Home About us Contact
|
Home About us Contact | ||
|
|
||
Mortality Data (mortality + data)
Selected AbstractsAn evaluation of two Rapid Access Chest Pain Clinics in central Lancashire, UKJOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 3 2007Arif Rajpura BSc MBChB MBA MPH FFPH DRCOG DFFP Abstract Aim, The aim of the project was to assess critically, using Maxwell's six dimensions, the quality of the services provided by the two Rapid Access Chest Pain Clinics (RACPCs) in Central Lancashire. Methods, Data on the actual use of the clinic was obtained from the two RACPCs. A record linkage exercise between the database of patients from the RACPC and HES/mortality data was performed. Expected use of the clinic was established from the performance of other RACPCs and from published angina incidence figures. Patient and general practitioner views were obtained by conducting questionnaire surveys. Key recommendations, (1) Clinic is providing a valuable service and should be continued. (2) A standardized database should be created which includes ethnicity and final diagnosis. (3) Alternative methods for rapid diagnosis and management of chest pain need to be provided for patients who are not suitable for the exercise electrocardiogram. (4) Referral criteria should be redrafted in order to remove the exclusion criteria for patients with chest pain of longer duration than 3 months. (5) Further resources need to be targeted at cardiology outpatients and revascularizations, as waiting times for patients with a positive test are felt to be too long. [source] Ambient temperature and risk of death from accidental drug overdose in New York City, 1990,2006ADDICTION, Issue 6 2010Amy S. B. Bohnert ABSTRACT Background Mortality increases as ambient temperature increases. Because cocaine affects core body temperature, ambient temperature may play a role in cocaine-related mortality in particular. The present study examined the association between ambient temperature and fatal overdoses over time in New York City. Methods Mortality data were obtained from the Office of the Chief Medical Examiner for 1990 to 2006, and temperature data from the National Oceanic and Atmospheric Association. We used generalized additive models to test the relationship between weekly average temperatures and counts of accidental overdose deaths in New York City, controlling for year and average length of daylight hours. Results We found a significant relation between ambient temperature and accidental overdose fatality for all models where the overdoses were due in whole or in part to cocaine (all P < 0.05), but not for non-cocaine overdoses. Risk of accidental overdose deaths increased for weeks when the average temperature was above 24°Celsius. Conclusions These results suggest a strong relation between temperature and accidental overdose mortality that is driven by cocaine-related overdoses rising at temperatures above 24°Celsius; this is a substantially lower temperature than prior estimates. To put this into perspective, approximately 7 weeks a year between 1990 and 2006 had an average weekly temperature of 24 or above in New York City. Heat-related mortality presents a considerable public health concern, and cocaine users constitute a high-risk group. [source] Acute and chronic toxicity of five selective serotonin reuptake inhibitors in Ceriodaphnia dubiaENVIRONMENTAL TOXICOLOGY & CHEMISTRY, Issue 9 2004Theodore B. Henry Abstract Contamination of surface waters by pharmaceutical chemicals has raised concern among environmental scientists because of the potential for negative effects on aquatic organisms. Of particular importance are pharmaceutical compounds that affect the nervous or endocrine systems because effects on aquatic organisms are possible at low environmental concentrations. Selective serotonin reuptake inhibitors (SSRIs) are drugs used to treat clinical depression in humans, and have been detected in low concentrations in surface waters. In this investigation, the acute and chronic toxicity of five SSRIs (fluoxetine, Prozac®; fluvoxamine, Luvox®; paroxetine, Paxil®; citalopram, Celexa®; and sertraline, Zoloft®) were evaluated in the daphnid Ceriodaphnia dubia. For each SSRI, the 48-h median lethal concentration (LC50) was determined in three static tests with neonate C. dubia, and chronic (8-d) tests were conducted to determine no-observable-effect concentrations (NOEC) and lowest-observable-effect concentrations (LOEC) for reproduction endpoints. The 48-h LC50 for the SSRIs ranged from 0.12 to 3.90 mg/L and the order of toxicity of the compounds was (lowest to highest): Citalopram, fluvoxamine, paroxetine, fluoxetine, sertraline. Mortality data for the 8-d chronic tests were similar to the 48-h acute data. The SSRIs negatively affected C. dubia reproduction by reducing the number of neonates per female, and for some SSRIs, by reducing the number of broods per female. For sertraline, the most toxic SSRI, the LOEC for the number of neonates per female was 0.045 mg/L and the NOEC was 0.009 mg/L. Results indicate that SSRIs can impact survival and reproduction of C. dubia; however, only at concentrations that are considerably higher than those expected in the environment. [source] Relationship between dental health and 10-year mortality in a cohort of community-dwelling elderly peopleEUROPEAN JOURNAL OF ORAL SCIENCES, Issue 4 2003Piia Hämäläinen Dental examinations were carried out as part of the Evergreen project, which focuses on functional capacity and health among the elderly residents of the city of Jyväskylä, central Finland. Dental status was examined in 1990 for the whole population born in 1910 (n = 226). Mortality data were collected over 10 yr. The aim of the study was to assess the possible role of dental health as a predictor of