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Sample records for national longitudinal mortality

  1. Brain cancer mortality and potential occupational exposure to lead: findings from the National Longitudinal Mortality Study, 1979-1989.

    PubMed

    van Wijngaarden, Edwin; Dosemeci, Mustafa

    2006-09-01

    We evaluated the association between potential occupational lead exposure and the risk of brain cancer mortality in the National Longitudinal Mortality Study (NLMS), which is a prospective census-based cohort study of mortality among the noninstitutionalized United States population (1979-1989). The present study was limited to individuals for whom occupation and industry were available (n = 317,968). Estimates of probability and intensity of lead exposure were assigned using a job-exposure matrix (JEM). Risk estimates for the impact of lead on brain cancer mortality were computed using standardized mortality ratio (SMR) and proportional hazards and Poisson regression techniques, adjusting for the effects of age, gender and several other covariates. Brain cancer mortality rates were greater among individuals in jobs potentially involving lead exposure as compared to those unexposed (age- and gender-adjusted hazard ratio (HR) = 1.5; 95% confidence interval (CI) = 0.9-2.3) with indications of an exposure-response trend (probability: low HR = 0.7 (95% CI = 0.2-2.2), medium HR = 1.4 (95% CI = 0.8-2.5), high HR = 2.2 (95% CI = 1.2-4.0); intensity: low HR = 1.2 (95% CI = 0.7-2.1), medium/high HR = 1.9 (95% CI = 1.0-3.4)). Brain cancer risk was greatest among individuals with the highest levels of probability and intensity (HR = 2.3; 95% CI = 1.3-4.2). These findings provide further support for an association between occupational lead exposure and brain cancer mortality, but need to be interpreted cautiously due to the consideration of brain cancer as one disease entity and the absence of biological measures of lead exposure.

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

    PubMed

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

    2014-07-09

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

  3. Is an internal comparison better than using national data when estimating mortality in longitudinal studies?

    PubMed Central

    Card, T R; Solaymani‐Dodaran, M; Hubbard, R; Logan, R F A; West, J

    2006-01-01

    Background Discrepancies between the results of different studies looking at mortality in similar disease cohorts led us to consider the impact of methodology upon outcome. Methods Cohort studies were carried out using age, sex, practice, and calendar time matched control groups in the general practice research database. Data were used on all subjects with inflammatory bowel disease, coeliac disease, or Barrett's oesophagus. Mortality data for the population of England and Wales were obtained from the UK Office for National Statistics. The study compared hazard ratios (HR) for mortality using the matched controls to those found when an indirect standardisation to the mortality experience of England and Wales was carried out. Results For all three conditions the mortality risk was slightly lower when the national population data were used compared with the internal comparison group (coeliac disease HR 1.33 v standardised mortality ratios (SMR) 1.25, Barrett's oesophagus HR 1.32 v SMR 1.32, inflammatory bowel disease HR 1.50 v SMR 1.34). Conclusions A bias was found towards underestimating mortality risk when cohort studies use national population death rates as a comparator. Estimates obtained when an internal comparison group has been used are probably more appropriate. PMID:16905729

  4. The associations between US state and local social spending, income inequality, and individual all-cause and cause-specific mortality: The National Longitudinal Mortality Study.

    PubMed

    Kim, Daniel

    2016-03-01

    To investigate government state and local spending on public goods and income inequality as predictors of the risks of dying. Data on 431,637 adults aged 30-74 and 375,354 adults aged 20-44 in the 48 contiguous US states were used from the National Longitudinal Mortality Study to estimate the impacts of state and local spending and income inequality on individual risks of all-cause and cause-specific mortality for leading causes of death in younger and middle-aged adults and older adults. To reduce bias, models incorporated state fixed effects and instrumental variables. Each additional $250 per capita per year spent on welfare predicted a 3-percentage point (-0.031, 95% CI: -0.059, -0.0027) lower probability of dying from any cause. Each additional $250 per capita spent on welfare and education predicted 1.6-percentage point (-0.016, 95% CI: -0.031, -0.0011) and 0.8-percentage point (-0.008, 95% CI: -0.0156, -0.00024) lower probabilities of dying from coronary heart disease (CHD), respectively. No associations were found for colon cancer or chronic obstructive pulmonary disease; for diabetes, external injury, and suicide, estimates were inverse but modest in magnitude. A 0.1 higher Gini coefficient (higher income inequality) predicted 1-percentage point (0.010, 95% CI: 0.0026, 0.0180) and 0.2-percentage point (0.002, 95% CI: 0.001, 0.002) higher probabilities of dying from CHD and suicide, respectively. Empirical linkages were identified between state-level spending on welfare and education and lower individual risks of dying, particularly from CHD and all causes combined. State-level income inequality predicted higher risks of dying from CHD and suicide. Copyright © 2015 The Author. Published by Elsevier Inc. All rights reserved.

  5. Mortality variations in England and Wales between types of place: an analysis of the ONS longitudinal study. Office of National Statistics.

    PubMed

    Ecob, R; Jones, K

    1998-12-01

    This study investigates the extent to which individuals, in England and Wales, in different types of place experience differential mortality once account is taken of personal (individual and household) social circumstances. Data comes from the Longitudinal Study of England and Wales of the Office of National Statistics, the respondents being a one percent national random sample of people aged between 25 and 74 at the 1971 census, followed until the end of 1985. For males and females separately, differences in mortality are found for the 36 types of Craig-Webber classification in models which include, at the individual level, a number of demographic and socio-economic variables (women being classified by their own occupation). In general, for both males and females, the same types of place have elevated or lowered mortality. For males a (cross-level) interaction exists between the proportion in the area in professional social classes and individual social class, the effects of individual social class being larger in areas containing a higher proportion of those in professional occupations. For females mortality is negatively related to the proportion of car-ownership in the area.

  6. Social class, race/ethnicity and all-cause mortality in the US: longitudinal results from the 1986-1994 National Health Interview Survey.

    PubMed

    Muntaner, Carles; Hadden, Wilbur C; Kravets, Nataliya

    2004-01-01

    Occupational social class has become a leading indicator of social inequalities in health. In the US, economic sectors are distinct with respect to wages, benefits, job security, promotion ladders and working conditions. The growing economic sector of self-employed workers is characterized by lower wages and benefits, and greater job insecurity. Little attention has been given to the association between economic sector measures of social class and all-cause mortality, and there have been no studies of mortality among the self-employed. To determine risk of death associated with economic sector social class, this study entails a longitudinal analysis of the National Health Interview Survey (NHIS), an annual household survey representative of the US population for the period 1986-1994 (n = 377,129). The sample includes 201,566 men and 175,563 women, aged 24-65 years of age, in the civilian labor force. Non- professionals are at higher risk of death than professionals across all sectors and self-employed professionals are at higher risk of death than professionals employed in government and production. Additional social class differences are accounted for by age, race, gender and marital status. Results are also partially explained by income. After controlling for income, Black professionals did not show a lower risk of death than Black non-professionals and self-employed Hispanic professionals had a higher risk of death than Hispanic professionals employed in the private sector. Given the growth of self-employment in the US, the noted increased risk of death among self-employed professionals merits further investigation and monitoring.

  7. Association between expansion of primary healthcare and racial inequalities in mortality amenable to primary care in Brazil: A national longitudinal analysis.

    PubMed

    Hone, Thomas; Rasella, Davide; Barreto, Mauricio L; Majeed, Azeem; Millett, Christopher

    2017-05-01

    Universal health coverage (UHC) can play an important role in achieving Sustainable Development Goal (SDG) 10, which addresses reducing inequalities, but little supporting evidence is available from low- and middle-income countries. Brazil's Estratégia de Saúde da Família (ESF) (family health strategy) is a community-based primary healthcare (PHC) programme that has been expanding since the 1990s and is the main platform for delivering UHC in the country. We evaluated whether expansion of the ESF was associated with differential reductions in mortality amenable to PHC between racial groups. Municipality-level longitudinal fixed-effects panel regressions were used to examine associations between ESF coverage and mortality from ambulatory-care-sensitive conditions (ACSCs) in black/pardo (mixed race) and white individuals over the period 2000-2013. Models were adjusted for socio-economic development and wider health system variables. Over the period 2000-2013, there were 281,877 and 318,030 ACSC deaths (after age standardisation) in the black/pardo and white groups, respectively, in the 1,622 municipalities studied. Age-standardised ACSC mortality fell from 93.3 to 57.9 per 100,000 population in the black/pardo group and from 75.7 to 49.2 per 100,000 population in the white group. ESF expansion (from 0% to 100%) was associated with a 15.4% (rate ratio [RR]: 0.846; 95% CI: 0.796-0.899) reduction in ACSC mortality in the black/pardo group compared with a 6.8% (RR: 0.932; 95% CI: 0.892-0.974) reduction in the white group (coefficients significantly different, p = 0.012). These differential benefits were driven by greater reductions in mortality from infectious diseases, nutritional deficiencies and anaemia, diabetes, and cardiovascular disease in the black/pardo group. Although the analysis is ecological, sensitivity analyses suggest that over 30% of black/pardo deaths would have to be incorrectly coded for the results to be invalid. This study is limited by the use

  8. Impact of socioeconomic status on cancer incidence and stage at diagnosis: selected findings from the surveillance, epidemiology, and end results: National Longitudinal Mortality Study

    PubMed Central

    Clegg, Limin X.; Reichman, Marsha E.; Miller, Barry A.; Hankey, Benjamin F.; Singh, Gopal K.; Lin, Yi Dan; Goodman, Marc T.; Lynch, Charles F.; Schwartz, Stephen M.; Chen, Vivien W.; Bernstein, Leslie; Gomez, Scarlett L.; Graff, John J.; Lin, Charles C.; Johnson, Norman J.; Edwards, Brenda K.

    2009-01-01

    Background Population-based cancer registry data from the Surveillance, Epidemiology, and End Results (SEER) Program at the National Cancer Institute (NCI) are mainly based on medical records and administrative information. Individual-level socioeconomic data are not routinely reported by cancer registries in the United States because they are not available in patient hospital records. The U.S. representative National Longitudinal Mortality Study (NLMS) data provide self-reported, detailed demographic and socioeconomic data from the Social and Economic Supplement to the Census Bureau's Current Population Survey (CPS). In 1999, the NCI initiated the SEER-NLMS study, linking the population-based SEER cancer registry data to NLMS data. The SEER-NLMS data provide a new unique research resource that is valuable for health disparity research on cancer burden. We describe the design, methods, and limitations of this data set. We also present findings on cancer-related health disparities according to individual-level socioeconomic status (SES) and demographic characteristics for all cancers combined and for cancers of the lung, breast, prostate, cervix, and melanoma. Methods Records of cancer patients diagnosed in 1973–2001 when residing 1 of 11 SEER registries were linked with 26 NLMS cohorts. The total number of SEER matched cancer patients that were also members of an NLMS cohort was 26,844. Of these 26,844 matched patients, 11,464 were included in the incidence analyses and 15,357 in the late-stage diagnosis analyses. Matched patients (used in the incidence analyses) and unmatched patients were compared by age group, sex, race, ethnicity, residence area, year of diagnosis, and cancer anatomic site. Cohort-based age-adjusted cancer incidence rates were computed. The impact of socioeconomic status on cancer incidence and stage of diagnosis was evaluated. Results Men and women with less than a high school education had elevated lung cancer rate ratios of 3.01 and 2

  9. Association between expansion of primary healthcare and racial inequalities in mortality amenable to primary care in Brazil: A national longitudinal analysis

    PubMed Central

    Rasella, Davide; Millett, Christopher

    2017-01-01

    Background Universal health coverage (UHC) can play an important role in achieving Sustainable Development Goal (SDG) 10, which addresses reducing inequalities, but little supporting evidence is available from low- and middle-income countries. Brazil’s Estratégia de Saúde da Família (ESF) (family health strategy) is a community-based primary healthcare (PHC) programme that has been expanding since the 1990s and is the main platform for delivering UHC in the country. We evaluated whether expansion of the ESF was associated with differential reductions in mortality amenable to PHC between racial groups. Methods and findings Municipality-level longitudinal fixed-effects panel regressions were used to examine associations between ESF coverage and mortality from ambulatory-care-sensitive conditions (ACSCs) in black/pardo (mixed race) and white individuals over the period 2000–2013. Models were adjusted for socio-economic development and wider health system variables. Over the period 2000–2013, there were 281,877 and 318,030 ACSC deaths (after age standardisation) in the black/pardo and white groups, respectively, in the 1,622 municipalities studied. Age-standardised ACSC mortality fell from 93.3 to 57.9 per 100,000 population in the black/pardo group and from 75.7 to 49.2 per 100,000 population in the white group. ESF expansion (from 0% to 100%) was associated with a 15.4% (rate ratio [RR]: 0.846; 95% CI: 0.796–0.899) reduction in ACSC mortality in the black/pardo group compared with a 6.8% (RR: 0.932; 95% CI: 0.892–0.974) reduction in the white group (coefficients significantly different, p = 0.012). These differential benefits were driven by greater reductions in mortality from infectious diseases, nutritional deficiencies and anaemia, diabetes, and cardiovascular disease in the black/pardo group. Although the analysis is ecological, sensitivity analyses suggest that over 30% of black/pardo deaths would have to be incorrectly coded for the results to be

  10. Poverty or income inequality as predictor of mortality: longitudinal cohort study.

    PubMed Central

    Fiscella, K.; Franks, P.

    1997-01-01

    OBJECTIVE: To determine the effect of inequality in income between communities independent of household income on individual all cause mortality in the United States. DESIGN: Longitudinal cohort study. SUBJECTS: A nationally representative sample of 14,407 people aged 25-74 years in the United States from the first national health and nutrition examination survey. SETTING: Subjects were followed from initial interview in 1971-5 until 1987. Complete follow up information was available for 92.2% of the sample. MAIN OUTCOME MEASURES: Relation between both household income and income inequality in community of residence and individual all cause mortality at follow up was examined with Cox proportional hazards survival analysis. RESULTS: Community income inequality showed a significant association with subsequent community mortality, and with individual mortality after adjustment for age, sex, and mean income in the community of residence. After adjustment for individual household income, however, the association with mortality was lost. CONCLUSIONS: In this nationally representative American sample, family income, but not community income inequality, independently predicts mortality. Previously reported ecological associations between income inequality and mortality may reflect confounding between individual family income and mortality. PMID:9185498

  11. Baseline patient characteristics and mortality associated with longitudinal intervention compliance.

    PubMed

    Lin, Julia Y; Ten Have, Thomas R; Bogner, Hillary R; Elliott, Michael R

    2007-12-10

    Lin et al. (http://www.biostatsresearch.com/upennbiostat/papers/, 2006) proposed a nested Markov compliance class model in the Imbens and Rubin compliance class model framework to account for time-varying subject noncompliance in longitudinal randomized intervention studies. We use superclasses, or latent compliance class principal strata, to describe longitudinal compliance patterns, and time-varying compliance classes are assumed to depend on the history of compliance. In this paper, we search for good subject-level baseline predictors of these superclasses and also examine the relationship between these superclasses and all-cause mortality. Since the superclasses are completely latent in all subjects, we utilize multiple imputation techniques to draw inferences. We apply this approach to a randomized intervention study for elderly primary care patients with depression.

  12. The National Longitudinal Surveys Handbook. Revised.

    ERIC Educational Resources Information Center

    Ohio State Univ., Columbus. Center for Human Resource Research.

    Designed as a comprehensive guide to the National Longitudinal Surveys of Labor Market Experience (NLS), this handbook is intended for two major categories of readers. For persons who wish to ascertain whether their research interests can be served by the NLS data, the handbook can provide the detailed description of the objectives of the surveys,…

  13. Global determinants of mortality in under 5s: 10 year worldwide longitudinal study.

    PubMed

    Hanf, Matthieu; Nacher, Mathieu; Guihenneuc, Chantal; Tubert-Bitter, Pascale; Chavance, Michel

    2013-11-08

    To assess at country level the association of mortality in under 5s with a large set of determinants. Longitudinal study. 193 United Nations member countries, 2000-09. Yearly data between 2000 and 2009 based on 12 world development indicators were used in a multivariable general additive mixed model allowing for non-linear relations and lag effects. National rate of deaths in under 5s per 1000 live births The model retained the variables: gross domestic product per capita; percentage of the population having access to improved water sources, having access to improved sanitation facilities, and living in urban areas; adolescent fertility rate; public health expenditure per capita; prevalence of HIV; perceived level of corruption and of violence; and mean number of years in school for women of reproductive age. Most of these variables exhibited non-linear behaviours and lag effects. By providing a unified framework for mortality in under 5s, encompassing both high and low income countries this study showed non-linear behaviours and lag effects of known or suspected determinants of mortality in this age group. Although some of the determinants presented a linear action on log mortality indicating that whatever the context, acting on them would be a pertinent strategy to effectively reduce mortality, others had a threshold based relation potentially mediated by lag effects. These findings could help designing efficient strategies to achieve maximum progress towards millennium development goal 4, which aims to reduce mortality in under 5s by two thirds between 1990 and 2015.

  14. Hearing, mobility, and pain predict mortality: a longitudinal population-based study

    PubMed Central

    Feeny, David; Huguet, Nathalie; McFarland, Bentson H.; Kaplan, Mark S.; Orpana, Heather; Eckstrom, Elizabeth

    2012-01-01

    Objective Measures of health-related quality of life (HRQL), including the Health Utilities Index Mark 3 (HUI3) are predictive of mortality. HUI3 includes eight attributes, vision, hearing, speech, ambulation, dexterity, cognition, emotion, and pain and discomfort, with five or six levels per attribute that vary from no to severe disability. This study examined associations between individual HUI3 attributes and mortality. Study Design and Setting Baseline data and 12 years of follow-up data from a closed longitudinal cohort study, the 1994/95 Canadian National Population Health Survey, consisting of 12,375 women and men aged 18 and older. A priori hypotheses were that ambulation, cognition, emotion, and pain would predict mortality. Cox proportional hazards regression models were applied controlling for standard determinants of health and risk factors. Results Single-attribute utility scores for ambulation (hazard ratio [HR] = 0.10; 0.04–0.22), hearing (HR = 0.18; 0.06–0.57), and pain (HR = 0.53; 0.29–0.96) were statistically significantly associated with an increased risk of mortality; ambulation and hearing were predictive for the 60+ cohort. Conclusion Few studies have identified hearing or pain as risk factors for mortality. This study is innovative because it identifies specific components of HRQL that predict mortality. Further research is needed to understand better the mechanisms through which deficits in hearing and pain affect mortality risks. PMID:22521576

  15. Snakebite Mortality in India: A Nationally Representative Mortality Survey

    PubMed Central

    Mohapatra, Bijayeeni; Warrell, David A.; Suraweera, Wilson; Bhatia, Prakash; Dhingra, Neeraj; Jotkar, Raju M.; Rodriguez, Peter S.; Mishra, Kaushik; Whitaker, Romulus; Jha, Prabhat

    2011-01-01

    Background India has long been thought to have more snakebites than any other country. However, inadequate hospital-based reporting has resulted in estimates of total annual snakebite mortality ranging widely from about 1,300 to 50,000. We calculated direct estimates of snakebite mortality from a national mortality survey. Methods and Findings We conducted a nationally representative study of 123,000 deaths from 6,671 randomly selected areas in 2001–03. Full-time, non-medical field workers interviewed living respondents about all deaths. The underlying causes were independently coded by two of 130 trained physicians. Discrepancies were resolved by anonymous reconciliation or, failing that, by adjudication. A total of 562 deaths (0.47% of total deaths) were assigned to snakebites. Snakebite deaths occurred mostly in rural areas (97%), were more common in males (59%) than females (41%), and peaked at ages 15–29 years (25%) and during the monsoon months of June to September. This proportion represents about 45,900 annual snakebite deaths nationally (99% CI 40,900 to 50,900) or an annual age-standardised rate of 4.1/100,000 (99% CI 3.6–4.5), with higher rates in rural areas (5.4/100,000; 99% CI 4.8–6.0), and with the highest state rate in Andhra Pradesh (6.2). Annual snakebite deaths were greatest in the states of Uttar Pradesh (8,700), Andhra Pradesh (5,200), and Bihar (4,500). Conclusions Snakebite remains an underestimated cause of accidental death in modern India. Because a large proportion of global totals of snakebites arise from India, global snakebite totals might also be underestimated. Community education, appropriate training of medical staff and better distribution of antivenom, especially to the 13 states with the highest prevalence, could reduce snakebite deaths in India. PMID:21532748

  16. Education and Mortality in the Rome Longitudinal Study

    PubMed Central

    Cacciani, Laura; Bargagli, Anna Maria; Cesaroni, Giulia; Forastiere, Francesco; Agabiti, Nera; Davoli, Marina

    2015-01-01

    Background A large body of evidence supports an inverse association between socioeconomic status and mortality. We analysed data from a large cohort of residents in Rome followed-up between 2001 and 2012 to assess the relationship between individual education and mortality. We distinguished five causes of death and investigated the role of age, gender, and birthplace. Methods From the Municipal Register we enrolled residents of Rome on October 21st 2001 and collected information on educational level attained from the 2001 Census. We selected Italian citizens aged 30–74 years and followed-up their vital status until 2012 (n = 1,283,767), identifying the cause of death from the Regional Mortality Registry. We calculated hazard ratios (HRs) for overall and cause-specific mortality in relation to education. We used age, gender, and birthplace for adjusted or stratified analyses. We used the inverse probability weighting approach to account for right censoring due to emigration. Results We observed an inverse association between education (none vs. post-secondary+ level) and overall mortality (HRs(95%CIs): 2.1(1.98–2.17), males; 1.5(1.46–1.59), females) varying according to demographic characteristics. Cause-specific analysis also indicated an inverse association with education, in particular for respiratory, digestive or circulatory system related-mortality, and the youngest people seemed to be more vulnerable to low education. Conclusion Our results confirm the inverse association between education and overall or cause-specific mortality and show differentials particularly marked among young people compared to the elderly. The findings provide further evidence from the Mediterranean area, and may contribute to national and cross-country comparisons in Europe to understand the mechanisms generating socioeconomic differentials especially during the current recession period. PMID:26376166

  17. Education and Mortality in the Rome Longitudinal Study.

    PubMed

    Cacciani, Laura; Bargagli, Anna Maria; Cesaroni, Giulia; Forastiere, Francesco; Agabiti, Nera; Davoli, Marina

    2015-01-01

    A large body of evidence supports an inverse association between socioeconomic status and mortality. We analysed data from a large cohort of residents in Rome followed-up between 2001 and 2012 to assess the relationship between individual education and mortality. We distinguished five causes of death and investigated the role of age, gender, and birthplace. From the Municipal Register we enrolled residents of Rome on October 21st 2001 and collected information on educational level attained from the 2001 Census. We selected Italian citizens aged 30-74 years and followed-up their vital status until 2012 (n = 1,283,767), identifying the cause of death from the Regional Mortality Registry. We calculated hazard ratios (HRs) for overall and cause-specific mortality in relation to education. We used age, gender, and birthplace for adjusted or stratified analyses. We used the inverse probability weighting approach to account for right censoring due to emigration. We observed an inverse association between education (none vs. post-secondary+ level) and overall mortality (HRs(95%CIs): 2.1(1.98-2.17), males; 1.5(1.46-1.59), females) varying according to demographic characteristics. Cause-specific analysis also indicated an inverse association with education, in particular for respiratory, digestive or circulatory system related-mortality, and the youngest people seemed to be more vulnerable to low education. Our results confirm the inverse association between education and overall or cause-specific mortality and show differentials particularly marked among young people compared to the elderly. The findings provide further evidence from the Mediterranean area, and may contribute to national and cross-country comparisons in Europe to understand the mechanisms generating socioeconomic differentials especially during the current recession period.

  18. Providing instrumental social support is more beneficial to reduce mortality risk among the elderly with low educational level in Taiwan: a 12-year follow-up national longitudinal study.

    PubMed

    Liao, C C; Yeh, C J; Lee, S H; Liao, W C; Liao, M Y; Lee, M C

    2015-04-01

    To evaluate whether the effects of providing or receiving social support are more beneficial to reduce mortality risk among the elderly with different educational levels. In this long-term prospective cohort study, data were retrieved from the Taiwan Longitudinal Study on Aging. This study was initiated from 1996 until 2007. The complete data from 1492 males and 1177 females aged ≥67 years were retrieved. Participants received financial, instrumental, and emotional support, and they actively provided instrumental and emotional support to others and involved in social engagement. Education attainment was divided into two levels: high and low. The low education level included illiterate and elementary school. The high education level included junior high school to senior high school and above college. Cox regression analysis was used to examine the association between providing or receiving social support on mortality with different educational levels. The average age of the participants in 1996 was 73.0 (IQR=8.0) years, and the median survival following years (1996-2007) of participants was 10.3 (IQR=6.7) years. Most participants were low educational level including illiterate (39.3%) and elementary school (41.2%). Participants with high educational level tend to be younger and more male significantly. On the contrary, participants with low educational level tend to have significant more poor income, more depression, more cognition impairment, more with IADL and ADL disability than high educational level. Most participants received instrumental support from others (95.5%) and also provided emotional support to others (97.7%). Providing instrumental support can reduce 17% of mortality risk among the elderly with a low level of education after adjusting several covariates [Hazard ratio (HR) = 0.83; 95% confidence interval (CI) = 0.70-0.99; p = 0.036]. Providing instrumental social support to others confer benefits to the giver and prolong life expectancy among the

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

    PubMed

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

    2005-04-01

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

  20. Objectives, Design, and History of the National Longitudinal Study.

    ERIC Educational Resources Information Center

    Davis, J. A.; Collins, Elmer

    The National Longitudinal Study of the High School Class of 1972 (NLS) is a federally supported longitudinal study of a national sample of some 23,000 young people first surveyed as high school seniors in the spring of 1972. The historical precedents of such a study include the work of Friend and Haggert in a Boston settlement house, Louis…

  1. Objectives, Design, and History of the National Longitudinal Study.

    ERIC Educational Resources Information Center

    Davis, J. A.; Collins, Elmer

    The National Longitudinal Study of the High School Class of 1972 (NLS) is a federally supported longitudinal study of a national sample of some 23,000 young people first surveyed as high school seniors in the spring of 1972. The historical precedents of such a study include the work of Friend and Haggert in a Boston settlement house, Louis…

  2. A Longitudinal Analysis of Publications on Maternal Mortality.

    PubMed

    de Groot, Christianne J M; van Leeuwen, Thed; Mol, Ben Willem J; Waltman, Ludo

    2015-11-01

    The fifth Millennium Development Goal formulated by the WHO in 2000 aimed to reduce global maternal mortality by 75% in 2015. We studied the extent to which medical research has supported this by studying maternal mortality. We performed a bibliometric analysis of the literature on maternal mortality and of the development of this literature over time. We searched for publications on maternal mortality in the Web of Science database in the period 1994-2013. We visualised the subjects of these publications using a term map showing the most significant terms occurring in the titles and abstracts of publications on maternal mortality. We identified 3794 publications on maternal mortality in Web of Science. The annual number increased from 87 in 1994 to 397 in 2013. The largest number of maternal mortality publications was found in the field of Obstetrics and Gynecology, followed by the Public, Environmental, and Occupational Health field (increase from 1994 until 2013 of 300% and 700%, respectively). In both fields, the number of maternal mortality publications has increased at a much higher rate than the overall number of publications in the field. In line with the focus of the fifth Millennium Development Goal on reducing maternal mortality, during the past 20 years, there has been a steady increase in the amount of attention paid to maternal mortality in the medical literature. This is largely driven by an increase, mainly in recent years, in public health research on maternal mortality. © 2015 John Wiley & Sons Ltd.

  3. Longitudinal study of mortality among refugees in Sweden.

    PubMed

    Hollander, Anna-Clara; Bruce, Daniel; Ekberg, Jan; Burström, Bo; Borrell, Carme; Ekblad, Solvig

    2012-08-01

    Refugee immigrants have poorer health than other immigrant groups but little is known about their mortality. A comparison of mortality among refugees and non-refugee immigrants is liable to exaggerate the former if the latter includes labour migrants, whose mortality risk may be lower than that of the general population. To avoid bias, labour migrants are not included in this study. The aim was to investigate mortality risks among refugees compared with non-labour non-refugee immigrants in Sweden. Population-based cohort design, starting 1 January 1998 and ending with death or censoring 31 December 2006. Persons included in the study were those aged 18-64 years, had received a residence permit in Sweden 1992-98 and were defined by the Swedish Board of Migration as either a refugee or a non-labour non-refugee immigrant. The outcomes were all-cause and cause-specific mortalities and the main exposure was being a refugee. Cox-regression models estimated hazard ratios (HRs) of mortality. The study population totalled 86,395 persons, 49.3% women, 24.2 % refugees. Adjusted for age and origin, refugee men had an over-risk of cardiovascular mortality (HR = 1.58, 95% CI = 1.08-2.33). With socio-economic factors added to the model, refugee men still had an over-risk mortality in cardiovascular disease (HR = 1.53, 95% CI = 1.04-2.24) and external causes (HR = 1.59, 95% CI = 1.01-2.50). Refugee men in Sweden have a higher mortality risk in cardiovascular and external causes compared with male non-labour non-refugee immigrants. This study suggests that the refugee experience resembles other stressors in terms of the association with cardiovascular mortality.

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

    PubMed

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

    2016-04-01

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

  5. Mortality in Autism: A Prospective Longitudinal Community-Based Study

    ERIC Educational Resources Information Center

    Gillberg, Christopher; Billstedt, Eva; Sundh, Valter; Gillberg, I. Carina

    2010-01-01

    The purposes of the present study were to establish the mortality rate in a representative group of individuals (n = 120) born in the years 1962-1984, diagnosed with autism/atypical autism in childhood and followed up at young adult age (greater than or equal to 18 years of age), and examine the risk factors and causes of death. The study group,…

  6. Longitudinal Analysis of Patient Specific Predictors for Mortality in Sickle Cell Disease

    PubMed Central

    Danda, Neeraja; Etzion, Zipora; Cohen, Hillel W.

    2016-01-01

    Introduction White Blood Cell (WBC) count, %HbF, and serum creatinine (Cr), have been identified as markers for increased mortality in sickle cell anemia (SCA) but no studies have examined the significance of longitudinal rate of change in these or other biomarkers for SCA individuals. Methods Clinical, demographic and laboratory data from SCA patients seen in 2002 by our hospital system were obtained. Those who were still followed in 2012 (survival cohort) were compared to those who had died in the interim (mortality cohort). Patients lost to follow-up were excluded. Age adjusted multivariable Cox proportional hazards models were constructed to assess hazard ratios of mortality risk associated with the direction and degree of change for each variable. Results 359 SCA patients were identified. Baseline higher levels of WBC, serum creatinine and hospital admissions were associated with increased mortality, as were alkaline phosphatase and aspartate aminotransaminase levels. Lower baseline levels of %HbF were also associated with increased mortality. When longitudinal rates of change for individuals were assessed, increases in Hb or WBC over patient baseline values were associated with greater mortality risk (HR 1.54, p = 0.02 and HR 1.16, p = 0.01 with negative predictive values of 87.8 and 94.4 respectively), while increasing ED use was associated with decreased mortality (HR 0.84, p = 0.01). We did not detect any increased mortality risk for longitudinal changes in annual clinic visits or admissions, creatinine or %HbF. Conclusions Although initial steady state observations can help predict survival in SCA, the longitudinal course of a patient may give additional prognostic information. PMID:27764159

  7. The National Early Intervention Longitudinal Study (NEILS) Design Overview.

    ERIC Educational Resources Information Center

    Hebbeler, Kathleen; Wagner, Mary

    The National Early Intervention Longitudinal Study (NEILS) is being conducted to address some of the most important questions related to the implementation and outcomes of Part C of the Individuals with Disabilities Education Act (IDEA). NEILS is following a nationally representative sample of children from birth to 3 years old and their families…

  8. Using National Education Longitudinal Data Sets in School Counseling Research

    ERIC Educational Resources Information Center

    Bryan, Julia A.; Day-Vines, Norma L.; Holcomb-McCoy, Cheryl; Moore-Thomas, Cheryl

    2010-01-01

    National longitudinal databases hold much promise for school counseling researchers. Several of the more frequently used data sets, possible professional implications, and strategies for acquiring training in the use of large-scale national data sets are described. A 6-step process for conducting research with the data sets is explicated:…

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

    ERIC Educational Resources Information Center

    Myers, GeorgeC.

    1978-01-01

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

  10. Infant Mortality: A Challenge to the Nation.

    ERIC Educational Resources Information Center

    Children's Bureau (DHEW), Washington, DC.

    From 1956-1960 an estimated 34,000 infants annually failed to survive in many parts of the United States due to risks far in excess of those for some areas of the country. There is a growing gap between death rates for white and nonwhite infants in the United States, with the excess mortality rate of nonwhite infants continuing to rise. Only 15…

  11. North-South disparities in English mortality1965–2015: longitudinal population study

    PubMed Central

    Kontopantelis, Evangelos; Sperrin, Matthew; Doran, Tim

    2017-01-01

    Background Social, economic and health disparities between northern and southern England have persisted despite Government policies to reduce them. We examine long-term trends in premature mortality in northern and southern England across age groups, and whether mortality patterns changed after the 2008–2009 Great Recession. Methods Population-wide longitudinal (1965–2015) study of mortality in England's five northernmost versus four southernmost Government Office Regions – halves of overall population. Main outcome measure: directly age-sex adjusted mortality rates; northern excess mortality (percentage excess northern vs southern deaths, age-sex adjusted). Results From 1965 to 2010, premature mortality (deaths per 10 000 aged <75 years) declined from 64 to 28 in southern versus 72 to 35 in northern England. From 2010 to 2015 the rate of decline in premature mortality plateaued in northern and southern England. For most age groups, northern excess mortality remained consistent from 1965 to 2015. For 25–34 and 35–44 age groups, however, northern excess mortality increased sharply between 1995 and 2015: from 2.2% (95% CI –3.2% to 7.6%) to 29.3% (95% CI 21.0% to 37.6%); and 3.3% (95% CI –1.0% to 7.6%) to 49.4% (95% CI 42.8% to 55.9%), respectively. This was due to northern mortality increasing (ages 25–34) or plateauing (ages 35–44) from the mid-1990s while southern mortality mainly declined. Conclusions England's northern excess mortality has been consistent among those aged <25 and 45+ for the past five decades but risen alarmingly among those aged 25–44 since the mid-90s, long before the Great Recession. This profound and worsening structural inequality requires more equitable economic, social and health policies, including potential reactions to the England-wide loss of improvement in premature mortality. PMID:28790164

  12. The Association of Longitudinal and Interpersonal Continuity of Care with Emergency Department Use, Hospitalization, and Mortality among Medicare Beneficiaries

    PubMed Central

    Bentler, Suzanne E.; Morgan, Robert O.; Virnig, Beth A.; Wolinsky, Fredric D.

    2014-01-01

    Background Continuity of medical care is widely believed to lead to better health outcomes and service utilization patterns for patients. Most continuity studies, however, have only used administrative claims to assess longitudinal continuity with a provider. As a result, little is known about how interpersonal continuity (the patient's experience at the visit) relates to improved health outcomes and service use. Methods We linked claims-based longitudinal continuity and survey-based self-reported interpersonal continuity indicators for 1,219 Medicare beneficiaries who completed the National Health and Health Services Use Questionnaire. With these linked data, we prospectively evaluated the effect of both types of continuity of care indicators on emergency department use, hospitalization, and mortality over a five-year period. Results Patient-reported continuity was associated with reduced emergency department use, preventable hospitalization, and mortality. Most of the claims-based measures, including those most frequently used to assess continuity, were not associated with reduced utilization or mortality. Conclusion Our results indicate that the patient- and claims-based indicators of continuity have very different effects on these important health outcomes, suggesting that reform efforts must include the patient-provider experience when evaluating health care quality. PMID:25531108

  13. Relationships of Suicide Ideation with Cause-Specific Mortality in a Longitudinal Study of South Koreans

    ERIC Educational Resources Information Center

    Khang, Young-Ho; Kim, Hye-Ryun; Cho, Seong-Jin

    2010-01-01

    Using 7-year mortality follow-up data (n = 341) from the 1998 National Health and Nutrition Examination Surveys of South Korean individuals (N = 5,414), the authors found that survey participants with suicide ideation were at increased risk of suicide mortality during the follow-up period compared with those without suicide ideation. The…

  14. Relationships of Suicide Ideation with Cause-Specific Mortality in a Longitudinal Study of South Koreans

    ERIC Educational Resources Information Center

    Khang, Young-Ho; Kim, Hye-Ryun; Cho, Seong-Jin

    2010-01-01

    Using 7-year mortality follow-up data (n = 341) from the 1998 National Health and Nutrition Examination Surveys of South Korean individuals (N = 5,414), the authors found that survey participants with suicide ideation were at increased risk of suicide mortality during the follow-up period compared with those without suicide ideation. The…

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

    PubMed

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

    2016-01-01

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

  16. Weight loss from maximum body weight and mortality: the Third National Health and Nutrition Examination Survey Linked Mortality File.

    PubMed

    Ingram, D D; Mussolino, M E

    2010-06-01

    The aim of this longitudinal study is to examine the relationship between weight loss from maximum body weight, body mass index (BMI), and mortality in a nationally representative sample of men and women. Longitudinal cohort study. In all, 6117 whites, blacks, and Mexican-Americans 50 years and over at baseline who survived at least 3 years of follow-up, from the Third National Health and Nutrition Examination Survey Linked Mortality Files (1988-1994 with passive mortality follow-up through 2000), were included. Measured body weight and self-reported maximum body weight obtained at baseline. Weight loss (maximum body weight minus baseline weight) was categorized as <5%, 5-<15%, and >or=15%. Maximum BMI (reported maximum weight (kg)/measured baseline height (m)(2)) was categorized as healthy weight (18.5-24.9), overweight (25.0-29.9), and obese (>or=30.0). In all, 1602 deaths were identified. After adjusting for age, race, smoking, health status, and preexisting illness, overweight men with weight loss of 15% or more, overweight women with weight loss of 5-<15%, and women in all BMI categories with weight loss of 15% or more were at increased risk of death from all causes compared with those in the same BMI category who lost <5%; hazard ratios ranged from 1.46 to 2.70. Weight loss of 5-<15% reduced risk of death from cardiovascular diseases among obese men. Weight loss of 15% or more from maximum body weight is associated with increased risk of death from all causes among overweight men and among women regardless of maximum BMI.

  17. Secondary Analysis of National Longitudinal Transition Study 2 Data

    ERIC Educational Resources Information Center

    Hicks, Tyler A.; Knollman, Greg A.

    2015-01-01

    This review examines published secondary analyses of National Longitudinal Transition Study 2 (NLTS2) data, with a primary focus upon statistical objectives, paradigms, inferences, and methods. Its primary purpose was to determine which statistical techniques have been common in secondary analyses of NLTS2 data. The review begins with an…

  18. Secondary Analysis of National Longitudinal Transition Study 2 Data

    ERIC Educational Resources Information Center

    Hicks, Tyler A.; Knollman, Greg A.

    2015-01-01

    This review examines published secondary analyses of National Longitudinal Transition Study 2 (NLTS2) data, with a primary focus upon statistical objectives, paradigms, inferences, and methods. Its primary purpose was to determine which statistical techniques have been common in secondary analyses of NLTS2 data. The review begins with an…

  19. Connecticut Participation in the National Educational Longitudinal Study (NELS).

    ERIC Educational Resources Information Center

    Connecticut State Department of Education Research Bulletin, 1990

    1990-01-01

    Statewide information concerning the Connecticut eight-grade public school students who particpated in the National Education Longitudinal Study (NELS) in the spring of 1988 is presented. Over 900 students in 46 schools in 35 school districts, almost evenly divided between males and females, completed cognitive tests and student surveys about…

  20. Hispanic Mortality Paradox: A Systematic Review and Meta-Analysis of the Longitudinal Literature

    PubMed Central

    Steffen, Patrick; Smith, Timothy B.

    2013-01-01

    To investigate the possibility of a Hispanic mortality advantage, we conducted a systematic review and meta-analysis of the published longitudinal literature reporting Hispanic individuals’ mortality from any cause compared with any other race/ethnicity. We searched MEDLINE, PubMed, EMBASE, HealthSTAR, and PsycINFO for published literature from January 1990 to July 2010. Across 58 studies (4 615 747 participants), Hispanic populations had a 17.5% lower risk of mortality compared with other racial groups (odds ratio = 0.825; P < .001; 95% confidence interval = 0.75, 0.91). The difference in mortality risk was greater among older populations and varied by preexisting health conditions, with effects apparent for initially healthy samples and those with cardiovascular diseases. The results also differed by racial group: Hispanics had lower overall risk of mortality than did non-Hispanic Whites and non-Hispanic Blacks, but overall higher risk of mortality than did Asian Americans. These findings provided strong evidence of a Hispanic mortality advantage, with implications for conceptualizing and addressing racial/ethnic health disparities. PMID:23327278

  1. Migration, urbanisation and mortality: 5-year longitudinal analysis of the PERU MIGRANT study.

    PubMed

    Burroughs Pena, Melissa S; Bernabé-Ortiz, Antonio; Carrillo-Larco, Rodrigo M; Sánchez, Juan F; Quispe, Renato; Pillay, Timesh D; Málaga, Germán; Gilman, Robert H; Smeeth, Liam; Miranda, J Jaime

    2015-07-01

    To compare all-cause and cause-specific mortality among 3 distinct groups: within-country, rural-to-urban migrants, and rural and urban dwellers in a longitudinal cohort in Peru. The PERU MIGRANT Study, a longitudinal cohort study, used an age-stratified and sex-stratified random sample of urban dwellers in a shanty town community in the capital city of Peru, rural dwellers in the Andes, and migrants from the Andes to the shanty town community. Participants underwent a questionnaire and anthropomorphic measurements at a baseline evaluation in 2007-2008 and at a follow-up visit in 2012-2013. Mortality was determined by death certificate or family interview. Of the 989 participants evaluated at baseline, 928 (94%) were evaluated at follow-up (mean age 48 years; 53% female). The mean follow-up time was 5.1 years, totalling 4732.8 person-years. In a multivariable survival model, and relative to urban dwellers, migrant participants had lower all cause mortality (HR=0.30; 95% CI 0.12-0.78), and both the migrant (HR=0.07; 95% CI 0.01-0.41) and rural (HR=0.06; 95% CI 0.01-0.62) groups had lower cardiovascular mortality. Cardiovascular mortality of migrants remains similar to that of the rural group, suggesting that rural-to-urban migrants do not appear to catch up with urban mortality in spite of having a more urban cardiovascular risk factor profile. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  2. Longitudinal change in the BODE index predicts mortality in severe emphysema.

    PubMed

    Martinez, Fernando J; Han, Meilan K; Andrei, Adin-Cristian; Wise, Robert; Murray, Susan; Curtis, Jeffrey L; Sternberg, Alice; Criner, Gerard; Gay, Steven E; Reilly, John; Make, Barry; Ries, Andrew L; Sciurba, Frank; Weinmann, Gail; Mosenifar, Zab; DeCamp, Malcolm; Fishman, Alfred P; Celli, Bartolome R

    2008-09-01

    The predictive value of longitudinal change in BODE (Body mass index, airflow Obstruction, Dyspnea, and Exercise capacity) index has received limited attention. We hypothesized that decrease in a modified BODE (mBODE) would predict survival in National Emphysema Treatment Trial (NETT) patients. To determine how the mBODE score changes in patients with lung volume reduction surgery versus medical therapy and correlations with survival. Clinical data were recorded using standardized instruments. The mBODE was calculated and patient-specific mBODE trajectories during 6, 12, and 24 months of follow-up were estimated using separate regressions for each patient. Patients were classified as having decreasing, stable, increasing, or missing mBODE based on their absolute change from baseline. The predictive ability of mBODE change on survival was assessed using multivariate Cox regression models. The index of concordance was used to directly compare the predictive ability of mBODE and its separate components. The entire cohort (610 treated medically and 608 treated surgically) was characterized by severe airflow obstruction, moderate breathlessness, and increased mBODE at baseline. A wide distribution of change in mBODE was seen at follow-up. An increase in mBODE of more than 1 point was associated with increased mortality in surgically and medically treated patients. Surgically treated patients were less likely to experience death or an increase greater than 1 in mBODE. Indices of concordance showed that mBODE change predicted survival better than its separate components. The mBODE demonstrates short- and intermediate-term responsiveness to intervention in severe chronic obstructive pulmonary disease. Increase in mBODE of more than 1 point from baseline to 6, 12, and 24 months of follow-up was predictive of subsequent mortality. Change in mBODE may prove a good surrogate measure of survival in therapeutic trials in severe chronic obstructive pulmonary disease. Clinical

  3. Mortality level and predictors in a rural Ethiopian population: community based longitudinal study.

    PubMed

    Weldearegawi, Berhe; Spigt, Mark; Berhane, Yemane; Dinant, Geertjan

    2014-01-01

    Over the last fifty years the world has seen enormous decline in mortality rates. However, in low-income countries, where vital registration systems are absent, mortality statistics are not easily available. The recent economic growth of Ethiopia and the parallel large scale healthcare investments make investigating mortality figures worthwhile. Longitudinal health and demographic surveillance data collected from September 11, 2009 to September 10, 2012 were analysed. We computed incidence of mortality, overall and stratified by background variables. Poisson regression was used to test for a linear trend in the standardized mortality rates. Cox-regression analysis was used to identify predictors of mortality. Households located at <2300 meter and ≥ 2300 meter altitude were defined to be midland and highland, respectively. An open cohort, with a baseline population of 66,438 individuals, was followed for three years to generate 194,083 person-years of observation. The crude mortality rate was 4.04 (95% CI: 3.77, 4.34) per 1,000 person-years. During the follow-up period, incidence of mortality significantly declined among under five (P<0.001) and 5-14 years old (P<0.001), whereas it increased among 65 years and above (P<0.001). Adjusted for other covariates, mortality was higher in males (hazard ratio (HR) = 1.42, 95% CI: 1.22, 1.66), rural population (HR = 1.74, 95% CI: 1.32, 2.31), highland (HR = 1.20, 95% CI: 1.03, 1.40) and among those widowed (HR = 2.25, 95% CI: 1.81, 2.80) and divorced (HR = 1.80, 95% CI: 1.30, 2.48). Overall mortality rate was low. The level and patterns of mortality indicate changes in the epidemiology of major causes of death. Certain population groups had significantly higher mortality rates and further research is warranted to identify causes of higher mortality in those groups.

  4. North-South disparities in English mortality1965-2015: longitudinal population study.

    PubMed

    Buchan, Iain E; Kontopantelis, Evangelos; Sperrin, Matthew; Chandola, Tarani; Doran, Tim

    2017-09-01

    Social, economic and health disparities between northern and southern England have persisted despite Government policies to reduce them. We examine long-term trends in premature mortality in northern and southern England across age groups, and whether mortality patterns changed after the 2008-2009 Great Recession. Population-wide longitudinal (1965-2015) study of mortality in England's five northernmost versus four southernmost Government Office Regions - halves of overall population. directly age-sex adjusted mortality rates; northern excess mortality (percentage excess northern vs southern deaths, age-sex adjusted). From 1965 to 2010, premature mortality (deaths per 10 000 aged <75 years) declined from 64 to 28 in southern versus 72 to 35 in northern England. From 2010 to 2015 the rate of decline in premature mortality plateaued in northern and southern England. For most age groups, northern excess mortality remained consistent from 1965 to 2015. For 25-34 and 35-44 age groups, however, northern excess mortality increased sharply between 1995 and 2015: from 2.2% (95% CI -3.2% to 7.6%) to 29.3% (95% CI 21.0% to 37.6%); and 3.3% (95% CI -1.0% to 7.6%) to 49.4% (95% CI 42.8% to 55.9%), respectively. This was due to northern mortality increasing (ages 25-34) or plateauing (ages 35-44) from the mid-1990s while southern mortality mainly declined. England's northern excess mortality has been consistent among those aged <25 and 45+ for the past five decades but risen alarmingly among those aged 25-44 since the mid-90s, long before the Great Recession. This profound and worsening structural inequality requires more equitable economic, social and health policies, including potential reactions to the England-wide loss of improvement in premature mortality. © 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.

  5. Parenting style in childhood and mortality risk at older ages: a longitudinal cohort study.

    PubMed

    Demakakos, Panayotes; Pillas, Demetris; Marmot, Michael; Steptoe, Andrew

    2016-08-01

    Parenting style is associated with offspring health, but whether it is associated with offspring mortality at older ages remains unknown. We examined whether childhood experiences of suboptimal parenting style are associated with increased risk of death at older ages. Longitudinal cohort study of 1964 community-dwelling adults aged 65-79 years. The association between parenting style and mortality was inverse and graded. Participants in the poorest parenting style score quartile had increased risk of death (hazard ratio (HR) = 1.72, 95% CI 1.20-2.48) compared with those in the optimal parenting style score quartile after adjustment for age and gender. Full adjustment for covariates partially explained this association (HR = 1.49, 95% CI 1.02-2.18). Parenting style was inversely associated with cancer and other mortality, but not cardiovascular mortality. Maternal and paternal parenting styles were individually associated with mortality. Experiences of suboptimal parenting in childhood are associated with increased risk of death at older ages. © The Royal College of Psychiatrists 2016.

  6. Longitudinal Relation of Community-Level Income Inequality and Mortality in Costa Rica

    PubMed Central

    Modrek, Sepideh; Ahern, Jennifer

    2011-01-01

    The controversy regarding the direct relationship between income distribution and health remains unresolved. Empirical evidence has often failed to advance our understanding because in the countries studied there was limited ability to distinguish hypotheses. This study examines the relation between inequality and mortality in the context of Costa Rica. Costa Rica’s unique social and political structure makes confounding through resource and political channels less likely, thus any effects would work predominantly through direct psychosocial channels. Using mortality data extracted from the Vital Statistics Registry, we evaluate the longitudinal relations between income inequality and cause-specific mortality in Costa Rica from 1989–2005. For those aged 15–60, results indicate that there is a significant adverse relation between increases in lagged inequality and mortality from liver disease, and marginal adverse relations with mortality from diabetes and suicide. For those aged 60 and over, there is a limited evidence of a relation between inequality and health. These results suggest increases in inequality may impact health behavior of the working aged population in Costa Rica. PMID:21873102

  7. New Zealand juvenile oyster mortality associated with ostreid herpesvirus 1-an opportunistic longitudinal study.

    PubMed

    Keeling, S E; Brosnahan, C L; Williams, R; Gias, E; Hannah, M; Bueno, R; McDonald, W L; Johnston, C

    2014-07-03

    During the 2010-11 summer outbreak of ostreid herpesvirus 1 (OsHV-1) in New Zealand, an opportunistic longitudinal field study was conducted. OsHV-1 PCR-negative oyster spat (Crassostrea gigas) were relocated to an OsHV-1 PCR-positive area of the North Island of New Zealand that was experiencing juvenile oyster mortalities. Over a period of 13 d, spat were monitored for mortality, sampled for histopathology, and tested for the presence of OsHV-1 using real time PCR and Vibrio culture. Histopathology showed some evidence of tissue pathology; however, no consistent progressive pathology was apparent. Field mortalities were evident from Day 6 on. After 5 and 7 d of exposure, 83 and 100% of spat, respectively, tested positive for the virus by real time PCR. Vibrio species recovered during the longitudinal study included V. splendidus and V. aestuarianus. This study offers insight into the rapidity of onset and virulence of the virus in naïve oyster spat in New Zealand waters.

  8. Reversible Cognitive Frailty, Dementia, and All-Cause Mortality. The Italian Longitudinal Study on Aging.

    PubMed

    Solfrizzi, Vincenzo; Scafato, Emanuele; Seripa, Davide; Lozupone, Madia; Imbimbo, Bruno P; D'Amato, Angela; Tortelli, Rosanna; Schilardi, Andrea; Galluzzo, Lucia; Gandin, Claudia; Baldereschi, Marzia; Di Carlo, Antonio; Inzitari, Domenico; Daniele, Antonio; Sabbà, Carlo; Logroscino, Giancarlo; Panza, Francesco

    2017-01-01

    Cognitive frailty, a condition describing the simultaneous presence of physical frailty and mild cognitive impairment, has been recently defined by an international consensus group. We estimated the predictive role of a "reversible" cognitive frailty model on incident dementia, its subtypes, and all-cause mortality in nondemented older individuals. We verified if vascular risk factors or depressive symptoms could modify this predictive role. Longitudinal population-based study with 3.5- and 7-year of median follow-up. Eight Italian municipalities included in the Italian Longitudinal Study on Aging. In 2150 older individuals from the Italian Longitudinal Study on Aging, we operationalized reversible cognitive frailty with the presence of physical frailty and pre-mild cognitive impairment subjective cognitive decline, diagnosed with a self-report measure based on item 14 of the Geriatric Depression Scale. Incidence of dementia, its subtypes, and all-cause mortality. Over a 3.5-year follow-up, participants with reversible cognitive frailty showed an increased risk of overall dementia [hazard ratio (HR) 2.30, 95% confidence interval (CI) 1.02-5.18], particularly vascular dementia (VaD), and all-cause mortality (HR 1.74, 95% CI 1.07-2.83). Over a 7-year follow-up, participants with reversible cognitive frailty showed an increased risk of overall dementia (HR 2.12, 95% CI 1.12-4.03), particularly VaD, and all-cause mortality (HR 1.39, 95% CI 1.03-2.00). Vascular risk factors and depressive symptoms did not have any effect modifier on the relationship between reversible cognitive frailty and incident dementia and all-cause mortality. A model of reversible cognitive frailty was a short- and long-term predictor of all-cause mortality and overall dementia, particularly VaD. The absence of vascular risk factors and depressive symptoms did not modify the predictive role of reversible cognitive frailty on these outcomes. Copyright © 2016 AMDA – The Society for Post-Acute and

  9. ICU Telemedicine and Critical Care Mortality: A National Effectiveness Study.

    PubMed

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

    2016-03-01

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

  10. Fried potato consumption is associated with elevated mortality: an 8-y longitudinal cohort study.

    PubMed

    Veronese, Nicola; Stubbs, Brendon; Noale, Marianna; Solmi, Marco; Vaona, Alberto; Demurtas, Jacopo; Nicetto, Davide; Crepaldi, Gaetano; Schofield, Patricia; Koyanagi, Ai; Maggi, Stefania; Fontana, Luigi

    2017-07-01

    Background: Few studies have assessed the association between potato consumption and mortality.Objective: We investigated whether potato consumption (including fried and unfried potatoes) is associated with increased premature mortality risk in a North American cohort.Design: A longitudinal analysis included 4440 participants aged 45-79 y at baseline with an 8-y follow-up from the Osteoarthritis Initiative cohort study. Potato consumption (including fried and unfried potatoes) was analyzed by using a Block Brief 2000 food-frequency questionnaire and categorized as ≤1 time/mo, 2-3 times/mo, 1 time/wk, 2 times/wk, or ≥3 times/wk. Mortality was ascertained through validated cases of death. To investigate the association between potato consumption and mortality, Cox regression models were constructed to estimate HRs with 95% CIs, with adjustment for potential confounders.Results: Of the 4400 participants, 2551 (57.9%) were women with a mean ± SD age of 61.3 ± 9.2 y. During the 8-y follow-up, 236 participants died. After adjustment for 14 potential baseline confounders, and taking those with the lowest consumption of potatoes as the reference group, participants with the highest consumption of potatoes did not show an increased risk of overall mortality (HR: 1.11; 95% CI: 0.65, 1.91). However, subgroup analyses indicated that participants who consumed fried potatoes 2-3 times/wk (HR: 1.95; 95% CI: 1.11, 3.41) and ≥3 times/wk (HR: 2.26; 95% CI: 1.15, 4.47) were at an increased risk of mortality. The consumption of unfried potatoes was not associated with an increased mortality risk.Conclusions: The frequent consumption of fried potatoes appears to be associated with an increased mortality risk. Additional studies in larger sample sizes should be performed to confirm if overall potato consumption is associated with higher mortality risk. This trial was registered at clinicaltrials.gov as NCT00080171. © 2017 American Society for Nutrition.

  11. Design and methods of the national Vietnam veterans longitudinal study.

    PubMed

    Schlenger, William E; Corry, Nida H; Kulka, Richard A; Williams, Christianna S; Henn-Haase, Clare; Marmar, Charles R

    2015-09-01

    The National Vietnam Veterans Longitudinal Study (NVVLS) is the second assessment of a representative cohort of US veterans who served during the Vietnam War era, either in Vietnam or elsewhere. The cohort was initially surveyed in the National Vietnam Veterans Readjustment Study (NVVRS) from 1984 to 1988 to assess the prevalence, incidence, and effects of post-traumatic stress disorder (PTSD) and other post-war problems. The NVVLS sought to re-interview the cohort to assess the long-term course of PTSD. NVVLS data collection began July 3, 2012 and ended May 17, 2013, comprising three components: a mailed health questionnaire, a telephone health survey interview, and, for a probability sample of theater Veterans, a clinical diagnostic telephone interview administered by licensed psychologists. Excluding decedents, 78.8% completed the questionnaire and/or telephone survey, and 55.0% of selected living veterans participated in the clinical interview. This report provides a description of the NVVLS design and methods. Together, the NVVRS and NVVLS constitute a nationally representative longitudinal study of Vietnam veterans, and extend the NVVRS as a critical resource for scientific and policy analyses for Vietnam veterans, with policy relevance for Iraq and Afghanistan veterans.

  12. A longitudinal investigation of mortality in anorexia nervosa and bulimia nervosa.

    PubMed

    Franko, Debra L; Keshaviah, Aparna; Eddy, Kamryn T; Krishna, Meera; Davis, Martha C; Keel, Pamela K; Herzog, David B

    2013-08-01

    OBJECTIVE Although anorexia nervosa has a high mortality rate, our understanding of the timing and predictors of mortality in eating disorders is limited. The authors investigated mortality in a long-term study of patients with eating disorders. METHOD Beginning in 1987, 246 treatment-seeking female patients with anorexia nervosa or bulimia nervosa were interviewed every 6 months for a median of 9.5 years to obtain weekly ratings of eating disorder symptoms, comorbidity, treatment participation, and psychosocial functioning. From January 2007 to December 2010 (median follow-up of 20 years), vital status was ascertained with a National Death Index search. RESULTS Sixteen deaths (6.5%) were recorded (lifetime anorexia nervosa, N=14; bulimia nervosa with no history of anorexia nervosa, N=2). The standardized mortality ratio was 4.37 (95% CI=2.4-7.3) for lifetime anorexia nervosa and 2.33 (95% CI=0.3-8.4) for bulimia nervosa with no history of anorexia nervosa. Risk of premature death among patients with lifetime anorexia nervosa peaked within the first 10 years of follow-up, resulting in a standardized mortality ratio of 7.7 (95% CI=3.7-14.2). The standardized mortality ratio varied by duration of illness and was 3.2 (95% CI=0.9-8.3) for patients with lifetime anorexia nervosa for 0 to 15 years (4/119 died), and 6.6 (95% CI=3.2-12.1) for those with lifetime anorexia nervosa for >15 to 30 years (10/67 died). Multivariate predictors of mortality included alcohol abuse, low body mass index, and poor social adjustment. CONCLUSIONS These findings highlight the need for early identification and intervention and suggest that a long duration of illness, substance abuse, low weight, and poor psychosocial functioning raise the risk for mortality in anorexia nervosa.

  13. Longitudinal Trends in Hypertension Management and Mortality Among Octogenarians: Prospective Cohort Study.

    PubMed

    Dregan, Alex; Ravindrarajah, Rathi; Hazra, Nisha; Hamada, Shota; Jackson, Stephen H D; Gulliford, Martin C

    2016-07-01

    The role of hypertension management among octogenarians is controversial. In this long-term follow-up (>10 years) study, we estimated trends in hypertension prevalence, awareness, treatment, and control among octogenarians, and evaluated the relationship of systolic blood pressure (SBP) ranges with mortality. Data were based on the English Longitudinal Study of Ageing (ELSA). Outcome measures were hypertension prevalence, awareness, treatment and control, and cardiovascular disease, and all-cause mortality events. Participants were separated into 8 categories of SBP values (<110, 110-119, 120-129, 130-139, 140-149, 150-159, 160-169, and >169 mm Hg). Among 2692 octogenarians, mean SBP levels declined from 147 mm Hg in 1998/2000 to 134 mm Hg in 2012/2013. The decline was of lower magnitude in the 50 to 79 years old subgroup (n=22007). Hypertension prevalence and awareness were 40% and 13%, respectively, higher among octogenarians than the 50 to 79 years of age subgroup, but hypertension treatment rates were similar (≈90%). Around 47% of the treated octogenarians achieved conventional BP targets (<140/90 mm Hg), increasing to 59% when assessed against revised targets (<150/90 mm Hg). All-cause mortality rates were higher (hazard ratio, 1.55; 95% confidence interval, 0.89-2.72) at lower extremes of SBP values (<110 mm Hg). The lowest cardiovascular disease and all-cause mortality risk among treated octogenarians was observed for an SBP range of 140 to 149 mm Hg (1.04, 0.60-1.78) and 160 to 169 mm Hg (0.78, 0.51-1.21). An increasing trend in hypertension awareness and treatment was observed in a large sample of community-dwelling octogenarians. The results do not support the view that more stringent BP targets may be associated with lower mortality. © 2016 The Authors.

  14. Independent early predictors of mortality in polytrauma patients: a prospective, observational, longitudinal study

    PubMed Central

    da Costa, Luiz Guilherme V.; Carmona, Maria José C.; Malbouisson, Luiz M.; Rizoli, Sandro; Rocha-Filho, Joel Avancini; Cardoso, Ricardo Galesso; Auler-Junior, José Otávio C.

