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Vafaee-Shahi, Mohammad, Elaheh Soltanieh, Hossein Saidi, and Aina Riahi. "Etiology, Risk Factors, Mortality and Morbidity of Status Epilepticus in Children: A Retrospective Cross-Sectional Study in Tehran, Iran." Open Neurology Journal 14, no. 1 (December 15, 2020): 95–102. http://dx.doi.org/10.2174/1874205x02014010095.
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Background: Risk factors identification associated with status epilepticus is valuable in order to prevent morbidity and mortality in children. This study aimed to consider the etiology, risk factors, morbidity and mortality in children with status epilepticus. Methods: This retrospective cross-sectional study was performed on 119 patients aged from one month old to 15 years old. Patients’ data were recorded, including basic demographic, etiology and clinical information. The different risk factors correlated to morbidity and mortality were evaluated in this study. Results: The most common etiologies were acute symptomatic and febrile status epilepticus by 32.8% and 22.7%, respectively. Abnormal brain imaging results were reported far more frequently in patients with a history of neurodevelopmental delay and previous status epilepticus (p<0.001). The overall morbidity and mortality rates were 18.9% and 10.9%, respectively; while these rates in patients with delayed development (45.16% and 18.42%, respectively) were significantly higher than patients with normal development (8% and 7.4%, respectively). The morbidity rates in patients with previous seizures and previous status epilepticus were remarkably higher than those without previous history of seizure (26.41% vs 11.32%; p=0.047) and without previous status epilepticus (36.36% versus 14.28%; p=0.018). The length of hospital stay in patients with mortality was considerably longer than patients without mortality (12.30 ± 16.1 days vs 7.29 ± 6.24 days; p=0.033). The mortality rate in patients with normal Lumbar Puncture result was notably lower than those with abnormal LP result (2.9% vs 50%). The morbidity rate in patients with abnormal brain imaging results (p<0.001) was significantly greater than those in patients with normal results. The mortality rate was relatively higher in patients with abnormal imaging results compared to those normal results. Etiology was an important predictor of mortality and morbidity rates; acute symptomatic (32.8%), febrile status epilepticus (22.7%) and remote symptomatic (16.8%) etiologies were the most common underlying causes of S.E. While in children less than 3 years old, the acute symptomatic etiology and febrile status epilepticus etiologies were estimated as the most common, in most patients older than 3 years old the most common etiology of status epilepticus was unknown. Congenital brain defects etiology had the highest mortality (36.36%) and morbidity (42.85%) rate. The lowest morbidity (3.84%) and mortality (0%) rates were for patients with febrile status epilepticus etiology. Conclusion: Age, developmental delay, history of previous status epilepticus, the length of hospital stay, abnormal brain imaging results and the underlying etiology of status epilepticus were associated with increased morbidity and mortality among children with status epilepticus.
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Crimmins, Eileen M., Mark D. Hayward, and Yasuhiko Saito. "Changing Mortality and Morbidity Rates and the Health Status and Life Expectancy of the Older Population." Demography 31, no. 1 (February 1994): 159. http://dx.doi.org/10.2307/2061913.
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Wilkinson, Tim J., and Richard Sainsbury. "The Association between Mortality, Morbidity and Age in New Zealand's Oldest Old." International Journal of Aging and Human Development 46, no. 4 (January 1, 1998): 333–43. http://dx.doi.org/10.2190/9te4-jcb5-4c8t-pfk9.
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People aged eighty-five years and over (the oldest old) will form an increasing proportion of the population of New Zealand and many other countries. Because of their smaller numbers and relative inaccessibility, their health status has sometimes been extrapolated from populations of people aged sixty-five to eighty-four years. For people aged sixty-five to eighty-four years an exponential relationship is seen between age and morbidity and mortality. We explore if this exponential relationship extends to people aged ninety years and over. We analyzed data from the New Zealand 1991 Census and 1992 hospital discharge records and, for people aged sixty to eighty-nine years, confirmed an exponential relationship between age and mortality, inactivity, hospital utilization, and occupation of residential institutions. This exponential trend did not continue for people aged ninety years and over for whom mortality rates and indicators of morbidity were considerably lower than expected, and conclude that the actual health status of people aged ninety years and over is better than the status extrapolated from that of people aged sixty to eighty-nine years.
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Sinimole, K. R. "Emerging Patterns of Morbidity and Hospitalization— A Comparison of Kerala and Bihar." Illness, Crisis & Loss 28, no. 4 (November 28, 2017): 321–46. http://dx.doi.org/10.1177/1054137317744249.
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Health status of the population is one of the significant indicators of social and economic well-being. Government of India has tried to ensure the highest possible health status of India’s population and access to quality health care through a number of policy documents. Improved overall health status and socioeconomic pressures have resulted in changes in the demographic profile. The type of health-care service requirement has changed due to the rise of lifestyle-related diseases and communicable diseases. It is also crucially relevant that maternal and infant mortality continue to remain unacceptably high in several parts of the country. States like Kerala have performed well and “Kerala Model Health System” is often viewed as a rare combination of higher order human development and not so noticeable pattern of consistent exponential economic growth. However, the well-known “Kerala Model Health System” has been facing a crisis due to the demographic transition in Kerala and it is reflected in its patterns of morbidity and hospitalization. Bihar, on the other hand, has low longevity and performs poor in terms of medical and educational facilities, and it has the lowest rates of reported morbidity. At this context, this article tries to assess the socioeconomic determinants of morbidity and hospitalization in the states of Kerala and Bihar.
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Rebhun, Uzi. "Inter-country variations in COVID-19 incidence from a social science perspective." Migration Letters 18, no. 4 (July 20, 2021): 413–23. http://dx.doi.org/10.33182/ml.v18i4.1254.
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COVID-19 has spread unevenly among countries. Beyond its pathogenicity and its contagious nature, it is of the utmost importance to explore the epidemiological determinants of its health outcomes. I focus on the thirty-six OECD member states and examine country-level characteristics of the timing of the coronavirus outbreak and its morbidity and case-fatality rates. I harvested data on dependent variables from daily WHO reports and information on the independent variables from official publications of major world organizations. I clustered the latter information under three rubrics—socio-demographic, risk behaviours, and economic and public health—and subjected the totality of the data to OLS regressions. Independent variables successfully explain much of the overall variance among OECD countries in morbidity (R2=50.0%) and mortality (R2=41.5%). Immigration stock enhanced the outbreak of the pandemic in host countries; it did not, however, had a significant effect neither on morbidity nor on mortality rates. Country economic status and healthcare services are significant in moderating the health outcomes of coronavirus infection. Nevertheless, the paramount determinants for restraining contagion and mortality are governmental measures. I speculate that this may reshape the equilibrium between push and pull factors hence, the international migration system in near future.
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Schnelldorfer, Thomas, and David B. Adams. "Should Elective Surgery for Chronic Pancreatitis be Performed in High-Risk Patients?" American Surgeon 72, no. 7 (July 2006): 592–98. http://dx.doi.org/10.1177/000313480607200705.
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As morbidity and mortality rates for pancreatic surgery have improved over the past decades, patients with major medical comorbidities have been considered for operative treatment. The influence of poor health status on operative morbidity in patients with chronic pancreatitis is evaluated in this study. The records of 313 consecutive patients who underwent pancreaticoduodenectomy (n = 78), distal pancreatectomy (n = 83), or lateral pancreaticojejunostomy (n = 152) for chronic pancreatitis were retrospectively reviewed and analyzed. Patients’ risk for adverse outcome resulting from overall health status was audited using age, comorbidities, and Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity (POSSUM) physiological score. Univariate analysis showed that patient's age did not contribute to change in morbidity (odds ratio [OR] = 1.01, P = 0.59). The presence of cardiac disease but not other comorbidities increased adverse outcome affected the need for intensive care unit stay and length of hospital stay (morbidity: 29% vs. 51%, OR = 2.6, P = 0.003). POSSUM physiological score was associated with an increase in morbidity and mortality (morbidity: OR = 1.16, P = 0.001; mortality: OR = 1.49, P = 0.001), in particular intraabdominal abscesses. Multivariate analysis showed that the only variable independently correlating with perioperative complications was POSSUM physiological score. Single comorbidities do not independently influence outcome after operations for chronic pancreatitis. A combination of several comorbidities is associated with an increase in postoperative infectious morbidity and mortality. High-risk patients should not be excluded from operative treatment, but need to be closely selected on a case-by-case basis.
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Burke, Rachel, Ralph Whitehead, Janet Figueroa, Denis Whelan, Anna Aceituno, Paulina Rebolledo, Rita Revollo, Juan Leon, and Parminder Suchdev. "Effects of Inflammation on Biomarkers of Vitamin A Status among a Cohort of Bolivian Infants." Nutrients 10, no. 9 (September 5, 2018): 1240. http://dx.doi.org/10.3390/nu10091240.
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Globally, vitamin A deficiency (VAD) affects nearly 200 million children with negative health consequences. VAD can be measured by a retinol-binding protein (RBP) and serum retinol concentrations. Their concentrations are not always present in a 1:1 molar ratio and are affected by inflammation. This study sought to quantify VAD and its impact on infant mortality and infectious morbidity during the first 18 months of life in a cohort of mother-infant dyads in El Alto, Bolivia, while accounting for the previously mentioned measurement issues. Healthy mother-infant dyads (n = 461) were enrolled from two hospitals and followed for 12 to 18 months. Three serum samples were collected (at one to two, six to eight, and 12 to 18 months of infant age) and analyzed for RBP, and a random 10% subsample was analyzed for retinol. Linear regression of RBP on retinol was used to generate RBP cut-offs equivalent to retinol <0.7 µmol/L. All measures of RBP and retinol were adjusted for inflammation, which was measured by a C-reactive protein and alpha (1)-acid glycoprotein serum concentrations using linear regression. Infant mortality and morbidity rates were calculated and compared by early VAD status at two months of age. Retinol and RBP were weakly affected by inflammation. This association varied with infant age. Estimated VAD (RBP < 0.7 µmol/L) decreased from 71.0% to 14.8% to 7.7% at two, six to eight, and 12 to 18 months of age. VAD was almost nonexistent in mothers. Early VAD was not significantly associated with infant mortality or morbidity rates. This study confirmed a relationship between inflammation and vitamin A biomarkers for some subsets of the population and suggested that the vitamin A status in early infancy improves with age and may not have significantly affected morbidity in this population of healthy infants.
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Ransom, Montrece McNeill, Amelia Greiner, Chris Kochtitzky, and Kristin S. Major. "Pursuing Health Equity: Zoning Codes and Public Health." Journal of Law, Medicine & Ethics 39, S1 (2011): 94–97. http://dx.doi.org/10.1111/j.1748-720x.2011.00576.x.
