death rates of 3 septic groups receiving 40 cc/kg intravenous boluses of either 7

20 CFR 10.411 - What are the maximum and minimum rates of compensation in death cases?

Code of Federal Regulations, 2011 CFR

2011-04-01

... maximum and minimum rates of compensation in death cases? (a) Compensation for death may not exceed the... 20 Employees' Benefits 1 2011-04-01 2011-04-01 false What are the maximum and minimum rates of compensation in death cases? 10.411 Section 10.411 Employees' Benefits OFFICE OF WORKERS' COMPENSATION PROGRAMS...

20 CFR 10.411 - What are the maximum and minimum rates of compensation in death cases?

Code of Federal Regulations, 2013 CFR

2013-04-01

... maximum and minimum rates of compensation in death cases? (a) Compensation for death may not exceed the... 20 Employees' Benefits 1 2013-04-01 2012-04-01 true What are the maximum and minimum rates of compensation in death cases? 10.411 Section 10.411 Employees' Benefits OFFICE OF WORKERS' COMPENSATION PROGRAMS...

20 CFR 10.411 - What are the maximum and minimum rates of compensation in death cases?

Code of Federal Regulations, 2012 CFR

2012-04-01

... maximum and minimum rates of compensation in death cases? (a) Compensation for death may not exceed the... 20 Employees' Benefits 1 2012-04-01 2012-04-01 false What are the maximum and minimum rates of compensation in death cases? 10.411 Section 10.411 Employees' Benefits OFFICE OF WORKERS' COMPENSATION PROGRAMS...

20 CFR 10.411 - What are the maximum and minimum rates of compensation in death cases?

Code of Federal Regulations, 2014 CFR

2014-04-01

... maximum and minimum rates of compensation in death cases? (a) Compensation for death may not exceed the... 20 Employees' Benefits 1 2014-04-01 2012-04-01 true What are the maximum and minimum rates of compensation in death cases? 10.411 Section 10.411 Employees' Benefits OFFICE OF WORKERS' COMPENSATION PROGRAMS...

20 CFR 10.411 - What are the maximum and minimum rates of compensation in death cases?

Code of Federal Regulations, 2010 CFR

2010-04-01

... maximum and minimum rates of compensation in death cases? (a) Compensation for death may not exceed the... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false What are the maximum and minimum rates of compensation in death cases? 10.411 Section 10.411 Employees' Benefits OFFICE OF WORKERS' COMPENSATION PROGRAMS...

Examining the impact of introducing ICD-MM on observed trends in maternal mortality rates in the UK 2003-13.

PubMed

Knight, Marian; Nair, Manisha; Brocklehurst, Peter; Kenyon, Sara; Neilson, James; Shakespeare, Judy; Tuffnell, Derek; Kurinczuk, Jennifer J

2016-07-20

The causes of maternal death are now classified internationally according to ICD-MM. One significant change with the introduction of ICD-MM in 2012 was the reclassification of maternal suicide from the indirect group to the direct group. This has led to concerns about the impact of this reclassification on calculated mortality rates. The aim of this analysis was to examine the trends in maternal deaths in the UK over the past 10 years, and to investigate the impact of reclassification using ICD-MM on the observed rates. Data about all maternal deaths between 2003-13 in the UK were included in this analysis. Data about maternal deaths occurring prior to 2009 were obtained from previously published reports. The deaths of women from 2009-13 during or after pregnancy were identified through the MBRRACE-UK Confidential Enquiry into Maternal Deaths. The underlying causes of maternal death were reclassified from a disease-based system to ICD-MM. Maternal mortality rates with 95 % confidence intervals were calculated using national data on the number of maternities as the denominator. Rate ratios with 95 % CI were calculated to compare the change in rates of maternal death as per ICD-MM relative to the old classification system. There was a decrease in the maternal death rate between 2003-05 and 2011-13 (rate ratio (RR) 0.65; 95 % CI 0.54-0.77 comparing 2003-5 with 2011-13; p = 0.005 for trend over time). The direct maternal death rate calculated using the old classification decreased with a RR of 0.47 (95 % CI 0.34-0.63) when comparing 2011-13 with 2003-05; p = 0.005 for trend over time. Reclassification using ICD-MM made little material difference to the observed trend in direct maternal death rates, RR = 0.51 (95 % CI 0.39-0.68) when comparing 2003-5 with 2011-13; p = 0.005 for trend over time. The impact of reclassifying maternal deaths according to ICD-MM in the UK was minimal. However, such reclassification raises awareness of maternal suicides and hence is the first step to actions to prevent women dying by suicide in the future. Recognising and acknowledging these women's deaths is more important than concerns over the impact reclassification using ICD-MM might have on reported maternal death rates.

The effect of television news items on intimate partner violence murders.

PubMed

Vives-Cases, C; Torrubiano-Domínguez, J; Alvarez-Dardet, C

2009-12-01

This study has been carried out in order to explore the effect of the growing appearance of IPV in television news items on deaths by this cause. Ecological study based on 340 deaths by intimate partner violence (IPV) and 3733 television news items covering this topic on Spanish television channels (2003 and 2007). Logistic regression analysis was carried out. Dependent variable: the difference between the number of IPV deaths in the 7 days following a news item broadcast and the number of IPV deaths in the 7 days before a media item. This outcome variable was conceptualised as a binary variable: increase vs. no increase. days with IPV news items-in general, concerning deaths, measures or other IPV crimes. Adjusted variables: day of the week, month, year and public holidays. A small copycat effect was observed in the IPV murder rate (RR = 1.32, CI(95%) = 1.07 - 1.62) for IPV-related news item days compared with days without such news. This effect continued when information about deaths was broadcast (RR = 1.28, CI(95%) = 1.01 - 1.62). News items concerning measures (RR = 0.90, CI(95%) = 0.82 - 0.98) or other IPV crimes (0.84, CI(95%) = 0.82 - 0.98) were related to a lower possibility of an increase in deaths compared with days with death-related news. Given the results observed in the case of IPV-related news, there is an evident need to develop a journalistic style guide in order to determine what type of information is recommended due to the potential positive or negative effects.

Fatal dog attacks, 1989-1994.

PubMed

Sacks, J J; Lockwood, R; Hornreich, J; Sattin, R W

1996-06-01

To update data on fatal dog bites and see if past trends have continued. To merge data from vital records, the Humane Society of the United States, and searches of electronic news files. United States. U.S. residents dying in the U.S. from 1989 through 1994 from dog bites. We identified 109 dog bite-related fatalities, of which 57% were less than 10 years of age. The death rate for neonates was two orders of magnitude higher than for adults and the rate for children one order of magnitude higher. Of classifiable deaths, 22% involved an unrestrained dog off the owner's property, 18% involved a restrained dog on the owner's property, and 59% involved an unrestrained dog on the owner's property. Eleven attacks involved a sleeping infant; 19 dogs involved in fatal attacks had a prior history of aggression; and 19 of 20 classifiable deaths involved an unneutered dog. Pit bulls, the most commonly reported breed, were involved in 24 deaths; the next most commonly reported breeds were rottweilers (16) and German shepherds (10). The dog bite problem should be reconceptualized as a largely preventable epidemic. Breed-specific approaches to the control of dog bites do not address the issue that many breeds are involved in the problem and that most of the factors contributing to dog bites are related to the level of responsibility exercised by dog owners. To prevent dog bite-related deaths and injuries, we recommend public education about responsible dog ownership and dog bite prevention, stronger animal control laws, better resources for enforcement of these laws, and better reporting of bites. Anticipatory guidance by pediatric health care providers should address dog bite prevention.

Is there progress toward eliminating racial/ethnic disparities in the leading causes of death?

PubMed

Keppel, Kenneth G; Pearcy, Jeffrey N; Heron, Melonie P

2010-01-01

We examined changes in relative disparities between racial/ethnic populations for the five leading causes of death in the United States from 1990 to 2006. The study was based on age-adjusted death rates for four racial/ethnic populations from 1990-1998 and 1999-2006. We compared the percent change in death rates over time between racial/ethnic populations to assess changes in relative differences. We also computed an index of disparity to assess changes in disparities relative to the most favorable group rate. Except for stroke deaths from 1990 to 1998, relative disparities among racial/ethnic populations did not decline between 1990 and 2006. Disparities among racial/ethnic populations increased for heart disease deaths from 1999 to 2006, for chronic obstructive pulmonary disease deaths from 1990 to 1998, and for chronic lower respiratory disease deaths from 1999 to 2006. Deaths rates for the leading causes of death are generally declining; however, relative differences between racial/ethnic groups are not declining. The lack of reduction in relative differences indicates that little progress is being made toward the elimination of racial/ethnic disparities.

7 CFR 784.11 - Death, incompetence, or disappearance.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 7 2010-01-01 2010-01-01 false Death, incompetence, or disappearance. 784.11 Section 784.11 Agriculture Regulations of the Department of Agriculture (Continued) FARM SERVICE AGENCY... Death, incompetence, or disappearance. In the case of death, incompetence, disappearance or dissolution...

7 CFR 786.111 - Death, incompetence, or disappearance.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 7 2010-01-01 2010-01-01 false Death, incompetence, or disappearance. 786.111 Section 786.111 Agriculture Regulations of the Department of Agriculture (Continued) FARM SERVICE AGENCY... Death, incompetence, or disappearance. In the case of death, incompetency, disappearance, or dissolution...

7 CFR 701.33 - Death, incompetency, or disappearance.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 7 2014-01-01 2014-01-01 false Death, incompetency, or disappearance. 701.33 Section 701.33 Agriculture Regulations of the Department of Agriculture (Continued) FARM SERVICE AGENCY... Death, incompetency, or disappearance. In case of death, incompetency, or disappearance of any...

7 CFR 784.11 - Death, incompetence, or disappearance.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 7 2011-01-01 2011-01-01 false Death, incompetence, or disappearance. 784.11 Section 784.11 Agriculture Regulations of the Department of Agriculture (Continued) FARM SERVICE AGENCY... Death, incompetence, or disappearance. In the case of death, incompetence, disappearance or dissolution...

7 CFR 701.33 - Death, incompetency, or disappearance.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 7 2012-01-01 2012-01-01 false Death, incompetency, or disappearance. 701.33 Section 701.33 Agriculture Regulations of the Department of Agriculture (Continued) FARM SERVICE AGENCY... Death, incompetency, or disappearance. In case of death, incompetency, or disappearance of any...

7 CFR 701.33 - Death, incompetency, or disappearance.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 7 2013-01-01 2013-01-01 false Death, incompetency, or disappearance. 701.33 Section 701.33 Agriculture Regulations of the Department of Agriculture (Continued) FARM SERVICE AGENCY... Death, incompetency, or disappearance. In case of death, incompetency, or disappearance of any...

7 CFR 784.11 - Death, incompetence, or disappearance.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 7 2013-01-01 2013-01-01 false Death, incompetence, or disappearance. 784.11 Section 784.11 Agriculture Regulations of the Department of Agriculture (Continued) FARM SERVICE AGENCY... Death, incompetence, or disappearance. In the case of death, incompetence, disappearance or dissolution...

7 CFR 701.33 - Death, incompetency, or disappearance.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 7 2011-01-01 2011-01-01 false Death, incompetency, or disappearance. 701.33 Section 701.33 Agriculture Regulations of the Department of Agriculture (Continued) FARM SERVICE AGENCY... Death, incompetency, or disappearance. In case of death, incompetency, or disappearance of any...

7 CFR 786.111 - Death, incompetence, or disappearance.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 7 2013-01-01 2013-01-01 false Death, incompetence, or disappearance. 786.111 Section 786.111 Agriculture Regulations of the Department of Agriculture (Continued) FARM SERVICE AGENCY... Death, incompetence, or disappearance. In the case of death, incompetency, disappearance, or dissolution...

7 CFR 784.11 - Death, incompetence, or disappearance.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 7 2012-01-01 2012-01-01 false Death, incompetence, or disappearance. 784.11 Section 784.11 Agriculture Regulations of the Department of Agriculture (Continued) FARM SERVICE AGENCY... Death, incompetence, or disappearance. In the case of death, incompetence, disappearance or dissolution...

7 CFR 786.111 - Death, incompetence, or disappearance.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 7 2012-01-01 2012-01-01 false Death, incompetence, or disappearance. 786.111 Section 786.111 Agriculture Regulations of the Department of Agriculture (Continued) FARM SERVICE AGENCY... Death, incompetence, or disappearance. In the case of death, incompetency, disappearance, or dissolution...

7 CFR 786.111 - Death, incompetence, or disappearance.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 7 2014-01-01 2014-01-01 false Death, incompetence, or disappearance. 786.111 Section 786.111 Agriculture Regulations of the Department of Agriculture (Continued) FARM SERVICE AGENCY... Death, incompetence, or disappearance. In the case of death, incompetency, disappearance, or dissolution...

7 CFR 786.111 - Death, incompetence, or disappearance.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 7 2011-01-01 2011-01-01 false Death, incompetence, or disappearance. 786.111 Section 786.111 Agriculture Regulations of the Department of Agriculture (Continued) FARM SERVICE AGENCY... Death, incompetence, or disappearance. In the case of death, incompetency, disappearance, or dissolution...

7 CFR 784.11 - Death, incompetence, or disappearance.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 7 2014-01-01 2014-01-01 false Death, incompetence, or disappearance. 784.11 Section 784.11 Agriculture Regulations of the Department of Agriculture (Continued) FARM SERVICE AGENCY... Death, incompetence, or disappearance. In the case of death, incompetence, disappearance or dissolution...

The flu fighters

NASA Astrophysics Data System (ADS)

Colizza, Vittoria; Vespignani, Alessandro

2010-02-01

The Black Death was one of the most devastating pandemics in history. Beginning in 1347, the plague took just three years to spread from Constantinople in western Turkey to Italy and then on to the rest of Europe, leaving nearly a quarter of the continent's population dead in its wake. Historical studies confirm that the disease diffused smoothly, generating an epidemic front that travelled through the continent as a continuous wave at a rate of about 200-400 miles per year.

Impact of Diabetes Mellitus on Hospitalization for Heart Failure, Cardiovascular Events, and Death: Outcomes at 4 Years From the Reduction of Atherothrombosis for Continued Health (REACH) Registry.

