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Life Expectancy (life + expectancy)
Kinds of Life Expectancy Selected AbstractsENDOGENOUS HEALTH CARE, LIFE EXPECTANCY AND ECONOMIC GROWTHPACIFIC ECONOMIC REVIEW, Issue 1 2010Michael C. M. Leung We study the endogenous relationship between health care, life expectancy and output in a neoclassical growth model. Although health care directly diverts resources away from goods production, it prolongs life expectancy, which in turn leads to higher savings and, hence, capital formation through a private annuity market. We show that savings and health care are complements in equilibrium, with both rising with economic development. Our model is therefore consistent with several observed stylized development patterns across countries. Moreover, through the longevity-enhancing channel, health care and health production technology are found by simulation to be growth and welfare promoting. [source] Linguistic Life Expectancies: Immigrant Language Retention in Southern CaliforniaPOPULATION AND DEVELOPMENT REVIEW, Issue 3 2006Rubén G. Rumbaut First page of article [source] Impact of late-life self-reported emotional problems on Disability-Free Life Expectancy: results from the MRC Cognitive Function and Ageing StudyINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 6 2008Karine Pérès Abstract Objectives Depression in old age is a major public health problem though its relationship to onset of disability and death is not well understood. We aim to quantify the impact of late-life self-reported depression and emotional problems on both the length and quality of remaining life. Methods Longitudinal analysis of 11,022 individuals from the MRC Cognitive Function and Ageing Study (MRC CFAS), multi-centre longitudinal study on ageing in individuals age 65 years and older living in England and Wales. Individuals have been followed at intermittent time intervals over 10 years. Subjects reporting at baseline that they had consulted about emotional problems for the first time since the age of 60 years were considered, along with a subgroup where a GP suggested depression. Disability was defined as an IADL or ADL disability that required help at least once a week. Total and Disability-Free Life Expectancy (TLE and DFLE) were calculated using multi-state models, separately by gender, and with presence of emotional problems/depression and multimorbidity as covariates. Results Emotional problems had a greater impact on DFLE than TLE, reducing DFLE by 1.8 years, but TLE by only 0.5 years at age 65 with the effect increasing with age. The effect was most marked in older people reporting other co-morbidities where emotional problems in addition resulted in a reduction of 0.9 years in total and 2.6 years disability-free. Conclusions Although emotional problems were only self-reported, these results highlight the burden of late-life depression on the quality of remaining years of life. Copyright © 2007 John Wiley & Sons, Ltd. [source] Weight, Mortality, Years of Healthy Life, and Active Life Expectancy in Older AdultsJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 1 2008Paula Diehr PhD OBJECTIVES: To determine whether weight categories predict subsequent mortality and morbidity in older adults. DESIGN: Multistate life tables, using data from the Cardiovascular Health Study, a longitudinal population-based cohort of older adults. SETTING: Data were provided by community-dwelling seniors in four U.S. counties: Forsyth County, North Carolina; Sacramento County, California; Washington County, Maryland; and Allegheny County, Pennsylvania. PARTICIPANTS: Five thousand eight hundred eighty-eight adults aged 65 and older at baseline. MEASUREMENTS: The age- and sex-specific probabilities of transition from one health state to another and from one weight category to another were estimated. From these probabilities, future life expectancy, years of healthy life, active life expectancy, and the number of years spent in each weight and health category after age 65 were estimated. RESULTS: Women who are healthy and of normal weight at age 65 have a life expectancy of 22.1 years. Of that, they spend, on average, 9.6 years as overweight or obese and 5.3 years in fair or poor health. For both men and women, being underweight at age 65 was associated with worse outcomes than being normal weight, whereas being overweight or obese was rarely associated with worse outcomes than being normal weight and was sometimes associated with significantly better outcomes. CONCLUSION: Similar to middle-aged populations, older adults are likely to be or to become overweight or obese, but higher weight is not associated with worse health in this age group. Thus, the number of older adults at a "healthy" weight may be much higher than currently believed. [source] Mortality and Life Expectancy in Dutch Residential Centres for Individuals with Intellectual Disability, 1991,1995JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES, Issue 3 2002Marian A. Maaskant Background Several studies showed that the individuals with intellectual disability have a shorter life expectancy than their intellectually average peers. To gain insight in the present life expectancy of people with intellectual disability, a study with recent data was performed. Methods We used data of the National Case Register (LRZ) with data of almost all residents of residential centres in the Netherlands for the period 1991,1995 (N = 29 290). Approximately 40% of all people with intellectual