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Health equity can be defined as the absence of disadvantage to individuals and communities in health outcomes, access to health care, and quality of health care regardless of one’s race, gender, nationality, age, ethnicity, religion, and socioeconomic status. Health equity concerns those disparities in public health that can be traced to unequal, systemic economic, and social conditions. Despite significant improvements in the health of the overall population, health inequities in America persist. Racial and ethnic minorities continue to experience higher rates of morbidity and mortality than non-minorities across a range of health issues. For example, African-American children with asthma have a seven times greater mortality rate than Non-Hispanic white children with the illness. While cancer is the second leading cause of death among all populations in the U.S., ethnic minorities are especially burdened with the disease.
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Bradbury, R. C., J. H. Golec, and P. M. Steen. "Linking Health Outcomes and Resource Efficiency for Hospitalized Patients: Do Physicians with Low Mortality and Morbidity Rates Also Have Low Resource Expenditures?" Health Services Management Research 13, no. 1 (February 2000): 57–68. http://dx.doi.org/10.1177/095148480001300106.
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This study addresses the question of whether physicians with better health outcomes for their patients spend more or less to accomplish these results. Several studies have examined this outcome–cost relationship at the hospital level, but the results are conflicting. The study sample (using an administrative database [1995 MQPro Comparative Database, MediQual Systems, Inc., Westborough, MA, USA]) comprised 175 249 adult medical service admissions to 100 hospitals in 25 states spanning 26 diagnosis-related groups (DRGs) during 1993 and 1994. Logistic regression models were used to estimate the expected probability of in-hospital mortality or morbidity; age, sex, severity of illness on admission, year of admission, insurance status and hospital were controlled for. The regression residuals were employed as quality indicators. Residual charges and length of stay (LOS) were estimated for each patient using an ordinary least squares regression model and were employed as resource efficiency indicators. A positive, statistically significant association at the physician level was found between mean morbidity residuals and each of the three mean resource efficiency residuals (LOS, 1.42 beta coefficient; ancillary charges, 1.78; and total charges, 1.27, all significant at the P < 0.001 level). The same positive and significant association was found between mortality residuals and each resource efficiency residual (LOS, 0.77 beta coefficient; ancillary charges, 0.80; and total charges, 0.68, all significant at the P < 0.01 level) when patients staying only one or two days were excluded. The results support our hypothesis that, on average, physicians with lower adjusted mortality or morbidity rates also have lower adjusted resource expenditures.
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Lauret, Gert-Jan, Daniëlle C. W. van Dalen, Edith M. Willigendael, Erik J. M. Hendriks, Rob A. de Bie, Sandra Spronk, and Joep A. W. Teijink. "Supervised exercise therapy for intermittent claudication: current status and future perspectives." Vascular 20, no. 1 (February 2012): 12–19. http://dx.doi.org/10.1258/vasc.2011.ra0052.
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Intermittent claudication (IC) has a high prevalence in the older population and is closely associated with cardiovascular and cerebrovascular disease. High mortality rates are reported due to ongoing atherosclerotic disease. Because of these serious health risks, treatment of IC should address reduction of cardiovascular events (and related morbidity/mortality) and improvement of the poor health-related quality of life (QoL) and functional capacity. In several randomized clinical trials and systematic reviews, supervised exercise therapy (SET) is compared with non-supervised exercise, usual care, placebo, walking advice or vascular interventions. The current evidence supports SET as the primary treatment for IC. SET improves maximum walking distance and health-related QoL with a marginal risk of co-morbidity or mortality. This is also illustrated in contemporary international guidelines. Community-based SET appears to be at least as efficacious as programs provided in a clinical setting. In the Netherlands, a national integrated care network (ClaudicatioNet) providing specialized care for patients with IC is currently being implemented. Besides providing a standardized form of SET, the specialized physical therapists stimulate medication compliance and perform lifestyle coaching. Future research should focus on the influence of co-morbidities on prognosis and effect of SET outcome and the potential beneficial effects of SET combined with a vascular intervention.
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Jovanovic, Jovica, and Milan Jovanovic. "Frequency of occupational injuries and the health status of workers." Medical review 57, no. 11-12 (2004): 536–40. http://dx.doi.org/10.2298/mpns0412536j.
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Introduction Occupational injuries are the leading cause of morbidity and mortality among workers. The aim of this study was to analyze the frequency of occupational injuries and health status of workers. Material and methods The examined group consisted of 3.750 workers with health disorders. The control group included 1.800 healthy workers. Both groups were similar in terms of many factors that could contribute to the occurrence of occupational injuries. The injury rates were calculated in both groups. Results Workers with psychomotor and sensorimotor disorders, neuroses, obstructive sleep apnea, arterial hypertension, diabetes mellitus, hearing, vascular and sight impairments have been frequently injured compared to workers with other diseases. Discussion Due to the belief that accidents and occupational injuries are preventable, it is an imperative to study those factors which are likely to contribute to occurrence of accidents. The contributing factors could be the physical and mental state of workers. Conclusion Occupational injuries are significantly more common in the examined group than in controls.
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Darmon, Nicole, and Myriam Khlat. "An overview of the health status of migrants in France, in relation to their dietary practices." Public Health Nutrition 4, no. 2 (April 2001): 163–72. http://dx.doi.org/10.1079/phn200064.
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AbstractObjectiveTo review studies on the morbidity, mortality and nutrition of migrant populations in France.DesignA systematic search of the bibliographic database Medline, and direct contact with associations and institutions concerned with migrants' health.ResultsIn France, as in other host countries, migrants belong to the lowest socio-economic strata. They have on average better health and lower mortality than the local-born population. Health benefits are particularly noticeable in Mediterranean men, especially for affluence-related diseases such as cancer and cardiovascular diseases. North African men smoke as heavily as the local-born of the same occupational categories, and yet their mortality rates from lung cancer are notably lower. Such a paradox may be the result of a synergy between different phenomena such as the selection of the fittest applicants for immigration and the maintenance of healthy lifestyles from the countries of origin. In contrast, migrant women do not enjoy the same health advantages, possibly because they are less likely to be selected on the basis of their health and because they are often non-working. Adult migrants from southern Europe and North Africa report dietary practices consistent with the typical Mediterranean diet, which is renowned for its positive effects on health.ConclusionsThe diet of Mediterranean adults living in France may partly explain the low rates of chronic diseases and high adult life expectancy observed in migrant men from northern Africa. Information about their diets might provide clues for the design of nutritional education campaigns aimed at low-income people.
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Mahmood, Naushin, and Syed Mubashir Ali. "The Disease Pattern and Utilisation of Health Care Services in Pakistan." Pakistan Development Review 41, no. 4II (December 1, 2002): 745–57. http://dx.doi.org/10.30541/v41i4iipp.745-757.
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Health is an important aspect of human life. In general terms, better health status of individuals reflects reduced illnesses, low level of morbidity, and less burden of disease in a given population. It is widely recognised that improved health not only lowers mortality, morbidity and level of fertility, but also contributes to increased productivity and regular school attendance of children as a result of fewer work days lost due to illness, which in turn have implications for economic and social well-being of the population at large. Hence investing in health is vital for promoting human resource development and economic growth in a country [World Bank (1993)]. A view of Pakistan’s health profile indicates that the sector has expanded considerably in terms of physical infrastructure and its manpower in both the public and private sector. This has contributed to some improvement in selected health status indicators over the years. However, the public health care delivery system has been inadequate in meeting the needs of the fast growing population and in filtering down its benefits to the gross-root level. As such, Pakistan still has one of the highest rates of infant and child mortality, total fertility and maternal mortality when compared with many other countries in the Asian region [UNDP (2000)]. Due to low priority given to social sector development in the past and low budgetary allocations made to the health sector, the evidence shows that mortality and morbidity indices have not reduced to the desired level and large gaps remain in the quality of care indicators, especially in rural areas [Federal Bureau of Statistics (2000)].
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Chang, Chih-Hsiang, Chee-Jen Chang, Yi-Chun Wang, Chih-Chien Hu, Yuhan Chang, Pang-Hsin Hsieh, and Dave W. Chen. "Increased incidence, morbidity, and mortality in cirrhotic patients with hip fractures: A nationwide population-based study." Journal of Orthopaedic Surgery 28, no. 3 (May 1, 2020): 230949902091803. http://dx.doi.org/10.1177/2309499020918032.
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Objectives: Hip fractures mostly require surgical treatment and are associated with increased health-care costs and mortality rates. Patients with cirrhosis have low bone marrow density and inferior immune status which contribute to a higher fracture rate and higher surgical complication rate. This population-based study evaluated the prevalence, complication, and mortality rates due to hip fractures in cirrhotic patients. Methods: Taiwan National Health Insurance Research Database data were used. The study group included 117,129 patients with hip fractures diagnosed from 2004 to 2010, including 4048 patients with cirrhosis. The overall prevalence, morbidity, and mortality rates of the cirrhosis group with hip fractures were compared with the rates of a general group with hip fractures. Results: The cirrhosis group patients were younger than the general group patients (71.2 vs. 73.96 years, p < 0.001). The annual incidence of hip fractures in the cirrhosis and general groups was 46–54 and 7–7.5 per 10,000 person-years, respectively, with an incidence rate ratio of 6.95 (95% confidence interval 6.74–7.18). The rates of infection, urinary tract infection, and peptic ulcer disease were higher in the cirrhosis group (3.46% vs. 1.91%, 9.56% vs. 9.11%, and 8.05% vs. 3.55%, respectively; all p < 0.001). The mortality rate after hip fracture was also higher in the cirrhosis group than in the general group (within 3 months: 8.76–12.64% vs. 4.96–5.30% and within 1 year: 29.72–37.99% vs. 12.84–14.57%). Conclusion: Cirrhotic patients with hip fractures were relatively younger; had a seven times higher annual hip fracture incidence; had higher complication rates of infection, urinary tract infection, and peptic ulcer disease; and had two to three times higher a mortality rate at 3 months and 1 year. Clinicians should pay particular attention to the possibility of osteoporosis and hip fractures in patients with liver cirrhosis. Level of Evidence: Level III, case–control study
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Palacio-Mejía, Lina Sofía, Maylen Rojas-Botero, Diana Molina-Vélez, Concepción García-Morales, Leonel González-González, Ana Lidia Salgado-Salgado, Juan Eugenio Hernández-Ávila, and Mauricio Hernández-Ávila. "Overview of acute diarrheal disease at the dawn of the 21st century: The case of Mexico." Salud Pública de México 62, no. 1, ene-feb (December 20, 2019): 14. http://dx.doi.org/10.21149/9954.
