Academic literature on the topic 'Infant mortality rates search'
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Journal articles on the topic "Infant mortality rates search"
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Jafarian, Saleh, Masoud Amiri, and Mahmoud Mobasheri. "The Effect of Twin Birth on Neonatal and Infant Mortality Rates: A Systematic Review." International Journal of Epidemiologic Research 5, no. 3 (September 18, 2018): 113–18. http://dx.doi.org/10.15171/ijer.2018.24.
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Background and aims: Twin birth may account for higher mortality rates in infants and neonates. To investigate the potential relationship between twin birth and infant and neonatal mortality rates (NMRs), a systematic review was conducted. Methods: To gather the evidence for the relationship between twin birth and its potential effect on mortality during infancy and neonatal periods, a systematic review was conducted. The most important used databases were PubMed, Google Scholar, Web of Science, Scopus, ProQuest, Cochrane and Springer. Then, the databases were searched by appropriate keywords. After reviewing and evaluating the collected studies, trends in the different countries were compared. Results: A total of 13 790 related studies were found, of which 128 studies were selected in the first step. The studies which were not related to the subject, in addition to repetitive studies, were excluded from the search in the second step based on inclusion and exclusion criteria by reviewing the abstract and, in some cases, the full article. Finally, 7 studies entered the last step. Conclusion: This study showed that the mortality could be higher among twins than among non-twins, especially among boys.
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Verstraeten, Barbara S. E., Jane Mijovic-Kondejewski, Jun Takeda, Satomi Tanaka, and David M. Olson. "Canada’s pregnancy-related mortality rates: doing well but room for improvement." Clinical & Investigative Medicine 38, no. 1 (February 6, 2015): 15. http://dx.doi.org/10.25011/cim.v38i1.22410.
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Purpose: Canada’s perinatal, infant and maternal mortality rates were examined and compared with other Organization for Economic Cooperation and Development (OECD) countries. The type and the quality of the available data and best practices in several OECD countries were evaluated. Source: A literature search was performed in PubMed and the Cochrane Library. Vital statistics data were obtained from the OECD Health Database and Statistics Canada and subjected to secondary analysis. Principal findings: Overall, Canadian pregnancy mortality rates have fallen dramatically since the early 1960’s. Perinatal and infant mortality rates remain low and stable, but the maternal mortality rate has increased slightly and both mortality rates have declined in their relative OECD rankings over the last 20 years. Data quality and coverage across Canada and internationally, especially for Indigenous peoples, is inconsistent and registration practices differ greatly, making comparisons difficult. Available data do show that Indigenous people’s perinatal and infant mortality rates are nearly twice those of the general population. Best practices in other OECD countries include Australia’s National Maternity Services plan to improve Aboriginal perinatal health, the Netherlands’ midwifery services and National Perinatal Registry and Japan’s national pregnancy registration and Maternal Handbook. Conclusion: To diminish Canadian disparities in perinatal health rates and improve health outcomes we recommend a) uniform registration practices across Canada, b) better data quality and coverage especially among Indigenous communities, c) adoption of a national pregnancy registration and a maternal handbook along with d) improved midwifery and primary practice services to rural and remote communities. At a time when Canada is focusing upon improving pregnancy health in developing nations, it also needs to address its own challenges in improving pregnancy outcomes.
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Paes, Bosco, Ian Mitchell, Abby Li, Tetsuhiro Harimoto, and Krista L. Lanctôt. "Respiratory-Related Hospitalizations following Prophylaxis in the Canadian Registry for Palivizumab (2005–2012) Compared to Other International Registries." Clinical and Developmental Immunology 2013 (2013): 1–15. http://dx.doi.org/10.1155/2013/917068.
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Respiratory syncytial virus (RSV) infection occurs commonly in infants aged ≤2 years, and severe infection results in hospitalization with accompanying morbidity and mortality. Palivizumab has been available for prophylaxis for the past 15 years. Prospective data on patients who received palivizumab from 2005 to 2012 has been assembled in the Canadian registry (CARESS) to document utilization, compliance, and health outcomes in both hospital and community settings. Long-term data is necessary to evaluate the impact of palivizumab on the incidence of RSV infections, minimize healthcare resources, and identify which infant subpopulations are receiving prophylaxis. A database search was also conducted for similar information from published registries, and hospitalization rates were compared to results from randomized clinical trials (RCTs).Overall hospitalization rates (percent; range) for respiratory-related illnesses and RSV-specific infection in infants who meet standard indications for prophylaxis were 6.6 (3.3–7.7) and 1.55 (0.3–2.06), respectively, in CARESS, which closely aligns with registry data from 4 other countries, despite the former comprising the largest cohort of complex patients internationally. Overall RSV-related hospitalization rates were lower across registries compared to equivalent patients in RCTs. Registry data provides valuable information regarding real-world experience with palivizumab, while facilitating the genesis of new research themes.
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Rudge, Marilza Vieira Cunha, Silvana Andrea Molina Lima, Regina Paolucci El Dib, Gabriela Marini, Claudia Magalhaes, and Iracema de Mattos Paranhos Calderon. "Effect of ambulatory versus hospital treatment for gestational diabetes or hyperglycemia on infant mortality rates: a systematic review." Sao Paulo Medical Journal 131, no. 5 (2013): 331–37. http://dx.doi.org/10.1590/1516-3180.2013.1315560.
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CONTEXT AND OBJECTIVE: Pregnancies complicated by diabetes are associated with increased neonatal and maternal complications. The most serious maternal complication is the risk of developing type 2 diabetes, 10-12 years after the delivery. For rigorous control over blood glucose, pregnant women are treated through ambulatory management or hospitalization. The aim of this study was to evaluate the effectiveness of ambulatory management versus hospitalization in pregnancies complicated by diabetes or hyperglycemia. DESIGN AND SETTING: Systematic review conducted in a public university hospital. METHODS: A systematic review of the literature was performed and the main electronic databases were searched. The date of the most recent search was September 4, 2011. Two authors independently selected relevant clinical trials, assessed their methodological quality and extracted data. RESULTS: Only three studies were selected, with small sample sizes. There was no statistically significance different between ambulatory management and hospitalization, regarding mortality in any of the subcategories analyzed: perinatal and neonatal deaths (relative risk [RR] 0.65; 95% confidential interval [CI]: 0.11 to 3.84; P = 0.63); neonatal deaths (RR 0.29; 95% CI: 0.01 to 6.07; P = 0.43); and infant deaths (RR 0.29; 95% CI: 0.01 to 6.07; P = 0.43). CONCLUSIONS: This review, based on studies with high or moderate risk of bias, showed that there was no statistically significant difference between ambulatory management and hospital care, regarding reduction of mortality rates in pregnancies complicated by diabetes or hyperglycemia. It also suggested that there is a need for further randomized controlled trials on this issue.
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Hut, Janneke. "In Search of Affirmed Aboriginality as Christian: “If you do not walk on the tracks of your grandparents, you will get lost . . .”." Exchange 41, no. 1 (2012): 19–43. http://dx.doi.org/10.1163/157254312x618771.
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Abstract The marginalized position in which the Indigenous peoples of Australia find themselves today is undeniable. Within the tragedy of low life-expectancy, high rates of substance abuse, malnutrition, poor housing, high infant mortality, deaths in custody etc. lies a spiritual crisis. This crisis is aggravated by the circumstance that the loss of the land to the European invaders has caused a loss of Aboriginal identity. In their attempt to recover from this colonial legacy the Aborigines try to re-find their (religious) self-identity and to unite through Aboriginality. In this search for Aboriginal identity through spirituality and faith some Christian theologians explore the possibilities of an Aboriginal contextual theology as a response to this crisis.
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Ivanov, Dmitry O., and Kseniia G. Shevtsova. "Analysis of selected statistical indicators of the North-Western Federal district in aspect of infant mortality and stillbirths." Pediatrician (St. Petersburg) 9, no. 2 (May 15, 2018): 5–15. http://dx.doi.org/10.17816/ped925-15.
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The paper presents results of some analyzed statistical indicators of infant mortality and stillbirth in the North-Western Federal District of Russia. The following indicators are considered: availability of medical personnel and inpatient beds, morbidity of pregnant women, the number of abortions, as well as some socio-economic indicators. The negative correlation between infant mortality rate in the region and availability of obstetricians-gynecologists, pediatricians, neonatologists was revealed. Stillbirth rates in the region were found to be related to the provision of pregnant pathology beds, to the proportion of these beds in the total number of obstetric beds, to provision of the population with obstetricians and gynecologists. In addition, both factors are equally dependent on such index of work of women's family planning counseling services as the number of abortions per 100 live and stillbirths. A comparative analysis of the pregnant women morbidity, together with the investigated medical care provision in the region, emphasized the effective organization of the child protection and child delivery service activity in the North-Western Federal District, on the one hand. On the other hand, it determined that, in the search for a reserve of reducing fetal and infantile losses in North-Western Federal District, the priority area is a differentiated study of the pregnant women morbidity aimed at developing an appropriate comprehensive prevention program to reduce of the pregnant women morbidity.
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Goley, Stephanie Michele, Sidonie Sakula-Barry, Nana Adofo-Ansong, Laurence Isaaya Ntawunga, Maame Tekyiwa Botchway, Ann Horton Kelly, and Naomi Wright. "Investigating the use of ultrasonography for the antenatal diagnosis of structural congenital anomalies in low-income and middle-income countries: a systematic review." BMJ Paediatrics Open 4, no. 1 (August 2020): e000684. http://dx.doi.org/10.1136/bmjpo-2020-000684.
