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Mortality Rate Decreased (mortality + rate_decreased)
Selected AbstractsOverdose deaths following previous non-fatal heroin overdose: Record linkage of ambulance attendance and death registry dataDRUG AND ALCOHOL REVIEW, Issue 4 2009MARK A. STOOVÉ Abstract Introduction and Aims. Experiencing previous non-fatal overdoses have been identified as a predictor of subsequent non-fatal overdoses; however, few studies have investigated the association between previous non-fatal overdose experiences and overdose mortality. We examined overdose mortality among injecting drug users who had previously been attended by an ambulance for a non-fatal heroin overdose. Design and Methods. Using a retrospective cohort design, we linked data on non-fatal heroin overdose cases obtained from ambulance attendance records in Melbourne, Australia over a 5-year period (2000,2005) with a national death register. Results. 4884 people who were attended by ambulance for a non-fatal heroin overdose were identified. One hundred and sixty-four overdose deaths occurred among this cohort, with an average overdose mortality rate of 1.20 per 100 person-years (95% CI, 1.03,1.40). Mortality rate decreased 10-fold after 2000 coinciding with widely reported declines in heroin availability. Being male, of older age (>35 years) and having been attended multiple times for previous non-fatal overdoses were associated with increased mortality risk. Discussion and Conclusions. As the first to show a direct association between non-fatal overdose and subsequent overdose mortality, this study has important implications for the prevention of overdose mortality. This study also shows the profound effect of macro-level heroin market dynamics on overdose mortality.[Stoové MA, Dietze PM, Jolley D. Overdose deaths following previous non-fatal heroin overdose: Record linkage of ambulance attendance and death registry data. Drug Alcohol Rev 2009;28:347,352] [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] Infant abuse in Osaka: Health center activities from 1988 to 1999PEDIATRICS INTERNATIONAL, Issue 2 2001Michiko Kobayashi AbstractBackground: In 1988, the first survey of child abuse in Japan was conducted in Osaka Prefecture as a joint effort between medical, health and welfare agencies. Ensuing surveys in 1988 revealed that infant abuse had a death rate of 10% in Health Center. Methods: In 1996 and 1999, surveys were performed on 130 and 215 abused children under 18 years of age. They were studied in terms of their activity of Health Center, including help, means of involvement by health visitors. Results: Fifty-five percent of children were detected via health centers. In 69% of cases, health visitors listened to parents and promptly contacted other agencies. Ninety-five percent of cases had home visits. The concerted effort of the health centers with allied disciplines in Osaka Prefecture yielded the following changes: the mortality rate decreased from 9.8% in 1988 to 2.3% in 1996, and institutionalized cases tripled from 13.7% in 1988 to 39.5% in 1999. The rate of admission to day care centers increased from 22.4% in 1988 to 58.7% in 1999. Along with the constant support of health visitors, day care centers provided secure support and protection for parents and infants. Conclusions: Effective prevention and treatment become possible only when treatment of the child's physical and psychological health, mental care for parents and tangible support for childrearing and daily life were undertaken in a concerted way. To this end, a systematic commitment of all child agencies, child guidance centers, as well as medical, health educational, welfare and other allied disciplines is required. [source] The health of Arctic populations: Does cold matter?AMERICAN JOURNAL OF HUMAN BIOLOGY, Issue 1 2010T. Kue Young The objective of the study was to examine whether cold climate is associated with poorer health in diverse Arctic populations. With climate change increasingly affecting the Arctic, the association between climate and population health status is of public health significance. The mean January and July temperatures were determined for 27 Arctic regions based on weather station data for the period 1961,1990 and their association with a variety of health outcomes assessed by correlation and multiple linear regression analyses. Mean January temperature was inversely associated with infant and perinatal mortality rate, age-standardized mortality rate from respiratory diseases, and age-specific fertility rate for teens and directly associated with life expectancy at birth in both males and females, independent of a variety of socioeconomic, demographic, and health care factors. Mean July temperature was also associated with infant mortality and mortality from respiratory diseases, and with total fertility rate. For every 10°C increase in mean January temperature, the life expectancy at birth among males increased by about 6 years and infant mortality rate decreased by about 4 deaths/1,000 livebirths. Cold climate is significantly associated with higher mortality and fertility in Arctic populations and should be recognized in public health planning. Am. J. Hum. Biol., 2010. © 2009 Wiley-Liss, Inc. [source] Decrease in risk of lung cancer death in Japanese men after smoking cessation by age at quitting: Pooled analysis of three large-scale cohort studiesCANCER SCIENCE, Issue 4 2007Kenji Wakai To evaluate the impact of smoking cessation on individuals and populations, we examined the decrease in risk of lung cancer death in male