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Kippen, Rebecca. "Death in Tasmania: Using civil death registers to measure nineteenth-century cause-specific mortality." Phd thesis, Canberra, ACT : The Australian National University, 2002. http://hdl.handle.net/1885/9221.
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Studies of nineteenth-century cause-specific mortality date from the nineteenth century itself. Of necessity, most of these studies are based on published cause-of-death data, where causes have already been classified according to some system, rather than data from the original death registers. This thesis investigates nineteenth-century Tasmanian mortality. The main data source for this investigation is a computer database containing individual-level death-registration data for Tasmania from the period 1838-99. Annual life tables are
calculated using adjusted census and death registration data. Causes of death are analysed using a new cause-:of-death classification system that combines elements from
the Farr system of registration, in use in England and adopted in Tasmania in the nineteenth century, and the latest revision of the International Statistical Classification of Diseases and Related Health Problems.
The study seeks to answer the following three questions:
How accurately were causes of death registered in nineteenth-century Tasmania? How were causes of death classified in the Statistics of Tasmania? What were the mortality patterns and trends over time in Tasmania and what causes of death resulted in these patterns and trends? The thesis confirms the need for researchers to be aware of the pitfalls of nineteenth century
cause-of-death data, while recognising the wealth of information that such data can provide about nineteenth-century causes of death, and perceptions of these causes.
The thesis also emphasises the importance of considering changes in mortality over time separately by age. The causes of mortality in infancy, childhood, adulthood and
middle and old age were all very different, and calculating just one measure of mortality, such as life expectancy or an age-standardised mortality rate, often masks the very different trends occurring for various life stages.
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Snyder, Michelle, Shelly-Ann Love, Paul Sorlie, Wayne Rosamond, Carmen Antini, Patricia Metcalf, Shakia Hardy, Chirayath Suchindran, Eyal Shahar, and Gerardo Heiss. "Redistribution of heart failure as the cause of death: the Atherosclerosis Risk in Communities Study." BioMed Central, 2014. http://hdl.handle.net/10150/610236.
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BACKGROUND:Heart failure is sometimes incorrectly listed as the underlying cause of death (UCD) on death certificates, thus compromising the accuracy and comparability of mortality statistics. Statistical redistribution of the UCD has been used to examine the effect of misclassification of the UCD attributed to heart failure, but sex- and race-specific redistribution of deaths on coronary heart disease (CHD) mortality in the United States has not been examined.METHODS:We used coarsened exact matching to infer the UCD of vital records with heart failure as the UCD from 1999 to 2010 for decedents 55years old and older from states encompassing regions under surveillance by the Atherosclerosis Risk in Communities (ARIC) Study (Maryland, Minnesota, Mississippi, and North Carolina). Records with heart failure as the UCD were matched on decedent characteristics (five-year age groups, sex, race, education, year of death, and state) to records with heart failure listed among the multiple causes of death. Each heart failure death was then redistributed to plausible UCDs proportional to the frequency among matched records.RESULTS:After redistribution the proportion of deaths increased for CHD, chronic obstructive pulmonary disease, diabetes, hypertensive heart disease, and cardiomyopathy, P<0.001. The percent increase in CHD mortality after redistribution was the highest in Mississippi (12%) and lowest in Maryland (1.6%), with variations by year, race, and sex. Redistribution proportions for CHD were similar to CHD death classification by a panel of expert reviewers in the ARIC study.CONCLUSIONS:Redistribution of ill-defined UCD would improve the accuracy and comparability of mortality statistics used to allocate public health resources and monitor mortality trends.
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Bamber, Andrew Richard. "A proteomic approach to determining cause of death in sudden unexpected death in infancy (SUDI)." Thesis, University College London (University of London), 2017. http://discovery.ucl.ac.uk/10033880/.
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Introduction: Despite improvements in the understanding of infant death over recent years, many infants die each year in whom no cause of death is identified. There is evidence to suggest that a proportion of these unexplained deaths are the consequence of infection, either by a classical mechanism or as a consequence of the action of bacterial toxins. Post mortem tests for bacteria are robust, but there is a lack of effective post mortem tests for inflammatory markers which might assist in the interpretation of bacteriological results, and for identification of bacterial toxins. Methods: Proteomic techniques including biomarker discovery techniques using liquid chromatography mass spectrometry, and targeted techniques using multiple reaction monitoring tandem mass spectrometry, were used to identify potential biomarkers for infection and identify bacterial organisms and toxins, with a view to creating clinically-useful tests. Results: First, a rapid test for three biomarkers was developed which allows identification of infection and sepsis with high sensitivity and specificity in post mortem liver samples; this may be rapidly translated for clinical use. Second, a highly specific and sensitive test for Staphylococcus aureus and seven Staphylococcal exotoxins was developed which may be used to study the significance of Staphylococcal toxins in infant deaths. Furthermore this technique may adapted to identify other organisms; allowing potential use as a rapid diagnostic test in clinical practice in the living. Thirdly, the tests developed have identified inflammatory markers which are decreased in infants dying of infection; raising the possibility that acquired immune paresis may contribute to these deaths. This finding contributes to the understanding of mechanisms of fatal infection in infants, and in their prevention and management. Finally, a number of mitochondrial proteins have found to be raised in SIDS cases, which may provide additional insight into the mechanism of death in some of these cases.
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Christofis, Madison. "Biomarkers and their application towards cause of death investigations." Thesis, Christofis, Madison (2018) Biomarkers and their application towards cause of death investigations. Masters by Coursework thesis, Murdoch University, 2018. https://researchrepository.murdoch.edu.au/id/eprint/42903/.
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Causes of deaths are frequently unknown, and in general a post mortem examination must take place as establishing an individual’s cause of death is the foremost task for a forensic pathologist. Cause of death refers to the illness or injury that initiated the event that lead directly to death or the circumstances of the accident or violence that produced the injury.
However, autopsies or post mortem examinations occasionally cannot determine the cause of one’s death this is due to the body not automatically exhibiting visible evidence of how the fatality transpired and similarly there may not be a history of illness which could be as a means of death. Thus the practise of biomarkers is also involved to determine the cause of fatality in problematic cases.
Biomarkers reflect an interaction between the body’s biological system and a possible threat which can be either biological, chemical or physical. Although biomarkers have been reviewed and known about for some time in regards to disease and therapeutic intervention the concept for their application in a post mortem examination is relatively new. There is limited literature with regards to this topic with no exact correlation between the use of biomarkers and establishing cause of death, hence the purpose of this literature review is to determine and review the application of various biomarkers in cause of death investigations. This review will also support the use of biomarkers as diagnostic markers and used to generate diagnostic tests to conclude specific causes of death and encourage further biomarker research.
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Adamsson, Wahren Caroline. "Mortality and psychiatric morbidity among drug addicts in Stockholm /." Stockholm, 1997. http://diss.kib.ki.se/1997/91-628-2765-0l.
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Rozman, Mauro Abrahão. "Mortalidade por causa mal definida no Brasil, Estado de São Paulo e Baixada Santista. 1980 - 2002." Universidade de São Paulo, 2007. http://www.teses.usp.br/teses/disponiveis/5/5137/tde-11092007-135433/.
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Introdução: A proporção de óbitos classificados como de causa básica mal definida é um dos principais indicadores da qualidade das estatísticas de mortalidade, de grande importância na avaliação da situação e na orientação das políticas de saúde. Estudos preliminares encontraram uma evolução temporal discrepante na comparação da mortalidade proporcional por causa mal definida no Brasil, no Estado de São Paulo, na Baixada Santista e no Município do Guarujá. Este estudo foi realizado com o objetivo de tentar compreender tais diferenças. Métodos: A evolução temporal da proporção de óbitos por causa mal definida foi analisada no período de 1980 a 2002, dividindo-se o Estado de São Paulo em grupos de municípios com e sem o Serviço de Verificação de Óbitos (SVO) e a Baixada Santista. Além da mortalidade proporcional, a classificação do óbito por causa mal definida foi estudada com base no que se convencionou chamar de ?primeiro médico? a avaliar a causa de morte. Ou seja, o profissional que preenche a Declaração de Óbito ou encaminha o caso ao SVO ou ao Instituto Médico Legal (IML). Exclui os médicos do SVO e do IML que preenchem a declaração. A qualidade do preenchimento foi avaliada nos óbitos ocorridos em hospitais e em domicílios, baseada nas informações do tipo de atestante. Resultados: Observou-se um aumento na proporção de óbitos por causa mal definida pelo primeiro médico avaliador da causa de morte em todas as áreas do Estado de São Paulo. Em 1980, na Baixada Santista, a mortalidade proporcional por causa mal definida (MPCMD) era muito baixa, pois mais de 90% dos casos classificados como de causa mal definida pelo primeiro médico avaliador da causa de morte eram encaminhados aos IMLs da região ou ao SVO do Guarujá, onde a maioria dos casos era reclassificada para óbito de causa definida sem a realização de necropsia. A partir de 1984, progressivamente, os casos deixaram de ser encaminhados aos IMLs e passaram a ser classificados como de causa mal definida, com aumento da mortalidade proporcional de mais de nove vezes. A MPCMD no Estado de São Paulo manteve-se estável no período analisado em virtude do aumento da proporção de óbitos em serviços de saúde e de realização de necropsias. No Brasil, onde se observou uma queda de 36,4% da MPCMD, pode-se atribuir ao aumento dos óbitos hospitalares mais de 50% da redução desse indicador. O aumento do encaminhamento dos casos aos SVOs e aos IMLs foi fator importante na redução da mortalidade por causa mal definida nos óbitos domiciliares. Na Baixada Santista, no Estado de São Paulo e nos óbitos hospitalares do país, verificou-se uma piora na qualidade do preenchimento da Declaração de Óbito. Conclusão: A despeito da melhoria dos recursos diagnósticos, observou-se no período estudado uma piora na qualidade do preenchimento da Declaração de Óbito no Estado de São Paulo e nos óbitos hospitalares do país. Para enfrentar o problema da elevada mortalidade proporcional por causa mal definida, sugere-se rediscutir o modelo do fluxo de preenchimento das declarações de óbito, com redefinição das atribuições dos SVOs e dos IMLs.Introduction: The proportion of deaths classified as due to ill-defined causes is one of the major indicators of the quality of mortality statistics, and is of great value for evaluating and orienting public policies. Preliminary studies indicate discrepant time trends in the evolution of the proportion of deaths due to ill-defined causes between Brazil as a whole, the state of Sao Paulo, the Baixada Santista region, and the municipality of Guarujá. The present study was designed as an attempt to understand these discrepancies. Methods: We analyzed the temporal evolution in the proportion of deaths due to illdefined causes between 1980 and 2002, dividing the state of Sao Paulo into three groups of municipalities: those with Death Verification Service (DVS), those without DVS, and those located in the Baixada Santista. In addition to proportional mortality, we also studied the classification of ill-defined deaths based on what was defined as the ?first physician? to evaluate cause of death. This consisted either of the professional who completed the Death Certificate or who referred the case to the DVS or medical examiner. This definition excludes any DVS or Medical Examiner physicians who filled certificates. The quality of the information in the certificate was evaluated for deaths occurred in hospitals and at home based on information on the type of physician. Results: There was an increase in the proportion of deaths due to ill-defined causes as defined by the first physician to evaluate cause of death in all areas of the State of Sao Paulo. In 1980, in the Baixada Santista, proportional mortality due to ill-defined causes (PMIDC) was very low, with over 90% of cases considered as due to illdefined causes by the first physician being referred to the region?s Medical Examiners or to the Guarujá DVS, where the majority of cases was assigned to a defined cause without need for autopsy. Beginning in 1984, the number of cases referred to Medical Examiners began to fall, leading to a 9-fold increase in PMIDC. PMIDC in the State of Sao Paulo remained stable throughout the period as a consequence of the increase in the proportion of autopsies and of deaths occurred within healthcare facilities. In the country as a whole, there was a 36.4% decrease in PMIDC, of which more than 50% can be attributed to the increase in the number of hospital deaths. Increased referral of cases to DVSs and medical examiners was an important factor in the reduction of mortality due to ill-defined causes among athome deaths. The quality of information in Death Certificates decreased in the Baixada Santista, in the State of Sao Paulo, and among hospital deaths in Brazil as a whole. Conclusion: Despite improvements in diagnosis, quality of information in Death Certificates decreased during the studied period in the State of Sao Paulo and among hospital deaths in the country as a whole. In order to tackle the issue of high proportional mortality due to ill-defined causes, we suggest a reevaluation of the flow of information in Death Certificates, with a redefinition of the role of medical examiners and DVSs.
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Lekoloana, Matome Abel. "Factors influencing knowledge of doctors on medical certification of cause of death in Limpopo Province." Thesis, University of Limpopo, 2019. http://hdl.handle.net/10386/2872.