disability in the Netherlands reside in such centres. Results Results showed that 5-year-old people with intellectual disability in Dutch residential centres have a life expectancy of 41 years. The life expectancy of their peers with Down's syndrome in the centres is 46. At the age of 30 years, the respective figures are 36 and 26 years. No statistically significant differences in mortality were found between women and men and between levels of intellectual disability. Conclusions Due to prolonged longevity, the client population in residential centres will continue to age and thus the numbers of older individuals will increase. This ageing process has implications for the care for elderly individuals, because they need other care than before due to physical, psychological and social changes and spiritual challenges. [source] The Ethics of Life ExpectancyBIOETHICS, Issue 4 2002Robin Small Some ethical dilemmas in health care, such as over the use of age as a criterion of patient selection, appeal to the notion of life expectancy. However, some features of this concept have not been discussed. Here I look in turn at two aspects: one positive , our expectation of further life , and the other negative , the loss of potential life brought about by death. The most common method of determining this loss, by counting only the period of time between death and some particular age, implies that those who die at ages not far from that one are regarded as losing very little potential life, while those who die at greater ages are regarded as losing none at all. This approach has methodological advantages but ethical disadvantages, in that it fails to correspond to our strong belief that anyone who dies is losing some period of life that he or she would otherwise have had. The normative role of life expectancy expressed in the ,fair innings' attitude arises from a particular historical situation: not the increase of life expectancy in modern societies, but a related narrowing in the distribution of projected life spans. Since life expectancy is really a representation of existing patterns of mortality, which in turn are determined by many influences, including the present allocation of health resources, it should not be taken as a prediction, and still less as a statement of entitlement. [source] Osteoporosis in adults with cerebral palsyDEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 2009KEVIN J SHERIDAN MD Life expectancy for the 400 000 adults with cerebral palsy (CP) in the USA is increasing. Although there is a perception of increased fractured rate in the adult with CP, it has not been well studied. Low bone mineral density is found in more than 50% of adults with a variety of disabilities, including CP. Dual-energy X-ray absorptiometry scanning is commonly used to assess bone mineral density, but is limited by positioning and other artifacts in adults with CP. Novel scanning regions of interest, such as the distal femur, are not yet standardized in adults. Nutritional assessment and physical activity, the basis of most fracture prevention programs, are difficult to do in the adult with CP. A better understanding of the ,muscle-bone unit' physiology and its exploitation may lead to better treatment modifications. Clinical research trials with bisphosphonates (e.g. pamidronate), estrogen, selective estrogen receptor modulators, parathyroid hormone analogs, and growth hormone need to be targeted to the adult with CP. Longitudinal studies of fracture risk factors, genetic research in bone and neuromuscular biology, and the development of treatment surrogates for physical activity are additional areas of needed expertise. This could be facilitated by an adult CP registry and the centralization of clinical research efforts. [source] Life expectancy among people with cerebral palsy in Western AustraliaDEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 8 2001E Blair PhD This report describes trends, predictors, and causes of mortality in persons with cerebral palsy (CP)using individuals identified by the Western Australian Cerebral Palsy Register and born between 1958 and 1994. Two thousand and fourteen people were identified (1154 males, 860 females), of whom 225 had died by 1 June 1997. Using date-of-death data, crude and standardized mortality rates were estimated and predictors of mortality sought using survival analysis stratified by decade of birth, description of impairments, and demographic and perinatal variables. For those born after 1967, the cause of death profile was examined over time. Mortality exceeded 1% per annum in the first 5 years and declined to age 15 years after which it remained steady at about 0.35% for the next 20 years. The strongest single predictor was intellectual disability, but all forms of disability contributed to decreased life expectancy. Half of those with IQ/DQ score <20 survived to adulthood, increasing to 76% with IQ/DQ score 20,34, and exceeding 92% for higher scores. Severe motor impairment primarily increased the risk of early mortality. Despite there being 72 persons aged from 25 to 41 years with severe motor impairment in our data set, none had died after the age of 25 years. Infants born after more than 32 weeks'gestation were at significantly higher risk of mortality than very preterm infants, accounted for by their higher rates of intellectual disability. No improvements in survival of persons with CP were seen over the study period despite advances in medical care, improved community awareness, and