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BackgroundCongenital anomalies are the fifth leading cause of under-5 mortality globally. The greatest burden is faced by those in low/middle-income countries (LMICs), where over 95% of deaths occur. Many of these deaths may be preventable through antenatal diagnosis and early intervention. This systematic literature review investigates the use of antenatal ultrasound to diagnose congenital anomalies and improve the health outcomes of infants in LMICs.MethodsA systematic literature review was conducted using three search strings: (1) structural congenital anomalies; (2) LMICs; and (3) antenatal diagnosis. The search was conducted on the following databases: Medline, Embase, PubMed and the Cochrane Library. Title, abstract and full-text screening was undertaken in duplicate by two reviewers independently. Consensus among the wider authorship was sought for discrepancies. The primary analysis focused on the availability and effectiveness of antenatal ultrasound for diagnosing structural congenital anomalies. Secondary outcomes included neonatal morbidity and mortality, termination rates, referral rates for further antenatal care and training level of the ultrasonographer. Relevant policy data were sought.ResultsThe search produced 4062 articles; 97 were included in the review. The median percentage of women receiving an antenatal ultrasound examination was 50.0% in African studies and 90.7% in Asian studies (range 6.8%–98.8%). Median detection rates were: 16.7% Africa, 34.3% South America, 34.7% Asia and 47.3% Europe (range 0%–100%). The training level of the ultrasound provider may affect detection rates. Four articles compared morbidity and mortality outcomes, with inconclusive results. Significant variations in termination rates were found (0%–98.3%). No articles addressed referral rates.ConclusionAntenatal detection of congenital anomalies remains highly variable across LMICs and is particularly low in sub-Saharan Africa. Further research is required to investigate the role of antenatal diagnosis for improving survival from congenital anomalies in LMICs.PROSPERO registration numberCRD42019105620.
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Angia Sari, Intan Dewi, Muhammad Ilham Aldika Akbar, and Atika Atika. "Neonatal Death in Women with Severe Preeclampsia Receiving Conservative Management: Literature Review." KESANS : International Journal of Health and Science 1, no. 10 (July 20, 2022): 876–82. http://dx.doi.org/10.54543/kesans.v1i10.93.
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Introduction: In developing countries that still have places with inadequate supporting facilities, equipment and limited trained personnel, infants less than 37 weeks may still be at high risk for severe complications and even death if active management or termination is carried out, so conservative care is recommended. Object: The aim of this study was to analyze the perinatal outcome of neonatal mortality in women with severe preeclampsia who received conservative management. Method: This study uses a literature review method which includes searching for articles in electroncic research journal databases. Search articles using Scopus and Google Scholar with no year limit. The keywords used in the search were Preeclampsia, Conservative Management, Expectative Management, and Perinatal Outcomes. A total of 637 articles were obtained, and six articles were analyzed based on the research setting, design study, samples characteristics, and research results for each article. Results and Discussion: of this study are conservative management of women with severe preeclampsia can reduce neonatal mortality rates in care in developed countries, but still shows high rates of care in developing countries. Conclusion: of the results, this study indicate that conservative management can improve maternal outcomes in the form of neonatal mortality in developed countries
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Ichihara, Maria Yury, Andrêa J. F. Ferreira, Camila S. S. Teixeira, Flávia Jôse O. Alves, Aline Santos Rocha, Victor Hugo Dias Diógenes, Dandara Oliveira Ramos, et al. "Mortality inequalities measured by socioeconomic indicators in Brazil: a scoping review." Revista de Saúde Pública 56 (October 10, 2022): 85. http://dx.doi.org/10.11606/s1518-8787.2022056004178.
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OBJECTIVE Summarize the literature on the relationship between composite socioeconomic indicators and mortality in different geographical areas of Brazil. METHODS This scoping review included articles published between January 1, 2000, and August 31, 2020, retrieved by means of a bibliographic search carried out in the Medline, Scopus, Web of Science, and Lilacs databases. Studies reporting on the association between composite socioeconomic indicators and all-cause, or specific cause of death in any age group in different geographical areas were selected. The review summarized the measures constructed, their associations with the outcomes, and potential study limitations. RESULTS Of the 77 full texts that met the inclusion criteria, the study reviewed 24. The area level of composite socioeconomic indicators analyzed comprised municipalities (n = 6), districts (n = 5), census tracts (n = 4), state (n = 2), country (n = 2), and other areas (n = 5). Six studies used composite socioeconomic indicators such as the Human Development Index, Gross Domestic Product, and the Gini Index; the remaining 18 papers created their own socioeconomic measures based on sociodemographic and health indicators. Socioeconomic status was inversely associated with higher rates of all-cause mortality, external cause mortality, suicide, homicide, fetal and infant mortality, respiratory and circulatory diseases, stroke, infectious and parasitic diseases, malnutrition, gastroenteritis, and oropharyngeal cancer. Higher mortality rates due to colorectal cancer, leukemia, a general group of neoplasms, traffic accident, and suicide, in turn, were observed in less deprived areas and/or those with more significant socioeconomic development. Underreporting of death and differences in mortality coverage in Brazilian areas were cited as the main limitation. CONCLUSIONS Studies analyzed mortality inequalities in different geographical areas by means of composite socioeconomic indicators, showing that the association directions vary according to the mortality outcome. But studies on all-cause mortality and at the census tract level remain scarce. The results may guide the development of new composite socioeconomic indicators for use in mortality inequality analysis.
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Wirayuda, Anak Agung Bagus, and Moon Fai Chan. "A Systematic Review of Sociodemographic, Macroeconomic, and Health Resources Factors on Life Expectancy." Asia Pacific Journal of Public Health 33, no. 4 (January 7, 2021): 335–56. http://dx.doi.org/10.1177/1010539520983671.
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This review was aimed at systematically synthesizing and appraising the existing literature of sociodemographic, macroeconomic, and health resources factors on life expectancy. A systematic literature search of English databases, that is, PubMed/MEDLINE were scrutinized for exploring sociodemographic, macroeconomic, and health resources factors on life expectancy. The literature search was conducted in January 2020, covering a total of 46 articles from 2004 to 2019 met the review criteria, which were fully discussed subsequently. Among sociodemographic factors, infant mortality rate, literacy rate, education level, socioeconomic status, population growth, and gender inequality have a significant impact on life expectancy. Gross domestic product, Gini, income level, unemployment rate, and inflation rate are the main macroeconomic factors that significantly correlated with life expectancy. Among various health care resources, health care facilities, the number of the health care profession, public health expenditure, death rates, smoking rate, pollution, and vaccinations had a significant correlation with life expectancy. The systematic review showed general conformity of different studies, with a significant association between life expectancy and factors comprising several sociodemographic, macroeconomic, and various health care variables. This review found that only one study examined factors affecting life expectancy in Arabic countries. More studies on this region to fill this research gap were highly recommended.
Dissertations / Theses on the topic "Infant mortality rates search"
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Klotz, Angie. "Income inequality, racial composition and the infant mortality rates of U.S. counties." Cincinnati, Ohio : University of Cincinnati, 2005. http://www.ohiolink.edu/etd/view.cgi?acc%5Fnum=ucin1115693615.
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KLOTZ, ANGIE. "INCOME INEQUALITY, RACIAL COMPOSITION AND THE INFANT MORTALITY RATES OF US COUNTIES." University of Cincinnati / OhioLINK, 2005. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1115693615.
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Grayson, Keoka Yonette. "Essays on Income Inequality and Health During the Great Depression." Diss., The University of Arizona, 2012. http://hdl.handle.net/10150/242473.
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The Great Recession has brought income inequality to the forefront of the American psyche. Parallels have been made between the Great Depression and the Great Recession, and as such, economic history can act as a powerful analytical tool in directing policy. The first essay in Income Inequality during the Great Depression is a qualitative analysis of income transitions from 1929 to 1933 using 33 representative cities as surveyed by the Civil Works Administration. The second essay investigates the welfare effects of income inequality on infant mortality during the Depression. And the third essay on noninfant mortality gives context to the analysis of infant mortality and stillbirths.
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Vianna, Jacqueline Rodrigues de Freitas. "A mortalidade na infância no Município de Franca-SP nos anos de 1968/70 e 2002." Universidade de São Paulo, 2004. http://www.teses.usp.br/teses/disponiveis/17/17139/tde-13022007-090754/.
