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Premature Mortality (premature + mortality)
Selected AbstractsPREMATURE MORTALITY AND POVERTY MEASUREMENTBULLETIN OF ECONOMIC RESEARCH, Issue 4 2007Ravi Kanbur I32 ABSTRACT There is a glaring paradox in all commonly used measures of poverty. The death of a poor person, because of poverty, reduces poverty according to these measures. This surely violates our basic intuitions of how poverty measures should behave. It cannot be right in concept that differentially higher mortality among the poor serves to reduce poverty. This article begins the task of developing poverty measures that are not perversely mortality sensitive. A family of measures is proposed that is an intuitive modification of standard poverty measures to take into account the fact that the rich live longer than the poor. [source] Congenital Cardiovascular Disease in Turner SyndromeCONGENITAL HEART DISEASE, Issue 1 2008Carolyn A. Bondy MD ABSTRACT Turner syndrome (TS), or monosomy X, occurs in ,1/2000 live born females. Intelligence is normal and short stature is the most obvious and consistent feature of the syndrome. Congenital cardiovascular disease affects ,50% of individuals and is the major cause of premature mortality in adults. Unfortunately, this most important aspect of the syndrome has received little attention outside of pediatric medicine, and adult cardiological follow-up is seriously lacking. This review describes the spectrum of cardiovascular defects with particular attention to identifying risk factors for aortic dissection/rupture. X-chromosome genetic pathways implicated in Turner cardiovascular disease, including premature coronary artery disease, are discussed. Recent guidelines for diagnosis and treatment of girls and women with TS are reviewed. [source] ,Lipoproteins, glycoxidation and diabetic angiopathy'DIABETES/METABOLISM: RESEARCH AND REVIEWS, Issue 5 2004Alicia J. Jenkins Abstract The chronic vascular complications of diabetes (nephropathy, retinopathy and accelerated atherosclerosis) are a major cause of morbidity and premature mortality. In spite of the more widespread availability of intensive diabetes management, approximately one in three people with diabetes develop aggressive complications and over 70% die of atherosclerosis-related diseases. Genetic and acquired factors are likely to be contributory. Potential mediators of vascular damage may include the interrelated processes of lipoprotein abnormalities, glycation, oxidation and endothelial dysfunction. Lipoprotein abnormalities encompass alterations in lipid concentrations, lipoprotein composition and subclass distribution and lipoprotein-related enzymes. Nonenzymatic glycation and oxidative damage to lipoproteins, other proteins and to vascular structures may also be deleterious. As atherosclerosis is a chronic condition commencing in youth, and because clinical events may be silent in diabetes, surrogate measures of vascular disease are important for early identification of diabetic patients with or at high risk of vascular damage, and for monitoring efficacy of interventions. The increasing array of biochemical assays for markers and mediators of vascular damage, noninvasive measures of vascular health, and therapeutic options should enable a reduction in the excessive personal and economic burden of vascular disease in type 1 and type 2 diabetes. Copyright © 2004 John Wiley & Sons, Ltd. [source] Valuation of health states in the US study to establish disability weights: lessons from the literatureINTERNATIONAL JOURNAL OF METHODS IN PSYCHIATRIC RESEARCH, Issue 1 2010Jürgen Rehm Abstract The metric of disability-adjusted life years (DALYs) has become the global standard of measuring burden of disease. DALYs are comprised of years of life lost due to premature mortality and years of healthy life lost due to living with disability. In order to calculate the second part of the DALY equation, disease specific disability weights have to be established, i.e. measures for the decline of health associated with these disease states, which vary between zero for perfect health and one for death. Although these disability weights are key for estimating DALYs, there have not been many comprehensive studies with empirical determinations of them. This article describes a systematic review on the state of the art with respect to empirically determining disability weights. Based on this review, a multi-method approach is outlined, which has also been implemented in a US study to measure burden of disease. This approach involves the use of psychometric methodology as well as economic trade-off methods for determining the value of health states. It is conceptualized as a disaggregated approach, where the disability weight of any health state can be calculated if the attributes of this health state are known. The US study received the collaboration of experts from more than 20 institutes of the National Institutes of Health and of the Centers for Disease Control and Prevention. First results will be available by the end of this year. Copyright © 2010 John Wiley & Sons, Ltd. [source] Lifestyle factors and mortality among adults with diabetes: findings from the European Prospective Investigation into Cancer and Nutrition,Potsdam study,JOURNAL OF DIABETES, Issue 2 2010Ute NÖTHLINGS Abstract Background:, Healthy lifestyle behaviors are among the cornerstones of diabetes self-management, but the extent to which healthy lifestyle factors could potentially prevent