district (Bhat 1987; Krishnaji and James 2002; Saikia et al. 2011; Ram et al. 2015). Fi- nally, there are some studies on socioeconomic disparity in adult mortality in develop- ing countries in large sample surveys. Using DSS data in African countries, a few studies documented a strong association between SES and adult mortality. Yet, these studies are not nationally representative studies because they are based on small popu- lation numbers with low case numbers (Nikoi and Odimegwu 2013; Ashenafi et al. 2017). Using nationally representative sample survey data, a few studies in China and India have documented the association between SES and adult or old-age mortality (Saikia and Ram 2010; Luo and Xie 2014; Barik et al. 2018). However, in these studies, the analysis was limited to show the statistical relationship between socioeconomic conditions and the adult mortality rate. For instance, Saikia and Ram (2010) demon- strated that the risk of death for adults belonging to households with at least one liter- ate person was about 34% lower than in households without any literate person. Barik et al. (2018) found a strong negative relationship between economic status (measured by income, consumption, and ownership of consumer durables) and adult mortality. Yet, neither of these studies estimated mortality by socioeconomic characteristics, nor disparities in adult life expectancy across socioeconomic groups.
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Abstract: The purpose of this study is to investigate adult mortality variations among regional states in Ethiopia. Data from Ethiopian Demographic and Health Survey (EDHS 2011) are used. Multilevel logistic regression model is fitted to the data. The findings show that the correlates of adult mortality are adult's age, age of household head, sex of household head, wealth index, type of toilet facility, and type of cooking fuels. The between-region variance is estimated to be 0.1727 which is significant at 5% level of significance, indicating that variation of adult mortality among regional states is non-zero. The intra- correlation is estimated to be 0.0099, suggesting that about 1% of the variation in adult mortality could be attributed to differences across regional states. The variance of the random coefficient model is statistically significant, implying the presence of adult mortality variation among regional states of the country. The deviance statistic is about 4113.945 and it is compared with Chi-square at difference of full and empty model with degree of freedom 33.924 at df 22 and p-value < 0.000. This reveals that there is enough evidence against null hypothesis. Therefore, the multilevel model consisting the explanatory variables is considered the final model. It revealed that the random coefficient multilevel logistic regression analysis suggests that there exist considerable differences in adult mortality across regions in the country.
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A variation of the orphanhood method is to use paren- tal survival data by 5-year age group from two censuses and to construct a hypothetical cohort of respondents to estimate adult mortality based on changes in the survival status of each cohort’s parents [27, 28]. This can be done using female mortality in PNG from the 2000 and 2011 censuses. This method provides more accurate estimates of adult mortality than derived from one census alone because it is based on the survival of parents of hypo- thetical cohorts during an intercensal period; the same information is being asked of the same cohorts of re- spondents at two points in time, and so any bias intro- duced by systematic under-reporting of mothers’ mortality would be minimal. The 45q15 is estimated as the average of the 45q15 of each age group 20-24 to 45-49. The reference date for the 45q15 estimates is the geometric mean of the two census dates. The method relies upon the calculation of the mean age of childbear- ing of the mothers in each census using births in the previous year; these data are only available in the 2011 census and so the mean age at childbearing in 2011 was assumed to apply in 2000 as well.
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male drinking behavior would be responsible. Usually, male adult mortality increases with heavy and uncontrolled drinking behavior (43,44) and this behavior has multiple impacts; increasing violence and murder, worsening of infectious diseases like tuberculosis and hepatitis, limiting life expectancy with liver and heart diseases, in- creasing mental diseases and suicide and increas- ing unintentional injuries due to drunk driving (45). Moreover, unprotected sex behavior is common after alcohol consumption and the risk for sexually transmitted diseases particularly HIV is increased (46). In South Africa, alcohol users were more vulnerable to risky sexual intercourse (47) and the prevalence of adult mortality was high in Africa due to this circumstance.
Past studies examining SES effects on mortality have not adequately stratified samples by race. Thus, it is unknown whether the protective effects of higher SES variables are more pronounced among certain racial/ethnic groups than others. With few exceptions, most studies to date have also relied on cross-sectional data. Yet longitudinal data may be best suited for a fuller accounting of the SES-mortality relationship. The objectives of the study were to investigate associations between income and education on all-cause mortality in the United States, and determine whether racial stratification accounts for the SES differences. Specifically the following questions are addressed: (1) Do indicators of socioeconomic status, such as income and education affect mortality? (2) Does the effect persist once controls are made for race/ethnicity? (3) Are the presumed protective effects of higher economic status (income, and education) invariant across racial/ethnic groups?