PubMed

Cavender, Matthew A; Steg, Ph Gabriel; Smith, Sidney C; Eagle, Kim; Ohman, E Magnus; Goto, Shinya; Kuder, Julia; Im, Kyungah; Wilson, Peter W F; Bhatt, Deepak L

2015-09-08

Despite the known association of diabetes mellitus with cardiovascular events, there are few contemporary data on the long-term outcomes from international cohorts of patients with diabetes mellitus. We sought to describe cardiovascular outcomes at 4 years and to identify predictors of these events in patients with diabetes mellitus. The Reduction of Atherothrombosis for Continued Health (REACH) registry is an international registry of patients at high risk of atherothrombosis or established atherothrombosis. Four-year event rates in patients with diabetes mellitus were determined with the corrected group prognosis method. Of the 45 227 patients in the REACH registry who had follow-up at 4 years, 43.6% (n=19 699) had diabetes mellitus at baseline. The overall risk and hazard ratio (HR) of cardiovascular death, nonfatal myocardial infarction, or nonfatal stroke were greater in patients with diabetes compared with patients without diabetes (16.5% versus 13.1%; adjusted HR, 1.27; 95% confidence interval [CI] 1.19-1.35). There was also an increase in both cardiovascular death (8.9% versus 6.0%; adjusted HR, 1.38; 95% CI, 1.26-1.52) and overall death (14.3% versus 9.9%; adjusted HR, 1.40; 95% CI, 1.30-1.51). Diabetes mellitus was associated with a 33% greater risk of hospitalization for heart failure (9.4% versus 5.9%; adjusted odds ratio, 1.33; 95% CI, 1.18-1.50). In patients with diabetes mellitus, heart failure at baseline was independently associated with cardiovascular death (adjusted HR, 2.45; 95% CI, 2.17-2.77; P<0.001) and hospitalization for heart failure (adjusted odds ratio, 4.72; 95% CI, 4.22-5.29; P<0.001). Diabetes mellitus substantially increases the risk of death, ischemic events, and heart failure. Patients with both diabetes mellitus and heart failure are at particularly elevated risk of cardiovascular death, highlighting the need for additional therapies in this high-risk population. © 2015 American Heart Association, Inc.

The triple threat of pregnancy, HIV infection and malaria: reported causes of maternal mortality in two nationwide health facility assessments in Mozambique, 2007 and 2012.

PubMed

Bailey, Patricia E; Keyes, Emily; Moran, Allisyn C; Singh, Kavita; Chavane, Leonardo; Chilundo, Baltazar

2015-11-09

The paper's primary purpose is to determine changes in magnitude and causes of institutional maternal mortality in Mozambique. We also describe shifts in the location of institutional deaths and changes in availability of prevention and treatment measures for malaria and HIV infection. Two national cross-sectional assessments of health facilities with childbirth services were conducted in 2007 and 2012. Each collected retrospective data on deliveries and maternal deaths and their causes. In 2007, 2,199 cases of maternal deaths were documented over a 12 month period; in 2012, 459 cases were identified over a three month period. In 2007, data collection also included reviews of maternal deaths when records were available (n = 712). Institutional maternal mortality declined from 541 to 284/100,000 births from 2007 to 2012. The rate of decline among women dying of direct causes was 66% compared to 26% among women dying of indirect causes. Cause-specific mortality ratios fell for all direct causes. Patterns among indirect causes were less conclusive given differences in cause-of-death recording. In absolute numbers, the combination of antepartum and postpartum hemorrhage was the leading direct cause of death each year and HIV and malaria the main non-obstetric causes. Based on maternal death reviews, evidence of HIV infection, malaria or anemia was found in more than 40% of maternal deaths due to abortion, ectopic pregnancy and sepsis. Almost half (49%) of all institutional maternal deaths took place in the largest hospitals in 2007 while in 2012, only 24% occurred in these hospitals. The availability of antiretrovirals and antimalarials increased in all types of facilities, but increases were most dramatic in health centers. The rate at which women died of direct causes in Mozambique's health facilities appears to have declined significantly. Despite a clear improvement in access to antiretrovirals and antimalarials, especially at lower levels of health care, malaria, HIV, and anemia continue to exact a heavy toll on child-bearing women. Going forward, efforts to end preventable maternal and newborn deaths must maximize the use of antenatal care that includes integrated preventive/treatment options for HIV infection, malaria and anemia.

Struck-by-lightning deaths in the United States.

PubMed

Adekoya, Nelson; Nolte, Kurt B

2005-05-01

The objective of the research reported here was to examine the epidemiologic characteristics of struck-by-lightning deaths. Using data from both the National Centers for Health Statistics (NCHS) multiple-cause-of-death tapes and the Census of Fatal Occupational Injuries (CFOI), which is maintained by the Bureau of Labor Statistics, the authors calculated numbers and annualized rates of lightning-related deaths for the United States. They used resident estimates from population microdata files maintained by the Census Bureau as the denominators. Work-related fatality rates were calculated with denominators derived from the Current Population Survey of employment data. Four illustrative investigative case reports of lightning-related deaths were contributed by the New Mexico Office of the Medical Investigator. It was found that a total of 374 struck-by-lightning deaths had occurred during 1995-2000 (an average annualized rate of 0.23 deaths per million persons). The majority of deaths (286 deaths, 75 percent) were from the South and the Midwest. The numbers of lightning deaths were highest in Florida (49 deaths) and Texas (32 deaths). A total of 129 work-related lightning deaths occurred during 1995-2002 (an average annual rate of 0.12 deaths per million workers). Agriculture and construction industries recorded the most fatalities at 44 and 39 deaths, respectively. Fatal occupational injuries resulting from being struck by lightning were highest in Florida (21 deaths) and Texas (11 deaths). In the two national surveillance systems examined, incidence rates were higher for males and people 20-44 years of age. In conclusion, three of every four struck-by-lightning deaths were from the South and the Midwest, and during 1995-2002, one of every four struck-by-lightning deaths was work-related. Although prevention programs could target the entire nation, interventions might be most effective if directed to regions with the majority of fatalities because they have the majority of lightning strikes per year.

Cardiac surgery during pregnancy: continuous fetal monitoring using umbilical artery Doppler flow velocity indices.

PubMed

Mishra, Manisha; Sawhney, Ravindra; Kumar, Anil; Bapna, Kumar Ramesh; Kohli, Vijay; Wasir, Harpreet; Trehan, Naresh

2014-01-01

The fetal death rate associated with cardiac surgery with cardiopulmonary bypass (CPB) is as high as 9.5-29%. We report continuous monitoring of fetal heart rate and umbilical artery flow-velocity waveforms by transvaginal ultrasonography and their analyses in relation to events of the CPB in two cases in second trimester of pregnancy undergoing mitral valve replacement. Our findings suggest that the transition of circulation from corporeal to extracorporeal is the most important event during surgery; the associated decrease in mean arterial pressure (MAP) at this stage potentially has deleterious effects on the fetus, which get aggravated with the use of vasopressors. We suggest careful management of CPB at this stage, which include partial controlled CPB at initiation and gradual transition to full CPB; this strategy maintains high MAP and avoids the use of vasopressors. Maternal and fetal monitoring can timely recognize the potential problems and provide window for the required treatment.

Sickle-Cell Trait as a Risk Factor for Sudden Death in Physical Training

DTIC Science & Technology

1987-09-24

8 percent for black and 0.08 ->We conclude that recruits in basic training with the percent for nonblack recruits), death rates (per 100,000) sickle...there is no for calculation of death rates . means of distinguishing histologically between incon- We investigated the risk of sudden death in conipa...from alter- pt 00)renddrtn iit ida prto exhubitd an (Fig.s tIt. gic epgottsadth teFa ondda nbd able 2 summarizes the death rates for subjects Thirty

Air Force Health Study. An Epidemiologic Investigation of Health Effects in Air Force Personnel Following Exposure to Herbicides

DTIC Science & Technology

1991-10-15

Ranch Hand unit was active in Vietnam. Table 1 shows summary counts, person-years and death rates by group (Ranch Hand, Comparison). A person-year is...dif- ferent causes of death [6]. Except when otherwise noted, all death rates (per 1000 person-years), expected deaths and SMR’s are adjusted for year...enlisted personnel are enlisted ground personnel. Enlisted personnel are flying enlisted and nonflying enlisted personnel. All Ranch Hand death rates in

PR01 Molecular Pathogenesis of Rickettsioses and Development of Anti-Rickettsial Treatment by Combinatorial Peptide-Based Libraries

DTIC Science & Technology

2006-02-01

likely reflecting similar cell death rates in all monolayers at late time points. By the end of the experiment at 120 hours, all monolayers showed a...50-55% increase in permeability when compared to the controls. 2. Cell death rates in rickettsiae-infected SV-HCEC monolayers In order to...necrotic cell death. Quantification of cell death was performed by determining the percent of total cells staining positive for PI. Cell death rates did

Surveillance for Violent Deaths —
National Violent Death Reporting System, 18 States, 2014

PubMed Central

Jack, Shane P.D.; Lyons, Bridget H.; Betz, Carter J.; Petrosky, Emiko

2018-01-01

Problem/Condition In 2014, approximately 59,000 persons died in the United States as a result of violence-related injuries. This report summarizes data from CDC’s National Violent Death Reporting System (NVDRS) regarding violent deaths from 18 U.S. states for 2014. Results are reported by sex, age group, race/ethnicity, marital status, location of injury, method of injury, circumstances of injury, and other selected characteristics. Reporting Period Covered 2014. Description of System NVDRS collects data from participating states regarding violent deaths. Data are obtained from death certificates, coroner/medical examiner reports, law enforcement reports, and secondary sources (e.g., child fatality review team data, supplemental homicide reports, hospital data, and crime laboratory data). This report includes data from 18 states that collected statewide data for 2014 (Alaska, Colorado, Georgia, Kentucky, Maryland, Massachusetts, Michigan, New Jersey, New Mexico, North Carolina, Ohio, Oklahoma, Oregon, Rhode Island, South Carolina, Utah, Virginia, and Wisconsin). NVDRS collates documents for each death and links deaths that are related (e.g., multiple homicides, a homicide followed by a suicide, or multiple suicides) into a single incident. Results For 2014, a total of 22,098 fatal incidents involving 22,618 deaths were captured by NVDRS in the 18 states included in this report. The majority of deaths were suicides (65.6%), followed by homicides (22.5%), deaths of undetermined intent (10.0%), deaths involving legal intervention (1.3%) (i.e., deaths caused by law enforcement and other persons with legal authority to use deadly force, excluding legal executions), and unintentional firearm deaths (<1%). The term “legal intervention” is a classification incorporated into the International Classification of Diseases, Tenth Revision (ICD-10) and does not denote the lawfulness or legality of the circumstances surrounding a death caused by law enforcement. Suicides occurred at higher rates among males, non-Hispanic American Indian/Alaska Natives (AI/AN), non-Hispanic whites, persons aged 45–54 years, and males aged ≥75 years. Suicides were preceded primarily by a mental health, intimate partner, substance abuse, or physical health problem or a crisis during the previous or upcoming 2 weeks. Homicide rates were higher among males and persons aged <1 year and 15–44 years; rates were highest among non-Hispanic black and AI/AN males. Homicides primarily were precipitated by arguments and interpersonal conflicts, occurrence in conjunction with another crime, or related to intimate partner violence (particularly for females). When the relationship between a homicide victim and a suspected perpetrator was known, it was most often either an acquaintance/friend or an intimate partner. Legal intervention death rates were highest among males and persons aged 20–44 years; rates were highest among non-Hispanic black males and Hispanic males. Precipitating factors for the majority of legal intervention deaths were alleged criminal activity in progress, the victim reportedly using a weapon in the incident, a mental health or substance abuse problem, an argument or conflict, or a recent crisis. Deaths of undetermined intent occurred more frequently among males, particularly non-Hispanic black and AI/AN males, and persons aged 30–54 years. Substance abuse, mental health problems, physical health problems, and a recent crisis were the most common circumstances preceding deaths of undetermined intent. Unintentional firearm deaths were more frequent among males, non-Hispanic whites, and persons aged 10–24 years; these deaths most often occurred while the shooter was playing with a firearm and were most often precipitated by a person unintentionally pulling the trigger or mistakenly thinking the firearm was unloaded. Interpretation This report provides a detailed summary of data from NVDRS for 2014. The results indicate that violent deaths resulting from self-inflicted or interpersonal violence disproportionately affected persons aged <65 years, males, and certain minority populations. The primary precipitating factors for homicides and suicides were intimate partner problems, interpersonal conflicts, mental health and substance abuse problems, and recent crises. Public Health Action NVDRS data are used to monitor the occurrence of violence-related fatal injuries and assist public health authorities in the development, implementation, and evaluation of programs and policies to reduce and prevent violent deaths. For example, North Carolina VDRS data were used to improve case ascertainment of pregnancy-associated suicides, Wisconsin VDRS data were used to develop the statewide suicide prevention strategy, and Colorado VDRS data were used to develop programs and prevention strategies for suicide among veterans. The continued development and expansion of NVDRS to include all U.S. states, territories, and the District of Columbia are essential to public health efforts to reduce the impact of violence. PMID:29389917

Surveillance for Violent Deaths -
National Violent Death Reporting System, 18 States, 2014.