    2017-01-01

    OBJECTIVES: Trauma is an important public health issue and associated with substantial socioeconomic impacts and major adverse clinical outcomes. No single study has previously investigated the predictors of mortality across all stages of care (pre-hospital, emergency room, surgical center and intensive care unit) in a general trauma population. This study was designed to identify early predictors of mortality in severely injured polytrauma patients across all stages of care to provide a better understanding of the physiologic changes and mechanisms by which to improve care in this population. METHODS: A longitudinal, prospective, observational study was conducted between 2010 and 2013 in São Paulo, Brazil. Patients submitted to high-energy trauma were included. Exclusion criteria were as follows: injury severity score <16, <18 years old or insufficient data. Clinical and laboratory data were collected at four time points: pre-hospital, emergency room, and 3 and 24 hours after hospital admission. The primary outcome assessed was mortality within 30 days. Data were analyzed using tests of association as appropriate, nonparametric analysis of variance and generalized estimating equation analysis (p<0.05). ClinicalTrials.gov: NCT01669577. RESULTS: Two hundred patients were included. Independent early predictors of mortality were as follows: arterial hemoglobin oxygen saturation (p<0.001), diastolic blood pressure (p<0.001), lactate level (p<0.001), Glasgow Coma Scale score (p<0.001), infused crystalloid volume (p<0.015) and presence of traumatic brain injury (p<0.001). CONCLUSION: Our results suggest that arterial hemoglobin oxygen saturation, diastolic blood pressure, lactate level, Glasgow Coma Scale, infused crystalloid volume and presence of traumatic brain injury are independent early mortality predictors. PMID:28954004

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

    PubMed Central

    Zaninotto, Paola; Wardle, Jane

    2016-01-01

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

  16. Income Inequality and Child Mortality in Wealthy Nations.

    PubMed

    Collison, David

    2016-01-01

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

  17. Coexisting geriatric anxiety and depressive disorders may increase the risk of ischemic heart disease mortality-a nationwide longitudinal cohort study.

    PubMed

    Chang, Wei Hung; Lee, I Hui; Chen, Wei Tseng; Chen, Po See; Yang, Yen Kuang; Chen, Kao Chin

    2016-12-14

    In the elderly, the risk of mortality because of physical illnesses related to anxiety disorders varies with potential confounding influences, including comorbidity with depressive disorders. Our study aimed to explore (i) whether anxiety disorders increase the risk of mortality in the elderly, and (ii) whether the risk of mortality mediated by anxiety and depressive disorders differs between physical illnesses. Our longitudinal cohort study included subjects aged over 60 years from the National Health Insurance Research Database. One thousand and eighty-six subjects with anxiety disorders and 50 554 control subjects without anxiety disorders were included. Propensity score-matched cohorts were analyzed. Rate ratios (RRs) were calculated for the risk of mortality associated with different physical illnesses with comorbidities of either anxiety disorders only or both anxiety and depressive disorders. The risk of mortality in patients with anxiety disorders was significantly higher than controls, and was even higher when subjects had both anxiety and depressive disorder comorbidities. Furthermore, the co-occurrence of anxiety and depressive disorders increased the risk of mortality in elderly patients with ischemic heart diseases (RR = 1.60; 95% CI: 1.14-2.24). Coexisting anxiety and depressive disorders could increase the risk of mortality in elderly patients with ischemic heart diseases. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  18. Predictors of perinatal mortality in rural population of Northwest Ethiopia: a prospective longitudinal study.

    PubMed

    Andargie, Gashaw; Berhane, Yemane; Worku, Alemayehu; Kebede, Yigzaw

    2013-02-23

    Perinatal mortality is one of the serious challenges in meeting maternal and child Millennium Development Goals in developing countries. Identifying its predictors is an important step to develop focused and appropriate health interventions for reducing perinatal deaths. This study therefore aims at identifying predictors of perinatal mortality in a rural setting in northwest Ethiopia. A prospective longitudinal study was conducted at Dabat Health and Demographic Surveillance site, northwest Ethiopia, from November 2009 to August 2011. Data were collected by interviewing the mothers or guardians of eligible children. Multiple logistic regressions were employed to identify potential predictors. A total of 1752 eligible children were included in the study. Perinatal mortality rate in the study population was 50.22 per 1000 (95% CI: 39.99, 60.46) total births. In multiple logistic analysis, previous still birth [(AOR = 8.38, 95% CI: 3.94, 17.83)], twin birth [(AOR = 7.09, 95% CI: (3.22, 15.61)], not receiving tetanus toxoid vaccine during the index pregnancy [(AOR = 3.62, 95% CI: 1.57, 8.34)], short birth interval of less than 24 months [(AOR = 2.58, 95% CI: (1.61, 4.13)], maternal illiteracy [(AOR = 4.83, 95% CI: (1.45, 16.05)] and mothers' running own business [(AOR = 5.40, 95% CI: 1.40, 27.96)] were the main predictors associated with increased risk of perinatal death. Predictors of perinatal death in the study area are easily recognizable and potentially preventable with the existing maternal health programs. Efforts need to be intensified in expanding maternal and newborn health services to significantly reduce perinatal mortality in rural settings.

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

    PubMed Central

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

    2015-01-01

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

  20. Prognostic impact of peritonitis in hemodialysis patients: A national-wide longitudinal study in Taiwan

    PubMed Central

    Lee, Cheng-Chia; Wu, Patricia W.; Chang, Chee-Jen; Tian, Ya-Chung; Yang, Chih-Wei

    2017-01-01

    Background Peritonitis has been independently associated with increased morbidity and mortality in peritoneal dialysis patients. However, there are few reports on peritonitis in hemodialysis patients. We aim at investigating both the risk profiles and prognostic impact of peritonitis in hemodialysis patients. Methods This nation-wide longitudinal study uses claims data obtained from the Taiwan National Health Insurance Research Database. A total of 80,733 incident hemodialysis patients of age ≥ 20 years without a history of peritonitis were identified between January 1, 1998 and December 31, 2009. Predictors of peritonitis events were estimated using Cox proportional hazard models. Time-dependent Cox proportional hazard models were used to estimate hazard ratio for mortality attributed to peritonitis exposure. Results Of 80,733 incident hemodialysis patients over a 13-year study period, peritonitis was diagnosed in 935 (1.16%), yielding an incidence rate of 2.91 per 1000 person-years. Female gender, liver cirrhosis and polycystic kidney disease were three of the most significant factors for peritonitis in both non-diabetic and diabetic hemodialysis patients. The cumulative survival rate of patients with peritonitis was 38.8% at 1 year and 10.1% at 5 years. A time-dependent Cox multivariate analysis showed that peritonitis had significantly increased hazard ratio for all cause mortality. Additionally, the risk of mortality remained significantly higher for non-diabetic hemodialysis patients that experienced peritonitis. Conclusions The risk of peritonitis in hemodialysis patients is higher in female gender, liver cirrhosis and polycystic kidney disease. Although peritonitis is a rare condition, it is associated with significantly poorer outcome in hemodialysis patients. PMID:28301536

  1. Prognostic impact of peritonitis in hemodialysis patients: A national-wide longitudinal study in Taiwan.

    PubMed

    Lu, Yueh-An; Tu, Kun-Hua; Lee, Cheng-Chia; Wu, Patricia W; Chang, Chee-Jen; Tian, Ya-Chung; Yang, Chih-Wei; Chu, Pao-Hsien

    2017-01-01

    Peritonitis has been independently associated with increased morbidity and mortality in peritoneal dialysis patients. However, there are few reports on peritonitis in hemodialysis patients. We aim at investigating both the risk profiles and prognostic impact of peritonitis in hemodialysis patients. This nation-wide longitudinal study uses claims data obtained from the Taiwan National Health Insurance Research Database. A total of 80,733 incident hemodialysis patients of age ≥ 20 years without a history of peritonitis were identified between January 1, 1998 and December 31, 2009. Predictors of peritonitis events were estimated using Cox proportional hazard models. Time-dependent Cox proportional hazard models were used to estimate hazard ratio for mortality attributed to peritonitis exposure. Of 80,733 incident hemodialysis patients over a 13-year study period, peritonitis was diagnosed in 935 (1.16%), yielding an incidence rate of 2.91 per 1000 person-years. Female gender, liver cirrhosis and polycystic kidney disease were three of the most significant factors for peritonitis in both non-diabetic and diabetic hemodialysis patients. The cumulative survival rate of patients with peritonitis was 38.8% at 1 year and 10.1% at 5 years. A time-dependent Cox multivariate analysis showed that peritonitis had significantly increased hazard ratio for all cause mortality. Additionally, the risk of mortality remained significantly higher for non-diabetic hemodialysis patients that experienced peritonitis. The risk of peritonitis in hemodialysis patients is higher in female gender, liver cirrhosis and polycystic kidney disease. Although peritonitis is a rare condition, it is associated with significantly poorer outcome in hemodialysis patients.

  2. National Longitudinal Study. Withdrawal from Institutions of Higher Education. An Appraisal with Longitudinal Data Involving Diverse Institutions.

    ERIC Educational Resources Information Center

    Fetters, William B.

    Using data from the National Longitudinal Study of the High School Class of 1972, the National Center for Education Statistics undertook a study of dropouts in higher education. Specifically, the study was designed to discover: (1) to what extent students withdraw from institutions of higher education before completion, and how these rates might…

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

    PubMed

    Pannwitz, Gunter

    2015-03-01

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

  4. Mortality among workers at Oak Ridge National Laboratory.

    PubMed

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

    2013-07-01

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

  5. Longitudinal multistage model for lung cancer incidence, mortality, and CT detected indolent and aggressive cancers

    PubMed Central

    Hazelton, William D.; Goodman, Gary; Rom, William N.; Tockman, Melvyn; Thornquist, Mark; Moolgavkar, Suresh; Weissfeld, Joel L.; Feng, Ziding

    2012-01-01

    It is currently not known whether most lung cancers detected by computerized tomography (CT) screening are aggressive and likely to be fatal if left untreated, or if a sizable fraction are indolent and unlikely to cause death during the natural lifetime of the individual. We developed a longitudinal biologically-based model of the relationship between individual smoking histories and the probability for lung cancer incidence, CT screen detection, lung cancer mortality, and other-cause mortality. The longitudinal model relates these different outcomes to an underlying lung cancer disease pathway and an effective other-cause mortality pathway, which are both influenced by the individual smoking history. The longitudinal analysis provides additional information over that available if these outcomes were analyzed separately, including testing if the number of CT detected and histologically-confirmed lung cancers is consistent with the expected number of lung cancers “in the pipeline”. We assume indolent nodules undergo Gompertz growth and are detectable by CT, but do not grow large enough to contribute significantly to symptom-based lung cancer incidence or mortality. Likelihood-based model calibration was done jointly to data from 6,878 heavy smokers without asbestos exposure in the control (placebo) arm of the Carotene and Retinol Efficacy Trial (CARET); and to 3,642 heavy smokers with comparable smoking histories in the Pittsburgh Lung Screening Study (PLuSS), a single-arm prospective trial of low-dose spiral CT screening for diagnosis of lung cancer. Model calibration was checked using data from two other single-arm prospective CT screening trials, the New York University Lung Cancer Biomarker Center (NYU) (n=1,021), and Moffitt Cancer Center (Moffitt) cohorts (n=677). In the PLuSS cohort, we estimate that at the end of year 2, after the baseline and first annual CT exam, that 33.0 (26.9, 36.9)% of diagnosed lung cancers among females and 7.0 (4.9, 11.7)% among

  6. An Investigation into Using National Longitudinal Studies to Examine Trends in Educational Attainment and Development

    ERIC Educational Resources Information Center

    McNiece, Rosie; Bidgood, Penelope; Soan, Peter

    2004-01-01

    Longitudinal studies can provide individual histories of educational attainment and are becoming widely used in educational research. Two national longitudinal studies, the National Child Development Study (NCDS) and the British Cohort Study of 1970 (BCS70), are used here to investigate changing trends in the educational attainment of children in…

  7. Declines in Strength and Mortality Risk Among Older Mexican Americans: Joint Modeling of Survival and Longitudinal Data.

    PubMed

    Peterson, Mark D; Zhang, Peng; Duchowny, Kate A; Markides, Kyriakos S; Ottenbacher, Kenneth J; Snih, Soham Al

    2016-12-01

    Grip strength is a noninvasive method of risk stratification; however, the association between changes in strength and mortality is unknown. The purposes of this study were to examine the association between grip strength and mortality among older Mexican Americans and to determine the ability of changes in strength to predict mortality. Longitudinal data were included from 3,050 participants in the Hispanic Established Population for the Epidemiological Study of the Elderly. Strength was assessed using a hand-held dynamometer and normalized to body mass. Conditional inference tree analyses were used to identify sex- and age-specific weakness thresholds, and the Kaplan-Meier estimator was used to determine survival estimates across various strata. We also evaluated survival with traditional Cox proportional hazard regression for baseline strength, as well as with joint modeling of survival and longitudinal strength change trajectories. Survival estimates were lower among women who were weak at baseline for only 65- to 74-year-olds (11.93 vs 16.69 years). Survival estimates were also lower among men who were weak at baseline for only ≥75-year-olds (5.80 vs 7.39 years). Lower strength at baseline (per 0.1 decrement) was significantly associated with mortality (hazard ratio [HR]: 1.10; 95% confidence interval [CI]: 1.01-1.19) for women only. There was a strong independent, longitudinal association between strength decline and early mortality, such that each 0.10 decrease in strength, within participants over time, resulted in a HR of 1.12 (95% CI: 1.00-1.25) for women and a HR of 1.15 (95% CI: 1.04-1.28) for men. Longitudinal declines in strength are significantly associated with all-cause mortality in older Mexican Americans. © The Author 2016. 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.

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

    PubMed Central

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

    2014-01-01

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

  9. Disparities in cervical cancer mortality rates as determined by the longitudinal hyperbolastic mixed-effects type II model.

    PubMed

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

    2014-01-01

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

  10. Longitudinal study of winter mortality disease in Sydney rock oysters Saccostrea glomerata.

    PubMed

    Spiers, Zoe B; Gabor, Melinda; Fell, Shayne A; Carnegie, Ryan B; Dove, Michael; O'Connor, Wayne; Frances, Jane; Go, Jeffrey; Marsh, Ian B; Jenkins, Cheryl

    2014-07-24

    Winter mortality (WM) is a poorly studied disease affecting Sydney rock oysters Saccostrea glomerata in estuaries in New South Wales, Australia, where it can cause significant losses. WM is more severe in oysters cultured deeper in the water column and appears linked to higher salinities. Current dogma is that WM is caused by the microcell parasite Bonamia roughleyi, but evidence linking clinical signs and histopathology to molecular data identifying bonamiasis is lacking. We conducted a longitudinal study between February and November 2010 in 2 estuaries where WM has occurred (Georges and Shoalhaven Rivers). Results from molecular testing of experimental oysters for Bonamia spp. were compared to clinical disease signs and histopathology. Available environmental data from the study sites were also collated and compared. Oyster condition declined over the study period, coinciding with decreasing water temperatures, and was inversely correlated with the presence of histological lesions. While mortalities occurred in both estuaries, only oysters from the Georges River study site showed gross clinical signs and histological changes characteristic of WM (lesions were prevalent and intralesional microcell-like structures were sometimes noted). PCR testing for Bonamia spp. revealed the presence of an organism belonging to the B. exitiosa-B. roughleyi clade in some samples; however, the very low prevalence of this organism relative to histological changes and the lack of reactivity of affected oysters in subsequent in situ hybridisation experiments led us to conclude that this Bonamia sp. is not responsible for WM. Another aetiological agent and a confluence of environmental factors are a more likely explanation for the disease.

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

    PubMed Central

    2016-01-01

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

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

    PubMed

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

    2016-07-01

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

  13. Assessment of Social Network Change in a National Longitudinal Survey

    PubMed Central

    Schumm, L. Philip; Laumann, Edward O.; Kim, Juyeon; Kim, Young-Jin

    2014-01-01

    Objectives. This article describes new longitudinal data on older adults’ egocentric social networks collected by the National Social Life, Health, and Aging Project (NSHAP). We describe a novel survey technique that was used to record specific personnel changes that occurred within respondents’ networks during the 5-year study period, and we make recommendations regarding usage of the resulting data. Method. Descriptive statistics are presented for measures of network size, composition, and structure at both waves, respondent-level summary measures of change in these characteristics between waves, as well as measures that distinguish between changes associated with losses of Wave 1 network members, additions of new ones, and changes in relationships with network members who were present at both waves. Results. The NSHAP network change module was successful in providing reliable information about specific changes that occurred within respondents’ confidant networks. Most respondents lost at least one confidant from W1 and added at least one new confidant between waves as well. Network growth was more common than network shrinkage. Both lost and new ties were weaker than ties that persisted throughout the study period. Discussion. These data provide new insight into the dynamic nature of networks in later life, revealing norms of network turnover, expansion, and weakening. Data limitations are discussed. PMID:25360026

  14. Food Habits, Lifestyle Factors and Mortality among Oldest Old Chinese: The Chinese Longitudinal Healthy Longevity Survey (CLHLS)

    PubMed Central

    Shi, Zumin; Zhang, Tuohong; Byles, Julie; Martin, Sean; Avery, Jodie C.; Taylor, Anne W.

    2015-01-01

    There are few studies reporting the association between lifestyle and mortality among the oldest old in developing countries. We examined the association between food habits, lifestyle factors and all-cause mortality in the oldest old (≥80 years) using data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS). In 1998/99, 8959 participants aged 80 years and older took part in the baseline survey. Follow-up surveys were conducted every two to three years until 2011. Food habits were assessed using an in-person interview. Deaths were ascertained from family members during follow-up. Cox and Laplace regression were used to assess the association between food habits, lifestyle factors and mortality risk. There were 6626 deaths during 31,926 person-years of follow-up. Type of staple food (rice or wheat) was not associated with mortality. Daily fruit and vegetable intake was inversely associated with a higher mortality risk (hazard ratios (HRs): 0.85 (95% CI (confidence interval) 0.77–0.92), and 0.74 (0.66–0.83) for daily intake of fruit and vegetables, respectively). There was a positive association between intake of salt-preserved vegetables and mortality risk (consumers had about 10% increase of HR for mortality). Fruit and vegetable consumption were inversely, while intake of salt-preserved vegetables positively, associated with mortality risk among the oldest old. Undertaking physical activity is beneficial for the prevention of premature death. PMID:26371039

  15. Food Habits, Lifestyle Factors and Mortality among Oldest Old Chinese: The Chinese Longitudinal Healthy Longevity Survey (CLHLS).

    PubMed

    Shi, Zumin; Zhang, Tuohong; Byles, Julie; Martin, Sean; Avery, Jodie C; Taylor, Anne W

    2015-09-09

    There are few studies reporting the association between lifestyle and mortality among the oldest old in developing countries. We examined the association between food habits, lifestyle factors and all-cause mortality in the oldest old (≥80 years) using data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS). In 1998/99, 8959 participants aged 80 years and older took part in the baseline survey. Follow-up surveys were conducted every two to three years until 2011. Food habits were assessed using an in-person interview. Deaths were ascertained from family members during follow-up. Cox and Laplace regression were used to assess the association between food habits, lifestyle factors and mortality risk. There were 6626 deaths during 31,926 person-years of follow-up. Type of staple food (rice or wheat) was not associated with mortality. Daily fruit and vegetable intake was inversely associated with a higher mortality risk (hazard ratios (HRs): 0.85 (95% CI (confidence interval) 0.77-0.92), and 0.74 (0.66-0.83) for daily intake of fruit and vegetables, respectively). There was a positive association between intake of salt-preserved vegetables and mortality risk (consumers had about 10% increase of HR for mortality). Fruit and vegetable consumption were inversely, while intake of salt-preserved vegetables positively, associated with mortality risk among the oldest old. Undertaking physical activity is beneficial for the prevention of premature death.

  16. Identifying Probable Suicide Clusters in Wales Using National Mortality Data

    PubMed Central

    Jones, Phillip; Gunnell, David; Platt, Stephen; Scourfield, Jonathan; Lloyd, Keith; Huxley, Peter; John, Ann; Kamran, Babar; Wells, Claudia; Dennis, Michael

    2013-01-01

    Background Up to 2% of suicides in young people may occur in clusters i.e., close together in time and space. In early 2008 unprecedented attention was given by national and international news media to a suspected suicide cluster among young people living in Bridgend, Wales. This paper investigates the strength of statistical evidence for this apparent cluster, its size, and temporal and geographical limits. Methods and findings The analysis is based on official mortality statistics for Wales for 2000–2009 provided by the UK's Office for National Statistics (ONS). Temporo-spatial analysis was performed using Space Time Permutation Scan Statistics with SaTScan v9.1 for suicide deaths aged 15 and over, with a sub-group analysis focussing on cases aged 15–34 years. These analyses were conducted for deaths coded by ONS as: (i) suicide or of undetermined intent (probable suicides) and (ii) for a combination of suicide, undetermined, and accidental poisoning and hanging (possible suicides). The temporo-spatial analysis did not identify any clusters of suicide or undetermined intent deaths (probable suicides). However, analysis of all deaths by suicide, undetermined intent, accidental poisoning and accidental hanging (possible suicides) identified a temporo-spatial cluster (p = 0.029) involving 10 deaths amongst 15–34 year olds centred on the County Borough of Bridgend for the period 27th December 2007 to 19th February 2008. Less than 1% of possible suicides in younger people in Wales in the ten year period were identified as being cluster-related. Conclusions There was a possible suicide cluster in young people in Bridgend between December 2007 and February 2008. This cluster was smaller, shorter in duration, and predominantly later than the phenomenon that was reported in national and international print media. Further investigation of factors leading to the onset and termination of this series of deaths, in particular the role of the media, is required. PMID

  17. Differences in mortality by immigrant status in Italy. Results of the Italian Network of Longitudinal Metropolitan Studies.

    PubMed

    Pacelli, Barbara; Zengarini, Nicolás; Broccoli, Serena; Caranci, Nicola; Spadea, Teresa; Di Girolamo, Chiara; Cacciani, Laura; Petrelli, Alessio; Ballotari, Paola; Cestari, Laura; Grisotto, Laura; Giorgi Rossi, Paolo

    2016-07-01

    Despite a rapid increase in immigration from low-income countries, studies on immigrants' mortality in Italy are scarce. We aimed to describe differences in all and cause-specific mortality among immigrants and Italians residing in Turin and Reggio Emilia (Northern Italy), two cities participating in the Italian Network of Longitudinal Metropolitan Studies (IN-LiMeS). We used individual data from the municipal population registers linked to the cause of death registers. All people aged 1-64 years residing between 2001 and 2010 were enrolled (open cohort) and followed up until 2013. The mortality of citizens from high migratory pressure countries (as a whole, and for each macro-area group) was compared with that of Italians; differences were estimated by Poisson regression adjusted by age and calendar year mortality rate ratios (MRRs), and by age-standardized mortality ratios for the analysis of cause-specific mortality. Compared with Italians, immigrants had lower overall mortality (MRR for men: 0.82, 95 % CI: 0.75-0.90; for women: 0.71, 95 % CI: 0.63-0.81). Sub-Saharan Africans experienced a significant higher mortality than Italians (MRR for men 1.29, 95 % CI: 1.03-1.61; for women: 1.70, 95 % CI: 1.22-2.36). Higher mortality for immigrants compared to Italians was observed for infectious diseases, congenital anomalies, some site-specific tumours and homicide mortality. Our study showed heterogeneity in mortality across the macro-areas of origin, and in particular Sub-Saharan Africans seemed to be a vulnerable population. The extension to other cohorts of IN-LiMeS will allow the health status of immigrants and vulnerable groups to be studied and monitored in more depth.

  18. Residence near power lines and mortality from neurodegenerative diseases: longitudinal study of the Swiss population.

    PubMed

    Huss, Anke; Spoerri, Adrian; Egger, Matthias; Röösli, Martin

    2009-01-15

    The relation between residential magnetic field exposure from power lines and mortality from neurodegenerative conditions was analyzed among 4.7 million persons of the Swiss National Cohort (linking mortality and census data), covering the period 2000-2005. Cox proportional hazard models were used to analyze the relation of living in the proximity of 220-380 kV power lines and the risk of death from neurodegenerative diseases, with adjustment for a range of potential confounders. Overall, the adjusted hazard ratio for Alzheimer's disease in persons living within 50 m of a 220-380 kV power line was 1.24 (95% confidence interval (CI): 0.80, 1.92) compared with persons who lived at a distance of 600 m or more. There was a dose-response relation with respect to years of residence in the immediate vicinity of power lines and Alzheimer's disease: Persons living at least 5 years within 50 m had an adjusted hazard ratio of 1.51 (95% CI: 0.91, 2.51), increasing to 1.78 (95% CI: 1.07, 2.96) with at least 10 years and to 2.00 (95% CI: 1.21, 3.33) with at least 15 years. The pattern was similar for senile dementia. There was little evidence for an increased risk of amyotrophic lateral sclerosis, Parkinson's disease, or multiple sclerosis.

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

    PubMed

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

    2014-03-01

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

  20. Educational expansion and inequalities in mortality-A fixed-effects analysis using longitudinal data from 18 European populations.

    PubMed

    Östergren, Olof; Lundberg, Olle; Artnik, Barbara; Bopp, Matthias; Borrell, Carme; Kalediene, Ramune; Leinsalu, Mall; Martikainen, Pekka; Regidor, Enrique; Rodríguez-Sanz, Maica; de Gelder, Rianne; Mackenbach, Johan P

    2017-01-01

    The aim of this paper is to empirically evaluate whether widening educational inequalities in mortality are related to the substantive shifts that have occurred in the educational distribution. Data on education and mortality from 18 European populations across several decades were collected and harmonized as part of the Demetriq project. Using a fixed-effects approach to account for time trends and national variation in mortality, we formally test whether the magnitude of relative inequalities in mortality by education is associated with the gender and age-group specific proportion of high and low educated respectively. The results suggest that in populations with larger proportions of high educated and smaller proportions of low educated, the excess mortality among intermediate and low educated is larger, all other things being equal. We conclude that the widening educational inequalities in mortality being observed in recent decades may in part be attributed to educational expansion.

  1. Strategies to reduce hospital 30-day risk-standardized mortality rates for patients with acute myocardial infarction: a cross-sectional and longitudinal survey.

    PubMed

    Bradley, Elizabeth H; Sipsma, Heather; Brewster, Amanda L; Krumholz, Harlan M; Curry, Leslie

    2014-09-24

    Survival rates after acute myocardial infarction (AMI) vary markedly across U.S. hospitals. Although substantial efforts have been made to improve hospital performance, we lack contemporary evidence about changes in hospital strategies and features of organizational culture that might contribute to reducing hospital AMI mortality rates. We sought to describe current use of several strategies and features of organizational culture linked to AMI mortality in a national sample of hospitals and examine changes in use between 2010 and 2013. We conducted a cross-sectional survey of 543 hospitals (70% response rate) in 2013, and longitudinal analysis of a subsample of 107 hospitals that had responded to a survey in 2010 (67% response rate). Between 2010 and 2013, the use of many strategies increased, but the use of only two strategies increased significantly: the percentage of hospitals providing regular training to Emergency Medical Service (EMS) providers about AMI care increased from 36% to 71% (P-value < 0.001) and the percentage of hospitals using computerized assisted physician order entry more than doubled (P-value < 0.001). Most, but not all, hospitals reported having environments conducive to communication, coordination and problem solving. We found few significant changes between 2010 and 2013 in hospital strategies or in key features of organizational culture that have been associated with lower AMI mortality rates. Findings highlight several opportunities to help close remaining performance gaps in AMI mortality among hospitals.

  2. Pitfalls of national routine death statistics for maternal mortality study.

    PubMed

    Saucedo, Monica; Bouvier-Colle, Marie-Hélène; Chantry, Anne A; Lamarche-Vadel, Agathe; Rey, Grégoire; Deneux-Tharaux, Catherine

    2014-11-01

    The lessons learned from the study of maternal deaths depend on the accuracy of data. Our objective was to assess time trends in the underestimation of maternal mortality (MM) in the national routine death statistics in France and to evaluate their current accuracy for the selection and causes of maternal deaths. National data obtained by enhanced methods in 1989, 1999, and 2007-09 were used as the gold standard to assess time trends in the underestimation of MM ratios (MMRs) in death statistics. Enhanced data and death statistics for 2007-09 were further compared by characterising false negatives (FNs) and false positives (FPs). The distribution of cause-specific MMRs, as assessed by each system, was described. Underestimation of MM in death statistics decreased from 55.6% in 1989 to 11.4% in 2007-09 (P < 0.001). In 2007-09, of 787 pregnancy-associated deaths, 254 were classified as maternal by the enhanced system and 211 by the death statistics; 34% of maternal deaths in the enhanced system were FNs in the death statistics, and 20% of maternal deaths in the death statistics were FPs. The hierarchy of causes of MM differed between the two systems. The discordances were mainly explained by the lack of precision in the drafting of death certificates by clinicians. Although the underestimation of MM in routine death statistics has decreased substantially over time, one third of maternal deaths remain unidentified, and the main causes of death are incorrectly identified in these data. Defining relevant priorities in maternal health requires the use of enhanced methods for MM study. © 2014 John Wiley & Sons Ltd.

  3. A Longitudinal Evaluation of the National Cancer Institute Science Enrichment Program.

    ERIC Educational Resources Information Center

    Manning, Colleen F.; Goodman, Irene F.

    This paper proposes the design and key methodological features of a longitudinal evaluation of the National Cancer Institute Science Enrichment Program (NCISEP). Goodman Research Group's (GRG) five-year longitudinal evaluation is designed as a randomized experiment with a control group and employs both quantitative and qualitative data collection…

  4. Surgical Mortality Audit-lessons Learned in a Developing Nation.

    PubMed

    Bindroo, Sandiya; Saraf, Rakesh

    2015-06-01

    Surgical audit is a systematic, critical analysis of the quality of surgical care that is reviewed by peers against explicit criteria or recognized standards. It is used to improve surgical practice with the ultimate goal of improving patient care. As the pattern of surgical care is different in the developing world, we analyzed mortalities in a referral medical institute of India to suggest interventions for improvement. An analysis of total admissions, different surgeries, and mortalities over 1 year in an urban referral medical institute of northern India was performed, followed by "peer review" of the mortalities. Mortality rates as outcomes and classification was done to provide comparative results. Of 10,005 surgical patients, 337 (male = 221, female = 116) deaths were reported over 1 year. The overall mortality rate was 3.36%, while mortality in operative cases was 1.76%. Total deaths were classified into (1) Viable: 153 (45%), (2) Nonviable: 174 (52%), and (3) Indeterminate: 10 (3%). Exclusion of the nonviable group reduced the mortality rate from 3.36% to 1.62%. Trauma was the major cause of mortality (n = 235; 70%) as compared to other surgical patients (n = 102; 30%). Increased mortality was also associated with emergency procedures (3.66%) as compared to elective surgeries (0.34%). In conclusion, audit of mortality and morbidity helps in initiating and implementing preventive strategies to improve surgical practice and patient care, and to reduce mortality rates. The mortality and morbidity forum is an important educational activity. It should be considered a mandatory activity in all postgraduate training programs.

  5. Surgical Mortality Audit–lessons Learned in a Developing Nation

    PubMed Central

    Bindroo, Sandiya; Saraf, Rakesh

    2015-01-01

    Surgical audit is a systematic, critical analysis of the quality of surgical care that is reviewed by peers against explicit criteria or recognized standards. It is used to improve surgical practice with the ultimate goal of improving patient care. As the pattern of surgical care is different in the developing world, we analyzed mortalities in a referral medical institute of India to suggest interventions for improvement. An analysis of total admissions, different surgeries, and mortalities over 1 year in an urban referral medical institute of northern India was performed, followed by “peer review” of the mortalities. Mortality rates as outcomes and classification was done to provide comparative results. Of 10,005 surgical patients, 337 (male = 221, female = 116) deaths were reported over 1 year. The overall mortality rate was 3.36%, while mortality in operative cases was 1.76%. Total deaths were classified into (1) Viable: 153 (45%), (2) Nonviable: 174 (52%), and (3) Indeterminate: 10 (3%). Exclusion of the nonviable group reduced the mortality rate from 3.36% to 1.62%. Trauma was the major cause of mortality (n = 235; 70%) as compared to other surgical patients (n = 102; 30%). Increased mortality was also associated with emergency procedures (3.66%) as compared to elective surgeries (0.34%). In conclusion, audit of mortality and morbidity helps in initiating and implementing preventive strategies to improve surgical practice and patient care, and to reduce mortality rates. The mortality and morbidity forum is an important educational activity. It should be considered a mandatory activity in all postgraduate training programs. PMID:26414825

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

    PubMed Central

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

    2015-01-01

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

  7. Executive Function [Capacity for Behavioral Self-regulation]and Decline Predicted Mortality in a Longitudinal Study in Southern Colorado

    PubMed Central

    Amirian, E.; Baxter, Judith; Grigsby, Jim; Curran-Everett, Douglas; Hokanson, John E; Bryant, Lucinda L

    2009-01-01

    Objective To assess the relationship between mortality and impairment and decline in a specific executive cognitive function, the capacity for behavioral self-regulation. Study Design & Setting This study examined the association between mortality and baseline and 22-month decline in the capacity for behavioral self-regulation, as measured by the Behavioral Dyscontrol Scale, among 1,293 participants of the San Luis Valley Health and Aging Study (SLVHAS), a population-based longitudinal study. The Behavioral Dyscontrol Scale and a measure of overall mental status, the Mini-Mental State Examination, were administered at baseline and follow-up interviews. Cox regression was used to examine baseline and decline in capacity for behavioral self-regulation as possible predictors of morality. Results Baseline Behavioral Dyscontrol Scale score was predictive of mortality, independent of demographics and comorbidity count (HR=1.07; 95% CI:1.04–1.09). It remained a significant predictor with further adjustment for Mini-Mental State Examination score. Decline in this specific executive cognitive function was associated with mortality after adjustment for covariates and baseline cognitive scores (HR=1.09; 95% CI:1.04–1.13). Conclusion Thus, both baseline capacity for behavioral self-regulation and its decline over time predicted mortality in the SLVHAS cohort. These associations may partly be due to maintaining the ability for self-care. Understanding how specific forms of impairment contribute to mortality may help identify patients who could benefit from early intervention. PMID:19716261

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

    PubMed

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

    2016-11-01

    Observational studies suggest that low concentrations of serum 25-hydroxyvitamin D (25(OH)D) and high concentrations of parathyroid hormone (PTH) are associated with a higher risk of mortality. The aim of this study was to examine whether 25(OH)D and PTH concentrations are independently associated with overall and disease-specific (cardiovascular and cancer-related) mortality in a large, prospective population-based cohort of older adults. Data from 1317 men and women (65-85 years) of the Longitudinal Aging Study Amsterdam were used. Cox proportional hazard analyses were used to examine whether 25(OH)D and PTH at baseline were associated with overall mortality (with a follow-up of 18 years) and disease-specific mortality (with a follow-up of 13 years). Compared to persons in the reference category of ≥75nmol/L, persons with serum 25(OH)D <25nmol/L (HR 1.46; 95% CI: 1.12-1.91) and 25-49.9nmol/L (HR 1.24; 95% CI: 1.01-1.53) had a significantly higher risk of overall mortality, as well as men with baseline PTH concentrations ≥7pmol/L (HR 2.54 (95% CI: 1.58-4.08)), compared to the reference category of <2.33pmol/L. The relationship of 25(OH)D with overall mortality was partly mediated by PTH. Furthermore, men with PTH concentrations of ≥7pmol/L (HR 3.22; 95% CI: 1.40-7.42) had a higher risk of cardiovascular mortality, compared to the reference category. No significant associations of 25(OH)D or PTH with cancer-related mortality were observed. Both 25(OH)D and PTH should be considered as important health markers. Copyright © 2015 Elsevier Ltd. All rights reserved.

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

    PubMed Central

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

    2015-01-01

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

  10. A longitudinal study on the incidence of mortality of infectious diseases of commercial layer birds in Bangladesh.

    PubMed

    Rashid, Md Harunur; Xue, Chunyi; Islam, Md Rafiqul; Islam, Md Taohidul; Cao, Yongchang

    2013-05-01

    A 20-month longitudinal field study was undertaken during the period from January 2010 to August 2011 to determine the incidence of mortality due to infectious diseases affecting commercial layer birds in 8 upazilas (an administrative unit) of 5 different districts in Bangladesh. Diagnosis of different diseases was made based on the flock history, age of birds, clinical signs, characteristic gross and microscopic lesions, and isolation and identification of the organisms. During the study period, 4710 birds were found dead as a result of disease occurrence. The incidence rate (true incidence rate) of mortality for the study period was 0.0171 per bird-months at risk. The incidences of mortality of almost all the infectious diseases were significantly higher in rainy followed by summer seasons. Particularly, mortality rate of ND and FC was significantly higher in rainy and summer seasons compared to winter and autumn seasons. And higher mortality rate of IBD, salmonellosis, IB, colibacillosis and MD was found in rainy than other three seasons. The highest mortality was recorded in birds below 8 weeks of age followed by birds aged 21 weeks and above. The mortality due to IBD was significantly higher (0.006) in the young birds (<8 weeks of age) than older birds. On the other hand, mortality rate of ND was significantly higher (0.003) in older birds (>8 weeks of age). Statistically no significant difference (p>0.05) was observed in the mortality rate of colibacillosis between different age groups. The proportional mortality due to infectious diseases was 54.2% (including single or mixed infections). Of the overall mortality, 13.4% was attributed to ND, 9.53% to IBD, 6.69% to MD, 4.33% to IB, 4.23% to salmonellosis, 3.23% to FC, 3.31% to colibacillosis, 1.1% to aspergillosis and 45.8% to non-infectious causes. The findings indicated that infectious diseases appear to be a major constraint of commercial layer birds in Bangladesh.

  11. Variation in the BDNF gene interacts with age to predict mortality in a prospective, longitudinal cohort with severe TBI

    PubMed Central

    Failla, Michelle D.; Kumar, Raj; Peitzman, Andrew; Conley, Yvette P.; Ferrell, Robert E.; Wagner, Amy K.

    2014-01-01

    Background Mortality predictions following traumatic brain injury (TBI) may be improved by including genetic risk in addition to traditional prognostic variables. One promising target is the gene coding for brain-derived neurotrophic factor (BDNF), a ubiquitous neurotrophin important for neuronal survival and neurogenesis. Objective We hypothesized the addition of BDNF genetic variation would improve mortality prediction models and that BDNF Met-carriers (rs6265) and C-carriers (rs7124442) would have the highest mortality rates post-TBI. Methods This study examined BDNF functional single nucleotide polymorphisms (SNPs) rs6265r (val66met) and rs7124442 (T>C) in relation to mortality in a prospective, longitudinal cohort with severe TBI. We examined 315 individuals receiving care for a closed head injury within the University of Pittsburgh Medical Center, aged 16–79. Mortality was examined acutely (0–7 days post-injury) and post-acutely (8–365 days post-injury). A gene risk score (GRS) was developed to examine both BDNF loci. Cox proportional hazards models were used to calculate hazard ratios for survivability post-TBI while controlling for covariates. Results BDNF GRS was significantly associated with acute mortality, regardless of age. Interestingly, subjects in the hypothesized no-risk allele group had the lowest survival probability. Post-acutely, BDNF-GRS interacted with age such that younger participants in the no-risk group had the highest survival probability, while older participants in the hypothesized no-risk group had the lowest probability of survival. Conclusions These data suggest complex relationships between BDNF and TBI mortality that interact with age to influence survival predictions beyond clinical variables alone. Evidence supporting dynamic, temporal balances of pro-survival/pro-apoptotic target receptors may explain injury and age-related gene associations. PMID:25063686

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

    PubMed

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

    2016-08-01

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

  13. Technological Change and the Skill Acquisition of Young Workers. National Longitudinal Surveys Discussion Paper.

    ERIC Educational Resources Information Center

    Bartel, Ann P.; Sicherman, Nachum

    Data from the National Longitudinal Survey of Youth and several alternative data sets containing proxies for industries' rates of technological change (including the Jorgenson productivity growth series, National Bureau of Economic Research productivity data, and the Census of Manufacturers series on investments in computers, the Research and…

  14. Families' First Experiences with Early Intervention: National Early Intervention Longitudinal Study. NEILS Data Report.

    ERIC Educational Resources Information Center

    Bailey, Don; Scarborough, Anita; Hebbeler, Kathleen

    This report describes several aspects of families' experiences in beginning early intervention services using data from the National Early Intervention Longitudinal Study (NEILS). Funded by the U.S. Department of Education, NEILS is following a nationally representative sample of 3,338 infants and toddlers and their families from the time they…

  15. National Education Longitudinal Study of 1988 (NELS:88) Research Framework and Issues. Working Paper Series.

    ERIC Educational Resources Information Center

    Huang, Gary; Salvucci, Sameena; Peng, Samuel; Owings, Jeffrey

    This report presents an analysis blueprint for data provided by the National Education Longitudinal Study of 1988 (NELS:88), a survey system sponsored by the National Center for Education Statistics (NCES). The report will inform beginning NELS:88 data users of the many substantive issues that can be addressed by the data, and it should present…

  16. Income Inequality, Economic Growth and Stroke Mortality in Brazil: Longitudinal and Regional Analysis 2002-2009

    PubMed Central

    2015-01-01

    Background and Purpose Stroke accounts for more than 10% of all deaths globally and most of it occurs in low- and middle-income countries (LMIC). Income inequality and gross domestic product (GDP) per capita has been associated to stroke mortality in developed countries. In LMIC, GDP per capita is considered to be a more relevant health determinant than income inequality. This study aims to investigate if income inequality is associated to stroke mortality in Brazil at large, but also on regional and state levels, and whether GDP per capita modulates the impact of this association. Methods Stroke mortality rates, Gini index and GDP per capita data were pooled for the 2002 to 2009 period from public available databases. Random effects models were fitted, controlling for GDP per capita and other covariates. Results Income inequality was independently associated to stroke mortality rates, even after controlling for GDP per capita and other covariates. GDP per capita reduced only partially the impact of income inequality on stroke mortality. A decrease in 10 points in the Gini index was associated with 18% decrease in the stroke mortality rate in Brazil. Conclusions Income inequality was independently associated to stroke mortality in Brazil. PMID:26352415

  17. Income Inequality, Economic Growth and Stroke Mortality in Brazil: Longitudinal and Regional Analysis 2002-2009.

    PubMed

    Vincens, Natalia; Stafström, Martin

    2015-01-01

    Stroke accounts for more than 10% of all deaths globally and most of it occurs in low- and middle-income countries (LMIC). Income inequality and gross domestic product (GDP) per capita has been associated to stroke mortality in developed countries. In LMIC, GDP per capita is considered to be a more relevant health determinant than income inequality. This study aims to investigate if income inequality is associated to stroke mortality in Brazil at large, but also on regional and state levels, and whether GDP per capita modulates the impact of this association. Stroke mortality rates, Gini index and GDP per capita data were pooled for the 2002 to 2009 period from public available databases. Random effects models were fitted, controlling for GDP per capita and other covariates. Income inequality was independently associated to stroke mortality rates, even after controlling for GDP per capita and other covariates. GDP per capita reduced only partially the impact of income inequality on stroke mortality. A decrease in 10 points in the Gini index was associated with 18% decrease in the stroke mortality rate in Brazil. Income inequality was independently associated to stroke mortality in Brazil.

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

    PubMed Central

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

    2016-01-01

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

  19. Individual surgeon mortality rates: can outliers be detected? A national utility analysis

    PubMed Central

    Drake, Thomas M; Shaw, Catherine A; Garden, O James; Wigmore, Stephen J

    2016-01-01

    Objectives There is controversy on the proposed benefits of publishing mortality rates for individual surgeons. In some procedures, analysis at the level of an individual surgeon may lack statistical power. The aim was to determine the likelihood that variation in surgeon performance will be detected using published outcome data. Design A national analysis surgeon-level mortality rates to calculate the level of power for the reported mortality rate across multiple surgical procedures. Setting The UK from 2010 to 2014. Participants Surgeons who performed colon cancer resection, oesophagectomy or gastrectomy, elective aortic aneurysm repair, hip replacement, bariatric surgery or thyroidectomy. Outcomes The likelihood of detecting an individual with a 30-day, 90-day or in-patient mortality rate of up to 5 times the national mean or median (as available). This was represented using a novel heat-map approach. Results Overall mortality rates for the procedures ranged from 0.07% to 4.5% and mean/median surgeon volume was between 23 and 75 cases. The national median case volume for colorectal (n=55) and upper gastrointestinal (n=23) cancer resections provides around 20% power to detect a mortality rate of 3 times the national median, while, for hip replacement, this is a rate 5 times the national average. At the mortality rates reported for thyroid (0.08%) and bariatric (0.07%) procedures, it is unlikely a surgeon would perform a sufficient number of procedures in his/her entire career to stand a good chance of detecting a mortality rate 5 times the national average. Conclusions At present, surgeons with increased mortality rates are unlikely to be detected. Performance within an expected mortality rate range cannot be considered reliable evidence of acceptable performance. Alternative approaches should focus on commonly occurring meaningful outcome measures, with infrequent events analysed predominately at the hospital level. PMID:27799243

  20. Substance use disorders, psychiatric disorders, and mortality after release from prison: a nationwide longitudinal cohort study

    PubMed Central

    Chang, Zheng; Lichtenstein, Paul; Larsson, Henrik; Fazel, Seena

    2015-01-01

    Summary Background High mortality rates have been reported in people released from prison compared with the general population. However, few studies have investigated potential risk factors associated with these high rates, especially psychiatric determinants. We aimed to investigate the association between psychiatric disorders and mortality in people released from prison in Sweden. Methods We studied all people who were imprisoned since Jan 1, 2000, and released before Dec 31, 2009, in Sweden for risks of all-cause and external-cause (accidents, suicide, homicide) mortality after prison release. We obtained data for substance use disorders and other psychiatric disorders, and criminological and sociodemographic factors from population-based registers. We calculated hazard ratios (HRs) by Cox regression, and then used them to calculate population attributable fractions for post-release mortality. To control for potential familial confounding, we compared individuals in the study with siblings who were also released from prison, but without psychiatric disorders. We tested whether any independent risk factors improved the prediction of mortality beyond age, sex, and criminal history. Findings We identified 47 326 individuals who were imprisoned. During a median follow-up time of 5·1 years (IQR 2·6–7·5), we recorded 2874 (6%) deaths after release from prison. The overall all-cause mortality rate was 1205 deaths per 100 000 person-years. Substance use disorders significantly increased the rate of all-cause mortality (alcohol use: adjusted HR 1·62, 95% CI 1·48–1·77; drug use: 1·67, 1·53–1·83), and the association was independent of sociodemographic, criminological, and familial factors. We identified no strong evidence that other psychiatric disorders increased mortality after we controlled for potential confounders. In people released from prison, 925 (34%) of all-cause deaths in men and 85 (50%) in women were potentially attributable to substance

  1. Caribou calf mortality in Denali National Park, Alaska

    USGS Publications Warehouse

    Adams, L.G.; Singer, F.J.; Dale, B.W.

    1995-01-01

    Calf mortality is major component of caribou population dynamics, but little is known about the timing or causes of calf losses, or of characteristics that predispose calves to mortality. During 1984-87, we radiocollared 226 calves (less than or equal to 3 days old) in the Denali Caribou Herd (DCH), an unhunted population utilized by a natural complement of predators, to determine the extent, timing, and causes of calf mortality and to evaluate influences of year, sex, birthdate, and birth mass on those losses. Overall, 39% of radio-collared calves died as neonates (less than or equal to 15 days old), and 98% of those deaths were attributed to predation. Most neonatal deaths (85%) occurred within 8 days of birth. Few deaths occurred after the neonatal period (5, 10, and 0% of calves instrumented died during 16-30, 31-150, and greater than 150 days of age, respectively). Survival of neonates was lower (P = 0.038) in 1985, following a severe winter, than during the other 3 years. In years other than 1985, calves born during the peak of calving (approx 50% of the total, born 5-8 days after calving onset) experienced higher (P less than 0.001) neonatal survival than did other calves. Grizzly bears, wolves, and unknown large predators (i.e., grizzly bears or wolves) accounted for 49, 29, and 16% of the neonatal deaths, respectively. The rate of bear-caused mortalities declined (P less than 0.001) with calf age, and bears killed few calves greater than 10 days old. Wolf predation was not related (P greater than 0.05) to calf age and peaked 10 days after onset of calving. Grizzly bear and wolf predation on neonates during the calving season was a limiting factor for the DCH.

  2. Neighborhood Socioeconomic Characteristics, Birth Outcomes and Infant Mortality among First Nations and Non-First Nations in Manitoba, Canada.

    PubMed

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

    2010-01-01

    OBJECTIVE: Little is known about the possible impacts of neighborhood socioeconomic status on birth outcomes and infant mortality among Aboriginal populations. We assessed birth outcomes and infant mortality by neighborhood socioeconomic status among First Nations and non-First Nations in Manitoba. STUDY DESIGN: We conducted a retrospective birth cohort study of all live births (26,176 First Nations, 129,623 non-First Nations) to Manitoba residents, 1991-2000. Maternal residential postal codes were used to assign four measures of neighborhood socioeconomic status (concerning income, education, unemployment, and lone parenthood) obtained from 1996 census data. RESULTS: First Nations women were much more likely to live in neighborhoods of low socioeconomic status. First Nations infants were much more likely to die during their first year of life [risk ratio (RR) =1.9] especially during the postneonatal period (RR=3.6). For both First Nations and non-First Nations, living in neighborhoods of low socioeconomic status was associated with an increased risk of infant death, especially postneonatal death. For non-First Nations, higher rates of pre-term and small-for-gestational-age birth were consistently observed in low socioeconomic status neighborhoods, but for First Nations the associations were less consistent across the four measures of socioeconomic status. Adjusting for neighborhood socioeconomic status, the disparities in infant and postneonatal mortality between First Nations and non-First Nations were attenuated. CONCLUSION: Low neighborhood socioeconomic status was associated with an elevated risk of infant death even among First Nations, and may partly account for their higher rates of infant mortality compared to non-First Nations in Manitoba.

  3. Young Stroke Mortality in Fiji Islands: An Economic Analysis of National Human Capital Resource Loss

    PubMed Central

    Maharaj, Jagdish C.; Reddy, Mahendra

    2012-01-01

    Introduction. The objective of this study was to perform an economic analysis in terms of annual national human capital resource loss from young stroke mortality in Fiji. The official retirement age is 55 years in Fiji. Method. Stroke mortality data, for working-age group 15–55 years, obtained from the Ministry of Health and per capita national income figure for the same year was utilised to calculate the total output loss for the economy. The formula of output loss from the economy was used. Results. There were 273 stroke deaths of which 53.8% were of working-age group. The annual national human capital loss from stroke mortality for Fiji for the year was calculated to be F$8.85 million (US$5.31 million). The highest percentage loss from stroke mortality was from persons in their forties; that is, they still had more then 10 years to retirement. Discussion. This loss equates to one percent of national government revenue and 9.7% of Ministry of Health budget for the same year. The annual national human capital loss from stroke mortality is an important dimension in the overall economic equation of total economic burden of stroke. Conclusion. This study demonstrates a high economic burden for Fiji from stroke mortality of young adults in terms of annual national human capital loss. PMID:22778993

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

    PubMed

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

    2006-07-01

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

  5. A Longitudinal Examination of Childhood Maltreatment and Adolescent Obesity: Results from the National Longitudinal Study of Adolescent Health (AddHealth) Study

    ERIC Educational Resources Information Center

    Shin, Sunny Hyucksun; Miller, Daniel P.

    2012-01-01

    Objectives: We sought to explore the association between childhood maltreatment (e.g., neglect, physical and sexual abuse) and longitudinal growth trajectories of body mass index (BMI) from adolescence to young adulthood. Methods: We used latent curve modeling to examine data from the National Longitudinal Study of Adolescent Health (N = 8,471),…

  6. A Longitudinal Examination of Childhood Maltreatment and Adolescent Obesity: Results from the National Longitudinal Study of Adolescent Health (AddHealth) Study

    ERIC Educational Resources Information Center

    Shin, Sunny Hyucksun; Miller, Daniel P.

    2012-01-01

    Objectives: We sought to explore the association between childhood maltreatment (e.g., neglect, physical and sexual abuse) and longitudinal growth trajectories of body mass index (BMI) from adolescence to young adulthood. Methods: We used latent curve modeling to examine data from the National Longitudinal Study of Adolescent Health (N = 8,471),…

  7. Do Mortality Rates in Eating Disorders Change over Time? A Longitudinal Look at Anorexia Nervosa and Bulimia Nervosa

    PubMed Central

    Franko, Debra L.; Keshaviah, Aparna; Eddy, Kamryn T.; Krishna, Meera; Davis, Martha C.; Keel, Pamela K.; Herzog, David B.

    2014-01-01

    Objective Although anorexia nervosa has a high mortality rate, our understanding of the timing and predictors of mortality in eating disorders is limited. The authors investigated mortality in a long-term study of patients with eating disorders. Method Beginning in 1987, 246 treatment-seeking women with anorexia nervosa or bulimia nervosa were interviewed every 6 months for a median of 9.5 years to obtain weekly ratings of eating disorder symptoms, comorbidity, treatment participation, and psychosocial functioning. From January 2007 to December 2010 (median follow-up of 20 years), vital status was ascertained with a National Death Index search. Results Sixteen deaths (6.5%) were recorded (lifetime anorexia nervosa, N=14; bulimia nervosa with no history of anorexia nervosa, N=2). The standardized mortality ratio was 4.37 [95% CI=2.4-7.3] for lifetime anorexia nervosa and 2.33 [95% CI=0.3-8.4] for bulimia nervosa with no history of anorexia nervosa. Risk of premature death among women with lifetime anorexia nervosa peaked within the first 10 years of follow-up resulting in a standardized mortality ratio of 7.7 [95% CI=3.7-14.2]. The standardized mortality ratio varied by duration of illness and was 3.2 [95% CI=0.9-8.3] for women with lifetime anorexia nervosa for 0-15 years (4/119 died), and 6.6 [95% CI=3.2-12.1] for women with lifetime anorexia nervosa for >15-30 years (10/67 died). Multivariate predictors of mortality included alcohol abuse (p<0.0001), low body mass index (p=0.0005), and poor social adjustment (p=0.0090). Conclusions These findings highlight the need for early identification and intervention and suggest that a long duration of illness, substance abuse, low weight, and/or poor psychosocial functioning raise the risk for mortality in anorexia nervosa. PMID:23771148

  8. Short- and long-term associations between widowhood and mortality in the United States: longitudinal analyses

    PubMed Central

    Moon, J. Robin; Glymour, M. Maria; Vable, Anusha M.; Liu, Sze Y.; Subramanian, S. V.

    2014-01-01

    Background Past research shows that spousal death results in elevated mortality risk for the surviving spouse. However, most prior studies have inadequately controlled for socioeconomic status (SES), and it is unclear whether this ‘widowhood effect’ persists over time. Methods Health and Retirement Study participants aged 50+ years and married in 1998 (n = 12 316) were followed through 2008 for widowhood status and mortality (2912 deaths). Discrete-time survival analysis was used to compare mortality for the widowed versus the married. Results Odds of mortality during the first 3 months post-widowhood were significantly higher than in the continuously married (odds ratio (OR) for men = 1.87, 95% CI: 1.27, 2.75; OR for women = 1.47, 95% CI: 0.96, 2.24) in models adjusted for age, gender, race and baseline SES (education, household wealth and household income), behavioral risk factors and co-morbidities. Twelve months following bereavement, men experienced borderline elevated mortality (OR = 1.16, 95% CI: 1.00, 1.35), whereas women did not (OR = 1.07, 95% CI: 0.90, 1.28), though the gender difference was non-significant. Conclusion The ‘widowhood effect’ was not fully explained by adjusting for pre-widowhood SES and particularly elevated within the first few months after widowhood. These associations did not differ by sex. PMID:24167198

  9. Heart disease mortality following widowhood: some results from the OPCS Longitudinal Study. Office of Population Censuses and Surveys.

    PubMed

    Jones, D R

    1987-01-01

    Many studies have suggested that following the experience of 'stressful' life events the risks of myocardial infarction, accidents and perhaps other diseases are elevated. In the OPCS Longitudinal Study routinely collected data on deaths, and deaths of a spouse occurring in a 1% sample of the population of England and Wales in the period 1971-1981 are linked together, and with 1971 census records of sample members. The timing and patterns of death following the potentially very stressful event of conjugal bereavement may thus be analysed. Overall the mortality (from ischaemic heart disease) was less than 10% in excess of that in all members of the LS sample. As in many earlier studies, some increases in death rates shortly after widowhood are observed. Unusually, for deaths from all causes these increases are more marked in widows than in widowers with, for example, a two-fold increase in mortality from all causes in the first month after widowhood. However, no peak of post-bereavement mortality from ischaemic heart disease is clearly established in either sex. Although the study is large, with a well-chosen control group, only a limited characterisation of study members from data collected in the census is possible. In particular, no measures of personality, behaviour or diet are available. Investigation of potential effects of social or familial support, as measured by household structure and numbers of children, led to equivocal results. Several possible explanations for the increased mortality rates are examined. Hypotheses based on common marital environment, homogamy or simultaneous accidental death are seen to be of very limited value. The observed patterns, although consistent with an early effect of a stressful life event, do not suggest that stress following bereavement leads to an excess of ischaemic heart disease mortality.

  10. Malnutrition, functional ability and mortality among older people aged ⩾ 60 years: a 7-year longitudinal study.

    PubMed

    Naseer, M; Forssell, H; Fagerström, C

    2016-03-01

    This study aimed to assess the association between risk of malnutrition and 7-year mortality, controlling for functional ability, socio-demographics, lifestyle behavior and diseases, and investigate the interaction between risk of malnutrition and functional ability on the risk of mortality. A longitudinal study on home-living and special-housing residents aged ⩾ 60 years was conducted. Of 2312 randomly invited participants, 1402 responded and 1203 provided information on both nutritional status and functional ability. The risk of malnutrition was estimated by the occurrence of at least one anthropometric measure (BMI, MAC and CC) below cut-off in addition to the presence of at least one subjective measure (decreased food intake, weight loss and eating difficulty). At baseline, 8.6% of subjects were at risk of malnutrition and during the 7-year follow-up 34.6% subjects died. The risk of malnutrition was independently associated with 7-year mortality (hazard ratio (HR) 1.84, 95% confidence interval (CI) 1.28-2.65). Additional independent predictors were dementia (HR 2.76, 95% CI 1.85-4.10), activity of daily living (ADL) dependence (HR 2.08, 95% CI 1.62-2.67), heart disease (HR 1.44, 95% CI 1.16-1.78), diabetes (HR 1.41, 95% CI 1.03-1.93) and older age (HR 1.09, 95% CI 1.07-1.10). Moreover, the risk of malnutrition and ADL dependence in combination predicted the poorest survival rate (18.7%, P<0.001). The risk of malnutrition significantly increases the risk of mortality in older people. Moreover, risk of malnutrition and ADL dependence together explain a significantly poorer survival rate; however, the importance of this interaction decreased in the multivariable model and risk of malnutrition and ADL dependence independently explained a significant risk of mortality.

  11. Adoption Does Not Increase the Risk of Mortality among Taiwanese Girls in a Longitudinal Analysis

    PubMed Central

    Mattison, Siobhán M.; Brown, Melissa J.; Floyd, Bruce; Feldman, Marcus W.

    2015-01-01

    Adopted children often experience health and well-being disadvantages compared to biological children remaining in their natal households. The degree of genetic relatedness is thought to mediate the level of parental investment in children, leading to poorer outcomes of biologically unrelated children. We explore whether mortality is related to adoption in a historical Taiwanese population where adoption rarely occurred among kin. Using Cox proportional hazards models in which adoption is included as a time-dependent covariate, we show that adoption of girls does not increase the risk of mortality, as previously suggested; in fact, it is either protective or neutral with respect to mortality. These results suggest that socio-structural variables may produce positive outcomes for adopted children, even compared to biological children who remain in the care of their parents. PMID:25923106

  12. Adoption Does Not Increase the Risk of Mortality among Taiwanese Girls in a Longitudinal Analysis.

    PubMed

    Mattison, Siobhán M; Brown, Melissa J; Floyd, Bruce; Feldman, Marcus W

    2015-01-01

    Adopted children often experience health and well-being disadvantages compared to biological children remaining in their natal households. The degree of genetic relatedness is thought to mediate the level of parental investment in children, leading to poorer outcomes of biologically unrelated children. We explore whether mortality is related to adoption in a historical Taiwanese population where adoption rarely occurred among kin. Using Cox proportional hazards models in which adoption is included as a time-dependent covariate, we show that adoption of girls does not increase the risk of mortality, as previously suggested; in fact, it is either protective or neutral with respect to mortality. These results suggest that socio-structural variables may produce positive outcomes for adopted children, even compared to biological children who remain in the care of their parents.