premature mortality among people with diabetes remains unknown. The aim of the present study was to estimate the reduction in mortality that could be achieved if people with diabetes did not smoke, had a body mass index <30 kg/m2, performed physical activity for ,3.5 h/week, reported better dietary habits, and consumed alcohol moderately. Methods:, A prospective cohort study of 1263 German men and women with diabetes aged 35,65 years who were followed for an average of 7.8 years was used and multivariate Cox regression models for all-cause and cause-specific mortality were calculated. Results:, Approximately 7% of study participants had no favorable factors, 24% had one, 35% had two, and 34% had three or more. Compared with participants who had no favorable factors, the reduction in risk was 34% [95% confidence interval (CI) 19%, 63%] for those with one favorable factor, 49% (95% CI 9%, 71%) for those with two, and 63% (95% CI 31%, 80%) for those with three or more. Furthermore, a competing risk analysis did not show any difference in the inverse associations with mortality due to cardiovascular disease, cancer, or other causes. Conclusions:, Favorable lifestyle factors can potentially achieve substantial reductions in premature mortality among people with diabetes. Our results emphasize the importance of helping people with diabetes optimize their lifestyle behaviors. [source] Impact of Chronic Alcohol Ingestion on Cardiac Muscle Protein ExpressionALCOHOLISM, Issue 7 2010Rachel L. Fogle Background:, Chronic alcohol abuse contributes not only to an increased risk of health-related complications, but also to a premature mortality in adults. Myocardial dysfunction, including the development of a syndrome referred to as alcoholic cardiomyopathy, appears to be a major contributing factor. One mechanism to account for the pathogenesis of alcoholic cardiomyopathy involves alterations in protein expression secondary to an inhibition of protein synthesis. However, the full extent to which myocardial proteins are affected by chronic alcohol consumption remains unresolved. Methods:, The purpose of this study was to examine the effect of chronic alcohol consumption on the expression of cardiac proteins. Male rats were maintained for 16 weeks on a 40% ethanol-containing diet in which alcohol was provided both in drinking water and agar blocks. Control animals were pair-fed to consume the same caloric intake. Heart homogenates from control- and ethanol-fed rats were labeled with the cleavable isotope coded affinity tags (ICATŌ). Following the reaction with the ICATŌ reagent, we applied one-dimensional gel electrophoresis with in-gel trypsin digestion of proteins and subsequent MALDI-TOF-TOF mass spectrometric techniques for identification of peptides. Differences in the expression of cardiac proteins from control- and ethanol-fed rats were determined by mass spectrometry approaches. Results:, Initial proteomic analysis identified and quantified hundreds of cardiac proteins. Major decreases in the expression of specific myocardial proteins were observed. Proteins were grouped depending on their contribution to multiple activities of cardiac function and metabolism, including mitochondrial-, glycolytic-, myofibrillar-, membrane-associated, and plasma proteins. Another group contained identified proteins that could not be properly categorized under the aforementioned classification system. Conclusions:, Based on the changes in proteins, we speculate modulation of cardiac muscle protein expression represents a fundamental alteration induced by chronic alcohol consumption, consistent with changes in myocardial wall thickness measured under the same conditions. [source] Promoting Health in Older Adults: A Four-Year AnalysisJOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, Issue 1 2001Barbara Resnick PhD, FAANP PURPOSE The purpose of this study was to consider the influence of selected health promotion and disease prevention interventions in elderly residents of a continuing care retirement community (CCRC) over a four-year period by comparing actual health promotion practices of the residents. DATA SOURCES Original research using a descriptive design, face-to-face interviews of residents (N=176-200), chart reviews, and administration of a minimental state exam (MMSE) and health survey administered annually. CONCLUSIONS In each year the mean age of the residents was at least 85, the majority were female, Caucasian, and unmarried. With the exception of checking stools for occult blood, there was a statistically significant change in all health promotion behaviors over the four-year period. The most significant change was in the area of exercise behavior, which increased from 24% of the residents participating in regular exercise in year one to 61% by year four. IMPLICATIONS FOR PRACTICE The purpose of health promotion and disease prevention in older adults is to reduce the potential years of life lost in premature mortality and ensure better quality of remaining life. In addition to regularly scheduled interventions (group education, on-site administration of pneumonia and flu vaccines, on-site exercise room and walking group), individualized counseling regarding the pros and cons of health-promotion activities was provided to help residents make an educated decision about engaging in these activities. These interventions can be used to help facilitate participation in health promotion activities as appropriate and desired for each older adult. [source] Protein