PubMed

Fowler, Katherine A; Jack, Shane P D; Lyons, Bridget H; Betz, Carter J; Petrosky, Emiko

2018-02-02

In 2014, approximately 59,000 persons died in the United States as a result of violence-related injuries. This report summarizes data from CDC's National Violent Death Reporting System (NVDRS) regarding violent deaths from 18 U.S. states for 2014. Results are reported by sex, age group, race/ethnicity, marital status, location of injury, method of injury, circumstances of injury, and other selected characteristics. 2014. NVDRS collects data from participating states regarding violent deaths. Data are obtained from death certificates, coroner/medical examiner reports, law enforcement reports, and secondary sources (e.g., child fatality review team data, supplemental homicide reports, hospital data, and crime laboratory data). This report includes data from 18 states that collected statewide data for 2014 (Alaska, Colorado, Georgia, Kentucky, Maryland, Massachusetts, Michigan, New Jersey, New Mexico, North Carolina, Ohio, Oklahoma, Oregon, Rhode Island, South Carolina, Utah, Virginia, and Wisconsin). NVDRS collates documents for each death and links deaths that are related (e.g., multiple homicides, a homicide followed by a suicide, or multiple suicides) into a single incident. For 2014, a total of 22,098 fatal incidents involving 22,618 deaths were captured by NVDRS in the 18 states included in this report. The majority of deaths were suicides (65.6%), followed by homicides (22.5%), deaths of undetermined intent (10.0%), deaths involving legal intervention (1.3%) (i.e., deaths caused by law enforcement and other persons with legal authority to use deadly force, excluding legal executions), and unintentional firearm deaths (<1%). The term "legal intervention" is a classification incorporated into the International Classification of Diseases, Tenth Revision (ICD-10) and does not denote the lawfulness or legality of the circumstances surrounding a death caused by law enforcement. Suicides occurred at higher rates among males, non-Hispanic American Indian/Alaska Natives (AI/AN), non-Hispanic whites, persons aged 45-54 years, and males aged ≥75 years. Suicides were preceded primarily by a mental health, intimate partner, substance abuse, or physical health problem or a crisis during the previous or upcoming 2 weeks. Homicide rates were higher among males and persons aged <1 year and 15-44 years; rates were highest among non-Hispanic black and AI/AN males. Homicides primarily were precipitated by arguments and interpersonal conflicts, occurrence in conjunction with another crime, or related to intimate partner violence (particularly for females). When the relationship between a homicide victim and a suspected perpetrator was known, it was most often either an acquaintance/friend or an intimate partner. Legal intervention death rates were highest among males and persons aged 20-44 years; rates were highest among non-Hispanic black males and Hispanic males. Precipitating factors for the majority of legal intervention deaths were alleged criminal activity in progress, the victim reportedly using a weapon in the incident, a mental health or substance abuse problem, an argument or conflict, or a recent crisis. Deaths of undetermined intent occurred more frequently among males, particularly non-Hispanic black and AI/AN males, and persons aged 30-54 years. Substance abuse, mental health problems, physical health problems, and a recent crisis were the most common circumstances preceding deaths of undetermined intent. Unintentional firearm deaths were more frequent among males, non-Hispanic whites, and persons aged 10-24 years; these deaths most often occurred while the shooter was playing with a firearm and were most often precipitated by a person unintentionally pulling the trigger or mistakenly thinking the firearm was unloaded. This report provides a detailed summary of data from NVDRS for 2014. The results indicate that violent deaths resulting from self-inflicted or interpersonal violence disproportionately affected persons aged <65 years, males, and certain minority populations. The primary precipitating factors for homicides and suicides were intimate partner problems, interpersonal conflicts, mental health and substance abuse problems, and recent crises. NVDRS data are used to monitor the occurrence of violence-related fatal injuries and assist public health authorities in the development, implementation, and evaluation of programs and policies to reduce and prevent violent deaths. For example, North Carolina VDRS data were used to improve case ascertainment of pregnancy-associated suicides, Wisconsin VDRS data were used to develop the statewide suicide prevention strategy, and Colorado VDRS data were used to develop programs and prevention strategies for suicide among veterans. The continued development and expansion of NVDRS to include all U.S. states, territories, and the District of Columbia are essential to public health efforts to reduce the impact of violence.

Hip fracture mortality. A prospective, multifactorial study to predict and minimize death risk.

PubMed

Mullen, J O; Mullen, N L

1992-07-01

Four hundred consecutive hip fractures were studied prospectively. Two hundred forty-seven patients were classified as unhealthy (poor cardiac status, pneumonia, cancer history, bowel obstruction history, malnutrition, dehydration, stroke history, renal failure history, cirrhosis). Twenty-two percent of this unhealthy group died, while only 6% of the remaining healthy group died. Death rates varied with admission activity level and mental status but not when patient health status was factored out. After factoring out health status, age was associated with higher death rates only in patients older than age 85. Confusion, a change of mental status in the hospital, occurred in 25% of patients. Confusion was associated with a medical complication in 94% of cases, was the presenting symptom of a medical complication in 79% of cases, and was associated with a 39% death rate. Major medical complications occurred in 9% of the healthy group (29% of them died) and 21% of the unhealthy group (64% of them died). Major medical complications in unhealthy, shut-in patients were associated with an 80% death rate. Vigorous urinary tract monitoring and early treatment of bacteriuria decreased death rate. Postfracture malnutrition was associated with higher complication rates. Hip surgery performed within 72 hours on patients with acute medical illnesses in addition to their fracture was associated with a higher death rate. Whether a patient walked postfracture seemed not to be correlated with the death rate. Patients who were not walking prefracture but treated by internal fixation had a 34% failure rate.

Surveillance for violent deaths--National Violent Death Reporting System, 16 states, 2009.

PubMed

Karch, Debra L; Logan, Joseph; McDaniel, Dawn; Parks, Sharyn; Patel, Nimesh

2012-09-14

An estimated 50,000 persons die annually in the United States as a result of violence-related injuries. This report summarizes data from CDC's National Violent Death Reporting System (NVDRS) regarding violent deaths from 16 U.S. states for 2009. Results are reported by sex, age group, race/ethnicity, marital status, location of injury, method of injury, circumstances of injury, and other selected characteristics. 2009. NVDRS collects data regarding violent deaths obtained from death certificates, coroner/medical examiner reports, and law enforcement reports. NVDRS data collection began in 2003 with seven states (Alaska, Maryland, Massachusetts, New Jersey, Oregon, South Carolina, and Virginia) participating; six states (Colorado, Georgia, North Carolina, Oklahoma, Rhode Island, and Wisconsin) joined in 2004, four (California, Kentucky, New Mexico, and Utah) in 2005, and two (Ohio and Michigan) in 2010, for a total of 19 states. This report includes data from 16 states that collected statewide data in 2009. California is excluded because data were collected in only four counties. Ohio and Michigan are excluded because data collection did not begin until 2010. For 2009, a total of 15,981 fatal incidents involving 16,418 deaths were captured by NVDRS in the 16 states included in this report. The majority (60.6%) of deaths were suicides, followed by homicides and deaths involving legal intervention (i.e., deaths caused by police and other persons with legal authority to use deadly force, excluding legal executions) (24.7%), deaths of undetermined intent (14.2%), and unintentional firearm deaths (0.5%). Suicides occurred at higher rates among males, non-Hispanic whites, American Indians/Alaska Natives, and persons aged 45-54 years. Suicides occurred most often in a house or apartment and involved the use of firearms. Suicides were preceded primarily by mental health, intimate partner, or physical health problems or by a crisis during the previous 2 weeks. Homicides occurred at higher rates among males and persons aged 20-24 years; rates were highest among non-Hispanic black males. The majority of homicides involved the use of a firearm and occurred in a house or apartment or on a street/highway. Homicides were preceded primarily by arguments and interpersonal conflicts or in conjunction with another crime. Characteristics associated with other manners of death, circumstances preceding death, and special populations also are highlighted in this report. This report provides a detailed summary of data from NVDRS for 2009. The results indicate that violent deaths resulting from self-inflicted or interpersonal violence disproportionately affected adults aged <55 years, males, and certain racial/ethnic minority populations. For homicides and suicides, relationship problems, interpersonal conflicts, mental health problems, and recent crises were among the primary factors that might have precipitated the fatal injuries. Because additional information might be reported subsequently as participating states update their findings, the data provided in this report are preliminary. For the occurrence of violent deaths in the United States to be better understood and ultimately prevented, accurate, timely, and comprehensive surveillance data are necessary. NVDRS data can be used to monitor the occurrence of violence-related fatal injuries and assist public health authorities in the development, implementation, and evaluation of programs and policies to reduce and prevent violent deaths at the national, state, and local levels. The continued development and expansion of NVDRS is essential to CDC's efforts to reduce the personal, familial, and societal costs of violence. Additional efforts are needed to increase the number of states participating in NVDRS, with an ultimate goal of full national representation.

Surveillance for violent deaths--national violent death reporting system, 16 States, 2006.

PubMed

Karch, Debra L; Dahlberg, Linda L; Patel, Nimesh; Davis, Terry W; Logan, Joseph E; Hill, Holly A; Ortega, Lavonne

2009-03-20

An estimated 50,000 persons die annually in the United States as a result of violence-related injuries. This report summarizes data from CDC's National Violent Death Reporting System (NVDRS) regarding violent deaths from 16 U.S. states for 2006. Results are reported by sex, age group, race/ethnicity, marital status, location of injury, method of injury, circumstances of injury, and other selected characteristics. 2006. NVDRS collects data regarding violent deaths obtained from death certificates, coroner/medical examiner reports, and law enforcement reports. NVDRS began operation in 2003 with seven states (Alaska, Maryland, Massachusetts, New Jersey, Oregon, South Carolina, and Virginia) participating; six states (Colorado, Georgia, North Carolina, Oklahoma, Rhode Island, and Wisconsin) joined in 2004 and four (California, Kentucky, New Mexico, and Utah) in 2005, for a total of 17 states. This report includes data from 16 states that collected statewide data; data from California are not included in this report because NVDRS has been implemented only in a limited number of California cities and counties rather than statewide. For 2006, a total of 15,007 fatal incidents involving 15,395 violent deaths occurred in the 16 NVDRS states included in this report. The majority (55.9%) of deaths were suicides, followed by homicides and deaths involving legal intervention (e.g. a suspect is killed by a law enforcement officer in the line of duty)(28.2%), violent deaths of undetermined intent (15.1%), and unintentional firearm deaths (0.7%). Suicides occurred at higher rates among males, American Indians/Alaska Natives (AI/ANs), non-Hispanic whites, and persons aged 45--54 years and occurred most often in a house or apartment and involved the use of firearms. Suicides were precipitated primarily by mental-health, intimate-partner, or physical-health problems or by a crisis during the preceding 2 weeks. Homicides occurred at higher rates among males and persons aged 20--24 years; rates were highest among non-Hispanic black males. The majority of homicides involved the use of a firearm and occurred in a house or apartment or on a street/highway. Homicides were precipitated primarily by arguments and interpersonal conflicts or in conjunction with another crime. Other manners of death and special situations or populations also are highlighted in this report. This report provides a detailed summary of data concerning violent deaths collected by NVDRS for 2006. The results indicate that violent deaths resulting from self-inflicted or interpersonal violence affected adults aged 20--54 years, males, and certain minority populations disproportionately. For many types of violent death, relationship problems, interpersonal conflicts, mental-health problems, and recent crises were among the primary precipitating factors. Because additional information might be reported subsequently as participating states update their findings, the data provided in this report are preliminary. For the occurrence of violent deaths in the United States to be better understood and ultimately prevented, accurate, timely, and comprehensive surveillance data are necessary. NVDRS data can be used to track the occurrence of violence-related fatal injuries and assist public health authorities in the development, implementation, and evaluation of programs and policies to reduce and prevent violent deaths at the national, state, and local levels. The continued development and expansion of NVDRS is essential to CDC's efforts to reduce the personal, familial, and societal costs of violence. Further efforts are needed to increase the number of states participating in NVDRS, with an ultimate goal of full national representation.

Kinematics at the intersection of the Garlock and Death Valley fault zones, California: Integration of TM data and field studies

NASA Technical Reports Server (NTRS)

Abrams, Michael; Verosub, Ken; Finnerty, Tony; Brady, Roland

1987-01-01

The Garlock and Death Valley fault zones in SE California are two active strike-slip faults coming together on the east side of the Avawatz Mtns. The kinematics of this intersection, and the possible continuation of either fault zone, are being investigated using a combination of field mapping, and processing and interpretation of remotely sensed image data. Regional and local relationships are derivable from Thematic Mapper data (30 m resolution), including discrimination and relative age dating of alluvial fans, bedrock mapping, and fault mapping. Aircraft data provide higher spatial resolution over more limited areas. Hypotheses being considered are: (1) the Garlock fault extends east of the intersection; (2) the Garlock fault terminates at the intersection and the Death Valley fault continues southeastward; and (3) the Garlock fault has been offset right laterally by the Death Valley fault which continues to the southeast. Preliminary work indicates that the first hypothesis is invalid. From kinematic considerations, image analysis, and field work the third hypothesis is favored. The projected continuation of the Death Valley zone defines the boundary between the Mojave crustal block and the Basin and Range block.

Malignant Mesothelioma Mortality - United States, 1999-2015.

PubMed

Mazurek, Jacek M; Syamlal, Girija; Wood, John M; Hendricks, Scott A; Weston, Ainsley

2017-03-03

Malignant mesothelioma is a neoplasm associated with occupational and environmental inhalation exposure to asbestos* fibers and other elongate mineral particles (EMPs) (1-3). Patients have a median survival of approximately 1 year from the time of diagnosis (1). The latency period from first causative exposure to malignant mesothelioma development typically ranges from 20 to 40 years but can be as long as 71 years (2,3). Hazardous occupational exposures to asbestos fibers and other EMPs have occurred in a variety of industrial operations, including mining and milling, manufacturing, shipbuilding and repair, and construction (3). Current exposures to commercial asbestos in the United States occur predominantly during maintenance operations and remediation of older buildings containing asbestos (3,4). To update information on malignant mesothelioma mortality (5), CDC analyzed annual multiple cause-of-death records † for 1999-2015, the most recent years for which complete data are available. During 1999-2015, a total of 45,221 deaths with malignant mesothelioma mentioned on the death certificate as the underlying or contributing cause of death were reported in the United States, increasing from 2,479 deaths in 1999 to 2,597 in 2015 (in the same time period the age-adjusted death rates § decreased from 13.96 per million in 1999 to 10.93 in 2015). Malignant mesothelioma deaths increased for persons aged ≥85 years, both sexes, persons of white, black, and Asian or Pacific Islander race, and all ethnic groups. Despite regulatory actions and the decline in use of asbestos the annual number of malignant mesothelioma deaths remains substantial. The continuing occurrence of malignant mesothelioma deaths underscores the need for maintaining measures to prevent exposure to asbestos fibers and other causative EMPs and for ongoing surveillance to monitor temporal trends.

