Journal articles on the topic 'Youth Victoria Mortality Statistics'
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Werdecker, Andrea, and Ulrich Mueller. "The pressing need for better statistics on youth mortality." Lancet Global Health 9, no. 4 (April 2021): e373-e374. http://dx.doi.org/10.1016/s2214-109x(21)00080-2.
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Berecki-Gisolf, Janneke, Bosco Rowland, Nicola Reavley, Barbara Minuzzo, and John Toumbourou. "Evaluation of community coalition training effects on youth hospital-admitted injury incidence in Victoria, Australia: 2001–2017." Injury Prevention 26, no. 5 (November 21, 2019): 463–70. http://dx.doi.org/10.1136/injuryprev-2019-043386.
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BackgroundInjuries are one of the three leading causes of morbidity and mortality for young people internationally. Although community risk factors are modifiable causes of youth injury, there has been limited evaluation of community interventions. Communities That Care (CTC) offers a coalition training process to increase evidence-based practices that reduce youth injury risk factors.MethodUsing a non-experimental design, this study made use of population-based hospital admissions data to evaluate the impact on injuries for 15 communities that implemented CTC between 2001 and 2017 in Victoria, Australia. Negative binomial regression models evaluated trends in injury admissions (all, unintentional and transport), comparing CTC and non-CTC communities across different age groups.ResultsStatistically significant relative reductions in all hospital injury admissions in 0–4 year olds were associated with communities completing the CTC process and in 0–19 year olds when communities began their second cycle of CTC. When analysed by subgroup, a similar pattern was observed with unintentional injuries but not with transport injuries.ConclusionThe findings support CTC coalition training as an intervention strategy for preventing youth hospital injury admissions. However, future studies should consider stronger research designs, confirm findings in different community contexts, use other data sources and evaluate intervention mechanisms.
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Shepherd, Stephane M., and Benjamin L. Spivak. "Estimating the extent and nature of offending by Sudanese-born individuals in Victoria." Australian & New Zealand Journal of Criminology 53, no. 3 (June 2, 2020): 352–68. http://dx.doi.org/10.1177/0004865820929066.
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The involvement in crime of some young Sudanese-born Victorians has received sustained public attention in recent years. The media coverage of these occurrences has been extensive, with some outlets criticised for sensationalist reporting and prejudiced undertones. A range of views were held across the commentariat including, for example, the notion that Sudanese-Victorian criminal involvement has been overstated; that some level of justice over-representation was inevitable due to the demographics of Sudanese-born Victorians, which skew young and male (i.e. the demographic hypothesis); and that offending rates may be associated with heightened law enforcement responses following a high-profile criminal incident in March 2016 that received protracted media coverage and political commentary (i.e. the racial-profiling hypothesis). This paper sought to address these contentions by (i) examining the offending rates of both young and adult males across three cultural sub-groups (i.e. Sudanese-born, Indigenous Australian, Australian-born) across several offending categories between 2015 and 2018 and (ii) exploring the impact of a high-profile criminal incident in March 2016, on the offending rates of Sudanese-born Victorians. Offending rates were calculated using offender incident data from the Victorian Crime Statistics Agency and population estimates from the Australian Bureau of Statistics Census data. Findings indicate that Sudanese-born individuals figure prominently in both youth and adult offending categories relative to other major cultural sub-groups. Rates for ‘crimes against the person’ were especially pronounced for Sudanese-born youth and significantly higher than rates for crimes more subject to police discretion (i.e. public order offences). The ‘demographic hypothesis’ did not hold for the specified age range of 10 to 17 years. An increase in offending was observed post-March 2016 across two offending categories for Sudanese-born Victorians. Findings are contextualised within.
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Alalageri, Kavya M., Shobha ., and Ranganath Timmanahalli Sobagaih. "A study to assess premature mortality and years of potential life lost among the mortality victims of Victoria Hospital, Bengaluru." International Journal Of Community Medicine And Public Health 4, no. 10 (September 22, 2017): 3927. http://dx.doi.org/10.18203/2394-6040.ijcmph20174276.