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Complementing the ability of census and survey data to describe macro-level trends in mortality, community-based studies that collect data on the HIV serostatus of participants can compare the mortality of infected and uninfected individuals. The age profile of the effect of HIV on mortality is determined by the stage of the epidemic, the age profile of incidence in the past, and the average time between infection and death. Because com- munity studies have the ability to track the survival times of infected individuals, they are one of the only sources of data able to provide average times between infection and death. Studies like this that have prospectively monitored cohorts of HIV positive people esti- mate survival times in the range 9-11 years for individuals infected in their 20s and shorter survival times for people infected at older ages (Porter and Zaba 2004; Todd et al. 2007). Direct evidence from community-based studies provides the best understanding of the ef- fect of HIV on the level and age pattern of adult mortality (see for example: Porter and Zaba 2004; Groenewald et al. 2005; Adjuik et al. 2006; Nyirenda et al. 2007; Smith et al. 2007; Zaba et al. 2007; Marston et al. 2007). Data from health and demographic surveil- lance system (HDSS) field sites in Africa and Asia – all prospective community-level sites – identify seven age patterns of mortality, two of which likely reflect a substantial effect of HIV. Those two patterns have significant humps in the age pattern of mortality between ages 20 to 55 for males and 20 to 45 for females (Clark 2002).
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There are substantial educational differentials in survival chances (Elo and Preston 1996; Lleras-Muney 2005). We also have evidence for educational differentials in adult mortality and maternal educational differentials in child mortality in South Korea (Choe 1987; Kim 1988; Kim 2004). Hence, improvements in educational attainment should increase the number of survivors in old age and the number of surviving offspring. Because child mortality in South Korea is fairly low, we expect that educational differentials in adult mortality will matter more than maternal educational differentials in child mortality. In other words, educational upgrading makes the population older as well as healthier. Increasing longevity eventually increases the number of less healthy or vulnerable people in the population. To fully account for the implications of changing survival chances, we need information on the joint distribution of survival probability, health status, own and spousal education, and the number and educational attainment of offspring. Unfortunately, such data do not exist for South Korea. Instead, we address the implications of differential mortality by using information available from period life tables by education. In Appendix A2, we present a supplementary analysis to assess the implications of differential mortality by using bivariate relationships between education and mortality on the aggregate level. Based on this analysis, we assume that the simulated changes in women‘s education lead to a 1 percent increase in elderly population. Please see Appendix A2 for more detailed discussion.
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A total of 76,692 female deaths (of which 26,427 deaths were of women aged 15–49) were recorded for the 12 months prior to the 2010 census. In rural areas 47,554 females deaths were recorded and 13,640 deaths were of women aged 15–49, while in urban areas 29,138 female deaths in total and 12,786 deaths of women aged 15–49. For rural areas, all three methods of evaluation (GGB, SEG, and combined GGB-SEG) indicated underreporting of female deaths, while in urban areas the three methods indicated over-reporting of deaths (Tables 2 and 3). In rural areas, the percentage point difference between the GGB and SEG estimates of deaths coverage was 18 %, twice the difference in urban areas. For both rural and urban areas, deaths coverage was differential by age as ob- served from the plots of the SEG and combined GGB- SEG (Figs. 1 and 2) showing that the estimates were not aligned along a straight line. (The same was also the case for the GGB plots; data not shown.) However, deaths coverage by age was more stable in rural areas compared to urban areas (where the line was highly curvilinear; see Fig. 2). The coverage estimates from the combined GGB- SEG were used to adjust recorded deaths. Summary mea- sures of adult mortality are also provided in Tables 2 and 3. The estimated number of life table deaths in early adult- hood (before age 40) was higher than in late adulthood (age group 40–60) in both rural and urban areas. How- ever, the probability of dying was high in late adulthood relative to the probability of dying in early adulthood. The probability of dying between ages 15 and 50 was 39 % in rural areas and 25 % in urban areas, while the probability of dying between ages 15 and 60 was 50 % in rural and 34 % in urban areas.
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The success of Brass’ approach to estimating child mortality also increased interest in the possibility of estimating adult mortality from information on the survival of other relatives. Brass and Hill (1973) proposed methods for estimating life table survivorship ratios from proportions of respondents of successive five-year age groups with mother alive or father alive. The methods have been improved by several subsequent authors (Hill and Trussell 1977; Timæus 1991b, 1992; Timæus and Nunn 1997). The age group of respondents represents the survival time of the mother, so the proportion of respondents of a given age group with mother alive approximates a survivorship ratio from an average age of childbearing to that age plus the age of the respondents. The available methods model this relation using different patterns of fertility, mortality and age distribution to allow the conversion of a proportion with parent surviving into a life table survivorship ratio, controlling for the actual age pattern of childbearing. Timæus (1991a) has also developed methods for respondents whose mothers died before marriage or after marriage. Brass and Bamgboye (1981) developed a general method for estimating the reference date of estimates derived from data on survival of parents (as well as other relatives).