Numbers of Brain Deaths and Deceased Donors in Hospitals in Istanbul Region That Have Transplantation Units: A Retrospective Analysis Between the Years 2005 and 2015.

PubMed

Harmanci Seren, A K; Yavuz, H

2017-04-01

Turkey is one of the countries facing a serious organ shortage problem, with thousands of patients with end-stage organ failure. The Social Security Institution started to increase the reimbursement for transplantation operations in 2007 to solve this problem, and this policy has continued since then. Although the number of transplantation centers and operations in Turkey increased in this term, according to organ donation and transplantation statistics from the Ministry of Health, the rate of organ retrieval from deceased organ donors has decreased. This study was performed with the purpose of retrospectively analyzing (between the years 2005 and 2015) the number of brain deaths and donors after brain death in hospitals that are affiliated with the Istanbul Regional Coordination Office and have transplantation units. Data were collected via the website of the Ministry of Health. Hospitals were categorized as those directly affiliated with the Ministry of Health, university hospitals, and private hospitals. This study found that the number of transplantation centers has increased >3 times since 2005, and the number of private transplantation centers has increased 9 times for the same period. We also found that the number of brain deaths, donors after brain death in hospitals, and number of brain deaths and donors after brain death per hospital had varied throughout the study years. Although the number of transplantation centers has increased since 2005, the number of brain deaths and donors after brain death has not increased to the same extent for this period in these hospitals that have transplantation units. Copyright © 2017 Elsevier Inc. All rights reserved.

7 CFR 1430.222 - Death, incompetency, or disappearance.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 10 2010-01-01 2010-01-01 false Death, incompetency, or disappearance. 1430.222 Section 1430.222 Agriculture Regulations of the Department of Agriculture (Continued) COMMODITY CREDIT... Contract Program § 1430.222 Death, incompetency, or disappearance. In the case of death, incompetency...

7 CFR 1430.311 - Death, incompetence, or disappearance.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 10 2010-01-01 2010-01-01 false Death, incompetence, or disappearance. 1430.311 Section 1430.311 Agriculture Regulations of the Department of Agriculture (Continued) COMMODITY CREDIT... Disaster Assistance Payment Program § 1430.311 Death, incompetence, or disappearance. In the case of death...

7 CFR 1429.112 - Death, incompetence, or disappearance.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 10 2013-01-01 2013-01-01 false Death, incompetence, or disappearance. 1429.112 Section 1429.112 Agriculture Regulations of the Department of Agriculture (Continued) COMMODITY CREDIT... ASSISTANCE PAYMENT PROGRAM § 1429.112 Death, incompetence, or disappearance. (a) In the case of death...

7 CFR 1430.311 - Death, incompetence, or disappearance.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 10 2012-01-01 2012-01-01 false Death, incompetence, or disappearance. 1430.311 Section 1430.311 Agriculture Regulations of the Department of Agriculture (Continued) COMMODITY CREDIT... Disaster Assistance Payment Program § 1430.311 Death, incompetence, or disappearance. In the case of death...

7 CFR 1430.311 - Death, incompetence, or disappearance.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 10 2014-01-01 2014-01-01 false Death, incompetence, or disappearance. 1430.311 Section 1430.311 Agriculture Regulations of the Department of Agriculture (Continued) COMMODITY CREDIT... Disaster Assistance Payment Program § 1430.311 Death, incompetence, or disappearance. In the case of death...

7 CFR 1430.222 - Death, incompetency, or disappearance.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 10 2012-01-01 2012-01-01 false Death, incompetency, or disappearance. 1430.222 Section 1430.222 Agriculture Regulations of the Department of Agriculture (Continued) COMMODITY CREDIT... Contract Program § 1430.222 Death, incompetency, or disappearance. In the case of death, incompetency...

7 CFR 1429.112 - Death, incompetence, or disappearance.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 10 2012-01-01 2012-01-01 false Death, incompetence, or disappearance. 1429.112 Section 1429.112 Agriculture Regulations of the Department of Agriculture (Continued) COMMODITY CREDIT... ASSISTANCE PAYMENT PROGRAM § 1429.112 Death, incompetence, or disappearance. (a) In the case of death...

7 CFR 1429.112 - Death, incompetence, or disappearance.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 10 2014-01-01 2014-01-01 false Death, incompetence, or disappearance. 1429.112 Section 1429.112 Agriculture Regulations of the Department of Agriculture (Continued) COMMODITY CREDIT... ASSISTANCE PAYMENT PROGRAM § 1429.112 Death, incompetence, or disappearance. (a) In the case of death...

7 CFR 1430.222 - Death, incompetency, or disappearance.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 10 2013-01-01 2013-01-01 false Death, incompetency, or disappearance. 1430.222 Section 1430.222 Agriculture Regulations of the Department of Agriculture (Continued) COMMODITY CREDIT... Contract Program § 1430.222 Death, incompetency, or disappearance. In the case of death, incompetency...

7 CFR 1430.222 - Death, incompetency, or disappearance.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 10 2011-01-01 2011-01-01 false Death, incompetency, or disappearance. 1430.222 Section 1430.222 Agriculture Regulations of the Department of Agriculture (Continued) COMMODITY CREDIT... Contract Program § 1430.222 Death, incompetency, or disappearance. In the case of death, incompetency...

7 CFR 1430.222 - Death, incompetency, or disappearance.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 10 2014-01-01 2014-01-01 false Death, incompetency, or disappearance. 1430.222 Section 1430.222 Agriculture Regulations of the Department of Agriculture (Continued) COMMODITY CREDIT... Contract Program § 1430.222 Death, incompetency, or disappearance. In the case of death, incompetency...

7 CFR 1430.311 - Death, incompetence, or disappearance.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 10 2011-01-01 2011-01-01 false Death, incompetence, or disappearance. 1430.311 Section 1430.311 Agriculture Regulations of the Department of Agriculture (Continued) COMMODITY CREDIT... Disaster Assistance Payment Program § 1430.311 Death, incompetence, or disappearance. In the case of death...

7 CFR 1430.311 - Death, incompetence, or disappearance.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 10 2013-01-01 2013-01-01 false Death, incompetence, or disappearance. 1430.311 Section 1430.311 Agriculture Regulations of the Department of Agriculture (Continued) COMMODITY CREDIT... Disaster Assistance Payment Program § 1430.311 Death, incompetence, or disappearance. In the case of death...

2007 traffic crash facts annual report

DOT National Transportation Integrated Search

2007-01-01

In 2007, the death rate on Nebraska roadways was 1.3 persons killed per : 100 million vehicle miles traveled. The death rate in Nebraska, from 1961 : to 2007 is represented in Figure 1. Even though the death rate fluctuates : from year to year, there...

2006 traffic crash facts annual report

DOT National Transportation Integrated Search

2006-01-01

In 2006, the death rate on Nebraska roadways was 1.4 persons killed per : 100 million vehicle miles traveled. The death rate in Nebraska, from 1961 to : 2006 is represented in Figure 1. Even though the death rate fluctuates from : year to year, there...

2008 traffic crash facts annual report

DOT National Transportation Integrated Search

2008-01-01

In 2008, the death rate on Nebraska roadways was 1.1 persons killed per : 100 million vehicle miles traveled. This is the lowest rate ever recorded. The : death rate in Nebraska, from 1961 to 2008 is represented in Figure 1. Even : though the death r...

2003 traffic crash facts annual report

DOT National Transportation Integrated Search

2003-01-01

In 2003, the death rate on Nebraska roadways was 1.6 persons killed per : 100 million vehicle miles traveled. The death rate in Nebraska, from 1961 : to 2003 is represented in Figure 1 (Page 2). Even though the death rate : fluctuates from year to ye...

2005 traffic crash facts annual report

DOT National Transportation Integrated Search

2005-01-01

In 2005, the death rate on Nebraska roadways was 1.4 persons killed per : 100 million vehicle miles traveled. The death rate in Nebraska, from 1961 to : 2004 is represented in Figure 1. Even though the death rate fluctuates from : year to year, there...

2001 traffic crash facts annual report

DOT National Transportation Integrated Search

2001-01-01

In 2001, the death rate on Nebraska roadways was 1.6 persons killed per : 100 million vehicle miles traveled. The death rate in Nebraska, from 1961 to : 2001 is represented in Figure 1 (Page 2). Even though the death rate fluctuates : from year to ye...

Illicit Drug Use, Illicit Drug Use Disorders, and Drug Overdose Deaths in Metropolitan and Nonmetropolitan Areas - United States.

PubMed

Mack, Karin A; Jones, Christopher M; Ballesteros, Michael F

2017-10-20

Drug overdoses are a leading cause of injury death in the United States, resulting in approximately 52,000 deaths in 2015. Understanding differences in illicit drug use, illicit drug use disorders, and overall drug overdose deaths in metropolitan and nonmetropolitan areas is important for informing public health programs, interventions, and policies. Illicit drug use and drug use disorders during 2003-2014, and drug overdose deaths during 1999-2015. The National Survey of Drug Use and Health (NSDUH) collects information through face-to-face household interviews about the use of illicit drugs, alcohol, and tobacco among the U.S. noninstitutionalized civilian population aged ≥12 years. Respondents include residents of households and noninstitutional group quarters (e.g., shelters, rooming houses, dormitories, migratory workers' camps, and halfway houses) and civilians living on military bases. NSDUH variables include sex, age, race/ethnicity, residence (metropolitan/nonmetropolitan), annual household income, self-reported drug use, and drug use disorders. National Vital Statistics System Mortality (NVSS-M) data for U.S. residents include information from death certificates filed in the 50 states and the District of Columbia. Cases were selected with an underlying cause of death based on the ICD-10 codes for drug overdoses (X40-X44, X60-X64, X85, and Y10-Y14). NVSS-M variables include decedent characteristics (sex, age, and race/ethnicity) and information on intent (unintentional, suicide, homicide, or undetermined), location of death (medical facility, in a home, or other [including nursing homes, hospices, unknown, and other locations]) and county of residence (metropolitan/nonmetropolitan). Metropolitan/nonmetropolitan status is assigned independently in each data system. NSDUH uses a three-category system: Core Based Statistical Area (CBSA) of ≥1 million persons; CBSA of <1 million persons; and not a CBSA, which for simplicity were labeled large metropolitan, small metropolitan, and nonmetropolitan. Deaths from NVSS-M are categorized by the county of residence of the decedent using CDC's National Center for Health Statistics 2013 Urban-Rural Classification Scheme, collapsed into two categories (metropolitan and nonmetropolitan). Although both metropolitan and nonmetropolitan areas experienced significant increases from 2003-2005 to 2012-2014 in self-reported past-month use of illicit drugs, the prevalence was highest for the large metropolitan areas compared with small metropolitan or nonmetropolitan areas throughout the study period. Notably, past-month use of illicit drugs declined over the study period for the youngest respondents (aged 12-17 years). The prevalence of past-year illicit drug use disorders among persons using illicit drugs in the past year varied by metropolitan/nonmetropolitan status and changed over time. Across both metropolitan and nonmetropolitan areas, the prevalence of past-year illicit drug use disorders declined during 2003-2014. In 2015, approximately six times as many drug overdose deaths occurred in metropolitan areas than occurred in nonmetropolitan areas (metropolitan: 45,059; nonmetropolitan: 7,345). Drug overdose death rates (per 100,000 population) for metropolitan areas were higher than in nonmetropolitan areas in 1999 (6.4 versus 4.0), however, the rates converged in 2004, and by 2015, the nonmetropolitan rate (17.0) was slightly higher than the metropolitan rate (16.2). Drug use and subsequent overdoses continue to be a critical and complicated public health challenge across metropolitan/nonmetropolitan areas. The decline in illicit drug use by youth and the lower prevalence of illicit drug use disorders in rural areas during 2012-2014 are encouraging signs. However, the increasing rate of drug overdose deaths in rural areas, which surpassed rates in urban areas, is cause for concern. Understanding the differences between metropolitan and nonmetropolitan areas in drug use, drug use disorders, and drug overdose deaths can help public health professionals to identify, monitor, and prioritize responses. Consideration of where persons live and where they die from overdose could enhance specific overdose prevention interventions, such as training on naloxone administration or rescue breathing. Educating prescribers on CDC's guideline for prescribing opioids for chronic pain (Dowell D, Haegerich TM, Chou R. CDC guideline for prescribing opioids for chronic pain-United States, 2016. MMWR Recomm Rep 2016;66[No. RR-1]) and facilitating better access to medication-assisted treatment with methadone, buprenorphine, or naltrexone could benefit communities with high opioid use disorder rates.

What Happens After a Patient Safety Event? Medical Expenditures and Outcomes in Medicare

DTIC Science & Technology

2005-01-01

can see that about 68 percent ($24,317) of the $35,618 is most likely preventable. The readmission and death rates of Table 4 are risk-adjusted... death rates , we see that potentially preventable adverse medical events were responsible for a death rate of 4.53 percent. In the last column of...the death rates predicted from Table 4, 0.0615 for potentially preventable adverse medical events and 0.0162 otherwise, we can calculate that for the

Project Ranch Hand II. An Epidemiologic Investigation of Health Effects in Air Force Personnel Following Exposure to Herbicides. Mortality Update - 1985.

DTIC Science & Technology

1985-11-29

Table 3 in the baseline report aind contains surrinary counts and death rates by occupation, race and group. In thp flecember IV4 report, the...these diminished death rates appear to be found in the Ranch Hand cffwcers borr, b.f(jre 1935, while Ranch Hand officers with later birth dates...death rate than their Comparisons. 12 - .*.*.s...-...*. -~~~. "... . .. . . .. . .. . .. . .... . ’N Table 14 Death Rates by Group, Rank, Occupation

The Unique Impact of Abolition of Jim Crow Laws on Reducing Inequities in Infant Death Rates and Implications for Choice of Comparison Groups in Analyzing Societal Determinants of Health

PubMed Central

Chen, Jarvis T.; Coull, Brent; Waterman, Pamela D.; Beckfield, Jason

2013-01-01

Objectives. We explored associations between the abolition of Jim Crow laws (i.e., state laws legalizing racial discrimination overturned by the 1964 US Civil Rights Act) and birth cohort trends in infant death rates. Methods. We analyzed 1959 to 2006 US Black and White infant death rates within and across sets of states (polities) with and without Jim Crow laws. Results. Between 1965 and 1969, a unique convergence of Black infant death rates occurred across polities; in 1960 to 1964, the Black infant death rate was 1.19 times higher (95% confidence interval [CI] = 1.18, 1.20) in the Jim Crow polity than in the non–Jim Crow polity, whereas in 1970 to 1974 the rate ratio shrank to and remained at approximately 1 (with the 95% CI including 1) until 2000, when it rose to 1.10 (95% CI = 1.08, 1.12). No such convergence occurred for Black–White differences in infant death rates or for White infants. Conclusions. Our results suggest that abolition of Jim Crow laws affected US Black infant death rates and that valid analysis of societal determinants of health requires appropriate comparison groups. PMID:24134378

The unique impact of abolition of Jim Crow laws on reducing inequities in infant death rates and implications for choice of comparison groups in analyzing societal determinants of health.