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Background: Premature mortality by age 60 accounted for one-third of total deaths in low and middle income countries in 2008. While under-5 mortality as a proportion of premature mortality remains high in some countries, premature adult mortality is also increasing. Non-communicable diseases (NCDs) are the leading cause of death and primarily affect those of productive age. India is also experiencing rapid demographic and epidemiological transition. Although evidence suggests recent reductions in infant and child mortality, little is known about the age and sex patterns of premature deaths in India.Methods: Record based study was conducted from 4 months mortality statistics who belong to less than 69 yrs during the period June-September 2016 at Victoria Hospital. Data is entered in MS-Excel and analyzed in the form of descriptive statistics. Data is presented in the form of figures, tables, charts and percentages wherever necessary.Results: There were total of 1265 deaths in 4 months, among them 890 deaths occurred <69 yrs of age. Most of them belong to 45-54 yrs which is the income generating age-group. Most of them belong to 45-54 yrs which is the income generating age-group. Most of the mortality victims admitted in hospital for <24 hrs (45.28%) followed by a week (45.05%). Infectious diseases, burns, hypertension, and alcohol related complications and poly trauma are the top 5 causes of premature deaths. Mean years of potential life lost (YPLL) due to NCDs like cardiovascular diseases, diabetes mellitus and hypertension is 20.92 yrs.Conclusions: Health system should gear up at all levels of health care in order to reduce mortality due to NCDs and thus to increase life-expectancy.
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Semyonova, Victoria G., Alla E. Ivanova, Tamara P. Sabgayda, and Galina N. Evdokushkina. "The age vector of risk factors for mortality of young Muscovites." City Healthcare 2, no. 2 (July 22, 2021): 15–25. http://dx.doi.org/10.47619/2713-2617.zm.2021.v2i2;15-25.
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European-like life expectancy levels in Moscow are attributable to the prevalence of older population and the manifold increase in the working-age population mortality, especially among young people. The goal of the study is to identify the age-specific risk factors for Moscow youth mortality. This analysis is based on the official Russian Statistics Service’ data on mortality in the age groups of 15–24 and 25–34 years between 2000 and 2019. As demonstrated, during the study period, the Moscow youth mortality rates decreased twofold between both age groups. Starting from 2017, the mortality rate of Moscow youth began to increase, mainly among the 15–24-year-olds. The age vector of the youth mortality structure indicates a change in risk factors associated with age: while adolescents die from external causes, i.e. specific risks directly leading to death, later on youth mortality is more often associated with long-term behavioral factors indirectly resulting in death (such as sexual conduct as a risk factor for HIV/AIDS mortality, alcohol as the main cause for deaths from digestive system diseases and mental disorders, drugs as a risk factor for deaths from cardiovascular diseases and mental disorders). It is important to take note of the wide age range of the population classified as «young»: while it might be justified in legal and social context, in the demographic context it blurs the differences in mortality among people of different ages. Moreover, the abnormally high level and contribution of mortality from inaccurately described conditions, which the Moscow youth suffered from in the 2000s, calls into question the official rates of mortality due to underlying causes, primarily injuries, poisonings, and circulatory diseases. At the same time, given the increase in the young people’s overall mortality in the recent years, the extremely high mortality rates from inaccurately described conditions make it difficult to identify health priorities for the Moscow youth and, therefore, do not allow determining the reserves for their effective decline.
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Pritchard, Colin. "Youth Suicide and Gender in Australia and New Zealand Compared with Countries of the Western World 1973–1987." Australian & New Zealand Journal of Psychiatry 26, no. 4 (December 1992): 609–17. http://dx.doi.org/10.3109/00048679209072096.
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Based upon standardised mortality figures, between 1973–1987, Australian male suicide rose by 39%, and New Zealand male suicide by 53%. In both countries there were even greater increases in male youth suicides (15–24 years), 66% and 127% respectively. The female suicide statistics were more varied with a fall of −24% in Australia, but an increase of 26% in New Zealand. In both countries however, female youth suicide, relative to their general rates, increased. A comparison of youth suicide in the western world demonstrated that Australia and New Zealand were unique as they were the only countries in which male and female youth suicide levels were higher than their average rates.