  13. Impact of different domains of physical activity on cause-specific mortality: a longitudinal study.

    PubMed

    Wanner, Miriam; Tarnutzer, Silvan; Martin, Brian W; Braun, Julia; Rohrmann, Sabine; Bopp, Matthias; Faeh, David

    2014-05-01

    The aim of this paper is to examine the associations between different domains of physical activity and all-cause, cardiovascular disease (CVD) and cancer mortality. Participants (n=17,663, aged 16-92 years) of two general population health studies conducted between 1977 and 1993 in Switzerland were included. Physical activity was assessed at baseline in the domains of commuting to work, work-related physical activity, and leisure-time physical activity (including leisure-time activity level and sport activity). A median follow-up time of 20.2 years was obtained with anonymous record linkage providing 3878 deaths (CVD: 1357; cancer: 1351). Adjusted Cox proportional hazard models were calculated. There were no significant associations between commuting and work-related physical activities, respectively, and mortality. Leisure-time activity level was associated with all-cause mortality in men [adjusted hazard ratio (HR) 0.75, 95% confidence intervals (CI) 0.63-0.89] and women [HR 0.82 (0.74-0.91)], with CVD mortality in women only [HR 0.79 (0.67-0.94)] and with cancer mortality in men only [HR 0.63 (0.47-0.86)]. Sport activity was associated with all-cause, CVD and cancer mortality in men [HR ranged between 0.76 (0.63-0.92) and 0.85 (0.76-0.95)], but not in women. These results underline the public health relevance of physical activity for the prevention of CVD and cancer, especially regarding leisure-time physical activity. Copyright © 2014 Elsevier Inc. All rights reserved.

  14. Increased Mortality for Elective Surgery during Summer Vacation: A Longitudinal Analysis of Nationwide Data

    PubMed Central

    Caillet, Pascal; Payet, Cécile; Polazzi, Stéphanie; Carty, Matthew J.; Lifante, Jean-Christophe; Duclos, Antoine

    2015-01-01

    Surgical safety during vacation periods may be influenced by the interplay of several factors, including workers' leave, hospital activity, climate, and the variety of patient cases. This study aimed to highlight an annually recurring peak of surgical mortality during summer in France and explore its main predictors. We selected all elective of open surgical procedures performed in French hospitals between 2007 and 2012. Surgical mortality variation was analyzed over time in relation to workers leaving on vacation, the volume of procedures performed by hospitals, and temperature changes. We ran a multilevel logistic regression for exploring the determinants of surgical mortality, taking into account the clustering of patients within hospitals and adjusting for patient and hospital characteristics. A total of 609 French hospitals had 8,926,120 discharges related to open elective surgery. During 6 years, we found a recurring mortality peak of 1.15% (95% CI 1.09–1.20) in August compared with 0.81% (0.79–0.82, p<.001) in other months. The incidence of worker vacation was 43.0% (38.9–47.2) in August compared with 7.3% (4.6–10.1, p<.001) in other months. Hospital activity decreased substantially in August (78,126 inpatient stays, 75,298–80,954) in relation to other months (128,142, 125,697–130,586, p<.001). After adjusting for all covariates, we found an "August effect" reflecting a higher risk to patients undergoing operations at this time (OR 1.16, 95% CI 1.12–1.19, p<.001). The main study limitation was the absence of data linkage between surgical staffing and mortality at the hospital level. The observed, recurring mortality peak in August raises questions about how to maintain hospital activity and optimal staffing through better regulation of human activities. PMID:26407191

  15. Longitudinal study on morbidity and mortality in white veal calves in Belgium

    PubMed Central

    2012-01-01

    Background Mortality and morbidity are hardly documented in the white veal industry, despite high levels of antimicrobial drug use and resistance. The objective of the present study was to determine the causes and epidemiology of morbidity and mortality in dairy, beef and crossbred white veal production. A total of 5853 calves, housed in 15 production cohorts, were followed during one production cycle. Causes of mortality were determined by necropsy. Morbidity was daily recorded by the producers. Results The total mortality risk was 5,3% and was significantly higher in beef veal production compared to dairy or crossbreds. The main causes of mortality were pneumonia (1.3% of the calves at risk), ruminal disorders (0.7%), idiopathic peritonitis (0.5%), enterotoxaemia (0.5%) and enteritis (0.4%). Belgian Blue beef calves were more likely to die from pneumonia, enterotoxaemia and arthritis. Detection of bovine viral diarrhea virus at necropsy was associated with chronic pneumonia and pleuritis. Of the calves, 25.4% was treated individually and the morbidity rate was 1.66 cases per 1000 calf days at risk. The incidence rate of respiratory disease, diarrhea, arthritis and otitis was 0.95, 0.30, 0.11 and 0.07 cases per 1000 calf days at risk respectively. Morbidity peaked in the first three weeks after arrival and gradually declined towards the end of the production cycle. Conclusions The present study provided insights into the causes and epidemiology of morbidity and mortality in white veal calves in Belgium, housed in the most frequent housing system in Europe. The necropsy findings, identified risk periods and differences between production systems can guide both veterinarians and producers towards the most profitable and ethical preventive and therapeutic protocols. PMID:22414223

  16. Increased Mortality for Elective Surgery during Summer Vacation: A Longitudinal Analysis of Nationwide Data.

    PubMed

    Caillet, Pascal; Payet, Cécile; Polazzi, Stéphanie; Carty, Matthew J; Lifante, Jean-Christophe; Duclos, Antoine

    2015-01-01

    Surgical safety during vacation periods may be influenced by the interplay of several factors, including workers' leave, hospital activity, climate, and the variety of patient cases. This study aimed to highlight an annually recurring peak of surgical mortality during summer in France and explore its main predictors. We selected all elective of open surgical procedures performed in French hospitals between 2007 and 2012. Surgical mortality variation was analyzed over time in relation to workers leaving on vacation, the volume of procedures performed by hospitals, and temperature changes. We ran a multilevel logistic regression for exploring the determinants of surgical mortality, taking into account the clustering of patients within hospitals and adjusting for patient and hospital characteristics. A total of 609 French hospitals had 8,926,120 discharges related to open elective surgery. During 6 years, we found a recurring mortality peak of 1.15% (95% CI 1.09-1.20) in August compared with 0.81% (0.79-0.82, p<.001) in other months. The incidence of worker vacation was 43.0% (38.9-47.2) in August compared with 7.3% (4.6-10.1, p<.001) in other months. Hospital activity decreased substantially in August (78,126 inpatient stays, 75,298-80,954) in relation to other months (128,142, 125,697-130,586, p<.001). After adjusting for all covariates, we found an "August effect" reflecting a higher risk to patients undergoing operations at this time (OR 1.16, 95% CI 1.12-1.19, p<.001). The main study limitation was the absence of data linkage between surgical staffing and mortality at the hospital level. The observed, recurring mortality peak in August raises questions about how to maintain hospital activity and optimal staffing through better regulation of human activities.

  17. Factors associated with poor hospital mortality rates after the National Health Insurance program.

    PubMed

    Chang, Li

    2015-03-01

    The study examined whether hospital mortality rates have improved since National Health Insurance (NHI) in Taiwan and what factors affect the hospital mortality rates. The related hospital data were collected from databases belonging to the NHI Annual Statistics Information. In addition, panel data analysis and stepwise regression are used to indicate the determinants of hospital mortality rates from 1995 to 2008. The evidence shows that mortality rates have not improved since the NHI; competition, the elderly, family income, the poor, the number of clinical departments, length of stay, new technology, public hospitals and family medical expenses-all affect mortality rates. Moreover, longer length of stay, increase in the number of elderly and low-income families, and inequality of resource allocation have led to high mortality rates. Policy makers first have to realize what drives them to change and then set the benchmarks for their improvement.

  18. Impact of Health System Inputs on Health Outcome: A Multilevel Longitudinal Analysis of Botswana National Antiretroviral Program (2002-2013)

    PubMed Central

    Price, Natalie; El-Halabi, Shenaaz; Mlaudzi, Naledi; Keapoletswe, Koona; Lebelonyane, Refeletswe; Fetogang, Ernest Benny; Chebani, Tony; Kebaabetswe, Poloko; Masupe, Tiny; Gabaake, Keba; Auld, Andrew F.; Nkomazana, Oathokwa; Marlink, Richard

    2016-01-01

    Objective To measure the association between the number of doctors, nurses and hospital beds per 10,000 people and individual HIV-infected patient outcomes in Botswana. Design Analysis of routinely collected longitudinal data from 97,627 patients who received ART through the Botswana National HIV/AIDS Treatment Program across all 24 health districts from 2002 to 2013. Doctors, nurses, and hospital bed density data at district-level were collected from various sources. Methods A multilevel, longitudinal analysis method was used to analyze the data at both patient- and district-level simultaneously to measure the impact of the health system input at district-level on probability of death or loss-to-follow-up (LTFU) at the individual level. A marginal structural model was used to account for LTFU over time. Results Increasing doctor density from one doctor to two doctors per 10,000 population decreased the predicted probability of death for each patient by 27%. Nurse density changes from 20 nurses to 25 nurses decreased the predicted probability of death by 28%. Nine percent decrease was noted in predicted mortality of an individual in the Masa program for every five hospital bed density increase. Conclusion Considerable variation was observed in doctors, nurses, and hospital bed density across health districts. Predictive margins of mortality and LTFU were inversely correlated with doctor, nurse and hospital bed density. The doctor density had much greater impact than nurse or bed density on mortality or LTFU of individual patients. While long-term investment in training more healthcare professionals should be made, redistribution of available doctors and nurses can be a feasible solution in the short term. PMID:27490477

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

    PubMed

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

    2002-11-01

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

  20. The Risk of Mortality in Patients with Psoriatic Arthritis, Rheumatoid Arthritis, and Psoriasis: A Longitudinal Cohort Study

    PubMed Central

    Haynes, Kevin; Troxel, Andrea B.; Love, ThorvardurJon; Hennessy, Sean; Choi, Hyon; Gelfand, Joel M.

    2013-01-01

    Background Conflicting reports of the mortality risk among patients with psoriatic arthritis (PsA) exist in the literature. The objective of this study was to examine the risk of mortality in patients with PsA compared to matched controls and to patients with psoriasis and those with rheumatoid arthritis (RA). Methods A longitudinal cohort study was performed in a large United Kingdom medical record database,The Health Improvement Network (THIN), among patients with PsA, RA, or psoriasis with data from 1994-2010. Unexposed controls were matched on practice and start date within the practice for each patient with PsA. Cox proportional hazards models were used to calculate the relative hazards for death. Results Patients with PsA (N=8,706), RA (N=41,752), psoriasis (N=138,424) and unexposed controls (N=82,258) were identified; 1,442,357 person-years were observed during which 21,825 deaths occurred. Compared with population controls, patients with PsA did not have an increased risk of mortality after adjusting for age and sex (DMARD users: HR 0.94, 95%CI: 0.80-1.10, DMARD non-users: HR 1.06, 95%CI: 0.94-1.19) whereas RA patients had increased mortality (DMARD users HR 1.59, 95%CI: 1.52-1.66, DMARD non-users HR 1.54, 95%CI: 1.47-1.60). Patients with psoriasis who had not been prescribed a DMARD had a small increased risk of mortality (HR 1.08, 95%CI: 1.04-1.12) while those who had been prescribed a DMARD, indicating severe psoriasis, were at increased risk (HR 1.75, 95%CI: 1.56-1.95). Conclusion Patients with RA and psoriasis had elevated mortality compared to the general population. However, patients with PsA did not have a significantly elevated risk of mortality. PMID:23264338

  1. Mortality among immigrants in England and Wales by major causes of death, 1971-2012: A longitudinal analysis of register-based data.

    PubMed

    Wallace, Matthew; Kulu, Hill

    2015-12-01

    Recent research has found a migrant mortality advantage among immigrants relative to the UK-born population living in England and Wales. However, while all-cause mortality is useful to show differences in mortality between immigrants and the host population, it can mask variation in mortality patterns from specific causes of death. This study analyses differences in the causes of death among immigrants living in England and Wales. We extend previous research by applying competing-risks survival analysis to study a large-scale longitudinal dataset from 1971 to 2012 to directly compare causes of death. We confirm low all-cause mortality among nearly all immigrants, except immigrants from Scotland, Northern Ireland and the Republic of Ireland (who have high mortality). In most cases, low all-cause mortality among immigrants is driven by lower mortality from chronic diseases (in nearly all cases by lower cancer mortality and in some cases by lower mortality from cardiovascular diseases (CVD)). This low all-cause mortality often coexists with low respiratory disease mortality and among non-western immigrants, coexists with high mortality from infectious diseases; however, these two causes of death contribute little to mortality among immigrants. For men, CVD is the leading cause of death (particularly among South Asians). For women, cancer is the leading cause of death (except among South Asians, for whom CVD is also the leading cause). Differences in CVD mortality over time remain constant between immigrants relative to UK-born, but immigrant cancer patterns shows signs of some convergence to the cancer mortality among the UK-born (though cancer mortality is still low among immigrants by age 80). The study provides the most up-to-date, reliable UK-based analysis of immigrant mortality. Copyright © 2015 Elsevier Ltd. All rights reserved.

  2. Road traffic injury mortality and its mechanisms in India: nationally representative mortality survey of 1.1 million homes

    PubMed Central

    Hsiao, Marvin; Malhotra, Ajai; Thakur, J S; Sheth, Jay K; Nathens, Avery B; Dhingra, Neeraj; Jha, Prabhat

    2013-01-01

    Objectives To quantify and describe the mechanism of road traffic injury (RTI) deaths in India. Design We conducted a nationally representative mortality survey where at least two physicians coded each non-medical field staff's verbal autopsy reports. RTI mechanism data were extracted from the narrative section of these reports. Setting 1.1 million homes in India. Participants Over 122 000 deaths at all ages from 2001 to 2003. Primary and secondary outcome measures Age-specific and sex-specific mortality rates, place and timing of death, modes of transportation and injuries sustained. Results The 2299 RTI deaths in the survey correspond to an estimated 183 600 RTI deaths or about 2% of all deaths in 2005 nationally, of which 65% occurred in men between the ages 15 and 59 years. The age-adjusted mortality rate was greater in men than in women, in urban than in rural areas, and was notably higher than that estimated from the national police records. Pedestrians (68 000), motorcyclists (36 000) and other vulnerable road users (20 000) constituted 68% of RTI deaths (124 000) nationally. Among the study sample, the majority of all RTI deaths occurred at the scene of collision (1005/1733, 58%), within minutes of collision (883/1596, 55%), and/or involved a head injury (691/1124, 62%). Compared to non-pedestrian RTI deaths, about 55 000 (81%) of pedestrian deaths were associated with less education and living in poorer neighbourhoods. Conclusions In India, RTIs cause a substantial number of deaths, particularly among pedestrians and other vulnerable road users. Interventions to prevent collisions and reduce injuries might address over half of the RTI deaths. Improved prehospital transport and hospital trauma care might address just over a third of the RTI deaths. PMID:23959748

  3. Short- and long-term associations between widowhood and mortality in the United States: longitudinal analyses.

    PubMed

    Moon, J Robin; Glymour, M Maria; Vable, Anusha M; Liu, Sze Y; Subramanian, S V

    2014-09-01

    Past research shows that spousal death results in elevated mortality risk for the surviving spouse. However, most prior studies have inadequately controlled for socioeconomic status (SES), and it is unclear whether this 'widowhood effect' persists over time. Health and Retirement Study participants aged 50+ years and married in 1998 (n = 12 316) were followed through 2008 for widowhood status and mortality (2912 deaths). Discrete-time survival analysis was used to compare mortality for the widowed versus the married. Odds of mortality during the first 3 months post-widowhood were significantly higher than in the continuously married (odds ratio (OR) for men = 1.87, 95% CI: 1.27, 2.75; OR for women = 1.47, 95% CI: 0.96, 2.24) in models adjusted for age, gender, race and baseline SES (education, household wealth and household income), behavioral risk factors and co-morbidities. Twelve months following bereavement, men experienced borderline elevated mortality (OR = 1.16, 95% CI: 1.00, 1.35), whereas women did not (OR = 1.07, 95% CI: 0.90, 1.28), though the gender difference was non-significant. The 'widowhood effect' was not fully explained by adjusting for pre-widowhood SES and particularly elevated within the first few months after widowhood. These associations did not differ by sex. © The Author 2013. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  4. Mortality from road traffic accidents in Switzerland: longitudinal and spatial analyses.

    PubMed

    Spoerri, Adrian; Egger, Matthias; von Elm, Erik

    2011-01-01

    Road traffic accidents (RTA) are an important cause of premature death. We examined socio-demographic and geographical determinants of RTA mortality in Switzerland by linking 2000 census data to RTA mortality records 2000-2005 (ICD-10 codes V00-V99). Data from 5.5 million residents aged 18-94 years, 1744 study areas, and 1620 RTA deaths were analyzed, including 978 deaths (60.4%) in motor vehicle occupants, 254 (15.7%) in motorcyclists, 107 (6.6%) in cyclists, and 259 (16.0%) in pedestrians. Weibull survival models and Bayesian methods were used to calculate hazard ratios (HR), and standardized mortality ratios (SMR) across study areas. Adjusted HR comparing women with men ranged from 0.04 (95% CI 0.02-0.07) in motorcyclists to 0.43 (95% CI 0.32-0.56) in pedestrians. There was a u-shaped relationship with age in motor vehicle occupants and motorcyclists. In cyclists and pedestrians, mortality increased after age 55 years. Mortality was higher in individuals with primary education (HR 1.53; 95% CI 1.29-1.81), and higher in single (HR 1.24; 95% CI 1.05-1.46), widowed (HR 1.31; 95% CI 1.05-1.65) and divorced individuals (HR 1.62; 95% CI 1.33-1.97), compared to persons with tertiary education or married persons. The association with education was particularly strong for pedestrians (HR 1.87; 95% CI 1.20-2.91). RTA mortality increased with decreasing population density of study areas for motor vehicle occupants (test for trend p<0.0001) and motorcyclists (p=0.0021) but not for cyclists (p=0.39) or pedestrians (p=0.29). SMR standardized for socio-demographic and geographical variables ranged from 82 to 190. Prevention efforts should aim to reduce inequities across socio-demographic and educational groups, and across geographical areas, with interventions targeted at high-risk groups and areas, and different traffic users, including pedestrians.

  5. Pets and Human Health in Germany and Australia: National Longitudinal Results

    ERIC Educational Resources Information Center

    Headey, Bruce; Grabka, Markus M.

    2007-01-01

    The German and Australian "longitudinal" surveys analysed here are the first national representative surveys to show that (1) people who continuously own a pet are the healthiest group and (2) people who cease to have a pet or never had one are less healthy. Most previous studies which have claimed that pets confer health benefits were…

  6. Work and Family: Never Too Old To Learn. Data from the National Longitudinal Surveys. Report 856.

    ERIC Educational Resources Information Center

    Bureau of Labor Statistics (DOL), Washington, DC.

    Data from the Mature Women's cohort of the National Longitudinal Surveys were used in an analysis of the acquisition of education and training by women at later ages over the 1979-89 period. These data described a sample of women who were between the ages of 30 and 45 in 1967 and who had been interviewed regularly at later intervals. Between the…

  7. NLS Annotated Bibliography 1968-1989. The National Longitudinal Surveys of Labor Market Experience.

    ERIC Educational Resources Information Center

    Ohio State Univ., Columbus. Center for Human Resource Research.

    Part of an ongoing effort to maintain a record of research based on data from the National Longitudinal Surveys of Labor Market Experience (NLS), this document contains approximately 1,600 summaries of NLS-based journal articles, working papers, and dissertations that have been published over the past 20 years. It couples newly found research for…

  8. National Longitudinal Study of the High School Class of 1972. Review and Annotation of Study Reports.

    ERIC Educational Resources Information Center

    Peng, Samuel S.; And Others

    Over 150 journal articles, papers presented at professional meetings, dissertations, government publications, contract reports, and studies in progress as of March 1977 on the National Longitudinal Study of the High School Class of 1972 (NLS) are annotated and indexed by subject, author, and sponsoring agency. Introductory chapters describe the…

  9. Pets and Human Health in Germany and Australia: National Longitudinal Results

    ERIC Educational Resources Information Center

    Headey, Bruce; Grabka, Markus M.

    2007-01-01

    The German and Australian "longitudinal" surveys analysed here are the first national representative surveys to show that (1) people who continuously own a pet are the healthiest group and (2) people who cease to have a pet or never had one are less healthy. Most previous studies which have claimed that pets confer health benefits were…

  10. State-to-State Variations in Early Intervention Systems. National Early Intervention Longitudinal Study (NEILS).

    ERIC Educational Resources Information Center

    Hebbeler, Kathleen; Spiker, Donna; Wagner, Mary; Cameto, Renee; McKenna, Patti

    This report provides descriptive information on variations in selected features of state and local early intervention systems. Information was gathered from 20 states as part of the National Early Intervention Longitudinal Study (NEILS). Results indicate a considerable variation along a number of dimensions, including: eligibility criteria; type…

  11. National Education Longitudinal Study of 1988. Second Follow-up: Transcript Component Data File User's Manual.

    ERIC Educational Resources Information Center

    Ingels, Steven J.; And Others

    This manual familiarizes data users with the procedures followed for data collection and processing of the high school transcript component of the National Education Longitudinal Study of 1988 (NELS:88). A second objective is to provide the necessary documentation for using the data files. Chapter 6 and appendix F, in particular, contain…

  12. Colorism and Educational Outcomes of Asian Americans: Evidence from the National Longitudinal Study of Adolescent Health

    ERIC Educational Resources Information Center

    Ryabov, Igor

    2016-01-01

    Using a nationally representative longitudinal data set, the current study examines the link between colorism and educational attainment of Asian American young adults. Three levels of educational attainment are used as outcomes: high school diploma, some college and a Bachelor's degree or higher. Independent variables include skin tone, ethnic…

  13. Nonstandard Work and Marital Instability: Evidence from the National Longitudinal Survey of Youth

    ERIC Educational Resources Information Center

    Kalil, Ariel; Ziol-Guest, Kathleen M.; Epstein, Jodie Levin

    2010-01-01

    This article replicated and extended Harriet Presser's (2000) investigation of the linkages between nonstandard work and marital instability. We reexplored this question using data from a sample of 2,893 newlywed couples from the National Longitudinal Survey of Youth (NLSY) and using different analytic techniques. In contrast to Presser, we found…

  14. Youth and the Labor Market. Analyses of the National Longitudinal Survey.

    ERIC Educational Resources Information Center

    Borus, Michael E., Ed.

    This collection consists of analyses based on data from the 1979, 1980, and 1981 National Longitudinal Surveys of Youth Labor Market Experience. In a paper entitled "A Description of Employed and Unemployed Youth in 1981," Michael E. Borus describes employed, unemployed, and discouraged workers between the ages of 16 and 21. Next, Tom K.…

  15. Models Matter--The Final Report of the National Longitudinal Evaluation of Comprehensive School Reform

    ERIC Educational Resources Information Center

    Aladjem, Daniel K.; LeFloch, Kerstin Carlson; Zhang, Yu; Kurki, Anja; Boyle, Andrea; Taylor, James E.; Herrmann, Suzannah; Uekawa, Kazuaki; Thomsen, Kerri; Fashola, Olatokunbo

    2006-01-01

    The National Longitudinal Evaluation of Comprehensive School Reform (NLECSR) is a quantitative and qualitative study of behavior, decisions, processes, and outcomes. It employs a quasi-experimental design with matched treatment and comparison schools. NLECSR seeks to determine the effects of CSR models on student achievement in about 650…

  16. National Longitudinal Transition Study 2012: Design Documentation. NCEE 2017-4021

    ERIC Educational Resources Information Center

    Burghardt, John; Haimson, Joshua; Lipscomb, Stephen; Liu, Albert Y.; Potter, Frank; Waits, Tiffany; Wang, Sheng

    2017-01-01

    The National Longitudinal Transition Study 2012 (NLTS 2012) is the third in the series of NLTS studies sponsored by the U.S. Department of Education to examine youth with disabilities receiving services under the Individuals with Disabilities Education Act (IDEA), a long-standing federal law last updated in 2004. Under IDEA, youth with…

  17. Colorism and Educational Outcomes of Asian Americans: Evidence from the National Longitudinal Study of Adolescent Health

    ERIC Educational Resources Information Center

    Ryabov, Igor

    2016-01-01

    Using a nationally representative longitudinal data set, the current study examines the link between colorism and educational attainment of Asian American young adults. Three levels of educational attainment are used as outcomes: high school diploma, some college and a Bachelor's degree or higher. Independent variables include skin tone, ethnic…

  18. Nonstandard Work and Marital Instability: Evidence from the National Longitudinal Survey of Youth

    ERIC Educational Resources Information Center

    Kalil, Ariel; Ziol-Guest, Kathleen M.; Epstein, Jodie Levin

    2010-01-01

    This article replicated and extended Harriet Presser's (2000) investigation of the linkages between nonstandard work and marital instability. We reexplored this question using data from a sample of 2,893 newlywed couples from the National Longitudinal Survey of Youth (NLSY) and using different analytic techniques. In contrast to Presser, we found…

  19. The Association of Baseline and Longitudinal Change in Endothelial Microparticle Count with Mortality in Chronic Kidney Disease.

    PubMed

    Green, Darren; Skeoch, Sarah; Alexander, M Yvonne; Kalra, Philip A; Parker, Ben

    2017-01-01

    Chronic kidney disease (CKD) is associated with a unique milieu of vascular pathology, and effective biomarkers of active vascular damage are lacking. A candidate biomarker is the quantification of circulating endothelial microparticles (EMPs). This study observed baseline and longitudinal EMP change (δEMP) and established the association of these with all-cause mortality and cardiovascular events in CKD. An observational study in adults with CKD (estimated glomerular filtration rate [eGFR] <60 mL/min/1.73 m2). EMPs were quantified by flow cytometry of platelet poor plasma in 2 samples 12 months apart and categorised as EMP if AnnexinV+/CD31+/CD42b- EMPs were compared between primary renal diagnoses, and correlations between EMP/δEMP and other parameters made. Adjusted hazard ratios (HRs) for time to all-cause mortality and cardiovascular events were calculated for log-transformed EMP and δEMP using a Cox proportional hazard model. There were 123 patients (age 63 ± 11 years, systolic blood pressure 135 ± 18 mm Hg, eGFR 32 ± 16 mL/min/1.73 m2). The median baseline EMP count was 144/μL (range 10-714/μL). EMPs were numerically the highest in autosomal dominant polycystic kidney disease (253 [41-610]). An increase in urine protein:creatinine ratio was associated with an increase in EMP (co-efficient 0.21, p = 0.02). The adjusted HR for all-cause mortality for EMP was 8.20 (1.67-40.2, p = 0.01) and for δEMP was 2.69 (0.04-165, p = 0.64). There was no association between EMP or δEMP and cardiovascular events. Although EMP count was a significant marker of mortality risk, longitudinal change was not. This may reflect disease-specific EMP behaviour and the limitation of EMP as a generalised biomarker in CKD. © 2017 S. Karger AG, Basel.

  20. Longitudinal study of astronaut health: Mortality in the years 1959-1991

    SciTech Connect

    Peterson, L.E.; Pepper, L.J.; Hamm, P.B.; Gilbert, S.L. )

    1993-02-01

    We conducted a historical cohort study of mortality among 195 astronauts who were exposed to space and medical sources of radiation between 1959 and 1991. Cumulative occupational and medical radiation exposures were obtained from the astronaut radiation exposure history data base. Causes of death were obtained from obligatory death certificates and autopsy reports that were on file in the medical records. There was a total of 20 deaths that occurred during the 32-year follow-up period of which 16 were due to accidents. The all-cause standardized mortality ratio (SMR) was 181 (95% confidence interval 110, 279). There was 1 cancer death in the buccal cavity and pharyngeal ICD-9 rubric whose occurrence was significantly beyond expectation. Mortality for coronary disease was 53% lower than expected (2 deaths; SMR = 47; 95% confidence limits 5, 168). The crude death rate for 12 occupationally related accidents was 445 deaths per 100,000 person-years and was an order of magnitude greater than accidental death rates in the mining industries. The SMR of 1346 for fatal accidents was significantly beyond expectation (16 deaths; 95% confidence limits 769, 2168) and was similar to SMRs for accidents among aerial pesticide applicators. The 10-year cumulative risk of occupational fatalities based on the exponential, Weibull, Gompertz, and linear-exponential distributions was 10%. Mortality from motor vehicle accidents was slightly higher than expected, but was not significant (1 death; SMR = 165; 95% confidence limits 2,922). Radiation exposures from medical procedures accounted for a majority of cumulative dose when compared with space radiation exposures. Overall, it was found that astronauts are at a health disadvantage as a result of catastrophic accidents.

  1. Longitudinal study of astronaut health: Mortality in the years 1959-1991

    NASA Technical Reports Server (NTRS)

    Peterson, Leif E.

    1993-01-01

    We conducted a historical cohort study of mortality among 195 astronauts who were exposed to space and medical sources of radiation between 1959 and 1991. Cumulative occupational and medical radiation exposures were obtained from the astronaut radiation exposure history data base. Causes of death were obtained from obligatory death certificates and autopsy reports that were on file in the medical records. A total of 18 deaths occurred during the 32-year follow-up period for which the all-cause standardized mortality ratio (SMR) was 142 (95 percent confidence interval 84 225). There was one cancer death in the buccal cavity and pharynegeal ICD-9 rubric whose occurrence was significantly beyond expectation. Mortality for coronary disease was 59 percent lower than expected (2 deaths; SMR = 41; 95 percent confidence limit 5 147). The crude death rate for 10 occupationally related accidents was 400 deaths per 100,000 person-years, which is an order of magnitude greater than accidental death rates in mining industries. The SMR of 1027 for fatal accidents was significantly beyond expectation (14 deaths; 95 percent confidence limit 561 1723) and was similar to SMRs for accidents among aerial pesticide applications. The 10-year cumulative risk of occupational fatalities based on the exponential, Weibull, Gompertz, and linear-exponential distributions was 10 percent. Mortality from motor vehicle accidents was slightly higher than expected but was not significant (1 death; SMR = 145; 95 percent confidence limit 2 808). Radiation exposures from medical procedures accounted for a majority of cumulative dose when compared with space radiation exposures. The results of the study do not confirm the impression that astronauts are at increased risk of cancer, but this does not obviate the need for further study. Overall, it was found that astronauts are at a health disadvantage as a result of catastrophic accidents.

  2. Longitudinal study of astronaut health: Mortality in the years 1959-1991

    NASA Technical Reports Server (NTRS)

    Peterson, Leif E.

    1993-01-01

    We conducted a historical cohort study of mortality among 195 astronauts who were exposed to space and medical sources of radiation between 1959 and 1991. Cumulative occupational and medical radiation exposures were obtained from the astronaut radiation exposure history data base. Causes of death were obtained from obligatory death certificates and autopsy reports that were on file in the medical records. A total of 18 deaths occurred during the 32-year follow-up period for which the all-cause standardized mortality ratio (SMR) was 142 (95 percent confidence interval 84 225). There was one cancer death in the buccal cavity and pharynegeal ICD-9 rubric whose occurrence was significantly beyond expectation. Mortality for coronary disease was 59 percent lower than expected (2 deaths; SMR = 41; 95 percent confidence limit 5 147). The crude death rate for 10 occupationally related accidents was 400 deaths per 100,000 person-years, which is an order of magnitude greater than accidental death rates in mining industries. The SMR of 1027 for fatal accidents was significantly beyond expectation (14 deaths; 95 percent confidence limit 561 1723) and was similar to SMRs for accidents among aerial pesticide applications. The 10-year cumulative risk of occupational fatalities based on the exponential, Weibull, Gompertz, and linear-exponential distributions was 10 percent. Mortality from motor vehicle accidents was slightly higher than expected but was not significant (1 death; SMR = 145; 95 percent confidence limit 2 808). Radiation exposures from medical procedures accounted for a majority of cumulative dose when compared with space radiation exposures. The results of the study do not confirm the impression that astronauts are at increased risk of cancer, but this does not obviate the need for further study. Overall, it was found that astronauts are at a health disadvantage as a result of catastrophic accidents.

  3. Longitudinal trends in prostate cancer incidence, mortality, and survival of patients from two Shanghai city districts: a retrospective population-based cohort study, 2000–2009

    PubMed Central

    2014-01-01

    Background Prostate cancer is the fifth most common cancer affecting men of all ages in China, but robust surveillance data on its occurrence and outcome is lacking. The specific objective of this retrospective study was to analyze the longitudinal trends of prostate cancer incidence, mortality, and survival in Shanghai from 2000 to 2009. Methods A retrospective population-based cohort study was performed using data from a central district (Putuo) and a suburban district (Jiading) of Shanghai. Records of all prostate cancer cases reported to the Shanghai Cancer Registry from 2000 to 2009 for the two districts were reviewed. Prostate cancer outcomes were ascertained by matching cases with individual mortality data (up to 2010) from the National Death Register. The Cox proportional hazards model was used to analyze factors associated with prostate cancer survival. Results A total of 1022 prostate cancer cases were diagnosed from 2000 to 2009. The average age of patients was 75 years. A rapid increase in incidence occurred during the study period. Compared with the year 2000, 2009 incidence was 3.28 times higher in Putuo and 5.33 times higher in Jiading. Prostate cancer mortality declined from 4.45 per 105 individuals per year in 2000 to 1.94 per 105 in 2009 in Putuo and from 5.45 per 105 to 3.5 per 105 in Jiading during the same period. One-year and 5-year prostate cancer survival rates were 95% and 56% in Putuo, and 88% and 51% in Jiading, respectively. Staging of disease, Karnofsky Performance Scale Index, and selection of chemotherapy were three independent factors influencing the survival of prostate cancer patients. Conclusions The prostate cancer incidence increased rapidly from 2000 to 2009, and prostate cancer survival rates decreased in urban and suburban Chinese populations. Early detection and prompt prostate cancer treatment is important for improving health and for increasing survival rates of the Shanghai male population. PMID:24731197

  4. Relative deprivation and mortality--a longitudinal study in a Swedish population of 4.7 million, 1990-2006.

    PubMed

    Åberg Yngwe, Monica; Kondo, Naoki; Hägg, Sara; Kawachi, Ichiro

    2012-08-16

    Relative deprivation has previously been discussed as a possible mechanism underlying the income-health relation. The idea is that income matters to the individual's health, over and above the increased command over resources, as the basis of social comparisons between a person and his or her reference group. The following study aimed to analyze the role of individual-level relative deprivation for all-cause mortality in the Swedish population. The Swedish context, characterized by relatively small income inequalities and promoting values as egalitarianism and equality, together with a large data material provide unique possibilities for analyzing the hypothesized mechanism. The data used are prospective longitudinal data from the Swedish population and based on a linkage of registers. Restricting selection to individuals 25-64 years, alive January 1st 1990, gave 4.7 million individuals, for whom a mortality follow-up was done over a 16-year period. The individual level relative deprivation was measured using the Yitzhaki index, calculating the accumulated shortfall between the individual's income and the income of all other's in the person's reference group. All-cause mortality was used as the outcome measure. Relative deprivation, generated through social comparisons, is one possible mechanism within the income and health relation. The present study analyzed different types of objectively defined reference groups, all based on the idea that people compare themselves to similar others. Results show relative deprivation, when measured by the Yitzhaki index, to be significantly associated with mortality. Also, we found a stronger effect among men than among women. Analyzing the association within different income strata, the effect was shown to be weak among the poorest. Revealing the importance of relative deprivation for premature mortality, over and above the effect of absolute income, these results resemble previous findings. Relative deprivation, based on

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

    PubMed

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

    2015-09-01

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

  6. Secular Trends in Neuroblastoma Mortality Before and After the Cessation of National Mass Screening in Japan

    PubMed Central

    Katanoda, Kota; Hayashi, Kunihiko; Yamamoto, Keiko; Sobue, Tomotaka

    2009-01-01

    Background In 2003, the Japanese government halted the national mass screening program for neuroblastoma (NB), which had been running since the mid-1980s. It is not known whether the NB mortality rate subsequently increased or decreased. Methods Utilizing vital statistics data from 1980 through 2006, we analyzed the secular trends in NB mortality by using cancer of the adrenal gland as a surrogate. We examined the validity of this substitution by comparing the results with data from death certificates. Using a joinpoint regression model, we examined the trends in age-specific mortality rates by calendar year and cumulative mortality rates by birth year. The cumulative mortality rate was analyzed for age under 1 or 2 years for infants born after the cessation of the mass screening program. Results The number of deaths from cancer of the adrenal gland was closely correlated with the number of deaths from NB. Significant decreases in the mortality rate were observed from 1980 through 2006 by calendar year for those aged under 1 year, 1 to 4 years, and 5 to 9 years. The cumulative mortality rates by birth year also significantly decreased from the 1980 birth cohort. Although the cumulative mortality rates under the age of 2 appear to have increased after the 2003 birth cohort, the change was not statistically significant. Conclusions No significant increase in the NB mortality rate was detected after the cessation of the mass screening program in Japan. However, continuous monitoring is still needed to fully evaluate this health policy decision. PMID:19652443

  7. Factors associated with maternal mortality in rural Guinea-Bissau. A longitudinal population-based study.

    PubMed

    Høj, L; da Silva, D; Hedegaard, K; Sandström, A; Aaby, P

    2002-07-01

    To assess demographic and obstetric risk factors for pregnancy-related death in a multiethnic rural population in a developing country. A prospective survey of women in the fertile age-range. Rural Guinea-Bissau. More than 15,000 women living in 100 clusters were visited at six-monthly intervals over a period of more than six years. A total of 10,931 pregnancies were registered prospectively; 85 of these pregnancies resulted in maternal or late maternal death. Maternal mortality ratio. In the rural areas of Guinea-Bissau, we conducted a prospective survey of women in the fertile age range. More than 15,000 women living in 100 clusters were visited at 6-monthly intervals over a period of more than six years. An analysis of demographic, environmental and obstetric risk factors for maternal death was performed based on 10,931 prospectively registered pregnancies; 85 of these pregnancies resulted in maternal or late maternal death. In the adjusted model maternal mortality ratio increased with increasing distance from the regional hospital (OR>25 km = 7.4 [95% CI: 1.6-132]). Multiple pregnancy was found to increase the risk of maternal death (OR = 3.4 [95% CI: 1.3-7.5]). The risk of subsequent maternal death was increased if the fetus was stillborn (OR = 5.3 [95% CI: 2.8-9.4]). Women living in the region of Gabu had higher mortality than those living in Biombo (OR = 2.5 [95% CI: 1.3-5.1]). No category of age or parity were associated with an increased risk of maternal mortality. Predictive values did not exceed 3% for any of the significant risk factors. For the purpose of reducing maternal mortality, the screening approach of antenatal care is of limited value. Age and parity should not be used routinely as selection criteria for transfer of otherwise healthy pregnant women to higher-level health institutions. Twin pregnancy seems to be the only operational risk factor identified in this study. Stillbirth is associated with an increased risk of maternal death. Regional

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

    PubMed

    Singh, Rajvir; Tripathi, Vrijesh

    2015-01-01

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

  9. Longitudinal study of psychiatric symptoms, disability, mortality, and emigration among Bosnian refugees.

    PubMed

    Mollica, R F; Sarajlic, N; Chernoff, M; Lavelle, J; Vukovic, I S; Massagli, M P

    2001-08-01

    Evidence is emerging that psychiatric disorders are common in populations affected by mass violence. Previously, we found associations among depression, posttraumatic stress disorder (PTSD), and disability in a Bosnian refugee cohort. To investigate whether previously observed associations continue over time and are associated with mortality emigration to another region. Three-year follow-up study conducted in 1999 among 534 adult Bosnian refugees originally living in a refugee camp in Croatia. At follow-up, 376 (70.4%) remained living in the region, 39 (7.3%) were deceased, 114 (21.3%) had emigrated, and 5 (1%) were lost to follow-up. Those still living in the region and the families of the deceased were reinterviewed (77.7% of the original participants). Depression and PTSD diagnoses, based on Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria and measured by the Hopkins Symptom Checklist-25 and the Harvard Trauma Questionnaire, respectively; disability, measured by the Medical Outcomes Study Short-Form 20; and cause of death, determined by family interviews with review of death certificates, if available. In 1999, 45% of the original respondents who met the DSM-IV criteria for depression, PTSD, or both continued to have these disorders and 16% of respondents who were asymptomatic in 1996 developed 1 or both disorders. Forty-six percent of those who initially met disability criteria remained disabled. Log-linear analysis revealed that disability and psychiatric disorder were related at both times. Male sex, isolation from family, and older age were associated with increased mortality after adjusting for demographic characteristics, trauma history, and health status (for male sex, adjusted odds ratio [OR], 2.63; 95% confidence interval [CI], 1.17-5.92; living alone, OR, 2.40; 95% CI, 1.07-5.38; and each 10-year increase in age, OR, 1.91; 95% CI, 1.34-2.71). Depression was associated with higher mortality in unadjusted analysis

  10. Monitoring trends in under-5 mortality rates through national birth history surveys.

    PubMed

    Korenromp, E L; Arnold, F; Williams, B G; Nahlen, B L; Snow, R W

    2004-12-01

    We assessed whether Demographic and Health Surveys (DHS), a large and high-quality source of under-5 mortality estimates in developing countries, would be able to detect reductions in under-5 mortality as established in global child health goals. Mortality estimates from 41 DHS conducted in African countries between 1986 and 2002, for the interval of 0-4 years preceding each survey (with a mean time lag of 2.5 years), were reviewed. The median relative error on national mortality rates was 4.4%. In multivariate regression, the relative error decreased with increasing sample size, increasing fertility rates, and increasing mortality rates. The error increased with the magnitude of the survey design effect, which resulted from cluster sampling. With levels of precision observed in previous surveys, reductions in all-cause under-5 mortality rates between two subsequent surveys of 15% or more would be detectable. The detection of smaller mortality reductions would require increases in sample size, from a current median of 7060 to over 20,000 women. Across the actual surveys conducted between 1986 and 2002, varying mortality trends were apparent at a national scale, but only around half of these were statistically significant. The interpretation of changes in under-5 mortality rates between subsequent surveys needs to take into account statistical significance. DHS birth history surveys with their present sampling design would be able to statistically confirm under-5 mortality reductions in African countries if true reductions were 15% or larger, and are highly relevant to tracking progress towards existing international child health targets.

  11. The National Longitudinal Study of Adolescent Health (Add Health) Sibling Pairs Data

    PubMed Central

    Harris, Kathleen Mullan; Halpern, Carolyn Tucker; Haberstick, Brett C.; Smolen, Andrew

    2013-01-01

    This article describes the design and phenotype and genotype data available for sibling pairs with varying genetic relatedness in the National Longitudinal Study of Adolescent Health (Add Health). Add Health is a nationally-representative longitudinal study of over 20,000 adolescents in the U.S. in 1994-95 who have been followed for fifteen years into adulthood. The Add Health design included oversamples of more than 3,000 pairs of individuals with varying genetic resemblance, ranging from monozygotic twins, dizygotic twins, full siblings, half siblings, and unrelated siblings who were raised in the same household. Add Health sibling pairs are therefore nationally representative and followed longitudinally from early adolescence into adulthood with 4 in-home interviews during the period 1994-2009. Add Health has collected rich longitudinal social, behavioral, environmental, and biological data, as well as buccal cell DNA from all sample members, including siblings pairs. Add Health has an enlightened dissemination policy and to date has released phenotype and genotype data to more than 10,000 researchers in the scientific community. PMID:23231780

  12. The National Longitudinal Study of Adolescent Health (Add Health) sibling pairs data.

    PubMed

    Harris, Kathleen Mullan; Halpern, Carolyn Tucker; Haberstick, Brett C; Smolen, Andrew

    2013-02-01

    This article describes the design and phenotype and genotype data available for sibling pairs with varying genetic relatedness in the National Longitudinal Study of Adolescent Health (Add Health). Add Health is a nationally representative longitudinal study of over 20,000 adolescents in the United States in 1994-1995 who have been followed for 15 years into adulthood. The Add Health design included oversamples of more than 3,000 pairs of individuals with varying genetic resemblance, ranging from monozygotic twins, dizygotic twins, full siblings, half siblings, and unrelated siblings who were raised in the same household. Add Health sibling pairs are therefore nationally representative and followed longitudinally from early adolescence into adulthood with four in-home interviews during the period 1994-2009. Add Health has collected rich longitudinal social, behavioral, environmental, and biological data, as well as buccal cell DNA from all sample members, including sibling pairs. Add Health has an enlightened dissemination policy and to date has released phenotype and genotype data to more than 10,000 researchers in the scientific community.

  13. [Maternal mortality in Central America. The basis for national programs on epidemiologic surveillance].

    PubMed

    Kestler, E

    1989-01-01

    Although maternal mortality rates worldwide have declined dramatically over the past several decades, maternal mortality rates in developing countries are considered a public health problem. The true rates of maternal mortality are unknown and frequently underestimated. Data from the UN annual demographic report show that only 4 Central American countries met the requirements for publication of their maternal mortality rates. 1984 rates ranged from the high of 75.6/100,000 live births in Guatemala to the low of 22.4/100,000 in Costa Rica. The principal or only source of maternal mortality data in Central American countries is vital statistics reported by official organizations. Difficulties in reporting and collecting this information and the fact that vital statistics were not developed for study of maternal mortality make them a poor source of data. Death certificates do not include the final cause of death. Review of death certificates of fertile-aged women and combining other sources of data such as clinical histories or autopsy reports with the vital statistics are techniques for improving the registration of maternal deaths. A national system of epidemiologic surveillance of maternal mortality has the advantage of obtaining information from multiple sources, including the press, private physicians, midwives, hospital obstetrics and gynecology departments, health centers and posts, family planning clinics, private hospitals, maternal mortality committees, families, and the local and national vital statistics. A national level surveillance program should be recognized as the coordinator of activities in this area, and the systems of data collection, analysis, and use of the results should be easily adaptable, inexpensive, simple, and able to motivate. An outline of steps to be followed in organizing and developing a system of surveillance is included in this work, beginning with establishing the objectives and determining what data are needed and ending with

  14. Sedation depth and long-term mortality in mechanically ventilated critically ill adults: a prospective longitudinal multicentre cohort study.

    PubMed

    Shehabi, Yahya; Chan, Lucy; Kadiman, Suhaini; Alias, Anita; Ismail, Wan Nasrudin; Tan, Mohd Ali T Ismail; Khoo, Tien Meng; Ali, Saedah Binti; Saman, Mat Ariffin; Shaltut, Ahmad; Tan, Cheng Cheng; Yong, Cow Yen; Bailey, Michael

    2013-05-01

    To ascertain the relationship among early (first 48 h) deep sedation, time to extubation, delirium and long-term mortality. We conducted a multicentre prospective longitudinal cohort study in 11 Malaysian hospitals including medical/surgical patients (n = 259) who were sedated and ventilated ≥24 h. Patients were followed from ICU admission up to 28 days in ICU with 4-hourly sedation and daily delirium assessments and 180-day mortality. Deep sedation was defined as Richmond Agitation Sedation Score (RASS) ≤-3. The cohort had a mean (SD) age of 53.1 (15.9) years and APACHE II score of 21.3 (8.2) with hospital and 180-day mortality of 82 (31.7%) and 110/237 (46.4%). Patients were followed for 2,657 ICU days and underwent 13,836 RASS assessments. Midazolam prescription was predominant compared to propofol, given to 241 (93%) versus 72 (28%) patients (P < 0.0001) for 966 (39.6%) versus 183 (7.5%) study days respectively. Deep sedation occurred in (182/257) 71% patients at first assessment and in 159 (61%) patients and 1,658 (59%) of all RASS assessments at 48 h. Multivariable Cox proportional hazard regression analysis adjusting for a priori assigned covariates including sedative agents, diagnosis, age, APACHE II score, operative, elective, vasopressors and dialysis showed that early deep sedation was independently associated with longer time to extubation [hazard ratio (HR) 0.93, 95% confidence interval (CI) 0.89-0.97, P = 0.003], hospital death (HR 1.11, 95% CI 1.05-1.18, P < 0.001) and 180-day mortality (HR 1.09, 95% CI 1.04-1.15, P = 0.002), but not time to delirium (HR 0.98, P = 0.23). Delirium occurred in 114 (44%) of patients. Irrespective of sedative choice, early deep sedation was independently associated with delayed extubation and higher mortality, and thus was a potentially modifiable risk in interventional trials.

  15. Income is a stronger predictor of mortality than education in a national sample of US adults.

    PubMed

    Sabanayagam, Charumathi; Shankar, Anoop

    2012-03-01

    Low socioeconomic status (SES) is associated with mortality in several populations. SES measures, such as education and income, may operate through different pathways. However, the independent effect of each measure mutually adjusting for the effect of other SES measures is not clear. The association between poverty-income ratio (PIR) and education and all-cause mortality among 15,646 adults, aged >20 years, who participated in the Third National Health and Nutrition Examination Survey in the USA, was examined. The lower PIR quartiles and less than high school education were positively associated with all-cause mortality in initial models adjusting for the demographic, lifestyle and clinical risk factors. After additional adjustment for education, the lower PIR quartiles were still significantly associated with all-cause mortality. The multivariable odds ratio (OR) [95% confidence interval (CI)] of all-cause mortality comparing the lowest to the highest quartile of PIR was 2.11 (1.52-2.95, p trend < or = 0.0001). In contrast, after additional adjustment for income, education was no longer associated with all-cause mortality [multivariable OR (95% CI) of all-cause mortality comparing less than high school to more than high school education was 1.05 (0.85-1.31, p trend=0.57)]. The results suggest that income may be a stronger predictor of mortality than education, and narrowing the income differentials may reduce the health disparities.

  16. Effects of nurse staffing ratios on patient mortality in Taiwan acute care hospitals: a longitudinal study.

    PubMed

    Liang, Yia-Wun; Tsay, Shwu-Feng; Chen, Wen-Yi

    2012-03-01

    The nurse workload in Taiwan averages two to seven times more than that in the United States and other developed countries. Previous studies have indicated heavy nursing workload as an underlying cause of preventable patient death. No studies have yet explored the relationship between nurse staffing ratio and patient mortality in Taiwan. This study explored the effect of nurse staffing ratios on patient mortality in acute care hospitals in Taiwan and considered the implications in terms of policy. Using stratified random sampling, 108 hospital nursing units in 32 of Taiwan's 441 accredited Western medicine district/regional hospitals and medical centers were included in the study. Variables were retrospectively measured from 108 wards by using monthly data during a 7-month period. A generalized estimating equation logistic model was used to obtain more precise estimates of the nurse staffing effect by controlling for hospital characteristic and patient acuity variables. The population-averaged odds ratio for the incidence of death between the low and high patient-nurse ratio groups was 3.617 (95% CI = [1.930, 6.776]). The risk of death in the high patient-nurse ratio group was significantly higher than in the low patient-nurse ratio group. Nurse staffing levels affect patient outcomes. Faced with the problem of inadequate nurses for hospital healthcare needs, Taiwanese policymakers should work to implement a legislatively mandated minimum patient-nurse ratio on a shift-by-shift basis to regulate nurse staffing. In setting guidelines for nurse staffing, policymakers must consider nursing staff characteristics in addition to the number of nurses.

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

    PubMed

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

    2016-03-08

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

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed

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

    2016-07-20

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

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

    PubMed

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

    2006-07-01

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

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

    PubMed

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

    2012-12-01

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

  2. Longitudinal Changes in Depression Symptoms and Survival Among Patients With Lung Cancer: A National Cohort Assessment.

    PubMed

    Sullivan, Donald R; Forsberg, Christopher W; Ganzini, Linda; Au, David H; Gould, Michael K; Provenzale, Dawn; Slatore, Christopher G

    2016-11-20

    Purpose Depression symptoms are common among patients with lung cancer; however, longitudinal changes and their impact on survival are understudied. Methods This was a prospective, observational study from the Cancer Care Outcomes Research and Surveillance Consortium from five US geographically defined regions from September 2003 through December 2005. Patients enrolled within 3 months of their lung cancer diagnosis were eligible. The eight-item Center for Epidemiologic Studies Depression scale was administered at diagnosis and 12 months' follow-up. The main outcome was survival, which was evaluated using Kaplan-Meyer curves and adjusted Cox proportional hazards modeling. Results Among 1,790 participants, 681 (38%) had depression symptoms at baseline and an additional 105 (14%) developed new-onset depression symptoms during treatment. At baseline, depression symptoms were associated with increased mortality (hazard ratio [HR], 1.17; 95% CI, 1.03 to 1.32; P = .01). Participants were classified into the following four groups based on longitudinal changes in depression symptoms from baseline to follow-up: never depression symptoms (n = 640), new-onset depression symptoms (n = 105), depression symptom remission (n = 156), and persistent depression symptoms (n = 254) and HRs were calculated. Using the never-depression symptoms group as a reference group, HRs were as follows: new-onset depression symptoms, 1.50 (95% CI, 1.12 to 2.01; P = .006); depression symptom remission, 1.02 (95% CI, 0.79 to 1.31; P = .89), and persistent depression symptoms, 1.42 (95% CI, 1.15 to 1.75; P = .001). At baseline, depression symptoms were associated with increased mortality among participants with early-stage disease (stages I and II; HR, 1.61; 95% CI, 1.26 to 2.04), but not late-stage disease (stages III and IV; HR, 1.05; 95% CI, 0.91 to 1.22). At follow-up, depression symptoms were associated with increased mortality among participants with early-stage disease (HR, 1.71; 95% CI, 1

  3. Longitudinal Changes in Depression Symptoms and Survival Among Patients With Lung Cancer: A National Cohort Assessment

    PubMed Central

    Forsberg, Christopher W.; Ganzini, Linda; Au, David H.; Gould, Michael K.; Provenzale, Dawn; Slatore, Christopher G.

    2016-01-01

    Purpose Depression symptoms are common among patients with lung cancer; however, longitudinal changes and their impact on survival are understudied. Methods This was a prospective, observational study from the Cancer Care Outcomes Research and Surveillance Consortium from five US geographically defined regions from September 2003 through December 2005. Patients enrolled within 3 months of their lung cancer diagnosis were eligible. The eight-item Center for Epidemiologic Studies Depression scale was administered at diagnosis and 12 months’ follow-up. The main outcome was survival, which was evaluated using Kaplan-Meyer curves and adjusted Cox proportional hazards modeling. Results Among 1,790 participants, 681 (38%) had depression symptoms at baseline and an additional 105 (14%) developed new-onset depression symptoms during treatment. At baseline, depression symptoms were associated with increased mortality (hazard ratio [HR], 1.17; 95% CI, 1.03 to 1.32; P = .01). Participants were classified into the following four groups based on longitudinal changes in depression symptoms from baseline to follow-up: never depression symptoms (n = 640), new-onset depression symptoms (n = 105), depression symptom remission (n = 156), and persistent depression symptoms (n = 254) and HRs were calculated. Using the never-depression symptoms group as a reference group, HRs were as follows: new-onset depression symptoms, 1.50 (95% CI, 1.12 to 2.01; P = .006); depression symptom remission, 1.02 (95% CI, 0.79 to 1.31; P = .89), and persistent depression symptoms, 1.42 (95% CI, 1.15 to 1.75; P = .001). At baseline, depression symptoms were associated with increased mortality among participants with early-stage disease (stages I and II; HR, 1.61; 95% CI, 1.26 to 2.04), but not late-stage disease (stages III and IV; HR, 1.05; 95% CI, 0.91 to 1.22). At follow-up, depression symptoms were associated with increased mortality among participants with early-stage disease (HR, 1.71; 95% CI, 1

  4. Leukocyte Telomere Length and Mortality in the National Health and Nutrition Examination Survey, 1999–2002

    PubMed Central

    Needham, Belinda L.; Rehkopf, David; Adler, Nancy; Gregorich, Steven; Lin, Jue; Blackburn, Elizabeth H.; Epel, Elissa S.

    2015-01-01

    Background This study examined the association between leukocyte telomere length – a marker of cell aging – and mortality in a nationally representative sample of US adults aged 50–84. We also examined moderating effects of age, sex, race/ethnicity, and education. Methods Data were from the National Health and Nutrition Examination Survey (NHANES), 1999–2002 (n=3,091). Cox proportional hazards regression was used to estimate the risk of all-cause and cause-specific mortality adjusting for sociodemographic characteristics, smoking, body mass index, and chronic conditions. Results 870 deaths occurred over an average of 9.5 years of follow-up. In the full sample, a decrease of 1 kilobase pair in telomere length at baseline was marginally associated with a 10% increased hazard of all-cause mortality (HR: 1.1, 95% CI: 0.9, 1.4) and a 30% increased hazard of death due to diseases other than cardiovascular disease or cancer (HR: 1.3, 95% CI: 0.9, 1.9). Among African-American but not white or Mexican-American respondents, a decrease of 1 kilobase pair in telomere length at baseline was associated with a two-fold increased hazard of cardiovascular mortality (HR: 2.0, 95% CI: 1.3, 3.1). There was no association between telomere length and cancer mortality. Conclusions The association between leukocyte telomere length and mortality differs by race/ethnicity and cause of death. PMID:26039272

  5. Mortality of workers exposed to ionizing radiation at the French National Electricity Company.

    PubMed

    Rogel, Agnès; Carré, Nicolas; Amoros, Emmanuèle; Bonnet-Belfais, Monique; Goldberg, Marcel; Imbernon, Ellen; Calvez, Thierry; Hill, Catherine

    2005-01-01

    Exposure to ionizing radiation increases the risk of cancer in humans. Nuclear workers receive low doses over a relatively long period of time. A mortality study of a cohort of workers exposed to ionizing radiation at Electricité de France (EDF) was conducted. The cohort consisted of 22,395 individuals monitored for radiation exposure between 1961 and 1994, and followed-up for an average of 11.7 years. Our study demonstrates a clear healthy worker effect (HWE) since mortality is less than half what is expected from National mortality statistics. The HWE is greater among workers who have spent most of their career in the nuclear sector. The analysis by cancer site shows no excess compared with the general population. No significant trend was observed according to level of exposure to ionizing radiation. The mortality of workers exposed to ionizing radiation at the French National Electricity company is very low compared to the French national mortality. Copyright (c) 2004 Wiley-Liss, Inc.

  6. Surveying the Nation: Longitudinal Surveys and the Construction of National Solutions to Educational Inequity

    ERIC Educational Resources Information Center

    Hutt, Ethan L.

    2016-01-01

    This paper examines the origins and influences of the introduction of longitudinal student data-sets as a way of gaining insight into the operation of American schools and as a tool for policy-makers. The paper argues that the creation of this new form of data in the 1960s and 1970s represented a relatively new way of thinking about American…

  7. Surveying the Nation: Longitudinal Surveys and the Construction of National Solutions to Educational Inequity

    ERIC Educational Resources Information Center

    Hutt, Ethan L.

    2016-01-01

    This paper examines the origins and influences of the introduction of longitudinal student data-sets as a way of gaining insight into the operation of American schools and as a tool for policy-makers. The paper argues that the creation of this new form of data in the 1960s and 1970s represented a relatively new way of thinking about American…

  8. National patterns of heart failure hospitalizations and mortality by sex and age.

    PubMed

    Rodriguez, Fátima; Wang, Yun; Johnson, Caitlin E; Foody, Joanne M

    2013-08-01

    Earlier work has demonstrated significant sex and age disparities in ischemic heart disease. However, it remains unclear if an age or sex gap exists for heart failure (HF) patients. Using data from the 2007-2008 Healthcare Cost and Utilization Project, we constructed hierarchic regression models to examine sex differences and age-sex interactions in HF hospitalizations and in-hospital mortality. Among 430,665 HF discharges, 51% were women and 0.3%, 27%, and 73% were aged <25, 25-64, and >64 years respectively. There were significant sex differences among HF risk factors, with a higher prevalence of coronary disease among men. Men had higher hospitalization rates for HF and in-hospital mortality across virtually all ages. The relationship between age and HF mortality appeared U-shaped; mortality rates for ages <25, 25-64, and >64 years were 2.9%, 1.4%, and 3.8%, respectively. No age-sex interaction was found for in-hospital mortality for adults >25 years old. Using a large nationally representative administrative dataset we found age and sex disparities in HF outcomes. In general, men fared worse than women regardless of age. Furthermore, we found a U-shaped relationship between age and in-hospital mortality during an HF hospitalization, such that young adults have similar mortality rates to older adults. Additional studies are warranted to elucidate the patient-specific and treatment characteristics that result in these patterns. Copyright © 2013 Elsevier Inc. All rights reserved.

  9. [Overview of hospital mortality at the National Institute of Neurology and Neurosurgery of Mexico City].

    PubMed

    Velásquez-Pérez, Leora; Núñez-Santes, Agustín; Contreras-Cortés, Guadalupe Araceli

    2009-01-01

    Knowing the mortality of the population that goes to medical care, allows to the hospitals institutions and the government to make decisions on the services of health and the conditions of attention. Our objective was to describe the frequency and trend of the main causes of neurological hospital mortality for the period 2002-2007 in the National Institute of Neurology andNeurosurgery "Manuel Velasco Suárez". The data was obtained from hospital discharge registers and medical records. Rates of hospital mortality and the tendency were calculated during the period of study. The overall mortality rate was 4.9 per each 100 discharges. The leading causes of death were cerebrovascular diseases and brain tumors and there was a tendency for increased mortality in cases associated with human immunodeficiency virus (HIV) for men p = 0.004 and p = 0.05 for women with epilepsy, and with a status of epileptic condition. The cerebrovascular diseases and brain tumors tend to hold the first places. The mortality for neurological complications resulting from the diseases caused by the HIV is increasing. It is necessary to promote programs to prevent cardiovascular and HIV infection risk factors, to decrease the mortality rates from these diseases.

  10. Evaluating the Quality of National Mortality Statistics from Civil Registration in South Africa, 1997–2007

    PubMed Central

    Joubert, Jané; Rao, Chalapati; Bradshaw, Debbie; Vos, Theo; Lopez, Alan D.