PubMed

Krieger, Nancy; Chen, Jarvis T; Coull, Brent; Waterman, Pamela D; Beckfield, Jason

2013-12-01

We explored associations between the abolition of Jim Crow laws (i.e., state laws legalizing racial discrimination overturned by the 1964 US Civil Rights Act) and birth cohort trends in infant death rates. We analyzed 1959 to 2006 US Black and White infant death rates within and across sets of states (polities) with and without Jim Crow laws. Between 1965 and 1969, a unique convergence of Black infant death rates occurred across polities; in 1960 to 1964, the Black infant death rate was 1.19 times higher (95% confidence interval [CI] = 1.18, 1.20) in the Jim Crow polity than in the non-Jim Crow polity, whereas in 1970 to 1974 the rate ratio shrank to and remained at approximately 1 (with the 95% CI including 1) until 2000, when it rose to 1.10 (95% CI = 1.08, 1.12). No such convergence occurred for Black-White differences in infant death rates or for White infants. Our results suggest that abolition of Jim Crow laws affected US Black infant death rates and that valid analysis of societal determinants of health requires appropriate comparison groups.

Rates and Correlates of Undetermined Deaths among African Americans: Results from the National Violent Death Reporting System

ERIC Educational Resources Information Center

Huguet, Nathalie; Kaplan, Mark S.; McFarland, Bentson H.

2012-01-01

Little is known about the factors associated with undetermined death classifications among African Americans. In this study, the rates of undetermined deaths were assessed, the prevalence of missing information was estimated, and whether the circumstances preceding death differ by race were examined. Data were derived from the 2005-2008 National…

The public health value of vaccination for seniors in Europe.

PubMed

Esposito, Susanna; Franco, Elisabetta; Gavazzi, Gaetan; de Miguel, Angel Gil; Hardt, Roland; Kassianos, George; Bertrand, Isabelle; Levant, Marie-Cécile; Soubeyrand, Benoit; López Trigo, Jose Antonio

2018-05-03

Longer life expectancy and decreasing fertility rates mean that the proportion of older people is continually increasing worldwide, and particularly in Europe. Ageing is associated with an increase in the risk and severity of infectious diseases. These diseases are also more difficult to diagnose and manage in seniors who often have at least one comorbid condition (60% of seniors have two or more conditions). Infectious diseases increase the risk of hospitalization, loss of autonomy and death in seniors. Effective vaccines are available in Europe for infectious diseases such as influenza, pneumococcal diseases, herpes zoster, diphtheria, tetanus and pertussis. Their effectiveness has been demonstrated in terms of reducing the rates of hospitalization, disability, dependency and death. The prevention of diseases in seniors also results in savings in healthcare and societal costs each year in Europe. Despite the availability of vaccines, vaccine-preventable diseases affect millions of European citizens annually, with the greatest burden of disease occurring in seniors, and the medical and economic benefits associated with are not being achieved. Vaccination coverage rates must be improved to achieve the full benefits of vaccination of seniors in Europe. Copyright © 2018 Elsevier Ltd. All rights reserved.

Evaluation of garlic plant and indinavir drug efficacy in the treatment of cryptosporidiosis in experimentally immumosuppressed rats.

PubMed

Toulah, Fawzia H; El-Shafei, Amal A; Al-Rashidi, Hyat S

2012-08-01

The present study evaluated the efficacy of garlic plant and Indinavir on cryptosporidiosis in experimentally immunosuppressed infected rats. One hundred forty five Wister rats aging 3 weeks were divided into five groups: GI: normal control, GII: Indinavir treated control, GIII: immunosuppressed infected, GIV: immunosuppressed infected and treated with garlic and GV: immunosuppressed infected and treated with Indinavir. All were subjected to clinical, parasitological and histopathological examination at different days post infection (P.I.). The results showed that in GIII, all rats had diarrhea, loss of appetite, weakness and limited movement, with 51.4% death rate. In both treated groups, some rats regained activities, with death rate of 33.3% (GV) and non GIV. There was significant decrease in the number of excreted oocysts at 5th and 10th day post treatment (P.T.) in treated groups. One week P.T., in GIV, the number of excreted oocysts had continued in decreasing while in GV, it was insignificantly increased. No cure rate was detected in both treated groups as oocysts still excreted till the end of experiment. The histopathological changes improved in treated groups in spite of the presence of some parasites on the epithelial surfaces of ileum.

How have changes in front air bag designs affected frontal crash death rates? An update.

PubMed

Teoh, Eric R

2014-01-01

Provide updated death rates comparing latest generations of frontal air bags in fatal crashes. Rates of driver and right-front passenger deaths in frontal crashes per 10 million registered vehicle years were compared using Poisson marginal structural models for passenger vehicles equipped with air bags certified as advanced and compliant (CAC), sled-certified air bags with advanced features, and sled-certified air bags without any advanced features. Analyses of driver death rates were disaggregated by age group, gender, and belt use. CAC air bags were associated with slightly elevated frontal crash death rates for both drivers and right-front passengers compared to sled-certified air bags with advanced features, but the differences were not statistically significant. Sled-certified air bags with advanced features were associated with significant benefits for drivers and for right-front passengers compared to sled-certified air bags without advanced features. CAC air bags were associated with a significant increase in belted driver death rate and a comparable but nonsignificant decrease in unbelted driver death rate compared to sled-certified air bags with advanced features. Sled-certified air bags with advanced features were associated with a nonsignificant 2 percent increase in belted driver death rate and a significant 26 percent decrease in unbelted driver death rate, relative to sled-certified air bags without advanced features. Implementing advanced features in sled-certified air bags was beneficial overall to drivers and right-front passengers with sled-certified air bags. No overall benefit was observed for CAC air bags compared to sled-certified air bags with advanced features. Further study is needed to understand the apparent reduction in belted driver protection observed for CAC air bags.

UPDATE ON THE GLOBAL BURDEN OF ISCHAEMIC AND HAEMORRHAGIC STROKE IN 1990–2013: THE GBD 2013 STUDY

PubMed Central

Feigin, Valery L.; Krishnamurthi, Rita; Parmar, Priya; Norrving, Bo; Mensah, George A.; Bennett, Derrick A.; Barker-Collo, Suzanne; Moran, Andrew; Sacco, Ralph L.; Truelsen, Thomas; Davis, Stephen; Pandian, Jeyaraj Durai; Naghavi, Mohsen; Forouzanfar, Mohammad H.; Nguyen, Grant; Johnson, Catherine O.; Vos, Theo; Meretoja, Atte; Murray, Christopher; Roth, Gregory A.; Thrift, Amanda; Banerjee, Amitava; Kengne, Andre Pascal; Misganaw, Awoke; Kissela, Brett M.; Wolfe, Charles; Yu, Chuanhua; Anderson, Craig; Kim, Daniel; Rojas-Rueda, David; Tanne, David; Tirschwell, David Lawrence; Nand, Devina; Kazi, Dhruv S.; Pourmalek, Farshad; Catalá-López, Ferrán; Abd-Allah, Foad; Gankpé, Fortuné; deVeber, Gabrielle; Donnan, Geoffrey; Hankey, Graeme J.; Christensen, Hanne K.; Campos-Nonato, Ismael; Shiue, Ivy; Fernandes, Jefferson G.; Jonas, Jost B.; Sheth, Kevin; Kim, Yunjin; Dokova, Klara; Stroumpoulis, Konstantinos; Sposato, Luciano A.; Bahit, Maria Cecilia; Geleijnse, Johanna M.; Mackay, Mark T.; Mehndiratta, Man Mohan; Endres, Matthias; Giroud, Maurice; Brainin, Michael; Kravchenko, Michael; Piradov, Michael; Soljak, Michael; Liu, Ming; Connor, Myles; Venketasubramanian, Narayanaswamy; Bornstein, Natan; Shamalov, Nikolay; Roy, Nobhojit; Cabral, Norberto; Beauchamp, Norman J.; Lavados, Pablo M.; Jeemon, Panniyammakal; Lotufo, Paulo A.; Chowdhury, Rajiv; Sahathevan, Ramesh; Hamadeh, Randah R.; Malekzadeh, Reza; Gillium, Richard; Westerman, Ronny; Akinyemi, Rufus Olusola; Salman, Rustam Al-Shahi; Dharmaratne, Samath D.; Basu, Sanjay; Abera, Semaw Ferede; Kosen, Soewarta; Sampson, Uchechukwu K. A.; Caso, Valeria; Vlassov, Vasiliy; Melaku, Yohannes Adama; Kokubo, Yoshiohiro; Shinohara, Yukito; Varakin, Yuri; Wang, Wenzhi

2015-01-01

Background Global stroke epidemiology is changing rapidly. Although age-standardised rates of stroke mortality have decreased worldwide in the past two decades, the absolute numbers of people who have a stroke every year, live with the consequences of stroke, and die from their stroke are increasing. Regular updates on the current level of stroke burden are important for advancing our knowledge on stroke epidemiology and facilitate organization and planning of evidence-based stroke care. Objectives To estimate incidence, prevalence, mortality, disability-adjusted life-years (DALYs) and years lived with disability (YLDs), and their trends for ischaemic stroke (IS) and haemorrhagic stroke (HS) for 188 countries from 1990–2013. Methodology Stroke incidence, prevalence, mortality, DALYs and YLDs were estimated using all available data on mortality and stroke incidence, prevalence and excess mortality. Statistical models and country-level covariate data were employed and all rates were age-standardised to a global population. All estimated were produced with 95% uncertainty intervals (UI). Results In 2013, there were globally almost 25.7 million stroke survivors (71% with IS), 6.5 million deaths from stroke (51% died from IS), 113 million DALYs due to stroke (58% due to IS), and 10.3 million new strokes (67% IS). Over the 1990–2013 period, there was a significant increase in the absolute number of DALYs due to IS, and of deaths from IS and HS, survivors and incident events for both IS and HS. The preponderance of the burden of stroke continued to reside in developing countries, comprising 75.2% of deaths from stroke and 81.0% of stroke-related DALYs. Globally, the proportional contribution of stroke-related DALYs and deaths due to stroke compared to all diseases increased from 1990 (3.54% [95% UI 3.11–4.00%] and 9.66% [95% UI 8.47–10.70%]) to 2013 (4.62% [95% UI 4.01–5.30%] and 11.75% [95% UI 10.45–13.31%], respectively), but there was a diverging trend in developed and developing countries with a significant increase in DALYs and deaths in developing countries, and no measurable change in the proportional contribution of DALYs and deaths from stroke in developed countries. Conclusion Global stroke burden continues to increase globally. More efficient stroke prevention and management strategies are urgently needed to halt and eventually reverse the stroke pandemic, while universal access to organized stroke services should be a priority. PMID:26505981

Update on the Global Burden of Ischemic and Hemorrhagic Stroke in 1990-2013: The GBD 2013 Study.

PubMed

Feigin, Valery L; Krishnamurthi, Rita V; Parmar, Priya; Norrving, Bo; Mensah, George A; Bennett, Derrick A; Barker-Collo, Suzanne; Moran, Andrew E; Sacco, Ralph L; Truelsen, Thomas; Davis, Stephen; Pandian, Jeyaraj Durai; Naghavi, Mohsen; Forouzanfar, Mohammad H; Nguyen, Grant; Johnson, Catherine O; Vos, Theo; Meretoja, Atte; Murray, Christopher J L; Roth, Gregory A

2015-01-01

Global stroke epidemiology is changing rapidly. Although age-standardized rates of stroke mortality have decreased worldwide in the past 2 decades, the absolute numbers of people who have a stroke every year, and live with the consequences of stroke or die from their stroke, are increasing. Regular updates on the current level of stroke burden are important for advancing our knowledge on stroke epidemiology and facilitate organization and planning of evidence-based stroke care. This study aims to estimate incidence, prevalence, mortality, disability-adjusted life years (DALYs) and years lived with disability (YLDs) and their trends for ischemic stroke (IS) and hemorrhagic stroke (HS) for 188 countries from 1990 to 2013. Stroke incidence, prevalence, mortality, DALYs and YLDs were estimated using all available data on mortality and stroke incidence, prevalence and excess mortality. Statistical models and country-level covariate data were employed, and all rates were age-standardized to a global population. All estimates were produced with 95% uncertainty intervals (UIs). In 2013, there were globally almost 25.7 million stroke survivors (71% with IS), 6.5 million deaths from stroke (51% died from IS), 113 million DALYs due to stroke (58% due to IS) and 10.3 million new strokes (67% IS). Over the 1990-2013 period, there was a significant increase in the absolute number of DALYs due to IS, and of deaths from IS and HS, survivors and incident events for both IS and HS. The preponderance of the burden of stroke continued to reside in developing countries, comprising 75.2% of deaths from stroke and 81.0% of stroke-related DALYs. Globally, the proportional contribution of stroke-related DALYs and deaths due to stroke compared to all diseases increased from 1990 (3.54% (95% UI 3.11-4.00) and 9.66% (95% UI 8.47-10.70), respectively) to 2013 (4.62% (95% UI 4.01-5.30) and 11.75% (95% UI 10.45-13.31), respectively), but there was a diverging trend in developed and developing countries with a significant increase in DALYs and deaths in developing countries, and no measurable change in the proportional contribution of DALYs and deaths from stroke in developed countries. Global stroke burden continues to increase globally. More efficient stroke prevention and management strategies are urgently needed to halt and eventually reverse the stroke pandemic, while universal access to organized stroke services should be a priority. © 2015 S. Karger AG, Basel.