mortality. The Kaplan,Meier method was used to analyse survival curves and Cox regression models, with the number of chronic conditions and self-rated health used as covariates in analysing the risks of death. The results showed that the more teeth or filled teeth a subject had, the smaller was their risk for death. The effect of missing teeth was significant after adjusting for the general health variables. Thus, our results support the hypothesis that poor dental health is linked to increased mortality among elderly people. [source] The burden of lung disease in Hong Kong: A report from the Hong Kong Thoracic SocietyRESPIROLOGY, Issue 2008Moira CHAN-YEUNG Background and objective: The burden of lung disease in Hong Kong is not known. This study determined the mortality and hospitalization rates of respiratory diseases in Hong Kong in 2005, their trend in the past decade and their incidence/prevalence. Methods: Mortality data were obtained from the Department of Health and hospitalization data from the Hospital Authority, Hong Kong. Incidence/prevalence data were obtained from local registries or local studies. Trends of mortality and hospitalization rates of various respiratory diseases from 1997 and 2005 were calculated after age standardization and were tested for significance using negative binomial regression analysis. Age standardized mortality rates in Hong Kong were compared with those of the UK and globally. Results: Respiratory disease was the most common cause of mortality and hospitalization in Hong Kong in 2005. Globally and in the UK, cardiovascular disease ranked first in mortality. Respiratory infections ranked first in respiratory mortality, followed by respiratory tract cancer and chronic obstructive lung disease. Respiratory infections also ranked first followed by chronic obstructive lung disease in the utilization of respiratory inpatient bed-days. While mortality rates from all respiratory diseases decreased in the past decade, hospitalization rates remained unchanged. Unlike other respiratory diseases, mortality from respiratory infections have increased since 2001. Smoking is the most important risk factor in non-communicable respiratory diseases. Conclusions: Respiratory disease is responsible for the highest health-care burden locally. Increased efforts in improving management and prevention of these diseases, including tobacco control, improving air quality and vaccination against influenza and pneumococci, are necessary. [source] Urban-Rural Disparities in Injury Mortality in China, 2006THE JOURNAL OF RURAL HEALTH, Issue 1 2010Guoqing Hu PhD Abstract Context: Urban-rural disparity is an important issue for injury control in China. Details of the urban-rural disparities in fatal injuries have not been analyzed. Purpose: To target key injury causes that most contribute to the urban-rural disparity, we decomposed total urban-rural differences in 2006 injury mortality by gender, age, and cause. Methods: Mortality data came from the Chinese Vital Registration data, covering a sample of about 10% of the total population. The chi-square test was used to test the significance of urban-rural disparities. Findings: For all ages combined, the injury death rate for males was 60.1/100,000 in rural areas compared with 40.9 in urban areas; for females, the respective rates were 31.5 and 23.6/100,000. The greatest disparity was at age <1 year for both sexes, where the rate from unintentional suffocation in rural areas was more than twice the urban rate. The higher mortality from drowning among males of all ages and among females ages 1-24 and 35+ contributed substantially to the age-specific urban-rural disparities. For both sexes, transportation incidents and suicide were the most important contributors to higher rates among rural residents ages 15+. Conclusions: Unintentional suffocation, drowning, transportation incidents, and suicide not only are the major causes of injury death, but also play a key role in explaining the urban-rural disparities in fatal injuries. Further research is needed to identify factors leading to higher rural death rates and to explore economical and feasible interventions for reducing injuries and narrowing the urban-rural gap in injury mortality. [source] Long-term trends in cancer mortality in the United States, 1930,1998,CANCER, Issue S12 2003M.S., Phyllis A. Wingo Ph.D. Abstract BACKGROUND Progress against cancer can be examined by analyzing long-term trends in cancer incidence and mortality. The recent directive from the U.S. Department of Health and Human Services to adopt the 2000 U.S. standard population for the age adjustment of death rates prompted the American Cancer Society to update historical cancer mortality statistics using the new standard. METHODS Mortality data were abstracted by race, gender, year, and age at death for 1930 through 1959 from annual volumes of Vital Statistics of the United States. For 1960 through 1998, these data were obtained from data tapes provided by the National Center for Health Statistics. Two U.S. standard million populations (1970 and 2000) were used to calculate age-adjusted rates. Average annual percent change was estimated for each decade by site, gender, and age, and the statistical significance of the change was assessed at p < 0.05. RESULTS After long-term increases or mostly level trends that date from the 1930s for some sites, death rates for cancers of the lung (in males), prostate, female breast, colon-rectum, pancreas, leukemia, and ovary were decreasing in the 1990s. Liver cancer death rates were increasing in the 1990s. Throughout the study period, death rates for female lung cancer increased, while death rates for stomach and uterine cancers declined. CONCLUSIONS The trends of decreasing cancer death rates for the