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A saúde das crianças menores de 5 anos é um dos problemas mais críticos que se enfrenta na Região das Américas. A mortalidade na infância é ainda um grande desafio para a maioria das regiões do nosso País. Este estudo tem como objetivo analisar a mortalidade na infância no município de Franca no ano de 2002,comparando-a com os dados obtidos no município na Investigação de 1968/70. Foram estudados 76 óbitos de crianças menores de 5 anos, ocorridos no município de Franca no período de 1 de janeiro a 31 de dezembro de 2002, residentes na zona urbana, excluindo os óbitos ocorridos fora do município ou do Estado, utilizando as informações das declarações de óbito, do Sistema de Informação de Mortalidade, do Sistema de Informação de Nascimentos da Vigilância Epidemiológica, e do Comitê de Mortalidade Infantil, da Secretaria Municipal de Saúde de Franca e dos inquéritos domiciliares. As variáveis estudadas foram idade, sexo, causas básicas e associadas de óbito, peso ao nascer, tipo de parto, fatores biológicos associados como (idade materna, duração da gestação e tipo de gestação), assistência médica, necropsias, local de ocorrência da morte e alguns fatores sócio-econômicos como, grau de instrução e ocupação da mãe. O processamento dos dados foi efetuado pelo programa Epi-info 6 e planilha Excel 2000. As análises foram feitas através da distribuição dos óbitos segundo as diferentes variáveis e dos coeficientes dos óbitos por idade, causas básicas e associadas, sexo, tipo de parto e peso ao nascer. O coeficiente de mortalidade na infância decresceu de 19,40/mil Hab. em 1968/70 para 2,83/mil Hab.em 2002, assim como o CMI de 71,5/mil NV para 12,71/mil NV.Ambos os componentes da mortalidade infantil: o neonatal (36,9/mil NV para 10,69/mil NV) e o pós-neonatal (34,6/mil NV para 2,02/mil NV), foram reduzidos, embora o componente de maior redução tenha sido o pós-neonatal. A maioria dos óbitos infantis ocorreu no período neonatal, principalmente no neonatal precoce, nas crianças com menos de 37 semanas (73,02%), em crianças com baixo peso ao nascer (77,7%), do sexo masculino (57,14%) e que nasceram através de parto normal (61,90%). A mortalidade no período de 1 à 4 anos esteve relacionada com escolaridade inferior a 7 anos de estudo (69,23%) e renda inferior a 2 salários mínimos (76,93%). Em 2002 os 2 principais grupos de causas básicas foram as afecções perinatais e as más formações congênitas. Já em 1968/70 os 2 principais grupos foram as doenças infecciosas e as afecções perinatais. As afecções perinatais que ocupavam o 2o. lugar como causa básica 24,0/mil NV) e associada (40,3/mil NV) de morte de menores de 1 ano em 1968/70, passa a ocupar o 1o. lugar como causa básica (8,8/mil NV) e associadas (16,34/mil NV), mostrando coeficientes bem menores em 2002. Apesar do decréscimo no coeficiente por doenças respiratórias de 7,9/mil NV para 1,01/mil NV estas continuam a ocupar o 3o. lugar como causa básica, tanto dos óbitos infantis (1,01/mil NV), quanto nos óbitos de 1 a 4 anos (0,046/mil NV). As causas principais no período de 1 a 4 anos, foram as doenças do sistema nervoso e causas externas, bem diferente de 1968/70, onde eram as doenças infecciosas e parasitárias e as deficiências nutricionais. Constatou-se também que a prematuridade e os transtornos respiratórios e cardiovasculares específicos do período perinatal foram as causas associadas mais freqüentes dos óbitos infantis (82,92%). As doenças infecciosas e parasitárias que em 1968/70 ocupavam o 1o.lugar em causa de morte infantil (28,3/mil NV), passam a não ocorrer como causa básica e, como associada é mínima (0,61/mil NV), vale ainda ressaltar que não ocorreu nenhum caso de diarréia, sarampo ou deficiências nutricionais como causa básica. Esta análise indica que a redução do CMI se deve principalmente às custas da queda da mortalidade pós-neonatal, com resultados apontando a importância do baixo peso ao nascer e da prematuridade, como os maiores determinantes da mortalidade infantil.The health of children younger than 5 years old is one of the most critical problems faced in the American region. Child mortality is still a challenge for the majority of the Brazilian regions. This study aimed to analyze child mortality in the City of Franca-Brazil in the year of 2002, comparing it with the data obtained in the citys inquiry of 1968/70. 76 cases of deaths in children younger than 5 years of age were studied. They happened in Franca, from January 1st to December 31st of the year 2002, with residents of the urban zone, excluding deaths occurred outside the city or the state, using the informations on the declarations of death, the System of Information of Mortality, the System of Information of Births of the Monitoring Epidemiologist, the Committee of Infant Mortality, the Municipal Department of health of Franca, complementary examinations and inquiries domiciliary were also used. The variables studied were age, sex, basic and associated causes of death, weight at birth, type of childbirth, associate biological factors (such as mother age, duration of the gestation and kind of gestation), medical assistance, autopsies, the place the death occurred and some partner-economic factors such as degree of mother instruction and occupation. Data processing was done with the programs Epiinfo 6 and Excel 2000. The analysis was made by the distribution of deaths according to the different variables and coefficients of death by age, basic and associated causes of death, sex, type of childbirth and weight at birth. The rates of child mortality decreased from 19,40 hab. in 1968/70 to 2,83 hab. in 2002, as well as the CMI from 71,5 NV to 12,71 NV. Both components of infant mortality neonatal (36,9 NV to 10,69 NV) and post neonatal (34,6 NV to 2,02 NV) were reduced, although the component of highestreduction was the post neonatal.Most infant deaths happened during the neonatal period, mainly in the precocious neonatal, in children with less than 37 weeks (73,02%), with low weight at rising (77,7%), of masculine sex (57,14%) and who had been born through normal childbirth (61,90%). Mortality in the period between 1 and 4 years of age was related to mother schooling inferior to 7 years of study (69,23%) and income smaller than 2 minimum wages (76,93%). The 2 main groups of basic causes were the perinatal causes and congenital malformations. However, in 1968/70, the two main groups had been the infectious diseases and the perinatal causes. The perinatal causes, which stood in second place (24,0 NV) as a basic and associated cause (40,3 NV) of death in infants younger than 1 year old in 1968/70, now reached first place (8,8 NV), although it´s coefficient is much smaller in 2002. Despite the decrease in the rates for respiratory causes from 7,9 NV to 1,01 NV, they still occupy third place in basic cause, in both infant deaths (1,01 NV) and deaths of children aging between 1 and 4 years (0,046 NV). The main causes in the period of 1 to 4 years are the nervous system causes and external causes, well different of 1968/70, where they were the infectious and parasitic illnesses and the nutritious deficiencies. It was also evidenced that the prematurity and specific respiratory and cardiovascular upheavals of the perinatal period had been the most frequent associated causes of infant deaths (82,92%). The infectious and parasitic causes, which, in 1968/70, occupied the first place in infant mortality cause (28,3/mil NV), no longer occur as basic causes and, are minimum as associated causes (0,61/mil NV). It is important to stand out that there were no cases of diarrhea, measles or nutritious deficiencies as basic causes. This analysis indicates that the reduction of the CMI is mainly due to the decrease of post neonatal mortality, with results point the importance of low weight at birth and the prematurity, as the biggest causes of infant mortality.
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Pires, Maria do Perpétuo Socorro Balby. "Mortalidade infantil em São Luis, MA, no ano de 2010." Universidade Federal do Maranhão, 2012. http://tedebc.ufma.br:8080/jspui/handle/tede/1367.
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Introduction: Higher than the national average and regional levels, the infant mortality rate in São Luís still shows the early neonatal and post neonatal components, and its decrease has occurred more slowly in the south, southeast and northeast. The present study aims to estimate rates, and to identify factors associated with infant mortality in São Luís, MA, in 2010. Methodology: This is a transversal study which identified all deaths of live births occurring in the period from January to June 2010, the death certificates of the SIM, the Municipal Health Secretary of São Luís. Infant mortality was divided in early neonatal, late neonatal and post-neonatal mortality, and the studied variables were: sex, birth weight, mother’s age, child's age, length of gestation, type of birth, place of death, basic cause of death. The selection of the basic cause of death was carried out according to the WHO criteria for classification of infant mortality and tabulated according to the 10th. CID review. The causes were divided into five major groups: perinatal causes, congenital anomalies, pneumonias, diarrheas and others. Results: It was evaluate 126 death certificates in the period from January to June, 2010. The infant mortality rate for the period studied was 14.75 per thousand, 65 in the early neonatal period, 19 late neonatal and 42 in the post-neonatal period. Related to maternal age, 20.6% had less than 19 years, 75% from 19 to less than 35 years and 5.5% over 35 years. About the weight, 35% had weight below 1000g, 27.2% had weight between 1000g and less than 2500g and 29.3%, more than 2500g. The gestational age, 48.4% had less than 22-36 weeks and 35.7% 37-41 weeks, and 10.31%, less than 22 weeks. Vaginal delivery was predominant 62.7%. Causes: DMH (31%), neonatal infection (28%) and malformations (24%). Conclusion: The early neonatal mortality rate remains high, with associated factors that demonstrate attention to deficiency in pregnancy and childbirth in the city of São Luís.
Introdução: O Coeficiente de Mortalidade Infantil em São Luís ainda apresenta os componentes neonatal precoce e pós-neonatal, superiores à média nacional e regional, e o seu decréscimo tem se dado de forma mais lenta que nas regiões Sul, Sudeste e outras cidades do Nordeste. Metodologia: Trata-se de um estudo transversal onde foram identificados todos os óbitos de nascidos vivos, ocorridos no período de janeiro a junho de 2010, nas declarações de óbitos do Sistema de Informação de Mortalidade (SIM), da Secretaria Municipal de Saúde de São Luís. A mortalidade infantil foi dividida em neonatal precoce, neonatal tardio e pósneonatal, sendo as variáveis estudadas: sexo, peso ao nascer, idade da mãe, idade da criança, duração da gestação, tipo de parto, local de óbito, causa básica do óbito, escolaridade materna. A seleção da causa básica do óbito foi realizada de acordo com os critérios da OMS para classificação da mortalidade infantil e tabulada de acordo com a 10a revisão da CID. As causas foram distribuídas em 5 grandes grupos: causas perinatais, anomalias congênitas, pneumonias, diarréias e outras. Resultados: Foram avaliadas 126 declarações de óbitos, no período de janeiro a junho de 2010. O coeficiente de mortalidade infantil para o período estudado foi 14,75 por mil nascidos vivos, sendo 65 no período neonatal precoce, 19 neonatal tardio e 42, no período pós-neonatal. Em relação à idade materna, 20,6% tinham menos que 20 anos, 75% de 20 a 35 anos ou mais. Quanto ao peso, 35% tinham peso abaixo de 1000g, e 29,3%, mais que 2.500g. Quanto à idade gestacional, 48,4% tinham de 22-36 semanas e 35,7% de 37-41 semanas. O parto vaginal foi predominante (62,7%). As causas mais frequentes foram Doença de Membrana Hialina (31%), infecção neonatal (28%) e malformações (24%). Conclusão: O coeficiente de mortalidade infantil teve como principal componente o coeficiente neonatal precoce, que permanece elevado, tendo como fatores associados o baixo peso ao nascer e a duração da gestação.
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Wussobo, Adane M. "Health and Poverty: The Issue of Health Inequalities in Ethiopia." Thesis, University of Bradford, 2012. http://hdl.handle.net/10454/6312.