the increasing proportion of very preterm births among people with CP. This may be the result of improved neonatal care enabling the survival of infants with increasingly severe disabilities. [source] Patient-centred and professional-directed implementation strategies for diabetes guidelines: a cluster-randomized trial-based cost-effectiveness analysisDIABETIC MEDICINE, Issue 2 2006R. F. Dijkstra Abstract Aims Economic evaluations of diabetes interventions do not usually include analyses on effects and cost of implementation strategies. This leads to optimistic cost-effectiveness estimates. This study reports empirical findings on the cost-effectiveness of two implementation strategies compared with usual hospital outpatient care. It includes both patient-related and intervention-related cost. Patients and methods In a clustered-randomized controlled trial design, 13 Dutch general hospitals were randomly assigned to a control group, a professional-directed or a patient-centred implementation programme. Professionals received feedback on baseline data, education and reminders. Patients in the patient-centred group received education and diabetes passports. A validated probabilistic Dutch diabetes model and the UKPDS risk engine are used to compute lifetime disease outcomes and cost in the three groups, including uncertainties. Results Glycated haemoglobin (HbA1c) at 1 year (the measure used to predict diabetes outcome changes over a lifetime) decreased by 0.2% in the professional-change group and by 0.3% in the patient-centred group, while it increased by 0.2% in the control group. Costs of primary implementation were < 5 Euro per head in both groups, but average lifetime costs of improved care and longer life expectancy rose by 9389 Euro and 9620 Euro, respectively. Life expectancy improved by 0.34 and 0.63 years, and quality-adjusted life years (QALY) by 0.29 and 0.59. Accordingly, the incremental cost per QALY was 32 218 Euro for professional-change care and 16 353 for patient-centred care compared with control, and 881 Euro for patient-centred vs. professional-change care. Uncertainties are presented in acceptability curves: above 65 Euro per annum the patient-directed strategy is most likely the optimum choice. Conclusion Both guideline implementation strategies in secondary care are cost-effective compared with current care, by Dutch standards, for these patients. Additional annual costs per patient using patient passports are low. This analysis supports patient involvement in diabetes in the Netherlands, and probably also in other Western European settings. [source] An economic evaluation of atenolol vs. captopril in patients with Type 2 diabetes (UKPDS 54)DIABETIC MEDICINE, Issue 6 2001A. Gray Abstract Aims To compare the net cost of a tight blood pressure control policy with an angiotensin converting enzyme inhibitor (captopril) or , blocker (atenolol) in patients with Type 2 diabetes. Design A cost-effectiveness analysis based on outcomes and resources used in a randomized controlled trial and assumptions regarding the use of these therapies in a general practice setting. Setting Twenty United Kingdom Prospective Diabetes Study Hospital-based clinics in England, Scotland and Northern Ireland. Subjects Hypertensive patients (n= 758) with Type 2 diabetes (mean age 56 years, mean blood pressure 159/94 mmHg), 400 of whom were allocated to the angiotensin converting enzyme inhibitor captopril and 358 to the , blocker atenolol. Main outcome measures Life expectancy and mean cost per patient. Results There was no statistically significant difference in life expectancy between groups. The cost per patient over the trial period was £6485 in the captopril group, compared with £5550 in the atenolol group, an average cost difference of £935 (95% confidence interval £188, £1682). This 14% reduction arose partly because of lower drug prices, and also because of significantly fewer and shorter hospitalizations in the atenolol group, and despite higher antidiabetic drug costs in the atenolol group. Conclusions Treatment of hypertensive patients with Type 2 diabetes using atenolol or captopril was equally effective. However, total costs were significantly lower in the atenolol group. Diabet. Med. 18, 438,444 (2001) [source] Life expectancy and welfare in Latin America and the CaribbeanHEALTH ECONOMICS, Issue S1 2009*Article first published online: 17 MAR 200, Rodrigo R. Soares Abstract This paper analyses the recent evolution of life expectancy in Latin American and Caribbean countries, and evaluates how much it has contributed to the overall improvements in welfare. We argue that increases in life expectancy between 1960 and 2000, which were largely independent of income, represented gains in welfare comparable to the ones derived from income growth. For countries in the region, estimates of welfare improvements accounting for health increase the numbers obtained from income alone by 40% on average. The available evidence suggests that improvements in public health infrastructure , such as provision of treated water and sewerage services , and large-scale immunization programs may have been the key factors behind the mortality reductions observed in the period. Copyright © 2009 John Wiley & Sons, Ltd. [source] The European Male Ageing Study (EMAS): design, methods and recruitmentINTERNATIONAL JOURNAL OF ANDROLOGY, Issue 1 2009David M. Lee Summary Life expectancy is increasing in most developed countries, in part due to improved socioeconomic conditions