ex-smokers by age at quitting by pooling the data from three large-scale cohort studies in Japan. For simplicity, subjects were limited to male never smokers and former or current smokers who started smoking at ages 18,22 years, and 110 002 men aged 40,79 years at baseline were included. During the mean follow-up of 8.5 years, 968 men died from lung cancer. The mortality rate ratio compared to current smokers decreased with increasing attained age in men who stopped smoking before age 70 years. Among men who quit in their fifties, the cohort-adjusted mortality rate ratios (95% confidence interval) were 0.57 (0.40,0.82), 0.44 (0.29,0.66) and 0.36 (0.13,1.00) at attained ages 60,69, 70,79 and 80,89 years, respectively. The corresponding figures for those who quit in their sixties were 0.81 (0.44,1.48), 0.60 (0.43,0.82) and 0.43 (0.21,0.86). Overall, the mortality rate ratio for current smokers, relative to non-smokers, was 4.71 (95% confidence interval 3.76,5.89) and those for ex-smokers who had quit smoking 0,4, 5,9, 10,14, 15,19, 20,24 and ,25 years before were 3.99 (2.97,5.35), 2.55 (1.80,3.62), 1.87 (1.23,2.85), 1.21 (0.66,2.22), 0.76 (0.33,1.75) and 0.67 (0.34,1.32), respectively. Although earlier cessation of smoking generally resulted in a lower rate of lung cancer mortality in each group of attained age, the absolute mortality rate decreased appreciably after stopping smoking even in men who quit at ages 60,69 years. (Cancer Sci 2007; 98: 584,589) [source] Tropical forest tree mortality, recruitment and turnover rates: calculation, interpretation and comparison when census intervals varyJOURNAL OF ECOLOGY, Issue 6 2004SIMON L. LEWIS Summary 1Mathematical proofs show that rate estimates, for example of mortality and recruitment, will decrease with increasing census interval when obtained from censuses of non-homogeneous populations. This census interval effect could be confounding or perhaps even driving conclusions from comparative studies involving such rate estimates. 2We quantify this artefact for tropical forest trees, develop correction methods and re-assess some previously published conclusions about forest dynamics. 3Mortality rates of > 50 species at each of seven sites in Africa, Latin America, Asia and Australia were used as subpopulations to simulate stand-level mortality rates in a heterogeneous population when census intervals varied: all sites showed decreasing stand mortality rates with increasing census interval length. 4Stand-level mortality rates from 14 multicensus long-term forest plots from Africa, Latin America, Asia and Australia also showed that, on average, mortality rates decreased with increasing census interval length. 5Mortality, recruitment or turnover rates with differing census interval lengths can be compared using the mean rate of decline from the 14 long-term plots to standardize estimates to a common census length using ,corr = , × t0.08, where , is the rate and t is time between censuses in years. This simple general correction should reduce the bias associated with census interval variation, where it is unavoidable. 6Re-analysis of published results shows that the pan-tropical increase in stem turnover rates over the late 20th century cannot be attributed to combining data with differing census intervals. In addition, after correction, Old World tropical forests do not have significantly lower turnover rates than New World sites, as previously reported. Our pan-tropical best estimate adjusted stem turnover rate is 1.81 ± 0.16% a,1 (mean ± 95% CI, n = 65). 7As differing census intervals affect comparisons of mortality, recruitment and turnover rates, and can lead to erroneous conclusions, standardized field methods, the calculation of local correction factors at sites where adequate data are available, or the use of our general standardizing formula to take account of sample intervals, are to be recommended. [source] Improved operative and survival outcomes of surgical treatment for hilar cholangiocarcinomaBRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 12 2006C. L. Liu Background: The aim of the present study was to assess whether an aggressive surgical approach in the management of patients with hilar cholangiocarcinoma was associated with improved operative and survival outcomes. Methods: Eighty-two patients with hilar cholangiocarcinoma treated between 1989 and 1998 (period 1), and 60 patients treated between 1999 and 2004 (period 2), were evaluated. Modifications to management in period 2 primarily included percutaneous biliary drainage instead of endoscopic drainage for relief of obstructive jaundice, preoperative right portal vein embolization before right-sided hepatectomy, routine total caudate lobectomy and radical lymphadenectomy during surgical resection of the tumour. Results: The surgical resection rate was significantly higher in period 2 than in period 1 (45 versus 16 per cent; P < 0·001). All patients in period 2 underwent major hepatectomy with concomitant caudate lobectomy. The operative morbidity and hospital mortality rates decreased significantly in period 2 compared with period 1, with significantly better survival outcomes. In multivariate analysis, resection of the tumour in period 2 and operative blood loss of 1·5 litres or less were the significant independent factors associated with improved survival. Conclusion: An aggressive surgical approach was associated with improved operative and survival outcomes for patients with hilar cholangiocarcinoma. Copyright © 2006 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. [source] | |||||||||||||