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Zandy, Moe, Li Rita Zhang, Diana Kao, Fahra Rajabali, Kate Turcotte, Alex Zheng, Megan Oakey, Kate Smolina, Ian Pike, and Drona Rasali. "Area-based socioeconomic disparities in mortality due to unintentional injury and youth suicide in British Columbia, 2009–2013." Health Promotion and Chronic Disease Prevention in Canada 39, no. 2 (February 2019): 35–44. http://dx.doi.org/10.24095/hpcdp.39.2.01.
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Introduction The association between health outcomes and socioeconomic status (SES) has been widely documented, and mortality due to unintentional injuries continues to rank among the leading causes of death among British Columbians. This paper quantified the SES-related disparities in the mortality burden of three British Columbia’s provincial injury prevention priority areas: falls among seniors, transport injury, and youth suicide. Methods Mortality data (2009 to 2013) from Vital Statistics and dissemination area or local health area level socioeconomic data from CensusPlus 2011 were linked to examine age-standardized mortality rates (ASMRs) and disparities in ASMRs of unintentional injuries and subtypes including falls among seniors (aged 65+) and transport-related injuries as well as the intentional injury type of youth suicide (aged 15 to 24). Disparities by sex and geography were examined, and relative and absolute disparities were calculated between the least and most privileged areas based on income, education, employment, material deprivation, and social deprivation quintiles. Results Our study highlighted significant sex differences in the mortality burden of falls among seniors, transport injury, and youth suicide with males experiencing significantly higher mortality rates. Notable geographic variations in overall unintentional injury ASMR were also observed across the province. In general, people living in areas with lower income and higher levels of material deprivation had increasingly higher mortality rates compared to their counterparts living in more privileged areas. Conclusion The significant differences in unintentional and intentional injury-related mortality outcomes between the sexes and by SES present opportunities for targeted prevention strategies that address the disparities.
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Ryazantsev, S. V., V. G. Semenova, A. E. Ivanova, T. P. Sabgayda, and G. N. Evdokushkina. "Demographic implications of social deviations of Russian youth." Вестник Российской академии наук 89, no. 3 (March 24, 2019): 221–31. http://dx.doi.org/10.31857/s0869-5873893221-231.
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The article provides an assessment of the demographic losses among Russian youth due to social deviations – suicides, murders, alcohol and drug poisoning compared with the countries of the “old” (before May 2004) and the “new” (after May 2004) European Union. It has been shown that in Russia and in Europe over the past 30 years, the contribution of losses due to deviant behavior to the total mortality of young people has increased, but in Russia this undoubtedly preventable factor has been of special significance. Currently, this factor causes more than a third of the total mortality of young men in our country and almost a quarter of their contemporaries. The evolution of the structure of losses caused by social deviations testifies to multidirectional processes in Russia and Europe. If both in the "old" and in the "new" European Union the importance of suicides increases, in Russia there is damage with uncertain intentions. In essence, due to this vague diagnosis, underreporting of deaths from alcohol and drug poisoning, suicides and murders is masked – in general, from one third to 100% of cases. This means that the death rate from social deviations in Russia compared to the EU is even more than official statistics show.
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Lee, Joshua, Tyler Black, Garth Meckler, and Quynh Doan. "Outcome of pediatric emergency mental health visits: incidence and timing of suicide." CJEM 22, no. 3 (January 20, 2020): 321–30. http://dx.doi.org/10.1017/cem.2019.470.