and in part to advances in healthcare. It is widely acknowledged that the promotion of healthy ageing by delaying, minimizing or preventing disabilities or diseases is one of the most important public health objectives in this century. In contrast to the menopausal transition in females, we know relatively little about the contribution of androgens and anabolic hormones to the quality of ageing in men. The European Male Ageing Study (EMAS) is a multicentre prospective cohort designed to examine the prevalence, incidence and geographical distribution of gender-specific and general symptoms of ageing in men, including their endocrine, genetic and psychosocial predictors. Men aged 40,79 years were recruited from eight European centres: Florence (Italy), Leuven (Belgium), Lodz (Poland), Malmö (Sweden), Manchester (UK), Santiago de Compostela (Spain), Szeged (Hungary) and Tartu (Estonia). Subjects were recruited from population registers and those who agreed to take part completed a detailed questionnaire including aspects of personal and medical history, lifestyle factors and sexual function. Objective measures of body size, cognition, vision, skeletal health and neuromuscular function were obtained. Blood and DNA specimens were collected for a range of biochemical and genetic analyses. After an average of 4 years, it is planned to resurvey the participants with similar assessments. A total of 3369 men with a mean age of 60 ± 11 years were recruited. The mean centre response rate was 43%, and highest in those aged 50,59 years. Those who participated were marginally younger than those who were invited but declined to participate (60.0 vs. 61.1 years). Participants left education slightly later than a sample of non-participants, though there were no consistent differences in levels of general health, physical activity, or smoking. EMAS will provide new population-based data concerning the main features that characterize ageing in men and its critical determinants, particularly with reference to age-related changes in hormone levels. Such information is an important prerequisite to develop effective strategies to reduce age-related disabilities and optimise health and well-being into old-age. [source] Estimating Hip Fracture Morbidity, Mortality and CostsJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 3 2003R. Scott Braithwaite MD OBJECTIVES: To estimate lifetime morbidity, mortality, and costs from hip fracture incorporating the effect of deficits in activities of daily living. DESIGN: Markov computer cohort simulation considering short- and long-term outcomes attributable to hip fractures. Data estimates were based on published literature, and costs were based primarily on Medicare reimbursement rates. SETTING: Postacute hospital facility. PARTICIPANTS: Eighty-year-old community dwellers with hip fractures. MEASUREMENTS: Life expectancy, nursing facility days, and costs. RESULTS: Hip fracture reduced life expectancy by 1.8 years or 25% compared with an age- and sex-matched general population. About 17% of remaining life was spent in a nursing facility. The lifetime attributable cost of hip fracture was $81,300, of which nearly half (44%) related to nursing facility expenses. The development of deficits in ADLs after hip fracture resulted in substantial morbidity, mortality, and costs. CONCLUSION: Hip fractures result in significant mortality, morbidity, and costs. The estimated lifetime cost for all hip fractures in the United States in 1997 likely exceeded $20 billion. These results emphasize the importance of current and future interventions to decrease the incidence of hip fracture. [source] Incidence-based estimates of life expectancy of the healthy for the UK: coherence between transition probabilities and aggregate life-tablesJOURNAL OF THE ROYAL STATISTICAL SOCIETY: SERIES A (STATISTICS IN SOCIETY), Issue 1 2008Ehsan Khoman Summary., Will the UK's aging population be fit and independent, or suffer from greater chronic ill health? Life expectancy of healthy people represents the expected number of years of healthy well-being that a life-table cohort would experience if age-specific rates of mortality and disability prevailed throughout the cohort's lifetime. Robust estimation of this life expectancy is thus essential for examining whether additional years of life are spent in good health and whether life expectancy is increasing faster than the decline of rates of disability. The paper examines a means of generating estimates of life expectancy for people who are healthy and unhealthy for the UK that are consistent with exogenous population mortality data. The method takes population transition matrices and adjusts these in a statistically coherent way so as to render them consistent with aggregate life-tables. [source] A retrospective survey of outpatients with long-term tracheostomyACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 4 2006G. Björling Background:, The Respiratory Unit (RU) at Danderyd University Hospital opened in 1982, with the expressed goal of supporting outpatients with long-term tracheostomy. The primary aim of this retrospective study in tracheostomized patients was to compare the need for hospital care in the 2-year period before and after the tracheostomy. Methods:, Data were collected from patient medical records at the RU, from the National Board of Health and Welfare, Sweden and from the Official Statistics of Sweden. The subjects were RU patients in 1982 (Group 1, n = 27) and in 1997 (Group 2, n = 