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The objectives of this study are to provide a comprehensive assessment of inequalities in infant and under-five years' child survival, access to and utilisations of child health services among different socio-economic groups in Ethiopia; and identify issues for policies and programmes at national and sub-national levels. This thesis examines the effect of parental socioeconomic status, maternal and delivery care services, mothers' bio-demographic and background characteristics on the level of differences in infant and under-five years' child survival and access to and utilisation of child health services. Descriptive and multivariate analyses were carried out for selected variables in the literature which were consider as the major determinants of infant mortality rate (IMR) and under-five years' child mortality rate (U5MR); access to and utilisations of child health services based on data from Ethiopian demographic and health survey (EDHS), covering the years 2000-2005. In the multivariate analysis a logit regression model was used to estimates inequalities in infant and under-five years' child survival, and inequalities in access to and utilisation of child health services. In Ethiopia, little was known about inequalities in IMR and U5MR, and inequalities in access to and utilisation of child health services. Besides, there is no systematic analysis of health inequalities and into its determinants using logistic regression. According to the available literature, this is the first comprehensive and systematic analysis of inequality of health in Ethiopia. The findings show that compared to under-five years' children of mothers' partners with no work, mothers' partners in professional, technical and managerial occupations had 13 times more chance of under-five years child survival for 2000 weighted observations. In addition, compared to infants of mothers who were gave birth to one child in last 5 years preceding the survey, infants of mothers who were gave birth to 2 children in last 5 years preceding the survey had 70% less chance of infant survival while infants of mothers who were gave birth to 3 or more children had 89% less chance of infant survival for 2000 weighted observations. Moreover, this study finding also indicates that inequalities increased significantly in the five years period between 2000 and 2005 among mothers with different birth interval. Most of the relations between birth interval and receiving childhood immunisation for vaccine-preventable diseases were statistically significant. Moreover compared to non-educated mothers, mothers who completed secondary and higher education were nearly 10 times more likely to receive DPT3 immunisation for their young children. This study concludes that policy measures that tackle health inequalities will have a positive impact in the implementation of health sector strategy of Ethiopia. Health inequalities studies in Ethiopia and Sub-Saharan Africa (SSA) countries should focus on systematic analysis of different socio-economic groups. The finding of this study support investing in the Ethiopia's health extension package (HEP) is a necessary but not sufficient condition for addressing rural poor health problem. HEP is successful in increasing primary health care coverage in rural Ethiopia to 89.6% (FMOH, 2009) but unable to reduce Ethiopia's higher level of IMR and U5MR. HEP is one of the success stories that address the rural poor health problem and can also be adapted to developing countries of SSA. The finding also shows that the success stories such as health insurance programs like Rwanda (World Bank, 2008a) and Ethiopia (FMOH, 2009/10) will play a key role in achieving country's health care financing goal of universal coverage. This can also be replicated in the developing SSA countries.
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Makhado, Langanani Christinah. "Factors contributing to high perinatal mortality rates in the selected public hospitals of Vhembe District in Limpopo Province, South Africa." Diss., 2018. http://hdl.handle.net/11602/1168.
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MCurDepartment of Advanced Nursing Science
Background: Perinatal and neonatal mortality rates remain high in South Africa especially in rural areas and townships where the majority of poor people live. With regard to perinatal and neonatal mortality, South Africa like many other developing countries has failed to achieve MDG 4 and 5 by 2015 regardless of many efforts by the governments. To achieve the SDG which replaced MDGs for child health, it is necessary for the South African public and private health care to reduce substantially perinatal and new born deaths, particularly in rural areas. There are many factors that contribute to a high perinatal mortality rate in public hospitals in rural areas. To understand these factors, a study was conducted with midwives from selected public hospitals in Limpopo, Vhembe district which experiences the highest perinatal mortality rates in South Africa. Purpose and methodology: The purpose of this research study was to assess factors contributing to high perinatal mortality rates in the selected public hospitals in Vhembe district. A quantitative, descriptive, exploratory and cross-sectional design was used to collect data from the sampled hospitals in the Vhembe district. Hospitals were purposively sampled based on the statistics of monthly deliveries. The target population consisted of all registered midwives who had been working in the maternity units for at least two years. Cochrane's formula was used to determine the sample from the target population for each hospital. A random sample of 110 respondents was selected upon which a questionnaire was administered to each by the researcher. Responses from the close-ended and open-ended questions was grouped and analysed quantitatively by means of Statistical Package for Social Sciences 23.0 (SPSS). Results and findings: Results were presented in frequency tables and graphs revealed that most of the midwives lacked knowledge and skills in a number of key areas needed for them to operate efficiently in the maternity wards. There was also high staff turnover which led to a few midwives being overworked. The utilisation of guidelines and protocols in maternity was left to individual midwives as the hospitals did not evaluate the use of it. Conclusions: Lack of key skills in assisting women in labour, and poor use of guidelines and understaffing were the main contributing factors to high perinatal mortality rates in the selected public hospitals of Vhembe district. Midwife attitudes were not a contributory factor.
NRF
Books on the topic "Infant mortality rates search"
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Bongaarts, John. Does family planning reduce infant mortality rates? (New York: Population Council, 1987.
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Bongaarts, John. Does family planning reduce infant mortality rates? New York: Population Council, 1987.
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J, Collins William. Exploring the racial gap in infant mortality rates, 1920-1970. Cambridge, MA: National Bureau of Economic Research, 2002.
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Shehzad, Shafqat. How can Pakistan reduce infant and child mortality rates?: A decomposition analysis. Islamabad: Sustainable Development Policy Institute, 2004.
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Shehzad, Shafqat. How can Pakistan reduce infant and child mortality rates?: A decomposition analysis. Islamabad: Sustainable Development Policy Institute, 2004.
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Rice, James. Urban slums and the social production of infant mortality rates in the less developed countries: A macro-comparative, quantitative analysis. Hauppauge, N.Y: Nova Science Publisher's, 2011.
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Cawthon, Laurie. First Steps database: Birth rates after welfare welform. Olympia, Wash: Research and Data Analysis, Dept. of Social and Health Services, 2001.
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Infant & child mortality rates in Egypt, 1980-87. Cairo: Central Agency of Public Mobilization and Statistics, 1989.
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1954-, Peterson Christine E., ed. Why were infant and child mortality rates highest in the poorest states of Peninsular Malaysia, 1941-75? Santa Monica, CA (P.O. Box 2138, Santa Monica 90406-2138): Rand, 1986.
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Fichtner, Alexander, and Franz Schaefer. Acute kidney injury in children. Edited by Norbert Lameire. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199592548.003.0239.
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In the past few decades, the overall incidence of acute kidney injury (AKI) in paediatric patients has increased and the aetiological spectrum has shifted from infection-related and intrinsic renal causes towards secondary forms of AKI related to exposure to nephrotoxic drugs and complex surgical, oncological, and intensive care manoeuvres. In addition, neonatal kidney impairment and haemolytic uraemic syndrome continue to be important specific paediatric causes of AKI raising unique challenges regarding prevention, diagnosis, and treatment. The search for new biomarkers is a current focus of research in paediatric as in adult AKI research.Pharmacological intervention studies to prevent or attenuate AKI have provided positive evidence only for the prophylactic use of theophylline in severely depressed neonates, whereas dopamine and loop diuretics did not demonstrate any efficacy. Preliminary findings support a dose-dependent renoprotective action of fenoldopam in infants undergoing cardiac surgery.Critical issues in the management of AKI in children include fluid handling, maintenance of adequate nutrition, and the choice of renal replacement therapy modality. Observational studies have suggested an adverse impact of fluid overload and late start of renal replacement therapy, and a randomized clinical trial revealed detrimental effects of aggressive fluid bolus therapy in volume-depleted children.Technological advances have made it possible to apply continuous replacement therapies in children of all ages, including preterm neonates, using appropriately sized catheters, filters, tubing, and flow settings adapted to paediatric needs. However, the majority of children with AKI worldwide are still treated with peritoneal dialysis, and comparative studies demonstrating superiority of extracorporeal techniques over peritoneal dialysis are lacking.The outcomes of paediatric AKI are comparable to adult patients. In critically ill children, mortality risk increases with each stage of AKI; mortality rates typically range between 15% and 30% for all AKI stages and 30% to 60% in children requiring renal replacement therapy. Chronic kidney disease develops in approximately 10% of children surviving AKI.
Book chapters on the topic "Infant mortality rates search"
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Banerjee, Sudipto, and Bradley P. Carlin. "Spatial Semiparametric Proportional Hazards Models for Analyzing Infant Mortality Rates in Minnesota Counties." In Case Studies in Bayesian Statistics, 137–51. New York, NY: Springer New York, 2002. http://dx.doi.org/10.1007/978-1-4612-2078-7_4.
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"A7 North America: Infant Mortality Rates (in thousands)." In International Historical Statistics, 2240–46. London: Palgrave Macmillan UK, 2013. http://dx.doi.org/10.1057/9781137305688_245.
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"A7 South America: Infant Mortality Rates (in thousands)." In International Historical Statistics, 2247–49. London: Palgrave Macmillan UK, 2013. http://dx.doi.org/10.1057/9781137305688_246.
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"A7 North America: Infant Mortality Rates (in thousands)." In International Historical Statistics, 2240–46. London: Palgrave Macmillan UK, 2013. http://dx.doi.org/10.1057/978-1-137-30568-8_245.
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"A7 South America: Infant Mortality Rates (in thousands)." In International Historical Statistics, 2247–49. London: Palgrave Macmillan UK, 2013. http://dx.doi.org/10.1057/978-1-137-30568-8_246.
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Barros, Juanita De. "Population Anxieties and Infant Mortality." In Reproducing the British Caribbean. University of North Carolina Press, 2014. http://dx.doi.org/10.5149/northcarolina/9781469616056.003.0003.
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In the years after the end of slavery, declining populations due to high death rates, especially among the very young, sparked deep concerns. Disease causation and infant mortality were blamed on former slaves. In Guyana, Jamaica, and Barbados, investigations into the causes of infant mortality highlighted the need for healthy populations, resulting in the introduction of infant and maternal welfare initiatives in the early twentieth century. This chapter examines the debates about the health and size of populations, much of which was centred on the problem of infant mortality, in Britain's Caribbean colonies during the late nineteenth and early twentieth centuries. It looks at the emergence of a range of new ideas about medicine and public health, together with immigration, designed to ensure the population growth needed to sustain the colonial economies.
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Canpolat Gökçe, Esra, and Veli Yılancı. "Smooth Breaks and Mean Reversion in Infant Mortality Rates." In Ekonometride Güncel Yöntemler ve Uygulamalar, 567–80. Istanbul University Press, 2021. http://dx.doi.org/10.26650/b/ss10.2021.013.32.
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Kara, Funda, and İrfan Ersin. "The Effects of Health Expenditures to Decrease Infant Mortality Rates in OECD Countries." In Multidimensional Perspectives and Global Analysis of Universal Health Coverage, 357–83. IGI Global, 2020. http://dx.doi.org/10.4018/978-1-7998-2329-2.ch014.
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There is a positive relationship between the health level of the society and its economic development. The main reason is that improving quality of the lives and increasing lifetime has lead to higher economic performance. This evaluates the relationship between health expenditure and infant mortality rate in OECD countries. In the analysis process, 20 different countries in the OECD are selected and annual data of these countries for the years between 1980 and 2017 is evaluated with the help of Kao panel cointegration and Dumitrescu-Hurlin causality analysis. The findings show that there is long term relationship between health expenditure and infant mortality rates in OECD countries. Another important conclusion is that there is a causality analysis from health expenditure to the infant mortality rate. While considering these results, it is recommended that OECD countries should take some actions in order to increase health expenditure so that it can be possible to decrease infant mortality rate.