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Thesis (MPHM. (Curriculum Studies)) -- University of Limpopo, 2019The quality of mortality data in South Africa has been questioned because of the high percentage of deaths reported to be due to ill-defined causes. We sought to assess the level of knowledge of doctors on the International Classification of Diseases (ICD) rules for medical certification of cause of death and determine the factors influencing that knowledge. Methods A cross-sectional study was conducted across 12 hospitals in Limpopo Province among the five districts stratified by level of care. Doctors completed selfadministered questionnaire, which included the baseline characteristics and questions that tested their theoretical knowledge of the ICD rules of death certification. The outcome, an adequate level of knowledge was set at a score of ≥ 60%. A chi square test was used to determine the factors associated with the outcome. Ethical approval was obtained from Turfloop Research Ethics Committee, University of Limpopo. Results Of the 301 doctors who participated, 50.5% were female, 64% were junior doctors and 13% were specialists. Up to 49% of doctors worked in the two tertiary hospitals. Only 18% of the doctors have ever attended a Continuing Professional Development (CPD) on the topic. The mean overall score on knowledge of medical certification for all the doctors was 59.80% (±11.95) with 53% obtaining at least 60% on the questionnaire. Doctors lacked knowledge on identifying unnatural deaths and discerning the underlying cause of death. Factors associated with the adequate knowledge included years of clinical experience (p=0.01), previous training (p<0.001), awareness of guidelines (p=0.04), comfort level (p=0.01) and rank (p=0.02). Conclusion The study highlighted the need for training of all doctors in the province and identified the knowledge gaps. Interactive capacity-building workshops have been shown to improve knowledge of doctors on medical certification of cause of death in other studies. To improve the quality of mortality data in Limpopo Province, such workshops must be conducted in all hospitals. Key words: death notification, medical certification, cause of death
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Nojilana, Beatrice. "Quality of cause of death certification at Groote Schuur Hospital in Cape Town." Thesis, University of the Western Cape, 2008. http://etd.uwc.ac.za/index.php?module=etd&action=viewtitle&id=gen8Srv25Nme4_6594_1259562750.
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Cause of death certification continues to be a useful tool in obtaining demographic, epidemiological and legal information. However errors in death certification are widespread and range from incomplete certificates to inaccurate causes and manners of death. The accuracy of the immediate and underlying causes of death listed on the death certificate depends to a large extent on the doctor and his or her understanding of the guidelines for reporting immediate and underlying causes of death. In 1998, South Africa adopted a new death certificate as per the format proposed by WHO. However, several studies have identified problems in the quality of cause of death certification. Furthermore, analysis of cause of death data suggested extensive underreporting of HIV as an underlying cause of death..."
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Mgawadere, Florence. "Identification of maternal deaths, cause of death and contributing factors in Mangochi District, Malawi : a RAMOS study." Thesis, University of Liverpool, 2014. http://livrepository.liverpool.ac.uk/2008304/.
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Introduction: The recent World Health Organization (WHO) report on trends in Maternal mortality (MM), from 1990 to 2013, ranks Malawi as one of the fifteen sub-Saharan countries with the highest Maternal Mortality Ratio (MM) of above 500 per 100,000live births (WHO 2014b). Malawi has no registration system for recording births and deaths. MM estimates are based on direct sisterhood methods, (used in Demographic and Health Surveys) and WHO modelled estimates, which are both highly susceptible to inaccuracies because they are both indirect methods which do not identify individual deaths within a defined population. The difficulties in obtaining accurate MMR estimates highlight the need to explore other methodologies that give more reliable data on levels as well as the cause of maternal deaths (MDs). A Reproductive Age Mortality Survey (RAMOS) is one such approach and can provide more direct and complete estimation of MMR in countries without reliable vital registration or other data sources. This is the first RAMOS used in Malawi. The aim of this study was to identify the magnitude, causes of, and factors associated with MDs in the Mangochi district in Malawi. Methods: Deaths of women of reproductive age (WRA), (15 to 49 years) that occurred from December, 2011 to November, 2012 in the district were identified. Multiple data sources were used to identify deaths, including; health facilities, communities, mortuary records and police records. Classification the death as a MD or not was done according to the ICD-10 definition. Facility based audit were conducted for all facility based MDs and verbal autopsies for all MDs. Cause of death attribution was done in three ways, 1) by a panel of experts in maternal health using the WHO application of ICD-10 to deaths during pregnancy, childbirth and puerperium (ICD-MM) (WHO 2012c), 2) by health professionals working in health facilities and 3) by using an InterVA-4 computer model. Cause of death attributed by the three methods was then compared. The three delays model was used to identify delays associated with MDs. The number of MDs identified in this study was compared to the official register in the district. MMR was calculated based on three proxy denominators; 1) number of babies who received BCG vaccine, 2) live births from the census report and 3) live births calculated from general fertility estimates. Results: A total of 424 deaths of WRA were identified and 151 of these (35.6%) were identified to be MDs. Based on the three denominators, the MMR for the Mangochi district was within the range of 341-363 per 100,000 live births (95% CI: 289-425 per 100,000 live births). Only 86 MDs had been reported via existing registers, giving an underreporting rate of 43%. The highest MMR was in age group 25-29 years (494/100,000 live births (95% CI: 349-683 per 100,000). Most MDs (62.3% (94/151)) occurred in health facilities. Based on ICD-MM cause classification, 74.8% were direct MDs, 17.3% were indirect and 7.9% were due to unknown causes. The leading cause of direct MDs (n=113) was obstetric haemorrhage (35.8%) followed by pregnancy related infections (14.4%) and hypertensive disorders (12.6%). The most frequent indirect cause of MD (n=26) was malaria (56.7%). There was low level of agreement over the cause of death between the panel of experts and health the professionals (κ= 0.37), while a substantial level of agreement was observed between the panel of experts and the InterVA-4 model (κ= 0.66). Based on ICD-MM, health professionals identified contributory factors (morbidity group) to 15.1% of MDs (n=86) as the underlying cause of death. Substandard care for obstetric emergencies, lack of blood, lack of transport, failures to recognize the severity of a problem at community level and delays in starting the decision-making process to seek health care were frequently factors associated with MDs. Conclusion: The current MD reporting system in Malawi needs strengthening. The high numbers of health facility deaths, cause of MDs and their contributing factors in Mangochi reflect serious deficiencies in the quality of maternal care that need to be urgently rectified. Urgent orientation of health workers on ICD-MM is required to obtain accurate information on cause of MDs that can be used to design effective interventions. There is need to strengthen the referral system and educate women on obstetric danger signs.
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Pass, Desiree Olga. "Evaluation of an educational intervention to improve the accuracy of death certification amongst medical interns." Thesis, University of the Western Cape, 2008. http://etd.uwc.ac.za/index.php?module=etd&action=viewtitle&id=gen8Srv25Nme4_5748_1263952584.
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Objectives: To assess the knowledge and attitudes of doctors in relation to death certification and also assess whether an educational intervention can improve the accuracy of death certificate completion and thereby improve mortality information.
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Clark, Colleen Marie. "Identifying forensic markers for determining elder mistreatment as cause of death." Thesis, Boston University, 2012. https://hdl.handle.net/2144/12330.
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Thesis (M.S.)--Boston University
PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you.Elders, people over the age of 64, comprise the fastest growing segment of the population, and it is expected that the incidence of elder mistreatment will increase just as rapidly. Elder mistreatment is a serious issue that has only recently gained public awareness. Elder mistreatment is one of the least understood, researched or reported social issues and studies estimate that only 1 of every 14 cases is ever discovered. When an elder dies, it is usually the responsibility of the local medical examiner or coroner to conduct a full investigation to determine the cause and manner of death. However, there are currently no guidelines in existence to help distinguish between mistreatment and the ravages of advanced age or disease. Without effective tools to aid detection of elder mistreatment, the problem cannot be properly addressed, making reporting, intervention and prosecution impossible. This paper evaluates several potential markers of elder mistreatment along with physiologic changes of age and disease, to ascertain the merit of each finding asan indicator of abuse or neglect and develop an investigative protocol. A table and figure summarize and categorize the findings discussed throughout this paper. To ensure more accurate certification of elder deaths, research was reviewed and compiled in order to compare natural aspects of aging or accidental injury to inflicted injuries. In addition to characterizing elder's injuries, this research also describes the typical victim, the usual perpetrator, the victimperpetrator relationship and risk factors of elder mistreatment as part of the investigative protocol development. Enhanced knowledge of the signs and typical features of abuse and neglect will help medical professionals, law enforcement officials, and social service providers, more readily detect, report, and intervene in cases of elder mistreatment when they occur.
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Reilly, William J. "Characteristics of Cause of Death, Victim, Crime, Offender, and Familial Relationship." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/7726.
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Broad personality or global traits are unlikely to assist in solving capital crimes, so forensic psychologists have begun to focus on characteristics of the crime to create differentiating profiles. The purpose of this study was to determine if offender and victim characteristics and method of murder could provide cluster profiles differentiating familial relationship between offender and victim. Guided by classical conditioning theory and social learning theory, an archival database of 147 capital offenders responsible for 506 victims was analyzed. Cluster analysis yielded 3 distinct profiles. Compared to other clusters, Cluster 1 offenders tended to be Black and unfamiliar with their victims, who tended to be male between 20 and 50 years old that were typically shot. Cluster 2 offenders tended to be White and familiar with their typically female victims under the age of 20 who they typically murdered by use of blunt force or strangulation. Cluster 3 offenders were distinguished from the other 2 clusters only by having accounted for 90.6% of all victims who were stabbed, but no other associations with variables in the data set were discovered to explain this finding. Though limited in sample size, range of variables, and supplemental insights that could have been gained from case files or interviews, the results contribute to positive social change with offender-victim characteristics and method of murder profiles that begin to differentiate the familial offender-victim relationship and that future research can prospectively build on to create retrospective profiling models, which could potentially lead to resolving unsolved serial murder cases.
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McCall, Marsha Joan. "Perceived causal attributions and their relationship to grief intensity in early miscarriage." Thesis, University of British Columbia, 1987. http://hdl.handle.net/2429/27720.
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Grief and causal attribution are two of the most commonly observed reactions to early miscarriage, yet little is known about these reactions or whether a relationship exists between them. This exploratory and descriptive correlational study examined the maternal grief intensities, the causal attributions, and the relationship between them in a convenience sample of 15 women who spontaneously aborted at 16 weeks' or less gestation. Women responded to both a written questionnaire and a semi-structured Interview at 6 to 10 weeks post-miscarriage. Their responses Indicated both current and retrospective reactions to their miscarriages. Responses were analysed using nonparametric statistics and content analysis.
Maternal grief Intensities were found to vary widely at the time of the miscarriage, but all decreased significantly 6 to 10 weeks later. All women reacted to their miscarriage with attribution-seeking behaviors. The explanations most women formed were comprised of more than one causal attribution. Attributions were observed to have four distinct characteristics. Causal attributions were found to be either philosophical or physically oriented; to be organic, non-specific or maternal/self-blaming In origin; to be either dominant or non-dominant, and/or to refer to causalities immediate or prior to the physical event.
At the time of the miscarriage a positive correlation between grief Intensity and maternal/self-blaming attributions and between grief Intensity and philosophical attributions was found. These relationships were not observed 6 to 10 weeks later. A positive correlation was found between grief intensity and attributions to maternal emotions at both the time of the miscarriage and 6 to 10 weeks later.Applied Science, Faculty of
Nursing, School of
Graduate
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Hasanally, Devin. "Bioactive oxidized phosphatidylcholines cause apoptotic cell death in cardiomyocytes during ischemia reperfusion." Springer-Verlag New York, 2014. http://hdl.handle.net/1993/30363.
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The main treatment for myocardial infarction is early reperfusion of ischemic tissue. Ischemia and reperfusion (IR) produces reactive oxygen species that oxidize membrane phospholipids. The production of oxidized lipids and their role on cell death in cardiac IR injury is unknown. Using in vitro model of IR, our goal was to identify oxidized phosphatidylcholines (OxPC) from cardiomyocytes, to determine their bioactivity on cardiomyocyte viability and mitochondrial permeability, and using an OxPC specific EO6 antibody inhibit OxPC activity on cardiomyocytes.
Rat cardiomyocytes were exposed to IR and lipid extracts underwent lipidomic analysis with HPLC-MS/MS to quantitate 82 novel OxPC species. Cell viability and mitochondrial permeability were determined in vehicle control, non-oxidized control PC, and fragmented OxPC molecules. EO6 antibody was applied and cell viability was assessed.
Cardiomyocytes under IR demonstrated increased relevant OxPCs particularly fragmented species. OxPC treatment resulted in loss of cardiomyocyte viability, increased mitochondrial permeability when compared to control. EO6 antibody blocked the loss of cardiomyocyte viability.
We have shown for the first time that OxPCs are generated cardiomyocytes during IR and they have detrimental effects on cardiomyocyte viability. Additionally the EO6 antibody inhibits the bioactivity of the OxPCs on cardiomyocytes and could be part of a future treatment regimen.
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Kim, Saechin. "Two C. elegans genes that can mutate to cause degenerative cell death." Thesis, Massachusetts Institute of Technology, 1994. http://hdl.handle.net/1721.1/11945.
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Slyvka, Nataliia Oleksyivna, O. V. Besedynska, V. O. Samsonyuk, and Igor Antonovych Plesh. "WERNICKE’S ENCEPHALOPATHY AS A CAUSE OF DEATH IN ALCOHOL ADDICTS: AUTOPSY STUDY." Thesis, Материалы научной конференции студентов-медиков с международным участием. - Актуальные проблемы современной медицинской науки. - Самарканд, 27 мая 2016 г, 2016. http://dspace.bsmu.edu.ua:8080/xmlui/handle/123456789/11619.