leading cancer sites in the 1990s are encouraging. However, surveillance researchers must continue to monitor these declines to assess whether the progress seen in this decade persists. Efforts also must be made to study the sites with increasing trends and identify potential underlying causes. Cancer 2003;97(12 Suppl):3133,3275. Published 2003 by the American Cancer Society. DOI 10.1002/cncr.11380 [source] Revisiting the value of assessing the mitotic rate of choroidal melanomaACTA OPHTHALMOLOGICA, Issue 2009SE COUPLAND Purpose To re-evaluate mitotic rate (MR) as an indicator of malignancy grade in uveal melanoma (UM) and as a predictor for UM-related mortality. Methods UM patients treated 1993-2006 by local resection or enucleation were included. Data on largest basal diameter (LBD), ciliary body involvement, extraocular extension, cell type, closed loops, MR per 40/HPF, cytogenetics were collected. Mortality data were obtained from NHS Cancer Registry. Results 918 patients (520 M; 398 F) had median age of 64.6 yrs with a median follow-up of 3.46 yrs (range 0.02-13). The UM had mean diameter of 14.9 mm with ciliary body involvement in 43.0%, epithelioid cells in 63.3%, closed loops in 41.2%, extraocular spread in 11.3%. Cytogenetics in 337 patients showed disomy 3 and 8 in 27%, monosomy 3 in 10.7%, chromosome 8 gains in 24.0%, both these abnormalities in 38.3%. The median MR was 3(range 0-61, SD 6). High MR correlated with ciliary body involvement (p = 0.001), epithelioid cells(p = 0.009), closed loops(p<0.0001), extraocular spread(p=0.027) & monosomy 3(p<0.0001;Mann-Whitney). MR also correlated with LBD(p=0.0001; t-test). Metastatic death occurred in 243 patients (26.7%). Kaplan-Meier analysis showed MR >4/40 HPF to be associated with increased 10-year metastatic mortality from 32.5 (95% confidence intervals [CI] 25.7-39.3) to 65.5 (95% CI 55-7-75.4; log rank statistic 53.28, p<0.0001). Cox multivariate analysis showed MR to be an independent predictive factor for metastatic death (p<0.0001). MR was predictive of metastatic death also in patients without detectable monosomy 3 (Log rank statistic 10.38, p = 0.002). Conclusion MR correlates with other known risk factors for metastatic death and independently predicts mortality even when cytogenetics show disomy 3. [source] Parental reported apnoea, admissions to hospital and sudden infant death syndromeACTA PAEDIATRICA, Issue 4 2001EA Mitchell Three studies were undertaken: (i) a nation-wide case-control study for sudden infant death syndrome (SIDS), with 393 cases and 1592 controls, examined the association between parental reported apnoea and SIDS; (ii) a case-cohort study, with 84 cases of parental reported apnoea and 1502 controls, aimed to identify risk factors for apnoea; and (ii) national hospital admission data for ALTE and national SIDS mortality data were compared for the years 1986 to 1994. Parental reported apnoea was associated with a significant increased risk of SIDS [adjusted odds ratio (OR) 1.86; 95% confidence interval (CI) 1.12, 3.09]. The population attributable risk was 8%. There was a significant increased risk for parental reported apnoea in infants who did not die after adjustment for potential confounders with maternal smokers, short gestation and admission to the neonatal unit. There was no association with prone sleeping position, co-sleeping and bottle feeding. The mean annual admission rate for ALTE was 9.4/1000 live births. This did not change significantly over the study period (1986,1994). In contrast, the SIDS mortality rate decreased from over 4/ 1000 to 2.1/1000. Admission rates were higher for Maori infants and boys. Conclusion: It may be concluded that the relationship between parental reported apnoea and SIDS is tenuous. [source] The changing prevalence of diagnosed diabetes and its associated vascular complications in a large region of the UK*DIABETIC MEDICINE, Issue 6 2010C. L. Morgan Diabet. Med. 27, 673,678 (2010) Abstract Aims, To characterize the prevalence of diabetes in a large health district in 2004 and compare it with a previous estimate made in 1996. Methods, The study population comprised the resident population of Cardiff and the Vale of Glamorgan. Routine record linkage was used to identify patients from various sources of hospital and mortality data. Patients with diabetes were identified according to biochemistry test results, coding on routine data or attendance at a diabetes-related clinic. Diabetes-related complications were ascribed according to coding on routine data. Results, It was possible to identify 17 088 people with diabetes alive on 1 January 2005. Of these patients, 9064 (53.0%) were male and 8024 (47.0%) were female. Mean age (± sd) was 59.6 ± 18.9 years for males and 61.2 ± 20.4 years for females. The crude prevalence of diabetes in 2005 was 3.9% (3.4% adjusted) compared with 2.5% in 1996 (2.3% adjusted). With the exception of females aged , 75 years, the prevalence of diabetes increased in all age- and sex-specific subgroups. Within the 2005 cohort, over two-thirds has no recorded complications compared with approximately one half of the 1996 cohort. The prevalence of individual complications decreased, with the exception of renal complications. Conclusions, The prevalence of identified diabetes appears to have increased substantially over a relatively short period of 9 years to 2004. The increase in prevalence was 46%, with an increase in numbers of patients with diabetes of 53%. A number of factors are likely to have contributed to this, including an increase in case ascertainment. [source] Mental health in Europe: problems, advances and challengesACTA PSYCHIATRICA SCANDINAVICA, Issue 2001W. Rutz Objective:,To describe mental health care needs and challenges across the WHO European region of 51 