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Sample records for specific mortality 1960-2000

  1. Methuselah's medicine: pharmaceutical innovation and mortality in the United States, 1960-2000.

    PubMed

    Schnittker, Jason; Karandinos, George

    2010-04-01

    Although there is a good deal of speculation surrounding the role of pharmaceutical innovation in late 20th century mortality improvements in the United States, there is little empirical evidence on the topic and there remains a good deal of doubt regarding whether pharmaceuticals matter at all for mortality. Using a reliable indicator of pharmaceutical innovation-yearly approvals of new molecular entities (NMEs) by the Food and Drug Administration, along with information on priority status and disease-category indication-this study examines the relationship between pharmaceutical innovation and life expectancy between 1960 and 2000. The study demonstrates a significant relationship between pharmaceutical innovation and life expectancy at birth, which is robust to controls for gross domestic product, as well as controls for various forms of medical spending. The relationship with life expectancy is robust, in part, because pharmaceutical innovation has a stronger relationship with early-life mortality (between 20 and 50) than with later-life mortality (65 and over), even though older persons consume more pharmaceuticals and many recently approved drugs target conditions more common in later life. There is, to be sure, another side to the results. There is some evidence, for example, that the relationship between pharmaceutical innovation and mortality has declined over time, suggesting a change in the kind of innovations now entering the market. Nevertheless, there is more to contemporary pharmaceutical innovation than the development of mere "halfway" technologies. The overall relationship between innovation and mortality is sufficiently strong to warrant further consideration as a key determinant of trends in mortality.

  2. The Effect of Education on Economic Growth in Greece over the 1960-2000 Period

    ERIC Educational Resources Information Center

    Tsamadias, Constantinos; Prontzas, Panagiotis

    2012-01-01

    This paper examines the impact of education on economic growth in Greece over the period 1960-2000 by applying the model introduced by Mankiw, Romer, and Weil. The findings of the empirical analysis reveal that education had a positive and statistically significant effect on economic growth in Greece over the period 1960-2000. The econometric…

  3. The Afar Depression: interpretation of the 1960-2000 earthquakes

    NASA Astrophysics Data System (ADS)

    Hofstetter, R.; Beyth, M.

    2003-11-01

    We studied the seismic activity of the Afar Depression (AD) and adjacent regions during the period 1960-2000. We define seven distinct seismogenic regions using geological, tectonic and seismological data. Based on the frequency-magnitude relationships we obtain b-values of about 1 for the different regions. The pattern of the distribution of the location of epicentres fits with the known active fault zone in the AD and the axial volcanic ridges. The Bab el Mandab area and the Danakil-Aysha'a blocks are less active. For 125 intermediate to strong earthquakes the seismic moment and source parameters were calculated. The results of the fault plane solutions for the Afar Depression indicate mainly strike-slip and normal sense of movement originating from fault planes striking NW-SE. These results indicate a clockwise block rotation described previously as a bookshelf model in central AD. There are a few right-lateral faults east of Massawa with E-W-striking fault planes. At the southern Red Sea, north of the Danakil block, the mixed focal mechanisms, with axial plane striking NW-SE, comprise several reverse faulting, strike-slip motion and normal faulting. Right-lateral movement was also calculated for a cluster of seismic events between the Manda Hararo and Alyata volcanic ridges along NW-SE-striking faults. Along the N-S-striking faults in the escarpment, at the western Afar margins, there are two distinct clusters of epicentres. The strong earthquakes at the southern cluster exhibit normal or strike-slip motions. The intermediate to small earthquakes in the northern cluster exhibit reverse and strike-slip motions. Mainly normal faults were calculated along NE-SW-striking faults of the Ethiopian East African Rift. Estimates of the seismic efficiency suggest that the maximal values are about 50 per cent or less, implying that most of the motion is taken aseismically.

  4. Sedentary behavior and residual-specific mortality

    PubMed Central

    Loprinzi, Paul D.; Edwards, Meghan K.; Sng, Eveleen; Addoh, Ovuokerie

    2016-01-01

    Background: The purpose of this study was to examine the association of accelerometer-assessed sedentary behavior and residual-specific mortality. Methods: Data from the 2003-2006 National Health and Nutrition Examination Survey (NHANES) were used (N = 5536), with follow-up through 2011. Sedentary behavior was objectively measured over 7 days via accelerometry. Results: When expressing sedentary behavior as a 60 min/day increase, the hazard ratio across the models ranged from 1.07-1.40 (P < 0.05). There was evidence of an interaction effect between sedentary behavior and total physical activity on residual-specific mortality (Hazard ratiointeraction [HR] = 0.9989; 95% CI: 0.9982-0.9997; P = 0.008). Conclusion: Sedentary behavior was independently associated with residual-specific mortality. However, there was evidence to suggest that residual-specific mortality risk was a function of sedentary behavior and total physical activity. These findings highlight the need for future work to not only examine the association between sedentary behavior and health independent of total physical activity, but evaluate whether there is a joint effect of these two parameters on health. PMID:27766237

  5. Estimates of Ground-Water Pumpage from the Yakima River Basin Aquifer System, Washington, 1960-2000

    USGS Publications Warehouse

    Vaccaro, J.J.; Sumioka, S.S.

    2006-01-01

    Ground-water pumpage in the Yakima River Basin, Washington, was estimated for eight categories of use for 1960-2000 as part of an investigation to assess ground-water availability in the basin. Methods used, pumpage estimates, reliability of the estimates, and a comparison with appropriated quantities are described. The eight categories of pumpage were public water supply, self-supplied domestic (exempt wells), irrigation, frost protection, livestock and dairy operations, industrial and commercial, fish and wildlife propagation, and ground-water claims. Pumpage estimates were based on methods that varied by the category and primarily represent pumpage for ground-water rights. Washington State Department of Ecology's digital database has 2,874 active ground-water rights in the basin that can withdraw an annual quantity of about 529,231 acre-feet during dry years. Irrigation rights are for irrigation of about 129,570 acres. All but 220 of the rights were associated with well drillers' logs, allowing for a spatial representation of the pumpage. Five-hundred and sixty of the irrigation rights were estimated to be standby/reserve rights. During this study, another 30 rights were identified that were not in the digital database. These rights can withdraw an annual quantity of about 20,969 acre-feet; about 6,700 acre-feet of these rights are near but outside the basin. In 1960, total annual pumpage in the basin, excluding standby/reserve pumpage, was about 115,776 acre-feet. By 2000, total annual pumpage was estimated to be 395,096 acre-feet, and excluding the standby/reserve rights, the total was 312,284 acre-feet. Irrigation accounts for about 60 percent of the pumpage, followed by public water supply at about 12 percent. The smallest category of pumpage was for livestock use with pumpage estimated to be 6,726 acre-feet. Total annual pumpage in 2000 was about 430 cubic feet per second, which is about 11 percent of the surface-water demand. Maximum pumpage is in July and

  6. Do childhood vaccines have non-specific effects on mortality?

    PubMed Central

    Cooper, William O.; Boyce, Thomas G.; Wright, Peter F.; Griffin, Marie R.

    2003-01-01

    A recent article by Kristensen et al. suggested that measles vaccine and bacille Calmette-Gu rin (BCG) vaccine might reduce mortality beyond what is expected simply from protection against measles and tuberculosis. Previous reviews of the potential effects of childhood vaccines on mortality have not considered methodological features of reviewed studies. Methodological considerations play an especially important role in observational assessments, in which selection factors for vaccination may be difficult to ascertain. We reviewed 782 English language articles on vaccines and childhood mortality and found only a few whose design met the criteria for methodological rigor. The data reviewed suggest that measles vaccine delivers its promised reduction in mortality, but there is insufficient evidence to suggest a mortality benefit above that caused by its effect on measles disease and its sequelae. Our review of the available data in the literature reinforces how difficult answering these considerations has been and how important study design will be in determining the effect of specific vaccines on all-cause mortality. PMID:14758409

  7. Formulation of work stress in 1960-2000: analysis of scientific works from the perspective of historical sociology.

    PubMed

    Väänänen, Ari; Anttila, Erkko; Turtiainen, Jussi; Varje, Pekka

    2012-09-01

    During the latter part of the 20th century, work stress became an important societal issue and a huge amount of scientific attention went to studying it. This paper examines the process of formulating and defining the concept of work stress in the occupational health sciences and in industrial and organizational psychology from the early 1960s to the late 1990s. The empirical material of the study encompasses 108 scientific articles, books, book chapters, 'state of the art' reviews, book reviews, and written conference presentations. The data are analysed in the frameworks of historical sociology, critical psychology, and the anthropology of knowledge. We argue that work stress as a life-structuring concept gained ground in psychosocial and occupational health sciences (and also in lay understanding) in the 1960s simultaneously with the rise of social reformist movements that called for fundamental changes emphasizing democratic and human-orientated work organizations and socially responsible values. With the passing of time, however, the focus on structural improvement of work life waned and the emphasis shifted towards the apolitical occupational health aspects of work stress. Researchers with a psychological orientation emphasized micro-level characteristics as factors affecting work stress, whereas stress-orientated epidemiologists turned to the study of specific occupational stress models and/or risk factors. The emergence and development of work stress research can be seen as a chain of attempts to define and identify new risks and experiences occurring in work life. The process, driven by a gradual shift from industrial environments towards organizational frameworks characterized by social and psychological dimensions, reflected the overall shift towards modern democratic work life and the information society in which employees' emotions and well-being became an issue.

  8. Mortality among rubber workers: Relationship to specific jobs.

    PubMed

    McMichael, A J; Spirtas, R; Gamble, J F; Tousey, P M

    1976-03-01

    This study has examined the ten-year mortality in a single-plant population of 6678 male rubber workers, in terms of the association of specific causes of death with a history of having worked in certain categories of jobs within the rubber industry. The work-histories of individual study subjects were analyzed, in detail, for all workers dying of selected causes of death. Comparison was made with the work-histories of a 22% age-stratified random sample of the total population. Age-adjusted exposure ratios (Tables 3 and 4) were calculated for all nine case groups in all 16 work areas, using differing exposure criteria (i.e. duration and calendar period). These ratios provide an approximation of the increased mortality risk associated with particular work areas. The risk ratios (with their associated confidence intervals), in Table 5, provide more rigorous estimates of these instances of increased mortality risk. For each cause of death studied, there were statistically significant associations with several work areas. For the cancers, the strongest associations tended to be with work areas at the front end of the production line (especially compounding and mixing), where the likelihood of contact with dusts, chemical ingredients, and vapors containing the early reaction byproducts, is high. The reclaim operation and the synthetic plant were each associated with several cancers (respiratory and bladder, and stomach and lymphato-hematopoietic cancers, respectively). The lymphatic leukemias were associated with solvent-exposure areas, especially inspection, finishing, and repair. Ischemic heart disease deaths, at ages 40-54, were strongly associated with having worked in extrusion and tread cementing, and in the synthetic plant. Deaths from diabetes mellitus were strongly associated with the janitoring-trucking category, and with jobs in the inspection, finishing and repair area. These observed associations, calculated after controlling for the variables sex and age

  9. Lifespan and Aggregate Size Variables in Specifications of Mortality or Survivorship

    PubMed Central

    Epelbaum, Michael

    2014-01-01

    A specification of mortality or survivorship provides respective explicit details about mortality's or survivorship's relationships with one or more other variables (e.g., age, sex, etc.). Previous studies have discovered and analyzed diverse specifications of mortality or survivorship; these discoveries and analyses suggest that additional specifications of mortality or survivorship have yet to be discovered and analyzed. In consistency with previous research, multivariable limited powered polynomials regression analyses of mortality and survivorship of selected humans (Swedes, 1760–2008) and selected insects (caged medflies) show age-specific, historical-time-specific, environmental-context-specific, and sex-specific mortality and survivorship. These analyses also present discoveries of hitherto unknown lifespan-specific, contemporary-aggregate-size-specific, and lifespan-aggregate-size-specific mortality and survivorship. The results of this investigation and results of previous research help identify variables for inclusion in regression models of mortality or survivorship. Moreover, these results and results of previous research strengthen the suggestion that additional specifications of mortality or survivorship have yet to be discovered and analyzed, and they also suggest that specifications of mortality and survivorship indicate corresponding specifications of frailty and vitality. Furthermore, the present analyses reveal the usefulness of a multivariable limited powered polynomials regression model-building approach. This article shows that much has yet to be learned about specifications of mortality or survivorship of diverse kinds of individuals in diverse times and places. PMID:24454719

  10. An assessment of global net irrigation water requirements from various water supply sources to sustain irrigation: rivers and reservoirs (1960-2000 and 2050)

    NASA Astrophysics Data System (ADS)

    Yoshikawa, S.; Cho, J.; Yamada, H. G.; Hanasaki, N.; Khajuria, A.; Kanae, S.

    2013-01-01

    Water supply sources for irrigation, such as rivers, reservoirs, and groundwater, are critically important for agricultural productivity. The current rapid increase in irrigation water use threatens sustainable food production. In this study, we estimated the time-varying dependency of the supply of irrigation water from rivers, large reservoirs with a greater than 1.0 km3 storage capacity, medium-size reservoirs with storage capacities ranging from 1.0 km3 to 3.0 Mm3, and non-local non-renewable blue water (NNBW), particularly taking into account variations in irrigation area during the period 1960-2000. We also estimated the future irrigation water requirements from water supply sources in addition to these four sources, using an irrigation area scenario. The net irrigation water requirements from various supply sources were assessed using the global H08 water resources model. The H08 model simulates water requirements on a daily basis at a resolution of 1.0° × 1.0°. We obtained net irrigation water from rivers and medium-size reservoirs, and determined that the NNBW increased continuously from 1960 to 1985, but the net irrigation water from large reservoirs increased only marginally. After 1985, the net irrigation water from rivers approached a critical limit with the continued expansion of the irrigation area. The irrigation water requirements from medium-size reservoirs and NNBW increased significantly following the expansion of the irrigation area and the increased storage capacity of medium-size reservoirs. Under the irrigation area scenario without climate change, global net irrigation water requirements from additional water supply sources will account for 26% of the total requirements in the year 2050. We found that expansion of irrigation areas due to population growth will generate an enormous demand for irrigation water from additional resources.

  11. Predictors of mortality after prostate-specific antigen failure

    SciTech Connect

    D'Amico, Anthony V. . E-mail: adamico@lroc.harvard.edu; Kantoff, Phillip; Loffredo, Marian; Renshaw, Andrew A.; Loffredo, Brittany; Chen Minghui

    2006-07-01

    Purpose: We identified factors associated with the length of survival after prostate-specific antigen (PSA) failure. Methods and Materials: The study cohort comprised 81 of 206 men enrolled on a randomized trial evaluating external-beam radiation therapy (RT) with or without androgen suppression therapy (AST) and who experienced PSA failure. Salvage AST was administered at a PSA level of {approx}10 ng/mL as per protocol. Cox regression was used to determine factors associated with length of survival after PSA failure. Results: A PSA DT (doubling time) <6 months (p = 0.04) and age at the time of PSA failure (p = 0.009) were significantly associated with length of survival. By 5 years, 35% and 65% of all-cause mortality was from prostate cancer in men whose age at PSA failure was 75 or higher vs. <75, respectively. Across all ages, 0%, 4%, as compared with 63% of men, were estimated to die of prostate cancer within 5 years after PSA failure if their PSA DT was >12, 6-12, or <6 months, respectively. Conclusions: Advanced age and a PSA DT <6 months at the time of PSA failure are associated with a significantly shorter survival.

  12. Diabetes and Cause-Specific Mortality in Mexico City.

    PubMed

    Alegre-Díaz, Jesus; Herrington, William; López-Cervantes, Malaquías; Gnatiuc, Louisa; Ramirez, Raul; Hill, Michael; Baigent, Colin; McCarthy, Mark I; Lewington, Sarah; Collins, Rory; Whitlock, Gary; Tapia-Conyer, Roberto; Peto, Richard; Kuri-Morales, Pablo; Emberson, Jonathan R

    2016-11-17

    Background Most large, prospective studies of the effects of diabetes on mortality have focused on high-income countries where patients have access to reasonably good medical care and can receive treatments to establish and maintain good glycemic control. In those countries, diabetes less than doubles the rate of death from any cause. Few large, prospective studies have been conducted in middle-income countries where obesity and diabetes have become common and glycemic control may be poor. Methods From 1998 through 2004, we recruited approximately 50,000 men and 100,000 women 35 years of age or older into a prospective study in Mexico City, Mexico. We recorded the presence or absence of previously diagnosed diabetes, obtained and stored blood samples, and tracked 12-year disease-specific deaths through January 1, 2014. We accepted diabetes as the underlying cause of death only for deaths that were due to acute diabetic crises. We estimated rate ratios for death among participants who had diabetes at recruitment versus those who did not have diabetes at recruitment; data from participants who had chronic diseases other than diabetes were excluded from the main analysis. Results At the time of recruitment, obesity was common and the prevalence of diabetes rose steeply with age (3% at 35 to 39 years of age and >20% by 60 years of age). Participants who had diabetes had poor glycemic control (mean [±SD] glycated hemoglobin level, 9.0±2.4%), and the rates of use of other vasoprotective medications were low (e.g., 30% of participants with diabetes were receiving antihypertensive medication at recruitment and 1% were receiving lipid-lowering medication). Previously diagnosed diabetes was associated with rate ratios for death from any cause of 5.4 (95% confidence interval [CI], 5.0 to 6.0) at 35 to 59 years of age, 3.1 (95% CI, 2.9 to 3.3) at 60 to 74 years of age, and 1.9 (95% CI, 1.8 to 2.1) at 75 to 84 years of age. Between 35 and 74 years of age, the excess mortality

  13. Cause-Specific Mortality and Death Certificate Reporting in Adults with Moderate to Profound Intellectual Disability

    ERIC Educational Resources Information Center

    Tyrer, F.; McGrother, C.

    2009-01-01

    Background: The study of premature deaths in people with intellectual disability (ID) has become the focus of recent policy initiatives in England. This is the first UK population-based study to explore cause-specific mortality in adults with ID compared with the general population. Methods: Cause-specific standardised mortality ratios (SMRs) and…

  14. Serotype-specific mortality from invasive Streptococcus pneumoniae disease revisited

    PubMed Central

    Martens, Pernille; Worm, Signe Westring; Lundgren, Bettina; Konradsen, Helle Bossen; Benfield, Thomas

    2004-01-01

    Background Invasive infection with Streptococcus pneumoniae (pneumococci) causes significant morbidity and mortality. Case series and experimental data have shown that the capsular serotype is involved in the pathogenesis and a determinant of disease outcome. Methods Retrospective review of 464 cases of invasive disease among adults diagnosed between 1990 and 2001. Multivariate Cox proportional hazard analysis. Results After adjustment for other markers of disease severity, we found that infection with serotype 3 was associated with an increased relative risk (RR) of death of 2.54 (95% confidence interval (CI): 1.22–5.27), whereas infection with serotype 1 was associated with a decreased risk of death (RR 0.23 (95% CI, 0.06–0.97)). Additionally, older age, relative leucopenia and relative hypothermia were independent predictors of mortality. Conclusion Our study shows that capsular serotypes independently influenced the outcome from invasive pneumococcal disease. The limitations of the current polysaccharide pneumococcal vaccine warrant the development of alternative vaccines. We suggest that the virulence of pneumococcal serotypes should be considered in the design of novel vaccines. PMID:15228629

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

    PubMed

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

    2013-01-01

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

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

    PubMed Central

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

    2013-01-01

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

  17. A review of methods to estimate cause-specific mortality in presence of competing risks

    USGS Publications Warehouse

    Heisey, Dennis M.; Patterson, Brent R.

    2006-01-01

    Estimating cause-specific mortality is often of central importance for understanding the dynamics of wildlife populations. Despite such importance, methodology for estimating and analyzing cause-specific mortality has received little attention in wildlife ecology during the past 20 years. The issue of analyzing cause-specific, mutually exclusive events in time is not unique to wildlife. In fact, this general problem has received substantial attention in human biomedical applications within the context of biostatistical survival analysis. Here, we consider cause-specific mortality from a modern biostatistical perspective. This requires carefully defining what we mean by cause-specific mortality and then providing an appropriate hazard-based representation as a competing risks problem. This leads to the general solution of cause-specific mortality as the cumulative incidence function (CIF). We describe the appropriate generalization of the fully nonparametric staggered-entry Kaplan–Meier survival estimator to cause-specific mortality via the nonparametric CIF estimator (NPCIFE), which in many situations offers an attractive alternative to the Heisey–Fuller estimator. An advantage of the NPCIFE is that it lends itself readily to risk factors analysis with standard software for Cox proportional hazards model. The competing risks–based approach also clarifies issues regarding another intuitive but erroneous "cause-specific mortality" estimator based on the Kaplan–Meier survival estimator and commonly seen in the life sciences literature.

  18. Trends in Sri Lankan cause-specific adult mortality 1950–2006

    PubMed Central

    2014-01-01

    Background Although all-cause mortality in Sri Lanka decreased significantly from 1950 to 1970, subsequent declines have been more modest with divergent trends by age and sex. This study investigates these trends through cause of death analysis for 1950–2006 in adults aged 15–64 years. Methods Deaths were obtained from the World Health Organisation (WHO) mortality database for 1950 to 2003, and the Department of Census and Statistics Sri Lanka for 1992–95 and 2004–06 where WHO data was unavailable. Adult deaths were categorised by age (15–34 and 35–64 years) and sex into: infectious diseases; external-causes; circulatory diseases; cancers; digestive diseases; respiratory diseases; pregnancy-related; ill-defined; and other-causes. Cause-specific mortality rates were directly age-standardised to the 2001 Sri Lankan Census population. Results Mortality declined in females aged 15–34 years by 85% over 1950–2006, predominantly due to sharp declines in infectious disease and pregnancy-related mortality over 1950–70. Among males aged 15–34 years the mortality decline was less at 47%, due to a rise in external-cause mortality during 1970–2000. In females aged 35–64 years mortality declined by 67% over 1950–2006, predominantly due to a sharp decline in infectious disease, ill-defined and other cause mortality over 1950–70. Among males aged 35–64 years, decline in mortality is evident to 1960 (19%) from decline in infectious disease mortality, followed by increased mortality from circulatory diseases and external cause mortality, despite continued decline in infectious disease mortality. All-cause mortality in males 35–64 years has stagnated since 1970, with fluctuating increases. Circulatory diseases were the leading cause of death among adults 35–64 years in 2002–06, with the male rate almost three times higher than females. Conclusions Significant disparities are demonstrated in Sri Lankan cause-specific adult mortality by sex and age

  19. Size-Specific Tree Mortality Varies with Neighbourhood Crowding and Disturbance in a Montane Nothofagus Forest

    PubMed Central

    Hurst, Jennifer M.; Allen, Robert B.; Coomes, David A.; Duncan, Richard P.

    2011-01-01

    Tree mortality is a fundamental process governing forest dynamics, but understanding tree mortality patterns is challenging because large, long-term datasets are required. Describing size-specific mortality patterns can be especially difficult, due to few trees in larger size classes. We used permanent plot data from Nothofagus solandri var. cliffortioides (mountain beech) forest on the eastern slopes of the Southern Alps, New Zealand, where the fates of trees on 250 plots of 0.04 ha were followed, to examine: (1) patterns of size-specific mortality over three consecutive periods spanning 30 years, each characterised by different disturbance, and (2) the strength and direction of neighbourhood crowding effects on size-specific mortality rates. We found that the size-specific mortality function was U-shaped over the 30-year period as well as within two shorter periods characterised by small-scale pinhole beetle and windthrow disturbance. During a third period, characterised by earthquake disturbance, tree mortality was less size dependent. Small trees (<20 cm in diameter) were more likely to die, in all three periods, if surrounded by a high basal area of larger neighbours, suggesting that size-asymmetric competition for light was a major cause of mortality. In contrast, large trees (≥20 cm in diameter) were more likely to die in the first period if they had few neighbours, indicating that positive crowding effects were sometimes important for survival of large trees. Overall our results suggest that temporal variability in size-specific mortality patterns, and positive interactions between large trees, may sometimes need to be incorporated into models of forest dynamics. PMID:22046327

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

    PubMed

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

    2015-12-01

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

  1. Estimating heritability for cause specific mortality based on twin studies.

    PubMed

    Scheike, Thomas H; Holst, Klaus K; Hjelmborg, Jacob B

    2014-04-01

    There has been considerable interest in studying the magnitude and type of inheritance of specific diseases. This is typically derived from family or twin studies, where the basic idea is to compare the correlation for different pairs that share different amount of genes. We here consider data from the Danish twin registry and discuss how to define heritability for cancer occurrence. The key point is that this should be done taking censoring as well as competing risks due to e.g.  death into account. We describe the dependence between twins on the probability scale and show that various models can be used to achieve sensible estimates of the dependence within monozygotic and dizygotic twin pairs that may vary over time. These dependence measures can subsequently be decomposed into a genetic and environmental component using random effects models. We here present several novel models that in essence describe the association in terms of the concordance probability, i.e., the probability that both twins experience the event, in the competing risks setting. We also discuss how to deal with the left truncation present in the Nordic twin registries, due to sampling only of twin pairs where both twins are alive at the initiation of the registries.

  2. Mortality among Coast Guard Shipyard workers: A retrospective cohort study of specific exposures.

    PubMed

    Rusiecki, Jennifer; Stewart, Patricia; Lee, Dara; Alexander, Melannie; Krstev, Srmena; Silverman, Debra; Blair, Aaron

    2017-02-06

    In a previous analysis of a cohort of shipyard workers, we found excess mortality from all causes, lung cancer, and mesothelioma for longer work durations and in specific occupations. Here, we expand the previous analyses by evaluating mortality associated with 5 chemical exposures: asbestos, solvents, lead, oils/greases, and wood dust. Data were gathered retrospectively for 4,702 workers employed at the Coast Guard Shipyard, Baltimore, MD (1950-1964). The cohort was traced through 2001 for vital status. Associations between mortality and these 5 exposures were calculated via standardized mortality ratios (SMRs). We found all 5 substances to be independently associated with mortality from mesothelioma, cancer of the respiratory system, and lung cancer. Findings from efforts to evaluate solvents, lead, oils/greases, and wood dust in isolation of asbestos suggested that the excesses from these other exposures may be due to residual confounding from asbestos exposure.

  3. Culling experiments demonstrate size-class specific biomass increases with mortality.

    PubMed

    Schröder, A; Persson, L; de Roos, A M

    2009-02-24

    Size-selective mortality inevitably leads to a decrease in population density and exerts a direct negative effect on targeted size classes. But density and population size structure are also shaped by food-dependent processes, such as individual growth, maturation, and reproduction. Mortality relaxes competition and thereby alters the dynamic interplay among these processes. As shown by the recently developed size-structured theory, which can account for food-dependent individual performance, this altered interplay can lead to overcompensatory responses in size class-specific biomass, with increasing mortality. We experimentally tested this theory by subjecting laboratory fish populations to a range of size-selective mortality rates. Overall, the results were in agreement with theoretical predictions. Biomass of the juvenile size class increased above control levels at intermediate adult mortality rates and thereafter declined at high mortality rates. Juvenile biomass also increased when juveniles themselves were subjected to intermediate mortality rates. Biomass in other size classes decreased with mortality. Such biomass overcompensation can have wide-ranging implications for communities and food webs, including a high sensitivity of top predators to irreversible catastrophic collapses, the establishment of alternative stable community states, and the promotion of coexistence and biodiversity.

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

    DTIC Science & Technology

    1984-07-01

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

  5. Menopausal hormone therapy and lung cancer-specific mortality following diagnosis: the California Teachers Study.

    PubMed

    Clague, Jessica; Reynolds, Peggy; Henderson, Katherine D; Sullivan-Halley, Jane; Ma, Huiyan; Lacey, James V; Chang, Shine; Delclos, George L; Du, Xianglin L; Forman, Michele R; Bernstein, Leslie

    2014-01-01

    Previous results from research on menopausal hormone therapy (MHT) and lung cancer survival have been mixed and most have not studied women who used estrogen therapy (ET) exclusively. We examined the associations between MHT use reported at baseline and lung cancer-specific mortality in the prospective California Teachers Study cohort. Among 727 postmenopausal women diagnosed with lung cancer from 1995 through 2007, 441 women died before January 1, 2008. Hazard Ratios (HR) and 95% Confidence Intervals (CI) for lung-cancer-specific mortality were obtained by fitting multivariable Cox proportional hazards regression models using age in days as the timescale. Among women who used ET exclusively, decreases in lung cancer mortality were observed (HR, 0.69; 95% CI, 0.52-0.93). No association was observed for estrogen plus progestin therapy use. Among former users, shorter duration (<5 years) of exclusive ET use was associated with a decreased risk of lung cancer mortality (HR, 0.56; 95% CI, 0.35-0.89), whereas among recent users, longer duration (>15 years) was associated with a decreased risk (HR, 0.60; 95% CI, 0.38-0.95). Smoking status modified the associations with deceases in lung cancer mortality observed only among current smokers. Exclusive ET use was associated with decreased lung cancer mortality.

  6. Cause-specific mortality in Finnish ferrochromium and stainless steel production workers

    PubMed Central

    Pukkala, E.

    2016-01-01

    Background Although stainless steel has been produced for more than a hundred years, exposure-related mortality data for production workers are limited. Aims To describe cause-specific mortality in Finnish ferrochromium and stainless steel workers. Methods We studied Finnish stainless steel production chain workers employed between 1967 and 2004, from chromite mining to cold rolling of stainless steel, divided into sub-cohorts by production units with specific exposure patterns. We obtained causes of death for the years 1971–2012 from Statistics Finland. We calculated standardized mortality ratios (SMRs) as ratios of observed and expected numbers of deaths based on population mortality rates of the same region. Results Among 8088 workers studied, overall mortality was significantly decreased (SMR 0.77; 95% confidence interval [CI] 0.70–0.84), largely due to low mortality from diseases of the circulatory system (SMR 0.71; 95% CI 0.61–0.81). In chromite mine, stainless steel melting shop and metallurgical laboratory workers, the SMR for circulatory disease was below 0.4 (SMR 0.33; 95% CI 0.07–0.95, SMR 0.22; 95% CI 0.05–0.65 and SMR 0.16; 95% CI 0.00–0.90, respectively). Mortality from accidents (SMR 0.84; 95% CI 0.67–1.04) and suicides (SMR 0.72; 95% CI 0.56–0.91) was also lower than in the reference population. Conclusions Working in the Finnish ferrochromium and stainless steel industry appears not to be associated with increased mortality. PMID:26655692

  7. Meat intake and cause-specific mortality: a pooled analysis of Asian prospective cohort studies123

    PubMed Central

    Lee, Jung Eun; McLerran, Dale F; Rolland, Betsy; Chen, Yu; Grant, Eric J; Vedanthan, Rajesh; Inoue, Manami; Tsugane, Shoichiro; Gao, Yu-Tang; Tsuji, Ichiro; Kakizaki, Masako; Ahsan, Habibul; Ahn, Yoon-Ok; Pan, Wen-Harn; Ozasa, Kotaro; Yoo, Keun-Young; Sasazuki, Shizuka; Yang, Gong; Watanabe, Takashi; Sugawara, Yumi; Parvez, Faruque; Kim, Dong-Hyun; Chuang, Shao-Yuan; Ohishi, Waka; Park, Sue K; Feng, Ziding; Thornquist, Mark; Boffetta, Paolo; Zheng, Wei; Kang, Daehee; Potter, John; Sinha, Rashmi

    2013-01-01

    Background: Total or red meat intake has been shown to be associated with a higher risk of mortality in Western populations, but little is known of the risks in Asian populations. Objective: We examined temporal trends in meat consumption and associations between meat intake and all-cause and cause-specific mortality in Asia. Design: We used ecological data from the United Nations to compare country-specific meat consumption. Separately, 8 Asian prospective cohort studies in Bangladesh, China, Japan, Korea, and Taiwan consisting of 112,310 men and 184,411 women were followed for 6.6 to 15.6 y with 24,283 all-cause, 9558 cancer, and 6373 cardiovascular disease (CVD) deaths. We estimated the study-specific HRs and 95% CIs by using a Cox regression model and pooled them by using a random-effects model. Results: Red meat consumption was substantially lower in the Asian countries than in the United States. Fish and seafood consumption was higher in Japan and Korea than in the United States. Our pooled analysis found no association between intake of total meat (red meat, poultry, and fish/seafood) and risks of all-cause, CVD, or cancer mortality among men and women; HRs (95% CIs) for all-cause mortality from a comparison of the highest with the lowest quartile were 1.02 (0.91, 1.15) in men and 0.93 (0.86, 1.01) in women. Conclusions: Ecological data indicate an increase in meat intake in Asian countries; however, our pooled analysis did not provide evidence of a higher risk of mortality for total meat intake and provided evidence of an inverse association with red meat, poultry, and fish/seafood. Red meat intake was inversely associated with CVD mortality in men and with cancer mortality in women in Asian countries. PMID:23902788

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

    SciTech Connect

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

    1996-06-01

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

  9. Association of Coffee Consumption with Total and Cause-Specific Mortality in Three Large Prospective Cohorts

    PubMed Central

    Ding, Ming; Satija, Ambika; Bhupathiraju, Shilpa N; Hu, Yang; Sun, Qi; Han, Jiali; Lopez-Garcia, Esther; Willett, Walter; van Dam, Rob M.; Hu, Frank B.

    2015-01-01

    Background The association between consumption of caffeinated and decaffeinated coffee and risk of mortality remains inconclusive. Methods and Results We examined the associations of consumption of total, caffeinated, and decaffeinated coffee with risk of subsequent total and cause-specific mortality among 74,890 women in the Nurses’ Health Study (NHS), 93,054 women in the NHS 2, and 40,557 men in the Health Professionals Follow-up Study. Coffee consumption was assessed at baseline using a semi-quantitative food frequency questionnaire. During 4,690,072 person-years of follow-up, 19,524 women and 12,432 men died. Consumption of total, caffeinated, and decaffeinated coffee were non-linearly associated with mortality. Compared to non-drinkers, coffee consumption one to five cups/d was associated with lower risk of mortality, while coffee consumption more than five cups/d was not associated with risk of mortality. However, when restricting to never smokers, compared to non-drinkers, the HRs of mortality were 0.94 (0.89 to 0.99) for ≤ 1 cup/d, 0.92 (0.87 to 0.97) for 1.1-3 cups/d, 0.85 (0.79 to 0.92) for 3.1-5 cups/d, and 0.88 (0.78 to 0.99) for > 5 cups/d (p for non-linearity = 0.32; p for trend < 0.001). Significant inverse associations were observed for caffeinated (p for trend < 0.001) and decaffeinated coffee (p for trend = 0.022). Significant inverse associations were observed between coffee consumption and deaths due to cardiovascular disease, neurological diseases, and suicide. No significant association between coffee consumption and total cancer mortality was found. Conclusions Higher consumption of total coffee, caffeinated coffee, and decaffeinated coffee was associated with lower risk of total mortality. PMID:26572796

  10. Elemental concentrations of ambient particles and cause specific mortality in Santiago, Chile: a time series study

    PubMed Central

    2012-01-01

    Background The health effects of particulate air pollution are widely recognized and there is some evidence that the magnitude of these effects vary by particle component. We studied the effects of ambient fine particles (aerodynamic diameter < 2.5μm, PM2.5) and their components on cause-specific mortality in Santiago, Chile, where particulate pollution is a major public health concern. Methods Air pollution was collected in a residential area in the center of Santiago. Daily mortality counts were obtained from the National Institute of Statistic. The associations between PM2.5 and cause-specific mortality were studied by time series analysis controlling for time trends, day of the week, temperature and relative humidity. We then included an interaction term between PM2.5 and the monthly averages of the mean ratios of individual elements to PM2.5 mass. Results We found significant effects of PM2.5 on all the causes analyzed, with a 1.33% increase (95% CI: 0.87-1.78) in cardiovascular mortality per 10μg/m3 increase in the two days average of PM2.5. We found that zinc was associated with higher cardiovascular mortality. Particles with high content of chromium, copper and sulfur showed stronger associations with respiratory and COPD mortality, while high zinc and sodium content of PM2.5 amplified the association with cerebrovascular disease. Conclusions Our findings suggest that PM2.5 with high zinc, chromium, copper, sodium, and sulfur content have stronger associations with mortality than PM2.5 mass alone in Santiago, Chile. The sources of particles containing these elements need to be determined to better control their emissions. PMID:23116481

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

    SciTech Connect

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

    1981-01-01

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

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

    SciTech Connect

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

    1981-09-01

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

  13. Shift work and overall and cause-specific mortality in the Danish nurse cohort.

    PubMed

    Jørgensen, Jeanette Therming; Karlsen, Sashia; Stayner, Leslie; Andersen, Johnni; Andersen, Zorana Jovanovic

    2017-03-01

    Objectives Evidence of an effect of shift work on all-cause and cause-specific mortality is inconsistent. This study aims to examine whether shift work is associated with increased all-cause and cause-specific mortality. Methods We linked 28 731 female nurses (age ≥44 years), recruited in 1993 or 1999 from the Danish nurse cohort where they reported information on shift work (night, evening, rotating, or day), to the Danish Register of Causes of Death to identify deaths up to 2013. We used Cox regression models with age as the underlying scale to examine the associations between night, evening, and rotating shift work (compared to day shift work) and all-cause and cause-specific mortality in models adjusted for potentially confounding variables. Results Of 18 015 nurses included in this study, 1616 died during the study time period from the following causes: cardiovascular disease (N=217), cancer (N= 945), diabetes (N=20), Alzheimer's disease or dementia (N=33), and psychiatric diseases (N=67). We found that working night [hazard ratio (HR) 1.26, 95% confidence interval 95% CI) 1.05-1.51] or evening (HR 1.29, 95% CI 1.11-1.49) shifts was associated with a significant increase in all-cause mortality when compared to working day shift. We found a significant association of night shift work with cardiovascular disease (HR 1.71, 95% CI 1.09-2.69) and diabetes (HR 12.0, 95% CI 3.17-45.2, based on 8 cases) and none with overall cancer mortality (HR 1.05, 95% CI 0.81-1.35) or mortality from psychiatric diseases (HR 1.17, 95% CI 0.47-2.92). Finally, we found strong association between evening (HR 4.28, 95% CI 1.62-11.3) and rotating (HR 5.39, 95% CI 2.35-12.3) shift work and mortality from Alzheimer's disease and dementia (based on 8 and 14 deaths among evening and rotating shift workers, respectively). Conclusions Women working night and evening shifts have increased all-cause, cardiovascular, diabetes, and Alzheimer's and dementia mortality.

  14. Estimating cause-specific mortality from community- and facility-based data sources in the United Republic of Tanzania: options and implications for mortality burden estimates.

    PubMed Central

    Whiting, David R.; Setel, Philip W.; Chandramohan, Daniel; Wolfson, Lara J.; Hemed, Yusuf; Lopez, Alan D.

    2006-01-01

    OBJECTIVE: To compare mortality burden estimates based on direct measurement of levels and causes in communities with indirect estimates based on combining health facility cause-specific mortality structures with community measurement of mortality levels. METHODS: Data from sentinel vital registration (SVR) with verbal autopsy (VA) were used to determine the cause-specific mortality burden at the community level in two areas of the United Republic of Tanzania. Proportional cause-specific mortality structures from health facilities were applied to counts of deaths obtained by SVR to produce modelled estimates. The burden was expressed in years of life lost. FINDINGS: A total of 2884 deaths were recorded from health facilities and 2167 recorded from SVR/VAs. In the perinatal and neonatal age group cause-specific mortality rates were dominated by perinatal conditions and stillbirths in both the community and the facility data. The modelled estimates for chronic causes were very similar to those from SVR/VA. Acute febrile illnesses were coded more specifically in the facility data than in the VA. Injuries were more prevalent in the SVR/VA data than in that from the facilities. CONCLUSION: In this setting, improved International classification of diseases and health related problems, tenth revision (ICD-10) coding practices and applying facility-based cause structures to counts of deaths from communities, derived from SVR, appears to produce reasonable estimates of the cause-specific mortality burden in those aged 5 years and older determined directly from VA. For the perinatal and neonatal age group, VA appears to be required. Use of this approach in a nationally representative sample of facilities may produce reliable national estimates of the cause-specific mortality burden for leading causes of death in adults. PMID:17242829

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

    PubMed

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

    1987-11-01

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

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

    PubMed Central

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

    2006-01-01

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

  17. Green tea consumption and cause-specific mortality: Results from two prospective cohort studies in China

    PubMed Central

    Zhao, Long-Gang; Li, Hong-Lan; Sun, Jiang-Wei; Yang, Yang; Ma, Xiao; Shu, Xiao-Ou; Zheng, Wei; Xiang, Yong-Bing

    2016-01-01

    Background Green tea is one of the most widely consumed beverages in Asia. While a possible protective role of green tea against various chronic diseases has been suggested in experimental studies, evidence from human studies remains controversial. Methods We conducted this study using data from Shanghai Men's Health Study (SMHS) and Shanghai Women's Health Study (SWHS), two population-based prospective cohorts of middle-aged and elderly Chinese adults in urban Shanghai, China. Hazard ratios (HR) and 95% confidence intervals (CI) for risk of all-cause and cause-specific mortality associated with green tea intake were estimated using Cox proportional hazards regression models. Results During a median follow-up of 8.3 and 14.2 years for men and women, respectively, 6517 (2741 men and 3776 women) deaths were documented. We found that green tea consumption was inversely associated with risk of all-cause mortality (HR 0.95; 95% CI, 0.90–1.01), particularly among never-smokers (HR 0.89; 95% CI, 0.82–0.96). The inverse association with cardiovascular disease (CVD) mortality (HR 0.86; 95% CI, 0.77–0.97) was slightly stronger than that with all-cause mortality. No significant association was observed between green tea intake and cancer mortality (HR 1.01; 95% CI, 0.93–1.10). Conclusions Green tea consumption may be inversely associated with risk of all-cause and CVD mortality in middle-aged and elderly Chinese adults, especially among never smokers. PMID:28135196

  18. General and specific mortality among the elderly during the 2003 heat wave in Genoa (Italy).

    PubMed

    Conti, Susanna; Masocco, Maria; Meli, Paola; Minelli, Giada; Palummeri, Ernesto; Solimini, Renata; Toccaceli, Virgilia; Vichi, Monica

    2007-02-01

    The effects of heat waves on health can be serious for elderly persons, especially those in urban areas. We investigated in-depth the mortality excess during the 2003 heat wave among elderly persons (>74 years) in the City of Genoa (Italy). The excess in general mortality was calculated for the period July 16-August 31, as the ratio of observed to expected deaths. To evaluate "harvesting", we compared observed and expected mortality in the period September 2003-April 2004. We also studied the relationship between mortality and climatic conditions considering daily maximum temperature and Humidex discomfort degrees, as well as "lag-time". For cause-specific mortality, we considered all pathologies reported on the death certificate. The excess in general mortality was significant and was greatest in the first half of August. During Summer 2003, in Genoa the climatic conditions (described in terms of maximum temperature and Humidex Index) were extremely hot; regarding lag-time, the greatest correlation between the number of observed deaths and the maximum temperature values was observed for the three preceding days (rho=0.568; significance level<0.01). The prominent causes of death, for which an excess was observed, were cerebrovascular diseases, severe respiratory diseases, severe renal diseases, dementia; moreover, certain pathologic conditions and symptoms, usually not lethal, were also frequent causes of death (e.g., hypovolemia, hyperpyrexia, decubitus ulcers and immobilization syndrome). The results of this study confirm the relationship between the heat waves and death among elderly, stressing that, because of their poorer physical health and the prevalence of cognitive disturbances that hinder risk perception, it is necessary to properly care for them during heat waves.

  19. Survival, cause-specific mortality, and harvesting of male black-tailed deer in washington

    USGS Publications Warehouse

    Bender, L.C.; Schirato, G.A.; Spencer, R.D.; McAllister, K.R.; Murphie, B.L.

    2004-01-01

    We determined survival rates, causes of mortality, and documented impacts of harvest on ???1.5-year-old male (hereafter, male) Columbian black-tailed deer (Odocoileus hemionus columbianus) in 2 Washington, USA, game management units (GMUs; Skookumchuck and Snoqualmie) characterized by different hunting-season structures. We monitored 66 males (n = 28 and 38 annually) in Skookumchuck and 58 males (n = 26 and 32 annually) in Snoqualmie, September 1999-September 2001. Annual survival rates were 0.498 (SE = 0.066) in Skookumchuck and 0.519 (SE = 0.067) in Snoqualmie. Survival rates derived from population age structure did not differ from rates derived from radiotelemetry. Harvest was the primary mortality factor for each population, accounting for 67% (SE = 7; Skookumchuck) to 44% (SE = 9; Snoqualmie) of total annual mortality. Annual harvest-specific mortality rates were 0.317 (SE = 0.032) in Skookumchuck and 0.211 (SE = 0.021) in Snoqualmie, likely due to longer hunting seasons and greater hunter effort in Skookumchuck. Following the elimination of a late buck season centered on the rut in Snoqualmie, male harvest declined 56% and annual survival increased 60%, indicating that male harvest was largely additive to other mortality. Our results indicated that harvest was the primary influence on male black-tailed deer populations in Washington, was additive, and that the effect of harvest varied with hunting-season structure and hunter effort. Managers should not assume that harvesting removes a constant proportion of the male population annually, and management models that assume compensatory mortality in adult harvest may result in over-harvest of male populations.

  20. Association of Metformin Use With Cancer-Specific Mortality in Hepatocellular Carcinoma After Curative Resection

    PubMed Central

    Seo, Young-Seok; Kim, Yun-Jung; Kim, Mi-Sook; Suh, Kyung-Suk; Kim, Sang Bum; Han, Chul Ju; Kim, Youn Joo; Jang, Won Il; Kang, Shin Hee; Tchoe, Ha Jin; Park, Chan Mi; Jo, Ae Jung; Kim, Hyo Jeong; Choi, Jin A; Choi, Hyung Jin; Polak, Michael N.; Ko, Min Jung

    2016-01-01

    Abstract Many preclinical reports and retrospective population studies have shown an anticancer effect of metformin in patients with several types of cancer and comorbid type 2 diabetes mellitus (T2DM). In this work, the anticancer effect of metformin was assessed in hepatocellular carcinoma (HCC) patients with T2DM who underwent curative resection. A population-based retrospective cohort design was used. Data were obtained from the National Health Insurance Service and Korea Center Cancer Registry in the Republic of Korea, identifying 5494 patients with newly diagnosed HCC who underwent curative resection between 2005 and 2011. Crude and adjusted hazard ratios (HRs) were calculated using Cox proportional hazard models to estimate effects. In the sensitivity analysis, we excluded patients who started metformin or other oral hypoglycemic agents (OHAs) after HCC diagnosis to control for immortal time bias. From the patient cohort, 751 diabetic patients who were prescribed an OHA were analyzed for HCC-specific mortality and retreatment upon recurrence, comparing 533 patients treated with metformin to 218 patients treated without metformin. In the fully adjusted analyses, metformin users showed a significantly lower risk of HCC-specific mortality (HR 0.38, 95% confidence interval [CI] 0.30–0.49) and retreatment events (HR 0.41, 95% CI 0.33–0.52) compared with metformin nonusers. Risks for HCC-specific mortality were consistently lower among metformin-using groups, excluding patients who started metformin or OHAs after diagnosis. In this large population-based cohort of patients with comorbid HCC and T2DM, treated with curative hepatic resection, metformin use was associated with improvement of HCC-specific mortality and reduced occurrence of retreatment events. PMID:27124061

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

    USGS Publications Warehouse

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

    2000-01-01

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

  2. Mortality Due to Chagas Disease in Brazil According to a Specific Cause

    PubMed Central

    da Nóbrega, Aglaêr Alves; de Araújo, Wildo Navegantes; Vasconcelos, Ana Maria Nogales

    2014-01-01

    A century after its discovery, Chagas disease (CD) is still considered a public health problem. Mortality caused by CD between 2000 and 2010 was described according to the specific underlying cause, year of occurrence, gender, age range, and region of Brazil. The standardized mortality rate decreased 32.4%, from 3.4% in 2000 to 2.3% in 2010. Most of the deaths (85.9%) occurred in male patients who were > 60 years of age caused by cardiac involvement. The mortality rate caused by cardiac involvement decreased in all regions of Brazil, except in the North region, where it increased by 1.6%. The Northeast had the smallest and the Central-West had the largest decrease. The mortality rate caused by a compromised digestive tract increased in all regions. Despite the control of transmission by vector and blood transfusions, CD should remain on the list of priority diseases for the public health service in Brazil, and surveillance actions cannot be interrupted. PMID:25002301

  3. Asian dust effect on cause-specific mortality in five cities across South Korea and Japan

    NASA Astrophysics Data System (ADS)

    Kashima, Saori; Yorifuji, Takashi; Bae, Sanghyuk; Honda, Yasushi; Lim, Youn-Hee; Hong, Yun-Chul

    2016-03-01

    Desert dust is considered to be potentially toxic and its toxicity may change during long-range transportation. In Asian countries, the health effects of desert dust in different locations are not well understood. We therefore evaluated the city-combined and city-specific effects of Asian dust events on all-cause and cause-specific mortality in five populous cities in South Korea (Seoul) and Japan (Nagasaki, Matsue, Osaka and Tokyo). We obtained daily mean concentrations of Asian dust using light detection and ranging (lidar) between 2005 and 2011. We then evaluated city-specific and pooled associations of Asian dust with daily mortality for elderly residents (≥65 years old) using time-series analyses. Each 10 μg/m3 increase in the concentration of same-day (lag 0) or previous-day (lag 1) Asian dust was significantly associated with an elevated pooled risk of all-cause mortality (relative risk (RR): 1.003 [95% CI: 1.001-1.005] at lag 0 and 1.001 [95% CI: 1.000-1.003] at lag 1) and cerebrovascular disease (RR: 1.006 [95% CI: 1.000-1.011] at lag 1). This association was especially apparent in Seoul and western Japan (Nagasaki and Matsue). Conversely, no significant associations were observed in Tokyo, which is situated further from the origin of Asian dust and experiences low mean concentrations of Asian dust. Adverse health effects on all-cause and cerebrovascular disease mortality were observed in South Korea and Japan. However, the effects of Asian dust differed across the cities and adverse effects were more apparent in cities closer to Asian dust sources.

  4. The Effect of Coffee and Quantity of Consumption on Specific Cardiovascular and All-Cause Mortality: Coffee Consumption Does Not Affect Mortality.

    PubMed

    Loomba, Rohit S; Aggarwal, Saurabh; Arora, Rohit R

    2016-01-01

    Previous studies have examined whether or not an association exists between the consumption of caffeinated coffee to all-cause and cardiovascular mortality. This study aimed to delineate this association using population representative data from the National Health and Nutrition Examination Survey III. Patients were included in the study if all the following criteria were met: (1) follow-up mortality data were available, (2) age of at least 45 years, and (3) reported amount of average coffee consumption. A total of 8608 patients were included, with patients stratified into the following groups of average daily coffee consumption: (1) no coffee consumption, (2) less than 1 cup, (3) 1 cup a day, (4) 2-3 cups, (5) 4-5 cups, (6) more than 6 cups a day. Odds ratios, 95% confidence intervals, and P values were calculated for univariate analysis to compare the prevalence of all-cause mortality, ischemia-related mortality, congestive heart failure-related mortality, and stroke-related mortality, using the no coffee consumption group as reference. These were then adjusted for confounding factors for a multivariate analysis. P < 0.05 were considered statistically significant. Univariate analysis demonstrated an association between coffee consumption and mortality, although this became insignificant on multivariate analysis. Coffee consumption, thus, does not seem to impact all-cause mortality or specific cardiovascular mortality. These findings do differ from those of recently published studies. Coffee consumption of any quantity seems to be safe without any increased mortality risk. There may be some protective effects but additional data are needed to further delineate this.

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

    PubMed

    Remes, V

    2007-01-01

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

  6. Forecasting Cause-Specific Mortality in Korea up to Year 2032.

    PubMed

    Yun, Jae-Won; Son, Mia

    2016-08-01

    Forecasting cause-specific mortality can help estimate the future burden of diseases and provide a clue for preventing diseases. Our objective was to forecast the mortality for causes of death in the future (2013-2032) based on the past trends (1983-2012) in Korea. The death data consisted of 12 major causes of death from 1983 to 2012 and the population data consisted of the observed and estimated populations (1983-2032) in Korea. The modified age-period-cohort model with an R-based program, nordpred software, was used to forecast future mortality. Although the age-standardized rates for the world standard population for both sexes are expected to decrease from 2008-2012 to 2028-2032 (males: -31.4%, females: -32.3%), the crude rates are expected to increase (males: 46.3%, females: 33.4%). The total number of deaths is also estimated to increase (males: 52.7%, females: 41.9%). Additionally, the largest contribution to the overall change in deaths was the change in the age structures. Several causes of death are projected to increase in both sexes (cancer, suicide, heart diseases, pneumonia and Alzheimer's disease), while others are projected to decrease (cerebrovascular diseases, liver diseases, diabetes mellitus, traffic accidents, chronic lower respiratory diseases, and pulmonary tuberculosis). Cancer is expected to be the highest cause of death for both the 2008-2012 and 2028-2032 time periods in Korea. To reduce the disease burden, projections of the future cause-specific mortality should be used as fundamental data for developing public health policies.

  7. Exploring mechanisms underlying sex-specific differences in mortality of Lake Michigan bloaters

    USGS Publications Warehouse

    Bunnell, D.B.; Madenjian, C.P.; Rogers, M.W.; Holuszko, J.D.; Begnoche, L.J.

    2012-01-01

    Sex-specific differences in mortality rates have been observed among freshwater and marine fish taxa, and underlying mechanisms can include sex-specific differences in (1) age at maturity, (2) growth rate, or (3) activity or behavior during the spawning period. We used a long-term (1973–2009) Lake Michigan data set to evaluate whether there were sex-specific differences in catch per unit effort, mortality, age at maturity, and length at age in bloaters Coregonus hoyi. Because bloater population biomass varied 200-fold during the years analyzed, we divided the data into three periods: (1) 1973–1982 (low biomass), (2) 1983–1997 (high biomass), and (3) 1998–2009 (low biomass). Mortality was higher for males than for females in periods 2 and 3; the average instantaneous total mortality rate (Z) over these two periods was 0.71 for males and 0.57 for females. Length at age was slightly greater (2–6%) for females than for males in different age-classes (3–6 years) during each period. Age at maturity was earlier for males than for females in periods 1 and 2, but the mean difference was only 0.2–0.4 years. To test the hypothesis that somatic lipids declined more in males than in females during spawning (perhaps due to increased activity or reduced feeding), we estimated sex-specific percent somatic lipids for fish sampled in 2005–2006 and 2007–2008. During 2005–2006, somatic lipids declined from prespawning to postspawning for males but were unchanged for females. During 2007–2008, however, somatic lipids were unchanged for males, whereas they increased for females. We found that sex-specific differences in Z occurred in the Lake Michigan bloater population, but our hypotheses that sex-specific differences in maturity and growth could explain this pattern were generally unsupported. Our hypothesis that somatic lipids in males declined during spawning at a faster rate than in females will require additional research to clarify its importance.

  8. Tree mortality across biomes is promoted by drought intensity, lower wood density and higher specific leaf area.

    PubMed

    Greenwood, Sarah; Ruiz-Benito, Paloma; Martínez-Vilalta, Jordi; Lloret, Francisco; Kitzberger, Thomas; Allen, Craig D; Fensham, Rod; Laughlin, Daniel C; Kattge, Jens; Bönisch, Gerhard; Kraft, Nathan J B; Jump, Alistair S

    2017-04-01

    Drought events are increasing globally, and reports of consequent forest mortality are widespread. However, due to a lack of a quantitative global synthesis, it is still not clear whether drought-induced mortality rates differ among global biomes and whether functional traits influence the risk of drought-induced mortality. To address these uncertainties, we performed a global meta-analysis of 58 studies of drought-induced forest mortality. Mortality rates were modelled as a function of drought, temperature, biomes, phylogenetic and functional groups and functional traits. We identified a consistent global-scale response, where mortality increased with drought severity [log mortality (trees trees(-1)  year(-1) ) increased 0.46 (95% CI = 0.2-0.7) with one SPEI unit drought intensity]. We found no significant differences in the magnitude of the response depending on forest biomes or between angiosperms and gymnosperms or evergreen and deciduous tree species. Functional traits explained some of the variation in drought responses between species (i.e. increased from 30 to 37% when wood density and specific leaf area were included). Tree species with denser wood and lower specific leaf area showed lower mortality responses. Our results illustrate the value of functional traits for understanding patterns of drought-induced tree mortality and suggest that mortality could become increasingly widespread in the future.

  9. Genetic markers associated with early cancer-specific mortality following prostatectomy

    PubMed Central

    Liu, Wennuan; Xie, Chunmei C.; Thomas, Christopher Y.; Kim, Seong-Tae; Lindberg, Johan; Egevad, Lars; Wang, Zhong; Zhang, Zheng; Sun, Jishan; Sun, Jielin; Koty, Patrick P.; Kader, A. Karim; Cramer, Scott D.; Bova, G. Steve; Zheng, S. Lilly; Grönberg, Henrik; Isaacs, William B.; Xu, Jianfeng

    2013-01-01

    BACKGROUND To identify novel effectors and markers of localized but potentially life-threatening prostate cancer (PCa), we evaluated chromosomal copy number alterations (CNAs) in tumors from patients who underwent prostatectomy and correlated these with clinicopathologic features and outcome. METHODS CNAs in tumor DNAs from 125 prostatectomy patients in the discovery cohort were assayed with high resolution Affymetrix 6.0 SNP microarrays and then analyzed using the Genomic Identification of Significant Targets in Cancer (GISTIC) algorithm. RESULTS The assays revealed twenty significant regions of CNAs, four of them novel, and identified the target genes of four of the alterations. By univariate analysis, seven CNAs were significantly associated with early PCa-specific mortality. These included gains of chromosomal regions that contain the genes MYC, ADAR, or TPD52 and losses of sequences that incorporate SERPINB5, USP10, PTEN, or TP53. On multivariate analysis, only the CNAs of PTEN and MYC contributed additional prognostic information independent of that provided by pathologic stage, Gleason score, and initial PSA level. Patients whose tumors had alterations of both genes had a markedly elevated risk of PCa-specific mortality (OR = 53; C.I.= 6.92–405, P = 1 × 10−4). Analyses of 333 tumors from three additional distinct patient cohorts confirmed the relationship between CNAs of PTEN and MYC and lethal PCa. CONCLUSION This study identified new CNAs and genes that likely contribute to the pathogenesis of localized PCa and suggests that patients whose tumors have acquired CNAs of PTEN, MYC, or both have an increased risk of early PCa-specific mortality. PMID:23609948

  10. Area-level socioeconomic context, total mortality and cause-specific mortality in Spain: Heterogeneous findings depending on the level of geographic aggregation.

    PubMed

    Regidor, Enrique; Vallejo, Fernando; Reques, Laura; Cea, Lucía; Miqueleiz, Estrella; Barrio, Gregorio

    2015-09-01

    The objective of this study was to estimate the association between area-level socioeconomic context and mortality in Spain, using two different geographic aggregations. Nation-wide prospective study covering all persons living in Spain in 2001. Mortality was analysed in Spanish citizens by province of residence and in citizens of Madrid by neighbourhood of residence. Provinces and neighbourhoods were grouped into quartiles according to two socioeconomic indicators: percentage of the population with university education and unemployment rate. The measure of association was the rate ratio for total mortality and cause-specific mortality, by each socioeconomic indicator in two age groups, 25-64 years (adult population) and 65 years and over (elderly population). After adjustment for all individual socioeconomic variables, the rate ratio for total mortality among residents in the provinces with the worst versus best socioeconomic context was 0.92 (95% CI 0.88-0.97) when the indicator was percentage of university population and 0.89 (0.85-0.93) when it was unemployment rate in the adult population, and 1.05 (1.00-1.11) and 1.08 (1.03-1.13), respectively, in the elderly population. No significant differences in mortality were observed between adults residing in neighbourhoods with the worst versus best socioeconomic context, but in the elderly population the mortality rate ratios for the two socioeconomic indicators were 1.04 (1.01-1.07) and 1.06 (1.03-1.09), respectively. Residents in provinces with the worst socioeconomic context had the lowest mortality from cancer and external causes and the highest mortality from cardiovascular diseases, while residents in neighbourhoods with the worst socioeconomic context had the highest mortality from respiratory and digestive diseases. Further research should find out the reasons for the lower total mortality in adult population residing in the Spanish provinces with the most adverse socioeconomic context and the reasons for

  11. Symptomatic Atherosclerotic Disease and Decreased Risk of Cancer-Specific Mortality

    PubMed Central

    Benito-León, Julián; de la Aleja, Jesús González; Martínez-Salio, Antonio; Louis, Elan D.; Lichtman, Judith H.; Bermejo-Pareja, Félix

    2015-01-01

    Abstract The few studies that have assessed the association between symptomatic atherosclerotic disease and risk of cancer have had conflicting results. In addition, these studies ascertained participants either from treatment settings (ie, service-based studies) or by using a records linkage system (ie, medical records of patients evaluated at clinics or hospitals) and, therefore, were prone to selection bias. Our purpose was to estimate the risk of cancer mortality in a large population-based sample of elderly people, comparing participants with symptomatic atherosclerotic disease (atherosclerotic stroke and coronary disease) to their counterparts without symptomatic atherosclerotic disease (ie, controls) in the same population. In this population-based, prospective study (Neurological Disorders of Central Spain, NEDICES), 5262 elderly community-dwelling participants with and without symptomatic atherosclerotic disease were identified and followed for a median of 12.1 years, after which the death certificates of those who died were reviewed. A total of 2701 (53.3%) of 5262 participants died, including 314 (68.6%) of 458 participants with symptomatic atherosclerotic disease and 2387 (49.7%) of 4804 controls. Cancer mortality was reported significantly less often in those with symptomatic atherosclerotic disease (15.6%) than in controls (25.6%) (P < 0.001). In an unadjusted Cox model, risk of cancer-specific mortality was decreased in participants with symptomatic atherosclerotic disease (HR = 0.74, 95% confidence interval [CI], 0.55−0.98, P = 0.04) vs. those without symptomatic atherosclerotic disease (reference group). In an adjusted Cox model, HR = 0.58; 95% CI, 0.38−0.89; P = 0.01. This population-based, prospective study suggests that there is an inverse association between symptomatic atherosclerotic disease and risk of cancer mortality. PMID:26266364

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

    PubMed

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

    2017-01-01

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

  13. Cause-specific mortality in adult epilepsy patients from Tyrol, Austria: hospital-based study.

    PubMed

    Granbichler, Claudia A; Oberaigner, Willi; Kuchukhidze, Giorgi; Bauer, Gerhard; Ndayisaba, Jean-Pierre; Seppi, Klaus; Trinka, Eugen

    2015-01-01

    Epilepsy is a devastating condition with a considerable increase in mortality compared to the general population. Few studies have focused on cause-specific mortality which we analyse in detail in over 4,000 well-characterized epilepsy patients. The cohort comprised of epilepsy patients ≥ 18, treated between 1970 and 2009 at the epilepsy clinic of Innsbruck Medical University, Austria, and living in the province of Tyrol, Austria. Epilepsy diagnosis was based on ILAE guidelines (1989); patients with brain tumor were excluded. Deceased patients and causes of death (ICD-codes) were obtained via record linkage to the national death registry. We computed age-, sex-, and period-adjusted standardized mortality rates (SMR) for 36 diagnoses subgroups in four major groups. Additional analyses were performed for an incidence cohort. Overall cohort: 4,295 patients, 60,649.1 person-years, 822 deaths, overall SMR 1.7 (95 % CI 1.6-1.9), highest elevated cause-specific SMR: congenital anomalies [7.1 (95 % CI 2.3-16.6)], suicide [4.2 (95 % CI 2.0-8.1)], alcohol dependence syndrome [3.9 (95 % CI 1.8-7.4)], malignant neoplasm of esophagus [3.1 (95 % CI 1.2-6.4)], pneumonia [2.7 (95 % CI 1.6-4.2)]. Incidence cohort: 1,299 patients, 14,215.4 person-years, 267 deaths, overall SMR 1.8 (95 % CI 1.6-2.1), highest elevated cause-specific SMR congenital anomalies [10.8 (95 % CI 1.3-39.3)], suicide [6.8 (95 % CI 1.4-19.8)], alcohol dependence syndrome (6.4 [95 % CI 1.8-16.5)], pneumonia [3.9 (95 % CI 1.8-7.4)], cerebrovascular disease at 3.5 (95 % CI 2.6-4.6). Mortality due to mental health problems, such as suicide or alcohol dependence syndrome, malignant neoplasms, and cerebrovascular diseases was highly increased in our study. In addition to aim for seizure freedom, we suggest improving general health promotion, including cessation of smoking, lowering of alcohol intake, and reduction of weight as well as early identification of psychiatric comorbidity in patients with epilepsy.

  14. The influence of the CHIEF pathway on colorectal cancer-specific mortality.

    PubMed

    Slattery, Martha L; Lundgreen, Abbie

    2014-01-01

    Many components of the CHIEF (Convergence of Hormones, Inflammation, and Energy Related Factors) pathway could influence survival given their involvement in cell growth, apoptosis, angiogenesis, and tumor invasion stimulation. We used ARTP (Adaptive Rank Truncation Product) to test if genes in the pathway were associated with colorectal cancer-specific mortality. Colon cancer (n = 1555) and rectal cancer (n = 754) cases were followed over five years. Age, center, stage at diagnosis, and tumor molecular phenotype were considered when calculating ARTP p values. A polygenic risk score was used to summarize the magnitude of risk associated with this pathway. The JAK/STAT/SOC was significant for colon cancer survival (PARTP = 0.035). Fifteen genes (DUSP2, INFGR1, IL6, IRF2, JAK2, MAP3K10, MMP1, NFkB1A, NOS2A, PIK3CA, SEPX1, SMAD3, TLR2, TYK2, and VDR) were associated with colon cancer mortality (PARTP < 0.05); JAK2 (PARTP  = 0.0086), PIK3CA (PARTP = 0.0098), and SMAD3 (PARTP = 0.0059) had the strongest associations. Over 40 SNPs were significantly associated with survival within the 15 significant genes (PARTP < 0.05). SMAD3 had the strongest association with survival (HRGG 2.46 95% CI 1.44,4.21 PTtrnd = 0.0002). Seven genes (IL2RA, IL8RA, IL8RB, IRF2, RAF1, RUNX3, and SEPX1) were significantly associated with rectal cancer (PARTP < 0.05). The HR for colorectal cancer-specific mortality among colon cancer cases in the upper at-risk alleles group was 11.81 (95% CI 7.07, 19. 74) and was 10.99 (95% CI 5.30, 22.78) for rectal cancer. These results suggest that several genes in the CHIEF pathway are important for colorectal cancer survival; the risk associated with the pathway merits validation in other studies.