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Objective. To provide an overview of morbidity and mortality due to acute diarrheal disease in Mexico in order to understand its magnitude, distribution, and evolution from 2000 to 2016. Materials and methods. We carried out a longitudinal ecological study with secondary sources of information. We used data from epidemiological surveillance, health services, and vital statistics. We calculated and mapped measures of utilization of health services rates and mortality due to diarrheal diseases. Results. Diarrhea morbidity decreased by 42.1% across the period. However, emergency department attendances increased by 50.7% in the Ministry of Health. The hospitalization rate and mortality among the general population decreased by 37.6 and 39.7%, respectively, and the infant mortality rate decreased by 72.3% among children under five years of age. Chiapas and Oaxaca had the highest mortality among the states of Mexico. Conclusions. Cases of diarrhea, including rotavirus, have decreased in Mexico. However, in 2016, 3.4 per 100 000 people died due to diarrhea, which could have been avoided with health promotion.
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Li, Akkus, Yu, Joyner, Kmet, Sweat, and Jia. "Heatwave Events and Mortality Outcomes in Memphis, Tennessee: Testing Effect Modification by Socioeconomic Status and Urbanicity." International Journal of Environmental Research and Public Health 16, no. 22 (November 18, 2019): 4568. http://dx.doi.org/10.3390/ijerph16224568.
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Heatwave studies typically estimate heat-related mortality and morbidity risks at the city level; few have addressed the heterogeneous risks by socioeconomic status (SES) and location within a city. This study aimed to examine the impacts of heatwaves on mortality outcomes in Memphis, Tennessee, a Mid-South metropolitan area top-ranked in morbidity and poverty rates, and to investigate the effects of SES and urbanicity. Mortality data were retrieved from the death records in 2008–2017, and temperature data from the Applied Climate Information System. Heatwave days were defined based on four temperature metrics. Heatwave effects on daily total-cause, cardiovascular, and respiratory mortality were evaluated using Poisson regression, accounting for temporal trends, sociodemographic factors, urbanicity, and air pollution. We found higher cardiovascular mortality risk (cumulative RR (relative risk) = 1.25, 95% CI (confidence interval): 1.01–1.55) in heatwave days defined as those with maximum daily temperature >95th percentile for more than two consecutive days. The effects of heatwaves on mortality did not differ by SES, race, or urbanicity. The findings of this study provided evidence to support future heatwave planning and studies of heatwave and health impacts at a coarser geographic resolution.
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Case, Anne, and Angus Deaton. "Rising morbidity and mortality in midlife among white non-Hispanic Americans in the 21st century." Proceedings of the National Academy of Sciences 112, no. 49 (November 2, 2015): 15078–83. http://dx.doi.org/10.1073/pnas.1518393112.
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This paper documents a marked increase in the all-cause mortality of middle-aged white non-Hispanic men and women in the United States between 1999 and 2013. This change reversed decades of progress in mortality and was unique to the United States; no other rich country saw a similar turnaround. The midlife mortality reversal was confined to white non-Hispanics; black non-Hispanics and Hispanics at midlife, and those aged 65 and above in every racial and ethnic group, continued to see mortality rates fall. This increase for whites was largely accounted for by increasing death rates from drug and alcohol poisonings, suicide, and chronic liver diseases and cirrhosis. Although all education groups saw increases in mortality from suicide and poisonings, and an overall increase in external cause mortality, those with less education saw the most marked increases. Rising midlife mortality rates of white non-Hispanics were paralleled by increases in midlife morbidity. Self-reported declines in health, mental health, and ability to conduct activities of daily living, and increases in chronic pain and inability to work, as well as clinically measured deteriorations in liver function, all point to growing distress in this population. We comment on potential economic causes and consequences of this deterioration.
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Banatvala, Nicholas, Alison J. Roger, Ailsa Denny, and John P. Howarth. "Mortality and Morbidity Among Rwandan Refugees Repatriated from Zaire, November, 1996." Prehospital and Disaster Medicine 13, no. 2-4 (December 1998): 17–21. http://dx.doi.org/10.1017/s1049023x00030107.
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AbstractIntroduction:Following renewed ethnic violence at the end of September 1996, conflict between Tutsi rebels and the Zairian army spread to North Kivu, Zaire where approximately 700,000 Rwandan Hutu refugees resided following the 1994 genocide. After a major rebel offensive against the camps' militia groups on 15 November, a massive movement of refugees towards Rwanda through Goma town, the capital of North Kivu, began. Massive population movements such as this are likely to be associated with substantial mortality and morbidity.Objective:To study patterns of mortality, morbidity, and health care associated with the Rwandan refugee population repatriation during November 1996.Methods:This study observed the functioning of the health-care facilities in the Gisenyi District in Rwanda and the Goma District in Zaire, and surveyed mortality and morbidity among Rwandan refugees returning from Zaire to Rwanda. Patterns of mortality, morbidity, and health care were measured mainly by mortality and health centre consultation rates.Results:Between 15 and 21 November 1996, 553,000 refugees returned to Rwanda and 4,530 (8.2/1,000 refugees) consultations took place at the border dispensary (watery diarrhea, 63%; bloody diarrhea, 1%). There were 129 (0.2/1,000) surgical admissions (72% soft tissue trauma) to the Gisenyi hospital in the subsequent two weeks. The average number of consultations from the 13 health centres during the same period was 500/day. Overall, the recorded death rate was 0.5/10,000 (all associated with diarrhea). A total of 3,586 bodies were identified in the refugee camps and surrounding areas of Goma, almost all the result of trauma. Many had died in the weeks before the exodus. Health centres were overwhelmed and many of the deficiencies in provision of health care identified in 1994 again were evident.Results:Non-violent death rates were low, a reflection of the population's health status prior to migration and immunity acquired from the 1994 cholera out-break. Health facilities were over stretched, principally because of depleted numbers of local, health-care workers associated with the 1994 genocide. Health-care facilities running parallel to the existing health-care system functioned most effectively.
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Blakely, Tony, Cristine Cleghorn, Frederieke Petrović-van der Deen, Linda J. Cobiac, Anja Mizdrak, Johan P. Mackenbach, Alistair Woodward, Pieter van Baal, and Nick Wilson. "Prospective impact of tobacco eradication and overweight and obesity eradication on future morbidity and health-adjusted life expectancy: simulation study." Journal of Epidemiology and Community Health 74, no. 4 (January 20, 2020): 354–61. http://dx.doi.org/10.1136/jech-2019-213091.
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BackgroundInterventions that reduce morbidity, in addition to mortality, warrant prioritisation. It is important to understand the magnitude of potential morbidity and health gains from changing risk factor distributions. We quantified the impact of tobacco compared with overweight/obesity eradication on future morbidity and health-adjusted life expectancy (HALE) for the New Zealand population alive in 2011.MethodsBusiness-as-usual (BAU) future smoking rates were set based on past falling rates, but we assumed no future change in Body Mass Index (BMI) distribution, given historic trends. Population impact fractions and the percentage reduction in incidence rates for 16 tobacco-related and 14 overweight/obesity-related diseases (allowing for time lags) were calculated using the difference between BAU and eradication risk factor scenarios combined with tobacco and BMI incidence rate ratios. We used two multistate lifetable models to estimate HALE changes over the remaining lifespan and morbidity rate changes 30 years hence.ResultsHALE gains always exceeded life expectancy (LE) gains for overweight/obesity eradication (ie, absolute compression of morbidity), but for eradication of tobacco, the pattern was mixed. For example, among 32-year-olds in 2011, overweight/obesity eradication increased HALE by 2.06 years and LE by 1.21 years, compared with 0.54 and 0.50 years for tobacco eradication.Morbidity rate reductions 30 years into the future were considerably greater for overweight/obesity eradication (eg, a 15.8% reduction for 72-year-olds in 2041, or the cohort that was aged 42 years in 2011) than for tobacco eradication (2.7%). The same rate of morbidity experienced at age 65 years under BAU was deferred by 5 years with overweight/obesity eradication.ConclusionsPreventive programmes that reduce overweight and obesity have strong potential to reduce or compress morbidity, improving the average health status of ageing populations. This paper simulated eradication of tobacco and overweight/obesity; actual interventions will have lesser health impacts, but the relativities of morbidity to mortality gains should be similar.
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Rentería-Ramos, Rafael, Rafael Hurtado-Heredia, and B. Piedad Urdinola. "Morbi-Mortality of the Victims of Internal Conflict and Poor Population in the Risaralda Province, Colombia." International Journal of Environmental Research and Public Health 16, no. 9 (May 11, 2019): 1644. http://dx.doi.org/10.3390/ijerph16091644.
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This work studies the health status of two populations similar in most social and environmental interactions but one: the individuals from one population are victims of an internal armed conflict. Both populations are located in the Risaralda province, Colombia and the data for this study results from a combination of administrative records from the health system, between 2011 and 2016. We implemented a methodology based on graph theory that defines the system as a set of heterogeneous social actors, including individuals as well as organizations, embedded in a biological environment. The model of analysis uses the diagnoses in medical records to detect morbidity and mortality patterns for each individual (ego-networks), and assumes that these patterns contain relevant information about the effects of the actions of social actors, in a given environment, on the status of health. The analysis of the diagnoses and causes of specific mortality, following the Social Network Analysis framework, shows similar morbidity and mortality rates for both populations. However, the diagnoses’ patterns show that victims portray broader interactions between diagnoses, including mental and behavioral disorders, due to the hardships of this population.
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Hudson, Toni-Marie L., Benjamin G. Klekamp, and Sarah D. Matthews. "Local Public Health Surveillance of Heroin-Related Morbidity and Mortality, Orange County, Florida, 2010-2014." Public Health Reports 132, no. 1_suppl (July 2017): 80S—87S. http://dx.doi.org/10.1177/0033354917709783.
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Objectives: Heroin-related deaths have increased substantially in the past 10 years in the United States, particularly in Florida. Our objectives were to measure heroin-related morbidity and mortality rates in Orange County, Florida, and to assess trends in those rates during 2010-2014. Methods: We used 3 heroin surveillance methods, based on data from the Florida Medical Examiner, the Florida Agency for Health Care Administration (AHCA), and the Electronic Surveillance System for the Early Notification of Community-Based Epidemics–Florida (ESSENCE-FL). We conducted descriptive and geographic spatial analyses of all 3 data sets, determined heroin-related mortality and morbidity (emergency department [ED] visit) rates, and compared the timeliness of data availability from the 3 data sources. Results: Heroin-related deaths in Orange County increased by 590%, from 10 in 2010 to 69 in 2014. Heroin-related ED visits during the same period increased 12-fold (from 13 to 154) and 6-fold (from 49 to 307) when based on AHCA and ESSENCE-FL data, respectively. ESSENCE-FL identified 140% more heroin-related visits than did AHCA. Spatial analysis found geographic clustering of heroin-related morbidity and mortality. Hospitals facing the greatest burden of heroin-related ED visits were close to communities with the highest crude heroin-related ED visit rates. Of the 3 data sources, ESSENCE-FL provided the timeliest data availability. Conclusions: These 3 data sources can be considered acceptable surveillance systems for monitoring heroin-related events in Orange County. The timely availability of data from ESSENCE-FL makes it the most useful source for obtaining near–real-time data about the heroin epidemic, potentially leading to improved identification of populations most in need of interventions to reduce morbidity and mortality.