    2013-01-01

    Background Two World Health Organization comparative assessments rated the quality of South Africa’s 1996 mortality data as low. Since then, focussed initiatives were introduced to improve civil registration and vital statistics. Furthermore, South African cause-of-death data are widely used by research and international development agencies as the basis for making estimates of cause-specific mortality in many African countries. It is hence important to assess the quality of more recent South African data. Methods We employed nine criteria to evaluate the quality of civil registration mortality data. Four criteria were assessed by analysing 5.38 million deaths that occurred nationally from 1997–2007. For the remaining five criteria, we reviewed relevant legislation, data repositories, and reports to highlight developments which shaped the current status of these criteria. Findings National mortality statistics from civil registration were rated satisfactory for coverage and completeness of death registration, temporal consistency, age/sex classification, timeliness, and sub-national availability. Epidemiological consistency could not be assessed conclusively as the model lacks the discriminatory power to enable an assessment for South Africa. Selected studies and the extent of ill-defined/non-specific codes suggest substantial shortcomings with single-cause data. The latter criterion and content validity were rated unsatisfactory. Conclusion In a region marred by mortality data absences and deficiencies, this analysis signifies optimism by revealing considerable progress from a dysfunctional mortality data system to one that offers all-cause mortality data that can be adjusted for demographic and health analysis. Additionally, timely and disaggregated single-cause data are available, certified and coded according to international standards. However, without skillfully estimating adjustments for biases, a considerable confidence gap remains for single-cause data

  11. Some estimates of growth and mortality from the Malheur National Forest in eastern Oregon.

    Treesearch

    Donald R. Gedney; Floyd A. Johnson; Vernon E. Hicks

    1959-01-01

    During 1955-56 an inventory was made of forested land in the Middle Fork Working Circle of the Malheur National Forest to provide information necessary for calculation of the allowable cut and for other management purposes. The growth and mortality estimates in the following report were obtained from this inventory. Although the estimates apply directly to the Middle...

  12. Family Structure and Child Mortality in Sub-Saharan Africa: Cross-National Effects of Polygyny

    ERIC Educational Resources Information Center

    Omariba, D. Walter Rasugu; Boyle, Michael H.

    2007-01-01

    This study applies multilevel logistic regression to Demographic and Health Survey data from 22 sub-Saharan African countries to examine whether the relationship between child mortality and family structure, with a specific emphasis on polygyny, varies cross-nationally and over time. Hypotheses were developed on the basis of competing theories on…

  13. Family Structure and Child Mortality in Sub-Saharan Africa: Cross-National Effects of Polygyny

    ERIC Educational Resources Information Center

    Omariba, D. Walter Rasugu; Boyle, Michael H.

    2007-01-01

    This study applies multilevel logistic regression to Demographic and Health Survey data from 22 sub-Saharan African countries to examine whether the relationship between child mortality and family structure, with a specific emphasis on polygyny, varies cross-nationally and over time. Hypotheses were developed on the basis of competing theories on…

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

    ERIC Educational Resources Information Center

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

    2005-01-01

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

  15. National Education Longitudinal Study: 1988-94. Data Files and Electronic Codebook System. Base Year through Third Follow-Up ECB/CD-ROM, 1996. [CD-ROM].

    ERIC Educational Resources Information Center

    National Center for Education Statistics (ED), Washington, DC.

    The National Education Longitudinal Study of 1988 (NELS:88) is the first nationally representative longitudinal study of eighth grade students in public and private schools. It is sponsored by the National Center for Education Statistics to provide longitudinal data about critical transitions experienced by young people as they develop, attend…

  16. Predictive Factors of Hospital Mortality Due to Myocardial Infarction: A Multilevel Analysis of Iran's National Data

    PubMed Central

    Ahmadi, Ali; Soori, Hamid; Mehrabi, Yadollah; Etemad, Koorosh; Sajjadi, Homeira; Sadeghi, Mehraban

    2015-01-01

    Background: Regarding failure to establish the statistical presuppositions for analysis of the data by conventional approaches, hierarchical structure of the data as well as the effect of higher-level variables, this study was conducted to determine the factors independently associated with hospital mortality due to myocardial infarction (MI) in Iran using a multilevel analysis. Methods: This study was a national, hospital-based, and cross-sectional study. In this study, the data of 20750 new MI patients between April, 2012 and March, 2013 in Iran were used. The hospital mortality due to MI was considered as the dependent variable. The demographic data, clinical and behavioral risk factors at the individual level and environmental data were gathered. Multilevel logistic regression models with Stata software were used to analyze the data. Results: Within 1-year of study, the frequency (%) of hospital mortality within 30 days of admission was derived 2511 (12.1%) patients. The adjusted odds ratio (OR) of mortality with (95% confidence interval [CI]) was derived 2.07 (95% CI: 1.5–2.8) for right bundle branch block, 1.5 (95% CI: 1.3–1.7) for ST-segment elevation MI, 1.3 (95% CI: 1.1–1.4) for female gender, and 1.2 (95% CI: 1.1–1.3) for humidity, all of which were considered as risk factors of mortality. But, OR of mortality was 0.7 for precipitation (95% CI: 0.7–0.8) and 0.5 for angioplasty (95% CI: 0.4–0.6) were considered as protective factors of mortality. Conclusions: Individual risk factors had independent effects on the hospital mortality due to MI. Variables in the province level had no significant effect on the outcome of MI. Increasing access and quality to treatment could reduce the mortality due to MI. PMID:26730342

  17. Community Remoteness, Perinatal Outcomes and Infant Mortality among First Nations in Quebec

    PubMed Central

    Wassimi, Spogmai; Mchugh, Nancy G. L.; Wilkins, Russell; Heaman, Maureen; Martens, Patricia; Smylie, Janet; Simonet, Fabienne; Fraser, William D; Luo, Zhong-Cheng

    2011-01-01

    Objective Little is known about community remoteness in relation to birth outcomes among Indigenous populations. We assessed whether community remoteness matters for perinatal outcomes and infant mortality in Quebec First Nations communities. Study Design A retrospective cohort study of all births (n=11,033) to residents of First Nations communities in Quebec 1991–2000, using linked vital statistics data. First Nations communities were grouped by community remoteness into four zones from the least to most remote. Results Preterm birth rates declined progressively from the least remote (8.0%) to the most remote (5.7%) zones (p=0.002). In contrast, total fetal and infant mortality rose progressively from the least remote (10.4 per 1000) to the most remote (22.7 per 1000) zones (p<0.001). The excess infant mortality in the more remote zones was mainly due to higher rates of postneonatal mortality. Similar patterns were observed after adjusting for maternal age, education, parity and marital status. Substantially elevated risks in most remote communities remained for perinatal death (adjusted OR=2.1), postneonatal death (adjusted OR=2.7), and total fetal and infant death (adjusted OR=2.3). Conclusion Living in more remote First Nations communities was associated with a substantially higher risk of fetal and infant death, especially postneonatal death, despite a lower risk of preterm delivery. There is a need for more effective perinatal and infant care programs in more remote First Nations communities to reduce perinatal and infant mortality. PMID:22282717

  18. Longitudinal trends in HbA1c and associations with comorbidity and all-cause mortality in Asian patients with type 2 diabetes: A cohort study.

    PubMed

    Luo, Miyang; Lim, Wei Yen; Tan, Chuen Seng; Ning, Yilin; Chia, Kee Seng; van Dam, Rob M; Tang, Wern Ee; Tan, Ngiap Chuan; Chen, Richard; Tai, E Shyong; Venkataraman, Kavita

    2017-08-24

    This study examined longitudinal trends in HbA1c in a multi-ethnic Asian cohort of diabetes patients, and the associations of these trends with future risk of acute myocardial infarction (AMI), stroke, end stage renal failure (ESRD) and all-cause mortality. 6079 participants with type 2 diabetes mellitus in Singapore were included. HbA1c measurements for the five years previous to recruitment were used to identify patterns of HbA1c trends. Outcomes were recorded through linkage with the National Disease Registry. The median follow-up for longitudinal trends in HbA1c was 4.1years and for outcomes was between 7.0 and 8.3years. HbA1c patterns were identified using latent class growth modeling, and associations with outcomes were analyzed using Cox proportional hazards models. Four distinct HbA1c patterns were observed; "low-stable" (72·2%), "moderate-stable" (22·0%), "moderate-increase" (2·9%), and "high-decrease" (2·8%). The risk of comorbidities and death was significantly higher in moderate-increase and high-decrease groups compared to the low-stable group; the hazard ratios for stroke, ESRD, and death for moderate increase group were 3.22 (95%CI 1.27-8.15), 4.76 (95%CI 1.92-11.83), and 1.88 (95%CI 1.15-3.07), respectively, and for high-decrease group were 2.16 (95%CI 1.02-4.57), 3.05 (95%CI 1.54-6.07), and 2.79 (95%CI 1.97-3.95), respectively. Individuals in the moderate-increase group were significantly younger, with longer diabetes duration, and greater proportions of Malays and Indians. Deteriorating HbA1c pattern and extremely high initial HbA1c are associated with increased risk of long-term comorbidities and death. Therapeutic interventions to alter longitudinal HbA1c trends may be helpful in reducing this risk. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

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

    SciTech Connect

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

    2006-10-12

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

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

    PubMed

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

    2014-01-01

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

  1. Metabolic syndrome and total cancer mortality in the Third National Health and Nutrition Examination Survey.

    PubMed

    Gathirua-Mwangi, Wambui G; Monahan, Patrick O; Murage, Mwangi J; Zhang, Jianjun

    2017-02-01

    Although metabolic syndrome incidence has substantially increased during the last few decades, it largely remains unclear whether this metabolic disorder is associated with total cancer mortality. The present study was carried out to investigate this important question. A total of 687 cancer deaths were identified from 14,916 participants in the third National Health and Nutrition Examination Survey by linking them to the National Death Index database through December 31, 2006. Cox proportional hazards regression was performed to calculate hazard ratios (HR) and 95% confidence intervals (CI) for total cancer mortality in relation to metabolic syndrome and its individual components. After adjustment for confounders, a diagnosis of metabolic syndrome was associated with 33% elevated total cancer mortality. Compared with individuals without metabolic syndrome, those with 3, 4 and 5 abnormal components had HRs (95% CIs) of 1.28 (1.03-1.59), 1.24 (0.96-1.60), and 1.87 (1.34-2.63), respectively (p-trend = 0.0003). Systolic blood pressure and serum glucose were associated with an increased risk of death from total cancer [HR (95% CI) for highest vs. lowest quartiles: 1.67 (1.19-2.33), p-trend = 0.002 and 1.34 (1.04-1.74), p-trend = 0.003, respectively]. Overall null results were obtained for lung cancer mortality. The effects of metabolic syndrome and its components on non-lung cancer mortality were generally similar to, but somewhat larger than, those for total cancer mortality. Our study is among the first to reveal that metabolic syndrome is associated with increased total cancer mortality.

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

    PubMed

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

    2014-02-01

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

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

    PubMed

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

    2016-01-01

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

  4. Discrepancies between national maternal mortality data and international estimates: the experience of Papua New Guinea.

    PubMed

    Mola, Glen; Kirby, Barry

    2013-11-01

    Over the past 30 years maternal mortality estimates for Papua New Guinea have varied widely. There is no mandatory vital registration in PNG, and 85% of the population live in rural areas with limited or no access to health services. Demographic Health Survey data for PNG estimates the maternal mortality ratio to be 370 deaths per 100,000 live births in 1996 and 733 in 2006, whereas estimates based upon mathematical models (as calculated by international bodies) gave figures of 930 for 1980 and 230 for 2010. This disparity has been a source of considerable confusion for health workers, policy makers and development partners. In this study, we compared 2009 facility-based survey data with figures from the national Health Information System records. The comparison revealed similar maternal mortality ratios: for provincial hospitals (245 and 295), government health centres (574 and 386), church agency health centres (624 and 624), and nationally (394 and 438). Synthesizing these estimates for supervised births in facilities and data on unsupervised births from a community-based survey in one province indicates a national MMR of about 500. Knowing the maternal mortality ratio is a necessary starting point for working out how to reduce it.

  5. Association of macrosomia with perinatal and postneonatal mortality among First Nations people in Quebec

    PubMed Central

    Wassimi, Spogmai; Wilkins, Russell; Mchugh, Nancy G.L.; Xiao, Lin; Simonet, Fabienne; Luo, Zhong-Cheng

    2011-01-01

    Background High prevalence of infant macrosomia (up to 36%, the highest in the world) has been reported in some First Nations communities in the Canadian province of Quebec and the eastern area of the province of Ontario. We aimed to assess whether infant macrosomia was associated with elevated risks of perinatal and postneonatal mortality among First Nations people in Quebec. Methods We calculated risk ratios (RRs) of perinatal and postneonatal mortality by birthweight for gestational age, comparing births to First Nations women (n = 5193) versus women whose mother tongue is French (n = 653 424, the majority reference group) in Quebec 1991–2000. Results The prevalence of infant macrosomia (birthweight for gestational age > 90th percentile) was 27.5% among births to First Nations women, which was 3.3 times (confidence interval [CI] 3.2–3.5) higher than the prevalence (8.3%) among births to women whose mother tongue is French. Risk ratios for perinatal mortality among births to First Nations women were 1.8 (95% CI 1.3–2.5) for births with weight appropriate for gestational age, 4.1 (95% CI 2.4–7.0) for small-for-gestational-age (< 10th percentile) births and < 1 (not significant) for macrosomic births compared to births among women whose mother tongue is French. The RRs for postneonatal mortality were 4.3 (95% CI 2.7–6.7) for infants with appropriate-for-gestational-age birthweight and 8.3 (95% CI 4.0–17.0) for infants with macrosomia. Interpretation Macrosomia was associated with a generally protective effect against perinatal death, but substantially greater risks of postneonatal death among births to First Nations women in Quebec versus women whose mother tongue is French. PMID:21242271

  6. Mortality in Adult Offspring of Immigrants: A Swedish National Cohort Study

    PubMed Central

    Manhica, Hélio; Toivanen, Susanna; Hjern, Anders; Rostila, Mikael

    2015-01-01

    Background Higher risks of psychiatric disorders and lower-than-average subjective health in adulthood have been demonstrated in offspring of immigrants in Sweden compared with offspring of native Swedes, and linked to relative socioeconomic disadvantage. The present study investigated mortality rates in relation to this inequity from a gender perspective. Methods We used data from national registers covering the entire Swedish population aged 18-65 years. Offspring of foreign-born parents who were either Swedish born or had received residency in Sweden before school age (<7 years) were defined as “offspring of immigrants.” We used Cox regression models to examine the association between parental country of birth and mortality between 1990 and 2008, with adjustment for education, income, age and family type. Results Male offspring of immigrants from the Middle East (HR:2.00, CI:1.66-2.26), other non-European countries (HR:1.80, CI:1.36-2.36) and Finland (HR:1.56, CI:1.48-1.65) showed an age-adjusted excess mortality risk from all causes of death when compared to offspring with Swedish-born parents. Income, but not education, greatly attenuated these increased mortality risks. No excess mortality rates were found among female offspring of immigrants, with the exception of external cause of death among offspring of Finnish immigrants. Conclusion The study demonstrates high mortality rates in male offspring of immigrants from Finland and non-European countries that are associated with economic, but not educational, disadvantage. No increased mortality rates were found among female offspring of immigrants. Future studies are needed to explain this gender differential and why income, but not education, predicts mortality in male offspring of immigrants. PMID:25706297

  7. The impact of cognitive functioning on mortality and the development of functional disability in older adults with diabetes: the second longitudinal study on aging.

    PubMed

    McGuire, Lisa C; Ford, Earl S; Ajani, Umed A

    2006-05-01

    For older adults without diabetes, cognitive functioning has been implicated as a predictor of death and functional disability for older adults and those with mild to severe cognitive impairment. However, little is known about the relationship between cognition functioning on mortality and the development of functional disability in late life for persons with diabetes. We examined the relative contribution of cognitive functioning to mortality and functional disability over a 2-year period in a sample of nationally representative older US adults with diabetes who were free from cognitive impairment through secondary data analyses of the Second Longitudinal Study of Aging (LSOA II). Participants included 559 US adults (232 males and 327 females) >or= 70 years old who had diabetes and who were free from cognitive impairment were examined using an adapted Telephone Interview of Cognitive Status (TICS), Activities of Daily Living (ADL), and Instrumental Activities of Daily Living (IADL). Multivariate logistic regression was conducted to investigate the independent contribution of cognitive functioning to three mutually exclusive outcomes of death and two measures of functional disability status. The covariates included in the model were participants' sex, age, race, marital status, educational level, duration of diabetes, cardiovascular disease (CVD) status, and self-rated health. Persons with diabetes who had the lowest levels of cognitive functioning relative to the highest level of cognitive functioning had a greater odds of dying (AOR = 0.80, 95% CI = 0.67-0.96) or becoming disabled (AOR = 0.87, 95% CI = 0.78-0.97) compared to those people who were disability free. Older adults with diabetes and low normal levels of cognition, yet within normal ranges, were approximately 20% more likely to die and 13% more likely to become disabled than those with higher levels of cognitive functioning over a 2-year period. Brief screening measures of cognitive functioning could be

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

    ERIC Educational Resources Information Center

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

    2010-01-01

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

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

    ERIC Educational Resources Information Center

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

    2010-01-01

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

  10. The USA National Longitudinal Lesbian Family Study (NLLFS): homophobia, psychological adjustment, and protective factors.

    PubMed

    Bos, Henny M W; Gartrell, Nanette K; Peyser, Heidi; van Balen, Frank

    2008-01-01

    The study assessed the influence of protective factors on the psychological adjustment of children who had experienced homophobia and whose mothers were participants in a longitudinal study of planned lesbian families. Data were collected as part of the National Longitudinal Lesbian Family Study by interviewing the children and having the mothers complete questionnaires. No significant differences were found in the psychological adjustment of children in the present study and their age-matched peers in a U.S.-population sample. Homophobia had a negative impact on the well-being of children who experienced it. Attending schools with LGBT curricula and their mothers' participation in the lesbian community were found to protect children against the negative influences of homophobia.

  11. The neuropsychological underpinnings to psychopathic personality traits in a nationally representative and longitudinal sample.

    PubMed

    Beaver, Kevin M; Vaughn, Michael G; DeLisi, Matt; Barnes, J C; Boutwell, Brian B

    2012-06-01

    Although psychopathy is a major area of research in psychology and criminology, much remains unknown about its etiological underpinnings. Drawing on data from the National Longitudinal Study of Adolescent Health, the current study explored the association between neuropsychological deficits and psychopathic personality traits and produced three key findings. First, four neuropsychological deficits measures were consistently related to the measure of psychopathic personality traits both longitudinally and cross-sectionally. Second, neuropsychological deficits measures predicted variation in psychopathic personality traits for both males and females and the magnitude of the association between neuropsychological deficits and psychopathic personality traits did not vary as a function of gender. Third, parental socialization measures had relatively small and inconsistent effects on psychopathic personality traits. Suggestions for future research are offered.

  12. Vitamin D, Race, and Cardiovascular Mortality: Findings From a National US Sample

    PubMed Central

    Fiscella, Kevin; Franks, Peter

    2010-01-01

    PURPOSE Findings are conflicting about the relationship between vitamin D levels and cardiovascular mortality. We wanted to determine the contribution of vitamin D levels to black-white disparities in cardiovascular mortality. METHODS We examined the association of serum 25(OH)D levels with cardiovascular mortality and its contribution to elevated risk among blacks through a retrospective cohort using baseline data from the third National Health and Nutrition Examination Survey 1988–1994 and cause-specific mortality through 2001 using the National Death Index. Using piecewise Poisson regression models, we examined the risk of cardiovascular death (coronary heart disease, heart failure, and stroke) by sample 25(OH)D quartile, adjusting for cardiovascular risk factors, and compared models of adjusted race-related cardiovascular mortality with and without further adjustment for 25(OH)D levels. RESULTS Participants with 25(OH)D levels in the lowest quartile (mean = 13.9 ng/mL) compared with those in the 3 higher quartiles (mean = 21.6, 28.4, and 41.6 ng/mL) had higher adjusted risk of cardiovascular death (incident rate ratio [IRR] = 1.40; 95% confidence interval [CI], 1.16–1.70). The higher age- and sex-adjusted cardiovascular mortality observed in blacks vs whites (IRR = 1.38; 95% CI, 1.13–1.70) was attenuated (IRR = 1.14; 95% CI, 0.91–1.44) by adjustment for 25(OH)D levels and fully eliminated with further adjustment for income (IRR=1.01; 95% CI, 0.82–1.24). CONCLUSIONS Low serum levels of 25(OH)D are associated with increased cardiovascular mortality in a nationally representative US sample. Black-white differences in 25(OH)D levels may contribute to excess cardiovascular mortality in blacks. Interventional trials among persons with low vitamin D levels are needed to determine whether oral supplementation improves cardiovascular outcomes. PMID:20065273

  13. Longitudinal Association of Registered Nurse National Nursing Specialty Certification and Patient Falls in Acute Care Hospitals.

    PubMed

    Boyle, Diane K; Cramer, Emily; Potter, Catima; Staggs, Vincent S

    2015-01-01

    Researchers have studied inpatient falls in relation to aspects of nurse staffing, focusing primarily on staffing levels and proportion of nursing care hours provided by registered nurses (RNs). Less attention has been paid to other nursing characteristics, such as RN national nursing specialty certification. The aim of the study was to examine the relationship over time between changes in RN national nursing specialty certification rates and changes in total patient fall rates at the patient care unit level. We used longitudinal data with standardized variable definitions across sites from the National Database of Nursing Quality Indicators. The sample consisted of 7,583 units in 903 hospitals. Relationships over time were examined using multilevel (units nested in hospitals) latent growth curve modeling. The model indices indicated a good fit of the data to the model. At the unit level, there was a small statistically significant inverse relationship (r = -.08, p = .04) between RN national nursing specialty certification rates and total fall rates; increases in specialty certification rates over time tended to be associated with improvements in total fall rates over time. Our findings may be supportive of promoting national nursing specialty certification as a means of improving patient safety. Future study recommendations are (a) modeling organizational leadership, culture, and climate as mediating variables between national specialty certification rates and patient outcomes and (b) investigating the association of patient safety and specific national nursing specialty certifications which test plans include patient safety, quality improvement, and diffusion of innovation methods in their certifying examinations.

  14. Morbidity and mortality of childhood- and adolescent-onset epilepsy: A controlled national study.

    PubMed

    Jennum, Poul; Pickering, Line; Christensen, Jakob; Ibsen, Rikke; Kjellberg, Jakob

    2017-01-01

    Epilepsy is associated with significant morbidities and mortality. We aimed to evaluate the 30-year morbidities and mortality in a national group of patients after a first diagnosis of epilepsy. From the Danish National Patient Registry (NPR), in total, 3123 patients with epilepsy aged 0-5years and 5018 patients aged 6-20years diagnosed in 1998-2002 were identified and compared with, respectively, 6246 and 10,036 persons matched for age, gender, and place of living with randomly chosen citizens from the Danish Civil Registration System Statistics. In the NPR, all morbidities in the following 30years were grouped into major WHO disease classes. Patients with epilepsy had significantly higher rates of comorbidities including almost all health-related comorbidities compared with controls. Mortality rates were elevated: the hazard ratio (5%; 95% CI) was 14.46 (11.8; 17.7, p<0.001) and 5.58 (4.9; 6.4, P<0.001) for patients aged 0-5years and 6-20years at first diagnosis of epilepsy, respectively. Epilepsy is associated with significant comorbidities and mortality including all health care domains, especially among persons who were young at the onset of epilepsy. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Effectiveness of antenatal care services in reducing neonatal mortality in Kenya: analysis of national survey data.

    PubMed

    Arunda, Malachi; Emmelin, Anders; Asamoah, Benedict Oppong

    2017-01-01

    Although global neonatal mortality declined by about 40 percent from 1990 to 2013, it still accounted for about 2.6 million deaths globally and constituted 42 percent of global under-five deaths. Most of these deaths occur in developing countries. Antenatal care (ANC) is a globally recommended strategy used to prevent neonatal deaths. In Kenya, over 90 percent of pregnant women attend at least one ANC visit during pregnancy. However, Kenya is currently among the 10 countries that contribute the most neonatal deaths globally. The aim of this study is to examine the effectiveness of ANC services in reducing neonatal mortality in Kenya. We used binary logistic regression to analyse cross-sectional data from the 2014 Kenya Demographic and Health Survey to investigate the effectiveness of ANC services in reducing neonatal mortality in Kenya. We determined the population attributable neonatal mortality fraction for the lack of selected antenatal interventions. The highest odds of neonatal mortality were among neonates whose mothers did not attend any ANC visit (adjusted odds ratio [aOR] 4.0, 95% confidence interval [CI] 1.7-9.1) and whose mothers lacked skilled ANC attendance during pregnancy (aOR 3.0, 95% CI 1.4-6.1). Lack of tetanus injection relative to one tetanus injection was significantly associated with neonatal mortality (aOR 2.5, 95% CI 1.0-6.0). About 38 percent of all neonatal deaths in Kenya were attributable to lack of check-ups for pregnancy complications. Lack of check-ups for pregnancy complications, unskilled ANC provision and lack of tetanus injection were associated with neonatal mortality in Kenya. Integrating community ANC outreach programmes in the national policy strategy and training geared towards early detection of complications can have positive implications for neonatal survival.

  16. Mixed conifer forest mortality and establishment before and after prescribed fire in Sequoia National Park, California

    USGS Publications Warehouse

    Mutch, L.S.; Parsons, D.J.

    1998-01-01

    Pre-and post-burn tree mortality rates, size structure, basal area, and ingrowth were determined for four 1.0 ha mixed conifer forest stands in the Log Creek and Tharp's Creek watersheds of Sequoia National Park. Mean annual mortality between 1986 and 1990 was 0.8% for both watersheds. In the fall of 1990, the Tharp's Creek watershed was treated with a prescribed burn. Between 1991 and 1995, mean annual mortality was 1.4% in the unburned Log Creek watershed and 17.2% in the burned Tharp's Creek watershed. A drought from 1987 to 1992 likely contributed to the mortality increase in the Log Creek watershed. The high mortality in the Tharp's Creek watershed was primarily related to crown scorch from the 1990 fire and was modeled with logistic regression for white fir (Abies concolor [Gord. and Glend.]) and sugar pine (Pinus lambertiana [Dougl.]). From 1989 to 1994, basal area declined an average of 5% per year in the burned Tharp's Creek watershed, compared to average annual increases of less than 1% per year in the unburned Log Creek watershed and in the Tharp's watershed prior to burning. Post-burn size structure was dramatically changed in the Tharp's Creek stands: 75% of trees ???50 cm and 25% of trees >50 cm were killed by the fire.

  17. Causes of mortality in sea ducks (Mergini) necropsied at the USGS-National Wildlife Health Center

    USGS Publications Warehouse

    Skerratt, L.F.; Franson, J.C.; Meteyer, C.U.; Hollmén, Tuula E.

    2005-01-01

    A number of factors were identified as causes of mortality in 254 (59%) of 431 sea ducks submitted for necropsy at the USGS-National Wildlife Health Center, Madison, Wisconsin from 1975 until 2003. Bacteria causing large outbreaks of mortality were Pasteurella multocida and Clostridium botulinum Type E. Starvation was responsible for large mortality events as well as sporadic deaths of individuals. Lead toxicity, gunshot and exposure to petroleum were important anthropogenic factors. Other factors that caused mortality were avian pox virus, bacteria (Clostridium botulinum Type C, Riemerella anatipestifer and Clostridium perfringens), fungi (Aspergillus fumigatus and an unidentified fungus), protozoans (unidentified coccidia), nematodes (Eustrongylides spp.), trematodes (Sphaeridiotrema globulus and Schistosoma spp.), acanthocephalans (Polymorphus spp.), predation, cyanide and trauma (probably due to collisions). There were also a number of novel infectious organisms in free-living sea ducks in North America, which were incidental to the death, including avipoxvirus and reovirus, bacteria Mycobacterium avium, protozoans Sarcocystis sp. and nematodes Streptocara sp. Apart from anthropogenic factors, the other important mortality factors listed here have not been studied as possible causes for the decline of sea ducks in North America.

  18. Dependency, democracy, and infant mortality: a quantitative, cross-national analysis of less developed countries.

    PubMed

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

    2004-07-01

    This study presents quantitative, sociological models designed to account for cross-national variation in infant mortality rates. We consider variables linked to four different theoretical perspectives: the economic modernization, social modernization, political modernization, and dependency perspectives. The study is based on a panel regression analysis of a sample of 59 developing countries. Our preliminary analysis based on additive models replicates prior studies to the extent that we find that indicators linked to economic and social modernization have beneficial effects on infant mortality. We also find support for hypotheses derived from the dependency perspective suggesting that multinational corporate penetration fosters higher levels of infant mortality. Subsequent analysis incorporating interaction effects suggest that the level of political democracy conditions the effects of dependency relationships based upon exports, investments from multinational corporations, and international lending institutions. Transnational economic linkages associated with exports, multinational corporations, and international lending institutions adversely affect infant mortality more strongly at lower levels of democracy than at higher levels of democracy: intranational, political factors interact with the international, economic forces to affect infant mortality. We conclude with some brief policy recommendations and suggestions for the direction of future research.

  19. Childhood cancer mortality and birth characteristics in Korea: a national population-based birth cohort study.

    PubMed

    Cha, Eun Shil; Kong, Kyoung Ae; Moon, Eun Kyeong; Khang, Young-Ho; Lee, Won Jin

    2011-03-01

    To examine the relationship between birth characteristics and childhood cancer mortality, a retrospective cohort study of Korean children was conducted using data collected by the national birth register between 1995 and 2006, which were then individually linked to death data. A cohort of 6,479,406 children was followed from birth until their death or until December 31, 2006. Poisson regression analyses were used to calculate rate ratios of childhood cancer deaths according to birth characteristics. A total of 1,469 cancer deaths were noted and the childhood cancer mortality rate was found to be 3.43 per 100,000 person-years in Korea during the period of 1995-2006. The birth characteristics examined in this study (i.e. , birth weight, gestational age, multiple births, parental ages, and number of siblings) were generally found to be not significantly associated with childhood cancer mortality, and the associations did not vary meaningfully with gender nor with cancer sites. However, among children aged 5-11 yr, higher birth weight was associated with elevated childhood cancer mortality (rate ratio = 1.28, 95% confidence interval 1.04-1.58). Our results offer no overall associations between childhood cancer mortality and birth characteristics, but suggest that the association may be specific to age group.

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

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

    2015-04-01

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

  2. Improving mortality trends for hospitalization of aortic dissection in the National Inpatient Sample.

    PubMed

    Zimmerman, Kate P; Oderich, Gustavo; Pochettino, Alberto; Hanson, Kristine T; Habermann, Elizabeth B; Bower, Thomas C; Gloviczki, Peter; DeMartino, Randall R

    2016-09-01

    Population-based assessment of aortic dissection (AD) hospitalizations in the general United States population is limited. We assessed the current trends in AD admissions and in-hospital mortality for surgical and medical AD treatment. Patients admitted for primary diagnosis of AD were identified from the National Inpatient Sample database (2003-2012). Patients were identified by International Classification of Diseases-Ninth Revision diagnosis codes and categorized by treatment type: type A open surgical repair (TASR), type B open surgical repair (TBSR), thoracic endovascular aortic repair (TEVAR), and medical management (MM). Our primary outcomes were to evaluate admission trends and in-hospital mortality of AD. Secondary outcomes included postoperative complications. We used weighted national estimates of admissions to assess trends over time using linear regression. We also identified factors associated with mortality via a hierarchical multivariable logistic regression model. We identified 15,641 patients (60.7% male; mean age, 63.5 years) admitted with a primary diagnosis of AD between 2003 and 2012. Intervention types included TASR in 3253 (20.8%), TBSR in 3007 (19.2%), TEVAR in 1417 (9.1%), and MM in 7964 (50.9%). Overall weighted admissions for AD increased significantly, from 6980 in 2003 to 8875 in 2012 (P < .01, test of trend), with increases in admission for TASR, from 1143 in 2003 to 2130 in 2012 (P < .01, test of trend), and TEVAR from 96 in 2005 to 1130 in 2012 (P < .01, test of trend). TBSR and MM admissions were stable, with TBSR admissions at 1519 in 2003 and 1540 in 2012 (P = .9, test of trend) and MM admissions at 4319 in 2003 and 4075 in 2012 (P = .8, test of trend). During the same interval, overall in-hospital mortality rates for AD decreased from 18.1% to 13.0% (P < .01, test of trend). When stratified by intervention type, mortality rates decreased for TASR, from 20.5% to 14.8% (P < .01, test of trend), for TBSR, from 18.0% to 14

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

    PubMed Central

    Huicho, Luis; Trelles, Miguel; Gonzales, Fernando

    2006-01-01

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

  4. Using the National Health Information Database of the National Health Insurance Service in Korea for Monitoring Mortality and Life Expectancy at National and Local Levels.

    PubMed

    Bahk, Jinwook; Kim, Yeon Yong; Kang, Hee Yeon; Lee, Jeehye; Kim, Ikhan; Lee, Juyeon; Yun, Sung Cheol; Park, Jong Heon; Shin, Soon Ae; Khang, Young Ho

    2017-11-01

    This study explores whether the National Health Information Database (NHID) can be used to monitor health status of entire population in Korea. We calculated the crude mortality rate and life expectancy (LE) at birth across the national, provincial, and municipal levels using the NHID eligibility database from 2004 to 2015, and compared the results with the corresponding values obtained from the Korean Statistical Information Service (KOSIS) of Statistics Korea. The study results showed that the ratio of crude mortality rate between the two data was 0.99. The absolute difference between the LE of the two data was not more than 0.5 years, and did not exceed 0.3 years in gender specific results. The concordance correlation coefficients (CCC) between the crude mortality rates from NHID and the rates from KOSIS ranged 0.997-0.999 among the municipalities. For LE, the CCC between the NHID and KOSIS across the municipalities were 0.990 in 2004-2009 and 0.985 in 2010-2015 among men, and 0.952 in 2004-2009 and 0.914 in 2010-2015 among women, respectively. Overall, the NHID was a good source for monitoring mortality and LE across national, provincial, and municipal levels with the population representativeness of entire Korean population. The results of this study indicate that NHID may well contribute to the national health promotion policy as a part of the health and health equity monitoring system. © 2017 The Korean Academy of Medical Sciences.

  5. Social integration and maternal smoking: A longitudinal analysis of a national birth cohort

    PubMed Central

    Mumford, Elizabeth A; Liu, Weiwei

    2016-01-01

    Objectives Social support and engagement are related to smoking behavior in general populations, but it is unknown whether these measures of social integration as experienced by recent mothers are related to longitudinal maternal smoking patterns. The purpose of this study is, first, to describe longitudinal patterns of maternal smoking before, during, and after pregnancy through the early childhood parenting years, as well as variation in these patterns; and second, to examine these patterns in relation to social integration, emotional, behavioral, and sociodemographic factors. Methods Among 9,050 mothers of the Early Childhood Longitudinal Study-Birth Cohort (a nationally representative probability sample of children born in 2001), we estimated trajectories of maternal smoking with general growth mixture model (GGMM), and examined how baseline predictors are associated with these patterns over a 5 to 6 year period beginning three months prior to pregnancy. Results A 5-class solution identified trajectories of nonsmokers (70.5%), temporary quitters (9.4%), pregnancy-inspired quitters (3.3%), delayed initiators (5.1%), and persistent smokers (11.7%). Modifiable risk factors included postpartum alcohol consumption and behavioral cues from co-resident smokers, while breastfeeding beyond six months and social engagement through religious service attendance were protective characteristics. Conclusions Prevention of and treatment for maternal perinatal and postpartum smoking is best informed by mothers’ emotional, behavioral and sociodemographic characteristics. Religious service attendance, but not measures of social support or social engagement, is a protective factor for maternal smoking trajectories. PMID:26987858

  6. Mortality associations with long-term exposure to outdoor air pollution in a national English cohort.

    PubMed

    Carey, Iain M; Atkinson, Richard W; Kent, Andrew J; van Staa, Tjeerd; Cook, Derek G; Anderson, H Ross

    2013-06-01

    Cohort evidence linking long-term exposure to outdoor particulate air pollution and mortality has come largely from the United States. There is relatively little evidence from nationally representative cohorts in other countries. To investigate the relationship between long-term exposure to a range of pollutants and causes of death in a national English cohort. A total of 835,607 patients aged 40-89 years registered with 205 general practices were followed from 2003-2007. Annual average concentrations in 2002 for particulate matter with a median aerodynamic diameter less than 10 (PM(10)) and less than 2.5 μm (PM(2.5)), nitrogen dioxide (NO(2)), ozone, and sulfur dioxide (SO(2)) at 1 km(2) resolution, estimated from emission-based models, were linked to residential postcode. Deaths (n = 83,103) were ascertained from linkage to death certificates, and hazard ratios (HRs) for all- and cause-specific mortality for pollutants were estimated for interquartile pollutant changes from Cox models adjusting for age, sex, smoking, body mass index, and area-level socioeconomic status markers. Residential concentrations of all pollutants except ozone were positively associated with all-cause mortality (HR, 1.02, 1.03, and 1.04 for PM(2.5), NO(2), and SO(2), respectively). Associations for PM(2.5), NO(2), and SO(2) were larger for respiratory deaths (HR, 1.09 each) and lung cancer (HR, 1.02, 1.06, and 1.05) but nearer unity for cardiovascular deaths (1.00, 1.00, and 1.04). These results strengthen the evidence linking long-term ambient air pollution exposure to increased all-cause mortality. However, the stronger associations with respiratory mortality are not consistent with most US studies in which associations with cardiovascular causes of death tend to predominate.

  7. Longitudinal study of parasite-induced mortality of a long-lived host: the importance of exposure to non-parasitic stressors.

    PubMed

    Chin, Hilary M-H; Luong, Lien T; Shostak, Allen W

    2017-07-11

    Hosts face mortality from parasitic and environmental stressors, but interactions of parasitism with other stressors are not well understood, particularly for long-lived hosts. We monitored survival of flour beetles (Tribolium confusum) in a longitudinal design incorporating cestode (Hymenolepis diminuta) infection, starvation and exposure to the pesticide diatomaceous earth (DE). We found that cestode cysticercoids exhibit increasing morphological damage and decreasing ability to excyst over time, but were never eliminated from the host. In the presence of even mild environmental stressors, host lifespan was reduced sufficiently that extensive degradation of cysticercoids was never realized. Median host lifespan was 200 days in the absence of stressors, and 3-197 days with parasitism, starvation and/or DE. Early survival of parasitized hosts was higher relative to controls in the presence of intermediate concentrations of DE, but reduced under all other conditions tested. Parasitism increased host mortality in the presence of other stressors at times when parasitism alone did not cause mortality, consistent with an interpretation of synergy. Environmental stressors modified the parasite numbers needed to reveal intensity-dependent host mortality, but only rarely masked intensity dependence. The longitudinal approach produced observations that would have been overlooked or misinterpreted if survival had only been monitored at a single time point.

  8. Sarcoidosis in the national veteran population: association of ocular inflammation and mortality.

    PubMed

    Birnbaum, Andrea D; French, Dustin D; Mirsaeidi, Mehdi; Wehrli, Sarah

    2015-05-01

    To describe the distribution of ocular sarcoidosis in the veteran population and to determine the association between ocular disease and all-cause mortality. Retrospective review. The Veterans Health Administration National Patient Care Database information on medical diagnoses, date of diagnosis, age, race, gender, and Veterans Administration medical center station number for site-specific calculations for fiscal years 2010 through 2012 was collected. Mortality data were obtained from the Beneficiary Identification Records Locator Subsystem. The patient cohort was identified with a primary diagnosis of sarcoidosis using International Classification of Disease, ninth edition, code of 135 in outpatient treatment files for the study period. The sarcoidosis patients were divided into those with uveitis or orbital inflammation (defined as ocular inflammation for this study) and those without uveitis or orbital inflammation. Survival analysis was performed using the Cox proportional hazard method. Association between ocular inflammation and 1-year mortality. Of 15 130 subjects with sarcoidosis, 3364 (22.2%) were evaluated in an eye clinic within a Veterans Administration Medical Center. Most patients were diagnosed with anterior uveitis (n = 1013; 80.7% of ocular inflammation), and the least common diagnosis was orbital granuloma (n = 28; 2.2% of ocular inflammation). Male gender was protective to the development of uveitis (estimate, 0.76; 95% confidence interval, 0.65-0.88; P = 0.0005). The overall 1-year all-cause mortality for all patients with a diagnosis of sarcoidosis was 2.0%. Ocular inflammation was associated with a decrease in 1-year all-cause mortality (simple model: hazard ratio, 0.36; P = 0.0015; complex model: hazard ratio, 0.35; P = 0.013). Veterans with ocular inflammation had significantly lower 1-year all-cause mortality than those without documented ocular inflammation. The reason for this finding remains to be established. Copyright © 2015 American

  9. Cancer incidence, mortality, and stage at diagnosis in First Nations living in Manitoba

    PubMed Central

    Decker, K.M.; Kliewer, E.V.; Demers, A.A.; Fradette, K.; Biswanger, N.; Musto, G.; Elias, B.; Turner, D.

    2016-01-01

    Background In the present study, we examined breast (bca) and colorectal cancer (crc) incidence and mortality and stage at diagnosis for First Nations (fn) individuals and all other Manitobans (aoms). Methods Several population-based databases were linked to determine ethnicity and to calculate age-standardized incidence and mortality rates. Logistic regression was used to compare bca and crc stage at diagnosis. Results From 1984–1988 to 2004–2008, the incidence of bca increased for fn and aom women. Breast cancer mortality increased for fn women and decreased for aom women. First Nations women were significantly more likely than aom women to be diagnosed at stages iii–iv than at stage i [odds ratio (or) for women ≤50 years of age: 3.11; 95% confidence limits (cl): 1.20, 8.06; or for women 50–69 years of age: 1.72; 95% cl: 1.03, 2.88). The incidence and mortality of crc increased for fn individuals, but decreased for aoms. First Nations status was not significantly associated with crc stage at diagnosis (or for stages i–ii compared with stages iii–iv: 0.98; 95% cl: 0.68, 1.41; or for stages i–iii compared with stage iv: 0.91; 95% cl: 0.59, 1.40). Conclusions Our results underscore the need for improved cancer screening participation and targeted initiatives that emphasis collaboration with fn communities to reduce barriers to screening and to promote healthy lifestyles. PMID:27536172

  10. Elder Mistreatment Predicts Later Physical and Psychological Health: Results from a National Longitudinal Study

    PubMed Central

    Wong, Jaclyn S.; Waite, Linda J.

    2017-01-01

    Stress process theory predicts that elder mistreatment leads to declines in health, and that social support buffers its ill effects. We test this theory using nationally representative, longitudinal data from 2,261 older adults in the National Social Life Health and Aging Project. We regress psychological and physical health in 2010/2011 on verbal and financial mistreatment experience in 2005/2006 and find that the mistreated have more anxiety symptoms, greater feelings of loneliness, and worse physical and functional health five years later, than those who did not report mistreatment. In particular, we show a novel association between financial mistreatment and functional health. Contrary to the stress buffering hypothesis, we find little evidence that social support moderates the relationship between mistreatment and health. Our findings point to the lasting impact of mistreatment on health, but show little evidence of a buffering role of social support in this process. PMID:27636657

  11. National Institute of Statistical Sciences Configuration and Data Integration for Longitudinal Studies Technical Panel. Final Report. NCES 2011-607

    ERIC Educational Resources Information Center

    Karr, Alan F.

    2011-01-01

    This is the final report of the National Institute of Statistical Sciences (NISS) Technical Panel on Configuration and Data Integration for Longitudinal Studies (hereafter, CDI). The principal recommendations regarding configuration are as follows: (1) The National Center for Education Statistics (NCES) should configure grades K-12 studies as a…

  12. From Eighth Grade Social Studies to Young Adulthood Voting and Community Service: National Education Longitudinal Study of 1988 Eighth Graders.

    ERIC Educational Resources Information Center

    Chapin, June R.

    Using data from the National Education Longitudinal Study 1988 (NELS:88), a nationally representative sample of eighth graders in 1988, who were studies again in 1994 as was analyzed for three voting patterns: registered to vote (68.1%), voted in 1992 presidential election (45.5%), and voted last year in local or state election (30.6%) and…

  13. Status Variations in Alcohol Use among Young Adults: Results from the 1984 National Longitudinal Surveys of Youth.

    ERIC Educational Resources Information Center

    Crowley, Joan E.

    This document gives descriptive results on alcohol use patterns among young adults from the 1984 National Longitudinal Survey of Labor Market of Youth, a survey of a large, nationally representative sample supplemented by samples of blacks, Hispanics, and economically disadvantaged non-black, non-Hispanic youth and covering the entire range of…

  14. School, Individual and Item Nonresponse in the National Education Longitudinal Study of 1988 (NELS:88) Base Year Survey.

    ERIC Educational Resources Information Center

    Ingels, Steven J.; And Others

    Nonresponse issues are investigated for the base year (1988) survey of the United States Department of Education's National Education Longitudinal Study of 1988 (NELS:88), a national probability sample of middle schools and eighth-grade students in the spring of 1988. The total eighth-grade enrollment for the NELS:88 sample of schools was 203,002;…

  15. Is There "White Flight" into Private Schools? Evidence from the National Educational Longitudinal Survey. JCPR Working Paper.

    ERIC Educational Resources Information Center

    Fairlie, Robert W.; Resch, Alexandra M.

    This report investigates the issue of white flight into private schools by examining data from the National Educational Longitudinal Survey (NELS) and a dataset from the National Center for Educational Statistics. The NELS provides information on student and parental characteristics such as geographical location, religious affiliation, school…

  16. Using Data from the National Longitudinal Study of the Class of 1972 for Research Outside the Education Field.

    ERIC Educational Resources Information Center

    Cooksey, Elizabeth C.; Rindfuss, Ronald R.

    1992-01-01

    The National Longitudinal Study of the Class of 1972 represents a rich data source on life events experienced by a national sample of U.S. students from the time they left school until just after their thirtieth birthdays. Using this public-use source for other than educational research is discussed. (SLD)

  17. Participant Retention in a Longitudinal National Telephone Survey of African American Men and Women.

    PubMed

    Holt, Cheryl L; Le, Daisy; Calvanelli, Joe; Huang, Jin; Clark, Eddie M; Roth, David L; Williams, Beverly; Schulz, Emily

    2015-01-01

    The purpose of this article is to describe participant demographic factors related to retention, and to report on retention strategies in a national study of African Americans re-contacted 2.5 years after an initial baseline telephone interview. The Religion and Health in African Americans (RHIAA) study was originally developed as a cross-sectional telephone survey to examine relationships between religious involvement and health-related factors in a national sample of African Americans. The cohort was re-contacted on average of 2.5 years later for a follow-up interview. RHIAA participants were 2,803 African American men (1,202) and women (1,601). RHIAA used retention strategies consistent with recommendations from Hunt and White. Participants also received a lay summary of project findings. Retention at the follow-up interview. Retention rates ranged from 39%- 41%. Retained participants tended to be older and female. In age- and sex-adjusted analyses, retained participants were more educated, single, and in better health status than those not retained. There was no difference in religious involvement in adjusted analyses. Although overall retention rates are lower than comparable longitudinal studies, RHIAA was not originally designed as a longitudinal study and so lacked a number of structures associated with long-term studies. However, this project illustrates the feasibility of conducting lengthy cold call telephone interviews with an African American population and helps to identify some participant factors related to retention and study strategies that may aid in retention.

  18. Designing a National Longitudinal Faculty Development Curriculum Focused on Educational Scholarship: Process, Outcomes, and Lessons Learned.

    PubMed

    Chandran, Latha; Gusic, Maryellen E; Lane, J Lindsey; Baldwin, Constance D

    2017-01-01

    Clinical educators at U.S. academic health centers are frequently disadvantaged in the academic promotion system, lacking needed faculty development, mentoring, and networking support. In 2006, we implemented the national Educational Scholars Program to offer faculty development in educational scholarship for early career educators in pediatrics. We aimed to provide them with skills, experience, and initial success in educational scholarship and dissemination. The 3-year curriculum is delivered in interactive sessions at the annual pediatric academic meetings and online intersession modules. Curriculum content progresses from educational scholarship and implementing scholarly projects to dissemination and professional networking. Intersession modules address project planning, building an educator portfolio, reviewing the literature, using technology, authorship, and peer review. Concurrently, all scholars must complete a mentored educational project and demonstrate national dissemination of a peer-reviewed product to obtain a Certificate of Excellence in Educational Scholarship. The setting of this study was a national, longitudinal, cohort-based faculty development program built within the Academic Pediatric Association, a 2,000-member professional organization. In 10 years, the Educational Scholars Program has enrolled 172 scholars in 8 cohorts; 94 have graduated so far. We describe how formative evaluation guided curriculum refinement and process improvement. Summative evaluations show that faculty and scholars were satisfied with the program. Participant outcomes from Cohort 1, assessed at Kirkpatrick's four levels of evaluation, demonstrate increases in scholarly productivity, leadership activities, and academic promotions. Curriculum building is a dynamic process of ongoing evaluation and modification. Our program benefited from designing an integrated and focused curriculum, developing educational principles to guide program improvements, creating

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

    PubMed

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

    2016-02-01

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

  20. Declining sex differences in mortality from lung cancer in high-income nations.

    PubMed

    Pampel, Fred C

    2003-02-01

    After decades of widening, the difference in mortality from lung cancer between men and women has begun to narrow in recent years. Recognizing that the increase in smoking among women relative to men is the proximate cause of the changing sex difference in rates of lung cancer, I analyzed two approaches to identify the more distant sources of the changes. A gender-equality argument suggests that the difference is related to the more general equalization of women's and men's work and family roles, which also encourages the adoption of harmful behaviors such as smoking by women. An alternative explanation suggests that the convergence in mortality from lung cancer among men and women is the byproduct of a lag in the adoption, diffusion, and abatement of smoking by women. Using mortality data on 21 nations from 1955 to 1996, an analysis of logged rates of men's and women's lung cancer mortality and the logged ratio of the rates demonstrated little relationship between the sex difference and gender equality. However, I found a strong and consistent relationship between the sex difference and the stage of diffusion of the use of cigarettes.

  1. Pattern of childbearing and mortality in married women--a national prospective study from Norway.

    PubMed Central

    Lund, E; Arnesen, E; Borgan, J K

    1990-01-01

    STUDY OBJECTIVE--The aim of the study was to investigate the effect of different pattern of childbearing on total mortality. DESIGN--A cohort study with all currently married women aged 25 years or more at the Norwegian census in 1970 with follow up to the end of 1985. Information on childbearing was obtained by questionnaires collected by enumerators. Follow up on death was found by a linkage based on the unique Norwegian identification number, between census information and the death register in the Central Bureau of Statistics. SETTING--The study was a national population survey. PARTICIPANTS--A total of 822,593 women with 11.5 million years of follow up and 112,023 deaths. MAIN RESULTS--Nulliparous women had higher mortality than parous women in all age groups. Parity showed a weak association with increasing mortality among high parous women. Lowest mortality was found for parous women with 2-4 children and a late first and last birth, adjusted for socioeconomic group by level of women's education. CONCLUSION--The findings indicate that postponed childbearing may benefit the health of women. PMID:2273363

  2. Oral cancer: the association between nation-based alcohol-drinking profiles and oral cancer mortality.

    PubMed

    Petti, Stefano; Scully, Crispian

    2005-09-01

    The unclear association between different nation-based alcohol-drinking profiles and oral cancer mortality was investigated using, as observational units, 20 countries from Europe, Northern America, Far Eastern Asia, with cross-nationally comparable data. Stepwise multiple regression analyses were run with male age-standardised, mortality rate (ASMR) as explanatory variable and annual adult alcohol consumption, adult smoking prevalence, life expectancy, as explanatory. Large between-country differences in ASMR (range, 0.88-6.87 per 100,000) were found, but the mean value was similar to the global estimate (3.31 vs. 3.09 per 100,000). Differences in alcohol consumption (2.06-21.03 annual litres per capita) and in distribution between beverages were reported. Wine was the most prevalent alcoholic beverage in 45% of cases. Significant increases in ASMR for every litre of pure ethanol (0.15 per 100,000; 95 CI, 0.01-0.29) and spirits (0.26 per 100,000; 95 CI, 0.03-0.49), non-significant effects for beer and wine were estimated. The impact of alcohol on oral cancer deaths would be higher than expected and the drinking profile could affect cancer mortality, probably because of the different drinking pattern of spirit drinkers, usually consuming huge alcohol quantities on single occasions, and the different concentrations of ethanol and cancer-preventing compounds such as polyphenols, in the various beverages.

  3. Missing dose from mortality studies of radiation effects among workers at Oak Ridge National Laboratory.

    PubMed

    Kerr, G D

    1994-02-01

    Missing dose is a problem that has not been adequately addressed in the mortality studies of radiation effects among workers at Oak Ridge National Laboratory. The missing dose is a result of recording a zero for below-detectable doses, especially for frequent (weekly) film badge readings. To make the thorough dosimetry assessment needed in the current Oak Ridge National Laboratory worker studies, it will probably be necessary to consider all data at hand including personnel dose records, daily pocket meter readings used to supplement weekly and quarterly readings from other dosimeters, and monitoring results from both building surveys and fixed stations. The fixed-station data should be extremely useful in developing a better understanding of the unusual temporal variation of the external radiation doses to Oak Ridge National Laboratory workers during the high exposure-rate periods of the 1950s and early 1960s.

  4. The 90-day mortality after pancreatectomy for cancer is double the 30-day mortality: more than 20,000 resections from the national cancer data base.

    PubMed

    Swanson, Richard S; Pezzi, Christopher M; Mallin, Katherine; Loomis, Ashley M; Winchester, David P

    2014-12-01

    Operative mortality traditionally has been defined as the rate within 30 days or during the initial hospitalization, and studies that established the volume-outcome relationship for pancreatectomy used similar definitions. Pancreatectomies reported to the National Cancer Data Base (NCDB) during 2007-2010 were examined for 30- and 90-day mortality. Unadjusted mortality rates were compared by type of resection, stage, comorbidities, and average annual hospital volume. Hierarchical logistic regression models generated risk-adjusted odds ratios for 30- and 90-day mortality. After 21,482 pancreatectomies, the unadjusted 30-day mortality rate was 3.7 % (95 % confidence interval [CI] 3.4-3.9 %), which doubled at 90 days to 7.4 % (95 % CI 7.0-7.8). The unadjusted and risk-adjusted mortality rates were higher at 30 days with increasing age, increasing stage, male gender, lower income, low hospital volume, resections other than distal pancreatectomy, Medicare or Medicaid insurance coverage, residence in a Southern census division, history of prior cancer, and multiple comorbidities. The lowest-volume hospitals (<5 per year) performed 19 % of the pancreatectomies, with a risk-adjusted odds ratios for mortality that were 4.2 times higher (95 % CI 3.1-5.8) at 30 days and remained 1.9 times higher (95 % CI 1.5-2.3) at 30-90 days compared with hospitals that had high volumes (≥40 per year). Mortality rates within 90 days after pancreatic resection are double those at 30 days. The volume-outcome relationship persists in the NCDB. Reporting mortality rates 90 days after pancreatectomy is important. Hospitals should be aware of their annual volume and mortality rates 30 and 90 days after pancreatectomy and should benchmark the use of high-volume hospitals.

  5. Longitudinal Association of Registered Nurse National Nursing Specialty Certification and Patient Falls in Acute Care Hospitals

    PubMed Central

    Boyle, Diane K.; Cramer, Emily; Potter, Catima; Staggs, Vincent S.

    2015-01-01

    Background Researchers have studied inpatient falls in relation to aspects of nurse staffing, focusing primarily on staffing levels and proportion of nursing care hours provided by registered nurses (RNs). Less attention has been paid to other nursing characteristics, such as RN national nursing specialty certification. Objective The aim of the study was to examine the relationship over time between changes in RN national nursing specialty certification rates and changes in total patient fall rates at the patient care unit level. Methods We used longitudinal data with standardized variable definitions across sites from the National Database of Nursing Quality Indicators. The sample consisted of 7,583 units in 903 hospitals. Relationships over time were examined using multilevel (units nested in hospitals) latent growth curve modeling. Results The model indices indicated a good fit of the data to the model. At the unit level, there was a small statistically significant inverse relationship (r = −.08, p = .04) between RN national nursing specialty certification rates and total fall rates; increases in specialty certification rates over time tended to be associated with improvements in total fall rates over time. Discussion Our findings may be supportive of promoting national nursing specialty certification as a means of improving patient safety. Future study recommendations are (a) modeling organizational leadership, culture, and climate as mediating variables between national specialty certification rates and patient outcomes and (b) investigating the association of patient safety and specific national nursing specialty certifications which test plans include patient safety, quality improvement, and diffusion of innovation methods in their certifying examinations. PMID:26049719

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed

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

    2016-01-01

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

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

    PubMed Central

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

    2015-01-01

    Abstract International collaboration is important in healthcare quality evaluation; however, few international comparisons of general surgery outcomes have been accomplished. Furthermore, predictive model application for risk stratification has not been internationally evaluated. The National Clinical Database (NCD) in Japan was developed in collaboration with the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP), with a goal of creating a standardized surgery database for quality improvement. The study aimed to compare the consistency and impact of risk factors of 3 major gastroenterological surgical procedures in Japan and the United States (US) using web-based prospective data entry systems: right hemicolectomy (RH), low anterior resection (LAR), and pancreaticoduodenectomy (PD). Data from NCD and ACS-NSQIP, collected over 2 years, were examined. Logistic regression models were used for predicting 30-day mortality for both countries. Models were exchanged and evaluated to determine whether the models built for one population were accurate for the other population. We obtained data for 113,980 patients; 50,501 (Japan: 34,638; US: 15,863), 42,770 (Japan: 35,445; US: 7325), and 20,709 (Japan: 15,527; US: 5182) underwent RH, LAR, and, PD, respectively. Thirty-day mortality rates for RH were 0.76% (Japan) and 1.88% (US); rates for LAR were 0.43% versus 1.08%; and rates for PD were 1.35% versus 2.57%. Patient background, comorbidities, and practice style were different between Japan and the US. In the models, the odds ratio for each variable was similar between NCD and ACS-NSQIP. Local risk models could predict mortality using local data, but could not accurately predict mortality using data from other countries. We demonstrated the feasibility and efficacy of the international collaborative research between Japan and the US, but found that local risk models remain essential for quality improvement. PMID:26656350

  9. Longitudinal Rates and Risk Factors for Adverse Birth Weight Among First Nations Pregnancies in Alberta.

    PubMed

    Oster, Richard Thomas; Toth, Ellen Louise

    2016-01-01

    We wished to identify the prevalence, longitudinal trends, and associated risk factors for various birth weight categories by First Nations ethnicity in the province of Alberta. We performed a retrospective analysis of administrative data for the years 2000 to 2009 inclusive. Age-adjusted prevalence trends for high birth weight (HBW; > 4000g), very HBW (> 4500g), low birth weight (LBW; < 2500g), and very LBW (< 1500g) were compared via average annual percent change analyses. Logistic regression analysis was used to determine risk factors. First Nations ethnicity was a significant independent predictor of HBW (OR 1.82 [95% CI 1.75, 1.89]), very HBW (OR 2.35 [95% CI 2.18, 2.52]), and very LBW (OR 1.35 [95% CI 1.23, 1.48]), but not of LBW (OR 0.98 [95% CI 0.93, 1.03]). However, HBW prevalence decreased and other birth weight categories remained stable over time in First Nations populations. Gestational diabetes and maternal weight ≥ 91 kg were potentially manageable risk factors for HBW. Potentially manageable risk factors for LBW included pre-gestational renal disease, hypertension, and maternal weight ≤ 45 kg, as well as smoking, illicit drug dependence, and alcohol consumption. Although HBW, very HBW, and very LBW remain more common in Alberta First Nations populations than in the general population, their prevalence is not increasing. Copyright © 2016 Society of Obstetricians and Gynaecologists of Canada. Published by Elsevier Inc. All rights reserved.

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

    PubMed

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

    2017-01-01

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

  11. National Education Longitudinal Study: 1988-2000 Data Files and Electronic Codebook System. Base Year through Fourth Follow-Up ECB/CD-ROM. [CD-ROM].

    ERIC Educational Resources Information Center

    National Center for Education Statistics (ED), Washington, DC.

    The National Education Longitudinal Study of 1988 (NELS:88) was the first nationally representative study of eighth graders in public and private schools. It was sponsored by the National Center for Education Statistics to provide longitudinal data about critical transitions experienced by young people as they develop, attend school, and embark on…

  12. Pre-dialysis serum sodium and mortality in a national incident hemodialysis cohort.

    PubMed

    Rhee, Connie M; Ravel, Vanessa A; Ayus, Juan Carlos; Sim, John J; Streja, Elani; Mehrotra, Rajnish; Amin, Alpesh N; Nguyen, Danh V; Brunelli, Steven M; Kovesdy, Csaba P; Kalantar-Zadeh, Kamyar

    2016-06-01

    A consistent association between low serum sodium measured at a single-point-in-time (baseline sodium) and higher mortality has been observed in hemodialysis patients. We hypothesized that both low and high time-varying sodium levels (sodium levels updated at quarterly intervals as a proxy of short-term exposure) are independently associated with higher death risk in hemodialysis patients. We examined the association of baseline and time-varying pre-dialysis serum sodium levels with all-cause mortality among adult incident hemodialysis patients receiving care from a large national dialysis organization during January 2007-December 2011. Hazard ratios were estimated using multivariable Cox models accounting for case-mix+laboratory covariates and incrementally adjusted for inter-dialytic weight gain, blood urea nitrogen and glucose. Among 27 180 patients, a total of 7562 deaths were observed during 46 194 patient-years of follow-up. Median (IQR) at-risk time was 1.4 (0.6, 2.5) years. In baseline analyses adjusted for case-mix+laboratory results, sodium levels <138 mEq/L were associated with incrementally higher mortality risk, while the association of sodium levels ≥140 mEq/L with lower mortality reached statistical significance only for the highest level of pre-dialysis sodium (reference: 138-<140 mEq/L). In time-varying analyses, we observed a U-shaped association between sodium and mortality such that sodium levels <138 and ≥144 mEq/L were associated with higher mortality risk. Similar patterns were observed in models incrementally adjusted for inter-dialytic weight gain, blood urea nitrogen and glucose. We observed a U-shaped association of time-varying pre-dialysis serum sodium and all-cause mortality in hemodialysis patients, suggesting that both hypo- and hypernatremia carry short-term risk in this population. © The Author 2015. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.