  15. All-cause and cause-specific mortality of immigrants and native born in the United States.

    PubMed Central

    Singh, G K; Siahpush, M

    2001-01-01

    OBJECTIVES: This study examined whether US-born people and immigrants 25 years or older differ in their risks of all-cause and cause-specific mortality and whether these differentials, if they exist, vary according to age, sex, and race/ethnicity. METHODS: Using data from the National Longitudinal Mortality Study (1979-1989), we derived mortality risks of immigrants relative to those of US-born people by using a Cox regression model after adjusting for age, race/ethnicity, marital status, urban/rural residence, education, occupation, and family income. RESULTS: Immigrant men and women had, respectively, an 18% and 13% lower risk of overall mortality than their US-born counterparts. Reduced mortality risks were especially pronounced for younger and for Black and Hispanic immigrants. Immigrants showed significantly lower risks of mortality from cardiovascular diseases, lung and prostate cancer, chronic obstructive pulmonary diseases, cirrhosis, pneumonia and influenza, unintentional injuries, and suicide but higher risks of mortality from stomach and brain cancer and infectious diseases. CONCLUSIONS: Mortality patterns for immigrants and for US-born people vary considerably, with immigrants experiencing lower mortality from several major causes of death. Future research needs to examine the role of sociocultural and behavioral factors in explaining the mortality advantage of immigrants. PMID:11236403

  16. Mortality trajectory analysis reveals the drivers of sex-specific epidemiology in natural wildlife-disease interactions.

    PubMed

    McDonald, Jennifer L; Smith, Graham C; McDonald, Robbie A; Delahay, Richard J; Hodgson, Dave

    2014-09-07

    In animal populations, males are commonly more susceptible to disease-induced mortality than females. However, three competing mechanisms can cause this sex bias: weak males may simultaneously be more prone to exposure to infection and mortality; being 'male' may be an imperfect proxy for the underlying driver of disease-induced mortality; or males may experience increased severity of disease-induced effects compared with females. Here, we infer the drivers of sex-specific epidemiology by decomposing fixed mortality rates into mortality trajectories and comparing their parameters. We applied Bayesian survival trajectory analysis to a 22-year longitudinal study of a population of badgers (Meles meles) naturally infected with bovine tuberculosis (bTB). At the point of infection, infected male and female badgers had equal mortality risk, refuting the hypothesis that acquisition of infection occurs in males with coincidentally high mortality. Males and females exhibited similar levels of heterogeneity in mortality risk, refuting the hypothesis that maleness is only a proxy for disease susceptibility. Instead, sex differences were caused by a more rapid increase in male mortality rates following infection. Males are indeed more susceptible to bTB, probably due to immunological differences between the sexes. We recommend this mortality trajectory approach for the study of infection in animal populations.

  17. Dialysis Dose Scaled to Body Surface Area and Size-Adjusted, Sex-Specific Patient Mortality

    PubMed Central

    Kapke, Alissa; Port, Friedrich K.; Wolfe, Robert A.; Saran, Rajiv; Pearson, Jeffrey; Hirth, Richard A.; Messana, Joseph M.; Daugirdas, John T.

    2012-01-01

    Summary Background and objectives When hemodialysis dose is scaled to body water (V), women typically receive a greater dose than men, but their survival is not better given a similar dose. This study sought to determine whether rescaling dose to body surface area (SA) might reveal different associations among dose, sex, and mortality. Design, setting, participants, & measurements Single-pool Kt/V (spKt/V), equilibrated Kt/V, and standard Kt/V (stdKt/V) were computed using urea kinetic modeling on a prevalent cohort of 7229 patients undergoing thrice-weekly hemodialysis. Data were obtained from the Centers for Medicare & Medicaid Services 2008 ESRD Clinical Performance Measures Project. SA-normalized stdKt/V (SAN-stdKt/V) was calculated as stdKt/V × ratio of anthropometric volume to SA/17.5. Patients were grouped into sex-specific dose quintiles (reference: quintile 1 for men). Adjusted hazard ratios (HRs) for 1-year mortality were calculated using Cox regression. Results spKt/V was higher in women (1.7±0.3) than in men (1.5±0.2; P<0.001), but SAN-stdKt/V was lower (women: 2.3±0.2; men: 2.5±0.3; P<0.001). For both sexes, mortality decreased as spKt/V increased, until spKt/V was 1.6–1.7 (quintile 4 for men: HR, 0.62; quintile 3 for women: HR, 0.64); no benefit was observed with higher spKt/V. HR for mortality decreased further at higher SAN-stdKt/V in both sexes (quintile 5 for men: HR, 0.69; quintile 5 for women: HR, 0.60). Conclusions SA-based dialysis dose results in dose-mortality relationships substantially different from those with volume-based dosing. SAN-stdKt/V analyses suggest women may be relatively underdosed when treated by V-based dosing. SAN-stdKt/V as a measure for dialysis dose may warrant further study. PMID:22977208

  18. ICD coding changes and discontinuities in trends in cause-specific mortality in six European countries, 1950-99.

    PubMed Central

    Janssen, Fanny; Kunst, Anton E.

    2004-01-01

    OBJECTIVE: To evaluate how often coding changes between and within revisions of the International Classification of Diseases (ICD) complicate the description of long-term trends in cause-specific mortality. METHODS: Data on cause-specific mortality between 1950 and 1999 for men and women aged 60 and older were obtained from Denmark, England and Wales, Finland, the Netherlands, Norway and Sweden. Data were obtained by five-year age groups. We constructed a concordance table using three-digit ICD codes. In addition we evaluated the occurrence of mortality discontinuities by visually inspecting cause-specific trends and country-specific background information. Evaluation was also based on quantification of the discontinuities using a Poisson regression model (including period splines). We compared the observed trends in cause-specific mortality with the trends after adjustment for the discontinuities caused by changes to coding. FINDINGS: In 45 out of 416 (10.8 %) instances of ICD revisions to cause-specific mortality codes, significant discontinuities that were regarded as being due to ICD revisions remained. The revisions from ICD-6 and ICD-7 to ICD-8 and a wide range of causes of death, with the exception of the specific cancers, were especially affected. Incidental changes in coding rules were also important causes of discontinuities in trends in cause-specific mortality, especially in England and Wales, Finland and Sweden. Adjusting for these discontinuities can lead to significant changes in trends, although these primarily affect only limited periods of time. CONCLUSION: Despite using a carefully constructed concordance table based on three-digit ICD codes, mortality discontinuities arising as a result of coding changes (both between and within revisions) can lead to substantial changes in long-term trends in cause-specific mortality. Coding changes should therefore be evaluated by researchers and, where necessary, controlled for. PMID:15654404

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

    PubMed

    Gan, J; Zheng, Z; Li, G

    1998-01-01

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

  20. Multimorbidity as specific disease combinations, an important predictor factor for mortality in octogenarians: the Octabaix study

    PubMed Central

    Ferrer, Assumpta; Formiga, Francesc; Sanz, Héctor; Almeda, Jesús; Padrós, Glòria

    2017-01-01

    Background The population is aging and multimorbidity is becoming a common problem in the elderly. Objective To explore the effect of multimorbidity patterns on mortality for all causes at 3- and 5-year follow-up periods. Materials and methods A prospective community-based cohort (2009–2014) embedded within a randomized clinical trial was conducted in seven primary health care centers, including 328 subjects aged 85 years at baseline. Sociodemographic variables, sensory status, cardiovascular risk factors, comorbidity, and geriatric tests were analyzed. Multimorbidity patterns were defined as combinations of two or three of 16 specific chronic conditions in the same individual. Results Of the total sample, the median and interquartile range value of conditions was 4 (3–5). The individual morbidities significantly associated with death were chronic obstructive pulmonary disease (COPD; hazard ratio [HR]: 2.47; 95% confidence interval [CI]: 1.3; 4.7), atrial fibrillation (AF; HR: 2.41; 95% CI: 1.3; 4.3), and malignancy (HR: 1.9; 95% CI: 1.0; 3.6) at 3-year follow-up; whereas dementia (HR: 2.04; 95% CI: 1.3; 3.2), malignancy (HR: 1.84; 95% CI: 1.2; 2.8), and COPD (HR: 1.77; 95% CI: 1.1; 2.8) were the most associated with mortality at 5-year follow-up, after adjusting using Barthel functional index (BI). The two multimorbidity patterns most associated with death were AF, chronic kidney disease (CKD), and visual impairment (HR: 4.19; 95% CI: 2.2; 8.2) at 3-year follow-up as well as hypertension, CKD, and malignancy (HR: 3.24; 95% CI: 1.8; 5.8) at 5 years, after adjusting using BI. Conclusion Multimorbidity as specific combinations of chronic conditions showed an effect on mortality, which would be higher than the risk attributable to individual morbidities. The most important predicting pattern for mortality was the combination of AF, CKD, and visual impairment after 3 years. These findings suggest that a new approach is required to target multimorbidity in

  1. Diagnosis-specific sickness absence and all-cause mortality in the GAZEL study

    PubMed Central

    Ferrie, Jane E.; Vahtera, Jussi; Kivimäki, Mika; Westerlund, Hugo; Melchior, Maria; Alexanderson, Kristina; Head, Jenny; Chevalier, Anne; Leclerc, Annette; Zins, Marie; Goldberg, Marcel; Singh-Manoux, Archana

    2009-01-01

    Objective To examine diagnosis-specific sickness absence as a risk marker for all-cause mortality. Design Prospective occupational cohort (the GAZEL study). Medically-certified sickness absence spells greater than 7 days for 15 diagnostic categories, 1990–1992, were examined in relation to all-cause mortality, January 1993-February 2007. The reference group for each diagnostic category was participants with no spell >7 days for that diagnosis. Participants French public utility workers (5,271 women and 13,964 men) aged 37–51 in 1990, the GAZEL study. Over the follow-up period there were 144 deaths in women and 758 in men. Main results 7,875 employees (41.0%) had at least one spell of sickness absence >7 days over the three-year period. The commonest diagnoses were mental disorders, musculoskeletal diseases, respiratory diseases and external causes in both sexes; genitourinary diseases in women, and digestive and circulatory diseases in men. Of these common diagnoses mental disorders in women, hazard ratio (95% confidence intervals) 1.24 (1.1–1.4); and mental disorders 1.35 (1.3–1.5), digestive diseases 1.29 (1.1–1.6) and circulatory diseases 1.35 (1.2–1.6) in men were associated with mortality after adjustment for age, employment grade and sickness absence in all other diagnostic categories. Conclusions Employees with medically-certified absence spells of one week or more over a three-year period had a 60% excess risk of early death. In women and men, this excess risk was associated with some of the commonest diagnoses of sickness absence, in particular mental disorders. Sickness absence for mental disorders may be a useful early indicator of groups at increased risk of fatal disease. PMID:19039005

  2. Economic inequality, working-class power, social capital, and cause-specific mortality in wealthy countries.

    PubMed

    Muntaner, Carles; Lynch, John W; Hillemeier, Marianne; Lee, Ju Hee; David, Richard; Benach, Joan; Borrell, Carme

    2002-01-01

    This study tests two propositions from Navarro's critique of the social capital literature: that social capital's importance has been exaggerated and that class-related political factors, absent from social epidemiology and public health, might be key determinants of population health. The authors estimate cross-sectional associations between economic inequality, working-class power, and social capital and life expectancy, self-rated health, low birth weight, and age- and cause-specific mortality in 16 wealthy countries. Of all the health outcomes, the five variables related to birth and infant survival and nonintentional injuries had the most consistent association with economic inequality and working-class power (in particular with strength of the welfare state) and, less so, with social capital indicators. Rates of low birth weight and infant deaths from all causes were lower in countries with more "left" (e.g., socialist, social democratic, labor) votes, more left members of parliament, more years of social democratic government, more women in government, and various indicators of strength of the welfare state, as well as low economic inequality, as measured in a variety of ways. Similar associations were observed for injury mortality, underscoring the crucial role of unions and labor parties in promoting workplace safety. Overall, social capital shows weaker associations with population health indicators than do economic inequality and working-class power. The popularity of social capital and exclusion of class-related political and welfare state indicators does not seem to be justified on empirical grounds.

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

    PubMed Central

    2012-01-01

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

  4. Abrupt transitions of the top-down controlled Black Sea pelagic ecosystem during 1960 2000: Evidence for regime-shifts under strong fishery exploitation and nutrient enrichment modulated by climate-induced variations

    NASA Astrophysics Data System (ADS)

    Oguz, Temel; Gilbert, Denis

    2007-02-01

    Functioning of the Black Sea ecosystem has profoundly changed since the early 1970s under cumulative effects of excessive nutrient enrichment, strong cooling/warming, over-exploitation of pelagic fish stocks, and population outbreak of gelatinous carnivores. Applying a set of criteria to the long-term (1960-2000) ecological time-series data, the present study demonstrates that the Black Sea ecosystem was reorganised during this transition phase in different forms of top-down controlled food web structure through successive regime-shifts of distinct ecological properties. The Secchi disc depth, oxic-anoxic interface zone, dissolved oxygen and hydrogen sulphide concentrations also exhibit abrupt transition between their alternate regimes, and indicate tight coupling between the lower trophic food web structure and the biogeochemical pump in terms of regime-shift events. The first shift, in 1973-1974, marks a switch from large predatory fish to small planktivore fish-controlled system, which persisted until 1989 in the form of increasing small pelagic and phytoplankton biomass and decreasing zooplankton biomass. The increase in phytoplankton biomass is further supported by a bottom-up contribution due to the cumulative response to high anthropogenic nutrient load and the concurrent shift of the physical system to the "cold climate regime" following its ˜20-year persistence in the "warm climate regime". The end of the 1980s signifies the depletion of small planktivores and the transition to a gelatinous carnivore-controlled system. By the end of the 1990s, small planktivore populations take over control of the system again. Concomitantly, their top-down pressure when combined with diminishing anthropogenic nutrient load and more limited nutrient supply into the surface waters due to stabilizing effects of relatively warm winter conditions switched the "high production" regime of phytoplankton to its background "low production" regime. The Black Sea regime

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

    PubMed Central

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

    2016-01-01

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

  6. The Influence of the CHIEF Pathway on Colorectal Cancer-Specific Mortality

    PubMed Central

    Slattery, Martha L.; Lundgreen, Abbie

    2014-01-01

    Many components of the CHIEF (Convergence of Hormones, Inflammation, and Energy Related Factors) pathway could influence survival given their involvement in cell growth, apoptosis, angiogenesis, and tumor invasion stimulation. We used ARTP (Adaptive Rank Truncation Product) to test if genes in the pathway were associated with colorectal cancer-specific mortality. Colon cancer (n = 1555) and rectal cancer (n = 754) cases were followed over five years. Age, center, stage at diagnosis, and tumor molecular phenotype were considered when calculating ARTP p values. A polygenic risk score was used to summarize the magnitude of risk associated with this pathway. The JAK/STAT/SOC was significant for colon cancer survival (PARTP = 0.035). Fifteen genes (DUSP2, INFGR1, IL6, IRF2, JAK2, MAP3K10, MMP1, NFkB1A, NOS2A, PIK3CA, SEPX1, SMAD3, TLR2, TYK2, and VDR) were associated with colon cancer mortality (PARTP <0.05); JAK2 (PARTP  = 0.0086), PIK3CA (PARTP = 0.0098), and SMAD3 (PARTP = 0.0059) had the strongest associations. Over 40 SNPs were significantly associated with survival within the 15 significant genes (PARTP<0.05). SMAD3 had the strongest association with survival (HRGG 2.46 95% CI 1.44,4.21 PTtrnd = 0.0002). Seven genes (IL2RA, IL8RA, IL8RB, IRF2, RAF1, RUNX3, and SEPX1) were significantly associated with rectal cancer (PARTP<0.05). The HR for colorectal cancer-specific mortality among colon cancer cases in the upper at-risk alleles group was 11.81 (95% CI 7.07, 19. 74) and was 10.99 (95% CI 5.30, 22.78) for rectal cancer. These results suggest that several genes in the CHIEF pathway are important for colorectal cancer survival; the risk associated with the pathway merits validation in other studies. PMID:25541970

  7. Overall and cause-specific excess mortality in HIV-positive persons compared with the general population

    PubMed Central

    Alejos, Belén; Hernando, Victoria; Iribarren, Jose; Gonzalez-García, Juan; Hernando, Asuncion; Santos, Jesus; Asensi, Victor; Gomez-Berrocal, Ana; del Amo, Julia; Jarrin, Inma

    2016-01-01

    Abstract We aimed to estimate overall and cause-specific excess mortality of HIV-positive patients compared with the general population, and to assess the effect of risk factors. We included patients aged >19 years, recruited from January 1, 2004 to May 31, 2014 in Cohort of the Spanish Network on HIV/AIDS Research. We used generalized linear models with Poisson error structure to model excess mortality rates. In 10,340 patients, 368 deaths occurred. Excess mortality was 0.82 deaths per 100 person-years for all-cause mortality, 0.11 for liver, 0.08 for non-AIDS-defining malignancies (NADMs), 0.08 for non-AIDS infections, and 0.02 for cardiovascular-related causes. Lower CD4 count and higher HIV viral load, lower education, being male, and over 50 years were predictors of overall excess mortality. Short-term (first year follow-up) overall excess hazard ratio (eHR) for subjects with AIDS at entry was 3.71 (95% confidence interval [CI] 2.66, 5.19) and 1.37 (95% CI 0.87, 2.15) for hepatitis C virus (HCV)-coinfected; medium/long-term eHR for AIDS at entry was 0.90 (95% CI 0.58, 1.39) and 3.83 (95% CI 2.37, 6.19) for HCV coinfection. Liver excess mortality was associated with low CD4 counts and HCV coinfection. Patients aged ≥50 years and HCV-coinfected showed higher NADM excess mortality, and HCV-coinfected patients showed increased non-AIDS infections excess mortality. Overall, liver, NADM, non-AIDS infections, and cardiovascular excesses of mortality associated with being HIV-positive were found, and HCV coinfection and immunodeficiency played significant roles. Differential short and medium/long-term effects of AIDS at entry and HCV coinfection were found for overall excess mortality. PMID:27603368

  8. Stage-specific biomass overcompensation by juveniles in response to increased adult mortality in a wild fish population.

    PubMed

    Ohlberger, Jan; Langangen, Øystein; Edeline, Eric; Claessen, David; Winfield, Ian J; Stenseth, Nils Chr; Vøllestad, L Asbjørn

    2011-12-01

    Recently developed theoretical models of stage-structured consumer-resource systems have shown that stage-specific biomass overcompensation can arise in response to increased mortality rates. We parameterized a stage-structured population model to simulate the effects of increased adult mortality caused by a pathogen outbreak in the perch (Perca fluviatilis) population of Windermere (UK) in 1976. The model predicts biomass overcompensation by juveniles in response to increased adult mortality due to a shift in food-dependent growth and reproduction rates. Considering cannibalism between life stages in the model reinforces this compensatory response due to the release from predation on juveniles at high mortality rates. These model predictions are matched by our analysis of a 60-year time series of scientific monitoring of Windermere perch, which shows that the pathogen outbreak induced a strong decrease in adult biomass and a corresponding increase in juvenile biomass. Age-specific adult fecundity and size at age were higher after than before the disease outbreak, suggesting that the pathogen-induced mortality released adult perch from competition, thereby increasing somatic and reproductive growth. Higher juvenile survival after the pathogen outbreak due to a release from cannibalism likely contributed to the observed biomass overcompensation. Our findings have general implications for predicting population- and community-level responses to increased size-selective mortality caused by exploitation or disease outbreaks.

  9. 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…

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

    NASA Astrophysics Data System (ADS)

    Ibrahim, Rose Irnawaty; Siri, Zailan

    2014-07-01

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

  11. Cause-Specific Mortality in HIV-Positive Patients Who Survived Ten Years after Starting Antiretroviral Therapy

    PubMed Central

    May, Margaret T.; Vehreschild, Janne; Obel, Niels; Gill, Michael John; Crane, Heidi; Boesecke, Christoph; Samji, Hasina; Grabar, Sophie; Cazanave, Charles; Cavassini, Matthias; Shepherd, Leah; d’Arminio Monforte, Antonella; Smit, Colette; Saag, Michael; Lampe, Fiona; Hernando, Vicky; Montero, Marta; Zangerle, Robert; Justice, Amy C.; Sterling, Timothy; Miro, Jose; Ingle, Suzanne; Sterne, Jonathan A. C.

    2016-01-01

    Objectives To estimate mortality rates and prognostic factors in HIV-positive patients who started combination antiretroviral therapy between 1996–1999 and survived for more than ten years. Methods We used data from 18 European and North American HIV cohort studies contributing to the Antiretroviral Therapy Cohort Collaboration. We followed up patients from ten years after start of combination antiretroviral therapy. We estimated overall and cause-specific mortality rate ratios for age, sex, transmission through injection drug use, AIDS, CD4 count and HIV-1 RNA. Results During 50,593 person years 656/13,011 (5%) patients died. Older age, male sex, injecting drug use transmission, AIDS, and low CD4 count and detectable viral replication ten years after starting combination antiretroviral therapy were associated with higher subsequent mortality. CD4 count at ART start did not predict mortality in models adjusted for patient characteristics ten years after start of antiretroviral therapy. The most frequent causes of death (among 340 classified) were non-AIDS cancer, AIDS, cardiovascular, and liver-related disease. Older age was strongly associated with cardiovascular mortality, injecting drug use transmission with non-AIDS infection and liver-related mortality, and low CD4 and detectable viral replication ten years after starting antiretroviral therapy with AIDS mortality. Five-year mortality risk was <5% in 60% of all patients, and in 30% of those aged over 60 years. Conclusions Viral replication, lower CD4 count, prior AIDS, and transmission via injecting drug use continue to predict higher all-cause and AIDS-related mortality in patients treated with combination antiretroviral therapy for over a decade. Deaths from AIDS and non-AIDS infection are less frequent than deaths from other non-AIDS causes. PMID:27525413

  12. Sensitivity and specificity of administrative mortality data for identifying prescription opioid–related deaths

    PubMed Central

    Gladstone, Emilie; Smolina, Kate; Morgan, Steven G.; Fernandes, Kimberly A.; Martins, Diana; Gomes, Tara

    2016-01-01

    Background: Comprehensive systems for surveilling prescription opioid–related harms provide clear evidence that deaths from prescription opioids have increased dramatically in the United States. However, these harms are not systematically monitored in Canada. In light of a growing public health crisis, accessible, nationwide data sources to examine prescription opioid–related harms in Canada are needed. We sought to examine the performance of 5 algorithms to identify prescription opioid–related deaths from vital statistics data against data abstracted from the Office of the Chief Coroner of Ontario as a gold standard. Methods: We identified all prescription opioid–related deaths from Ontario coroners’ data that occurred between Jan. 31, 2003, and Dec. 31, 2010. We then used 5 different algorithms to identify prescription opioid–related deaths from vital statistics death data in 2010. We selected the algorithm with the highest sensitivity and a positive predictive value of more than 80% as the optimal algorithm for identifying prescription opioid–related deaths. Results: Four of the 5 algorithms had positive predictive values of more than 80%. The algorithm with the highest sensitivity (75%) in 2010 improved slightly in its predictive performance from 2003 to 2010. Interpretation: In the absence of specific systems for monitoring prescription opioid–related deaths in Canada, readily available national vital statistics data can be used to study prescription opioid–related mortality with considerable accuracy. Despite some limitations, these data may facilitate the implementation of national surveillance and monitoring strategies. PMID:26622006

  13. 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.

  14. Impact of surgical margin status on prostate-cancer-specific mortality

    PubMed Central

    Chalfin, Heather J.; Dinizo, Michael; Trock, Bruce J.; Feng, Zhaoyong; Partin, Alan W.; Walsh, Patrick C.; Humphreys, Elizabeth; Han, Misop

    2013-01-01

    OBJECTIVE To examine the relative impact of a positive surgical margin (PSM) and other clinicopathological variables on prostate-cancer-specific mortality (PCSM) in a large retrospective cohort of patients undergoing radical prostatectomy (RP). PATIENTS AND METHODS Between 1982 and 2011, 4569 men underwent RP performed by a single surgeon. Of the patient population, 4461 (97.6%) met all the inclusion criteria. The median (range) age was 58 (33–75) years and the median prostate-specific antigen (PSA) was 5.4 ng/mL; RP Gleason score was ≤6 in 2834 (63.7%), 7 in 1351 (30.3%), and 8–10 in 260 (6.0%) patients; PSMs were found in 462 (10.4%) patients. Cox proportional hazards models were used to determine the impact of a PSM on PCSM. RESULTS At a median (range) follow-up of 10 years (1–29), 187 men (4.3%) had died from prostate cancer. The 20-year prostate-cancer-specific survival rate was 75% for those with a PSM and 93% for those without. Compared with those with a negative surgical margin, men with a PSM were more likely to be older (median age 60 vs 58 years) and to have undergone RP in the pre-PSA era (36.6% vs 11.8%). Additionally, they were more likely to have a higher PSA level (median 7.6 vs 5.2 ng/mL), a Gleason score of ≥7 (58.7% vs 33.7%), and a non-organ-confined tumour (90.9% vs 30.6% [P < 0.001 for all]). In a univariate model for PCSM, PSM was highly significant (hazard ratio [HR] 5.0, 95% confidence interval [CI] 3.7–6.7, P < 0.001). In a multivariable model, adjusting for pathological variables and RP year, PSM remained an independent predictor of PCSM (HR 1.4, 95% CI 1.0–1.9, P = 0.036) with a modest effect relative to RP Gleason score (HR 5.7–12.6) and pathological stage (HR 2.2–11.0 [P < 0.001]). CONCLUSION Although a PSM has a statistically significant adverse effect on prostate-cancer-specific survival in multivariable analysis, Gleason grade and pathological stage were stronger predictors. PMID:22788795

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

    SciTech Connect

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

    1996-06-01

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

  16. All-Cause and Cause-Specific Mortality Associated with Bariatric Surgery: A Review

    PubMed Central

    Mehta, Tapan S.; Davidson, Lance E.; Hunt, Steven C.

    2016-01-01

    The question of whether or not nonsurgical intentional or voluntary weight loss results in reduced mortality has been equivocal, with long-term mortality following weight loss being reported as increased, decreased, and not changed. In part, inconsistent results have been attributed to the uncertainty of whether the intentionality of weight loss is accurately reported in large population studies and also that achieving significant and sustained voluntary weight loss in large intervention trials is extremely difficult. Bariatric surgery has generally been free of these conflicts. Patients voluntarily undergo surgery and the resulting weight is typically significant and sustained. These elements, combined with possible non-weight loss-related mechanisms, have resulted in improved comorbidities, which likely contribute to a reduction in longterm mortality. This paper reviews the association between bariatric surgery and long-term mortality. From these studies, the general consensus is that bariatric surgical patients have: 1) significantly reduced long-term all-cause mortality when compared to severely obese non-bariatric surgical control groups; 2) greater mortality when compared to the general population, with the exception of one study; 3) reduced cardiovascular-, stroke-, and cancer-caused mortality when compared to severely obese non-operated controls; and 4) increased risk for externally caused death such as suicide. PMID:26496931

  17. [Mortality and risk factors for non-communicable diseases in Russia: Specific features, trends, and prognosis].

    PubMed

    Boytsov, S A; Deev, A D; Shalnova, S A

    2017-01-01

    In the Russian Federation, the increase in all-cause and cardiovascular disease mortality began in the 1960s and lasted almost continuously until 2003. In our country, the characteristics of mortality are its substantially higher rates among men and a large regional variability, which is associated with economic, climatic, and geographic factors. Urbanization coupled with dietary changes and the higher prevalence of hypertension is the most likely initial impetus to the rise in mortality rates. The subsequent increase in mortality can be explained by the higher prevalence of behavioral and biological risk factors, alcoholism, and, since the 1990s, by heavy and protracted socioeconomic upheavals and lifestyle changes. The mortality decline since 2006 has been linked to the strengthening of the health system and to the reduction in the prevalence of smoking among men and hypertension in women. The slowing down of the pace of mortality decline may be due to the increase in the prevalence of hypertension and obesity among men. The modelling data show that by 2025, reductions in smoking prevalence rates by 23% among men and by 12% among women and increases in the efficiency of hypertension treatment by 17.2% in men and by 11.2% in women will reduce cardiovascular mortality rates by 15%.

  18. Trends in prostate cancer incidence and mortality in Canada during the era of prostate-specific antigen screening

    PubMed Central

    Dickinson, James; Shane, Amanda; Tonelli, Marcello; Gorber, Sarah Connor; Joffres, Michel; Singh, Harminder; Bell, Neil

    2016-01-01

    Background: Widespread use of prostate-specific antigen (PSA) to screen for prostate cancer began in the early 1990s. Advocates for screening assert that this has caused a decrease in prostate cancer mortality. We sought to describe secular changes in prostate cancer incidence and mortality in Canada in relation to the onset of PSA screening. Methods: Age-standardized and age-specific prostate cancer incidence (1969-2007) and mortality (1969-2009) from Public Health Agency of Canada databases were analyzed by joinpoint regression. Changes in incidence and mortality were related to introduction of PSA screening. Results: Prior to PSA screening, prostate cancer incidence increased from 54.2 to 99.8 per 100 000 between 1969 and 1990. Thereafter, incidence increased sharply (12.8% per year) to peak at 140.8/100 000 in 1993. After decreasing in all age groups between 1993 and 1996, incidence continued to increase for men aged less than 70 years, but decreased for older men. Age-standardized mortality was stable from 1969 to 1977, increased 1.4% per year to peak in 1995 and subsequently decreased at 3.3% per year; the decline started from 1987 in younger men (age < 60 yr). Interpretation: Incidence was increasing before PSA screening occurred, but rose further after it was introduced. Reductions in prostate cancer mortality began before PSA screening was widely used and were larger than could be anticipated from screening alone. These findings suggest that screening caused artifactual increase in incidence, but no more than a part of reductions in prostate cancer mortality. The reduction may be due to changing treatment or certification of death. PMID:27280117

  19. Cause‐specific long‐term mortality in survivors of childhood cancer in Switzerland: A population‐based study

    PubMed Central

    Schindler, Matthias; Spycher, Ben D.; Ammann, Roland A.; Ansari, Marc; Michel, Gisela

    2016-01-01

    Survivors of childhood cancer have a higher mortality than the general population. We describe cause‐specific long‐term mortality in a population‐based cohort of childhood cancer survivors. We included all children diagnosed with cancer in Switzerland (1976–2007) at age 0–14 years, who survived ≥5 years after diagnosis and followed survivors until December 31, 2012. We obtained causes of death (COD) from the Swiss mortality statistics and used data from the Swiss general population to calculate age‐, calendar year‐, and sex‐standardized mortality ratios (SMR), and absolute excess risks (AER) for different COD, by Poisson regression. We included 3,965 survivors and 49,704 person years at risk. Of these, 246 (6.2%) died, which was 11 times higher than expected (SMR 11.0). Mortality was particularly high for diseases of the respiratory (SMR 14.8) and circulatory system (SMR 12.7), and for second cancers (SMR 11.6). The pattern of cause‐specific mortality differed by primary cancer diagnosis, and changed with time since diagnosis. In the first 10 years after 5‐year survival, 78.9% of excess deaths were caused by recurrence of the original cancer (AER 46.1). Twenty‐five years after diagnosis, only 36.5% (AER 9.1) were caused by recurrence, 21.3% by second cancers (AER 5.3) and 33.3% by circulatory diseases (AER 8.3). Our study confirms an elevated mortality in survivors of childhood cancer for at least 30 years after diagnosis with an increased proportion of deaths caused by late toxicities of the treatment. The results underline the importance of clinical follow‐up continuing years after the end of treatment for childhood cancer. PMID:26950898

  20. 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

  1. High juvenile mortality is associated with sex-specific adult survival and lifespan in wild roe deer.

    PubMed

    Garratt, Michael; Lemaître, Jean-François; Douhard, Mathieu; Bonenfant, Christophe; Capron, Gilles; Warnant, Claude; Klein, François; Brooks, Robert C; Gaillard, Jean-Michel

    2015-03-16

    Male mammals typically have shorter lifespans than females [1]. Sex differences in survival may result, in part, from sex-specific optima in investment in reproduction, with higher male mortality rates from sexual competition selecting for a "live-fast die-young" strategy in this sex [2]. In the wild, lifespan is also influenced by environmental conditions experienced early in life. Poor conditions elevate juvenile mortality, which may selectively remove individuals with a particular phenotype or genotype from a cohort [3], and can alter the subsequent phenotypic condition and fate of those that survive to adulthood [4]. Males and females can respond differently to the same early-life environmental experiences [5, 6], but whether such environmental pressures generate sex differences in lifespan has rarely been considered. We show that sex differences in adult survival and lifespan in cohorts of roe deer (Capreolus capreolus) range from virtually absent in some years to females living 30% longer than males in others. The extent of this sex difference in adult longevity is strongly linked to the level of mortality each cohort experiences as juveniles, with high juvenile mortality generating a strong sex difference in both adult survival and lifespan. In females, high juvenile mortality leads to increased adult survival for those remaining individuals, whereas in males survival is actually reduced. Early environmental conditions and the selective pressures they impose may help to explain variability in sex-specific aging across animal taxa.

  2. 26 CFR 1.430(h)(3)-2 - Plan-specific substitute mortality tables used to determine present value.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... to determine present value. 1.430(h)(3)-2 Section 1.430(h)(3)-2 Internal Revenue INTERNAL REVENUE... § 1.430(h)(3)-2 Plan-specific substitute mortality tables used to determine present value. (a) In...)(C) in determining any present value or making any computation under section 430 in accordance...

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

    ERIC Educational Resources Information Center

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

    2007-01-01

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

  4. PREDICTING FIFTEEN-YEAR CANCER-SPECIFIC MORTALITY BASED ON THE PATHOLOGICAL FEATURES OF PROSTATE CANCER

    PubMed Central

    Eggener, Scott E.; Scardino, Peter T.; Walsh, Patrick C.; Han, Misop; Partin, Alan W.; Trock, Bruce J.; Feng, Zhaoyong; Wood, David P.; Eastham, James A.; Yossepowitch, Ofer; Rabah, Danny M.; Kattan, Michael W.; Yu, Changhong; Klein, Eric A.; Stephenson, Andrew J.

    2014-01-01

    Purpose Long-term prostate cancer-specific mortality (PCSM) after radical prostatectomy is poorly defined in the era of widespread screening. An understanding of the treated natural history of screen-detected cancers and the pathological risk factors for PCSM are needed for treatment decision-making. Methods Using Fine and Gray competing risk regression analysis, the clinical and pathological data and follow-up information of 11,521 patients treated by radical prostatectomy at four academic centers from 1987 to 2005 were modeled to predict PCSM. The model was validated on 12,389 patients treated at a separate institution during the same period. Results The overall 15-year PCSM was 7%. Primary and secondary pathological Gleason grade 4–5 (P < 0.001 for both), seminal vesicle invasion (P < 0.001), and year of surgery (P = 0.002) were significant predictors of PCSM. A nomogram predicting 15-year PCSM based on standard pathological parameters was accurate and discriminating with an externally-validated concordance index of 0.92. Stratified by patient age, 15-year PCSM for Gleason score ≤ 6, 3+4, 4+3, and 8–10 ranged from 0.2–1.2%, 4.2–6.5%, 6.6–11%, and 26–37%, respectively. The 15-year PCSM risks ranged from 0.8–1.5%, 2.9–10%, 15–27%, and 22–30% for organ-confined cancer, extraprostatic extension, seminal vesicle invasion, and lymph node metastasis, respectively. Only 3 of 9557 patients with organ-confined, Gleason score ≤ 6 cancers have died from prostate cancer. Conclusions The presence of poorly differentiated cancer and seminal vesicle invasion are the prime determinants of PCSM after radical prostatectomy. The risk of PCSM can be predicted with unprecedented accuracy once the pathological features of prostate cancer are known. PMID:21239008

  5. Cause-Specific Mortality Due to Malignant and Non-Malignant Disease in Korean Foundry Workers

    PubMed Central

    Yoon, Jin-Ha; Ahn, Yeon-Soon

    2014-01-01

    Background Foundry work is associated with serious occupational hazards. Although several studies have investigated the health risks associated with foundry work, the results of these studies have been inconsistent with the exception of an increased lung cancer risk. The current study evaluated the mortality of Korean foundry workers due to malignant and non-malignant diseases. Methods This study is part of an ongoing investigation of Korean foundry workers. To date, we have observed more than 150,000 person-years in male foundry production workers. In the current study, we stratified mortality ratios by the following job categories: melting-pouring, molding-coremaking, fettling, and uncategorized production work. We calculated standard mortality ratios (SMR) of foundry workers compare to general Korean men and relative risk (RR) of mortality of foundry production workers reference to non-production worker, respectively. Results Korean foundry production workers had a significantly higher risk of mortality due to malignant disease, including stomach (RR: 3.96; 95% CI: 1.41–11.06) and lung cancer (RR: 2.08; 95% CI: 1.01–4.30), compared with non-production workers. High mortality ratios were also observed for non-malignant diseases, including diseases of the circulatory (RR: 1.92; 95% CI: 1.18–3.14), respiratory (RR: 1.71; 95% CI: 1.52–21.42 for uncategorized production worker), and digestive (RR: 2.27; 95% CI: 1.22–4.24) systems, as well as for injuries (RR: 2.36; 95% CI: 1.52–3.66) including suicide (RR: 3.64; 95% CI: 1.32–10.01). Conclusion This study suggests that foundry production work significantly increases the risk of mortality due to some kinds of malignant and non-malignant diseases compared with non-production work. PMID:24505454

  6. [Mortality among able-bodied population in industrial cities in accordance with specific enterprise forming a company city].

    PubMed

    Tikhonova, G I; Gorchakova, T Iu; Churanova, A N

    2013-01-01

    The article covers comparative analysis of mortality causes and levels among male able-bodied population in small and medium industrial cities of Murmansk region in accordance with specific enterprise forming a company city. Findings are that, if compared to Murmansk having no enterprise forming a company, other industrial cities in the region, situated in the same climate area, demonstrated higher levels of mortality among the male able-bodied population with the death causes associated etiologically to occupational hazards on the enterprises forming a company city.

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

    PubMed

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

    2015-01-01

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

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed Central

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

    2016-01-01

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

  10. Apparent temperature and cause-specific mortality in Copenhagen, Denmark: a case-crossover analysis.

    PubMed

    Wichmann, Janine; Andersen, Zorana Jovanovic; Ketzel, Matthias; Ellermann, Thomas; Loft, Steffen

    2011-09-01

    Temperature, a key climate change indicator, is expected to increase substantially in the Northern Hemisphere, with potentially grave implications for human health. This study is the first to investigate the association between the daily 3-hour maximum apparent temperature (Tapp(max)), and respiratory, cardiovascular and cerebrovascular mortality in Copenhagen (1999-2006) using a case-crossover design. Susceptibility was investigated for age, sex, socio-economic status and place of death. For an inter-quartile range (7 °C) increase in Tapp(max), an inverse association was found with cardiovascular mortality (-7% 95% CI -13%; -1%) and none with respiratory and cerebrovascular mortality. In the cold period all associations were inverse, although insignificant.

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

    PubMed

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

    2007-09-12

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

  12. City-Specific Spatiotemporal Infant and Neonatal Mortality Clusters: Links with Socioeconomic and Air Pollution Spatial Patterns in France

    PubMed Central

    Padilla, Cindy M.; Kihal-Talantikit, Wahida; Vieira, Verónica M.; Deguen, Séverine

    2016-01-01

    Infant and neonatal mortality indicators are known to vary geographically, possibly as a result of socioeconomic and environmental inequalities. To better understand how these factors contribute to spatial and temporal patterns, we conducted a French ecological study comparing two time periods between 2002 and 2009 for three (purposefully distinct) Metropolitan Areas (MAs) and the city of Paris, using the French census block of parental residence as the geographic unit of analysis. We identified areas of excess risk and assessed the role of neighborhood deprivation and average nitrogen dioxide concentrations using generalized additive models to generate maps smoothed on longitude and latitude. Comparison of the two time periods indicated that statistically significant areas of elevated infant and neonatal mortality shifted northwards for the city of Paris, are present only in the earlier time period for Lille MA, only in the later time period for Lyon MA, and decrease over time for Marseille MA. These city-specific geographic patterns in neonatal and infant mortality are largely explained by socioeconomic and environmental inequalities. Spatial analysis can be a useful tool for understanding how risk factors contribute to disparities in health outcomes ranging from infant mortality to infectious disease—a leading cause of infant mortality. PMID:27338439

  13. Physical activity and cancer-specific mortality in the NIH-AARP Diet and Health Study cohort.

    PubMed

    Arem, Hannah; Moore, Steve C; Park, Yikyung; Ballard-Barbash, Rachel; Hollenbeck, Albert; Leitzmann, Michael; Matthews, Charles E

    2014-07-15

    Higher physical activity levels have been associated with a lower risk of developing various cancers and all-cancer mortality, but the impact of pre-diagnosis physical activity on cancer-specific death has not been fully characterized. In the prospective National Institutes of Health-AARP Diet and Health Study with 293,511 men and women, we studied prediagnosis moderate to vigorous intensity leisure time physical activity (MVPA) in the past 10 years and cancer-specific mortality. Over a median 12.1 years, we observed 15,001 cancer deaths. Using Cox proportional hazards regression, we estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for MVPA with cancer mortality overall and by 20 specific cancer sites, adjusting for relevant risk factors. Compared to participants reporting never/rare MVPA, those reporting >7 hr/week MVPA had a lower risk of total cancer mortality (HR = 0.89, 95% CI 0.84-0.94; p-trend <0.001). When analyzed by cancer site-specific deaths, comparing those reporting >7 hr/week of MVPA to those reporting never/rare MVPA, we observed a lower risk of death from colon (HR = 0.70; 95% CI 0.57-0.85; p-trend <0.001), liver (0.71; 0.52-0.98; p-trend = 0.012) and lung cancer (0.84; 0.77-0.92; p-trend <0.001) and a significant p-trend for non-Hodgkins lymphoma (0.80; 0.62-1.04; p-trend = 0.017). An unexpected increased mortality p-trend with increasing MVPA was observed for death from kidney cancer (1.42; 0.98-2.03; p-trend = 0.016). Our findings suggest that higher prediagnosis leisure time physical activity is associated with lower risk of overall cancer mortality and mortality from multiple cancer sites. Future studies should confirm observed associations and further explore timing of physical activity and underlying biological mechanisms.

  14. The heterologous (non-specific) effects of vaccines: implications for policy in high-mortality countries.

    PubMed

    Shann, Frank

    2015-01-01

    There are important interactions between vaccines, and between vaccines and unrelated (heterologous) infections. In high-mortality regions, until the next vaccine is given, live vaccines such as bacillus Calmette-Guérin (BCG) and measles vaccines reduce mortality from infections such as pneumonia and sepsis. However, non-live vaccines such as diphtheria, tetanus and whole-cell pertussis vaccine (DTP) may increase mortality from infections other than diphtheria, tetanus and pertussis. All-cause mortality might be reduced if an extra dose of Edmonston-Zagreb measles vaccine were given at 20 weeks of age, 4-6 weeks after the third dose of DTP, with no subsequent doses of DTP in girls, and no vitamin A in girls or boys before the second dose of measles vaccine at 9 months of age. Policy should change to increase the proportion of babies given BCG and oral polio vaccine at birth, and should recognize the important differences between BCG, DTP and measles vaccines produced by different manufacturers.

  15. Sleep disturbances and cause-specific mortality: Results from the GAZEL cohort study.

    PubMed

    Rod, Naja Hulvej; Vahtera, Jussi; Westerlund, Hugo; Kivimaki, Mika; Zins, Marie; Goldberg, Marcel; Lange, Theis

    2011-02-01

    Poor sleep is an increasing problem in modern society, but most previous studies on the association between sleep and mortality rates have addressed only duration, not quality, of sleep. The authors prospectively examined the effects of sleep disturbances on mortality rates and on important risk factors for mortality, such as body mass index, hypertension, and diabetes. A total of 16,989 participants in the GAZEL cohort study were asked validated questions on sleep disturbances in 1990 and were followed up until 2009, with <1% loss to follow-up. Body mass index, hypertension, and diabetes were measured annually through self-reporting. During follow-up, a total of 1,045 men and women died. Sleep disturbances were associated with a higher overall mortality risk in men (P = 0.005) but not in women (P = 0.33). This effect was most pronounced for men <45 years of age (≥3 symptoms vs. none: hazard ratio = 2.03, 95% confidence interval: 1.24, 3.33). There were no clear associations between sleep disturbances and cardiovascular mortality rates, although men and women with sleep disturbances were more likely to develop hypertension and diabetes (P < 0.001). Compared with people with no sleep disturbances, men who reported ≥3 types of sleep disturbance had an almost 5 times' higher risk of committing suicide (hazard ratio = 4.99, 95% confidence interval: 1.59, 15.7). Future strategies to prevent premature deaths may benefit from assessment of sleep disturbances, especially in younger individuals.

  16. Spatiotemporal analysis for the effect of ambient particulate matter on cause-specific respiratory mortality in Beijing, China.

    PubMed

    Wang, Xuying; Guo, Yuming; Li, Guoxing; Zhang, Yajuan; Westerdahl, Dane; Jin, Xiaobin; Pan, Xiaochuan; Chen, Liangfu

    2016-06-01

    This study explored the association between particulate matter with an aerodynamic diameter of less than 10 μm (PM10) and the cause-specific respiratory mortality. We used the ordinary kriging method to estimate the spatial characteristics of ambient PM10 at 1-km × 1-km resolution across Beijing during 2008-2009 and subsequently fit the exposure-response relationship between the estimated PM10 and the mortality due to total respiratory disease, chronic lower respiratory disease, chronic obstructive pulmonary disease (COPD), and pneumonia at the street or township area levels using the generalized additive mixed model (GAMM). We also examined the effects of age, gender, and season in the stratified analysis. The effects of ambient PM10 on the cause-specific respiratory mortality were the strongest at lag0-5 except for pneumonia, and an inter-quantile range increase in PM10 was associated with an 8.04 % (95 % CI 4.00, 12.63) increase in mortality for total respiratory disease, a 6.63 % (95 % CI 1.65, 11.86) increase for chronic lower respiratory disease, and a 5.68 % (95 % CI 0.54, 11.09) increase for COPD, respectively. Higher risks due to the PM10 exposure were observed for females and elderly individuals. Seasonal stratification analysis showed that the effects of PM10 on mortality due to pneumonia were stronger during spring and autumn. While for COPD, the effect of PM10 in winter was statistically significant (15.54 %, 95 % CI 5.64, 26.35) and the greatest among the seasons. The GAMM model evaluated stronger associations between concentration of PM10. There were significant associations between PM10 and mortality due to respiratory disease at the street or township area levels. The GAMM model using high-resolution PM10 could better capture the association between PM10 and respiratory mortality. Gender, age, and season also acted as effect modifiers for the relationship between PM10 and respiratory mortality.

  17. Walking and running produce similar reductions in cause-specific disease mortality in hypertensives.

    PubMed

    Williams, Paul T

    2013-09-01

    To test prospectively in hypertensives whether moderate and vigorous exercise produces equivalent reductions in mortality, Cox-proportional hazard analyses were applied to energy expenditure (metabolic equivalents hours/d [METh/d]) in 6973 walkers and 3907 runners who used hypertensive medications at baseline. A total of 1121 died during 10.2-year follow-up: 695 cardiovascular disease (International Classification of Diseases, Tenth Revision [ICD10] I00-99; 465 underlying cause and 230 contributing cause), 124 cerebrovascular disease, 353 ischemic heart disease (ICD10 I20-25; 257 underlying and 96 contributing), 122 heart failure (ICD10 I50; 24 underlying and 98 contributing), and 260 dysrhythmias (ICD10 I46-49; 24 underlying and 236 contributing). Relative to <1.07 METh/d, running or walking 1.8 to 3.6 METh/d produced significantly lower all-cause (29% reduction; 95% confidence interval [CI], 17%-39%; P=0.0001), cardiovascular disease (34% reduction; 95% CI, 20%-46%; P=0.0001), cerebrovascular disease (55% reduction; 95% CI, 27%-73%; P=0.001), dysrhythmia (47% reduction; 95% CI, 27%-62%; P=0.0001), and heart failure mortality (51% reduction; 95% CI, 21%-70%; P=0.003), as did ≥ 3.6 METh/d with all-cause (22% reduction; 95% CI, 6%-35%; P=0.005), cardiovascular disease (36% reduction; 95% CI, 19%-50%; P=0.0002), cerebrovascular disease (47% reduction; 95% CI, 6%-71%; P=0.03), and dysrhythmia mortality (43% reduction; 95% CI, 16%-62%; P=0.004). Diabetes mellitus and chronic kidney disease mortality also decreased significantly with METh/d. All results remained significant when body mass index adjusted. Merely meeting guideline levels (1.07-1.8 METh/d) did not significantly reduced mortality. The dose-response was significantly nonlinear for all end points except diabetes mellitus, and cerebrovascular and chronic kidney disease. Results did not differ between running and walking. Thus, walking and running produce similar reductions in mortality in hypertensives.

  18. The relationship between incarceration and premature adult mortality: gender specific evidence.

    PubMed

    Massoglia, Michael; Pare, Paul-Philippe; Schnittker, Jason; Gagnon, Alain

    2014-07-01

    We examine the relationship between incarceration and premature mortality for men and women. Analyses using the National Longitudinal Survey of Youth (NLSY79) reveal strong gender differences. Using two different analytic procedures the results show that women with a history of incarceration are more likely to die than women without such a history, even after controlling for health status and criminal behavior prior to incarceration, the availability of health insurance, and other socio-demographic factors. In contrast, there is no relationship between incarceration and mortality for men after accounting for these factors. The results point to the importance of examining gender differences in the collateral consequences of incarceration. The results also contribute to a rapidly emerging literature linking incarceration to various health hazards. Although men constitute the bulk of inmates, future research should not neglect the special circumstances of female former inmates and their rapidly growing numbers.

  19. Knock down of Whitefly Gut Gene Expression and Mortality by Orally Delivered Gut Gene-Specific dsRNAs.

    PubMed

    Vyas, Meenal; Raza, Amir; Ali, Muhammad Yousaf; Ashraf, Muhammad Aleem; Mansoor, Shahid; Shahid, Ahmad Ali; Brown, Judith K

    2017-01-01

    Control of the whitefly Bemisia tabaci (Genn.) agricultural pest and plant virus vector relies on the use of chemical insecticides. RNA-interference (RNAi) is a homology-dependent innate immune response in eukaryotes, including insects, which results in degradation of the corresponding transcript following its recognition by a double-stranded RNA (dsRNA) that shares 100% sequence homology. In this study, six whitefly 'gut' genes were selected from an in silico-annotated transcriptome library constructed from the whitefly alimentary canal or 'gut' of the B biotype of B. tabaci, and tested for knock down efficacy, post-ingestion of dsRNAs that share 100% sequence homology to each respective gene target. Candidate genes were: Acetylcholine receptor subunit α, Alpha glucosidase 1, Aquaporin 1, Heat shock protein 70, Trehalase1, and Trehalose transporter1. The efficacy of RNAi knock down was further tested in a gene-specific functional bioassay, and mortality was recorded in 24 hr intervals, six days, post-treatment. Based on qPCR analysis, all six genes tested showed significantly reduced gene expression. Moderate-to-high whitefly mortality was associated with the down-regulation of osmoregulation, sugar metabolism and sugar transport-associated genes, demonstrating that whitefly survivability was linked with RNAi results. Silenced Acetylcholine receptor subunit α and Heat shock protein 70 genes showed an initial low whitefly mortality, however, following insecticide or high temperature treatments, respectively, significantly increased knockdown efficacy and death was observed, indicating enhanced post-knockdown sensitivity perhaps related to systemic silencing. The oral delivery of gut-specific dsRNAs, when combined with qPCR analysis of gene expression and a corresponding gene-specific bioassay that relates knockdown and mortality, offers a viable approach for functional genomics analysis and the discovery of prospective dsRNA biopesticide targets. The approach can

  20. Paleolithic and Mediterranean Diet Pattern Scores Are Inversely Associated with All-Cause and Cause-Specific Mortality in Adults.

    PubMed

    Whalen, Kristine A; Judd, Suzanne; McCullough, Marjorie L; Flanders, W Dana; Hartman, Terryl J; Bostick, Roberd M

    2017-04-01

    Background: Poor diet quality is associated with a higher risk of many chronic diseases that are among the leading causes of death in the United States. It has been hypothesized that evolutionary discordance may account for some of the higher incidence and mortality from these diseases.Objective: We investigated associations of 2 diet pattern scores, the Paleolithic and the Mediterranean, with all-cause and cause-specific mortality in the REGARDS (REasons for Geographic and Racial Differences in Stroke) study, a longitudinal cohort of black and white men and women ≥45 y of age.Methods: Participants completed questionnaires, including a Block food-frequency questionnaire (FFQ), at baseline and were contacted every 6 mo to determine their health status. Of the analytic cohort (n = 21,423), a total of 2513 participants died during a median follow-up of 6.25 y. We created diet scores from FFQ responses and assessed their associations with mortality using multivariable Cox proportional hazards regression models adjusting for major risk factors.Results: For those in the highest relative to the lowest quintiles of the Paleolithic and Mediterranean diet scores, the multivariable adjusted HRs for all-cause mortality were, respectively, 0.77 (95% CI: 0.67, 0.89; P-trend < 0.01) and 0.63 (95% CI: 0.54, 0.73; P-trend < 0.01). The corresponding HRs for all-cancer mortality were 0.72 (95% CI: 0.55, 0.95; P-trend = 0.03) and 0.64 (95% CI: 0.48, 0.84; P-trend = 0.01), and for all-cardiovascular disease mortality they were 0.78 (95% CI: 0.61, 1.00; P-trend = 0.06) and HR: 0.68 (95% CI: 0.53, 0.88; P-trend = 0.01).Conclusions: Findings from this biracial prospective study suggest that diets closer to Paleolithic or Mediterranean diet patterns may be inversely associated with all-cause and cause-specific mortality.

  1. The Interval to Biochemical Failure Is Prognostic for Metastasis, Prostate Cancer-Specific Mortality, and Overall Mortality After Salvage Radiation Therapy for Prostate Cancer

    SciTech Connect

    Johnson, Skyler; Jackson, William; Li, Darren; Song, Yeohan; Foster, Corey; Foster, Ben; Zhou, Jessica; Vainshtein, Jeffrey; Feng, Felix; Hamstra, Daniel

    2013-07-01

    Purpose: To investigate the utility of the interval to biochemical failure (IBF) after salvage radiation therapy (SRT) after radical prostatectomy (RP) for prostate cancer as a surrogate endpoint for distant metastasis (DM), prostate cancer-specific mortality (PCSM), and overall mortality (OM). Methods and Materials: A retrospective analysis of 575 patients treated with SRT after RP from a single institution. Of those, 250 patients experienced biochemical failure (BF), with the IBF defined as the time from commencement of SRT to BF. The IBF was evaluated by Kaplan-Meier and Cox proportional hazards models for its association with DM, PCSM, and OM. Results: The median follow-up time was 85 (interquartile range [IQR] 49.8-121.1) months, with a median IBF of 16.8 (IQR, 8.5-37.1) months. With a cutoff time of 18 months, as previously used, 129 (52%) of patients had IBF ≤18 months. There were no differences among any clinical or pathologic features between those with IBF ≤ and those with IBF >18 months. On log–rank analysis, IBF ≤18 months was prognostic for increased DM (P<.0001, HR 4.9, 95% CI 3.2-7.4), PCSM (P<.0001, HR 4.1, 95% CI 2.4-7.1), and OM (P<.0001, HR 2.7, 95% CI 1.7-4.1). Cox proportional hazards models with adjustment for other clinical variables demonstrated that IBF was independently prognostic for DM (P<.001, HR 4.9), PCSM (P<.0001, HR 4.0), and OM (P<.0001, HR 2.7). IBF showed minimal change in performance regardless of androgen deprivation therapy (ADT) use. Conclusion: After SRT, a short IBF can be used for early identification of patients who are most likely to experience progression to DM, PCSM, and OM. IBF ≤18 months may be useful in clinical practice or as an endpoint for clinical trials.

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

    PubMed Central

    2016-01-01

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

  3. All-Cause and Cause-Specific Mortality Among Men Released From State Prison, 1980–2005

    PubMed Central

    Rosen, David L.; Wohl, David A.

    2008-01-01

    Objectives. We compared mortality of ex-prisoners and other state residents to identify unmet health care needs among former prisoners. Methods. We linked North Carolina prison records with state death records for 1980 to 2005 to estimate the number of overall and cause-specific deaths among male ex-prisoners aged 20 to 69 years and used standardized mortality ratios (SMRs) to compare these observed deaths with the number of expected deaths had they experienced the same age-, race-, and cause-specific death rates as other state residents. Results. All-cause mortality among White (SMR = 2.08; 95% confidence interval [CI] = 2.04, 2.13) and Black (SMR = 1.03; 95% CI = 1.01, 1.05) ex-prisoners was greater than for other male NC residents. Ex-prisoners' deaths from homicide, accidents, substance use, HIV, liver disease, and liver cancer were greater than the expected number of deaths estimated using death rates among other NC residents. Deaths from cardiovascular disease, lung cancer, respiratory diseases, and diabetes were at least 30% greater than expected for White ex-prisoners, but less than expected for Black ex-prisoners. Conclusions. Ex-prisoners experienced more deaths than would have been expected among other NC residents. Excess deaths from injuries and medical conditions common to prison populations highlight ex-prisoners' medical vulnerability and the need to improve correctional and community preventive health services. PMID:18923131

  4. Cause-specific mortality by race in low-income Black and White people with Type 2 diabetes

    PubMed Central

    Conway, B N; May, M E; Fischl, A; Frisbee, J; Han, X; Blot, W J

    2015-01-01

    Aim To investigate, with extended follow-up, cause-specific mortality among low-income Black and White Americans with Type 2 diabetes who have similar socio-economic status. Methods Black and White Americans aged 40–79 years with Type 2 diabetes (n = 12 498) were recruited from community health centres as part of the Southern Community Cohort Study. Multivariable Cox analysis was used to estimate mortality hazard ratios and 95% CIs for subsequent cause-specific mortality, based on both underlying and contributing causes of death. Results During the follow-up (median 5.9 years), 13.3% of the study population died. The leading causes of death in each race were ischaemic heart disease, respiratory disorders, cancer, renal failure and heart failure; however, Blacks were at a lower risk of dying from ischaemic heart disease (hazard ratio 0.70, 95% CI 0.54–0.91) or respiratory disorders (hazard ratio 0.70, 0.53–0.92) than Whites but had higher or similar mortality attributable to renal failure (hazard ratio 1.57, 95% CI 1.02–2.40), heart failure (hazard ratio 1.47, 95% CI 0.98–2.19) and cancer (hazard ratio 0.87, 95% CI 0.62–1.22). Risk factors for each cause of death were generally similar in each race. Conclusions These findings suggest that the leading causes of death and their risk factors are largely similar among Black and White Americans with diabetes. For the two leading causes of death in each race, however, ischaemic heart disease and respiratory disorders, the magnitude of risk is lower among Black Americans and contributes to their higher survival rates. PMID:25112863

  5. Aetiology-Specific Estimates of the Global and Regional Incidence and Mortality of Diarrhoeal Diseases Commonly Transmitted through Food

    PubMed Central

    Pires, Sara M.; Fischer-Walker, Christa L.; Lanata, Claudio F.; Devleesschauwer, Brecht; Hall, Aron J.; Kirk, Martyn D.; Duarte, Ana S. R.; Black, Robert E.; Angulo, Frederick J.

    2015-01-01

    Background Diarrhoeal diseases are major contributors to the global burden of disease, particularly in children. However, comprehensive estimates of the incidence and mortality due to specific aetiologies of diarrhoeal diseases are not available. The objective of this study is to provide estimates of the global and regional incidence and mortality of diarrhoeal diseases caused by nine pathogens that are commonly transmitted through foods. Methods and Findings We abstracted data from systematic reviews and, depending on the overall mortality rates of the country, applied either a national incidence estimate approach or a modified Child Health Epidemiology Reference Group (CHERG) approach to estimate the aetiology-specific incidence and mortality of diarrhoeal diseases, by age and region. The nine diarrhoeal diseases assessed caused an estimated 1.8 billion (95% uncertainty interval [UI] 1.1–3.3 billion) cases and 599,000 (95% UI 472,000–802,000) deaths worldwide in 2010. The largest number of cases were caused by norovirus (677 million; 95% UI 468–1,153 million), enterotoxigenic Escherichia coli (ETEC) (233 million; 95% UI 154–380 million), Shigella spp. (188 million; 95% UI 94–379 million) and Giardia lamblia (179 million; 95% UI 125–263); the largest number of deaths were caused by norovirus (213,515; 95% UI 171,783–266,561), enteropathogenic E. coli (121,455; 95% UI 103,657–143,348), ETEC (73,041; 95% UI 55,474–96,984) and Shigella (64,993; 95% UI 48,966–92,357). There were marked regional differences in incidence and mortality for these nine diseases. Nearly 40% of cases and 43% of deaths caused by these nine diarrhoeal diseases occurred in children under five years of age. Conclusions Diarrhoeal diseases caused by these nine pathogens are responsible for a large disease burden, particularly in children. These aetiology-specific burden estimates can inform efforts to reduce diarrhoeal diseases caused by these nine pathogens commonly

  6. Geo-Specific disease and the Stroke Belt: Do soils play a role in stroke mortality?

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The concept of geo-specific disease is commonly associated with socio-economic factors, such as income and education that can affect the incidence of preventable diseases. However, geo-specific diseases may also be influenced by environmental factors, such as soil and water quality. Local soil and w...

  7. Air pollution and mortality: effect modification by personal characteristics and specific cause of death in a case-only study.

    PubMed

    Qiu, Hong; Tian, Linwei; Ho, Kin-Fai; Pun, Vivian C; Wang, Xiaorong; Yu, Ignatius T S

    2015-04-01

    Short-term effects of air pollution on mortality have been well documented in the literature worldwide. Less is known about which subpopulations are more vulnerable to air pollution. We conducted a case-only study in Hong Kong to examine the potential effect modification by personal characteristics and specific causes of death. Individual information of 402,184 deaths of non-external causes and daily mean concentrations of air pollution were collected from 2001 to 2011. For a 10 μg/m(3) increase of pollution concentration, people aged ≥ ∇65 years (compared with younger ages) had a 0.9-1.8% additional increase in mortality related to PM, NO2, and SO2. People dying from cardiorespiratory diseases (compared with other non-external causes) had a 1.6-2.3% additional increase in PM and NO2 related mortality. Other subgroups that were particularly susceptible were females and those economically inactive. Lower socioeconomic status and causes of cardiorespiratory diseases would increase the likelihood of death associated with air pollution.

  8. Knock down of Whitefly Gut Gene Expression and Mortality by Orally Delivered Gut Gene-Specific dsRNAs

    PubMed Central

    Ali, Muhammad Yousaf; Ashraf, Muhammad Aleem; Mansoor, Shahid; Shahid, Ahmad Ali; Brown, Judith K.

    2017-01-01

    Control of the whitefly Bemisia tabaci (Genn.) agricultural pest and plant virus vector relies on the use of chemical insecticides. RNA-interference (RNAi) is a homology-dependent innate immune response in eukaryotes, including insects, which results in degradation of the corresponding transcript following its recognition by a double-stranded RNA (dsRNA) that shares 100% sequence homology. In this study, six whitefly ‘gut’ genes were selected from an in silico-annotated transcriptome library constructed from the whitefly alimentary canal or ‘gut’ of the B biotype of B. tabaci, and tested for knock down efficacy, post-ingestion of dsRNAs that share 100% sequence homology to each respective gene target. Candidate genes were: Acetylcholine receptor subunit α, Alpha glucosidase 1, Aquaporin 1, Heat shock protein 70, Trehalase1, and Trehalose transporter1. The efficacy of RNAi knock down was further tested in a gene-specific functional bioassay, and mortality was recorded in 24 hr intervals, six days, post-treatment. Based on qPCR analysis, all six genes tested showed significantly reduced gene expression. Moderate-to-high whitefly mortality was associated with the down-regulation of osmoregulation, sugar metabolism and sugar transport-associated genes, demonstrating that whitefly survivability was linked with RNAi results. Silenced Acetylcholine receptor subunit α and Heat shock protein 70 genes showed an initial low whitefly mortality, however, following insecticide or high temperature treatments, respectively, significantly increased knockdown efficacy and death was observed, indicating enhanced post-knockdown sensitivity perhaps related to systemic silencing. The oral delivery of gut-specific dsRNAs, when combined with qPCR analysis of gene expression and a corresponding gene-specific bioassay that relates knockdown and mortality, offers a viable approach for functional genomics analysis and the discovery of prospective dsRNA biopesticide targets. The

  9. Childhood cause-specific mortality in rural Western Kenya: application of the InterVA-4 model

    PubMed Central

    Amek, Nyaguara O.; Odhiambo, Frank O.; Khagayi, Sammy; Moige, Hellen; Orwa, Gordon; Hamel, Mary J.; Van Eijk, Annemieke; Vulule, John; Slutsker, Laurence; Laserson, Kayla F.

    2014-01-01

    Background Assessing the progress in achieving the United Nation's Millennium Development Goals in terms of population health requires consistent and reliable information on cause-specific mortality, which is often rare in resource-constrained countries. Health and demographic surveillance systems (HDSS) have largely used medical personnel to review and assign likely causes of death based on the information gathered from standardized verbal autopsy (VA) forms. However, this approach is expensive and time consuming, and it may lead to biased results based on the knowledge and experience of individual clinicians. We assessed the cause-specific mortality for children under 5 years old (under-5 deaths) in Siaya County, obtained from a computer-based probabilistic model (InterVA-4). Design Successfully completed VA interviews for under-5 deaths conducted between January 2003 and December 2010 in the Kenya Medical Research Institute/US Centers for Disease Control and Prevention HDSS were extracted from the VA database and processed using the InterVA-4 (version 4.02) model for interpretation. Cause-specific mortality fractions were then generated from the causes of death produced by the model. Results A total of 84.33% (6,621) childhood deaths had completed VA data during the study period. Children aged 1–4 years constituted 48.53% of all cases, and 42.50% were from infants. A single cause of death was assigned to 89.18% (5,940) of cases, 8.35% (556) of cases were assigned two causes, and 2.10% (140) were assigned ‘indeterminate’ as cause of death by the InterVA-4 model. Overall, malaria (28.20%) was the leading cause of death, followed by acute respiratory infection including pneumonia (25.10%), in under-5 children over the study period. But in the first 5 years of the study period, acute respiratory infection including pneumonia was the main cause of death, followed by malaria. Similar trends were also reported in infants (29 days–11 months) and children aged 1

  10. Association of Coffee Consumption With Overall and Cause-Specific Mortality in a Large US Prospective Cohort Study.

    PubMed

    Loftfield, Erikka; Freedman, Neal D; Graubard, Barry I; Guertin, Kristin A; Black, Amanda; Huang, Wen-Yi; Shebl, Fatma M; Mayne, Susan T; Sinha, Rashmi

    2015-12-15

    Concerns about high caffeine intake and coffee as a vehicle for added fat and sugar have raised questions about the net impact of coffee on health. Although inverse associations have been observed for overall mortality, data for cause-specific mortality are sparse. Additionally, few studies have considered exclusively decaffeinated coffee intake or use of coffee additives. Coffee intake was assessed at baseline by self-report in the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial. Hazard ratios were estimated using Cox proportional hazards models. Among 90,317 US adults without cancer at study baseline (1998-2001) or history of cardiovascular disease at study enrollment (1993-2001), 8,718 deaths occurred during 805,644 person-years of follow-up from 1998 through 2009. Following adjustment for smoking and other potential confounders, coffee drinkers, as compared with nondrinkers, had lower hazard ratios for overall mortality (<1 cup/day: hazard ratio (HR) = 0.99 (95% confidence interval (CI): 0.92, 1.07); 1 cup/day: HR = 0.94 (95% CI: 0.87, 1.02); 2-3 cups/day: HR = 0.82 (95% CI: 0.77, 0.88); 4-5 cups/day: HR = 0.79 (95% CI: 0.72, 0.86); ≥6 cups/day: HR = 0.84 (95% CI: 0.75, 0.95)). Similar findings were observed for decaffeinated coffee and coffee additives. Inverse associations were observed for deaths from heart disease, chronic respiratory diseases, diabetes, pneumonia and influenza, and intentional self-harm, but not cancer. Coffee may reduce mortality risk by favorably affecting inflammation, lung function, insulin sensitivity, and depression.