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Field, David, Elaine Boyle, Elizabeth Draper, Alun Evans, Samantha Johnson, Kamran Khan, Bradley Manktelow, et al. "Towards reducing variations in infant mortality and morbidity: a population-based approach." Programme Grants for Applied Research 4, no. 1 (March 2016): 1–218. http://dx.doi.org/10.3310/pgfar04010.
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BackgroundOur aims were (1) to improve understanding of regional variation in early-life mortality rates and the UK’s poor performance in international comparisons; and (2) to identify the extent to which late and moderately preterm (LMPT) birth contributes to early childhood mortality and morbidity.ObjectiveTo undertake a programme of linked population-based research studies to work towards reducing variations in infant mortality and morbidity rates.DesignTwo interlinked streams: (1) a detailed analysis of national and regional data sets and (2) establishment of cohorts of LMPT babies and term-born control babies.SettingCohorts were drawn from the geographically defined areas of Leicestershire and Nottinghamshire, and analyses were carried out at the University of Leicester.Data sourcesFor stream 1, national data were obtained from four sources: the Office for National Statistics, NHS Numbers for Babies, Centre for Maternal and Child Enquiries and East Midlands and South Yorkshire Congenital Anomalies Register. For stream 2, prospective data were collected for 1130 LMPT babies and 1255 term-born control babies.Main outcome measuresDetailed analysis of stillbirth and early childhood mortality rates with a particular focus on factors leading to biased or unfair comparison; review of clinical, health economic and developmental outcomes over the first 2 years of life for LMPT and term-born babies.ResultsThe deprivation gap in neonatal mortality has widened over time, despite government efforts to reduce it. Stillbirth rates are twice as high in the most deprived as in the least deprived decile. Approximately 70% of all infant deaths are the result of either preterm birth or a major congenital abnormality, and these are heavily influenced by mothers’ exposure to deprivation. Births at < 24 weeks’ gestation constitute only 1% of all births, but account for 20% of infant mortality. Classification of birth status for these babies varies widely across England. Risk of LMPT birth is greatest in the most deprived groups within society. Compared with term-born peers, LMPT babies are at an increased risk of neonatal morbidity, neonatal unit admission and poorer long-term health and developmental outcomes. Cognitive and socioemotional development problems confer the greatest long-term burden, with the risk being amplified by socioeconomic factors. During the first 24 months of life each child born LMPT generates approximately £3500 of additional health and societal costs.ConclusionsHealth professionals should be cautious in reviewing unadjusted early-life mortality rates, particularly when these relate to individual trusts. When more sophisticated analysis is not possible, babies of < 24 weeks’ gestation should be excluded. Neonatal services should review the care they offer to babies born LMPT to ensure that it is appropriate to their needs. The risk of adverse outcome is low in LMPT children. However, the risk appears higher for some types of antenatal problems and when the mother is from a deprived background.Future workFuture work could include studies to improve our understanding of how deprivation increases the risk of mortality and morbidity in early life and investigation of longer-term outcomes and interventions in at-risk LMPT infants to improve future attainment.FundingThe National Institute for Health Research Programme Grants for Applied Research programme.
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Sorin Cimpean, Alexandre Grapotte, Nicolas Boyer, Mathilde Poras, Dario Raglione, and Gloire à Dieu Byabene. "Focus on the totally laparoscopic feeding gastrostomy tube placement operative technique." World Journal of Advanced Research and Reviews 9, no. 1 (January 30, 2021): 127–33. http://dx.doi.org/10.30574/wjarr.2021.9.1.0005.
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Laparoscopic feeding gastrostomy placement is a surgical operation that allows the feeding of malnourished patients through a tube that is placed in the gastric lumen. The benefits of an improved nutritional status in terms of improving clinical outcomes are well documented in the literature and consist in a reduction of the complication rates of the surgical patients, the length of hospital stay, the readmission rates, and a reduction of the cost of health services by reducing the morbidity or mortality. We present a totally laparoscopic technique of feeding tube placement.
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Desai, Virendra, David Gonda, Sheila L. Ryan, Valentina Briceño, Sandi K. Lam, Thomas G. Luerssen, Sohail H. Syed, and Andrew Jea. "The effect of weekend and after-hours surgery on morbidity and mortality rates in pediatric neurosurgery patients." Journal of Neurosurgery: Pediatrics 16, no. 6 (December 2015): 726–31. http://dx.doi.org/10.3171/2015.6.peds15184.
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OBJECT Several studies have indicated that the 30-day morbidity and mortality risks are higher among pediatric and adult patients who are admitted on the weekends. This “weekend effect” has been observed among patients admitted with and fora variety of diagnoses and procedures, including myocardial infarction, pulmonary embolism, ruptured abdominal aortic aneurysm, stroke, peptic ulcer disease, and pediatric surgery. In this study, morbidity and mortality outcomes for emergency pediatric neurosurgical procedures carried out on the weekend or after hours are compared with emergency surgical procedures performed during regular weekday business hours. METHODS A retrospective analysis of operative data was conducted. Between December 1, 2011, and August 20, 2014, a total of 710 urgent or emergency neurosurgical procedures were performed at Texas Children’s Hospital in children younger than than 18 years of age. These procedures were then stratified into 3 groups: weekday regular hours, weekday after hours, and weekend hours. By cross-referencing these events with a prospectively collected morbidity and mortality database, the impact of the day and time on complication incidence was examined. Outcome metrics were compared using logistic regression models. RESULTS The weekday regular hours and after-hours (weekday after hours and weekends) surgery groups consisted of 341 and 239 patients and 434 and 276 procedures, respectively. There were no significant differences in the types of cases performed (p = 0.629) or baseline preoperative health status as determined by American Society of Anesthesiologists classifications (p = 0.220) between the 2 cohorts. After multivariate adjustment and regression, children undergoing emergency neurosurgical procedures during weekday after hours or weekends were more likely to experience complications (p = 0.0227). CONCLUSIONS Weekday after-hours and weekend emergency pediatric neurosurgical procedures are associated with significantly increased 30-day morbidity and mortality risk compared with procedures performed during weekday regular hours.
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Crimmins, Eileen M., Hyunju Shim, Yuan S. Zhang, and Jung Ki Kim. "Differences between Men and Women in Mortality and the Health Dimensions of the Morbidity Process." Clinical Chemistry 65, no. 1 (January 1, 2019): 135–45. http://dx.doi.org/10.1373/clinchem.2018.288332.
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Abstract BACKGROUND Do men have worse health than women? This question is addressed by examining sex differences in mortality and the health dimensions of the morbidity process that characterize health change with age. We also discuss health differences across historical time and between countries. CONTENT Results from national-level surveys and data systems are used to identify male/female differences in mortality rates, prevalence of diseases, physical functioning, and indicators of physiological status. Male/female differences in health outcomes depend on epidemiological and social circumstances and behaviors, and many are not consistent across historical time and between countries. In all countries, male life expectancy is now lower than female life expectancy, but this was not true in the past. In most countries, women have more problems performing instrumental activities of daily living, and men do better in measured performance of functioning. Men tend to have more cardiovascular diseases; women, more inflammatory-related diseases. Sex differences in major cardiovascular risk factors vary between countries—men tend to have more hypertension; women, more raised lipids. Indicators of physiological dysregulation indicate greater inflammatory activity for women and generally higher cardiovascular risk for men, although women have higher or similar cardiovascular risk in some markers depending on the historical time and country. SUMMARY In some aspects of health, men do worse; in others, women do worse. The lack of consistency across historical times and between countries in sex differences in health points to the complexity and the substantial challenges in extrapolating future trends in sex differences.
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Saha, Somen, Priya Kotwani, Apurvakumar Pandya, Deepak Saxena, Tapasvi Puwar, Shrey Desai, Gaurav Dahiya, et al. "PP143 TeCHO+ Program In Gujarat, India: A Protocol For Health Technology Assessment." International Journal of Technology Assessment in Health Care 36, S1 (December 2020): 17. http://dx.doi.org/10.1017/s0266462320001294.
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IntroductionThe Health and Family Welfare Department of the Government of Gujarat is implementing a program called Technology for Community Health Operation (TeCHO+) to address the state's priority health issues. This paper details the protocol for using health technology assessment to assess the impact of the TeCHO+ program on data quality, service delivery coverage, rates of morbidity and mortality, and cost effectiveness.MethodsThis mixed-method study will be conducted in five districts. Data will be validated in a phased manner over a three-year period, along with an assessment of key outcome indicators. Additionally, key informant interviews will be conducted and cost data will be gathered.ResultsEarly implementation of TeCHO+ has highlighted mixed impact at an operational level, with gaps in implementation. Despite some gaps in the available evidence, TeCHO+ solutions can significantly improve health service delivery through increased accuracy of data management, high-risk identification, and quality and accessibility of care. However, implementation challenges require even greater efforts to establish comprehensive systems for troubleshooting and corrective measures for improving data quality. Positive experiences encourage grassroots teams for continuing the use of TeCHO+.ConclusionsTeCHO+ is expected to improve service coverage and reduce rates of morbidity and mortality by improving the population's nutritional status, the timeliness of care for high-risk cases, and the non-communicable disease profile of the community.
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Evdokimov, V. I., I. G. Mosyagin, P. P. Sivashchenko, and N. A. Mukhina. "Analysis of medical and statistical measures of morbidity in officers of the Navy and Ground Forces of the Russian Federation in 2003–2018." Medicо-Biological and Socio-Psychological Problems of Safety in Emergency Situations, no. 2 (June 22, 2019): 63–98. http://dx.doi.org/10.25016/2541-7487-2019-0-2-62-98.