nations. Method:,Based on morbidity and mortality data from HFA Statistical Database and Health21, the policy framework of WHO Europe, major trends in mental health care needs, psychiatric reform and mental health promotion are discussed. Results:,There is a mortality crisis related to mental ill health in Eastern European populations of transition. Destigmatization is required to improve early intervention and humanization of services, and national mental health audits are needed to create the basis for national mental health planning, implementation and monitoring. There are both problems and advances in service restructuring, and comprehensive mental health promotion programmes, preventive and monitoring strategies are required. Conclusion:,Partnerships between national and international organizations, especially WHO and the European Union, have to be strengthened to make progress on the way to integrated community mental health services. [source] Using Design Effects From Previous Cluster Surveys to Guide Sample Size Calculation in Emergency SettingsDISASTERS, Issue 2 2006Reinhard Kaiser Abstract A good estimate of the design effect is critical for calculating the most efficient sample size for cluster surveys. We reviewed the design effects for seven nutrition and health outcomes from nine population-based cluster surveys conducted in emergency settings. Most of the design effects for outcomes in children, and one-half of the design effects for crude mortality, were below two. A reassessment of mortality data from Kosovo and Badghis, Afghanistan revealed that, given the same number of clusters, changing sample size had a relatively small impact on the precision of the estimate of mortality. We concluded that, in most surveys, assuming a design effect of 1.5 for acute malnutrition in children and two or less for crude mortality would produce a more efficient sample size. In addition, enhancing the sample size in cluster surveys without increasing the number of clusters may not result in substantial improvements in precision. [source] The definition of opioid-related deaths in Australia: implications for surveillance and policyDRUG AND ALCOHOL REVIEW, Issue 5 2005MARIANNE E. JAUNCEY Abstract The reported number of deaths caused by opioid use depends on the definition of an opioid-related death. In this study, we used Australian Bureau of Statistics (ABS) mortality data to illustrate how choice of classification codes used to record cause of death can impact on the statistics reported for national surveillance of opioid deaths. Using International Classification of Diseases version 10 (ICD-10) codes from ABS mortality data 1997,2002, we examined all deaths where opioids were reported as a contributing or underlying cause. For the 6-year period there was a total of 5839 deaths where opioids were reported. Three possible surveillance definitions of accidental opioid-related deaths were examined, and compared to the total number of deaths where opioids were reported for each year. Age restrictions, often placed on surveillance definitions, were also examined. As expected, the number of deaths was higher with the more inclusive definitions. Trends in deaths were found to be similar regardless of the definition used; however, a comparison between Australian states revealed up to a twofold difference in the absolute numbers of accidental opioid-related deaths, depending on the definition. Any interpretation of reported numbers of opioid deaths should specify any restrictions placed on the data, and describe the implications of definitions used. [source] Estimating the number of alcohol-attributable deaths: methodological issues and illustration with French data for 2006ADDICTION, Issue 6 2010Grégoire Rey ABSTRACT Aims Computing the number of alcohol-attributable deaths requires a series of hypotheses. Using French data for 2006, the potential biases are reviewed and the sensitivity of estimates to various hypotheses evaluated. Methods Self-reported alcohol consumption data were derived from large population-based surveys. The risks of occurrence of diseases associated with alcohol consumption and relative risks for all-cause mortality were obtained through literature searches. All-cause and cause-specific population alcohol-attributable fractions (PAAFs) were calculated. In order to account for potential under-reporting, the impact of adjustment on sales data was tested. The 2006 mortality data were restricted to people aged between 15 and 75 years. Results When alcohol consumption distribution was adjusted for sales data, the estimated number of alcohol-attributable deaths, the sum of the cause-specific estimates, was 20 255. Without adjustment, the estimate fell to 7158. Using an all-cause mortality approach, the adjusted number of alcohol-attributable deaths was 15 950, while the non-adjusted estimate was a negative number. Other methodological issues, such as computation based on risk estimates for all causes for ,all countries' or only ,European countries', also influenced the results, but to a lesser extent. Discussion The estimates of the number of alcohol-attributable deaths varied greatly, depending upon the hypothesis used. The most realistic and evidence-based estimate seems to be obtained by adjusting the consumption data for national alcohol sales, and by summing the cause-specific estimates. However, interpretation of the estimates must be cautious in view of their potentially large imprecision. [source] Alcohol-related cirrhosis,early abstinence is a key factor in prognosis, even in the most severe casesADDICTION, Issue 5 2009Clare Verrill ABSTRACT Aims To determine the effect of pathological severity of cirrhosis on survival in patients with alcohol-related cirrhosis. Design Liver biopsies from 100 patients were