  11. Cause-specific premature death from ambient PM2.5 exposure in India: Estimate adjusted for baseline mortality.

    PubMed

    Chowdhury, Sourangsu; Dey, Sagnik

    2016-05-01

    In India, more than a billion population is at risk of exposure to ambient fine particulate matter (PM2.5) concentration exceeding World Health Organization air quality guideline, posing a serious threat to health. Cause-specific premature death from ambient PM2.5 exposure is poorly known for India. Here we develop a non-linear power law (NLP) function to estimate the relative risk associated with ambient PM2.5 exposure using satellite-based PM2.5 concentration (2001-2010) that is bias-corrected against coincident direct measurements. We show that estimate of annual premature death in India is lower by 14.7% (19.2%) using NLP (integrated exposure risk function, IER) for assumption of uniform baseline mortality across India (as considered in the global burden of disease study) relative to the estimate obtained by adjusting for state-specific baseline mortality using GDP as a proxy. 486,100 (811,000) annual premature death in India is estimated using NLP (IER) risk functions after baseline mortality adjustment. 54.5% of premature death estimated using NLP risk function is attributed to chronic obstructive pulmonary disease (COPD), 24.0% to ischemic heart disease (IHD), 18.5% to stroke and the remaining 3.0% to lung cancer (LC). 44,900 (5900-173,300) less premature death is expected annually, if India achieves its present annual air quality target of 40μgm(-3). Our results identify the worst affected districts in terms of ambient PM2.5 exposure and resulting annual premature death and call for initiation of long-term measures through a systematic framework of pollution and health data archive.

  12. Application of a Modified Garbage Code Algorithm to Estimate Cause-Specific Mortality and Years of Life Lost in Korea

    PubMed Central

    2016-01-01

    Years of life lost (YLLs) are estimated based on mortality and cause of death (CoD); therefore, it is necessary to accurately calculate CoD to estimate the burden of disease. The garbage code algorithm was developed by the Global Burden of Disease (GBD) Study to redistribute inaccurate CoD and enhance the validity of CoD estimation. This study aimed to estimate cause-specific mortality rates and YLLs in Korea by applying a modified garbage code algorithm. CoD data for 2010–2012 were used to calculate the number of deaths. The garbage code algorithm was then applied to calculate target cause (i.e., valid CoD) and adjusted CoD using the garbage code redistribution. The results showed that garbage code deaths accounted for approximately 25% of all CoD during 2010–2012. In 2012, lung cancer contributed the most to cause-specific death according to the Statistics Korea. However, when CoD was adjusted using the garbage code redistribution, ischemic heart disease was the most common CoD. Furthermore, before garbage code redistribution, self-harm contributed the most YLLs followed by lung cancer and liver cancer; however, after application of the garbage code redistribution, though self-harm was the most common leading cause of YLL, it is followed by ischemic heart disease and lung cancer. Our results showed that garbage code deaths accounted for a substantial amount of mortality and YLLs. The results may enhance our knowledge of burden of disease and help prioritize intervention settings by changing the relative importance of burden of disease. PMID:27775249

  13. Prospective Evaluation of the Association of Nut/Peanut Consumption With Total and Cause-Specific Mortality

    PubMed Central

    Luu, Hung N.; Blot, William J.; Xiang, Yong-Bing; Cai, Hui; Hargreaves, Margaret K.; Li, Honglan; Yang, Gong; Signorello, Lisa; Gao, Yu-Tang; Zheng, Wei; Shu, Xiao-Ou

    2015-01-01

    Importance High intake of nuts has been linked to a reduced risk of mortality. Previous studies, however, were primarily conducted among people of European descent, particularly those of high socioeconomic status. Objective To examine the association of nut consumption with total and cause-specific mortality in Americans of African and European descent who were predominantly of low socioeconomic status (SES) and in Chinese individuals in Shanghai, China. Design, Setting, and Participants Three large cohorts were evaluated in the study. One included 71 764 US residents of African and European descent, primarily of low SES, who were participants in the Southern Community Cohort Study (SCCS) in the southeastern United States (March 2002 to September 2009), and the other 2 cohorts included 134 265 participants in the Shanghai Women's Health Study (SWHS) (December 1996 to May 2000) and the Shanghai Men's Health Study (SMHS) (January 2002 to September 2006) in Shanghai, China. Self-reported nut consumption in the SCCS (approximately 50% were peanuts) and peanut-only consumption in the SMHS/SWHS were assessed using validated food frequency questionnaires. Main Outcomes and Measures Deaths were ascertained through linkage with the National Death Index and Social Security Administration mortality files in the SCCS and annual linkage with the Shanghai Vital Statistics Registry and by biennial home visits in the SWHS/SMHS. Cox proportional hazards regression models were used to calculate hazard ratios (HRs) and 95% CIs. Results With a median follow-up of 5.4 years in the SCCS, 6.5 years in the SMHS, and 12.2 years in the SWHS, 14 440 deaths were identified. More than half of the women in the SCCS were ever smokers compared with only 2.8% in the SWHS. The ever-smoking rate for men was 77.1% in the SCCS and 69.6% in the SMHS. Nut intake was inversely associated with risk of total mortality in all 3 cohorts (all P < .001 for trend), with adjusted HRs associated with the highest

  14. 26 CFR 1.430(h)(3)-2 - Plan-specific substitute mortality tables used to determine present value.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... paragraph (c)(1)(ii) of this section. Separate mortality tables must be established for each gender under the plan, and a substitute mortality table is permitted to be established for a gender only if the plan has credible mortality experience with respect to that gender. (ii) Credible mortality...

  15. 26 CFR 1.430(h)(3)-2 - Plan-specific substitute mortality tables used to determine present value.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... paragraph (c)(1)(ii) of this section. Separate mortality tables must be established for each gender under the plan, and a substitute mortality table is permitted to be established for a gender only if the plan has credible mortality experience with respect to that gender. (ii) Credible mortality...

  16. 26 CFR 1.430(h)(3)-2 - Plan-specific substitute mortality tables used to determine present value.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... paragraph (c)(1)(ii) of this section. Separate mortality tables must be established for each gender under the plan, and a substitute mortality table is permitted to be established for a gender only if the plan has credible mortality experience with respect to that gender. (ii) Credible mortality...

  17. 26 CFR 1.430(h)(3)-2 - Plan-specific substitute mortality tables used to determine present value.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... paragraph (c)(1)(ii) of this section. Separate mortality tables must be established for each gender under the plan, and a substitute mortality table is permitted to be established for a gender only if the plan has credible mortality experience with respect to that gender. (ii) Credible mortality...

  18. Statistically tested comparisons of the accuracy of forecasting methods for age-specific and sex-specific mortality and life expectancy.

    PubMed

    Shang, Han Lin

    2015-01-01

    Although there are continuing developments in the methods for forecasting mortality, there are few comparisons of the accuracy of the forecasts. The subject of the statistical validity of these comparisons, which is essential to demographic forecasting, has all but been ignored. We introduce Friedman's test statistics to examine whether the differences in point and interval forecast accuracies are statistically significant between methods. We introduce the Nemenyi test statistic to identify which methods give results that are statistically significantly different from others. Using sex-specific and age-specific data from 20 countries, we apply these two test statistics to examine the forecast accuracy obtained from several principal component methods, which can be categorized into coherent and non-coherent forecasting methods.

  19. Association between Six Minute Walk Test and All-Cause Mortality, Coronary Heart Disease-Specific Mortality, and Incident Coronary Heart Disease

    PubMed Central

    Yazdanyar, Ali; Aziz, Michael M; Enright, Paul L; Edmundowicz, Daniel; Boudreau, Robert; Sutton-Tyrell, Kim; Kuller, Lewis; Newman, Anne B

    2015-01-01

    Objectives To examine the association between six-minute walk test (6 MWT) performance and all-cause mortality, coronary heart disease mortality, and incident coronary heart disease in older adults. Methods We conducted a time-to-event analysis of 1,665 Cardiovascular Health Study participants with a 6 MWT and without prevalent cardiovascular disease. Results During a mean follow-up of 8 years, there were 305 incident coronary heart disease events, 504 deaths of which 100 were coronary heart disease-related deaths. The 6 MWT performance in the shortest two distance quintiles was associated with increased risk of all-cause mortality (290-338 meters: HR 1.7; 95% CI, 1.2-2.5; <290 meters: HR 2.1; 95% CI, 1.4-3.0). The adjusted risk of coronary heart disease mortality incident events among those with a 6 MWT <290 meters was not significant. Discussion Performance on the 6 MWT is independently associated with all-cause mortality and is of prognostic utility in community-dwelling older adults. PMID:24695552

  20. A retrospective cohort study of cause-specific mortality and incidence of hematopoietic malignancies in Chinese benzene-exposed workers.

    PubMed

    Linet, Martha S; Yin, Song-Nian; Gilbert, Ethel S; Dores, Graça M; Hayes, Richard B; Vermeulen, Roel; Tian, Hao-Yuan; Lan, Qing; Portengen, Lutzen; Ji, Bu-Tian; Li, Gui-Lan; Rothman, Nathaniel

    2015-11-01

    Benzene exposure has been causally linked with acute myeloid leukemia (AML), but inconsistently associated with other hematopoietic, lymphoproliferative and related disorders (HLD) or solid tumors in humans. Many neoplasms have been described in experimental animals exposed to benzene. We used Poisson regression to estimate adjusted relative risks (RR) and the likelihood ratio statistic to derive confidence intervals for cause-specific mortality and HLD incidence in 73,789 benzene-exposed compared with 34,504 unexposed workers in a retrospective cohort study in 12 cities in China. Follow-up and outcome assessment was based on factory, medical and other records. Benzene-exposed workers experienced increased risks for all-cause mortality (RR = 1.1, 95% CI = 1.1, 1.2) due to excesses of all neoplasms (RR = 1.3, 95% CI = 1.2, 1.4), respiratory diseases (RR = 1.7, 95% CI = 1.2, 2.3) and diseases of blood forming organs (RR = ∞, 95% CI = 3.4, ∞). Lung cancer mortality was significantly elevated (RR = 1.5, 95% CI = 1.2, 1.9) with similar RRs for males and females, based on three-fold more cases than in our previous follow-up. Significantly elevated incidence of all myeloid disorders reflected excesses of myelodysplastic syndrome/acute myeloid leukemia (RR = 2.7, 95% CI = 1.2, 6.6) and chronic myeloid leukemia (RR = 2.5, 95% CI = 0.8, 11), and increases of all lymphoid disorders included excesses of non-Hodgkin lymphoma (RR = 3.9, 95%CI = 1.5, 13) and all lymphoid leukemia (RR = 5.4, 95%CI = 1.0, 99). The 28-year follow-up of Chinese benzene-exposed workers demonstrated increased risks of a broad range of myeloid and lymphoid neoplasms, lung cancer, and respiratory diseases and suggested possible associations with other malignant and non-malignant disorders.

  1. Saharan dust and association between particulate matter and case-specific mortality: a case-crossover analysis in Madrid (Spain)

    PubMed Central

    2012-01-01

    Background Saharan dust intrusions are a common phenomenon in the Madrid atmosphere, leading induce exceedances of the 50 μg/m3- EU 24 h standard for PM10. Methods We investigated the effects of exposure to PM10 between January 2003 and December 2005 in Madrid (Spain) on daily case-specific mortality; changes of effects between Saharan and non-Saharan dust days were assessed using a time-stratified case-crossover design. Results Saharan dust affected 20% of days in the city of Madrid. Mean concentration of PM10 was higher during dust days (47.7 μg/m3) than non-dust days (31.4 μg/m3). The rise of mortality per 10 μg/m3 PM10 concentration were always largely for Saharan dust-days. When stratifying by season risks of PM10, at lag 1, during Saharan dust days were stronger for respiratory causes during cold season (IR% = 3.34% (95% CI: 0.36, 6.41) versus 2.87% (95% CI: 1.30, 4.47)) while for circulatory causes effects were stronger during warm season (IR% = 4.19% (95% CI: 1.34, 7.13) versus 2.65% (95% CI: 0.12, 5.23)). No effects were found for cerebrovascular causes. Conclusions We found evidence of strongest effects of particulate matter during Saharan dust days, providing a suggestion of effect modification, even though interaction terms were not statistically significant. Further investigation is needed to understand the mechanism by which Saharan dust increases mortality. PMID:22401495

  2. All-cause and cause-specific mortality among US youth: socioeconomic and rural-urban disparities and international patterns.

    PubMed

    Singh, Gopal K; Azuine, Romuladus E; Siahpush, Mohammad; Kogan, Michael D

    2013-06-01

    We analyzed international patterns and socioeconomic and rural-urban disparities in all-cause mortality and mortality from homicide, suicide, unintentional injuries, and HIV/AIDS among US youth aged 15-24 years. A county-level socioeconomic deprivation index and rural-urban continuum measure were linked to the 1999-2007 US mortality data. Mortality rates were calculated for each socioeconomic and rural-urban group. Poisson regression was used to derive adjusted relative risks of youth mortality by deprivation level and rural-urban residence. The USA has the highest youth homicide rate and 6th highest overall youth mortality rate in the industrialized world. Substantial socioeconomic and rural-urban gradients in youth mortality were observed within the USA. Compared to their most affluent counterparts, youth in the most deprived group had 1.9 times higher all-cause mortality, 8.0 times higher homicide mortality, 1.5 times higher unintentional-injury mortality, and 8.8 times higher HIV/AIDS mortality. Youth in rural areas had significantly higher mortality rates than their urban counterparts regardless of deprivation levels, with suicide and unintentional-injury mortality risks being 1.8 and 2.3 times larger in rural than in urban areas. However, youth in the most urbanized areas had at least 5.6 times higher risks of homicide and HIV/AIDS mortality than their rural counterparts. Disparities in mortality differed by race and sex. Socioeconomic deprivation and rural-urban continuum were independently related to disparities in youth mortality among all sex and racial/ethnic groups, although the impact of deprivation was considerably greater. The USA ranks poorly in all-cause mortality, youth homicide, and unintentional-injury mortality rates when compared with other industrialized countries.

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

    PubMed Central

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

    2014-01-01

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

  4. Risk Factors for Cause-specific Mortality of Very-Low-Birth-Weight Infants in the Korean Neonatal Network.

    PubMed

    Lim, Jae Woo; Chung, Sung-Hoon; Kang, Dae Ryong; Kim, Chang-Ryul

    2015-10-01

    This study attempted to assess the risk factors for mortality of very-low-birth-weight (VLBW) infants in the neonatal intensive care unit (NICU, n=2,386). Using data from the Korean Neonatal Network, we investigated infants with birth weights <1,500 g and gestational ages (GAs) of 22-31 weeks born between January 2013 and June 2014. Cases were defined as death at NICU discharge. Controls were randomly selected from live VLBW infants and frequency matched to case subjects by GA. Relevant variables were compared between the cases (n=236) and controls (n=236) by Cox proportional hazards regression to determine their associations with cause-specific mortality (cardiorespiratory, neurologic, infection, gastrointestinal, and others). In a Cox regression analysis, cardiorespiratory death were associated with a foreign mother (hazard ratio, HR, 4.33; 95% confidence interval, CI, 2.08-9.02), multiple gestation (HR, 1.65; 95% CI, 1.07-2.54), small for gestational age (HR, 2.06; 95% CI, 1.25-3.41), male gender (HR, 1.69; 95% CI, 1.10-2.60), Apgar score ≤3 at 5 min (HR, 1.97; 95% CI, 1.18-3.31), and delivery room resuscitation (HR, 2.60; 95% CI, 1.53-4.40). An Apgar score ≤3 at 5 min was also associated with neurological death (HR, 2.95; 95% CI, 1.29-6.73). Death due to neonatal infection was associated with outborn delivery (HR, 5.09; 95% CI, 1.46-17.74). Antenatal steroid and preterm premature rupture of membranes reduced risk of cardiorespiratory death (HR, 0.43; 95% CI, 0.27-0.67) and gastrointestinal death (HR, 0.30; 95% CI, 0.13-0.70), respectively. In conclusion, foreign mother, multiple gestation, small gestation age, male gender, Apgar score ≤3 at 5 min, and resuscitation in the delivery room are associated with cardiorespiratory mortality of VLBW infants in NICU. An Apgar score ≤3 at 5 min and outborn status are associated with neurological and infection mortality, respectively.

  5. Physical Activity, Sedentary Behavior, and Cause-Specific Mortality in Black and White Adults in the Southern Community Cohort Study

    PubMed Central

    Matthews, Charles E.; Cohen, Sarah S.; Fowke, Jay H.; Han, Xijing; Xiao, Qian; Buchowski, Maciej S.; Hargreaves, Margaret K.; Signorello, Lisa B.; Blot, William J.

    2014-01-01

    There is limited evidence demonstrating the benefits of physical activity with regard to mortality risk or the harms associated with sedentary behavior in black adults, so we examined the relationships between these health behaviors and cause-specific mortality in a prospective study that had a large proportion of black adults. Participants (40–79 years of age) enrolled in the Southern Community Cohort Study between 2002 and 2009 (n = 63,308) were prospectively followed over 6.4 years, and 3,613 and 1,394 deaths occurred in blacks and whites, respectively. Black adults who reported the highest overall physical activity level (≥32.3 metabolic equivalent-hours/day vs. <9.7 metabolic equivalent-hours/day) had lower risks of death from all causes (hazard ratio (HR) = 0.76. 95% confidence interval (CI): 0.69, 0.85), cardiovascular disease (HR = 0.81, 95% CI: 0.67, 0.98), and cancer (HR = 0.76, 95% CI: 0.62, 0.94). In whites, a higher physical activity level was associated with a lower risk of death from all causes (HR = 0.76, 95% CI: 0.64, 0.90) and cardiovascular disease (HR = 0.69, 95% CI: 0.49, 0.99) but not cancer (HR = 0.95, 95% CI: 0.67, 1.34). Spending more time being sedentary (>12 hours/day vs. <5.76 hours/day) was associated with a 20%–25% increased risk of all-cause mortality in blacks and whites. Blacks who reported the most time spent being sedentary (≥10.5 hours/day) and lowest level of physical activity (<12.6 metabolic equivalent-hours/day) had a greater risk of death (HR = 1.47, 95% CI: 1.25, 1.71). Our study provides evidence that suggests that health promotion efforts to increase physical activity level and decrease sedentary time could help reduce mortality risk in black adults. PMID:25086052

  6. Strain-specific innate immune signaling pathways determine malaria parasitemia dynamics and host mortality.

    PubMed

    Wu, Jian; Tian, Linjie; Yu, Xiao; Pattaradilokrat, Sittiporn; Li, Jian; Wang, Mingjun; Yu, Weishi; Qi, Yanwei; Zeituni, Amir E; Nair, Sethu C; Crampton, Steve P; Orandle, Marlene S; Bolland, Silvia M; Qi, Chen-Feng; Long, Carole A; Myers, Timothy G; Coligan, John E; Wang, Rongfu; Su, Xin-zhuan

    2014-01-28

    Malaria infection triggers vigorous host immune responses; however, the parasite ligands, host receptors, and the signaling pathways responsible for these reactions remain unknown or controversial. Malaria parasites primarily reside within RBCs, thereby hiding themselves from direct contact and recognition by host immune cells. Host responses to malaria infection are very different from those elicited by bacterial and viral infections and the host receptors recognizing parasite ligands have been elusive. Here we investigated mouse genome-wide transcriptional responses to infections with two strains of Plasmodium yoelii (N67 and N67C) and discovered differences in innate response pathways corresponding to strain-specific disease phenotypes. Using in vitro RNAi-based gene knockdown and KO mice, we demonstrated that a strong type I IFN (IFN-I) response triggered by RNA polymerase III and melanoma differentiation-associated protein 5, not Toll-like receptors (TLRs), binding of parasite DNA/RNA contributed to a decline of parasitemia in N67-infected mice. We showed that conventional dendritic cells were the major sources of early IFN-I, and that surface expression of phosphatidylserine on infected RBCs might promote their phagocytic uptake, leading to the release of parasite ligands and the IFN-I response in N67 infection. In contrast, an elevated inflammatory response mediated by CD14/TLR and p38 signaling played a role in disease severity and early host death in N67C-infected mice. In addition to identifying cytosolic DNA/RNA sensors and signaling pathways previously unrecognized in malaria infection, our study demonstrates the importance of parasite genetic backgrounds in malaria pathology and provides important information for studying human malaria pathogenesis.

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

    PubMed Central

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

    2014-01-01

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

  8. Update of the Texaco mortality study 1947-93: Part II. Analyses of specific causes of death for white men employed in refining, research, and petrochemicals

    PubMed Central

    Divine, B. J.; Hartman, C. M.; Wendt, J. K.

    1999-01-01

    OBJECTIVE: To examine patterns of mortality for specific causes of death with increases in the Texaco mortality study to determine if the patterns are related to employment in the petroleum industry. METHODS: Mortality patterns by duration of employment in various job groups were examined for mesothelioma, non-Hodgkin's lymphoma, multiple myeloma, cell type specific leukaemia, and brain tumours. RESULTS: Mortality from mesothelioma was examined for the total cohort and for two maintenance groups with the greatest potential for exposure to asbestos. The insulator group had a standardised mortality ratio (SMR) of 3029, and a larger group consisting of insulators, carpenters, labourers, electricians, pipefitters, boiler-makers, and welders had an SMR of 411. The mortalities from mesothelioma increased with increasing duration of employment. Mortality was lower for those first employed after 1950. An analysis of all brain tumours for the total cohort and some job and unit subgroups resulted in an SMR of 178 for those employed on the units related to motor oil and 166 for those employed as laboratory workers. Mortality from brain tumours in both of these job groups was higher for those employed > or = 5 years in the group. An analysis of non-Hodgkin's lymphoma showed no consistent patterns among the various employment groups. Mortality from multiple myeloma was non-significantly increased among people employed on the crude (SMR = 155) and fluid catalytic cracking units (SMR = 198). Leukaemia mortality was not increased for the total cohort, and a cell type analysis of leukaemia mortality for the total cohort showed no significant increases for the major cell types. However, there were significant increases for acute unspecified leukaemia (SMR = 276) and leukaemia of unknown cell type (SMR = 231). CONCLUSIONS: Analyses of specific causes of death by duration of employment in various job and process units did not show any patterns which suggest that, other than for

  9. 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.

  10. Impact of Heat and Cold on Total and Cause-Specific Mortality in Vadu HDSS—A Rural Setting in Western India

    PubMed Central

    Ingole, Vijendra; Rocklöv, Joacim; Juvekar, Sanjay; Schumann, Barbara

    2015-01-01

    Many diseases are affected by changes in weather. There have been limited studies, however, which have examined the relationship between heat and cold and cause-specific mortality in low and middle-income countries. In this study, we aimed to estimate the effects of heat and cold days on total and cause-specific mortality in the Vadu Health and Demographic Surveillance System (HDSS) area in western India. We used a quasi-Poisson regression model allowing for over-dispersion to examine the association of total and cause-specific mortality with extreme high (98th percentile, >39 °C) and low temperature (2nd percentile, <25 °C) over the period January 2003 to December 2012. Delays of 0 and 0–4 days were considered and relative risks (RR) with 95% confidence intervals (CI) were calculated. Heat was significantly associated with daily deaths by non-infectious diseases (RR = 1.57; CI: 1.18–2.10). There was an increase in the risk of total mortality in the age group 12–59 years on lag 0 day (RR = 1.43; CI: 1.02–1.99). A high increase in total mortality was observed among men at lag 0 day (RR = 1.38; CI: 1.05–1.83). We did not find any short-term association between total and cause-specific mortality and cold days. Deaths from neither infectious nor external causes were associated with heat or cold. Our results showed a strong and rather immediate relationship between high temperatures and non-infectious disease mortality in a rural population located in western India, during 2003–2012. This study may be used to develop targeted interventions such as Heat Early Warning Systems in the area to reduce mortality from extreme temperatures. PMID:26633452

  11. Impact of Heat and Cold on Total and Cause-Specific Mortality in Vadu HDSS--A Rural Setting in Western India.

    PubMed

    Ingole, Vijendra; Rocklöv, Joacim; Juvekar, Sanjay; Schumann, Barbara

    2015-12-02

    Many diseases are affected by changes in weather. There have been limited studies, however, which have examined the relationship between heat and cold and cause-specific mortality in low and middle-income countries. In this study, we aimed to estimate the effects of heat and cold days on total and cause-specific mortality in the Vadu Health and Demographic Surveillance System (HDSS) area in western India. We used a quasi-Poisson regression model allowing for over-dispersion to examine the association of total and cause-specific mortality with extreme high (98th percentile, >39 °C) and low temperature (2nd percentile, <25 °C) over the period January 2003 to December 2012. Delays of 0 and 0-4 days were considered and relative risks (RR) with 95% confidence intervals (CI) were calculated. Heat was significantly associated with daily deaths by non-infectious diseases (RR = 1.57; CI: 1.18-2.10). There was an increase in the risk of total mortality in the age group 12-59 years on lag 0 day (RR = 1.43; CI: 1.02-1.99). A high increase in total mortality was observed among men at lag 0 day (RR = 1.38; CI: 1.05-1.83). We did not find any short-term association between total and cause-specific mortality and cold days. Deaths from neither infectious nor external causes were associated with heat or cold. Our results showed a strong and rather immediate relationship between high temperatures and non-infectious disease mortality in a rural population located in western India, during 2003-2012. This study may be used to develop targeted interventions such as Heat Early Warning Systems in the area to reduce mortality from extreme temperatures.

  12. Macro determinants of cause-specific injury mortality in the OECD countries: an exploration of the importance of GDP and unemployment.

    PubMed

    Muazzam, Sana; Nasrullah, Muazzam

    2011-08-01

    Gross Domestic Product (GDP) and unemployment has a strong documented impact on injury mortality. The aim of our study is to investigate the relationship of GDP per capita and unemployment with gender- and cause-specific injury mortalities in the member nations of Organization for Economic Cooperation and Development (OECD). Country-based data on injury mortality per 100,000 population, including males and females aged 1-74, for the 4 year period 1996-1999, were gathered from the World Health Organization's Statistical Information System. We selected fourteen cause-specific injury mortalities. Data on GDP, unemployment rate and population growth were taken from World Development Indicators. GDP and unemployment rate per 100 separately were regressed on total and cause-specific injury mortality rate per 100,000 for males and females. Overall in the OECD countries, GDP per capita increased 12.5% during 1996-1999 (P = 0.03) where as unemployment rate decreased by 12.3% (P = 0.05). Among males, most cause-specific injury mortality rates decreased with increasing GDP except motor vehicle traffic crashes (MTC) that increased with increasing GDP (coefficient = 0.75; P < 0.001). Similar trend was found in females, except suicidal injury mortalities that also increased with increasing GDP (coefficient = 0.31; P = 0.04). When we modeled cause-specific injury mortality rates with unemployment, injuries due to firearm missiles (coefficient = 0.53; P < 0.001), homicide (coefficient = 0.36; P < 0.001), and other violence (coefficient = 0.41; P < 0.001) increased with increase in unemployment rate among males. However, among females only accidental falls (coefficient = 0.36; P = 0.01) were found significantly associated with increasing unemployment rate. GDP is more related to cause-specific injury mortality than unemployment. Injury mortality does not relate similarly to each diagnosis-specific cause among males and females. Further research on

  13. Risk of All-Cause and Prostate Cancer-Specific Mortality After Brachytherapy in Men With Small Prostate Size

    SciTech Connect

    Nguyen, Paul L.; Chen, Ming H.; Choueiri, Toni K.; Hoffman, Karen E.; Hu, Jim C.; Martin, Neil E.; Beard, Clair J.; Dosoretz, Daniel E.; Moran, Brian J.; Katin, Michael J.; Braccioforte, Michelle H.; Ross, Rudi; Salenius, Sharon A.; Kantoff, Philip W.; D'Amico, Anthony V.

    2011-04-01

    Background: Brachytherapy for prostate cancer can be technically challenging in men with small prostates ({<=}20 cc), but it is unknown whether their outcomes are different than those of men with larger prostates. Methods and Materials: We studied 6,416 men treated with brachytherapy in one of 21 community-based practices. Cox regression and Fine and Gray's regression were used to determine whether volume {<=}20 cc was associated with a higher risk of all-cause mortality (ACM) or prostate cancer-specific mortality (PCSM), respectively, after adjustment for other known prognostic factors. Results: 443 patients (6.9%) had a prostate volume {<=}20 cc. After a median follow-up of 2.91 years (interquartile range, 1.06-4.79), volume {<=}20 cc was associated with a significantly higher risk of ACM (adjusted hazard ratio = 1.33 [95% CI 1.08-1.65], p = 0.0085) with 3-year estimates of ACM for {<=}20 cc vs. >20 cc of 13.0% vs. 6.9% (p = 0.028). Only 23 men (0.36%) have died of prostate cancer, and no difference was seen in PCSM by volume (p = 0.4). Conclusion: Men with small prostates at the time of implant had a 33% higher risk of ACM, and the underlying cause of this remains uncertain. No increase in PCSM was observed in men with volume {<=}20cc, suggesting that a small prostate should not in itself be a contraindication for brachytherapy, but inasmuch as absolute rates of PCSM were small, further follow-up will be needed to confirm this finding.

  14. Total and cause-specific mortality of Finnish military personnel following service in international peacekeeping operations 1990–2010: a comprehensive register-based cohort study

    PubMed Central

    Laukkala, T; Parkkola, K; Henriksson, M; Pirkola, S; Kaikkonen, N; Pukkala, E; Jousilahti, P

    2016-01-01

    Objectives To estimate total and cause-specific mortality after international peacekeeping deployments among the Finnish military peacekeeping personnel in comparison to the general population of similar age and sex. Design A register-based study of a cohort of military peacekeeping personnel in 1990–2010 followed for mortality until the end of 2013. Causes of death were obtained from the national Causes of Death Register. The standardised mortality ratio (SMR) for total and cause-specific mortality was calculated as the ratio of observed and expected number of deaths. Setting Finland (peacekeeping operations in different countries in Africa, Asia and in an area of former Yugoslavia in Europe). Participants 14 584 men and 418 women who had participated in international military peacekeeping operations ending between 1990 and 2010. Interventions Participation in military peacekeeping operations. Main outcome Total and cause-specific mortality. Results 209 men and 3 women died after their peacekeeping service. The SMR for all-cause mortality was 0.55 (95% CI 0.48 to 0.62). For the male peacekeeping personnel, the SMR for all diseases was 0.44 (95% CI 0.35 to 0.53) and for accidental and violent deaths 0.69 (95% CI 0.57 to 0.82). The SMR for suicides was 0.71 (95% CI 0.53 to 0.92). Conclusions Even though military peacekeeping personnel are working in unique and often stressful conditions, their mortality after their service is lower compared with the general population. Military peacekeeping personnel appear to be a selected population group with low general mortality and no excess risk of any cause of death after peacekeeping service. PMID:27799241

  15. High-Dose Conformal Radiotherapy Reduces Prostate Cancer-Specific Mortality: Results of a Meta-analysis

    SciTech Connect

    Viani, Gustavo Arruda; Godoi Bernardes da Silva, Lucas; Stefano, Eduardo Jose

    2012-08-01

    Purpose: To determine in a meta-analysis whether prostate cancer-specific mortality (PCSM), biochemical or clinical failure (BCF), and overall mortality (OM) in men with localized prostate cancer treated with conformal high-dose radiotherapy (HDRT) are better than those in men treated with conventional-dose radiotherapy (CDRT). Methods and Materials: The MEDLINE, Embase, CANCERLIT, and Cochrane Library databases, as well as the proceedings of annual meetings, were systematically searched to identify randomized, controlled studies comparing conformal HDRT with CDRT for localized prostate cancer. Results: Five randomized, controlled trials (2508 patients) that met the study criteria were identified. Pooled results from these randomized, controlled trials showed a significant reduction in the incidence of PCSM and BCF rates at 5 years in patients treated with HDRT (p = 0.04 and p < 0.0001, respectively), with an absolute risk reduction (ARR) of PCSM and BCF at 5 years of 1.7% and 12.6%, respectively. Two trials evaluated PCSM with 10 years of follow up. The pooled results from these trials showed a statistical benefit for HDRT in terms of PCSM (p = 0.03). In the subgroup analysis, trials that used androgen deprivation therapy (ADT) showed an ARR for BCF of 12.9% (number needed to treat = 7.7, p < 0.00001), whereas trials without ADT had an ARR of 13.6% (number needed to treat = 7, p < 0.00001). There was no difference in the OM rate at 5 and 10 years (p = 0.99 and p = 0.11, respectively) between the groups receiving HDRT and CDRT. Conclusions: This meta-analysis is the first study to show that HDRT is superior to CDRT in preventing disease progression and prostate cancer-specific death in trials that used conformational technique to increase the total dose. Despite the limitations of our study in evaluating the role of ADT and HDRT, our data show no benefit for HDRT arms in terms of BCF in trials with or without ADT.

  16. Psychological distress in relation to site specific cancer mortality: pooling of unpublished data from 16 prospective cohort studies

    PubMed Central

    Russ, Tom C; Stamatakis, Emmanuel; Kivimäki, Mika

    2017-01-01

    Objective To examine the role of psychological distress (anxiety and depression) as a potential predictor of site specific cancer mortality. Design Pooling of individual participant data from 16 prospective cohort studies initiated 1994-2008. Setting Nationally representative samples drawn from the health survey for England (13 studies) and the Scottish health survey (three studies). Participants 163 363 men and women aged 16 or older at study induction, who were initially free of a cancer diagnosis, provided self reported psychological distress scores (based on the general health questionnaire, GHQ-12) and consented to health record linkage. Main outcome measure Vital status records used to ascertain death from 16 site specific malignancies; the three Scottish studies also had information on cancer registration (incidence). Results The studies collectively contributed an average of 9.5 years of mortality surveillance during which there were 16 267 deaths (4353 from cancer). After adjustment for age, sex, education, socioeconomic status, body mass index (BMI), and smoking and alcohol intake, and with reverse causality (by left censoring) and missing data (by imputation) taken into account, relative to people in the least distressed group (GHQ-12 score 0-6), death rates in the most distressed group (score 7-12) were consistently raised for cancer of all sites combined (multivariable adjusted hazard ratio 1.32, 95% confidence interval 1.18 to 1.48) and cancers not related to smoking (1.45, 1.23 to 1.71), as well as carcinoma of the colorectum (1.84, 1.21 to 2.78), prostate (2.42, 1.29 to 4.54), pancreas (2.76, 1.47 to 5.19), oesophagus (2.59, 1.34 to 5.00), and for leukaemia (3.86, 1.42 to 10.5). Stepwise associations across the full range of distress scores were observed for colorectal and prostate cancer. Conclusion This study contributes to the growing evidence that psychological distress might have some predictive capacity for selected cancer

  17. The Changing Body Mass-Mortality Association in the United States: Evidence of Sex-Specific Cohort Trends from Three National Health and Nutrition Examination Surveys.

    PubMed

    Yu, Yan

    2016-01-01

    The association between body mass index (BMI) categories and mortality remains uncertain. Using three National Health and Nutrition Examination Surveys covering the 1971-2006 period for cohorts born between 1896 and 1968, this study estimates separately for men and women models for year-of-birth (cohort) and year-of-observation (period) trends in how age-specific mortality rates differ across BMI categories. Among women, relative to the normal weight (BMI 18.5-24.9 kg/m(2)), there are increasing trends in mortality rates for the overweight (BMI 25-29.9) or obese (BMI ≥ 30). Among men, mortality rates relative to the normal weight decrease for the overweight, do not change for the moderately obese (BMI 30-34.9), and increase for the severely obese (BMI ≥ 35). Period and cohort trends are similar, but the cohort trends are more consistent. In the latest cohorts, compared with the normal weight, mortality rates are 50 percent lower for overweight men, not different for moderately obese men, and 100-200 percent higher for severely obese men and for overweight or obese women. For U.S. cohorts born after the 1920s, a lower overweight than normal weight mortality is confined to men. I speculate on possible reasons why the mortality association with overweight and obesity varies by sex and cohort.

  18. Employment grade differences in cause specific mortality. A 25 year follow up of civil servants from the first Whitehall study

    PubMed Central

    van Rossum, C. T M; Shipley, M.; van de Mheen, H.; Grobbee, D.; Marmot, M.

    2000-01-01

    STUDY OBJECTIVE—To test the hypothesis that the association between socioeconomic status and mortality rates cuts across the major causes of death for middle aged and elderly men.
DESIGN—25 year follow up of mortality in relation to employment grade.
SETTING—The first Whitehall study.
PARTICIPANTS—18 001 male civil servants aged 40-69 years who attended the initial screening between 1967 and 1970 and were followed up for at least 25 years.
MAIN OUTCOME MEASURE—Specific causes of death.
RESULTS—After more than 25 years of follow up of civil servants, aged 40-69 years at entry to the study, employment grade differences still exist in total mortality and for nearly all specific causes of death. Main risk factors (cholesterol, smoking, systolic blood pressure, glucose intolerance and diabetes) could only explain one third of this gradient. Comparing the older retired group with the younger pre-retirement group, the differentials in mortality remained but were less pronounced. The largest decline was seen for chronic bronchitis, gastrointestinal diseases and genitourinary diseases.
CONCLUSIONS—Differentials in mortality persist at older ages for almost all causes of death.


Keywords: mortality; socioeconomic factors; cause of death. PMID:10746111

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

    PubMed

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

    2017-01-20

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

  20. Income inequality, life expectancy and cause-specific mortality in 43 European countries, 1987-2008: a fixed effects study.

    PubMed

    Hu, Yannan; van Lenthe, Frank J; Mackenbach, Johan P

    2015-08-01

    Whether income inequality is related to population health is still open to debate. We aimed to critically assess the relationship between income inequality and mortality in 43 European countries using comparable data between 1987 and 2008, controlling for time-invariant and time-variant country-level confounding factors. Annual data on income inequality, expressed as Gini index based on net household income, were extracted from the Standardizing the World Income Inequality Database. Data on life expectancy at birth and age-standardized mortality by cause of death were obtained from the Human Lifetable Database and the World Health Organization European Health for All Database. Data on infant mortality were obtained from the United Nations World Population Prospects Database. The relationships between income inequality and mortality indicators were studied using country fixed effects models, adjusted for time trends and country characteristics. Significant associations between income inequality and many mortality indicators were found in pooled cross-sectional regressions, indicating higher mortality in countries with larger income inequalities. Once the country fixed effects were added, all associations between income inequality and mortality indicators became insignificant, except for mortality from external causes and homicide among men, and cancers among women. The significant results for homicide and cancers disappeared after further adjustment for indicators of democracy, education, transition to national independence, armed conflicts, and economic freedom. Cross-sectional associations between income inequality and mortality seem to reflect the confounding effects of other country characteristics. In a European context, national levels of income inequality do not have an independent effect on mortality.

  1. Socioeconomic Factors and All Cause and Cause-Specific Mortality among Older People in Latin America, India, and China: A Population-Based Cohort Study

    PubMed Central

    Ferri, Cleusa P.; Acosta, Daisy; Guerra, Mariella; Huang, Yueqin; Llibre-Rodriguez, Juan J.; Salas, Aquiles; Sosa, Ana Luisa; Williams, Joseph D.; Gaona, Ciro; Liu, Zhaorui; Noriega-Fernandez, Lisseth; Jotheeswaran, A. T.; Prince, Martin J.

    2012-01-01

    Background Even in low and middle income countries most deaths occur in older adults. In Europe, the effects of better education and home ownership upon mortality seem to persist into old age, but these effects may not generalise to LMICs. Reliable data on causes and determinants of mortality are lacking. Methods and Findings The vital status of 12,373 people aged 65 y and over was determined 3–5 y after baseline survey in sites in Latin America, India, and China. We report crude and standardised mortality rates, standardized mortality ratios comparing mortality experience with that in the United States, and estimated associations with socioeconomic factors using Cox's proportional hazards regression. Cause-specific mortality fractions were estimated using the InterVA algorithm. Crude mortality rates varied from 27.3 to 70.0 per 1,000 person-years, a 3-fold variation persisting after standardisation for demographic and economic factors. Compared with the US, mortality was much higher in urban India and rural China, much lower in Peru, Venezuela, and urban Mexico, and similar in other sites. Mortality rates were higher among men, and increased with age. Adjusting for these effects, it was found that education, occupational attainment, assets, and pension receipt were all inversely associated with mortality, and food insecurity positively associated. Mutually adjusted, only education remained protective (pooled hazard ratio 0.93, 95% CI 0.89–0.98). Most deaths occurred at home, but, except in India, most individuals received medical attention during their final illness. Chronic diseases were the main causes of death, together with tuberculosis and liver disease, with stroke the leading cause in nearly all sites. Conclusions Education seems to have an important latent effect on mortality into late life. However, compositional differences in socioeconomic position do not explain differences in mortality between sites. Social protection for older people, and the

  2. Cooking Coal Use and All-Cause and Cause-Specific Mortality in a Prospective Cohort Study of Women in Shanghai, China

    PubMed Central

    Kim, Christopher; Seow, Wei Jie; Shu, Xiao-Ou; Bassig, Bryan A.; Rothman, Nathaniel; Chen, Bingshu E.; Xiang, Yong-Bing; Hosgood, H. Dean; Ji, Bu-Tian; Hu, Wei; Wen, Cuiju; Chow, Wong-Ho; Cai, Qiuyin; Yang, Gong; Gao, Yu-Tang; Zheng, Wei; Lan, Qing

    2016-01-01

    Background: Nearly 4.3 million deaths worldwide were attributable to exposure to household air pollution in 2012. However, household coal use remains widespread. Objectives: We investigated the association of cooking coal and all-cause and cause-specific mortality in a prospective cohort of primarily never-smoking women in Shanghai, China. Methods: A cohort of 74,941 women were followed from 1996 through 2009 with annual linkage to the Shanghai vital statistics database. Cause-specific mortality was identified through 2009. Use of household coal for cooking was assessed through a residential history questionnaire. Cox proportional hazards models estimated the risk of mortality associated with household coal use. Results: In this cohort, 63% of the women ever used coal (n = 46,287). Compared with never coal use, ever use of coal was associated with mortality from all causes [hazard ratio (HR) = 1.12; 95% confidence interval (CI): 1.05, 1.21], cancer (HR = 1.14; 95% CI: 1.03, 1.27), and ischemic heart disease (overall HR = 1.61; 95% CI: 1.14, 2.27; HR for myocardial infarction specifically = 1.80; 95% CI: 1.16, 2.79). The risk of cardiovascular mortality increased with increasing duration of coal use, compared with the risk in never users. The association between coal use and ischemic heart disease mortality diminished with increasing years since cessation of coal use. Conclusions: Evidence from this study suggests that past use of coal among women in Shanghai is associated with excess all-cause mortality, and from cardiovascular diseases in particular. The decreasing association with cardiovascular mortality as the time since last use of coal increased emphasizes the importance of reducing use of household coal where use is still widespread. Citation: Kim C, Seow WJ, Shu XO, Bassig BA, Rothman N, Chen BE, Xiang YB, Hosgood HD III, Ji BT, Hu W, Wen C, Chow WH, Cai Q, Yang G, Gao YT, Zheng W, Lan Q. 2016. Cooking coal use and all-cause and cause-specific mortality in

  3. Perineural invasion associated with increased cancer-specific mortality after external beam radiation therapy for men with low- and intermediate-risk prostate cancer

    SciTech Connect

    Beard, Clair . E-mail: cbeard@lroc.harvard.edu; Schultz, Delray; Loffredo, Marian; Cote, Kerri; Renshaw, Andrew A.; Hurwitz, Mark D.; D'Amico, Anthony V.

    2006-10-01

    Purpose: To identify an association between perineural invasion (PNI) and cancer-specific survival in patients with prostate cancer after standard-dose external beam radiation therapy (RT). Methods and Materials: A total of 517 consecutive patients who underwent RT (median dose, 70.5 Gy) between 1989 and 2003 for low-risk or intermediate-risk prostate cancer were studied. A genitourinary pathologist (AAR) scored presence or absence of PNI on all prostate needle-biopsy specimens. A Cox regression multivariable analysis was performed to assess whether the presence of PNI was associated with risk of prostate cancer-specific mortality after RT when the recognized risk-group variables were factored into the model. Estimates of cancer-specific mortality were made using a cumulative incidence method. Comparisons of survival were made using a two-tailed log-rank test. Results: At a median follow-up of 4.5 years, 84 patients (16%) have died, 15 of 84 (18%) from prostate cancer. PNI was the only significant predictor of prostate cancer-specific mortality after RT (p = 0.012). The estimated prostate cancer-specific mortality was 14% at 8 years for PNI+ patients vs. 5% for PNI- patients (p = 0.0008). Conclusions: Patients with low- or intermediate-risk prostate cancer who have PNI on prostate needle biopsy have a significantly higher rate of prostate cancer-specific mortality after standard-dose radiation therapy than patients without PNI. Although this analysis is retrospective, this association argues for consideration of the use of more aggressive therapy, such as hormonal therapy with RT or dose escalation, in these select patients.

  4. Enduring health effects of asbestos use in Belgian industries: a record-linked cohort study of cause-specific mortality (2001–2009)

    PubMed Central

    Van den Borre, Laura; Deboosere, Patrick

    2015-01-01

    Objective To investigate cause-specific mortality among asbestos workers and potentially exposed workers in Belgium and evaluate potential excess in mortality due to established and suspected asbestos-related diseases. Design This cohort study is based on an individual record linkage between the 1991 Belgian census and cause-specific mortality information for Flanders and Brussels (2001–2009). Setting Belgium (Flanders and Brussels region). Participants The study population consists of 1 397 699 male workers (18–65 years) with 72 074 deaths between 1 October 2001 and 31 December 2009. Using a classification of high-risk industries, mortality patterns between 2056 asbestos workers, 385 046 potentially exposed workers and the working population have been compared. Outcome measures Standardised mortality ratios (SMRs) and 95% CIs are calculated for manual and non-manual workers. Results Our findings show clear excess in asbestos-related mortality in the asbestos industry with SMRs for mesothelioma of 4071 (CI 2327 to 6611) among manual workers and of 4489 (CI 1458 to 10 476) among non-manual workers. Excess risks in asbestos-related mortality are also found in the chemical industry, the construction industry, the electrical generation and distribution industry, the basic metals manufacturing industry, the metal products manufacturing industry, the railroad industry, and the shipping industry. Oral cancer mortality is significantly higher for asbestos workers (SMR 383; CI 124 to 894), railroad workers (SMR 192; CI 112 to 308), shipping workers (SMR 172; CI 102 to 271) and construction workers (SMR 125; CI 100 to 153), indicating a possible association with occupational asbestos exposure. Workers in all four industries have elevated mortality rates for cancer of the mouth. Only construction workers experience significantly higher pharyngeal cancer mortality (SMR 151; CI 104 to 212). Conclusions The study identifies vulnerable groups of Belgian asbestos

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

    PubMed Central

    2011-01-01

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

  6. Associations of Plasma Phospholipid SFAs with Total and Cause-Specific Mortality in Older Adults Differ According to SFA Chain Length1234

    PubMed Central

    Fretts, Amanda M; Mozaffarian, Dariush; Siscovick, David S; King, Irena B; McKnight, Barbara; Psaty, Bruce M; Rimm, Eric B; Sitlani, Colleen; Sacks, Frank M; Song, Xiaoling; Sotoodehnia, Nona; Spiegelman, Donna; Lemaitre, Rozenn N

    2016-01-01

    Background: Not much is known about the relations of circulating saturated fatty acids (SFAs), which are influenced by both metabolic and dietary determinants, with total and cause-specific mortality. Objective: We examined the associations of plasma phospholipid SFAs with total and cause-specific mortality among 3941 older adults from the Cardiovascular Health Study, a population-based prospective study of adults aged ≥65 y who were followed from 1992 through 2011. Methods: The relations of total and cause-specific mortality with plasma phospholipid palmitic acid (16:0), stearic acid (18:0), arachidic acid (20:0), behenic acid (22:0), and lignoceric acid (24:0) were assessed using Cox proportional hazards models. Results: During 45,450 person-years of follow-up, 3134 deaths occurred. Higher concentrations of the plasma phospholipid SFAs 18:0, 22:0, and 24:0 were associated with a lower risk of total mortality [multivariable-adjusted HRs (95% CIs)] for the top compared with the bottom quintile: 0.85 (0.75, 0.95) for 18:0; 0.85 (0.75, 0.95) for 22:0; and 0.80 (0.71, 0.90) for 24:0. In contrast, plasma 16:0 concentrations in the highest quintile were associated with a higher risk of total mortality compared with concentrations in the lowest quintile [1.25 (1.11, 1.41)]. We also found no association of plasma phospholipid 20:0 with total mortality. Conclusions: These findings suggest that the associations of plasma phospholipid SFAs with the risk of death differ according to SFA chain length and support future studies to better characterize the determinants of circulating SFAs and to explore the mechanisms underlying these relations. PMID:26701797

  7. Brachytherapy boost and cancer-specific mortality in favorable high-risk versus other high-risk prostate cancer

    PubMed Central

    Muralidhar, Vinayak; Xiang, Michael; Orio, Peter F.; Martin, Neil E.; Beard, Clair J.; Feng, Felix Y.; Hoffman, Karen E.

    2016-01-01

    Purpose Recent retrospective data suggest that brachytherapy (BT) boost may confer a cancer-specific survival benefit in radiation-managed high-risk prostate cancer. We sought to determine whether this survival benefit would extend to the recently defined favorable high-risk subgroup of prostate cancer patients (T1c, Gleason 4 + 4 = 8, PSA < 10 ng/ml or T1c, Gleason 6, PSA > 20 ng/ml). Material and methods We identified 45,078 patients in the Surveillance, Epidemiology, and End Results database with cT1c-T3aN0M0 intermediate- to high-risk prostate cancer diagnosed 2004-2011 treated with external beam radiation therapy (EBRT) only or EBRT plus BT. We used multivariable competing risks regression to determine differences in the rate of prostate cancer-specific mortality (PCSM) after EBRT + BT or EBRT alone in patients with intermediate-risk, favorable high-risk, or other high-risk disease after adjusting for demographic and clinical factors. Results EBRT + BT was not associated with an improvement in 5-year PCSM compared to EBRT alone among patients with favorable high-risk disease (1.6% vs. 1.8%; adjusted hazard ratio [AHR]: 0.56; 95% confidence interval [CI]: 0.21-1.52, p = 0.258), and intermediate-risk disease (0.8% vs. 1.0%, AHR: 0.83, 95% CI: 0.59-1.16, p = 0.270). Others with high-risk disease had significantly lower 5-year PCSM when treated with EBRT + BT compared with EBRT alone (3.9% vs. 5.3%; AHR: 0.73; 95% CI: 0.55-0.95; p = 0.022). Conclusions Brachytherapy boost is associated with a decreased rate of PCSM in some men with high-risk prostate cancer but not among patients with favorable high-risk disease. Our results suggest that the recently-defined “favorable high-risk” category may be used to personalize therapy for men with high-risk disease. PMID:26985191

  8. Testing the hypothesis that diphtheria–tetanus–pertussis vaccine has negative non-specific and sex-differential effects on child survival in high-mortality countries

    PubMed Central

    Benn, Christine; Nielsen, Jens; Lisse, Ida Maria; Rodrigues, Amabelia; Ravn, Henrik

    2012-01-01

    Background Measles vaccines (MV) have sex-differential effects on mortality not explained by protection against measles infection. Objective The authors examined whether whole-cell diphtheria–tetanus–pertussis (DTP) vaccine has sex-differential and non-specific effects. Data sources and eligibility Following previous reviews and a new search, the effect of DTP on mortality up to the next vaccination was assessed in all studies where DTP was given after BCG or DTP was given after MV and there was prospective follow-up after ascertainment of vaccination status. Setting High-mortality countries in Africa and Asia. Methods The initial observation of negative effect of DTP generated six hypotheses, which were examined in all available studies and two randomised trials reducing the time of exposure to DTP. Main outcome Consistency between studies. Results In the first study, DTP had negative effects on survival in contrast to the beneficial effects of BCG and MV. This pattern was repeated in the six other studies available. Second, the two ‘natural experiments’ found significantly higher mortality for DTP-vaccinated compared with DTP-unvaccinated children. Third, the female–male mortality ratio was increased after DTP in all nine studies; in contrast, the ratio was decreased after BCG and MV in all studies. Fourth, the increased female mortality associated with high-titre measles vaccine was found only among children who had received DTP after high-titre measles vaccine. Fifth, in six randomised trials of early MV, female but not male mortality was increased if DTP was likely to be given after MV. Sixth, the mortality rate declined markedly for girls but not for boys when DTP-vaccinated children received MV. The authors reduced exposure to DTP as most recent vaccination by administering a live vaccine (MV and BCG) shortly after DTP. Both trials reduced child mortality. Conclusions These observations are incompatible with DTP merely protecting against the

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

    PubMed Central

    2014-01-01

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

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

    PubMed Central

    2011-01-01

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

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

    PubMed

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

    2016-03-01

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

  12. Does sickness absence due to psychiatric disorder predict cause-specific mortality? A 16-year follow-up of the GAZEL occupational cohort study.

    PubMed

    Melchior, Maria; Ferrie, Jane E; Alexanderson, Kristina; Goldberg, Marcel; Kivimaki, Mika; Singh-Manoux, Archana; Vahtera, Jussi; Westerlund, Hugo; Zins, Marie; Head, Jenny

    2010-09-15

    Mental disorders are a frequent cause of morbidity and sickness absence in working populations; however, the status of psychiatric sickness absence as a predictor of mortality is not established. The authors tested the hypothesis that psychiatric sickness absence predicts mortality from leading medical causes. Data were derived from the French GAZEL cohort study (n = 19,962). Physician-certified sickness absence records were extracted from administrative files (1990-1992) and were linked to mortality data from France's national registry of mortality (1993-2008, mean follow-up: 15.5 years). Analyses were conducted by using Cox regression models. Compared with workers with no sickness absence, those absent due to psychiatric disorder were at increased risk of cause-specific mortality (hazard ratios (HRs) adjusted for age, gender, occupational grade, other sickness absence-suicide: 6.01, 95% confidence interval (CI): 3.07, 11.75; cardiovascular disease: 1.84, 95% CI: 1.10, 3.08; and smoking-related cancer: 1.65, 95% CI: 1.07, 2.53). After full adjustment, the excess risk of suicide remained significant (HR = 5.13, 95% CI: 2.60, 10.13) but failed to reach statistical significance for fatal cardiovascular disease (HR = 1.59, 95% CI: 0.95, 2.66) and smoking-related cancer (HR = 1.31, 95% CI: 0.85, 2.03). Psychiatric sickness absence records could help identify individuals at risk of premature mortality and serve to monitor workers' health.

  13. Blood Lead Levels and Cause-Specific Mortality of Inorganic Lead-Exposed Workers in South Korea

    PubMed Central

    Kim, Min-Gi; Ryoo, Jae-Hong; Chang, Se-Jin; Kim, Chun-Bae; Park, Jong-Ku; Koh, Sang-Baek; Ahn, Yeon-Soon

    2015-01-01

    The objective of this study was to identify the association of blood lead level (BLL) with mortality in inorganic lead-exposed workers of South Korea. A cohort was compiled comprising 81,067 inorganic lead exposed workers working between January 1, 2000, and December 31, 2004. This cohort was merged with the Korean National Statistical Office to follow-up for mortality between 2000 and 2008. After adjusting for age and other carcinogenic metal exposure, all-cause mortality (Relative risk [RR] 1.36, 95% confidence interval [CI] 1.03–1.79), digestive disease (RR 3.23, 95% CI 1.33–7.86), and intentional self-harm (RR 2.92, 95% CI 1.07–7.81) were statistically significantly higher in males with BLL >20 μg/dl than of those with BLL ≤10μg/dl. The RR of males with BLL of 10–20 μg/dl was statistically higher than of those with BLL ≤10μg/dl in infection (RR 3.73. 95% CI, 1.06–13.06). The RRs of females with 10–20 μg/dl BLL was statistically significantly greater than those with BLL <10μg/dl in all-cause mortality (RR 1.93, 95% CI 1.16–3.20) and colon and rectal cancer (RR 13.42, 95% CI 1.21–149.4). The RRs of females with BLL 10–20 μg/dl (RR 10.45, 95% CI 1.74–62.93) and BLL ≥20 μg/dl (RR 12.68, 95% CI 1.69–147.86) was statistically significantly increased in bronchus and lung cancer. The increased suicide of males with ≥20 μg/dl BLLs, which might be caused by major depression, might be associated with higher lead exposure. Also, increased bronchus and lung cancer mortality in female workers with higher BLL might be related to lead exposure considering low smoking rate in females. The kinds of BLL-associated mortality differed by gender. PMID:26469177

  14. Association of Metformin Use With Cancer-Specific Mortality in Hepatocellular Carcinoma After Curative Resection: A Nationwide Population-Based Study.

    PubMed

    Seo, Young-Seok; Kim, Yun-Jung; Kim, Mi-Sook; Suh, Kyung-Suk; Kim, Sang Bum; Han, Chul Ju; Kim, Youn Joo; Jang, Won Il; Kang, Shin Hee; Tchoe, Ha Jin; Park, Chan Mi; Jo, Ae Jung; Kim, Hyo Jeong; Choi, Jin A; Choi, Hyung Jin; Polak, Michael N; Ko, Min Jung

    2016-04-01

    Many preclinical reports and retrospective population studies have shown an anticancer effect of metformin in patients with several types of cancer and comorbid type 2 diabetes mellitus (T2DM). In this work, the anticancer effect of metformin was assessed in hepatocellular carcinoma (HCC) patients with T2DM who underwent curative resection.A population-based retrospective cohort design was used. Data were obtained from the National Health Insurance Service and Korea Center Cancer Registry in the Republic of Korea, identifying 5494 patients with newly diagnosed HCC who underwent curative resection between 2005 and 2011. Crude and adjusted hazard ratios (HRs) were calculated using Cox proportional hazard models to estimate effects. In the sensitivity analysis, we excluded patients who started metformin or other oral hypoglycemic agents (OHAs) after HCC diagnosis to control for immortal time bias.From the patient cohort, 751 diabetic patients who were prescribed an OHA were analyzed for HCC-specific mortality and retreatment upon recurrence, comparing 533 patients treated with metformin to 218 patients treated without metformin. In the fully adjusted analyses, metformin users showed a significantly lower risk of HCC-specific mortality (HR 0.38, 95% confidence interval [CI] 0.30-0.49) and retreatment events (HR 0.41, 95% CI 0.33-0.52) compared with metformin nonusers. Risks for HCC-specific mortality were consistently lower among metformin-using groups, excluding patients who started metformin or OHAs after diagnosis.In this large population-based cohort of patients with comorbid HCC and T2DM, treated with curative hepatic resection, metformin use was associated with improvement of HCC-specific mortality and reduced occurrence of retreatment events.

  15. Non-steroidal anti-inflammatory drug use, hormone receptor status, and breast cancer-specific mortality in the Carolina Breast Cancer Study.

    PubMed

    Allott, E H; Tse, C-K; Olshan, A F; Carey, L A; Moorman, P G; Troester, M A

    2014-09-01

    Epidemiologic studies report a protective association between non-steroidal anti-inflammatory drug (NSAID) use and hormone receptor-positive breast cancer risk, a finding consistent with NSAID-mediated suppression of aromatase-driven estrogen biosynthesis. However, the association between NSAID use and breast cancer-specific mortality is uncertain and it is unknown whether this relationship differs by hormone receptor status. This study comprised 935 invasive breast cancer cases, of which 490 were estrogen receptor (ER)-positive, enrolled between 1996 and 2001 in the Carolina Breast Cancer Study. Self-reported NSAID use in the decade prior to diagnosis was categorized by duration and regularity of use. Differences in tumor size, stage, node, and receptor status by NSAID use were examined using Chi-square tests. Associations between NSAID use and breast cancer-specific mortality were examined using age- and race-adjusted Cox proportional hazards analysis. Tumor characteristics did not differ by NSAID use. Increased duration and regularity of NSAID use was associated with reduced breast cancer-specific mortality in women with ER-positive tumors (long-term regular use (≥8 days/month for ≥ 3 years) versus no use; hazard ratio (HR) 0.48; 95 % confidence interval (CI) 0.23-0.98), with a statistically significant trend with increasing duration and regularity (p-trend = 0.036). There was no association for ER-negative cases (HR 1.19; 95 %CI 0.50-2.81; p-trend = 0.891). Long-term, regular NSAID use in the decade prior to breast cancer diagnosis was associated with reduced breast cancer-specific mortality in ER-positive cases. If confirmed, these findings support the hypothesis that potential chemopreventive properties of NSAIDs are mediated, at least in part, through suppression of estrogen biosynthesis.

  16. Population-Based Long-Term Cardiac-Specific Mortality Among 34 489 Five-Year Survivors of Childhood Cancer in Great Britain

    PubMed Central

    Fidler, Miranda M.; Reulen, Raoul C.; Henson, Katherine; Kelly, Julie; Cutter, David; Levitt, Gill A.; Frobisher, Clare; Winter, David L.

    2017-01-01

    Background: Increased risks of cardiac morbidity and mortality among childhood cancer survivors have been described previously. However, little is known about the very long-term risks of cardiac mortality and whether the risk has decreased among those more recently diagnosed. We investigated the risk of long-term cardiac mortality among survivors within the recently extended British Childhood Cancer Survivor Study. Methods: The British Childhood Cancer Survivor Study is a population-based cohort of 34 489 five-year survivors of childhood cancer diagnosed from 1940 to 2006 and followed up until February 28, 2014, and is the largest cohort to date to assess late cardiac mortality. Standardized mortality ratios and absolute excess risks were used to quantify cardiac mortality excess risk. Multivariable Poisson regression models were used to evaluate the simultaneous effect of risk factors. Likelihood ratio tests were used to test for heterogeneity and trends. Results: Overall, 181 cardiac deaths were observed, which was 3.4 times that expected. Survivors were 2.5 times and 5.9 times more at risk of ischemic heart disease and cardiomyopathy/heart failure death, respectively, than expected. Among those >60 years of age, subsequent primary neoplasms, cardiac disease, and other circulatory conditions accounted for 31%, 22%, and 15% of all excess deaths, respectively, providing clear focus for preventive interventions. The risk of both overall cardiac and cardiomyopathy/heart failure mortality was greatest among those diagnosed from 1980 to 1989. Specifically, for cardiomyopathy/heart failure deaths, survivors diagnosed from 1980 to 1989 had 28.9 times the excess number of deaths observed for survivors diagnosed either before 1970 or from 1990 on. Conclusions: Excess cardiac mortality among 5-year survivors of childhood cancer remains increased beyond 50 years of age and has clear messages in terms of prevention strategies. However, the fact that the risk was greatest in

  17. Combined associations of body weight and lifestyle factors with all cause and cause specific mortality in men and women: prospective cohort study

    PubMed Central

    Veronese, Nicola; Li, Yanping; Manson, JoAnn E; Willett, Walter C; Fontana, Luigi

    2016-01-01

    Objective To evaluate the combined associations of diet, physical activity, moderate alcohol consumption, and smoking with body weight on risk of all cause and cause specific mortality. Design Longitudinal study with up to 32 years of follow-up. Setting Nurses’ Health Study (1980-2012) and Health Professionals Follow-up Study (1986-2012). Participants 74 582 women from the Nurses’ Health Study and 39 284 men from the Health Professionals Follow-up Study who were free from cardiovascular disease and cancer at baseline. Main outcome measures Exposures included body mass index (BMI), score on the alternate healthy eating index, level of physical activity, smoking habits, and alcohol drinking while outcome was mortality (all cause, cardiovascular, cancer). Cox proportional hazard models were used to calculate the adjusted hazard ratios of all cause, cancer, and cardiovascular mortality with their 95% confidence intervals across categories of BMI, with 22.5-24.9 as the reference. Results During up to 32 years of follow-up, there were 30 013 deaths (including 10 808 from cancer and 7189 from cardiovascular disease). In each of the four categories of BMI studied (18.5-22.4, 22.5-24.9, 25-29.9, ≥30), people with one or more healthy lifestyle factors had a significantly lower risk of total, cardiovascular, and cancer mortality than individuals with no low risk lifestyle factors. A combination of at least three low risk lifestyle factors and BMI between 18.5-22.4 was associated with the lowest risk of all cause (hazard ratio 0.39, 95% confidence interval 0.35 to 0.43), cancer (0.40, 0.34 to 0.47), and cardiovascular (0.37, 0.29 to 0.46) mortality, compared with those with BMI between 22.5-24.9 and none of the four low risk lifestyle factors. Conclusion Although people with a higher BMI can have lower risk of premature mortality if they also have at least one low risk lifestyle factor, the lowest risk of premature mortality is in people in the 18

  18. [Association between body mass index and both total and cause-specific mortality in China: findings from data through the China Kadoorie Biobank].