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Relevance. Professional activities of the officers of the Navy of Russia and the Ground Forces of Russia are obviously different. Due to autonomous combat missions, medical support for the officers of the Russian Navy is quite specific, with high requirements to the health status of the navy personnel.Intention. To analyze morbidity of officers of the Russian Navy and the Ground Forces in 2003–2018.Methodology. A selective statistical analysis was performed using medical reports on the state of health of personnel and activities of the medical service according to Form 3 / MED in military units, in which about 60% of the total number of officers of the Armed Forces of Russia served in 2003–2018. Commonly accepted medical and statistical morbidity indicators were analyzed by disease categories of the International Statistical Classification of Diseases and Health Problems, 10th revision.Results and Discussion. The average annual morbidity rates for Russian Navy officers were (918.9 ± 35.3) and (1014.0 ± 79.2) ‰ for the Russian Navy and Ground Forces officers, respectively; primary morbidity rates were (351.0 ± 9.2) and (473.5 ± 38.0) ‰, respectively (p < 0.01); the need for case follow-up was (151.0 ± 9.1) and (114.2 ± 9.2) ‰, respectively (p <0.05); hospital admissions (236.5 ± 11.1) and (194.6 ± 17.8) ‰, respectively; work days lost (4997 ± 183) and (4180 ± 354) ‰, respectively; dismissal rates (15.90 ± 1.36) and (12.27 ± 2.72) ‰, respectively; mortality rates were (102.53 ± 5.95) and (138.35 ± 9.49) per 100 thousand officers of the respective cohort (p < 0.01). The trends in almost all morbidity and mortality types are not consistent, which may indicate the influence of various factors, for example, military-professional ones. The consistency of the trends of dismissal rates is moderate and statistically significant (r = 0.56; p <0.05), which indicates the influence of unidirectional factors, possibly organizational ones. When assessing the military-epidemiological significance of disase categories, the following diseases ranked first: acute respiratory infections of the upper respiratory tract (J00 – J06 by ICD-10), coronary heart disease (I20 – I25), hypertensive diseases (I10 – I15), diseases of the esophagus, stomach and duodenum (K20 – K31). In the Russian Navy officers, the leading 10 disease categories included malignant neoplasms (C00 – C80), obesity and other hyperalimentation (E65 – E68); other acute respiratory infections of the lower respiratory tract (J20 – J22), infections of the skin and subcutaneous tissue (L00 – L08).Conclusion. Prevention, timely treatment and rehabilitation will help improve the health status of officers. Taking into account the rates and structure of morbidity will optimize allocation of resources the medical service of the Armed Forces of Russia.
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Kenny, Dianna T., and Anthony Asher. "Gender Differences in Mortality and Morbidity Patterns in Popular Musicians Across the Lifespan." Medical Problems of Performing Artists 32, no. 1 (March 1, 2017): 13–19. http://dx.doi.org/10.21091/mppa.2017.1004.
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Recent studies have highlighted the disturbing morbidity and early mortality of popular musicians. Most of the studies have focused on male musicians because, until recently, there were relatively few female popular musicians on which to base a population study. With the sharp increase in female popular musicians from fewer than 2% in the 1950s to 32% in the current decade, researchers are better able to examine the health status and mortality profile of female popular musicians. To this end, this paper makes what we believe is the first detailed analysis of mortality and morbidity in female popular musicians. Mortality patterns were similar for male and female musicians, and both were highly discrepant from population curves. Examination of death rates for younger (<45 yrs) and older (>45 yrs) musicians by sex and genre showed that violent deaths continued to dominate cause of death even in older musicians, accounting for 20% of all deaths, a figure three times higher than for a comparable general population. Unlike females in the general population, female gender did not bestow any protection against early death or manner of death by suicide, homicide, or accident compared with male popular musicians.
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Gregg, Edward W., Andrea M. Kriska, Kathleen M. Fox, and Jane A. Cauley. "Self-Rated Health and the Spectrum of Physical Activity and Physical Function in Older Women." Journal of Aging and Physical Activity 4, no. 4 (October 1996): 349–61. http://dx.doi.org/10.1123/japa.4.4.349.
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Self-rated health has been related to functional status, disability, and mortality in a variety of populations. This study examined whether self-rated health was related to physical activity levels independent of functional status in a population of older women. For this study, 9,704 women aged 65-99 rated their health on a scale ranging from excellent to very poor. Physical activity and functional status questionnaires and physical function tests were administered to evaluate levels of physical activity, strength, and function. Comparisons between women in three groups of self-rated health (good and excellent; fair; poor and very poor) indicated that higher self-rated health was strongly related to physical activity independent of physical strength, functional status, and co-morbidity. These findings suggest that physical activity is an important determinant of self-rated health in older women regardless of functional status.
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Stratton, Anne Troike, Richard Ogden Roberts III, Oren Kupfer, Terri Carry, Julie Parsons, and Susan Apkon. "Pediatric neuromuscular disorders: Care considerations during the COVID-19 pandemic." Journal of Pediatric Rehabilitation Medicine 13, no. 3 (November 23, 2020): 405–14. http://dx.doi.org/10.3233/prm-200768.
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COVID-19, the respiratory and frequently systemic disease caused by the novel SARS-COV-2 virus, was first recognized in December 2019 and quickly spread to become a pandemic and world-wide public health emergency over the subsequent 3–4 months. While COVID-19 has a very low morbidity rate across approximately 80% of the population, it has a high morbidity and mortality rate in the remaining 20% of the population.1 These numbers have put a significant strain on medical systems around the world. Patients with neuromuscular diseases such as those with Duchenne muscular dystrophy (DMD) and spinal muscular atrophy (SMA), tend to be more medically fragile and have higher health care needs than the general population. Respiratory insufficiency, cardiac disease, obesity, and immunocompromised status due to chronic steroid treatments in certain patient populations with neuromuscular conditions are specific risk factors for severe COVID-19 disease. In general, the pediatric population has shown to be less severely impacted with lower infection rates and lower morbidity and mortality rates than the adult population, however, as expected, children with underlying medical conditions are at higher risk of morbidity from COVID-19 than their peers.2 Many patients with neuromuscular disease also rely heavily on caregiver support through their lifetime and thus maintaining the health of their primary caregivers is also a significant consideration in the health and well-being of the patients. This paper will address routine and emergency medical care, rehabilitation services, and other considerations for the pediatric patient with a neuromuscular condition during the COVID-19 pandemic.
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Mhyre, Jill M., Brian T. Bateman, and Lisa R. Leffert. "Influence of Patient Comorbidities on the Risk of Near-miss Maternal Morbidity or Mortality." Anesthesiology 115, no. 5 (November 1, 2011): 963–72. http://dx.doi.org/10.1097/aln.0b013e318233042d.
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Background Maternal morbidity and mortality are increased in the United States compared with that of other developed countries. The objective of this investigation is to determine the extent to which it is possible to predict which patients will experience near-miss morbidity or mortality. Methods The authors defined near-miss morbidity as end-organ injury associated with length of stay greater than the 99 percentile or discharge to a second medical facility, and identified all cases of near-miss morbidity or death from admissions for delivery in the 2003-2006 Nationwide Inpatient Sample. Logistic regression was used to examine the effect of maternal characteristics on rates of near-miss morbidity/mortality. Results Approximately 1.3 per 1,000 hospitalizations for delivery was complicated by near-miss morbidity/mortality as defined in this study (95% CI 1.3-1.4). Most of these events (58.3%) occurred in 11.8% of the delivering population-in those women with important medical comorbidities or obstetric complications identified before admission for delivery. The highest rates were noted among women with pulmonary hypertension (98.0 cases per 1,000 deliveries), malignancy (23.4 per 1,000), and systemic lupus erythematosus (21.1 per 1,000). Conclusions Risk for near-miss morbidity or mortality is substantially increased among an identifiable subset of pregnant women. To the extent that antepartum multidisciplinary coordination and high-quality intrapartum care improve delivery outcomes for women with significant antepartum medical and obstetric disease, then public health investments to reduce the national burden of delivery-related near-miss morbidity and mortality will have the greatest effect by focusing resources on identifying and serving these high-risk groups.
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Hristova, Lidiya, Nevena Tzacheva, Rouja Nikolova, and Velik Grigorov. "RETROSPECTIVE DYNAMIC STUDY OF THE CURRENT MORBIDITY OF MEDICAL AND NON-MEDICAL SPECIALISTS IN PRE-HOSPITAL HEALTH CARE." Journal of IMAB - Annual Proceeding (Scientific Papers) 27, no. 2 (May 26, 2021): 3741–46. http://dx.doi.org/10.5272/jimab.2021272.3741.
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In recent years, the healthcare system has been considered by researchers to be a high-risk area, with registered diseases above the average level compared to other economic activities. This leads to high rates of permanently reduced efficiency and premature mortality. In the present study, we looked for the determinants of negative changes in the health status of employees in pre-hospital medical care, which in addition to socio-economic, are related to the work environment and the work process. The main guidelines for really overcoming these negative trends are: occupational health activities such as creating adequate regimes of work and rest, healthy and safe working conditions, health promotion and the unifying details of the Unified Health Integrated Dossier [UHID]. This occupational medicine dossier, developed as a module of "cloud structure" of E-health in Bulgaria, allowed the study of the health status in dynamics for a retrospective period of medical and non-medical specialists in two large diagnostic counseling centers [DCC] in Varna. It was found that in the structure of momentary disease for the two DCC in the first place are diseases of the eye and its appendages – 221,74%, followed by diseases of the circulatory system -101,45% and diseases of the musculoskeletal system and connective tissue by 28,99%. UHID with occupational medicine orientation is useful both for the employers and for the control and expert structures for assessment of the health status under specific working conditions in pre-hospital medical care. The study is supported by the National Scientific Program "e-Health in Bulgaria" [2018-2020], incl. and with financial support for participation in international scientific forums.
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Waghray, Abhijeet, Nisheet Waghray, Hicham Khallafi, and K. V. Narayanan Menon. "Vaccinating Adult Patients with Cirrhosis: Trends over a Decade in the United States." Gastroenterology Research and Practice 2016 (2016): 1–7. http://dx.doi.org/10.1155/2016/5795712.
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Introduction. The progression of chronic liver disease to cirrhosis involves both innate and adaptive immune system dysfunction resulting in increased risk of infectious complications. Vaccinations against pneumococcus, hepatitis A virus (HAV), and hepatitis B virus (HBV) are well tolerated and effective in disease prevention and reduction in morbidity and mortality. Prior studies assessing vaccination rates in patients with cirrhosis have specific limitations and to date no study has provided a comprehensive evaluation of vaccination rates in patients with cirrhosis in the United States.Aim. This study assessed vaccination rates for pneumococcus, HAV, and HBV in patients with cirrhosis.Results. Overall 59.7% of patients with cirrhosis received at least 1 vaccination during the study period. Vaccination rates within the same or following year of cirrhosis diagnosis were 19.9%, 7.7%, and 11.0% against pneumococcus, HAV, and HBV, respectively. Trend analysis revealed significant increases in vaccination rates for pneumococcus in all patients with cirrhosis and within subgroups based on age, gender, and presence of concomitant diabetes.Conclusion. The study demonstrated that vaccination rates in patients with cirrhosis remain suboptimal. Ultimately, the use of electronic medical record (EMR) reminders improved communication between healthcare professionals and public health programs to increase awareness are fundamental to reducing morbidity, mortality, and health-care related costs of vaccine preventable diseases in patients with cirrhosis.