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Abstract The biological activity of four spices powder namely black pepper (Piper nigrum L.), black cumin (Nigella sativa L.), methi (Trigonella foenum-graecum) and garlic (Allium sativum L.) was assessed on the basis of adult mortality, oviposition performance, adult emergence of pulse beetle Callosobruchus chinensis L, and seed damage and consequent weight loss of gram (Cicer arietinum) caused by this insect at 0.25 g, 0.50 g and 1.00 g powder/kg gram seeds. All the tested spices powder showed significant effect on the above parameters. The highest adult mortality was recorded when gram seeds were treated with black pepper powder at 1.00 g/kg. whereas methi showed the least effect on adult mortality. Spices powder used in the experiment effectively controlled adult emergence by inhibiting oviposition and growth and development of life stages of pulse beetle. In all the treatments lowest number of adult emergence was obtained from gram seeds treated with black pepper at 1.00 g/kg seeds. The highest weight loss was observed in control treated seeds followed by methi powder at 0.25 g/kg gram seeds. Black pepper treated seeds showed the lowest seed weight loss followed by black cumin, garlic and methi. From this present study the toxicity of the spices powder were found in the order black pepper > black cumin > garlic > methi.
The percentage of adult mortality (Table IV) at 1 ml/100 gm seeds in seeds treated with 2– phenyl–3–(1’H–mor pholinomethyl–2’–methyl benzimidazolo)–6,8 dibromo quinazolin–4(3H)–one was maximum in 6 i (26.7%) while three derivatives 6 a , 6 c , 6 g showed the minimum value of 6.67%.
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From the Human Development Report of 2014, we calculated the product of infant mortality rate, under-five mortality rate, female adult mortality rate, and male adult mortality rate as a new measure of national health, the total mortality rate or TMR, and the ratio of per capita health spending in purchasing power parity to inequality in life expectancy as a new measure of national health, the health spending per health inequality or Health/c/IneqLE. Of the 172 nations reporting sufficient data to evaluate these parameters, 52 were healthy (TMR < 1 billion). All healthy nations were rich (Health/c/IneqLE> 101). Of the 120 sick nations (TMR > 1 billion), 108 were poor (Health/c/IneqLE< 102). We conclude that Health/c/IneqLE> 101 is a necessary condition for national health. Twelve nations were rich but sick. None of these twelve had Health/c/IneqLE> 186. All nations with Health/c/IneqLE> 194 were healthy. We conclude that Health/c/IneqLE> 194 is a sufficient condition for national health. We recommend that efforts to improve human development be directed at increasing Health/c or decreasing IneqLE. Efforts to increase Health/c should increase per capita health spending and/or diminish population growth. Efforts to decrease IneqLE should enhance primary health care for the poor.
The main contribution of this study is to offer robust econometric evidence on the direction and magnitude of health system coverage effects on mortality outcomes. We do so by using a large panel data set of countries with annual data for a period of 14 years (1995–2008), analysed through IV speciﬁcations that allow for potential reverse causality and unobserved country-speciﬁc characteristics. The two-step IV strategy that is adopted starts by directly and consistently estimating any reverse causal effects of mortality on system coverage measures. Thus, as a further contribution to the ﬁeld, the empirical approach can shed light on the existence and magnitude of simultaneity between population health and system coverage, which can then be explicitly accounted for in the second estimation step that assesses the effects of coverage on population outcomes. We employ various pooled health ﬁnancing and access indicators as proxies for the level of coverage in a health system, reﬂecting its two main dimensions of effective access to needed care and protection from health-related ﬁnancial hardship. We ﬁnd that expansions in health system coverage, particularly through higher publicly pooled health spending, result in lower child and adult mortality. We also ﬁnd that the beneﬁcial effect of pooled health funds on child mortality is only unearthed once the important reverse causal effect of mortality on pooled expenditures has been taken into account, and that the spending impact is larger in poorer countries.