    PubMed

    Wang, L X; Fan, M Y; Yu, C Q; Guo, Y; Bian, Z; Tan, Y L; Pei, P; Chen, J S; Lyu, J; Li, L M

    2017-02-10

    Objective: To evaluate the associations between body mass index (BMI) and both total and cause-specific mortality. Methods: After excluding participants with heart disease, stroke, cancer, chronic obstructive pulmonary disease, and diabetes at baseline study, 428 593 participants aged 30-79 in the China Kadoorie Biobank study were chosen for this study. Participants were categorized into 9 groups according to their BMI status. Cox regression analysis was used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) of mortality on BMI. Results: Among 3 085 054 person-years of the follow-up program between 2004 and 2013 (median 7.2 years), a total of 7 862 men and 6 315 women died. After adjusting for known or potential confounders, an increased risks of all-cause deaths were shown among participants with a BMI less than 18.5 (HR=1.40, 95%CI: 1.31-1.50), between 18.5-20.4 (HR=1.11, 95%CI: 1.05-1.17), and more than 35.0 (HR=2.05, 95%CI: 1.60-2.61), when compared to those with BMI between 20.5-22.4. Ranges of BMI with lower risk of cause-specific mortality were: 18.5-23.9 for ischemic heart disease, <26.0 for cerebro-vascular disease, 26.0-34.9 for cancers, and 24.0-25.9 for respiratory diseases. Conclusions: In this large prospective study, both underweight and obesity were associated with the increased total and certain cause-specific mortality, which were independent from other risk factors of death. Programs related to extensive follow-up, thorough analysis BMI and the risks of incidence on major chronic diseases all need to be developed, in order to better understand the impact of BMI on human health.

  19. Acute Effects of Nitrogen Dioxide on Cardiovascular Mortality in Beijing: An Exploration of Spatial Heterogeneity and the District-specific Predictors

    NASA Astrophysics Data System (ADS)

    Luo, Kai; Li, Runkui; Li, Wenjing; Wang, Zongshuang; Ma, Xinming; Zhang, Ruiming; Fang, Xin; Wu, Zhenglai; Cao, Yang; Xu, Qun

    2016-12-01

    The exploration of spatial variation and predictors of the effects of nitrogen dioxide (NO2) on fatal health outcomes is still sparse. In a multilevel case-crossover study in Beijing, China, we used mixed Cox proportional hazard model to examine the citywide effects and conditional logistic regression to evaluate the district-specific effects of NO2 on cardiovascular mortality. District-specific predictors that could be related to the spatial pattern of NO2 effects were examined by robust regression models. We found that a 10 μg/m3 increase in daily mean NO2 concentration was associated with a 1.89% [95% confidence interval (CI): 1.33–2.45%], 2.07% (95% CI: 1.23–2.91%) and 1.95% (95% CI: 1.16–2.72%) increase in daily total cardiovascular (lag03), cerebrovascular (lag03) and ischemic heart disease (lag02) mortality, respectively. For spatial variation of NO2 effects across 16 districts, significant effects were only observed in 5, 4 and 2 districts for the above three outcomes, respectively. Generally, NO2 was likely having greater adverse effects on districts with larger population, higher consumption of coal and more civilian vehicles. Our results suggested independent and spatially varied effects of NO2 on total and subcategory cardiovascular mortalities. The identification of districts with higher risk can provide important insights for reducing NO2 related health hazards.

  20. Acute Effects of Nitrogen Dioxide on Cardiovascular Mortality in Beijing: An Exploration of Spatial Heterogeneity and the District-specific Predictors

    PubMed Central

    Luo, Kai; Li, Runkui; Li, Wenjing; Wang, Zongshuang; Ma, Xinming; Zhang, Ruiming; Fang, Xin; Wu, Zhenglai; Cao, Yang; Xu, Qun

    2016-01-01

    The exploration of spatial variation and predictors of the effects of nitrogen dioxide (NO2) on fatal health outcomes is still sparse. In a multilevel case-crossover study in Beijing, China, we used mixed Cox proportional hazard model to examine the citywide effects and conditional logistic regression to evaluate the district-specific effects of NO2 on cardiovascular mortality. District-specific predictors that could be related to the spatial pattern of NO2 effects were examined by robust regression models. We found that a 10 μg/m3 increase in daily mean NO2 concentration was associated with a 1.89% [95% confidence interval (CI): 1.33–2.45%], 2.07% (95% CI: 1.23–2.91%) and 1.95% (95% CI: 1.16–2.72%) increase in daily total cardiovascular (lag03), cerebrovascular (lag03) and ischemic heart disease (lag02) mortality, respectively. For spatial variation of NO2 effects across 16 districts, significant effects were only observed in 5, 4 and 2 districts for the above three outcomes, respectively. Generally, NO2 was likely having greater adverse effects on districts with larger population, higher consumption of coal and more civilian vehicles. Our results suggested independent and spatially varied effects of NO2 on total and subcategory cardiovascular mortalities. The identification of districts with higher risk can provide important insights for reducing NO2 related health hazards. PMID:27910959

  1. Glycated Hemoglobin and All-Cause and Cause-Specific Mortality in Singaporean Chinese Without Diagnosed Diabetes: The Singapore Chinese Health Study

    PubMed Central

    Bancks, Michael P.; Odegaard, Andrew O.; Pankow, James S.; Koh, Woon-Puay; Yuan, Jian-Min; Gross, Myron D.

    2014-01-01

    OBJECTIVE Glycated hemoglobin (HbA1c) is a robust biomarker of the preceding 2 to 3 months average blood glucose level. The aim of this study was to examine the association between HbA1c and mortality in a cohort of Southeast Asians. RESEARCH DESIGN AND METHODS Analysis of 7,388 men and women, mean age 62 years, from the Singapore Chinese Health Study who provided a blood sample at the follow-up I visit (1999–2004) and reported no history of diabetes, previous adverse cardiovascular events, or cancer. A total of 888 deaths were identified through 31 December 2011 via registry linkage. Participants represented a random study sample of potential control subjects for a nested case-control genome-wide association study of type 2 diabetes in the population. Hazard ratios (HRs) for all-cause and cause-specific mortality by six categories of HbA1c were estimated with Cox regression models. RESULTS Relative to participants with an HbA1c of 5.4–5.6% (36–38 mmol/mol), participants with HbA1c ≥6.5% (≥48 mmol/mol) had an increased risk of all-cause, cardiovascular, and cancer mortality during an average of 10.1 years of follow-up; HRs (95% CIs) were 1.96 (1.56–2.46), 2.63 (1.77–3.90), and 1.51 (1.04–2.18), respectively. No level of HbA1c was associated with increased risk of respiratory mortality. Levels <6.5% HbA1c were not associated with mortality during follow-up. The results did not materially change after excluding observation of first 3 years post–blood draw. CONCLUSIONS HbA1c levels consistent with undiagnosed type 2 diabetes (≥6.5%) are associated with an increased risk of all-cause and cause-specific mortality in Chinese men and women. PMID:25216509

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

    PubMed Central

    Lipfert, F; Morris, S

    2002-01-01

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

  3. Establishment of Definitions and Review Process for Consistent Adjudication of Cause-Specific Mortality After Allogeneic Unrelated Donor Hematopoietic Cell Transplantation

    PubMed Central

    Preus, Leah; Zhu, Xiaochun; Hansen, John A.; Martin, Paul J.; Yan, Li; Liu, Song; Spellman, Stephen; Tritchler, David; Clay, Alyssa

    2015-01-01

    Clinical trials commonly use adjudication committees to refine endpoints, but observational research or genome-wide association studies rarely do. Our goals were to establish definitions of cause-specific death after unrelated donor allogeneic hematopoietic cell transplantation (URD-HCT), estimate discordance between reported and adjudicated cause-specific death, and identify factors contributing to inconsistency in cause-specific deathdetermination. A consensus panel adjudicated cause-specific deathin 1,484 patients who died within 1 year after HCT, derived from 3,532 acute leukemia or myelodysplasia patients after URD-HCT 2000-2011 reported by 151 U.S. transplant centers to CIBMTR. Deaths were classified as disease-related (DRM) or transplant-related (TRM). The panel agreed with >99% of deaths reported by centers as DRM and 80% reported as TRM. Year of transplant (cohort effect) and disease status significantly influenced agreement between panel and centers. Sensitivity analysis of deaths <100 days post-transplant yielded lowest agreement between the panel and centers for myelodysplastic syndrome patients. Standard pre-defined criteria for adjudicating cause-specific deathled to consistent application to similar clinical scenarios and clearer delineation of cause-specific deathcategories. Other studies of competing events like cancer-specific vs treatment-related mortality would benefit from our results. Our detailed algorithm should result in more consistent reporting of cause-specific deathby centers. PMID:26028504

  4. Kidney function and specific mortality in 60-80 years old post-myocardial infarction patients: A 10-year follow-up study

    PubMed Central

    Geleijnse, Johanna M.; Giltay, Erik J.; Soedamah-Muthu, Sabita S.; de Goede, Janette; Oude Griep, Linda M.; Stijnen, Theo; Kromhout, Daan

    2017-01-01

    Chronic kidney disease (CKD) is highly prevalent among older post-myocardial infarction (MI) patients. It is not known whether CKD is an independent risk factor for mortality in older post-MI patients with optimal cardiovascular drug-treatment. Therefore, we studied the relation between kidney function and all-cause and specific mortality among older post-MI patients, without severe heart failure, who are treated with state-of-the-art pharmacotherapy. From 2002–2006, 4,561 Dutch post-MI patients were enrolled and followed until death or January 2012. We estimated Glomerular Filtration Rate (eGFR) with cystatin C (cysC) and creatinine (cr) using the CKD-EPI equations and analyzed the relation with any and major causes of death using Cox models and restricted cubic splines. Mean (SD) for age was 69 years (5.6), 79% were men, 17% smoked, 21% had diabetes, 90% used antihypertensive drugs, 98% used antithrombotic drugs and 85% used statins. Patients were divided into four categories of baseline eGFRcysC: ≥90 (33%; reference), 60–89 (47%), 30–59 (18%), and <30 (2%) ml/min/1.73m2. Median follow-up was 6.4 years. During follow-up, 873 (19%) patients died: 370 (42%) from cardiovascular causes, 309 (35%) from cancer, and 194 (22%) from other causes. After adjustment for age, sex and classic cardiovascular risk factor, hazard ratios (95%-confidence intervals) for any death according to the four eGFRcysC categories were: 1 (reference), 1.4 (1.1–1.7), 2.9 (2.3–3.6) and 4.4 (3.0–6.4). The hazard ratios of all-cause and cause-specific mortality increased linearly below kidney functions of 80 ml/min/1.73 m2. Weaker results were obtained for eGFRcr. To conclude, we found in optimal cardiovascular drug-treated post-MI patients an inverse graded relation between kidney function and mortality for both cardiovascular as well as non-cardiovascular causes. Risk of mortality increased linearly below kidney function of about 80 ml/min/1.73 m2. PMID:28182761

  5. Impact of cervical screening on cervical cancer mortality: estimation using stage-specific results from a nested case–control study

    PubMed Central

    Landy, Rebecca; Pesola, Francesca; Castañón, Alejandra; Sasieni, Peter

    2016-01-01

    Background: It is well established that screening can prevent cervical cancer, but the magnitude of the impact of regular screening on cervical cancer mortality is unknown. Methods: Population-based case–control study using prospectively recorded cervical screening data, England 1988–2013. Case women had cervical cancer diagnosed during April 2007–March 2013 aged 25–79 years (N=11 619). Two cancer-free controls were individually age matched to each case. We used conditional logistic regression to estimate the odds ratio (OR) of developing stage-specific cancer for women regularly screened or irregularly screened compared with women not screened in the preceding 15 years. Mortality was estimated from excess deaths within 5 years of diagnosis using stage-specific 5-year relative survival from England with adjustment for age within stage based on SEER (Surveillance, Epidemiology and End Results, USA) data. Results: In women aged 35–64 years, regular screening is associated with a 67% (95% confidence interval (CI): 62–73%) reduction in stage 1A cancer and a 95% (95% CI: 94–97%) reduction in stage 3 or worse cervical cancer: the estimated OR comparing regular (⩽5.5yearly) screening to no (or minimal) screening are 0.18 (95% CI: 0.16–0.19) for cancer incidence and 0.08 (95% CI: 0.07–0.09) for mortality. It is estimated that in England screening currently prevents 70% (95% CI: 66–73%) of cervical cancer deaths (all ages); however, if everyone attended screening regularly, 83% (95% CI: 82–84%) could be prevented. Conclusions: The association between cervical cancer screening and incidence is stronger in more advanced stage cancers, and screening is more effective at preventing death from cancer than preventing cancer itself. PMID:27632376

  6. Trajectory of body shape in early and middle life and all cause and cause specific mortality: results from two prospective US cohort studies

    PubMed Central

    Hu, Frank B; Wu, Kana; Must, Aviva; Chan, Andrew T; Willett, Walter C; Giovannucci, Edward L

    2016-01-01

    Objective To assess body shape trajectories in early and middle life in relation to risk of mortality. Design Prospective cohort study. Setting Nurses’ Health Study and Health Professionals Follow-up Study. Population 80 266 women and 36 622 men who recalled their body shape at ages 5, 10, 20, 30, and 40 years and provided body mass index at age 50, followed from age 60 over a median of 15-16 years for death. Main outcome measures All cause and cause specific mortality. Results Using a group based modeling approach, five distinct trajectories of body shape from age 5 to 50 were identified: lean-stable, lean-moderate increase, lean-marked increase, medium-stable/increase, and heavy-stable/increase. The lean-stable group was used as the reference. Among never smokers, the multivariable adjusted hazard ratio for death from any cause was 1.08 (95% confidence interval 1.02 to 1.14) for women and 0.95 (0.88 to 1.03) for men in the lean-moderate increase group, 1.43 (1.33 to 1.54) for women and 1.11 (1.02 to 1.20) for men in the lean-marked increase group, 1.04 (0.97 to 1.12) for women and 1.01 (0.94 to 1.09) for men in the medium-stable/increase group, and 1.64 (1.49 to 1.81) for women and 1.19 (1.08 to 1.32) for men in the heavy-stable/increase group. For cause specific mortality, participants in the heavy-stable/increase group had the highest risk, with a hazard ratio among never smokers of 2.30 (1.88 to 2.81) in women and 1.45 (1.23 to 1.72) in men for cardiovascular disease, 1.37 (1.14 to 1.65) in women and 1.07 (0.89 to 1.30) in men for cancer, and 1.59 (1.38 to 1.82) in women and 1.10 (0.95 to 1.29) in men for other causes. The trajectory-mortality association was generally weaker among ever smokers than among never smokers (for all cause mortality: P for interaction <0.001 in women and 0.06 in men). When participants were classified jointly according to trajectories and history of type 2 diabetes, the increased risk of death associated with heavier

  7. Male Pattern Baldness in Relation to Prostate Cancer–Specific Mortality: A Prospective Analysis in the NHANES I Epidemiologic Follow-up Study

    PubMed Central

    Zhou, Cindy Ke; Levine, Paul H.; Cleary, Sean D.; Hoffman, Heather J.; Graubard, Barry I.; Cook, Michael B.

    2016-01-01

    We used male pattern baldness as a proxy for long-term androgen exposure and investigated the association of dermatologist-assessed hair loss with prostate cancer–specific mortality in the first National Health and Nutrition Examination Survey Epidemiologic Follow-up Study. From the baseline survey (1971–1974), we included 4,316 men who were 25–74 years of age and had no prior cancer diagnosis. We estimated hazard ratios and used Cox proportional hazards regressions with age as the time metric and baseline hazard stratified by baseline age. A hybrid framework was used to account for stratification and clustering of the sample design, with adjustment for the variables used to calculate sample weights. During follow-up (median, 21 years), 3,284 deaths occurred; prostate cancer was the underlying cause of 107. In multivariable models, compared with no balding, any baldness was associated with a 56% higher risk of fatal prostate cancer (hazard ratio = 1.56; 95% confidence interval: 1.02, 2.37), and moderate balding specifically was associated with an 83% higher risk (hazard ratio = 1.83; 95% confidence interval: 1.15, 2.92). Conversely, patterned hair loss was not statistically significantly associated with all-cause mortality. Our analysis suggests that patterned hair loss is associated with a higher risk of fatal prostate cancer and supports the hypothesis of overlapping pathophysiological mechanisms. PMID:26764224

  8. Male Pattern Baldness in Relation to Prostate Cancer-Specific Mortality: A Prospective Analysis in the NHANES I Epidemiologic Follow-up Study.

    PubMed

    Zhou, Cindy Ke; Levine, Paul H; Cleary, Sean D; Hoffman, Heather J; Graubard, Barry I; Cook, Michael B

    2016-02-01

    We used male pattern baldness as a proxy for long-term androgen exposure and investigated the association of dermatologist-assessed hair loss with prostate cancer-specific mortality in the first National Health and Nutrition Examination Survey Epidemiologic Follow-up Study. From the baseline survey (1971-1974), we included 4,316 men who were 25-74 years of age and had no prior cancer diagnosis. We estimated hazard ratios and used Cox proportional hazards regressions with age as the time metric and baseline hazard stratified by baseline age. A hybrid framework was used to account for stratification and clustering of the sample design, with adjustment for the variables used to calculate sample weights. During follow-up (median, 21 years), 3,284 deaths occurred; prostate cancer was the underlying cause of 107. In multivariable models, compared with no balding, any baldness was associated with a 56% higher risk of fatal prostate cancer (hazard ratio = 1.56; 95% confidence interval: 1.02, 2.37), and moderate balding specifically was associated with an 83% higher risk (hazard ratio = 1.83; 95% confidence interval: 1.15, 2.92). Conversely, patterned hair loss was not statistically significantly associated with all-cause mortality. Our analysis suggests that patterned hair loss is associated with a higher risk of fatal prostate cancer and supports the hypothesis of overlapping pathophysiological mechanisms.

  9. HIV cause-specific deaths, mortality, risk factors, and the combined influence of HAART and late diagnosis in Zhejiang, China, 2006–2013

    PubMed Central

    Chen, Lin; Pan, Xiaohong; Ma, Qiaoqin; Yang, Jiezhe; Xu, Yun; Zheng, Jinlei; Wang, Hui; Zhou, Xin; Jiang, Tingting; Jiang, Jun; He, Lin; Jiang, Jianmin

    2017-01-01

    To examine patterns of human immunodeficiency virus (HIV) cause-specific deaths, risk factors, and the effect of interactions on mortality, we conducted a retrospective cohort study in Zhejiang, China, from 2006 to 2013. All data were downloaded from the acquired immune deficiency syndrome (AIDS) Prevention and Control Information System. The Cox proportional hazards model was used to assess predictors of cause-specific death. The relative excess risk due to interaction and ratio of hazard ratios (RHR) were calculated for correlations between HAART, late diagnosis, and age. A total of 13,812 HIV/AIDS patients were enrolled with 31,553 person-years (PY) of follow-up. The leading causes of death of HIV patients were accidental death and suicide (21.5%), and the leading cause of death for those with AIDS was AIDS-defining disease (76.4%). Both additive and multiplicative scale correlations were found between receiving HAART and late diagnosis, with RERI of 5.624 (95% CI: 1.766–9.482) and RHR of 2.024 (95% CI: 1.167–2.882). The effects of HAART on AIDS-related mortalities were affected by late diagnosis. Early detection of HIV infection and increased uptake of HAART are important for greater benefits in terms of lives saved. PMID:28198390

  10. Human T-lymphotropic virus type-I infection, antibody titers and cause-specific mortality among atomic-bomb survivors.

    PubMed

    Arisawa, K; Soda, M; Akahoshi, M; Matsuo, T; Nakashima, E; Tomonaga, M; Saito, H

    1998-08-01

    There have been few longitudinal studies on the long-term health effects of human T-lymphotropic virus type-I (HTLV-I) infection. The authors performed a cohort study of HTLV-I infection and cause-specific mortality in 3,090 atomic-bomb survivors in Nagasaki, Japan, who were followed from 1985-1987 to 1995. The prevalence of HTLV-I seropositivity in men and women was 99/1,196 (8.3%) and 171/1,894 (9.0%), respectively. During a median follow-up of 8.9 years, 448 deaths occurred. There was one nonfatal case of adult T-cell leukemia/lymphoma (incidence rate = 0.46 cases/1,000 person-years; 95% confidence interval [CI] 0.01-2.6). After adjustment for sex, age and other potential confounders, significantly increased risk among HTLV-I carriers was observed for deaths from all causes (rate ratio [RR] = 1.41), all cancers (RR = 1.64), liver cancer (RR = 3.04), and heart diseases (RR = 2.22). The association of anti-HTLV-I seropositivity with mortality from all non-neoplastic diseases (RR = 1.40) and chronic liver diseases (RR = 5.03) was of borderline significance. Possible confounding by blood transfusions and hepatitis C/B (HCV/HBV) viral infections could not be precluded in this study. However, even after liver cancer and chronic liver diseases were excluded, mortality rate was still increased among HTLV-I carriers (RR = 1.32, 95% CI 0.99-1.78), especially among those with high antibody titers (RR = 1.56, 95% CI 0.99-2.46, P for trend = 0.04). These findings may support the idea that HTLV-I infection exerts adverse effects on mortality from causes other than adult T-cell leukemia/lymphoma. Further studies on confounding by HCV/HBV infections and the interaction between HCV/HBV and HTLV-I may be required to analyze the increased mortality from liver cancer and chronic liver diseases.

  11. Influence of advections of particulate matter from biomass combustion on specific-cause mortality in Madrid in the period 2004-2009.

    PubMed

    Linares, C; Carmona, R; Tobías, A; Mirón, I J; Díaz, J

    2015-05-01

    Approximately, 20 % of particulate and aerosol emissions into the urban atmosphere are of natural origin (including wildfires and Saharan dust). During these natural episodes, PM10 and PM2.5 levels usually exceed World Health Organisation (WHO) health protection thresholds. This study sought to evaluate the possible effect of advections of particulate matter from biomass fuel combustion on daily specific-cause mortality among the general population and the segment aged ≥ 75 years in Madrid. Ecological time-series study in the city of Madrid from January 01, 2004 to December 31, 2009. The dependent variable analysed was daily mortality due to natural (ICD-10:A00-R99), circulatory (ICD-10:I00-I99), and respiratory (ICD-10:J00-J99) causes in the population, both general and aged ≥ 75 years. The following independent and control variables were considered: a) daily mean PM2.5 and PM10 concentrations; b) maximum daily temperature; c) daily mean O3 and NO2 concentrations; d) advection of particulate matter from biomass combustion ( http://www.calima.ws/ ), using a dichotomous variable and e) linear trend and seasonalities. We conducted a descriptive analysis, performed a test of means and, to ascertain relative risk, fitted a model using autoregressive Poisson regression and stratifying by days with and without biomass advection, in both populations. Of the 2192 days analysed, biomass advection occurred on 56, with mean PM2.5 and PM10 values registering a significant increase during these days. PM10 had a greater impact on organic mortality with advection (RRall ages = 1.035 [1.011-1.060]; RR  ≥  75 years = 1.066 [1.031-1.103]) than did PM2.5 without advection (RRall ages = 1.017 [1.009-1.025]; RR  ≥  75 years = 1.012 [1.003-1.022]). Among specific causes, respiratory-though not circulatory-causes were associated with PM10 on days with advection in ≥ 75 year age group. PM10, rather than PM2.5, were associated with an increase in natural

  12. All cause mortality and the case for age specific alcohol consumption guidelines: pooled analyses of up to 10 population based cohorts

    PubMed Central

    Coombs, Ngaire; Stamatakis, Emmanuel; Biddulph, Jane P

    2015-01-01

    Objectives To examine the suitability of age specific limits for alcohol consumption and to explore the association between alcohol consumption and mortality in different age groups. Design Population based data from Health Survey for England 1998-2008, linked to national mortality registration data and pooled for analysis using proportional hazards regression. Analyses were stratified by sex and age group (50-64 and ≥65 years). Setting Up to 10 waves of the Health Survey for England, which samples the non-institutionalised general population resident in England. Participants The derivation of two analytical samples was based on the availability of comparable alcohol consumption data, covariate data, and linked mortality data among adults aged 50 years or more. Two samples were used, each utilising a different variable for alcohol usage: self reported average weekly consumption over the past year and self reported consumption on the heaviest day in the past week. In fully adjusted analyses, the former sample comprised Health Survey for England years 1998-2002, 18 368 participants, and 4102 deaths over a median follow-up of 9.7 years, whereas the latter comprised Health Survey for England years 1999-2008, 34 523 participants, and 4220 deaths over a median follow-up of 6.5 years. Main outcome measure All cause mortality, defined as any death recorded between the date of interview and the end of data linkage on 31 March 2011. Results In unadjusted models, protective effects were identified across a broad range of alcohol usage in all age-sex groups. These effects were attenuated across most use categories on adjustment for a range of personal, socioeconomic, and lifestyle factors. After the exclusion of former drinkers, these effects were further attenuated. Compared with self reported never drinkers, significant protective associations were limited to younger men (50-64 years) and older women (≥65 years). Among younger men, the range of protective effects was

  13. Daytime napping and the risk of all-cause and cause-specific mortality: a 13-year follow-up of a British population.

    PubMed

    Leng, Yue; Wainwright, Nick W J; Cappuccio, Francesco P; Surtees, Paul G; Hayat, Shabina; Luben, Robert; Brayne, Carol; Khaw, Kay-Tee

    2014-05-01

    Epidemiologic studies have reported conflicting results on the relationship between daytime napping and mortality risk, and there are few data on the potential association in the British population. We investigated the associations between daytime napping and all-cause or cause-specific mortality in the European Prospective Investigation Into Cancer-Norfolk study, a British population-based cohort study. Among the 16,374 men and women who answered questions on napping habits between 1998 and 2000, a total of 3,251 died during the 13-year follow-up. Daytime napping was associated with an increased risk of all-cause mortality (for napping less than 1 hour per day on average, hazard ratio = 1.14, 95% confidence interval: 1.02, 1.27; for napping 1 hour or longer per day on average, hazard ratio = 1.32, 95% confidence interval: 1.04, 1.68), independent of age, sex, social class, educational level, marital status, employment status, body mass index, physical activity level, smoking status, alcohol intake, depression, self-reported general health, use of hypnotic drugs or other medications, time spent in bed at night, and presence of preexisting health conditions. This association was more pronounced for death from respiratory diseases (for napping less than 1 hour, hazard ratio = 1.40, 95% confidence interval: 0.95, 2.05; for napping 1 hour or more, hazard ratio = 2.56, 95% confidence interval: 1.34, 4.86) and in individuals 65 years of age or younger. Excessive daytime napping might be a useful marker of underlying health risk, particularly of respiratory problems, especially among those 65 years of age or younger. Further research is required to clarify the nature of the observed association.

  14. Cause-specific mortality among children and young adults with epilepsy: Results from the U.S. National Child Death Review Case Reporting System.

    PubMed

    Tian, Niu; Shaw, Esther C; Zack, Matthew; Kobau, Rosemarie; Dykstra, Heather; Covington, Theresa M

    2015-04-01

    We investigated causes of death in children and young adults with epilepsy by using data from the U.S. National Child Death Review Case Reporting System (NCDR-CRS), a passive surveillance system composed of comprehensive information related to deaths reviewed by local child death review teams. Information on a total of 48,697 deaths in children and young adults 28days to 24years of age, including 551 deaths with epilepsy and 48,146 deaths without epilepsy, was collected from 2004 through 2012 in 32 states. In a proportionate mortality analysis by official manner of death, decedents with epilepsy had a significantly higher percentage of natural deaths but significantly lower percentages of deaths due to accidents, homicide, and undetermined causes compared with persons without epilepsy. With respect to underlying causes of death, decedents with epilepsy had significantly higher percentages of deaths due to drowning and most medical conditions including pneumonia and congenital anomalies but lower percentages of deaths due to asphyxia, weapon use, and unknown causes compared with decedents without epilepsy. The increased percentages of deaths due to pneumonia and drowning in children and young adults with epilepsy suggest preventive interventions including immunization and better instruction and monitoring before or during swimming. State-specific and national population-based mortality studies of children and young adults with epilepsy are recommended.

  15. Childhood Body Weight in Relation to Cause-Specific Mortality: 67 Year Follow-up of Participants in the 1947 Scottish Mental Survey.

    PubMed

    Batty, George David; Calvin, Catherine M; Brett, Caroline E; Čukić, Iva; Deary, Ian J

    2016-02-01

    The association between childhood body weight and adult health has been little-examined, and findings are inconsistent.In a representative sample of the Scottish nation (the Scottish Mental Survey of 1947), we examined the association between body mass index measured at 11 years of age and future cause-specific mortality by age 77 years. In this cohort study, a maximum of 67 years of follow-up of 3839 study members gave rise to 1568 deaths (758 from cardiovascular disease, 610 from any malignancy). After adjustment for covariates, there was some evidence of a relation between elevated childhood body mass index and rates of mortality ascribed to all-causes (hazard ratio per 1 SD increase in body mass index; 95% confidence interval: 1.09; 1.03, 1.14), cardiovascular disease (1.09; 1.01, 1.17), all cancers combined (1.12; 1.03, 1.21), smoking-related cancers (1.13; 1.03, 1.25), and breast cancer in women (1.27; 1.04, 1.56).In conclusion, we provide further observational evidence for the need for weight control measures in youth.

  16. Multiple Organ Dysfunction Score Is Superior to the Obstetric-Specific Sepsis in Obstetrics Score in Predicting Mortality in Septic Obstetric Patients

    PubMed Central

    Ryan, Helen M.; Magee, Laura A.; von Dadelszen, Peter; Fjell, Chris; Walley, Keith R.

    2017-01-01

    Objectives: Mortality prediction scores have been used for a long time in ICUs; however, numerous studies have shown that they over-predict mortality in the obstetric population. With sepsis remaining a major cause of obstetric mortality, we aimed to look at five mortality prediction scores (one obstetric-based and four general) in the septic obstetric population and compare them to a nonobstetric septic control group. Subject and Design: Women in the age group of 16–50 years with an admission diagnosis or suspicion of sepsis were included. In a multicenter obstetric population (n = 797), these included all pregnant and postpartum patients up to 6 weeks postpartum. An age- and gender-matched control nonobstetric population was drawn from a single-center general critical care population (n = 2,461). Sepsis in Obstetric Score, Acute Physiology and Chronic Health Evaluation II, Simplified Acute Physiology Score II, Sequential Organ Failure Assessment, and Multiple Organ Dysfunction Scores were all applied to patients meeting inclusion criteria in both cohorts, and their area under the receiver-operator characteristic curves was calculated to find the most accurate predictor. Measurements and Main Results: A total of 146 septic patients were found for the obstetric cohort and 299 patients for the nonobstetric control cohort. The Sepsis in Obstetric Score, Acute Physiology and Chronic Health Evaluation II, Simplified Acute Physiology Score II, Sequential Organ Failure Assessment, and Multiple Organ Dysfunction Scores gave area under the receiver-operator characteristic curves of 0.67, 0.68, 0.72, 0.79, and 0.84 in the obstetric cohort, respectively, and 0.64, 0.72, 0.61, 0.78, and 0.74 in the nonobstetric cohort, respectively. The Sepsis in Obstetric Score performed similarly to all the other scores with the exception of the Multiple Organ Dysfunction Score, which was significantly better (p < 0.05). Conclusion: The Sepsis in Obstetric Score, designed specifically for

  17. Infant Mortality

    MedlinePlus

    ... Control and Prevention. (2013). CDC health disparities and inequalities report—United States, 2013. Morbidity and Mortality Weekly ... M. (2008). The fall and rise of U.S. inequalities in premature mortality: 1960–2002. PLOS Medicine, 5 ( ...

  18. Long term cause specific mortality among 34 489 five year survivors of childhood cancer in Great Britain: population based cohort study

    PubMed Central

    Fidler, Miranda M; Reulen, Raoul C; Winter, David L; Kelly, Julie; Jenkinson, Helen C; Skinner, Rod; Frobisher, Clare

    2016-01-01

    Objective To determine whether modern treatments for cancer are associated with a net increased or decreased risk of death from neoplastic and non-neoplastic causes among survivors of childhood cancer. Design Population based cohort study. Setting British Childhood Cancer Survivor Study. Participants Nationwide population based cohort of 34 489 five year survivors of childhood cancer with a diagnosis from 1940 to 2006 and followed up until 28 February 2014. Main outcome measures Cause specific standardised mortality ratios and absolute excess risks are reported. Multivariable Poisson regression models were utilised to evaluate the simultaneous effect of risk factors. Likelihood ratio tests were used to test for heterogeneity or trend. Results Overall, 4475 deaths were observed, which was 9.1 (95% confidence interval 8.9 to 9.4) times that expected in the general population, corresponding to 64.2 (95% confidence interval 62.1 to 66.3) excess deaths per 10 000 person years. The number of excess deaths from all causes declined among those treated more recently; those treated during 1990-2006 experienced 30% of the excess number of deaths experienced by those treated before 1970. The corresponding percentages for the decline in excess deaths from recurrence or progression and non-neoplastic causes were 30% and 60%, respectively. Among survivors aged 50-59 years, 41% and 22% of excess deaths were attributable to subsequent primary neoplasms and circulatory conditions, respectively, whereas the corresponding percentages among those aged 60 years or more were 31% and 37%. Conclusions The net effects of changes in cancer treatments, and surveillance and management for late effects, over the period 1940 to 2006 was to reduce the excess number of deaths from both recurrence or progression and non-neoplastic causes among those treated more recently. Among survivors aged 60 years or more, the excess number of deaths from circulatory causes exceeds the excess number

  19. Patterns and Trends in Age-Specific Black-White Differences in Breast Cancer Incidence and Mortality - United States, 1999-2014.

    PubMed

    Richardson, Lisa C; Henley, S Jane; Miller, Jacqueline W; Massetti, Greta; Thomas, Cheryll C

    2016-10-14

    Breast cancer continues to be the most commonly diagnosed cancer and the second leading cause of cancer deaths among U.S. women (1). Compared with white women, black women historically have had lower rates of breast cancer incidence and, beginning in the 1980s, higher death rates (1). This report examines age-specific black-white disparities in breast cancer incidence during 1999-2013 and mortality during 2000-2014 in the United States using data from United States Cancer Statistics (USCS) (2). Overall rates of breast cancer incidence were similar, but death rates remained higher for black women compared with white women. During 1999-2013, breast cancer incidence decreased among white women but increased slightly among black women resulting in a similar average incidence at the end of the period. Breast cancer incidence trends differed by race and age, particularly from 1999 to 2004-2005, when rates decreased only among white women aged ≥50 years. Breast cancer death rates decreased significantly during 2000-2014, regardless of age with patterns varying by race. For women aged ≥50 years, death rates declined significantly faster among white women compared with black women; among women aged <50 years, breast cancer death rates decreased at the same rate among black and white women. Although some of molecular factors that lead to more aggressive breast cancer are known, a fuller understanding of the exact mechanisms might lead to more tailored interventions that could decrease mortality disparities. When combined with population-based approaches to increase knowledge of family history of cancer, increase physical activity, promote a healthy diet to maintain a healthy bodyweight, and increase screening for breast cancer, targeted treatment interventions could reduce racial disparities in breast cancer.

  20. Prior-Cancer Diagnosis in Men with Nonmetastatic Prostate Cancer and the Risk of Prostate-Cancer-Specific and All-Cause Mortality

    PubMed Central

    Chen, Ming-Hui; D'Amico, Anthony V.

    2014-01-01

    Purpose. We evaluated the impact a prior cancer diagnosis had on the risk of prostate-cancer-specific mortality (PCSM) and all-cause mortality (ACM) in men with PC. Methods. Using the SEER data registry, 166,104 men (median age: 66) diagnosed with PC between 2004 and 2007 comprised the study cohort. Competing risks and Cox regression were used to evaluate whether a prior cancer diagnosis impacted the risk of PCSM and ACM adjusting for known prognostic factors PSA level, age at and year of diagnosis, race, and whether PC treatment was curative, noncurative, or active surveillance (AS)/watchful waiting (WW). Results. At a median followup of 2.75 years, 12,453 men died: 3,809 (30.6%) from PC. Men with a prior cancer were followed longer, had GS 8 to 10 PC more often, and underwent WW/AS more frequently (P < 0.001). Despite these differences that should increase the risk of PCSM, the adjusted risk of PCSM was significantly decreased (AHR: 0.66 (95% CI: (0.45, 0.97); P = 0.033), while the risk of ACM was increased (AHR: 2.92 (95% CI: 2.64, 3.23); P < 0.001) in men with a prior cancer suggesting that competing risks accounted for the reduction in the risk of PCSM. Conclusion. An assessment of the impact that a prior cancer has on life expectancy is needed at the time of PC diagnosis to determine whether curative treatment for unfavorable-risk PC versus AS is appropriate. PMID:24634786

  1. Matrix-assisted laser desorption/ionisation (MALDI) TOF analysis identifies serum angiotensin II concentrations as a strong predictor of all-cause and breast cancer (BCa)-specific mortality following breast surgery.

    PubMed

    Boccardo, Francesco; Rubagotti, Alessandra; Nuzzo, Pier Vitale; Argellati, Francesca; Savarino, Grazia; Romano, Paolo; Damonte, Gianluca; Rocco, Mattia; Profumo, Aldo

    2015-11-15

    MALDI-TOF MS was used to recognise serum peptidome profiles predictive of mortality in women affected by early BCa. Mortality was analysed based on signal profiling, and appropriate statistics were used. The results indicate that four signals were increased in deceased patients compared with living patients. Three of the four signals were individually associated with all-cause mortality, but only one having mass/charge ratio (m/z) 1,046.49 was associated with BCa-specific mortality and was the only peak to maintain an independent prognostic role after multivariate analysis. Two groups exhibiting different mortality probabilities were identified after clustering patients based on the expression of the four peptides, but m/z 1,046.49 was exclusively expressed in the cluster exhibiting the worst mortality outcome, thus confirming the crucial value of this peptide. The specific role of this peak was confirmed by competing risk analysis. MS findings were validated by ELISA analysis after demonstrating that m/z 1,046.49 structurally corresponded to Angiotensin II (ATII). In fact, mortality results obtained after arbitrarily dividing patients according to an ATII serum value of 255 pg/ml (which corresponds to the 66(th) percentile value) were approximately comparable to those previously demonstrated when the same patients were analysed according to the expression of signal m/z 1,046.49. Similarly, ATII levels were specifically correlated with BCa-related deaths after competing risk analysis. In conclusion, ATII levels were increased in women who exhibited worse mortality outcomes, reinforcing the evidence that this peptide potentially significantly affects the natural history of early BCa. Our findings also confirm that MALDI-TOF MS is an efficient screening tool to identify novel tumour markers and that MS findings can be rapidly validated through less complex techniques, such as ELISA.

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

    PubMed

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

    2017-01-04

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

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

    PubMed Central

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

    2017-01-01

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

  4. Sleep duration and total and cause-specific mortality in a large US cohort: interrelationships with physical activity, sedentary behavior, and body mass index.

    PubMed

    Xiao, Qian; Keadle, Sarah K; Hollenbeck, Albert R; Matthews, Charles E

    2014-11-15

    Both short and long durations of sleep are associated with higher mortality, but little is known about the interrelationship between sleep and other modifiable factors in relation to mortality. In the National Institutes of Health-AARP Diet and Health Study (1995-1996), we examined associations between sleep duration and total, cardiovascular disease (CVD), and cancer mortality among 239,896 US men and women aged 51-72 years who were free of cancer, CVD, and respiratory disease. We evaluated the influence of moderate-to-vigorous physical activity, television viewing, and body mass index (BMI; weight (kg)/height (m)(2)) on the sleep-mortality association and assessed their combined association with mortality. During an average of 14 years of follow-up, we identified 44,100 deaths. Compared with 7-8 hours of sleep per day, both shorter and longer sleep durations were associated with higher total and CVD mortality. We found a greater elevation in CVD mortality associated with shorter sleep among overweight and obese people, suggesting a synergistic interaction between sleep and BMI. People in the unhealthy categories of all 4 risk factors (sleep <7 hours/day, moderate-to-vigorous physical activity ≤1 hour/week, television viewing ≥3 hours/day, and BMI ≥25) had significantly higher all-cause (relative risk (RR) = 1.42, 95% confidence interval (CI): 1.34, 1.52), CVD (RR = 1.90, 95% CI: 1.67, 2.17), and cancer (RR = 1.21, 95% CI: 1.09, 1.34) mortality. Short sleep duration may predict higher mortality, particularly CVD mortality, among overweight and obese people.

  5. Predictors of Prostate Cancer-Specific Mortality in Elderly Men With Intermediate-Risk Prostate Cancer Treated With Brachytherapy With or Without External Beam Radiation Therapy

    SciTech Connect

    Nanda, Akash; Moran, Brian J.; Braccioforte, Michelle H.; Dosoretz, Daniel; Salenius, Sharon; Katin, Michael; Ross, Rudi; D'Amico, Anthony V.

    2010-05-01

    Purpose: To identify clinical factors associated with prostate cancer-specific mortality (PCSM), adjusting for comorbidity, in elderly men with intermediate-risk prostate cancer treated with brachytherapy alone or in conjunction with external beam radiation therapy. Methods and Materials: The study cohort comprised 1,978 men of median age 71 (interquartile range, 66-75) years with intermediate-risk disease (Gleason score 7, prostate-specific antigen (PSA) 20 ng/mL or less, tumor category T2c or less). Fine and Gray's multivariable competing risks regression was used to assess whether prevalent cardiovascular disease (CVD), age, treatment, year of brachytherapy, PSA level, or tumor category was associated with the risk of PCSM. Results: After a median follow-up of 3.2 (interquartile range, 1.7-5.4) years, the presence of CVD was significantly associated with a decreased risk of PCSM (adjusted hazard ratio, 0.20; 95% CI 0.04-0.99; p = 0.05), whereas an increasing PSA level was significantly associated with an increased risk of PCSM (adjusted hazard ratio 1.14; 95% CI 1.02-1.27; p = 0.02). In the absence of CVD, cumulative incidence estimates of PCSM were higher (p = 0.03) in men with PSA levels above as compared with the median PSA level (7.3 ng/mL) or less; however, in the setting of CVD there was no difference (p = 0.27) in these estimates stratified by the median PSA level (6.9 ng/mL). Conclusions: In elderly men with intermediate-risk prostate cancer, CVD status is a negative predictor of PCSM and affects the prognostic capacity of pretreatment PSA level. These observations support the potential utility of prerandomization stratification by comorbidity to more accurately assess prognostic factors and treatment effects within this population.

  6. Predictive Validity of the American College of Cardiology/American Heart Association Pooled Cohort Equations in Predicting All-Cause and Cardiovascular Disease-Specific Mortality in a National Prospective Cohort Study of Adults in the United States.

    PubMed

    Loprinzi, Paul D; Addoh, Ovuokerie

    2016-06-01

    The predictive validity of the Pooled Cohort risk (PCR) equations for cardiovascular disease (CVD)-specific and all-cause mortality among a national sample of US adults has yet to be evaluated, which was this study's purpose. Data from the 1999-2010 National Health and Nutrition Examination Survey were used, with participants followed up through December 31, 2011, to ascertain mortality status via the National Death Index probabilistic algorithm. The analyzed sample included 11,171 CVD-free adults (40-79 years of age). The 10-year risk of a first atherosclerotic cardiovascular disease (ASCVD) event was determined from the PCR equations. For the entire sample encompassing 849,202 person-months, we found an incidence rate of 1.00 (95% CI, 0.93-1.07) all-cause deaths per 1000 person-months and an incidence rate of 0.15 (95% CI, 0.12-0.17) CVD-specific deaths per 1000 person-months. The unweighted median follow-up duration was 72 months. For nearly all analyses (unadjusted and adjusted models with ASCVD expressed as a continuous variable as well as dichotomized at 7.5% and 20%), the ASCVD risk score was significantly associated with all-cause and CVD-specific mortality (P<.05). In the adjusted model, the increased all-cause mortality risk ranged from 47% to 77% based on an ASCVD risk of 20% or higher and 7.5% or higher, respectively. Those with an ASCVD score of 7.5% or higher had a 3-fold increased risk of CVD-specific mortality. The 10-year predicted risk of a first ASCVD event via the PCR equations was associated with all-cause and CVD-specific mortality among those free of CVD at baseline. In this American adult sample, the PCR equations provide evidence of predictive validity.

  7. Genetic Variation in the JAK/STAT/SOCS signaling pathway influences breast cancer-specific mortality through interaction with cigarette smoking and use of aspirin/NSAIDs: The Breast Cancer Health Disparities Study

    PubMed Central

    Slattery, Martha L.; Lundgreen, Abbie; Hines, Lisa M.; Torres-Mejia, Gabriela; Wolff, Roger K.; Stern, Mariana C.; John, Esther M.

    2014-01-01

    Purpose The Janus kinase (JAK)/signal transducer and activator of transcription (STAT)-signaling pathway is involved in immune function and cell growth; genetic variation in this pathway could influence breast cancer risk. Methods We examined 12 genes in the JAK/STAT/SOCS-signaling pathway with breast cancer risk and mortality in an admixed population of Hispanic (2111 cases, 2597 controls) and non-Hispanic white (1481 cases, 1585 controls) women. Associations were assessed by Indigenous American (IA) ancestry. Results After adjustment for multiple comparisons, JAK1 (3 of 10 SNPs) and JAK2 (4 of 11 SNPs) interacted with body mass index (BMI) among pre-menopausal women, while STAT3 (4 of 5 SNPs) interacted significantly with BMI among post-menopausal women to alter breast cancer risk. STAT6 rs3024979 and TYK2 rs280519 altered breast cancer-specific mortality among all women. Associations with breast cancer-specific mortality differed by IA ancestry; SOCS1 rs193779, STAT3 rs1026916, and STAT4 rs11685878 associations were limited to women with low IA ancestry and associations with JAK1 rs2780890, rs2254002, and rs310245 and STAT1 rs11887698 were observed among women with high IA ancestry. JAK2 (5 of 11 SNPs), SOCS2 (1of 3 SNPs), and STAT4 (2 of 20 SNPs) interacted with cigarette smoking status to alter breast-cancer specific mortality. SOCS2 (1 of 3 SNPs) and all STAT3, STAT5A, and STAT5B SNPs significantly interacted with use of aspirin/NSAIDs to alter breast cancer-specific mortality. Conclusions Genetic variation in the JAK/STAT/SOCS pathway was associated with breast cancer-specific mortality. The proportion of SNPs within a gene that significantly interacted with lifestyle factors lends support for the observed associations. PMID:25104439

  8. Non-specific effect of measles vaccination on overall child mortality in an area of rural India with high vaccination coverage: a population-based case-control study.

    PubMed Central

    Kabir, Zubair; Long, Jean; Reddaiah, Vankadara P.; Kevany, John; Kapoor, Suresh K.

    2003-01-01

    OBJECTIVE: To determine whether vaccination against measles in a population with sustained high vaccination coverage and relatively low child mortality reduces overall child mortality. METHODS: In April and May 2000, a population-based, case-control study was conducted at Ballabgarh (an area in rural northern India). Eligible cases were 330 children born between 1 January 1991 and 31 December 1998 who died aged 12-59 months. A programme was used to match 320 controls for age, sex, family size, and area of residence from a birth cohort of 15 578 born during the same time period. FINDINGS: The analysis used 318 matched pairs and suggested that children aged 12-59 months who did not receive measles vaccination in infancy were three times more likely to die than those vaccinated against measles. Children from lower caste households who were not vaccinated in infancy had the highest risk of mortality (odds ratio, 8.9). A 27% increase in child mortality was attributable to failure to vaccinate against measles in the study population. CONCLUSION: Measles vaccine seems to have a non-specific reducing effect on overall child mortality in this population. If true, children in lower castes may reap the greatest gains in survival. The findings should be interpreted with caution because the nutritional status of the children was not recorded and may be a residual confounder. "All-cause mortality" is a potentially useful epidemiological endpoint for future vaccine trials. PMID:12764490

  9. Smoking increases risks of all-cause and breast cancer specific mortality in breast cancer individuals: a dose-response meta-analysis of prospective cohort studies involving 39725 breast cancer cases.

    PubMed

    Wang, Kang; Li, Feng; Zhang, Xiang; Li, Zhuyue; Li, Hongyuan

    2016-12-13

    Smoking is associated with the risks of mortality from breast cancer (BC) or all causes in BC survivors. Two-stage dose-response meta-analysis was conducted. A search of PubMed and Embase was performed, and a random-effect model was used to yield summary hazard ratios (HRs). Eleven prospective cohort studies were included. The summary HR per 10 cigarettes/day, 10 pack-years, 10 years increase were 1.10 (95% confidence interval (CI) = 1.04-1.16), 1.09 (95% CI = 1.06-1.12), 1.10 (95% CI = 1.06-1.14) for BC specific mortality, and 1.15 (95% CI = 1.10-1.19), 1.15 (95% CI = 1.10-1.20), 1.17 (95% CI = 1.11-1.23) for all-cause mortality, respectively. The linear or non-linear associations between smoking and risks of mortality from BC or all causes were revealed. Subgroup analyses suggested a positive association between ever or former smoking and the risk of all-cause mortality in BC patients, especially in high doses consumption. In conclusion, higher smoking intensity, more cumulative amount of cigarettes consumption and longer time for smoking is associated with elevated risk of mortality from BC and all causes in BC individuals. The results regarding smoking cessation and "ever or former" smokers should be treated with caution due to limited studies.

  10. Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013

    PubMed Central

    2015-01-01

    Summary Background Up-to-date evidence on levels and trends for age-sex-specific all-cause and cause-specific mortality is essential for the formation of global, regional, and national health policies. In the Global Burden of Disease Study 2013 (GBD 2013) we estimated yearly deaths for 188 countries between 1990, and 2013. We used the results to assess whether there is epidemiological convergence across countries. Methods We estimated age-sex-specific all-cause mortality using the GBD 2010 methods with some refinements to improve accuracy applied to an updated database of vital registration, survey, and census data. We generally estimated cause of death as in the GBD 2010. Key improvements included the addition of more recent vital registration data for 72 countries, an updated verbal autopsy literature review, two new and detailed data systems for China, and more detail for Mexico, UK, Turkey, and Russia. We improved statistical models for garbage code redistribution. We used six different modelling strategies across the 240 causes; cause of death ensemble modelling (CODEm) was the dominant strategy for causes with sufficient information. Trends for Alzheimer’s disease and other dementias were informed by meta-regression of prevalence studies. For pathogen-specific causes of diarrhoea and lower respiratory infections we used a counterfactual approach. We computed two measures of convergence (inequality) across countries: the average relative difference across all pairs of countries (Gini coefficient) and the average absolute difference across countries. To summarise broad findings, we used multiple decrement life-tables to decompose probabilities of death from birth to exact age 15 years, from exact age 15 years to exact age 50 years, and from exact age 50 years to exact age 75 years, and life expectancy at birth into major causes. For all quantities reported, we computed 95% uncertainty intervals (UIs). We constrained cause-specific fractions within each age

  11. Ki-67 Is an Independent Predictor of Metastasis and Cause-Specific Mortality for Prostate Cancer Patients Treated on Radiation Therapy Oncology Group (RTOG) 94-08

    SciTech Connect

    Verhoven, Bret; Yan, Yan; Ritter, Mark; Khor, Li-Yan; Hammond, Elizabeth; Jones, Christopher; Amin, Mahul; Bahary, Jean-Paul; Zeitzer, Kenneth; Pollack, Alan

    2013-06-01

    Purpose: The association of Ki-67 staining index (Ki67-SI) with overall survival (OS), disease-specific mortality (DSM), distant metastasis (DM), and biochemical failure (BF) was examined in men with favorable- to intermediate-risk prostate cancer receiving radiation therapy (RT) alone or with short-term androgen deprivation (ADT) in Radiation Therapy Oncology Group (RTOG) 94-08. Methods and Materials: 468 patients (23.6%) on RTOG 94-08 had sufficient tissue for Ki67-SI analysis. The median follow-up time was 7.9 years. Ki67-SI was determined by immunohistochemistry and quantified manually and by image analysis. Correlative analysis versus clinical outcome was performed using the third quartile (≥Q3) cutpoint. A proportional hazards multivariable analysis (MVA) dichotomized covariates in accordance with trial stratification and randomization criteria. Results: In MVAs adjusted for all treatment covariates, high Ki67-SI (≥Q3) was correlated with increased DSM (hazard ratio [HR] 2.48, P=.03), DM (HR 3.5, P=.002), and BF (HR 3.55, P<.0001). MVA revealed similar Ki67-associated hazard ratios in each separate treatment arm for DSM, DM, and BF; these reached significance only for DM in the RT-alone arm and for BF in both arms. Ki67-SI was not a significant predictor of intraprostatic recurrence assessed by repeated biopsy 2 years after treatment. Patients with a high or low Ki67-SI seemed to experience a similar relative benefit from the addition of ADT to radiation. Conclusions: High Ki67-SI independently predicts for increased DSM, DM, and protocol BF in primarily intermediate-risk prostate cancer patients treated with RT with or without ADT on RTOG 94-08 but does not predict for local recurrence or for increased relative benefit from ADT. This and prior studies lend support for the use of Ki67-SI as a stratification factor in future trials.

  12. Lycopene, tomato products and prostate cancer-specific mortality among men diagnosed with nonmetastatic prostate cancer in the Cancer Prevention Study II Nutrition Cohort.

    PubMed

    Wang, Ying; Jacobs, Eric J; Newton, Christina C; McCullough, Marjorie L

    2016-06-15

    While dietary lycopene and tomato products have been inversely associated with prostate cancer incidence, there is limited evidence for an association between consumption of lycopene and tomato products and prostate-cancer specific mortality (PCSM). We examined the associations of prediagnosis and postdiagnosis dietary lycopene and tomato product intake with PCSM in a large prospective cohort. This analysis included men diagnosed with nonmetastatic prostate cancer between enrollment in the Cancer Prevention Study II Nutrition Cohort in 1992 or 1993 and June 2011. Prediagnosis dietary data, collected at baseline, were available for 8,898 men, of whom 526 died of prostate cancer through 2012. Postdiagnosis dietary data, collected on follow-up surveys in 1999 and/or 2003, were available for 5,643 men, of whom 363 died of prostate cancer through 2012. Cox proportional hazards regression was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for PCSM. Neither prediagnosis nor postdiagnosis dietary lycopene intake was associated with PCSM (fourth vs. first quartile HR = 1.00, 95% CI 0.78-1.28; HR = 1.22, 95% CI 0.91-1.64, respectively). Similarly, neither prediagnosis nor postdiagnosis consumption of tomato products was associated with PCSM. Among men with high-risk cancers (T3-T4 or Gleason score 8-10, or nodal involvement), consistently reporting lycopene intake ≥ median on both postdiagnosis surveys was associated with lower PCSM (HR = 0.41, 95% CI 0.17-0.99, based on ten PCSM cases consistently ≥ median intake) compared to consistently reporting intake < median. Future studies are needed to confirm the potential inverse association of consistently high lycopene intake with PCSM among men with high-risk prostate cancers.

  13. Weather-Related Mortality

    PubMed Central

    Anderson, Brooke G.; Bell, Michelle L.

    2012-01-01

    Background Many studies have linked weather to mortality; however, role of such critical factors as regional variation, susceptible populations, and acclimatization remain unresolved. Methods We applied time-series models to 107 US communities allowing a nonlinear relationship between temperature and mortality by using a 14-year dataset. Second-stage analysis was used to relate cold, heat, and heat wave effect estimates to community-specific variables. We considered exposure timeframe, susceptibility, age, cause of death, and confounding from pollutants. Heat waves were modeled with varying intensity and duration. Results Heat-related mortality was most associated with a shorter lag (average of same day and previous day), with an overall increase of 3.0% (95% posterior interval: 2.4%–3.6%) in mortality risk comparing the 99th and 90th percentile temperatures for the community. Cold-related mortality was most associated with a longer lag (average of current day up to 25 days previous), with a 4.2% (3.2%–5.3%) increase in risk comparing the first and 10th percentile temperatures for the community. Mortality risk increased with the intensity or duration of heat waves. Spatial heterogeneity in effects indicates that weather–mortality relationships from 1 community may not be applicable in another. Larger spatial heterogeneity for absolute temperature estimates (comparing risk at specific temperatures) than for relative temperature estimates (comparing risk at community-specific temperature percentiles) provides evidence for acclimatization. We identified susceptibility based on age, socioeconomic conditions, urbanicity, and central air conditioning. Conclusions Acclimatization, individual susceptibility, and community characteristics all affect heat-related effects on mortality. PMID:19194300

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

    PubMed Central

    John, Ulrich; Hanke, Monika

    2016-01-01

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

  15. The effects of cholesterol lowering with simvastatin on cause-specific mortality and on cancer incidence in 20,536 high-risk people: a randomised placebo-controlled trial [ISRCTN48489393

    PubMed Central

    2005-01-01

    Background There have been concerns that low blood cholesterol concentrations may cause non-vascular mortality and morbidity. Randomisation of large numbers of people to receive a large, and prolonged, reduction in cholesterol concentrations provides an opportunity to address such concerns reliably. Methods 20,536 UK adults (aged 40–80 years) with vascular disease or diabetes were randomly allocated to receive 40 mg simvastatin daily or matching placebo. Prespecified safety analyses were of cause-specific mortality, and of total and site-specific cancer incidence. Comparisons between all simvastatin-allocated versus all placebo-allocated participants (ie, "intention-to-treat") involved an average difference in blood total cholesterol concentration of 1.2 mmol/L (46 mg/dL) during the scheduled 5-year treatment period. Results There was a highly significant 17% (95% CI 9–25) proportional reduction in vascular deaths, along with a non-significant reduction in all non-vascular deaths, which translated into a significant reduction in all-cause mortality (p = 0.0003). The proportional reduction in the vascular mortality rate was about one-sixth in each subcategory of participant studied, including: men and women; under and over 70 years at entry; and total cholesterol below 5.0 mmol/L or LDL cholesterol below 3.0 mmol/L. No significant excess of non-vascular mortality was observed in any subcategory of participant (including the elderly and those with pretreatment total cholesterol below 5.0 mmol/L), and there was no significant excess in any particular cause of non-vascular mortality. Cancer incidence rates were similar in the two groups, both overall and in particular subcategories of participant, as well as at particular primary sites. There was no suggestion that any adverse trends in non-vascular mortality or morbidity were beginning to emerge with more prolonged treatment. Conclusion These findings, which are based on large numbers of deaths and non

  16. Variations in the relation between education and cause-specific mortality in 19 European populations: a test of the "fundamental causes" theory of social inequalities in health.

    PubMed

    Mackenbach, Johan P; Kulhánová, Ivana; Bopp, Matthias; Deboosere, Patrick; Eikemo, Terje A; Hoffmann, Rasmus; Kulik, Margarete C; Leinsalu, Mall; Martikainen, Pekka; Menvielle, Gwenn; Regidor, Enrique; Wojtyniak, Bogdan; Östergren, Olof; Lundberg, Olle

    2015-02-01

    Link and Phelan have proposed to explain the persistence of health inequalities from the fact that socioeconomic status is a "fundamental cause" which embodies an array of resources that can be used to avoid disease risks no matter what mechanisms are relevant at any given time. To test this theory we compared the magnitude of inequalities in mortality between more and less preventable causes of death in 19 European populations, and assessed whether inequalities in mortality from preventable causes are larger in countries with larger resource inequalities. We collected and harmonized mortality data by educational level on 19 national and regional populations from 16 European countries in the first decade of the 21st century. We calculated age-adjusted Relative Risks of mortality among men and women aged 30-79 for 24 causes of death, which were classified into four groups: amenable to behavior change, amenable to medical intervention, amenable to injury prevention, and non-preventable. Although an overwhelming majority of Relative Risks indicate higher mortality risks among the lower educated, the strength of the education-mortality relation is highly variable between causes of death and populations. Inequalities in mortality are generally larger for causes amenable to behavior change, medical intervention and injury prevention than for non-preventable causes. The contrast between preventable and non-preventable causes is large for causes amenable to behavior change, but absent for causes amenable to injury prevention among women. The contrast between preventable and non-preventable causes is larger in Central & Eastern Europe, where resource inequalities are substantial, than in the Nordic countries and continental Europe, where resource inequalities are relatively small, but they are absent or small in Southern Europe, where resource inequalities are also large. In conclusion, our results provide some further support for the theory of "fundamental causes". However

  17. The Impact of Brachytherapy on Prostate Cancer-Specific Mortality for Definitive Radiation Therapy of High-Grade Prostate Cancer: A Population-Based Analysis

    SciTech Connect

    Shen Xinglei; Keith, Scott W.; Mishra, Mark V.; Dicker, Adam P.; Showalter, Timothy N.

    2012-07-15

    Purpose: This population-based analysis compared prostate cancer-specific mortality (PCSM) in a cohort of patients with high-risk prostate cancer after nonsurgical treatment with external beam radiation therapy (EBRT), brachytherapy (BT), or combination (BT + EBRT). Methods and Materials: We identified from the Surveillance, Epidemiology and End Results database patients diagnosed from 1988 through 2002 with T1-T3N0M0 prostate adenocarcinoma of poorly differentiated grade and treated with BT, EBRT, or BT + EBRT. During this time frame, the database defined high grade as prostate cancers with Gleason score 8-10, or Gleason grade 4-5 if the score was not recorded. This corresponds to a cohort primarily with high-risk prostate cancer, although some cases where only Gleason grade was recorded may have included intermediate-risk cancer. We used multivariate models to examine patient and tumor characteristics associated with the likelihood of treatment with each radiation modality and the effect of radiation modality on PCSM. Results: There were 12,745 patients treated with EBRT (73.5%), BT (7.1%), or BT + EBRT (19.4%) included in the analysis. The median follow-up time for all patients was 6.4 years. The use of BT or BT + EBRT increased from 5.1% in 1988-1992 to 31.4% in 1998-2002. Significant predictors of use of BT or BT + EBRT were younger age, later year of diagnosis, urban residence, and earlier T-stage. On multivariate analysis, treatment with either BT (hazard ratio, 0.66; 95% confidence interval, 0.49-0.86) or BT + EBRT (hazard ratio, 0.77; 95% confidence ratio, 0.66-0.90) was associated with significant reduction in PCSM compared with EBRT alone. Conclusion: In patients with high-grade prostate cancer, treatment with brachytherapy is associated with reduced PCSM compared with EBRT alone. Our results suggest that brachytherapy should be investigated as a component of definitive treatment strategies for patients with high-risk prostate cancer.

  18. Does oral polio vaccine have non-specific effects on all-cause mortality? Natural experiments within a randomised controlled trial of early measles vaccine

    PubMed Central

    Aaby, Peter; Andersen, Andreas; Martins, Cesário L; Fisker, Ane B; Rodrigues, Amabelia; Whittle, Hilton C; Benn, Christine S

    2016-01-01

    Background BCG and measles vaccine (MV) may have beneficial non-specific effects (NSEs). If an unplanned intervention with a vaccine (a natural experiment) modifies the estimated effect in a randomised controlled trial (RCT), this suggests NSEs. We used this approach to test NSEs of triple oral polio vaccine (OPV). Methods During an RCT of 2 doses of MV at 4.5 and 9 months versus 1 dose of MV at 9 months of age, we experienced 2 natural experiments with OPV. We assessed whether these OPV experiments modified the effect of 2-dose MV in the MV trial. Setting MV RCT conducted in urban Guinea-Bissau 2003–2009. Interventions Natural experiments with OPV due to missing vaccine and the implementation of OPV campaigns. Main outcome measure Changes in the mortality rate ratio (MRR) for 2-dose MV versus 1-dose MV. Results First, the MRR (2-dose/1-dose MV) overall was 0.70 (0.52 to 0.94), but the MRR was 1.04 (0.53 to 2.04) when OPV at birth (OPV0) was not given, suggesting that early priming with OPV was important for the effect of 2-dose MV. The effect of OPV0 depended on age of administration; the MRR (2-dose/1-dose MV) was 0.45 (0.29 to 0.71) for children receiving OPV0 in the first week of life, but 3.63 (0.87 to 15.2) for those receiving OPV0 after the first month of life (p=0.007, test of no interaction). Second, campaign-OPV may have reduced the difference between the randomisation groups since the MRR (2-dose/1-dose MV) was 0.60 (0.42 to 0.85) for children who had not received campaign-OPV before RCT-enrolment versus 0.72 (0.23 to 2.31) and 1.42 (0.70 to 2.90) for children who had received 1 or 2 doses of campaign-OPV-before-enrolment, respectively. Conclusions Bissau had no polio infection during this trial, so OPV0 and campaign-OPV may have NSEs since they modified the effect of 2-dose MV in an RCT. Different interventions may interact to a much larger effect than usually assumed. PMID:28011813

  19. Crop-specific mortality of southern green stink-bug eggs in Bt- and non-Bt cotton, soybean, and peanut

    Technology Transfer Automated Retrieval System (TEKTRAN)

    There is a need to characterize the mechanisms underlying population dynamics of stink bugs relative to major crops in the southeastern US. To this end, we investigated predation and parasitism of Southern green stink bug eggs and the agents causing mortality by placing sentinel egg masses in plots ...

  20. All‐cause and cause‐specific mortality in rheumatoid arthritis are not greater than expected when treated with tumour necrosis factor antagonists

    PubMed Central

    Carmona, Loreto; Descalzo, Miguel Ángel; Perez‐Pampin, Eva; Ruiz‐Montesinos, Dolores; Erra, Alba; Cobo, Tatiana; Gómez‐Reino, Juan J

    2007-01-01

    Background Mortality is increased in rheumatoid arthritis (RA), mainly because of cardiovascular (CV) events, cancer and infections. Recent data suggest that treatment with tumour necrosis factor (TNF) antagonists may affect this trend. Objective To assess whether treatment with TNF antagonists is associated with reduction in CV events, cancer and infection rates, and in mortality in patients with RA treated and not treated with TNF antagonists. Methods BIOBADASER is a registry for active long‐term follow‐up of safety of biological treatments in patients with RA. It includes 4459 patients with RA treated with TNF antagonists. EMECAR is an external RA cohort (n = 789) established to define the characteristics of the disease in Spain and to assess comorbidity. The incidence density (ischaemic heart disease) of CV events, cancer and infections was estimated and compared. The standardised mortality ratio was compared with the rate in the general population. A propensity score was used to match cohorts by the probability of being treated. Results Rates of CV and cancer events are significantly higher in EMECAR than in BIOBADASER (RR 5–7 for different CV events, and RR 2.9 for cancer), whereas the rate of serious infections is significantly higher in BIOBADASER (RR 1.6). Mortality ratio of BIOBADASER by EMECAR is 0.32 (0.20–0.53) for all causes of death, 0.58 (0.24–1.41) for CV events, 0.52 (0.21–1.29) for infection and 0.36 (0.10–1.30) for cancer‐related deaths. Conclusion Morbidity, other than infection, and mortality are not higher than expected in patients with RA treated with TNF antagonists. PMID:17324968

  1. Smoking increases risks of all-cause and breast cancer specific mortality in breast cancer individuals: a dose-response meta-analysis of prospective cohort studies involving 39725 breast cancer cases

    PubMed Central

    Wang, Kang; Li, Feng; Zhang, Xiang; Li, Zhuyue; Li, Hongyuan

    2016-01-01

    Smoking is associated with the risks of mortality from breast cancer (BC) or all causes in BC survivors. Two-stage dose-response meta-analysis was conducted. A search of PubMed and Embase was performed, and a random-effect model was used to yield summary hazard ratios (HRs). Eleven prospective cohort studies were included. The summary HR per 10 cigarettes/day, 10 pack-years, 10 years increase were 1.10 (95% confidence interval (CI) = 1.04–1.16), 1.09 (95% CI = 1.06–1.12), 1.10 (95% CI = 1.06–1.14) for BC specific mortality, and 1.15 (95% CI = 1.10–1.19), 1.15 (95% CI = 1.10–1.20), 1.17 (95% CI = 1.11–1.23) for all-cause mortality, respectively. The linear or non-linear associations between smoking and risks of mortality from BC or all causes were revealed. Subgroup analyses suggested a positive association between ever or former smoking and the risk of all-cause mortality in BC patients, especially in high doses consumption. In conclusion, higher smoking intensity, more cumulative amount of cigarettes consumption and longer time for smoking is associated with elevated risk of mortality from BC and all causes in BC individuals. The results regarding smoking cessation and “ever or former” smokers should be treated with caution due to limited studies. PMID:27863414

  2. [Mortality in metropolitan regions].