scored for Laennec score of severity of cirrhosis, and medical notes were reviewed to determine various clinical factors, including drinking status. Up-to-date mortality data were obtained using the National Health Service Strategic Tracing Service. Setting Southampton General Hospital between 1 January 1995 and 31 December 2000. Participants A total of 100 consecutive patients with biopsy proven alcohol-induced liver cirrhosis. Measurements Laennec score of severity of cirrhosis and mortality. Findings Most surprisingly, the severity of cirrhosis on biopsy had little impact on survival; indeed, early death was more likely in patients with the least severe cirrhosis. Abstinence from alcohol at 1 month after diagnosis of cirrhosis was the more important factor determining survival with a 7-year survival of 72% for the abstinent patients versus 44% for the patients continuing to drink. Conclusions It is never too late to stop drinking, even with the most severe degrees of cirrhosis on biopsy. Early drinking status is the most important factor determining long-term survival in alcohol-related cirrhosis. [source] The lethal effects of gamma irradiation on larvae of the Huhu beetle, Prionoplus reticularis: a potential quarantine treatment for New Zealand export pine treesENTOMOLOGIA EXPERIMENTALIS ET APPLICATA, Issue 3 2000Philip J. Lester Abstract Gamma irradiation was investigated as a possible method for disinfestation of huhu beetle larvae, Prionoplus reticularis White, in Pinus radiata D. Don. Larvae of four representative size classes were irradiated at six doses, and the lethal dose (LD99) calculated from mortality data 3 days and 10 days post treatment. All larval size classes showed a similar sensitivity to gamma irradiation and required 3677 Gray (Gy) and 2476 Gy for a LD99 3 and 10 days post-treatment, respectively. The penetration of gamma irradiation into pine wood was found to be lowest in freshly cut logs, and decreased linearly at a rate of 0.698 Gy mm,1 of wood. The penetration was greatest in wood that had been stored for 2 years, and decreased 0.512 Gy mm,1 of wood. These results are likely to be correlated with wood moisture content. Gamma irradiation appears to be a potential alternative method to fumigation for quarantine treatment of P. reticularis. [source] Modelling the effects of air pollution on health using Bayesian dynamic generalised linear modelsENVIRONMETRICS, Issue 8 2008Duncan Lee Abstract The relationship between short-term exposure to air pollution and mortality or morbidity has been the subject of much recent research, in which the standard method of analysis uses Poisson linear or additive models. In this paper, we use a Bayesian dynamic generalised linear model (DGLM) to estimate this relationship, which allows the standard linear or additive model to be extended in two ways: (i) the long-term trend and temporal correlation present in the health data can be modelled by an autoregressive process rather than a smooth function of calendar time; (ii) the effects of air pollution are allowed to evolve over time. The efficacy of these two extensions are investigated by applying a series of dynamic and non-dynamic models to air pollution and mortality data from Greater London. A Bayesian approach is taken throughout, and a Markov chain monte carlo simulation algorithm is presented for inference. An alternative likelihood based analysis is also presented, in order to allow a direct comparison with the only previous analysis of air pollution and health data using a DGLM. Copyright © 2008 John Wiley & Sons, Ltd. [source] Benchmark dose estimation based on epidemiologic cohort dataENVIRONMETRICS, Issue 5 2005Knashawn H. Morales Abstract Risk assessments based on epidemiologic studies are becoming increasingly common in evaluating environmental health risks and setting health standards. This article will discuss and compare some of the available methods for exposure,response modeling and risk estimation based on environmental epidemiologic studies with age-specific incidence and mortality data. Recommendations will be made regarding approaches that can be used in practice. Copyright © 2005 John Wiley & Sons, Ltd. [source] Empirical Bayes estimators and non-parametric mixture models for space and time,space disease mapping and surveillanceENVIRONMETRICS, Issue 5 2003Dankmar Böhning Abstract The analysis of the geographic variation of disease and its representation on a map is an important topic in epidemiological research and in public health in general. Identification of spatial heterogeneity of relative risk using morbidity and mortality data is required. Frequently, interest is also in the analysis of space data with respect to time, where typically data are used which are aggregated in certain time windows like 5 or 10 years. The occurrence measure of interest is usually the standardized mortality (morbidity) ratio (SMR). It is well known that disease maps in space or in space and time should not solely be based upon the crude SMR but rather some smoothed version of it. This fact has led to a tremendous amount of theoretical developments in spatial methodology, in particular in the area of hierarchical modeling in connection with fully Bayesian estimation techniques like Markov chain Monte Carlo. It seems, however, that at the same time, where these theoretical developments took place, on the practical side only very few of these developments have found their way into daily practice of epidemiological work and surveillance routines. In this article we focus on developments that avoid the pitfalls of the crude SMR and simultaneously retain a simplicity and, at least approximately, the validity of more complex models. After an illustration of the typical pitfalls of the crude SMR the article is