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Slyvka, N. O., O. V. Besedynska, V. O. Samsonyuk, and Igor Antonovych Plesh. "WERNICKE’S ENCEPHALOPATHY AS A CAUSE OF DEATH IN ALCOHOL ADDICTS: AUTOPSY STUDY." Thesis, Материалы научной конференции студентов-медиков с международным участием. - Актуальные проблемы современной медицинской науки. - Самарканд, 27 мая 2016 г, 2016. http://dspace.bsmu.edu.ua:8080/xmlui/handle/123456789/11717.
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Ragow, Dina P. (Dina Paige). "The Relationship between Cause of Death, Perceptions of Funerals, and Bereavement Adjustment." Thesis, University of North Texas, 1995. https://digital.library.unt.edu/ark:/67531/metadc278046/.
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Although funerals are seen as universal rituals to honor the death of a loved one, their value in facilitating the grief process is not known. The present study explored the relationships between cause of death, feelings and attitudes toward the funeral, and subsequent bereavement adjustment.
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Danso, Samuel Odei. "Text analytics to predict time and cause of death from verbal autopsies." Thesis, University of Leeds, 2015. http://etheses.whiterose.ac.uk/12400/.
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This thesis describes the first Text Analytics approach to predicting Causes of Death (CoD) from Verbal Autopsies (VA). VA is an alternative technique recommended by the World Health Organisation for ascertaining CoD in low and middle-income countries (LMIC). CoD information is vitally important in the provision of healthcare. CoD information from VA can be obtained via two main approaches: manual, also referred to as the physician-review and automatic. The automatic-based approach is an active research area due to its efficiency and cost effectiveness over the manual approach. VA contains both closed responses and open narrative text. However, the open narrative text has been ignored by the state-of-art automatic approaches and this remains a challenge and an important research issue. We hypothesise that it is feasible to predict CoD from the narratives of VA. We further contend that an automatic approach that could utilise the information contained in both narrative and closed response text of VA could lead to an improved prediction accuracy of CoD. This research has been formulated as a Text Classification problem, which employs Corpus and Computational Linguistics, Natural Language Processing and Machine Learning techniques to automatically classify VA documents according to CoD. Firstly, the research uses a VA corpus built from a sample collection of over 11,400 VA documents collected during a 10 year period in Ghana, West Africa. About 80 per cent of these documents have been annotated with CoD by medical experts. Secondly, we design experiments to identify Machine Learning techniques (algorithm, feature representation scheme, and feature reduction strategy) suitable for classifying VA open narratives (VAModel1). Thirdly, we propose novel methods of extracting features to build a model that predicts CoD from VA narratives using the annotated VA corpus as training and testing set. Furthermore, we develop two additional models: only closed responses based (VAModel2); and a hybrid of closed and open narrative based model (VAModel3). Our VAModel1 performs reasonably better than our baseline model, suggesting the feasibility of predicting the CoD from the VA open narratives. Overall, VAModel3 performance was observed to achieve better performance than VAModel1 but not significantly better than VAModel2. Also, in terms of reliability, VAModel1 obtained a moderate agreement (kappa score = 0.4) when compared with the gold standard– medical experts (average annotation agreement between medical experts, kappa score= 0.64). Furthermore, an acceptable agreement was obtained for VAModel2 (kappa score =0.71) and VAModel3 (kappa score =0.75), suggesting the reliability of these two models is better than medical experts. Also, a detailed analysis suggested that combining information from narratives and closed responses leads to an increase in performance for some CoD categories whereas information obtained from the closed responses part is enough for other CoD categories. Our research provides an alternative automatic approach to predicting CoD from VA, which is essential for LMIC. Therefore, further research into various aspects of the modelling process could improve the current performance of automatically predicting CoD from VAs.
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Huong, Dao Lan. "Mortality in transitional Vietnam." Doctoral thesis, Umeå : Umeå University, 2006. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-878.
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Piscoya, Alejandro, Noé Atamari-Anahui, Maycol Suker Ccorahua-Rios, and Riego Angela Parra del. "National trends of hepatocellular carcinoma mortality registered by the ministry of health in Peru, from 2005 to 2016." Sociedad Argentina de Gastroenterologia, 2020. http://hdl.handle.net/10757/655696.
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Background. Hepatocellular carcinoma results in most cases from underlying chronic liver disease. The most common causes are the Hepatitis B virus and the Hepatitis C virus in-fections, the alcoholism and the aflatoxin. Mortality statistics of liver cell carcinoma in Peru is limited. Objectives. Update statistics on hepatocellular carcinoma mortality in Peru between the years 2005 and 2016. Methods. Observation-al, descriptive studyand secondary analysis of the Ministry of Health database. Records with the basic cause of death ICD 10: C22, the liver cell carcinoma were reviewed. Mortality was calculated according to the age, the sex and the department in which death was recorded; Also, standardized mortality by age was calculated. Results. 2,170 people were registered as deceased due to hepatocellular carcinoma. The 50.1% were male and the 67.5% older than 60 years. The standardized mortality rate in Peru decreased from 1.1 to 0.7 per 100,000 population from 2005 to 2016. The raw cup of mortality per 100,000 population shows that when comparing the first period (2005-2010) with the second (2011-2016), the tendency in Peru has decreased. The only region that presented a decrease in mortality was the Mountains (% change =-40.1). Conclusions. Standardized mortality by age had a slight decrease from 2005 to 2016; however, this difference does not show considerable variations. Mortality from this neoplasm seems to remain high and stable since the period from 1995 to 2000.Revisión por pares
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Pereira, Edméa Costa. "Mortalidade relacionada à tuberculose no município de São Paulo - 2002 a 2004." Universidade de São Paulo, 2007. http://www.teses.usp.br/teses/disponiveis/6/6132/tde-09102007-234112/.
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Introdução A partir de 1999, os coeficientes anuais de mortalidade por tuberculose no Estado de São Paulo apresentam declínio, segundo dados do Centro de Vigilância Epidemiológica da Secretaria Estadual de Saúde (CVE). Para caracterizar os óbitos e entender a tendência, explora-se o fato de o óbito por tuberculose possuir características que possibilitam estudos com enfoque em causas múltiplas, podendo a doença ser causa básica ou causa associada da morte. Objetivo Traçar o perfil da mortalidade relacionada à tuberculose no Município de São Paulo, segundo causas múltiplas de morte e suas inter-relações com outras causas básicas e verificar se os casos de tuberculose estão notificados ao banco de dados do CVE. Metodologia Estudo descritivo utilizando dados secundários. Foram estudados todos os óbitos de pessoas residentes no Município de São Paulo, ocorridos entre 2002 e 2004, que tiveram, na declaração de óbito, tuberculose como causa básica ou causa associada, ou seqüela de tuberculose como causa básica (N=2.325). Causa básica e causas associadas de morte foram caracterizadas segundo as disposições da Organização Mundial de Saúde. Pesquisaram-se os registros do CVE para verificar se os casos de tuberculose estavam notificados. As fontes de dados foram o Programa de Aprimoramento das Informações de Mortalidade no Município de São Paulo (PRO-AIM) e o banco de dados do CVE. Os dados de população provieram da Fundação SEADE. Resultados A utilização de causas múltiplas de morte aumentou o número de óbitos em 82,6%. A tuberculose foi selecionada como causa básica de morte em 1.212 óbitos (54,8%), tendo sido mencionada como causa associada em 1.001 óbitos (45,2%). Destes, 676 (30,5%) foram devidos à aids e 325 (14,7%), a outras causas. A seqüela de tuberculose foi causa básica de morte em 112 óbitos. As formas clínicas mais freqüentes, quando a tuberculose foi causa básica, foram a pulmonar e a miliar. O sexo masculino foi o mais atingido (1.690 óbitos, ou 72,7%). Em 46,3% dos óbitos que tinham tuberculose como causa básica, a declaração de óbito foi fornecida pelo Serviço de Verificação de Óbitos ou pelo Instituto Médico Legal, indicando dificuldades para fazer o diagnóstico ou falha na assistência aos casos. Os óbitos não encontrados no banco de dados do CVE, portanto desconhecidos pelo Sistema de Vigilância, foram 1.200 (51,6%). Conclusões A análise segundo causas múltiplas de morte revelou óbitos em que a tuberculose estava presente mas não aparecia nas estatísticas de mortalidade por causa única. As notificações de casos de tuberculose ao CVE não foram satisfatórias, necessitando ter seus fluxos e procedimentos reavaliados.Background According to data from CVE Centro de Vigilância Epidemiológica da Secretaria de Saúde do Estado de São Paulo (Epidemic Control Center / State Dept), yearly death rates caused by tuberculosis have declined in the state of São Paulo. In order to characterize deaths and understand the mentioned decrease, the issue death related to tuberculosis will be investigated whilst presenting certain characteristics that might enable studies to be taken over, by focusing on multiple causes. Moreover, the tuberculosis might be regarded as an underlying cause of death or as death-associated cause. Objective The outlining of tuberculosis mortality, as a result from multiple causes and its relations with other underlying causes, and to verify if patients were underreported to CVE. Methodology Secondary data descriptive study. Deaths occurring between 2002 and 2004 were considered for this study, from people living in São Paulo. The people died, as stated by their death certificate, from tuberculosis as an underlying or associated cause, or tuberculosis sequel as an underlying cause (N=2.325). Both underlying and associated causes of death were characterized according to the World Health Organization guidelines. The study searched tuberculosis cases on CVEs database. Data were supplied by Programa de Aprimoramento das Informações de Mortalidade no Município de São Paulo (PRO-AIM) and CVEs database. Results Studies focusing on multiple causes increase deaths (82,6%). Tuberculosis was selected as an underlying cause of death in 1.212 deaths (54,8%). In 1.001 deaths (45,2%) it was regarded as associated cause: in these deaths, the underlying cause was AIDS (676 deaths 30,5%) or other causes (325 deaths 14,7%). Tuberculosis sequel was underlying cause in 112 deaths. The most frequent clinical forms observed, having tuberculosis as an underlying cause, were the pulmonary and the miliary types. Male sex was inflicted the most (1.690 deaths 72,7%). Either Serviço de Verificação de Óbitos or Forensics issued death certificates where tuberculosis was selected as underlying cause of death in 46,3% of total deaths, denoting deficient diagnosis and poor assistance to cases. Death records 1.200 (51,6%) are not to be found in CVEs database, so tuberculosis cases are underreported. Conclusion Analyses that use multiple-cause data brings to view other deaths where tuberculosis was present, in spite of not being observed in statistics of mortality resulting from underlying causes. The flow of information to CVE must be inspected.
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Bozgunchie, Maratbek, and Katsuki Ito. "Avoidable Mortality Measured by Years of Potential Life Lost (YPLL) Aged 5 Before 65 Years in Kyrgyzstan, 1989-2003." Nagoya University School of Medicine, 2007. http://hdl.handle.net/2237/7480.
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Al-Omair, Noura. "Role of autopsy in sudden natural deaths in adults." Thesis, University of Edinburgh, 2013. http://hdl.handle.net/1842/16243.
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The aim of this study was to determine the extent to which the cause of death in sudden natural death in adults could be ascertained without autopsy, based on information provided in the police report, and to evaluate any degree of error between that and the officially certified cause of death. Two methods were carried out: 1. A questionnaire-based retrospective survey of sudden natural deaths distributed to practitioners. The predicted cause of death was compared with the actual cause of death as determined after autopsy. The difference between the two causes of death was classified into 'no difference', minor and major difference according to the classification scheme developed for this study. 2. A prospective study of adult sudden natural deaths referred by the procurators fiscal in Lothian and Borders to the department during 2009 and 2010. The police reports were reviewed and a cause of death was ascribed by the author. This cause was compared with the actual cause of death in the final autopsy report and any difference assessed according to the classification scheme. In the view of the retrospective study results, it is possible to determine the cause of death which is with no or minor difference to that determined by autopsy if, in addition to provide sufficient information regarding deceased’s medical history and circumstances of death, the participants are given the option to select which cases should undergo external examination only. The prospective study results indicate that in certain circumstances the cause of death could be ascribed correctly based on the available information prior to autopsy. Causes of death such as ischaemic heart disease, hypertensive heart disease and alcohol related death are more frequently ascribed correctly. However, ischaemic and hypertensive heart disease were over-predicted. Results indicate that there are criteria to select which cases might be subject to a "view and grant" procedure with no significant loss of accuracy. The implications of the study for the development of medico-legal services are considered with specific reference to Kuwait.
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Santos, Glauber Palha dos. "Vigilância dos óbitos por HIV/aids no município de Ribeirão Preto - SP, 2012 e 2013." Universidade de São Paulo, 2015. http://www.teses.usp.br/teses/disponiveis/22/22133/tde-23122015-102049/.