Explorative spatial analysis of traffic accident statistics and road mortality among the provinces of Turkey.

PubMed

Erdogan, Saffet

2009-10-01

The aim of the study is to describe the inter-province differences in traffic accidents and mortality on roads of Turkey. Two different risk indicators were used to evaluate the road safety performance of the provinces in Turkey. These indicators are the ratios between the number of persons killed in road traffic accidents (1) and the number of accidents (2) (nominators) and their exposure to traffic risk (denominator). Population and the number of registered motor vehicles in the provinces were used as denominators individually. Spatial analyses were performed to the mean annual rate of deaths and to the number of fatal accidents that were calculated for the period of 2001-2006. Empirical Bayes smoothing was used to remove background noise from the raw death and accident rates because of the sparsely populated provinces and small number of accident and death rates of provinces. Global and local spatial autocorrelation analyses were performed to show whether the provinces with high rates of deaths-accidents show clustering or are located closer by chance. The spatial distribution of provinces with high rates of deaths and accidents was nonrandom and detected as clustered with significance of P<0.05 with spatial autocorrelation analyses. Regions with high concentration of fatal accidents and deaths were located in the provinces that contain the roads connecting the Istanbul, Ankara, and Antalya provinces. Accident and death rates were also modeled with some independent variables such as number of motor vehicles, length of roads, and so forth using geographically weighted regression analysis with forward step-wise elimination. The level of statistical significance was taken as P<0.05. Large differences were found between the rates of deaths and accidents according to denominators in the provinces. The geographically weighted regression analyses did significantly better predictions for both accident rates and death rates than did ordinary least regressions, as indicated by adjusted R(2) values. Geographically weighted regression provided values of 0.89-0.99 adjusted R(2) for death and accident rates, compared with 0.88-0.95, respectively, by ordinary least regressions. Geographically weighted regression has the potential to reveal local patterns in the spatial distribution of rates, which would be ignored by the ordinary least regression approach. The application of spatial analysis and modeling of accident statistics and death rates at provincial level in Turkey will help to identification of provinces with outstandingly high accident and death rates. This could help more efficient road safety management in Turkey.

QuickStats: Brain Cancer Death Rates Among Children and Teens Aged 1-19 Years,* by Sex† and Age Group - United States, 2013-2015.

PubMed

2017-05-05

The death rate for brain cancer, the most common cancer cause of death for children and teens aged 1-19 years, was 24% higher in males (0.73 per 100,000) than females (0.59) aged 1-19 years during 2013-2015. Death rates were higher for males than females for all age groups, but the difference did not reach statistical significance for the age group 5-9 years. Death rates caused by brain cancer were highest at ages 5-9 years (0.98 for males and 0.85 for females).

76 FR 4376 - Agency Information Collection Activities; Submission for OMB Review; Comment Request; Application...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-25

... for OMB Review; Comment Request; Application for Continuation of Death Benefit for Student ACTION... Continuation of Death Benefit for Student,'' to the Office of Management and Budget (OMB) for review and...-266 is used by the OWCP as an [[Page 4377

Violence-related firearm deaths among residents of metropolitan areas and cities---United States, 2006--2007.

PubMed

2011-05-13

Violence-related firearm deaths remain an important public health concern in the United States. During 2006--2007, a total of 25,423 firearm homicides and 34,235 firearm suicides occurred among U.S. residents. These national totals include 4,166 firearm homicides and 1,446 firearm suicides among youths aged 10--19 years; the rate of firearm homicides among youths slightly exceeded the rate among persons of all ages. This report presents statistics on firearm homicides and firearm suicides for major metropolitan areas and cities, with an emphasis on youths aged 10--19 years in recognition of the importance of early prevention efforts. It integrates analyses conducted by CDC in response to requests for detailed information, arising from a heightened focus on urban violence by the media, the public, and policymakers over the past year. Firearm homicides and suicides and annual rates were tabulated for the 50 largest U.S. metropolitan statistical areas (MSAs) and their central cities for 2006--2007, using data from the National Vital Statistics System and the U.S. Census Bureau. Firearm homicide rates in approximately two thirds of the MSAs exceeded the national rate, and 86% of cities had rates higher than those of their MSAs. The youth firearm homicide rate exceeded the all-ages rate in 80% of the MSAs and in 88% of the cities. Firearm suicide rates in just over half of the MSAs were below the national rate, and 55% of cities had rates below those of their MSAs. Youth firearm suicide rates in the MSAs and cities were collectively low compared with all-ages rates. Such variations in firearm homicide and firearm suicide rates, with respect to both urbanization and age, should be considered in the continuing development of prevention programs directed at reducing firearm violence.

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

PubMed

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

2015-12-05

In 2000, world leaders agreed on the Millennium Development Goals (MDGs). MDG 4 called for a two-thirds reduction in the under-5 mortality rate between 1990 and 2015. We aimed to estimate levels and trends in under-5 mortality for 195 countries from 1990 to 2015 to assess MDG 4 achievement and then intended to project how various post-2015 targets and observed rates of change will affect the burden of under-5 deaths from 2016 to 2030. We updated the UN Inter-agency Group for Child Mortality Estimation (UN IGME) database with 5700 country-year datapoints. As of July, 2015, the database contains about 17 000 country-year datapoints for mortality of children younger than 5 years for 195 countries, and includes all available nationally-representative data from vital registration systems, population censuses, household surveys, and sample registration systems. We used these data to generate estimates, with uncertainty intervals, of under-5 (age 0-4 years) mortality using a Bayesian B-spline bias-reduction model (B3 model). This model includes a data model to adjust for systematic biases associated with different types of data sources. To provide insights into the global and regional burden of under-5 deaths associated with post-2015 targets, we constructed five scenario-based projections for under-5 mortality from 2016 to 2030 and estimated national, regional, and global under-5 mortality rates up to 2030 for each scenario. The global under-5 mortality rate has fallen from 90·6 deaths per 1000 livebirths (90% uncertainty interval 89·3-92·2) in 1990 to 42·5 (40·9-45·6) in 2015. During the same period, the annual number of under-5 deaths worldwide dropped from 12·7 million (12·6 million-13·0 million) to 5·9 million (5·7 million-6·4 million). The global under-5 mortality rate reduced by 53% (50-55%) in the past 25 years and therefore missed the MDG 4 target. Based on point estimates, two regions-east Asia and the Pacific, and Latin America and the Caribbean-achieved the MDG 4 target. 62 countries achieved the MDG 4 target, of which 24 were low-income and lower-middle income countries. Between 2016 and 2030, 94·4 million children are projected to die before the age of 5 years if the 2015 mortality rate remains constant in each country, and 68·8 million would die if each country continues to reduce its mortality rate at the pace estimated from 2000 to 2015. If all countries achieve the Sustainable Development Goal of an under-5 mortality rate of 25 or fewer deaths per 1000 livebirths by 2030, we project 56·0 million deaths by 2030. About two-thirds of all sub-Saharan African countries need to accelerate progress to achieve this target. Despite substantial progress in reducing child mortality, concerted efforts remain necessary to avoid preventable under-5 deaths in the coming years and to accelerate progress in improving child survival further. Urgent actions are needed most in the regions and countries with high under-5 mortality rates, particularly those in sub-Saharan Africa and south Asia. None. Copyright © 2015 World Health Organization. Published by Elsevier Ltd/Inc/BV. All rights reserved. Published by Elsevier Ltd.. All rights reserved.

Reconstructing meaning through occupation after the death of a family member: accommodation, assimilation, and continuing bonds.

PubMed

Hoppes, Steve; Segal, Ruth

2010-01-01

Reactions to death have been studied extensively from psychological, behavioral, and physiological perspectives. Occupational adaptation to loss has received scant attention. Qualitative research was undertaken to identify and describe occupational responses in bereavement. The constant comparative approach was used to analyze and interpret the occupational responses. Adaptive strategies of occupational accommodation and assimilation were used after the death of a family member. Desire to sustain bonds with the deceased motivated specific occupational engagements. These occupational responses served to reconstruct meaning after the death of a family member. These findings contribute to understanding adaptation after death by adding an occupational perspective to previous theories. Occupational therapists' abilities to support clients after loss can be enhanced through appreciation of occupational accommodation and assimilation and the role of continuing occupational bonds after the death of a loved one.

Will the European Union reach the United Nations Millennium declaration target of a 50% reduction of tuberculosis mortality between 1990 and 2015?

PubMed

van der Werf, Marieke J; Bonfigli, Sandro; Hruba, Frantiska

2017-07-06

The Millennium Development Goals (MDG) provide targets for 2015. MDG 6 includes a target to reduce the tuberculosis (TB) death rate by 50% compared with 1990. We aimed to assess whether this target was reached by the European Union (EU) and European Economic Area countries. We used Eurostat causes of death data to assess whether the target was reached in the EU. We calculated the reduction in reported and adjusted death rates and the annual average percentage decline based on the available data. Between 1999 and 2014, the TB death rate decreased by 50%, the adjusted death rate by 56% and the annual average percentage decline was 5.43% (95% confidence interval 4.94-6.74) for the EU. Twenty of 26 countries reporting >5 TB deaths in the first reporting year reached the target of 50% reduction in adjusted death rate. The EU reached the MDG target of a 50% reduction of the TB death rate and also the annual average percentage decline was larger than the 2.73% needed to reach the target. The World Health Organization 'End TB Strategy' requires a further reduction of the number of TB deaths of 35% by 2020 compared to 2015, which will challenge TB prevention and care services in the EU.

2009 traffic crash facts annual report

DOT National Transportation Integrated Search

2009-01-01

In 2009, the death rate on Nebraska roadways was 1.2 persons killed per 100 million vehicle miles traveled. The death rate in Nebraska, from 1961 to 2009 is represented in Figure 1. Even though the death rate fluctuates from year to year, there has b...

2004 traffic crash facts annual report

DOT National Transportation Integrated Search

2004-01-01

In 2004, the death rate on Nebraska roadways was 1.4 persons killed per 100 million vehicle miles traveled. The death rate in Nebraska, from 1961 to 2004 is represented in Figure 1. Even though the death rate fluctuates from year to year, there has b...

Georgia Kids Count Factbook, 1992.

ERIC Educational Resources Information Center

Georgians for Children, Atlanta, GA.

This factbook presents statistics and examines trends for nine indicators of children's well-being in Georgia. The indicators are: (1) number and percent of low birthweight infants; (2) infant death rate; (3) death rate of children ages 1 to 14 years; (4) violent death rate of teenagers aged 15 to 19 years; (5) rate of child abuse and neglect; (6)…

7 CFR 760.1311 - Death, incompetence, or disappearance.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 7 2010-01-01 2010-01-01 false Death, incompetence, or disappearance. 760.1311 Section 760.1311 Agriculture Regulations of the Department of Agriculture (Continued) FARM SERVICE AGENCY... Program § 760.1311 Death, incompetence, or disappearance. (a) In the case of the death, incompetency, or...

7 CFR 760.29 - Death, incompetency, or disappearance.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 7 2010-01-01 2010-01-01 false Death, incompetency, or disappearance. 760.29 Section 760.29 Agriculture Regulations of the Department of Agriculture (Continued) FARM SERVICE AGENCY... Provisions § 760.29 Death, incompetency, or disappearance. In the case of the death, incompetency, or...

7 CFR 760.29 - Death, incompetency, or disappearance.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 7 2014-01-01 2014-01-01 false Death, incompetency, or disappearance. 760.29 Section 760.29 Agriculture Regulations of the Department of Agriculture (Continued) FARM SERVICE AGENCY... Provisions § 760.29 Death, incompetency, or disappearance. In the case of the death, incompetency, or...

7 CFR 760.29 - Death, incompetency, or disappearance.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 7 2013-01-01 2013-01-01 false Death, incompetency, or disappearance. 760.29 Section 760.29 Agriculture Regulations of the Department of Agriculture (Continued) FARM SERVICE AGENCY... Provisions § 760.29 Death, incompetency, or disappearance. In the case of the death, incompetency, or...

7 CFR 760.1311 - Death, incompetence, or disappearance.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 7 2014-01-01 2014-01-01 false Death, incompetence, or disappearance. 760.1311 Section 760.1311 Agriculture Regulations of the Department of Agriculture (Continued) FARM SERVICE AGENCY... Program § 760.1311 Death, incompetence, or disappearance. (a) In the case of the death, incompetency, or...

7 CFR 760.29 - Death, incompetency, or disappearance.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 7 2012-01-01 2012-01-01 false Death, incompetency, or disappearance. 760.29 Section 760.29 Agriculture Regulations of the Department of Agriculture (Continued) FARM SERVICE AGENCY... Provisions § 760.29 Death, incompetency, or disappearance. In the case of the death, incompetency, or...

7 CFR 760.1311 - Death, incompetence, or disappearance.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 7 2012-01-01 2012-01-01 false Death, incompetence, or disappearance. 760.1311 Section 760.1311 Agriculture Regulations of the Department of Agriculture (Continued) FARM SERVICE AGENCY... Program § 760.1311 Death, incompetence, or disappearance. (a) In the case of the death, incompetency, or...

7 CFR 760.1311 - Death, incompetence, or disappearance.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 7 2011-01-01 2011-01-01 false Death, incompetence, or disappearance. 760.1311 Section 760.1311 Agriculture Regulations of the Department of Agriculture (Continued) FARM SERVICE AGENCY... Program § 760.1311 Death, incompetence, or disappearance. (a) In the case of the death, incompetency, or...

7 CFR 760.1311 - Death, incompetence, or disappearance.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 7 2013-01-01 2013-01-01 false Death, incompetence, or disappearance. 760.1311 Section 760.1311 Agriculture Regulations of the Department of Agriculture (Continued) FARM SERVICE AGENCY... Program § 760.1311 Death, incompetence, or disappearance. (a) In the case of the death, incompetency, or...