    PubMed

    Simoes Ccds

    1980-01-01

    Data from the 1970 census and a 1974-1975 survey carried out in Brazil by the Fundacao Instituto Brasileiro de Geografia e Estatistica are used to examine recent mortality trends in urban areas. Specifically, life expectancy in nine metropolitan areas is analyzed in relation to income, diet, and sanitary facilities in the home.

  3. Diverging Trends in Cause-Specific Mortality and Life Years Lost by Educational Attainment: Evidence from United States Vital Statistics Data, 1990-2010

    PubMed Central

    Sasson, Isaac

    2016-01-01

    Background Life expectancy at birth in the United States will likely surpass 80 years in the coming decade. Yet recent studies suggest that longevity gains are unevenly shared across age and socioeconomic groups. First, mortality in midlife has risen among non-Hispanic whites. Second, low-educated whites have suffered stalls (men) or declines (women) in adult life expectancy, which is significantly lower than among their college-educated counterparts. Estimating the number of life years lost or gained by age and cause of death, broken down by educational attainment, is crucial in identifying vulnerable populations. Methods and Findings Using U.S. vital statistics data from 1990 to 2010, this study decomposes the change in life expectancy at age 25 by age and cause of death across educational attainment groups, broken down by race and gender. The findings reveal that mortality in midlife increased for white women (and to a lesser extent men) with 12 or fewer years of schooling, accounting for most of the stalls or declines in adult life expectancy observed in those groups. Among blacks, mortality declined in nearly all age and educational attainment groups. Although an educational gradient was found across multiple causes of death, between 60 and 80 percent of the gap in adult life expectancy was explained by cardiovascular diseases, smoking-related diseases, and external causes of death. Furthermore, the number of life years lost to smoking-related, external, and other causes of death increased among low- and high school-educated whites, explaining recent stalls or declines in longevity. Conclusions Large segments of the American population—particularly low- and high school-educated whites under age 55—are diverging from their college-educated counterparts and losing additional years of life to smoking-related diseases and external causes of death. If this trend continues, old-age mortality may also increase for these birth cohorts in the coming decades. PMID

  4. Autoantibodies, mortality and ageing.

    PubMed

    Richaud-Patin, Y; Villa, A R

    1995-01-01

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

  5. Mortal assets

    SciTech Connect

    Howe, Geoffrey R.; Zablotska, Lydia B.; Fix, John J.; Egel, John N.; Buchanan, Jeffrey A.

    2005-11-01

    Workers employed in 15 utilities that generate nuclear power in the United States have been followed for up to 18 years between 1979 and 1997. Their cumulative dose from whole-body ionizing radiation has been determined from the dose records maintained by the facilities themselves and the REIRS and REMS systems maintained by the Nuclear Regulatory Commission and the Department of Energy, respectively. Mortality in the cohort from a number of causes has been analyzed with respect to individual radiation doses. The cohort displays a very substantial healthy worker effect, i.e. considerably lower cancer and noncancer mortality than the general population. Based on 26 and 368 deaths, respectively, positive though statistically nonsignificant associations were seen for mortality from leukemia (excluding chronic lymphocytic leukemia) and all solid cancers combined, with excess relative risks per sievert of 5.67 (95% confidence interval (CI) -2.56, 30.4) and 0.596 (95% CI -2.01, 4.64), respectively. These estimates are very similar to those from the atomic bomb survivors study, though the wide confidence intervals are also consistent with lower or higher risk estimates. A strong positive and statistically significant association between radiation dose and deaths from arteriosclerotic heart disease including coronary heart disease was also observed in the cohort, with an ERR of 8.78 (95% CI 2.10, 20.0). Whle associations with heart disease have been reported in some other occupational studies, the magnitude of the present association is not consistent with them and therefore needs cautious interpretation and merits further attention. At present, the relatively small number of deaths and the young age of the cohort (mean age at end of follow-up is 45 years) limit the power of the study, but further follow-up is 45 years) limit the power of the study, but further follow-up and the inclusion of the present data in an ongoing IARC combined analysis of nuclear workers from 15

  6. [Maternal mortality and perinatal mortality].

    PubMed

    Boutaleb, Y; Mesbahi, M; Lahlou, D; Aderdour, M

    1982-01-01

    94 maternal deaths and 1546 fetal and neonatal deaths were registered among 28,706 births at the CHU Averroes in Casablanca between 1978-80. 45% of women who deliver at the clinic are very poor and only 10% are relatively well off. Obstetrical antecedents were noted in 27% of the fetal deaths. 70% of the maternal deaths occurred in women aged 20-34. 32 maternal deaths occurred among 16,232 women with 1-2 children, 30 among 6514 women with 3-5 children, and 32 among 5960 women with 6-14 children. 11,027 of the 28,706 were primaparas. Perinatal mortality was 4.46% among primaparas, 8.24% among grand multiparas, and 4.1% among secondiparas. In 58 of the 94 cases of maternal mortality the woman was hospitalized after attempting delivery at home or in a village clinic. Among women with 1 or 2 children, hemorrhage was the cause of death in 8 cases, infection in 7 cases, eclampsia in 3 cases, thromboembolism in 2 cases, uterine inversion in 2 cases, pulmonary tuberculosis in 1 case, embolism in 5 cases, and other causes 1 case each. Among women with 3-5 children hemorrhage was the cause of death in 10 cases, septicemia in 3 cases, uterine rupture in 3 cases, eclampsia in 3 cases, uterine inversion in 2 cases, viral hepatitis in 2 cases, emboli in 2 cases, and other reasons 1 case each. Among grand multiparas hemorrhage was the cause of death in 11 cases, uterine rupture in 12 cases, peritonitis in 2 cases, eclampsia in 2 cases, emboli in 2 cases, and other causes 1 case each. 19 of the maternal deaths were judged to have been avoidable with better management. Prematurity and birth weight of 1000-2500 g associated or not with other pathology were found in 714 of 1546 perinatal deaths. Of 390 cases of death in utero with retention and maceration, 68 were caused by reno-vascular syndromes, 76 by maternal infections, 33 by maternal syphilis, 26 by fetal malformation, 18 by maternal diabetes, 10 by Rh incompatability, and 159 by indeterminate causes. In 795 cases of

  7. Spaceflight hardware for conducting plant growth experiments in space: the early years 1960-2000

    NASA Technical Reports Server (NTRS)

    Porterfield, D. M.; Neichitailo, G. S.; Mashinski, A. L.; Musgrave, M. E.

    2003-01-01

    The best strategy for supporting long-duration space missions is believed to be bioregenerative life support systems (BLSS). An integral part of a BLSS is a chamber supporting the growth of higher plants that would provide food, water, and atmosphere regeneration for the human crew. Such a chamber will have to be a complete plant growth system, capable of providing lighting, water, and nutrients to plants in microgravity. Other capabilities include temperature, humidity, and atmospheric gas composition controls. Many spaceflight experiments to date have utilized incomplete growth systems (typically having a hydration system but lacking lighting) to study tropic and metabolic changes in germinating seedlings and young plants. American, European, and Russian scientists have also developed a number of small complete plant growth systems for use in spaceflight research. Currently we are entering a new era of experimentation and hardware development as a result of long-term spaceflight opportunities available on the International Space Station. This is already impacting development of plant growth hardware. To take full advantage of these new opportunities and construct innovative systems, we must understand the results of past spaceflight experiments and the basic capabilities of the diverse plant growth systems that were used to conduct these experiments. The objective of this paper is to describe the most influential pieces of plant growth hardware that have been used for the purpose of conducting scientific experiments during the first 40 years of research. c2002 COSPAR. Published by Elsevier Science Ltd. All rights reserved.

  8. The Social Characteristics and Demographics of Australian Vice-Chancellors, 1960-2000

    ERIC Educational Resources Information Center

    O'Meara, Bernard; Petzall, Stanley

    2007-01-01

    Purpose: The purpose of this paper is to identify the key demographics and social characteristics of Vice-Chancellors of Australian universities so that an accurate profile of Vice-Chancellors can be established. At present, there is no contemporary profile of incumbents despite the high level of responsibility associated with these roles.…

  9. "Alternative" Education in Flanders, 1960-2000: Transformation of Knowledge in a Neo-Liberal Context

    ERIC Educational Resources Information Center

    De Coster, Tom; Simon, Frank; Depaepe, Marc

    2009-01-01

    The founding of "alternative" schools, mainly by parents or other individuals, has made New Education in Flanders tangible today for the general public. In this article, the authors set out to study the knowledge of the "emancipatory" starting points of the post-1968 movements and "alternative" schools in the…

  10. An indicator-based evaluation of Black Sea food web dynamics during 1960-2000

    NASA Astrophysics Data System (ADS)

    Akoglu, Ekin; Salihoglu, Baris; Libralato, Simone; Oguz, Temel; Solidoro, Cosimo

    2014-06-01

    Four Ecopath mass-balance models were implemented for evaluating the structure and function of the Black Sea ecosystem using several ecological indicators during four distinctive periods (1960s, 1980-1987, 1988-1994 and 1995-2000). The results exemplify how the Black Sea ecosystem structure started to change after the 1960s as a result of a series of trophic transformations, i.e., shifts in the energy flow pathways through the food web. These transformations were initiated by anthropogenic factors, such as eutrophication and overfishing, that led to the transfer of large quantities of energy to the trophic dead-end species, which had no natural predators in the ecosystem, i.e., jellyfish whose biomass increased from 0.03 g C m- 2 in 1960-1969 to 0.933 g C m- 2 in 1988-1994. Concurrently, an alternative short pathway for energy transfer was formed that converted significant amounts of system production back to detritus. This decreased the transfer efficiency of energy flow from the primary producers to the higher trophic levels from 9% in the 1960s to 3% between 1980 and 1987. We conclude that the anchovy stock collapse and successful establishment of the alien comb-jelly Mnemiopsis in 1989 were rooted in the trophic interactions in the food web, all of which were exacerbated because of the long-term establishment of a combination of anthropogenic stressors.

  11. Defining an epidemic: the body mass index in British and US obesity research 1960-2000.

    PubMed

    Fletcher, Isabel

    2014-03-01

    Between the 1970s and the mid-1990s the body mass index (BMI) became the standard means of assessing obesity both in populations and in individuals, replacing previously diverse and contested definitions of excess body weight. This article draws on theoretical approaches from the sociology of standards and science and technology studies to describe the development of this important new standard and the ways in which its adoption facilitated the development of obesity science, that is, knowledge about the causes, health effects and treatments of excess body weight. Using an analysis of policy and healthcare literatures, I argue that the adoption of the BMI, along with associated standard cut-off points defining overweight and obesity, was crucial in the framing of obesity as an epidemic. This is because, I suggest, these measures enabled, firstly, the creation of large data sets tracking population-level changes in average body weight, and, secondly, the construction of visual representations of these changes. The production of these two new techniques of representation made it possible for researchers in this field, and others such as policymakers, to argue credibly that obesity should be described as an epidemic.

  12. Spaceflight hardware for conducting plant growth experiments in space: the early years 1960-2000.

    PubMed

    Porterfield, D M; Neichitailo, G S; Mashinski, A L; Musgrave, M E

    2003-01-01

    The best strategy for supporting long-duration space missions is believed to be bioregenerative life support systems (BLSS). An integral part of a BLSS is a chamber supporting the growth of higher plants that would provide food, water, and atmosphere regeneration for the human crew. Such a chamber will have to be a complete plant growth system, capable of providing lighting, water, and nutrients to plants in microgravity. Other capabilities include temperature, humidity, and atmospheric gas composition controls. Many spaceflight experiments to date have utilized incomplete growth systems (typically having a hydration system but lacking lighting) to study tropic and metabolic changes in germinating seedlings and young plants. American, European, and Russian scientists have also developed a number of small complete plant growth systems for use in spaceflight research. Currently we are entering a new era of experimentation and hardware development as a result of long-term spaceflight opportunities available on the International Space Station. This is already impacting development of plant growth hardware. To take full advantage of these new opportunities and construct innovative systems, we must understand the results of past spaceflight experiments and the basic capabilities of the diverse plant growth systems that were used to conduct these experiments. The objective of this paper is to describe the most influential pieces of plant growth hardware that have been used for the purpose of conducting scientific experiments during the first 40 years of research.

  13. Non-syndromal oro-facial clefts in the Canterbury/ West Coast region, 1960-2000.

    PubMed

    Fowler, Peter; Esson, Ian

    2005-09-01

    The paper-based clinical assessment notes from Christchurch Hospital Cleft Clinic were transferred to electronic form in 2002. This enabled analysis of the types of non-syndromal orofacial clefts presenting within the Canterbury and West Coast region over a 41 year period. The incidence of oro-facial clefting was similar to that described in previous New Zealand studies, but higher than that found in United Kingdom studies. Orthodontists providing care in the cleft clinics in New Zealand have begun to investigate the use of a standardised electronic national database of patients presenting with oro-facial clefts. It is expected that this could provide the basis for a more detailed, robust and standardised database for future analysis.

  14. The effect of changes in health sector resources on infant mortality in the short-run and the long-run: a longitudinal econometric analysis.

    PubMed

    Farahani, Mansour; Subramanian, S V; Canning, David

    2009-06-01

    While countries with higher levels of human resources for health typically have better population health, the evidence that increases in the level of human resources for health leads to improvements in population health is limited. We use a dynamic regression model to obtain estimates of both the short-run and long-term effects of changes in physicians per capita, our measure of health system resources, on infant mortality. Using a dataset of 99 countries at 5-year intervals from 1960-2000, we estimate that increasing the number of physicians by one per 1000 population (roughly a doubling of current levels of provision) decreases the infant mortality rate by 15% within 5 years and by 45% in the long-run with half the long-run gain being achieved in 15 years. We conclude that the long-run effects of heath system resources are substantially larger than previously estimated. Our results suggest, however, that countries that have delayed action on the Millennium Development Goal of reducing infant and child mortality rate by two-thirds by 2015 (relative to 1990) may have difficulty meeting this goal even if they rapidly increase resources now.

  15. Prognostic significance of the 2004 WHO/ISUP classification for prediction of recurrence, progression, and cancer-specific mortality of non-muscle-invasive urothelial tumors of the urinary bladder: a clinicopathologic study of 1,515 cases.

    PubMed

    Pan, Chin-Chen; Chang, Yen-Hwa; Chen, Kuang-Kuo; Yu, Hui-Jung; Sun, Chih-Hao; Ho, Donald M T

    2010-05-01

    To verify prognostic significance of the 2004 World Health Organization (WHO)/International Society of Urological Pathology (ISUP) grading systems, we retrospectively studied the tumors of 1,515 patients who underwent transurethral resection of primary non-muscle-invasive urothelial tumors (pTa, 1,006 patients; pT1, 509 patients) confined to the bladder. Cases were classified according to the 2004 WHO/ISUP systems as 212 cases of papillary urothelial neoplasm of low malignant potential (PUNLMP), 706 low-grade papillary urothelial carcinomas (LPUCs), and 597 high-grade papillary urothelial carcinomas (HPUCs). PUNLMP showed the statistically significantly lowest recurrence cumulative incidence compared with the other tumor types. There were significant differences and trends for higher progression and cancer-specific mortality cumulative incidence in the following order: PUNLMP, LPUC, pTa HPUC, and pT1 HPUC. No differences of progression and cancer-specific mortality cumulative incidence were found between pTa and pT1 LPUC. Our study validates the usefulness of the 2004 WHO/ISUP system to classify urothelial tumors into prognostically distinct categories that would contribute to the design of therapeutic and monitoring strategies for patients with non-muscle-invasive bladder urothelial tumors.

  16. The cause-specific morbidity and mortality, and referral patterns of all neonates admitted to a tertiary referral hospital in the northern provinces of Vietnam over a one year period

    PubMed Central

    Miles, Merinda; Dung, Khu Thi Khanh; Ha, Le Thi; Liem, Nguyen Thanh; Ha, Khu; Hunt, Rod W.; Mulholland, Kim; Morgan, Chris

    2017-01-01

    Objective To describe the cause-specific morbidity and mortality, and referral patterns of all neonates admitted to a tertiary referral hospital in the northern provinces of Vietnam. Design A prospective hospital based observational study. Setting The Neonatal Department, National Hospital of Pediatrics, Hanoi, Vietnam. Patients All admissions to the Neonatal Department over a 12 month period. Main outcome measures Cause-specific morbidity and mortality; deaths. Results There were 5064 admissions with the commonest discharge diagnoses being infection (32%) and prematurity (29%). The case fatality ratio (CFR) was 13.9% (n = 703). Infection (38%), cardio/respiratory disorders (27%), congenital abnormalities (20%) and neurological conditions (10%) were the main causes of death. Of all the deaths, 38% had an admission weight ≥2500g. Higher CFR were associated with lower admission weights. Very few deaths (3%) occurred in the first 24 hours of life. Most referrals and deaths came from Hanoi and neighbouring provincial hospitals, with few from the most distant provinces. Two distant referral provinces had the highest CFR. Conclusions The CFR was high and few deaths occurred in neonates <24 hours old. The high rates of infection call for an improvement in infection control practices and peripartum antibiotic use at provincial and tertiary level. Understanding provincial hospital capacity and referral pathways is crucial to improving the outcomes at tertiary centres. A quality of care audit tool would enable more targeted interventions and monitoring of health outcomes. PMID:28282433

  17. Mortality rates decline in Malaysia.

    PubMed

    1991-11-01

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

  18. National and sub-national age-sex specific and cause-specific mortality and disability-adjusted life years (DALYs) attributable to household air pollution from solid cookfuel use (HAP) in Iran, 1990-2013.

    PubMed

    Abtahi, Mehrnoosh; Koolivand, Ali; Dobaradaran, Sina; Yaghmaeian, Kamyar; Mohseni-Bandpei, Anoushiravan; Khaloo, Shokooh Sadat; Jorfi, Sahand; Saeedi, Reza

    2017-03-21

    National and sub-national mortality, years of life lost due to premature mortality (YLLs), years lived with disability (YLDs) and disability-adjusted life years (DALYs) for household air pollution from solid cookfuel use (HAP) in Iran, 1990-2013 were estimated based on the Global Burden of Disease Study 2013 (GBD 2013). The burden of disease attributable to HAP was quantified by the comparative risk assessment method using four inputs: (1) exposure to HAP, (2) the theoretical minimum risk exposure level (TMREL), (3) exposure-response relationships of related causes (4) disease burden of related causes. All across the country, solid fuel use decreased from 5.26% in 1990 to 0.15% in 2013. The drastic reduction of solid fuel use leaded to DALYs attributable to HAP fell by 97.8% (95% uncertainty interval 97.7-98.0%) from 87,433 (51072-144303) in 1990 to 1889 (1016-3247) in 2013. Proportion of YLLs in DALYs from HAP decreased from 95.7% in 1990 to 86.6% in 2013. Contribution of causes in the attributable DALYs was variable during the study period and in 2013 was in the following order: ischemic heart disease for 43.4%, chronic obstructive pulmonary disease for 24.7%, hemorrhagic stroke for 9.7%, lower respiratory infections for 9.3%, ischemic stroke for 7.8%, lung cancer for 3.4% and cataract for 1.8%. Based on the Gini coefficient, the spatial inequality of the disease burden from HAP increased during the study period. The remained burden of disease was relatively scarce and it mainly occurred in seven southern provinces. Further reduction of the disease burden from HAP as well as compensation of the increasing spatial inequality in Iran could be attained through an especial plan for providing cleaner fuels in the southern provinces.

  19. Deciphering infant mortality

    NASA Astrophysics Data System (ADS)

    Berrut, Sylvie; Pouillard, Violette; Richmond, Peter; Roehner, Bertrand M.

    2016-12-01

    This paper is about infant mortality. In line with reliability theory, "infant" refers to the time interval following birth during which the mortality (or failure) rate decreases. This definition provides a systems science perspective in which birth constitutes a sudden transition falling within the field of application of the Transient Shock (TS) conjecture put forward in Richmond and Roehner (2016c). This conjecture provides predictions about the timing and shape of the death rate peak. It says that there will be a death rate spike whenever external conditions change abruptly and drastically and also predicts that after a steep rise there will be a much longer hyperbolic relaxation process. These predictions can be tested by considering living organisms for which the transient shock occurs several days after birth. Thus, for fish there are three stages: egg, yolk-sac and young adult phases. The TS conjecture predicts a mortality spike at the end of the yolk-sac phase and this timing is indeed confirmed by observation. Secondly, the hyperbolic nature of the relaxation process can be tested using very accurate Swiss statistics for postnatal death rates spanning the period from one hour immediately after birth through to age 10 years. It turns out that since the 19th century despite a significant and large reduction in infant mortality, the shape of the age-specific death rate has remained basically unchanged. Moreover the hyperbolic pattern observed for humans is also found for small primates as recorded in the archives of zoological gardens. Our overall objective is to identify a series of cases which start from simple systems and move step by step to more complex organisms. The cases discussed here we believe represent initial landmarks in this quest.

  20. Impact of Neoadjuvant Prostate-Specific Antigen Kinetics on Biochemical Failure and Prostate Cancer Mortality: Results From a Prospective Patient Database

    SciTech Connect

    Foo, Marcus; Lavieri, Mariel; Pickles, Tom

    2013-02-01

    Purpose: To confirm findings from an earlier report showing that neoadjuvant (NA) prostate-specific antigen (PSA) halving time (PSAHT) impacts biochemical failure (BF) rates, and to examine its association with prostate cancer-specific survival (PCSS), in a large prospective cohort of patients. Methods and Materials: A total of 502 patients were selected from a prospective database, who had localized prostate adenocarcinoma treated with 2-12 months of neoadjuvant androgen deprivation therapy (N-ADT) followed by external beam radiation therapy (EBRT) between 1994 and 2000, and had at least 2 NA PSA values. Seventy-four percent of patients had high-risk prostate cancer. Median initial PSA value, N-ADT duration, total ADT duration, and radiation therapy dose were 14 ng/mL, 6.9 months, 10.8 months, and 68 Gy, respectively. Results: At a median follow-up of 9.9 years, 210 patients have had a BF. Median PSAHT was 18 days. On univariate analysis, PSAHT was not shown to predict for BF (P=.69) or PCSS (P=.28). However, NA nadir PSA (nanPSA) and post-therapy nadir PSA (ptnPSA), when analyzed as continuous or categoric variables, predicted for BF (P<.001) and PCSS (P<.001). On multivariate analysis, nanPSA (P=.037) and ptnPSA (P<.001) continued to be significantly associated with BF. However, N-ADT duration lost significance (P=.67), and PSAHT remained a nonsignificant predictor (P=.97). For PCSS, multivariate analysis showed nanPSA (P=.049) and ptnPSA (P<.001) to be significant. Again PSAHT (P=.49) remained nonsignificant. Conclusions: In this large, prospective cohort of patients, NA PSA kinetics, expressed as PSAHT, did not predict BF or PCSS. However, nadir PSAs, in both the NA and post-therapy settings, were significant predictors of BF and PCSS. Optimization of therapy could potentially be based on early PSA response, with shorter durations of ADT for those predicted to do favorably, and intensification of therapy for those likely to have poorer outcomes.

  1. 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

  2. Mortality table construction

    NASA Astrophysics Data System (ADS)

    Sutawanir

    2015-12-01

    Mortality tables play important role in actuarial studies such as life annuities, premium determination, premium reserve, valuation pension plan, pension funding. Some known mortality tables are CSO mortality table, Indonesian Mortality Table, Bowers mortality table, Japan Mortality table. For actuary applications some tables are constructed with different environment such as single decrement, double decrement, and multiple decrement. There exist two approaches in mortality table construction : mathematics approach and statistical approach. Distribution model and estimation theory are the statistical concepts that are used in mortality table construction. This article aims to discuss the statistical approach in mortality table construction. The distributional assumptions are uniform death distribution (UDD) and constant force (exponential). Moment estimation and maximum likelihood are used to estimate the mortality parameter. Moment estimation methods are easier to manipulate compared to maximum likelihood estimation (mle). However, the complete mortality data are not used in moment estimation method. Maximum likelihood exploited all available information in mortality estimation. Some mle equations are complicated and solved using numerical methods. The article focus on single decrement estimation using moment and maximum likelihood estimation. Some extension to double decrement will introduced. Simple dataset will be used to illustrated the mortality estimation, and mortality table.

  3. Accident mortality among children

    PubMed Central

    Swaroop, S.; Albrecht, R. M.; Grab, B.

    1956-01-01

    The authors present statistics on mortality from accidents, with special reference to those relating to the age-group 1-19 years. For a number of countries figures are given for the proportional mortality from accidents (the number of accident deaths expressed as a percentage of the number of deaths from all causes) and for the specific death-rates, per 100 000 population, from all causes of death, from selected causes, from all causes of accidents, and from various types of accident. From these figures it appears that, in most countries, accidents are becoming relatively increasingly prominent as a cause of death in childhood, primarily because of the conquest of other causes of death—such as infectious and parasitic diseases, which formerly took a heavy toll of children and adolescents—but also to some extent because the death-rate from motor-vehicle accidents is rising and cancelling out the reduction in the rate for other causes of accidental death. In the authors' opinion, further epidemiological investigations into accident causation are required for the purpose of devising quicker and more effective methods of accident prevention. PMID:13383361

  4. Challenge of Fetal Mortality

    MedlinePlus

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

  5. Race and Mortality.

    ERIC Educational Resources Information Center

    Scanlan, James P.

    2000-01-01

    Discusses increasing racial and socioeconomic disparities in mortality despite general declines in mortality, examining disparities in infant mortality and explaining that whenever two groups differ in their susceptibility to some condition, the less prevalent the condition, the greater will be the disparity in rates of experiencing the condition.…

  6. Universal mortality law and immortality

    NASA Astrophysics Data System (ADS)

    Azbel', Mark Ya.

    2004-10-01

    Well-protected human and laboratory animal populations with abundant resources are evolutionarily unprecedented. Physical approach, which takes advantage of their extensively quantified mortality, establishes that its dominant fraction yields the exact law, which is universal for all animals from yeast to humans. Singularities of the law demonstrate new kinds of stepwise adaptation. The law proves that universal mortality is an evolutionary by-product, which at any given age is reversible, independent of previous life history, and disposable. Life expectancy may be extended, arguably to immortality, by minor biological amendments in the animals. Indeed, in nematodes with a small number of perturbed genes and tissues it increased 6-fold (to 430 years in human terms), with no apparent loss in health and vitality. The law relates universal mortality to specific processes in cells and their genetic regulation.

  7. Black and White Differentials in Mortality.

    ERIC Educational Resources Information Center

    Rene, Antonio A.; Clifford, Patrick R.

    1986-01-01

    Overviews vital statistics data, emphasizing differences in health status between the Black and White populations with respect to specific diseases and mortality. Discusses major causes of death among US Blacks. (GC)

  8. Cancer mortality in Brazil

    PubMed Central

    Barbosa, Isabelle R.; de Souza, Dyego L.B.; Bernal, María M.; Costa, Íris do C.C.

    2015-01-01

    Abstract Cancer is currently in the spotlight due to their heavy responsibility as main cause of death in both developed and developing countries. Analysis of the epidemiological situation is required as a support tool for the planning of public health measures for the most vulnerable groups. We analyzed cancer mortality trends in Brazil and geographic regions in the period 1996 to 2010 and calculate mortality predictions for the period 2011 to 2030. This is an epidemiological, demographic-based study that utilized information from the Mortality Information System on all deaths due to cancer in Brazil. Mortality trends were analyzed by the Joinpoint regression, and Nordpred was utilized for the calculation of predictions. Stability was verified for the female (annual percentage change [APC] = 0.4%) and male (APC = 0.5%) sexes. The North and Northeast regions present significant increasing trends for mortality in both sexes. Until 2030, female mortality trends will not present considerable variations, but there will be a decrease in mortality trends for the male sex. There will be increases in mortality rates until 2030 for the North and Northeast regions, whereas reductions will be verified for the remaining geographic regions. This variation will be explained by the demographic structure of regions until 2030. There are pronounced regional and sex differences in cancer mortality in Brazil, and these discrepancies will continue to increase until the year 2030, when the Northeast region will present the highest cancer mortality rates in Brazil. PMID:25906105

  9. Is diphtheria-tetanus-pertussis (DTP) associated with increased female mortality? A meta-analysis testing the hypotheses of sex-differential non-specific effects of DTP vaccine

    PubMed Central

    Aaby, Peter; Ravn, Henrik; Fisker, Ane B.; Rodrigues, Amabelia; Benn, Christine S.

    2016-01-01

    Background Ten years ago, we formulated two hypotheses about whole-cell diphtheria-tetanus-pertussis (DTP) vaccination: first, when given after BCG, DTP increases mortality in girls and, second, following DTP there is an increase in the female/male mortality rate ratio (MRR). A recent review by WHO found no convincing evidence that DTP increases mortality in females. Methods We used previous DTP reviews as well as the recent WHO review for assessing the hypotheses. As pre-specified we excluded studies with survival or frailty bias; if children had received BCG and DTP simultaneously; and if the children had received neonatal vitamin A. Results In seven studies of BCG-vaccinated children, DTP vaccination was associated with a 2.54 (95% CI 1.68–3.86) increase in mortality in girls (with no increase in boys [ratio 0.96, 0.55–1.68]). In 10 studies of BCG-vaccinated children, the female-to-male mortality ratio was 2.45 (1.48–4.06) times higher after DTP than before DTP. In 15 studies of children who had received DTP after previous BCG vaccination, mortality was 1.53 (1.21–1.93) times higher in girls than boys. The findings were similar in studies conducted before and after formulation of the hypotheses. Conclusions The two hypotheses were confirmed in the studies that fulfilled pre-specified criteria. PMID:27856947

  10. On forecasting mortality.

    PubMed

    Olshansky, S J

    1988-01-01

    Official forecasts of mortality made by the U.S. Office of the Actuary throughout this century have consistently underestimated observed mortality declines. This is due, in part, to their reliance on the static extrapolation of past trends, an atheoretical statistical method that pays scant attention to the behavioral, medical, and social factors contributing to mortality change. A "multiple cause-delay model" more realistically portrays the effects on mortality of the presence of more favorable risk factors at the population level. Such revised assumptions produce large increases in forecasts of the size of the elderly population, and have a dramatic impact on related estimates of population morbidity, disability, and health care costs.

  11. Mortality rates among Arab Americans in Michigan.

    PubMed

    Dallo, Florence J; Schwartz, Kendra; Ruterbusch, Julie J; Booza, Jason; Williams, David R

    2012-04-01

    The objectives of this study were to: (1) calculate age-specific and age-adjusted cause-specific mortality rates for Arab Americans; and (2) compare these rates with those for blacks and whites. Mortality rates were estimated using Michigan death certificate data, an Arab surname and first name list, and 2000 U.S. Census data. Age-specific rates, age-adjusted all-cause and cause-specific rates were calculated. Arab Americans (75+) had higher mortality rates than whites and blacks. Among men, all-cause and cause-specific mortality rates for Arab Americans were in the range of whites and blacks. However, Arab American men had lower mortality rates from cancer and chronic lower respiratory disease compared to both whites and blacks. Among women, Arab Americans had lower mortality rates from heart disease, cancer, stroke, and diabetes than whites and blacks. Arab Americans are growing in number. Future study should focus on designing rigorous separate analyses for this population.

  12. Reducing child mortality in India in the new millennium.

    PubMed Central

    Claeson, M.; Bos, E. R.; Mawji, T.; Pathmanathan, I.

    2000-01-01

    Globally, child mortality rates have been halved over the last few decades, a developmental success story. Nevertheless, progress has been uneven and in recent years mortality rates have increased in some countries. The present study documents the slowing decline in infant mortality rates in india; a departure from the longer-term trends. The major causes of childhood mortality are also reviewed and strategic options for the different states of India are proposed that take into account current mortality rates and the level of progress in individual states. The slowing decline in childhood mortality rates in India calls for new approaches that go beyond disease-, programme- and sector-specific approaches. PMID:11100614

  13. Variations of Radon Risk with Changing Mortality Rates

    NASA Astrophysics Data System (ADS)

    Chen, Jing

    2008-08-01

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

  14. Variations of Radon Risk with Changing Mortality Rates

    SciTech Connect

    Chen Jing

    2008-08-07

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

  15. High Summer Temperatures and Mortality in Estonia

    PubMed Central

    Oudin Åström, Daniel; Åström, Christofer; Rekker, Kaidi; Indermitte, Ene; Orru, Hans

    2016-01-01

    Background On-going climate change is predicted to result in a growing number of extreme weather events—such as heat waves—throughout Europe. The effect of high temperatures and heat waves are already having an important impact on public health in terms of increased mortality, but studies from an Estonian setting are almost entirely missing. We investigated mortality in relation to high summer temperatures and the time course of mortality in a coastal and inland region of Estonia. Methods We collected daily mortality data and daily maximum temperature for a coastal and an inland region of Estonia. We applied a distributed lag non-linear model to investigate heat related mortality and the time course of mortality in Estonia. Results We found an immediate increase in mortality associated with temperatures exceeding the 75th percentile of summer maximum temperatures, corresponding to approximately 23°C. This increase lasted for a couple of days in both regions. The total effect of elevated temperatures was not lessened by significant mortality displacement. Discussion We observed significantly increased mortality in Estonia, both on a country level as well as for a coastal region and an inland region with a more continental climate. Heat related mortality was higher in the inland region as compared to the coastal region, however, no statistically significant differences were observed. The lower risks in coastal areas could be due to lower maximum temperatures and cooling effects of the sea, but also better socioeconomic condition. Our results suggest that region specific estimates of the impacts of temperature extremes on mortality are needed. PMID:27167851

  16. Peptic ulcers: mortality and hospitalization.

    PubMed

    Riley, R

    1991-01-01

    This study analyzes data on peptic ulcer disease based on deaths for 1951-1988 and hospital separations for 1969-1988. The source of the data are mortality and morbidity statistics provided to Statistics Canada by the provinces. The age-standardized mortality rates (ASMR) for peptic ulcer disease decreased from 1951 to 1988 by 69.4% for men (8.5 to 2.6 per 100,000 population), and 31.8% for women (2.2 to 1.5). Separation rates from hospitals during 1969-1988 for peptic ulcer disease also decreased by 59.8% for men (242.7 to 97.6 per 100,000 population) and 35.6% for women (103.2 to 66.5). Age-specific rates for both mortality and hospital separations increased with age. Epidemiological studies indicate that the incidence of peptic ulcer disease is declining in the general population. The downward trends in mortality and hospitalization rates for peptic ulcer disease reflect this change in incidence, but additional factors probably contribute as well to this decline. Male rates for both mortality and hospital separations were much higher than female rates at the beginning of the study period; but toward the end, the gap between the sexes narrowed considerably, mainly because the male rates declined substantially while the female rates decline moderately. The slower decline in the rates for women may be related to such factors as the increasing labour force participation among women and the slower decline in the population of female smokers.

  17. Structural pluralism and all-cause mortality.

    PubMed Central

    Young, F W; Lyson, T A

    2001-01-01

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

  18. Mortality patterns among workers exposed to acrylamide

    SciTech Connect

    Collins, J.J.; Swaen, G.M.; Marsh, G.M.; Utidjian, H.M.; Caporossi, J.C.; Lucas, L.J. )

    1989-07-01

    A cohort of 8854 men, 2293 of whom were exposed to acrylamide, was examined from 1925 to 1983 for mortality. This cohort consisted of four plant populations in two countries: the United States and The Netherlands. No statistically significant excess of all-cause or cause-specific mortality was found among acrylamide workers. Analysis by acrylamide exposure levels showed no trend of increased risk of mortality from several cancer sites. These results do not support the hypothesis that acrylamide is a human carcinogen.

  19. Standardization of age-adjusted mortality rates

    SciTech Connect

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

    1980-02-01

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

  20. Mortality among aircraft manufacturing workers

    PubMed Central

    Boice, J. D.; Marano, D. E.; Fryzek, J. P.; Sadler, C. J.; McLaughlin, J. K.

    1999-01-01

    OBJECTIVES: To evaluate the risk of cancer and other diseases among workers engaged in aircraft manufacturing and potentially exposed to compounds containing chromate, trichloroethylene (TCE), perchloroethylene (PCE), and mixed solvents. METHODS: A retrospective cohort mortality study was conducted of workers employed for at least 1 year at a large aircraft manufacturing facility in California on or after 1 January 1960. The mortality experience of these workers was determined by examination of national, state, and company records to the end of 1996. Standardised mortality ratios (SMRs) were evaluated comparing the observed numbers of deaths among workers with those expected in the general population adjusting for age, sex, race, and calendar year. The SMRs for 40 cause of death categories were computed for the total cohort and for subgroups defined by sex, race, position in the factory, work duration, year of first employment, latency, and broad occupational groups. Factory job titles were classified as to likely use of chemicals, and internal Poisson regression analyses were used to compute mortality risk ratios for categories of years of exposure to chromate, TCE, PCE, and mixed solvents, with unexposed factory workers serving as referents. RESULTS: The study cohort comprised 77,965 workers who accrued nearly 1.9 million person-years of follow up (mean 24.2 years). Mortality follow up, estimated as 99% complete, showed that 20,236 workers had died by 31 December 1996, with cause of death obtained for 98%. Workers experienced low overall mortality (all causes of death SMR 0.83) and low cancer mortality (SMR 0.90). No significant increases in risk were found for any of the 40 specific cause of death categories, whereas for several causes the numbers of deaths were significantly below expectation. Analyses by occupational group and specific job titles showed no remarkable mortality patterns. Factory workers estimated to have been routinely exposed to chromate were

  1. Mortality among professional drivers.

    PubMed

    Rafnsson, V; Gunnarsdóttir, H

    1991-10-01

    The mortality of truck drivers and taxi drivers was studied in Reykjavík. The national mortality rate was used for comparison, and the follow-up lasted until 1 December 1988. The 868 truck drivers (28,788.0 person-years) had an excess of lung cancer deaths [24 observed, 11.2 expected, standardized mortality ratio (SMR) 2.14], but fewer deaths than expected from respiratory diseases (15 observed versus 30.1 expected). The SMR from lung cancer did not steadily increase as the duration of employment increased, nor did it change with the length of follow-up. The SMR values did not deviate substantially from unity for the taxi drivers. Since the high mortality from lung cancer among the truck drivers did not seem to be due to their smoking habits, it might have been caused by one or more occupational factors, especially in light of this group's exposure to engine exhaust gases.

  2. Legal abortion mortality.

    PubMed

    Kestelman, P

    1978-04-01

    Statistics on legal abortion in Britain between 1968-1974 are presented. There was a mortality rate of 10+ or -2 per 100,000 abortions: 27+ or -11 in 1968-1969, 12+ or -4 in 1970-1972, and 6+ or -3 in 1973-1974. Legal abortion mortality increased from 4+ or -3 when performed at gestation under 9 weeks to 5+ or -2 at 9-12 weeks, 13+ or -7 at 13-16 weeks, and 62+ or -33 at 17 weeks and over. The ratio was 11+ or -6 for women under 20 years of age, increasing to 5+ or -3 at age 20-29, 10+ or -6 at age 30-39, and 23+ or -19 at age 40 and over. The parity had little influence on abortion mortality, but the technique used had a great influence. Hysterotomy, hypertonic saline, and abortifacient paste were the most dangerous, in increasing order, with mortality rates of 39+ or -30, 106+ or -75, and 152+ or -89, respectively. The rates for aspiration and curretage were 4+ or -2 and 4+ or -3, respectively. There was a higher mortality risk with abortion with sterilization. The main causes of legal abortion mortality were infection, pulmonary embolism, and complications of general anesthesia. The high incidence of mortality associated with legal abortion in Britain is partially caused by: 1) high incidence of concurrent sterilization, 2) former use of dangerous techniques, 3) significant incidence of second trimester abortion, 4) routine use of general anesthesia, and 5) previous ill health of some of the women.

  3. Cholesterol trials and mortality.

    PubMed

    Warren, John B; Dimmitt, Simon B; Stampfer, Hans G

    2016-07-01

    An overview of clinical trials can reveal a class effect on mortality that is not apparent from individual trials. Most large trials of lipid pharmacotherapy are not powered to detect differences in mortality and instead assess efficacy with composite cardiovascular endpoints. We illustrate the importance of all-cause mortality data by comparing survival in three different sets of the larger controlled lipid trials that underpin meta-analyses. These trials are for fibrates and statins. Fibrate treatment in five of the six main trials was associated with a decrease in survival, one fibrate trial showed a non-significant reduction in mortality that can be explained by a different target population. In secondary prevention, statin treatment increased survival in all five of the main trials, absolute mean increase ranged from 0.43% to 3.33%, the median change was 1.75%, which occurred in the largest trial. In primary prevention, statin treatment increased survival in six of the seven main trials, absolute mean change in survival ranged from -0.09% to 0.89%, median 0.49%. Composite safety endpoints are rare in these trials. The failure to address composite safety endpoints in most lipid trials precludes a balanced summary of risk-benefit when a composite has been used for efficacy. Class effects on survival provide informative summaries of the risk-benefit of lipid pharmacotherapy. We consider that the presentation of key mortality/survival data adds to existing meta-analyses to aid personal treatment decisions.

  4. The History and Problems in the Making of Education Policy at the World Bank 1960-2000

    ERIC Educational Resources Information Center

    Heyneman, S. P.

    2003-01-01

    The reports seem contradictory. With about three billion dollars per year in new loan commitments, the World Bank has become the single largest source of development capital in the field of international education. These resources help expand educational opportunities for young women in South Asia and rebuild primary schools following civil…

  5. Neonatal mortality in Utah.

    PubMed

    Woolley, F R; Schuman, K L; Lyon, J L

    1982-09-01

    A cohort study of neonatal mortality (N = 106) in white singleton births (N = 14,486) in Utah for January-June 1975 was conducted. Using membership and activity in the Church of Jesus Christ of Latter-day Saints (LDS or Mormon) as a proxy for parental health practices, i.e., tobacco and alcohol abstinence, differential neonatal mortality rates were calculated. The influence of potential confounding factors was evaluated. Low activity LDS members were found to have an excess risk of neonatal death five times greater than high activity LDS, with an upper bound of a two-sided 95% confidence interval of 7.9. The data consistently indicate a lower neonatal mortality rate for active LDS members. Non-LDS were found to have a lower rate than either medium or low activity LDS.

  6. The mortality of companies

    PubMed Central

    Daepp, Madeleine I. G.; Hamilton, Marcus J.; West, Geoffrey B.; Bettencourt, Luís M. A.

    2015-01-01

    The firm is a fundamental economic unit of contemporary human societies. Studies on the general quantitative and statistical character of firms have produced mixed results regarding their lifespans and mortality. We examine a comprehensive database of more than 25 000 publicly traded North American companies, from 1950 to 2009, to derive the statistics of firm lifespans. Based on detailed survival analysis, we show that the mortality of publicly traded companies manifests an approximately constant hazard rate over long periods of observation. This regularity indicates that mortality rates are independent of a company's age. We show that the typical half-life of a publicly traded company is about a decade, regardless of business sector. Our results shed new light on the dynamics of births and deaths of publicly traded companies and identify some of the necessary ingredients of a general theory of firms. PMID:25833247

  7. Mortality scoring in ITU.

    PubMed

    Niewiński, Grzegorz; Kański, Andrzej

    2012-01-01

    Chronic shortage of ITU beds makes decisions on admission difficult and responsible. The use of computer-based mortality scoring should help in decision-making and for this purpose, a number of different scoring systems have been created; in principle, they should be easy to use, adaptable to all populations of patients and suitable for predicting the risk of mortality during both ITU and hospital stay. Most of existing scales and scoring systems were included in this review. They are frequently used in ITUs and become a necessary tool to describe ITU populations and to explain differences in mortality. As there are several pitfalls related to the interpretation of the numbers supplied by the systems, they should be used with the knowledge on the severity scoring science. Moreover, the cost and significant workload limit the use of scoring systems; in many cases an extra person has to be employed for collection and analysis of data only.

  8. Biplot models applied to cancer mortality rates.

    PubMed

    Osmond, C

    1985-01-01

    "A graphical method developed by Gabriel to display the rows and columns of a matrix is applied to tables of age- and period-specific cancer mortality rates. It is particularly useful when the pattern of age-specific rates changes with time. Trends in age-specific rates and changes in the age distribution are identified as projections. Three examples [from England and Wales] are given."

  9. The influence of weather on human mortality in Hong Kong.

    PubMed

    Yan, Y Y

    2000-02-01

    This study is the first attempt to investigate mortality seasonality and weather-mortality relationships in Hong Kong from 1980 to 1994. Monthly mortality data from all causes of death, neoplasm, circulatory and respiratory diseases were obtained from the Census and Statistics Department and the weather data were obtained from the Hong Kong Observatory. Regression analyses and ANOVA were employed. Significant winter peaks in sex specific and total deaths from all causes, circulatory and respiratory diseases were ascertained. Cancer mortality, however, was not seasonal. Mortality seasonality only existed in age groups 45-64 and > or =65. For the impact of weather on mortality, no significant relationship between weather variables and cancer mortality was observed. A significant negative association between minimum temperature and a positive relationship between cloud and deaths were found. This suggests that colder and cloudy conditions may heighten mortality. Wind was discovered to have a negative association with mortality. This finding revealed that the stressful effect of wind on mortality was negligible. There was no apparent sex difference. Deaths from the younger age groups (0-24 yr old) were not weather related. Weak weather connection with mortality for age group 25-44 was discovered, with Adj r2 values ranging from 0.05 to 0.07. The elderly (age > or =65) were more vulnerable to weather stress and strong weather-mortality relationship was uncovered, with Adj r2 values from 0.36 to 0.66. These results are important information for formulating public health policies.

  10. Adolescents, Egocentrism, and Mortality

    ERIC Educational Resources Information Center

    Hanna, Jennie L.

    2017-01-01

    Adolescents are often described as egocentric, but a major source of this external behavior is the internal fear of adolescents have about feeling invisible, being different, and even their own mortality. Facing this fear through a curricular focus on death can help to combat this behavior. This can be accomplished through novel studies of books…

  11. Mortality among Swedish Journalists.

    ERIC Educational Resources Information Center

    Furhoff, Anna-Karin; Furhoff, Lars

    1987-01-01

    Charts the various environmental factors that might influence the mortality rate of Swedish journalists. Concludes that, although there may be a slightly higher death rate among Swedish journalists in the 50-59 age group, the death rate for journalists is the same as for the population in general. (MM)

  12. Mechanical vulnerability explains size-dependent mortality of reef corals

    PubMed Central

    Madin, Joshua S; Baird, Andrew H; Dornelas, Maria; Connolly, Sean R

    2014-01-01

    Understanding life history and demographic variation among species within communities is a central ecological goal. Mortality schedules are especially important in ecosystems where disturbance plays a major role in structuring communities, such as coral reefs. Here, we test whether a trait-based, mechanistic model of mechanical vulnerability in corals can explain mortality schedules. Specifically, we ask whether species that become increasingly vulnerable to hydrodynamic dislodgment as they grow have bathtub-shaped mortality curves, whereas species that remain mechanically stable have decreasing mortality rates with size, as predicted by classical life history theory for reef corals. We find that size-dependent mortality is highly consistent between species with the same growth form and that the shape of size-dependent mortality for each growth form can be explained by mechanical vulnerability. Our findings highlight the feasibility of predicting assemblage-scale mortality patterns on coral reefs with trait-based approaches. PMID:24894390

  13. Mortality in Vietnam, 1979-1989.

    PubMed

    Merli, M G

    1998-08-01

    Little is known about past and present mortality in Vietnam, as the first official data on mortality have only recently become available from censuses taken in 1979 and 1989. Using these data, I estimate Vietnamese mortality during the intercensal period using two techniques that rely on age-specific growth rates from two successive age distributions. Intercensal emigration and differential completeness of census enumeration associated with massive outflows of refugees in the wake of the Vietnam War, population-redistribution policies, and a highly mobile population represent important sources of bias for the estimation of intercensal mortality. I incorporate several strategies to minimize bias from these sources and to select the method that is least sensitive to errors associated with them. Life expectancy at birth estimated for the 1979-1989 intercensal period is 61.4 years for males and 63.2 for females. These results suggest a trend of declining mortality between the 1970s and the 1980s and add solid empirical evidence to the debate over whether mortality in Vietnam has been deteriorating or improving.

  14. Liver cancer mortality rate model in Thailand

    NASA Astrophysics Data System (ADS)

    Sriwattanapongse, Wattanavadee; Prasitwattanaseree, Sukon

    2013-09-01

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

  15. Social capital, income inequality, and mortality.

    PubMed Central

    Kawachi, I; Kennedy, B P; Lochner, K; Prothrow-Stith, D

    1997-01-01

    OBJECTIVES: Recent studies have demonstrated that income inequality is related to mortality rates. It was hypothesized, in this study, that income inequality is related to reduction in social cohesion and that disinvestment in social capital is in turn associated with increased mortality. METHODS: In this cross-sectional ecologic study based on data from 39 states, social capital was measured by weighted responses to two items from the General Social Survey: per capita density of membership in voluntary groups in each state and level of social trust, as gauged by the proportion of residents in each state who believed that people could be trusted. Age-standardized total and cause-specific mortality rates in 1990 were obtained for each state. RESULTS: Income inequality was strongly correlated with both per capita group membership (r = -.46) and lack of social trust (r = .76). In turn, both social trust and group membership were associated with total mortality, as well as rates of death from coronary heart disease, malignant neoplasms, and infant mortality. CONCLUSIONS: These data support the notion that income inequality leads to increased mortality via disinvestment in social capital. PMID:9314802

  16. Allometric scaling of mortality rates with body mass in abalones.

    PubMed

    Rossetto, Marisa; De Leo, Giulio A; Bevacqua, Daniele; Micheli, Fiorenza

    2012-04-01

    The existence of an allometric relationship between mortality rates and body mass has been theorized and extensively documented across taxa. Within species, however, the allometry between mortality rates and body mass has received substantially less attention and the consistency of such scaling patterns at the intra-specific level is controversial. We reviewed 73 experimental studies to examine the relationship between mortality rates and body size among seven species of abalone (Haliotis spp.), a marine herbivorous mollusk. Both in the field and in the laboratory, log-transformed mortality rates were negatively correlated with log-transformed individual body mass for all species considered, with allometric exponents remarkably similar among species. This regular pattern confirms previous findings that juvenile abalones suffer higher mortality rates than adult individuals. Field mortality rates were higher overall than those measured in the laboratory, and the relationship between mortality and body mass tended to be steeper in field than in laboratory conditions for all species considered. These results suggest that in the natural environment, additional mortality factors, especially linked to predation, could significantly contribute to mortality, particularly at small body sizes. On the other hand, the consistent allometry of mortality rates versus body mass in laboratory conditions suggests that other sources of mortality, beside predation, are size-dependent in abalone.

  17. 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.

  18. [Mortality by socio-occupational categories in urban and rural areas].

    PubMed

    Bouvier-Colle, M H; Barberena, A; Hatton, F

    1983-01-01

    Mortality data in France are studied by a cross sectional analysis including both population density (urban or rural aggregates) and socio-economic groups. The socio-economic differentials in mortality increase with the size of localities. Specific social class distribution partly explains the excess of mortality in rural areas and the lowest mortality in the parisian agglomeration. On the contrary social class distribution does not affect mortality in small towns. Nevertheless, the expected effect of social class does not explain all the discrepancies in mortality between urban and rural areas. The population density is a parameter that should be taken into account when analyzing mortality.

  19. Maternal education and child mortality in Zimbabwe.

    PubMed

    Grépin, Karen A; Bharadwaj, Prashant

    2015-12-01

    In 1980, Zimbabwe rapidly expanded access to secondary schools, providing a natural experiment to estimate the impact of increased maternal secondary education on child mortality. Exploiting age specific exposure to these reforms, we find that children born to mothers most likely to have benefited from the policies were about 21% less likely to die than children born to slightly older mothers. We also find that increased education leads to delayed age at marriage, sexual debut, and first birth and that increased education leads to better economic opportunities for women. We find little evidence supporting other channels through which increased education might affect child mortality. Expanding access to secondary schools may greatly accelerate declines in child mortality in the developing world today.

  20. The decline in child mortality: a reappraisal.

    PubMed Central

    Ahmad, O. B.; Lopez, A. D.; Inoue, M.

    2000-01-01

    The present paper examines, describes and documents country-specific trends in under-five mortality rates (i.e., mortality among children under five years of age) in the 1990s. Our analysis updates previous studies by UNICEF, the World Bank and the United Nations. It identifies countries and WHO regions where sustained improvement has occurred and those where setbacks are evident. A consistent series of estimates of under-five mortality rate is provided and an indication is given of historical trends during the period 1950-2000 for both developed and developing countries. It is estimated that 10.5 million children aged 0-4 years died in 1999, about 2.2 million or 17.5% fewer than a decade earlier. On average about 15% of newborn children in Africa are expected to die before reaching their fifth birthday. The corresponding figures for many other parts of the developing world are in the range 3-8% and that for Europe is under 2%. During the 1990s the decline in child mortality decelerated in all the WHO regions except the Western Pacific but there is no widespread evidence of rising child mortality rates. At the country level there are exceptions in southern Africa where the prevalence of HIV is extremely high and in Asia where a few countries are beset by economic difficulties. The slowdown in the rate of decline is of particular concern in Africa and South-East Asia because it is occurring at relatively high levels of mortality, and in countries experiencing severe economic dislocation. As the HIV/AIDS epidemic continues in Africa, particularly southern Africa, and in parts of Asia, further reductions in child mortality become increasingly unlikely until substantial progress in controlling the spread of HIV is achieved. PMID:11100613

  1. Mortality of atomic bomb survivors predicted from laboratory animals

    NASA Technical Reports Server (NTRS)

    Carnes, Bruce A.; Grahn, Douglas; Hoel, David

    2003-01-01

    Exposure, pathology and mortality data for mice, dogs and humans were examined to determine whether accurate interspecies predictions of radiation-induced mortality could be achieved. The analyses revealed that (1) days of life lost per unit dose can be estimated for a species even without information on radiation effects in that species, and (2) accurate predictions of age-specific radiation-induced mortality in beagles and the atomic bomb survivors can be obtained from a dose-response model for comparably exposed mice. These findings illustrate the value of comparative mortality analyses and the relevance of animal data to the study of human health effects.

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

    NASA Astrophysics Data System (ADS)

    Tan, Chon Sern; Pooi, Ah Hin

    2015-12-01

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

  3. Mortality among rubber workers: V. processing workers.

    PubMed

    Delzell, E; Monson, R R

    1982-07-01

    Cause-specific mortality was evaluated among 2,666 men employed in the processing division of a rubber manufacturing plant. The division was divided into two sections: front processing (compounding, mixing and milling operations) and back processing (extrusion, calendering, cement mixing and rubberized fabrics operations). Mortality rates for all processing workers combined and for men in each section were compared with rates for U.S. White males or for workers employed in other divisions of the same plant. Compared with either referent group, men in the processing division had increased mortality from leukemia, emphysema, and cancers of the stomach, large intestine, and biliary passages and liver. An excess number of deaths from stomach and larger intestine cancer was found predominantly among men in the front processing section (33 observed vs. 17.7 expected deaths, based on rates in nonprocessing workers). Increased mortality from leukemia (14 observed vs. 7.3 expected) and from emphysema (22 observed vs. 11.0 expected) was present among men employed in the back processing section. Examination of mortality from these causes according to age and the year starting work, duration of employment, and years since starting work in the relevant sections of the processing division suggested that observed excesses of stomach cancer, large intestine cancer, leukemia, and emphysema among processing workers are related to occupational exposures. These results are consistent with the findings of studies of other groups of rubber workers.

  4. Mortality of tanners.

    PubMed

    Pippard, E C; Acheson, E D; Winter, P D

    1985-04-01

    The mortality of 833 male tannery workers known to have been employed in the industry in 1939 and who were followed up to the end of 1982 was studied. A total of 573 men had been employed in making leather tanned by vegetable extracts for soles and heels, and 260 men had used chrome tanning to make leather for the upper parts of shoes. No significant excesses of deaths were found for any of the common sites of cancer in either group of workers. One death from nasal cancer (0.21 expected) was reported among the men who worked with sole and heel leather.

  5. Mortality and cancer morbidity among cement workers.

    PubMed Central

    Jakobsson, K; Horstmann, V; Welinder, H

    1993-01-01

    OBJECTIVE--To explore associations between exposure to cement dust and cause specific mortality and tumour morbidity, especially gastrointestinal tumours. DESIGN--A retrospective cohort study. SUBJECTS AND SETTING--2400 men, employed for at least 12 months in two Swedish cement factories. MAIN OUTCOME MEASURES--Cause specific morality from death certificates (1952-86). Cancer morbidity from tumour registry information (1958-86). Standardised mortality rates (SMRs; national reference rates) and standardised morbidity incidence rates (SIRs; regional reference rates) were calculated. RESULTS--An increased risk of colorectal cancer was found > or = 15 years since the start of employment (SIR 1.6, 95% confidence interval (95% CI) 1.1-2.3), mainly due to an increased risk for tumours in the right part of the colon (SIR 2.7, 95% CI 1.4-4.8), but not in the left part (SIR 1.0, 95% CI 0.3-2.5). There was a numerical increase of rectal cancer (SIR 1.5, 95% CI 0.8-2.5). Exposure (duration of blue collar employment)-response relations were found for right sided colon cancer. After > or = 25 years of cement work, the risk was fourfold (SIR 4.3, 95% CI 1.7-8.9). There was no excess of stomach cancer or respiratory cancer. Neither total mortality nor cause specific mortality were significantly increased. CONCLUSIONS--Diverging risk patterns for tumours with different localisations within the large bowel were found in the morbidity study. Long term exposure to cement dust was a risk factor for right sided colon cancer. The mortality study did not show this risk. PMID:8457494

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

    PubMed

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

    2007-12-01

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

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

    PubMed

    Dolejs, Josef

    2016-05-21

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

  8. Aqueous metallic factors and cancer mortality

    SciTech Connect

    Pence, H.L.

    1984-01-01

    The purpose of this study was to investigate the possible relationships between aqueous metals and cancer mortality in the upper Colorado River Basin in the State of Colorado for the period 1970-1980. All death certificates for the State of Colorado for the study period were examined for cause of death, and a magnetic tape containing abstracts of certificates for all cancer mortality was produced by the Vital Statistics Division of the Colorado Department of Health. Decedents were grouped by county, sex, and type of cancer and all records for cancers of the digestive organs, genital organs, and urinary organs were categorized by county and sex. Standardized cause- and sex-specific mortality ratios were calculated for each year for each of the fourteen counties in the Colorado Basin and were used as the dependent variables in subsequent analyses. Aqueous metals data were obtained from the Environmental Protection Agency master data base for the area and period and were factor analyzed to establish objective groups of metals which were present in the waters of the Basin. Metals included in the study were As, Be, Cd, Cu, Cr, Fe, Pb, Mn, Hg, Ni, Se, and Zn. The correlation matrix was factor analyzed and five common factors were extracted by promax rotation. The set of Mn, Zn, Cu, Fe, and Pb was found to relate to cancer mortality in each sex. Further independent analyses for each sex. Further independent analyses for each sex indicated that Mn was most directly related to cancer mortality for both sexes, and that Zn was most inversely related to cancer mortality for both sexes.

  9. Ozone and daily mortality in Shanghai, China

    SciTech Connect

    Zhang, Y.H.; Huang, W.; London, S.J.; Song, G.X.; Chen, G.H.; Jiang, L.L.; Zhao, N.Q.; Chen, B.H.; Kan, H.D.

    2006-08-15

    Given the changes in types of air pollution from conventional coal combustion to the mixed coal combustion/motor vehicle emissions in China's large cities, it is worthwhile to investigate the acute effect of O{sub 3} on mortality outcomes in the country. We conducted a time-series study to investigate the relation between O{sub 3} and daily mortality in Shanghai using 4 years of daily data (2001-2004). O{sub 3} was found to be significantly associated with total and cardiovascular mortality in the cold season but not in the warm season. In the whole-year analysis, an increase of 10 pg/m{sup 3} of 2-day average O{sub 3} corresponds to 0.45% (95% confidence interval (CI), 0.16-0.73%), 0.53% (95% CI, 0.10-0.96%), and 0.35% (95% CI, -0.40 to 1.09%) increase of total nonaccidental, cardiovascular, and respiratory mortality, respectively. In the cold season, the estimates increased to 1.38% (95% CI , 0.68-2.07%), 1.53% (95% CI, 0.54-2.52%), and 0.95% (95% CI, -0.71 to 2.60%), respectively. In the warm season, we did not observe significant associations for both total and causespecific mortality. The results were generally insensitive to model specifications such as lag structure of O{sub 3} concentrations and degree of freedom for time trend. Multipoflutant models indicate that the effect of O{sub 3} was not confounded by particulate matter {<=} 10 {mu} m in diameter (PM10) or by sulfur dioxide; however, after adding nitrogen dioxide into the model, the association of O{sub 3} with total and cardiovascular mortality became statistically insignificant.

  10. Mortality of fecal bacteria in seawater

    SciTech Connect

    Garcia-Lara, J.; Menon, P.; Servais, P.; Billen, G. )

    1991-03-01

    The authors propose a method for determining the mortality rate for allochthonous bacteria released in aquatic environments without interference due to the loss of culturability in specific culture media. This method consists of following the disappearance of radioactivity from the trichloracetic acid-insoluble fraction in water samples to which ({sup 3}H)thymidine-prelabeled allochthonous bacteria have been added. In coastal seawater, they found that the actual rate of disappearance of fecal bacteria was 1 order of magnitude lower than the rate of loss of culturability on specific media. Minor adaptation of the procedure may facilitate assessment of the effect of protozoan grazing and bacteriophage lysis on the overall bacterial mortality rate.

  11. Global Progress in Road Injury Mortality since 2010

    PubMed Central

    Ning, Peishan; Schwebel, David C.; Huang, Helai; Li, Li; Li, Jun; Hu, Guoqing

    2016-01-01

    We aimed to examine progress in global road injury mortality since the initiation of Global Plan for the Decade of Action for Road Safety 2011–2020. We examined annual percent changes in age-adjusted road traffic mortality using data from the Global Burden of Disease Study 2013. Association between changes in road traffic mortality and legislative efforts in individual nations was explored using data from Global Status Reports on Road Safety 2013 and 2015. We found that global age-adjusted mortality, both overall and for user-specific road traffic injuries, decreased significantly between 2010 and 2013 (annual percent change in rates range from -1.43% to -0.99%). Developed countries witnessed a larger decrease than developing countries in both overall and user-specific road mortality (about 2.0–4.6 times). However, there were substantial disparities within developed countries and within developing countries, with some countries seeing large reductions in mortality rates and others seeing none. The annual percent change in road traffic mortality during 2010–2013 was significantly correlated with total national law enforcement score (Spearman rs = -0.38). We concluded that results highlight the need for continued effort to reduce the burden of road injury mortality, especially in LMIC countries. PMID:27727318

  12. Mortality of lead smelter workers

    SciTech Connect

    Selevan, S.G.; Landrigan, P.J.; Stern, F.B.; Jones, J.H.

    1985-10-01

    To examine patterns of death in lead smelter workers, a retrospective analysis of mortality was conducted in a cohort of 1,987 males employed between 1940 and 1965 at a primary lead smelter in Idaho. Overall mortality was similar to that of the United States white male population (standardized mortality ratio (SMR) = 98). Excess mortality, however, was found from chronic renal disease (SMR = 192; confidence interval (CI) = 88-364), and the risk of death from renal disease increased with increasing duration of employment, such that after 20 years employment, the standardized mortality ratio reached 392 (CI = 107-1,004). Excess mortality was also noted for nonmalignant respiratory disease (SMR = 187, CI = 128-264). Eight of 32 deaths in this category were caused by silicosis; at least five workers who died of silicosis had been miners for a part of their lives. An additional 11 deaths resulted from tuberculosis (SMR = 139; CI = 69-249); in six of these cases, silicosis was a contributory cause of death. Cancer mortality was not increased overall (SMR = 95; CI = 78-114). An increase, however, was noted for deaths from kidney cancer (six cases; SMR = 204; CI = 75-444). Finally, excess mortality was noted for injuries (SMR = 138; CI = 104-179); 13 (23%) of the 56 deaths in this category were caused by mining injuries. The data from this study are consistent with previous reports of increased mortality from chronic renal disease in persons exposed occupationally to lead.

  13. A cohort mortality study of petrochemical workers

    SciTech Connect

    Austin, S.G.; Schnatter, A.R.

    1983-04-01

    A historical prospective cohort mortality study was conducted for a cohort of 6,588 white male employees of a Texas petrochemical plant because of a suspected increased incidence of malignant brain tumors. Mortality experience from 1941 to 1977 was determined and compared with that of the general U.S. white male population adjusting for age and time period. Overall and cause-specific standardized mortality ratios were calculated for various subgroups of the population defined by length of employment, latency and payroll status. Significant deficits in total cohort mortality were found for all causes of death, all circulatory diseases, all respiratory diseases and all digestive diseases. Although not statistically significant, fewer deaths were observed (O) than expected (E) for all malignant neoplasms. No statistically significant excess of malignant brain tumors was found in the overall plant population (O/E = 12/7.42 = 1.62). A borderline significant excess of brain cancer deaths was found among hourly employees with more than six months' employment based on 10 observed and five expected deaths. This excess was observed to occur among elderly employees (over 55 years) and in later follow-up years (post-1970). Risk did not appear to be related to length of employment. Because of the nature of the problem that prompted this study, the small number of cases involved and the lack of a suspect agent in the plant that could have produced this excess, insufficient evidence was found to conclude that these tumors were occupationally related.

  14. Predictors of Mortality in Staphylococcus aureus Bacteremia

    PubMed Central

    Jensen, Slade O.; Vaska, Vikram L.; Espedido, Björn A.; Paterson, David L.; Gosbell, Iain B.