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Apesar dos avanços tecnológicos e terapêuticos para o manejo do HIV/aids, os óbitos pela doença em algumas realidades sócio sanitárias ainda representam um importante desafio. Em 2011, Ribeirão Preto se destacou dentre os municípios com maior número de óbitos pela doença no Estado de São Paulo. Nesse sentido, objetivou-se analisar os óbitos por aids ocorridos em Ribeirão Preto nos anos de 2012 e 2013. Trata-se de um estudo descritivo, exploratório, de abordagem quantitativa. Foram incluídos os indivíduos que viviam com HIV/aids que foram a óbito pela doença no período supracitado, tendo como causa básica, segundo o código Internacional de Doenças, os códigos de B20 ao B24. Foram excluídos os casos com idade igual ou inferior a 18 anos e pertencentes ao sistema prisional. Elaborou-se um formulário específico para a coleta de dados, cujas fontes secundárias de informação utilizadas foram: Sistema de Informação de Mortalidade e Sistema de Informação de Agravos de Notificação. Os dados foram analisados por meio do software Statística 9.1 da StatSoft, utilizando-se técnicas de análise exploratórias, incluindo proporções, medidas de tendência central e variabilidade. Os resultados sinalizaram possíveis fragilidades relacionadas à não integração dos sistemas de informação, bem como a qualidade dos dados inseridos nos mesmos. Quanto às características sociodemográficas, a maioria dos óbitos esteve relacionada ao sexo masculino (56,5%), sendo a razão entre os sexos de 1,3 homens/mulher. Houve um acometimento de faixas etárias mais velhas (40 a 59 anos, 56,5%) e, ao se considerar a composição étnico-racial do município para os anos estudados, identificou-se elevada taxa de mortalidade (52/100 mil hab.) entre as pessoas da cor preta. Houve predomínio de óbitos entre os indivíduos solteiros (61,1%) e com ensino fundamental (44,4%). Elevados percentuais de dados ignorados foram identificados nas variáveis ocupação (56,6%) e escolaridade (40,7%). O tempo mediano entre o diagnóstico da doença e o óbito foi de 61,5 meses, sendo que para os homens esse tempo foi de 16 meses (29,6% ocorreu em menos de um mês após o diagnóstico). Indivíduos na faixa etária de 21 a 39 anos morreram mais rápido após o diagnóstico da doença, com um tempo mediano de 19 meses (30,3% dos óbitos ocorreu em menos de um mês após o diagnóstico da aids. Entre as causas do óbito estão doenças não definidoras da aids e outras condições associadas, como a coinfecção de hepatites virais, outras comorbidades e condições de risco (uso de substâncias psicoativas). Espera-se contribuir com reflexões acerca do acesso ao diagnóstico precoce, tratamento oportuno e os desafios para a adesão terapêutica das pessoas que vivem com HIV/aids, além da necessidade de se repensar as práticas e políticas públicas em consonância com as demandas individuais e sociais em um determinado contexto, ampliando-se o escopo das ações e intervenções segundo perspectivas intersetoriaisDespite technological and therapeutic advances in the management of HIV/AIDS, the deaths from AIDS in some socio health institutions still represent a major challenge. In 2011, Ribeirão Preto stoodout among the municipalities with the highest number of deaths from AIDS in the São Paulo State. In this sense, it aimed to analyze deaths from AIDS occurred in Ribeirão Preto in the years 2012 and 2013. It was a descriptive, exploratory study with a quantitative approach. Individuals living with HIV/AIDS who died from the disease during the considered period were included, with the underlying cause, according to the International Classification of Diseases code, the codes B20 to B24. Cases aged under 18 and belonging to the prison system were excluded. A specific form was elaborated for data collection, the secondary sources of information used were: Mortality Information System and the Notifiable Diseases Information System. Data were analyzed using the Statistica 9.1 StatSoft software, by exploratory analysis techniques, including proportions, central tendency and variability. The results signaled possible weaknesses related to the non-integration of information systems and the quality of data entered in them. As for sociodemographic characteristics, most of the deaths was related to male (56.5%), and the sex ratio of 1.3 men/women. There was an involvement of older age groups (40 to 59 years, 56.5%) and, when considering the ethnic and racial composition of the municipality for the years studied, it was identified high mortality rate (52/100 thousand inhabitants) among people of black skin color. There was a predominance of deaths among single individuals (61.1%) and elementary education (44.4%). High percentages of missing data were identified in the occupation variables (56.6%) and education (40.7%). The median time between diagnosis of disease and death was 61.5 months, and for men this time was 16 months (29.6% of this deaths occurred in less than a month after diagnosis). Individuals aged 21 to 39 died soon after diagnosis of the disease, with a median time of 19 months (30.3% of deaths occurred in less than a month after diagnosis of AIDS). Among the causes of death are not defining disease of AIDS and other associated conditions such as viral hepatitis coinfection, other comorbidities and risk conditions (psychoactive substance). It is expected to contribute to reflections on the access to early diagnosis, timely treatment and challenges for adherence of people living with HIV/AIDS, and the need to rethink the practices and policies in step with the individual and social demands in a particular context, expanding the scope of actions and interventions according intersectoral prospects
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Gibney, Elizabeth Helen. "Does Neospora caninum cause death by multiplying uncontrollably in an immunologically immature foetus?" Thesis, University of Liverpool, 2008. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.502538.
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The last two decades have seen the emergence of the protozoan parasite Neospora caninum as the most frequently diagnosed cause of bovine abortion in the UK. The polymerase chain reaction (PCR) is a commonly used tool for molecular diagnosis. In chapter 2, the relative diagnostic sensitivity of two PCR protocols routinely used within our laboratory for the detection of N. caninum in tissues from aborted foetuses was determined. Method one was a nested PCR method based on the internal transcribed spacer I region of the rRNA sequence and was consistently more sensitive than method two, a single step PCR designed to amplifY a fragment of Nc5 N. caninum-specific genomic DNA, in our laboratory environment. Method one was therefore used to analyse samples for the rest ofthe experiment. It is not fully understood why some infected cattle abort, but previous studies have shown that abortion is more likely if transplacental spread ofthe parasite occurs early in gestation. Bovine foetal immunocompetence develops gradually during the second half of gestation, and it has been suggested that the immunocompetence of the foetus at the time of infection may determine its ability to control parasitaemia and survive. To test this hypothesis in chapter 3, we compared the distribution of parasites and the histopathological changes in the placenta and foetus following experimental infection of cattle with N. caninum in early and late gestation. In early gestation, following foetal death, N. caninum DNA was detected and evidence of widespread parasite infiltration was demonstrated immunohistologically in the placenta. This was associated with extensive focal epithelial necrosis, serum leakage and a moderate maternal predominantly CD4+ mononuclear cell interstitial inflammatory response. Widespread parasite infiltration was also evident in the foetus, with parasites in most tissues, often associated with necrosis. In late gestation, N. caninum DNA was detected sporadically but parasites were not evident immunohistologically in the placenta. Small foci of necrosis were seen occasionally, with a mild CD4+ and CD8+ mononuclear cell interstitial inflammation. Detection of N. caninum DNA in the foetus was sporadic and parasites were demonstrated immunohistologically in brain and spinal cord only, with an associated non-suppurative inflammatory response. We further investigated the pathogenesis of abortion in chapter 4, where we monitored ten chronically infected cattle throughout gestation and parasite recrudescence was pinpointed in 9/10 via a sharp rise in N. caninum-specific antibodies.
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Ribeiro, Filipe. "Statistical analysis and forecasting of cause of death data: novel approaches and insights." Doctoral thesis, Universidade de Évora, 2015. http://hdl.handle.net/10174/17344.
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Substantial improvements in public health resulted in exceptional increases in life
expectancy. Nevertheless, mortality related processes have been change differentially
at distinctive stages and accordingly with different related processes. To understand
and analyze properly the mortality phenomena under a demographic point of view, it
is indispensable to study populations as a heterogeneous mixture of individuals.
Within this heterogeneous mixture, individuals are frailer than others and there are
diverse risks of death competing with each other to be successful. Under this
assumption, it is possible to differentiate between the individual pace of mortality
increase with age, i.e., the individual rate of aging and the population rate of aging. If
the first proves to be a biological constant invariant across humans and over time,
besides a great demographic and biological finding, many research disciplines and
policymakers may take advantage of previous knowledge and validated information.
Insurance companies, e.g., could make use of this previous knowledge to elaborate a
more precise and complete evaluation of risks. Thus, coherent and accurate mortality
forecasts could be also performed. But if this hypothesis proves to be wrong, recent
coherent compositional approaches are available and need to be tested to fulfill the
need for detailed forecast discriminated by cause-specific probabilities. Nevertheless,
in order to let doubts aside, a distinction between population and individual rate of
aging needs to be realized in a clear end complete perspective.
Briefly, in this piece of research we develop a consistent contemporary exploration of
mortality patterns, under a heterogeneous perspective, and make use of obtained
information to provide not only an interesting demographic and social perspective,
but also a tool for decision-makers to evaluate and identify possible points of
intervention in what concerns to public health; Análise Estatística e Métodos de Previsão de Diferentes Causas de
Morte: Uma Nova Abordagem
Resumo:
De uma forma geral, apesar da evolução extremamente positiva dos comportamentos
de mortalidade se traduzir em indicadores-resumo como é o caso da esperança de vida
à nascença, ao longo dos anos, as melhorias registadas na saúde pública, encontram-se
relacionada com diversos processos distintos. A elaboração de uma análise completa e
detalhada do fenómeno da mortalidade sob uma perspectiva demográfica, torna-se
assim, unicamente possível se esta análise tiver em conta a composição heterogenia
da população. Por entre esta heterogeneidade populacional, existem indivíduos
considerados mais frágeis do que outros, onde diversos riscos associados à
probabilidade de morte, competem entre si para conseguirem levar a melhor sobre o
indivíduo. Deste modo, tendo em conta esta conjetura, torna-se possível diferenciar
entre o ritmo de aumento nos níveis de mortalidade por idade, i.e., a velocidade de
envelhecimento, tanto associada ao próprio indivíduo, como à população em si. Caso
a teoria de que o primeiro indicador será uma constante biológica invariável entre
indivíduos e por todo o seu tempo de vida se verificar verdadeira, apesar de ser uma
importante descoberta ao nível biológico e demográfico, resultará em informação
relevante tanto para diversas áreas de investigação, como para decisores políticos.
Companhias de seguros, por exemplo, poderiam utilizar este conhecimento prévio e
elaborar uma avaliação de riscos muito mais precisa. Consequentemente, a elaboração
de previsões de mortalidade mais precisas e coerentes seria uma realidade. No
entanto, se esta teoria não for validada, os resultados obtidos não deixam de ser
importantes, pois contribuirão sempre para trabalho futuro, e novas abordagens
metodológicas consideradas coerentes para a previsão dos padrões de mortalidade
continuam a emergir e a necessitar de serem testadas.
Resumidamente, com este estudo desenvolveu-se uma análise rigorosa e
contemporânea dos padrões de mortalidade tendo em conta a heterogeneidade
populacional, fazendo uso da informação obtida para elaborar não só uma análise
interessante do ponto de vista demográfico, mas também proporcionar informação
indispensável para a sociedade e para os decisores políticos.
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Coelho, Juliana Chaves. "Hipertensão arterial: estudo Post Mortem na Região Metropolitana de São Paulo." Universidade de São Paulo, 2016. http://www.teses.usp.br/teses/disponiveis/7/7139/tde-06092017-143731/.