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ABSTRACTObjectivesTo determine the incidence, risk, and timing of mortality (unnatural and natural causes) among youth seen in a pediatric emergency department (ED) for mental health concerns, compared with matched non–mental health ED controls.MethodsThis was a retrospective cohort study conducted at a quaternary pediatric ED in British Columbia. All visits for a mental health related condition between July 1st, 2005, and June 30th, 2015, were matched on age, sex, triage acuity, socioeconomic status, and year of visit to a non–mental health control visit. Mortality outcomes were obtained from vital statistics data through December 31st, 2016 (cumulative follow-up 74,390 person-years).ResultsAmong all cases in our study, including 6,210 youth seen for mental health concerns and 6,210 matched controls, a total of 13 died of suicide (7.5/100,000 person-years) and 33 died of suicide or indeterminate causes (44/100,000 person-years). All-cause mortality was significantly lower among mental health presentations (121.3/100,000 v. 214.5/100,000 person-years; hazard ratio [HR], 0.54; 95% confidence interval [CI], 0.37–0.78). The median time from initial emergency visit to suicide was 5.2 years (interquartile range, 4.2–7.3). Among mental health related visits, risk of death by suicide or indeterminate cause was three-fold that of matched controls (HR, 3.05 95%CI, 1.37–6.77).ConclusionsWhile youth seeking emergency mental health care are at increased risk of death by unnatural causes, their overall mortality risk is lower than non–mental health controls. The protracted duration from initial presentation to suicide highlights the need for long-term surveillance and preventative care for youth seen in the ED for all mental health concerns.
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JABEEN, SALMA, SOHAIL MEHMOOD CH., SARWAT FARIDI, and Afzaal Ahmed. "MATERNAL MORBIDITY AND MORTALITY;." Professional Medical Journal 19, no. 06 (November 3, 2012): 797–803. http://dx.doi.org/10.29309/tpmj/2012.19.06.2460.
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Objective: To assess the demographic features of unsafe abortion and associated maternal morbidity and mortality, andavailability of post abortion care. Study Design: A Case-Series. Place and Duration of Study: The study was carried out in Gynae Unit-1 ofBahawal Victoria Hospital (BVH), Bahawalpur from 1st January 2009 to 31st December 2009. Material and Methods: Patients admitted withcomplicated unsafe abortion were evaluated regarding age, parity, marital status, educational status, socio-economic status, indication ofabortion, qualification of abortionist and method used for abortion, contraceptive usage, immediate complications and death rate in abortionseekers. Descriptive statistics were used for describing variable. Results: 119 patients were admitted with unsafe abortion. The mean age was28.5 years. 90.8% women were married, 59.6% multiparous, 21% got secondary and higher education, 62 belonged to poor socio-economicstatus. In 72% cases unsafe abortion was done during 1st trimester and 80% of women had previous history of unsafe abortion, 95%approached unqualified / semi skilled abortion providers who used instrumentation in 53% cases. The most common reason for abortion wasmultiparity (48%),& poor socio-economic status (19%), only 26.5% were using some kind of contraception. Most common complications werecontinued ongoing haemorrhage (incomplete abortion in 44%), followed by septic complications in 25% of cases and trauma to urogenital tract(22%) which also involved gut in 6% of cases. 2.5% patients reached in very critical stage & could not survived. Post abortion care provided toall patients of which 22% managed conservatively & 78% managed surgically. Contraception services offered to all but 24% refused themtotally. Conclusions: Unsafe abortion constitutes a major threat to health and lives of women. Most of them are multiparous, married at peak oftheir reproductive life and belong to poor economic status. The associated immediate morbidity is much higher than mortality in terms ofcontinued haemorrhage, sepsis, and trauma. The study focused on the need of post abortion care and easy accessibility to contraception toimprove quality of life.
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Roberts, Phillip. "Determining the Meaning behind Historical Disease Terminology through an Examination of Patterns of Terminology Used in the Mortality Statistics of Victoria, 1853-1900." Health and History 10, no. 1 (2008): 63–87. http://dx.doi.org/10.1353/hah.2008.0021.
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Roberts, Phillip. "Determining the Meaning behind Historical Disease Terminology through an Examination of Patterns of Terminology Used in the Mortality Statistics of Victoria, 1853-1900." Health and History 10, no. 1 (2008): 63. http://dx.doi.org/10.2307/40111594.
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Murray-Garcia, Jann. "African-American Youth: Essential Prevention Strategies for Every Pediatrician." Pediatrics 96, no. 1 (July 1, 1995): 132–37. http://dx.doi.org/10.1542/peds.96.1.132.