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Ali, Hamid E., and Ubah A. Adan. "Conflict Types and Child and Infant Mortality Rates: Evidence from Panel Data." In Political and Military Sociology, 137–62. Routledge, 2017. http://dx.doi.org/10.4324/9781315126586-7.
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BHARGAVA, ALOK, and JIANG YU. "A Longitudinal Analysis of Infant and Child Mortality Rates in Developing Countries." In Econometrics, Statistics and Computational Approaches in Food and Health Sciences, 289–301. WORLD SCIENTIFIC, 2006. http://dx.doi.org/10.1142/9789812773319_0021.
Full textConference papers on the topic "Infant mortality rates search"
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Barlas, Emin, Fatih Şantaş, and Ahmet Kar. "Comparative Analysis of the Inter-Regional Infant Mortality Rate from the Perspective of Health Economics in Turkey." In International Conference on Eurasian Economies. Eurasian Economists Association, 2014. http://dx.doi.org/10.36880/c05.00959.
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Being healthy is a condition which all individuals and all countries are willing to achieve. However, health is a difficult concept to define and describe. Countries that are striving to achieve better status of health allocate an increasing part of their national income to health sector and expect to get these expenditures' worth. Health economy is an important tool that can be utilized in determining the effect of expenditures on the status of health and improving the effectiveness of expenditures. Thus, health economics is being used both in micro and macro scales. One of the important criteria showing the health status and development of countries is infant mortality rate. Turkey is among the countries which closed the gap between itself and the developed countries in terms of infant mortality rate. In this study, velocity ratio between 2006 and 2012 in Turkey had been calculated in order to compare them with those of the developed countries. In order to compare Turkey's regional infant mortality rates, territorial velocity ratios had been calculated, Turkey Health Statistics Annual data belonging to the years 2009, 2010, 2011 and 2012 had been used to carry out various statistical analyses in order to determine the factors affecting infant mortality rate. Although Turkey had improved itself in terms of infant mortality rates, there are still things to be achieved at the scale of the country and the regions.
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Palupi, Endang, Harsono Salimo, and Bhisma Murti. "Contextual Effect of Village and Other Determinants on Infant Mortality: A Multilevel Analysis from Karanganyar, Central Java." In The 7th International Conference on Public Health 2020. Masters Program in Public Health, Universitas Sebelas Maret, 2020. http://dx.doi.org/10.26911/the7thicph.03.114.
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ABSTRACT Background: Rural children face higher mortality rates than their urban counterparts. Although the rural disadvantage in average child survival in developing countries is firmly established, its explanation is less clear. Several studies suggest that household-level factors appear to be important in explaining rural-urban differences in child mortality. This study aimed to examine the contextual effect of village and other determinants on infant mortality in Karanganyar, Central Java. Subjects and Method: A cross-sectional study was conducted in Karanganyar, Central Java, from February to May 2020. A sample of 200 infants aged 1 to 23 months was selected by fixed disease sampling. The dependent variable was infant mortality. The independent variables were exclusive breastfeeding, nutritional intake, immunization status, maternal education, family income, and contextual effect of village. The data were collected by questionnaire and analyzed by a multiple multilevel logistic regression run on Stata 13. Results: Infant mortality decreased with exclusive breastfeeding (b= -5.10; 95% CI= -9.60 to -0.59; p= 0.026), high family income (b= -5.96; 95% CI= – 9.91 to -2.02; p= 0.003), high maternal education (b= -4.09; 95% CI= -7.79 to -0.38; p= 0.030), and complete immunization (b= -4.67; 95% CI= -8.69 to -0.67; p= 0.022). Infant mortality increased with poor nutritional status (b= 4.99; 95% CI= 1.79 to 8.19; p= 0.002). Village had contextual effect on infant mortality with ICC= 32%. Conclusion: Infant mortality decreases with exclusive breastfeeding, high family income, high maternal education, and complete immunization. Infant mortality increases with poor nutritional status. Village has contextual effect on infant mortality. Keywords: infant mortality, contextual effect of village Correspondence: Endang Palupi. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: epalupi11@gmail.com. Mobile: +6281331872723. DOI: https://doi.org/10.26911/the7thicph.03.114
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Herna´ndez, Alberto M., George S. Dulikravich, Sally Blower, Marcelo J. Colaco, and Ramon J. Moral. "Identification of Parameters in a System of Differential Equations Modeling Evolution of Infectious Diseases." In ASME 2008 International Design Engineering Technical Conferences and Computers and Information in Engineering Conference. ASMEDC, 2008. http://dx.doi.org/10.1115/detc2008-49595.
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The objective of this project was to perform an inverse parameter identification study to determine parameter values in a system of ten ordinary differential equations modeling the prediction of the evolutionary spread of syphilis. The goal was to predict infant mortality rates due to syphilis by using this model and match them to actual field data collected in the United States from 1900 to 1970. The syphilis model was developed by the UCLA Disease Modeling Group. The model involves 23 unknown user-specified parameters, each with specified maximum and minimum possible values. An accurate ordinary differential equation system integration algorithm was used to numerically integrate these equations. A hybrid evolutionary optimization algorithm was then used to iteratively find the proper values of the 23 unknown parameters by minimizing the difference between the predicted and the actual values of annual infant mortality rates due to syphilis. The parameters were originally treated as constants, meaning that they did not vary in time. During this study, they were also considered as time-dependent by modeling them as second degree polynomials. The sexually active population in the original model was assumed linearly increasing with time. To improve on the results, an eight term Fourier series fit was performed on the actual evolution of the sexually active population data during period 1900–1970. It was found that treating the 23 parameters as constants yielded an average fit of the infant mortality rates. By treating the parameters as time-dependent the fit still appeared average, but the variations of mortality during certain periods were captured more accurately.
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"Infant Mortality in the Shadrinsky Uyezd in the Early 20Th Century: the Role of Religious Factors." In XII Ural Demographic Forum “Paradigms and models of demographic development”. Institute of Economics of the Ural Branch of the Russian Academy of Sciences, 2021. http://dx.doi.org/10.17059/udf-2021-1-2.
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The paper analyses the influence of religious factors on infant mortality in the Shadrinsky uyezd of the Perm governorate in the early 20th century. The Shadrinsky Uyezd was characterized by its relative natural, climatic and economic homogeneity and poorly developed social infrastructure for children. Based on ethno-religious and legal factors, the population of the uyezd was divided into Orthodox Russian former state peasants and Bashkir-Meshcheryak landowners/landless Muslims employed in agriculture. According to the research results, all other factors equal, Muslim religious precepts had a tremendous impact on the survival of children: the difference in infant mortality rates between confessional groups was more than 200 ‰.
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Pillay, T., S. Marson, K. Porter, and S. Fullwood. "G28(P) Developing a sustainable early life parent education programme in response to high infant mortality rates in a socio-economicall disadvantaged population." In Royal College of Paediatrics and Child Health, Abstracts of the Annual Conference, 24–26 May 2017, ICC, Birmingham. BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health, 2017. http://dx.doi.org/10.1136/archdischild-2017-313087.28.
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Pasa, Laura Fogaça, Bianca Brinques da Silva, Stephan Kunz, Rafaela Boff, Antonio Pacheco, Victoria Bento Alves Paglioli, and Cristiano Amaral De Leon. "Epidemiological profile of childhood deaths caused by intercurrences of epilepsy in Brazil between 2010 and 2019." In XIII Congresso Paulista de Neurologia. Zeppelini Editorial e Comunicação, 2021. http://dx.doi.org/10.5327/1516-3180.036.
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Background: Epilepsy is one of the most common neurologic disorders among children, with a higher incidence in the first year of life. An accurate epilepsy diagnosis is essential for a proper treatment. Objectives: To assess the rates of childhood deaths from epilepsy in Brazil. DESIGN AND SETTING: Descriptive documentary study based on data from 2010 to 2019 in Brazil. Methods: Evaluating data provided by DATASUS, the information department of Brazil’s publicly funded health care system (SUS). Results: 238 infant deaths due to epilepsy were documented in Brazil during the studied period. The Southeast region had the highest rates, representing 31.51% of the total deaths, followed by the Northeast region, 29.83%, the South region, 18.91%, and the North region, 11.34%. Considering the population in each region, the North had the highest relative rates, followed by the Midwest, Northeast, South and Southeast regions. In the years 2017, 2018 and 2019 the highest death rates were documented, a total of 93 (39.08%). Regarding gender, boys had more deaths, 142 (59.66%) and girls 96 (40.34%). The most affected color / race was white, 133 deaths (55.88%), followed by brown, 79 (33.19%). Blacks and Indians registered the lowest rates, 2.52% each. Conclusion: A predominance of infant deaths due to epilepsy is noticed in the North, which points to the need for greater investment in health in this region, since there was a progressive increase in mortality. It was also found that the male gender and white color are risk factors for complications of the disease.
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Clarke-Sather, Abigail R., and Lindsay Naylor. "Survey As a Contextual Design Method Applied to Breastfeeding Wearables for Mothers Caring for Infants in NICUs." In 2019 Design of Medical Devices Conference. American Society of Mechanical Engineers, 2019. http://dx.doi.org/10.1115/dmd2019-3245.
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Preterm and critically ill infants are treated in neonatal intensive care units (NICUs), where human milk is increasingly recommended and prescribed to this population as a medical intervention [1]. However, due to the medical acuity and complex character of caring for preterm infants, sometimes feeding at the breast is not possible. When feeding at the breast is not possible medical devices or commercial products may influence a mothers’ decision to express human milk for her NICU infant. Feeding human milk to infants cared for in NICUs reduces rates of mortality by decreasing instances of necrotizing enterocolitis (NEC) especially for extremely low birthweight infants [2] and is implicated in reducing incidence and severity of retinopathy of prematurity [3].
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Teixeira, Marcela Menezes, Martina Marcante, Laura Fogaça Pasa, Fabiana Roehrs, Rafaela Fernandes Pulice, Carolina da Mota Iglesias, and Manoel Ernani Garcia Junior. "Mortality profile of Parkinson’s disease in Brazil between 2010 and 2019." In XIII Congresso Paulista de Neurologia. Zeppelini Editorial e Comunicação, 2021. http://dx.doi.org/10.5327/1516-3180.323.