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Introdução: Hipertensão arterial é um dos principais fatores de risco para doença cardiovascular e sua falta de controle pode levar a complicações que contribuem para o aumento da mortalidade. Neste estudo foram analisadas causas de óbitos, somadas à informações clínicas do falecido a fim de fornecer subsídios para identificação da prevalência de hipertensão arterial em óbitos e seus fatores relacionados, utilizando, para tal, o método considerado padrão ouro, que é a autópsia. Objetivo:Analisar a prevalência de hipertensão arterial referida e seus fatores relacionados, em óbitos ocorridos na região metropolitana de São Paulo. Método: Estudo epidemiológico, observacional, transversal, realizado no Laboratório de Fisiopatologia no Envelhecimento, da Faculdade de Medicina da Universidade de São Paulo, localizado no Serviço de Verificação de Óbitos da Capital. Neste serviço são coletados os casos incluídos no biobanco do Grupo de Estudos do Envelhecimento, através de entrevistas clínicas com informantes do recém falecido. A amostra constou de 356 casos ocorridos entre os anos de 2004 a 2014.Os dados foram extraídos do banco de dados do grupo de estudos, pela seleção das variáveis: sociodemográficas e de identificação; local do óbito; antecedentes patológicos pessoais e familiares; fatores de risco e estilo de vida; uso de medicamentos, capacidade funcional, episódio depressivo maior e classificação socioeconômica. Hipertensão arterial foi definida como autorrelato da doença pelo informante e/ ou uso de medicamento anti-hipertensivo. O estudo foi aprovado pelo Comitê de Ética em Pesquisa da Escola de Enfermagem da Universidade de São Paulo (CAAE 53857116.7.0000.5392) e pelo grupo de estudos no envelhecimento. Foram realizadas análises descritivas de todas as variáveis e as associações bivariadas foram feitas pelo teste Qui-quadrado ou teste Fisher para variáveis categóricas e teste t-student para variáveis quantitativas, considerando estatisticamente significativo valores de p<0,05. Na análise multivariada foram incluídas todas as variáveis com valor p<0,20, utilizando para tal, a regressão logística. Resultados: Pouco mais da metade das pessoas falecidas era do sexo masculino (56,2%) e aposentados (53,7%); a maioria da raça branca (68%) e baixa escolaridade, sendo 19% analfabetos e 62,9% com apenas 1º grau incompleto; a maior parte vivia com companheiros (48%) e da classe econômica C (48,5%) e D (22,1%); a média de idade foi 70,83 (11,54) anos e média total de filhos de 3,65 (3,06). A prevalência de hipertensão foi de 66,2%. A avaliação das atividades básica e instrumental de vida diária revelou que a maioria dos participantes apresentou elevado nível de independência. A prevalência de depressão maior foi de 15,4%. A causa imediata de óbito mais frequente foi o edema pulmonar (31,1%), seguida pelas doenças isquêmicas do coração (25,0%). Porém, quando avaliada a causa básica, a aterosclerose representou a primeira causa de óbito (37,8%), e em segundo lugar a hipertensão arterial (25,6%). Na análise multivariada,verificou-se que as variáveis que mais contribuíram com a hipertensão foram antecedente pessoal de acidente vascular encefálico (OR=5,16; IC=1,98-13,50) e arritmia (OR=5,80; IC=1,26-26,93),seguido de antecedente de doença arterial coronariana (OR=4,18; IC=1,74- 10,03) e menores chances para histórico pessoal de diabetes (OR=2,69; IC=1,45-4,97), Índice de Massa Corporal (OR=1,17; IC=1,10-1,25) e sexo feminino (OR=1,96; IC=1,16-3,31). Conclusões: A prevalência de hipertensão arterial foi elevada e representou a segunda causa básica de óbito mais frequente, associando-se, principalmente, aos antecedentes pessoais de doenças.Introduction: Hypertension is one of the main risk factors for cardiovascular disease and its lack of control may lead to complications that contribute to the mortality increase. In this study, we analyzed the causes of deaths and the clinical information of the dead person to subsidize the identification of hypertension prevalence in death and its related factors. We used the gold standard method, the autopsy. Objective: To analyze the prevalence of self-rated hypertension and its related factors in deaths in metropolitan area of São Paulo, Brazil. Method: Epidemiological observational, cross-sectional study taken at the Brain Bank of the Brazilian Aging Study Group of University of São Paulo School of Medicine, located in the São Paulo City Autopsy Service. In this service, the data of the cases included in the Brain Bank is collected through clinical interviews with informants of the recently dead person. The sample was composed by 356 cases occurred between 2004 and 2014. Data was extracted from Brazilian Aging Study Group database. The selected variables were sociodemographic; death location; personal and family pathological background; risk factors and life style; drugs use, functional capacity, major depression episode and socioeconomic classification. Hypertension was defined as self-reported disease by the informant, and/or use of antihypertensive drug. The study was approved by The Research Ethics Committee of the School of Nursing of University of São Paulo (CAAE 53857116.7.0000.5392), and also by the Brazilian Aging Study Group. We made descriptive analysis of all the variables. Bivariate associations were made by chi-square test or Fisher test for categorical variables, and t-student test for quantitative variables. Statistical significant values (p<0.05) were considered. In the multivariate analysis we included all the variables (p<0.20) using logistic regression. Results: More than half of the dead people was male (56.2%) and retired (53.7%); the majority was white (68%) and had low education level - 19% were illiterate and 62.9% has not completed the elementary education; the major part of the sample used to live with their spouses (48%), and belonged to the economic class C (48.5%) and D (22.1%); the age average was 70.83 (11.54) years old and the average of number of children was 3.65 (3.06). There was a hypertension prevalence of 66.2%. The evaluation of the basic and instrumental daily living activities revealed that the majority of the participants presented high level of independence. There was a depression prevalence of 15.4%. The most frequent immediate cause of death was lung edema (31.1%) followed by ischemic heart diseases (25.0%). However, when we evaluated the basic cause, the atherosclerosis represented the first death cause (37.8%), and the hypertension was in the second position (25,6%). In the multivariate analysis, we verified that the variables that contributed the most with hypertension were personal background of stroke (OR=5.16; CI=1.98-13.50) and arrhythmia (OR=.,80; CI=1.26-26.93), followed by coronary heart disease background (OR=4.18; CI=1.74-10.03) and less chances for personal history of diabetes (OR=2.69; CI=1,.5-4.97), Body Mass Index (OR=1.17; CI=1.10-1.25) and being female (OR=1.96; CI=1.16-3.31). Conclusions: There was a high prevalence of hypertension, representing the second more frequent basic death cause, mainly when associated to the personal disease background.
29
Lawn, J. E. "4 million neonatal deaths : an analysis of available cause-of-death data and systematic country estimates with a focus on 'birth asphyxia'." Thesis, University College London (University of London), 2009. http://discovery.ucl.ac.uk/19027/.
Full textAbstract:
Background: Of the world’s four million neonatal deaths, 99% occur in low/middleincome countries, but most information relates to the 1% dying in high-income countries. Reliable cause-of-death data are lacking. The aim of this thesis is to develop programmatically-relevant, national estimates for neonatal cause-of-death, focusing on “birth asphyxia” to illustrate specific challenges in the available data and for systematic national estimates. Objectives: 1. Review estimation methods, giving implications for neonatal cause-of-death estimation. 2. Propose programmatic categories for neonatal cause-of-death, reviewing measurement options for intrapartum-related outcomes (“birth asphyxia”). 3. Identify and analyse existing neonatal cause-of-death data. 4. Estimate intrapartum-related neonatal deaths for all countries, comparing single-cause and multi-cause models. 5. Summarise priorities for improving neonatal cause-of-death estimates and input data. Data inputs: Case definitions were reviewed for neonatal cause-of-death and intrapartumrelated outcomes. Six programmatically relevant cause-of-death categories were defined, plus a residual “other neonatal” category. Two sources of neonatal cause-of-death data were examined: Vital Registration (VR) datasets for countries with high coverage (>90%) based on a new analysis from 83 countries; and published/unpublished studies identified through systematic searches. Inclusion criteria for representativeness and comparability were applied. Data from 44 countries with VR (96,797 neonatal deaths) and from 56 studies (29 countries, 13,685 neonatal deaths) met inclusion criteria, despite screening almost 7,000 abstracts. These data represent <3% of the world’s neonatal deaths. Thus estimation is necessary for global level information. No useable data were identified from Central and North-West Africa, or Central Asia. Modelling: Methods were developed to estimate intrapartum-related neonatal deaths (single-cause), and then simultaneously estimate seven causes of neonatal death (multi-cause). Applying these proportions to the numbers of neonatal deaths in 192 countries gives a global estimate of intrapartum-related neonatal deaths of 0.90 (0.65-1.17) million using single-cause and 0.91 (0.60-1.08) million using multi-cause methods. Discussion: The multi-cause model has become WHO’s standard method for neonatal cause-of-death estimates. However, complex statistical models are not a panacea. More representative data are required. Simplified case definitions and consistent hierarchical cause-of- death attribution would improve comparability, especially for intrapartum-related deaths.
30
Salawu, Emmanuel Oluwatobi. "Spatiotemporal Variations in Coexisting Multiple Causes of Death and the Associated Factors." ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/6108.
Full textAbstract:
The study and practice of epidemiology and public health benefit from the use of mortality statistics, such as mortality rates, which are frequently used as key health indicators. Furthermore, multiple causes of death (MCOD) data offer important information that could not possibly be gathered from other mortality data. This study aimed to describe the interrelationships between various causes of death in the United States in order to improve the understanding of the coexistence of MCOD and thereby improve public health and enhance longevity. The social support theory was used as a framework, and multivariate linear regression analyses were conducted to examine the coexistence of MCOD in approximately 80 million death cases across the United States from 1959 to 2005. The findings showed that in the United States, there is a statistically significant relationship between the number of coexisting MCOD, race, education, and the state of residence. Furthermore, age, gender, and marital status statistically influence the average number of coexisting MCOD. The results offer insights into how the number of coexisting MCOD vary across the United States, races, education levels, gender, age, and marital status and lay a foundation for further investigation into what people are dying from. The results have the long-term potential of helping public health practitioners identify individuals or communities that are at higher risks of death from a number of coexisting MCOD such that actions could be taken to lower the risks to improve people's wellbeing, enhance longevity, and contribute to positive social change.
31
Aleixo, Cintia Nogueira. "Contribuição dos efeitos congenitos para a mortalidade pre-natal durante um periodo de 8 anos (1999-2007) em uma maternidade terciaria." [s.n.], 2008. http://repositorio.unicamp.br/jspui/handle/REPOSIP/308795.
Full textAbstract:
Orientador: Denise Pontes CavalcantiDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas
Made available in DSpace on 2018-08-11T12:05:12Z (GMT). No. of bitstreams: 1 Aleixo_CintiaNogueira_M.pdf: 3345062 bytes, checksum: 312a7b2cb7ac2054263960b084875b6e (MD5) Previous issue date: 2008
Resumo: O presente estudo relata uma investigação de óbitos pré-natais na Maternidade do Centro de Atenção Integral a Saúde da Mulher (CAISM ¿ UNICAMP), durante o período de setembro de 1999 a setembro de 2007, com o objetivo geral de conhecer as causas de mortalidade pré-natal, com ênfase ao fator fetal. Os objetivos específicos foram: identificar a prevalência de óbitos pré-natais na maternidade do CAISM; identificar as causas de óbito maternas e fetais mais freqüentes, com suas proporções; identificar as malformações mais freqüentes, com suas proporções e diferentes tipos de apresentação clínica; avaliar a contribuição de exames de necropsia, radiografia e cariótipo para o diagnóstico e a proporção de óbitos fetais potencialmente evitáveis. Realizou-se um estudo retrospectivo dos óbitos pré-natais durante o intervalo proposto, com a investigação de 1.011 casos, segundo protocolo específico que incluiu avaliação dismorfológica, anamnese, estudo radiológico, citogenético, necropsias e documentação fotográfica. Na casuística avaliada, 52,4% dos casos de mortalidade pré-natal foram de origem fetal, 40,4% de origem materna, 2,5% de origem mista (materna e fetal) e 4,7% de origem indeterminada. Entre os óbitos de causa fetal predominaram as malformações (80,8%), representadas predominantemente por malformações isoladas (38,8%). Entre as demais malformações observou-se 34,8% de síndromes diversas e 20,6% de malformações múltiplas não caracterizadas como síndromes específicas. Entre os óbitos de origem materna, predominaram a hipertensão (25,5%) e o descolamento prematuro da placenta (18,1%). A avaliação dos exames complementares entre os óbitos de causa fetal mostrou que 3,4% dos exames radiológicos realizados foram essenciais para a conclusão, assim como 10,2% dos exames citogenéticos e 22,5% dos exames anátomo-patológicos. Finalmente, os resultados do presente estudo permitiram estimar que 42,4% de óbitos seriam potencialmente evitáveis na gestação em questão (relacionados predominantemente a condições maternas) e 20,7% de óbitos poderiam ser potencialmente evitáveis em uma gestação futura (correspondendo em sua maioria a defeitos de fechamento do tubo neural e anomalias cromossômicas)
Abstract: Contribution of congenital anomalies to prenatal mortality during an 8 years period (1999-2007) in a tertiary hospital in Brazil. An investigation was performed concerning all the stillbirths born at CAISM ¿ UNICAMP, during an 8 years period (1999-2007). The purpose was to evaluate causes of prenatal mortality, with a clinical-genetical approach, emphasizing fetal causes of death. Specific objectives were to identify prevalence of fetal mortality; identify and classify causes of death (fetal and non-fetal) and its proportions, frequencies of congenital anomalies and its clinical presentations within each group; evaluate the contribution of a postmortem protocol exams and the proportion of avoidable deaths. A retrospective study was performed, with 1,011 cases submitted to a investigation protocol that includes dysmorphological exam, clinical history, X-ray, cytogenetic study and autopsy. The entire study stablished that 52.4% of deaths were of fetal origin, 40.4% were of maternal origin, 2.5% were of both origin (fetal and maternal) and 4.7% remain undeterminated. Among deaths of fetal origin predominated malformations (80.8%), the majority of them isolated (38.8%). Among others malformations was noticed that 34.8% were varied syndromes and 20.6% were multiple malformations. Among deaths of maternal origin predominated hypertension (25.5%) and placental abruption (18.1%). Analysis of complementary exams on fetal causes of death showed that 3.4% of X-rays was essential to diagnosis, as well as 10.2% of cytogenetic exams, and 22.5% of autopsies. Finally, results of entire study allowed to estimate that 42.4% of deaths would be potencially avoidable in the present pregnancy, as well as 20.7% of deaths would be potencially avoidable in a future pregnancy
Mestrado
Genetica Medica
Mestre em Ciências Médicas
32
Johansson, Lars Age. "Targeting Non-obvious Errors in Death Certificates." Doctoral thesis, Uppsala : Acta Universitatis Upsaliensis : Universitetsbiblioteket [distributör], 2008. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-8420.
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33
Benedicto, Rubia Paixão. "Causas múltiplas de morte relacionadas ao consumo de álcool na microrregião de Ribeirão Preto - SP, 1996 - 2007." Universidade de São Paulo, 2011. http://www.teses.usp.br/teses/disponiveis/22/22131/tde-31102011-094741/.