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Kumar, Mrudul, Keerti Swarnkar, and Jayant Vagha. "Clinical profile of low birth babies in NICU: a rural tertiary care hospital based study." International Journal of Contemporary Pediatrics 5, no. 1 (December 21, 2017): 239. http://dx.doi.org/10.18203/2349-3291.ijcp20175592.
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Background: The low birth weight (LBW) infant remains at much higher risk of mortality than the infant at normal weight at birth. In the neonatal period when most infant deaths occur, the proportion of low birth weight infants is the major determinant of the magnitude of mortality rates. Mortality and morbidity among low birth weight babies are a major public health problem in our country. It is important to identify risk factors associated with LBW babies.Methods: Prospective observational study was conducted on 222 neonates with low birth weight admitted in Neonatal intensive care unit (NICU) of Acharya Vinoba Bhave Rural Hospital, Jawaharlal Nehru Medical College, Sawangi Meghe, Wardha from September 2015 to August 2017. Maternal risk factors and neonatal morbidities were recorded. The study was designed to assess the risk factors of LBW babies and their short-term outcome.Results: 222 low birth weight babies were studied, among which 36(16.22%) were weighed less than 1500 grams and 186 (83.78%) were 1500-2500 grams. The most common maternal risk factors which were associated with very low birth weight were low socio-economic status, occupations with more strenuous activity, low maternal educational status, poor antenatal care, poor pregnancy weight gain and chronic illnesses. Anemia was present in 99 (44.595%) mothers. Among other risk factors during pregnancy oligohydramnios was present in 43 (19.369%) mothers, followed by preeclampsia in 42 (18.918%) mothers and pyrexia in 31 (13.963%) mothers. 166 (74.76%) babies are small for gestational age (SGA) babies. Overall mortality rate was 40.54%.Conclusions: Most of LBW babies are SGA babies. Low socio-economic status, low maternal educational status and poor antenatal care were the important risk factors. Morbidity and mortality of low birth weight babies could be reduced considerably by proper health education, improved antenatal care, prompt identification of high risk pregnancies, proper referral, better nursing care and management.
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Edington, Jackie, Paul D. Winter, Steve J. Coles, Catharine R. Gale, and Christopher N. Martyn. "Outcomes of undernutrition in patients in the community with cancer or cardiovascular disease." Proceedings of the Nutrition Society 58, no. 3 (August 1999): 655–61. http://dx.doi.org/10.1017/s0029665199000853.
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Public health concern has tended to focus on the dangers of obesity, but there is evidence that undernutrition may also pose a risk to physical and mental well-being, particularly in those who are already ill. Using the General Practice Research Database (see office for Population Censuses and Surveys, 1995), we followed up 10 128 men and women aged 18 years and over who had been diagnosed with cancer or cardiovascular disease to examine whether nutritional status, as indicated by BMI, affected rates of use of health care resources and mortality. In both diagnostic groups, patients with a BMI below 20 kg/m 2 had higher rates of consultation with GP, higher rates of prescription and higher death rates during the follow-up period compared with those with a BMI of 20 – < 25 kg/m 2. In men and women with cardiovascular disease, poor nutritional status was associated with a sharply increased risk of hospital admission. Patients whose BMI was 30 – <40 kg/m 2 also tended to have increased rates of GP consultation and prescription, and if they were under the age of 65 years, they had an increased risk of death. The results of the present study suggest that in men and women with cancer or cardiovascular disease, even minor degrees of undernutrition are associated with a marked increase in morbidity and mortality.
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Singh, Gopal K. "Trends and Social Inequalities in Maternal Mortality in the United States, 1969-2018." International Journal of Maternal and Child Health and AIDS (IJMA) 10, no. 1 (December 30, 2020): 29–42. http://dx.doi.org/10.21106/ijma.444.
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Background: Despite the previous long-term decline and a recent increase in maternal mortality, detailed social inequalities in maternal mortality in the United States (US) have not been analyzed. This study examines trends and inequalities in US maternal mortality by maternal race/ethnicity, socioeconomic status, nativity/immigrant status, marital status, area deprivation, urbanization level, and cause of death. Methods: National vital statistics data from 1969 to 2018 were used to compute maternal mortality rates by sociodemographic factors. Mortality trends by deprivation level were analyzed by using censusbased deprivation indices. Rate ratios and log-linear regression were used to model mortality trends and differentials. Results: Maternal mortality declined by 68% between 1969 and 1998. However, there was a recent upturn in maternal mortality, with the rate increasing from 9.9 deaths/100,000 live births in 1999 to 17.4 in 2018. The large racial disparity persisted over time; Black women in 2018 had a 2.4 times higher risk of maternal mortality than White women. During 2013-2017, the rate varied from 7.0 for Chinese women to 42.0 for non-Hispanic Black women. Unmarried status, US-born status, lower education, and rural residence were associated with 50-114% higher maternal mortality risks. Mothers in the most-deprived areas had a 120% higher risk of mortality than those in the most-affluent areas; both absolute and relative disparities in mortality by deprivation level widened between 2002 and 2018. Hemorrhage, pregnancy-related hypertension, embolism, infection, and chronic conditions were the leading causes of maternal death, with 31% of the deaths attributable to indirect obstetric causes. Conclusions and Global Health Implications: Despite the steep long-term decline in US maternal mortality, substantial racial/ethnic, socioeconomic, and rural-urban disparities remain. Monitoring disparities according to underlying social determinants is key to reducing maternal mortality as they give rise to inequalities in social conditions and health-risk factors that lead to maternal morbidity and mortality. Key words: Maternal mortality • Socioeconomic status • Deprivation • Race/ethnicity • Rural-urban • Disparities • Cause of death • Trend. Copyright © 2021 Singh. Published by Global Health and Education Projects, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in this journal, is properly cited.
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Adhikari, Lal Mani. "Social Epidemiology of HIV/TB Co-infection: A Triad with Poverty." Journal of Advanced Academic Research 1, no. 1 (September 29, 2015): 53–57. http://dx.doi.org/10.3126/jaar.v1i1.13513.
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The dual epidemics of Tuberculosis (TB) and Human Immunodeficiency Virus (HIV) infection are of growing concern in Asia including countries like Nepal. Tuberculosis incidence rates correlate positively with poverty rates and with HIV incidence rates. TB is a leading cause of morbidity and mortality in patients with HIV infections. TB and HIV are commonly known as the diseases of poverty and their co-infection are known to be the deadliest mixture. Social epidemiology of TB and HIV infection reveals that there are more commonalities of risk factors which are associated with poor individual as well as communal socioeconomic status. Poverty is not only a major factor for complexity but also there are more issues associated with social inequality and inaccessibility to health care services. The double burden of TB and HIV pose a serious threat to the people’s health that needs urgent address from health policy makers and health organizations to avert the economic loss in the future. This concept paper concludes that the TB/HIV co-infection is highly linked to an individual’s socio economic status, sociopsychosocial and ecosocial paradigms of disease manifestation and their impact.Journal of Advanced Academic Research Vol.1(1) 2014: 53-57
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Noursi, Samia, Janine Austin Clayton, Jacquelyn Campbell, and Phyllis Sharps. "The Intersection of Maternal Morbidity and Mortality and Intimate Partner Violence in the United States." Current Women s Health Reviews 16, no. 4 (September 9, 2020): 298–312. http://dx.doi.org/10.2174/1573404816999200502024742.
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Background: In the United States, rates of maternal morbidity and mortality (MMM) are high compared with other high-income countries and are characterized by significant racial/ethnic disparities. Typically, research on MMM focuses on obstetrical problems. Less research examines the role of intimate partner violence (IPV). Maternal health, IPV, and their intersection are linked with the impacts of social determinants of health. Objective: We sought to understand the intersection of MMM and IPV in the United States, particularly data issues that hinder research in this area and the resulting knowledge gaps. Methods: We identified major articles of interest regarding maternal morbidity and mortality and IPV in the United States and drafted a mini review based on relevant information. Results: Despite the prevalence of IPV during pregnancy, the intersection of maternal health and IPV has not been widely reviewed or discussed. Conclusion: There are a number of limitations in surveillance activities and data collection that underestimate the impact of IPV on MMM. Importantly, women who die by homicide or suicide— which in many cases is linked with IPV—are not counted as pregnancy-related deaths in the United States under the current definition. Establishing separate panels of local experts in maternal health or maternal mortality review committees (MMRCs) that are dedicated to examining violent deaths and use of the Maternal Mortality Review Information Application system would likely improve data accuracy of pregnancy-associated deaths. Based on the literature reviewed and limitations of current data, there are significant knowledge gaps on the effects of IPV and maternal health.
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Evdokimov, V. I., I. G. Mosyagin, P. P. Sivashchenko, and N. A. Mukhina. "ANALYSIS OF MEDICAL AND STATISTICAL MEASURES OF MORBIDITY IN CONSCRIPTS OF THE NAVY AND GROUND FORCES OF THE RUSSIAN FEDERATION IN 2003–2018." Medicо-Biological and Socio-Psychological Problems of Safety in Emergency Situations, no. 3 (October 15, 2019): 15–51. http://dx.doi.org/10.25016/2541-7487-2019-0-3-15-51.