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

    PubMed

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

    2016-05-01

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

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

    PubMed

    Khang, Young-Ho; Kim, Hye-Ryun

    2016-03-22

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

  15. Do Health Behaviors Explain the Effect of Neuroticism on Mortality? Longitudinal Findings from the VA Normative Aging Study

    PubMed Central

    Mroczek, Daniel K.; Spiro, Avron; Turiano, Nick

    2009-01-01

    Studies have shown that higher levels of neuroticism are associated with greater risk of mortality. Yet what accounts for this association? One major theoretical position holds that persons higher in neuroticism engage in poorer health behaviors, such as smoking and excessive drinking, thus leading to earlier death. We tested this hypothesis using 30-year mortality in 1,788 men from the VA Normative Aging Study. Using proportional hazards (Cox) models we found that one health behavior, smoking, attenuated the effect of neuroticism on mortality by 40%. However, 60% remained unexplained, suggesting that the effects of other pathways (e.g., biological) also influence the relationship between neuroticism and mortality. PMID:20161240

  16. The relationship between marijuana use and intimate partner violence in a nationally representative, longitudinal sample.

    PubMed

    Reingle, Jennifer M; Staras, Stephanie A S; Jennings, Wesley G; Branchini, Jennifer; Maldonado-Molina, Mildred M

    2012-05-01

    Intimate partner violence is a significant public health problem, as these behaviors have been associated with a number of negative health outcomes including illicit drug use, physical injury, chronic pain, sexually transmitted diseases, depression, and posttraumatic stress disorder. The current study examined the association between marijuana use and intimate partner violence using a longitudinal survey of adolescents and young adults ages 15 to 26 years. Data were obtained from 9,421 adolescents in the National Longitudinal Study of Adolescent Health (Add Health) Waves 1 through 4 (1995-2008). Marijuana use was measured in the past year at each wave and participants were categorized as "users" or "nonusers." Partner violence was constructed using six items (three pertaining to victimization and three concerning perpetration) from Wave 4 (2007-2008). Using these six items, participants were categorized as "victims only," "perpetrators only," or "victims and perpetrators." Survey multinomial regression was used to examine the relationship between marijuana use and intimate partner violence. Consistent use of marijuana during adolescence was most predictive of intimate partner violence (OR = 2.08, p < .001). Consistent marijuana use (OR = 1.85, p < .05) was related to an increased risk of intimate partner violence perpetration. Adolescent marijuana use, particularly consistent use throughout adolescence, is associated with perpetration or both perpetration of and victimization by intimate partner violence in early adulthood. These findings have implications for intimate partner violence prevention efforts, as marijuana use should be considered as a target of early intimate partner violence intervention and treatment programming.

  17. Reflecting on the Delivery of a Longitudinal Coping Intervention Amongst Junior National Netball Players

    PubMed Central

    Devonport, Tracey J.; Lane, Andrew M.

    2009-01-01

    Recent research suggests that appropriately-tailored interventions can assist adolescents enhance their coping skills (Frydenberg and Lewis, 2004). The present paper reflects upon the delivery of a longitudinal coping intervention utilized by junior national netball players. Reflection is focused on issues such as the rationale for the intervention, operational issues surrounding the delivery and management of the work. It is also focused on interpersonal issues relating to intervention implementation. We contend that being explicit about developmental and applied processes may enable theoretically sound and efficacious practices to be identified. In addition, unpacking operational issues related to delivery may assist applied sport and exercise psychologists in the development of related work. Key points This paper exemplifies the potential benefits of reflective practice and offers an insight into the lessons learned during longitudinal applied research. We conclude that intervention-based research must accommodate the idiosyncrasies of an organization and requires the sport organisation to buy into the value of the work. Whilst thoughts and associations are offered, readers are encouraged to consider these and alternative associations. PMID:24149523

  18. Predictors of Dental Care Use: Findings from the National Longitudinal Study of Adolescent Health

    PubMed Central

    Okunseri, Christopher; Okunseri, Elaye; Garcia, Raul I.; Visotcky, Alexis (Dye); Szabo, Aniko

    2013-01-01

    Objective To examine longitudinal trends and associated factors in dental service utilization by adolescents progressing to early adulthood in the United States. Data Source The National Longitudinal Study of Adolescent Health from Waves I (1994-95), II (1996), III (2001-2002) and IV (2007-2008). Study Design This is a retrospective, observational study of adolescents' transition to early adulthood. We obtained descriptive statistics and performed logistic regression analyses to identify the effects of baseline and concurrent covariates on dental service utilization from adolescence to early adulthood over time. Principal Findings Dental service utilization within the prior 12 months peaked at age 16 (72%), gradually decreased until age 21 (57%), and thereafter remained flat. Whites and Asians had a 10-20 percentage points higher proportion of dental service utilization at most ages compared to Blacks and Hispanics. Dental service utilization at later follow-up visits was strongly associated with baseline utilization with OR= 10.7, 2.4 and 1.5 at the 1-year, 7-year and 13-year follow-ups respectively. These effects decreased when adjusted for current income, insurance and education. Compared to Whites, Blacks were consistently less likely to report any dental examination. Conclusion Dental service utilization was highest in adolescents. Gender, education, health insurance and income in young adulthood were significant predictors of reporting a dental examination. Blacks had lower odds of reporting a dental examination either as adolescents or as young adults. PMID:23850156

  19. Who Participates? Longitudinal Retention in the MIDUS National Study of Health and Well-Being

    PubMed Central

    Radler, Barry T.; Ryff, Carol D.

    2010-01-01

    Objectives This article uses data from MIDUS (Midlife in the United States), a national study of Americans (N = 7,108), to investigate factors that predict longitudinal retention. With its extensive age range (25–75 at Time 1) and long-term design (9- to 10-year survey interval), MIDUS is useful for investigating common sociodemographic and health predictors of continuing participation. Method The authors conducted logistic regression analyses of baseline sociodemographic and health variables predicting retention. Select interaction terms examined the interplay between targeted variables. Results Consistent with prior research, higher retention rates were found among Whites, females, and married individuals as well as those with better health and more education. Interaction analyses further clarified that (a) health status better predicted retention among older compared to younger respondents and among women compared to men, (b) marital status better predicted retention among Whites compared to non-Whites and among women compared to men, and (c) economic status better predicted retention among those with poorer functional health status. Discussion The authors’ analyses clarify that longitudinal retention varied depending on respondents’ sociodemographic characteristics and their health status. The unique contribution of this article is that factors predicting nonparticipation can be offset by, or compensated for, other factors. PMID:20103686

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

    PubMed

    Raj, Anita; Boehmer, Ulrike

    2013-04-01

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

  1. Job factors, radiation and cancer mortality at Oak Ridge National Laboratory: Follow-up through 1984

    SciTech Connect

    Wing, S.; Shy, C.M.; Wood, J.L.; Wolf, S.; Cragle, D.L.; Tankersley, W.; Frome, E.L. )

    1993-01-01

    A previous study of mortality among white men hired at Oak Ridge National Laboratory between 1943 and 1972 (n = 8,318) revealed an association between low-dose external penetrating ionizing radiation and cancer mortality in follow-up through 1984. The association was not observed in follow-up through 1977. This report considers the role of possible selection and confounding factors not previously studied. Control for hire during the World War II era and employment duration of less than 1 year had little effect on the radiation risk estimates. Risks associated with length of time spent in 15 job categories were considered as proxies for the effects of other occupational carcinogens. Adjustment for employment duration in each job category one at a time produced only small changes in the radiation risk estimate. Adjustment for potential exposures to beryllium, lead, and mercury also had little effect on the radiation risk estimates. These analyses suggest that selection factors and potential for chemical exposure do not account for the previously noted association of external radiation dose with cancer mortality. However, power to detect effects of chemical exposures is limited by a lack of individual exposure measures.

  2. Job factors, radiation and cancer mortality at Oak Ridge National Laboratory: follow-up through 1984.

    PubMed

    Wing, S; Shy, C M; Wood, J L; Wolf, S; Cragle, D L; Tankersley, W; Frome, E L

    1993-02-01

    A previous study of mortality among white men hired at Oak Ridge National Laboratory between 1943 and 1972 (n = 8,318) revealed an association between low-dose external penetrating ionizing radiation and cancer mortality in follow-up through 1984. The association was not observed in follow-up through 1977. This report considers the role of possible selection and confounding factors not previously studied. Control for hire during the World War II era and employment duration of less than 1 year had little effect on the radiation risk estimates. Risks associated with length of time spent in 15 job categories were considered as proxies for the effects of other occupational carcinogens. Adjustment for employment duration in each job category one at a time produced only small changes in the radiation risk estimate. Adjustment for potential exposures to beryllium, lead, and mercury also had little effect on the radiation risk estimates. These analyses suggest that selection factors and potential for chemical exposure do not account for the previously noted association of external radiation dose with cancer mortality. However, power to detect effects of chemical exposures is limited by a lack of individual exposure measures.

  3. Educational Mismatch and Mortality among Native-Born Workers in Sweden. a 19-Year Longitudinal Study of 2.5 Million Over-Educated, Matched and Under-Educated Individuals, 1990-2008

    ERIC Educational Resources Information Center

    Garcy, Anthony M

    2015-01-01

    This study tests the hypothesis that a disjuncture between an individual's attained level of education and that held by average workers in the individual's occupation leads to higher mortality among those with a prolonged mismatched status. Swedish register data are used in a 19-year longitudinal mortality follow-up study of all causes and…

  4. Personality development across the life span: longitudinal analyses with a national sample from Germany.

    PubMed

    Lucas, Richard E; Donnellan, M Brent

    2011-10-01

    Longitudinal data from a national sample of Germans (N = 20,434) were used to evaluate stability and change in the Big Five personality traits. Participants completed a brief measure of personality twice, 4 years apart. Structural equation modeling techniques were used to establish measurement invariance over time and across age groups. Substantive questions about differential (or rank-order) and mean-level stability and change were then evaluated. Results showed that differential stability was relatively strong among all age groups but that it increased among young adults, peaked in later life, and then declined among the oldest old. Patterns of mean-level change showed that Extraversion and Openness declined over the life span, whereas Agreeableness increased. Mean levels of Conscientiousness increased among young adults and then decreased among older adults. Trajectories for Neuroticism were relatively flat, with slight increases during middle age and a slight decline in late life. 2011 APA, all rights reserved

  5. Promoting school connectedness: evidence from the National Longitudinal Study of Adolescent Health.

    PubMed

    McNeely, Clea A; Nonnemaker, James M; Blum, Robert W

    2002-04-01

    Increasing evidence shows that when adolescents feel cared for by people at their school and feel like a part of their school, they are less likely to use substances, engage in violence, or initiate sexual activity at an early age. However, specific strategies to increase students' connectedness to school have not been studied. This study examined the association between school connectedness and the school environment to identify ways to increase students' connectedness to school. Data from the in-school and school administrator surveys of the National Longitudinal Study of Adolescent Health (75,515 students in 127 schools) and hierarchical linear models were used to estimate the association between school characteristics and the average level of school connectedness in each school. Positive classroom management climates, participation in extracurricular activities, tolerant disciplinary policies, and small school size were associated positively with higher school connectedness.

  6. Racial Differences in Effects of Religiosity and Mastery on Psychological Distress: Evidence from National Longitudinal Data.

    PubMed

    Oates, Gary L; Goode, Jennifer

    2013-03-01

    This research engages nationally representative longitudinal data and a multipopulation LISREL model to investigate variation among black and white Americans in the impact of religiosity and mastery on psychological distress. Guided by the stress and coping perspective and prominent theorizing about how religiosity influences mental health, the model assesses not only direct effects of religiosity and mastery on distress but also the possibility of religiosity and mastery inhibiting distress indirectly (via effects on other coping resources or stressors) and attenuating the distress-inducing properties of individual stressors. Findings solidly support the endorsed proposition of religiosity's being particularly beneficial to blacks' emotional well-being and moderately support the prediction of mastery's being primarily helpful to whites'. Public religiosity substantially eclipses private and subjective religiosity as a facilitator of blacks' emotional well-being, and although main effects dominate, there are significant mediation and moderation effects of religiosity or mastery within each race.

  7. Longitudinal pathways of victimization, substance use, and delinquency: Findings from the National Survey of Adolescents☆

    PubMed Central

    Begle, Angela M.; Hanson, Rochelle F.; Danielson, Carla Kmett; McCart, Michael R.; Ruggiero, Kenneth J.; Amstadter, Ananda B.; Resnick, Heidi S.; Saunders, Benjamin E.; Kilpatrick, Dean G.

    2011-01-01

    Using a nationally representative sample of 3614 adolescents, age 12 to 17 years, this study examines longitudinal associations among interpersonal victimization (i.e., sexual abuse, physical abuse and/or assault, and witnessed community and domestic violence) and high risk behavior (i.e., alcohol use, drug use, and delinquent behavior). A bidirectional relationship was hypothesized between high risk behavior and victimization for the full sample. Descriptive results indicated that a high correlation between types of high risk behavior, with over 50% of adolescents having engaged in at least one type of high risk behavior by Wave 2 in the study. Results suggested strong links between victimization and high risk behaviors, whereas sequential order of the constructs across time was dependent on gender and type of victimization. Specifically, hypotheses concerning victimization and high risk behavior were fully supported with boys, but different patterns emerged in the data for girls. PMID:21377805

  8. Racial Differences in Effects of Religiosity and Mastery on Psychological Distress: Evidence from National Longitudinal Data

    PubMed Central

    Oates, Gary L.; Goode, Jennifer

    2012-01-01

    This research engages nationally representative longitudinal data and a multipopulation LISREL model to investigate variation among black and white Americans in the impact of religiosity and mastery on psychological distress. Guided by the stress and coping perspective and prominent theorizing about how religiosity influences mental health, the model assesses not only direct effects of religiosity and mastery on distress but also the possibility of religiosity and mastery inhibiting distress indirectly (via effects on other coping resources or stressors) and attenuating the distress-inducing properties of individual stressors. Findings solidly support the endorsed proposition of religiosity’s being particularly beneficial to blacks’ emotional well-being and moderately support the prediction of mastery’s being primarily helpful to whites’. Public religiosity substantially eclipses private and subjective religiosity as a facilitator of blacks’ emotional well-being, and although main effects dominate, there are significant mediation and moderation effects of religiosity or mastery within each race. PMID:23762783

  9. Excess mortality due to Depression and Anxiety in the United States: Results from a Nationally Representative Survey

    PubMed Central

    Druss, Benjamin G; Manderscheid, Ronald W.; Walker, Elizabeth R.

    2016-01-01

    Objectives We compared the mortality of persons with and without anxiety and depression in a nationally representative survey and examined the role of socioeconomic factors, chronic diseases, and health behaviors in explaining excess mortality. Methods The 1999 National Health Interview Survey was linked with mortality data through 2011. We calculated the hazard ratio (HR) for mortality by presence or absence of anxiety/depression and evaluated potential mediators. We calculated the population attributable risk of mortality for anxiety/depression. Results Persons with anxiety/depression died 7.9 years earlier than other persons. At a population level, 3.5% of deaths were attributable to anxiety/depression. Adjusting for demographic factors, anxiety/depression was associated with an elevated risk of mortality (HR=1.61, 95% confidence interval [CI]=1.40, 1.84). Chronic diseases and health behaviors explained much of the elevated risk. Adjusting for demographic factors, people with past-year contact with a mental health professional did not demonstrate excess mortality associated with anxiety/depression while those without contact did. Conclusions Anxiety/depression presents a mortality burden at both an individual and population level. Our findings are consistent with targeting health behaviors and physical illnesses as strategies for reducing this excess mortality among people with anxiety/depression. PMID:26791259

  10. Participant Retention in a Longitudinal National Telephone Survey of African American Men and Women

    PubMed Central

    Holt, Cheryl L.; Le, Daisy; Calvanelli, Joe; Huang, Jin; Clark, Eddie M.; Roth, David L.; Williams, Beverly; Schulz, Emily

    2015-01-01

    Objective The purpose of this article is to describe participant demographic factors related to retention, and to report on retention strategies in a national study of African Americans re-contacted 2.5 years after an initial baseline telephone interview. Design & Setting The Religion and Health in African Americans (RHIAA) study was originally developed as a cross-sectional telephone survey to examine relationships between religious involvement and health-related factors in a national sample of African Americans. The cohort was re-contacted on average of 2.5 years later for a follow-up interview. Participants RHIAA participants were 2,803 African American men (1,202) and women (1,601). Interventions RHIAA used retention strategies consistent with recommendations from Hunt and White.1 Participants also received a lay summary of project findings. Main outcome measures Retention at the follow-up interview. Results Retention rates ranged from 39%–41%. Retained participants tended to be older and female. In age- and sex-adjusted analyses, retained participants were more educated, single, and in better health status than those not retained. There was no difference in religious involvement in adjusted analyses. Conclusions Although overall retention rates are lower than comparable longitudinal studies, RHIAA was not originally designed as a longitudinal study and so lacked a number of structures associated with long-term studies. However, this project illustrates the feasibility of conducting lengthy cold call telephone interviews with an African American population and helps to identify some participant factors related to retention and study strategies that may aid in retention. PMID:26118147

  11. Dengue in Malaysia: Factors Associated with Dengue Mortality from a National Registry.

    PubMed

    Liew, Su May; Khoo, Ee Ming; Ho, Bee Kiau; Lee, Yew Kong; Omar, Mimi; Ayadurai, Vickneswari; Mohamed Yusoff, Fazlina; Suli, Zailiza; Mudin, Rose Nani; Goh, Pik Pin; Chinna, Karuthan

    2016-01-01

    The increasing incidence and geographical distribution of dengue has had significant impact on global healthcare services and resources. This study aimed to determine the factors associated with dengue-related mortality in a cohort of Malaysian patients. This was a retrospective cohort study of patients in the Malaysian National Dengue Registry of 2013. The outcome measure was dengue-related mortality. Associations between sociodemographic and clinical variables with the outcome were analysed using multivariate analysis. There were 43 347 cases of which 13081 were serologically confirmed. The mean age was 30.0 years (SD 15.7); 60.2% were male. The incidence of dengue increased towards the later part of the calendar year. There were 92 probable dengue mortalities, of which 41 were serologically confirmed. Multivariate analysis in those with positive serology showed that increasing age (OR 1.03; CI:1.01-1.05), persistent vomiting (OR 13.34; CI: 1.92-92.95), bleeding (OR 5.84; CI 2.17-15.70) and severe plasma leakage (OR 66.68; CI: 9.13-487.23) were associated with mortality. Factors associated with probable dengue mortality were increasing age (OR 1.04; CI:1.03-1.06), female gender (OR 1.53; CI:1.01-2.33), nausea and/or vomiting (OR 1.80; CI:1.17-2.77), bleeding (OR 3.01; CI:1.29-7.04), lethargy and/or restlessness (OR 5.97; CI:2.26-15.78), severe plasma leakage (OR 14.72; CI:1.54-140.70), and shock (OR 1805.37; CI:125.44-25982.98), in the overall study population. Older persons and those with persistent vomiting, bleeding or severe plasma leakage, which were associated with mortality, at notification should be monitored closely and referred early if indicated. Doctors and primary care practitioners need to detect patients with dengue early before they develop these severe signs and symptoms.

  12. Factors associated with mortality after an asthma admission: a national United Kingdom database analysis.

    PubMed

    Watson, Louise; Turk, Florian; James, Philip; Holgate, Stephen T

    2007-08-01

    Lack of a United Kingdom (UK) fatal asthma registry has resulted in few recent analyses regarding patient characteristics, co-morbidities, and admission type in relation to mortality post an asthma admission. This study aims to report these factors in addition to season of event for the years 2000-2005 to provide data regarding asthma burden in the in-patient hospital setting. Data were analysed from the CHKS database collated from UK National Health Service data providing 70% of in-patient coverage in the UK. Patients with admissions under ICD-10 codes J45 "Asthma" and J46 "acute severe asthma" were included. Codes for associated co-morbidity at time of admission were identified, as well as month of admission and death, age, gender and length of stay. The mortality rate over the 5-year period was 1063 patients from 250,043 asthma admissions (0.43%). Critical care mortality was far higher and an annual rate indicated that for every 100,000 admissions 2878 (95% CI 2091;3857) patients died. Respiratory infection, cardiovascular disease and diabetes were common co-morbidities for all admissions. December and January had the peak number of deaths post asthma admission which were nearly all in adults, death being rarer in children. Women and those over 45 years had the highest rate of death which may reflect asthma prevalence. Co-morbid conditions experienced by older asthma patients may contribute to mortality post an asthma admission and greater understanding of risk factors contributing to fatality are required.

  13. Suicide Mortality Among Retired National Football League Players Who Played 5 or More Seasons.

    PubMed

    Lehman, Everett J; Hein, Misty J; Gersic, Christine M

    2016-10-01

    There is current disagreement in the scientific literature about the relationship between playing football and suicide risk, particularly among professional players in the National Football League (NFL). While some research indicates players are at high risk of football-related concussions, which may lead to chronic traumatic encephalopathy and suicide, other research finds such a connection to be speculative and unsupported by methodologically sound research. To compare the suicide mortality of a cohort of NFL players to what would be expected in the general population of the United States. Cohort study; Level of evidence, 3. A cohort of 3439 NFL players with at least 5 credited playing seasons between 1959 and 1988 was assembled for statistical analysis. The vital status for this cohort was updated through 2013. Standardized mortality ratios (SMRs), the ratio of observed deaths to expected deaths, and 95% CIs were computed for the cohort; 95% CIs that excluded unity were considered statistically significant. For internal comparison purposes, standardized rate ratios were calculated to compare mortality results between players stratified into speed and nonspeed position types. Suicide among this cohort of professional football players was significantly less than would be expected in comparison with the United States population (SMR = 0.47; 95% CI, 0.24-0.82). There were no significant differences in suicide mortality between speed and nonspeed position players. There is no indication of elevated suicide risk in this cohort of professional football players with 5 or more credited seasons of play. Because of the unique nature of this cohort, these study results may not be applicable to professional football players who played fewer than 5 years or to college or high school players. © 2016 The Author(s).

  14. Suicide Mortality Among Retired National Football League Players Who Played 5 or More Seasons

    PubMed Central

    Lehman, Everett J.; Hein, Misty J.; Gersic, Christine M.

    2016-01-01

    Background There is current disagreement in the scientific literature about the relationship between playing football and suicide risk, particularly among professional players in the National Football League (NFL). While some research indicates players are at high risk of football-related concussions, which may lead to chronic traumatic encephalopathy and suicide, other research finds such a connection to be speculative and unsupported by methodologically sound research. Purpose To compare the suicide mortality of a cohort of NFL players to what would be expected in the general population of the United States. Study Design Cohort study; Level of evidence, 3. Methods A cohort of 3439 NFL players with at least 5 credited playing seasons between 1959 and 1988 was assembled for statistical analysis. The vital status for this cohort was updated through 2013. Standardized mortality ratios (SMRs), the ratio of observed deaths to expected deaths, and 95% CIs were computed for the cohort; 95% CIs that excluded unity were considered statistically significant. For internal comparison purposes, standardized rate ratios were calculated to compare mortality results between players stratified into speed and nonspeed position types. Results Suicide among this cohort of professional football players was significantly less than would be expected in comparison with the United States population (SMR = 0.47; 95% CI, 0.24–0.82). There were no significant differences in suicide mortality between speed and nonspeed position players. Conclusion There is no indication of elevated suicide risk in this cohort of professional football players with 5 or more credited seasons of play. Because of the unique nature of this cohort, these study results may not be applicable to professional football players who played fewer than 5 years or to college or high school players. PMID:27159317

  15. Causes of mortality in eagles submitted to the National Wildlife Health Center 1975-2013

    USGS Publications Warehouse

    Russell, Robin E.; Franson, J. Christian

    2014-01-01

    We summarized the cause of death for 2,980 bald eagles (Haliaeetus leucocephalus) and 1,427 golden eagles (Aquila chrysaetos) submitted to the National Wildlife Health Center in Madison, Wisconsin, USA, for diagnosis between 1975 and the beginning of 2013. We compared the proportion of eagles with a primary diagnosis as electrocuted, emaciated, traumatized, shot or trapped, diseased, poisoned, other, and undetermined among the 4 migratory bird flyways of the United States (Atlantic, Mississippi, Central, and Pacific). Additionally, we compared the proportion of lead-poisoned bald eagles submitted before and after the autumn 1991 ban on lead shot for waterfowl hunting. Trauma and poisonings (including lead poisoning) were the leading causes of death for bald eagles throughout the study period, and a greater proportion of bald eagles versus golden eagles were diagnosed as poisoned. For golden eagles, the major causes of mortality were trauma and electrocution. The proportion of lead poisoning diagnoses for bald eagles submitted to the National Wildlife Health Center displayed a statistically significant increase in all flyways after the autumn 1991 ban on the use of lead shot for waterfowl hunting. Thus, lead poisoning was a significant cause of mortality in our necropsied eagles, suggesting a continued need to evaluate the trade-offs of lead ammunition for use on game other than waterfowl versus the impacts of lead on wildlife populations. Published 2014. This article is a U.S. Government work and is in the public domain in the USA.

  16. HIV morbidity and mortality in Jamaica: analysis of national surveillance data, 1993–2005

    PubMed Central

    Losina, Elena; Figueroa, Peter; Duncan, Jacqueline; Divi, Nomita; Wolf, Lindsey L.; Hirschhorn, Lisa R.; Robertson, Minnette; Harvey, Kevin; Whorms, Sheldon; Freedberg, Kenneth A.; Gebre, Yitades

    2008-01-01

    Summary Objectives Pre-antiretroviral therapy (ART) HIV-related survival and timing of HIV identification have not been reported from the Caribbean. Using Jamaican national surveillance data, we estimated overall, AIDS-free, and AIDS survival, identified factors influencing HIV-related mortality, and examined factors associated with late HIV/AIDS identification. Methods The Jamaican HIV/AIDS tracking system (HATS) national surveillance data included timing of first positive HIV test, stage at identification, date of AIDS diagnosis, and death. We estimated overall and AIDS-free survival by initial stage, using a proportional hazard model to identify factors associated with worse survival, and logistic regression to examine factors related to later case identification. Results Of 10 674 reported HIV cases, 48% were asymptomatic, 14% symptomatic, and 38% first reported with AIDS. Five-year AIDS-free survival was 77% for asymptomatic persons and 63% for symptomatic. Median survival after AIDS diagnosis was 1.02 years. Age, number of opportunistic diseases, and initial stage were strongly associated with mortality. Older age, drug use, and sex with a commercial sex worker were associated with later identification. Conclusions In the pre-ART era, over one-third of HIV-infected persons in Jamaica were first identified with advanced disease. This highlights the need for earlier diagnosis as ART programs roll out in the Caribbean. PMID:17706448

  17. Burn mortality in Bangladesh: findings of national health and injury survey.

    PubMed

    Mashreky, S R; Rahman, A; Svanström, L; Khan, T F; Rahman, F

    2011-05-01

    The study was designed to explore the epidemiology of burn mortality in Bangladesh. A population-based cross-sectional survey was conducted between January and December 2003. Nationally representative data was collected from 171,366 rural and urban households, comprising of a total population of 819,429. Overall mortality burn rate was 2.2 per 100,000 populations per year. The rate was higher amongst females. Most of the deaths were accidental in nature, only 5% of deaths were from self-inflected burn. The rate was higher amongst the rural population compared to the urban population. About 90% of the burn incidences were at home with the kitchen the most frequent place at home for burn incidence to occur. A majority, 89%, of the deaths were caused by flame burn. Cooking fire, heating fire and fire from kerosene lamps were the major sources of flames. The majority of burn deaths occurred during winter season. Burn is a considerable cause of death in Bangladesh. Females, rural dwellers and populations of low socioeconomic condition are more vulnerable to burn injury. With simple intervention many of the deaths due to burn can be prevented. Considering the magnitude of the problem it is very important to address it as a public health problem and develop a national burn prevention program. 2009 Elsevier Ltd. All rights reserved.

  18. Month of birth and cause-specific mortality between 50 and 80 years: a population-based longitudinal cohort study in Sweden.

    PubMed

    Ueda, Peter; Edstedt Bonamy, Anna-Karin; Granath, Fredrik; Cnattingius, Sven

    2014-02-01

    Month of birth-a proxy for a variety of prenatal and early postnatal exposures including nutritional status, ambient temperature and infections-has been linked to mortality risk in adult life. We assessed the relation between month of birth and cause-specific mortality risk from cardiovascular diseases, infections, tumors and external causes-in ages of more than 50-80 years. In this nation-wide Swedish study, 4,240,338 subjects were followed from 1991 to 2010, using data from population-based health and administrative registries. The relation between month of birth and cause-specific mortality risk was assessed by fitting Cox proportional hazard regression models with attained age as the underlying time scale. In models adjusted for sex and education, month of birth was associated with cardiovascular and infectious mortality, but not with deaths from tumors or external causes. Compared with subjects born in November, a higher cardiovascular mortality was seen in subjects born from January through August, peaking in March/April [hazard ratio (HR) 1.066 compared to November, 95 % CI 1.045-1.086]. The mortality from infections was lowest for the birth months November and December and a distinct peak was observed for September-born (HR 1.108 compared to November, 95 % CI 1.046-1.175). Month of birth is associated with mortality from cardiovascular diseases and infections in ages of more than 50-80 years in Sweden. The mechanisms behind these associations remain to be elucidated.

  19. Mortality Attributable to Seasonal Influenza A and B Infections in Thailand, 2005–2009: A Longitudinal Study

    PubMed Central

    Cooper, Ben S.; Kotirum, Surachai; Kulpeng, Wantanee; Praditsitthikorn, Naiyana; Chittaganpitch, Malinee; Limmathurotsakul, Direk; Day, Nicholas P. J.; Coker, Richard; Teerawattananon, Yot; Meeyai, Aronrag

    2015-01-01

    Influenza epidemiology differs substantially in tropical and temperate zones, but estimates of seasonal influenza mortality in developing countries in the tropics are lacking. We aimed to quantify mortality due to seasonal influenza in Thailand, a tropical middle-income country. Time series of polymerase chain reaction–confirmed influenza infections between 2005 and 2009 were constructed from a sentinel surveillance network. These were combined with influenza-like illness data to derive measures of influenza activity and relationships to mortality by using a Bayesian regression framework. We estimated 6.1 (95% credible interval: 0.5, 12.4) annual deaths per 100,000 population attributable to influenza A and B, predominantly in those aged ≥60 years, with the largest contribution from influenza A(H1N1) in 3 out of 4 years. For A(H3N2), the relationship between influenza activity and mortality varied over time. Influenza was associated with increases in deaths classified as resulting from respiratory disease (posterior probability of positive association, 99.8%), cancer (98.6%), renal disease (98.0%), and liver disease (99.2%). No association with circulatory disease mortality was found. Seasonal influenza infections are associated with substantial mortality in Thailand, but evidence for the strong relationship between influenza activity and circulatory disease mortality reported in temperate countries is lacking. PMID:25899091

  20. Distinct age and self-rated health crossover mortality effects for African Americans: Evidence from a national cohort study.

    PubMed

    Roth, David L; Skarupski, Kimberly A; Crews, Deidra C; Howard, Virginia J; Locher, Julie L

    2016-05-01

    The predictive effects of age and self-rated health (SRH) on all-cause mortality are known to differ across race and ethnic groups. African American adults have higher mortality rates than Whites at younger ages, but this mortality disparity diminishes with advancing age and may "crossover" at about 75-80 years of age, when African Americans may show lower mortality rates. This pattern of findings reflects a lower overall association between age and mortality for African Americans than for Whites, and health-related mechanisms are typically cited as the reason for this age-based crossover mortality effect. However, a lower association between poor SRH and mortality has also been found for African Americans than for Whites, and it is not known if the reduced age and SRH associations with mortality for African Americans reflect independent or overlapping mechanisms. This study examined these two mortality predictors simultaneously in a large epidemiological study of 12,181 African Americans and 17,436 Whites. Participants were 45 or more years of age when they enrolled in the national REasons for Geographic and Racial Differences in Stroke (REGARDS) study between 2003 and 2007. Consistent with previous studies, African Americans had poorer SRH than Whites even after adjusting for demographic and health history covariates. Survival analysis models indicated statistically significant and independent race*age, race*SRH, and age*SRH interaction effects on all-cause mortality over an average 9-year follow-up period. Advanced age and poorer SRH were both weaker mortality risk factors for African Americans than for Whites. These two effects were distinct and presumably tapped different causal mechanisms. This calls into question the health-related explanation for the age-based mortality crossover effect and suggests that other mechanisms, including behavioral, social, and cultural factors, should be considered in efforts to better understand the age-based mortality

  1. Economic downturns, universal health coverage, and cancer mortality in high-income and middle-income countries, 1990-2010: a longitudinal analysis.

    PubMed

    Maruthappu, Mahiben; Watkins, Johnathan; Noor, Aisyah Mohd; Williams, Callum; Ali, Raghib; Sullivan, Richard; Zeltner, Thomas; Atun, Rifat

    2016-08-13

    The global economic crisis has been associated with increased unemployment and reduced public-sector expenditure on health care (PEH). We estimated the effects of changes in unemployment and PEH on cancer mortality, and identified how universal health coverage (UHC) affected these relationships. For this longitudinal analysis, we obtained data from the World Bank and WHO (1990-2010). We aggregated mortality data for breast cancer in women, prostate cancer in men, and colorectal cancers in men and women, which are associated with survival rates that exceed 50%, into a treatable cancer class. We likewise aggregated data for lung and pancreatic cancers, which have 5 year survival rates of less than 10%, into an untreatable cancer class. We used multivariable regression analysis, controlling for country-specific demographics and infrastructure, with time-lag analyses and robustness checks to investigate the relationship between unemployment, PEH, and cancer mortality, with and without UHC. We used trend analysis to project mortality rates, on the basis of trends before the sharp unemployment rise that occurred in many countries from 2008 to 2010, and compared them with observed rates. Data were available for 75 countries, representing 2.106 billion people, for the unemployment analysis and for 79 countries, representing 2.156 billion people, for the PEH analysis. Unemployment rises were significantly associated with an increase in all-cancer mortality and all specific cancers except lung cancer in women. By contrast, untreatable cancer mortality was not significantly linked with changes in unemployment. Lag analyses showed significant associations remained 5 years after unemployment increases for the treatable cancer class. Rerunning analyses, while accounting for UHC status, removed the significant associations. All-cancer, treatable cancer, and specific cancer mortalities significantly decreased as PEH increased. Time-series analysis provided an estimate of more than

  2. Fever in pregnancy and offspring mortality - a longitudinal study of a cohort from 1927 to 1937 on the Faroe Islands.

    PubMed

    Helmsdal, Gunnhild; Olsen, Sjúrour F

    2009-01-01

    In a birth cohort from 1927 to 1937 consisting of 4,208 individuals, we examined the relation between complications in pregnancy and offspring adult mortality. Patterns of increased mortality were observed in the group of males whose mothers had experienced fever during pregnancy, i.e. with all-cause mortality (rate ratio 1.505; 95% CI 1.084-1.926; p=0.057), premature death (rate ratio 1.943; 95% CI 1.486-2.400; p=0.004), and with cancer (rate ratio 2.625; 95% CI 1.845-3.405; p=0.015). To our knowledge, this is the first study to report an association between fever in pregnancy and offspring mortality.

  3. The Demographics and Education of Emergency Medical Services (EMS) Professionals: A National Longitudinal Investigation.

    PubMed

    Bentley, Melissa A; Shoben, Abigail; Levine, Roger

    2016-12-01

    The objectives of this study were to assess longitudinal and cross-sectional changes in Emergency Medical Technician (EMT)-Basics and Paramedics: (1) demographics, (2) employment characteristics, and (3) initial Emergency Medical Services (EMS) education. These data were collected between 1999 and 2008 employing survey techniques aimed at collecting valid data. A random, stratified sample was utilized to allow results to be generalizable to the nationally certified EMS population. Survey weights that were adjusted for each stratum's response were estimated. Weighted percentages, averages for continuous variables, and 95% confidence intervals (CIs) were calculated. Significant changes over time were noted when the CIs did not overlap. In all 10 years of data collection, the proportion of EMT-Paramedics who were male was greater than the proportion of EMT-Basics who were male. A substantial proportion of respondents performed EMS services for more than one agency: between 39.8% and 43.5% of EMT-Paramedics and 18.4% and 22.4% of EMT-Basic respondents reported this. The most common type of employer for both EMT-Basics and EMT-Paramedics was fire-based organizations. About one-third of EMT-Basics (32.3%-40.1%) and almost one-half of EMT-Paramedics (43.1%-45.3%) reported that these organizations were their main EMS employer. Rural areas (<25,000 residents) were the most common practice settings for EMT-Basics (52.1%-63.7%), while more EMT-Paramedics worked in urban settings (65.2%-77.7%). This analysis serves as a useful baseline to measure future changes in the EMS profession. This study described the demographic and work-life characteristics of a cohort of nationally certified EMT-Basics and Paramedics over a 10-year period. This analysis also summarized initial EMS education changes over time. Bentley MA , Shoben A , Levine R . The demographics and education of Emergency Medical Services (EMS) professionals: a national longitudinal investigation. Prehosp Disaster Med

  4. School social capital and body mass index in the National Longitudinal Study of Adolescent Health.

    PubMed

    Richmond, Tracy K; Milliren, Carly; Walls, Courtney E; Kawachi, Ichiro

    2014-12-01

    Social capital in neighborhoods and workplaces positively affects health. Less is known about the influence of school social capital on student health outcomes, in particular weight status. We sought to examine the association between individual- and school-level social capital and student body mass index (BMI). Analyzing data from the National Longitudinal Study of Adolescent Health, a nationally representative sample of adolescents in grades 7-12 (N = 13,428), we used principal components analysis to define 3 school social capital factors: "connectedness" (feel part of/close to people/safe in school), "treatment" (get along with teachers/students, teachers treat students fairly), and "parental involvement" (school administrator reported percent family/parent self-reported participation in Parent Teacher Organization, average daily school attendance). We examined the associations between individual- and school-level social capital and individual BMI using multilevel modeling techniques. In girls, both feeling connected to one's school (β = -0.06, p < .05) and attending schools with overall high connectedness (b = -0.43, p < .01) were associated with lower BMIs. In boys only attending a school with high "treatment" was inversely associated with BMI (b = -0.61, p < .01), adjusting for individual and school demographics. Although further studies are needed, our findings suggest enhancing school social capital as a novel approach to addressing student obesity. © 2014, American School Health Association.

  5. Criminal-justice and school sanctions against nonheterosexual youth: a national longitudinal study.

    PubMed

    Himmelstein, Kathryn E W; Brückner, Hannah

    2011-01-01

    Nonheterosexual adolescents are vulnerable to health risks including addiction, bullying, and familial abuse. We examined whether they also suffer disproportionate school and criminal-justice sanctions. The National Longitudinal Study of Adolescent Health followed a nationally representative sample of adolescents who were in grades 7 through 12 in 1994-1995. Data from the 1994-1995 survey and the 2001-2002 follow-up were analyzed. Three measures were used to assess nonheterosexuality: same-sex attraction, same-sex romantic relationships, and lesbian, gay, or bisexual (LGB) self-identification. Six outcomes were assessed: school expulsion; police stops; juvenile arrest; juvenile conviction; adult arrest; and adult conviction. Multivariate analyses controlled for adolescents' sociodemographics and behaviors, including illegal conduct. Nonheterosexuality consistently predicted a higher risk for sanctions. For example, in multivariate analyses, nonheterosexual adolescents had greater odds of being stopped by the police (odds ratio: 1.38 [P < .0001] for same-sex attraction and 1.53 [P < .0001] for LGB self-identification). Similar trends were observed for school expulsion, juvenile arrest and conviction, and adult conviction. Nonheterosexual girls were at particularly high risk. Nonheterosexual youth suffer disproportionate educational and criminal-justice punishments that are not explained by greater engagement in illegal or transgressive behaviors. Understanding and addressing these disparities might reduce school expulsions, arrests, and incarceration and their dire social and health consequences.

  6. Criminal-Justice and School Sanctions Against Nonheterosexual Youth: A National Longitudinal Study

    PubMed Central

    Brückner, Hannah

    2011-01-01

    OBJECTIVE: Nonheterosexual adolescents are vulnerable to health risks including addiction, bullying, and familial abuse. We examined whether they also suffer disproportionate school and criminal-justice sanctions. METHODS: The National Longitudinal Study of Adolescent Health followed a nationally representative sample of adolescents who were in grades 7 through 12 in 1994–1995. Data from the 1994–1995 survey and the 2001–2002 follow-up were analyzed. Three measures were used to assess nonheterosexuality: same-sex attraction, same-sex romantic relationships, and lesbian, gay, or bisexual (LGB) self-identification. Six outcomes were assessed: school expulsion; police stops; juvenile arrest; juvenile conviction; adult arrest; and adult conviction. Multivariate analyses controlled for adolescents' sociodemographics and behaviors, including illegal conduct. RESULTS: Nonheterosexuality consistently predicted a higher risk for sanctions. For example, in multivariate analyses, nonheterosexual adolescents had greater odds of being stopped by the police (odds ratio: 1.38 [P < .0001] for same-sex attraction and 1.53 [P < .0001] for LGB self-identification). Similar trends were observed for school expulsion, juvenile arrest and conviction, and adult conviction. Nonheterosexual girls were at particularly high risk. CONCLUSIONS: Nonheterosexual youth suffer disproportionate educational and criminal-justice punishments that are not explained by greater engagement in illegal or transgressive behaviors. Understanding and addressing these disparities might reduce school expulsions, arrests, and incarceration and their dire social and health consequences. PMID:21135011

  7. Longitudinal Links between Spanking and Children's Externalizing Behaviors in a National Sample of White, Black, Hispanic, and Asian American Families

    ERIC Educational Resources Information Center

    Gershoff, Elizabeth T.; Lansford, Jennifer E.; Sexton, Holly R.; Davis-Kean, Pamela; Sameroff, Arnold J.

    2012-01-01

    This study examined whether the longitudinal links between mothers' use of spanking and children's externalizing behaviors are moderated by family race/ethnicity, as would be predicted by cultural normativeness theory, once mean differences in frequency of use are controlled. A nationally representative sample of White, Black, Hispanic, and Asian…

  8. NLSY Child Handbook: A Guide to the 1986-1990 National Longitudinal Survey of Youth Child Data. Revised Edition.

    ERIC Educational Resources Information Center

    Baker, Paula C.; And Others

    This handbook is a guide and reference document for those researching the child data files of the 1986-1990 National Longitudinal Survey of Youth, sponsored by the Bureau of Labor Statistics. It describes the child data collection procedures, the nature of the child sample, the child data files available, and the specifics of the child assessments…

  9. The Longitudinal Association of Childhood School Engagement with Adult Educational and Occupational Achievement: Findings from an Australian National Study

    ERIC Educational Resources Information Center

    Abbott-Chapman, Joan; Martin, Kara; Ollington, Nadia; Venn, Alison; Dwyer, Terry; Gall, Seana

    2014-01-01

    The research investigated the association between school engagement and adult education and occupation outcomes, within the context of a 1985 Australian longitudinal national cohort study of the factors affecting children's long-term health and well-being. School engagement may be more modifiable than other factors related to academic success,…

  10. The Secondary School Programs of Students with Disabilities. A Report from the National Longitudinal Transition Study of Special Education Students.

    ERIC Educational Resources Information Center

    Wagner, Mary, Ed.

    Data from the National Longitudinal Transition Study of Special Education Students were used to examine five key aspects of secondary education: (1) the overall high school experience, (2) academic course-taking, (3) vocational preparation, (4) placement, and (5) support services for students. An executive summary reports major findings in these…

  11. Trajectories of HIV Risk Behavior from Age 15 to 25 in the National Longitudinal Survey of Youth Sample

    ERIC Educational Resources Information Center

    Murphy, Debra A.; Brecht, Mary-Lynn; Herbeck, Diane M.; Huang, David

    2009-01-01

    This study utilized data from the National Longitudinal Survey of Youth to investigate youth risk trajectories for HIV and factors associated with different trajectories. The sample (N = 8,208) was 49.2% female, with a mean age of 14.31 (SD = 1.48). A group-based trajectory model was applied, which identified four distinct trajectories for both…

  12. Development of Adjusted School Weights for the National Longitudinal Survey of the High School Class of 1972. Contractor Report.

    ERIC Educational Resources Information Center

    Benrud, C. H.; Williams, R. L.

    The major emphasis of the National Longitudinal Study of the High School Class of 1972 (NLS) has been directed toward individuals in the 1972 high school graduating class. Consequently, sampling parameters were established to ensure student representation, and the bulk of data collected were individual-level data. School-level data exist on a…

  13. Changes in Wages and Benefits among Young Adults. Data from the National Longitudinal Surveys. Work and Family. Report 849.

    ERIC Educational Resources Information Center

    Bureau of Labor Statistics (DOL), Washington, DC.

    Recent changes in the structure of wages and in employer-provided benefits made available to young workers were examined. Changes in the wage structure and in benefits were compared by educational level. Data from the Youth, Young Men, and Young Women's cohorts of the National Longitudinal Surveys provided information on a sample of young men and…

  14. National Longitudinal Study of the High School Class of 1972: Preliminary Analyses of Student Financial Aid. RTI-22U-884.

    ERIC Educational Resources Information Center

    Riccobono, John A.; Dunteman, George H.

    Six classification variables were used, jointly and singly, to define subpopulations of respondents to the National Longitudinal Study of the High School Class of 1972: sex, high school program, race, geographic region, ability, and socioeconomic status. Seven financial aid variables were used, to describe source and type of student aid planned…

  15. Policy Findings Related to Military Service from the Youth Cohort of the National Longitudinal Surveys of Labor Market Experience.

    ERIC Educational Resources Information Center

    Borus, Michael E.; And Others

    Two data waves from the Youth Cohort of the National Longitudinal Surveys of Labor Market Experience compared Black, Hispanic, and White servicemen with their civilian counterparts to determine what types of persons are more likely to enlist in the military. Comparisons of minority servicemen with their civilian peers who are employed full time…

  16. Work Patterns of Women near Retirement. Data from the National Longitudinal Surveys. Work and Family. Report 830.

    ERIC Educational Resources Information Center

    Bureau of Labor Statistics (DOL), Washington, DC.

    The work patterns of women with some work experience over the 1976 to 1989 period were examined as they approach retirement, using data from the Mature Women's cohort of the National Longitudinal Surveys. The data provided information on a sample of women who were between the ages of 30 and 45 in 1967 and who have been interviewed regularly since…

  17. Longitudinal Links between Spanking and Children's Externalizing Behaviors in a National Sample of White, Black, Hispanic, and Asian American Families

    ERIC Educational Resources Information Center

    Gershoff, Elizabeth T.; Lansford, Jennifer E.; Sexton, Holly R.; Davis-Kean, Pamela; Sameroff, Arnold J.

    2012-01-01

    This study examined whether the longitudinal links between mothers' use of spanking and children's externalizing behaviors are moderated by family race/ethnicity, as would be predicted by cultural normativeness theory, once mean differences in frequency of use are controlled. A nationally representative sample of White, Black, Hispanic, and Asian…

  18. The Stability of Self-Reported Marijuana Use across Eight Years of the National Longitudinal Survey of Youth

    ERIC Educational Resources Information Center

    Shillington, Audrey M.; Clapp, John D.; Reed, Mark B.

    2011-01-01

    This study examined teen marijuana report stability over 8 years. The stability of self-reports refers to the consistency of self-reported use across several years. This study used fives waves of data across 8 years from the National Longitudinal Survey of Youth. Analyses were conducted to examine the internal or within-wave consistency as well as…

  19. The Stability of Self-Reported Marijuana Use across Eight Years of the National Longitudinal Survey of Youth

    ERIC Educational Resources Information Center

    Shillington, Audrey M.; Clapp, John D.; Reed, Mark B.

    2011-01-01

    This study examined teen marijuana report stability over 8 years. The stability of self-reports refers to the consistency of self-reported use across several years. This study used fives waves of data across 8 years from the National Longitudinal Survey of Youth. Analyses were conducted to examine the internal or within-wave consistency as well as…

  20. Transition Supports to Students with Mental Retardation: An Examination of Data from the National Longitudinal Transition Study 2

    ERIC Educational Resources Information Center

    Katsiyannis, Antonis; Zhang, Dalun; Woodruff, Nancy; Dixon, April

    2005-01-01

    Effective transition planning is of paramount importance in maximizing post school outcomes for students with disabilities. The purpose of this study is to examine data from the National Longitudinal Transition Study--2 regarding the transition planning for students with mental retardation. In addition, for comparison purposes, data on transition…

  1. National Longitudinal Study of the High School Class of 1972: Fourth Follow-up Survey. Final Methodological Report.

    ERIC Educational Resources Information Center

    Riccobono, John A., Ed.; And Others

    The fourth mail and personal interview followup survey from October 1979 to May 1980 is reported as part of the National Longitudinal Study of the High School Class of 1972 (NLS). The report is methodological, historical and descriptive in nature, but contains no analytical results. Reference to earlier reports is provided in determining post…

  2. National Longitudinal Study of High School Seniors. Group Profiles on Self-Esteem, Locus of Control, and Life Goals.

    ERIC Educational Resources Information Center

    Research Triangle Inst., Durham, NC. Center for Educational Research and Evaluation.

    Data obtained from thousands of respondents to the Base-Year Student Questionnaire and First Followup Questionnaire of the National Longitudinal Study of the High School Class of 1972 were used to investigate self-esteem, locus of control, and work-, community-, and family-related life goals, and to generate profile means and standard deviations…

  3. Active social participation and mortality risk among older people in Japan: results from a nationally representative sample.

    PubMed

    Minagawa, Yuka; Saito, Yasuhiko

    2015-07-01

    A large literature suggests that active social participation contributes to the well-being of older people. Japan provides a compelling context to test this hypothesis due to its rapidly growing elderly population and the phenomenal health of the population. Using the Nihon University Japanese Longitudinal Study of Aging, this study examines how social participation, measured by group membership, is related to the risk of overall mortality among Japanese elders aged 65 and older. Results from Cox proportional hazards models show that group affiliation confers advantages against mortality risk, even after controlling for sociodemographic characteristics, physical health measures, and family relationship variables. In particular, activities geared more toward self-development, such as postretirement employment and lifelong learning, are strongly associated with lower levels of mortality. Findings suggest that continued social participation at advanced ages produces positive health consequences, highlighting the importance of active aging in achieving successful aging in the Japanese context. © The Author(s) 2014.

  4. Incidence, National Trend, and Outcome of Nontraumatic Subarachnoid Haemorrhage in Taiwan: Initial Lower Mortality, Poor Long-Term Outcome

    PubMed Central

    Lin, Hsing-Lin; Soo, Kwan-Ming; Chen, Chao-Wen; Lin, Yen-Ko; Lin, Tsung-Ying; Kuo, Liang-Chi; Lee, Wei-Che; Huang, Shiuh-Lin

    2014-01-01

    To investigate the longitudinal trend of nontraumatic subarachnoid haemorrhage (SAH), we analyzed the annual population-based incidence and mortality rate of nontraumatic subarachnoid hemorrhage in Taiwan. Logistic regression was used to identify independent predictors of mortality. The average incidence rate (IR) of nontraumatic SAH was 6.25 ± 0.88 per 100,000 per year. The prevalence of female patients was higher than in the male population (54.5% versus 45.5%). The average age of these patients was 55.78 ± 17.09 and females were older than males (58.50 ± 15.9 versus 52.45 ± 18.50, P < 0.001). Of these patients, 97.6% (611/626) were treated with surgical intervention with clipping procedure and 2.9% (18/626) with coiling. Total mortality of these patients was 13.4% (84/626). In adjusted analysis, age (odds ratio [OR], 0.97; 95% confidence interval [CI], 0.98-0.98; P < 0.001) and Charlson comorbidity index (OR, 0.709; 95% CI, 0.57–0.88; P = 0.002) remained independent predictors of the mortality. Patients with nontraumatic SAH had a much higher prevalence in older age groups and in females than in the general population. Patients with old age and more comorbidity have higher mortality. Aggressive management of patients might reduce the initial mortality; however, patient outcome still remains poor. PMID:24804209

  5. Incidence, national trend, and outcome of nontraumatic subarachnoid haemorrhage in Taiwan: initial lower mortality, poor long-term outcome.

    PubMed

    Lin, Hsing-Lin; Soo, Kwan-Ming; Chen, Chao-Wen; Lin, Yen-Ko; Lin, Tsung-Ying; Kuo, Liang-Chi; Lee, Wei-Che; Huang, Shiuh-Lin

    2014-01-01

    To investigate the longitudinal trend of nontraumatic subarachnoid haemorrhage (SAH), we analyzed the annual population-based incidence and mortality rate of nontraumatic subarachnoid hemorrhage in Taiwan. Logistic regression was used to identify independent predictors of mortality. The average incidence rate (IR) of nontraumatic SAH was 6.25 ± 0.88 per 100,000 per year. The prevalence of female patients was higher than in the male population (54.5% versus 45.5%). The average age of these patients was 55.78 ± 17.09 and females were older than males (58.50 ± 15.9 versus 52.45 ± 18.50, P < 0.001). Of these patients, 97.6% (611/626) were treated with surgical intervention with clipping procedure and 2.9% (18/626) with coiling. Total mortality of these patients was 13.4% (84/626). In adjusted analysis, age (odds ratio [OR], 0.97; 95% confidence interval [CI], 0.98-0.98; P < 0.001) and Charlson comorbidity index (OR, 0.709; 95% CI, 0.57-0.88; P = 0.002) remained independent predictors of the mortality. Patients with nontraumatic SAH had a much higher prevalence in older age groups and in females than in the general population. Patients with old age and more comorbidity have higher mortality. Aggressive management of patients might reduce the initial mortality; however, patient outcome still remains poor.

  6. A Longitudinal Study of the Mini-Mental State Examination in Late Nonagenarians and Its Relationship with Dementia, Mortality, and Education.

    PubMed

    Skoog, Johan; Backman, Kristoffer; Ribbe, Mats; Falk, Hanna; Gudmundsson, Pia; Thorvaldsson, Valgeir; Borjesson-Hanson, Anne; Ostling, Svante; Johansson, Boo; Skoog, Ingmar

    2017-06-01

    To examine level of and change in cognitive status using the Mini-Mental State Examination (MMSE) in relation to dementia, mortality, education, and sex in late nonagenarians. Three-year longitudinal study with examinations at ages 97, 99, and 100. Trained psychiatric research nurses examined participants at their place of living. A representative population-based sample of 97-year-old Swedes (N = 591; 107 men, 484 women) living in Gothenburg, Sweden. A Swedish version of the MMSE was used to measure cognitive status. Geriatric psychiatrists diagnosed dementia according to the Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised. Mixed models were fitted to the data to model the longitudinal relationship between MMSE score and explanatory variables. Individuals with dementia between age 97 and 100 had lower mean MMSE scores than those without dementia. Those who died during the 3-year follow-up had lower MMSE scores than those who survived. MMSE scores at baseline did not differ between those without dementia and those who developed dementia during the 3-year follow-up. Participants with more education had higher MMSE scores, but there was no association between education and linear change. MMSE score is associated with dementia and subsequent mortality even in very old individuals, although the preclinical phase of dementia may be short in older age. Level of education is positively associated with MMSE score but not rate of decline in individuals approaching age 100. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

  7. A Meta-Analysis of Time-Series Studies of Ozone and Mortality With Comparison to the National Morbidity, Mortality, and Air Pollution Study

    PubMed Central

    Bell, Michelle L.; Dominici, Francesca; Samet, Jonathan M.

    2013-01-01

    Background Although many time-series studies of ozone and mortality have identified positive associations, others have yielded null or inconclusive results, making the results of these studies difficult to interpret. Methods We performed a meta-analysis of 144 effect estimates from 39 time-series studies, and estimated pooled effects by lags, age groups, cause-specific mortality, and concentration metrics. We compared results with pooled estimates from the National Morbidity, Mortality, and Air Pollution Study (NMMAPS), a time-series study of 95 large U.S. urban centers from 1987 to 2000. Results Both meta-analysis and NMMAPS results provided strong evidence of a short-term association between ozone and mortality, with larger effects for cardiovascular and respiratory mortality, the elderly, and current-day ozone exposure. In both analyses, results were insensitive to adjustment for particulate matter and model specifications. In the meta-analysis, a 10-ppb increase in daily ozone at single-day or 2-day average of lags 0, 1, or 2 days was associated with an 0.87% increase in total mortality (95% posterior interval = 0.55% to 1.18%), whereas the lag 0 NMMAPS estimate is 0.25% (0.12% to 0.39%). Several findings indicate possible publication bias: meta-analysis results were consistently larger than those from NMMAPS; meta-analysis pooled estimates at lags 0 or 1 were larger when only a single lag was reported than when estimates for multiple lags were reported; and heterogeneity of city-specific estimates in the meta-analysis were larger than with NMMAPS. Conclusions This study provides evidence of short-term associations between ozone and mortality as well as evidence of publication bias. PMID:15951661

  8. The impact of asthma in Brazil: a longitudinal analysis of data from a Brazilian national database system.

    PubMed

    Cardoso, Thiago de Araujo; Roncada, Cristian; Silva, Emerson Rodrigues da; Pinto, Leonardo Araujo; Jones, Marcus Herbert; Stein, Renato Tetelbon; Pitrez, Paulo Márcio

    2017-01-01

    To present official longitudinal data on the impact of asthma in Brazil between 2008 and 2013. This was a descriptive study of data collected between 2008 and 2013 from an official Brazilian national database, including data on asthma-related number of hospitalizations, mortality, and hospitalization costs. A geographical subanalysis was also performed. In 2013, 2,047 people died from asthma in Brazil (5 deaths/day), with more than 120,000 asthma-related hospitalizations. During the whole study period, the absolute number of asthma-related deaths and of hospitalizations decreased by 10% and 36%, respectively. However, the in-hospital mortality rate increased by approximately 25% in that period. The geographic subanalysis showed that the northern/northeastern and southeastern regions had the highest asthma-related hospitalization and in-hospital mortality rates, respectively. An analysis of the states representative of the regions of Brazil revealed discrepancies between the numbers of asthma-related hospitalizations and asthma-related in-hospital mortality rates. During the study period, the cost of asthma-related hospitalizations to the public health care system was US$ 170 million. Although the numbers of asthma-related deaths and hospital admissions in Brazil have been decreasing since 2009, the absolute numbers are still high, resulting in elevated direct and indirect costs for the society. This shows the relevance of the burden of asthma in middle-income countries. Apresentar dados longitudinais oficiais sobre o impacto da asma no Brasil entre 2008 e 2013. Estudo descritivo de dados extraídos de um banco de dados do governo brasileiro entre 2008 e 2013, no qual foram analisados as hospitalizações e óbitos por asma, bem como o custo das hospitalizações. Foi também realizada uma subanálise geográfica. Em 2013, 2.047 pessoas morreram de asma no Brasil (5 óbitos/dia), com mais de 120.000 hospitalizações por asma. Durante o período de estudo, o n

  9. Factors predicting depression across multiple domains in a national longitudinal sample of Canadian youth.

    PubMed

    Bellamy, Sherry; Hardy, Cindy

    2015-05-01

    This prospective longitudinal study aimed to investigate the strength and relative importance of multiple predictors of depression in youth aged 16 to 20 years. Data were drawn from Statistics Canada's National Longitudinal Survey of Children and Youth (Statistics Canada 2007a, b). Hierarchical regressions were conducted separately by child gender (N = 796 boys; N = 919 girls) for two overlapping samples: mixed parent-child dyads (e.g., biological mothers, fathers and other caregivers; N = 1,715) and a subsample containing only biological mother-child dyads (N = 1,425). Parent-reported data were used from Cycle 1 when the children were aged 4 to 8 years. Parent and child-reported data were used from Cycle 4 when children were aged 10 to 14 years. The outcome measure of depressive symptoms was taken from Cycle 7 when the youth were aged 16 to 20 years. Adolescents reported more depression symptoms than young adults and girls reported more than boys. For boys, higher anxiety/depression scores at ages 4 to 8 years and 10 to 14 years, along with lower self-esteem at 10 to 14 years, predicted higher depression scores. Girls' depression was predicted by loss of a parent by ages 4 to 8 years and higher self-reported anxiety/depression and aggression at ages 10 to 14 years. Among biological mother-child dyads, maternal depression reported by mother when child was aged 4 to 8 years and 10 to 14 years significantly predicted depression for girls. At 10 to 14 years, child-reported lower parental monitoring (girls only) and greater parental rejection (boys and girls) predicted depression at ages 16 to 20 years.