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Background: Parkinson’s disease is a chronic and degenerative condition. Recognizing its mortality profile can be useful in order to search for protective and risk factors. Objectives: Analyze the rates of deaths from Parkinson’s disease in Brazil between 2010 and 2019. Design and setting: Descriptive documentary study with data collected from the Mortality Information System (SIM), made available by the Information System of the Unified Health System of Brazil. Methods: A statistical analysis of deaths due to ICD G20 from the SIM database was performed. Results: In the analyzed period 340,291 deaths due to diseases affecting the CNS were recorded, with Parkinson’s disease being the second largest cause, behind Alzheimer’s disease. In the evaluated period, 34,208 deaths due to Parkinson’s disease were registered in Brazil. There was a steady increase in these values over time, with 2019 being the year with the highest number of deaths (n = 4,575). Most deaths occurred in white individuals (74.3%) and males (54.8%). Regarding the age group, those aged 80 or over had higher mortality (57.8%), followed by those aged 70 to 79 (30.9%) and 60 to 69 (8.9%). The level of education was mainly from 1 to 3 years (26.3%), with less than 7 years of schooling, together, accounting for 57.2% of deaths, not counting those ignored. Conclusions: The higher prevalence of deaths among men, especially above 80 years of age, may be related to menopause and its protective factor among women. Lower levels of education also contributed to higher mortality, which correlates with studies that demonstrate that higher levels of education may delay the clinical onset of the disease. In view of this, mapping the profiles and analyzing the protective and risk factors can contribute to the awareness of the population and the consequent reduction of their morbidity.
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Warella, Y., Sutopo Patria Jati, and Meidiana Dwidiyanti. "The Effectiveness of Collaborative Leadership on Improving Interprofessional Collaboration Practice in the Comprehensive Emergency Obstetric and Neonatal Services." In The 7th International Conference on Public Health 2020. Masters Program in Public Health, Universitas Sebelas Maret, 2020. http://dx.doi.org/10.26911/the7thicph.04.19.
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ABSTRACT Background: Maternal and infant mortality rates remain high in most developing countries including Indonesia. An approach so called as the interprofessional collaboration (IPC) has been considered to have its potential to improve the emergency obstetric and neonatal care. Little is known about the effectiveness of leadership in enhancing IPC. This study aimed to determine the effectiveness of leadership on improving the IPC in the comprehensive emergency obstetric and neonatal services. Subjects and Method: This was a qualitative study using an embedded case study approach. This study was conducted at PKU Muhammadiyah Gamping Hospital, Yogyakarta, as a type C teaching hospital. The data were collected by observation, in-depth interview, and document review. Results: This study found three themes: (1) collaborative leadership; (2) leadership issues; and (3) stakeholder input. The inter-professional collaboration included doctors, consultant doctors, supervisor, shift coordinator, and nurses in charge of nursing care. The interprofessional collaboration had been implemented. The principle of leadership had supported the interprofessional collaboration. The IPC team had understood and applied the principles of leadership that support the IPC. The leadership attributes on demand for the IPC included visionary, participatory, and coaching. The leadership issues included the difference in advice between doctors. The theme for nurses was improving the quality of interprofesional collaboration. Conclusion: The leadership attributes to improve the interprofessional collaboration include visionary, participatory, and coaching for the comprehensive emergency obstetric and neonatal services. Keywords: interprofessional collaboration, leadership Correspondence: Sulistyaningsih. Faculty of Health Sciences, Universitas ‘Aisyiyah Yogyakarta. Jl. Siliwangi (Lingkar Barat) No. 63 Pundung, Nogotirto, Gamping, Sleman, DIY, Indonesia. Email: sulistyaningsih@unisayogya.ac.id. Mobile: +6281328067154 DOI: https://doi.org/10.26911/the7thicph.04.19
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Naseralallah, Lina Mohammad, Tarteel Ali Hussain, Shane Pawluk, and Myriam Eljaam. "The Impact of Pharmacist Interventions on Reducing Medication Errors in Pediatric Patients: A Systematic Review and Meta-analysis." In Qatar University Annual Research Forum & Exhibition. Qatar University Press, 2020. http://dx.doi.org/10.29117/quarfe.2020.0153.
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Background: Medication errors are avoidable events that could occur at any stage of the medication use process. They are widespread in the healthcare system and are associated with increased risk of morbidity and mortality. Implementing a clinical pharmacist is one strategy that is believed to reduce medication errors in the general population including pediatric patients who are more vulnerable to medication errors due to several contributing factors including the challenges of weight-based dosing. Aim: The aim of this study is to qualitatively and quantitatively evaluate the impact of clinical pharmacist interventions on medication error rates for hospitalized pediatric patients. Methodology: PubMed, Embase, Cochrane and Google Scholar search engines were searched from database inception to February 2019. Study selection, data extraction and quality assessment was conducted by two independent reviewers. Observational and interventional studies were included. Data extraction was done manually and the Crowe Critical Appraisal Tool (CCAT) was used to critically appraise eligible articles. Summary odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using a random-effects model for rates of medication errors. Results: A total of 19 studies were systematically reviewed and 6 studies (29 291 patients) were included in the meta-analysis. Pharmacist interventions involved delivering educational sessions, reviewing prescriptions, attending rounds and implementing a unit-based clinical pharmacist. The systematic review showed that the most common trigger for pharmacist interventions was inappropriate dosing. Pharmacist involvement was associated with significant reductions in the overall rate of medication errors occurrence (OR, 0.27; 95% CI, 0.15 to 0.49). Conclusion: The most common cause for pharmacist interventions in pediatric patients at hospital settings was inappropriate dosing. Overall, pharmacist interventions are effective at reducing medication error rates.
Reports on the topic "Infant mortality rates search"
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Collins, William, and Melissa Thomasson. Exploring the Racial Gap in Infant Mortality Rates, 1920-1970. Cambridge, MA: National Bureau of Economic Research, March 2002. http://dx.doi.org/10.3386/w8836.
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Eriksson, Katherine, Gregory Niemesh, and Melissa Thomasson. Revising Infant Mortality Rates for the Early 20th Century United States. Cambridge, MA: National Bureau of Economic Research, March 2017. http://dx.doi.org/10.3386/w23263.
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Zamorano, Natalia, and Cristian Herrera. Can community-based intervention packages reduce maternal and neonatal morbidity and mortality? SUPPORT, 2017. http://dx.doi.org/10.30846/170115.
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In the last three decades, rates of neonatal mortality in low-income countries have declined much more slowly than the rates of infant and maternal mortality. A significant proportion of these deaths could potentially be addressed by community-based intervention packages, which are defined as delivering more than one intervention via different sets of strategies that include additional training of outreach workers, building community-support, community mobilization, antenatal and postnatal home visitation, training of traditional birth attendants, antenatal and delivery home visitation, and home-based neonatal care and treatment; usually supplemented by strengthening linkages with local health systems.
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Treadwell, Jonathan R., Mingche Wu, and Amy Y. Tsou. Management of Infantile Epilepsies. Agency for Healthcare Research and Quality (AHRQ), October 2022. http://dx.doi.org/10.23970/ahrqepccer252.
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Objectives. Uncontrolled seizures in children 1 to 36 months old have serious short-term health risks and may be associated with substantial developmental, behavioral, and psychological impairments. We evaluated the effectiveness, comparative effectiveness, and harms of pharmacologic, dietary, surgical, neuromodulation, and gene therapy treatments for infantile epilepsies. Data sources. We searched Embase®, MEDLINE®, PubMed®, the Cochrane Library, and gray literature for studies published from January 1, 1999, to August 19, 2021. Review methods. Using standard Evidence-based Practice Center methods, we refined the scope and applied a priori inclusion criteria to the >10,000 articles identified. We ordered full text of any pediatric epilepsy articles to determine if they reported any data on those age 1 month to <36 months. We extracted key information from each included study, rated risk of bias, and rated the strength of evidence. We summarized the studies and outcomes narratively. Results. Forty-one studies (44 articles) met inclusion criteria. For pharmacotherapy, levetiracetam may cause seizure freedom in some patients (strength of evidence [SOE]: low), but data on other medications (topiramate, lamotrigine, phenytoin, vigabatrin, rufinamide, stiripentol) were insufficient to permit conclusions. Both ketogenic diet and the modified Atkins diet may reduce seizure frequency (SOE: low for both). In addition, the ketogenic diet may cause seizure freedom in some infants (SOE: low) and may be more likely than the modified Atkins diet to reduce seizure frequency (SOE: low). Both hemispherectomy/hemispherotomy and non-hemispheric surgical procedures may cause seizure freedom in some infants (SOE: low for both), but the precise proportion is too variable to estimate. For three medications (levetiracetam, topiramate, and lamotrigine), adverse effects may rarely be severe enough to warrant discontinuation (SOE: low). For topiramate, non-severe adverse effects include loss of appetite and upper respiratory tract infection (SOE: moderate). Harms of diets were sparsely reported. For surgical interventions, surgical mortality is rare for functional hemispherectomy/hemispherotomy and non-hemispheric procedures (SOE: low), but evidence was insufficient to permit quantitative estimates of mortality or morbidity risk. Hydrocephalus requiring shunt placement after multilobar, lobar, or focal resection is uncommon (SOE: low). No studies assessed neuromodulation or gene therapy. Conclusions. Levetiracetam, ketogenic diet, modified Atkins diet, and surgery all appear to be effective for some infants. However, the strength of the evidence is low for all of these modalities due to lack of control groups, low patient enrollment, and inconsistent reporting. Future studies should compare different pharmacologic treatments and compare pharmacotherapy with dietary therapy. Critical outcomes underrepresented in the literature include quality of life, sleep outcomes, and long-term development.
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Caulfield, Laura E., Wendy L. Bennett, Susan M. Gross, Kristen M. Hurley, S. Michelle Ogunwole, Maya Venkataramani, Jennifer L. Lerman, Allen Zhang, Ritu Sharma, and Eric B. Bass. Maternal and Child Outcomes Associated With the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Agency for Healthcare Research and Quality (AHRQ), April 2022. http://dx.doi.org/10.23970/ahrqepccer253.