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Relevance. The Navy of Russia and the Ground Forces of Russia recieve new kinds of weapons, hence high requirements to the somatic and mental health of the conscripts.Intention: To analyze morbidity in conscripts of the Russian Navy and the Ground Forces in 2003–2018. Methodology. A selective statistical analysis was performed using medical reports on the state of health of personnel and activities of the medical service according to Form 3 / MED in military units, in which about 60 % of the total number of conscripts of the Armed Forces of Russia served in 2003–2018. Commonly accepted medical and statistical morbidity indicators were analyzed by disease categories of the International Statistical Classification of Diseases and Health Problems, 10th revision.Results and Discussion. The average annual morbidity rates were (1833.3 ± 84.9) ‰ in conscripts of the Russian Navy and (2008.,0 ± 102.4) ‰ in conscripts of the Russian Ground Forces; primary morbidity rates were (1019.9 ± 54,8) and (1014.0 ± 79.2) ‰, respectively; the need for case follow up was (166.5 ± 19.0) and (128.2 ± 8.1) ‰, respectively; hospital admissions were (968.5 ± 71.3) and (1033.5 ± 89.6) ‰, respectively; work days lost (13,166 ± 7.99) and (11,104 ± 595) ‰, respectively (p < 0.01); dismissal rates were (33.38 ± 1.79) and (18.28 ± 1.66) ‰, respectively; mortality rates were (24.87 ± 5.12) and (50.67 ± 7.84) per 100 thou sand conscripts of the respective cohort (p < 0.05). With determination coefficients of various significance, the polynomial trends show an increase in primary and general morbidity, hospital admissions and work days lost, as well as decrease in dismissal rates and mortality rates. The trends in almost all morbidity types are moderately and statistically significantly consistent, suggesting the influence of uniderectional factors, for example, military professional ones. There is a functional consistency between mortality trends in Russian male population aged 20–24 and conscripts of the Russian Navy and Ground Forces (r = 0.83 and 0.87; p < 0.001), thus suggesting the influence of uniderectional factors, for example, of macro social, behavioural or other nature. In the co horts of conscripts under study, the leading disease categories from military epidemiological point of view were similar: respiratory diseases (ICD 10 category X) ranked 1st; injury, poisoning and certain other consequences of external causes (XIX) ranked 2nd; mental and behavioural disorders (V) ranked 3rd; diseases of the skin and subcutaneous tissue (XII) ranked 4th; diseases of the digestive system (XI) ranked 5th. In conscripts, the leading diseases from military epidemiological point of view were as follows: acute respiratory infections of the upper respiratory tract (J00–J06 by ICD 10); head injuries (S00–S09); injuries to unspecified part of trunk, limb or body region (T00–T07); diseases of oesophagus, stomach and duodenum (K20–К31). In the Navy conscripts, neurotic and stress related and somatoform disorders (F40–F48) played an important role; in conscripts of the Ground Forces, infections of the skin and subcutaneous tissue (L00–L08).Conclusion. Prevention, timely treatment and rehabilitation will help improve the health status of conscripts. Taking into account the rates and structure of morbidity will optimize allocation of resources the medical service of the Armed Forces of Russia.
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Prykashchykova, K. Ye, Zh S. Yaroshenko, G. V. Kostiuk, V. I. Syrovenko, O. V. Olepir, V. O. Lukianiuk, I. V. Lytvyniuk, V. M. Polianska, and T. I. Movchun. "Non-neoplastic morbidity, disability, mortality in adult population at radioactively contaminated territories of Ukraine. Epidemiological research 1988-2016." Environment & Health 100 (3) (September 2021): 22–29. http://dx.doi.org/10.32402/dovkil2021.03.022.
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Objective: We presented a comprehensive description of the changes in the health status of the adult population of radioactively contaminated territories of Ukraine depending on gender and age at the date of the Chornobyl accident on the basis of cohort epidemiological studies after accident. Materials and methods: The epidemiological analysis of non-neoplastic morbidity, disability, mortality in the residents of radioactively contaminated territories (RCT) aged 18-60 years old at the date of the Chornobyl accident (65,189 people) was conducting during 1988-2016 for five-year observation periods and by eight classes of ICD-10. We applied the methods of mathematical and statistical analysis. Results: During 1988-2016, 90590 (100%) cases of non-neoplastic morbidity (34.94% in men and 65.06% in women), 11153 (100%) cases of disability (38.22% and61.78%, respectively), and 11586 (100%) cases of mortality(50,42% and 49,58%, respectively)were detected in the residents of the RCT for the first time as a result of epidemiological study. Most of the victims suffered from the nosological forms of the nosological forms of respiratory, circulatory and digestive systems, which made up 67.43% in the structure of non-neoplastic morbidity. Diseases of circulatory, endocrine and nervous systems (87.92%) were the main factors of disability and diseases of circulatory system (89.49%) - of mortality. The gender dependence of the development of the incidence of non-neoplastic diseases, disability and mortality due to them were established. The indices of mortality (116.08, ID/103 man-years of observation) and disability (13.57)in females significantly exceeded the males’ ones (86.57 and 11.65, respectively). But males had a higher mortality rate (16.01 vs. - 11.32). Changes in the incidence rates of non-neoplastic diseases, disability and mortality due to them throughout the observation period were characterized by a divergence of vectors: morbidity decreased, and disability and mortality increased simultaneously. The intersection of the dynamics of the mortality of non-neoplastic diseases with disability and mortality through those diseases was identified in 2008-2012. Conclusions 1. During epidemiological surveillance in 1988-2016, in the residents of RCT aged 18-60 years old on the date of the Chornobyl accident epidemiological surveillance, the non-neoplastic morbidity was formed mainly due to the significant development of diseases of the respiratory, circulatory and digestive systems, which together made up 67.43%. Non-neoplastic diseases of the circulatory, endocrine and nervous systems (87.92) were the main causes of disability, diseases of circulatory system (89.49%) - of mortality. 2. The gender dependence of the development of the morbidity of non-neoplastic diseases, disability and mortality in the residents of RCT over the thirty-year observation period was established. Diseases of the circulatory system were the main causes of disability and mortality. In males, disability and mortality were caused by the mental and behavioral disorders, diseases of respiratory and digestive systems, in females - by the diseases of nervous and urogenital systems. 3. In the residents of RCT, regardless of gender, over the years of observation, a feature of the development of morbidity, disability and mortality due to them was established, it was in the significant reduction of the incidence of diseases in 2008-2016, due to the increase of disability and mortality of the suffered, especially in 2008-2016, in comparison with the previous years, i.e. in 22-30 years after the Chornobyl accident. 4. Summarizing the obtained data, it is important to continue the epidemiological studies of the health status of the residents of RCT (non-neoplastic morbidity, disability, mortality) for the determination of the impact of radiation on the development of the main forms of non-neoplastic diseases.
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Ahmad, Kaashif Aqeeb, Monica Michelle Bennett, Samiya Fatima Ahmad, Reese Hunter Clark, and Veeral Nalin Tolia. "Morbidity and mortality with early pulmonary haemorrhage in preterm neonates." Archives of Disease in Childhood - Fetal and Neonatal Edition 104, no. 1 (January 27, 2018): F63—F68. http://dx.doi.org/10.1136/archdischild-2017-314172.
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ObjectiveThere are no large studies evaluating pulmonary haemorrhage (PH) in premature infants. We sought to quantify the clinical characteristics, morbidities and mortality associated with early PH.DesignData were abstracted from the Pediatrix Clinical Data Warehouse, a large de-identified data set. For incidence calculations, we included infants from 340 Pediatrix United States Neonatal Intensive Care Units from 2005 to 2014 without congenital anomalies. Infants <28 weeks’ gestation with PH within 7 days of birth were then matched with two controls for birth weight, gestational age, gender, antenatal steroid exposure, day of life 0 or 1 intubation and multiple gestation.ResultsFrom 596 411 total infants, we identified 2799 with a diagnosis of PH. Peak incidence was 86.9 cases per 1000 admissions for neonates born at 24 weeks’ gestation. We then identified 1476 infants <28 weeks’ gestation with an early PH diagnosis at ≤7 days of age of which 1363 (92.3%) were successfully matched. Patients with early PH had significantly higher exposure to poractant alfa (35.4% vs 28%), diagnosis of shock (63.7% vs 51%) and grade IV intraventricular haemorrhage (20.8% vs 6%). Patients with PH also had significantly higher mortality rates at 7 days of age (40.6% vs 18.9%), 30 days of age (54% vs 28.8%) and prior to discharge (56.9% vs 33.7).ConclusionIn this large cohort of premature infants, we found PH to be common among the most premature babies. Early PH was associated with significant morbidity and mortality in excess of 50%. A renewed focus on the underlying pathophysiology and prevention of PH is warranted.
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Fang, Jennifer L., Kristin C. Mara, Amy L. Weaver, Reese H. Clark, and William A. Carey. "Outcomes of outborn extremely preterm neonates admitted to a NICU with respiratory distress." Archives of Disease in Childhood - Fetal and Neonatal Edition 105, no. 1 (May 11, 2019): 33–40. http://dx.doi.org/10.1136/archdischild-2018-316244.
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ObjectiveTo compare the risk of mortality and morbidity between outborn and propensity score-matched inborn extremely preterm neonates.SettingMultiple neonatal intensive care units (NICU) across the USA.PatientsSingleton neonates born at 22–29 weeks’ gestation with no major anomalies who were admitted to a NICU and discharged between 2000 and 2014. Outborn neonates were restricted to those who transferred into a NICU on the day of birth.MethodsThe association between inborn-outborn status and the time-to-event outcomes of in-hospital mortality and necrotising enterocolitis (NEC) were assessed using Cox proportional hazards regression. Logistic regression was used to assess the remaining secondary outcomes: retinopathy of prematurity requiring treatment (tROP), chronic lung disease (CLD), periventricular leucomalacia (PVL) and severe intraventricular haemorrhage (IVH). Since outborn status was not random, we used 1:1 propensity score matching to reduce the imbalance in illness severity.ResultsThere were 59 942 neonates (7991 outborn) included in the study. Outborn neonates had poorer survival than inborns and higher rates of NEC, severe IVH, tROP and PVL. Inborn-outborn disparities in mortality were reduced over the study period. When analysing the matched cohort (6524 matched pairs), outborns were less likely to die in-hospital compared with inborns (HR 0.84, 95% CI 0.77 to 0.91). However, outborns experienced higher rates of NEC (HR 1.14, 95% CI 1.04 to 1.25), severe IVH (OR 1.52, 95% CI 1.38 to 1.68), tROP (OR 1.45, 95% CI 1.25 to 1.69) and CLD (OR 1.12, 95% CI 1.01 to 1.24).ConclusionAdditional research is needed to understand the contributors to increased morbidity for outborn extremely preterm neonates and identify interventions that mitigate this risk.
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Pearlin, Leonard I., Scott Schieman, Elena M. Fazio, and Stephen C. Meersman. "Stress, Health, and the Life Course: Some Conceptual Perspectives." Journal of Health and Social Behavior 46, no. 2 (June 2005): 205–19. http://dx.doi.org/10.1177/002214650504600206.
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This article proposes several conceptual perspectives designed to advance our understanding of the material and experiential conditions contributing to persistent disparities in rates of morbidity and mortality among groups unequal in their social and economic statuses. An underlying assumption is that these disparities, which are in clear evidence at mid- and late life, may be anchored to earlier circumstances of the life course. Of particular interest are those circumstances resulting in people with the least privileged statuses having the greatest chances of exposure to health-related stressors. Among the stressors closely linked to status and status attainment are those that continue or are repeated across the life course, such as enduring economic strain and discriminatory experiences. Also taking a long-range toll on health are circumstances of stress proliferation, a process that places people exposed to a serious adversity at risk for later exposure to additional adversities. We suggest that this process can be observed in instances of trauma, in early out-of-sequence transitions, and in the case of undesired changes that disrupt behaviors and relationships in established roles. Effective effort to close the systemic health gaps must recognize their structural underpinnings.