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with pulse oximetry, was associated with increased all- cause mortality and mortality caused by pulmonary dis- eases. This has not been described previously in population studies. This association remained significant after adjust- ing for sex, age, history of smoking, self-reported diseases and respiratory symptoms, BMI, and CRP concentration. When including FEV 1 % predicted as a covariate, the HR
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Lyte et al. suggested that the ability of inotropic cat- echolamines to stimulate bacterial proliferation and biofilm formation might be an etiological factor in the development of intravascular catheter colonization and catheter-related infection . This effect of inotropic catecholamines does not seem to be limited to only coagulase-negative Staphylococcus but also other gram- negative bacteria. The growth of these bacteria and production of virulence are associated with inotropic cate- cholamines . Thus, inotropic catecholamines, such as dobutamine, may have adverse effects in patients with sep- tic shock, and the decrease in β-adrenergic response in patients with sepsis-induced cardiomyopathy may be a protective mechanism to these effects. Morelli et al. suggest that β-blockade could be associated with reduc- tions in the heart rate without adverse effects and that this could help to improve survival . Although the mortality in the control group of their study was high, the study provided interesting preliminary data suggest- ing that β-blockade may be effective in septic shock treatment. For these reasons, despite the beneficial ef- fects of dobutamine, it appears that excessive increases in sympathetic tone during sepsis can create adverse effects.
In conclusion, the overall compliance with the audit criteria (ASCO guideline) was 63.7% (58/91) in our study. GCSF is an established effective therapy in approved indication. In our study, use of GCSF accelerates neutrophil recovery in both groups (appropriate or inappropriate according to guideline). Overall mortality was higher in the unjustified indications. Our resources are constrained in our country, so use of high cost medication like GCSF should be rational and optimized. We propose to design and implementing of studies to evaluate the cost-effectiveness of GCSF treatment and development of national guideline for optimizing the use of GCSF treatment.
Following the approach used by Hightower et al. (2001), we assumed that a transmitter that ceased movement represented a natural mortality, although catch-and-release delayed mortality was also a possible cause, especially following a tour- nament (Neal and Lopez-Clayton 2001). Tags that were undetected on multiple search occasions were assumed to have disappeared due to one of four possible causes: (1) unreported harvest mortality; (2) transmitter failure; (3) migration of fish over the dam or upriver during high-water periods; or (4) transport out of the lake by predators. Radio- telemetry results suggest that avian predation could account for a small fraction of lost tags (Wa- ters 1999), but the primary mechanism was as- sumed to be unreported harvest mortality.
Information on causes of death among adults in sub- Saharan Africa is essentially non-existent because death certificates are often not issued. In this regard, Bamenda which is an urban area in Africa and Cameroon in particular, suffers from the same problem of asthma mortality and morbidity. According to the latest WHO data published in April 2011, Asthma Deaths in Cameroon reached 1,914 or 0.81% of total deaths. The age adjusted Death Rate is 18.40 per 100,000 of population, thus ranking Cameroon number 26 in the world. In this light, changes in meteorological parameters such as temperature, rainfall and humidity substantially increase respiratory morbidity and mortality in adult patients with common chronic lung diseases, such as asthma and COPD, and other serious lung diseases in the city of Bamenda especially in the Bamenda I municipality experiencing high degree of cold. These Respiratory diseases in the city of Bamenda similarly increase among children during as they become the most vulnerable age group with less resistant systems. Cold weather, by increasing cold exposure, will increase overall respiratory infections in individuals with underlying COPD and asthma in particular. Given the significant health burdens associated with ambient are pollution, getting the numbers right is critical for designing policies that maximize future health protection in Bamenda. Although not regulated as air pollutants, naturally occurring air contaminants of relevance to human health, including smoke from wildfires and airborne pollens and molds, also may be influenced by climate change. Thus there are a range of air contaminants, both anthropogenic and natural, for which climate change impacts are of potential interest affecting the health conditions of the people of Bamenda, the case in point of climate change induced asthma.
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The risk of severe NNJ is highest between ∼3 and 6 postnatal days when the plasma or serum bilirubin level reaches its peak in most infants. Timely detection, monitoring, and treatment within this window is effective in preventing most bilirubin-induced mortality. For example, in many developed countries, infants are routinely screened during their birth hospitalization and monitored for the risk of subsequent severe hyperbilirubinemia postdischarge. This system facilitates a timely referral for jaundiced infants. However, the care pathway for jaundiced infants in resource- limited countries is compromised in many ways. 1 Firstly, a significant
Model 5, which controls for both maximum BMI and weight lost from maximum BMI, further supports the claim that reverse causation is at work in Model 4. In Model 5, the odds of dying increase by 3.5% for each additional unit of maximum BMI, and decrease by 5.0% for each BMI unit of weight loss. In this model, the survival advantage of a college degree shrinks to an all-time low: we can explain a greater share of the mortality gradient by controlling for the fact that while people with lower levels of education tend to have weighed more than their higher educated counterparts in the past, they also tend to have lost more weight, presumably because of illness. However, the goal of the present analysis is not to account for the largest share of the gradient possible, but rather to estimate the share of the gradient attributable to differential adiposity—not adiposity and weight loss. Models 4 and 5 illustrate that when both maximum and current BMI are in the model, the mortality hazards associated with weight loss become a
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