106) with long-term tracheostomy surviving at least 4 years after the tracheostomy. Results:, Both groups had few and unchanged needs for hospital care after tracheostomy. They spent ,,96% of their time out of hospital. In 1997, (group 2) the number of patients, diagnoses and need for home mechanical ventilation had increased. Life expectancy was assessed for patients in Group 1. Data showed that they lived as long as an age-matched and gender-adjusted control cohort. Conclusions:, Long-term tracheostomy may not increase the need for hospital care and does not reduce life expectancy. These clinical observations were made in a setting where patients had regular access to a dedicated outpatient unit. [source] A Comparison of Biological Risk Factors in Two Populations: The United States and JapanPOPULATION AND DEVELOPMENT REVIEW, Issue 3 2008Eileen M. Crimmins Life expectancy is higher in Japan than in the United States. We compared the prevalence of clinically recognized risk factors in the two countries to explore the possibility that differences in these likely precursors to disease and death are linked to the paths to higher mortality for Americans. We found that American men and women have higher levels of total biological risk than the Japanese, particularly for risk factors included in the metabolic syndrome. A significant difference between the two countries is the higher prevalence of overweight among Americans. On the other hand, measured blood pressure appears more favorable among Americans. A larger proportion of Americans use prescription drugs, which results in lowered levels of measured biological risk. There are large differences in the prevalence of a number of risk factors between American and Japanese women less than age 40; this could mean that Americans develop biological risk earlier in life or that the differences are growing larger in more recent cohorts. [source] Subjective mortality expectations and consumption and saving behaviours among the elderlyCANADIAN JOURNAL OF ECONOMICS, Issue 3 2010Martin Salm Abstract Life expectancy is an important factor that individuals have to take into account for saving and consumption choices. The life-cycle model of consumption and saving behaviour predicts that consumption growth should decrease with higher mortality rates. The aim of this study is to test this hypothesis based on data about subjective longevity expectations from the Health and Retirement Study merged with detailed consumption data from two waves of the Consumption and Activities Mail Survey. This study finds that an increase in subjective mortality by 1% corresponds to an annual decrease in consumption of non-durable goods of around 1.8%. L'espérance de vie est un facteur important dont les personnes doivent tenir compte dans leurs choix de consommation et d'épargne. Le modèle de comportement de consommation et d'épargne au cours du cycle de vie prédit que la croissance de la consommation devrait décroître à mesure que le taux de mortalité augmente. Cette étude met au test cette hypothèse à l'aide de données sur l'espérance de vie subjective tirées des résultats d'une étude sur la santé et la retraite arrimés aux résultats de deux vagues d'enquêtes postales sur la consommation et les activités qui ont produit des données détaillées sur la consommation. Cette étude montre qu'un accroissement de un pour cent dans l'anticipation subjective de mortalité correspond à un déclin d'à peu près 1.8% dans la consommation annuelle de biens non durables. [source] Life expectancy of screen-detected invasive breast cancer patients compared with women invited to the Nijmegen screening programCANCER, Issue 3 2010Johannes D. M. Otten Abstract BACKGROUND: Screening can lead to earlier detection of breast cancer and thus to an improvement in survival. The authors studied the life expectancy of women with screen-detected invasive breast cancer (patients) compared with women invited to the breast cancer screening program in Nijmegen, the Netherlands (comparison group). METHODS: Each patient diagnosed between 1975 and 2006 was randomly age-matched with a woman invited in the same calendar year and free from breast cancer at the time of diagnosis of the patient. Survival analyses were performed to study differences in life expectancy. RESULTS: The life expectancy for 858 patients was 6 years shorter than for the comparison group. However, for 360 patients with small (<15 mm) invasive breast cancer, life expectancy was similar to that of the comparison group. In contrast, for patients detected with larger tumors (,15 mm) the life expectancy was 6 to 12 years shorter, depending on tumor size. Furthermore, life expectancy was modified by screening history. For patients who had a negative screening examination 2 years before the detection of their breast cancer, the difference in life expectancy from the comparison group became smaller for the larger tumor sizes (,15 mm). CONCLUSIONS: In conclusion, about 40% (360 of 858) of all women with invasive screen-detected breast cancer have the same life expectancy as women from the comparison group (reflecting the general population). For women diagnosed with larger tumors at diagnosis, life expectancy diminishes with increasing tumor size and is modified by screening history. Cancer 2010. © 2009 American Cancer Society. [source] The value of medical interventions for lung cancer in the elderly,CANCER, Issue 11 2007Results from SEER-CMHSF Abstract BACKGROUND. Lung cancer is the leading source of cancer