hydrolysates from ,-conglycinin enriched soybean genotypes inhibit lipid accumulation and inflammation in vitroMOLECULAR NUTRITION & FOOD RESEARCH (FORMERLY NAHRUNG/FOOD), Issue 8 2009Cristina Martinez-Villaluenga Abstract Obesity is a worldwide health concern and a well recognized predictor of premature mortality associated with a state of chronic inflammation. The objective was to evaluate the effect of soy protein hydrolysates (SPH) produced from different soybean genotypes by alcalase (SAH) or simulated gastrointestinal digestion (SGIH) on lipid accumulation in 3T3-L1 adipocytes. The anti-inflammatory effect of SPH produced by alcalase on LPS-induced macrophage RAW 264.7 cell line was also investigated. SAH (100 ,M) derived from soybean enriched in ,-conglycinin (BC) (up to 47% total protein) decreased lipid accumulation (33,37% inhibition) through downregulation of gene expression of lipoprotein lipase (LPL) and fatty acid synthase (FAS). SGIH (100 ,M) inhibited lipid accumulation to a lesser extent (8,14% inhibition) through inhibition of LPL gene expression. SAH (5 ,M) decreased the production of nitric oxide (NO) (18,35%) and prostaglandin E2 (PGE2) (47,71%) and the expression of inducible nitric oxide synthase (iNOS) (31,53%) and cycloxygenase-2 (COX-2) (30,52%). This is the first investigation showing that soy hydrolysates inhibit LPS-induced iNOS/NO and COX-2/PGE2 pathways in macrophages. Soybeans enriched in BCs can provide hydrolysates that limit fat accumulation in fat cells and inflammatory pathways in vitro and therefore warrant further studies as a healthful food. [source] Social inequality in premature mortality among polish urban adults during economic transitionAMERICAN JOURNAL OF HUMAN BIOLOGY, Issue 6 2007Halina Ko, odziej Rates of premature mortality among adults are important measures of the economic and psychosocial well-being of human populations. In many countries, such rates are, as a rule, inversely related to the level of attained education. We examined changes in educational group-specific mortality rates among urban adults in Poland during the country's rapid transition in the 1990s from a socialist command economy to a free market system. Two census-based analyses of individual death records of urban dwellers aged 35,64 years were compared. We utilized all records of death, which occurred during the 2-year periods 1988,89 and 2001,02. Population denominators were taken from the censuses of 1988 and 2002. The age-specific mortality rates were used to evaluate absolute differences in mortality. To assess relative differences between educational levels, mortality rate ratios (MRRs) with 95% CI (confidence interval) were calculated using Poisson regression. A regular educational gradient in mortality persisted in each 10-year age group throughout the period covered by our data. Moreover, age-specific mortality rates declined steadily in all educational groups, and this decline was most marked in the two oldest age groups (45,54 and 55,64 years). The trend was accompanied by widening of educational differences in mortality as expressed by MRRs. Systemic political transformation in Poland has brought a mixture of beneficial and detrimental effects on the well-being of society. With regard to the changes in rates of premature mortality among adults, the benefits have prevailed, although individuals with the lowest educational level benefited less than those with the highest education. Am. J. Hum. Biol., 2007. © 2007 Wiley-Liss, Inc. [source] Small area population disease burdenAUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 4 2001Richard Taylor Small area health statistics has assumed increasing importance as the focus of population and public health moves to a more individualised approach of smaller area populations. Small populations and low event occurrence produce difficulties in interpretation and require appropriate statistical methods, including for age adjustment. There are also statistical questions related to multiple comparisons. Privacy and confidentiality issues include the possibility of revealing information on individuals or health care providers by fine cross-tabulations. Interpretation of small area population differences in health status requires consideration of migrant and Indigenous composition, socio-economic status and rural-urban geography before assessment of the effects of physical environmental exposure and services and interventions. Burden of disease studies produce a single measure for morbidity and mortality-disability adjusted life year (DALY)-which is the sum of the years of life lost (YLL) from premature mortality and the years lived with disability (YLD) for particular diseases (or all conditions). Calculation of YLD requires estimates of disease incidence (and complications) and duration, and weighting by severity. These procedures often mean problematic assumptions, as does future discounting and age weighting of both YLL and YLD. Evaluation of the Victorian small area population disease burden study presents important cross-disciplinary challenges as it relies heavily on synthetic approaches of demography and economics rather than on the empirical methods of epidemiology. Both empirical and synthetic methods are used to compute small area mortality and morbidity, disease burden, and then attribution to risk factors. Readers need to examine the methodology and assumptions carefully before accepting the results. [source] Potential non-target impact of Microctonus aethiopoides