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National statistics of morbidity and mortality warrant our urgent attention to the issue of effective prevention strategies among African-Americans. Implicit, explicit, and often internalized messages of inferior value, negative expectations, and expendability remain a part of everyday life for African-American youth. This sociopolitical disenfranchisement has a direct impact on their health and development and on our ability to provide effective preventive and therapeutic intervention. Pediatricians enjoy a deserved perception of expertise in those areas that bear directly on the healthy physical and psychosocial development of all children. We have not heretofore optimally exploited this perceived and real expertise in prevention efforts among African-American children. We ourselves are in need of reeducation. We need to first shatter the insidious conceptual barriers of our own impotence as well as the perceived impotence of African-American patients in our collective abilities to inspire and affect change. On a patient-by-patient basis, among our regional pediatric communities and in the public policy arena, we can be involved in the process that restores to our African-American patients a sense of full citizenship and potential within our society. Without adoption of this process of sociopolitical reenfranchisement, our best-intended efforts at prevention in this community will always tragically fall short of their full and critically needed potential.
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Lynskey, Michael, Louisa Degenhardt, and Wayne Hall. "Cohort Trends in Youth Suicide in Australia 1964–1997." Australian & New Zealand Journal of Psychiatry 34, no. 3 (June 2000): 408–12. http://dx.doi.org/10.1080/j.1440-1614.2000.00740.x.
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Objective: This paper examines trends in the rate of suicide among young Australians aged 15–24 years from 1964 to 1997 and presents an age-period-cohort analysis of these trends. Method: Study design consisted of an age-period-cohort analysis of suicide mortality in Australian youth aged between 15 and 24 for the years 1964–1997 inclusive. Data sources were Australian Bureau of Statistics data on: numbers of deaths due to suicide by gender and age at death; and population at risk in each of eight birth cohorts (1940–1944, 1945–1949, 1950–1954, 1955–1959, 1960–1964, 1965–1969, 1970–1974, and 1975–1979). Main outcome measures were population rates of deaths among males and females in each birth cohort attributed to suicide in each year 1964–1997. Results: The rate of suicide deaths among Australian males aged 15–24 years increased from 8.7 per 100 000 in 1964 to 30.9 per 100 000 in 1997, with the rate among females changing little over the period, from 5.2 per 100 000 in 1964 to 7.1 per 100 000 in 1997. While the rate of deaths attributed to suicide increased over the birth cohorts, analyses revealed that these increases were largely due to period effects, with suicide twice as likely among those aged 15–24 years in 1985–1997 than between 1964 and 1969. Conclusions: The rate of youth suicide in Australia has increased since 1964, particularly among males. This increase can largely be attributed to period effects rather than to a cohort effect and has been paralleled by an increased rate of youth suicides internationally and by an increase in other psychosocial problems including psychiatric illness, criminal offending and substance use disorders.
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Beautrais, Annette L. "Methods of Youth Suicide in New Zealand: Trends and Implications for Prevention." Australian & New Zealand Journal of Psychiatry 34, no. 3 (June 2000): 413–19. http://dx.doi.org/10.1080/j.1440-1614.2000.00690.x.
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Objective: One commonly suggested approach to reducing suicide is to restrict access to potentially lethal means of suicide. This paper summarises recent trends in methods of suicide among young people in New Zealand and examines the feasibility of suicide prevention through restricting access to methods of suicide. Method: Data derived from official mortality statistics were used to examine trends, from 1977 to 1996, in methods of suicide among young people aged 15–24 years. Results: During the last two decades, male youth suicide rates in New Zealand doubled, from 20.3 per 100 000 in 1977 to 39.5 per 100 000 in 1996. This increase was accounted for, almost entirely, by increased use of hanging (71% of total increase) and vehicle exhaust gas (26% of total increase). Suicide rates among young females also increased, from 4 per 100 000 in 1977 to 14.3 per 100 000 in 1996. As for males, the increased female suicide rate was largely accounted for by increased rates of hanging and vehicle exhaust gas. Conclusions: The marked increases in rates of youth suicide in New Zealand during the past two decades are accounted for, almost wholly, by increases in rates of suicide by hanging and, to a lesser extent, vehicle exhaust gas. In 1996 the majority (79.7%) of youth suicides were accounted for by these two methods: hanging (61.5%) and vehicle exhaust gas (18.2%). Both methods are widely available and difficult to restrict, implying that limiting access to means of suicide is a strategy which is unlikely to play a major role in reducing suicidal behaviour among young people in New Zealand.