centered around three issues: (a) the separation of spatial random variation from spatial structural variation; (b) a simple mixture model for capturing spatial heterogeneity; (c) an extension of this model for capturing temporal information. The techniques are illustrated by numerous examples. Public domain software like Dismap is mentioned that enables easy mixture modeling in the context of disease mapping. Copyright © 2003 John Wiley & Sons, Ltd. [source] Per capita alcohol consumption and liver cirrhosis mortality in 14 European countriesADDICTION, Issue 1s1 2001Mats Ramstedt Aim. To estimate the effects of changes in per capita alcohol consumption on liver cirrhosis mortality rates in various demographic groups across 14 western European countries. Method. Yearly changes in gender- and age-specific mortality rates from 1950 to 1995 were analysed in relation to corresponding yearly changes in per capita alcohol consumption, employing the Box-Jenkins technique for time series analysis. Country-specific estimates were pooled into three regions: northern, central and southern Europe. Measurements. Cirrhosis mortality data for 5-year age groups were converted into gender-specific mortality rates in the age groups 15 +, 15-44, 45-64 and 65 + and expressed as the number of deaths per 100 000 inhabitants. Alcohol sales were used to measure aggregate consumption, which were calculated into consumption (litres 100% alcohol) per year per inhabitant over 14 years of age and weighted with a 10-year distributed lag model. Findings. The country-specific analyses demonstrated a positive and statistically significant effect of changes in per capita consumption on changes in cirrhosis mortality in 13 countries for males and in nine countries for females. The strongest alcohol effect was found in northern Europe, due mainly to a large effect in Sweden. Moreover, when different age groups were analysed significant estimates were obtained in 29 of 42 cases for males and in 20 of 42 cases for females. Most of the non-significant estimates were found in older age groups. Conclusions. The results suggest clearly that a change in the overall level of drinking as a general rule affect cirrhosis mortality in different drinking cultures as well as among different demographic groups. Moreover, the findings correspond with what is expected from the collectivity theory of drinking cultures. [source] Alcohol consumption and overall accident mortality in 14 European countriesADDICTION, Issue 1s1 2001Ole-Jørgen Skog Aims. To evaluate the effects of changes in aggregate alcohol consumption on overall accident mortality in 14 western European countries after 1950, and to compare traditional beer, wine, and spirits countries with respect to the impact of alcohol. Design, setting and participants. The countries were sorted into three groups - traditional spirits countries of northern Europe, traditional beer countries of central Europe and wine countries of southern Europe. Gender- and age-specific annual mortality rates were analysed in relation to per capita alcohol consumption, utilizing the Box-Jenkins technique for time series analysis. All series were differenced to remove long-term trends. The results of the analyses in individual countries were pooled within each group of countries to increase the statistical power. Measurements. Overall accident mortality data for 5-year age groups were converted to gender and age specific mortality rates in the age groups 15-29, 30-49 and 50-69 years. Rates were age adjusted within groups. Data on per capita alcohol consumption were converted to consumption per inhabitant 15 years and older. Findings. The analyses demonstrated a statistically significant and positive relationship between changes in aggregate alcohol consumption in all three groups of countries. The estimated effect parameter was larger in northern Europe than in central Europe, and smallest in southern Europe. Conclusion. The results are compatible with the hypothesis that accident mortality rates are influenced by per capita alcohol consumption in southern, central and northern Europe. However, alcohol appears to play a larger role in northern Europe than in southern Europe. [source] An Approximation for the Rank Adjacency Statistic for Spatial Clustering with Sparse DataGEOGRAPHICAL ANALYSIS, Issue 1 2001John Paul Ekwaru The rank adjacency statistic D provides a simple method to assess regional clustering. It is defined as the weighted average absolute difference in ranks of the data, taken over all possible pairs of adjacent regions. In this paper the usual normal approximation to the D statistic is found to give inaccurate results if the data are sparse and some regions have tied ranks. Adjusted formulae for the moments of D that allow for the existence of ties are derived. An example of analyses of sparse mortality data (with many regions having no deaths, and hence tied ranks) showed satisfactory agreement between the adjusted formulae and the empirical distribution of the D statistic. We conclude that the D statistic, when used with adjusted moments, provides a valid approximate method to evaluate spatial clustering, even in sparse data situations. [source] Measuring health inequality with realization of potential life years (RePLY)HEALTH ECONOMICS, Issue S1 2009Kam Ki Tang Abstract This paper proposes a new method to measure health inequalities that are caused by conditions amenable to policy intervention. The method is built on a technique that can separate avoidable and unavoidable mortality risks, using world mortality data compiled by the World Health Organization for the year 2000. The new method is applied to data from 191 countries. It is found that controlling for unavoidable mortality risks leads to a lower estimate of health