mortality and spending. However, the value of spending on the treatment of lung cancer has not been conclusively demonstrated. The authors evaluated the value of medical care between 1983 and 1997 for nonsmall cell lung cancer in the elderly US population. METHODS. The authors used Surveillance, Epidemiology, and End Results (SEER) data to calculate life expectancy after diagnosis over the period 1983 to 1997. Direct costs for nonsmall cell lung cancer detection and treatment were determined by using Part A and Part B reimbursements from the Continuous Medicare History Sample File (CMHSF) data. The CMHSF and SEER data were linked to calculate lifetime treatment costs over the time period of interest. RESULTS. Life expectancy improved minimally, with an average increase of approximately 0.60 months. Total lifetime lung cancer spending rose by approximately $20,157 per patient in real, ie, adjusted for inflation, 2000 dollars from the early 1980s to the mid-1990s, for a cost-effectiveness ratio of $403,142 per life year (LY). The cost-effectiveness ratio was $143,614 for localized cancer, $145,861 for regional cancer, and $1,190,322 for metastatic cancer. CONCLUSIONS. The cost-effectiveness ratio for nonsmall cell lung cancer was higher than traditional thresholds used to define cost-effective care. The most favorable results were for persons diagnosed with early stage cancer. These results suggested caution when encouraging more intensive care for lung cancer patients without first considering the tradeoffs with the costs of this therapy and its potential effects on mortality and/or quality of life. Cancer 2007. © 2007 American Cancer Society. [source] Nutritional ecology and diachronic trends in Paleolithic diet and healthEVOLUTIONARY ANTHROPOLOGY, Issue 5 2003Bryan Hockett Modern nutritional studies have found that diverse diets are linked to lower infant mortality rates and longer life expectancies in humans. This is primarily because humans require more than fifty essential nutrients for growth and cell maintenance and repair; most of these essential nutrients must come from outside food sources rather than being manufactured by the body itself; and a diversity of food types is required to consume the full suite of essential nutrients necessary for optimal human health. These principles and their related affects on human adaptations and demography are the hallmarks of a theoretical paradigm defined as nutritional ecology. This essay applies concepts derived from nutritional ecology to the study of human evolution. Principles of nutritional ecology are applied to the study of the Middle-to-Upper Paleolithic transition in order to broadly illustrate the interpretive ramifications of this approach. At any stage in human evolution, those hominid populations that chose to diversify their subsistence base may have had a selective advantage over competitors who restricted their diet principally to one food type, such as terrestrial mammals. [source] There and back again: the impact of adult HIV prevalence on national life expectanciesHIV MEDICINE, Issue 2 2005AL McGuire Worldwide we have seen dramatic increases in HIV prevalence and decreases in life expectancy over the last decade. The aim of this study was to determine the association between HIV prevalence and life expectancy. A strong negative association between adult HIV prevalence and life expectancy was observed for 137 countries. Because high adult HIV prevalence poses the greatest threat to countries with limited health resources, our study supports increased efforts to provide antiretrovirals in these countries. [source] ,I send the wife to the doctor', Men's behaviour as health consumersINTERNATIONAL JOURNAL OF CONSUMER STUDIES, Issue 5 2010Joan Buckley Abstract This paper explores men's behaviour and attitudes in relation to health matters. While there has been some practical and research progress in engaging with users of health services, there is less development in the area of engaging non-users. In effect, all members of the society can be the consumers/users of health promotion, though not all are. This paper reports on the first stage of a wider project aimed at increasing the effectiveness of skin cancer awareness messages aimed at men. The project focuses on men over 50 from an area of socio-economic disadvantage, since these men tend to have the lowest life expectancies in general, and the highest incidences of mortality for skin cancer both at a national and international level. The research was conducted through community-based focus groups and while the sample was relatively, small it produced some interesting outcomes in terms of how this cohort audited and responded to public health promotion campaigns; how they perceive cancer and health issues in general; how they respond to health issues; and how they view both the public health service in Ireland and the ways health professionals relate to them. It confirms many theories about how men view their health and how they respond to health promotion campaigns. Among other points, it raises questions about the possible mixed benefits of testimonial-based advertising. It also indicates that there may be further layers of complexity connected to identity, fatalism, problem solving and respectful treatment that have not been sufficiently articulated in the literature. It points to the need for greater engagement by service planners and providers with the needs of their target audience, which may require a more encompassing definition