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Jok, Jok Madut. "Militarism, gender and reproductive suffering: the case of abortion in Western Dinka." Africa 69, no. 2 (April 1999): 194–212. http://dx.doi.org/10.2307/1161022.
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AbstractStudies of reproductive risk under war conditions pay a great deal of attention to statistics of sexual violence inflicted by one warring party upon women of the other. While such attention is justified, it mystifies the risk contained within families and local communities. This article examines the effects of the militarisation of youth in southern Sudan on women's reproductive well-being. The war has caused families to desire many children to make up for the high wartime infant mortality rate. The resultant social breakdown has prompted men to breach the rules of sexuality and sexual taboos to such an extent that women have lost much control over sexual and reproductive decisions. Women in Western Dinka, therefore, agree to conceive unwillingly. They also regard pregnancy as a difficult ordeal. Many, however, terminate pregnancy with unsafe techniques that risk infertility, infection or death.
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Leshchenko, Yaroslav A., and A. A. Lisovtsov. "MORTALITY TRENDS IN THE POPULATION OF THE IRKUTSK REGION IN THE PROCESS OF SOCIAL AND ENVIRONMENTAL TRANSFORMATIONS (1989-2017)." Hygiene and sanitation 98, no. 10 (October 15, 2019): 1141–47. http://dx.doi.org/10.18821/0016-9900-2019-98-10-1141-1147.
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Introduction. The policy in the field of public health care should take into account the peculiarities of regional development, due to the influence of socio-environmental factors and processes. Mortality indices are the most important medico-demographic index of the state of the regional socio-ecological system. The aim of the study is to characterize the mortality trends of various age groups of the population of the Irkutsk region in the context of social and environmental transformations of the post-Soviet period. Material and methods. A retrospective longitudinal study of the mortality characteristics of the population of the Irkutsk region, the Siberian Federal District (SFD) and the Russian Federation (RF) in the dynamics from the late 1980s to 2017 was carried out. Statistical materials were obtained from the databases of the Federal State Statistics Service, the Center for Demographic Studies of the New Economic School and Demographic Yearbooks of Russia. The analysis of trends in mortality rates and their socio-ecological interpretation is carried out. Results. Dynamics of the total mortality rate in the period 1989-2017 consisted of two stages (1991-1998 and 1999-2017). Each of these stages was characterized by a marked increase in the mortality rate and its subsequent decrease. The values of this index in the Irkutsk region during the entire observation period were higher than the values of the same indicator for the SFD by 6.5-10.0% and higher than the figure for the Russian Federation by 12.9-21.5%. The dynamic changes in the mortality rates of the working-age population are similar to the corresponding characteristics of total mortality. The trends in child and infant mortality rates were characterized by a consistent decrease. The dynamics of the mortality rate of the adolescent-youth contingent (15-19 years) was similar to the dynamics of the total mortality rate. Conclusion. The phenomena of a systemic transformational crisis led to the adverse dynamics of mortality characteristics from 1992 to 2006. A major positive shift in improving mortality rates occurred in 2007-2017. It was due to positive changes in the socio-economic sphere. Only the mortality levels of the working-age population did the lag behind the figures for 1989-1990 continue. The Irkutsk region should be characterized as a region of relative socio-ecological disadvantage in the mortality rates of all age groups of the population.
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Malone, K. M., L. Quinlivan, T. Grant, and C. C. Kelleher. "Ageing towards 21 as a risk factor for Young Adult Suicide in the UK and Ireland." Epidemiology and Psychiatric Sciences 22, no. 3 (November 13, 2012): 263–67. http://dx.doi.org/10.1017/s2045796012000649.