7 CFR 760.29 - Death, incompetency, or disappearance.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 7 2011-01-01 2011-01-01 false Death, incompetency, or disappearance. 760.29 Section 760.29 Agriculture Regulations of the Department of Agriculture (Continued) FARM SERVICE AGENCY... Provisions § 760.29 Death, incompetency, or disappearance. In the case of the death, incompetency, or...

Intensity of Renal Support in Critically Ill Patients with Acute Kidney Injury

PubMed Central

2008-01-01

BACKGROUND The optimal intensity of renal-replacement therapy in critically ill patients with acute kidney injury is controversial. METHODS We randomly assigned critically ill patients with acute kidney injury and failure of at least one nonrenal organ or sepsis to receive intensive or less intensive renal-replacement therapy. The primary end point was death from any cause by day 60. In both study groups, hemodynamically stable patients underwent intermittent hemodialysis, and hemodynamically unstable patients underwent continuous venovenous hemodiafiltration or sustained low-efficiency dialysis. Patients receiving the intensive treatment strategy underwent intermittent hemodialysis and sustained low-efficiency dialysis six times per week and continuous venovenous hemodiafiltration at 35 ml per kilogram of body weight per hour; for patients receiving the less-intensive treatment strategy, the corresponding treatments were provided thrice weekly and at 20 ml per kilogram per hour. RESULTS Baseline characteristics of the 1124 patients in the two groups were similar. The rate of death from any cause by day 60 was 53.6% with intensive therapy and 51.5% with less-intensive therapy (odds ratio, 1.09; 95% confidence interval, 0.86 to 1.40; P = 0.47). There was no significant difference between the two groups in the duration of renalreplacement therapy or the rate of recovery of kidney function or nonrenal organ failure. Hypotension during intermittent dialysis occurred in more patients randomly assigned to receive intensive therapy, although the frequency of hemodialysis sessions complicated by hypotension was similar in the two groups. CONCLUSIONS Intensive renal support in critically ill patients with acute kidney injury did not decrease mortality, improve recovery of kidney function, or reduce the rate of nonrenal organ failure as compared with less-intensive therapy involving a defined dose of intermittent hemodialysis three times per week and continuous renal-replacement therapy at 20 ml per kilogram per hour. (ClinicalTrials.gov number, NCT00076219.) PMID:18492867

Disease and injury in California with projections to the year 2007. Implications for medical education.

PubMed Central

Ragland, D R; Buffler, P A; Reingold, A L; Syme, S L; Buffler, M L

1998-01-01

In this article, as part of an evaluation of the future of medical education in California, we characterize the distribution of disease and injury in California; identify major factors that affect the epidemiology of disease and injury in California, and project the burden of disease and injury for California's population to the year 2007. Our goal is to elucidate the major causes of illness and disability at present and in the near future in order to focus state resources on the interventions likely to have the greatest impact. Data from various governmental agencies were utilized; the base year, 1993, is the most recent year with sufficient information available when this report was prepared. Several major risk factors have decreased, including smoking (30% decline from 1984 to 1993) and drinking and driving. However, hypertension prevalence has not changed, and overweight has increased dramatically. Poverty continues to burden about 15% of Californians, with poverty highest among children. During 1993, 220,271 Californians died, with 3 major causes accounting for 61% of these deaths: coronary heart disease (31%), cancer (23%), and stroke (7%). In terms of potential years of life lost (years lost before age 65), the most important causes of death in 1993 were unintentional injury (756 years lost/100,000 population), cancer (632 years), and the acquired immunodeficiency syndrome (AIDS; 491 years). Mortality rates were highest among blacks and lowest among Asians. Overall mortality in California has been declining for decades; in just 1 decade, from 1980 to 1991, mortality declined from 780 to 680 deaths per 100,000 population. Several major causes of death have declined, including coronary heart disease, stroke, unintentional injury, cirrhosis, and suicide, while others have increased, for example, chronic obstructive lung disease and diabetes mellitus. Death from AIDS increased dramatically in the past decade, but is leveling off, and death from cancer is beginning to decline. Rates for overall mortality and morbidity, and for most specific conditions, should continue to decline. A projected 28% population increase by 2007 will yield a corresponding increase in the absolute level of disease cases and death; a disproportionate increase in younger and older groups will yield increased conditions affecting young (unintentional injury, AIDS) and older (heart disease, cancer, stroke, diabetes mellitus) people. Californians should experience overall improved health in coming years, reaping benefits of reduced environmental and behavioral risk factors as well as improved medical treatment and rehabilitation. Coordinated strategies for health promotion, disease prevention, delivery of medical treatment, and rehabilitation are needed to maintain and improve present levels of health across the life span. Images Figure 5. Figure 6. Figure 7. Figure 8. Figure 22. Figure 25. Figure 26. PMID:9614796

Abortion surveillance--United States, 1992.

PubMed

Koonin, L M; Smith, J C; Ramick, M; Green, C A

1996-05-03

From 1980 through 1992, the number of legal induced abortions reported to the CDC remained stable, varying each year by < or = 5%. This report summarizes and reviews information reported to CDC regarding legal induced abortions obtained in the United States during 1992. This report also includes recently reported abortion-related deaths for 1988-1991 and an update on abortion-related deaths for 1985-1987. For each year since 1969, CDC has compiled abortion data received from 52 reporting areas (i.e., the 50 states, the District of Columbia, and New York City). In 1992, 1,359,145 abortions were reported--a 2.1% decrease from 1991. The abortion ratio was 335 legal induced abortions per 1,000 live births, and the abortion rate was 23 per 1,000 women 15-44 years of age. Women who were undergoing an abortion were more likely to be young, white, and unmarried; most had had no previous live births and were obtaining an abortion for the first time. More than half (51%) of all abortions were performed at or before the 8th week of gestation, and 87% were before the 13th week. Approximately 14% of abortions were performed at < or = 6 weeks of gestation, 15% were performed at 7 weeks of gestation, and 22% at 8 weeks of gestation. Younger women (i.e., women < or = 19 years of age) were more likely to obtain abortions later in pregnancy than were older women. Sixteen deaths in 1988, 12 deaths in 1989, and five deaths in 1990 were associated with legal induced abortion. The case-fatality rates for 1988, 1989, and 1990, respectively, were 1.2, 0.9, and 0.3 abortion-related deaths per 100,000 legal induced abortions. Since 1980, the number and rate of abortions have remained relatively stable, with only small year-to-year fluctuations of < or = 5%. However, since 1987, the abortion-to-live-birth ratio has declined; in 1992, the abortion ratio was the lowest recorded since 1977. More pregnant women have been opting to carry their pregnancies to term rather than choosing to have an abortion. As in previous years, deaths associated with legal induced abortions occurred rarely (i.e., one or fewer deaths per 100,000 legal induced abortions). The number and characteristics of women who obtain abortions in the United States should continue to be monitored so that efforts to prevent unintended pregnancy can be assessed and the preventable causes of morbidity and mortality associated with abortions can be identified and reduced.

Death and suicide among former child and adolescent psychiatric patients

PubMed Central

Engqvist, Ulf; Rydelius, Per-Anders

2006-01-01

Background Increased mortality rates among previous child and adolescent psychiatry (CAP) patients have been found in Scandinavian studies up to the 1980s. The suicide risk in this group has been estimated to be almost five times higher than expected. This article addresses two questions: Do Swedish CAP patients continue to risk premature death and what kind of information related to psychiatric symptoms and/or behavior problems can predict later suicide? Methods Hospital files, Sweden's census databases (including immigration and emigration) and administrative databases (including the Swedish Hospital Discharge register and the Persons Convicted of Offences register), and the Cause of Death register were examined to determine the mortality rate in a group of 1,400 former CAP inpatients and outpatients over a period of 12–33 years. Observed and expected numbers of deceased were calculated with the prospective method and the standardized mortality ratio (SMR) method. The relative risk or the risk ratio (RR) is presented with 95% confidence intervals (CIs). Significance level tests were made using two-by-two tables and chi-square tests. The Cox proportional-hazards regression model was used for survival analysis. Results Twenty-four males and 14 females died. Compared with the general population, the standardized mortality ratio in this group of CAP patients was significantly higher in both sexes. Behavioral problems, school problems, and co-morbid alcohol or drug abuse and criminality (including alcohol-related crimes) were found to be important predictors. Thirty-two deaths were attributed to suicide, intoxication, drug overdose, or accident; one patient died of an alcohol abuse-related disorder, and five patients died of natural causes. Suicide was the most common cause of death, but only 2 of these 19 cases were initially admitted for attempted suicide. Conclusion We suggest that suicide and death prevention among CAP patients may not be a psychiatric issue per se but a future function of society's juvenile social-welfare investments and juvenile-delinquency prevention programs. PMID:17081290

Death and suicide among former child and adolescent psychiatric patients.

PubMed

Engqvist, Ulf; Rydelius, Per-Anders

2006-11-02

Increased mortality rates among previous child and adolescent psychiatry (CAP) patients have been found in Scandinavian studies up to the 1980s. The suicide risk in this group has been estimated to be almost five times higher than expected. This article addresses two questions: Do Swedish CAP patients continue to risk premature death and what kind of information related to psychiatric symptoms and/or behavior problems can predict later suicide? Hospital files, Sweden's census databases (including immigration and emigration) and administrative databases (including the Swedish Hospital Discharge register and the Persons Convicted of Offences register), and the Cause of Death register were examined to determine the mortality rate in a group of 1,400 former CAP inpatients and outpatients over a period of 12-33 years. Observed and expected numbers of deceased were calculated with the prospective method and the standardized mortality ratio (SMR) method. The relative risk or the risk ratio (RR) is presented with 95% confidence intervals (CIs). Significance level tests were made using two-by-two tables and chi-square tests. The Cox proportional-hazards regression model was used for survival analysis. Twenty-four males and 14 females died. Compared with the general population, the standardized mortality ratio in this group of CAP patients was significantly higher in both sexes. Behavioral problems, school problems, and co-morbid alcohol or drug abuse and criminality (including alcohol-related crimes) were found to be important predictors. Thirty-two deaths were attributed to suicide, intoxication, drug overdose, or accident; one patient died of an alcohol abuse-related disorder, and five patients died of natural causes. Suicide was the most common cause of death, but only 2 of these 19 cases were initially admitted for attempted suicide. We suggest that suicide and death prevention among CAP patients may not be a psychiatric issue per se but a future function of society's juvenile social-welfare investments and juvenile-delinquency prevention programs.

Surveillance for violent deaths--National Violent Death Reporting System, 16 States, 2007.

PubMed

Karch, Debra L; Dahlberg, Linda L; Patel, Nimesh

2010-05-14

An estimated 50,000 persons die annually in the United States as a result of violence-related injuries. This report summarizes data from CDC's National Violent Death Reporting System (NVDRS) regarding violent deaths from 16 states for 2007. Results are reported by sex, age group, race/ethnicity, marital status, location of injury, method of injury, circumstances of injury, and other selected characteristics. 2007. NVDRS collects data regarding violent deaths obtained from death certificates, coroner/medical examiner reports, and law enforcement reports. NVDRS began operation in 2003 with seven states (Alaska, Maryland, Massachusetts, New Jersey, Oregon, South Carolina, and Virginia) participating; six states (Colorado, Georgia, North Carolina, Oklahoma, Rhode Island, and Wisconsin) joined in 2004, four (California, Kentucky, New Mexico, and Utah) in 2005, and two states (Ohio and Michigan) were funded to begin data collection in 2010, totaling 19 states. This report includes data from 16 states that collected statewide data in 2007. California data are not included in this report because NVDRS data are collected only in a limited number of California cities and counties rather than statewide. Ohio and Michigan are excluded because they did not begin data collection until 2010. For 2007, a total of 15,882 fatal incidents involving 16,319 deaths occurred in the 16 NVDRS states included in this report. The majority (56.6%) of deaths was suicides, followed by homicides and deaths involving legal intervention (i.e., deaths caused by police and other persons with legal authority to use deadly force, excluding legal executions) (28.0%), deaths of undetermined intent (14.7%), and unintentional firearm deaths (0.7%). Suicides occurred at higher rates among males, American Indians/Alaska Natives, non-Hispanic whites, and persons aged 45--54 years. Suicides occurred most often in a house or apartment and involved the use of firearms. Suicides were precipitated primarily by mental-health, intimate-partner, or physical-health problems, or by a crisis during the preceding 2 weeks. Homicides occurred at higher rates among males and persons aged 20--24 years; rates were highest among non-Hispanic black males. The majority of homicides involved the use of a firearm and occurred in a house or apartment or on a street/highway. Homicides were precipitated primarily by arguments and interpersonal conflicts or in conjunction with another crime. Other manners of death and special situations or populations also are highlighted in this report. This report provides a detailed summary of data from NVDRS for 2007. The results indicate that violent deaths resulting from self-inflicted or interpersonal violence disproportionately affected adults aged <55 years, males, and certain minority populations. For homicides and suicides, relationship problems, interpersonal conflicts, mental-health problems, and recent crises were among the primary precipitating factors. Because additional information might be reported subsequently as participating states update their findings, the data provided in this report are preliminary. For the occurrence of violent deaths in the United States to be better understood and ultimately prevented, accurate, timely, and comprehensive surveillance data are necessary. NVDRS data can be used to monitor the occurrence of violence-related fatal injuries and assist public health authorities in the development, implementation, and evaluation of programs and policies to reduce and prevent violent deaths at the national, state, and local levels. The continued development and expansion of NVDRS is essential to CDC's efforts to reduce the personal, familial, and societal costs of violence. Further efforts are needed to increase the number of states participating in NVDRS, with an ultimate goal of full national representation.

International comparisons of preterm birth: higher rates of late preterm birth are associated with lower rates of stillbirth and neonatal death.