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Objectives. The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) aims to safeguard the health of low-income, nutritionally at-risk pregnant and postpartum women and children less than 5 years old. This systematic review evaluates whether participation in WIC is associated with nutrition and health outcomes for women, infants, and children, and whether the associations vary by duration of participation or across subgroups. Because of major revisions to the WIC food package in 2009, we prioritized studies published since 2009 and included studies comparing outcomes before and after the 2009 food package change. Data sources. Using electronic publication databases, we conducted a literature search from January 2009 to September 2021 and a targeted search for selected outcomes from January 2000 to September 2021. Review methods. Paired team members independently screened search results, serially abstracted data, assessed risk of bias, and graded strength of evidence (SOE) using standard methods for observational studies. Results. We included 82 quantitative observational studies and 16 qualitative studies, with 49 studies comparing outcomes of WIC participants with WIC-eligible non-participants. WIC prenatal participation was associated with lower risk of three outcomes: preterm delivery (moderate SOE), low birth weight (moderate SOE), and infant mortality (moderate SOE). Prenatal WIC participation was associated with better maternal diet quality (low SOE), lower risk of inadequate gestational weight gain (low SOE), lower alcohol use in pregnancy (low SOE), and no difference in smoking (low SOE). Maternal WIC participation was associated with increased child preventive care and immunizations (each low SOE), and higher cognitive scores for children (low SOE). Child WIC participation was associated with better diet quality (moderate SOE), and greater intakes of 100 percent fruit juice, whole grain cereals, and age-appropriate milk (moderate SOE). Household WIC participation was associated with greater purchasing of healthy food groups (moderate SOE). Maternal WIC participation was not associated with breastfeeding initiation (moderate SOE). The evidence was insufficient for other outcomes related to maternal health and child growth. The evidence generally was insufficient on how WIC participation affects outcomes across subgroups. Conclusions. Maternal WIC participation was associated with improved birth outcomes, lower infant mortality, and better child cognitive development. WIC participation was associated with purchasing healthier foods and with improved diets for pregnant women and children. More research is needed on maternal health outcomes; food security; child growth, development, and academic achievement; and effectiveness of WIC in all segments of the eligible population.
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Tipton, Kelley, Brian F. Leas, Nikhil K. Mull, Shazia M. Siddique, S. Ryan Greysen, Meghan B. Lane-Fall, and Amy Y. Tsou. Interventions To Decrease Hospital Length of Stay. Agency for Healthcare Research and Quality (AHRQ), September 2021. http://dx.doi.org/10.23970/ahrqepctb40.
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Background. Timely discharge of hospitalized patients can prevent patient harm, improve patient satisfaction and quality of life, and reduce costs. Numerous strategies have been tested to improve the efficiency and safety of patient recovery and discharge, but hospitals continue to face challenges. Purpose. This Technical Brief aimed to identify and synthesize current knowledge and emerging concepts regarding systematic strategies that hospitals and health systems can implement to reduce length of stay (LOS), with emphasis on medically complex or vulnerable patients at high risk for prolonged LOS due to clinical, social, or economic barriers to timely discharge. Methods. We conducted a structured search for published and unpublished studies and conducted interviews with Key Informants representing vulnerable patients, hospitals, health systems, and clinicians. The interviews provided guidance on our research protocol, search strategy, and analysis. Due to the large and diverse evidence base, we limited our evaluation to systematic reviews of interventions to decrease hospital LOS for patients at potentially higher risk for delayed discharge; primary research studies were not included, and searches were restricted to reviews published since 2010. We cataloged the characteristics of relevant interventions and assessed evidence of their effectiveness. Findings. Our searches yielded 4,364 potential studies. After screening, we included 19 systematic reviews reported in 20 articles. The reviews described eight strategies for reducing LOS: discharge planning; geriatric assessment or consultation; medication management; clinical pathways; inter- or multidisciplinary care; case management; hospitalist services; and telehealth. All reviews included adult patients, and two reviews also included children. Interventions were frequently designed for older (often frail) patients or patients with chronic illness. One review included pregnant women at high risk for premature delivery. No reviews focused on factors linking patient vulnerability with social determinants of health. The reviews reported few details about hospital setting, context, or resources associated with the interventions studied. Evidence for effectiveness of interventions was generally not robust and often inconsistent—for example, we identified six reviews of discharge planning; three found no effect on LOS, two found LOS decreased, and one reported an increase. Many reviews also reported patient readmission rates and mortality but with similarly inconsistent results. Conclusions. A broad range of strategies have been employed to reduce LOS, but rigorous systematic reviews have not consistently demonstrated effectiveness within medically complex, high-risk, and vulnerable populations. Health system leaders, researchers, and policymakers must collaborate to address these needs.
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Totten, Annette, Dana M. Womack, Marian S. McDonagh, Cynthia Davis-O’Reilly, Jessica C. Griffin, Ian Blazina, Sara Grusing, and Nancy Elder. Improving Rural Health Through Telehealth-Guided Provider-to-Provider Communication. Agency for Healthcare Research and Quality, December 2022. http://dx.doi.org/10.23970/ahrqepccer254.
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Objectives. To assess the use, effectiveness, and implementation of telehealth-supported provider-to-provider communication and collaboration for the provision of healthcare services to rural populations and to inform a scientific workshop convened by the National Institutes of Health Office of Disease Prevention on October 12–14, 2021. Data sources. We conducted a comprehensive literature search of Ovid MEDLINE®, CINAHL®, Embase®, and Cochrane CENTRAL. We searched for articles published from January 1, 2015, to October 12, 2021, to identify data on use of rural provider-to-provider telehealth (Key Question 1) and the same databases for articles published January 1, 2010, to October 12, 2021, for studies of effectiveness and implementation (Key Questions 2 and 3) and to identify methodological weaknesses in the research (Key Question 4). Additional sources were identified through reference lists, stakeholder suggestions, and responses to a Federal Register notice. Review methods. Our methods followed the Agency for Healthcare Research and Quality Methods Guide (available at https://effectivehealthcare.ahrq.gov/topics/cer-methods-guide/overview) and the PRISMA reporting guidelines. We used predefined criteria and dual review of abstracts and full-text articles to identify research results on (1) regional or national use, (2) effectiveness, (3) barriers and facilitators to implementation, and (4) methodological weakness in studies of provider-to-provider telehealth for rural populations. We assessed the risk of bias of the effectiveness studies using criteria specific to the different study designs and evaluated strength of evidence (SOE) for studies of similar telehealth interventions with similar outcomes. We categorized barriers and facilitators to implementation using the Consolidated Framework for Implementation Research (CFIR) and summarized methodological weaknesses of studies. Results. We included 166 studies reported in 179 publications. Studies on the degree of uptake of provider-to-provider telehealth were limited to specific clinical uses (pharmacy, psychiatry, emergency care, and stroke management) in seven studies using national or regional surveys and claims data. They reported variability across States and regions, but increasing uptake over time. Ninety-seven studies (20 trials and 77 observational studies) evaluated the effectiveness of provider-to-provider telehealth in rural settings, finding that there may be similar rates of transfers and lengths of stay with telehealth for inpatient consultations; similar mortality rates for remote intensive care unit care; similar clinical outcomes and transfer rates for neonates; improvements in medication adherence and treatment response in outpatient care for depression; improvements in some clinical monitoring measures for diabetes with endocrinology or pharmacy outpatient consultations; similar mortality or time to treatment when used to support emergency assessment and management of stroke, heart attack, or chest pain at rural hospitals; and similar rates of appropriate versus inappropriate transfers of critical care and trauma patients with specialist telehealth consultations for rural emergency departments (SOE: low). Studies of telehealth for education and mentoring of rural healthcare providers may result in intended changes in provider behavior and increases in provider knowledge, confidence, and self-efficacy (SOE: low). Patient outcomes were not frequently reported for telehealth provider education, but two studies reported improvement (SOE: low). Evidence for telehealth interventions for other clinical uses and outcomes was insufficient. We identified 67 program evaluations and qualitative studies that identified barriers and facilitators to rural provider-to-provider telehealth. Success was linked to well-functioning technology; sufficient resources, including time, staff, leadership, and equipment; and adequate payment or reimbursement. Some considerations may be unique to implementation of provider-to-provider telehealth in rural areas. These include the need for consultants to better understand the rural context; regional initiatives that pool resources among rural organizations that may not be able to support telehealth individually; and programs that can support care for infrequent as well as frequent clinical situations in rural practices. An assessment of methodological weaknesses found that studies were limited by less rigorous study designs, small sample sizes, and lack of analyses that address risks for bias. A key weakness was that studies did not assess or attempt to adjust for the risk that temporal changes may impact the results in studies that compared outcomes before and after telehealth implementation. Conclusions. While the evidence base is limited, what is available suggests that telehealth supporting provider-to-provider communications and collaboration may be beneficial. Telehealth studies report better patient outcomes in some clinical scenarios (e.g., outpatient care for depression or diabetes, education/mentoring) where telehealth interventions increase access to expertise and high-quality care. In other applications (e.g., inpatient care, emergency care), telehealth results in patient outcomes that are similar to usual care, which may be interpreted as a benefit when the purpose of telehealth is to make equivalent services available locally to rural residents. Most barriers to implementation are common to practice change efforts. Methodological weaknesses stem from weaker study designs, such as before-after studies, and small numbers of participants. The rapid increase in the use of telehealth in response to the Coronavirus disease 2019 (COVID-19) pandemic is likely to produce more data and offer opportunities for more rigorous studies.
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Rankin, Nicole, Deborah McGregor, Candice Donnelly, Bethany Van Dort, Richard De Abreu Lourenco, Anne Cust, and Emily Stone. Lung cancer screening using low-dose computed tomography for high risk populations: Investigating effectiveness and screening program implementation considerations: An Evidence Check rapid review brokered by the Sax Institute (www.saxinstitute.org.au) for the Cancer Institute NSW. The Sax Institute, October 2019. http://dx.doi.org/10.57022/clzt5093.