Full textAbstract:
Existem inúmeras evidências que permitem caracterizar o papel do álcool como fator de risco para doenças e morte, além de diversas consequências sociais negativas. Assim, o consumo de bebidas alcoólicas tem se tornado uma preocupação em âmbito mundial, sendo apontado como um importante problema de saúde pública. Considerando as limitações das estatísticas de saúde que levam em conta apenas a causa básica, o objetivo do presente trabalho foi descrever a mortalidade relacionada ao consumo de álcool, segundo causas múltiplas de morte da microrregião de Ribeirão Preto-SP por residência e/ou ocorrência, no período de 1996 a 2007. Trata-se de um estudo epidemiológico do tipo descritivo que utilizou como fonte dados secundários do Sistema de Informações sobre Mortalidade do Ministério da Saúde (SIM/MS). Foi realizado o download de 100% dos arquivos de óbito ocorridos no Brasil de 1996 a 2007 através do banco de dados do SIM disponível no site do DATASUS (http://www.datasus.gov.br), sendo importados 324 arquivos referente às Declarações de Óbito (DOs). Utilizando o programa APPENDA, o banco de dados passou por diversos processos de filtragem sendo obtidos 1800 DOs que possuem menção álcool (F10) como causa básica ou associada. Observou-se nas 1800 DOs que 90,1% eram do sexo masculino, 56,9% estavam na faixa etária de 40-59 anos, 65,7% era da raça /cor branca, a análise de escolaridade esteve prejudicada devido ao número de ignorados (78,8%). Passaram pelo exame de necropsia 43,7% e, em 56,3% não foram colhidos exames ou quando colhidos não foram informados. Os capítulos da CID-10: IX - Doenças do aparelho circulatório, X - Doenças do aparelho respiratório e XI - Doenças do aparelho digestivo foram os três mais frequentes, totalizando 56,2% das causas básicas e praticamente a metade de todos os diagnósticos informados (48,7%). Entre as principais causas de morte destacam-se as doenças do fígado (K70-K77), pneumonias (J12-J18) e outras doenças do aparelho respiratório (J22, J66-J99), pancreatite aguda e outras doenças do pâncreas (K85-K86), transtornos mentais e comportamentais devido ao uso de outras substâncias psicoativas (F11-F19), outras doenças do aparelho digestivo (K82-K83, K87-K93), outras doenças do coração (I27-I43, I51-I52) e outras doenças hipertensivas (I11-I15). Apenas 1% dos óbitos com menção álcool estavam no capítulo de causas externas e a análise por agrupamento da CID-10 permitiu constatar a ausência dos diagnósticos de acidentes de transporte e agressões como causa básica, apontando a existência de um viés importante no fluxo de informação entre os Institutos de Medicina Legal - IMLs e o SIM. Os resultados deste estudo indicam que o IML dispõe de informações de que o setor da saúde necessita, não as transcrevendo, entretanto, na DO o que significa que não constam nas estatísticas oficiais. Dessa forma, levantou-se a necessidade de aprimoramento no fluxo de informação entre as unidades notificadoras e o SIM.There are great number of evidences the allow to characterize the role of alcohol as a risk factor for diseases and death, besides several negative social consequences. Thus, consumption of alcoholic beverages has become a worldwide concern, being hailed as a major public health problem. Considering the limitations of health statistics that take into consideration only the basic cause, the purpose of this study was to describe the mortality related to alcohol consumption, according to multiple causes of death of the Ribeirão Preto micro region - SP for residence and/or occurrence from 1996 to 2007. This is a descriptive epidemiological study that used as a source the secondary data from the Mortality Information System of the Ministry of Health (SIM / MS). It was downloaded 100% of the files of deaths occurred in Brazil from 1996 to 2007 through available database on the SIM DATASUS (http://www.datasus.gov.br), and it was imported 324 files relating to declaration of death (DD). Using the APPENDA program, the database has gone through several filtering processes and 1,800 DDs were found mentioning alcohol (F10) as basic or associated cause of death. In the 1,800 DD documents refering to \'alcohol\', there was predominance of males (90.1%), between 40-59 years old (56.9%), and of Caucasian ancestry (\'White\', 65.7% ). Analysis of educational level attained was confounded due to the high number where this parameter was classed as \'unknown\' (78.8%). Post mortem examinations had been undertaken in 43.7% of cases and in 56.3% of these no laboratory tests were requested. The ICD-10 Chapters: IX- Diseases of the circulatory system, X- Diseases of the respiratory system and XI- Diseases of the digestive system were the three most frequently assigned causes of death, totaling 56.2% of basic causes and 48.7% of all recorded diagnoses. Among the main causes of death include diseases of the liver (K70-K77), pneumonia (J12-J18) and other respiratory diseases (J22, J66-J99), acute pancreatitis and other diseases of the pancreas (K85-K86 ), mental and behavioral disorders due to use of other psychoactive substances (F11-F19), other diseases of the digestive system (K83-k82, K87-K93), other heart diseases (I27-I43, I51-I52) and other diseases hypertension (I11-I15). Only 1% of deaths due to alcohol were mentioned in the chapter on external causes, and the analysis of the group ICD-10 revealed the absence of diagnoses of traffic accidents and violence as a basic causes, pointing to the existence of an important bias in the information flow between Institutes of Forensic Medicine - IMLS and the SIM. These results indicate that IML has information that the health sector needs, and they don´t pass this information through. Because of this, the DDs are incomplete, which means they are not included in official statistics. Thus, it was aroused the necessity of improvement on information flow between the reporting units and the SIM.
34
TETTAMANTI, CAMILLA. "Correlazione tra i risultati delle indagini sierologiche e la diagnosi di morte nei decessi ospedalieri della prima ondata pandemica da SARS-COV 2." Doctoral thesis, Università degli studi di Genova, 2021. http://hdl.handle.net/11567/1046322.
Full textAbstract:
Nelle fasi iniziali dell’emergenza sanitaria da Sars-CoV 2, uno degli obbiettivi maggiori ha riguardato la ricerca di un test diagnostico rapido, affidabile ed applicabile su larga scala: le tre tipologie di test diagnostici su cui sin dall’inizio si sono concentrati gli sforzi sono state l’analisi molecolare, i test antigenici e le analisi sierologiche, ciascuna delle quali caratterizzata da vantaggi e limiti.
Alle metodiche di ricerca diretta o indiretta dell’esposizione al virus, si sono succedute quelle inerenti la radiodiagnostica, la clinica ed il profilo biochimico delle analisi di laboratorio.
Le modalità di diagnosi della COVID risultano fondamentali nella valutazione della causa del decesso dei pazienti morti durante la prima ondata pandemica e a giugno 2020 l’ISS ha approfondito il tema della certificazione delle cause del decesso relative alla COVID-19 in relazione ai risultati dei test diagnostici.
Questo lavoro si pone l’obbiettivo di analizzare i risultati dei test sierologici effettuati ai pazienti ricoverati presso l’Ospedale Policlinico San Martino di Genova nell’emergenza COVID e successivamente deceduti in una data compresa tra il 01.03.2020 ed il 17.05.2020 con lo scopo di valutare la concordanza tra tali risultati e la successiva diagnosi di morte certificata.
I risultati ottenuti permettono di affermare come la positvità ai test sierologici non sia statisticamente correlata alla certificazione di morte COVID-correlata, mostrando come in oltre il 50% del campione la negatività anticorpale non abbia influito nella certificazione clinica della causa della morte, anche a fronte di una conferma negativa molecolare ottenuta sull’analisi dell’ultimo prelievo mediante tampone naso-faringeo (il 22,7% dei casi con sierologia negativa e diagnosi di morte COVID-correlata, era caratterizzata anche da un dato molecolare negativo cronologicamente vicino al decesso).In the first wave of the sars-cov 2 pandemy, one of the main targets was to find a rapid and reliable diagnostic test, applicable on a large number of people. Most of the efforts have focused on three types of tests: the molecular analysis, the antigenic tests and the serological analyses. Each of these is characterized by advantages and limitations. The methods of direct or indirect research of exposure to the virus have also included the radiodiagnostics, the clinical datas and the biochemical profile of laboratory analyses. The methods of diagnosing COVID are of fundamental importance in the assessment of the cause of death of patients who died during the first pandemic wave. In June 2020 the ISS provided guidelines about the certification of the causes of death related to COVID-19 in relation to the results of diagnostic tests. This paper aims to analyze the results of the serological tests carried out on patients that have been admitted to the San Martino Hospital in Genoa during the COVID emergency and then died on a date between 01.03.2020 and 17.05.2020, with the purpose of evaluating the concordance between these results and the diagnosis of the cause of death. The results show how the positity to serological tests is not statistically related to the certification of COVID-related death. In more than 50% of the cases the antibody negativity did not affect the clinical certification of the cause of death, even when a negative molecular confirmation has been obtained on the latest analysis by naso-pharyngeal swab (22.7% of cases with negative serology and diagnosis of COVID-related death were also characterized by a negative molecular data chronologically close to the death).
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Bongino, John Daniel Nordt Lee C. "Late quaternary history of the Waco Mammoth site environmental reconstruction and interpreting the cause of death /." Waco, Tex. : Baylor University, 2007. http://hdl.handle.net/2104/5047.
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Jorgenson, Christer Ivar Ole. "The common cause : the life and death of the Anglo-Swedish Alliance against France,1805-1809." Thesis, University College London (University of London), 1999. http://discovery.ucl.ac.uk/1317901/.
Full textAbstract:
This thesis will view the Napoleonic War from three distinct angles. Firstly, as a world war that was fought beyond the narrow confines of Europe where events on other continents were as important as those taking place in Europe. Secondly, the thesis will view the war from an Anglo-Swedish angle with an emphasis upon the northern and Baltic regions of Europe. This region of Europe is often forgotten when the Napoleonic War is written about despite the fact it was of vital economic and strategic importance to Britain. Thirdly, this military contest between the Great Powers will be viewed from 'below' or in other words from the perspective of a minor power unable to influence events as much as these powers. One good reason for Anglo-Swedish friendship was the strong trade links between the two countries, which led to their successful but neglected economic sabotage of Napoleon's Continental system. Yet economic factors, though vital, did not primarily account for the creation and continued life of the 'common cause'. Instead geopolitical and ideological factors gave rise to the 'common cause'. Firstly, although seeing themselves as nations apart from the continent Sweden and Britain's independence and strategic security depended upon no one power being able to upset or usurp the European balance of power. Secondly, in the eyes of Swedish and British conservatives (they ruled both countries for most of the alliance's life) Napoleonic France was not only a direct threat to their external security but Napoleon also came to symbolise everything they disliked about the new European order. To the architect of the alliance, Gustavus IV , and his fellow conservatives, Napoleon had to be defeated at all costs if Sweden, Britain and all of Europe was to survive. But the conservatives had a monopoly on neither political power nor the truth, for powerful groups in both countries opposed the war with Napoleon. These groups, in opposition during most of the war in both countries,believed an accommodation with Napoleon was possible. In 1806 the British Whigs tried and failed to find a peaceful accommodation with Napoleon. Following defeat at Russian hands and the diversion of British interest to the Iberian peninsula, the Anglo-Swedish alliance was almost dead when in early 1809 the Swedish opposition took power through a coup. They managed, unlike their British colleagues, to get peace with Napoleon, but at a high price. Defeat, despair and domestic turmoil the following year led to the election of marshal Bernadotte as ruler of Sweden. Within two years Bernadotte had begun rebuilding the 'common cause' with Britain, and in 1814 Sweden finally saw its great protagonist Napoleon defeated. The pro-war line had showed itself to be the only realistic and viable long-term option for either country.
37
Sumer, Emrah. "The Transformation Of Health Policies In Turkey As Part Of The European Integration:the Cause Of Death Statistics." Master's thesis, METU, 2007. http://etd.lib.metu.edu.tr/upload/12609173/index.pdf.
Full textAbstract:
The thesis builds up on the significance of the social aspect of the statistics giving direct reference to the standards of the European Union (EU) on statistics. The study concentrates on the modernization, reformation and transformation process of the Turkish Statistical System, particularly the health statistics on the basis of a specific Programme called &ldquoUpgrading the Statistical System of Turkey&rdquo
funded by the EU and the Law on Turkish Statistics (No: 5429) within the process of the harmonization of the Turkish Statistical System, which aims the integration of the current system to the international one via the EU acquis communautaire. This thesis presents the causes of the death statistics as one of the most significant dimensions of statistics since it is the most extensive and the oldest public health surveillance system in the world. The reformation in the certification process, the classification stage and the analysis of the cause of the death statistics (COD) are examined in detail hereby. Improvement of the coverage, introduction of the International Classification of Diseases-10th Revision (ICD-10), development of institutional coordination and a new formation of the causes of death statistics in line with the EU requirements are analyzed in depth. Based on the findings of this study, it is proposed that the introduction of ICD-10 and improvement of the coverage of the COD statistics are not sufficient to ameliorate the shortcomings of the current death certificate system rested upon on the two documents including the &ldquo
COD forms&rdquo
and the &ldquo
burial licence&rdquo
in Turkey. The study also suggests that solutions to be proposed should be radical and effective since the problems encountered in the death certificate system are deep-rooted. Consequently, with regard to the issues of increasing the coverage of physical autopsy and providing training for the COD forms and with the aim of reducing diversified and complex chain of bureaucratic transactions, it is essential to bring an encompassing new legal base for the current death certificate system.
38
Crane-Kramer, G. M. M., and Jo Buckberry. "Is the pen mightier than the sword? Exploring urban and rural health in Victorian England and Wales using the Registrar General Reports." Springer, 2020. http://hdl.handle.net/10454/18356.