of service user. [source] Calculating compensation for loss of future earnings: estimating and using work life expectancyJOURNAL OF THE ROYAL STATISTICAL SOCIETY: SERIES A (STATISTICS IN SOCIETY), Issue 4 2008Zoltan Butt Summary., Where personal injury results in displacement and/or continuing disability (or death), damages include an element of compensation for loss of future earnings. This is calculated with reference to the loss of future expected time in gainful employment. We estimate employment risks in the form of reductions to work life expectancies for the UK workforce by using data from the Labour Force Survey with the purpose of improving the accuracy of the calculation of future lifetime earnings. Work life expectancies and reduction factors are modelled within the framework of a multiple-state Markov process, conditional on age, sex, starting employment state, educational attainment and disability. [source] Estimating life expectancy in health and ill health by using a hidden Markov modelJOURNAL OF THE ROYAL STATISTICAL SOCIETY: SERIES C (APPLIED STATISTICS), Issue 4 2009Ardo Van Den Hout Summary., Population studies with longitudinal follow-up and mortality information can be used to estimate transitions between healthy and unhealthy states before death. When health is defined with respect to cognitive ability during old age, the trajectory of performance is either static or downwards. The paper presents a hidden Markov model to describe the underlying categorized cognitive decline, where observed improvement of cognitive ability is modelled as misclassification. Maximum likelihood is used to estimate the transition intensities between the normal cognitive state, the cognitively impaired state and death. The methodology is extended to estimate total life expectancy and life expectancy with and without cognitive impairment. The paper presents estimates from the Medical Research Council cognitive function and ageing study that began in 1991 and where individuals have had up to eight interviews over the next 10 years. It is shown that the misclassification of the states is mainly caused by not detecting an impaired state. Individuals with more years of education have lower impaired life expectancies. [source] Modelling natural conditions and impacts of consumptive water use and sedimentation of Lake Abaya and Lake Chamo, EthiopiaLAKES & RESERVOIRS: RESEARCH AND MANAGEMENT, Issue 2 2006Seleshi Bekele Awulachew Abstract There is few available information regarding the water resource systems of Abaya Lake and Chamo Lake, which are found in the Southern Rift Valley Region of Ethiopia. This paper describes modelling of the water balance components of these lakes, as well as the impacts of water uses, and sediment transport and deposition in the lakes. The various parameters and data needed for the water balance model are derived on the basis of various surveys, analysis of data and modelling efforts. The watershed characteristics are derived using geographical information system, whereas the morphometry of the lakes is investigated by undertaking bathymetry surveys. The hydrometeorological components of this lake system also were investigated through the development of relevant database and information systems, by identifying regional relationships, and by a rainfall-run-off model. These information systems have subsequently been integrated to model the water balance of the two lakes, and simulating the in-lake water levels. Several scenarios reflecting the natural conditions, water consumptive development possibilities, and sedimentation impacts have been investigated in this study. Based on the model simulation results, and on the computation of the life expectancies of the two lakes, it was found that sediment inflow and deposition significantly threaten their existence. [source] Beyond Material Explanations: Family Solidarity and Mortality, a Small Area-level AnalysisPOPULATION AND DEVELOPMENT REVIEW, Issue 1 2010Jon Anson Social solidarity, being embedded in a network of binding social relationships, tends to extend human longevity. Yet while average incomes in the Western world, and with them, life expectancies, have risen dramatically, the second demographic transition has occasioned a breakdown in traditional family forms. This article considers whether these trends in family life may have slowed the rise in life expectancy. I present a cross-sectional analysis of Israeli statistical areas (SAs), for which I construct indexes of Standard of Living (SOL), Traditional Family Structure (TFS), and Religiosity (R). I show that (1) increases in all three of these indexes are associated with lower levels of mortality, (2) male mortality is more sensitive to differences in SOL and TFS than is female mortality, and (3) net of differences in SOL and TFS, there is no difference in the mortality levels of Arab and Jewish populations. [source] A multivariate time series approach to projected life tablesAPPLIED STOCHASTIC MODELS IN BUSINESS AND INDUSTRY, Issue 6 2009Dorina Lazar Abstract The method of mortality forecasting proposed by Lee and Carter describes a time series of age-specific log-death rates as a sum of an independent of time age-specific component and a bilinear term in which one of the component is a time-varying factor reflecting general change in mortality and the second one is an age-specific parameter. Such a rigid model structure implies that on average the mortality improvements for different age groups should be proportional, regardless