    2012-01-01

    Summary: Staphylococcus aureus bacteremia (SAB) is an important infection with an incidence rate ranging from 20 to 50 cases/100,000 population per year. Between 10% and 30% of these patients will die from SAB. Comparatively, this accounts for a greater number of deaths than for AIDS, tuberculosis, and viral hepatitis combined. Multiple factors influence outcomes for SAB patients. The most consistent predictor of mortality is age, with older patients being twice as likely to die. Except for the presence of comorbidities, the impacts of other host factors, including gender, ethnicity, socioeconomic status, and immune status, are unclear. Pathogen-host interactions, especially the presence of shock and the source of SAB, are strong predictors of outcomes. Although antibiotic resistance may be associated with increased mortality, questions remain as to whether this reflects pathogen-specific factors or poorer responses to antibiotic therapy, namely, vancomycin. Optimal management relies on starting appropriate antibiotics in a timely fashion, resulting in improved outcomes for certain patient subgroups. The roles of surgery and infectious disease consultations require further study. Although the rate of mortality from SAB is declining, it remains high. Future international collaborative studies are required to tease out the relative contributions of various factors to mortality, which would enable the optimization of SAB management and patient outcomes. PMID:22491776

  15. Indonesia lowers infant mortality.

    PubMed

    Bain, S

    1991-11-01

    Indonesia's success in reaching World Health Organization (WHO) universal immunization coverage standards is described as the result of a strong national program with timely, targeted donor support. USAID/Indonesia's Expanded Program for Immunization (EPI) and other USAID bilateral cooperation helped the government of Indonesia in its goal to immunize children against diphtheria, pertussis, tetanus, polio, tuberculosis, and measles by age 1. The initial project was to identify target areas and deliver vaccines against the diseases, strengthen the national immunization organization and infrastructure, and develop the Ministry of Health's capacity to conduct studies and development activities. This EPI project spanned the period 1979-90, and set the stage for continued expansion of Indonesia's immunization program to comply with the full international schedule and range of immunizations of 3 DPT, 3 polio, 1 BCG, and 1 measles inoculation. The number of immunization sites has increased from 55 to include over 5,000 health centers in all provinces, with additional services provided by visiting vaccinators and nurses in most of the 215,000 community-supported integrated health posts. While other contributory factors were at play, program success is at least partially responsible for the 1990 infant mortality rate of 58/1,000 live births compared to 72/1,000 in 1985. Strong national leadership, dedicated health workers and volunteers, and cooperation and funding from UNICEF, the World Bank, Rotary International, and WHO also played crucially positive roles in improving immunization practice in Indonesia.

  16. Till Death Do Us Part: Marital Status and U. S. Mortality Trends, 1986-2000

    ERIC Educational Resources Information Center

    Liu, Hui

    2009-01-01

    Although the association of being married and a lower mortality rate has been well established, most previous research on marital status and mortality did not consider potential change in this relationship over time. In this study, I adopted a survey cohort perspective to examine both overall and cause-specific mortality trends by marital status…

  17. Child Mortality: A Preventable Tragedy.

    ERIC Educational Resources Information Center

    Seipel, Michael M. O.

    1996-01-01

    Worldwide data reveal that child mortality (ages 1-5) accounts for about 10-15% of all deaths in developing countries, and less than 1% of all deaths in developed countries. Strategies for reducing child mortality include improving health services, improving environmental conditions, enhancing the social conditions of children, and protecting and…

  18. Oral health problems and mortality

    PubMed Central

    Kim, Jung Ki; Baker, Lindsey A.; Davarian, Shieva; Crimmins, Eileen

    2013-01-01

    Background/purpose Previous studies have shown the relationship between individual oral health conditions and mortality; however, the relationship between mortality and multiple oral health conditions has not been examined. This study investigates the link between individual oral health problems and oral comorbidity and mortality risk. Materials and methods Data are derived from the National Health and Nutrition Examination Survey 1999–2004, which is linked to the National Death Index for mortality follow-up through 2006. We estimated the risk of mortality among people with three individual oral health conditions—tooth loss, root caries, and periodontitis as well as with oral comorbidity—or having all three conditions. Results Significant tooth loss, root caries, and periodontal disease were associated with increased odds of dying. The relationship between oral health conditions and mortality disappeared when controlling for sociodemographic, health, and/or health behavioral indicators. Having multiple oral health problems was associated with an even higher rate of mortality. Conclusion Individual oral health conditions—tooth loss, root caries, and periodontal disease—were not related to mortality when sociodemographic, health, and/or health behavioral factors were considered, and there was no differential pattern between the three conditions. Multiple oral health problems were associated with a higher risk of dying. PMID:24416472

  19. The changing face of death: recent trends in Australian mortality.

    PubMed

    Ireland, A W; Lawson, J S

    1980-06-14

    The principal causes of death for persons aged between 55 and 64 years are identified from Australian mortality data for 1966 and 1977. Four conditions--ischaemic heart disease, cerebrovascular disease, bronchial carcinoma, and chronic airways disease--account for 62% of deaths in this age group, with 36% of deaths being attributed to ischaemic heart disease. Changes in age-specific mortality rates during the period from 1966 to 1977 are described for each of these four conditions. There have been substantial reductions in mortality from vascular disease in both sexes, and this trend has accelerated since 1974. A recent fall in mortality from bronchial carcinoma and chronic airways disease is indicated for males, while death rates from these disorders continue to increase rapidly for females. The introduction of beta-blockade in the treatment of vascular disease, and changes in the pattern of cigarette smoking are discussed in relation to these mortality trends.

  20. Association of Cardiometabolic Multimorbidity With Mortality

    PubMed Central

    2015-01-01

    IMPORTANCE The prevalence of cardiometabolic multimorbidity is increasing. OBJECTIVE To estimate reductions in life expectancy associated with cardiometabolic multimorbidity. DESIGN, SETTING, AND PARTICIPANTS Age- and sex-adjusted mortality rates and hazard ratios (HRs) were calculated using individual participant data from the Emerging Risk Factors Collaboration (689 300 participants; 91 cohorts; years of baseline surveys: 1960–2007; latest mortality follow-up: April 2013; 128 843 deaths). The HRs from the Emerging Risk Factors Collaboration were compared with those from the UK Biobank (499 808 participants; years of baseline surveys: 2006–2010; latest mortality follow-up: November 2013; 7995 deaths). Cumulative survival was estimated by applying calculated age-specific HRs for mortality to contemporary US age-specific death rates. EXPOSURES A history of 2 or more of the following: diabetes mellitus, stroke, myocardial infarction (MI). MAIN OUTCOMES AND MEASURES All-cause mortality and estimated reductions in life expectancy. RESULTS In participants in the Emerging Risk Factors Collaboration without a history of diabetes, stroke, or MI at baseline (reference group), the all-cause mortality rate adjusted to the age of 60 years was 6.8 per 1000 person-years. Mortality rates per 1000 person-years were 15.6 in participants with a history of diabetes, 16.1 in those with stroke, 16.8 in those with MI, 32.0 in those with both diabetes and MI, 32.5 in those with both diabetes and stroke, 32.8 in those with both stroke and MI, and 59.5 in those with diabetes, stroke, and MI. Compared with the reference group, the HRs for all-cause mortality were 1.9 (95%CI, 1.8–2.0) in participants with a history of diabetes, 2.1 (95%CI, 2.0–2.2) in those with stroke, 2.0 (95%CI, 1.9–2.2) in those with MI, 3.7 (95%CI, 3.3–4.1) in those with both diabetes and MI, 3.8 (95%CI, 3.5–4.2) in those with both diabetes and stroke, 3.5 (95%CI, 3.1–4.0) in those with both stroke and

  1. Seasonal mortality in zoo ruminants.

    PubMed

    Carisch, Lea; Müller, Dennis W H; Hatt, Jean-Michel; Bingaman Lackey, Laurie; Rensch, E Eberhard; Clauss, Marcus; Zerbe, Philipp

    2017-01-01

    While seasonality has often been investigated with respect to reproduction, seasonality of mortality has received less attention. We investigated whether a seasonal signal of mortality exists in wild ruminants kept in zoos, using data from 60,591 individuals of 88 species. We quantified the mortality in the 3 consecutive months with the highest above-baseline mortality (3 MM). 3 MM was not related to relative life expectancy of species, indicating that seasonal mortality does not necessarily impact husbandry success. Although 3 MM was mainly observed in autumn/winter months, there was no evidence for an expected negative relationship with the latitude of the species' natural habitat and no positive relationship between 3 MM and the mean temperature in that habitat, indicating no evidence for species from lower latitudes/warmer climates being more susceptible to seasonal mortality under zoo conditions. 3 MM was related to reproductive biology, with seasonally reproducing species also displaying more seasonal mortality. This pattern differed between groups: In cervids, the onset of seasonal mortality appeared linked to the onset of rut in both sexes. This was less evident in bovids, where in a number of species (especially caprids), the onset of female seasonal mortality was linked to the lambing period. While showing that the origin of a species from warmer climate zones does not constrain husbandry success in ruminants in terms of an increased seasonal mortality, the results suggest that husbandry measures aimed at protecting females from rutting males are important, especially in cervids. Zoo Biol. 36:74-86, 2017. © 2016 Wiley Periodicals, Inc.

  2. Population Surveillance of Dementia Mortality

    PubMed Central

    Gillum, Richard F.; Yorrick, Ralston; Obisesan, Thomas O.

    2011-01-01

    Geographic and temporal variation in occurrence of dementia within the US has received little attention despite its importance for generation of new etiologic hypotheses and health services research. We examine methodological problems in the use of vital statistics data for assessing variation over time, among states and within states in the US. We analyzed the US multiple cause of death files for 2005–2006 and 1999–2000 US deaths with Alzheimer’s Disease (International Classification of Disease 10th revision code G30) and other dementias (codes F01, F02, R54) coded as underlying or contributing cause of death based on the death certificate. Age-adjusted death rates were computed by year, state or county for persons aged 65 years and over. In 2005–2006 combined, 555,904 total deaths occurred with any dementia type (212,386 for Alzheimer’s disease) coded as underlying or contributing cause. Among the states, age-adjusted rates per 100,000 per year varied by two fold ranging from 458 in New York to 921 in Oregon. Similar geographic patterns were seen for Alzheimer’s disease. However, between 1999–2000 and 2005–2006 the US death rate for all dementia increased only from 559 to 695 (24%) while that for Alzheimer’s disease doubled from 135 to 266. Use of specific (G30, F01) versus non-specific diagnoses (F02, R54) varied among states and over time, explaining most of the temporal increase in rate of Alzheimer’s disease. Further research is needed to assess artifacts of diagnosis, certification or coding, utilization of health services, versus biological variation as possible causes of temporal and geographic variation to enhance utility of mortality data for dementia monitoring and research. PMID:21695038

  3. Case-mix adjusted hospital mortality is a poor proxy for preventable mortality: a modelling study

    PubMed Central

    Girling, Alan J; Hofer, Timothy P; Wu, Jianhua; Chilton, Peter J; Nicholl, Jonathan P; Mohammed, Mohammed A; Lilford, Richard J

    2012-01-01

    Risk-adjustment schemes are used to monitor hospital performance, on the assumption that excess mortality not explained by case mix is largely attributable to suboptimal care. We have developed a model to estimate the proportion of the variation in standardised mortality ratios (SMRs) that can be accounted for by variation in preventable mortality. The model was populated with values from the literature to estimate a predictive value of the SMR in this context—specifically the proportion of those hospitals with SMRs among the highest 2.5% that fall among the worst 2.5% for preventable mortality. The extent to which SMRs reflect preventable mortality rates is highly sensitive to the proportion of deaths that are preventable. If 6% of hospital deaths are preventable (as suggested by the literature), the predictive value of the SMR can be no greater than 9%. This value could rise to 30%, if 15% of deaths are preventable. The model offers a ‘reality check’ for case mix adjustment schemes designed to isolate the preventable component of any outcome rate. PMID:23069860

  4. Urban poverty and infant mortality rate disparities.

    PubMed Central

    Sims, Mario; Sims, Tammy L.; Bruce, Marino A.

    2007-01-01

    This study examined whether the relationship between high poverty and infant mortality rates (IMRs) varied across race- and ethnic-specific populations in large urban areas. Data were drawn from 1990 Census and 1992-1994 Vital Statistics for selected U.S. metropolitan areas. High-poverty areas were defined as neighborhoods in which > or = 40% of the families had incomes below the federal poverty threshold. Bivariate models showed that high poverty was a significant predictor of IMR for each group; however, multivariate analyses demonstrate that maternal health and regional factors explained most of the variance in the group-specific models of IMR. Additional analysis revealed that high poverty was significantly associated with minority-white IMR disparities, and country of origin is an important consideration for ethnic birth outcomes. Findings from this study provide a glimpse into the complexity associated with infant mortality in metropolitan areas because they suggest that the factors associated with infant mortality in urban areas vary by race and ethnicity. PMID:17444423

  5. Urban poverty and infant mortality rate disparities.

    PubMed

    Sims, Mario; Sims, Tammy L; Bruce, Marino A

    2007-04-01

    This study examined whether the relationship between high poverty and infant mortality rates (IMRs) varied across race- and ethnic-specific populations in large urban areas. Data were drawn from 1990 Census and 1992-1994 Vital Statistics for selected U.S. metropolitan areas. High-poverty areas were defined as neighborhoods in which > or = 40% of the families had incomes below the federal poverty threshold. Bivariate models showed that high poverty was a significant predictor of IMR for each group; however, multivariate analyses demonstrate that maternal health and regional factors explained most of the variance in the group-specific models of IMR. Additional analysis revealed that high poverty was significantly associated with minority-white IMR disparities, and country of origin is an important consideration for ethnic birth outcomes. Findings from this study provide a glimpse into the complexity associated with infant mortality in metropolitan areas because they suggest that the factors associated with infant mortality in urban areas vary by race and ethnicity.

  6. Measuring Hospital-Wide Mortality-Pitfalls and Potential.

    PubMed

    Mackenzie, Simon J; Goldmann, Don A; Perla, Rocco J; Parry, Gareth J

    2016-01-01

    Risk-adjusted hospital-wide mortality has been proposed as a key indicator of system-level quality. Several risk-adjusted measures are available, and one-the hospital standardized mortality ratio (HSMR) - is publicly reported in a number of countries, but not in the United States. This paper reviews potential uses of such measures. We conclude that available methods are not suitable for interhospital comparisons or rankings and should not be used for pay-for-performance or value-based purchasing/payment. Hospital-wide mortality is a relatively imprecise, crude measure of quality, but disaggregation into condition- and service-line-specific mortality can facilitate targeted improvement efforts. If tracked over time, both observed and expected mortality rates should be monitored to ensure that apparent improvement is not due to increasing expected mortality, which could reflect changes in case mix or coding. Risk-adjusted mortality can be used as an initial signal that a hospital's mortality rate is significantly higher than statistically expected, prompting further inquiry.

  7. Vulnerability to temperature-related mortality in Seoul, Korea

    NASA Astrophysics Data System (ADS)

    Son, Ji-Young; Lee, Jong-Tae; Anderson, G. Brooke; Bell, Michelle L.

    2011-07-01

    Studies indicate that the mortality effects of temperature may vary by population and region, although little is known about the vulnerability of subgroups to these risks in Korea. This study examined the relationship between temperature and cause-specific mortality for Seoul, Korea, for the period 2000-7, including whether some subgroups are particularly vulnerable with respect to sex, age, education and place of death. The authors applied time-series models allowing nonlinear relationships for heat- and cold-related mortality, and generated exposure-response curves. Both high and low ambient temperatures were associated with increased risk for daily mortality. Mortality risk was 10.2% (95% confidence interval 7.43, 13.0%) higher at the 90th percentile of daily mean temperatures (25 °C) compared to the 50th percentile (15 °C). Mortality risk was 12.2% (3.69, 21.3%) comparing the 10th (-1 °C) and 50th percentiles of temperature. Cardiovascular deaths showed a higher risk to cold, whereas respiratory deaths showed a higher risk to heat effect, although the differences were not statistically significant. Susceptible populations were identified such as females, the elderly, those with no education, and deaths occurring outside of a hospital for heat- and cold-related total mortality. Our findings provide supportive evidence of a temperature-mortality relationship in Korea and indicate that some subpopulations are particularly vulnerable.

  8. Radon and nonrespiratory mortality in the American Cancer Society cohort.

    PubMed

    Turner, Michelle C; Krewski, Daniel; Chen, Yue; Pope, C Arden; Gapstur, Susan M; Thun, Michael J

    2012-11-01

    Radon is a known cause of human lung cancer. Previously, the authors observed a significant positive association between mean county-level residential radon concentrations and lung cancer mortality in the Cancer Prevention Study II (CPS-II), a large prospective study of nearly 1.2 million participants recruited in 1982 by the American Cancer Society. There was also a significant positive association with mortality from chronic obstructive pulmonary disease. Because it is unclear whether radon is associated with mortality from other malignant or nonmalignant disease, the authors examined the association between radon and nonrespiratory mortality in the CPS-II. Mean county-level residential radon concentrations (mean = 53.5 (standard deviation: 38.0) Bq/m(3)) were linked to participants by their zip code at enrollment. Cox proportional hazards regression models were used to estimate adjusted hazard ratios and 95% confidence intervals for all-cause (excluding lung cancer and respiratory mortality) and cause-specific mortality associated with radon concentrations. A total of 811,961 participants in 2,754 counties were analyzed, including 265,477 deaths through 2006. There were no clear associations between radon and nonrespiratory mortality in the CPS-II. These findings suggest that residential radon is not associated with any other mortality beyond lung cancer or chronic obstructive pulmonary disease.

  9. Beverage Habits and Mortality in Chinese Adults12

    PubMed Central

    Odegaard, Andrew O; Koh, Woon-Puay; Yuan, Jian-Min; Pereira, Mark A

    2015-01-01

    Background: There is limited research examining beverage habits, one of the most habitual dietary behaviors, with mortality risk. Objective: This study examined the association between coffee, black and green tea, sugar-sweetened beverages (soft drinks and juice), and alcohol and all-cause and cause-specific mortality. Methods: A prospective data analysis was conducted with the use of the Singapore Chinese Health Study, including 52,584 Chinese men and women (aged 45–74 y) free of diabetes, cardiovascular disease (CVD), and cancer at baseline (1993–1998) and followed through 2011 with 10,029 deaths. Beverages were examined with all-cause and cause-specific (cancer, CVD, and respiratory disease) mortality risk with the use of Cox proportional hazards regression. Results: The associations between coffee, black tea, and alcohol intake and all-cause mortality were modified by smoking status. Among never-smokers there was an inverse dose-response association between higher amounts of coffee and black tea intake and all-cause, respiratory-related, and CVD mortality (black tea only). The fully adjusted HRs for all-cause mortality for coffee for <1/d, 1/d, and ≥2/d relative to no coffee intake were 0.89, 0.86, and 0.83, respectively (P-trend = 0.0003). For the same black tea categories the HRs were 0.95, 0.90, and 0.72, respectively (P-trend = 0.0005). Among ever-smokers there was no association between coffee or black tea and the outcomes. Relative to no alcohol, light to moderate intake was inversely associated with all-cause mortality (HR: 0.87; 95% CI: 0.79, 0.96) in never-smokers with a similar magnitude of association in ever-smokers. There was no association between heavy alcohol intake and all-cause mortality in never-smokers and a strong positive association in ever-smokers (HR: 1.56; 95% CI: 1.40, 1.74). Green tea and sugar-sweetened beverages were not associated with all-cause or cause-specific mortality. Conclusions: Higher coffee and black tea intake was

  10. Dietary patterns and mortality in a Chinese population123

    PubMed Central

    Odegaard, Andrew O; Koh, Woon-Puay; Yuan, Jian-Min; Gross, Myron D; Pereira, Mark A

    2014-01-01

    Background: Limited research has examined the association between dietary patterns and mortality, especially in non-Western populations. Objective: We examined the association of dietary patterns with all-cause mortality and cause-specific mortality in the Singapore Chinese Health Study, which included a unique ethnic population with strong Western and South Asian cultural influences. Design: We conducted a prospective data analysis of the Singapore Chinese Health Study, which included 52,584 Chinese men and women (aged 45–74 y) who were free of diabetes, cardiovascular disease (CVD), and cancer at baseline (1993–1998) and followed through 2011 with 10,029 deaths. The following 2 major dietary patterns were identified by using a principal components analysis: a vegetable-, fruit-, and soy-rich (VFS) pattern and a dim sum– and meat-rich (DSM) dietary pattern. Pattern scores for each participant were calculated and examined with all-cause and cause-specific mortality risks by using a Cox proportional hazards regression. Results: The VFS pattern was inversely associated with all-cause mortality and each cause-specific category (CVD, cancer, and respiratory) of mortality during the follow-up period. Compared with the lowest quintile of the VFS pattern, HRs for quintiles 2–5 for all-cause mortality were 0.90, 0.79, 0.80, and 0.75, respectively (P-trend < 0.0001). The DSM pattern was positively associated with CVD mortality in the whole population (HR for fifth quintile compared with first quintile: 1.23; 95% CI: 1.07, 1.40; P-trend = 0.001). Positive associations between the DSM pattern and cancer and all-cause mortality were only present in ever-smokers. In ever-smokers, relative to the first quintile, HRs for quintiles 2–5 of the DSM pattern for all-cause mortality were 1.04, 1.04, 1.13, and 1.24, respectively (P-trend < 0.0001). Similarly, HRs for quintiles 2–5 for cancer mortality were 1.08, 1.03, 1.25, and 1.34, respectively (P-trend < 0.0001). The DSM

  11. Giving to Others and the Association Between Stress and Mortality

    PubMed Central

    Brown, Stephanie L.; Dillard, Amanda J.; Smith, Dylan M.

    2013-01-01

    Objectives. We sought to test the hypothesis that providing help to others predicts a reduced association between stress and mortality. Methods. We examined data from participants (n = 846) in a study in the Detroit, Michigan, area. Participants completed baseline interviews that assessed past-year stressful events and whether the participant had provided tangible assistance to friends or family members. Participant mortality and time to death was monitored for 5 years by way of newspaper obituaries and monthly state death-record tapes. Results. When we adjusted for age, baseline health and functioning, and key psychosocial variables, Cox proportional hazard models for mortality revealed a significant interaction between helping behavior and stressful events (hazard ratio [HR] = 0.58; P < .05; 95% confidence interval [CI] = 0.35, 0.98). Specifically, stress did not predict mortality risk among individuals who provided help to others in the past year (HR = 0.96; 95% CI = 0.79, 1.18), but stress did predict mortality among those who did not provide help to others (HR = 1.30; P < .05; 95% CI = 1.05, 1.62). Conclusions. Helping others predicted reduced mortality specifically by buffering the association between stress and mortality. PMID:23327269

  12. Social class differences in child mortality, Sweden 1981-1986.

    PubMed Central

    Ostberg, V

    1992-01-01

    STUDY OBJECTIVE--The aim was to analyse social class differences in mortality among Swedish children, 1-19 years old, during the period 1981-86. In order to study the development of these differences, mortality differences during the study period were compared with those 20 years earlier, ie, 1961-66. DESIGN--The study used data from two census linked death registries (CDR80 and CDR60). These were constructed by linkages between the 1980 and 1960 population censuses, respectively, and the corresponding national cause of death registries. Age specific and age standardised death rates, for total and cause specific mortality, were calculated for each social class and for the genders separately. To compare the death rates of social classes, relative risks with approximately 95% confidence limits were calculated. STUDY POPULATION--The study included children younger than 16 years at the time of the censuses and all deaths in the age range 1-19 years. The children were followed up for a period of six years after the censuses with respect to mortality. MAIN RESULTS--During the period 1981-86, children in families of both manual workers and self employed persons had a significantly higher mortality than children in families of non-manual workers. CONCLUSIONS--Although there has been a marked decrease in child mortality during the last decades the study shows that social class differences in child mortality still exist and show little tendency to disappear. PMID:1479315

  13. [Asthma mortality trends in Mexico].

    PubMed

    Salas Ramírez, M; Segura Méndez, N H; Martínez-Cairo Cueto, S

    1994-04-01

    The objective of this cross-sectional study was to estimate mortality and morbidity from asthma in Mexico by federative entity (state) of residence, age, and sex during the period between 1960 and 1988. Statistics published by the National Institute of Statistics, Geography, and Information Science were reviewed, as were vital statistics and information from other sources. Data were selected on mortality, hospital admissions, and outpatient visits, as well as population by federative entity, age, and sex. Mortality and morbidity rates were adjusted for age using the direct method. From 1960 to 1987, mortality decreased for both sexes. The groups with the highest asthma mortality were those under 4 years of age and those over 50. From 1960 to the present, the state with the highest mortality was Tlaxcala. Hospitalizations increased from 10 to 140 per 100,000 population for the country as a whole. When both outpatient visits and hospitalizations were considered, the morbidity rates rose from 180 to 203.4 per 100,000 between 1960 and 1970. In 1970, hospital morbidity was higher among males than females. From 1960 up to the 1990s, the highest rates of hospitalization and outpatient visits were registered among those under 4 and those over 60. The states with the highest asthma hospitalization rates were Morelos, Baja California Sur, Nuevo León, Durango, and Tamaulipas. It is concluded that asthma mortality in Mexico is showing a downward trend, while morbidity is increasing considerably, especially among adolescents.

  14. Exposures and mortality among chrysotile asbestos workers. Part II: mortality

    SciTech Connect

    Dement, J.M.; Harris, R.L. Jr.; Symons, M.J.; Shy, C.M.

    1983-01-01

    A retrospective cohort mortality study was conducted among a cohort of 1,261 white males employed one or more months in chrysotile asbestos textile operations and followed between 1940 and 1975. Statistically significant excess mortality was observed for all causes combined (standardized mortality ratio (SMR) . 150), lung cancer (SMR . 135), diseases of the circulatory system (SMR . 125), nonmalignant respiratory diseases (SMR . 294), and accidents (SMR . 134). Using estimated fiber exposure levels in conjunction with detailed worker job histories, exposure-response relationships were investigated. Strong exposure-response relationships for lung cancer and asbestos related non-malignant respiratory diseases were observed. Compared with data for chrysotile miners and millers, chrysotile textile workers were found to experience significantly greater lung cancer mortality at lower lifetime cumulative exposure levels. Factors such as differences in airborne fiber characteristics may partially account for the large differences in exposure response between textile workers and miners and millers.

  15. Trends in child mortality in India.

    PubMed

    Behl, A S

    2013-01-08

    To assess Indias recent trends in child mortality rates and disparities and identify ways to reduce child mortality and wealth-related health disparities, we analyzed three years of data from Indias National Family Health Survey related to child mortality. Nationally, declines in average child mortality were statistically significant, but declines in inequality were not. Urban areas had lower child mortality rates than rural areas but higher inequalities. Interstate differences in child mortality rates were significant, with rates in the highest-mortality states four to six times higher than in the lowest-mortality states. However, child mortality in most states declined.

  16. The law of mortality revisited: interspecies comparisons of mortality.

    PubMed

    Olshansky, S J

    2010-01-01

    In 1825 the British actuary Benjamin Gompertz believed he had discovered a consistency in the timing of death in people that was so important that he labelled his observation a 'law of mortality'. To Gompertz, this 'law' was equivalent in importance to Newton's law of gravity because he believed it would be observed in all living things. Gompertz's quest for the 'law' eventually failed, as did similar efforts by other scientists in the 19th and most of the 20th century. However, the search for the law of mortality was successfully resolved in 1996 when my colleagues and I discovered that the only way to 'see' Gompertz's law expressed as common age patterns of death across species was to partition total mortality into its intrinsic and extrinsic components, and examine mortality schedules on a uniform time scale. Scientists had been unable to reveal the law of mortality in the past not only because they could not partition total mortality, but also because of the previous anthropocentric perspective that forced some scientists to view duration of life along a single time scale - one based on human measurements of chronological time. The law of mortality is relevant today not only because it links the epidemiology of disease, ageing and death across species, but because it creates a window into the future for those who study disease epidemiology in animals that now live long enough in protected environments to experience the biological consequences of ageing. In this paper I summarize the historical search for the law of mortality, explain why the solution could only be found by linking two seemingly unconnected scientific disciplines (evolution biology and actuarial/demographics), explain why age patterns of disease and death in humans may be used to understand and predict disease epidemiology in other species, and describe how a new scientific discipline has arisen in the modern era as a result of this research.

  17. Zebra mussel mortality with chlorine

    SciTech Connect

    Van Benschoten, J.E.; Jensen, J.N.; Harrington, D.; DeGirolamo, D.J.

    1995-05-01

    The rate of mortality of the zebra mussel in response to chlorine is described by a kinetic model that combines a statistical characterization of mussel mortality with a disinfection-type modeling approach. Parameter estimates were made with nine sets of data from experiments conducted in Niagara River water. From the kinetic model, an operational diagram was constructed that describes the time to 95% mortality as a function of chlorine concentration and temperature. Either the model or the diagram can be used to assist utilities in planning chlorination treatments for controlling zebra mussels.

  18. Recent mortality patterns in California.

    PubMed

    O'Brien, K F; Zaharia, E S

    1998-10-01

    Mortality among people with developmental disabilities was reviewed using recent data obtained from the California Department of Developmental Services. The time interval for this report was 1991-1995. We defined two study cohorts: one beginning in January 1991 and a second in April 1993. The latter period represented the years of implementation of the Coffelt settlement. Our primary interest was in the Coffelt period cohort. Statistically significant association with increased rates of mortality was found for community residence. A trend of declining mortality was noted for the community facilities from 1991-1995, but not for the developmental centers.

  19. Snakebite mortality in the world

    PubMed Central

    Swaroop, S.; Grab, B.

    1954-01-01

    In examining the relative importance of snakebite mortality in different parts of the world, the authors review the information collected concerning both snakebite mortality and the species of snake incriminated. Available statistical data are known to be unreliable and at best can serve to provide only an approximate and highly conservative estimate of the relative magnitude of the snakebite problem. The sources of error inherent in the data are discussed, and estimates are made of the probable mortality from snakebite in various areas of the world. PMID:13150169

  20. Cardiovascular Disease Mortality Among Breast Cancer Survivors

    PubMed Central

    Bradshaw, Patrick T.; Stevens, June; Khankari, Nikhil; Teitelbaum, Susan L.; Neugut, Alfred I.; Gammon, Marilie D.

    2015-01-01

    Background Cardiovascular disease (CVD) is of increasing concern among breast cancer survivors. However the burden of this comorbidity in this group relative to the general population, and its temporal pattern, remains unknown. Methods We compared deaths due to CVD in a population-based sample of 1,413 women with incident breast cancer diagnosed in 1996-1997, and 1,411 age-matched women without breast cancer. Date and cause of death through December 31, 2009 were assessed through the National Death Index and covariate data was gathered through structured interviews and medical record abstraction. Hazard ratios and 95% confidence intervals (CI) were calculated using Cox regression for overall mortality (HR) and CVD-specific death (cause-specific HR). Subdistribution hazard ratios (sHR) for CVD death were estimated from the Fine-Gray model. Results Risk of death was greater among breast cancer survivors compared to women without breast cancer [HR: 1.8 (1.5, 2.1)]. An increase in CVD-related death among breast cancer survivors was evident only 7 years after diagnosis [years 0-7, cause-specific HR: 0.80 (0.53, 1.2), subdistribution HR: 0.59 (0.40, 0.87)]; years 7+, cause-specific HR: 1.8 (1.3, 2.5), subdistribution HR: 1.9 (1.4, 2.7); p-interaction: 0.001]. An increase in CVD-related mortality was observed among breast cancer survivors receiving chemotherapy. Conclusions Breast cancer survivors are at greater risk for CVD-related mortality compared to women without breast cancer and this increase in risk is manifest approximately 7 years after diagnosis. Efforts should be made to identify risk factors and interventions that can be employed during this brief window to reduce the excess burden of CVD in this vulnerable population. PMID:26414938

  1. Mortality and Cause of Death in Patients with Pemphigus.

    PubMed

    Kridin, Khalaf; Zelber-Sagi, Shira; Bergman, Reuven

    2017-01-17

    All-cause and cause-specific mortality among patients with pemphigus compared with the general population is yet to be established. This study investigated overall mortality and cause-specific mortality in a large immunopathologically validated cohort of patients with pemphigus. Mortality of patients with pemphigus was compared with age- and gender-matched control subjects in the general population. All-cause and cause-specific standardized mortality ratios (SMRs) were estimated. The study cohort included 245 patients newly-diagnosed with pemphigus between January 1990 and June 2016, contributing 2,679.4 person-years of follow-up. Overall, 48 deaths were observed during a mean follow-up period of 10.9 ± 8.1 years, which was more than twice the number expected (SMR 2.4; 95% confidence interval (95% CI) 1.82-3.20). The SMRs for death due to infections (22.6; 95% CI 13.6-35.3), namely pneumonia (25.7; 95% CI 11.7-48.8) and septicaemia (8.6; 95% CI 1.7-25.0), and due to cardiovascular diseases (2.8; 95% CI 1.0-6.0) were significantly higher than expected. Overall mortality among patients with pemphigus is 2.4-times greater than for the general population, mainly due to infections.

  2. A Specific Screening Strategy to Reduce Prostate Cancer Mortality

    DTIC Science & Technology

    2014-09-01

    receiving US-stimulated therapy after intratumoral injection of Ad5/3-CMV-Luc (1 x 106 plaque forming units) demonstrated a 95.1% enhancement in tumor...results indicated that tumors receiving US-stimulated therapy after intra-tumoral injection of Ad5/3-CMV-Luc (1 3 106 plaque -forming units) exhibited a...applying MBs and low-intensity US-stimulated therapy to enhance a ubiqui- tous Ad for tumor delivery is a novel application of this US technology . To

  3. A Specific Screening Strategy to Reduce Prostate Cancer Mortality

    DTIC Science & Technology

    2013-09-01

    W81XWH-12-1-0356 PI : Zinn, Kurt R 5 a. Ad3 receptor expression characterization: A prostate cancer cell panel (PC3, LNCaP, CA- HPV ...Type Culture Collection, Manassas, VA). Two commonly used prostate cell lines, (RWPE-1 and Ca- HPV -10), were excluded from the cell panel due to...immortalization vector HPV -18 interaction with endogenous Id1 protein [29-31]. LNCaP cells were maintained in RPMI-1640 with 10% fetal bovine serum (FBS

  4. Nonhunting mortality in sandhill cranes

    USGS Publications Warehouse

    Windingstad, R.M.

    1988-01-01

    Records of 170 sandhill cranes (Grus canadensis) necropsied at the National Wildlife Health Research Center, Wisconsin, from 1976 through 1985 were reviewed as representative samples to determine causes of nonhunting mortality in the mid-continent and Rocky Mountain populations of sandhill cranes. Avian cholera, avian botulism, and ingestion of mycotoxins were leading causes of nonhunting mortality. Hailstorms, lightning, lead poisoning, predation, avian tuberculosis, and collisions with power lines also killed cranes.

  5. Mortality among female manual workers.

    PubMed Central

    Gunnarsdóttir, H; Rafnsson, V

    1992-01-01

    STUDY OBJECTIVE--The aim was to determine whether female manual workers have higher mortality than other women. DESIGN--This was a retrospective cohort study in which mortality was compared with that of the general female population. Main outcome measures were standardised mortality ratio (SMR) and 95% confidence intervals (CI). SETTING--Reykjavík region. PARTICIPANTS--Participants were 18,878 women, the cumulated members of a pension fund for manual workers between 1970 and 1986. MAIN RESULTS--A healthy worker effect was observed in the total cohort. The study was then restricted to those who had contributed to the pension fund any time after reaching 20 years of age, and a 10 year latency period was instituted. When analysing subcohorts by duration of employment the standardised mortality ratios for all causes of death and all cancers increased with longer employment time up to 10 years. However, the ratios were low in the group with over 10 years of employment. Those who began contributing to the fund in 1977 or later had higher mortality than those who began earlier. There was an excess of lung and bladder cancer in the total cohort and in all the subcohorts except in the group with over 10 years' employment. Mortality from accidents and suicides was in excess in all the groups. CONCLUSIONS--Mortality is high among some groups of female manual workers. A deficit was found among those with the longest employment. Differences in mortality have widened in recent years. An excess of suicides shows that women in this group have, for some reason, less will to live than other women. PMID:1494075

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

    PubMed Central

    Krishnan, E; Hubert, H B

    2006-01-01

    Objective To study ethnic differences in mortality from systemic lupus erythematosus (lupus) in two large, population‐based datasets. Methods We analysed the national death data (1979–98) from the National Center for Health Statistics (Hyattsville, Maryland, USA) and hospitalisation data (1993–2002) from the Nationwide Inpatient Sample (NIS), the largest hospitalisation database in the US. Results The overall, unadjusted, lupus mortality in the National Center for Health Statistics data was 4.6 per million, whereas the proportion of in‐hospital mortality from the NIS was 2.9%. African‐Americans had disproportionately higher mortality risk than Caucasians (all‐cause mortality relative risk adjusted for age = 1.24 (women), 1.36 (men); lupus mortality relative risk = 3.91 (women), 2.40 (men)). Excess risk was found among in‐hospital deaths (odds ratio adjusted for age = 1.4 (women), 1.3 (men)). Lupus death rates increased overall from 1979 to 98 (p<0.001). The proportional increase was greatest among African‐Americans. Among Caucasian men, death rates declined significantly (p<0.001), but rates did not change substantially for African‐American men. The African‐American:Caucasian mortality ratio rose with time among men, but there was little change among women. In analyses of the NIS data adjusted for age, the in‐hospital mortality risk decreased with time among Caucasian women (p<0.001). Conclusions African‐Americans with lupus have 2–3‐fold higher lupus mortality risk than Caucasians. The magnitude of the risk disparity is disproportionately higher than the disparity in all‐cause mortality. A lupus‐specific biological factor, as opposed to socioeconomic and access‐to‐care factors, may be responsible for this phenomenon. PMID:16627544

  7. Estimating fishing mortality, natural mortality, and selectivity using recoveries from tagging young fish

    USGS Publications Warehouse

    Jiang, H.; Brownie, C.; Hightower, J.E.; Pollock, K.H.

    2007-01-01

    Current methods for estimation of age- and year-specific instantaneous mortality rates based on multiyear, multiple-age tagging studies assume that it is feasible to tag fish in a wide range of ages. For some species, however, only the youngest one or two age-classes are readily available for tagging. Given the practical advantages of tagging young fish only, an important question is whether such studies would provide the information needed for estimation of age-dependent mortality rates. We investigated three designs: tagging only the youngest available age-class, tagging the two youngest age-classes, and tagging the first five age-classes. We carried out simulation studies to assess estimator performance under these three designs, in each case assuming the same total number of tagged fish. Data were generated assuming fishing mortality rates to be age and year dependent and natural mortality rates to be constant or with limited age dependence. Estimator performance is best when fish are tagged in five age-classes, and tagging fish in the two youngest age-classes shows substantial improvement compared with tagging one age-class only. External information about the tag-reporting rate is necessary to obtain estimators with reasonable properties, especially in the case of models with age-dependent natural mortality. Such information can be obtained from auxiliary studies by means of high-reward tags or planted tags. Collecting recovery information for several additional years after the last release produces small improvements in precision and bias. If tagging fish in multiple age-classes is impractical, reasonable precision can be obtained by tagging one or preferably two age-classes and obtaining supplemental information on the reporting rate. For illustration, estimates of age-dependent fishing and natural mortality rates were obtained from tag returns on Chesapeake Bay striped bass Morone saxatilis tagged at ages 3 and 4 years. ?? Copyright by the American

  8. Antioxidant Vitamin Intake and Mortality

    PubMed Central

    Paganini-Hill, Annlia; Kawas, Claudia H.; Corrada, María M.

    2015-01-01

    To assess the relationship between antioxidant vitamin intake and all-cause mortality in older adults, we examined these associations using data from the Leisure World Cohort Study, a prospective study of residents of the Leisure World retirement community in Laguna Hills, California. In the early 1980s, participants (who were aged 44–101 years) completed a postal survey, which included details on use of vitamin supplements and dietary intake of foods containing vitamins A and C. Age-adjusted and multivariate-adjusted (for factors related to mortality in this cohort—smoking, alcohol intake, caffeine consumption, exercise, body mass index, and histories of hypertension, angina, heart attack, stroke, diabetes, rheumatoid arthritis, and cancer) hazard ratios for death were calculated using Cox regression for 8,640 women and 4,983 men (median age at entry, 74 years). During follow-up (1981–2013), 13,104 participants died (median age at death, 88 years). Neither dietary nor supplemental intake of vitamin A or vitamin C nor supplemental intake of vitamin E was significantly associated with mortality after multivariate adjustment. A compendium that summarizes previous findings of cohort studies evaluating vitamin intake and mortality is provided. Attenuation in the observed associations between mortality and antioxidant vitamin use after adjustment for confounders in our study and in previous studies suggests that such consumption identifies persons with other mortality-associated lifestyle and health risk factors. PMID:25550360

  9. Trends in infant mortality rate and mortality for neonates born at less than 32 weeks and with very low birth weight.

    PubMed

    Barría-Pailaquilén, René Mauricio; Mendoza-Maldonado, Yessy; Urrutia-Toro, Yohana; Castro-Mora, Cristian; Santander-Manríquez, Gema

    2011-01-01

    The aim of the study was to assess the trend of the infant mortality rate between 1990-2004 and the neonatal mortality between 2000-2005 in infants born at less than 32 weeks of gestational age or with very low birth-weight. Based on secondary data, infant mortality rate and by its component for Valdivia city were compared with national indicators. Mortality at <32 weeks and <1500g was calculated, establishing causes of death and evaluating its relation with specific interventions, such as the use of surfactant and antenatal corticoids. Since the year 2000, infant mortality rates have stopped their decrease in comparison to the preceding decade and the gap between national and local rates before 2000 was drastically reduced. Mortality at <32 weeks and <1500g varied between 88% and 200% of liveborns, emphasizing respiratory distress as the main cause of death. The use of corticoids and surfactant was in line with reductions in mortality rates.

  10. Accidents in Canada: mortality and hospitalization.

    PubMed

    Riley, R; Paddon, P

    1989-01-01

    For Canadians under 45, accidents are the leading cause of both death and hospitalization. For the Canadian population as a whole, accidents rank fourth as a cause of death, after cardiovascular disease (CVD), cancer and respiratory disease. This article analyzes accident mortality and hospitalization in Canada using age-specific rates, age-standardized mortality rates (ASMR), and potential years of life lost (PYLL). The six major causes of accidental death for men are motor vehicle traffic accidents (MVTA), falls, drowning, fires, suffocation and poisoning. For women, the order is slightly different: MVTA, falls, fires, suffocation, poisoning and drowning. From 1971 to 1986, age-standardized mortality rates (ASMR) for accidents decreased by 44% for men and 39% for women. The largest decrease occurred in the under 15 age group. Accidents accounted for 11.5% of total hospital days in 1985, and 8% of hospital discharges. Because young people have the highest rates of accidental death, potential years of life lost (PYLL) are almost as high for accidents as for cardiovascular disease, although CVD deaths outnumbered accidental deaths by almost five to one in 1985.

  11. Morbidity and mortality of diabetes with surgery.

    PubMed

    Chuah, L L; Papamargaritis, D; Pillai, D; Krishnamoorthy, A; le Roux, C W

    2013-03-01

    The prevalence of Type 2 diabetes mellitus (T2DM) has increased; as a result the number of patients with T2DM undergoing surgical procedures has also increased. This population is at high risk of macrovascular (cardiovascular disease, peripheral vascular disease) or microvascular (retinopathy, nephropathy or neuropathy) complications, both increasing their perioperative morbidity and mortality. Diabetes patients are more at risk of poor wound healing, respiratory infection, myocardial infarction, admission to intensive care, and increased hospital length of stay. This leads to increased inpatient costs. The outcome of perioperative glycaemia management remains a significant clinical problem without a universally accepted solution. The majority of evidence on morbidity and mortality of T2DM patients undergoing surgery comes from the setting of cardiac surgery; there was less evidence on noncardiac surgery and bariatric surgery. Bariatric surgery is increasingly performed in patients with severe obesity complicated by T2DM, but is distinguished from general surgery as it immediately improves the glucose homeostasis postoperatively. The improvements in glycaemia are thought to be independent of weight loss and this requires different postoperative management. Patients usually have to follow specific preoperative diets which lead to improvement in glycaemia immediately before surgery. Here we review the available data on the mortality and morbidity of patients with T2DM who underwent elective surgery (cardiac, non-cardiac and bariatric surgery) and the current knowledge of the impact that preoperative, intraoperative and postoperative glycaemic management has on operative outcomes.

  12. Recessions, Job Loss, and Mortality Among Older US Adults

    PubMed Central

    Beckfield, Jason

    2014-01-01

    Objectives. We analyzed how recessions and job loss jointly shape mortality risks among older US adults. Methods. We used data for 50 states from the Health and Retirement Study and selected individuals who were employed at ages 45 to 66 years during 1992 to 2011. We assessed whether job loss affects mortality risks, whether recessions moderate the effect of job loss on mortality, and whether individuals who do and do not experience job loss are differentially affected by recessions. Results. Compared with individuals not experiencing job loss, mortality risks among individuals losing their job in a recession were strongly elevated (hazard ratio = 1.6; 95% confidence interval = 1.1, 2.3). Job loss during normal times or booms is not associated with mortality. For employed workers, we found a reduction in mortality risks if local labor market conditions were depressed, but this result was not consistent across different model specifications. Conclusions. Recessions increase mortality risks among older US adults who experience job loss. Health professionals and policymakers should target resources to this group during recessions. Future research should clarify which health conditions are affected by job loss during recessions and whether access to health care following job loss moderates this relation. PMID:25211731

  13. Metropolitan governance, residential segregation, and mortality among African Americans.

    PubMed Central

    Hart, K D; Kunitz, S J; Sell, R R; Mukamel, D B

    1998-01-01

    OBJECTIVES: This study tested the hypothesis that the degree to which local government is metropolitanized is associated with mortality rates for African Americans and with residential segregation, which has itself previously been shown to be positively associated with mortality among African Americans. METHODS: One hundred fourteen US standard metropolitan statistical areas were examined. The primary dependent variable was the age-adjusted, race- and sex-specific all-cause mortality rate, averaged for 1990 and 1991. The 2 primary independent variables were residential segregation, as measured by the index of dissimilarity, and metropolitanization of government, as measured by the central city's elasticity score. RESULTS: Mortality rates for male and female African Americans were lower in metropolitan statistical areas with more metropolitanized local governments and lower levels of residential segregation. Mortality for male and female Whites was not associated in either direction with residential segregation. White male mortality showed no association with level of metropolitanization, but lower White female mortality rates were associated with less metropolitanization. CONCLUSIONS: This study suggests the need for further research into whether policy changes in areas not traditionally thought of as "health policy" areas can improve the health of urban minorities. PMID:9518976

  14. Muscle Quality and Myosteatosis: Novel Associations With Mortality Risk

    PubMed Central

    Reinders, Ilse; Murphy, Rachel A.; Brouwer, Ingeborg A.; Visser, Marjolein; Launer, Lenore; Siggeirsdottir, Kristin; Eiriksdottir, Gudny; Gudnason, Vilmundur; Jonsson, Palmi V.; Lang, Thomas F.; Harris, Tamara B.

    2016-01-01

    Muscle composition may affect mortality risk, but prior studies have been limited to specific samples or less precise determination of muscle composition. We evaluated associations of thigh muscle composition, determined using computed tomography imaging, and knee extension strength with mortality risk among 4,824 participants aged 76.4 (standard deviation (SD), 5.5) years from the Age, Gene/Environment Susceptibility (AGES)-Reykjavik Study (2002–2006). Cox proportional hazards models were used to estimate hazard ratios. After 8.8 years of follow-up, there were 1,942 deaths. For men, each SD-increment increase in muscle lean area, muscle quality, and strength was associated with lower mortality risk, with decreases ranging between 11% and 22%. Each SD-increment increase in intermuscular adipose tissue and intramuscular adipose tissue was associated with higher mortality risk (hazard ratio (HR) = 1.13 (95% confidence interval (CI): 1.06, 1.22) and HR = 1.23 (95% CI: 1.15, 1.30), respectively). For women, each SD-increment increase in muscle lean area, muscle quality, and strength was associated with lower mortality risk, with decreases ranging between 12% and 19%. Greater intramuscular adipose tissue was associated with an 8% higher mortality risk (HR = 1.08, 95% CI: 1.01, 1.16). This study shows that muscle composition is associated with mortality risk. These results also show the importance of improving muscle strength and area and lowering muscle adipose tissue infiltration. PMID:26643983

  15. Mortality as a function of obesity and diabetes mellitus.

    PubMed

    Pettitt, D J; Lisse, J R; Knowler, W C; Bennett, P H

    1982-03-01

    Mortality according to body mass index (weight/height2) was studied in 2197 Pima Indians aged 15-74 years, as part of the longitudinal study of diabetes begun in 1965 in the Gila River Indian Community of Arizona. The Pima Indians are a population with a high prevalence of obesity, and they have the highest known incidence of type II (non-insulin dependent) diabetes mellitus. Among males, mortality was greatest in those with a body mass index of at least 40 kg/m2, but obesity had little effect on mortality at body mass indices below 40 kg/m2. Age-specific death rates in women were not consistently related to obesity, although mortality in subjects with diabetes was higher than in those without. In men, diabetes had little effect on mortality. In this study, as in several other mortality studies, the lowest mortality rates were experienced by people with body weights well above those recommended as "desirable" by the Society of Actuaries in 1959. Thus, the applicability of the "desirable" weight standards in common use is questioned.

  16. Evolution of infant and child mortality in Chile: a model.

    PubMed

    Hojman, D E

    1992-10-01

    The author contends that birth rate and infant and child mortality rates are jointly determined by demographic, economic, health care, and other influences. Working under this structural assumption, a multiequation model is developed, estimated, and simulated, in which real earnings, unemployment, midwife visits, access to cheap energy, public health expenditures, and degree of urbanization are determinant factors of declining infant and child mortality in Chile. Most notably, mortality declined during a period of increasing unemployment and falling living standards for at least part of the population. The study found all 3 rates to be jointly determined, but by different variables. Specifically, unemployment affected birth rate and child mortality rate, while declining infant mortality was based upon midwife visits, health expenditure, and access to cheap energy. At the policy level, trade-offs often result between infant and child mortality, especially where high birth rates prevail. Where movement along the Phillips curve is possible, higher earnings should be preferred over lower unemployment for the benefit of infant and child mortality. Preferred policy would week to provide a carefully balanced combination of better earnings and more midwife visits.

  17. Cancer mortality patterns among Turkish immigrants in four European countries and in Turkey.

    PubMed

    Spallek, Jacob; Arnold, Melina; Razum, Oliver; Juel, Knud; Rey, Grégoire; Deboosere, Patrick; Mackenbach, Johan Pieter; Kunst, Anton Eduard

    2012-12-01

    The aim of this study on cancer mortality among Turkish immigrants, for the first time, traditional comparisons in migrant health research have been extended simultaneously in two ways. First, comparisons were made to cancer mortality from the immigrants' country of origin and second, cancer mortality among Turkish immigrants across four host countries (Belgium, Denmark, France and the Netherlands) was compared. Population-based cancer mortality data from these countries were included. Age-standardized mortality rates were computed for the local-born and Turkish population of each country. Relative differences in cancer mortality were examined by fitting country-specific Poisson regression models. Globocan data on cancer mortality in Turkey from 2008 were used in order to compare mortality rates of Turkish immigrants with those from their country of origin. Turkish immigrants had lower all-cancer mortality than the local-born populations of their host countries, and mortality levels comparable to all-cancer mortality rates in Turkey. In the Netherlands and France breast cancer mortality was consistently lower in Turkish immigrants women than among local-born women. Lung cancer mortality was slightly lower in Turkish immigrants in the Netherlands and France but varied considerably between migrants in these two host countries. Stomach cancer mortality was significantly higher in Turkish immigrants when compared to local-born French and Dutch. Our findings indicate that exposures both in the country of origin and in the host country can have an effect on the cancer mortality of immigrants. Despite limitations affecting any cross-country comparison of mortality, the innovative multi-comparison approach is a promising way to gain further insights into determinants of trends in cancer mortality of immigrants.

  18. Occupational exposure to talc containing asbestos. Morbidity, mortality, and environmental studies of miners and millers

    SciTech Connect

    Dement, J.M.; Zumwalde, R.D.; Gamble, J.F.; Fellner, W.; DeMeo, M.J.

    1980-02-01

    The National Institute for Occupational Safety and Health (NIOSH) conducted studies of mortality and morbidity patterns and occupational exposures among talc miners and millers in upper New York. The mortality study was based on 398 white male workers who began employment between January 1, 1947 and December 31, 1959 and whose vital status was determined as of June 30, 1975. Observed cause specific mortality for the cohort as compared with that expected based on U.S. white male mortality rates indicated a significant increase in mortality due to bronchogenic cancer, nonmalignant respiratory disease (excluding influenza and pneumonia) and respiratory tuberculosis. The average latency period for bronchogenic cancer was 20 years.

  19. Mortality differentials among Israeli men.

    PubMed Central

    Manor, O; Eisenbach, Z; Peritz, E; Friedlander, Y

    1999-01-01

    OBJECTIVES: This study examined differentials in mortality among adult Israeli men with respect to ethnic origin, marital status, and several measures of social status. METHODS: Data were based on a linkage of records from a 20% sample of the 1983 census to records of deaths occurring before the end of 1992. The study population included 72,527 men, and the number of deaths was 17,378. RESULTS: Differentials is mortality by origin show that mortality was higher among individuals of North African origin than among those of Asian and European origin. After allowance for several socioeconomic indicators, the excess mortality among North African Jews was eliminated. Substantial and consistent differences in mortality were found according to education, occupation, income, possession of a car, housing, and household amenities. Differentials among the elderly were markedly narrower than those among men younger than 70 years. CONCLUSIONS: Some sectors of Israeli society have higher risks of death than others, including, among the male population, these who are poor, less educated, unmarried, unskilled, out of the labor force, and of North African origin. PMID:10589307

  20. Iran Mortality and Measures of Risk: Rankings for Public policy

    PubMed Central

    Aalabaf-Sabaghi, M

    2010-01-01

    Background: This paper offers mortality risk rankings for Iranian mortality data. It extends methods to include mixed cohorts, tests changes in mortality risks, compares measures of risk and discusses public policy implications. Methods: The methodology used in risk measures takes current practice and extends it to include variations in population dynamics. The specification is presented and compared with existing literature. Results: Our findings confirm literature results in the re-ordering that takes place when different risk measures are used. In addition, we find there is consistency in risk rankings between 1999 and 2000 records of Iranian mortality data. Thus, these risk measures are stable, robust across time and relay risk information consistently. Conclusions: There are considerable implications in adopting particular risk measures for public policy. However, given properties of risk measures discussed here, it is clear that policy makers can select relevant risk measures depending on their priorities. PMID:23112989

  1. Cancer mortality disparities among New York City's Upper Manhattan neighborhoods.

    PubMed

    Hashim, Dana; Manczuk, Marta; Holcombe, Randall; Lucchini, Roberto; Boffetta, Paolo

    2016-04-21

    The East Harlem (EH), Central Harlem (CH), and Upper East Side (UES) neighborhoods of New York City are geographically contiguous to tertiary medical care, but are characterized by cancer mortality rate disparities. This ecological study aims to disentangle the effects of race and neighborhood on cancer deaths. Mortality-to-incidence ratios were determined using neighborhood-specific data from the New York State Cancer Registry and Vital Records Office (2007-2011). Ecological data on modifiable cancer risk factors from the New York City Community Health Survey (2002-2006) were stratified by sex, age group, race/ethnicity, and neighborhood and modeled against stratified mortality rates to disentangle race/ethnicity and neighborhood using logistic regression. Significant gaps in mortality rates were observed between the UES and both CH and EH across all cancers, favoring UES. Mortality-to-incidence ratios of both CH and EH were similarly elevated in the range of 0.41-0.44 compared with UES (0.26-0.30). After covariate and multivariable adjustment, black race (odds ratio=1.68; 95% confidence interval: 1.46-1.93) and EH residence (odds ratio=1.20; 95% confidence interval: 1.07-1.35) remained significant risk factors in all cancers' combined mortality. Mortality disparities remain among EH, CH, and UES neighborhoods. Both neighborhood and race are significantly associated with cancer mortality, independent of each other. Multivariable adjusted models that include Community Health Survey risk factors show that this mortality gap may be avoidable through community-based public health interventions.

  2. Educational Inequality in Obesity-Related Mortality in Korea

    PubMed Central

    2017-01-01

    The prevalence of obesity has been increasing worldwide, which raises concerns about the disease burden associated with obesity. Socioeconomic status (SES) has been suggested to be associated with obesity and obesity related diseases. This study aimed to evaluate the time trend in socioeconomic inequality in obesity-related mortality over the last decade in Korean population. We evaluated the influence of education level, as an indicator of SES, on obesity-related mortality using death data from the Cause of Death Statistics and the Korean Population and Housing Census databases. The rate ratio of the mortality of people at the lowest education level as compared with those at the highest education level (relative index of inequality [RII]) was estimated using Poisson regression analysis. Between 2001 and 2011, RII (95% confidence interval) for overall obesity-related disease mortality increased from 2.10 (2.02–2.19) to 6.50 (6.19–6.82) in men, and from 1.94 (1.79–2.10) to 3.25 (3.05–3.45) in women, respectively. Cause-specifically, the same trend in RII was found for cardiovascular mortality and mortality from diabetes mellitus, whereas the RII of mortality from obesity-related cancers in men did not show the similar trend. Subgroup analysis stratified by age revealed that the RII of obesity-related mortality was much higher in younger people than in older people. In conclusion, there has been persistent socioeconomic inequality in obesity-related mortality in Korea, which was more evident in younger people than in older people and has been deepened over the last decade especially for cardiovascular disease and diabetes. PMID:28145639

  3. Hospital resource intensity and cirrhosis mortality in United States

    PubMed Central

    Mathur, Amit K; Chakrabarti, Apurba K; Mellinger, Jessica L; Volk, Michael L; Day, Ryan; Singer, Andrew L; Hewitt, Winston R; Reddy, Kunam S; Moss, Adyr A

    2017-01-01

    AIM To determine whether hospital characteristics predict cirrhosis mortality and how much variation in mortality is attributable to hospital differences. METHODS We used data from the 2005-2011 Nationwide Inpatient Sample and the American Hospital Association Annual survey to identify hospitalizations for decompensated cirrhosis and corresponding facility characteristics. We created hospital-specific risk and reliability-adjusted odds ratios for cirrhosis mortality, and evaluated patient and facility differences based on hospital performance quintiles. We used hierarchical regression models to determine the effect of these factors on mortality. RESULTS Seventy-two thousand seven hundred and thirty-three cirrhosis admissions were evaluated in 805 hospitals. Hospital mean cirrhosis annual case volume was 90.4 (range 25-828). Overall hospital cirrhosis mortality rate was 8.00%. Hospital-adjusted odds ratios (aOR) for mortality ranged from 0.48 to 1.89. Patient characteristics varied significantly by hospital aOR for mortality. Length of stay averaged 6.0 ± 1.6 days, and varied significantly by hospital performance (P < 0.001). Facility level predictors of risk-adjusted mortality were higher Medicaid case-mix (OR = 1.00, P = 0.029) and LPN staffing (OR = 1.02, P = 0.015). Higher cirrhosis volume (OR = 0.99, P = 0.025) and liver transplant program status (OR = 0.83, P = 0.026) were significantly associated with survival. After adjusting for patient differences, era, and clustering effects, 15.3% of variation between hospitals was attributable to differences in facility characteristics. CONCLUSION Hospital characteristics account for a significant proportion of variation in cirrhosis mortality. These findings have several implications for patients, providers, and health care delivery in liver disease care and inpatient health care design. PMID:28348492

  4. Educational Inequality in Obesity-Related Mortality in Korea.

    PubMed

    Kim, Mi Hyun; Jung-Choi, Kyunghee; Ko, Hyeonyoung; Song, Yun Mi

    2017-03-01

    The prevalence of obesity has been increasing worldwide, which raises concerns about the disease burden associated with obesity. Socioeconomic status (SES) has been suggested to be associated with obesity and obesity related diseases. This study aimed to evaluate the time trend in socioeconomic inequality in obesity-related mortality over the last decade in Korean population. We evaluated the influence of education level, as an indicator of SES, on obesity-related mortality using death data from the Cause of Death Statistics and the Korean Population and Housing Census databases. The rate ratio of the mortality of people at the lowest education level as compared with those at the highest education level (relative index of inequality [RII]) was estimated using Poisson regression analysis. Between 2001 and 2011, RII (95% confidence interval) for overall obesity-related disease mortality increased from 2.10 (2.02-2.19) to 6.50 (6.19-6.82) in men, and from 1.94 (1.79-2.10) to 3.25 (3.05-3.45) in women, respectively. Cause-specifically, the same trend in RII was found for cardiovascular mortality and mortality from diabetes mellitus, whereas the RII of mortality from obesity-related cancers in men did not show the similar trend. Subgroup analysis stratified by age revealed that the RII of obesity-related mortality was much higher in younger people than in older people. In conclusion, there has been persistent socioeconomic inequality in obesity-related mortality in Korea, which was more evident in younger people than in older people and has been deepened over the last decade especially for cardiovascular disease and diabetes.

  5. Level of education and mortality after radical prostatectomy

    PubMed Central

    Froehner, Michael; Koch, Rainer; Propping, Stefan; Liebeheim, Dorothea; Hübler, Matthias; Baretton, Gustavo B; Hakenberg, Oliver W; Wirth, Manfred P

    2017-01-01

    Estimating the risk of competing mortality is of importance in men with early prostate cancer to choose the most appropriate way of management and to avoid over- or under-treatment. In this study, we investigated the impact of the level of education in this context. The study sample consisted of 2630 patients with complete data on level of education (college, university degree, master craftsmen, comparable profession, or others), histopathological tumor stage (organ confined or extracapsular), lymph node status (negative or positive), and prostatectomy specimen Gleason score (<7, 7, or 8–10) who underwent radical prostatectomy between 1992 and 2007. Overall, prostate cancer-specific, competing, and second cancer-related mortalities were study endpoints. Cox proportional hazard models for competing risks were used to study combined effects of the variables on these endpoints. A higher level of education was independently associated with decreased overall mortality after radical prostatectomy (hazard ratio [HR]: 0.75, 95% confidence interval [95% CI]: 0.62–0.91, P = 0.0037). The mortality difference was attributable to decreased second cancer mortality (HR: 0.59, 95% CI: 0.40–0.85, P = 0.0052) and noncancer mortality (HR: 0.73, 95% CI: 0.55–0.98, P = 0.0345) but not to differences in prostate cancer-specific mortality (HR: 1.16, 95% CI: 0.79–1.69, P = 0.4536 in the full model). In conclusion, the level of education might serve as an independent prognostic parameter supplementary to age, comorbidity, and smoking status to estimate the risk of competing mortality and to choose optimal treatment for men with early prostate cancer who are candidates for radical prostatectomy. PMID:28051039

  6. Level of education and mortality after radical prostatectomy.

    PubMed

    Froehner, Michael; Koch, Rainer; Propping, Stefan; Liebeheim, Dorothea; Hübler, Matthias; Baretton, Gustavo B; Hakenberg, Oliver W; Wirth, Manfred P

    2017-01-01

    Estimating the risk of competing mortality is of importance in men with early prostate cancer to choose the most appropriate way of management and to avoid over- or under-treatment. In this study, we investigated the impact of the level of education in this context. The study sample consisted of 2630 patients with complete data on level of education (college, university degree, master craftsmen, comparable profession, or others), histopathological tumor stage (organ confined or extracapsular), lymph node status (negative or positive), and prostatectomy specimen Gleason score (<7, 7, or 8-10) who underwent radical prostatectomy between 1992 and 2007. Overall, prostate cancer-specific, competing, and second cancer-related mortalities were study endpoints. Cox proportional hazard models for competing risks were used to study combined effects of the variables on these endpoints. A higher level of education was independently associated with decreased overall mortality after radical prostatectomy (hazard ratio [HR]: 0.75, 95% confidence interval [95% CI]: 0.62-0.91, P = 0.0037). The mortality difference was attributable to decreased second cancer mortality (HR: 0.59, 95% CI: 0.40-0.85, P = 0.0052) and noncancer mortality (HR: 0.73, 95% CI: 0.55-0.98, P = 0.0345) but not to differences in prostate cancer-specific mortality (HR: 1.16, 95% CI: 0.79-1.69, P = 0.4536 in the full model). In conclusion, the level of education might serve as an independent prognostic parameter supplementary to age, comorbidity, and smoking status to estimate the risk of competing mortality and to choose optimal treatment for men with early prostate cancer who are candidates for radical prostatectomy.

  7. Breastfeeding and the risk for diarrhea morbidity and mortality

    PubMed Central

    2011-01-01

    Background Lack of exclusive breastfeeding among infants 0-5 months of age and no breastfeeding among children 6-23 months of age are associated with increased diarrhea morbidity and mortality in developing countries. We estimate the protective effects conferred by varying levels of breastfeeding exposure against diarrhea incidence, diarrhea prevalence, diarrhea mortality, all-cause mortality, and hospitalization for diarrhea illness. Methods We systematically reviewed all literature published from 1980 to 2009 assessing levels of suboptimal breastfeeding as a risk factor for selected diarrhea morbidity and mortality outcomes. We conducted random effects meta-analyses to generate pooled relative risks by outcome and age category. Results We found a large body of evidence for the protective effects of breastfeeding against diarrhea incidence, prevalence, hospitalizations, diarrhea mortality, and all-cause mortality. The results of random effects meta-analyses of eighteen included studies indicated varying degrees of protection across levels of breastfeeding exposure with the greatest protection conferred by exclusive breastfeeding among infants 0-5 months of age and by any breastfeeding among infants and young children 6-23 months of age. Specifically, not breastfeeding resulted in an excess risk of diarrhea mortality in comparison to exclusive breastfeeding among infants 0-5 months of age (RR: 10.52) and to any breastfeeding among children aged 6-23 months (RR: 2.18). Conclusions Our findings support the current WHO recommendation for exclusive breastfeeding during the first 6 months of life as a key child survival intervention. Our findings also highlight the importance of breastfeeding to protect against diarrhea-specific morbidity and mortality throughout the first 2 years of life. PMID:21501432

  8. Vermont granite workers' mortality study.

    PubMed

    Costello, J; Graham, W G

    1988-01-01

    A cohort mortality study was carried out in Vermont granite workers who had been employed between the years 1950 and 1982. The cohort included men who had been exposed to high levels of granite dust prior to 1938-1940 (average cutters to 40 million parts/cubic foot), and those employed at dust levels after 1940, which on average were less than 10 million parts/cubic foot. Deaths were coded by a qualified nosologist and standardized mortality ratios were calculated. The results confirm previous studies that show that death rates from silicosis and tuberculosis, the major health threats in the years before 1940, were essentially eliminated after dust controls. However, we found excessive mortality rates from lung cancer in stone shed workers who had been employed prior to 1930, and hence had been exposed to high levels of granite dust. When information was available, 100% of those dying from lung cancer had been smokers.