  10. Risk markers for poor developmental attainment in young children: results from a longitudinal national survey.

    PubMed

    To, Teresa; Guttmann, Astrid; Dick, Paul T; Rosenfield, Jay D; Parkin, Patricia C; Tassoudji, Marjan; Vydykhan, Tatiana N; Cao, Hongmei; Harris, Jennifer K

    2004-07-01

    To evaluate social and environmental determinants of poor developmental attainment among preschool children by means of longitudinal data from a population-based sample of Canadian children. Secondary analysis of data from cycles 1 (1994-1995) and 2 (1996-1997) of the National Longitudinal Survey of Children and Youth using a cohort design with 2-year follow-up. A total of 4987 children aged 1 to 5 years at baseline, whose biological mother completed risk factor information and who were included in both cycles. Poor developmental attainment (developing unusually slowly) was defined as scores more than 1 SD below the age-standardized mean for the Motor and Social Development Scale, revised Peabody Picture Vocabulary Test, or Canadian Achievement Tests in mathematics and reading/comprehension, depending on the child's age. The prevalence of sustained poor developmental attainment after 2 years of follow-up was 4.6%. Factors found to be associated with poor developmental attainment included male sex (odds ratio [OR], 1.37; 95% confidence interval [CI], 1.10-1.70), maternal depression (OR, 1.64; 95% CI, 1.25-2.15), low maternal education (OR, 1.57; 95% CI, 1.19-2.08), maternal immigrant status (OR, 1.93; 95% CI, 1.38-2.71), and household low income adequacy (OR, 1.43; 95% CI, 1.11-1.83). Having a mother who has symptoms of depression, has low education, or is an immigrant, and living in a household with low income adequacy increase the risk of poor developmental attainment in children aged 1 to 5 years. The notable risks associated with these factors indicate them as possible targets for screening and interventions to prevent poor developmental attainment.

  11. The Relationship Between Marijuana Use and Intimate Partner Violence in a Nationally Representative, Longitudinal Sample

    PubMed Central

    Reingle, Jennifer M.; Staras, Stephanie A. S.; Jennings, Wesley G.; Branchini, Jennifer; Maldonado-Molina, Mildred M.

    2013-01-01

    Intimate partner violence is a significant public health problem, as these behaviors have been associated with a number of negative health outcomes including illicit drug use, physical injury, chronic pain, sexually transmitted diseases, depression, and posttraumatic stress disorder. The current study examined the association between marijuana use and intimate partner violence using a longitudinal survey of adolescents and young adults ages 15 to 26 years. Data were obtained from 9,421 adolescents in the National Longitudinal Study of Adolescent Health (Add Health) Waves 1 through 4 (1995–2008). Marijuana use was measured in the past year at each wave and participants were categorized as “users” or “nonusers.” Partner violence was constructed using six items (three pertaining to victimization and three concerning perpetration) from Wave 4 (2007–2008). Using these six items, participants were categorized as “victims only,” “perpetrators only,” or “victims and perpetrators.” Survey multinomial regression was used to examine the relationship between marijuana use and intimate partner violence. Consistent use of marijuana during adolescence was most predictive of intimate partner violence (OR = 2.08, p < .001). Consistent marijuana use (OR = 1.85, p < .05) was related to an increased risk of intimate partner violence perpetration. Adolescent marijuana use, particularly consistent use throughout adolescence, is associated with perpetration or both perpetration of and victimization by intimate partner violence in early adulthood. These findings have implications for intimate partner violence prevention efforts, as marijuana use should be considered as a target of early intimate partner violence intervention and treatment programming. PMID:22080574

  12. Genetic Influences on Language, Reading, and Mathematics Skills in a National Sample: An Analysis Using the National Longitudinal Survey of Youth

    ERIC Educational Resources Information Center

    Hart, Sara A.; Petrill, Stephen A.; Kamp Dush, Claire M.

    2010-01-01

    Purpose: The present study had two purposes: provide an illustration of use of the National Longitudinal Survey of Youth 1979 Children's (CNLSY; U.S. Department of Labor, 2009) database and use the database to seek convergent evidence regarding the magnitude and significance of genetic effects influencing low and typical performers on measures of…

  13. Genetic Influences on Language, Reading, and Mathematics Skills in a National Sample: An Analysis Using the National Longitudinal Survey of Youth

    ERIC Educational Resources Information Center

    Hart, Sara A.; Petrill, Stephen A.; Kamp Dush, Claire M.

    2010-01-01

    Purpose: The present study had two purposes: provide an illustration of use of the National Longitudinal Survey of Youth 1979 Children's (CNLSY; U.S. Department of Labor, 2009) database and use the database to seek convergent evidence regarding the magnitude and significance of genetic effects influencing low and typical performers on measures of…

  14. Mortality from flash floods: a review of national weather service reports, 1969-81.

    PubMed Central

    French, J; Ing, R; Von Allmen, S; Wood, R

    1983-01-01

    Of all weather-related disasters that occur in the United States, floods are the main cause of death, and most flood-related deaths are attributed to flash floods. Whenever a weather-related disaster involves 30 or more deaths or more than $100 million in property damage, the National Weather Service (NWS) forms a survey team to investigate the disaster and write a report of findings. All NWS survey reports on flash floods issued during 1969-81 were reviewed to determine the mortality resulting from such floods, the effect of warnings on mortality, and the circumstances contributing to death. A total of 1,185 deaths were associated with 32 flash floods, an average of 37 deaths per flash flood. The highest average number of deaths per event was associated with the four flash floods in which dams broke after heavy rains. Although there were 18 flash floods in 1977-81 and only 14 in 1969-76, the number of deaths was 2 1/2 times greater during the earlier period. More than twice as many deaths were associated with flash floods for which the survey team considered the warnings inadequate than with those with warnings considered adequate. Ninety-three percent of the deaths were due to drowning and 42 percent of these drownings were car related. The other drownings occurred in homes, at campsites, or when persons were crossing bridges and streams. The need for monitoring dams during periods of heavy rainfall is highlighted. PMID:6419273

  15. Mortality from flash floods: a review of national weather service reports, 1969-81.

    PubMed

    French, J; Ing, R; Von Allmen, S; Wood, R

    1983-01-01

    Of all weather-related disasters that occur in the United States, floods are the main cause of death, and most flood-related deaths are attributed to flash floods. Whenever a weather-related disaster involves 30 or more deaths or more than $100 million in property damage, the National Weather Service (NWS) forms a survey team to investigate the disaster and write a report of findings. All NWS survey reports on flash floods issued during 1969-81 were reviewed to determine the mortality resulting from such floods, the effect of warnings on mortality, and the circumstances contributing to death. A total of 1,185 deaths were associated with 32 flash floods, an average of 37 deaths per flash flood. The highest average number of deaths per event was associated with the four flash floods in which dams broke after heavy rains. Although there were 18 flash floods in 1977-81 and only 14 in 1969-76, the number of deaths was 2 1/2 times greater during the earlier period. More than twice as many deaths were associated with flash floods for which the survey team considered the warnings inadequate than with those with warnings considered adequate. Ninety-three percent of the deaths were due to drowning and 42 percent of these drownings were car related. The other drownings occurred in homes, at campsites, or when persons were crossing bridges and streams. The need for monitoring dams during periods of heavy rainfall is highlighted.

  16. Challenges of maternal mortality reduction and opportunities under National Rural Health Mission--a critical appraisal.

    PubMed

    Kumar, Satish

    2005-01-01

    Maternal Mortality Ratio (MMR) continues to remain high in our country without showing any declining trend over a period of two decades. The proportions of maternal deaths contributed by direct obstetric causes have also remained more or less the same in rural areas. There is a strong need to improve coverage of antenatal care, promote institutional deliveries and provide emergency obstetric care. Delays occur in seeking care for obstetric complications and levels of 'met obstetric need' continue to be low in many parts of the country. Most of the First Referral Units (FRUs) and CHCs function at sub-optimal level in the country. National Rural Health Mission (NRHM) offers institutional mechanism and strategic options to reduce high MMR. 'Janani Suraksha Yojna', strengthening of CHCs (as per Indian Public Health standards) to offer 24 hours quality services including that of anesthetists and Accredited Social Health Activist (ASHA) are important proposals in this regard. District Health Mission can play an important role in monitoring maternal deaths occurring in hospitals or in community and thus create a social momentum to prevent and reduce maternal deaths. NRHM, however, depends largely on Panchayati Raj Institutions for effective implementation of proposed interventions and utilization of resources. In most parts of our country, State Governments have not empowered PRIs with real devolution of power. Therefore, much needs to be done locally to build the capacity of PRIs and develop state-specific guidelines in operational terms to implement interventions under NRHM for reducing maternal mortality ratio.

  17. Longitudinal associations between body composition, sarcopenic obesity and outcomes of frailty, disability, institutionalisation and mortality in community-dwelling older men: The Concord Health and Ageing in Men Project.

    PubMed

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

    2017-05-01

    to explore the longitudinal associations between body composition measures, sarcopenic obesity and outcomes of frailty, activities of daily living (ADL) and instrumental ADL (IADL) disability, institutionalisation and mortality. men aged ≥ 70 years (2005-07) from the Concord Health and Ageing in Men Project were assessed at baseline (n = 1,705), 2 (n = 1,366) and 5 years (n = 954). The main outcome measures were frailty (adapted Fried criteria), ADL, including personal care and mobility and IADL disability (ability to perform tasks for independent living), institutionalisation and mortality. The Foundation for the National Institutes of Health cut-points were used for low muscle mass: appendicular lean mass (ALM):Body Mass Index (BMI) ratio (ALMBMI) <0.789 and obesity was defined as >30% fat. Generalised estimating equations were used to examine the longitudinal associations between the independent variables (obesity alone, low muscle mass and sarcopenic obesity) and frailty, ADL and IADL disability. in unadjusted, age adjusted and fully adjusted analysis, men with low muscle mass showed increased risk of frailty and IADL disability. In fully adjusted analysis, men with sarcopenic obesity had an increased risk of frailty (odds ratio (OR): 2.00 (95% confidence of interval (CI): 1.42, 2.82)) ADL disability (OR: 1.58 (95% CI: 1.12, 2.24)) and IADL disability (OR: 1.36 (95% CI: 1.05, 1.76)). Obesity alone was protective for institutionalisation (OR: 0.51 (95% CI: 0.31, 0.84)) but was not associated with any other outcomes. low muscle mass and sarcopenic obesity were associated with poor functional outcomes, independent of confounders. This would suggest that future trials on frailty and disability prevention should be designed to intervene on both muscle mass and fat mass.

  18. Foliar injury, tree growth and mortality, and lichen studies in Mammoth Cave National Park. Final report, 1985-1986

    SciTech Connect

    McCune, B.; Cloonan, C.L.; Armentano, T.V.

    1987-03-01

    Foliar condition, tree growth, tree mortality, and lichen communities were studied in Mammoth Cave National Park, Kentucky, to document the present forest condition and to provide a basis for detecting future changes. Foliar injury by ozone was common on many plant species in 1985. Species showing the most injury were white ash, green ash, redbud, sycamore, tulip poplar, milkweed, and wild grape. Injury apparently depended on canopy position and vigor. Tree growth was equivocally related to visible symptoms in 1986, probably because of the low ozone levels in that year. Tree mortality rates from 1966-1985 in two natural stands were somewhat lower than mortality rates known for other midwestern woods.

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

    PubMed Central

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

    2015-01-01

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

  20. Mortality and causes of death among violent offenders and victims-a Swedish population based longitudinal study

    PubMed Central

    2012-01-01

    Background Most previous studies on mortality in violent offenders or victims are based on prison or hospital samples, while this study analyzed overall and cause specific mortality among violent offenders, victims, and individuals who were both offenders and victims in a general sample of 48,834 18-20 year-old men conscripted for military service in 1969/70 in Sweden. Methods Each person completed two non-anonymous questionnaires concerning family, psychological, and behavioral factors. The cohort was followed for 35 years through official registers regarding violent offenses, victimization, and mortality. The impact of violence, victimization, early risk factors and hospitalization for psychiatric diagnosis or alcohol and drug misuse during follow up on mortality was investigated using Cox proportional hazard regression analyses. Results Repeat violent offenses were associated with an eleven fold higher hazard of dying from a substance-related cause and nearly fourfold higher hazard of dying from suicide. These figures remained significantly elevated also in multivariate analyses, with a 3.03 and 2.39 hazard ratio (HR), respectively. Participants with experience of violence and inpatient care for substance abuse or psychiatric disorder had about a two to threefold higher risk of dying compared to participants with no substance use or psychiatric disorder. Conclusions Violent offending and being victimized are associated with excess mortality and a risk of dying from an alcohol or drug-related cause or suicide. Consequently, prevention of violent behavior might have an effect on overall mortality and suicide rates. Prevention of alcohol and drug use is also warranted. PMID:22251445

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

    PubMed

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

    2015-01-01

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

  2. Elevated overdose mortality rates among First Nations individuals in a Canadian setting: a population-based analysis.

    PubMed

    Milloy, M-J; Wood, Evan; Reading, Charlotte; Kane, Daniel; Montaner, Julio; Kerr, Thomas

    2010-11-01

    To determine the total burden of illicit drug overdose mortality over the study period in the province of British Columbia and investigate possible population-level determinants by estimating rates among subgroups including First Nations individuals. Review of coroner case files. The province of British Columbia, Canada. Individuals dying from an illicit drug overdose between 2001 and 2005. Age-adjusted mortality rates, standardized mortality ratios (SMR) and years of potential life lost (YPLL), stratified by major population groups. Over the study period, 909 individuals died from illicit drug overdoses, including 104 (11.4%) First Nations individuals. Compared to the general population, First Nations males and females suffered from substantially elevated SMR and YPLL. In a multivariate logistic regression analysis, First Nations deaths were significantly more likely to be among women, related to injection drug use and to have occurred in the Downtown Eastside area of Vancouver, the local epicentre of human immunodeficiency virus infection and open drug use (all P< 0.05). This report found highly elevated overdose death rates and levels of premature mortality among First Nations Canadians in British Columbia compared to the general population. While previously unidentified, these findings are consistent with the poorer population health profile of First Nations Canadians. Although further research is needed to identify the causes of the elevated death rates, our findings support increased availability of evidence-based overdose prevention measures. © 2010 The Authors, Addiction © 2010 Society for the Study of Addiction.

  3. Global, regional, and national causes of child mortality in 2008: a systematic analysis.

    PubMed

    Black, Robert E; Cousens, Simon; Johnson, Hope L; Lawn, Joy E; Rudan, Igor; Bassani, Diego G; Jha, Prabhat; Campbell, Harry; Walker, Christa Fischer; Cibulskis, Richard; Eisele, Thomas; Liu, Li; Mathers, Colin

    2010-06-05

    Up-to-date information on the causes of child deaths is crucial to guide global efforts to improve child survival. We report new estimates for 2008 of the major causes of death in children younger than 5 years. We used multicause proportionate mortality models to estimate deaths in neonates aged 0-27 days and children aged 1-59 months, and selected single-cause disease models and analysis of vital registration data when available to estimate causes of child deaths. New data from China and India permitted national data to be used for these countries instead of predictions based on global statistical models, as was done previously. We estimated proportional causes of death for 193 countries, and by application of these proportions to the country-specific mortality rates in children younger than 5 years and birth rates, the numbers of deaths by cause were calculated for countries, regions, and the world. Of the estimated 8.795 million deaths in children younger than 5 years worldwide in 2008, infectious diseases caused 68% (5.970 million), with the largest percentages due to pneumonia (18%, 1.575 million, uncertainty range [UR] 1.046 million-1.874 million), diarrhoea (15%, 1.336 million, 0.822 million-2.004 million), and malaria (8%, 0.732 million, 0.601 million-0.851 million). 41% (3.575 million) of deaths occurred in neonates, and the most important single causes were preterm birth complications (12%, 1.033 million, UR 0.717 million-1.216 million), birth asphyxia (9%, 0.814 million, 0.563 million-0.997 million), sepsis (6%, 0.521 million, 0.356 million-0.735 million), and pneumonia (4%, 0.386 million, 0.264 million-0.545 million). 49% (4.294 million) of child deaths occurred in five countries: India, Nigeria, Democratic Republic of the Congo, Pakistan, and China. These country-specific estimates of the major causes of child deaths should help to focus national programmes and donor assistance. Achievement of Millennium Development Goal 4, to reduce child mortality by

  4. Lifestyle, nutritional status, health, and mortality in elderly people across Europe: a review of the longitudinal results of the SENECA study.

    PubMed

    de Groot, Lisette C P M G; Verheijden, Marieke W; de Henauw, Stefaan; Schroll, Marianne; van Staveren, Wija A

    2004-12-01

    This article provides an overview of the longitudinal Survey in Europe on Nutrition and the Elderly: a Concerted Action (SENECA) study, which was designed to assess differences in dietary and lifestyle factors among elderly Europeans, and to identify the factors that contribute to healthy aging. Elderly people from Belgium, Denmark, France, Italy, Portugal, Spain, Switzerland, and The Netherlands participated in the SENECA study. Standardized measurements were conducted at baseline in 1988-1989 and were repeated in 1993 and 1999. Diet, physical activity, and smoking, as well as maintenance of health and survival, were assessed. At baseline, considerable differences in lifestyle factors existed among elderly people. Mealtime patterns as well as dietary intake varied across Europe, and geographical patterns were apparent. Similar results were found for engagement in sport or professional activities. The smoking prevalence among women was generally low. Distinct geographical differences were also observed in percentages of deaths during the SENECA study and in overall survival time. A healthy lifestyle was related to stable self-perceived health, a delay in functional dependence, and mortality. Inactivity and smoking, and to a lesser extent a low-quality diet, increased mortality risk. A combined effect of multiple unhealthy lifestyle factors was also observed. The SENECA study showed that a healthy lifestyle at older ages is related to a delay in the deterioration of health status and a reduced mortality risk. Improving and maintaining a healthy lifestyle in elderly people across Europe is a great challenge for the European Community.

  5. Do acute myocardial infarction and stroke mortality vary by distance to hospitals in Switzerland? Results from the Swiss National Cohort Study

    PubMed Central

    Zwahlen, Marcel

    2016-01-01

    Objective Switzerland has mountains and valleys complicating the access to a hospital and critical care in case of emergencies. Treatment success for acute myocardial infarction (AMI) or stroke depends on timely treatment. We examined the relationship between distance to different hospital types and mortality from AMI or stroke in the Swiss National Cohort (SNC) Study. Design and setting The SNC is a longitudinal mortality study of the census 2000 population of Switzerland. For 4.5 million Swiss residents not living in a nursing home and older than 30 years in the year 2000, we calculated driving time and straight-line distance from their home to the nearest acute, acute with emergency room, central and university hospital (in total 173 hospitals). On the basis of quintiles, we used multivariable Cox proportional hazard models to estimate HRs of AMI and stroke mortality for driving time distance groups compared to the closest distance group. Results Over 8 years, 19 301 AMI and 21 931 stroke deaths occurred. Mean driving time to the nearest acute hospital was 6.5 min (29.7 min to a university hospital). For AMI mortality, driving time to a university hospital showed the strongest association among the four types of hospitals with a hazard ratio (HR) of 1.19 (95% CI 1.10 to 1.30) and 1.10 (95% CI 1.01 to 1.20) for men and women aged 65+ years when comparing the highest quintile with the lowest quintile of driving time. For stroke mortality, the association with university hospital driving time was less pronounced than for AMI mortality and did not show a clear incremental pattern with increasing driving time. There was no association with driving time to the nearest hospital. Conclusions The increasing AMI mortality with increasing driving time to the nearest university hospital but not to any nearest hospital reflects a complex interplay of many factors along the care pathway. PMID:27803109

  6. The African Development Bank, structural adjustment, and child mortality: a cross-national analysis of Sub-Saharan Africa.

    PubMed

    Pandolfelli, Lauren E; Shandra, John M

    2013-01-01

    We conduct a cross-national analysis to test the hypothesis that African Development Bank (AfDB) structural adjustment adversely impacts child mortality in Sub-Saharan Africa. We use generalized least square random effects regression models and two-step Heckman models that correct for selection bias using data on 35 nations with up to four time points (1990, 1995, 2000, and 2005). We find substantial support for our hypothesis, which indicates that Sub-Saharan African nations that receive an AfDB structural adjustment loan tend to have higher levels of child mortality than Sub-Saharan African nations that do not receive such a loan. This finding remains stable even when controlling for selection bias on whether or not a Sub-Saharan African nation receives an AfDB structural adjustment loan. We conclude by discussing the methodological implications of the article, policy suggestions, and possible directions for future research.

  7. Association of hospital volume with conditional 90-day mortality after cystectomy: an analysis of the National Cancer Data Base.

    PubMed

    Nielsen, Matthew E; Mallin, Katherine; Weaver, Mark A; Palis, Bryan; Stewart, Andrew; Winchester, David P; Milowsky, Matthew I

    2014-07-01

    To examine the association of hospital volume and 90-day mortality after cystectomy, conditional on survival for 30 days. The National Cancer Data Base was used to evaluate 30- and 90-day mortality for 35,055 patients who underwent cystectomy for bladder cancer at one of 1118 hospitals. Patient data were aggregated into hospital volume categories based on the mean annual number of procedures (low-volume hospital: <10 procedures; intermediate-volume hospital: 10-19 procedures; high-volume hospital: ≥20 procedures). Associations between mortality and clinical, demographic and hospital characteristics were analysed using hierarchical logistic regression models. To assess the association between hospital volume and 90-day mortality independently of shorter-term mortality, 90-day mortality conditional on 30-day survival was assessed in the multivariate modelling. Unadjusted 30- and 90-day mortality rates were 2.7 and 7.2% overall, 1.9 and 5.7% among high-volume hospitals, and 3.2 and 8.0% among low-volume hospitals, respectively. Compared with high-volume hospitals, the adjusted risks among low-volume hospitals (odds ratio [95% CI]) of 30- and 90-day mortality, conditional on having survived for 30 days, from the hierarchical models were 1.5 (1.3-1.9), and 1.2 (1.0-1.4), respectively. A low hospital volume was associated with greater 30- and 90-day mortality. These data support the need for further research to better understand the relatively high mortality rates seen between 30 and 90 days, which are high and less variable across hospital volume strata. The stronger association between volume and 30-day mortality suggests that quality-reporting efforts should focus on shorter-term outcomes. © 2013 The Authors. BJU International © 2013 BJU International.

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

    PubMed Central

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

    2014-01-01

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

  9. Tobacco use transitions in the United States: The National Longitudinal Study of Adolescent Health.

    PubMed

    Kaufman, Annette R; Land, Stephanie; Parascandola, Mark; Augustson, Erik; Backinger, Cathy L

    2015-12-01

    The purpose of this study is to evaluate and describe transitions in cigarette and smokeless tobacco (ST) use, including dual use, prospectively from adolescence into young adulthood. The current study utilizes four waves of the National Longitudinal Study of Adolescent Health (Add Health) to examine patterns of cigarette and ST use (within 30 days of survey) over time among a cohort in the United States beginning in 7th-12th grade (1995) into young adulthood (2008-2009). Transition probabilities were estimated using Markov modeling. Among the cohort (N=20,774), 48.7% reported using cigarettes, 12.8% reported using ST, and 7.2% reported dual use (cigarettes and ST in the same wave) in at least one wave. In general, the risk for transitioning between cigarettes and ST was higher for males and those who were older. Dual users exhibited a high probability (81%) of continuing dual use over time. Findings suggest that adolescents who use multiple tobacco products are likely to continue such use as they move into young adulthood. When addressing tobacco use among adolescents and young adults, multiple forms of tobacco use should be considered. Published by Elsevier Inc.

  10. School, neighborhood, and family factors are associated with children's bullying involvement: a nationally representative longitudinal study.

    PubMed

    Bowes, Lucy; Arseneault, Louise; Maughan, Barbara; Taylor, Alan; Caspi, Avshalom; Moffitt, Terrie E

    2009-05-01

    To test whether school, neighborhood, and family factors are independently associated with children's involvement in bullying, over and above their own behaviors that may increase their risk for becoming involved in bullying. We examined bullying in the Environmental Risk (E-Risk) Longitudinal Twin Study, a nationally representative 1994-1995 birth cohort of 2,232 children. We used mother and teacher reports to identify children who experienced bullying between the ages of 5 and 7 years either as victims, bullies, or bully-victims. We collected information about school characteristics from the Department for Children, Schools and Families. We collected reports from mothers about children's neighborhood and home environments and reports from mothers and teachers about children's internalizing and externalizing problems when they were 5 years old. Multinomial logistic regressions showed that over and above other socioenvironmental factors and children's behavior problems, school size was associated with an increased risk for being a victim of bullying, problems with neighbors was associated with an increased risk for being a bully-victim, and family factors (e.g., child maltreatment, domestic violence) were associated with all groups of children involved in bullying. Socioenvironmental factors are associated with children's risk for becoming involved in bullying over and above their own behaviors. Intervention programs aimed at reducing bullying should extend their focus beyond schools to include local communities and families.

  11. Academic performance, educational aspiration and birth outcomes among adolescent mothers: a national longitudinal study

    PubMed Central

    2014-01-01

    Background Maternal educational attainment has been associated with birth outcomes among adult mothers. However, limited research explores whether academic performance and educational aspiration influence birth outcomes among adolescent mothers. Methods Data from Waves I and IV of the National Longitudinal Study of Adolescent Health (Add Health) were used. Adolescent girls whose first pregnancy occurred after Wave I, during their adolescence, and ended with a singleton live birth were included. Adolescents’ grade point average (GPA), experience of ever skipping a grade and ever repeating a grade, and their aspiration to attend college were examined as predictors of birth outcomes (birthweight and gestational age; n = 763). Univariate statistics, bivariate analyses and multivariable models were run stratified on race using survey procedures. Results Among Black adolescents, those who ever skipped a grade had higher offspring’s birthweight. Among non-Black adolescents, ever skipping a grade and higher educational aspiration were associated with higher offspring’s birthweight; ever skipping a grade was also associated with higher gestational age. GPA was not statistically significantly associated with either birth outcome. The addition of smoking during pregnancy and prenatal care visit into the multivariable models did not change these associations. Conclusions Some indicators of higher academic performance and aspiration are associated with better birth outcomes among adolescents. Investing in improving educational opportunities may improve birth outcomes among teenage mothers. PMID:24422664

  12. Academic performance, educational aspiration and birth outcomes among adolescent mothers: a national longitudinal study.

    PubMed

    Xie, Yiqiong; Harville, Emily Wheeler; Madkour, Aubrey Spriggs

    2014-01-15

    Maternal educational attainment has been associated with birth outcomes among adult mothers. However, limited research explores whether academic performance and educational aspiration influence birth outcomes among adolescent mothers. Data from Waves I and IV of the National Longitudinal Study of Adolescent Health (Add Health) were used. Adolescent girls whose first pregnancy occurred after Wave I, during their adolescence, and ended with a singleton live birth were included. Adolescents' grade point average (GPA), experience of ever skipping a grade and ever repeating a grade, and their aspiration to attend college were examined as predictors of birth outcomes (birthweight and gestational age; n = 763). Univariate statistics, bivariate analyses and multivariable models were run stratified on race using survey procedures. Among Black adolescents, those who ever skipped a grade had higher offspring's birthweight. Among non-Black adolescents, ever skipping a grade and higher educational aspiration were associated with higher offspring's birthweight; ever skipping a grade was also associated with higher gestational age. GPA was not statistically significantly associated with either birth outcome. The addition of smoking during pregnancy and prenatal care visit into the multivariable models did not change these associations. Some indicators of higher academic performance and aspiration are associated with better birth outcomes among adolescents. Investing in improving educational opportunities may improve birth outcomes among teenage mothers.

  13. Does watching sex on television predict teen pregnancy? Findings from a national longitudinal survey of youth.

    PubMed

    Chandra, Anita; Martino, Steven C; Collins, Rebecca L; Elliott, Marc N; Berry, Sandra H; Kanouse, David E; Miu, Angela

    2008-11-01

    There is increasing evidence that youth exposure to sexual content on television shapes sexual attitudes and behavior in a manner that may influence reproductive health outcomes. To our knowledge, no previous work has empirically examined associations between exposure to television sexual content and adolescent pregnancy. Data from a national longitudinal survey of teens (12-17 years of age, monitored to 15-20 years of age) were used to assess whether exposure to televised sexual content predicted subsequent pregnancy for girls or responsibility for pregnancy for boys. Multivariate logistic regression models controlled for other known correlates of exposure to sexual content and pregnancy. We measured experience of a teen pregnancy during a 3-year period. Exposure to sexual content on television predicted teen pregnancy, with adjustment for all covariates. Teens who were exposed to high levels of television sexual content (90th percentile) were twice as likely to experience a pregnancy in the subsequent 3 years, compared with those with lower levels of exposure (10th percentile). This is the first study to demonstrate a prospective link between exposure to sexual content on television and the experience of a pregnancy before the age of 20. Limiting adolescent exposure to the sexual content on television and balancing portrayals of sex in the media with information about possible negative consequences might reduce the risk of teen pregnancy. Parents may be able to mitigate the influence of this sexual content by viewing with their children and discussing these depictions of sex.

  14. Informal Care and Inter-vivos Transfers: Results from the National Longitudinal Survey of Mature Women

    PubMed Central

    Norton, Edward C.; Nicholas, Lauren H.; Huang, Sean Sheng-Hsiu

    2013-01-01

    Informal care is the largest source of long-term care for elderly, surpassing home health care and nursing home care. By definition, informal care is unpaid. It remains a puzzle why so many adult children give freely of their time. Transfers of time to the older generation may be balanced by financial transfers going to the younger generation. This leads to the question of whether informal care and inter-vivos transfers are causally related. We analyze data from the 1999 and 2003 waves of National Longitudinal Survey of Mature Women. We examine whether the elderly parents give more inter-vivos monetary transfers to adult children who provide informal care, by examining both the extensive and intensive margins of financial transfers and of informal care. We find statistically significant results that a child who provides informal care is more likely to receive inter-vivos transfers than a sibling who does not. If a child does provide care, there is no statistically significant effect on the amount of the transfer. PMID:25285181

  15. Trajectories of Delinquency from Age 14 to 23 in the National Longitudinal Survey of Youth Sample

    PubMed Central

    Murphy, Debra A.; Brecht, Mary-Lynn; Huang, David; Herbeck, Diane M.

    2012-01-01

    This study utilized data from the National Longitudinal Survey of Youth to investigate risk trajectories for delinquency and factors associated with different trajectories, particularly substance use. The sample (N = 8,984) was 49% female. A group-based trajectory model was applied, which identified four distinct trajectories for both males and females: (1) a High group with delinquency rates consistently higher than other groups, with some decrease across the age range; (2) a Decreased group, beginning at high levels with substantial decrease to near zero; (3) a Moderate group experiencing some decline but remaining at moderate rates of delinquency through most of the age range; and (4) a consistently Low group, having low rates of delinquency declining to near zero by mid- to late-teens. The Low group was distinguished by several protective factors, including higher rates of maternal authoritative parenting style, possible lower acculturation (higher rates of non-English spoken at home), higher rates of religious activity, later substance use initiation, lower rates of early delinquent activity, less early experience with neighborhood or personal violence, and higher rates of perceiving penalty for wrongdoing. Conversely, the High group was characterized by several vulnerability factors—essentially the converse of the protective factors above. PMID:23105164

  16. Tobacco use transitions in the United States: The National Longitudinal Study of Adolescent Health

    PubMed Central

    Kaufman, Annette R.; Land, Stephanie; Parascandola, Mark; Augustson, Erik; Backinger, Cathy L.

    2015-01-01

    Objectives The purpose of this study is to evaluate and describe transitions in cigarette and smokeless tobacco (ST) use, including dual use, prospectively from adolescence into young adulthood. Methods The current study utilizes four waves of the National Longitudinal Study of Adolescent Health (Add Health) to examine patterns of cigarette and ST use (within 30 days of survey) over time among a cohort in the United States beginning in 7th–12th grade (1995) into young adulthood (2008–2009). Transition probabilities were estimated using Markov modeling. Results Among the cohort (N = 20,774), 48.7% reported using cigarettes, 12.8% reported using ST, and 7.2% reported dual use (cigarettes and ST in the same wave) in at least one wave. In general, the risk for transitioning between cigarettes and ST was higher for males and those who were older. Dual users exhibited a high probability (81%) of continuing dual use over time. Conclusions Findings suggest that adolescents who use multiple tobacco products are likely to continue such use as they move into young adulthood. When addressing tobacco use among adolescents and young adults, multiple forms of tobacco use should be considered. PMID:26361752

  17. Informal Care and Inter-vivos Transfers: Results from the National Longitudinal Survey of Mature Women.

    PubMed

    Norton, Edward C; Nicholas, Lauren H; Huang, Sean Sheng-Hsiu

    2013-05-01

    Informal care is the largest source of long-term care for elderly, surpassing home health care and nursing home care. By definition, informal care is unpaid. It remains a puzzle why so many adult children give freely of their time. Transfers of time to the older generation may be balanced by financial transfers going to the younger generation. This leads to the question of whether informal care and inter-vivos transfers are causally related. We analyze data from the 1999 and 2003 waves of National Longitudinal Survey of Mature Women. We examine whether the elderly parents give more inter-vivos monetary transfers to adult children who provide informal care, by examining both the extensive and intensive margins of financial transfers and of informal care. We find statistically significant results that a child who provides informal care is more likely to receive inter-vivos transfers than a sibling who does not. If a child does provide care, there is no statistically significant effect on the amount of the transfer.

  18. Parents, parenting and toddler adaptation: evidence from a national longitudinal study of Australian children.

    PubMed

    Zimmer-Gembeck, Melanie J; Thomas, Rae

    2010-12-01

    Because infants and toddlers are particularly susceptible to parents' socialization efforts, the purpose of this 2-year longitudinal study (N=4271 infants) was to forecast toddlers' competence and problems (adaptational outcomes, age M=30 months) from parenting experiences when they were infants (age M=9 months). Using structural equation modeling and data from a nationally representative sample, parenting during infancy was important to toddlers' adaptational outcomes, with parenting warmth most strongly connected to toddler competence and parenting hostility most strongly connected to toddler problems. Additionally, toddlers' outcomes were associated with their parents' mental health symptoms, life difficulty, coping and self-efficacy when measured 2 years earlier (parent context), and parenting warmth and hostility mediated some of these associations. These pathways indicated that the infant parenting context had some spill over effect on toddlers via parental warmth and hostility. However, mediational paths were not as common as expected, suggesting that the parent context had more direct than indirect effects on toddlers. Conclusions were similar even after accounting for infant temperament, family demographic characteristics and infant birthweight, with substantial reductions in effects only found for associations of parenting self-efficacy with toddlers' outcomes. Copyright © 2010 Elsevier Inc. All rights reserved.

  19. Longitudinal trends in organophosphate incidents reported to the National Pesticide Information Center, 1995–2007

    PubMed Central

    2009-01-01

    Background Regulatory decisions to phase-out the availability and use of common organophosphate pesticides among the general public were announced in 2000 and continued through 2004. Based on revised risk assessments, chlorpyrifos and diazinon were determined to pose unacceptable risks. To determine the impact of these decisions, organophosphate (OP) exposure incidents reported to the National Pesticide Information Center (NPIC) were analyzed for longitudinal trends. Methods Non-occupational human exposure incidents reported to NPIC were grouped into pre- (1995–2000) and post-announcement periods (2001–2007). The number of total OP exposure incidents, as well as reports for chlorpyrifos, diazinon and malathion, were analyzed for significant differences between these two periods. The number of informational inquiries from the general public was analyzed over time as well. Results The number of average annual OP-related exposure incidents reported to NPIC decreased significantly between the pre- and post-announcement periods (p < 0.001). A significant decrease in the number of chlorpyrifos and diazinon reports was observed over time (p < 0.001). No significant difference in the number of incident reports for malathion was observed (p = 0.4), which was not phased-out of residential use. Similar to exposure incidents, the number of informational inquiries received by NPIC declined over time following the phase-out announcement. Conclusion Consistent with other findings, the number of chlorpyrifos and diazinon exposure incidents reported to NPIC significantly decreased following public announcement and targeted regulatory action. PMID:19379510

  20. Evaluation of the National Tips From Former Smokers Campaign: the 2014 Longitudinal Cohort

    PubMed Central

    Patel, Deesha; Davis, Kevin; Ridgeway, William; Shafer, Paul; Cox, Shanna

    2016-01-01

    Introduction Since 2012, the Centers for Disease Control and Prevention has aired a national tobacco education campaign to encourage quitting, Tips From Former Smokers (Tips), which consists of graphic antismoking advertisements that feature former cigarette smokers. We evaluated phase 2 of the 2014 campaign by using a nationally representative longitudinal cohort. Methods Cigarette smokers who participated in a baseline survey were re-contacted for follow-up (n = 4,248) approximately 4 months later, immediately after the campaign’s conclusion. The primary outcomes were incidence of a quit attempt in the previous 3 months, intention to quit within 30 days, and intention to quit within 6 months during the postcampaign period. We used multivariate logistic regression models to estimate the odds of each outcome. We also stratified models by race/ethnicity, education, and mental health status. Postcampaign rates of quit attempts, intentions to quit, and sustained quits were also estimated. Results Exposure to the campaign was associated with increased odds of a quit attempt in the previous 3 months (OR, 1.17; P = .03) among baseline smokers and intentions to quit within the next 6 months (OR, 1.28; P = .01) among current smokers at follow-up. The Tips campaign was associated with an estimated 1.83 million additional quit attempts, 1.73 million additional smokers intending to quit within 6 months, and 104,000 sustained quits of at least 6 months. Conclusion The Tips campaign continued to have a significant impact on cessation-related behaviors, providing further justification for the continued use of tobacco education campaigns to accelerate progress toward the goal of reducing adult smoking in the United States. PMID:27010845

  1. Emergent programme theories of a national quality register - a longitudinal study in Swedish elderly care.

    PubMed

    Nordin, Annika; Andersson Gäre, Boel; Andersson, Ann-Christine

    2017-07-27

    This study aimed to explore programme theories of a national quality register. A programme theory is a bundle of assumptions underpinning how and why an improvement initiative functions. The purpose was to examine and establish programme theories of a national quality register widely used in Sweden: Senior alert. The paper reports on how programme theories among change recipients emerge in relation to the established programme theory of the initiator. A qualitative approach and a longitudinal research design were used. To develop programme theories among change recipients, individual semistructured interviews were conducted. Three sets of interviews were conducted in the period of 2011 to 2013, totalling 22 interviews. In addition, 4 participant observations were made. To develop the initiator's programme theory, an iterative multistage collaboration process between the researchers and the initiator was used. A directed content analysis was used to analyse data. The initiator and change recipients described similar programme logics, but differing programme theories. With time, change recipients' programme theories emerged. Their programme theories converged and became more like the programme theory of the initiator. This study has demonstrated the importance of making both the initiator's and change recipients' programme theories explicit. To learn about conditions for improvement initiatives, comparisons between their programme theories are valuable. Differences in programme theories provide information on how initiators can customize support for their improvement initiatives. Similar programme logics can be underpinned by different programme theories, which can be deceptive. Programme theories emerge over time and need to be understood as dynamic phenomena. © 2017 The Authors Journal of Evaluation in Clinical Practice Published by John Wiley & Sons Ltd.

  2. Evaluation of the National Tips From Former Smokers Campaign: the 2014 Longitudinal Cohort.

    PubMed

    Neff, Linda J; Patel, Deesha; Davis, Kevin; Ridgeway, William; Shafer, Paul; Cox, Shanna

    2016-03-24

    Since 2012, the Centers for Disease Control and Prevention has aired a national tobacco education campaign to encourage quitting, Tips From Former Smokers (Tips), which consists of graphic antismoking advertisements that feature former cigarette smokers. We evaluated phase 2 of the 2014 campaign by using a nationally representative longitudinal cohort. Cigarette smokers who participated in a baseline survey were re-contacted for follow-up (n = 4,248) approximately 4 months later, immediately after the campaign's conclusion. The primary outcomes were incidence of a quit attempt in the previous 3 months, intention to quit within 30 days, and intention to quit within 6 months during the postcampaign period. We used multivariate logistic regression models to estimate the odds of each outcome. We also stratified models by race/ethnicity, education, and mental health status. Postcampaign rates of quit attempts, intentions to quit, and sustained quits were also estimated. Exposure to the campaign was associated with increased odds of a quit attempt in the previous 3 months (OR, 1.17; P = .03) among baseline smokers and intentions to quit within the next 6 months (OR, 1.28; P = .01) among current smokers at follow-up. The Tips campaign was associated with an estimated 1.83 million additional quit attempts, 1.73 million additional smokers intending to quit within 6 months, and 104,000 sustained quits of at least 6 months. The Tips campaign continued to have a significant impact on cessation-related behaviors, providing further justification for the continued use of tobacco education campaigns to accelerate progress toward the goal of reducing adult smoking in the United States.

  3. Dietary pattern and 20 year mortality in elderly men in Finland, Italy, and The Netherlands: longitudinal cohort study.

    PubMed Central

    Huijbregts, P.; Feskens, E.; Räsänen, L.; Fidanza, F.; Nissinen, A.; Menotti, A.; Kromhout, D.

    1997-01-01

    OBJECTIVE: To investigate the association of dietary pattern and mortality in international data. DESIGN: Cohort study with 20 years' follow up of mortality. SETTING: Five cohorts in Finland, the Netherlands, and Italy. SUBJECTS: Population based random sample of 3045 men aged 50-70 years in 1970. MAIN OUTCOME MEASURES: Food intake was estimated using a cross check dietary history. In this dietary survey method, the usual food consumption pattern in the 6-12 months is estimated. A healthy diet indicator was calculated for the dietary pattern, using the World Health Organisation's guidelines for the prevention of chronic diseases. Vital status was verified after 20 years of follow up, and death rates were calculated. RESULTS: Dietary intake varied greatly in 1970 between the three countries. In Finland and the Netherlands the intake of saturated fatty acids and cholesterol was high and the intake of alcohol was low; in Italy the opposite was observed. In total 1796 men (59%) died during 20 years of follow up. The healthy diet indicator was inversely associated with mortality (P for trend < 0.05). After adjustment for age, smoking, and alcohol consumption, the relative risk in the group with the healthiest diet indicator compared with the group with the least healthy was 0.87 (95% confidence interval 0.77 to 0.98). Estimated relative risks were essentially similar within each country. CONCLUSIONS: Dietary intake of men aged 50-70 is associated with a 20 year, all cause mortality in different cultures. The healthy diet indicator is useful in evaluating the relation of mortality to dietary patterns. PMID:9233319

  4. Cohabitation and U.S Adult Mortality: An Examination by Gender and Race

    ERIC Educational Resources Information Center

    Liu, Hui; Reczek, Corinne

    2012-01-01

    This study is the first to explore the relationship between cohabitation and U.S. adult mortality using a nationally representative sample. Using data from the National Health Interview Survey-Longitudinal Mortality Follow-up files 1997-2004 (N = 193,851), the authors found that divorced, widowed, and never-married White men had higher mortality…

  5. The Basic Act for Suicide Prevention: Effects on Longitudinal Trend in Deliberate Self-Harm with Reference to National Suicide Data for 1996-2014.

    PubMed

    Nakanishi, Miharu; Endo, Kaori; Ando, Shuntaro

    2017-01-21

    A suicide prevention strategy was launched in Japan in 2006 to address the high suicide rate, which had increased considerably since 1998. The national strategy from 2007 involved the enhancement of psychiatric treatment services at emergency medical facilities and supportive observation by individuals close to patients. The national suicide rate has decreased gradually since 2008; however, national information regarding the number of patients who had engaged in deliberate self-harm was absent. Therefore, the present study examined the longitudinal trend in hospital admissions due to deliberate self-harm in Japan. Data from the National Patient Survey between 1996 and 2014-a nationally representative cross-sectional survey of inpatient care every 3 years-were used. Data for 13,014 patients were included in the estimation of the number of hospital admissions due to deliberate self-harm. The results show that the estimated number of admissions due to deliberate self-harm increased from 2078 in September 1996 to 3189 in September 2008, when the national number of suicide cases peaked, and decreased to 1783 in 2014. Approximately half of the patients were admitted to hospital because of self-harm via means other than drug poisoning, which had a high mortality rate (5.6%). The proportion of patients receiving public assistance was higher in those who had engaged in deliberate self-harm (8.5%) relative to that observed in the general population. Overall, the trend in deliberate self-harm was synchronous with the number of suicide cases over time. As economic poverty has been associated with suicidal ideation and behavior and some recipients of public assistance tend to abuse psychotropic medication, the public assistance program should provide mental health support for recipients of social benefit schemes.

  6. The Basic Act for Suicide Prevention: Effects on Longitudinal Trend in Deliberate Self-Harm with Reference to National Suicide Data for 1996–2014

    PubMed Central

    Nakanishi, Miharu; Endo, Kaori; Ando, Shuntaro

    2017-01-01

    A suicide prevention strategy was launched in Japan in 2006 to address the high suicide rate, which had increased considerably since 1998. The national strategy from 2007 involved the enhancement of psychiatric treatment services at emergency medical facilities and supportive observation by individuals close to patients. The national suicide rate has decreased gradually since 2008; however, national information regarding the number of patients who had engaged in deliberate self-harm was absent. Therefore, the present study examined the longitudinal trend in hospital admissions due to deliberate self-harm in Japan. Data from the National Patient Survey between 1996 and 2014—a nationally representative cross-sectional survey of inpatient care every 3 years—were used. Data for 13,014 patients were included in the estimation of the number of hospital admissions due to deliberate self-harm. The results show that the estimated number of admissions due to deliberate self-harm increased from 2078 in September 1996 to 3189 in September 2008, when the national number of suicide cases peaked, and decreased to 1783 in 2014. Approximately half of the patients were admitted to hospital because of self-harm via means other than drug poisoning, which had a high mortality rate (5.6%). The proportion of patients receiving public assistance was higher in those who had engaged in deliberate self-harm (8.5%) relative to that observed in the general population. Overall, the trend in deliberate self-harm was synchronous with the number of suicide cases over time. As economic poverty has been associated with suicidal ideation and behavior and some recipients of public assistance tend to abuse psychotropic medication, the public assistance program should provide mental health support for recipients of social benefit schemes. PMID:28117707

  7. A longitudinal study on morbidity and mortality in youngstock smallholder dairy cattle with special reference to tick borne infections in Tanga region, Tanzania.

    PubMed

    Swai, Emmanuel S; Karimuribo, Esron D; Kambarage, Dominic M; Moshy, Winford E

    2009-03-09

    The incidence and potential determinants of tick borne diseases (TBDs) were estimated in a longitudinal study that was conducted in cohorts of youngstock animals of less than 3 years kept in smallholder dairy farms in Tanga region, Tanzania. A combination of serological tests, blood and lymph node smears were used as diagnostic tests for TBDs during the study. A total number of 549 youngstock were followed for a total of 532.2 animal years from August 1999 to July 2001. Overall morbidity and mortality rates (due to all causes) were 8.26 and 12.0 per 100 animals year at risk, respectively. Of the total deaths, 56% were attributed to TBDs (37.5%-East Coast fever (ECF) and 18%-anaplasmosis). Specific morbidity and mortality rates for ECF were estimated to be 3.57 and 4.51 per 100 animals year risk, respectively, and for anaplasmosis 2.21 and 2.25 per 100 animals year risk, respectively. Analysis of survival times to death indicated that calves < 6 months of age and those out on pasture had higher death rates than older calves and those kept under zero-grazing systems (relative risk [RR] 3.80, P = 0.001 for pasture-grazed calves). There was no mortality or morbidity arising specifically from cowdriosis (heartwater) or babesiosis during the whole period of monitoring. The study revealed that most farms were applying under strength acaricide and using acaricides at irregular intervals. It is concluded that TBDs namely ECF and anaplasmosis are important diseases in this farming system and reducing morbidity and mortality in smallholder dairy farms in Tanga region is an achievable goal. Both farmers and extension services should target at risk calves with the provision of both strict tick control and optimal husbandry management practices.

  8. Association of Healthy Habits Beliefs and Mortality in Older Adults: A Longitudinal Analysis of the Mexican Health and Aging Study.

    PubMed

    Fernandez-Villa, Julio M; Marquez, David X; Sanchez-Garrido, Natalia; Perez-Zepeda, Mario U; Gonzalez-Lara, Mariana

    2017-06-01

    The aim of this article is to establish the association between beliefs about healthy habits and mortality in a group of Mexican older adults. This is an 11-year follow-up secondary analysis of the Mexican Health and Aging Study. There was a significant difference ( p < .001) in survival rate between those participants who believed that healthy habits have the potential to improve health compared with those who did not. After adjustment for confounders, Cox regression models showed a hazard ratio (HR) of 0.17 (95% confidence interval [CI] [0.07, 0.38], p < .001) for the group that believed in healthy habits. Although the mechanism is not completely clear, according to our results, believing that healthy habits can improve health was associated with lower rates of mortality. Further research should elucidate potential strategies for changing beliefs in older adults with the goal of improving their overall health.

  9. Deaths from Symptomatically Identifiable Furious Rabies in India: A Nationally Representative Mortality Survey

    PubMed Central

    Suraweera, Wilson; Morris, Shaun K.; Kumar, Rajesh; Warrell, David A.; Warrell, Mary J.; Jha, Prabhat

    2012-01-01

    Background It is estimated that India has more deaths from rabies than any other country. However, existing estimates are indirect and rely on non-representative studies. Methods and Principal Findings We examined rabies deaths in the ongoing Million Death Study (MDS), a representative survey of over 122,000 deaths in India that uses enhanced types of verbal autopsy. We estimated the age-specific mortality rates of symptomatically identifiable furious rabies and its geographic and demographic distributions. A total of 140 deaths in our sample were caused by rabies, suggesting that in 2005 there were 12,700 (99% CI 10,000 to 15,500) symptomatically identifiable furious rabies deaths in India. Most rabies deaths were in males (62%), in rural areas (91%), and in children below the age of 15 years (50%). The overall rabies mortality rate was 1.1 deaths per 100,000 population (99%CI 0.9 to 1.4). One third of the national rabies deaths were found in Uttar Pradesh (4,300) and nearly three quarters (8,900) were in 7 central and south-eastern states: Chhattisgarh, Uttar Pradesh, Odisha, Andhra Pradesh, Bihar, Assam, and Madhya Pradesh. Conclusions and Significance Rabies remains an avoidable cause of death in India. As verbal autopsy is not likely to identify atypical or paralytic forms of rabies, our figure of 12,700 deaths due to classic and clinically identifiable furious rabies underestimates the total number of deaths due to this virus. The concentrated geographic distribution of rabies in India suggests that a significant reduction in the number of deaths or potentially even elimination of rabies deaths is possible. PMID:23056661

  10. National trauma databank analysis of mortality and limb loss in isolated lower extremity vascular trauma.

    PubMed

    Kauvar, David S; Sarfati, Mark R; Kraiss, Larry W

    2011-06-01

    Lower extremity injury is common in trauma patients; however, the influence of arterial injury on devastating patient and limb outcomes can be confounded by the presence and physiological derangement of concomitant head or thoracoabdominal injuries. We analyzed isolated lower extremity injuries with an arterial component. Our aim was to elucidate factors associated with mortality and limb loss in this selected population. We reviewed trauma incidents from the National Trauma Data Bank (2002-2006) containing isolated lower extremity injury codes and a specified infrainguinal arterial injury. Demographics, injury patterns, clinical characteristics, and adverse outcomes (death, amputation) during initial hospitalization were collected. Multivariate logistic regression was used to identify risk factors for limb loss. There were 651 isolated infrainguinal arterial injuries. Death (18) and early limb loss (42) were studied by mechanism (penetrating, n = 431; blunt, n = 220). Half of the deaths involved injury to the common femoral artery (CFA), and over 80% had injury to the CFA or superficial femoral artery (SFA). Death was three times as frequent in the CFA/SFA than in the popliteal/tibial injuries (P = .02). Penetrating injuries were present in almost 80% of deaths, and most of these were gunshot wounds. Patients who died had mean initial systolic blood pressure of 59.7 mm Hg, and almost 40% had no blood pressure on arrival. Mean initial Glasgow Coma Score was 4.5, and almost 80% arrived with a Glasgow Coma Score of 3 despite the absence of head injury. Twenty-seven above- and 15 below-the-knee amputations were performed. The popliteal artery was injured in half of the amputations, with injury isolated to the popliteal or tibial arteries in about three-quarters. Amputation was twice as frequent in popliteal/tibial than CFA/SFA injury (P = .03) and twice as frequent in blunt than penetrating injury (P = .05). Multiple arterial injuries (odds ratio, 5.2; 95% confidence

  11. Mortality among children and youth in high-percentage First Nations identity areas, 2000-2002 and 2005-2007.

    PubMed

    Peters, Paul A; Oliver, Lisa N; Kohen, Dafna E

    2013-01-01

    Many First Nations children live in communities that face diverse social and health challenges compared with their non-Aboriginal peers, including some of the most socio-economically challenging situations in Canada. These differences can be seen in broad indicators of the social determinants of health. Studies of mortality in Aboriginal populations across Canada are often restricted by the lack of Aboriginal identifiers on national death records. While some studies have utilised a record-linkage approach, this is often not possible for the entire country or for recent data. Some researchers have adopted a geographic approach and examined mortality and morbidity in areas that have a high percentage of Aboriginal identity residents, and have uniformly reported elevated rates of mortality and morbidity compared with other areas. The purpose of this article was to examine child and youth mortality (aged 1 to 19 years) in areas where a high percentage of the population identified as First Nations in comparison with areas where there is a low percentage of Aboriginal identity residents. Using a geographic threshold table approach, areas with a high percentage of Aboriginal identity peoples were classified as either First Nations, Métis, or Inuit communities based on the predominant identity group. The upper one-third of the total Aboriginal population distribution was used as a cut-off for high percentage First Nations areas, where 97.7% of the population aged 1-19 were of First Nations identity in 2006 (N=140 779). Mortality rates were then calculated for high-percentage First Nations identity areas and compared with low-percentage Aboriginal identity areas, excluding high-percentage Métis or Inuit identity areas. Deaths were aggregated for the 3 years surrounding the 2001 and 2006 census periods, and a total of 473 deaths were recorded for 2000-2002 and 493 deaths for 2005-2007. Analysis was facilitated via the correspondence of six-digit residential postal

  12. Mortality Trends among Cocaine Users Treated between 1989 and 2013 in Northern Italy: Results of a Longitudinal Study.

    PubMed

    Pavarin, Raimondo Maria; Fioritti, Angelo

    2017-08-28

    A total of 852 participants attending 11 centers for addiction treatment in north Italy following problems due to cocaine abuse between 1989 and 2013 were recruited. Two typologies were created: cocaine users (never heroin) (CU) and heroin and cocaine users (HCU). During the 38-year follow-up period, 4.8% of the whole cohort died. Over the whole period, tumors were the main causes of death; starting in 2010, suicide deaths became the first cause of death. Among CUs, most deaths were due to road accidents and suicide; among HCUs, most of the deaths were from opiate overdose and from cardio-circulatory system diseases. The excess mortality observed for all causes in either sex was 6.24; higher in females (15.03) as compared in males (6.23), higher in HCUs (9.06) as compared in CUs (5.21). The directly age-sex standardized mortality rates were 5.31 per 100, higher for females, declining after 2009 for all patients and after 2004 for HCUs. Multivariate analysis confirms the decreasing trend in the risk of death and shows a higher mortality risk for participants in the under-25 age group. Among cocaine users, special attention should be paid to the prevention of suicide deaths.

  13. The association between long-term longitudinal trends in guideline adherence and mortality in relation to age and sex.

    PubMed

    Frankenstein, Lutz; Remppis, Andrew; Fluegel, Andrea; Doesch, Andreas; Katus, Hugo A; Senges, Jochen; Zugck, Christian

    2010-06-01

    Using a large clinical multi-site prospective chronic heart failure registry, we sought to determine (i) implementation of guidelines over time and (ii) adjusted survival benefit there from. Clinical characteristics, mortality, and medication according to guidelines [guideline adherence index (GAI) for ACE-inhibitors or angiotensin receptor blockers, beta-blockers, aldosterone antagonists] were compared for 1481 patients included from 1994 to 2000 and 1811 patients from 2001 to 2007. The co-morbidity corrected GAI significantly increased from 1994-2000 to 2001-07 (P < 0.001). Concomitantly, 1- and 3-year mortality decreased (14.1-4.8 and 29.5-10.9%, respectively, P < 0.001 each). No interaction with age or sex was noted (P = 0.06, P = 0.25, respectively), though age determined complete medication according to guidelines (P < 0.05). The GAI was a significant predictor of lower overall mortality (adjusted HR per 10% increase: 0.92; 95% CI: 0.88-0.97; P = 0.001), again independent from age or sex. Results were essentially unchanged after controlling for co-morbidities and other potential confounders. This study shows that increased use of medication according to guidelines might occur without interventions targeting medication use. It seems to be associated with a substantial improvement in survival. Even though causality cannot be proven, the findings underscore the importance of meticulous implementation of guidelines irrespective of age, sex, or co-morbidities.

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

    PubMed Central

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

    2011-01-01

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

  15. Burden attributable to Cardiometabolic Diseases in Zimbabwe: a retrospective cross-sectional study of national mortality data.

    PubMed

    Mutowo, Mutsa P; Owen, Alice J; Billah, Baki; Lorgelly, Paula K; Gumbie, Kudzai E; Mangwiro, John C; Renzaho, Andre M N

    2015-12-07

    Cardiometabolic diseases (CMDs) are an important cause of mortality worldwide and the burden associated with them is increasing in Sub-Saharan Africa. The tracking of mortality helps support evidence based health policy and priority setting. Given the growing prevalence of non-communicable diseases in Zimbabwe, a study was designed to determine the mortality attributable to CMDs in Zimbabwe. The study design was a retrospective cross-sectional analysis of national mortality from 1996 to 2007, collated by the Ministry of Health and Child Welfare in Zimbabwe. We employed generalized additive models to flexibly estimate the trend of the CMD mortality and a logistic regression model was used to find significant factors (cause of death according to the death certificate) of the CMD mortality and predict CMD mortality to 2040. CMDs accounted for 8.13% (95% CI: 8.08% - 8.18%) of all deaths during 1996 to 2007 (p = 0.005). During the study period CMD mortality rate increased by 29.4% (95% CI: 19.9% - 41.1%). The association between gender and CMD mortality indicated female mortality was higher for diabetes (p < 0.001), hypertensive disease (p < 0.001), CVD (p < 0.001) and pulmonary disease (p < 0.001), while male mortality was higher for ischaemic (p = 0.010) and urinary diseases (p < 0.001). There was no gender difference for endocrine disease (p = 0.893). Overall, females have 1.65% higher mortality than males (p < 0.001). CMD mortality is predicted to increase from 9.6 (95% CI: 8.0% - 11.1%) in 2015 to 13.7% (95% CI: 10.2% - 17.2%) in 2040 for males, and from 11.6% (95% CI: 10.2% - 12.9%) in 2015 to 16.2% (95% CI: 13.1% - 19.3%) in 2040 in females. The findings of this study indicate a growing prevalence of CMDs and related mortality in Zimbabwe. Health policy decisions and cost-effective preventive strategies to reduce the burden of CMDs are urgently required.

  16. The combined association of psychological distress and socioeconomic status with all-cause mortality: a national cohort study.

    PubMed

    Lazzarino, Antonio Ivan; Hamer, Mark; Stamatakis, Emmanuel; Steptoe, Andrew

    2013-01-14

    Psychological distress and low socioeconomic status (SES) are recognized risk factors for mortality. The aim of this study was to test whether lower SES amplifies the effect of psychological distress on all-cause mortality. We selected 66 518 participants from the Health Survey for England who were 35 years or older, free of cancer and cardiovascular disease at baseline, and living in private households in England from 1994 to 2004. Selection used stratified random sampling, and participants were linked prospectively to mortality records from the Office of National Statistics (mean follow-up, 8.2 years). Psychological distress was measured using the 12-item General Health Questionnaire, and SES was indexed by occupational class. The crude incidence rate of death was 14.49 (95% CI, 14.17-14.81) per 1000 person-years. After adjustment for age and sex, psychological distress and low SES category were associated with increased mortality rates. In a stratified analysis, the association of psychological distress with mortality differed with SES (likelihood ratio test-adjusted P < .001), with the strongest associations being observed in the lowest SES categories. The detrimental effect of psychological distress on mortality is amplified by low SES category. People in higher SES categories have lower mortality rates even when they report high levels of psychological distress.

  17. Retrospective analysis of mortalities in elephant shrews (Macroscelididae) and tree shrews (Tupaiidae) at the Smithsonian National Zoological Park, USA.

    PubMed

    Clancy, Meredith M; Woc-Colburn, Margarita; Viner, Tabitha; Sanchez, Carlos; Murray, Suzan

    2013-06-01

    Investigations into the cause of mortality and other important findings at necropsy were made into two families of small mammals at the Smithsonian National Zoological Park (SNZP; USA). Necropsy reports from 1976 through 2008 were reviewed for all elephant shrews in family Macroscelididae (n = 118) and all tree shrews in family Tupaiidae (n = 90) that lived for greater than 30 days at the SNZP. Causes of mortality were classified by body system and etiology to identify prevalent diseases and trends across demographics for each family. In elephant shrews, gastrointestinal disease (n = 18) and respiratory disease (n = 22) were important causes of mortality with an increased prevalence of pneumonia in adult males. Trauma was a common cause of mortality in tree shrews (n = 22). Cryptococcosis was an important cause of mortality in both families (n = 8 elephant shrews; n = 13 tree shrews). Bacterial infections, often systemic at time of mortality, were also common (n = 16 elephant shrews; n = 17 tree shrews). Arteriosclerosis was a common comorbid pathology noted at necropsy in certain populations, seen only in Elephantulus rufescens in the family Macroscelididae (n = 22) and in only males in the family Tupaiidae (n = 11). Gongylonemiasis was seen commonly in tree shrews (n = 15), as a comorbid finding, or in 5 cases directly leading to mortality. Awareness of the prevalence of these diseases can help guide prevention and intervention strategies.