inequality than otherwise, especially for developed countries. Furthermore, although countries with a higher life expectancy at birth tend to have lower health inequality, there are significant variations in health inequalities across countries with the same life expectancy. The results therefore support the WHO's plea for using health inequality as a distinct parameter from the average level of health in assessing the performance of health systems. Copyright © 2009 John Wiley & Sons, Ltd. [source] Role of volume outcome data in assuring quality in HPB surgeryHPB, Issue 5 2007BERNARD LANGER Abstract Many studies have shown an association between both surgeon and hospital operative procedure volumes and outcomes, particularly operative mortality. It is also recognized that volume is only one of a number of factors, including 1) surgeon training and experience, and 2) hospital resources, organization, and processes of care, which can also influence outcomes. The Surgical Oncology Program at Cancer Care Ontario has included hospital volumes in a set of standards for the conduct of major pancreatic cancer surgery, along with recommendations for surgeon training and hospital resources, organization, support services, and processes of care to encourage regionalization of major HPB surgery. Cooperation with these recommendations was encouraged by the public reporting of mortality data and by an educational program directed at both surgeons and senior administrators in Ontario hospitals with the support of the provincial health ministry. The provincial mortality rate from major pancreatic cancer surgery has decreased by more than 50% since the introduction of this program. [source] Similar geographic variations of mortality and hospitalization associated with IBD and Clostridium difficile colitisINFLAMMATORY BOWEL DISEASES, Issue 3 2010Amnon Sonnenberg MD Abstract Background: Superinfection with Clostridium difficile can aggravate the symptoms of preexisting inflammatory bowel disease (IBD). The study served to assess whether the geographic variation of IBD within the United States might be influenced by C. difficile infection. Methods: Hospitalization data of the Healthcare Cost and Utilization Project (HCUP) from 2001,2006 and mortality data from 1979,2005 of the US were analyzed by individual states. Hospitalization and mortality associated with Crohn's disease (CD), ulcerative colitis (UC), and C. difficile colitis were correlated with each other, using weighted least square linear regression with the population size of individual states as weight. Results: Among the hospitalization rates, there were strong correlations between both types of IBD, as well as each type of IBD with C. difficile colitis. Similarly, among the mortality rates there were strong correlations between both types of IBD, as well as each type of IBD with C. difficile colitis. Lastly, each type of hospitalization rate was also strongly correlated with each type of mortality rate. In general, hospitalization and mortality associated with IBD tended to be frequent in many of the northern states and infrequent in the Southwest and several southern states. Conclusions: The similarity in the geographic distribution of the 3 diseases could indicate the influence of C. difficile colitis in shaping the geographic patterns of IBD. It could also indicate that shared environmental risk factors influence the occurrence of IBD, as well as C. difficile colitis. (Inflamm Bowel Dis 2010) [source] Seasonal and pandemic influenza surveillance considerations for constructing multicomponent systemsINFLUENZA AND OTHER RESPIRATORY VIRUSES, Issue 2 2009Lynnette Brammer Abstract, Surveillance for influenza is essential for the selection of influenza vaccine components and detection of human infections with novel influenza A viruses that may signal the start of a pandemic. Virologic surveillance provides the foundation from which this information can be obtained. However, morbidity and mortality data are needed to better understand the burden of disease, which, in turn, can provide useful information for policy makers relevant to the allocation of resources for prevention and control efforts. Data on the impact of influenza can be used to identify groups at increased risk for severe influenza-related complications, develop prevention and control policies, and monitor the effect of these policies. Influenza surveillance systems frequently monitor outpatient illness, hospitalizations, and deaths, but selection of influenza surveillance components should be based on the surveillance goals and objectives of the jurisdiction. [source] Prospective study of transfusion history and thyroid cancer incidence among females in JapanINTERNATIONAL JOURNAL OF CANCER, Issue 4 2004Yoshihisa Fujino Abstract A link between hepatitis C virus (HCV) infection and thyroid cancer was recently reported in a series of case-control studies in southern Italy. A prospective study could reinforce these findings. However, cohort studies that began before 1990 rarely assessed serological HCV infection. In addition, thyroid cancer is rare and generally has a good prognosis. Therefore, incidence outcome data are required, rather than mortality data, to evaluate the risk of thyroid cancer. Blood transfusion history might be a possible substitute measure to evaluate the cancer risks associated with HCV infection because blood transfusions were the major HCV transmission route in Japan until 1992. The purpose of our study was therefore to examine the association between transfusion history and thyroid cancer. A baseline survey of members of the JACC Study was conducted from 1988 until 1990, which involved 110,792 participants from 45 areas throughout Japan. Data were collected from a total of 37,983 women with no