Full textAbstract:
YesIn AD 1836, the General Register Office (GRO) was established to oversee the national system of civil registration in England and Wales, recording all births, deaths and marriages. Additional data regarding population size, division size and patterns of occupation within each division permit urban and rural areas (and those with both urban and rural characteristics, described here as ‘mixed’) to be directly compared to each other. The annual Reports of the Registrar General summarize the collected data, including cause of and age at death, which is of particular value to historical demographers and bioarcheologists, allowing us to investigate demographic patterns in urban and rural districts in the nineteenth century. Overall, this paper aims to highlight how this documentary evidence can supplement osteological and paleopathological data to investigate how urbanization affected the health of past populations. It examines the data contained within the first Registrar General report (for 1837-8), in order to assess patterns of mortality of diverse rural, urban, and mixed populations within England and Wales at a point in time during a period of rapid urbanization. It shows that urban and mixed districts typically had lower life expectancy and different patterns in cause of death compared to rural areas. The paper briefly compares how the documentary data differs from information regarding health from skeletal populations, focusing on the city of London, highlighting that certain age groups (the very young and very old) are typically underrepresented in archeological assemblages and reminding us that, while the paleopathological record offers much in terms of chronic health, evidence of acute disease and importantly cause of death can rarely be ascertained from skeletal remains.
This research was funded by the Royal Society of London (Grant Reference IES\R1\180138) and supported by the University of Bradford and SUNY Plattsburgh.
Full text of this book chapter will be released for public view at the end of the publisher embargo on 7 Nov 2021.
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Zagheni, Emilio, Raya Muttarak, and Erich Striessnig. "Differential mortality patterns from hydro-meteorological disasters: Evidence from cause-of-death data by age and sex." Austrian Academy of Sciences, 2015. http://epub.wu.ac.at/6884/1/90_VYPR13_047%2D070.pdf.
Full textAbstract:
This paper evaluates the heterogeneous impact of hydro-meteorological disasters
on populations along the dimensions of age, sex, and human development. The
analysis is based on previously untapped cause-of-death data over the period 1995-
2011 that were obtained from the WHO mortality database, and were based on the
civil registration records of 63 countries
/
territories. Using these data, we evaluate
patterns of mortality related to meteorological disasters in the spirit of model life
tables. We observe that mortality rates from hydro-meteorological disasters for men
are consistently higher than for women across all age groups, and that the di
ff
erential
by sex is larger for adults than for young children or the elderly. Furthermore, the sex
di
ff
erential in mortality becomes smaller with improvements in human development.
Comparing our disaster fatalities with those recorded in the Emergency Events
Database (EM-DAT), we find that the number of deaths from hydro-meteorological
disasters was underestimated in the WHO database, especially in the case of high-
impact events. In the paper we discuss issues of data quality and data harmonisation
for the study of the di
ff
erential demographic impact of natural disasters. One of our
main goals is to stimulate an interdisciplinary debate in this area.
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Wise, Matthew Eric. "Hepatitis C mortality and associated co-morbid conditions analysis of United States multiple-cause-of-death data /." Diss., Restricted to subscribing institutions, 2008. http://proquest.umi.com/pqdweb?did=1610045491&sid=1&Fmt=2&clientId=1564&RQT=309&VName=PQD.
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Ford, Debbie. "Junior clinical psychologists' experience of processing the death of a therapy client, from a cause other than suicide : a qualitative study." Thesis, University of Hertfordshire, 2010. http://hdl.handle.net/2299/4527.
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Aim: According to the existing evidence-base, the experience of the death of a therapy client (from a cause other than suicide) for Clinical Psychologists is substantially under researched. Moreover, previous studies into the experience of patient or client death for healthcare professionals indicate this may be an important focus for research. The present study aimed to explore the often unheard, lived experiences of client death for Clinical Psychologists at the beginning of their career. It was hoped that these research findings may assist training courses, clinical supervisors and other Psychologists of all grades to make sense of this experience in greater depth. Method: A qualitative approach was adopted for this study. Semi-structured interviews were conducted with nine female junior Clinical Psychologists (Trainee, Newly Qualified) who had experienced the death of a client. The accounts were analysed using IPA, which attempts to illuminate the lived experience of a phenomenon for small samples of individuals. Results: The analytic procedure highlighted three main themes as emerging from participants’ accounts in the context of their client’s death: Connected and affected: Being unprepared for initial reactions to the client's death; "we do it so why can't you?" facing institutional denial and avoidance; "It's not something I've forgotten about", The lasting impact of client death: Learning reluctant lessons and experiencing continuing bonds. Implications: This study highlights the importance of recognising the impact of client death on Clinical Psychologists in particular, and healthcare professionals in general. Client death, by all causes, appears much overlooked within the current research base, which may have led to a self-perpetuating cycle of hidden and unspoken stories. The findings indicate death needs to be on the research and teaching agenda within the institution of Clinical Psychology. As a result we may be able to begin to break the current cycle of silence which has served to potentially disservice us as professionals, our teams and most importantly our clients.
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Bonciani, Rosa Dalva Faustinone. "Mortalidade materna: uma análise da utilização de listas de causas presumíveis." Universidade de São Paulo, 2006. http://www.teses.usp.br/teses/disponiveis/6/6132/tde-09012007-154520/.
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Comitês de Mortalidade Materna, que não investigam todos os óbitos de mulheres de 10 a 49 anos, utilizam lista de causas presumíveis de morte materna para a busca ativa de causas maternas de óbito. Mediante dados do Comitê de Estudo e Prevenção da Mortalidade Materna, para o Município de São Paulo (CMMSP), e do Estudo de mortalidade de mulheres de 10 a 49 anos, com ênfase na mortalidade materna, realizado nas capitais de estados brasileiros e Distrito Federal (GPP), analisou-se a utilização da lista de causas presumíveis do Manual dos Comitês de Mortalidade Materna do Ministério da Saúde. Conforme investigação do CMMSP, em relação às causas maternas declaradas em 2001, houve um acréscimo de 72,7% de causas maternas. A análise dos dados com a utilização da lista mostrou que 39,4% eram causas maternas presumíveis e 33,3% não eram causas presumíveis. Entre as Declarações de Óbito (D.O.) originais do primeiro semestre de 2002, do estudo do GPP, em que causas maternas não estavam declaradas e se tornaram causas maternas, verificou-se que 52,6% eram presumíveis e 47,4% não eram presumíveis. Quanto à variável da D.O., que informa se a mulher estava grávida no momento da morte, ou esteve grávida nos doze meses que antecederam a morte, verificou-se a ausência de preenchimento dos campos 43 e 44, em mais de 50% das D.O. com outras causas declaradas e que se tornaram causas maternas, tanto na investigação do CMMSP quanto na do GPP. Concluiu-se que os Comitês de Prevenção da Mortalidade Materna deveriam investigar todas as mortes de mulheres de 10 a 49 anos.Committees of Maternal Mortality, which do not investigate all the deaths of women between 10 and 49 years old, use a list of presumable causes of maternal death for the active search of maternal causes of death. Based on the data from the Committee of Studies and Prevention of Maternal Mortality for the Municipality of São Paulo (CMMSP) and on the Study of mortality of women between 10 and 49 years old with an emphasis on maternal mortality, developed for the Brazilian state capitals and the Federal District (GPP), the utilization of the list of presumable causes from the Health Ministry Manual of the Committees of Maternal Mortality was analyzed. According to the CMMSP data, there was an increase of 72,7% of maternal causes in relation to the declared maternal causes in 2001. The analysis of data with the use of the list showed that 39,4% were presumable maternal causes and 33,3% were not presumable causes. Among the maternal causes which were not declared in the original Death Certificates of the GPP Study for the first semester of 2002, it was verified that 52,6% were presumable and 47,4% were not presumable. As to the pregnancy variable of Death Certificates, it was verified the absence of information in the form in more than 50% of the Certificates with other causes declared and that were maternal causes in the CMMSP and in the GPP investigation. The conclusion is that the Committees of Prevention of Maternal Mortality should investigate all the deaths of women in ages between 10 to 49 years old.
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Råsten, Almqvist Petra. "Sudden infant death syndrome : a medico-legal study of related cardiovascular, toxicological and genetic findings /." Stockholm, 2002. http://diss.kib.ki.se/2002/91-7349-167-5.
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Lopes, Thyana Cordeiro. "Caracter?sticas de ?bitos por causas externas em crian?as e adolescentes, segundo registros do Instituto M?dico Legal de Feira de Santana." Universidade Estadual de Feira de Santana, 2017. http://tede2.uefs.br:8080/handle/tede/674.
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Introduction: deaths from external causes are among the main causes of mortality in children and adolescents. Studies indicate that most of these events are preventable. Objective: to characterize the deaths due to external causes, according to sociodemographic variables, the type of death, the immediate cause that led to death. Method: descriptive epidemiological study on the characteristics of external causes of death in children and adolescents, submitted to necropsy in the Medicolegal Institute of Feira de Santana-Ba, from January 1, 2013 to December 31, 2015. Results: from 2013 -1015, 466 children and adolescents were killed, due to external causes and examined in the Santana-Bahia Feira IML, 86.3 %% belonged to the male sex; 86.3% were adolescents; 82% were brown; Homicide was the leading cause of death, with 61.6%, followed by traffic accidents, with 23.9% of cases; Being the public place the most frequent occurrence of the cases, with 65.2%; Of all deaths, 60.3% were caused by firearms; With traumatic brain injury being the most frequent among the immediate causes of death, with 33.5%. Conclusion: In Feira de Santana, the profiles found of these victims are young, male, brown and black, with the main type of death, homicide, followed by traffic accidents, such corroborate several studies in this area. The study points the magnitude of external causes as a social problem. In this way, it is necessary to work on the prevention of these causes, in order to reduce early deaths, as well as the economic impact of society's expenditures, besides avoiding emotional and psychological consequences for the families of these young people.
Introdu??o: os ?bitos por causas externas est?o entre as principais causas de mortalidade em crian?as e adolescentes. Estudos apontam que a maior parte desses eventos s?o evit?veis. Objetivo: caracterizar os ?bitos por causas externas, segundo vari?veis sociodemogr?ficas, o tipo de morte e causa imediata que levou a morte. M?todo: estudo epidemiol?gico descritivo sobre caracter?sticas dos ?bitos por causas externas em crian?as e adolescentes, submetidas a necropsia no IML de Feira de Santana-Ba, no per?odo de 01 de janeiro de 2013 a 31 de dezembro de 2015. Resultados: no per?odo de 2013-2015, foram necropsiados 466 crian?as e adolescentes, v?timas de mortes por causas externas no IML de Feira de Santana-Bahia, 86,3% pertenciam ao sexo masculino; 86,3% eram adolescentes; 82% eram pardos. O homic?dio foi a principal causa de morte, com 61,6%, seguido de acidentes de tr?nsito, com 23,9% casos; sendo a via p?blica o local de maior ocorr?ncia dos casos, com 65,2%; entre todos os tipos de mortes, 60,3% foram causadas por arma de fogo; sendo o traumatismo cr?nio encef?lico a causa imediata mais frequente, com 33,5%. Conclus?o: Em Feira de Santana, os perfis encontrados dessas v?timas s?o jovens, do sexo masculino, pardos e negros, tendo como principal tipo de morte, o homic?dio, seguido de acidentes de tr?nsito, dados que corroboram diversos estudos nesta ?rea. O estudo aponta a magnitude das causas externas como problema social. Dessa forma, observa-se a necessidade de trabalhar a preven??o dessas causas, a fim de reduzir mortes precoces, bem como minimizar o impacto econ?mico desses fatores nos gastos da sociedade, al?m de precaver poss?veis sequelas emocionais e psicol?gicas para as fam?lias desses jovens.
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Gunnarsdóttir, Oddný. "Users of a hospital emergency department : Diagnoses and mortality of those discharged home from the emergency department." Thesis, Nordic School of Public Health NHV, 2005. http://urn.kb.se/resolve?urn=urn:nbn:se:norden:org:diva-3323.
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Objectives – To ascertain the annual number of users who were discharged home after visits to the emergency department, grouped by age, gender and number of visits during the calendar year, and to assess whether an increasing number of visits to the department predicted a higher mortality. Methods – This is a retrospective cohort study, at the emergency department of Landspitali University Hospital, Reykjavik capital city area, Iceland. During the years of 1995 to 2001 19259 users visited the emergency department, and were discharged home and they were follow-up for cause specific mortality through a national registry. Standardised mortality ratio, with expected number based on national mortality rates was calculated and hazard ratios according to number of visits per calendar year using time dependent multivariate regression analysis were computed. Results – The annual increase of visits to the emergency department among the patients discharged home was seven to 14 per cent per age group during the period 1995 to 2001, with a highest increase among older men. The most common discharge diagnosis was the category Symptoms, signs and abnormal clinical and laboratory findings not elsewhere classified. When emergency department users were compared with the general population, the standardised mortality ratio was 1.81 for men and 1.93 for women. Among those attending the emergency department two times, and three or more times in a calendar year, the mortality rate was higher than among those coming only once in a year. The causes of death which led to the highest mortality among frequent users of the emergency department were neoplasm, ischemic heart diseases, and the category external causes, particularly drug intoxication, suicides and probable suicides. Conclusions – The mortality of users of the emergency department who had been discharged home turned out to be higher than that of the general population. Frequent users of the emergency department had a higher mortality than those visiting the department no more than once in a year. Since the emergency department serves general medicine and surgery patients, not injuries, the high mortality due to drug intoxication, suicide and probable suicide is notable. Further studies are needed into the diagnosis at discharge of those frequently using emergency departments, in an attempt to understand and possibly prevent this mortalityISBN 91-7997-128-8
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Ben, Taher Mohamed. "Detecting the cause of death in infants and children : whole body post-mortem computed tomography compared to autopsy." Thesis, University of Sheffield, 2019. http://etheses.whiterose.ac.uk/22429/.