of the calendar period: a single time factor drives the future death rates. This paper investigates the use of multivariate time series techniques for forecasting age-specific death rates. This approach allows for relative speed of decline in the log death rates specific to the different ages. The dynamic factor analysis and the Johansen cointegration methodology are successfully applied to project mortality. The inclusion of several time factors allows the model to capture the imperfect correlations in death rates from 1 year to the next. The benchmark Lee,Carter model appears as a special case of these approaches. An empirical study is conducted with the help of the Johansen cointegration methodology. A vector-error correction model is fitted to Belgian general population death rates. A comparison is performed with the forecast of life expectancies obtained from the classical Lee,Carter model. Copyright © 2009 John Wiley & Sons, Ltd. [source] Existential function of babies: Babies as a buffer of death-related anxietyASIAN JOURNAL OF SOCIAL PSYCHOLOGY, Issue 1 2009Xinyue Zhou The present study examined babies as death anxiety buffers with Chinese participants in three experiments. In Experiment 1, death-related thoughts increased college-aged participants' interest in human babies. In Experiment 2, images of newborn animals reduced the number of death-related thoughts recorded by college-aged participants. In Experiment 3, female factory workers who read news articles describing deaths of babies had pessimistic estimations of their own life expectancies. An explanation of these results is provided within a terror management theory framework, with a primary focus on how babies reinforce cultural worldviews and enhance self-esteem via the notion of symbolic immortality. Thus, the anxiety-buffering function of baby is subsumed under cultural worldviews validation and self-esteem enhancement. [source] Catherine's legacy: social communication development for individuals with profound learning difficulties and fragile life expectanciesBRITISH JOURNAL OF SPECIAL EDUCATION, Issue 3 2005Mary Kellett In this article, Mary Kellett, of the Children's Research Centre at the Open University, draws on case study evidence to illustrate how an 11,year-old girl's quality of life was transformed in the last few months before she died when an Intensive Interaction intervention approach was adopted. The study raises issues about the way we respond to individuals with the most profound disabilities who are hardest to reach and have fragile life expectancies. It also examines the role of the researcher in situations where a participant dies; how this impacts on data processing - particularly where this involves video footage of a participant -and the complex ethics which need to be considered. Initially, the sadness of the situation and the incompleteness of the data overshadowed the findings. Due attention was not given to the contribution Catherine's data could make to our knowledge and understanding of the lived experiences of children like her and the implications this has for policy and practice. However, ,interrupted' findings from her case study point to the effectiveness of the Intensive Interaction approach in developing sociability, particularly with regard to eye contact and the ability to attend to a joint focus. This article affirms the principle that it is never too late to start an intervention; that severity of impairment should not be a barrier to this; and that the social interaction Intensive Interaction promotes can make a crucial difference to quality of life. [source] Survival of individuals with cerebral palsy receiving continuous intrathecal baclofen treatment: a matched-cohort studyDEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 7 2010LINDA E KRACH Aim, To determine whether intrathecal baclofen (ITB) changes mortality risk in persons with cerebral palsy (CP). Method, Records were reviewed for all persons with CP who were managed with ITB for hypertonicity at a specialty hospital in Minnesota between May 1993 and August 2007. A comparison cohort was randomly selected from clients of the California Department of Developmental Services who were initially evaluated between 1987 and 1990 and were matched to those with ITB for age, sex, Gross Motor Function Classification System (GMFCS) level, presence or absence of epilepsy, and feeding-tube use. Survival probabilities were estimated using the Kaplan,Meier method, and differences were tested via log-rank. Results, Three hundred and fifty-nine persons with CP (202 males, 157 females) receiving ITB for hypertonicity (mean age 12y 8mo, SD 7y 9mo, range 3y 1mo to 39y 9mo) were matched to 349 persons without ITB pumps (195 males, 154 females; mean age 12y 7mo, SD 8y 4mo, range 2y 7mo to 40y). The proportion of patients at different GMFCS levels in the ITB and in the non-ITB cohorts, respectively, was as follows: level II 3% and 3%, level III 16% and 16%, level IV 38% and 37%, and level V 43% and 44%. Survival at 8 years of follow-up was 92% (SD 1.9%) in the ITB cohort and 82% (SD 2.4%) in the non-ITB cohort (p<0.001). After adjustment to account for recent trends in improved survival in CP, 8-year survival in the non-ITB cohort was 88%, which was not significantly different from the ITB cohort (p=0.073). Interpretation, ITB therapy does not increase mortality in individuals with CP and may suggest an increase in life expectancy. [source] | ||||||||||||||||||||||||||||||||||||||||||||||