  18. Modelling the incidence and mortality of psychotic disorders: data from the second Australian national survey of psychosis.

    PubMed

    Saha, Sukanta; Whiteford, Harvey; McGrath, John

    2014-04-01

    The aim of this study was to model estimates related to (a) the incidence of psychotic disorders and (b) the mortality associated with these disorders based on a large, population-based prevalence study. Data were drawn from the second national survey of adults with psychotic disorders conducted in seven Australian catchment areas during March to December 2010. To generate incidence rate estimates, we identified recent onset cases recruited as part of the prevalence study and then imputed population-based incidence rates using a set of conservative assumptions. Similarly, for mortality rates, we identified individuals who had died after being identified as 'screen-positive' for psychosis, but prior to full clinical assessment. Using a set of conservative assumptions, we then used these estimates to infer population-based mortality rates. Based on our models, we estimated that the incidence rate for psychotic disorders was 28 cases per 100,000 population. The rate estimates were significantly higher in males than females, with an overall male:female ratio of 1.57:1. Incidence rate estimates peaked in the youngest age group (18-24 years). The adjusted mortality rate estimated during the whole period of observation was 12.5 per 1000 persons, with a standardised mortality ratio of 5.5. Using treated prevalence data and observed deaths with appropriate algorithms, we were able to impute incidence and mortality rates for psychotic disorders consistent with the published literature. While the second national survey of psychotic disorders was not designed to identify mortality, our estimates provide a stark reminder of the increased mortality associated with these disorders.

  19. Economic cycles and child mortality: A cross-national study of the least developed countries.

    PubMed

    Pérez-Moreno, Salvador; Blanco-Arana, María C; Bárcena-Martín, Elena

    2016-09-01

    This paper examines the effects of growth and recession periods on child mortality in the Least Developed Countries (LDCs) during the period 1990-2010. We provide empirical evidence of uneven effects of variations in Gross Domestic Product (GDP) per capita on the evolution of child mortality rate in periods of economic recession and expansion. A decrease in GDP per capita entails a significant rise in child mortality rates, whereas an increase does not affect child mortality significantly. In this context, official development assistance seems to play a crucial role in counteracting the increment in child mortality rates in recession periods, at least in those LDCs receiving greater aid.

  20. Dimensions of Social Inequality in the Third World: A Cross-National Analysis of Income Inequaltiy and Mortality Decline.

    ERIC Educational Resources Information Center

    Crenshaw, Edward; Ameen, Ansari

    1993-01-01

    This cross-national assessment of the empirical determinants of income inequality and infant mortality employs policy-relevant variables suggested by the major macrosocial theory of development and stratification. Findings indicate that modernization and ecological-evolutionary theories provide more consistent explanations of social inequalities…

  1. Dimensions of Social Inequality in the Third World: A Cross-National Analysis of Income Inequaltiy and Mortality Decline.

    ERIC Educational Resources Information Center

    Crenshaw, Edward; Ameen, Ansari

    1993-01-01

    This cross-national assessment of the empirical determinants of income inequality and infant mortality employs policy-relevant variables suggested by the major macrosocial theory of development and stratification. Findings indicate that modernization and ecological-evolutionary theories provide more consistent explanations of social inequalities…

  2. Sugar and artificially sweetened beverage consumption and adiposity changes: National longitudinal study.

    PubMed

    Laverty, Anthony A; Magee, Lucia; Monteiro, Carlos A; Saxena, Sonia; Millett, Christopher

    2015-10-26

    In response to increasing policy action and public concern about the negative health effects of sugar-sweetened beverages (SSBs), there is increased promotion of artificially sweetened beverages (ASBs). These have been linked with obesity and diabetes in recent experimental work. This study examined associations between SSB and ASB consumption and changes in adiposity in a nationally representative sample of UK children. We conducted a longitudinal study of 13,170 children aged 7-11 years in the UK Millennium Cohort Study, collected in 2008 and 2012. Logistic regression was used to assess socio-demographic and behavioural correlates of weekly SSB and ASB consumption at 11 years. Linear regression examined associations between SSB/ASB consumption and changes in adiposity measures between 7 and 11 years. Boys were more likely to consume SSBs weekly (62.3% v 59.1%) than girls at age 11 years. South Asian children were more likely to consume SSBs weekly (78.8% v 58.4%) but less likely to consume ASBsweekly (51.7% v 66.3%) than White children. Daily SSB consumption was associated with increases in percentage body fat between ages 7 and 11 (+0.57%, 95% confidence intervals 0.30;0.83). Daily ASB consumption was associated with increased percentage body fat at age 11 (+1.18 kg/m(2), 0.81;1.54) and greater increases between ages 7 and 11 (+0.35 kg/m(2), 0.09;0.61). Consumption of SSBs and ASBs was associated with BMI and percentage body fat increases in UK children. Obesity prevention strategies which encourage the substitution of SSBs with ASBs may not yield the adiposity benefits originally intended and this area should be a focus for further research.

  3. Underemployment and alcohol misuse in the National Longitudinal Survey of Youth.

    PubMed

    Dooley, D; Prause, J

    1998-11-01

    This study measured the impact of unemployment and underemployment on alcohol misuse. A panel of respondents from the National Longitudinal Survey of Youth was studied in 1984-85 and 1988-89. In each pair of years, the effect of employment change (e.g., becoming underemployed) on alcohol misuse was assessed controlling for misuse in the first year. Alcohol misuse was operationalized in two ways: elevated symptoms and heavy drinking. Three samples were analyzed: a core sample of 2,441 who were available in both pairs of years (approximately 65% male) and two extended samples that included everyone available in one pair of years but not the other (n = 4,183 in 1984-85 and n = 3,926 in 1988-89). The 1984-85 analyses revealed a significant association of adverse change in employment with both elevated alcohol symptoms and heavy drinking (the latter moderated by prior heavy drinking). The 1988-89 analyses found no relationship between adverse change in employment and heavy drinking in the core sample and no main effect of adverse change in employment on symptoms, but they did reveal interactions involving prior symptoms (core sample) and marital status (extended sample). Several explanations for these decreasing effects over time were considered including changes in measurement reliability, statistical power, economic environment and respondents' maturity. These results confirm previous findings that job loss can increase the risk of alcohol misuse, provide new evidence that two types of underemployment (involuntary part-time and poverty-level wage) can also increase this risk and suggest that these effects vary over time.

  4. Mental illness in people who kill strangers: longitudinal study and national clinical survey

    PubMed Central

    Shaw, Jenny; Amos, Tim; Hunt, Isabelle M; Flynn, Sandra; Turnbull, Pauline; Kapur, Navneet; Appleby, Louis

    2004-01-01

    Objectives To establish changes over time in the frequency of homicides committed by strangers, and to describe the personal and clinical characteristics of perpetrators of stranger homicides. Design Longitudinal study and national clinical survey. Participants People convicted of homicide in England and Wales between 1996 and 1999 and whether the victim was known to the perpetrator. Setting England and Wales. Main outcome measure Characteristics of perpetrators of homicides according to whether victims were strangers or not. Results Stranger homicides increased between 1967 and 1997, both in number and as a proportion of all homicides. No increase was found, however, in the number of perpetrators placed under a hospital order after homicide, whether all homicides or stranger homicides only. 358 of 1594 (22%) homicides were stranger homicides. In these cases the perpetrator was more likely to be male and young. The method of killing was more likely to be by hitting, kicking, or pushing (36% (130 of 358) for victims who were strangers to the perpetrator compared with 14% (145 of 1074) for victims who were known). Perpetrators were less likely to have a history of mental disorder (34%, n = 80 ν 50%, n = 142), a history of contact with mental health services (16%, 37 of 234 ν 24%, 200 of 824), and psychiatric symptoms at the time of the offence (6%, n = 14 ν 18%, n = 143). They were more likely to have a history of drug misuse (47%, n = 93 ν 37%, n = 272); alcohol (56%, n = 94 ν 41%, n = 285) or drugs (24% n = 44 ν 12%, n = 86) were more likely to have contributed to the offence. Conclusions Stranger homicides have increased, but the increase is not the result of homicides by mentally ill people and therefore the “care in the community” policy. Stranger homicides are more likely to be related to alcohol or drug misuse by young men. PMID:15044289

  5. Mortality and Treatment Patterns Among Patients Hospitalized With Acute Cardiovascular Conditions During Dates of National Cardiology Meetings

    PubMed Central

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

    2014-01-01

    IMPORTANCE Thousands of physicians attend scientific meetings annually. Although hospital physician staffing and composition may be affected by meetings, patient outcomes and treatment patterns during meeting dates are unknown. OBJECTIVE To analyze mortality and treatment differences among patients admitted with acute cardiovascular conditions during dates of national cardiology meetings compared with nonmeeting dates. DESIGN, SETTING, AND PARTICIPANTS Retrospective analysis of 30-day mortality among Medicare beneficiaries hospitalized with acute myocardial infarction (AMI), heart failure, or cardiac arrest from 2002 through 2011 during dates of 2 national cardiology meetings compared with identical nonmeeting days in the 3 weeks before and after conferences (AMI, 8570 hospitalizations during 82 meeting days and 57 471 during 492 nonmeeting days; heart failure, 19 282 during meeting days and 11 4591 during nonmeeting days; cardiac arrest, 1564 during meeting days and 9580 during nonmeeting days). Multivariable analyses were conducted separately for major teaching hospitals and nonteaching hospitals and for low-and high-risk patients. Differences in treatment utilization were assessed. EXPOSURES Hospitalization during cardiology meeting dates. MAIN OUTCOMES AND MEASURES Thirty-day mortality, procedure rates, charges, length of stay. RESULTS Patient characteristics were similar between meeting and nonmeeting dates. In teaching hospitals, adjusted 30-day mortality was lower among high-risk patients with heart failure or cardiac arrest admitted during meeting vs nonmeeting dates (heart failure, 17.5% [95% CI, 13.7%–21.2%] vs 24.8% [95% CI, 22.9%–26.6%]; P < .001; cardiac arrest, 59.1% [95% CI, 51.4%–66.8%] vs 69.4% [95% CI, 66.2%–72.6%]; P = .01). Adjusted mortality for high-risk AMI in teaching hospitals was similar between meeting and nonmeeting dates (39.2% [95% CI, 31.8%–46.6%] vs 38.5% [95% CI, 35.0%–42.0%]; P = .86), although adjusted percutaneous

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

    PubMed

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

    2015-02-01

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

  7. A prospective study of water intake and subsequent risk of all-cause mortality in a national cohort.

    PubMed

    Kant, Ashima K; Graubard, Barry I

    2017-01-01

    Water, an essential nutrient, is believed to be related to a variety of health outcomes. Published studies have examined the association of fluid or beverage intake with risk of mortality from coronary diseases, diabetes, or cancer, but few studies have examined the association of total water intake with all-cause mortality. We examined prospective risk of mortality from all causes in relation to intakes of total water and each of the 3 water sources. We used public-domain, mortality-linked water intake data from the NHANES conducted in 1988-1994 and 1999-2004 for this prospective cohort study (n = 12,660 women and 12,050 men; aged ≥25 y). Mortality follow-up was completed through 31 December 2011. We used sex-specific Cox proportional hazards regression methods that were appropriate for complex surveys to examine the independent associations of plain water, beverage water, water in foods, and total water with multiple covariate-adjusted risk of mortality from all causes. Over a median of 11.4 y of follow-up, 3504 men and 3032 women died of any cause in this cohort. In men, neither total water intake nor each of the individual water source variables (plain water, water in beverages, and water in foods) was independently related with risk of all-cause mortality. In women, risk of mortality increased slightly in the highest quartile of total or plain water intake but did not approach the Bonferroni-corrected level of significance of P < 0.002. There was no survival advantage in association with higher total or plain water intake in men or women in this national cohort. The slight increase in risk of mortality noted in women with higher total and plain water intakes may be spurious and requires further investigation. © 2017 American Society for Nutrition.

  8. Mortality Among Patients Hospitalized With Heart Failure and Diabetes Mellitus: Results From the National Inpatient Sample 2000 to 2010.

    PubMed

    Win, Theingi Tiffany; Davis, Herbert T; Laskey, Warren K

    2016-05-01

    Case fatality and hospitalization rates for US patients with heart failure (HF) have steadily decreased during the past several decades. Diabetes mellitus (DM), a risk factor for, and frequent coexisting condition with, HF continues to increase in the general population. We used the National Inpatient Sample to estimate overall as well as age-, sex-, and race/ethnicity-specific trends in HF hospitalizations, DM prevalence, and in-hospital mortality among 2.5 million discharge records from 2000 to 2010 with HF as primary discharge diagnosis. Multivariable logistic and Poisson regression were used to assess the impact of the above demographic characteristics on in-hospital mortality. Age-standardized hospitalizations decreased significantly in HF overall and in HF with DM. Age-standardized in-hospital mortality with HF declined from 2000 to 2010 (4.57% to 3.09%, Ptrend<0.0001), whereas DM prevalence in HF increased (38.9% to 41.9%, Ptrend<0.0001) as did comorbidity burden. Age-standardized in-hospital mortality in HF with DM also decreased significantly (3.53% to 2.27%, Ptrend<0.0001). After adjusting for year, age, and comorbid burden, males remained at 17% increased risk versus females, non-Hispanics remained at 12% increased risk versus Hispanics, and whites had a 30% higher mortality versus non-white minorities. Absolute mortality rates were lower in younger versus older patients, although the rate of decline was attenuated in younger patients. In-hospital mortality in HF patients with DM significantly decreased during the past decade, despite increases in DM prevalence and comorbid conditions. Mortality rate decreases among younger patients were significantly attenuated, and mortality disparities remain among important demographic subgroups. © 2016 American Heart Association, Inc.

  9. Mortality Among Patients Hospitalized with Heart Failure and Diabetes Mellitus: Results from the National Inpatient Sample 2000 – 2010

    PubMed Central

    Win, Theingi Tiffany; Davis, Herbert T.; Laskey, Warren K.

    2016-01-01

    Background Case-fatality and hospitalization rates for U.S. heart failure (HF) patients have steadily decreased over the past several decades. Diabetes mellitus (DM), a risk factor for, and frequent co-existing condition with, HF continues to increase in the general population. Methods and Results We used the National Inpatient Sample to estimate overall as well as age-, sex-, and race/ethnicity-specific trends in HF hospitalizations, DM prevalence and in-hospital mortality among 2.5 million discharge records from 2000–2010 with HF as primary discharge diagnosis. Multivariable logistic and Poisson regression were used to assess the impact of the above demographic characteristics on in-hospital mortality. Age-standardized hospitalizations decreased significantly in HF overall and in HF with DM . Age-standardized in-hospital mortality with HF declined from 2000 to 2010 (4.57% to 3.09%, ptrend <0.0001), while DM prevalence in HF increased (38.9% to 41.9%, ptrend < 0.0001) as did comorbidity burden. Age-standardized in-hospital mortality in HF with DM also decreased significantly (3.53% to 2.27%, ptrend <0.0001). After adjusting for year, age and comorbid burden, males remained at 17% increased risk versus females, non-Hispanics remained at 12% increased risk versus Hispanics and whites had a 30% higher mortality versus non-white minorities. Absolute mortality rates were lower in younger versus older patients although the rate of decline was attenuated in younger patients. Conclusions In-hospital mortality in HF patients with DM significantly decreased over the past decade despite increases in DM prevalence and co-morbid conditions. Mortality rate decreases among younger patients were significantly attenuated and mortality disparities remain among important demographic sub-groups. PMID:27146551

  10. Hypertension awareness and control among young adults in the national longitudinal study of adolescent health.

    PubMed

    Gooding, Holly C; McGinty, Shannon; Richmond, Tracy K; Gillman, Matthew W; Field, Alison E

    2014-08-01

    Young adults are less likely than older adults to be aware they have hypertension or to be treated for hypertension. To describe rates of hypertension awareness and control in a cohort of young adults and understand the impact of health insurance, utilization of preventive care, and self-perception of health on rates of hypertension awareness and control in this age group. Cross-sectional study of 13,512 young adults participating in Wave IV of the National Longitudinal Study of Adolescent Health in 2007-2008. We defined hypertension as an average of two measured systolic blood pressures (SBP) ≥ 140 mmHg, diastolic blood pressures (DBP) ≥ 90 mmHg, or self-report of hypertension. We defined hypertension awareness as reporting having been told by a health care provider that one had high blood pressure, and assessed awareness among those with uncontrolled hypertension. We considered those aware of having hypertension controlled if their average measured SBP was < 140 mmHg and DBP was < 90 mmHg. Of the 3,303 young adults with hypertension, 2,531 (76%) were uncontrolled, and 1,893 (75%) of those with uncontrolled hypertension were unaware they had hypertension. After adjustment for age, sex, race/ethnicity, weight status, income, education, alcohol and tobacco use, young adults with uncontrolled hypertension who had (vs. didn't have) routine preventive care in the past 2 years were 2.4 times more likely (95% confidence interval [CI] 1.68-3.55) to be aware, but young adults who believed they were in excellent (vs. less than excellent) health were 64% less likely to be aware they had hypertension (OR 0.36, 95% CI 0.23-0.57). Neither preventive care utilization nor self-rated health was associated with blood pressure control. In this nationally representative group of young adults, rates of hypertension awareness and control were low. Efforts to increase detection of hypertension must address young adults' access to preventive care and perception of their need for care.

  11. Early childbearing, human capital attainment and mortality risk: Evidence from a longitudinal demographic surveillance area in rural-KwaZulu-Natal, South Africa

    PubMed Central

    Ardington, Cally; Menendez, Alicia; Mutevedzi, Tinofa

    2014-01-01

    Using a rich longitudinal dataset, we examine the relationship between teen fertility and both subsequent educational outcomes and HIV related mortality risk in rural South Africa. Human capital deficits among teen mothers are large and significant, with earlier births associated with greater deficits. In contrast to many other studies from developed countries, we find no clear evidence of selectivity into teen childbearing in either schooling trajectories or pre-fertility household characteristics. Enrolment rates among teen mothers only begin to drop in the period immediately preceding the birth and future teen mothers are not behind in their schooling relative to other girls. Older teen mothers and those further ahead in school for their age pre-birth are more likely to continue schooling after the birth. In addition to adolescents’ higher biological vulnerability to HIV infection, pregnancy also appears to increase the risk of contracting HIV. Following women over an extended period, we document a higher HIV related mortality risk for teen mothers that cannot be explained by household characteristics in early adulthood. Controlling for age at sexual debut, we find that teen mothers report lower condom use and older partners than other sexually active adolescents. PMID:26028690

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

    PubMed

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

    2009-09-01

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

  13. Red blood cell distribution width as a prognostic marker of mortality in patients on chronic dialysis: a single center, prospective longitudinal study

    PubMed Central

    Sičaja, Mario; Pehar, Mario; Đerek, Lovorka; Starčević, Boris; Vuletić, Vladimira; Romić, Željko; Božikov, Velimir

    2013-01-01

    Aim To determine if red cell distribution width (RDW) is associated with all-cause mortality in patients on chronic dialysis and to evaluate its prognostic value among validated prognostic biomarkers. Methods This is a single center, prospective longitudinal study. At the time of inclusion in January 2011, all patients were physically examined and a routine blood analysis was performed. A sera sample was preserved for determination of NT-pro-brain natriuretic peptide (NT-pro-BNP) and eosinophil cationic protein. Carotid intima media thickness (IMT) was also measured. Following one year, all-cause mortality was evaluated. Results Of 100 patients, 25 patients died during the follow-up period of one-year. Patients who died had significantly higher median [range] RDW levels (16.7% [14.3-19.5] vs 15.5% [13.2-19.7], P < 0.001. They had significantly higher Eastern Cooperative Oncology Group (ECOG) performance status (4 [2-4] vs 2 [1-4], P < 0.001), increased intima-media thickness (IMT) (0.71 [0.47-1.25] vs 0.63 [0.31-1.55], P = 0.011), increased NT-pro-BNP levels (8300 [1108-35000] vs 4837 [413-35000], P = 0.043), and increased C-reactive protein (CRP) levels (11.6 [1.3-154.2] vs 4.9 [0.4-92.9], P < 0.001). For each 1% point increase in RDW level as a continuous variable, one-year all cause mortality risk was increased by 54% in univariate Cox proportional hazard analysis. In the final model, when RDW was entered as a categorical variable, mortality risk was significantly increased (hazard ratio, 5.15, 95% confidence interval, 2.33 to 11.36) and patients with RDW levels above 15.75% had significantly shorter survival time (Log rank P < 0.001) than others. Conclusions RDW could be an additive predictor for all-cause mortality in patients on chronic dialysis. Furthermore, RDW combined with sound clinical judgment improves identification of patients who are at increased risk compared to RDW alone. PMID:23444243

  14. Increases in perinatal mortality in prefectures contaminated by the Fukushima nuclear power plant accident in Japan: A spatially stratified longitudinal study.

    PubMed

    Scherb, Hagen Heinrich; Mori, Kuniyoshi; Hayashi, Keiji

    2016-09-01

    Descriptive observational studies showed upward jumps in secular European perinatal mortality trends after Chernobyl. The question arises whether the Fukushima nuclear power plant accident entailed similar phenomena in Japan. For 47 prefectures representing 15.2 million births from 2001 to 2014, the Japanese government provides monthly statistics on 69,171 cases of perinatal death of the fetus or the newborn after 22 weeks of pregnancy to 7 days after birth. Employing change-point methodology for detecting alterations in longitudinal data, we analyzed time trends in perinatal mortality in the Japanese prefectures stratified by exposure to estimate and test potential increases in perinatal death proportions after Fukushima possibly associated with the earthquake, the tsunami, or the estimated radiation exposure. Areas with moderate to high levels of radiation were compared with less exposed and unaffected areas, as were highly contaminated areas hit versus untroubled by the earthquake and the tsunami. Ten months after the earthquake and tsunami and the subsequent nuclear accident, perinatal mortality in 6 severely contaminated prefectures jumped up from January 2012 onward: jump odds ratio 1.156; 95% confidence interval (1.061, 1.259), P-value 0.0009. There were slight increases in areas with moderate levels of contamination and no increases in the rest of Japan. In severely contaminated areas, the increases of perinatal mortality 10 months after Fukushima were essentially independent of the numbers of dead and missing due to the earthquake and the tsunami. Perinatal mortality in areas contaminated with radioactive substances started to increase 10 months after the nuclear accident relative to the prevailing and stable secular downward trend. These results are consistent with findings in Europe after Chernobyl. Since observational studies as the one presented here may suggest but cannot prove causality because of unknown and uncontrolled factors or confounders

  15. The National Longitudinal Study of the High School Class of 1972: A Description of the Merged Base-Year/First Follow-Up Data File.

    ERIC Educational Resources Information Center

    Levinsohn, Jay R.; Riccobono, John A.

    The National Longitudinal Study of the High School Class of 1972 (NLS) is a large-scale longitudinal survey effort. The current data tapes contain base-year (1972) survey data integrated with first follow-up (1973) survey data. The base-year data consist of responses to a Student Questionnaire, the results of an ability test, and information from…

  16. Comparisons across Time of the Outcomes of Youth with Disabilities up to 4 Years after High School. A Report of Findings from the National Longitudinal Transition Study (NLTS) and the National Longitudinal Transition Study-2 (NLTS2). NCSER 2010-3008

    ERIC Educational Resources Information Center

    Newman, Lynn; Wagner, Mary; Cameto, Renee; Knokey, Anne-Marie; Shaver, Debra

    2010-01-01

    In an effort to document the secondary school experiences and postsecondary outcomes of students with disabilities over the last two decades, the U.S. Department of Education (ED) sponsored two longitudinal research studies 15 years apart. The first study, the National Longitudinal Transition Study (NLTS) generated nationally representative…

  17. Serum Phosphorus and Mortality in the Third National Health and Nutrition Examination Survey (NHANES III): Effect Modification by Fasting

    PubMed Central

    Chang, Alex R.; Grams, Morgan

    2014-01-01

    Background Serum phosphorus levels have been associated with mortality in some but not all studies. Since dietary intake prior to measurement can affect serum phosphorus levels, we hypothesized that the association between serum phosphorus and mortality is strongest in those who have fasted for longer duration. Study Design Prospective cohort study. Setting & Participants Nationally representative sample of 12,984 participants aged 20 years or older in the Third National Health and Nutrition Examination Survey (1988–1994). Factors Serum phosphorus, fasting duration (dichotomized as ≥12 or <12 hours) Outcomes All-cause and cardiovascular mortality determined by death certificate data from the National Death Index. Measurements Serum phosphorus measured in a central laboratory and fasting duration recorded as amount of time since food or drink other than water was consumed. Results Individuals fasting ≥12 hours had lower serum phosphorus levels than those fasting < 12 hours (3.34 vs. 3.55 mg/dL; p<0.001) and higher correlation with repeated measurement (0.66 vs. 0.53; p=0.002). In multivariable-adjusted Cox regression models, the highest quartile of serum phosphorus was associated with increased mortality in participants fasting ≥12 hours (adjusted HR, 1.74; 95% CI, 1.38–2.20; reference, lowest quartile) but not in participants fasting <12 hours (adjusted HR, 1.08; 95% CI, 0.89–1.32; p for interaction=0.002). Relationships were consistent using 8 hours as the fasting cutpoint or cardiovascular mortality as the outcome. Limitations Observational study, lack of fibroblast growth factor 23 or intact parathyroid hormone measurements. Conclusions Fasting but not non-fasting serum phosphorus levels were associated with increased mortality. Risk prognostication based on serum phosphorus may be improved using fasting levels. PMID:24935232

  18. Population health and the health system: a comparative analysis of avoidable mortality in three nations and their world cities.

    PubMed

    Weisz, Daniel; Gusmano, Michael K; Rodwin, Victor G; Neuberg, Leland G

    2008-04-01

    Access to timely and effective medical services can reduce rates of premature mortality attributed to certain conditions. We investigate rates of total and avoidable mortality (AM) and the percentage of avoidable deaths in France, England and Wales and the United States, three wealthy nations with different health systems, and in the urban cores of their world cities, Paris, Inner London and Manhattan. We examine the association between AM and an income-related variable among neighbourhoods of the three cities. We obtained mortality data from vital statistics sources for each geographic area. For two time-periods, 1988-90 and 1998-2000, we assess the correlation between area of residence and age- and gender-adjusted total and AM rates. In our comparison of world cities, regression models are employed to analyse the association of a neighbourhood income-related variable with AM. France has the lowest mortality rates. The US exhibits higher total, but similar AM rates compared to England and Wales. Rates of AM are lowest in Paris and highest in London. Avoidable mortality rates are higher in poor neighbourhoods of all three cities; only in Manhattan is there a correlation between the percentage of deaths that are avoidable and an income related variable. Beyond the well-known association of income and mortality, persistent disparities in AM exist, particularly in Manhattan and Inner London. These disparities are disturbing and should receive greater attention from policy makers.

  19. Association of Coronary Artery Calcification and Mortality in the National Lung Screening Trial

    PubMed Central

    Chiles, Caroline; Duan, Fenghai; Gladish, Gregory W.; Ravenel, James G.; Baginski, Scott G.; Snyder, Bradley S.; DeMello, Sarah; Desjardins, Stephanie S.; Munden, Reginald F.

    2016-01-01

    Purpose To evaluate three coronary artery calcification (CAC) scoring methods to assess risk of coronary heart disease (CHD) death and all-cause mortality in National Lung Screening Trial (NLST) participants across levels of CAC scores. Materials and Methods The NLST was approved by the institutional review board at each participating institution, and informed consent was obtained from all participants. Image review was HIPAA compliant. Five cardiothoracic radiologists evaluated 1575 low-dose computed tomographic (CT) scans from three groups: 210 CHD deaths, 315 deaths not from CHD, and 1050 participants who were alive at conclusion of the trial. Radiologists used three scoring methods: overall visual assessment, segmented vessel-specific scoring, and Agatston scoring. Weighted Cox proportional hazards models were fit to evaluate the association between scoring methods and outcomes. Results In multivariate analysis of time to CHD death, Agatston scores of 1–100, 101–1000, and greater than 1000 (reference category 0) were associated with hazard ratios of 1.27 (95% confidence interval: 0.69, 2.53), 3.57 (95% confidence interval: 2.14, 7.48), and 6.63 (95% confidence interval: 3.57, 14.97), respectively; hazard ratios for summed segmented vessel-specific scores of 1–5, 6–11, and 12–30 (reference category 0) were 1.72 (95% confidence interval: 1.05, 3.34), 5.11 (95% confidence interval: 2.92, 10.94), and 6.10 (95% confidence interval: 3.19, 14.05), respectively; and hazard ratios for overall visual assessment of mild, moderate, or heavy (reference category none) were 2.09 (95% confidence interval: 1.30, 4.16), 3.86 (95% confidence interval: 2.02, 8.20), and 6.95 (95% confidence interval: 3.73, 15.67), respectively. Conclusion By using low-dose CT performed for lung cancer screening in older, heavy smokers, a simple visual assessment of CAC can be generated for risk assessment of CHD death and all-cause mortality, which is comparable to Agatston scoring and

  20. Effects of depression and anxiety on mortality in a mixed cancer group: a longitudinal approach using standardised diagnostic interviews.

    PubMed

    Chan, Caryn Mei Hsien; Wan Ahmad, Wan Azman; Yusof, Mastura M D; Ho, Gwo-Fuang; Krupat, Edward

    2015-06-01

    Distress and psychiatric morbidity in cancer patients are associated with poorer outcomes including mortality. In this study, we examined the prevalence of psychiatric morbidity and its association with cancer survival over time. Participants were 467 consecutive adult cancer patients attending oncology follow-ups at a single academic medical centre. Assessment consisted of the Hospital Anxiety and Depression Scale and Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, 4th edition, text revision. Comparison between co-morbid psychiatric cases and non-cases was made in follow-ups of up to 24 months. Of the 467 patients, 217 of 220 patients with elevated total Hospital Anxiety and Depression Scale scores (≥16) met the criteria for an Axis I disorder at 6 months follow-up, with 102 of the follow-up sample having a persistent diagnosable psychiatric disorder after 1 year. The most frequent initial diagnoses were minor depression (17.6%), major depressive disorder (15.8%) and adjustment disorder (15.8%). Cancer patients without psychiatric morbidity had a survival benefit of 2.24 months or 67 days. Mean survival at 24 months was 20.87 months (95% CI 20.06-21.69) for cancer patients with psychiatric morbidity versus 23.11 months (95% CI 22.78-23.43) for those without (p < 0.001 for log rank). After adjusting for demographics and cancer stage on a Cox proportional hazards model, psychiatric morbidity remained associated with worse survival (hazard ratio 4.13, 95% CI 1.32-12.92, p = 0.015). This study contributes to the growing body of evidence linking psychiatric morbidity to cancer mortality. Treating underlying psychiatric conditions in cancer may therefore improve not just quality of life but also survival. Copyright © 2014 John Wiley & Sons, Ltd.

  1. Bicyclist mortality between 2006 and 2010 in China: findings from national Disease Surveillance Points (DSP) data.

    PubMed

    Zhou, Maigeng; Hu, Guoqing; Wang, Lijun; Ma, Sai; Wang, Lin; Li, Qingfeng; Hyder, Adnan A

    2014-02-01

    While road traffic mortality has been reported to be seriously undercounted by the police in China, non-police-reported data have not been explored previously to examine vulnerable road user mortality. To examine changes in bicyclist mortality between 2006 and 2010 in China, using the Disease Surveillance Points (DSP) data of China. Mortality data of 2006-2010 from DSP data, covering 73 million population, was analysed. Poisson regression was used to examine the significance of year after controlling for sex, age and urban/rural location. Mortality rate and mortality rate ratio (MRR). Between 2006 and 2010, the mortality rate for bicyclists increased from 1.1 to 1.6 per 100 000 population according to DSP data. Between 2006 and 2010, more than 90% of bicyclist deaths were undercounted by the police compared to the findings from DSP data. Contrary to the 34% increase between 2006 and 2010 reflected by DSP data (adjusted MRR: 1.34, 95% CI 1.23 to 1.46), police data revealed a 64% decrease in bicyclist mortality (unadjusted MRR: 0.36, 95% CI 0.32 to 0.40) in the study time period. Health data should be used to assess the road traffic injuries in China. The recent increase in bicyclist mortality merits attention from policy makers and researchers.

  2. Lower extremity strength, systemic inflammation and all-cause mortality: Application to the "fat but fit" paradigm using cross-sectional and longitudinal designs.

    PubMed

    Buckner, Samuel L; Loenneke, Jeremy P; Loprinzi, Paul D

    2015-10-01

    No study has applied the "fat-but-fit" paradigm with respect to muscular strength as an index of fitness, despite muscular strength being independently associated with functional ability and mortality. To examine the relationship between lower extremity muscular strength, C-reactive protein (CRP), and all-cause mortality among normal weight, overweight and obese individuals. Data from the 1999-2002 NHANES were used (N=2740 adults; ≥ 50 years). CRP values were obtained from a blood sample. Lower body isokinetic knee extensor strength (IKES) was assessed using a Kin Kom MP isokinetic dynamometer. Participant data was linked to death certificate data from the National Death Index to ascertain all-cause mortality status. Participants were classified, based on body mass index (BMI) and strength as: normal weight and unfit (<75th IKES percentile); overweight and unfit; obese and unfit: normal weight and fit (≥ 75th IKES percentile); overweight and fit; and obese and fit. Independent of physical activity and other confounders, compared to those who were normal weight and unfit, unfit overweight (β=.14, p=0.009), unfit obese (β=.33, p<0.001), and obese and fit (β=.17, p=0.008) participants, had higher CRP levels. However, there was no difference in CRP levels between normal weight and unfit participants and overweight and fit participants (β=0.04, p=0.35). Compared to normal weight unfit adults, overweight fit (HR=0.28; 95% CI: 0.11-0.70; p=0.008) adults had a lower hazard rate for all-cause mortality. These finding suggest that increased lower body strength, independent of physical activity, may reduce premature all-cause mortality and attenuate systemic inflammation among overweight adults. Copyright © 2015 Elsevier Inc. All rights reserved.

  3. Development and Validation of a National System for Routine Monitoring of Mortality in People Recently Released from Prison

    PubMed Central

    Forsyth, Simon J.

    2016-01-01

    Background People released from prison are at increased risk of death. However, no country has established a system for routine monitoring of mortality in this population. The aims of this study were to (a) evaluate a system for routine monitoring of deaths after release from prison in Australia and (b) estimate the number of deaths annually within 28 and 365 days of prison release from 2000 to 2013. Methods Persons released from prison and deaths were identified in records held by Centrelink, Australia’s national provider of unemployment benefits. Estimates generated in this manner were compared with those from a study that probabilistically linked correctional records with the National Death Index (NDI), for each calendar year 2000 to 2007. Using Centrelink data, national estimates of mortality within 28 and 365 days of release were produced for each calendar year 2000 to 2013. Findings Compared with estimates based on linkage with the NDI, the estimated crude mortality rate based on Centrelink records was on average 52% lower for deaths within 28 days of release and 24% lower for deaths within 365 days of release. Nationally, over the period 2000 to 2013, we identified an average of 32 deaths per year within 28 days of release and 188 deaths per year within 365 days of release. The crude mortality rate for deaths within both 28 and 365 days of release increased over this time. Conclusions Using routinely collected unemployment benefits data we detected the majority of deaths in people recently released from prison in Australia. These data may be sufficient for routine monitoring purposes and it may be possible to adopt a similar approach in other countries. Routine surveillance of mortality in ex-prisoners serves to highlight their extreme vulnerability and provides a basis for evaluating policy reforms designed to reduce preventable deaths. PMID:27309540

  4. Clinical significance of national patients sample analysis: factors affecting mortality and length of stay of organophosphate and carbamate poisoned patients.

    PubMed

    Kim, Kyoung-Ho; Kwon, In Ho; Lee, Jun Yeob; Yeo, Woon Hyung; Park, Ha Young; Park, Kyung Hye; Cho, Junho; Kim, Hyunjong; Kim, Gun Bea; Park, Deuk Hyun; Yoon, Yoo Sang; Kim, Yang Weon

    2013-12-01

    This study considered whether there could be a change of mortality and length of stay as a result of inter-hospital transfer, clinical department, and size of hospital for patients with organophosphates and carbamates poisoning via National Patients Sample data of the year 2009, which was obtained from Health Insurance Review and Assessment Services (HIRA). The utility and representativeness of the HIRA data as the source of prognosis analysis in poisoned patients were also evaluated. Organophosphate and carbamate poisoned patients' mortality and length of stay were analyzed in relation to the initial and final treating hospitals and departments, as well as the presence of inter-hospital transfers. Among a total of 146 cases, there were 17 mortality cases, and the mean age was 56.8 ± 19.2 years. The median length of stay was 6 days. There was no inter-hospital or inter-departmental difference in length of stay. However, it significantly increased when inter-hospital transfer occurred (transferred 11 days vs. non-transferred 6 days; p = 0.037). Overall mortality rate was 11.6%. The mortality rate significantly increased when inter-hospital transfer occurred (transferred 23.5% vs. non-transferred 7.0%; p = 0.047), but there was no statistical difference in mortality on inter-hospital and inter-department comparison at the initial treating facility. However, at the final treating facility, there was a significant difference between tertiary and general hospitals (5.1% for tertiary hospitals and 17.3% for general hospitals; p = 0.024), although there was no significant inter-departmental difference. We demonstrated that hospital, clinical department, length of stay, and mortality could be analyzed using insurance claim data of a specific disease group. Our results also indicated that length of stay and mortality according to inter-hospital transfer could be analyzed, which was previously unknown.

  5. Association between gender inequality index and child mortality rates: a cross-national study of 138 countries.

    PubMed

    Brinda, Ethel Mary; Rajkumar, Anto P; Enemark, Ulrika

    2015-03-09

    Gender inequality weakens maternal health and harms children through many direct and indirect pathways. Allied biological disadvantage and psychosocial adversities challenge the survival of children of both genders. United Nations Development Programme (UNDP) has recently developed a Gender Inequality Index to measure the multidimensional nature of gender inequality. The global impact of Gender Inequality Index on the child mortality rates remains uncertain. We employed an ecological study to investigate the association between child mortality rates and Gender Inequality Indices of 138 countries for which UNDP has published the Gender Inequality Index. Data on child mortality rates and on potential confounders, such as, per capita gross domestic product and immunization coverage, were obtained from the official World Health Organization and World Bank sources. We employed multivariate non-parametric robust regression models to study the relationship between these variables. Women in low and middle income countries (LMICs) suffer significantly more gender inequality (p < 0.001). Gender Inequality Index (GII) was positively associated with neonatal (β = 53.85; 95% CI 41.61-64.09), infant (β = 70.28; 95% CI 51.93-88.64) and under five mortality rates (β = 68.14; 95% CI 49.71-86.58), after adjusting for the effects of potential confounders (p < 0.001). We have documented statistically significant positive associations between GII and child mortality rates. Our results suggest that the initiatives to curtail child mortality rates should extend beyond medical interventions and should prioritize women's rights and autonomy. We discuss major pathways connecting gender inequality and child mortality. We present the socio-economic problems, which sustain higher gender inequality and child mortality in LMICs. We further discuss the potential solutions pertinent to LMICs. Dissipating gender barriers and focusing on social well-being of women may augment the survival of

  6. The Effect of Burn Center Volume on Mortality in a Pediatric Population: An Analysis of the National Burn Repository.

    PubMed

    Hodgman, Erica I; Saeman, Melody R; Subramanian, Madhu; Wolf, Steven E

    2016-01-01

    The effect of burn center volume on mortality has been demonstrated in adults. The authors sought to evaluate whether such a relationship existed in burned children. The National Burn Repository, a voluntary registry sponsored by the American Burn Association, was queried for all data points on patients aged 18 years or less and treated from 2002 to 2011. Facilities were divided into quartiles based on average annual burn volume. Demographics and clinical characteristics were compared across groups, and univariate and multivariate logistic regressions were performed to evaluate relationships between facility volume, patient characteristics, and mortality. The authors analyzed 38,234 patients admitted to 88 unique facilities. Children under age 4 years or with larger burns were more likely to be managed at high-volume and very high-volume centers (57.12 and 53.41%, respectively). Overall mortality was low (0.85%). Comparing mortality across quartiles demonstrated improved unadjusted mortality rates at the low- and high-volume centers compared with the medium-volume and very high-volume centers although univariate logistic regression did not find a significant relationship. However, multivariate analysis identified burn center volume as a significant predictor of decreased mortality after controlling for patient characteristics including age, mechanism of injury, burn size, and presence of inhalation injury. Mortality among pediatric burn patients is low and was primarily related to patient and injury characteristics, such as burn size, inhalation injury, and burn cause. Average annual admission rate had a significant but small effect on mortality when injury characteristics were considered.

  7. National Longitudinal Study: Base Year (1972) through Fourth Follow-Up (1979). Data File Users' Manual. Volume I (Includes Appendix A through Appendix C)

    ERIC Educational Resources Information Center

    Riccobono, John; Henderson, Louise B.; Burkheimer, Graham J.; Place, Carol; Levinsohn, Jay R.

    1981-01-01

    The National Longitudinal Study (NLS) of the High School Class of 1972 is a large-scale long-term survey effort supported by the National Center for Education Statistics (NCES), Office of the Assistant Secretary for Educational Research and Improvement in the U.S. Department of Education. NLS is designed to provide statistics on a national sample…

  8. The National Longitudinal Study of the High School Class of 1972 (NLS-72): Fifth Follow-Up (1986). Sample Design Report

    ERIC Educational Resources Information Center

    Spencer, Bruce; Sebring, Penny; Campbell, Barbara

    1987-01-01

    This report is the methodology report for the National Longitudinal Study of the High School Class of 1972 follow-up in 1986. The fifth follow-up survey of the National Longitudinal Study of the High School Class of 1972 (NLS-72) took place during spring and summer of 1986. A mail questionnaire was sent to a subsample of 14,489 members of the…

  9. Environmental Predictors of US County Mortality Patterns on a National Basis

    PubMed Central

    Thomas, Reuben; Gohlke, Julia M.; Portier, Christopher J.

    2015-01-01

    A growing body of evidence has found that mortality rates are positively correlated with social inequalities, air pollution, elevated ambient temperature, availability of medical care and other factors. This study develops a model to predict the mortality rates for different diseases by county across the US. The model is applied to predict changes in mortality caused by changing environmental factors. A total of 3,110 counties in the US, excluding Alaska and Hawaii, were studied. A subset of 519 counties from the 3,110 counties was chosen by using systematic random sampling and these samples were used to validate the model. Step-wise and linear regression analyses were used to estimate the ability of environmental pollutants, socio-economic factors and other factors to explain variations in county-specific mortality rates for cardiovascular diseases, cancers, chronic obstructive pulmonary disease (COPD), all causes combined and lifespan across five population density groups. The estimated models fit adequately for all mortality outcomes for all population density groups and, adequately predicted risks for the 519 validation counties. This study suggests that, at local county levels, average ozone (0.07 ppm) is the most important environmental predictor of mortality. The analysis also illustrates the complex inter-relationships of multiple factors that influence mortality and lifespan, and suggests the need for a better understanding of the pathways through which these factors, mortality, and lifespan are related at the community level. PMID:26629706

  10. Effect of prescribed burning on mortality of resettlement ponderosa pines in Grand Canyon National Park

    Treesearch

    G. Alan Kaufmann; W. Wallace Covington

    2001-01-01

    Ponderosa pine (Pinus ponderosa) trees established before Euro-American settlement are becoming rare on the landscape. Prescribed fire is the prime tool used to restore ponderosa pine ecosystems, but can cause high mortality in presettlement ponderosa pines. This study uses retrospective techniques to estimate mortality from prescribed burns within Grand Canyon...

  11. The mental health impact of AIDS-related mortality in South Africa: a national study

    PubMed Central

    Myer, L; Seedat, S; Stein, D J; Moomal, H; Williams, D R

    2011-01-01

    Background Few data exist on how the HIV/AIDS epidemic may influence population mental health. The associations were examined between knowing someone who died of HIV/AIDS and common mental disorders among South African adults. Methods Between 2002 and 2004, a nationally representative sample of 4351 adults were interviewed about personally knowing someone who died of HIV/AIDS, and the World Health Organization Composite International Diagnostic Interview was used to generate psychiatric diagnoses for depression, anxiety and substance abuse disorders during the preceding 12 months based on the Diagnostic and Statistical Manual, 4th edition (DSM-IV). Results Overall, 42.2% of the sample knew someone who died of HIV/AIDS, and 16.5% met the criteria for at least one DSM-IV diagnosis. Individuals who knew someone who died of HIV/AIDS were significantly more likely to have any DSM-IV defined disorder, including any depressive, anxiety or substance-related disorder (p<0.001 for all associations). In multivariate models adjusted for participant demographic characteristics, life events and socioeconomic status, individual disorders significantly associated with knowing someone who died of HIV/AIDS included generalised anxiety disorder, social phobia and alcohol/drug dependence or abuse. Based on these results, it is estimated that up to 15% of 12-month DSM-IV disorders in the South African adult population may be related to knowing someone who died of HIV/AIDS. Conclusion These novel data suggest that AIDS-related mortality may contribute substantially to the burden of mental disorders in settings of high HIV prevalence. While this finding requires further investigation, these data suggest the need to strengthen mental health services in communities where HIV/AIDS is prevalent. PMID:19074926

  12. Coronary artery bypass grafting in Canada: national and provincial mortality trends, 1992-1995

    PubMed Central

    Ghali, W A; Quan, H; Brant, R

    1998-01-01

    BACKGROUND: Despite a body of research on outcomes of coronary artery bypass grafting (CABG) in Canada, little is known about Canada-wide outcome trends and interregional differences in outcome. The objectives of this study were to examine Canadian trends in rates of in-hospital death after CABG and to compare provincial risk-adjusted death rates. METHODS: Hospital discharge data were obtained from the Canadian Institute for Health Information and were used to identify complete cohorts of patients who underwent CABG in 8 provinces in fiscal years 1992/93 through 1995/96. Data from Quebec hospitals were not available. A logistic regression model was used to calculate risk-adjusted death rates by year, province, and province and year. RESULTS: A total of 50,357 CABG cases were studied, with an overall death rate of 3.6%. A national trend of decreasing mortality was found, with a risk-adjusted death rate of 3.8% in 1992/93 versus 3.2% in 1995/96 (relative decrease of 17%) (p < 0.001 for difference across years). Some provinces (e.g., Alberta, Manitoba and Ontario) achieved overall declines in death rates over the study period, whereas others (e.g., British Columbia and Saskatchewan) did not. The average severity of illness of patients who underwent CABG differed considerably across provinces. Despite risk adjustment for these differences, provincial death rates varied significantly (p < 0.001). INTERPRETATION: Rates of death after CABG in Canada decreased significantly in a relatively short period. Despite this encouraging finding, there were interprovincial differences in severity of illness and risk-adjusted death rates. This finding raises the possibility of unequal access to CABG and variable quality of care for patients undergoing the surgery across Canadian provinces. PMID:9679483

  13. Cardiovascular mortality associated with 5 leading risk factors: national and state preventable fractions estimated from survey data.

    PubMed

    Patel, Shivani A; Winkel, Munir; Ali, Mohammed K; Narayan, K M Venkat; Mehta, Neil K

    2015-08-18

    Impressive decreases in cardiovascular mortality have been achieved through risk factor reduction and clinical intervention, yet cardiovascular disease remains a leading cause of death nationally. To estimate up-to-date preventable fractions of cardiovascular mortality associated with elimination and reduction of 5 leading risk factors nationally and by state in the United States. Cross-sectional and cohort studies. Nationally representative and state-representative samples of the U.S. population. Adults aged 45 to 79 years. Self-reported risk factor status in the BRFSS (Behavioral Risk Factor Surveillance System) 2009-2010 was corrected to approximate clinical definitions. The relative hazards of cardiovascular death (International Classification of Diseases, 10th Revision, codes I00 to I99) associated with risk factors were estimated using data from NHANES (National Health and Nutrition Examination Survey) (1988-1994 and 1999-2004, followed through 2006). The preventable fraction of cardiovascular mortality associated with complete elimination of elevated cholesterol levels, diabetes, hypertension, obesity, and smoking was 54.0% for men and 49.6% for women in 2009 to 2010. When the more feasible target of reducing risk factors to the best achieved levels in the states was considered, diabetes (1.7% and 4.1%), hypertension (3.8% and 7.3%), and smoking (5.1% and 4.4%) were independently associated with the largest preventable fractions among men and women, respectively. With both targets, southern states had the largest preventable fractions, and western states had the smallest. Self-reported state data; mortality hazards relied on baseline risk factor status. Major modifiable cardiovascular risk factors collectively accounted for half of cardiovascular deaths in U.S. adults aged 45 to 79 years in 2009 to 2010. Fewer than 10% of cardiovascular deaths nationally could be prevented if all states were to achieve risk factor levels observed in the best

  14. Mortality on match days of the German national soccer team: a time series analysis from 1995 to 2009.

    PubMed

    Medenwald, D; Kuss, O

    2014-09-01

    There is inconsistent evidence on population mortality, especially cardiovascular disease mortality, on match days of national soccer teams during particular international tournaments. This study examines the number of deaths in Germany on match days of the national soccer team during a long-term period including several tournaments. We analysed all registered daily deaths in Germany from 1995 to 2009 (11 225 966 cases) using time series analysis methods. Following the Box/Jenkins approach, we applied a seasonal autoregressive integrated moving average model. To assess the effect of match days, we performed an intervention analysis by including a transfer function model representing match days of the national team in the statistical analyses. We conducted separate analyses for all matches and for matches during international tournaments (European and World Championships) only. Time series and results were stratified in terms of sex, age (<50 years, 50-70 years, >70 years) and cause of death (cardiovascular deaths, injuries, others). We performed a further independent analysis focusing only on the effect of match results (victory, loss, draw) and kind of tournament (international championships, qualifications, friendly matches). Most of the results did not indicate a distinct effect of matches of the national team on general mortality. Moreover, all null value deviations were small when compared with the average number of daily deaths (n=2270). There is no relevant increase or decrease in mortality on match days of the German national soccer team. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  15. Mortality-related factors disparity among Iranian deceased children aged 1-59 months according to the medical activities in emergency units: National mortality surveillance system.

    PubMed

    Kelishadi, Roya; Barakati, Sayyed-Hamed; Lornejad, Hamid Reza; Amiri, Masoud; Motlagh, Mohammad Esmaeil

    2012-12-01

    To determine disparity in mortality-related factors in 1-59 months children across Iran using hospital records of emergency units. After designing and validating a national questionnaire for mortality data collection of children 1-59 months, all 40 medical universities has been asked to fill in the questionnaires and return to the main researcher in the Ministry of Health and Medical Education. Age and sex of deceased children, the type of health center, staying more than 2 h in emergency unit, the reason of prolonged stay in emergency, having emergency (risk) signs, vaccination, need to blood transfusion, need to electroshock and so on have also been collected across the country. There was also a comparison of children based on their BMI. Chi-square test has been applied for nominal and ordinal variables. ANOVA and t-student test have been used for measuring the difference of continuous variables among groups. Mortality in 1-59 months children was unequally distributed across Iran. The average month of entrance to hospital was June, the average day was 16(th) of month, and the average hour of entrance to hospital was 14:00. The average of month, day and hour for discharge was July, 16, and 14:00, respectively. The hour of discharge was statistically significant between children with and without risk signs. More than half (54%) of patients had referred to educational hospital emergency units. There were no statistically significant differences between children with and without emergency signs. There were statistically significant differences between children with and without emergency signs in age less than 24 months (0.034), nutrition situation (P = 0.031), recommendation for referring (P = 0.013), access to electroshock facilities (P = 0.026), and having successful cardiopulmonary resuscitation (P = 0.01). This study is one of the first to show the distribution of the disparity of early childhood mortality-related factors within a developing country. Our results

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

    SciTech Connect

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

    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 were 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.

  17. Mortality in women with turner syndrome in Great Britain: a national cohort study.

    PubMed

    Schoemaker, Minouk J; Swerdlow, Anthony J; Higgins, Craig D; Wright, Alan F; Jacobs, Patricia A

    2008-12-01

    Turner syndrome is characterized by complete or partial X chromosome monosomy. It is associated with substantial morbidity, but mortality risks and causes of death are not well described. Our objective was to investigate mortality and causes of death in women with Turner syndrome. We constructed a cohort of women diagnosed with Turner syndrome at almost all cytogenetic centers in Great Britain and followed them for mortality. A total of 3,439 women diagnosed between 1959-2002 were followed to the end of 2006. Standardized mortality ratios (SMRs) and absolute excess risks were evaluated. In total, 296 deaths occurred. Mortality was significantly raised overall [SMR = 3.0; 95% confidence interval (CI) = 2.7-3.4] and was raised for nearly all major causes of death. Circulatory disease accounted for 41% of excess mortality, with greatest SMRs for aortic aneurysm (SMR = 23.6; 95% CI = 13.8-37.8) and aortic valve disease (SMR = 17.9; 95% CI = 4.9-46.0), but SMRs were also raised for other circulatory conditions. Other major contributors to raised mortality included congenital cardiac anomalies, diabetes, epilepsy, liver disease, noninfectious enteritis and colitis, renal and ureteric disease, and pneumonia. Absolute excess risks of death were considerably greater at older than younger ages. Mortality in women with Turner syndrome is 3-fold higher than in the general population, is raised for almost all major causes of death, and is raised at all ages, with the greatest excess mortality in older adulthood. These risks need consideration in follow-up and counseling of patients and add to reasons for continued follow-up and preventive measures in adult, not just pediatric, care.

  18. Effect of Governance Indicators on Under-Five Mortality in OECD Nations: Generalized Method of Moments.

    PubMed

    Emamgholipour, Sara; Asemane, Zahra

    2016-01-01

    Today, it is recognized that factors other than health services are involved in health improvement and decreased inequality so identifying them is the main concern of policy makers and health authorities. The aim of this study was to investigate the effect of governance indicators on health outcomes. A panel data study was conducted to investigate the effect of governance indicators on child mortality rate in 27 OECD countries from 1996 to 2012 using the Generalized Method of Moments (GMM) model and EVIEWS.8 software. According to the results obtained, under-five mortality rate was significantly related to all of the research variables (p < 0.05). One percent increase in under-five mortality in the previous period resulted in a 0.83% increase in the mortality rate in the next period, and a 1% increase in total fertility rate, increased the under-five mortality rate by 0.09%. In addition, a 1% increase in GDP per capita decreased the under-five mortality rate by 0.07%, and a 1% improvement in control of corruption and rule of law indicators decreased child mortality rate by 0.05 and 0.08%, respectively. Furthermore, 1% increase in public health expenditure per capita resulted in a 0.03% decrease in under-five mortality rate. The results of the study suggest that considering control variables, including GDP per capita, public health expenditure per capita, total fertility rate, and improvement of governance indicators (control of corruption and rule of law) would decrease the child mortality rate.

  19. In-Hospital Mortality for Hepatic Portal Venous Gas: Analysis of 1590 Patients Using a Japanese National Inpatient Database.

    PubMed

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

    2017-09-06

    Hepatic portal venous gas (HPVG) is rare but potentially serious condition. Main cause of HPVG is bowel ischemia, while detection of HPVG without bowel ischemia may have been increasing possibly due to widespread use of computed tomography. However, little is known about variation in etiologies of HPVG and mortality of HPVG with each etiology. We examined patient backgrounds, underlying diseases, and in-hospital mortality of HPVG patients using a national inpatient database. Using the Diagnosis Procedure Combination database in Japan, we identified inpatients diagnosed with HPVG from July 1, 2010 to March 31, 2015. Patients' data included age, sex, comorbidities at admission, complications after admission, body mass index, surgical procedures, medications, and discharge status. In-hospital mortality was compared between the subgroups divided by the patient backgrounds and underlying diseases. A total of 1590 patients were identified during the study period. The mean age was 79.3 years old and the proportion of bowel ischemia was 53%. The overall in-hospital mortality was 27.3%. In-hospital mortality of HPVG with bowel ischemia, gastrointestinal tract (GIT) obstruction or dilation, GIT perforation, GIT infection, or sepsis was 26.8, 31.1, 33.3, 13.6, or 56.4%, respectively. Among patients with bowel ischemia, 32.2% patients received operation and their in-hospital mortality was 16.5%. HPVG patients in the present study were relatively older but less likely to die than those in previous studies. Attention should be paid to the fact that mortality of HPVG without bowel ischemia was not always lower compared to that with bowel ischemia.

  20. Lower Mortality Associated With Overweight in the U.S. National Health Interview Survey: Is Overweight Protective?

    PubMed

    Wang, Zhiqiang; Liu, Meina; Pan, Tania; Tong, Shilu

    2016-01-01

    It is still debatable whether overweight has protective or detrimental effects on survival. The focus of the ongoing debate is on possible confounding bias due to factors such as preexisting illness and smoking. We aimed to assess the association between overweight and mortality and to examine confounding effects of various factors including smoking and preexisting cancer, cardiovascular disease (CVD), diabetes, asthma, bronchitis, and kidney disease on the overweight-mortality association in adults.The data were extracted from the public-use National Health Interview Survey (NHIS) 1997 to 2009. Mortality data up to December 31, 2011 were linked to 131,813 with normal weight and 120,217 overweight adults. We assessed the association between overweight and mortality using Cox proportional hazard model with adjustments for various sets of confounding factors-age, sex, smoking, race, survey year, diabetes, CVD, cancer, asthma, bronchitis, and kidney disease.During the period from the original surveys to December 31, 2011, 22,513 (11,815 normal weight and 10,698 overweight) adults died. Normal weight and overweight groups differed in the characteristics of age, sex, smoking, and preexisting diseases. After adjusting for age and sex, the risk of dying was lower for overweight than normal weight adults (hazard ratio [HR], 0.82; 95% confidence interval [CI]: 0.80-0.85). Lower mortality risk associated with overweight remained after further adjusting for smoking and preexisting diseases such as diabetes, CVD, cancer, asthma, bronchitis, and kidney disease (HR, 0.80; 95% CI: 0.78-0.82). We observed a similar pattern for men and women, and for those free from preexisting diabetes, hypertension, and CVD.In conclusion, overweight adults have a lower mortality risk than normal weight adults. Our findings do not support that the lower mortality in overweight adults is due to confounding effects of smoking and preexisting diseases.

  1. National economic and development indicators and international variation in prostate cancer incidence and mortality: an ecological analysis.

    PubMed

    Neupane, Subas; Bray, Freddie; Auvinen, Anssi

    2017-06-01

    Macroeconomic indicators are likely associated with prostate cancer (PCa) incidence and mortality globally, but have rarely been assessed. Data on PCa incidence in 2003-2007 for 49 countries with either nationwide cancer registry or at least two regional registries were obtained from Cancer Incidence in Five Continents Vol X and national PCa mortality for 2012 from GLOBOCAN 2012. We compared PCa incidence and mortality rates with various population-level indicators of health, economy and development in 2000. Poisson and linear regression methods were used to quantify the associations. PCa incidence varied more than 15-fold, being highest in high-income countries. PCa mortality exhibited less variation, with higher rates in many low- and middle-income countries. Healthcare expenditure (rate ratio, RR 1.46, 95 % CI 1.45-1.47) and population growth (RR 1.15, 95 % CI 1.14-1.16), as well as computer and mobile phone density, were associated with a higher PCa incidence, while gross domestic product, GDP (RR 0.94, 95 % CI 0.93-0.95) and overall mortality (RR 0.72, 95 % CI 0.71-0.73) were associated with a low incidence. GDP (RR 0.55, 95 % CI 0.46-0.66) was also associated with a low PCa mortality, while life expectancy (RR 3.93, 95 % CI 3.22-4.79) and healthcare expenditure (RR 1.20, 95 % CI 1.09-1.32) were associated with an elevated mortality. Our results show that healthcare expenditure and, thus, the availability of medical resources are an important contributor to the patterns of international variation in PCa incidence. This suggests that there is an iatrogenic component in the current global epidemic of PCa. On the other hand, higher healthcare expenditure is associated with lower PCa death rates.