  9. Mortality rates among wild chimpanzees.

    PubMed

    Hill, K; Boesch, C; Goodall, J; Pusey, A; Williams, J; Wrangham, R

    2001-05-01

    In order to compare evolved human and chimpanzees' life histories we present a synthetic life table for free-living chimpanzees, derived from data collected in five study populations (Gombe, Taï, Kibale, Mahale, Bossou). The combined data from all populations represent 3711 chimpanzee years at risk and 278 deaths. Males show higher mortality than females and data suggest some inter-site variation in mortality. Despite this variation, however, wild chimpanzees generally have a life expectancy at birth of less than 15 years and mean adult lifespan (after sexual maturity) is only about 15 years. This is considerably lower survival than that reported for chimpanzees in zoos or captive breeding colonies, or that measured among modern human hunter-gatherers. The low mortality rate of human foragers relative to chimpanzees in the early adult years may partially explain why humans have evolved to senesce later than chimpanzees, and have a longer juvenile period.

  10. Electrocardiographic Predictors of Cardiovascular Mortality

    PubMed Central

    Mozos, Ioana; Caraba, Alexandru

    2015-01-01

    Cardiovascular diseases are the main causes of mortality. Sudden cardiac death may also appear in athletes, due to underlying congenital or inherited cardiac abnormalities. The electrocardiogram is used in clinical practice and clinical trials, as a valid, reliable, accessible, inexpensive method. The aim of the present paper was to review electrocardiographic (ECG) signs associated with cardiovascular mortality and the mechanisms underlying those associations, providing a brief description of the main studies in this area, and consider their implication for clinical practice in the general population and athletes. The main ECG parameters associated with cardiovascular mortality in the present paper are the P wave (duration, interatrial block, and deep terminal negativity of the P wave in V1), prolonged QT and Tpeak-Tend intervals, QRS duration and fragmentation, bundle branch block, ST segment depression and elevation, T waves (inverted, T wave axes), spatial angles between QRS and T vectors, premature ventricular contractions, and ECG hypertrophy criteria. PMID:26257460

  11. Mortality plateaus and directionality theory.

    PubMed

    Demetrius, L

    2001-10-07

    Recent large scale studies of senescence in animals and humans have revealed mortality rates that levelled off at advanced ages. These empirical findings are now known to be inconsistent with evolutionary theories of senescence based on the Malthusian parameter as a measure of fitness. This article analyses the incidence of mortality plateaus in terms of directionality theory, a new class of models based on evolutionary entropy as a measure of fitness. We show that the intensity of selection, in the context of directionality theory, is a convex function of age, and we invoke this property to predict that in populations evolving under bounded growth constraints, evolutionarily stable mortality patterns will be described by rates which abate with age at extreme ages. The explanatory power of directionality theory, in contrast with the limitations of the Malthusian model, accords with the claim that evolutionary entropy, rather than the Malthusian parameter, constitutes the operationally valid measure of Darwinian fitness.

  12. Breast feeding and infant mortality.

    PubMed

    Golding, J; Emmett, P M; Rogers, I S

    1997-10-29

    The evidence linking bottle feeding to infant and early childhood mortality has been reviewed. Ecological studies of national time trends in infant mortality do not parallel breast feeding trends in those countries, and indicate that falling death rates are more likely to be related to better health care facilities and social conditions. Direct studies of deaths provide some contradictory findings; meta-analyses are not informative because of the many differences in statistical and sample methodology. The methodology exhibited in most studies is more likely to have over- rather than under-estimated a relationship between bottle feeding and infant mortality. Retrospective analyses must take account of changes in feeding pattern due to early signs of illness. Prospective population studies able to account for large numbers of potential confounders provide the best estimates, especially if proportional hazards models are used. Two such studies have been carried out--both showed protective effects of breast feeding.

  13. Why perinatal mortality cannot be a proxy for maternal mortality.

    PubMed

    Akalin, M Z; Maine, D; de Francisco, A; Vaughan, R

    1997-12-01

    In recent years, the perinatal mortality rate (PNMR) has been proposed as a proxy measure of maternal mortality, because perinatal deaths are more frequent and potentially more easily measured. This report assesses evidence for an association between these two statistics. This study, based upon data from Matlab, Bangladesh, shows that the maternal mortality ratio (MMR) and the PNMR do not vary together over time, and that the PNMR does not reliably indicate either the magnitude or the direction of change in the MMR from year to year. Statistical analysis shows that the correlation between the PNMR and the MMR is not significantly different from zero. An examination of the major causes of maternal and perinatal deaths indicates that the two measures cannot be expected to vary together. Almost half of perinatal deaths result from causes that do not pose a threat to the mother's life, and almost half of maternal deaths result from causes that do not lead to perinatal death. Monitoring of the PNMR can give an inaccurate picture of maternal mortality and should not be used as a proxy.

  14. Low mortality in the poorest areas of Spain: adults residing in provinces with lower per capita income have the lowest mortality.

    PubMed

    Regidor, Enrique; Vallejo, Fernando; Giráldez-García, Carolina; Ortega, Paloma; Santos, Juana M; Astasio, Paloma; de la Fuente, Luis

    2015-08-01

    The objective of this study is to ascertain whether income inequality and per capita income of area of residence show a relationship with mortality in Spain. Data are from a nation-wide prospective study with a 7-year mortality follow-up covering all persons living in Spain's 50 provinces in 2001. In total 28,944,854 subjects aged 25 years or over at baseline were studied. Rate ratio for total mortality and cause-specific mortality, according to provincial income inequality and per capita income in two age groups, 25-64 years (adult population) and 65 years and over (elderly population). Provincial income inequality was not related to total mortality or cause-specific mortality. Total mortality rate ratios among residents of the poorest versus the richest provinces were 0.89 (95% CI 0.95-0.93) in men and 0.91 (0.87-0.96) in women, among the adult population; and 1.02 (0.97-1.08) in men and 1.08 (1.02-1.16) in women, among the elderly population. With the exception of cardiovascular-disease mortality for which no association with per capita income was observed, adult residents of the poorest provinces registered the lowest mortality rate ratio for other causes of death. Elderly residents of the poorest provinces registered the highest mortality rate ratio for cardiovascular disease and the lowest mortality rate ratio for cancer and external causes. Aside from cardiovascular-disease mortality, the lowest mortality for most causes of death was registered by residents of the poorest provinces. Nevertheless, these findings need to be confirmed by similar studies using smaller areas as the unit of analysis.

  15. Antipsychotics and Mortality: Adjusting for Mortality Risk Scores to Address Confounding by Terminal Illness

    PubMed Central

    Park, Yoonyoung; Franklin, Jessica M.; Schneeweiss, Sebastian; Levin, Raisa; Crystal, Stephen; Gerhard, Tobias; Huybrechts, Krista F.

    2014-01-01

    OBJECTIVES Earlier studies have documented a greater mortality risk associated with conventional compared with atypical antipsychotics. Concern remains that the association is not causal, but due to residual confounding by differences in underlying health. To address this concern, we evaluated whether adjustment for prognostic indices specifically developed fornursing home (NH) populations affected the magnitude of the previously observed associations. DESIGN Cohort study SETTING A merged dataset of Medicaid, Medicare, the Minimum Data Set (MDS), the Online Survey Certification and Reporting system (OSCAR), and the National Death Index in the US for 2001-2005 PARTICIPANTS Dual eligible subjects ≥ 65 years who initiated antipsychotic treatment in a NH (n=75,445). MEASUREMENTS Three mortality risk scores (MRIS, MMRI-R, and ADEPT) were derived for each patient using baseline MDS data, and their performance was assessed using c-statistics and goodness-of-fit tests. The impact of adjusting for these indices in addition to propensity scores (PS) on the antipsychotic-mortality association was evaluated using Cox models with and without adjustment for risk scores. RESULTS Each risk score showed moderate discrimination for 6-month mortality with c-statistics ranging from 0.61 to 0.63. There was no evidence of lack of fit. Imbalances in risk scores between conventional and atypical antipsychotic users in the full cohort, suggesting potential confounding, were greatly reduced within PS deciles. Accounting for each score in the Cox model did not change the relative risk estimates: 2.24 with PS only adjustment vs. 2.20, 2.20, 2.22 after further adjustment for the three risk scores. CONCLUSION Although causality cannot be proven based on non-randomized studies, this study adds to the body of evidence rejecting alternative explanations for the increased mortality risk associated with conventional antipsychotics. PMID:25752911

  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. Mortality and cancer morbidity in workers from an aluminium smelter with prebaked carbon anodes--Part III: Mortality from circulatory and respiratory diseases.

    PubMed Central

    Rønneberg, A

    1995-01-01

    OBJECTIVE--To investigate associations between exposure to pot emissions (fluorides, sulphur dioxide) and mortality from chronic obstructive lung disease, coal tar pitch volatiles and mortality from diseases related to atherosclerosis, and carbon monoxide and mortality from ischaemic heart disease. METHODS--Mortality between 1962 to 1991 was investigated in a cohort of 1085 men hired by a Norwegian aluminium smelter between 1922 and 1975. Associations between cumulative exposure and mortality were investigated through SMR analysis based on national mortality rates; temporal relations were explored by considering exposures only within specific time windows. Circulatory mortality was also investigated by Poisson regression analysis. RESULTS--There were 501 deaths v 471.3 expected in the cohort. The excess was confined to short term workers and did not seem to be associated with exposures in the smelter. Analysis of mortality among the 661 men with at least three years employment showed associations between cumulative exposure to tar 40 years before observation and atherosclerotic mortality (P = 0.03), and between exposure to pot emissions 20-39 years before observation and mortality from chronic obstructive lung disease (P = 0.06). No association was found between exposure to carbon monoxide and mortality from ischaemic heart disease, but cerebrovascular mortality was associated with exposure to pot emissions (P = 0.02). Results for atherosclerotic and cerebrovascular diseases were confirmed through Poisson regression analysis. CONCLUSIONS--The data support previous findings of increased mortality from ischaemic heart disease in workers exposed to tar, and some support is also provided for earlier reports of increased respiratory mortality in potroom workers. PMID:7795741

  18. Adverse Trends in Ischemic Heart Disease Mortality among Young New Yorkers, Particularly Young Black Women

    PubMed Central

    Smilowitz, Nathaniel R.; Maduro, Gil A.; Lobach, Iryna V.; Chen, Yu; Reynolds, Harmony R.

    2016-01-01

    Background Ischemic heart disease (IHD) mortality has been on the decline in the United States for decades. However, declines in IHD mortality have been slower in certain groups, including young women and black individuals. Hypothesis Trends in IHD vary by age, sex, and race in New York City (NYC). Young female minorities are a vulnerable group that may warrant renewed efforts to reduce IHD. Methods IHD mortality trends were assessed in NYC 1980–2008. NYC Vital Statistics data were obtained for analysis. Age-specific IHD mortality rates and confidence bounds were estimated. Trends in IHD mortality were compared by age and race/ethnicity using linear regression of log-transformed mortality rates. Rates and trends in IHD mortality rates were compared between subgroups defined by age, sex and race/ethnicity. Results The decline in IHD mortality rates slowed in 1999 among individuals aged 35–54 years but not ≥55. IHD mortality rates were higher among young men than women age 35–54, but annual declines in IHD mortality were slower for women. Black women age 35–54 had higher IHD mortality rates and slower declines in IHD mortality than women of other race/ethnicity groups. IHD mortality trends were similar in black and white men age 35–54. Conclusions The decline in IHD mortality rates has slowed in recent years among younger, but not older, individuals in NYC. There was an association between sex and race/ethnicity on IHD mortality rates and trends. Young black women may benefit from targeted medical and public health interventions to reduce IHD mortality. PMID:26882207

  19. Pesticide sales and adult male cancer mortality in Brazil.

    PubMed

    Chrisman, Juliana de Rezende; Koifman, Sérgio; de Novaes Sarcinelli, Paula; Moreira, Josino Costa; Koifman, Rosalina Jorge; Meyer, Armando

    2009-05-01

    In Brazil, where the use of pesticide grows rapidly, studies that evaluate the impact of pesticide exposure on cancer incidence and mortality are very scarce. In this study, we evaluated the degree of correlation between pesticide sales in 1985 in eleven Brazilian states and cancer mortality rates during 1996-1998. Information of all cancer deaths occurred in men 30-69 years old from 1996 to 1998 were collected from National Mortality System. Single and multiple linear regression coefficients were obtained to assess the relationship between per capita sales of pesticides in 1985, specific-site cancer mortality rates (prostate, soft tissue, larynx, leukemia, lip, esophagus, lung, pancreas, bladder, liver, testis, stomach, brain, non-Hodgkin's lymphoma, and multiple myeloma) during 1996-1998, and several covariates. In addition, states were stratified into three groups according to tertiles of pesticides sales and cancer mortality rate ratios (MRR) were then calculated using first tertile as reference. Finally, a factor analysis was performed to reveal unapparent relationships between pesticide use and cancer mortality. Pesticide sales showed statistically significant correlation with the mortality rates for the cancers of prostate (r=0.69; p=0.019), soft tissue (r=0.71; p=0.015), leukemia (r=0.68; p=0.021), lip (r=0.73; p=0.010), esophagus (r=0.61; p=0.046), and pancreas (r=0.63; p=0.040). Moderate to weak correlations were observed for the cancers of larynx, lung, testis, bladder, liver, stomach, brain, and NHL and multiple myeloma. In addition, correlation between pesticide sales and specific-site cancer mortality rates was reinforced by multiple regression analysis. For all specific-sites, cancer mortality rates were significantly higher in the states of moderate (2nd tertile) and high (3rd tertile) pesticide sales, with MRR ranging from 1.11 to 5.61. Exploring hidden relationships between pesticide sales and cancer mortality in Brazil, through a factor analysis

  20. Sex mortality differentials and selective survival in large medfly cohorts: implications for human sex mortality differentials.

    PubMed

    Carey, J R; Liedo, P

    1995-10-01

    Experimental studies on male-female mortality differences in nonhuman species are important because they provide insights into both the nature of age-specific gender differences and the concept of selective survival--whether one subgroup in a population (e.g., males) is consistently more frail than another subgroup (e.g., females). We found that it was not possible to classify either sex as more robust or longer lived since relative longevity was conditional on age (young or old), cage conditions (solitary confinement or grouped cages), and treatment (starvation, irradiation, or density). Implications of these findings are discussed including selective survival, demographic selection, a framework for male-female mortality differentials, and an evolutionary perspective on gender differences in longevity.

  1. America's Infant-Mortality Puzzle.

    ERIC Educational Resources Information Center

    Eberstadt, Nicholas

    1991-01-01

    Conventional explanations attributing the high infant mortality rate in United States to the prevalence of poverty and lack of adequate health care do not tell the whole story. Contributions of parental behavior, lifestyles, and public health care availability versus utilization must be examined in determining public policies to address the…

  2. Manatee mortality in Puerto Rico

    USGS Publications Warehouse

    Mignucci-Giannoni, A. A.; Montoya-Ospina, R. A.; Jimenez-Marrero, N. M.; Rodriguez-Lopez, M.; Williams, E.H.; Bonde, R.K.

    2000-01-01

    The most pressing problem in the effective management of the West Indian manatee (Trichechus manatus) in Puerto Rico is mortality due to human activities. We assessed 90 cases of manatee strandings in Puerto Rico based on historical data and a coordinated carcass salvage effort from 1990 through 1995. We determined patterns of mortality, including type of event, condition of carcasses, spatial and temporal distribution, gender, size/age class, and the cause of death. The spatial distribution of stranding events was not uniform, with the north, northeast, and south coasts having the highest numbers. Six clusters representing the highest incidence included the areas of Fajardo and Ceiba, Bahia de Jobos, Toa Baja, Guayanilla, Cabo Rojo, and Rio Grande to Luquillo. The number of reported cases has increased at an average rate of 9.6%/yr since 1990. The seasonality of stranding events showed a bimodal pattern, from February through April and in August and September. Most identified causes of death were due to human interaction, especially captures and watercraft collisions. Natural causes usually involved dependent calves. From 1990 through 1995, most deaths were attributed to watercraft collisions. A reduction in anthropogenic mortality of this endangered species can be accomplished only through education and a proactive management and conservation plan that includes law enforcement, mortality assessment, scientific research, rescue and rehabilitation, and inter- and intraagency cooperation.

  3. Drought, Mortality and Social Structure.

    ERIC Educational Resources Information Center

    Sharma, Sanjay

    1995-01-01

    Examines the relationship between the human population explosion, resource depletion, drought, malnutrition, and disease. As a sample study, mortality trends in Rajasthan State in India in the 1980s were analyzed to correlate the increased death rate with the drought of 1987. It is demonstrated that drought-induced malnutrition was the root cause…

  4. Infant Mortality: The Shared Concern.

    ERIC Educational Resources Information Center

    Heagarty, Margaret C.

    1990-01-01

    Addresses the causes for and implications of infant mortality. Besides the more immediate causes such as disease, nutrition, and lifestyle, there are the additional hurdles of government bureaucracy, lack of funds, and institutional attitudes that block access to prenatal care. Suggests structural solutions, including a consistent, individual,…

  5. Infant Mortality: 1989 Research Accomplishments.

    ERIC Educational Resources Information Center

    National Inst. of Child Health and Human Development (NIH), Bethesda, MD.

    Collected in this document are reports of the National Institutes of Health's 1989 accomplishments in research on the problem of infant mortality. Reports are provided by the: (1) National Institute of Child Health and Human Development; (2) National Cancer Institute; (3) National Heart, Lung, and Blood Institute; (4) National Institute of…

  6. Gender Differences in Respiratory Morbidity and Mortality of Preterm Neonates

    PubMed Central

    Townsel, Courtney Denise; Emmer, Sawyer F.; Campbell, Winston A.; Hussain, Naveed

    2017-01-01

    For the past century, researchers have underscored the “disadvantage” observed in respiratory morbidity and mortality of male newborns. In this contemporary review, we examine gender differences in preterm infant respiratory morbidity and mortality specifically appraising differences in the very low birth weight (VLBW) population as well as the late preterm (LPT) population. In the era of postnatal surfactant and antenatal corticosteroids, the gender gap in neonatal outcomes has not narrowed. Structural, physiologic, and hormonal sex differences may be at the root of this disparity. Further exploration into the origin of gender differences in respiratory morbidity and neonatal mortality will shape future therapies. These therapies may need to be gender specific to close the gender gap. PMID:28194395

  7. Cancer mortality in workers employed at a transformer manufacturing plant.

    PubMed

    Yassi, A; Tate, R; Fish, D

    1994-03-01

    This study examined mortality to December 31, 1989 in a cohort of 2,222 males employed between 1947 and 1975 at a transformer manufacturing plant in Canada, where there had been extensive use of transformer fluid, some containing polychlorinated biphenyls (PCBs). A combined cohort list of 2,222 names was independently obtained from plant management and union officials. Mortality of 1,939 workers with known birthdates was ascertained by record linkage with the Canadian Mortality Data-base. Standardized mortality ratios (SMRs) for different criteria for acceptance of the death certificate link and for cohort membership (based on work history) ranged from .71-1.05. There was no significant increase in overall cancer deaths. The only significant site-specific increased mortality was pancreatic cancer (11 deaths), with SMRs ranging from 2.92-7.64 and higher mortality risk in those who entered the cohort prior to 1960. All but one of these deaths had a latency period of at least 10 years, and greatest SMRs were found in departments with the greatest exposure to transformer fluid. Several previous studies have found excess pancreatic cancers in association with oil exposures and electrical equipment manufacturing. The need to further investigate pancreatic cancer in transformer manufacturing and related exposures is evident.

  8. Twentieth century surge of excess adult male mortality

    PubMed Central

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

    2015-01-01

    Using historical data from 1,763 birth cohorts from 1800 to 1935 in 13 developed countries, we show that what is now seen as normal—a large excess of female life expectancy in adulthood—is a demographic phenomenon that emerged among people born in the late 1800s. We show that excess adult male mortality is clearly rooted in specific age groups, 50–70, and that the sex asymmetry emerged in cohorts born after 1880 when male:female mortality ratios increased by as much as 50% from a baseline of about 1.1. Heart disease is the main condition associated with increased excess male mortality for those born after 1900. We further show that smoking-attributable deaths account for about 30% of excess male mortality at ages 50–70 for cohorts born in 1900–1935. However, after accounting for smoking, substantial excess male mortality at ages 50–70 remained, particularly from cardiovascular disease. The greater male vulnerability to cardiovascular conditions emerged with the reduction in infectious mortality and changes in health-related behaviors. PMID:26150507

  9. The epidemiology of perinatal mortality in multiple births.

    PubMed Central

    Kiely, J. L.

    1990-01-01

    The epidemiology of perinatal mortality in multiple pregnancies was investigated from data on 16,831 multiple births from New York City's computerized vital records for 1978-1984. Twins had a sixfold higher rate of neonatal death and a threefold higher rate of fetal death during labor than had singleton infants. Much of this excess mortality can be explained by the lower birthweight distribution in twins: between 1,001 and 2,500 grams twins had birthweight-specific death rates equivalent to or substantially less than singletons. However, in infants of normal birthweights, twins had more than three times the mortality risk of singletons. For twins in vertex presentation between 1,001 and 3,000 grams, cesarean section did not appreciably reduce neonatal mortality risk. For twins in vertex presentation who weighted more than 3,000 grams the neonatal mortality rate was more than four times higher in vaginal deliveries than in cesarean sections (exact p = 0.034). Efforts to prevent intrapartum and neonatal mortality in multiple births should aim at reducing the incidence of low birthweight twins. More research is needed on the etiology of perinatal problems in normal birthweight twins (greater than or equal to 2,501 grams), especially on the effects of different modes of delivery. PMID:2282443

  10. Climate change impacts on projections of excess mortality at ...

    EPA Pesticide Factsheets

    We project the change in ozone-related mortality burden attributable to changes in climate between a historical (1995-2005) and near-future (2025-2035) time period while incorporating a non-linear and synergistic effect of ozone and temperature on mortality. We simulate air quality from climate projections varying only biogenic emissions and holding anthropogenic emissions constant, thus attributing changes in ozone only to changes in climate and independent of changes in air pollutant emissions. We estimate non-linear, spatially varying, ozone-temperature risk surfaces for 94 US urban areas using observeddata. Using the risk surfaces and climate projections we estimate daily mortality attributable to ozone exceeding 40 p.p.b. (moderate level) and 75 p.p.b. (US ozone NAAQS) for each time period. The average increases in city-specific median April-October ozone and temperature between time periods are 1.02 p.p.b. and 1.94 °F; however, the results variedby region . Increases in ozone because of climate change result in an increase in ozone mortality burden. Mortality attributed to ozone exceeding 40 p.p.b. increases by 7.7% (1 .6-14.2%). Mortality attributed to ozone exceeding 75 p.p.b. increases by 14.2% (1.628.9%). The absolute increase in excess ozone mortality is larger for changes in moderate ozone levels, reflecting the larger number of days with moderate ozone levels. In this study we evaluate changes in ozone related mortality due to changes in biogenic f

  11. Early neonatal lamb mortality: postmortem findings.

    PubMed

    Holmøy, I H; Waage, S; Granquist, E G; L'Abée-Lund, T M; Ersdal, C; Hektoen, L; Sørby, R

    2017-02-01

    An investigation of stillbirth and early neonatal lamb mortality was conducted in sheep flocks in Norway. Knowledge of actual causes of death are important to aid the interpretation of results obtained during studies assessing the risk factors for lamb mortality, and when tailoring preventive measures at the flock, ewe and individual lamb level. This paper reports on the postmortem findings in 270 liveborn lambs that died during the first 5 days after birth. The lambs were from 17 flocks in six counties. A total of 27% died within 3 h after birth, 41% within 24 h and 80% within 2 days. Most lambs (62%) were from triplet or higher order litters. In 81% of twin and larger litters, only one lamb died. The most frequently identified cause of neonatal death was infectious disease (n=97, 36%); 48% (n=47) of these died from septicaemia, 25% (n=24) from pneumonia, 22% (n=21) from gastrointestinal infections and 5% (n=5) from other infections. Escherichia coli accounted for 65% of the septicaemic cases, and were the most common causal agent obtained from all cases of infection (41%). In total, 14% of neonatal deaths resulted from infection by this bacterium. Traumatic lesions were the primary cause of death in 20% (n=53) of the lambs. A total of 46% of these died within 3 h after birth and 66% within 24 h. Severe congenital malformations were found in 10% (n=27) of the lambs, whereas starvation with no concurrent lesions was the cause of death in 6% (n=17). In 16% (n=43) of the lambs, no specific cause of death was identified, lambs from triplet and higher order litters being overrepresented among these cases. In this study, the main causes of neonatal lamb mortality were infection and traumatic lesions. Most neonatal deaths occurred shortly after birth, suggesting that events related to lambing and the immediate post-lambing period are critical for lamb survival.

  12. Maternal mortality in St. Petersburg, Russian Federation.

    PubMed Central

    Gurina, Natalia A.; Vangen, Siri; Forsén, Lisa; Sundby, Johanne

    2006-01-01

    OBJECTIVE: To study the levels and causes of maternal mortality in St. Petersburg, Russian Federation. METHODS: We collected data about all pregnancy-related deaths in St. Petersburg over the period 1992-2003 using several sources of information. An independent research group reviewed and classified all cases according to ICD-10 and the Confidential Enquiries into Maternal Deaths in the United Kingdom. We tested trends of overall and cause specific ratios (deaths per 100,000 births) for four 3-year intervals using the chi2 test. FINDINGS: The maternal mortality ratio for the study period was 43 per 100,000 live births. A sharp decline of direct obstetric deaths was observed from the first to fourth 3-year interval (49.8 for 1992-94 versus 18.5 for 2001-03). Sepsis and haemorrhage were the main causes of direct obstetric deaths. Among the total deaths from sepsis, 63.8% were due to abortion. Death ratios from sepsis declined significantly from the first to second study interval. In the last study interval (2001-03), 50% of deaths due to haemorrhage were secondary to ectopic pregnancies. The death ratio from thromboembolism remained low (2.9%) and stable throughout the study period. Among indirect obstetric deaths a non-significant decrease was observed for deaths from cardiac disease. Death ratios from infectious causes and suicides increased over the study period. CONCLUSIONS: Maternal mortality levels in St. Petersburg still exceed European levels by a factor of five. Improved management of abortion, emergency care for sepsis and haemorrhage, and better identification and control of infectious diseases in pregnancy, are needed. PMID:16628301

  13. Proximity to mining industry and cancer mortality.

    PubMed

    Fernández-Navarro, Pablo; García-Pérez, Javier; Ramis, Rebeca; Boldo, Elena; López-Abente, Gonzalo

    2012-10-01

    Mining installations are releasing toxic substances into the environment which could pose a health problem to populations in their vicinity. We sought to investigate whether there might be excess cancer-related mortality in populations residing in towns lying in the vicinity of Spanish mining industries governed by the Integrated Pollution Prevention and Control Directive, and the European Pollutant Release and Transfer Register Regulation, according to the type of extraction method used. An ecologic study was designed to examine municipal mortality due to 32 types of cancer, across the period 1997 through 2006. Population exposure to pollution was estimated on the basis of distance from town of residence to pollution source. Poisson regression models, using the Bayesian conditional autoregressive model proposed by Besag, York and Molliè and Integrated Nested Laplace Approximations for Bayesian inference, were used: to analyze risk of dying from cancer in a 5-kilometer zone around mining installations; effect of type of industrial activity; and to conduct individual analyses within a 50-kilometer radius of each installation. Excess mortality (relative risk, 95% credible interval) of colorectal cancer (1.097, 1.041-1.157), lung cancer (1.066, 1.009-1.126) specifically related with proximity to opencast coal mining, bladder cancer (1.106, 1.016-1.203) and leukemia (1.093, 1.003-1.191) related with other opencast mining installations, was detected among the overall population in the vicinity of mining installations. Other tumors also associated in the stratified analysis by type of mine, were: thyroid, gallbladder and liver cancers (underground coal installations); brain cancer (opencast coal mining); stomach cancer (coal and other opencast mining installations); and myeloma (underground mining installations). The results suggested an association between risk of dying due to digestive, respiratory, hematologic and thyroid cancers and proximity to Spanish mining

  14. [Infectious causes of perinatal mortalities in ruminants (author's transl)].

    PubMed

    Coetzer, J A; Schutte, A P

    1978-07-01

    The advantages and disadvantages of the different diagnostic techniques e.g. pathological and microbiological studies, immunoglobulin and specific antibody determinations and fluorescent antibody studies in relation to these mortalities are discussed. The most important pathological lesions in the placentas and foetuses are described.

  15. Does Mortality Vary between Asian Subgroups in New Zealand: An Application of Hierarchical Bayesian Modelling

    PubMed Central

    Jatrana, Santosh; Richardson, Ken; Blakely, Tony; Dayal, Saira

    2014-01-01

    The aim of this paper was to see whether all-cause and cause-specific mortality rates vary between Asian ethnic subgroups, and whether overseas born Asian subgroup mortality rate ratios varied by nativity and duration of residence. We used hierarchical Bayesian methods to allow for sparse data in the analysis of linked census-mortality data for 25–75 year old New Zealanders. We found directly standardised posterior all-cause and cardiovascular mortality rates were highest for the Indian ethnic group, significantly so when compared with those of Chinese ethnicity. In contrast, cancer mortality rates were lowest for ethnic Indians. Asian overseas born subgroups have about 70% of the mortality rate of their New Zealand born Asian counterparts, a result that showed little variation by Asian subgroup or cause of death. Within the overseas born population, all-cause mortality rates for migrants living 0–9 years in New Zealand were about 60% of the mortality rate of those living more than 25 years in New Zealand regardless of ethnicity. The corresponding figure for cardiovascular mortality rates was 50%. However, while Chinese cancer mortality rates increased with duration of residence, Indian and Other Asian cancer mortality rates did not. Future research on the mechanisms of worsening of health with increased time spent in the host country is required to improve the understanding of the process, and would assist the policy-makers and health planners. PMID:25140523

  16. Does compulsory education lower mortality?

    PubMed

    Albouy, Valerie; Lequien, Laurent

    2009-01-01

    Recent studies have claimed to show a significant causal impact of education on health status. Their empirical strategy usually relied on changes in compulsory schooling laws. Using a French longitudinal dataset, we focus on the effect of school leaving age on mortality at later ages. The two identifying shocks are the Zay and Berthoin reforms, which respectively raised the minimum school leaving age to 14 and 16 years. We implement a non-parametric regression discontinuity design, comparing cohorts born immediately before or after the reforms, and a parametric two-stage approach using information from a larger part of our sample. None of these approaches reveals a significant causality of education on health. Despite the fact that these reforms increased education levels, and that subsequent declines in mortality are observed, none of these declines appears to be significant. We conclude with a discussion on possible limitations of these two reforms as identifying devices.

  17. Studies of the mortality of A-bomb survivors. 8. Cancer mortality, 1950-1982

    SciTech Connect

    Preston, D.L.; Kato, H.; Kopecky, K.; Fujita, S.

    1987-07-01

    This study extends an earlier one by 4 years (1979-1982) and includes mortality data on 11,393 additional Nagasaki survivors. Significant dose responses are observed for leukemia, multiple myeloma, and cancers of the lung, female breast, stomach, colon, esophagus, and urinary tract. Due to diagnostic difficulties, results for liver and ovarian cancers, while suggestive of significant dose responses, do not provide convincing evidence for radiogenic effects. No significant dose responses are seen for cancers of the gallbladder, prostate, rectum, pancreas, or uterus, or for lymphoma. For solid tumors, largely due to sex-specific differences in the background rates, the relative risk of radiation-induced mortality is greater for women than for men. For nonleukemic cancers the relative risk seen in those who were young when exposed has decreased with time, while the smaller risks for those who were older at exposure have tended to increase. While the absolute excess risks of radiation-induced mortality due to nonleukemic cancer have increased with time for all age-at-exposure groups, both excess and relative risks of leukemia have generally decreased with time. For leukemia, the rate of decrease in risk and the initial level of risk are inversely related to age at exposure.

  18. Addressing the unemployment-mortality conundrum: non-linearity is the answer.

    PubMed

    Bonamore, Giorgio; Carmignani, Fabrizio; Colombo, Emilio

    2015-02-01

    The effect of unemployment on mortality is the object of a lively literature. However, this literature is characterized by sharply conflicting results. We revisit this issue and suggest that the relationship might be non-linear. We use data for 265 territorial units (regions) within 23 European countries over the period 2000-2012 to estimate a multivariate regression of mortality. The estimating equation allows for a quadratic relationship between unemployment and mortality. We control for various other determinants of mortality at regional and national level and we include region-specific and time-specific fixed effects. The model is also extended to account for the dynamic adjustment of mortality and possible lagged effects of unemployment. We find that the relationship between mortality and unemployment is U shaped. In the benchmark regression, when the unemployment rate is low, at 3%, an increase by one percentage point decreases average mortality by 0.7%. As unemployment increases, the effect decays: when the unemployment rate is 8% (sample average) a further increase by one percentage point decreases average mortality by 0.4%. The effect changes sign, turning from negative to positive, when unemployment is around 17%. When the unemployment rate is 25%, a further increase by one percentage point raises average mortality by 0.4%. Results hold for different causes of death and across different specifications of the estimating equation. We argue that the non-linearity arises because the level of unemployment affects the psychological and behavioural response of individuals to worsening economic conditions.

  19. The Effect of Neurobehavioral Test Performance on the All-Cause Mortality among US Population.

    PubMed

    Peng, Tao-Chun; Chen, Wei-Liang; Wu, Li-Wei; Chen, Ying-Jen; Liaw, Fang-Yih; Wang, Gia-Chi; Wang, Chung-Ching; Yang, Ya-Hui

    2016-01-01

    Evidence of the association between global cognitive function and mortality is much, but whether specific cognitive function is related to mortality is unclear. To address the paucity of knowledge on younger populations in the US, we analyzed the association between specific cognitive function and mortality in young and middle-aged adults. We analyzed data from 5,144 men and women between 20 and 59 years of age in the Third National Health and Nutrition Examination Survey (1988-94) with mortality follow-up evaluation through 2006. Cognitive function tests, including assessments of executive function/processing speed (symbol digit substitution) and learning recall/short-term memory (serial digit learning), were performed. All-cause mortality was the outcome of interest. After adjusting for multiple variables, total mortality was significantly higher in males with poorer executive function/processing speed (hazard ratio (HR) 2.02; 95% confidence interval 1.36 to 2.99) and poorer recall/short-term memory (HR 1.47; 95% confidence interval 1.02 to 2.12). After adjusting for multiple variables, the mortality risk did not significantly increase among the females in these two cognitive tests groups. In this sample of the US population, poorer executive function/processing speed and poorer learning recall/short-term memory were significantly associated with increased mortality rates, especially in males. This study highlights the notion that poorer specific cognitive function predicts all-cause mortality in young and middle-aged males.

  20. Modeling the Effects of Mortality on Sea Otter Populations

    USGS Publications Warehouse

    Bodkin, James L.; Ballachey, Brenda E.

    2010-01-01

    Conservation and management of sea otters can benefit from managing the magnitude and sex composition of human related mortality, including harvesting within sustainable levels. Using age and sex-specific reproduction and survival rates from field studies, we created matrix population models representing sea otter populations with growth rates of 1.005, 1.072, and 1.145, corresponding to stable, moderate, and rapid rates of change. In each modeled population, we incrementally imposed additional annual mortality over a 20-year period and calculated average annual rates of change (lambda). Additional mortality was applied to (1) males only, (2) at a 1:1 ratio of male to female, and (3) at a 3:1 ratio of male to female. Dependent pups (age 0-0.5) were excluded from the mortality. Maintaining a stable or slightly increasing population was largely dependent on (1) the magnitude of additional mortality, (2) the underlying rate of change in the population during the period of additional mortality, and (3) the extent that females were included in the additional mortality (due to a polygnous reproductive system where one male may breed with more than one female). In stable populations, additional mortality as high as 2.4 percent was sustainable if limited to males only, but was reduced to 1.2 percent when males and females were removed at ratios of 3:1 or 0.5 percent at ratios of 1:1. In moderate growth populations, additional mortality of 9.8 percent (male-only) and 15.0 percent (3:1 male to female) maximized the sustainable mortality about 3-10 ten-fold over the stable population levels. However, if additional mortality consists of males and females at equal proportions, the sustainable rate is 7.7 percent. In rapid growth populations, maximum sustainable levels of mortality as high as 27.3 percent were achieved when the ratio of additional mortality was 3:1 male to female. Although male-only mortality maximized annual harvest in stable populations, high male biased

  1. Mortality of white South African gold miners.

    PubMed Central

    Reid, P J; Sluis-Cremer, G K

    1996-01-01

    OBJECTIVES--This two part study aimed to determine whether there was an excess mortality generally or for some diseases among middle aged white South African gold miners on the Witwatersrand and whether the underground dust exposure of these miners contributed to the development of lung cancer, chronic obstructive pulmonary disease (COPD), or ischaemic heart disease (IHD). METHODS--A cohort of 4925 white miners in South Africa, born between 1 January 1916 and 31 December 1930 who were alive and working in the vicinity of Johannesburg on 1 January 1970, then aged between 39 and 54, was followed up for 20 years by which time 2032 had died. Most were gold miners (about 87% had worked 85% or more of their shifts in gold mines). Standardised mortality ratios (SMRs) were calculated as percentages of the number of deaths observed in the cohort for a condition as stated on the death certificate divided by the number expected on the basis of concurrent mortality in the reference population (the total age specific white male population of South Africa). A case-control analysis was performed for three diseases (lung cancer, COPD, and IHD), the results of which are presented for those miners in the cohort who had spent at least 85% of their service on gold mines and had worked at least 15% of their shifts underground. RESULTS--The SMR for all causes of death was 129.6%, raised because of excess mortality due to the following causes: lung cancer (SMR = 139.8%), IHD (124.1%), COPD (189%) and cirrhosis of the liver (155.3%). Smoking was confirmed to be the main risk factor for lung cancer and COPD although cumulative dust exposure was found to increase the risk of COPD in conjunction with smoking. No significant risk of lung cancer resulted from exposure to dust. High blood pressure and smoking were found to increase the risk of IHD, but no association between IHD and the quetelet index (weight/height2) was found. CONCLUSIONS--The most significant and unexpected finding was the

  2. Heat-Related Mortality in India: Excess All-Cause Mortality Associated with the 2010 Ahmedabad Heat Wave

    PubMed Central

    Azhar, Gulrez Shah; Mavalankar, Dileep; Nori-Sarma, Amruta; Rajiva, Ajit; Dutta, Priya; Jaiswal, Anjali; Sheffield, Perry; Knowlton, Kim; Hess, Jeremy J.; Azhar, Gulrez Shah; Deol, Bhaskar; Bhaskar, Priya Shekhar; Hess, Jeremy; Jaiswal, Anjali; Khosla, Radhika; Knowlton, Kim; Mavalankar, Mavalankar; Rajiva, Ajit; Sarma, Amruta; Sheffield, Perry

    2014-01-01

    Introduction In the recent past, spells of extreme heat associated with appreciable mortality have been documented in developed countries, including North America and Europe. However, far fewer research reports are available from developing countries or specific cities in South Asia. In May 2010, Ahmedabad, India, faced a heat wave where the temperatures reached a high of 46.8°C with an apparent increase in mortality. The purpose of this study is to characterize the heat wave impact and assess the associated excess mortality. Methods We conducted an analysis of all-cause mortality associated with a May 2010 heat wave in Ahmedabad, Gujarat, India, to determine whether extreme heat leads to excess mortality. Counts of all-cause deaths from May 1–31, 2010 were compared with the mean of counts from temporally matched periods in May 2009 and 2011 to calculate excess mortality. Other analyses included a 7-day moving average, mortality rate ratio analysis, and relationship between daily maximum temperature and daily all-cause death counts over the entire year of 2010, using month-wise correlations. Results The May 2010 heat wave was associated with significant excess all-cause mortality. 4,462 all-cause deaths occurred, comprising an excess of 1,344 all-cause deaths, an estimated 43.1% increase when compared to the reference period (3,118 deaths). In monthly pair-wise comparisons for 2010, we found high correlations between mortality and daily maximum temperature during the locally hottest “summer” months of April (r = 0.69, p<0.001), May (r = 0.77, p<0.001), and June (r = 0.39, p<0.05). During a period of more intense heat (May 19–25, 2010), mortality rate ratios were 1.76 [95% CI 1.67–1.83, p<0.001] and 2.12 [95% CI 2.03–2.21] applying reference periods (May 12–18, 2010) from various years. Conclusion The May 2010 heat wave in Ahmedabad, Gujarat, India had a substantial effect on all-cause excess mortality, even in this city where hot

  3. Child mortality estimation: accelerated progress in reducing global child mortality, 1990-2010.

    PubMed

    Hill, Kenneth; You, Danzhen; Inoue, Mie; Oestergaard, Mikkel Z

    2012-01-01

    Monitoring development indicators has become a central interest of international agencies and countries for tracking progress towards the Millennium Development Goals. In this review, which also provides an introduction to a collection of articles, we describe the methodology used by the United Nations Inter-agency Group for Child Mortality Estimation to track country-specific changes in the key indicator for Millennium Development Goal 4 (MDG 4), the decline of the under-five mortality rate (the probability of dying between birth and age five, also denoted in the literature as U5MR and (5)q(0)). We review how relevant data from civil registration, sample registration, population censuses, and household surveys are compiled and assessed for United Nations member states, and how time series regression models are fitted to all points of acceptable quality to establish the trends in U5MR from which infant and neonatal mortality rates are generally derived. The application of this methodology indicates that, between 1990 and 2010, the global U5MR fell from 88 to 57 deaths per 1,000 live births, and the annual number of under-five deaths fell from 12.0 to 7.6 million. Although the annual rate of reduction in the U5MR accelerated from 1.9% for the period 1990-2000 to 2.5% for the period 2000-2010, it remains well below the 4.4% annual rate of reduction required to achieve the MDG 4 goal of a two-thirds reduction in U5MR from its 1990 value by 2015. Thus, despite progress in reducing child mortality worldwide, and an encouraging increase in the pace of decline over the last two decades, MDG 4 will not be met without greatly increasing efforts to reduce child deaths.

  4. Simulation of solute transport of tetrachloroethylene in ground water of the glacial-drift aquifer at the Savage Municipal Well Superfund Site, Milford, New Hampshire, 1960-2000

    USGS Publications Warehouse

    Harte, Philip T.

    2004-01-01

    The Savage Municipal Well Superfund site, named after the former municipal water-supply well for the town of Milford, is underlain by a 0.5-square mile plume of volatile organic compounds (VOCs), primarily tetrachloroethylene (PCE). The plume occurs mostly within a highly transmissive sand-and-gravel unit, but also extends to an underlying till and bedrock unit. The plume logistically is divided into two areas termed Operable Unit No. 1 (OU1), which contains the primary source area, and Operable Unit No. 2 (OU2), which is the extended plume area. PCE concentrations in excess of 100,000 parts per billion (ppb) had been detected in the OU1 area in 1995, indicating a likely Dense Non-Aqueous Phase Liquid (DNAPL) source. In the fall of 1998, the New Hampshire Department of Environmental Services (NHDES) and the U.S. Environmental Protection Agency (USEPA) installed a remedial system in OU1. The OU1 remedial system includes a low-permeability barrier that encircles the highest detected concentrations of PCE, and a series of injection and extraction wells. The barrier primarily sits atop bedrock and penetrates the full thickness of the sand and gravel; and in some places, the full thickness of the underlying basal till. The sand and gravel unit and the till comprise the aquifer termed the Milford-Souhegan glacial-drift aquifer (MSGD). Two-dimensional and three-dimensional finite-difference solute-transport models of the unconsolidated sediments (MSGD aquifer) were constructed to help evaluate solute-transport processes, assess the effectiveness of remedial activities in OU1, and to help design remedial strategies in OU2. The solute-transport models simulate PCE concentrations, and model results were compared to observed concentrations of PCE. Simulations were grouped into the following three time periods: an historical calibration of the distribution of PCE from the initial input (circa 1960) of PCE into the subsurface to the 1990s, a pre-remedial calibration from 1995 to 1998, and a remedial (post-barrier wall) calibration from 1998 to 1999. Model results also were checked against observed PCE concentrations from May and June 2000 as a post-audit of model performance. Results of the simulations of the two-dimensional model for the historical calibration indicate that the model-computed length of the plume is affected by the retardation factor (retardation). Values of retardation greater than 3 caused the longitudinal length of the computed plume to be too short compared to the observed plume. A retardation of 2-2.5 produced a reasonable comparison between computed and observed PCE concentrations. Testing of different starting times and rates of mass input of PCE indicated that the plume reaches a quasi steady-state distribution in about 20 years regardless of the rate of mass input or values of the solute-transport parameters (retardation, dispersion, and irreversible reaction) assigned the model. Results of the simulations of the three-dimensional model for the pre-remedial (1995-98) calibration of PCE for the OU2 area identified some spatial biases in computed concentrations that generally were unaffected by changes in retardation. The computed PCE concentrations exceeded observed concentrations along the northern part of the plume in OU2, where PCE increases were observed in a bedrock well. These results indicate that some PCE in this area may be entering the bedrock, which is not simulated in the model. Conversely, computed PCE concentrations were less than observed concentrations along the southern part of the plume in OU2. Because testing of high (above 4) values of retardation did little to reduce residuals, it is concluded that the low computed PCE concentrations along the southern flank are likely the result of an underestimation of the initial PCE mass in this area or an unaccounted source of PCE. Results of the simulations of the three-dimensional model for the remedial calibration period (1998-99) and po

  5. Trend analysis of ground-water levels and spring discharge in the Yucca Mountain Region, Nevada and California, 1960-2000

    USGS Publications Warehouse

    Fenelon, Joseph M.; Moreo, Michael T.

    2002-01-01

    Ground-water level and discharge data from 1960 to 2000 were analyzed for the Yucca Mountain region of southern Nevada and eastern California. Included were water-level data from 37 wells and a fissure (Devils Hole) and discharge data from five springs and from a flowing well. Data were evaluated for variability and for upward, downward, or cyclic trends with an emphasis on the period 1992-2000. Potential factors causing trends in water levels and discharge include ground-water withdrawal, infiltration of precipitation, earthquakes, evapotranspiration, barometric pressure, and earth tides. Statistically significant trends in ground-water levels or spring discharge from 1992 to 2000 were upward at 12 water-level sites and downward at 14 water-level sites and 1 spring-discharge site. In general, the magnitude of the change in water level from 1992 to 2000 was small (less than 2 feet), except where influenced by pumping or local effects such as possible equilibration from well construction or diversion of nearby surface water. Seasonal trends are superimposed on some of the long-term (1992-2000) trends in water levels and discharge. Factors causing seasonal trends include barometric pressure, evapotranspiration, and pumping. The magnitude of seasonal change in water level can vary from as little as 0.05 foot in regional aquifers to greater than 5 feet in monitoring wells near large supply wells in the Amargosa Farms area. Three major episodes of earthquake activity affected water levels in wells in the Yucca Mountain region between 1992 and 2000: the Landers/Little Skull Mountain, Northridge, and Hector Mine earthquakes. The Landers/Little Skull Mountain earthquakes, in June 1992, had the largest observed effect on water levels and on discharge during the study period. Monthly measurements of wells in the study network show that earthquakes affected water levels from a few tenths of a foot to 3.5 feet. In the Ash Meadows area, water levels remained relatively stable from 1992 to 2000, with some water levels showing small rising trends and some declining slightly. Possible reasons for water-level fluctuations at sites AD-6 (Tracer Well 3), AM-5 (Devils Hole Well), and AM-4 (Devils Hole) from 1960 to 2000 include climate change, local and regional ground-water withdrawals, and tectonic activity. In Jackass Flats, water levels from 1992 to 2000 in six wells adjacent to Fortymile Wash displayed either small upward trends or no upward or downward trend. Comparison of trends in water levels from 1983 to 2000 for these six wells shows good correlations between all wells and suggests a common mechanism controlling water levels in the area. Of the likely controls on the system--precipitation or pumping in Jackass Flats--precipitation appears to be the predominant factor controlling water levels near Fortymile Wash. Water levels in the heavily pumped Amargosa Farms area declined from about 10 to 30 feet from 1964 to 2000. Water-level declines accelerated beginning in the early 1990's as pumping rates increased substantially. Pumping in the Amargosa Farms area may affect water levels in some wells as far away as 5-14 miles. The water level at site DV-3 (Travertine Point 1 Well) and discharge at site DV-2 (Navel Spring), both in the Death Valley hydrographic area, had downward trends from 1992 to 2000. The cause of these downward trends may be linked to earthquakes, pumping in the Amargosa Farms area, or both.

  6. Portable roots: Latin New Yorker community building and the meanings of women's return migration in San Juan, Puerto Rico, 1960-2000.

    PubMed

    Findlay, Eileen J

    2009-01-01

    This article examines the life histories of women return migrants to Puerto Rico. It emphasizes the cultural aspects of return migration, especially how the narrators understood and expressed their collective identity as distinctive from Puerto Ricans born and raised on the island. These informants turned their life histories into morality fables of class mobility, gender role restriction, and social rejection on the island. These tales asserted their radical differences from both middle class-islanders, whom they had joined, and the working-class diaspora in New York City, from which they had come. The narrators also built an organization which reinforced their "Latin New Yorker" identity, invented on the island.

  7. Social differences in avoidable mortality between small areas of 15 European cities: an ecological study

    PubMed Central

    2014-01-01

    Background Health and inequalities in health among inhabitants of European cities are of major importance for European public health and there is great interest in how different health care systems in Europe perform in the reduction of health inequalities. However, evidence on the spatial distribution of cause-specific mortality across neighbourhoods of European cities is scarce. This study presents maps of avoidable mortality in European cities and analyses differences in avoidable mortality between neighbourhoods with different levels of deprivation. Methods We determined the level of mortality from 14 avoidable causes of death for each neighbourhood of 15 large cities in different European regions. To address the problems associated with Standardised Mortality Ratios for small areas we smooth them using the Bayesian model proposed by Besag, York and Mollié. Ecological regression analysis was used to assess the association between social deprivation and mortality. Results Mortality from avoidable causes of death is higher in deprived neighbourhoods and mortality rate ratios between areas with different levels of deprivation differ between gender and cities. In most cases rate ratios are lower among women. While Eastern and Southern European cities show higher levels of avoidable mortality, the association of mortality with social deprivation tends to be higher in Northern and lower in Southern Europe. Conclusions There are marked differences in the level of avoidable mortality between neighbourhoods of European cities and the level of avoidable mortality is associated with social deprivation. There is no systematic difference in the magnitude of this association between European cities or regions. Spatial patterns of avoidable mortality across small city areas can point to possible local problems and specific strategies to reduce health inequality which is important for the development of urban areas and the well-being of their inhabitants. PMID:24618273

  8. Mortality Attributable to Low Levels of Education in the United States

    PubMed Central

    Krueger, Patrick M.; Tran, Melanie K.; Hummer, Robert A.; Chang, Virginia W.

    2015-01-01

    Background Educational disparities in U.S. adult mortality are large and have widened across birth cohorts. We consider three policy relevant scenarios and estimate the mortality attributable to: (1) individuals having less than a high school degree rather than a high school degree, (2) individuals having some college rather than a baccalaureate degree, and (3) individuals having anything less than a baccalaureate degree rather than a baccalaureate degree, using educational disparities specific to the 1925, 1935, and 1945 cohorts. Methods We use the National Health Interview Survey data (1986–2004) linked to prospective mortality through 2006 (N=1,008,949), and discrete-time survival models, to estimate education- and cohort-specific mortality rates. We use those mortality rates and data on the 2010 U.S. population from the American Community Survey, to calculate annual attributable mortality estimates. Results If adults aged 25–85 in the 2010 U.S. population experienced the educational disparities in mortality observed in the 1945 cohort, 145,243 deaths could be attributed to individuals having less than a high school degree rather than a high school degree, 110,068 deaths could be attributed to individuals having some college rather than a baccalaureate degree, and 554,525 deaths could be attributed to individuals having anything less than a baccalaureate degree rather than a baccalaureate degree. Widening educational disparities between the 1925 and 1945 cohorts result in a doubling of attributable mortality. Mortality attributable to having less than a high school degree is proportionally similar among women and men and among non-Hispanic blacks and whites, and is greater for cardiovascular disease than for cancer. Conclusions Mortality attributable to low education is comparable in magnitude to mortality attributable to individuals being current rather than former smokers. Existing research suggests that a substantial part of the association between

  9. Mortality among rubber workers: VII. Aerospace workers.

    PubMed

    Delzell, E; Monson, R R

    1984-01-01

    This study evaluated cause-specific mortality among 3,161 men who were employed in the aerospace division of a rubber manufacturing company. Compared to other production workers at the plant, aerospace workers in deicer and fuel cell manufacturing jobs experienced a 60% excess of deaths from lung cancer. Deicer and fuel cell workers who were under 65 years of age had lung cancer rates that were approximately twice those of other rubber workers of comparable age. Aerospace division employees also had elevated rates of bladder cancer, leukemia, lymphoma, and multiple myeloma. However, detailed analyses suggested that, with the exception of lung cancer, these cancer excesses were not likely to be attributable to employment in the aerospace division.

  10. First-year mortality rates for selected birth defects, Hawaii, 1986-1999.

    PubMed

    Forrester, Mathias B; Merz, Ruth D

    2003-06-15

    Birth defects have been the leading cause of infant death in the United States for over the last decade. However, there is little population-based data on the first-year mortality rates for many specific birth defects and the factors that may affect these mortality rates. This investigation examined the first-year mortality rates for 54 selected birth defects of various organ systems in Hawaii during 1986-1999 using data from a population-based birth defects registry and evaluated the impact of the presence of chromosomal abnormalities and other structural birth defects and the year of delivery on the mortality rates. Mortality rates varied widely by defect, being highest for anencephaly (100%), trisomy 13 (82%), and trisomy 18 (74%), while no first-year deaths were reported for glaucoma, bladder exstrophy, and persistent cloaca. The majority (36 of 54 or 67%) of the birth defects had a mortality rate of less than 25%. Among the 51 structural birth defects, 38 (75%) had higher first-year mortality rate for cases with chromosomal abnormalities and 42 (82%) had higher first-year mortality rates for cases with other major structural birth defects. The mortality rate among 1986-1992 deliveries was higher than the mortality rate among 1993-1999 deliveries for 37 (69%) of the 54 birth defects. This study indicates that first-year mortality rates vary widely by type of birth defect, although the mortality rate for the majority of birth defects is relatively low. The presence of a chromosomal abnormality or other structural birth defect increases the mortality rate, and mortality rates for the majority of birth defects have declined in Hawaii during the study period.

  11. Cancer mortality and morbidity among rubber workers.

    PubMed

    Monson, R R; Fine, L J

    1978-10-01

    Mortality and morbidity from cancer among a cohort of 13,570 white male rubber workers were examined. Each man worked for at least 5 years at the Akron, Ohio, plant of the B. F. Goodrich Company. The potential period of follow-up was from January 1, 1940 to June 30, 1976. Departmental work histories were based primarily on records maintained by Local no. 5, United Rubber Workers. The occurrence of cancer was measured by death certificates and by a survey of Akron-area hospital tumor registries from 1964 to 1974. Two types of analyses were made: 1) an external comparison of mortality rates of rubber workers versus rates of U.S. white males, and 2) an internal comparison of cancer morbidity rates among persons who were employed in various work areas of the plant. Excess cases of specific cancers (observed/expected numbers) among workers in specific work areas included: stomach and intestine: rubber making (30/14.4); lung: tire curing (31/14.1), fuel cells and/or deicers (46/29.1); bladder: chemical plant (6/2.4), and tire building (16/10.7); skin cancer: tire assembly (12/1.9); brain cancer: tire assembly (8/2.0); lymphatic cancer: tire building (8/3.2); and leukemia: calendering (8/2.2), tire curing (8/2.6), tire building (12/7.5), elevators (4/1.4), tubes (4/1.6), and rubber fabrics (4/1.1). Agents that may be responsible for these excesses were considered.

  12. GULF OF MEXICO AQUATIC MORTALITY NETWORK (GMNET)

    EPA Science Inventory

    Five U.S. states share the northern coast of the Gulf, and each has a program to monitor mortalities of aquatic organisms (fish, shellfish, birds). However, each state has different standards, procedures, and documentation of mortality events. The Gulf of Mexico Aquatic Mortality...

  13. Community Types and Mortality in Georgia Counties

    ERIC Educational Resources Information Center

    Young, Frank W.

    2012-01-01

    Using an "ecological regional analysis" methodology for defining types of communities and their associated mortality rates, this study of Georgia's 159 counties finds that the suburban and town centered counties have low mortality while the city-centered type predicts low mortality for the whites. The military-centered counties do not…

  14. Advance Report of Final Mortality Statistics, 1985.

    ERIC Educational Resources Information Center

    Monthly Vital Statistics Report, 1987

    1987-01-01

    This document presents mortality statistics for 1985 for the entire United States. Data analysis and discussion of these factors is included: death and death rates; death rates by age, sex, and race; expectation of life at birth and at specified ages; causes of death; infant mortality; and maternal mortality. Highlights reported include: (1) the…

  15. Temperature Variability and Mortality: A Multi-Country Study

    PubMed Central

    Guo, Yuming; Gasparrini, Antonio; Armstrong, Ben G.; Tawatsupa, Benjawan; Tobias, Aurelio; Lavigne, Eric; Coelho, Micheline de Sousa Zanotti Stagliorio; Pan, Xiaochuan; Kim, Ho; Hashizume, Masahiro; Honda, Yasushi; Guo, Yue Leon; Wu, Chang-Fu; Zanobetti, Antonella; Schwartz, Joel D.; Bell, Michelle L.; Overcenco, Ala; Punnasiri, Kornwipa; Li, Shanshan; Tian, Linwei; Saldiva, Paulo; Williams, Gail; Tong, Shilu

    2016-01-01

    Background: The evidence and method are limited for the associations between mortality and temperature variability (TV) within or between days. Objectives: We developed a novel method to calculate TV and investigated TV-mortality associations using a large multicountry data set. Methods: We collected daily data for temperature and mortality from 372 locations in 12 countries/regions (Australia, Brazil, Canada, China, Japan, Moldova, South Korea, Spain, Taiwan, Thailand, the United Kingdom, and the United States). We calculated TV from the standard deviation of the minimum and maximum temperatures during the exposure days. Two-stage analyses were used to assess the relationship between TV and mortality. In the first stage, a Poisson regression model allowing over-dispersion was used to estimate the community-specific TV-mortality relationship, after controlling for potential confounders. In the second stage, a meta-analysis was used to pool the effect estimates within each country. Results: There was a significant association between TV and mortality in all countries, even after controlling for the effects of daily mean temperature. In stratified analyses, TV was still significantly associated with mortality in cold, hot, and moderate seasons. Mortality risks related to TV were higher in hot areas than in cold areas when using short TV exposures (0–1 days), whereas TV-related mortality risks were higher in moderate areas than in cold and hot areas when using longer TV exposures (0–7 days). Conclusions: The results indicate that more attention should be paid to unstable weather conditions in order to protect health. These findings may have implications for developing public health policies to manage health risks of climate change. Citation: Guo Y, Gasparrini A, Armstrong BG, Tawatsupa B, Tobias A, Lavigne E, Coelho MS, Pan X, Kim H, Hashizume M, Honda Y, Guo YL, Wu CF, Zanobetti A, Schwartz JD, Bell ML, Overcenco A, Punnasiri K, Li S, Tian L, Saldiva P, Williams

  16. Infant mortality in South Africa - distribution, associations and policy implications, 2007: an ecological spatial analysis

    PubMed Central

    2011-01-01

    Background Many sub-Saharan countries are confronted with persistently high levels of infant mortality because of the impact of a range of biological and social determinants. In particular, infant mortality has increased in sub-Saharan Africa in recent decades due to the HIV/AIDS epidemic. The geographic distribution of health problems and their relationship to potential risk factors can be invaluable for cost effective intervention planning. The objective of this paper is to determine and map the spatial nature of infant mortality in South Africa at a sub district level in order to inform policy intervention. In particular, the paper identifies and maps high risk clusters of infant mortality, as well as examines the impact of a range of determinants on infant mortality. A Bayesian approach is used to quantify the spatial risk of infant mortality, as well as significant associations (given spatial correlation between neighbouring areas) between infant mortality and a range of determinants. The most attributable determinants in each sub-district are calculated based on a combination of prevalence and model risk factor coefficient estimates. This integrated small area approach can be adapted and applied in other high burden settings to assist intervention planning and targeting. Results Infant mortality remains high in South Africa with seemingly little reduction since previous estimates in the early 2000's. Results showed marked geographical differences in infant mortality risk between provinces as well as within provinces as well as significantly higher risk in specific sub-districts and provinces. A number of determinants were found to have a significant adverse influence on infant mortality at the sub-district level. Following multivariable adjustment increasing maternal mortality, antenatal HIV prevalence, previous sibling mortality and male infant gender remained significantly associated with increased infant mortality risk. Of these antenatal HIV sero

  17. Child mortality, commodity price volatility and the resource curse.

    PubMed

    Makhlouf, Yousef; Kellard, Neil M; Vinogradov, Dmitri

    2017-04-01

    Given many developing economies depend on primary commodities, the fluctuations of commodity prices may imply significant effects for the wellbeing of children. To investigate, this paper examines the relationship between child mortality and commodity price movements as reflected by country-specific commodity terms-of-trade. Employing a panel of 69 low and lower-middle income countries over the period 1970-2010, we show that commodity terms-of-trade volatility increases child mortality in highly commodity-dependent importers suggesting a type of 'scarce' resource curse. Strikingly however, good institutions appear able to mitigate the negative impact of volatility. The paper concludes by highlighting this tripartite relationship between child mortality, volatility and good institutions and posits that an effective approach to improving child wellbeing in low to lower-middle income countries will combine hedging, import diversification and improvement of institutional quality.

  18. Mortality from neglected tropical diseases in Brazil, 2000–2011

    PubMed Central

    Martins-Melo, Francisco Rogerlândio; Ramos, Alberto Novaes; Alencar, Carlos Henrique

    2016-01-01

    Abstract Objective To describe mortality from neglected tropical diseases (NTDs) in Brazil, 2000–2011. Methods We extracted information on cause of death, age, sex, ethnicity and place of residence from the nationwide mortality information system at the Brazilian Ministry of Health. We selected deaths in which the underlying cause of death was a neglected tropical disease (NTD), as defined by the World Health Organization (WHO) and based on its International statistical classification of diseases and related health problems, 10th revision (ICD-10) codes. For specific NTDs, we estimated crude and age-adjusted mortality rates and 95% confidence intervals (CI). We calculated crude and age-adjusted mortality rates and mortality rate ratios by age, sex, ethnicity and geographic area. Findings Over the 12-year study period, 12 491 280 deaths were recorded; 76 847 deaths (0.62%) were caused by NTDs. Chagas disease was the most common cause of death (58 928 deaths; 76.7%), followed by schistosomiasis (6319 deaths; 8.2%) and leishmaniasis (3466 deaths; 4.5%). The average annual age-adjusted mortality from all NTDs combined was 4.30 deaths per 100 000 population (95% CI: 4.21–4.40). Rates were higher in males: 4.98 deaths per 100 000; people older than 69 years: 33.12 deaths per 100 000; Afro-Brazilians: 5.25 deaths per 100 000; and residents in the central-west region: 14.71 deaths per 100 000. Conclusion NTDs are important causes of death and are a significant public health problem in Brazil. There is a need for intensive integrated control measures in areas of high morbidity and mortality. PMID:26908960

  19. Increased mortality in Philadelphia associated with daily air pollution concentrations.

    PubMed

    Schwartz, J; Dockery, D W

    1992-03-01

    Cause-specific deaths by day for the years 1973 to 1980 in Philadelphia, Pennsylvania, were extracted from National Center for Health Statistics mortality tapes. Death from accidents (International Classification of Disease, Revision 9 greater than or equal to 800) and deaths outside of the city were excluded. Daily counts of deaths were regressed using Poisson regression on total suspended particulate (TSP) and/or SO2 on the same day and on the preceding day, controlling for year, season, temperature, and humidity. A significant positive association was found between total mortality (mean of 48 deaths/day) and both TSP (second highest daily mean, 222 micrograms/m3) and SO2 (second highest daily mean, 299 micrograms/m3). The strongest associations were found with the mean pollution of the current and the preceding days. Total mortality was estimated to increase by 7% (95% CI, 4 to 10%) with each 100-micrograms/m3 increase in TSP, and 5% (95% CI, 3 to 7%) with each 100-micrograms/m3 increase in SO2. When both pollutants were considered simultaneously, the SO2 association was no longer significant. Mortality increased monotonically with TSP. The effect of 100 micrograms/m3 TSP was stronger in subjects older than 65 yr of age (10% increase) compared with those younger than 65 yr of age (3% increase). Cause-specific mortality was also associated with a 100-micrograms/m3 increase in TSP: chronic obstructive pulmonary disease (ICD9 490-496), +19% (95% CI, 0 to 42%), pneumonia (ICD9 480-486 & 507), +11% (95% CI, -3 to +27%), and cardiovascular disease (ICD9 390-448), +10% (95% CI, 6 to 14%). These results are somewhat higher than previously reported associations, and they add to the body of evidence showing that particulate pollution is associated with increased daily mortality at current levels in the United States.

  20. Municipal distribution of ovarian cancer mortality in Spain

    PubMed Central

    Lope, Virginia; Pollán, Marina; Pérez-Gómez, Beatriz; Aragonés, Nuria; Vidal, Enrique; Gómez-Barroso, Diana; Ramis, Rebeca; García-Pérez, Javier; Cabanes, Anna; López-Abente, Gonzalo

    2008-01-01

    Background Spain was the country that registered the greatest increases in ovarian cancer mortality in Europe. This study describes the municipal distribution of ovarian cancer mortality in Spain using spatial models for small-area analysis. Methods Smoothed relative risks of ovarian cancer mortality were obtained, using the Besag, York and Molliè autoregressive spatial model. Standardised mortality ratios, smoothed relative risks, and distribution of the posterior probability of relative risks being greater than 1 were depicted on municipal maps. Results During the study period (1989–1998), 13,869 ovarian cancer deaths were registered in 2,718 Spanish towns, accounting for 4% of all cancer-related deaths among women. The highest relative risks were mainly concentrated in three areas, i.e., the interior of Barcelona and Gerona (north-east Spain), the north of Lugo and Asturias (north-west Spain) and along the Seville-Huelva boundary (in the south-west). Eivissa (Balearic Islands) and El Hierro (Canary Islands) also registered increased risks. Conclusion Well established ovarian cancer risk factors might not contribute significantly to the municipal distribution of ovarian cancer mortality. Environmental and occupational exposures possibly linked to this pattern and prevalent in specific regions, are discussed in this paper. Small-area geographical studies are effective instruments for detecting risk areas that may otherwise remain concealed on a more reduced scale. PMID:18789142

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

    USGS Publications Warehouse

    Das, Adrian J.; Stephenson, Nathan L.