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Background Lung cancer is the number one cause of cancer death worldwide.(1) It is the fifth most commonly diagnosed cancer in Australia (12,741 cases diagnosed in 2018) and the leading cause of cancer death.(2) The number of years of potential life lost to lung cancer in Australia is estimated to be 58,450, similar to that of colorectal and breast cancer combined.(3) While tobacco control strategies are most effective for disease prevention in the general population, early detection via low dose computed tomography (LDCT) screening in high-risk populations is a viable option for detecting asymptomatic disease in current (13%) and former (24%) Australian smokers.(4) The purpose of this Evidence Check review is to identify and analyse existing and emerging evidence for LDCT lung cancer screening in high-risk individuals to guide future program and policy planning. Evidence Check questions This review aimed to address the following questions: 1. What is the evidence for the effectiveness of lung cancer screening for higher-risk individuals? 2. What is the evidence of potential harms from lung cancer screening for higher-risk individuals? 3. What are the main components of recent major lung cancer screening programs or trials? 4. What is the cost-effectiveness of lung cancer screening programs (include studies of cost–utility)? Summary of methods The authors searched the peer-reviewed literature across three databases (MEDLINE, PsycINFO and Embase) for existing systematic reviews and original studies published between 1 January 2009 and 8 August 2019. Fifteen systematic reviews (of which 8 were contemporary) and 64 original publications met the inclusion criteria set across the four questions. Key findings Question 1: What is the evidence for the effectiveness of lung cancer screening for higher-risk individuals? There is sufficient evidence from systematic reviews and meta-analyses of combined (pooled) data from screening trials (of high-risk individuals) to indicate that LDCT examination is clinically effective in reducing lung cancer mortality. In 2011, the landmark National Lung Cancer Screening Trial (NLST, a large-scale randomised controlled trial [RCT] conducted in the US) reported a 20% (95% CI 6.8% – 26.7%; P=0.004) relative reduction in mortality among long-term heavy smokers over three rounds of annual screening. High-risk eligibility criteria was defined as people aged 55–74 years with a smoking history of ≥30 pack-years (years in which a smoker has consumed 20-plus cigarettes each day) and, for former smokers, ≥30 pack-years and have quit within the past 15 years.(5) All-cause mortality was reduced by 6.7% (95% CI, 1.2% – 13.6%; P=0.02). Initial data from the second landmark RCT, the NEderlands-Leuvens Longkanker Screenings ONderzoek (known as the NELSON trial), have found an even greater reduction of 26% (95% CI, 9% – 41%) in lung cancer mortality, with full trial results yet to be published.(6, 7) Pooled analyses, including several smaller-scale European LDCT screening trials insufficiently powered in their own right, collectively demonstrate a statistically significant reduction in lung cancer mortality (RR 0.82, 95% CI 0.73–0.91).(8) Despite the reduction in all-cause mortality found in the NLST, pooled analyses of seven trials found no statistically significant difference in all-cause mortality (RR 0.95, 95% CI 0.90–1.00).(8) However, cancer-specific mortality is currently the most relevant outcome in cancer screening trials. These seven trials demonstrated a significantly greater proportion of early stage cancers in LDCT groups compared with controls (RR 2.08, 95% CI 1.43–3.03). Thus, when considering results across mortality outcomes and early stage cancers diagnosed, LDCT screening is considered to be clinically effective. Question 2: What is the evidence of potential harms from lung cancer screening for higher-risk individuals? The harms of LDCT lung cancer screening include false positive tests and the consequences of unnecessary invasive follow-up procedures for conditions that are eventually diagnosed as benign. While LDCT screening leads to an increased frequency of invasive procedures, it does not result in greater mortality soon after an invasive procedure (in trial settings when compared with the control arm).(8) Overdiagnosis, exposure to radiation, psychological distress and an impact on quality of life are other known harms. Systematic review evidence indicates the benefits of LDCT screening are likely to outweigh the harms. The potential harms are likely to be reduced as refinements are made to LDCT screening protocols through: i) the application of risk predication models (e.g. the PLCOm2012), which enable a more accurate selection of the high-risk population through the use of specific criteria (beyond age and smoking history); ii) the use of nodule management algorithms (e.g. Lung-RADS, PanCan), which assist in the diagnostic evaluation of screen-detected nodules and cancers (e.g. more precise volumetric assessment of nodules); and, iii) more judicious selection of patients for invasive procedures. Recent evidence suggests a positive LDCT result may transiently increase psychological distress but does not have long-term adverse effects on psychological distress or health-related quality of life (HRQoL). With regards to smoking cessation, there is no evidence to suggest screening participation invokes a false sense of assurance in smokers, nor a reduction in motivation to quit. The NELSON and Danish trials found no difference in smoking cessation rates between LDCT screening and control groups. Higher net cessation rates, compared with general population, suggest those who participate in screening trials may already be motivated to quit. Question 3: What are the main components of recent major lung cancer screening programs or trials? There are no systematic reviews that capture the main components of recent major lung cancer screening trials and programs. We extracted evidence from original studies and clinical guidance documents and organised this into key groups to form a concise set of components for potential implementation of a national lung cancer screening program in Australia: 1. Identifying the high-risk population: recruitment, eligibility, selection and referral 2. Educating the public, people at high risk and healthcare providers; this includes creating awareness of lung cancer, the benefits and harms of LDCT screening, and shared decision-making 3. Components necessary for health services to deliver a screening program: a. Planning phase: e.g. human resources to coordinate the program, electronic data systems that integrate medical records information and link to an established national registry b. Implementation phase: e.g. human and technological resources required to conduct LDCT examinations, interpretation of reports and communication of results to participants c. Monitoring and evaluation phase: e.g. monitoring outcomes across patients, radiological reporting, compliance with established standards and a quality assurance program 4. Data reporting and research, e.g. audit and feedback to multidisciplinary teams, reporting outcomes to enhance international research into LDCT screening 5. Incorporation of smoking cessation interventions, e.g. specific programs designed for LDCT screening or referral to existing community or hospital-based services that deliver cessation interventions. Most original studies are single-institution evaluations that contain descriptive data about the processes required to establish and implement a high-risk population-based screening program. Across all studies there is a consistent message as to the challenges and complexities of establishing LDCT screening programs to attract people at high risk who will receive the greatest benefits from participation. With regards to smoking cessation, evidence from one systematic review indicates the optimal strategy for incorporating smoking cessation interventions into a LDCT screening program is unclear. There is widespread agreement that LDCT screening attendance presents a ‘teachable moment’ for cessation advice, especially among those people who receive a positive scan result. Smoking cessation is an area of significant research investment; for instance, eight US-based clinical trials are now underway that aim to address how best to design and deliver cessation programs within large-scale LDCT screening programs.(9) Question 4: What is the cost-effectiveness of lung cancer screening programs (include studies of cost–utility)? Assessing the value or cost-effectiveness of LDCT screening involves a complex interplay of factors including data on effectiveness and costs, and institutional context. A key input is data about the effectiveness of potential and current screening programs with respect to case detection, and the likely outcomes of treating those cases sooner (in the presence of LDCT screening) as opposed to later (in the absence of LDCT screening). Evidence about the cost-effectiveness of LDCT screening programs has been summarised in two systematic reviews. We identified a further 13 studies—five modelling studies, one discrete choice experiment and seven articles—that used a variety of methods to assess cost-effectiveness. Three modelling studies indicated LDCT screening was cost-effective in the settings of the US and Europe. Two studies—one from Australia and one from New Zealand—reported LDCT screening would not be cost-effective using NLST-like protocols. We anticipate that, following the full publication of the NELSON trial, cost-effectiveness studies will likely be updated with new data that reduce uncertainty about factors that influence modelling outcomes, including the findings of indeterminate nodules. Gaps in the evidence There is a large and accessible body of evidence as to the effectiveness (Q1) and harms (Q2) of LDCT screening for lung cancer. Nevertheless, there are significant gaps in the evidence about the program components that are required to implement an effective LDCT screening program (Q3). Questions about LDCT screening acceptability and feasibility were not explicitly included in the scope. However, as the evidence is based primarily on US programs and UK pilot studies, the relevance to the local setting requires careful consideration. The Queensland Lung Cancer Screening Study provides feasibility data about clinical aspects of LDCT screening but little about program design. The International Lung Screening Trial is still in the recruitment phase and findings are not yet available for inclusion in this Evidence Check. The Australian Population Based Screening Framework was developed to “inform decision-makers on the key issues to be considered when assessing potential screening programs in Australia”.(10) As the Framework is specific to population-based, rather than high-risk, screening programs, there is a lack of clarity about transferability of criteria. However, the Framework criteria do stipulate that a screening program must be acceptable to “important subgroups such as target participants who are from culturally and linguistically diverse backgrounds, Aboriginal and Torres Strait Islander people, people from disadvantaged groups and people with a disability”.(10) An extensive search of the literature highlighted that there is very little information about the acceptability of LDCT screening to these population groups in Australia. Yet they are part of the high-risk population.(10) There are also considerable gaps in the evidence about the cost-effectiveness of LDCT screening in different settings, including Australia. The evidence base in this area is rapidly evolving and is likely to include new data from the NELSON trial and incorporate data about the costs of targeted- and immuno-therapies as these treatments become more widely available in Australia.
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Infant Mortality Among Non-Hispanic Asian Subgroups in the United States, 2018-2020. National Center for Health Statistics (U.S.), January 2023. http://dx.doi.org/10.15620/cdc:122451.
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This report compares infant, neonatal, and postneonatal mortality rates for infants of all U.S. women, all non-Hispanic Asian women, and infants of women in the five largest Asian subgroups for 2018-2020.
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District level baseline survey of family planning program in Uttar Pradesh: Gorakhpur. Population Council, 1995. http://dx.doi.org/10.31899/rh1995.1004.
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The state of Uttar Pradesh (UP) in India had a population of 139 million, as of the 1991 census. The socioeconomic profile is characterized by relatively low levels of per capita income and literacy. Further, assessment of the family planning program and the demographic status as measured by Couple Protection Rate (CPR) and Mortality/Fertility rates marks UP as one of the country’s more demographically disadvantaged states. UP has a relatively higher infant mortality rate, crude death rate, birth rate, and total fertility rate than the country as a whole, whereas CPR is much too low. The district of Gorakhpur falls in the Eastern Region of the state, which on the whole is more disadvantaged than the Western Region. As noted in this report, no systematic surveys have ever been done to provide district-level estimates of fertility and mortality or CPR except in a few districts. The present survey is designed to provide valid estimates of vital rates and CPR at the district level and to fill gaps in the available information on several aspects related to the demographic situation and family planning program.