Loan (Hymenoptera: Braconidae) on Cleopus japonicus Wingelmüller (Coleoptera: Curculionidae), a biocontrol agent for putative release to control the butterfly bush Buddleja davidii Franchet in New ZealandAUSTRALIAN JOURNAL OF ENTOMOLOGY, Issue 2 2005Mark R McNeill Abstract,Cleopus japonicus Wingelmüller (Coleoptera: Curculionidae) is being considered for release to control buddleia Buddleja davidii in New Zealand. As part of the pre-release testing, Moroccan and Irish biotypes of the solitary endoparasitoid Microctonus aethiopoides Loan (Hymenoptera: Braconidae) were evaluated for potential non-target impacts on adult C. japonicus should release occur. Laboratory experiments evaluated both the behavioural and physiological suitability of C. japonicus to both biotypes of the parasitoid. Parasitoid behavioural attraction was assessed using the pathenogenic bacterium Serratia marcescens (Enterobactereaceae), as an indicator of ovipositor penetration. Physiological suitability was assessed by comparing parasitism of C. japonicus with the natural hosts of the respective parasitoid biotypes. The parasitoid-bacteria study showed that C. japonicus was behaviourally acceptable to both Moroccan and Irish M. aethiopoides, with the two experiments producing 34% and 8% mortality, respectively. Cleopus japonicus did not support development of either Moroccan or Irish M. aethiopoides biotypes. None of the weevils dissected at the end of the experiment contained immature parasitoids. Comparison between unexposed and parasitoid-exposed C. japonicus found no difference in premature mortality during the experiment nor in the number of fully reproductive females at its conclusion. The results of this study predict that should C. japonicus be released, the potential impact of M. aethiopoides on field populations will be negligible. [source] Assessing the burden of injury in six European countriesCHILD: CARE, HEALTH AND DEVELOPMENT, Issue 4 2007Richard Reading Assessing the burden of injury in six European countries . PolinderS, MeerdingWJ, MulderS, PetridouE, Van BeeckE, and EUROCOST Reference Group . ( 2007 ) Bulletin of the World Health Organization , 85 , 27 , 34 . Objective To assess injury-related mortality, disability and disability-adjusted life years (DALYs) in six European countries. Methods Epidemiological data (hospital discharge registers, emergency department registers, mortality databases) were obtained for Austria, Denmark, Ireland, Netherlands, Norway and the United Kingdom (England and Wales). For each country, the burden of injury was estimated in years lost due to premature mortality (YLL), years lived with disability (YLD), and DALYs (per 1000 persons). Findings We observed marked differences in the burden of injury between countries. Austria lost the largest number of DALYs (25 per 1000 persons), followed by Denmark, Norway and Ireland (17,20 per 1000 persons). In the Netherlands and the United Kingdom, the total burden due to injuries was relatively low (12 per 1000 persons). The variation between countries was attributable to a high variation in premature mortality (YLL varied from 9 to 17 per 1000 persons) and disability (YLD varied from 2 to 8 per 1000 persons). In all countries, males aged 25,44 years represented one-third of the total injury burden, mainly due to traffic and intentional injuries. Spinal cord injury and skull,brain injury resulted in the highest burden due to permanent disability. Conclusion The burden of injury varies considerably among the six participating European countries, but males aged 15,24 years are responsible for a disproportionate share of the assessed burden of injury in all countries. Consistent injury control policy is supported by high-quality summary measures of population health. There is an urgent need for standardized data on the incidence and functional consequences of injury. [source] Fabry disease during childhood: clinical manifestations and treatment with agalsidase alfaACTA PAEDIATRICA, Issue 2008Uma Ramaswami Abstract Fabry disease is a rare X-linked disorder that leads to widespread and progressive disease manifestations, with patients at risk of premature mortality as a result of renal, cardiovascular or cerebrovascular complications. In recent years there has been a growing awareness that the first signs and symptoms of Fabry disease may begin during childhood. Studies show that clinical manifestations such as pain, hypohidrosis, gastrointestinal disturbances, angiokeratomas, cornea verticillata and acroparaesthesiae may be common in childhood and that such manifestations may become apparent during the first few years of life. Despite the early onset of these signs and symptoms, however, diagnosis is often delayed. Interest is now focused on whether enzyme replacement therapy can slow or prevent the onset of these disease manifestations. Preliminary data from two studies suggest that treatment with agalsidase alfa is well tolerated in children and that it may have beneficial clinical effects; however, further research is needed to determine whether enzyme replacement therapy can prevent the development of disease manifestations. Conclusion: The manifestations of Fabry disease first become apparent during childhood. It is well known that disease-associated manifestations are progressive; however, it has yet to be determined whether specific treatment with enzyme replacement therapy can prevent the development of the associated severe and life-threatening complications. [source] | |||||||||||||