  2. SOCIOECONOMIC DISPARITIES IN MORTALITY AMONG CHINESE ELDERLY*

    PubMed Central

    Luo, Weixiang; Xie, Yu

    2014-01-01

    This study examines the association of three different SES indicators (education, economic independence, and household per-capita income) with mortality, using a large, nationally representative longitudinal sample of 12,437 Chinese ages 65 and older. While the results vary by measures used, we find overall strong evidence for a negative association between SES and all-cause mortality. Exploring the association between SES and cause-specific mortality, we find that SES is more strongly related to a reduction of mortality from more preventable causes (i.e., circulatory disease and respiratory disease) than from less preventable causes (i.e., cancer). Moreover, we consider mediating causal factors such as support networks, health-related risk behaviors, and access to health care in contributing to the observed association between SES and mortality. Among these mediating factors, medical care is of greatest importance. This pattern holds true for both all-cause and cause-specific mortality. PMID:25098961

  3. Body size and longitudinal body weight changes do not increase mortality in incident peritoneal dialysis patients of the Brazilian peritoneal dialysis multicenter study

    PubMed Central

    da Silva Fernandes, Natália Maria; Bastos, Marcus Gomes; Franco, Márcia Regina Gianotti; Chaoubah, Alfredo; da Glória Lima, Maria; Divino-Filho, José Carolino; Qureshi, Abdul Rashid

    2013-01-01

    OBJECTIVES: To determine the roles of body size and longitudinal body weight changes in the survival of incident peritoneal dialysis patients. PATIENTS AND METHODS: Patients (n = 1911) older than 18 years of age recruited from 114 dialysis centers (Dec/2004-Oct/2007) and participating in the Brazilian Peritoneal Dialysis Multicenter Cohort Study were included. Clinical and laboratory data were collected monthly (except if the patient received a transplant, recovered renal function, was transferred to hemodialysis, or died). RESULTS: Survival analyses were performed using Kaplan-Meier survival curves and Cox proportional hazards. Total follow-up was 34 months. The mean age was 59 years (54% female). The weight category percentages were as follows: underweight: 8%; normal: 51%; overweight: 29%; and obese 12%. The multivariate model showed a higher risk of death for a body mass index <18.5 kg/m2, a neutral risk between 25 and 29.9 kg/m2 and a protective effect for an index >30 kg/m2. Patients were divided into five categories according to quintiles of body weight changes during the first year of dialysis: <−3.1%, −3.1 to+0.12%, +0.12 to <+3.1% (reference category), +3.1 to +7.1% and >+7.1%. Patients in the lowest quintile had significantly higher mortality, whereas no negative impact was observed in the other quintiles. CONCLUSION: These findings suggest that overweight/obesity and a positive body weight variation during the first year of peritoneal dialysis therapy do not increase mortality in incident dialysis patients in Brazil. PMID:23420157

  4. School, Neighborhood, and Family Factors Are Associated with Children's Bullying Involvement: A Nationally Representative Longitudinal Study

    ERIC Educational Resources Information Center

    Bowes, Lucy; Arseneault, Louise; Maughan, Barbara; Taylor, Alan; Caspi, Ashalom; Moffitt, Terrie E.

    2009-01-01

    School size and problems with neighbors is associated with a greater risk of being a bullying victim while family factors such as maltreatment and domestic violence are associated with involvement in bullying. The findings are based on the Environmental Risk Longitudinal Twin Study that involves 2,232 children.

  5. 2012 School Libraries Count! National Longitudinal Survey of School Library Programs

    ERIC Educational Resources Information Center

    American Association of School Librarians (NJ1), 2012

    2012-01-01

    AASL's School Libraries Count! annual longitudinal survey is an online survey that is open to all primary and secondary school library programs to participate. The 2012 survey was launched on January 24th and closed on March 20th. The survey was publicized through various professional organizations and events and through word of mouth. Data…

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

    PubMed

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

    2016-10-01

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

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

    PubMed

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

    2013-01-01

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

  8. National trends in silicosis mortality in the United States, 1981-2004.

    PubMed

    Bang, Ki Moon; Attfield, Michael D; Wood, John M; Syamlal, Girija

    2008-09-01

    This article describes trends in mortality with silicosis and identifies industries and occupations with elevated silicosis mortality. A total of 6,326 deaths with silicosis for 1981-2004 were analyzed for trends and association with occupation and industry. Annual mortality rates were age-adjusted to the U.S. Year 2000 population. A linear regression model was used for analyzing mortality trends. Proportionate mortality ratios (PMRs) were based on 1,440 deaths with information on usual industry and occupation. Overall age-adjusted mortality rates per million declined from 2.4 in 1981 to 0.7 in 2004. Industries having significantly elevated PMRs for silicosis included mining and quarrying. Occupations with elevated PMRs included those associated with metal and mineral processing. The results suggest that considerable progress has been made towards elimination of this preventable disease. However, about 30 silicosis deaths per year have been recorded since 1995 among those of working age, warranting continued efforts to effectively limit workplace exposures. Published 2008 Wiley-Liss, Inc.

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

    PubMed Central

    2017-01-01

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

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

    PubMed

    2017-09-16

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

  11. Understanding drug-related mortality in released prisoners: a review of national coronial records.

    PubMed

    Andrews, Jessica Y; Kinner, Stuart A

    2012-04-04

    The prisoner population is characterised by a high burden of disease and social disadvantage, and ex-prisoners are at increased risk of death following release. Much of the excess mortality can be attributed to an increased risk of unnatural death, particularly from drug overdose; however, relatively few studies have investigated the circumstances surrounding drug-related deaths among released prisoners. This study aimed to explore and compare the circumstances of death for those who died from accidental drug-related causes to those who died from all other reportable causes. A nationwide search of the Australian National Coroners Information System (NCIS) was conducted to identify reportable deaths among ex-prisoners from 2000 to 2007. Using a structured coding form, NCIS records for these cases were interrogated to explore causes and circumstances of death. Coronial records for 388 deceased ex-prisoners were identified. Almost half of these deaths were a result of accidental drug-related causes (45%). The majority of accidental drug-related deaths occurred in a home environment, and poly-substance use at or around the time of death was common, recorded in 72% of drug-related deaths. Ex-prisoners who died of accidental drug-related causes were on average younger and less likely to be Indigenous, born in Australia, married, or living alone at or around the time of death, compared with those who died from all other reportable causes. Evidence of mental illness or self-harm was less common among accidental drug-related deaths, whereas evidence of previous drug overdose, injecting drug use, history of heroin use and history of drug withdrawal in the previous six months were more common. Drug-related deaths are common among ex-prisoners and often occur in a home (vs. public) setting. They are often associated with use of multiple substances at or around the time of death, risky drug-use patterns, and even among this markedly disadvantaged group, extreme social

  12. Social support, social strain and inflammation: Evidence from a national longitudinal study of U.S. adults

    PubMed Central

    Yang, Yang Claire; Schorpp, Kristen; Harris, Kathleen Mullan

    2014-01-01

    Social relationships have long been held to have powerful effects on health and survival, but it remains unclear whether such associations differ by function and domain of relationships over time and what biophysiological mechanisms underlie these links. This study addressed these gaps by examining the longitudinal associations of persistent relationship quality across a ten year span with a major indicator of immune function. Specifically, we examined how perceived social support and social strain from relationships with family, friends, and spouse at a prior point in time are associated with subsequent risks of inflammation, as assessed by overall inflammation burden comprised of five markers (C-reactive protein, interleukin-6, fibrinogen, E-selectin, and intracellular adhesion molecule-1) in a national longitudinal study of 647 adults from the Midlife Development in the United States (1995–2009). Results from multivariate regression analysis show that (1) support from family, friends, and spouse modestly protected against risks of inflammation; (2) family, friend, and total social strain substantially increased risks of inflammation; and (3) the negative associations of social strain were stronger than the positive associations of social support with inflammation. The findings highlight the importance of enriched conceptualizations, measures, and longitudinal analyses of both social and biological stress processes to elucidate the complex pathways linking social relationships to health and illness. PMID:24607674

  13. A longitudinal ecological study of the influences of political, economic, and health services characteristics on under-five mortality in less-developed countries.

    PubMed

    Chuang, Ying-Chih; Sung, Pei-Wei; Chao, Hsing Jasmine; Bai, Chyi-Huey; Chang, Chia-Jung

    2013-09-01

    This study used a longitudinal dataset and lagged dependent-variable panel regression models to examine whether political and economic characteristics directly predict under-5-year mortality rates (U5MR), and moderate the effects of health services and environment on U5MR. We used a sample of 46 less-developed countries from 1980 to 2009. Our results showed that the effects of political and economic characteristics on U5MR varied by non-sub-Saharan and sub-Saharan countries. After controlling for baseline U5MR and other socioeconomic variables, while foreign investment and health services were negatively associated U5MR, democracy was positively associated with U5MR in nonsub-Saharan countries. In contrast, debt was positively associated with and democracy and foreign investment were negatively associated with U5MR in sub-Saharan countries. The interaction analyses indicated that for sub-Saharan countries, the effects of health services on U5MR only existed for countries with low foreign investment.

  14. Predicting 30-day mortality after hip fracture surgery: Evaluation of the National Hip Fracture Database case-mix adjustment model.

    PubMed

    Tsang, C; Boulton, C; Burgon, V; Johansen, A; Wakeman, R; Cromwell, D A

    2017-09-01

    The National Hip Fracture Database (NHFD) publishes hospital-level risk-adjusted mortality rates following hip fracture surgery in England, Wales and Northern Ireland. The performance of the risk model used by the NHFD was compared with the widely-used Nottingham Hip Fracture Score. Data from 94 hospitals on patients aged 60 to 110 who had hip fracture surgery between May 2013 and July 2013 were analysed. Data were linked to the Office for National Statistics (ONS) death register to calculate the 30-day mortality rate. Risk of death was predicted for each patient using the NHFD and Nottingham models in a development dataset using logistic regression to define the models' coefficients. This was followed by testing the performance of these refined models in a second validation dataset. The 30-day mortality rate was 5.36% in the validation dataset (n = 3861), slightly lower than the 6.40% in the development dataset (n = 4044). The NHFD and Nottingham models showed a slightly lower discrimination in the validation dataset compared with the development dataset, but both still displayed moderate discriminative power (c-statistic for NHFD = 0.71, 95% confidence interval (CI) 0.67 to 0.74; Nottingham model = 0.70, 95% CI 0.68 to 0.75). Both models defined similar ranges of predicted mortality risk (1% to 18%) in assessment of calibration. Both models have limitations in predicting mortality for individual patients after hip fracture surgery, but the NHFD risk adjustment model performed as well as the widely-used Nottingham prognostic tool and is therefore a reasonable alternative for risk adjustment in the United Kingdom hip fracture population.Cite this article: Bone Joint Res 2017;6:550-556. © 2017 Tsang et al.

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

    PubMed

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

    2013-01-01

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

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

    PubMed

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

    2016-01-01

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

  17. Short Sleep Duration as a Risk Factor for Hypercholesterolemia: Analyses of the National Longitudinal Study of Adolescent Health

    PubMed Central

    Gangwisch, James E.; Malaspina, Dolores; Babiss, Lindsay A.; Opler, Mark G.; Posner, Kelly; Shen, Sa; Turner, J. Blake; Zammit, Gary K.; Ginsberg, Henry N.

    2010-01-01

    Study Objectives: To explore the relationship between sleep duration in adolescence and hypercholesterolemia in young adulthood. Experimental sleep restriction has been shown to significantly increase total cholesterol and LDL cholesterol levels in women. Short sleep duration has been found in cross sectional studies to be associated with higher total cholesterol and lower HDL cholesterol levels. Sleep deprivation could increase the risk for hypercholesterolemia by increasing appetite and dietary consumption of saturated fats, decreasing motivation to engage in regular physical activity, and increasing stress and resultant catecholamine induced lipolysis. No previous published population studies have examined the longitudinal relationship between sleep duration and high cholesterol. Design: Multivariate longitudinal analyses stratified by sex of the ADD Health using logistic regression. Setting: United States nationally representative, school-based, probability-based sample. Participants: Adolescents (n = 14,257) in grades 7 to 12 at baseline (1994-95) and ages 18 to 26 at follow-up (2001-02). Measurements and Results: Among females, each additional hour of sleep was associated with a significantly decreased odds of being diagnosed with high cholesterol in young adulthood (OR = 0.85, 95% CI 0.75-0.96) after controlling for covariates. Additional sleep was associated with decreased, yet not statistically significant, odds ratios for hypercholesterolemia in males (OR = 0.91, 95% CI 0.79-1.05). Conclusions: Short sleep durations in adolescent women could be a significant risk factor for high cholesterol. Interventions that lengthen sleep could potentially serve as treatments and as primary preventative measures for hypercholesterolemia. Citation: Gangwisch JE; Malaspina D; Babiss LA; Opler MG; Posner K; Shen S; Turner JB; Zammit GK; Ginsberg HN. Short sleep duration as a risk factor for hypercholesterolemia: analyses of the National Longitudinal Study of Adolescent

  18. Early-Life Origins of the Race Gap in Men's Mortality

    ERIC Educational Resources Information Center

    Warner, David F.; Hayward, Mark D.

    2006-01-01

    Using a life course framework, we examine the early life origins of the race gap in men's all-cause mortality. Using the National Longitudinal Survey of Older Men (1966-1990), we evaluate major social pathways by which early life conditions differentiate the mortality experiences of blacks and whites. Our findings indicate that early life…

  19. Early-Life Origins of the Race Gap in Men's Mortality

    ERIC Educational Resources Information Center

    Warner, David F.; Hayward, Mark D.

    2006-01-01

    Using a life course framework, we examine the early life origins of the race gap in men's all-cause mortality. Using the National Longitudinal Survey of Older Men (1966-1990), we evaluate major social pathways by which early life conditions differentiate the mortality experiences of blacks and whites. Our findings indicate that early life…

  20. Perceptions and Expectations of Youth with Disabilities. A Special Topic Report of Findings from the National Longitudinal Transition Study-2 (NLTS2). NCSER 2007-3006

    ERIC Educational Resources Information Center

    Wagner, Mary; Newman, Lynn; Cameto, Renee; Levine, Phyllis; Marder, Camille

    2007-01-01

    The National Longitudinal Transition Study-2 (NLTS2) was initiated to provide a national picture of the characteristics and experiences of youth with disabilities, including their self-representations, their schooling, their personal relationships, and their hopes for the future. This report presents findings drawn from the first time (2003) data…

  1. Postsecondary Transition and English Learners with Disabilities: Data from the Second National Longitudinal Transition Study. WCER Working Paper No. 2014-4

    ERIC Educational Resources Information Center

    Trainor, Audrey A.; Murray, Angela; Kim, Hyejung

    2014-01-01

    Although English Learners (ELs) constitute one of the fastest growing subpopulations in U.S. schools, little is known about the postschool outcomes of ELs who are also students with disabilities (ELSWD). This descriptive study examines a nationally representative sample of ELSWD through a secondary analysis of the National Longitudinal Transition…

  2. The Problem of Excluded Baseline Students in a School-Based Longitudinal Study: Correcting National Dropout Estimates and Accommodating Eligibility Change over Time.

    ERIC Educational Resources Information Center

    Ingels, Steven J.

    Some students are excluded from the National Education Longitudinal Study of 1988 (NELS:88) because of an inability, whether due to physical, mental, or linguistic barriers, to participate in studies requiring questionnaire or cognitive test completion. The implications of this exclusion for sample representativeness, national estimation, and…

  3. A First Look at the Characteristics of Children and Families Entering Early Intervention Services. Data Report. National Early Intervention Longitudinal Study (NEILS).

    ERIC Educational Resources Information Center

    Hebbeler, Kathleen; Wagner, Mary; Spiker, Donna; Scarborough, Anita; Simeonsson, Rune; Collier, Marnie

    The National Early Intervention Longitudinal Study (NEILS) is being conducted to address important questions related to the implementation and outcomes of Part C of the Individuals with Disabilities Education Act (IDEA). NEILS is following a nationally representative sample of children from birth to 3 years old and their families through and after…

  4. The Characteristics, Experiences, and Outcomes of Youth with Emotional Disturbances. A Report from the National Longitudinal Transition Study-2. Volume 3, Issue 2.

    ERIC Educational Resources Information Center

    Wagner, Mary; Cameto, Renee

    2004-01-01

    The National Longitudinal Transition Study (NLTS) provided the first national pictureof the lives of youth with disabilities in their high school years and in their transition to early adulthood. NLTS analyses from the early 1990s showed tremendous variation across disability categories in the experiences and achievements of youth, yet the…

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

    PubMed Central

    Richardson, D B; Wing, S

    1999-01-01

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

  6. Accelerometer-Determined Physical Activity and Mortality in a National Prospective Cohort Study: Considerations by Hearing Sensitivity.

    PubMed

    Loprinzi, Paul D

    2015-12-01

    Previous work demonstrates that hearing impairment and physical inactivity are associated with premature all-cause mortality. The purpose of this study was to discern whether increased physical activity among those with hearing impairment can produce survival benefits. Data from the 2003-2006 National Health and Nutrition Examination Survey were used, with follow-up through 2011. Physical activity was objectively measured over 7 days via accelerometry. Hearing sensitivity was objectively measured using a modified Hughson Westlake procedure. Among the 1,482 participants, 152 died during the follow-up period (10.26%, unweighted); the unweighted median follow-up period was 89 months (interquartile range = 74-98 months). For those with normal hearing and after adjustments, for every 60-min increase in physical activity, adults had a 19% (HR [Hazard Ratio] = 0.81; 95% confidence interval [CI] [0.48-1.35]; p = .40) reduced risk of all-cause mortality; however, this association was not statistically significant. In a similar manner, physical activity was not associated with all-cause mortality among those with mild hearing loss (HR = 0.76; 95% CI [0.51-1.13]; p = .17). However, after adjustments, and for every 60-min increase in physical activity for those with moderate or greater hearing loss, there was a 20% (HR = 0.20; 95% CI [0.67-0.95]; p = .01) reduced risk of all-cause mortality. Physical activity may help to prolong survival among those with greater hearing impairment.

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

    PubMed

    Richardson, D B; Wing, S

    1999-08-01

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

  8. Periodontal disease, chronic kidney disease and mortality: results from the third National Health and Nutrition Examination Survey.

    PubMed

    Ricardo, Ana C; Athavale, Ambarish; Chen, Jinsong; Hampole, Hemanth; Garside, Daniel; Marucha, Phillip; Lash, James P

    2015-07-07

    Periodontal disease is associated with increased mortality in the general population, however its prognostic significance in chronic kidney disease (CKD) is not known. We evaluated the joint effect of periodontal disease and CKD on all-cause and cardiovascular mortality. Prospective observational study of 10,755 adult participants in the National Health and Nutrition Examination Survey, 1988-1994 (NHANES III). CKD was defined as estimated glomerular filtration rate < 60 ml/minute/1.73 m(2) or albumin-to-creatinine ratio ≥ 30 mg/g. Periodontal disease was defined as moderate (> 4 mm attachment loss in ≥ 2 mesial sites or 5 mm pocket depth in ≥ 2 mesial sites), or severe (> 6 mm attachment loss in ≥ 2 mesial sites and > 5 mm pocket depth in ≥ 1 mesial site). All-cause and cardiovascular mortality were evaluated using Cox proportional hazards models. There were 1,813 deaths over a median follow-up of 14 years. In multivariate analyses, as compared to participants with neither periodontal disease nor CKD, those with periodontal disease only or CKD only had increased all-cause mortality (HR 1.39; 95 % CI, 1.06-1.81 and 1.55; 1.30-1.84, respectively). The presence of both periodontal disease and CKD was associated with HR (95 % CI) 2.07 (1.65-2.59) for all-cause mortality, and 2.11 (1.52-2.94) for cardiovascular mortality. We found no evidence of multiplicativity or additivity between periodontal disease and CKD. In stratified analyses limited to individuals with CKD, periodontal disease (vs. not) was associated with adjusted HR (95 % CI) 1.35 (1.04-1.76) for all-cause, and 1.36 (0.95-1.95) for cardiovascular mortality. These findings confirm the well-established association between periodontal disease and increased mortality in the general population, and provide new evidence of this association among individuals with CKD.

  9. The Impact of a National Clinician-led Audit Initiative on Care and Mortality after Hip Fracture in England

    PubMed Central

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

    2015-01-01

    Background: Hip fracture is the most common serious injury of older people. The UK National Hip Fracture Database (NHFD) was launched in 2007 as a national collaborative, clinician-led audit initiative to improve the quality of hip fracture care, but has not yet been externally evaluated. Methods: We used routinely collected data on 471,590 older people (aged 60 years and older) admitted with a hip fracture to National Health Service (NHS) hospitals in England between 2003 and 2011. The main variables of interest were the use of early surgery (on day of admission, or day after) and mortality at 30 days from admission. We compared time trends in the periods 2003–2007 and 2007–2011 (before and after the launch of the NHFD), using Poisson regression models to adjust for demographic changes. Findings: The number of hospitals participating in the NHFD increased from 11 in 2007 to 175 in 2011. From 2007 to 2011, the rate of early surgery increased from 54.5% to 71.3%, whereas the rate had remained stable over the period 2003–2007. Thirty-day mortality fell from 10.9% to 8.5%, compared with a small reduction from 11.5% to 10.9% previously. The annual relative reduction in adjusted 30-day mortality was 1.8% per year in the period 2003–2007, compared with 7.6% per year over 2007–2011 (P<0.001 for the difference). Interpretation: The launch of a national clinician-led audit initiative was associated with substantial improvements in care and survival of older people with hip fracture in England. PMID:26172938

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

    PubMed Central

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

    2014-01-01

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

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

    PubMed

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

    2014-01-01

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

  12. Mammography service screening and breast cancer mortality in New Zealand: a National Cohort Study 1999–2011

    PubMed Central

    Morrell, Stephen; Taylor, Richard; Roder, David; Robson, Bridget; Gregory, Marli; Craig, Kirsty

    2017-01-01

    1999–2011, after adjusting for age and ethnicity, breast cancer mortality in ever-screened women is estimated to be 62% (95% CI: 51–70) lower than in never-screened women. After further adjustment for screening selection bias, the mortality reduction in NZ is estimated to be 29% (95% CI: 20–38) at an average screening coverage of 64% for 2001–2011, and 34% (95% CI: 25–43) for recent screening coverage (2012–13, 71%). For irregularly screened women, the mortality reduction is estimated to be 31% (95% CI: 21–40), and 39% (95% CI: 22–52) in regularly screened women compared with never-screened women, after adjusting for age, ethnicity and screening selection bias (using recent 2012–2013 screening coverage of 71%). Ever-screened women diagnosed with breast cancer have more favourable prognostic indicators than never-screened women, with a higher proportion of localised cancer (63 compared with 46%), a higher proportion with a well-differentiated tumour (30 compared with 18%), lower risk of multiple tumours (RR=0.48) and smaller median tumour size (15 mm compared with 20 mm)—all differences are statistically significant (P<0.0001). Conclusions: This is the first total population cohort study of an established nation-wide screening mammography programme using individual-level information on screening participation and mortality outcomes from breast cancer. The findings are in accord with other mammography screening service evaluations and with randomised trials of mammography screening. PMID:28183141

  13. Mammography service screening and breast cancer mortality in New Zealand: a National Cohort Study 1999-2011.

    PubMed

    Morrell, Stephen; Taylor, Richard; Roder, David; Robson, Bridget; Gregory, Marli; Craig, Kirsty

    2017-03-14

    and ethnicity, breast cancer mortality in ever-screened women is estimated to be 62% (95% CI: 51-70) lower than in never-screened women. After further adjustment for screening selection bias, the mortality reduction in NZ is estimated to be 29% (95% CI: 20-38) at an average screening coverage of 64% for 2001-2011, and 34% (95% CI: 25-43) for recent screening coverage (2012-13, 71%). For irregularly screened women, the mortality reduction is estimated to be 31% (95% CI: 21-40), and 39% (95% CI: 22-52) in regularly screened women compared with never-screened women, after adjusting for age, ethnicity and screening selection bias (using recent 2012-2013 screening coverage of 71%). Ever-screened women diagnosed with breast cancer have more favourable prognostic indicators than never-screened women, with a higher proportion of localised cancer (63 compared with 46%), a higher proportion with a well-differentiated tumour (30 compared with 18%), lower risk of multiple tumours (RR=0.48) and smaller median tumour size (15 mm compared with 20 mm)-all differences are statistically significant (P<0.0001). This is the first total population cohort study of an established nation-wide screening mammography programme using individual-level information on screening participation and mortality outcomes from breast cancer. The findings are in accord with other mammography screening service evaluations and with randomised trials of mammography screening.

  14. Mortality in Iraq Associated with the 2003–2011 War and Occupation: Findings from a National Cluster Sample Survey by the University Collaborative Iraq Mortality Study

    PubMed Central

    Hagopian, Amy; Flaxman, Abraham D.; Takaro, Tim K.; Esa Al Shatari, Sahar A.; Rajaratnam, Julie; Becker, Stan; Levin-Rector, Alison; Galway, Lindsay; Hadi Al-Yasseri, Berq J.; Weiss, William M.; Murray, Christopher J.; Burnham, Gilbert

    2013-01-01

    Background Previous estimates of mortality in Iraq attributable to the 2003 invasion have been heterogeneous and controversial, and none were produced after 2006. The purpose of this research was to estimate direct and indirect deaths attributable to the war in Iraq between 2003 and 2011. Methods and Findings We conducted a survey of 2,000 randomly selected households throughout Iraq, using a two-stage cluster sampling method to ensure the sample of households was nationally representative. We asked every household head about births and deaths since 2001, and all household adults about mortality among their siblings. We used secondary data sources to correct for out-migration. From March 1, 2003, to June 30, 2011, the crude death rate in Iraq was 4.55 per 1,000 person-years (95% uncertainty interval 3.74–5.27), more than 0.5 times higher than the death rate during the 26-mo period preceding the war, resulting in approximately 405,000 (95% uncertainty interval 48,000–751,000) excess deaths attributable to the conflict. Among adults, the risk of death rose 0.7 times higher for women and 2.9 times higher for men between the pre-war period (January 1, 2001, to February 28, 2003) and the peak of the war (2005–2006). We estimate that more than 60% of excess deaths were directly attributable to violence, with the rest associated with the collapse of infrastructure and other indirect, but war-related, causes. We used secondary sources to estimate rates of death among emigrants. Those estimates suggest we missed at least 55,000 deaths that would have been reported by households had the households remained behind in Iraq, but which instead had migrated away. Only 24 households refused to participate in the study. An additional five households were not interviewed because of hostile or threatening behavior, for a 98.55% response rate. The reliance on outdated census data and the long recall period required of participants are limitations of our study. Conclusions Beyond

  15. Mortality in Iraq associated with the 2003-2011 war and occupation: findings from a national cluster sample survey by the university collaborative Iraq Mortality Study.

    PubMed

    Hagopian, Amy; Flaxman, Abraham D; Takaro, Tim K; Esa Al Shatari, Sahar A; Rajaratnam, Julie; Becker, Stan; Levin-Rector, Alison; Galway, Lindsay; Hadi Al-Yasseri, Berq J; Weiss, William M; Murray, Christopher J; Burnham, Gilbert

    2013-10-01

    Previous estimates of mortality in Iraq attributable to the 2003 invasion have been heterogeneous and controversial, and none were produced after 2006. The purpose of this research was to estimate direct and indirect deaths attributable to the war in Iraq between 2003 and 2011. We conducted a survey of 2,000 randomly selected households throughout Iraq, using a two-stage cluster sampling method to ensure the sample of households was nationally representative. We asked every household head about births and deaths since 2001, and all household adults about mortality among their siblings. We used secondary data sources to correct for out-migration. From March 1, 2003, to June 30, 2011, the crude death rate in Iraq was 4.55 per 1,000 person-years (95% uncertainty interval 3.74-5.27), more than 0.5 times higher than the death rate during the 26-mo period preceding the war, resulting in approximately 405,000 (95% uncertainty interval 48,000-751,000) excess deaths attributable to the conflict. Among adults, the risk of death rose 0.7 times higher for women and 2.9 times higher for men between the pre-war period (January 1, 2001, to February 28, 2003) and the peak of the war (2005-2006). We estimate that more than 60% of excess deaths were directly attributable to violence, with the rest associated with the collapse of infrastructure and other indirect, but war-related, causes. We used secondary sources to estimate rates of death among emigrants. Those estimates suggest we missed at least 55,000 deaths that would have been reported by households had the households remained behind in Iraq, but which instead had migrated away. Only 24 households refused to participate in the study. An additional five households were not interviewed because of hostile or threatening behavior, for a 98.55% response rate. The reliance on outdated census data and the long recall period required of participants are limitations of our study. Beyond expected rates, most mortality increases in Iraq

  16. Morbidity and mortality in children with obstructive sleep apnoea: a controlled national study.

    PubMed

    Jennum, Poul; Ibsen, Rikke; Kjellberg, Jakob

    2013-10-01

    Little is known about the diagnostic patterns of obstructive sleep apnoea (OSA) in children. A study was undertaken to evaluate morbidity and mortality in childhood OSA. 2998 patients aged 0-19 years with a diagnosis of OSA were identified from the Danish National Patient Registry. For each patient we randomly selected four citizens matched for age, sex and socioeconomic status, thus providing 11 974 controls. Patients with OSA had greater morbidity at least 3 years before their diagnosis. The most common contacts with the health system arose from infections (OR 1.19, 95% CI 1.01 to 1.40); endocrine, nutritional and metabolic diseases (OR 1.30, 95% CI 0.94 to 1.80); nervous conditions (OR 2.12, 95% CI 1.65 to 2.73); eye conditions (OR 1.43, 95% CI 1.07 to 1.90); ear, nose and throat (ENT) diseases (OR 1.61, 95% CI 1.33 to 1.94); respiratory system diseases (OR 1.78, 95% CI 1.60 to 1.98); gastrointestinal diseases (OR 1.34, 95% CI 1.09 to 1.66); skin conditions (OR 1.32, 95% CI 1.02 to 1.71); congenital malformations (OR 1.56, 95% CI 1.31 to 1.85); abnormal clinical or laboratory findings (OR 1.21, 95% CI 1.06 to 1.39); and other factors influencing health status (OR 1.29, 95% CI 1.16 to 1.43). After diagnosis, OSA was associated with incidences of endocrine, nutritional and metabolic diseases (OR 1.78, 95% CI 1.29 to 2.45), nervous conditions (OR 3.16, 95% CI 2.58 to 3.89), ENT diseases (OR 1.45, 95% CI 1.14 to 1.84), respiratory system diseases (OR 1.94, 95% CI 1.70 to 2.22), skin conditions (OR 1.42, 95% CI 1.06 to 1.89), musculoskeletal diseases (OR 1.29, 95% CI 1.01 to 1.64), congenital malformations (OR 1.83, 95% CI 1.51 to 2.22), abnormal clinical or laboratory findings (OR 1.16, 95% CI 1.06 to 1.27) and other factors influencing health status (OR 1.35, 95% CI 1.20 to 1.51). The 5-year death rate was 70 per 10 000 for patients and 11 per 10 000 for controls. The HR for cases compared with controls was 6.58 (95% CI 3.39 to 12.79; p<0.001). Children with OSA

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

    PubMed Central

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

    2013-01-01

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

  18. Infant Mortality Rates: Socioeconomic Factors. United States. National Vital Statistics System, Series 22, Number 14.

    ERIC Educational Resources Information Center

    National Center for Health Statistics (DHEW/PHS), Hyattsville, MD.

    Statistics are presented on infant mortality rates according to race, sex, family income, education of mother, and education of father. The statistics are based on data collected by a questionnaire mailed to mothers of legitimate births and to medical care facilities and mothers of legitimate infant deaths. Samples were selected from records of…

  19. LBA-ECO TG-07 Soil Trace Gas Flux and Root Mortality, Tapajos National Forest

    Treesearch

    R.K. Varner; M.M. Keller

    2009-01-01

    This data set reports the results of an experiment that tested the short-term effects of root mortality on the soil-atmosphere fluxes of nitrous oxide, nitric oxide, methane, and carbon dioxide in a tropical evergreen forest. Weekly trace gas fluxes are provided for treatment and control plots on sand and clay tropical forest soils in two comma separated ASCII files....

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

    PubMed

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

    2013-01-01

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

  1. Self-Reported Age of Onset and Telescoping for Cigarettes, Alcohol, and Marijuana Across Eight Years of the National Longitudinal Survey of Youth

    PubMed Central

    Shillington, Audrey M.; Woodruff, Susan I.; Clapp, John D.; Reed, Mark B.; Lemus, Hector

    2012-01-01

    Smoking, drinking, and illicit drug use are leading causes of morbidity and mortality, both during adolescence as well as later in life. Although for some adolescents, substance use may last for only a brief period of experimentation, use of these substances in adolescence may have negative consequences. The determination of how well national and local policy and intervention efforts address teen substance use depends largely on the collection of valid and accurate data. Assessments of substance use rely heavily on retrospective self-report measures. The reliability and validity of self-reported substance use measures, however, may be limited by various sources of measurement error. This study utilizes four waves of data from the National Longitudinal Survey of Youth spanning eight years. Our wave-to-wave analyses examined the accuracy of self-reported age of onset for cigarette, alcohol and marijuana users. Findings indicate that approximately one-fourth of cigarette users, one-fifth of alcohol users and one-third of marijuana users reported their age of onset exactly the same across waves. Of those who reported the age of onset inaccurately, the error tended to be in the direction of reporting their age of onset as older at a latter wave relative to what was reported previously, known as forward telescoping. Results from multiple linear regression analyses showed that the single most consistent variable associated with telescoping was the number of years since the substance was first reported. Time since first report was the single consistent and strongly associated with telescoping in each wave-to-wave comparison for all three substances under study. Implications for policy and research are discussed. PMID:23284228

  2. Self-Reported Age of Onset and Telescoping for Cigarettes, Alcohol, and Marijuana Across Eight Years of the National Longitudinal Survey of Youth.

    PubMed

    Shillington, Audrey M; Woodruff, Susan I; Clapp, John D; Reed, Mark B; Lemus, Hector

    2012-09-01

    Smoking, drinking, and illicit drug use are leading causes of morbidity and mortality, both during adolescence as well as later in life. Although for some adolescents, substance use may last for only a brief period of experimentation, use of these substances in adolescence may have negative consequences. The determination of how well national and local policy and intervention efforts address teen substance use depends largely on the collection of valid and accurate data. Assessments of substance use rely heavily on retrospective self-report measures. The reliability and validity of self-reported substance use measures, however, may be limited by various sources of measurement error. This study utilizes four waves of data from the National Longitudinal Survey of Youth spanning eight years. Our wave-to-wave analyses examined the accuracy of self-reported age of onset for cigarette, alcohol and marijuana users. Findings indicate that approximately one-fourth of cigarette users, one-fifth of alcohol users and one-third of marijuana users reported their age of onset exactly the same across waves. Of those who reported the age of onset inaccurately, the error tended to be in the direction of reporting their age of onset as older at a latter wave relative to what was reported previously, known as forward telescoping. Results from multiple linear regression analyses showed that the single most consistent variable associated with telescoping was the number of years since the substance was first reported. Time since first report was the single consistent and strongly associated with telescoping in each wave-to-wave comparison for all three substances under study. Implications for policy and research are discussed.

  3. Individual and spousal education, mortality and life expectancy in Switzerland: a national cohort study.

    PubMed

    Spoerri, Adrian; Schmidlin, Kurt; Richter, Matthias; Egger, Matthias; Clough-Gorr, Kerri M

    2014-09-01

    Household measures of socioeconomic position may better account for the shared nature of material resources, lifestyle, and social position of cohabiting persons, but household measures of education are rarely used. We aimed to evaluate the association of combined educational attainment of married couples on mortality and life expectancy in Switzerland. The study included 3,496,163 ever-married persons aged ≥30 years. The 2000 census was linked to mortality records through 2008. Mortality by combined educational attainment was assessed by gender-age-specific HRs, with 95% CIs from adjusted models, life expectancy was derived using abridged life tables. Having a less educated partner was associated with increased mortality. For example, the HR comparing men aged 50-64 years with tertiary education married to women with tertiary education to men with compulsory education married to women with compulsory education was 2.05 (1.92-2.18). The estimated remaining life expectancy in tertiary educated men aged 30 years married to women with tertiary education was 4.6 years longer than in men with compulsory education married to women with compulsory education. The gradient based on individual education was less steep: the HR comparing men aged 50-64 years with tertiary education with men with compulsory education was 1.74 (1.67-1.81). Using individual educational attainment of married persons is common in epidemiological research, but may underestimate the combined effect of education on mortality and life expectancy. These findings are relevant to epidemiologic studies examining socio-demographic characteristics or aiming to adjust results for these characteristics. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  4. Cancer risk and all-cause mortality among Norwegian military United Nations peacekeepers deployed to Kosovo between 1999 and 2011.

    PubMed

    Strand, Leif Aage; Martinsen, Jan Ivar; Borud, Einar Kristian

    2014-08-01

    Media reports of leukaemia and other cancers among European United Nations (UN) peacekeepers who served in the Balkans, and a scientific finding of excess Hodgkin lymphoma among Italian UN peacekeepers who served in Bosnia, suggested a link between cancer incidence and depleted uranium (DU) exposure. This spurred several studies on cancer risk among UN peacekeepers who served in the Balkans. Although these studies turned out to be negative, the debate about possible cancers and other health risks caused by DU exposure continues. The aim of the present study was to investigate cancer incidence and all-cause mortality in a cohort of 6076 (4.4% women) Norwegian military UN peacekeepers deployed to Kosovo between 1999 and 2011. The cohort was followed for cancer incidence and mortality from 1999 to 2011. Standardised incidence ratios for cancer (SIR) and mortality ratios (SMR) were calculated from national rates. Sixty-nine cancer cases and 38 deaths were observed during follow-up. Cancer incidence in the cohort was similar to that in the general Norwegian population. No cancers in the overall cohort significantly exceeded incidence rates in the general Norwegian population, but there was an elevated SIR for melanoma of skin in men of 1.90 (95% confidence interval [CI] 0.95-3.40). A fivefold increased incidence of bladder cancer was observed among men who served in Kosovo for ≥ 1 year, based on 2 excess cases (SIR=5.27; 95% CI 1.09-15.4). All-cause mortality was half the expected rate (SMR=0.49; 95% CI 0.35-0.67). Our study did not support the suggestion that UN peacekeeping service in Kosovo is associated with increased cancer risk. Copyright © 2014 Elsevier Ltd. All rights reserved.

  5. National Education Longitudinal Study: 1988-94 Data Files and Electronic Codebook System, 1999 Re-Release. Base Year through Third Follow-Up ECB/CD-ROM. [CD-ROM].

    ERIC Educational Resources Information Center

    National Center for Education Statistics (ED), Washington, DC.

    The National Education Longitudinal Study of 1988 (NELS:88) is the first nationally representative study of eighth grade students in public and private schools. NELS:88, sponsored by the National Center for Education Statistics, is designed to provide longitudinal data about critical transitions experienced by young people as they develop, attend…

  6. The effects of raking on sugar pine mortality following prescribed fire in Sequoia and Kings Canyon National Parks, California, USA

    USGS Publications Warehouse

    Nesmith, Jonathan C. B.; O'Hara, Kevin L.; van Mantgem, Phillip J.; de Valpine, Perry

    2010-01-01

    Prescribed fire is an important tool for fuel reduction, the control of competing vegetation, and forest restoration. The accumulated fuels associated with historical fire exclusion can cause undesirably high tree mortality rates following prescribed fires and wildfires. This is especially true for sugar pine (Pinus lambertiana Douglas), which is already negatively affected by the introduced pathogen white pine blister rust (Cronartium ribicola J.C. Fisch. ex Rabenh). We tested the efficacy of raking away fuels around the base of sugar pine to reduce mortality following prescribed fire in Sequoia and Kings Canyon national parks, California, USA. This study was conducted in three prescribed fires and included 457 trees, half of which had the fuels around their bases raked away to mineral soil to 0.5 m away from the stem. Fire effects were assessed and tree mortality was recorded for three years after prescribed fires. Overall, raking had no detectable effect on mortality: raked trees averaged 30% mortality compared to 36% for unraked trees. There was a significant effect, however, between the interaction of raking and average pre-treatment forest floor fuel depth: the predicted probability of survival of a 50 cm dbh tree was 0.94 vs. 0.96 when average pre-treatment fuel depth was 0 cm for a raked and unraked tree, respectively. When average pre-treatment forest floor fuel depth was 30 cm, the predicted probability of survival for a raked 50 cm dbh tree was 0.60 compared to only 0.07 for an unraked tree. Raking did not affect mortality when fire intensity, measured as percent crown volume scorched, was very low (0% scorch) or very high (>80% scorch), but the raking treatment significantly increased the proportion of trees that survived by 9.6% for trees that burned under moderate fire intensity (1% to 80% scorch). Raking significantly reduced the likelihood of bole charring and bark beetle activity three years post fire. Fuel depth and anticipated fire intensity need

  7. [Electronic fetal monitoring and its relationship to neonatal and infant mortality in a national database: A sensitivity analysis].

    PubMed

    Philopoulos, D

    2015-05-01

    Sensitivity analysis of the association between electronic fetal monitoring and neonatal and infant mortality previously reported from a United States database. Retrospective cohort study of 11,916,806 live births linked to neonatal and infant deaths during the years 1997-2002 from the United States Centers for Disease Control's National Center of Health Statistics (NCHS) linked birth and infant death data. Restrictions were performed to exclude deliveries occurring outside of a hospital, precipitous labors, breech deliveries, eleven risk factors of pregnancy, multiple gestations, deliveries before 24 and after 44 weeks, implausible birthweights, repeat cesarean sections, and congenital anomalies. An additional analysis explored the effect of further restrictions to term births, birth weight≥2500 g, absence of maternal fever (>38°C), and absence of labor induction or augmentation. For each year, adjusted relative risks (RR) were estimated with log binomial regression. A six-year pooled association was estimated by the generic inverse variance method using a random effects model. For the six-year period, there was a significant reduction in risk in the group with electronic fetal monitoring for early neonatal mortality (RR=0.54, 95 % CI: 0.52-0.57), late neonatal mortality (RR=0.84, 95 % CI: 0.78-0.90), post-neonatal mortality (RR=0.86, 95 % CI: 0.83-0.90), and infant mortality from all causes (RR=0.75, 95 % CI: 0.73-0.77), from perinatal causes (RR=0.60, 95 % CI: 0.57-0.63), and from hypoxia (RR=0.67, 95 % CI: 0.54-0.84). In the additional analysis, which only examined the outcome of infant mortality from all causes, there was also a significant reduction in risk (RR=0.91, 95 % CI: 0.85-0.97). Using the NCHS linked birth and infant death data over a 6-year period, electronic fetal monitoring was associated with decreased neonatal and infant mortality as has been previously reported. These results were robust to two levels of restriction applied on potential

  8. Self-rated health and hospital services use in the Spanish National Health System: a longitudinal study.

    PubMed

    Tamayo-Fonseca, Nayara; Nolasco, Andreu; Quesada, Jose A; Pereyra-Zamora, Pamela; Melchor, Inmaculada; Moncho, Joaquin; Calabuig, Julia; Barona, Carmen

    2015-11-04

    Self-rated health is a subjective measure that has been related to indicators such as mortality, morbidity, functional capacity, and the use of health services. In Spain, there are few longitudinal studies associating self-rated health with hospital services use. The purpose of this study is to analyze the association between self-rated health and socioeconomic, demographic, and health variables, and the use of hospital services among the general population in the Region of Valencia, Spain. Longitudinal study of 5,275 adults who were included in the 2005 Region of Valencia Health Survey and linked to the Minimum Hospital Data Set between 2006 and 2009. Logistic regression models were used to calculate the odds ratios between use of hospital services and self-rated health, sex, age, educational level, employment status, income, country of birth, chronic conditions, disability and previous use of hospital services. By the end of a 4-year follow-up period, 1,184 participants (22.4%) had used hospital services. Use of hospital services was associated with poor self-rated health among both men and women. In men, it was also associated with unemployment, low income, and the presence of a chronic disease. In women, it was associated with low educational level, the presence of a disability, previous hospital services use, and the presence of chronic disease. Interactions were detected between self-rated health and chronic disease in men and between self-rated health and educational level in women. Self-rated health acts as a predictor of hospital services use. Various health and socioeconomic variables provide additional predictive capacity. Interactions were detected between self-rated health and other variables that may reflect different complex predictive models, by gender.

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

    PubMed Central

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

    2017-01-01

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

  10. One in Five Maternal Deaths in Bangladesh Associated with Acute Jaundice: Results from a National Maternal Mortality Survey.

    PubMed

    Shah, Rupal; Nahar, Quamrun; Gurley, Emily S

    2016-03-01

    We estimated the proportion of maternal deaths in Bangladesh associated with acute onset of jaundice. We used verbal autopsy data from a nationally representative maternal mortality survey to calculate the proportion of maternal deaths associated with jaundice and compared it to previously published estimates. Of all maternal deaths between 2008 and 2010, 23% were associated with jaundice, compared with 19% from 1998 to 2001. Approximately one of five maternal deaths was preceded by jaundice, unchanged in 10 years. Our findings highlight the need to better understand the etiology of these maternal deaths in Bangladesh. © The American Society of Tropical Medicine and Hygiene.

  11. One in Five Maternal Deaths in Bangladesh Associated with Acute Jaundice: Results from a National Maternal Mortality Survey

    PubMed Central

    Shah, Rupal; Nahar, Quamrun; Gurley, Emily S.

    2016-01-01

    We estimated the proportion of maternal deaths in Bangladesh associated with acute onset of jaundice. We used verbal autopsy data from a nationally representative maternal mortality survey to calculate the proportion of maternal deaths associated with jaundice and compared it to previously published estimates. Of all maternal deaths between 2008 and 2010, 23% were associated with jaundice, compared with 19% from 1998 to 2001. Approximately one of five maternal deaths was preceded by jaundice, unchanged in 10 years. Our findings highlight the need to better understand the etiology of these maternal deaths in Bangladesh. PMID:26755563

  12. Nonmedical Use of Prescription Opioids during the Transition to Adulthood: A Multi-Cohort National Longitudinal Study

    PubMed Central

    McCabe, Sean Esteban; Schulenberg, John E.; O’Malley, Patrick M.; Patrick, Megan E.; Kloska, Deborah D.

    2013-01-01

    Aims To examine nonmedical use of prescription opioids (NMUPO) patterns during the transition from adolescence to adulthood, and assess individual characteristics and other substance use behaviors associated with longitudinal patterns of NMUPO. Design Nationally representative samples of high school seniors in the United States (wave 1: modal age 18 years) were followed longitudinally across three biennial follow-up waves (waves 2, 3, and 4: modal ages 19/20, 21/22, and 23/24). Setting Data were collected via self-administered questionnaires to high school seniors and young adults. Participants The longitudinal sample consisted of 27,268 individuals in 30 cohorts (high school senior years 1976–2005) who participated in all four waves. Measurements Self-reports of NMUPO and other substance use behaviors. Findings Approximately 11.6% (95% CI = 11.2%, 12.0%) of the sample reported past-year NMUPO in at least one of the four waves. Among those who reported past-year NMUPO in at least one wave, 69.0% (67.6%, 70.4%), 20.5% (19.3%, 21.7%), 7.8% (7.1%, 8.6%), and 2.7% (2.3%, 3.1%) reported NMUPO at one, two, three, and four waves, respectively. Several wave 1 variables were associated with greater odds of multiple waves of NMUPO and individuals who reported more waves of NMUPO had greater odds of other substance use behaviors. Conclusions Although most nonmedical use of prescription opioids (NMUPO) among 18-year-olds in the United States appears to be non-continuing, about one-third of the sample reporting NMUPO appear to continue use beyond age 18 and have elevated odds of other substance use behaviors at ages 23/24. PMID:24025114

  13. Risk factors for infant mortality in rural and urban Nigeria: evidence from the national household survey.

    PubMed

    Adewuyi, Emmanuel Olorunleke; Zhao, Yun; Lamichhane, Reeta

    2017-07-01

    This study investigates the rural-urban differences in infant mortality rates (IMRs) and the associated risk factors in Nigeria. The dataset from the 2013 Nigeria demographic and health survey (NDHS), disaggregated by rural-urban residence, was analyzed using complex samples statistics. A multivariable logistic regression analysis was computed to explore the adjusted relationship and identify risk factors for infant mortality. In rural and urban Nigeria, IMRs were 70 and 49 deaths per 1000 live births, respectively. Risk factors in rural residence were past maternal marital union (adjusted odds ratio (AOR): 1.625, p = 0.020), small birth size (AOR: 1.550, p < 0.001), birth interval <24 months (AOR: 2.057, p < 0.001), residence in North-East (AOR: 1.346, p = 0.038) and North-West (AOR: 1.653, p < 0.001) regions, and cesarean delivery (AOR: 2.922, p = 0.001). Risk factors in urban residence were poor wealth index (AOR: 2.292, p < 0.001), small birth size (AOR: 2.276, p < 0.001), male gender (AOR: 1.416, p = 0.022), birth interval <24 months (AOR: 1.605, p = 0.002), maternal obesity (AOR: 1.641, p = 0.008), and cesarean delivery (AOR: 1.947, p = 0.032). Infants in rural residence had higher rates of mortality than their urban counterparts and disparities in risk factors exist between the residences.

  14. Maternal mortality cases from pulmonary embolism: A nation-wide study in Turkey.

    PubMed

    Sanisoğlu, Sema; Uygur, Dilek; Keskinkılıç, Bekir; Engin-Üstün, Yaprak; Keskin, Hüseyin Levent; Karaahmetoğlu, Selma; Özcan, Ayşe; Esen, Meral; Ongun, Veli; Özkan, Seçil

    2017-02-01

    The aim of the study was to evaluate the maternal mortality cases attributed to pulmonary embolism (PE). PE constituted 7.58% of maternal deaths in 2013. Risk factors for PE were present in 15 (88.2%) of the women. Five women (29.4%) were overweight, and 5 (29.4%) were obese. Four women (23.5%) had cardiac diseases. PE occurred in the postpartum period after caesarean delivery in 9 (52.9%) patients. Eleven (64.7%) of the maternal deaths were recognised as preventable. More deaths attributed to PE occurred in the postpartum period (n = 11) than the antepartum period (n = 5). One other maternal mortality case was after therapeutic abortion. Caesarean section, obesity and cardiac diseases were important risk factors. It can be suggested that monitoring all risk factors and timely recognition of related symptoms and signs with initiation of appropriate management have paramount importance for reducing maternal mortality rate related to pulmonary embolism. Increasing awareness of healthcare professionals as well as the public, and continuously reviewing the cases are also important tools for achieving this goal.

  15. Religious Participation is Associated with Increases in Religious Social Support in a National Longitudinal Study of African Americans.

    PubMed

    Le, Daisy; Holt, Cheryl L; Hosack, Dominic P; Huang, Jin; Clark, Eddie M

    2016-08-01

    This study reports on the association between religious beliefs and behaviors and the change in both general and religious social support using two waves of data from a national sample of African Americans. The Religion and Health in African Americans (RHIAA) study is a longitudinal telephone survey designed to examine relationships between various aspects of religious involvement and psychosocial factors over time. RHIAA participants were 3173 African American men (1281) and women (1892). A total of 1251 men (456) and women (795) participated in wave 2 of data collection. Baseline religious behaviors were associated with increased overall religious social support from baseline to wave 2 (p < .001) and with increased religious social support from baseline to wave 2 in each of the following religious social support subscales: emotional support received (p < .001), emotional support provided (p < .001), negative interaction (p < .001), and anticipated support (p < .001). Religious beliefs did not predict change in any type of support, and neither beliefs nor behaviors predicted change in general social support. African Americans who are active in faith communities showed increases in all types of religious social support, even the negative aspects, over a relatively modest longitudinal study period. This illustrates the strength of the church as a social network and the role that it plays in people's lives.

  16. Early maternal depressive symptoms and child growth trajectories: a longitudinal analysis of a nationally representative US birth cohort

    PubMed Central

    2014-01-01

    Background Maternal depressive symptoms are negatively associated with early child growth in developing countries; however, few studies have examined this relation in developed countries or used a longitudinal design with data past the second year of the child’s life. We investigated if and when early maternal depressive symptoms affect average growth in young children up to age 6 in a nationally representative sample of US children. Methods Using data from 6,550 singleton births from the Early Childhood Longitudinal Study -- Birth Cohort (ECLS-B), we fit growth trajectory models with random effects to examine the relation between maternal depressive symptoms at 9 months based on the twelve-item version of the Center for Epidemiologic Studies Depression Scale (CES-D) and child height and body mass index (BMI) to age 6 years. Results Mothers with moderate/severe depressive symptoms at 9 months postpartum had children with shorter stature at this same point in time [average 0.26 cm shorter; 95% CI: 5 cm, 48 cm] than mothers without depressive symptoms; children whose mothers reported postpartum depressive symptoms remained significantly shorter throughout the child’s first 6 years. Conclusions Results suggest that the first year postpartum is a critical window for addressing maternal depressive symptoms in order to optimize child growth. Future studies should investigate the role of caregiving and feeding practices as potential mechanisms linking maternal depressive symptoms and child growth trajectories. PMID:25047367

  17. Hospital Contributions to the Delivery of Public Health Activities in US Metropolitan Areas: National and Longitudinal Trends

    PubMed Central

    Mays, Glen P.; Mamaril, Cezar B.

    2015-01-01

    Objectives. We investigated changes in hospital participation in local public health systems and the delivery of public health activities over time and assessed the relationship between hospital participation and the scope of activities available in local public health systems. Methods. We used longitudinal observations from the National Longitudinal Survey of Public Health Systems to examine how hospital contributions to the delivery of core public health activities varied in 1998, 2006, and 2012. We then used multivariate regression to assess the relationship between the level of hospital contributions and the overall availability of public health activities in the system. Results. Hospital participation in public health activities increased from 37% in 1998 to 41% in 2006 and down to 39% in 2012. Regression results indicated a positive association between hospital participation in public health activities and the total availability of public health services in the systems. Conclusions. Hospital collaboration does play an important role in the overall availability of public health services in local public health systems. Efforts to increase hospital participation in public health may have a positive impact on the scope of services provided and population health in US communities. PMID:26066929

  18. Child Psychiatry Branch of the National Institute of Mental Health Longitudinal Structural Magnetic Resonance Imaging Study of Human Brain Development

    PubMed Central

    Giedd, Jay N; Raznahan, Armin; Alexander-Bloch, Aaron; Schmitt, Eric; Gogtay, Nitin; Rapoport, Judith L

    2015-01-01

    The advent of magnetic resonance imaging, which safely allows in vivo quantification of anatomical and physiological features of the brain, has revolutionized pediatric neuroscience. Longitudinal studies are useful for the characterization of developmental trajectories (ie, changes in imaging measures by age). Developmental trajectories (as opposed to static measures) have proven to have greater power in discriminating healthy from clinical groups and in predicting cognitive/behavioral measures, such as IQ. Here we summarize results from an ongoing longitudinal pediatric neuroimaging study that has been conducted at the Child Psychiatry Branch of the National Institute of Mental Health since 1989. Developmental trajectories of structural MRI brain measures from healthy youth are compared and contrasted with trajectories in attention-deficit/hyperactivity disorder (ADHD) and childhood-onset schizophrenia. Across ages 5–25 years, in both healthy and clinical populations, white matter volumes increase and gray matter volumes follow an inverted U trajectory, with peak size occurring at different times in different regions. At a group level, differences related to psychopathology are seen for gray and white matter volumes, rates of change, and for interconnectedness among disparate brain regions. PMID:25195638

  19. Religious participation is associated with increases in religious social support in a national longitudinal study of African Americans

    PubMed Central

    Le, Daisy; Holt, Cheryl L.; Hosack, Dominic P.; Huang, Jin; Clark, Eddie M.

    2015-01-01

    Objective This study reports on the association between religious beliefs and behaviors and the change in both general and religious social support using two waves of data from a national sample of African Americans. Design The Religion and Health in African Americans (RHIAA) study is a longitudinal telephone survey designed to examine relationships between various aspects of religious involvement and psychosocial factors over time. Participants RHIAA participants were 3,173 African American men (1,281) and women (1,892). A total of 1,251 men (456) and women (795) participated in wave 2 of data collection. Results Baseline religious behaviors were associated with increased overall religious social support from baseline to wave 2 (p<.001) and with increased religious social support from baseline to wave 2 in each of the following religious social support subscales: emotional support received (p<.001), emotional support provided (p<.001), negative interaction (p<.001), and anticipated support (p<.001). Religious beliefs did not predict change in any type of support, and neither beliefs nor behaviors predicted change in general social support. Conclusions African Americans who are active in faith communities showed increases in all types of religious social support, even the negative aspects, over a relatively modest longitudinal study period. This illustrates the strength of the church as a social network and the role that it plays in people’s lives. PMID:26493343

  20. Hospital Contributions to the Delivery of Public Health Activities in US Metropolitan Areas: National and Longitudinal Trends.

    PubMed

    Hogg, Rachel A; Mays, Glen P; Mamaril, Cezar B

    2015-08-01

    We investigated changes in hospital participation in local public health systems and the delivery of public health activities over time and assessed the relationship between hospital participation and the scope of activities available in local public health systems. We used longitudinal observations from the National Longitudinal Survey of Public Health Systems to examine how hospital contributions to the delivery of core public health activities varied in 1998, 2006, and 2012. We then used multivariate regression to assess the relationship between the level of hospital contributions and the overall availability of public health activities in the system. Hospital participation in public health activities increased from 37% in 1998 to 41% in 2006 and down to 39% in 2012. Regression results indicated a positive association between hospital participation in public health activities and the total availability of public health services in the systems. Hospital collaboration does play an important role in the overall availability of public health services in local public health systems. Efforts to increase hospital participation in public health may have a positive impact on the scope of services provided and population health in US communities.

  1. Who participates? Accounting for longitudinal retention in the MIDUS national study of health and well-being.

    PubMed

    Radler, Barry T; Ryff, Carol D

    2010-04-01

    This article uses data from MIDUS (Midlife in the United States), a national study of Americans (N = 7,108), to investigate factors that predict longitudinal retention. With its extensive age range (25-75 at Time 1) and long-term design (9- to 10-year survey interval), MIDUS is useful for investigating common sociodemographic and health predictors of continuing participation. The authors conducted logistic regression analyses of baseline sociodemographic and health variables predicting retention. Select interaction terms examined the interplay between targeted variables. Consistent with prior research, higher retention rates were found among Whites, females, and married individuals as well as those with better health and more education. Interaction analyses further clarified that (a) health status better predicted retention among older compared to younger respondents and among women compared to men, (b) marital status better predicted retention among Whites compared to non-Whites and among women compared to men, and (c) economic status better predicted retention among those with poorer functional health status. The authors' analyses clarify that longitudinal retention varied depending on respondents' sociodemographic characteristics and their health status. The unique contribution of this article is that factors predicting nonparticipation can be offset by, or compensated for, other factors.

  2. Short sleep duration as a risk factor for hypercholesterolemia: analyses of the National Longitudinal Study of Adolescent Health.

    PubMed

    Gangwisch, James E; Malaspina, Dolores; Babiss, Lindsay A; Opler, Mark G; Posner, Kelly; Shen, Sa; Turner, J Blake; Zammit, Gary K; Ginsberg, Henry N

    2010-07-01

    To explore the relationship between sleep duration in adolescence and hypercholesterolemia in young adulthood. Experimental sleep restriction has been shown to significantly increase total cholesterol and LDL cholesterol levels in women. Short sleep duration has been found in cross sectional studies to be associated with higher total cholesterol and lower HDL cholesterol levels. Sleep deprivation could increase the risk for hypercholesterolemia by increasing appetite and dietary consumption of saturated fats, decreasing motivation to engage in regular physical activity, and increasing stress and resultant catecholamine induced lipolysis. No previous published population studies have examined the longitudinal relationship between sleep duration and high cholesterol. Multivariate longitudinal analyses stratified by sex of the ADD Health using logistic regression. United States nationally representative, school-based, probability-based sample. Adolescents (n = 14,257) in grades 7 to 12 at baseline (1994-95) and ages 18 to 26 at follow-up (2001-02). Among females, each additional hour of sleep was associated with a significantly decreased odds of being diagnosed with high cholesterol in young adulthood (OR = 0.85, 95% CI 0.75-0.96) after controlling for covariates. Additional sleep was associated with decreased, yet not statistically significant, odds ratios for hypercholesterolemia in males (OR = 0.91, 95% CI 0.79-1.05). Short sleep durations in adolescent women could be a significant risk factor for high cholesterol. Interventions that lengthen sleep could potentially serve as treatments and as primary preventative measures for hypercholesterolemia.

  3. Healthcare utilization and costs in ARDS survivors: a 1-year longitudinal national US multicenter study.

    PubMed

    Ruhl, A Parker; Huang, Minxuan; Colantuoni, Elizabeth; Karmarkar, Taruja; Dinglas, Victor D; Hopkins, Ramona O; Needham, Dale M

    2017-07-01

    To evaluate (1) post-discharge healthcare utilization and estimated costs in ARDS survivors, and (2) the association between patient and intensive care-related variables, and 6-month patient status, with subsequent hospitalization and costs. Longitudinal cohort study enrolling from four ARDSNet trials in 44 US hospitals. Healthcare utilization was collected via structured interviews at 6 and 12 months post-ARDS, and hospital costs estimated via the Medical Expenditure Panel Survey. Adjusted odds ratios for hospitalization and adjusted relative medians for hospital costs were calculated using marginal two-part regression models. Of 859 consenting survivors, 839 (98%) reported healthcare utilization, with 52% female and a mean age of 49 years old. Over 12 months, 339 (40%) patients reported at least one post-discharge hospitalization, with median estimated hospital costs of US$18,756 (interquartile range $7852-46,174; 90th percentile $101,500). Of 16 patient baseline and ICU variables evaluated, only cardiovascular comorbidity and length of stay were associated with hospitalization, and sepsis was associated with hospital costs. At 6-month assessment, better patient-reported physical activity and quality of life status were associated with fewer hospitalizations and lower hospital costs during subsequent follow-up, and worse psychiatric symptoms were associated with increased hospitalizations. This multicenter longitudinal study found that 40% of ARDS survivors reported at least one post-discharge hospitalization during 12-month follow-up. Few patient- or ICU-related variables were associated with hospitalization; however, physical, psychiatric, and quality of life measures at 6-month follow-up were associated with subsequent hospitalization. Interventions to reduce post-ARDS morbidity may be important to improve patient outcomes and reduce healthcare utilization.

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

    PubMed Central

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

    2014-01-01

    Prostate cancer is one