history of cancer at the baseline (337,906 person-years) and 79 cases of thyroid cancer were identified among this group. A history of blood transfusion marginally increased the risk of thyroid cancer [risk ratio (RR) = 1.77, 95% confidence interval (CI) = 0.95,3.30], and a history of transfusion and/or liver disease significantly increased the thyroid cancer risk (RR = 1.84, 95% CI = 1.07,3.16). These results indirectly support an association between HCV and thyroid cancer. In addition, our data reveal an association between blood transfusion and thyroid cancer, which might be facilitated by transfusion-associated immunomodulation. © 2004 Wiley-Liss, Inc. [source] Comparison of suicide in people aged 65,74 and 75+ by gender in England and Wales and the major Western countries 1979,1999INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 1 2005Colin Pritchard Abstract Background The factors most strongly associated with suicide are age and gender,more men than women, and, more people over 65 kill themselves. As a number of Governments have targets to reduce suicide levels we compare elderly suicide rates over a 20-year period in England and Wales. And the major Western countries focusing upon age and gender. Method WHO mortality data were used to calculate three-year average General Population Suicide Rates (GPSR) for 1979,1981 to 1997,1999 and rates of people aged 65,74 and 75+ suicide by gender to provide ratios of change and a statistical comparison of England and Wales and the Major Western countries over the period. Results Male GSPR: ,65,74' suicide ratios fell significantly in six countries and in three for the ,75+'. Female GSPR: ,65,74' suicide ratios fell in every country except Spain. Proportionately, there were more suicides in the over 65s in countries with an ,extended family' tradition, Spain, Italy, Germany, France and Japan, than in the five ,secular' countries. England and Wales male ,65,74' suicide fell significantly more than Canada, France, Germany, Italy, Japan, Spain, Netherlands and the USA, and did significantly better than the other countries for all female senior citizen suicides. Conclusion Suicide of the over-65s has improved in seven countries, especially in England and Wales, who had the greatest proportional reduction, which reflects well upon the psycho-geriatric and community services. However, in all countries, male 65,74 rates did not match the female out so extra efforts are needed to improve male rates. Copyright © 2004 John Wiley & Sons, Ltd. [source] Holocaust Survivors in Old Age: The Jerusalem Longitudinal StudyJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 3 2008Jochanan Stesssman MD OBJECTIVES: To examine the hypothesis that Holocaust exposure during young adulthood negatively affects physical aging, causing greater morbidity, faster deterioration in health parameters, and shorter survival. DESIGN: A longitudinal cohort study of the natural history of an age-homogenous representative sample born in 1920/21 and living in Jerusalem. SETTING: Community-based home assessments. PARTICIPANTS: Four hundred fifty-eight subjects of European origin aged 70 at baseline and 77 at follow-up. MEASUREMENTS: Comprehensive assessment of physical, functional, and psychosocial domains; biographical history of concentration camp internment (Camp), exposure to Nazi occupation during World War II (Exposure), or lack thereof (Controls); and 7-year mortality data from the National Death Registry. RESULTS: Holocaust survivors of the Camp (n=93) and Exposure (n=129) groups were more likely than Controls (n=236) to be male and less educated and have less social support (P=.01), less physical activity (P=.03), greater difficulty in basic activities of daily living (P=.009), poorer self-rated health (P=.04), and greater usage of psychiatric medication (P=.008). No other differences in health parameters or physical illnesses were found. Holocaust survivors had similar rates of deterioration in health and illness parameters over the follow-up period, and 7-year mortality rates were identical. Proportional hazard models showed that being an elderly Holocaust survivor was not predictive of greter 7-year mortality. CONCLUSION: Fifty years after their Holocaust trauma, survivors still displayed significant psychosocial and functional impairment, although no evidence was found to support the hypothesis that the delayed effects of the trauma of the Holocaust negatively influence physical health, health trajectories, or mortality. [source] Preliminary estimates of the population parameters of major fish species in Lake Ayamé I (Bia basin; Côte d'Ivoire)JOURNAL OF APPLIED ICHTHYOLOGY, Issue 1 2010L. Tah Summary Length frequency data collected from artisanal fisheries in Lake Ayamé I (Côte d'Ivoire) from August 2004 to 2005 were analysed with Fisat software using the Elefan package to estimate the population parameters of 11 fish species. Asymptotic values for total length (L,) ranged from 20.5 cm for Brycinus imberi to 78 cm for Mormyrops anguilloides. Growth rates (k) varied from 0.24 year,1 for Chrysichthys nigrodigitatus to 0.57 year,1 for Hemichromis fasciatus. The growth performance estimates were close to the values found by others authors and reported in FishBase 2008. Fishing mortality (F) and exploitation rate (E) were found to be below optimum levels of exploitation for most fish species. Recruitment was noted as year,round and bimodal for most studied populations. The data sets were limited in most cases, thus this study provides preliminary population parameters only, but for species for which information is scarce. For application in stock assessment, the growth parameters and especially the natural mortality data require further confirmation. [source] | ||||||||||||||||||||||||||||||||||||||||