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Post-mortem investigation is a sensitive issue that needs to be studied in order to address the many issues that surround this topic. This thesis is divided into 7 chapters. Chapter One is a review of the literature, providing information about identifying the causes of death in children, autopsy protocols and the acceptability of post-mortem investigations among the public. Chapter Two determined the reaction towards post-mortem procedures among Muslims and non-Muslims in Libya and in the UK. Muslims were found to have a significant preference for post-mortem imaging compared to autopsy except in homicidal cases. Chapter Three is a systematic review of the literature which identified 3 papers totalling 262 patients and showed overall agreement between post-mortem CT and conventional autopsy of 51%. Chapter Four is an evaluation of the performance of PMCT compared to conventional autopsy in identifying the cause of death in 54 infants and children. Conventional autopsy detected significantly more abnormalities than PMCT and proved to be superior to PMCT for identifying organ' soft tissue abnormalities. PMCT however was superior at identifying skeletal pathology. Chapter Five investigated whether longitudinal changes in organ Hounsfield units (HU) and total body air volume (TBAV) can provide an estimate of post-mortem interval (PMI) in eight euthanised lambs. TBAV increased by 14 cm3 (p < 0.001) for each additional post-mortem day with an intercept of 116 cm3 (p < 0.001). There was clear and progressive decrease in tissue densities and increase in TBAV in individual cases over time. Chapter Six is a pilot study to determine whether PMCT can be used to estimate PMI in 51 infants and children by measuring HU of selected organs. Results suggest that further investigation of the reliability of using HU of the kidney and spleen to estimate PMI is warranted. Chapter Seven provides an overview, discussion and concludes this thesis.
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Kowalsky, Nathan Edward. ""Let me tell you why God made ..." death a philosophical development and critique of Capon's scientific and theological line of argument against sin as the cause of biological death /." Online full text .pdf document, available to Fuller patrons only, 2002. http://www.tren.com.
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Domingues, Carmen Silvia Bruniera. "Causas de óbito entre pessoas com aids no município de São Paulo. 1991-2006." Universidade de São Paulo, 2011. http://www.teses.usp.br/teses/disponiveis/6/6132/tde-05122011-112240/.
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Introdução: A partir da introdução dos antirretrovirais altamente potentes (HAART), assistiu-se, nos países desenvolvidos, a mudanças nos padrões de morbimortalidade associado à aids. No entanto, no Brasil, tem-se poucos estudos analisando esta questão. Objetivo: Analisar as causas básicas e associadas de óbito entre pessoas com aids, residentes no município de São Paulo (MSP), nos períodos pré e pós a introdução da HAART e investigar possíveis disparidades, segundo a área de residência entre 2000 e 2006. Métodos: Estudo descritivo. Os dados foram analisados segundo três períodos: pré-HAART (1991-1996), pós-HAART precoce (1997-1999) e pós-HAART tardio (2000-2006). Fontes de dados: Base Integrada Paulista de Aids (BIPAIDS), do Programa Estadual de DST/Aids-SP e Fundação SEADE e Fundação SEADE para estimativas populacionais. A classificação das causas de óbito foi feita de acordo com a CID-9 (1991-1995) e CID-10 (1996-2006). Foram estimadas as taxas de mortalidade ajustadas por idade para as principais causas básicas de morte, para o período de 1996 a 2006 e efetuada análise descritiva dos óbitos, segundo causas básicas e associadas de morte (1991 a 2006). As causas básicas foram classificadas em: definidoras e não definidoras de aids. Variáveis de interesse: características sociodemográficas, categorias de exposições hierarquizadas e causas básicas e associadas de morte. Para a análise comparativa das variáveis categóricas utilizou-se o teste do qui-quadrado de Pearson, ou o exato de Fisher, e para as variáveis contínuas, o teste t-Student. Para a análise segundo a área de residência, os distritos administrativos foram classificados de acordo com o Índice Paulista de Vulnerabilidade Social. Resultados: Após a HAART, comparando 1995 e 2005, houve declínio de 66,2% na mortalidade por aids no MSP. As causas básicas de morte por doenças não definidoras de aids aumentaram de 0,2% para 9,6% (p<0,001) entre o primeiro e terceiro períodos, respectivamente. As causas básicas de morte com maior aumento, no terceiro período, se comparado ao primeiro, foram: as doenças cardiovasculares, elevando-se de 0,01% para 1,7% (p<0,001), as pneumonias bacterianas/inespecíficas, de 0,01% para 1,6% (p<0,001) e as neoplasias não definidoras de aids, de 0,03% para 1,5% (p<0,001). As causas associadas de morte mais mencionadas no período pós-HAART tardio, se comparado ao préHAART, foram: pneumonias bacterianas/inespecíficas, elevando-se de 25,8% para 35,9%, as septicemias, de 14,5% para 33,5%, as doenças cardiovasculares, de 3,0% para 10,1% e as doenças do fígado, de 2,2% para 8,0%. No pós-HAART tardio, as causas básicas que se destacaram, além da aids, e se distribuíram de forma heterogênea, segundo local de residência, foram as neoplasias não definidoras de aids nas áreas predominantemente ricas, as doenças cardiovasculares nas áreas predominantemente de classe média e as agressões nas áreas predominantemente pobres. Conclusões: A HAART alterou o perfil da mortalidade associada à aids, refletindo, possivelmente, mudanças de igual importância nas características da morbidade, porém esse processo se mostrou heterogêneo, segundo área de residência. Será necessária a elaboração de políticas públicas para adequação dos serviços de saúde, frente a este novo cenário de morbimortalidade da infecção pelo HIVBackground: Since the introduction of highly active antiretroviral therapy (HAART), developed countries have witnessed changes in the patterns of morbidity and mortality associated with AIDS; however, there are only a few studies assessing this issue in Brazil. Objective: To analyze the underlying and associated causes of death among individuals with AIDS, living in the city of São Paulo, before and after the HAART era (1991-2006), and to investigate possible differences according to the area of residence, from 2000 to 2006. Methods: A population-based study among persons with AIDS, residents in the city of São Paulo who died from any cause, in three periods, according to the date of death: pre-HAART (1991-1996), early HAART (1997-1999) and late HAART (2000-2006) eras. Data sources: cases of AIDS reported to the São Paulo State STD/AIDS Program, and mortality and population data for the study periods obtained from the State Data Analysis System Department (Fundação SEADE). Causes of death were coded according to the Ninth (1991-1995) and Tenth (1996-2006) Revision of the International Classification of Diseases (ICD). Age-adjusted mortality rates of the main underlying causes of death from 1996 to 2006 were estimated and a descriptive analysis of the underlying and associated causes of death in the study period (1991-2006) was performed. Causes of death were classified in AIDS-defining and non AIDS-defining. Variables: age, gender, HIV transmission category, underlying and associated causes of death. Descriptive analyses were performed. Comparisons of the proportions of deaths in the pre-HAART and post-HAART eras used the Pearson\'s chi-square test or Fisher\'s exact test. Residence areas were classified into four groups of homogeneous areas according to the state of São Paulo Social Vulnerability Index. Results: Between 1995 and 2005, the AIDS mortality rate declined to 66.2%. The percentage of non AIDS-defining causes of death increased from 0.2% in the pre-HAART era to 9.6% (p<0.001) in late HAART era. The underlying causes of death that increased in the late HAART era compared to the pre-HAART era were: cardiovascular diseases, from 0.01% to 1.7% (p<0,001); pneumonia (bacterial or unspecified organism), from 0.01% to 1.6% (p<0,001) and non-AIDS defining cancers, from 0.03% to 1.5% (p<0,001). The main associated causes of death mentioned in death certificates, in the pre-HAART versus the late HAART era were: bacterial or unspecified organism pneumonia (25.8% vs 35.9%), septicemia (14.5% vs 33.5%), cardiovascular diseases (3.0% vs 10.1%) and liver disease (2.2% vs 8.0%). In the late HAART era, after AIDS, the leading underlying causes of death, according to the area of residence were: non-AIDS-defining cancers in predominantly rich areas; cardiovascular diseases in predominantly middle class area; and aggressions in predominantly poor areas. Conclusions: HAART not only increased survival of people living with AIDS significantly, but changed the profile of mortality, possibly reflecting the equally important changes in disease patterns. This process was not homogeneous according to the area of residence. The development of public policies to adjust health services to this new scenario of morbidity and mortality of HIV infection is required
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Martins, Renata Cristófani. "Avaliação da eficácia do software Iris para uso no Brasil." Universidade de São Paulo, 2017. http://www.teses.usp.br/teses/disponiveis/6/6132/tde-19072017-115153/.
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Introdução: As estatísticas de mortalidade são usadas pelo mundo inteiro e por isso precisa ter dados confiáveis e comparáveis. Uma das estratégias para melhorar sua qualidade é a automação de etapas do fluxo dos dados. O Iris é um sistema que codifica as causas de morte da declaração de óbito (DO) e seleciona a causa básica de morte. Objetivos: adaptar o software para uso no Brasil, testá-lo e comparar seu uso com a codificação manual e com a seleção do sistema usado na rotina brasileira, o Sistema de Seleção da Causa Básica de Morte (SCB). Métodos: foram utilizadas uma amostra de declarações de óbito de óbitos ocorridos no período de janeiro a junho de 2014 em nove cidades representando as cinco regiões do Brasil. Foram selecionados óbitos pelas causas mais comuns, com menção de doença transmissível, assim como óbitos infantis, maternos e óbitos com menção de causa externa ou cirurgia. A fase 1 visou a conclusão do dicionário e a fase 2 testar e comparar o uso do Iris. Resultados: 1848 DO, com uma média de 3,1 linhas preenchidas por DO. Foram realizadas 618 ajustes ou adições nas tabelas do dicionário ou nas tabelas de padronização. Em 45,9 por cento das DO o Iris codificou todas as causas de morte presente na DO assim como selecionou a causa básica de morte. Das DO que o Iris não conseguiu concluir o processo, a maioria (97,8 por cento) dessas rejeições foi por dificuldade em encontrar ou processar um código da CID. A concordância do Iris com a codificação manual nos níveis de 4 caracteres, 3 caracteres e 1 caractere dos códigos da CID-10 foi de 73,3 por cento, 78,2 por cento e 83,9 por cento respectivamente. Isso representou uma discordância em 49,1 por cento das DO. A concordância da causa básica de morte com o SCB foi de 74,2por cento, 84,3 por cento e 91,8 por cento nos níveis de 4 caracteres, 3 caracteres e 1 caractere dos códigos da CID-10 respectivamente. A principal causa de discordância (71 por cento) foi por codificações diferentes. Após as pequenas correções, o Iris finaliza 66,6 por cento das DO. Conclusão: As discordâncias tiveram como causa os hábitos e rotinas dos codificadores que variam entre eles, enquanto no Iris a codificação de uma causa é sempre a mesma. As tabelas de decisão do SCB precisam ser revistas. Os dados mostram que é possível usar esta ferramenta e que ela vai diminuir o trabalho dos codificadores. O Iris teve uma boa taxa de finalização, semelhante a países que o utilizam na sua rotina.Introduction: Mortality statistics is used all over the world and therefore needs reliable and comparable data. One of the strategies to improve quality is an automated data collection. Iris is a system that codes the causes of death of the death certificate (DC) and selects the underlying cause of death. Objective: To adapt Iris software to Brazil finalising the Portuguese dictionary, to test Iris and to compare it with manual coding and with the selection of the Basic Death Cause Selection System (Portuguese acronym is SCB). Methods: The sample was death certificates occurred from January to June of 2014 in nine cities representing the five regions of Brazil. Were selected to compose the sample: routine deaths, DC with mention of communicable disease, infant death, maternal death and DC with mention of external cause or surgery. Phase 1 aimed to complete the dictionary and phase 2 aimed to test and compare Iris. Results: The sample was1848 DC, with an average of 3.1 lines filled by DC. There were 618 adjustments or additions to dictionary tables or standardization tables. In 45.9 per cent of DC Iris coded all causes of death and selected the underlying cause of death. Of the DC that Iris was unable to complete the process, the majority (97.8 per cent) of these rejections were due to difficulty in finding or processing an ICD code. Iris agreement with manual coding at the 4-character, 3- character, and 1-character levels of ICD-10 codes was 73.3 per cent, 78.2 per cent and 83.9 per cent, respectively. This represented a disagreement in 49.1 per cent of DC. The concordance of the underlying cause of death with SCB was 74.2 per cent, 84.3 per cent and 91.8 per cent at the 4- character, 3-character and 1-character levels respectively. The main cause of discordance (71 per cent) was by different codes for the same cause of death. After the small corrections, Iris finalised 66.6 per cent of the DC. Conclusion: The disagreements were caused by coders routines that can vary between them, whereas in Iris the codification of a cause is always the same. The SCB decision tables need to be reviewed. The data show that it is possible to use this tool and that it will decrease the work of the coders. Iris had a good finalisation rate, similar to countries that use it in their routine.
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Zhang, Zhengguo [Verfasser]. "Uropathogenic Escherichia coli cause resistance to apoptotic cell death of infected cells by epigenetically suppressing BIM expression / Zhengguo Zhang." Gießen : Universitätsbibliothek, 2016. http://d-nb.info/1081013982/34.
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