PubMed

Lisonkova, S; Sabr, Y; Butler, B; Joseph, K S

2012-12-01

To examine international rates of preterm birth and potential associations with stillbirths and neonatal deaths at late preterm and term gestation. Ecological study. Canada, USA and 26 countries in Europe. All deliveries in 2004. Information on preterm birth (<37, 32-36, 28-31 and 24-27 weeks of gestation) and perinatal deaths was obtained for 28 countries. Data sources included files and publications from Statistics Canada, the EURO-PERISTAT project and the National Center for Health Statistics. Pearson correlation coefficients and random-intercept Poisson regression were used to examine the association between preterm birth rates and gestational age-specific stillbirth and neonatal death rates. Rate ratios with 95% confidence intervals were estimated after adjustment for maternal age, parity and multiple births. Stillbirths and neonatal deaths ≥ 32 and ≥ 37 weeks of gestation. International rates of preterm birth (<37 weeks) ranged between 5.3 and 11.4 per 100 live births. Preterm birth rates at 32-36 weeks were inversely associated with stillbirths at ≥ 32 weeks (adjusted rate ratio 0.94, 95% CI 0.92-0.96) and ≥ 37 weeks (adjusted rate ratio 0.88, 95% CI 0.85-0.91) of gestation and inversely associated with neonatal deaths at ≥ 32 weeks (adjusted rate ratio 0.88, 95% CI 0.85-0.91) and ≥ 37 weeks (adjusted rate ratio 0.82, 95% CI 0.78-0.86) of gestation. Countries with high rates of preterm birth at 32-36 weeks of gestation have lower stillbirth and neonatal death rates at and beyond 32 weeks of gestation. Contemporary rates of preterm birth are indicators of both perinatal health and obstetric care services. © 2012 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2012 RCOG.

Analysis of the Asbestos Permissible Exposure Level Threshold Standard

DTIC Science & Technology

1991-06-01

Risks from Smoki in. . .. . . .. ... .. 44 4. Is Society Paying Too Much? . . . . . . . . 44 a. Death Rates Compared to Lung Cancer .. 44 C. Conclusions...risk of death. Table 2 compares age-standardized lung cancer death rates (per 100,000 man-years) for cigarette smoking and/or occupational exposure to...Cancer Death Rates for Cigarette Smoking and Asbestos ZZposuze Group Exposed to Smoker Mortality Asbestos Ratio * Control No No 1.00 Asbestos Worker

QuickStats: Age-Adjusted Death Rates* for Top Five Causes of Cancer Death,(†) by Race/Hispanic Ethnicity - United States, 2014.

PubMed

2016-09-16

In 2014, the top five causes of cancer deaths for the total population were lung, colorectal, female breast, pancreatic, and prostate cancer. The non-Hispanic black population had the highest age-adjusted death rates for each of these five cancers, followed by non-Hispanic white and Hispanic groups. The age-adjusted death rate for lung cancer, the leading cause of cancer death in all groups, was 42.1 per 100,000 standard population for the total population, 45.4 for non-Hispanic white, 45.7 for non-Hispanic black, and 18.3 for Hispanic populations.

38 CFR 3.351 - Special monthly dependency and indemnity compensation, death compensation, pension and spouse's...

Code of Federal Regulations, 2011 CFR

2011-07-01

... dependency and indemnity compensation, death compensation, pension and spouse's compensation ratings. 3.351..., Compensation, and Dependency and Indemnity Compensation Ratings for Special Purposes § 3.351 Special monthly dependency and indemnity compensation, death compensation, pension and spouse's compensation ratings. (a...

38 CFR 3.351 - Special monthly dependency and indemnity compensation, death compensation, pension and spouse's...

Code of Federal Regulations, 2012 CFR

2012-07-01

... dependency and indemnity compensation, death compensation, pension and spouse's compensation ratings. 3.351..., Compensation, and Dependency and Indemnity Compensation Ratings for Special Purposes § 3.351 Special monthly dependency and indemnity compensation, death compensation, pension and spouse's compensation ratings. (a...

38 CFR 3.351 - Special monthly dependency and indemnity compensation, death compensation, pension and spouse's...

Code of Federal Regulations, 2014 CFR

2014-07-01

... dependency and indemnity compensation, death compensation, pension and spouse's compensation ratings. 3.351..., Compensation, and Dependency and Indemnity Compensation Ratings for Special Purposes § 3.351 Special monthly dependency and indemnity compensation, death compensation, pension and spouse's compensation ratings. (a...

38 CFR 3.351 - Special monthly dependency and indemnity compensation, death compensation, pension and spouse's...

Code of Federal Regulations, 2010 CFR

2010-07-01

... dependency and indemnity compensation, death compensation, pension and spouse's compensation ratings. 3.351..., Compensation, and Dependency and Indemnity Compensation Ratings for Special Purposes § 3.351 Special monthly dependency and indemnity compensation, death compensation, pension and spouse's compensation ratings. (a...

38 CFR 3.351 - Special monthly dependency and indemnity compensation, death compensation, pension and spouse's...

Code of Federal Regulations, 2013 CFR

2013-07-01

... dependency and indemnity compensation, death compensation, pension and spouse's compensation ratings. 3.351..., Compensation, and Dependency and Indemnity Compensation Ratings for Special Purposes § 3.351 Special monthly dependency and indemnity compensation, death compensation, pension and spouse's compensation ratings. (a...

BIRTH AND DEATH PROJECTIONS USED IN PRESENT STUDENT-TEACHER POPULATION GROWTH MODELS.

ERIC Educational Resources Information Center

OKADA, TETSUO

A BRIEF DESCRIPTION OF THE METHODOLOGY USED IN DYNAMOD II TO PROJECT BIRTHS AND DEATHS IS PRESENTED. THE COMPUTATION OF DEATH RATES FOLLOWED THE METHOD USED BY THE DEPARTMENT OF HEALTH, EDUCATION AND WELFARE, MORTALITY DIVISION--DEATH RATE FOR AGE INTERVAL I THROUGH J EQUALS SUMMATION OF NUMBER OF DEATHS AT AGES I THROUGH J/SUMMATION OF POPULATION…

Declines in Cancer Death Rates Among Children and Adolescents in the United States, 1999-2014.

PubMed

Curtin, Sally C; Minino, Arialdi M; Anderson, Robert N

2016-09-01

Data from the National Vital Statistics System •During 1999-2014, the cancer death rate for children and adolescents aged 1-19 years in the United States declined 20%, from 2.85 to 2.28 per 100,000 population. •The cancer death rate for males aged 1-19 years in 2014 was 30% higher than for females. •Declines in cancer death rates during 1999-2014 were experienced among both white and black persons aged 1-19 years and for all 5-year age groups. •During 1999-2014, brain cancer replaced leukemia as the most common cancer causing death among children and adolescents aged 1-19 years, accounting for 3 out of 10 cancer deaths in 2014. Since the mid-1970s, cancer death rates among children and adolescents in the United States showed marked declines despite a slow increase in incidence for some of the major types (1-3). These trends have previously been shown through 2012. This data brief extends previous research by showing trends in cancer death rates through 2014 among children and adolescents aged 1-19 years in the United States. Cancer death rates for 1999-2014 are presented and trends are compared for both females and males, by 5-year age group, and for white and black children and adolescents. Percent distributions of cancer deaths among children and adolescents aged 1-19 years are shown by anatomical site for 1999 and 2014. All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.

Estimating cause of adult (15+ years) death using InterVA-4 in a rural district of southern Ghana.

PubMed

Awini, Elizabeth; Sarpong, Doris; Adjei, Alexander; Manyeh, Alfred Kwesi; Amu, Alberta; Akweongo, Patricia; Adongo, Philip; Kukula, Vida; Odonkor, Gabriel; Narh, Solomon; Gyapong, Margaret

2014-01-01

Data needed to estimate causes of death and the pattern of these deaths are scarce in sub-Saharan Africa. Such data are very important for targeting, monitoring, and evaluating health interventions. To estimate the mortality rate and determine causes of death among adults (aged 15 years and older) in a rural district of southern Ghana, using the InterVA-4 model. Data used were generated from verbal autopsies conducted for registered adult members of the Dodowa Health and Demographic Surveillance System who died between 2006 and 2010. The InterVA-4 model was used to assign the cause of death. Overall, the mortality rate for the period under review was 7.5/1,000 person-years (py) for the general population and 10.4/1,000 py for those aged 15 and older. The leading cause of death was communicable diseases (CDs), with a malaria-specific mortality rate of 1.06/1,000 py. Pulmonary tuberculosis (TB)-specific mortality rate was the next highest (1.01/1,000 py). HIV/AIDS attributed deaths were lower among males than females. Non-communicable diseases (NCDs) contributed to 28.3% of the deaths with cause-specific mortality rate of 2.93/1,000 py. Stroke topped the list with cause-specific mortality rate of 0.69/1,000 py. As expected, young males (15-49 years) contributed to more road traffic accident (RTA) deaths; they had a lower RTA cause-specific mortality rate than older males (50-64 years). Data indicate that CDs (e.g. malaria and TB) remain the major cause of death with NCDs (e.g. stroke) following closely behind. Verbal autopsy data can provide the causes of mortality in poorly resourced settings where access to timely and accurate data is scarce.

Does the Body Survive Death? Cultural Variation in Beliefs About Life Everlasting.

PubMed

Watson-Jones, Rachel E; Busch, Justin T A; Harris, Paul L; Legare, Cristine H

2017-04-01

Mounting evidence suggests that endorsement of psychological continuity and the afterlife increases with age. This developmental change raises questions about the cognitive biases, social representations, and cultural input that may support afterlife beliefs. To what extent is there similarity versus diversity across cultures in how people reason about what happens after death? The objective of this study was to compare beliefs about the continuation of biological and psychological functions after death in Tanna, Vanuatu (a Melanesian archipelago), and the United States (Austin, Texas). Children, adolescents, and adults were primed with a story that contained either natural (non-theistic) or supernatural (theistic) cues. Participants were then asked whether or not different biological and psychological processes continue to function after death. We predicted that across cultures individuals would be more likely to endorse the continuation of psychological processes over biological processes (dualism) and that a theistic prime would increase continuation responses regarding both types of process. Results largely supported predictions; U.S. participants provided more continuation responses for psychological than biological processes following both the theistic and non-theistic primes. Participants in Vanuatu, however, provided more continuation responses for biological than psychological processes following the theistic prime. The data provide evidence for both cultural similarity and variability in afterlife beliefs and demonstrate that individuals use both natural and supernatural explanations to interpret the same events. Copyright © 2016 Cognitive Science Society, Inc.

5 CFR 843.302 - Time for filing applications for death benefits.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Time for filing applications for death... SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES RETIREMENT SYSTEM-DEATH BENEFITS AND EMPLOYEE REFUNDS Current and Former Spouse Benefits § 843.302 Time for filing applications for death benefits. A current or...

5 CFR 843.309 - Basic employee death benefit.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Basic employee death benefit. 843.309... REGULATIONS (CONTINUED) FEDERAL EMPLOYEES RETIREMENT SYSTEM-DEATH BENEFITS AND EMPLOYEE REFUNDS Current and Former Spouse Benefits § 843.309 Basic employee death benefit. (a) Except as provided in § 843.312, if an...

32 CFR 716.6 - Death occurring after active service.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 5 2010-07-01 2010-07-01 false Death occurring after active service. 716.6 Section 716.6 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL DEATH GRATUITY Provisions Applicable to the Navy and the Marine Corps § 716.6 Death occurring after active...

5 CFR 843.308 - Supplementary benefits on death of a retiree.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Supplementary benefits on death of a... SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES RETIREMENT SYSTEM-DEATH BENEFITS AND EMPLOYEE REFUNDS Current and Former Spouse Benefits § 843.308 Supplementary benefits on death of a retiree. (a) Except as...

5 CFR 843.309 - Basic employee death benefit.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 5 Administrative Personnel 2 2014-01-01 2014-01-01 false Basic employee death benefit. 843.309... REGULATIONS (CONTINUED) FEDERAL EMPLOYEES RETIREMENT SYSTEM-DEATH BENEFITS AND EMPLOYEE REFUNDS Current and Former Spouse Benefits § 843.309 Basic employee death benefit. (a) Except as provided in § 843.312, if an...

5 CFR 843.309 - Basic employee death benefit.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 5 Administrative Personnel 2 2013-01-01 2013-01-01 false Basic employee death benefit. 843.309... REGULATIONS (CONTINUED) FEDERAL EMPLOYEES RETIREMENT SYSTEM-DEATH BENEFITS AND EMPLOYEE REFUNDS Current and Former Spouse Benefits § 843.309 Basic employee death benefit. (a) Except as provided in § 843.312, if an...

32 CFR 716.6 - Death occurring after active service.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 32 National Defense 5 2013-07-01 2013-07-01 false Death occurring after active service. 716.6 Section 716.6 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL DEATH GRATUITY Provisions Applicable to the Navy and the Marine Corps § 716.6 Death occurring after active...

32 CFR 716.6 - Death occurring after active service.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 32 National Defense 5 2014-07-01 2014-07-01 false Death occurring after active service. 716.6 Section 716.6 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL DEATH GRATUITY Provisions Applicable to the Navy and the Marine Corps § 716.6 Death occurring after active...

5 CFR 843.309 - Basic employee death benefit.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 5 Administrative Personnel 2 2011-01-01 2011-01-01 false Basic employee death benefit. 843.309... REGULATIONS (CONTINUED) FEDERAL EMPLOYEES RETIREMENT SYSTEM-DEATH BENEFITS AND EMPLOYEE REFUNDS Current and Former Spouse Benefits § 843.309 Basic employee death benefit. (a) Except as provided in § 843.312, if an...

32 CFR 716.6 - Death occurring after active service.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 32 National Defense 5 2011-07-01 2011-07-01 false Death occurring after active service. 716.6 Section 716.6 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL DEATH GRATUITY Provisions Applicable to the Navy and the Marine Corps § 716.6 Death occurring after active...

5 CFR 843.309 - Basic employee death benefit.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 5 Administrative Personnel 2 2012-01-01 2012-01-01 false Basic employee death benefit. 843.309... REGULATIONS (CONTINUED) FEDERAL EMPLOYEES RETIREMENT SYSTEM-DEATH BENEFITS AND EMPLOYEE REFUNDS Current and Former Spouse Benefits § 843.309 Basic employee death benefit. (a) Except as provided in § 843.312, if an...

32 CFR 716.6 - Death occurring after active service.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 32 National Defense 5 2012-07-01 2012-07-01 false Death occurring after active service. 716.6 Section 716.6 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL DEATH GRATUITY Provisions Applicable to the Navy and the Marine Corps § 716.6 Death occurring after active...