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Shaheen, Abdel AM, Ranjani Somayaji, Robert Myers, and Christopher H. Mody. "Epidemiology and trends of cryptococcosis in the United States from 2000 to 2007: A population-based study." International Journal of STD & AIDS 29, no. 5 (October 3, 2017): 453–60. http://dx.doi.org/10.1177/0956462417732649.
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Cryptococcal disease, caused by Cryptococcus neoformans and Cryptococcus gattii, is associated with significant morbidity and mortality but limited data exist on its incidence and impact. A study utilizing the Nationwide Inpatient Sample from 2000 to 2007 to examine the epidemiology and impact of cryptococcal disease in the United States was undertaken. The International Classification of Diseases 9th Version code was used to identify hospital discharges with diagnosis of Cryptococcus (117.5). Our primary outcome was the incidence rate of cryptococcal admissions. The impact of AIDS, age, and sex on hospitalization rates, mortality, and costs was assessed. The results showed that a total of 10,077 hospitalizations for cryptococcosis occurred corresponding to a weighted estimate of 49,010 cases. The median age was 43 years (interquartile range 34–54), and 26% were female. Approximately 64% of cases occurred in persons with AIDS. Although rates declined overall, age-adjusted rates were significantly higher in males with AIDS than in uninfected persons (p < 0.001). The mortality rate decreased but was greater in HIV-uninfected versus infected cohorts (12% versus 10%, p < 0.001). Conversely, hospital costs were greater in persons with AIDS ($40,671 versus $40,096, p=0.02). Although cryptococcal disease rates are decreasing over time, the associated mortality and costs remain concerning.
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Mohanta, Uday Kumar, Md Nuruzzaman Munsi, Md Azharul Islam Talukder, Emdadul Haque Chowdhury, and Md Mafijul Islam. "Livestock and poultry health management in Saint Martins island." Asian Journal of Medical and Biological Research 1, no. 3 (February 23, 2016): 622–27. http://dx.doi.org/10.3329/ajmbr.v1i3.26486.
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The study was performed to find out the existing status of livestock and poultry in the Saint Martins island, to determine the prevalence of parasitic and other infectious and non-infectious diseases of these, and to find out the existence of intermediate hosts of various parasites in the island. Prevalence of endoparasites in cattle, buffalo and goat was higher in winter than that of summer. Prevalence of stomach worm was highest in goat in both winter (50%) and summer (40%). 31.47% cattle harbored stomach worm infection in winter and 15.79% in summer. More than 20% buffaloes suffered from either single infection with Fasciola and Paramphistomum or in combination in both the seasons. Goat suffered from some extra species like Moniezia and Trichuris and the prevalence is just double in winter than that of summer. Morbidity rate of FMD in cattle is high, although mortality is low. But, in case of chicken, both morbidity and mortality rates were high enough to make a massive loss with respect to number and production due to Ranikhet/Newcastle Disease (ND), pox in the island. About 92.11% of total chicken population was lost every year due to outbreak of ND. Incidence of infectious disease in livestock and poultry in the island is very high as because the farmers cannot immunize the animals through routine vaccination. Even some farmers do not know about the immunization of livestock and poultry, and the veterinary service is not available in the island.Asian J. Med. Biol. Res. December 2015, 1(3): 622-627
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Béra Potelle, C., C. V. Cuervo Lombard, É. Tran, S. Barrière, J. P. Schuster, and F. Limosin. "Quality of life and mortality in elderly patients with schizophrenia: a prospective cohort study." European Psychiatry 26, S2 (March 2011): 830. http://dx.doi.org/10.1016/s0924-9338(11)72535-4.
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IntroductionThe increase of elderly schizophrenia patients during the last few decades is a major health issue. Although life expectancy increased for patients with schizophrenia, there is a greater rate of the occurrence of somatic illnesses, and premature mortality remains 2 to 3 times higher in these patients than in general population.ObjectivesTo prospectively assess health care access, quality of life, functional status, and rates and causes of death in a cohort of elderly schizophrenia patients.MethodsWe initiated a national epidemiologic 5-year cohort study including a large sample of schizophrenic patients aged 60 or more. The first aim was to assess the geriatric psychiatric services provided by a large sample (n = 108) of departments of psychiatry in France (n = 829). The second aim was to assess the number of elderly schizophrenia patients followed by each participating centre. Finally, we prospectively assess some demographic, clinical and biological variables, as well as quality of life indexes.ResultsThe geriatric psychiatric services are heterogeneously spread in French territory. Schizophrenic patients aged 60 and more represent 15% of French public psychiatric department activity. The cohort is actually in course of constitution.ConclusionsOur data may help to identify factors associated with increased morbidity and mortality in elderly schizophrenia.
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Chun, June Young, Se Ik Kim, Eun Young Park, Sang-Yoon Park, Su-Jin Koh, Yongjun Cha, Heon Jong Yoo, et al. "Cancer Patients’ Willingness to Take COVID-19 Vaccination: A Nationwide Multicenter Survey in Korea." Cancers 13, no. 15 (August 1, 2021): 3883. http://dx.doi.org/10.3390/cancers13153883.
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Considering the high morbidity and mortality of Coronavirus disease 2019 (COVID-19) in patients with malignancy, they are regarded as a priority for COVID-19 vaccination. However, general vaccine uptake rates among cancer patients are known to be lower than in their healthy counterparts. Thus, we aimed to investigate the attitude and acceptance rates for the COVID-19 vaccine in cancer patients and identify predictive factors for vaccination that could be modified to increase vaccine uptake rates, via a paper-based survey (58 items over six domains). A total of 1001 cancer patients participated in this nationwide, multicenter survey between February and April 2021. We observed that 61.8% of respondents were willing to receive the COVID-19 vaccine. Positive predictive factors found to be independently associated with vaccination were male gender, older age, obesity, previous influenza vaccination history, absence of cancer recurrence, time since cancer diagnosis over 5 years, and higher EuroQol Visual Analogue Scale scores. Along with the well-known factors that are positively correlated with vaccination, here, we report that patients’ disease status and current health status were also associated with their acceptance of the COVID-19 vaccination. Moreover, 91.2% of cancer patients were willing to be vaccinated if their attending physicians recommend it, indicating that almost 30% could change their decision upon physicians’ recommendation. Unlike other factors, which are unmodifiable, physicians’ recommendation is the single modifiable factor that could change patients’ behavior. In conclusion, we firstly report that Korean cancer patients’ acceptance rate of the COVID-19 vaccination was 61.8% and associated with disease status and current health status. Physicians should play a major role in aiding cancer patients’ decision-making concerning COVID-19 vaccines.
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Morris, Katherine Ann, Jason Beckfield, and Clare Bambra. "Who benefits from social investment? The gendered effects of family and employment policies on cardiovascular disease in Europe." Journal of Epidemiology and Community Health 73, no. 3 (January 2, 2019): 206–13. http://dx.doi.org/10.1136/jech-2018-211283.
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BackgroundIn the context of fiscal austerity in many European welfare states, policy innovation often takes the form of ‘social investment’, a contested set of policies aimed at strengthening labour markets. Social investment policies include employment subsidies, skills training and job-finding services, early childhood education and childcare and parental leave. Given that such policies can influence gender equity in the labour market, we analysed the possible effects of such policies on gender health equity.MethodsUsing age-stratified and sex-stratified data from the Global Burden of Disease Study on cardiovascular disease (CVD) morbidity and mortality between 2005 and 2010, we estimated linear regression models of policy indicators on employment supports, childcare and parental leave with country fixed effects.FindingsWe found mixed effects of social investment for men versus women. Whereas government spending on early childhood education and childcare was associated with lower CVD mortality rates for both men and women equally, government spending on paid parental leave was more strongly associated with lower CVD mortality rates for women. Additionally, government spending on public employment services was associated with lower CVD mortality rates for men but was not significant for women, while government spending on employment training was associated with lower CVD mortality rates for women but was not significant for men.ConclusionsSocial investment policies were negatively associated with CVD mortality, but the ameliorative effects of specific policies were gendered. We discuss the implications of these results for the European social investment policy turn and for future research on gender health equity.
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Gool, Sophia, and Wendy Patton. "Voices Still to be Heard." Australian Journal of Indigenous Education 26, no. 1 (July 1998): 1–7. http://dx.doi.org/10.1017/s1326011100001757.
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In a climate of self-determination it is essential to clarify what Aboriginal and Torres Strait Islander people themselves feel about their cultural identity and future. These voices exist in a context of the great potential in Aboriginal culture and by contrast the severe problems which Aboriginal people face.Lippman (1994) argues that, although there is some evidence of Aboriginal status becoming more equitable, education being one instance to avail self-determination, data continue to reveal that Aboriginal mortality and morbidity rates lie in stark contrast to those of the general population of Australia. The death rate for Aboriginal men and women of 35 to 44 years is eight times higher than for the average non-Aboriginal (Ferrari, 1997). Queensland Health (1996) recently reported that Cape York has yet to experience the mortality gains seen by Indigenous populations in New Zealand and North America.
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McNamara, Robert K. "Membrane Omega-3 Fatty Acid Deficiency as a Preventable Risk Factor for Comorbid Coronary Heart Disease in Major Depressive Disorder." Cardiovascular Psychiatry and Neurology 2009 (September 16, 2009): 1–13. http://dx.doi.org/10.1155/2009/362795.
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Major depression disorder (MDD) significantly increases the risk for coronary heart disease (CHD) which is a leading cause of mortality in patients with MDD. Moreover, depression is frequently observed in a subset of patients following acute coronary syndrome (ACS) and increases risk for mortality. Here evidence implicating omega-3 (n-3) fatty acid deficiency in the pathoaetiology of CHD and MDD is reviewed, and the hypothesis that n-3 fatty acid deficiency is a preventable risk factor for CHD comorbidity in MDD patients is evaluated. This hypothesis is supported by cross-national and cross-sectional epidemiological surveys finding an inverse correlation between n-3 fatty acid status and prevalence rates of both CHD and MDD, prospective studies finding that lower dietary or membrane EPA+DHA levels increase risk for both MDD and CHD, case-control studies finding that the n-3 fatty acid status of MDD patients places them at high risk for emergent CHD morbidity and mortality, meta-analyses of controlled n-3 fatty acid intervention studies finding significant advantage over placebo for reducing depression symptom severity in MDD patients, and for secondary prevention of cardiac events in CHD patients, findings that n-3 fatty acid status is inversely correlated with other documented CHD risk factors, and patients diagnosed with MDD after ACS exhibit significantly lower n-3 fatty acid status compared with nondepressed ACS patients. This body of evidence provides strong support for future studies to evaluate the effects of increasing dietary n-3 fatty acid status on CHD comorbidity and mortality in MDD patients.