    2015-01-01

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

  2. Cancer mortality among laundry and dry cleaning workers.

    PubMed

    Walker, J T; Burnett, C A; Lalich, N R; Sestito, J P; Halperin, W E

    1997-12-01

    A cancer mortality study of 8,163 deaths occurring among persons formerly employed as laundering and dry cleaning workers in 28 states is described. Age-adjusted sex-race cause-specific proportionate mortality ratios (PMRs) and proportionate cancer mortality ratios (PCMRs) were computed for 1979 through 1990, using the corresponding 28-state mortality as the comparison. For those aged 15-64 years, there were excesses in black men for total cancer mortality (PMR = 130, 95% confidence interval (CI) = 105-159) and cancer of the esophagus 1 (PMR = 215, 95% CI = 111-376), and in white men for cancer of the larynx (PMR = 318, 95% CI = 117-693). For those aged 65 years and over, there were statistically nonsignificant excesses for cancer of the trachea, bronchus, and lung in black women (PMR = 128, CI = 94-170) and for cancer of other and unspecified female genital organs in white women (PMR = 225, CI = 97-443). The results of this and other studies point to the need for the effective implementation of available control measures to protect laundry and dry cleaning workers.

  3. Lung cancer mortality among U. S. uranium miners: a reappraisal

    SciTech Connect

    Whittemore, A.S.; McMillan, A.

    1983-09-01

    This report examines lung cancer mortality among a cohort of white underground uranium miners in the Colorado plateau and is based on mortality follow-up through December 31, 1977. The analytic methods represent a miner's annual age-specific lung cancer mortality rate as the (unspecified) rate among nonsmoking men born at the same time and with no mining history, multiplied by the relative risk factor R. This factor depends on the miner's total exposures to radon daughters (in working level months (WLM) and to cigarettes (in packs), accumulated from start of exposure until 10 years before his current age. Among those examined, the relative risk function giving the highest likelihood of the data was R . (1 + 0.31 X 10(-/sup 2/) WLM)(1 + 0.51 X 10(-/sup 3/) packs). This multiplicative function specifies that ratios of mortality rates for miners versus nonminers with similar age and smoking characteristics do not depend on smoking status. By contrast, differences between miners' and nonminers' mortality rates are substantially higher for smokers than for nonsmokers. The data rejected (P . .01) several additive functions for R that specify relative risk as a sum of components due to radiation and to cigarette smoking. Cumulative exposures to both radiation and cigarettes gave better fits to the data than did average annual exposure rates. Age at start of underground mining had no effect on risk, after controlling for age at lung cancer death, year of birth, and cumulative radiation and smoking exposures.

  4. Education and the gender gaps in health and mortality.

    PubMed

    Ross, Catherine E; Masters, Ryan K; Hummer, Robert A

    2012-11-01

    The positive associations between education and health and survival are well established, but whether the strength of these associations depends on gender is not. Is the beneficial influence of education on survival and on self-rated health conditioned by gender in the same way, in opposite ways, or not at all? Because women are otherwise disadvantaged in socioeconomic resources that are inputs to health, their health and survival may depend more on education than will men's. To test this hypothesis, we use data from the National Health Interview Survey-Linked Mortality Files (NHIS-LMF). We find that education's beneficial influence on feeling healthy and on survival are conditional on gender, but in opposite ways. Education has a larger effect on women's self-rated health than on men's, but a larger effect on men's mortality. To further examine the mortality results, we examine specific causes of death. We find that the conditional effect is largest for deaths from lung cancer, respiratory disease, stroke, homicide, suicide, and accidents. Because women report worse health but men's mortality is higher, education closes the gender gap in both health and mortality.

  5. Perinatal mortality in rural Tanzania.

    PubMed

    van Roosmalen, J

    1989-07-01

    Prolonged labour was the most frequent cause of perinatal death in a rural hospital in the south western highlands of Tanzania. After the introduction of an obstetric policy aiming to prevent prolonged labour by making use of the guidelines of the partogram, perinatal mortality was reduced from 71 to 39 per 1000 births. Baird's clinico-pathological classification is still considered a useful instrument for the discovery of avoidable factors in perinatal deaths. The concept of the partogram should be an integral part of the training of medical auxiliaries in the field of maternal and child health (MCH).

  6. Endogenous fertility, mortality and growth.

    PubMed

    Blackburn, K; Cipriani, G P

    1998-01-01

    This paper presents a model that illustrates the joint determination of population and development. "Economic and demographic outcomes are determined jointly in a choice-theoretic model of fertility, mortality and capital accumulation.... In addition to choosing savings and births, parents may reduce (infant) deaths by incurring expenditures on health-care which is also provided by the government. A generalised production technology accounts for long-run endogenous growth with short-run transitional dynamics. The analysis yields testable time series and cross-section implications which accord with the empirical evidence on the relationship between demography and development."

  7. Climate change and future temperature-related mortality in 15 Canadian cities.

    PubMed

    Martin, Sara Lauretta; Cakmak, Sabit; Hebbern, Christopher Alan; Avramescu, Mary-Luyza; Tremblay, Neil

    2012-07-01

    The environmental changes caused by climate change represent a significant challenge to human societies. One part of this challenge will be greater heat-related mortality. Populations in the northern hemisphere will experience temperature increases exceeding the global average, but whether this will increase or decrease total temperature-related mortality burdens is debated. Here, we use distributed lag modeling to characterize temperature-mortality relationships in 15 Canadian cities. Further, we examine historical trends in temperature variation across Canada. We then develop city-specific general linear models to estimate change in high- and low-temperature-related mortality using dynamically downscaled climate projections for four future periods centred on 2040, 2060 and 2080. We find that the minimum mortality temperature is frequently located at approximately the 75th percentile of the city's temperature distribution, and that Canadians currently experience greater and longer lasting risk from cold-related than heat-related mortality. Additionally, we find no evidence that temperature variation is increasing in Canada. However, the projected increased temperatures are sufficient to change the relative levels of heat- and cold-related mortality in some cities. While most temperature-related mortality will continue to be cold-related, our models predict that higher temperatures will increase the burden of annual temperature-related mortality in Hamilton, London, Montreal and Regina, but result in slight to moderate decreases in the burden of mortality in the other 11 cities investigated.

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

    PubMed

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

    2014-06-01

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

  9. High-mortality days during the winter season: comparing meteorological conditions across 5 US cities

    NASA Astrophysics Data System (ADS)

    Allen, Michael J.; Sheridan, Scott C.

    2014-03-01

    While the relationship between weather and human health has been studied from various perspectives, this study examines an alternative method of analysis by examining weather conditions on specific high-mortality days during the winter season. These high-mortality days, by definition, represent days with dramatic increases in mortality and the days with the highest mortality. By focusing solely on high-mortality days, this research examines the relationship between weather variables and mortality through a synoptic climatology, environment-to circulation approach. The atmospheric conditions during high-mortality days were compared to the days prior and the days not classified as high-mortality days. Similar patterns emerged across all five locations despite the spatial and temporal variability. Southern locations had a stronger relationship with temperature changes while northern locations showed a greater relationship to atmospheric pressure. Overall, all high-mortality days were associated with warmer temperatures, decreased pressure, and a greater likelihood of precipitation when compared to the previous subset of days. While the atmospheric conditions were consistent across all locations, the importance of the lag effect should not be overlooked as a contributing factor to mortality during the winter season. Through a variety of diverse, methodological approaches, future studies may build upon these results and explore in more detail the complex relationship between weather situations and the impact of short-term changes in weather and health outcomes.

  10. Evolutionary genetics of lifespan and mortality rates in two populations of the seed beetle, Callosobruchus maculatus.

    PubMed

    Fox, C W; Bush, M L; Roff, D A; Wallin, W G

    2004-03-01

    The age at which individuals die varies substantially within and between species, but we still have little understanding of why there is such variation in life expectancy. We examined sex-specific and genetic variation in adult lifespan and the shape of mortality curves both within and between two populations of the seed beetle, Callosobruchus maculatus, that differ in a suite of life history characters associated with adaptation to different host species. Mean adult lifespan and the shape of the logistic mortality curves differed substantially between males and females (males had lower initial mortality rates, but a faster increase in the rate of mortality with increasing age) and between populations (they differed in the rate of increase in mortality with age). Larger individuals lived longer than smaller individuals, both because they had lower initial mortality rates and a slower increase in the rate of mortality with increasing age. However, differences in body size were not adequate to explain the differences in mortality between the sexes or populations. Both lifespan and mortality rates were genetically variable within populations and genetic variance/covariance matrices for lifespan differed between the populations and sexes. This study thus demonstrated substantial genetic variation in lifespan and mortality rates within and between populations of C. maculatus.

  11. The historical development of suicide mortality in Russia, 1870-2007.

    PubMed

    Jukkala, Tanya; Mäkinen, Ilkka Henrik; Stickley, Andrew

    2015-01-01

    Russia has one of the highest suicide mortality rates in the world. This study investigates the development of Russian suicide mortality over a longer time period in order to provide a context within which the contemporary high level might be better understood. Annual sex- and age-specific suicide-mortality data for Russia for the period 1870-2007 were studied, where available. Russian suicide mortality increased 11-fold over the period. Trends in male and female suicide developed similarly, although male suicide rates were consistently much higher. From the 1990s suicide has increased in a relative sense among the young (15-34), while the high suicide mortality among middle-aged males has reduced. Changes in Russian suicide mortality over the study period may be attributable to modernization processes.

  12. Behind international rankings of infant mortality: how the United States compares with Europe.

    PubMed

    MacDorman, Marian F; Mathews, T J

    2009-11-01

    Infant mortality is an important indicator of the health of a nation, and the recent stagnation (since 2000) in the U.S. infant mortality rate has generated concern among researchers and policy makers. The percentage of preterm births in the United States has risen 36% since 1984 (1). In this report we compare infant mortality rates between the United States and Europe. We also compare two factors that determine the infant mortality rate-gestational age-specific infant mortality rates and the percentage of preterm births. U.S. data are from the Linked Birth/Infant Death Data Set (2,3), and European data for 2004 are from the recently published European Perinatal Health Report (4). We also examine requirements for reporting a live birth among countries to assess the possible effect of reporting differences on infant mortality data.

  13. Mortality of tuberculosis patients in Chennai, India.

    PubMed Central

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

    2006-01-01

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

  14. Dzuds, droughts, and livestock mortality in Mongolia

    NASA Astrophysics Data System (ADS)

    Palat Rao, Mukund; Davi, Nicole K.; D'Arrigo, Rosanne D.; Skees, Jerry; Nachin, Baatarbileg; Leland, Caroline; Lyon, Bradfield; Wang, Shih-Yu; Byambasuren, Oyunsanaa

    2015-07-01

    Recent incidences of mass livestock mortality, known as dzud, have called into question the sustainability of pastoral nomadic herding, the cornerstone of Mongolian culture. A total of 20 million head of livestock perished in the mortality events of 2000-2002, and 2009-2010. To mitigate the effects of such events on the lives of herders, international agencies such as the World Bank are taking increasing interest in developing tailored market-based solutions like index-insurance. Their ultimate success depends on understanding the historical context and underlying causes of mortality. In this paper we examine mortality in 21 Mongolian aimags (provinces) between 1955 and 2013 in order to explain its density independent cause(s) related to climate variability. We show that livestock mortality is most strongly linked to winter (November-February) temperatures, with incidences of mass mortality being most likely to occur because of an anomalously cold winter. Additionally, we find prior summer (July-September) drought and precipitation deficit to be important triggers for mortality that intensifies the effect of upcoming winter temperatures on livestock. Our density independent mortality model based on winter temperature, summer drought, summer precipitation, and summer potential evaporanspiration explains 48.4% of the total variability in the mortality dataset. The Mongolian index based livestock insurance program uses a threshold of 6% mortality to trigger payouts. We find that on average for Mongolia, the probability of exceedance of 6% mortality in any given year is 26% over the 59 year period between 1955 and 2013.

  15. Diagnosis and mortality in 47,XYY persons: a registry study

    PubMed Central

    2010-01-01

    Background Sex chromosomal abnormalities are relatively common, yet many aspects of these syndromes remain unexplored. For instance epidemiological data in 47,XYY persons are still limited. Methods Using a national Danish registry, we identified 208 persons with 47,XYY or a compatible karyotype, whereof 36 were deceased; all were diagnosed from 1968 to 2008. For further analyses, we identified age matched controls from the male background population (n = 20,078) in Statistics Denmark. We report nationwide prevalence data, data regarding age at diagnosis, as well as total and cause specific mortality data in these persons. Results The average prevalence was 14.2 47,XYY persons per 100,000, which is reduced compared to the expected 98 per 100,000. Their median age at diagnosis was 17.1 years. We found a significantly decreased lifespan from 77.9 years (controls) to 67.5 years (47,XYY persons). Total mortality was significantly increased compared to controls, with a hazard ratio of 3.6 (2.6-5.1). Dividing the causes of deaths according to the International Classification of Diseases, we identified an increased hazard ratio in all informative chapters, with a significantly increased ratio in cancer, pulmonary, neurological and unspecified diseases, and trauma. Conclusion We here present national epidemiological data regarding 47,XYY syndrome, including prevalence and mortality data, showing a significantly delay to diagnosis, reduced life expectancy and an increased total and cause specific mortality. PMID:20509956

  16. Modelling small-area inequality in premature mortality using years of life lost rates

    NASA Astrophysics Data System (ADS)

    Congdon, Peter

    2013-04-01

    Analysis of premature mortality variations via standardized expected years of life lost (SEYLL) measures raises questions about suitable modelling for mortality data, especially when developing SEYLL profiles for areas with small populations. Existing fixed effects estimation methods take no account of correlations in mortality levels over ages, causes, socio-ethnic groups or areas. They also do not specify an underlying data generating process, or a likelihood model that can include trends or correlations, and are likely to produce unstable estimates for small-areas. An alternative strategy involves a fully specified data generation process, and a random effects model which "borrows strength" to produce stable SEYLL estimates, allowing for correlations between ages, areas and socio-ethnic groups. The resulting modelling strategy is applied to gender-specific differences in SEYLL rates in small-areas in NE London, and to cause-specific mortality for leading causes of premature mortality in these areas.

  17. Mortality from lung cancer and chronic obstructive pulmonary disease in New Mexico, 1958-82.

    PubMed

    Samet, J M; Wiggins, C L; Key, C R; Becker, T M

    1988-09-01

    We examined mortality from lung cancer and from chronic obstructive pulmonary disease in Hispanic White, Other White, and Native American residents of New Mexico during the period 1958-82. Age-specific mortality was calculated by combining death certificate data with population estimates based on the 1960, 1970, and 1980 censuses that were adjusted for inconsistencies in the designation of race and ethnicity. In Other Whites, age-adjusted mortality rates from lung cancer and from chronic obstructive pulmonary disease increased progressively in males and females. Mortality rates for both diseases also increased in Hispanics during the study period, but the most recent rates for Hispanics were well below those for Other Whites. Age-specific mortality rates for lung cancer declined for more recently born Hispanic women at older ages. In Native Americans, rates for both diseases were low throughout the study period and did not show consistent temporal trends.

  18. Long-Term Trial Results Show No Mortality Benefit from Annual Prostate Cancer Screening

    Cancer.gov

    Thirteen year follow-up data from the Prostate, Lung, Colorectal and Ovarian (PLCO) cancer screening trial show higher incidence but similar mortality among men screened annually with the prostate-specific antigen (PSA) test and digital rectal examination

  19. Public health care funding modifies the effect of out-of-pocket spending on maternal, infant, and child mortality.

    PubMed

    Noel, Jonathan K

    2017-03-01

    Increased out-of-pocket (OOP) health care spending has been associated with increased maternal, infant, and child mortality, but the effect of public health care spending on mortality has not been studied. I identified a statistically significant interaction between public health care expenditure and OOP health care spending for maternal, infant, and child mortality. Generally, increases in public expenditure coincide with decreased rates of mortality, regardless of OOP spending levels. Specifically, higher levels of public expenditure with moderate levels of OOP spending may result in the lowest mortality rates. Increased public health care spending may improve health outcomes better than efforts to reduce OOP expenditure alone.

  20. Widening rural-urban disparities in all-cause mortality and mortality from major causes of death in the USA, 1969-2009.

    PubMed

    Singh, Gopal K; Siahpush, Mohammad

    2014-04-01

    This study examined trends in rural-urban disparities in all-cause and cause-specific mortality in the USA between 1969 and 2009. A rural-urban continuum measure was linked to county-level mortality data. Age-adjusted death rates were calculated by sex, race, cause-of-death, area-poverty, and urbanization level for 13 time periods between 1969 and 2009. Cause-of-death decomposition and log-linear and Poisson regression were used to analyze rural-urban differentials. Mortality rates increased with increasing levels of rurality overall and for non-Hispanic whites, blacks, and American Indians/Alaska Natives. Despite the declining mortality trends, mortality risks for both males and females and for blacks and whites have been increasingly higher in non-metropolitan than metropolitan areas, particularly since 1990. In 2005-2009, mortality rates varied from 391.9 per 100,000 population for Asians/Pacific Islanders in rural areas to 1,063.2 for blacks in small-urban towns. Poverty gradients were steeper in rural areas, which maintained higher mortality than urban areas after adjustment for poverty level. Poor blacks in non-metropolitan areas experienced two to three times higher all-cause and premature mortality risks than affluent blacks and whites in metropolitan areas. Disparities widened over time; excess mortality from all causes combined and from several major causes of death in non-metropolitan areas was greater in 2005-2009 than in 1990-1992. Causes of death contributing most to the increasing rural-urban disparity and higher rural mortality include heart disease, unintentional injuries, COPD, lung cancer, stroke, suicide, diabetes, nephritis, pneumonia/influenza, cirrhosis, and Alzheimer's disease. Residents in metropolitan areas experienced larger mortality reductions during the past four decades than non-metropolitan residents, contributing to the widening gap.

  1. Spatio-temporal trends of mortality in small areas of Southern Spain

    PubMed Central

    2010-01-01

    Background Most mortality atlases show static maps from count data aggregated over time. This procedure has several methodological problems and serious limitations for decision making in Public Health. The evaluation of health outcomes, including mortality, should be approached from a dynamic time perspective that is specific for each gender and age group. At the moment, researches in Spain do not provide a dynamic image of the population's mortality status from a spatio-temporal point of view. The aim of this paper is to describe the spatial distribution of mortality from all causes in small areas of Andalusia (Southern Spain) and evolution over time from 1981 to 2006. Methods A small-area ecological study was devised using the municipality as the unit for analysis. Two spatio-temporal hierarchical Bayesian models were estimated for each age group and gender. One of these was used to estimate the specific mortality rate, together with its time trends, and the other to estimate the specific rate ratio for each municipality compared with Spain as a whole. Results More than 97% of the municipalities showed a diminishing or flat mortality trend in all gender and age groups. In 2006, over 95% of municipalities showed male and female mortality specific rates similar or significantly lower than Spanish rates for all age groups below 65. Systematically, municipalities in Western Andalusia showed significant male and female mortality excess from 1981 to 2006 only in age groups over 65. Conclusions The study shows a dynamic geographical distribution of mortality, with a different pattern for each year, gender and age group. This information will contribute towards a reflection on the past, present and future of mortality in Andalusia. PMID:20089142

  2. Exploring geographic variation in US mortality rates using a spatial Durbin approach

    PubMed Central

    Yang, Tse-Chuan; Noah, Aggie; Shoff, Carla

    2015-01-01

    Previous studies focused on identifying the determinants of mortality in US counties have examined the relationships between mortality and explanatory covariates within a county only, and have ignored the well-documented spatial dependence of mortality. We challenge earlier literature by arguing that the mortality rate of a certain county may also be associated with the features of its neighboring counties beyond its own features. Drawing from both the spillover (i.e., same direction effect) and social relativity (i.e., opposite direction effect) perspectives, our spatial Durbin modeling results indicate that both theoretical perspectives provide valuable frameworks to guide the modeling of mortality variation in US counties. Our empirical findings support that mortality rate of a certain county is associated with the features of its neighbors beyond its own features. Specifically, we found support for the spillover perspective in which the percentage of the Hispanic population, concentrated disadvantage, and the social capital of a specific county are negatively associated with the mortality rate in the specific county and also in neighboring counties. On the other hand, the following covariates fit the social relativity process: health insurance coverage, percentage of non-Hispanic other races, and income inequality. Their direction of the associations with mortality in the specific county is opposite to that of the relationships with mortality in neighboring counties. Methodologically, spatial Durbin modeling addresses the shortcomings of traditional analytic approaches used in ecological mortality research such as ordinary least squares, spatial error, and spatial lag regression. Our results produce new insights drawn from unbiased estimates. PMID:25642156

  3. Exploring geographic variation in US mortality rates using a spatial Durbin approach.

    PubMed

    Yang, Tse-Chuan; Noah, Aggie; Shoff, Carla

    2015-01-01

    Previous studies focused on identifying the determinants of mortality in US counties have examined the relationships between mortality and explanatory covariates within a county only, and have ignored the well-documented spatial dependence of mortality. We challenge earlier literature by arguing that the mortality rate of a certain county may also be associated with the features of its neighboring counties beyond its own features. Drawing from both the spillover (i.e., same direction effect) and social relativity (i.e., opposite direction effect) perspectives, our spatial Durbin modeling results indicate that both theoretical perspectives provide valuable frameworks to guide the modeling of mortality variation in US counties. Our empirical findings support that mortality rate of a certain county is associated with the features of its neighbors beyond its own features. Specifically, we found support for the spillover perspective in which the percentage of the Hispanic population, concentrated disadvantage, and the social capital of a specific county are negatively associated with the mortality rate in the specific county and also in neighboring counties. On the other hand, the following covariates fit the social relativity process: health insurance coverage, percentage of non-Hispanic other races, and income inequality. Their direction of the associations with mortality in the specific county is opposite to that of the relationships with mortality in neighboring counties. Methodologically, spatial Durbin modeling addresses the shortcomings of traditional analytic approaches used in ecological mortality research such as ordinary least squares, spatial error, and spatial lag regression. Our results produce new insights drawn from unbiased estimates.

  4. QT-Interval Duration and Mortality Rate

    PubMed Central

    Zhang, Yiyi; Post, Wendy S.; Dalal, Darshan; Blasco-Colmenares, Elena; Tomaselli, Gordon F.; Guallar, Eliseo

    2012-01-01

    Background Extreme prolongation or reduction of the QT interval predisposes patients to malignant ventricular arrhythmias and sudden cardiac death, but the association of variations in the QT interval within a reference range with mortality end points in the general population is unclear. Methods We included 7828 men and women from the Third National Health and Nutrition Examination Survey. Baseline QT interval was measured via standard 12-lead electrocardiographic readings. Mortality end points were assessed through December 31, 2006 (2291 deaths). Results After an average follow-up of 13.7 years, the association between QT interval and mortality end points was U-shaped. The multivariate-adjusted hazard ratios comparing participants at or above the 95th percentile of age-, sex-, race-, and R-R interval–corrected QT interval (≥439 milliseconds) with participants in the middle quintile (401 to <410 milliseconds) were 2.03 (95% confidence interval, 1.46-2.81) for total mortality, 2.55 (1.59-4.09) for mortality due to cardiovascular disease (CVD), 1.63 (0.96-2.75) for mortality due to coronary heart disease, and 1.65 (1.16-2.35) for non-CVD mortality. The corresponding hazard ratios comparing participants with a corrected QT interval below the fifth percentile (<377 milliseconds) with those in the middle quintile were 1.39 (95% confidence interval, 1.02-1.88) for total mortality, 1.35 (0.77-2.36) for CVD mortality, 1.02 (0.44-2.38) for coronary heart disease mortality, and 1.42 (0.97-2.08) for non-CVD mortality. Increased mortality also was observed with less extreme deviations of QT-interval duration. Similar, albeit weaker, associations also were observed with Bazett-corrected QT intervals. Conclusion Shortened and prolonged QT-interval durations, even within a reference range, are associated with increased mortality risk in the general population. PMID:22025428

  5. Data base on animal mortality

    SciTech Connect

    Jones, T.D.

    1987-01-01

    A data base on animal mortality has been compiled. The literature on LD/sub 50/ and the dose-response function for radiation-induced lethality, reflect several inconsistencies - primarily due to dose assignments and to analytical methods and/or mathematical models used. Thus, in order to make the individual experiments which were included in the data base as consistent as possible, an estimate of the uniform dose received by the bone marrow in each treatment group was made so that the interspecies differences are minimized. The LD/sub 50/ was recalculated using a single estimation procedure for all studies for which sufficient experimental data are available. For small animals such as mice, the dose to the hematopoietic system is approximately equal to the treatment dose, but for large animals the marrow dose may be about half of the treatment dose.

  6. A Systematic Review of the Mortality from Untreated Leptospirosis

    PubMed Central

    Taylor, Andrew J.; Paris, Daniel H.; Newton, Paul N.

    2015-01-01

    Background Leptospirosis occurs worldwide, but the global incidence of human disease and its mortality are not well understood. Many patients are undiagnosed and untreated due to its non-specific symptoms and a lack of access to diagnostics. This study systematically reviews the literature to clarify the mortality from untreated leptospirosis. Results will help quantify the global burden of disease and guide health policies. Methodology/Principal Findings A comprehensive literature search was performed to identify untreated patient series. Included patients were symptomatic, but asymptomatic patients and those who had received antibiotics, dialysis or who were treated on Intensive Care Units were excluded. Included patients had a confirmed laboratory diagnosis by culture, PCR, or serological tests. Data was extracted and individual patient series were assessed for bias. Thirty-five studies, comprising 41 patient series and 3,390 patients, were included in the study. A high degree of bias within studies was shown due to limitations in study design, diagnostic tests and missing data. Median series mortality was 2.2% (Range 0.0 – 39.7%), but mortality was high in jaundiced patients (19.1%) (Range 0.0 – 39.7%), those with renal failure 12.1% (Range 0-25.0%) and in patients aged over 60 (60%) (Range 33.3-60%), but low in anicteric patients (0%) (Range 0-1.7%). Conclusions This systematic review contributes to our understanding of the mortality of untreated leptospirosis and provides data for the estimation of DALYs attributable to this disease. We show that mortality is significantly higher in older patients with icteric disease or renal failure but is lower in younger, anicteric patients. Increased surveillance and accurate point-of-care diagnostics are required to better understand the incidence and improve diagnosis of disease. Empirical treatment strategies should prioritize early treatment to improve outcomes from leptospirosis. PMID:26110270

  7. Fraction of stroke mortality attributable to alcohol consumption in Russia.

    PubMed

    Y E, Razvodovsky

    2014-01-01

    Stroke is an international health problem with high associated human and economic costs. The mortality rate from stroke in Russia is one of the highest in the world. Risk factors identification is therefore a high priority from the public health perspective. Epidemiological evidence suggests that binge drinking is an important determinant of high stroke mortality rate in Russia. The aim of the present study was to estimate the premature stroke mortality attributable to alcohol abuse in Russia on the basis of aggregate-level data of stroke mortality and alcohol consumption. Age-standardized sex-specific male and female stroke mortality data for the period 1980-2005 and data on overall alcohol consumption were analyzed by means ARIMA time series analysis. The results of the analysis suggest that 26.8% of all male stroke deaths and 18.4% female stroke deaths in Russia could be attributed to alcohol. The estimated alcohol-attributable fraction for men ranged from 16.2% (75+ age group) to 57,5% (30-44 age group) and for women from 21.7% (60-74 age group) and 43.5% (30- 44 age group). The outcomes of this study provide support for the hypothesis that alcohol is an important contributor to the high stroke mortality rate in Russian Federation. Therefore prevention of alcohol-attributable harm should be a major public health priority in Russia. Given the distribution of alcohol-related stroke deaths, interventions should be focused on the young and middle-aged men and women.

  8. Assessing adult mortality in HIV-1-afflicted Zimbabwe (1998 -2003).

    PubMed Central

    Lopman, Ben A.; Barnabas, Ruanne; Hallett, Timothy B.; Nyamukapa, Constance; Mundandi, Costa; Mushati, Phyllis; Garnett, Geoff P.; Gregson, Simon

    2006-01-01

    OBJECTIVE: To compare alternative methods to vital registration systems for estimating adult mortality, and describe patterns of mortality in Manicaland, Zimbabwe, which has been severely affected by HIV. METHODS: We compared estimates of adult mortality from (1) a single question on household mortality, (2) repeated household censuses, and (3) an adult cohort study with linked HIV testing from Manicaland, with a mathematical model fitted to local age-specific HIV prevalence (1998 -2000). FINDINGS: The crude death rate from the single question (29 per 1000 person-years) was roughly consistent with that from the mathematical model (22 -25 per 1000 person-years), but much higher than that from the household censuses (12 per 1000 person-years). Adult mortality in the household censuses (males 0.65; females 0.51) was lower than in the cohort study (males 0.77; females 0.57), while mathematical models gave a much higher estimate, especially for females (males 0.80 -0.83; females 0.75 -0.80). The population attributable fraction of adult deaths due to HIV was 0.61 for men and 0.70 for women, with life expectancy estimated to be 34.3 years for males and 38.2 years for females. CONCLUSION: Each method for estimating adult mortality had limitations in terms of loss to follow-up (cohort study), under-ascertainment (household censuses), transparency of underlying processes (single question), and sensitivity to parameterization (mathematical model). However, these analyses make clear the advantages of longitudinal cohort data, which provide more complete ascertainment than household censuses, highlight possible inaccuracies in model assumptions, and allow direct quantification of the impact of HIV. PMID:16583077

  9. Differential mortality among alcoholics by sample site.

    PubMed Central

    Combs-Orme, T; Taylor, J R; Robins, L N; Holmes, S J

    1983-01-01

    In a sample of 1,289 alcoholics from four clinical sites, the overall mortality rate after five to eight years of observation was 22.0 per cent, 3.1 times the expected rate. Patients from the medical and surgical services of a general hospital suffered 4.0 times the rate of expected mortality and died most often of medical causes associated with alcoholism. Patients of the public alcoholism ward had a mortality rate 3.3 times the expected rate and died of causes often associated with low social class. Private psychiatric patients had a mortality rate 2.3 times the expected rate, and psychiatric outpatients had an excess mortality ratio of 2.1. Sample site must be considered as a variable in the study of mortality among alcoholics. PMID:6869642

  10. Decreasing child mortality, spatial clustering and decreasing disparity in North-Western Burkina Faso.

    PubMed

    Becher, Heiko; Müller, Olaf; Dambach, Peter; Gabrysch, Sabine; Niamba, Louis; Sankoh, Osman; Simboro, Seraphin; Schoeps, Anja; Stieglbauer, Gabriele; Yé, Yazoume; Sié, Ali

    2016-04-01

    Within relatively small areas, there exist high spatial variations of mortality between villages. In rural Burkina Faso, with data from 1993 to 1998, clusters of particularly high child mortality were identified in the population of the Nouna Health and Demographic Surveillance System (HDSS), a member of the INDEPTH Network. In this paper, we report child mortality with respect to temporal trends, spatial clustering and disparity in this HDSS from 1993 to 2012. Poisson regression was used to describe village-specific child mortality rates and time trends in mortality. The spatial scan statistic was used to identify villages or village clusters with higher child mortality. Clustering of mortality in the area is still present, but not as strong as before. The disparity of child mortality between villages has decreased. The decrease occurred in the context of an overall halving of child mortality in the rural area of Nouna HDSS between 1993 and 2012. Extrapolated to the Millennium Development Goals target period 1990-2015, this yields an estimated reduction of 54%, which is not too far off the aim of a two-thirds reduction.

  11. Careers and mortality in France: evidence on how far occupational mobility predicts differentiated risks.

    PubMed

    Cambois, Emmanuelle

    2004-06-01

    This new study goes beyond the well-established correlation between mortality differentials and occupational status, to focus on the impact of professional careers on mortality risk. It shows heterogeneity in the mortality risks within occupational classes, strongly related to the type of occupational moves experienced. The occupational data are taken from the French longitudinal census sample-using 1968 and 1975 census records-and mortality risks are estimated over the 1975-1980 period, for both occupational classes and pathways between classes. Results show a close relationship between occupational mobility and mortality. For men, favorable occupational moves-e.g. from clerks to upper class-put them less at risk of mortality than their counterparts who remained in their class. An inverse relationship is found for unfavorable moves. In most cases, the mortality risks of the movers are in between the risks in the class left and in the class joined. Similar patterns apply to specific groups of women only (upper classes, manual workers, clerks) for which occupational moves are probably driven, as for most men, by mortality related determinants (level of education, qualifications, health, etc.). The findings strongly support the use of a dynamic approach, based on individuals' experiences, to improve our understanding of mortality differentials.

  12. 90-day postoperative mortality is a legitimate measure of hepatopancreatobiliary surgical quality

    PubMed Central

    Mise, Yoshihiro; Vauthey, Jean-Nicolas; Zimmitti, Giuseppe; Parker, Nathan H.; Conrad, Claudius; Aloia, Thomas A.; Lee, Jeffery E.; Fleming, Jason B.; Katz, Matthew H. G.

    2015-01-01

    Objective To investigate the legitimacy of 90-day mortality as a measure of hepatopancreatobiliary quality. Summary Background Data The 90-day mortality rate has been increasingly but not universally reported after hepatopancreatobiliary surgery. The legitimacy of this definition as a measure of surgical quality has not been evaluated. Methods We retrospectively reviewed the causes of all deaths that occurred within 365 postoperative days in patients undergoing hepatectomy (n = 2811) and/or pancreatectomy (n = 1092) from January 1997 through December 2012. The rates of surgery-related, disease-related, and overall mortality within 30 days, within 30 days or during the index hospitalization, within 90 days, and within 180 days following surgery were calculated. Results Seventy-nine (3%) surgery-related deaths and 92 (3%) disease-related deaths occurred within 365 days after hepatectomy. Twenty (2%) surgery-related deaths and 112 (10%) disease-related deaths occurred within 365 days after pancreatectomy. The overall mortality rates at 99 day and 118 days optimally reflected surgery-related mortality following hepatobiliary and pancreatic operations, respectively. The 90-day overall mortality rate was a less sensitive but equivalently specific measure of surgery-related death. Conclusions and Relevance The 99-day and 118-day definitions of postoperative mortality optimally reflected surgery-related mortality following hepatobiliary and pancreatic operations, respectively. However, among commonly reported metrics, the 90-day overall mortality rate represents a legitimate measure of surgical quality. PMID:25590497

  13. Income inequality and mortality in metropolitan areas of the United States.

    PubMed Central

    Lynch, J W; Kaplan, G A; Pamuk, E R; Cohen, R D; Heck, K E; Balfour, J L; Yen, I H

    1998-01-01

    OBJECTIVES: This study examined associations between income inequality and mortality in 282 US metropolitan areas. METHODS: Income inequality measures were calculated from the 1990 US Census. Mortality was calculated from National Center for Health Statistics data and modeled with weighted linear regressions of the log age-adjusted rate. RESULTS: Excess mortality between metropolitan areas with high and low income inequality ranged from 64.7 to 95.8 deaths per 100,000 depending on the inequality measure. In age-specific analyses, income inequality was most evident for infant mortality and for mortality between ages 15 and 64. CONCLUSIONS: Higher income inequality is associated with increased mortality at all per capita income levels. Areas with high income inequality and low average income had excess mortality of 139.8 deaths per 100,000 compared with areas with low inequality and high income. The magnitude of this mortality difference is comparable to the combined loss of life from lung cancer, diabetes, motor vehicle crashes, human immunodeficiency virus (HIV) infection, suicide, and homicide in 1995. Given the mortality burden associated with income inequality, public and private sector initiatives to reduce economic inequalities should be a high priority. Images FIGURE 1 PMID:9663157

  14. Injury mortality in New Mexico's American Indians, Hispanics, and non-Hispanic whites, 1958 to 1982.

    PubMed Central

    Sewell, C M; Becker, T M; Wiggins, C L; Key, C R; Hull, H F; Samet, J M

    1989-01-01

    New Mexico has extraordinarily high injury mortality rates. To better characterize the injury problem in New Mexico, we calculated proportionate injury mortality and age-adjusted and age-specific injury mortality rates for the state's 3 major ethnic groups--American Indians, Hispanics, and non-Hispanic whites. According to death certificate data collected from 1958 to 1982 and US population census figures, age-adjusted mortality rates for total external causes varied widely between the sexes and among the ethnic groups. Males in each ethnic group consistently had higher average annual age-adjusted external mortality rates than females. Injury mortality rates for American Indians of both sexes were 2 to 3 times higher than those for the other New Mexico ethnic groups. Motor vehicle crashes were the leading cause of death from injury for all 3 groups. Homicide accounted for twice the proportion of injury death in Hispanic compared with non-Hispanic white males (12.5% and 6.1%, respectively), while the proportion of males dying of suicide was highest in non-Hispanic whites. Deaths from excessive cold and exposure were leading causes of injury mortality for American Indians, but these causes were not among the leading causes of injury mortality for Hispanics or non-Hispanic whites. We conclude that the minority populations in New Mexico are at high risk for injury-related death and that the major causes of injury mortality vary substantially in the state's predominant ethnic populations. Images PMID:2750163

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

    PubMed Central

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

    2017-01-01

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

  16. Impact of temperature on mortality in Hubei, China: a multi-county time series analysis

    NASA Astrophysics Data System (ADS)

    Zhang, Yunquan; Yu, Chuanhua; Bao, Junzhe; Li, Xudong

    2017-03-01

    We examined the impact of extreme temperatures on mortality in 12 counties across Hubei Province, central China, during 2009–2012. Quasi-Poisson generalized linear regression combined with distributed lag non-linear model was first applied to estimate county-specific relationship between temperature and mortality. A multivariable meta-analysis was then used to pool the estimates of county-specific mortality effects of extreme cold temperature (1st percentile) and hot temperature (99th percentile). An inverse J-shaped relationship was observed between temperature and mortality at the provincial level. Heat effect occurred immediately and persisted for 2–3 days, whereas cold effect was 1–2 days delayed and much longer lasting. Higher mortality risks were observed among females, the elderly aged over 75 years, persons dying outside the hospital and those with high education attainment, especially for cold effects. Our data revealed some slight differences in heat- and cold- related mortality effects on urban and rural residents. These findings may have important implications for developing locally-based preventive and intervention strategies to reduce temperature-related mortality, especially for those susceptible subpopulations. Also, urbanization should be considered as a potential influence factor when evaluating temperature-mortality association in future researches.

  17. Impact of temperature on mortality in Hubei, China: a multi-county time series analysis

    PubMed Central

    Zhang, Yunquan; Yu, Chuanhua; Bao, Junzhe; Li, Xudong

    2017-01-01

    We examined the impact of extreme temperatures on mortality in 12 counties across Hubei Province, central China, during 2009–2012. Quasi-Poisson generalized linear regression combined with distributed lag non-linear model was first applied to estimate county-specific relationship between temperature and mortality. A multivariable meta-analysis was then used to pool the estimates of county-specific mortality effects of extreme cold temperature (1st percentile) and hot temperature (99th percentile). An inverse J-shaped relationship was observed between temperature and mortality at the provincial level. Heat effect occurred immediately and persisted for 2–3 days, whereas cold effect was 1–2 days delayed and much longer lasting. Higher mortality risks were observed among females, the elderly aged over 75 years, persons dying outside the hospital and those with high education attainment, especially for cold effects. Our data revealed some slight differences in heat- and cold- related mortality effects on urban and rural residents. These findings may have important implications for developing locally-based preventive and intervention strategies to reduce temperature-related mortality, especially for those susceptible subpopulations. Also, urbanization should be considered as a potential influence factor when evaluating temperature-mortality association in future researches. PMID:28327609

  18. Impact of temperature on mortality in Hubei, China: a multi-county time series analysis.

    PubMed

    Zhang, Yunquan; Yu, Chuanhua; Bao, Junzhe; Li, Xudong

    2017-03-22

    We examined the impact of extreme temperatures on mortality in 12 counties across Hubei Province, central China, during 2009-2012. Quasi-Poisson generalized linear regression combined with distributed lag non-linear model was first applied to estimate county-specific relationship between temperature and mortality. A multivariable meta-analysis was then used to pool the estimates of county-specific mortality effects of extreme cold temperature (1st percentile) and hot temperature (99th percentile). An inverse J-shaped relationship was observed between temperature and mortality at the provincial level. Heat effect occurred immediately and persisted for 2-3 days, whereas cold effect was 1-2 days delayed and much longer lasting. Higher mortality risks were observed among females, the elderly aged over 75 years, persons dying outside the hospital and those with high education attainment, especially for cold effects. Our data revealed some slight differences in heat- and cold- related mortality effects on urban and rural residents. These findings may have important implications for developing locally-based preventive and intervention strategies to reduce temperature-related mortality, especially for those susceptible subpopulations. Also, urbanization should be considered as a potential influence factor when evaluating temperature-mortality association in future researches.

  19. Divergent paths for adult mortality in Russia and Central Asia: evidence from Kyrgyzstan.

    PubMed

    Guillot, Michel; Gavrilova, Natalia; Torgasheva, Liudmila; Denisenko, Mikhail

    2013-01-01

    Adult mortality has been lower in Kyrgyzstan vs. Russia among males since at least 1981 and among females since 1999. Also, Kyrgyzstan's mortality fluctuations have had smaller amplitude. This has occurred in spite of worse macro-economic outcomes in Kyrgyzstan. To understand these surprising patterns, we analyzed cause-specific mortality in Kyrgyzstan vs. Russia for the period 1981-2010, using unpublished official data. We find that, as in Russia, fluctuations in Kyrgyzstan have been primarily due to changes in external causes and circulatory causes, and alcohol appears to play an important role. However, in contrast with Russia, mortality from these causes in Kyrgyzstan has been lower and has increased by a smaller amount. As a result, the mortality gap between the two countries is overwhelmingly attributable to external and cardio-vascular causes, and more generally, to causes that have been shown to be strongly related to alcohol consumption. These cause-specific results, together with the existence of large ethnic differentials in mortality in Kyrgyzstan, highlight the importance of cultural and religious differences, and their impact on patterns of alcohol consumption, in explaining the mortality gap between the two countries. These findings show that explanatory frameworks relying solely on macro-economic factors are not sufficient for understanding differences in mortality levels and trends among former Soviet republics.

  20. Population health and the economy: Mortality and the Great Recession in Europe.

    PubMed

    Tapia Granados, José A; Ionides, Edward L

    2017-03-27

    We analyze the evolution of mortality-based health indicators in 27 European countries before and after the start of the Great Recession. We find that in the countries where the crisis has been particularly severe, mortality reductions in 2007-2010 were considerably bigger than in 2004-2007. Panel models adjusted for space-invariant and time-invariant factors show that an increase of 1 percentage point in the national unemployment rate is associated with a reduction of 0.5% (p < .001) in the rate of age-adjusted mortality. The pattern of mortality oscillating procyclically is found for total and sex-specific mortality, cause-specific mortality due to major causes of death, and mortality for ages 30-44 and 75 and over, but not for ages 0-14. Suicides appear increasing when the economy decelerates-countercyclically-but the evidence is weak. Results are robust to using different weights in the regression, applying nonlinear methods for detrending, expanding the sample, and using as business cycle indicator gross domestic product per capita or employment-to-population ratios rather than the unemployment rate. We conclude that in the European experience of the past 20 years, recessions, on average, have beneficial short-term effects on mortality of the adult population.

  1. Modeling and forecasting U.S. sex differentials in mortality.

    PubMed

    Carter, L R; Lee, R D

    1992-11-01

    "This paper examines differentials in observed and forecasted sex-specific life expectancies and longevity in the United States from 1900 to 2065. Mortality models are developed and used to generate long-run forecasts, with confidence intervals that extend recent work by Lee and Carter (1992). These results are compared for forecast accuracy with univariate naive forecasts of life expectancies and those prepared by the Actuary of the Social Security Administration."

  2. [Methods to smooth mortality indicators: application to analysis of inequalities in mortality in Spanish cities [the MEDEA Project

    PubMed

    Barceló, M Antònia; Saez, Marc; Cano-Serral, Gemma; Martínez-Beneito, Miguel Angel; Martínez, José Miguel; Borrell, Carme; Ocaña-Riola, Ricardo; Montoya, Imanol; Calvo, Montse; López-Abente, Gonzalo; Rodríguez-Sanz, Maica; Toro, Silvia; Alcalá, José Tomás; Saurina, Carme; Sánchez-Villegas, Pablo; Figueiras, Adolfo

    2008-01-01

    Although there is some experience in the study of mortality inequalities in Spanish cities, there are large urban centers that have not yet been investigated using the census tract as the unit of territorial analysis. The coordinated project mortality in Spanish cities. The MEDEA project> was designed to fill this gap, with the participation of 10 groups of researchers in Andalusia, Aragon, Catalonia, Galicia, Madrid, Valencia, and the Basque Country. The MEDEA project has four distinguishing features: a) the census tract is used as the basic geographical area; b) statistical methods that include the geographical structure of the region under study are employed for risk estimation; c) data are drawn from three complementary data sources (information on air pollution, information on industrial pollution, and the records of mortality registrars), and d) a coordinated, large-scale analysis, favored by the implantation of coordinated research networks, is carried out. The main objective of the present study was to explain the methods for smoothing mortality indicators in the context of the MEDEA project. This study focusses on the methodology and the results of the Besag, York and Mollié model (BYM) in disease mapping. In the MEDEA project, standardized mortality ratios (SMR), corresponding to 17 large groups of causes of death and 28 specific causes, were smoothed by means of the BYM model; however, in the present study this methodology was applied to mortality due to cancer of the trachea, bronchi and lung in men and women in the city of Barcelona from 1996 to 2003. As a result of smoothing, a different geographical pattern for SMR in both genders was observed. In men, a SMR higher than unity was found in highly deprived areas. In contrast, in women, this pattern was observed in more affluent areas.

  3. Consistent Predictions of Future Forest Mortality

    NASA Astrophysics Data System (ADS)

    McDowell, N. G.

    2014-12-01

    We examined empirical and model based estimates of current and future forest mortality of conifers in the northern hemisphere. Consistent water potential thresholds were found that resulted in mortality of our case study species, pinon pine and one-seed juniper. Extending these results with IPCC climate scenarios suggests that most existing trees in this region (SW USA) will be dead by 2050. Further, independent estimates of future mortality for the entire coniferous biome suggest widespread mortality by 2100. The validity and assumptions and implications of these results are discussed.

  4. Pediatric trauma BIG score: Predicting mortality in polytraumatized pediatric patients

    PubMed Central

    El-Gamasy, Mohamed Abd El-Aziz; Elezz, Ahmed Abd El Basset Abo; Basuni, Ahmed Sobhy Mohamed; Elrazek, Mohamed El Sayed Ali Abd

    2016-01-01

    Background: Trauma is a worldwide health problem and the major cause of death and disability, particularly affecting the young population. It is important to remember that pediatric trauma care has made a significant improvement in the outcomes of these injured children. Aim of the Work: This study aimed at evaluation of pediatric trauma BIG score in comparison with New Injury Severity Score (NISS) and Pediatric Trauma Score (PTS) in Tanta University Emergency Hospital. Materials and Methods: The study was conducted in Tanta University Emergency Hospital to all multiple trauma pediatric patients attended to the Emergency Department for 1 year. Pediatric trauma BIG score, PTS, and NISS scores were calculated and results compared to each other and to observed mortality. Results: BIG score ≥12.7 has sensitivity 86.7% and specificity 71.4%, whereas PTS at value ≤3.5 has sensitivity 63.3% and specificity 68.6% and NISS at value ≥39.5 has sensitivity 53.3% and specificity 54.3%. There was a significant positive correlation between BIG score value and mortality rate. Conclusion: The pediatric BIG score is a reliable mortality-prediction score for children with traumatic injuries; it uses international normalization ratio (INR), Base Excess (BE), and Glasgow Coma Scale (GCS) values that can be measured within a few minutes of sampling, so it can be readily applied in the Pediatric Emergency Department, but it cannot be applied on patients with chronic diseases that affect INR, BE, or GCS. PMID:27994378

  5. Vicarious annihilation: the effect of mortality salience on perceptions of hate crimes.

    PubMed

    Lieberman, J D; Arndt, J; Personius, J; Cook, A

    2001-12-01

    Previous research has found that reminding participants of their mortality creates a need for individuals to maintain and defend subjective cultural worldviews. As a result, mortality salient participants typically strive to uphold legal sanctions and also react negatively to individuals who espouse alternative worldview beliefs, exhibiting behaviors toward those targets ranging from verbal derogation to physical aggression. This paper extends this line of research by examining perceptions of hate crimes. Hate crimes represent a unique class of crime where both the perpetrator and victim may be viewed as worldview violators. Study 1 revealed that mortality salient participants were more supportive of hate crime legislation than were control participants when hate crimes were described in abstract terms and no specific victim was mentioned. In Study 2, a specific victim who posed a potential worldview threat was identified. In this case, mortality salient participants were less punitive toward offenders who attacked these specific worldview-threatening victims.

  6. Oral cancer incidence and mortality in China, 2011

    PubMed Central

    Zhang, Shao-Kai; Zheng, Rongshou; Chen, Qiong; Zhang, Siwei

    2015-01-01

    Objective To descript the incidence and mortality rates of oral cancer among Chinese population in 2011, and provide valuable data for oral cancer prevention and research. Methods Data from 177 population-based cancer registries distributed in 28 provinces were accepted for this study after evaluation based on quality control criteria, covering a total of 175,310,169 populations and accounting for 13.01% of the overall national population in 2011. Incidence and mortality rates were calculated by area, gender and age groups. The numbers of new cases and deaths were estimated using the 5-year age-specific cancer incidence/mortality rates and the corresponding populations. The Chinese population in 2000 and World Segi’s population were used for age-standardized rates. Results The estimate of new cases diagnosed with oral cancer was 39,450 including 26,160 males and 13,290 females. The overall crude incidence rate for oral cancer was 2.93/100,000. The age-standardized rates by China (ASRCN) population and by World population (ASRwld) were 2.22/100,000 and 2.17/100,000, respectively. Among subjects aged 0-74 years, the cumulative incidence rate was 0.25%. The estimated number of oral cancer deaths of China in 2011 was 16,933, including 11,794 males and 5,139 females. The overall crude mortality rate was 1.26/100,000, accounting for 0.80% of all cancer deaths. The ASRCN and ASRwld for mortality were 0.90/100,000 and 0.89/100,000, respectively. Among subjects aged 0-74 years, the cumulative mortality rate was 0.10%. The incidence and mortality rates of oral cancer were much higher in males and urban areas than in females and rural areas. In addition, the incidence and mortality rates were increased by the raising of ages. Conclusions Results in the study may have important roles for oral cancer prevention and research. Although oral cancer burden of China is not high, we must pay attention to this malignancy as well. In addition, further researches need to be done for

  7. The unfinished health agenda: Neonatal mortality in Cambodia

    PubMed Central

    Hong, Rathmony; Ahn, Pauline Yongeun; Rathavy, Tung; Gauthier, Ludovic; Hong, Rathavuth; Laillou, Arnaud

    2017-01-01

    included: mother education level (none, primary, secondary+) and household wealth (asset-based index). Data on antenatal care, tetanus injection and skilled assistance at birth were used for the mother's last child. Between 2000 and 2014, Cambodia achieved a considerable reduction in neonatal mortality (46% reduction rate). By 2014, gender inequities became almost non-existent (for all measures of equality); inequity related to mother’s education decreased for all time periods; improvements were observed for differences in neonatal mortality by preceding birth interval; and a reduction in neonatal mortality rates could be noted among all the regional subgroups. Inequities increased between mothers who had limited antenatal care and those who received more than four antenatal care visits. In most scale indicators, the Slope Index of Inequality and Relative Index of Inequality estimates for all four rounds of the survey suggest inequity exacerbated in deprived communities. Also, wealth and residence (urban/rural divide) continued to be major determinants in neonatal mortality rates and related inequity trends. Conclusion Analysis highlighted some of the complex patterns and determinants of neonatal mortality, in Cambodia. There has been a considerable decline in neonatal mortality which echoes global trends. Our analysis reveals that despite these advances, additional socio-economic and demographic characteristics considerably affected neonatal mortality rates and its inequities. There continue to be pockets of vulnerable groups that are lagging behind. This analysis highlights the determinants along the urban-rural and rich-poor divides in neonatal mortality inequities and how these affect access to and utilization of quality basic health services. This calls for future policy and programming efforts to be deliberate in their equity approach. Quality improvements in health services and targeted interventions for specific socio-economic groups will be required to further

  8. Geographical and Temporal Variations in Female Breast Cancer Mortality in the Municipalities of Andalusia (Southern Spain)

    PubMed Central

    Ocaña-Riola, Ricardo; Montaño-Remacha, Carmen; Mayoral-Cortés, José María

    2016-01-01

    The last published figures have shown geographical variations in mortality with respect to female breast cancer in European countries. However, national health policies need a dynamic image of the geographical variations within the country. The aim of this paper was to describe the spatial distribution of age-specific mortality rates from female breast cancer in the municipalities of Andalusia (southern Spain) and to analyze its evolution over time from 1981 to 2012. An ecological study was devised. Two spatio-temporal hierarchical Bayesian models were estimated. One of these was used to estimate the age-specific mortality rate for each municipality, together with its time trends, and the other was used to estimate the age-specific rate ratio compared with Spain as a whole. The results showed that 98% of the municipalities exhibited a decreasing or a flat mortality trend for all the age groups. In 2012, the geographical variability of the age-specific mortality rates was small, especially for population groups below 65. In addition, more than 96.6% of the municipalities showed an age-specific mortality rate similar to the corresponding rate for Spain, and there were no identified significant clusters. This information will contribute towards a reflection on the past, present and future of breast cancer outcomes in Andalusia. PMID:27879690

  9. Geographical and Temporal Variations in Female Breast Cancer Mortality in the Municipalities of Andalusia (Southern Spain).

    PubMed

    Ocaña-Riola, Ricardo; Montaño-Remacha, Carmen; Mayoral-Cortés, José María

    2016-11-22

    The last published figures have shown geographical variations in mortality with respect to female breast cancer in European countries. However, national health policies need a dynamic image of the geographical variations within the country. The aim of this paper was to describe the spatial distribution of age-specific mortality rates from female breast cancer in the municipalities of Andalusia (southern Spain) and to analyze its evolution over time from 1981 to 2012. An ecological study was devised. Two spatio-temporal hierarchical Bayesian models were estimated. One of these was used to estimate the age-specific mortality rate for each municipality, together with its time trends, and the other was used to estimate the age-specific rate ratio compared with Spain as a whole. The results showed that 98% of the municipalities exhibited a decreasing or a flat mortality trend for all the age groups. In 2012, the geographical variability of the age-specific mortality rates was small, especially for population groups below 65. In addition, more than 96.6% of the municipalities showed an age-specific mortality rate similar to the corresponding rate for Spain, and there were no identified significant clusters. This information will contribute towards a reflection on the past, present and future of breast cancer outcomes in Andalusia.

  10. Mortality among atomic-bomb survivors, 1950-1990

    SciTech Connect

    Preston, D.L.; Mabuchi, Kiyohiko; Pierce, D.A.

    1997-03-01

    A comprehensive analysis of cancer mortality in the Life Span Study (LSS) cohort of atomic bomb survivors during the period from 1950 through 1990 was recently published in Radiation Research. Work is also nearing completion on an updated analysis of data on noncancer mortality in the LSS. The new LSS mortality reports, collectively called Report 12, differ from earlier LSS reports in several general aspects. The Report includes some simple tabular, and graphical summaries of the excess risks which were developed to make it easier to comprehend the magnitude and nature of the excess risks in this cohort while highlighting uncertainties in the current LSS data. In order to overcome problems inherent in the use of summary risk estimates averaged over the current follow-up, sex- and age-at-exposure-specific lifetime risks computed for the LSS cohort are used as primary summaries of the excess risks. Throughout the new report, risk estimates were derived from models that make explicit allowance for important risk-modifying factors, such as age-at-exposure, sex, or attained age. This chapter contains a brief summary of some of the findings of the cancer mortality report and provides a preview of the latest non-cancer results.

  11. Projection of mesothelioma mortality in Britain using Bayesian methods

    PubMed Central

    Tan, E; Warren, N; Darnton, A J; Hodgson, J T

    2010-01-01

    Background: Mesothelioma mortality has increased more than ten-fold over the past 40 years in Great Britain, with >1700 male deaths recorded in the British mesothelioma register in 2006. Annual mesothelioma deaths now account for >1% of all cancer deaths. A Poisson regression model based on a previous work by Hodgson et al has been fitted, which has allowed informed statistical inferences about model parameters and predictions of future mesothelioma mortality to be made. Methods: In the Poisson regression model, the mesothelioma risk of an individual depends on the average collective asbestos dose for the individual in a given year and an age-specific exposure potential. The model has been fitted to the data within a Bayesian framework using the Metropolis–Hastings algorithm, a Markov Chain Monte Carlo technique, providing credible intervals for model parameters as well as prediction intervals for the number of future cases of mortality. Results: Males were most likely to have been exposed to asbestos between the ages of 30 and 49 years, with the peak year of asbestos exposure estimated to be 1963. The estimated number of background cases was 1.08 cases per million population. Conclusion: Mortality among males is predicted to peak at approximately 2040 deaths in the year 2016, with a rapid decline thereafter. Approximately 91 000 deaths are predicted to occur from 1968 to 2050 with around 61 000 of these occurring from 2007 onwards. PMID:20628377

  12. Methodologies used to estimate tobacco-attributable mortality: a review

    PubMed Central

    Pérez-Ríos, Mónica; Montes, Agustín

    2008-01-01

    Background One of the most important measures for ascertaining the impact of tobacco on a population is the estimation of the mortality attributable to its use. To measure this, a number of indirect methods of quantification are available, yet there is no consensus as to which furnishes the best information. This study sought to provide a critical overview of the different methods of attribution of mortality due to tobacco consumption. Method A search was made in the Medline database until March 2005 in order to obtain papers that addressed the methodology employed for attributing mortality to tobacco use. Results Of the total of 7 methods obtained, the most widely used were the prevalence methods, followed by the approach proposed by Peto et al, with the remainder being used in a minority of studies. Conclusion Different methodologies are used to estimate tobacco attributable mortality, but their methodological foundations are quite similar in all. Mainly, they are based on the calculation of proportional attributable fractions. All methods show limitations of one type or another, sometimes common to all methods and sometimes specific. PMID:18211696

  13. Comments on "Cancer Mortality near Oak Ridge, Tennessee".

    PubMed

    Sharpe, C M

    1995-01-01

    A recent article by Joseph Mangano concluded that changes in cancer mortality near Oak Ridge (Anderson County) in Tennessee over a 40-year period (1950-1989) suggest an increase in cancer deaths linked to radiation contamination. These conclusions are not supported by available, representative data. In his analysis, Mangano selected for comparison two three-year periods (1950-1952 and 1987-1989) that are not representative of the entire 40 years. An analysis by decade of the 42-year period from 1950 to 1991, using U.S. mortality rates from the National Center for Health Statistics and Tennessee mortality rates from the NCHS and the Tennessee Health Department, shows that the relation between expected and actual cancer deaths for the white population of Anderson County does not differ from that for the State of Tennessee. In addition, changes in methods of reporting death statistics during the 40-year period invalidate any attempt to compare current cause-specific mortality data (such as cancer deaths) with data from the 1950s. Relevant comparisons that can be made for the period 1970-1991 again show that cancer deaths for whites in Anderson County have been statistically equivalent to the expected rates.

  14. Bacillus Calmette-Guérin vaccination and infant mortality.

    PubMed

    Roth, Adam; Garly, M L; Jensen, H; Nielsen, J; Aaby, P

    2006-04-01

    When the bacillus Calmette-Guérin (BCG) vaccine was introduced in the 1920s, it was suggested that BCG occasionally had nonspecific beneficial effects on mortality beyond the specific protection against tuberculosis. Considering that BCG has since then become the most used vaccine in the world, surprisingly few studies have been undertaken into the effect of BCG on general mortality and morbidity. Recent studies suggest that BCG has beneficial nontargeted effects on general infant morbidity and mortality in low-income countries, often with the most pronounced effect among girls. These observational findings are supported by early trials in which children were randomized or alternated to BCG vaccination. Furthermore, a BCG scar and a positive tuberculin reaction are related to better survival among BCG-vaccinated children in low-income countries, especially for girls. The findings are not explained by frailty bias, in other words, that healthy children are more likely to receive BCG vaccination. A nonspecific, gender-differential effect of BCG on general infant mortality may have large implications for tuberculosis vaccine research and routine vaccination policy.

  15. Condition dependence of male mortality drives the evolution of sex differences in longevity.

    PubMed

    Chen, Hwei-yen; Maklakov, Alexei A

    2014-10-20

    Males and females age at different rates and have different life expectancies across the animal kingdom, but what causes the longevity "gender gaps" remains one of the most fiercely debated puzzles among biologists and demographers. Classic theory predicts that the sex experiencing higher rate of extrinsic mortality evolves faster aging and reduced longevity. However, condition dependence of mortality can counter this effect by selecting against senescence in whole-organism performance. Contrary to the prevailing view but in line with an emerging new theory, we show that the evolution of sex difference in longevity depends on the factors that cause sex-specific mortality and cannot be predicted from the mortality rate alone. Experimental evolution in an obligately sexual roundworm, Caenorhabditis remanei, in which males live longer than females, reveals that sexual dimorphism in longevity erodes rapidly when the extrinsic mortality in males is increased at random. We thus experimentally demonstrate evolution of the sexual monomorphism in longevity in a sexually dimorphic organism. Strikingly, when extrinsic mortality is increased in a way that favors survival of fast-moving individuals, males evolve increased longevities, thereby widening the gender gap. Thus, sex-specific selection on whole-organism performance in males renders them less prone to the ravages of old age than females, despite higher rates of extrinsic mortality. Our results reconcile previous research with recent theoretical breakthroughs by showing that sexual dimorphism in longevity evolves rapidly and predictably as a result of the sex-specific interactions between environmental hazard and organism's condition.

  16. Cardiovascular disease mortality in the Americas.

    PubMed

    Nicholls, E S; Peruga, A; Restrepo, H E

    1993-01-01

    Despite subregional differences, mortality profiles have undergone major changes in most countries of the Americas. While the proportion of deaths caused by noncommunicable diseases, particularly cardiovascular diseases, has increased, overall age-adjusted mortality rates attributable to all cardiovascular disease are declining in 13 of the 15 countries selected for the present study. About half the countries showed decreasing mortality rates for ischaemic heart disease; the other half had increasing rates. The mortality rates for cerebrovascular disease and hypertensive disease declined in all but four countries. The ischaemic heart disease/cerebrovascular disease mortality ratio increased as a consequence of a greater decline in deaths due to cerebrovascular disease, except in two countries that exhibited a greater decline for ischaemic heart disease. With few exceptions the male-to-female mortality ratios increased for all cardiovascular disease, ischaemic heart disease and cerebrovascular disease, reflecting a greater decline in female mortality. In general there was a decline in all cardiovascular disease mortality for almost every age group in the North American, Southern Cone, English-speaking Caribbean, and Andean subregions, while there were increases in the Central American and Latin Caribbean subregions. The magnitude of the changes was related to the initial level of mortality and the date of onset of the decline. Change began earlier and the declines were largest in the countries with the highest initial mortality levels, whereas in the countries that initially had comparatively low values the mortality rates are still increasing. Insufficient information is available to permit elucidation of the determinants of the changes reported. There has been speculation about the possible role of factors such as demographic and sociocultural changes, changes in lifestyle and subsequently in the prevalence of risk factors for cardiovascular disease, and the

  17. Maternal mortality and unsafe abortion.

    PubMed

    Fawcus, Susan R

    2008-06-01

    Unsafe abortions refer to terminations of unintended pregnancies by persons lacking the necessary skills, or in an environment lacking the minimum medical standards, or both. Globally, unsafe abortions account for 67,900 maternal deaths annually (13% of total maternal mortality) and contribute to significant morbidity among women, especially in under-resourced settings. The determinants of unsafe abortion include restrictive abortion legislation, lack of female empowerment, poor social support, inadequate contraceptive services and poor health-service infrastructure. Deaths from unsafe abortion are preventable by addressing the above determinants and by the provision of safe, accessible abortion care. This includes safe medical or surgical methods for termination of pregnancy and management of incomplete abortion by skilled personnel. The service must also include provision of emergency medical or surgical care in women with severe abortion complications. Developing appropriate services at the primary level of care with a functioning referral system and the inclusion of post abortion contraceptive care with counseling are essential facets of abortion care.

  18. Long-Term Mortality Trends

    Cancer.gov

    This infographic shows the National Cancer Institute 10-year Mortality Trends. The graphs show the Average Annual Percent of Change (AAPC) 2002-2011. For Men, Liver & IBD: 2.6*, Soft Tissue inc. Heart: 0.8*, Pancreas: 0.3*, Melanoma: 0.3*, Bladder: 0, Brain & ONS: -0.4, Oral Cavity: -0.5, Esophagus: -0.5*, Kidney: -0.8*, Leukemia: -0.9*, Myeloma: -1.1*, All Sites: -1.8*, Non Hodgkin Lymphoma: -2.3*, Larynx: -2.5*, Lung and Bronchus: -2.6*, Colon and Rectum: -3.9*, Stomach: -3.1*, and Prostate: -3.3*. For Women, Liver & IBD: 1.9*, Corpus & Uterus: 1.0*, Pancreas: 0.4*, Bladder: -0.4*, Kidney: -0.9*, Brain & ONS: -0.9*, Leukemia: -1.1*, Gallbladder: -1.2*, Lung & Bronchus: -1.2*, Cervix: -1.3*, All Sites: -1.4*, Esophagus: -1.5*, Myeloma: -1.6*, Breast: -1.9*, Oral Cavity: -2.0*, Ovary: -2.0*, Stomach: -2.7*, Colon & Rectum: -2.9*, and Non-Hodgkin Lymphoma: -3.1*. * AAPC is significantly different from zero (p<.05). www.cancer.gov Source: Special section of the Annual Report to the Nation on the Status of Cancer, 1975-2011

  19. Mortality in Glasgow and Edinburgh: a paradigm of inequality in health.

    PubMed Central

    Watt, G C; Ecob, R

    1992-01-01

    STUDY OBJECTIVE--The aim was to describe, predict, and interpret mortality in Glasgow and Edinburgh. DESIGN--The study was an analysis of all cause and cause specific mortality data for quinquennia based on census years between 1931 and 1981, linking age and sex specific mortality rates by year of birth, for people dying between the ages of 25 and 74 years. SETTING--Glasgow and Edinburgh, Scotland. MAIN RESULTS--Age and sex specific mortality rates declined steadily in Edinburgh and Glasgow during the period 1931-1981, with rates always being lower in Edinburgh than in