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Aims.Youth and young adult suicide has increasingly appeared on international vital statistics as a rising trend of concern in age-specific mortality over the past 50 years. The reporting of suicide deaths in 5-year age bands, which has been the international convention to date, may mask a greater understanding of year-on-year factors that may accelerate or ameliorate the emergence of suicidal thoughts, acts and fatal consequences. The study objective was to identify any year-on-year period of increased risk for youth and young adult suicide in the UK and Ireland.Methods.Collation and examination of international epidemiological datasets on suicide (aged 18–35) for the UK and Ireland 2000–2006 (N = 11 964). Outcome measures included the age distribution of suicide mortality in international datasets from the UK and Ireland, 2000–2006.Results.An accelerated pattern of risk up to the age of 20 for the UK and Ireland which levels off moderately thereafter was uncovered, thus identifying a heretofore unreported age-related epidemiological transition for suicide.Conclusions.The current reporting of suicide in 5-year age bands may conceal age-related periods of risk for suicide. This may have implications for suicide prevention programmes for young adults under age 21.
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Nazeer, Muhammad Atif, Muhammad Mohsin, and Abdur Rehman. "Identifying the Causes and Protective Measures of Road Traffic Accidents (RTAs) in Bahawalpur City, Pakistan." Vol 3 Issue 4 3, no. 4 (December 31, 2021): 208–17. http://dx.doi.org/10.33411/ijist/2021030407.
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Road Traffic Accident (RTA) is a growing public issue and fall among the four top causes of mortality and morbidity globally. The main objective of this study was to identify the causes and protective measures of road traffic accidents in Bahawalpur City. Primary data was gathered through a structured questionnaire during a field survey in selected five public places as sample sites i.e. Larry Ada, University Chowk, Bahawal Victoria Hospital (BVH), One Unit Chowk, and Melad Chowk. Secondary data of road accidents was gathered form National Highway and Motor Way Police (NH&MP) while primary data was gathered from 150 respondents (30 from each study site) and analyzed in SPSS software by applying descriptive statistics and road accident risk index (RARI). Findings revealed that the main causes of these accidents include increase in population (62.66%), increase in demand for vehicles (22%), bike drivers (69.33%), overtaking of the vehicles (51.33%), over speed and hustle to reach the destination (34.66%). One wheeling is also a major reason, which results in the death of teenage drivers (52%), violation of the traffic rules (25.33%). RARI results also suggest the relationship between the affected persons and the road traffic accidents. Lastly, few suggestions were proposed to overcome the ratio and severity of road traffic accidents because these accidents are predictable and largely preventable through multi-disciplinary coherent strategies.
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Leshchenko, Ya A., and A. A. Lisovtsov. "Young health in the context of culture crisis." Public Health 2, no. 2 (July 27, 2022): 14–28. http://dx.doi.org/10.21045/2782-1676-2022-2-2-14-28.
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Purpose: assess changes in the health state of teenage-youth due to the transformation of the sociocultural environment (on the example of the Irkutsk region).Materials and methods. The observation contingent is the population of adolescence (15–19 years old). The subject of the study is the characteristics of the incidence and mortality of the contingent underline in the process of changes in the sociocultural medium. Data on mortality rates were obtained on sites of Federal State Statistics Service and of the Center for Demographic Research of the New Economic School, the trend analysis was carried out by a linear regression analysis using the SPSS program (IBM).Results. In the first half of the post-Soviet period (from 1991 to 2005–2009), in the Irkutsk region, in the contingent of adolescence, there was a rapid increase in the prevalence of some socially determined diseases and states (addiction, sexually transmitted diseases), as well as mortality rates. In the second half of the period (from 2006–2010 to 2020), there was a decrease in morbidity and mortality, however, with all positive shifts, even the relative well-being in these areas was not achieved. In 2019, the mortality rates of young men in connection with suicides in the region exceeded the corresponding figures of Poland 2,5 times, Sweden – 8,2 times; Mortality rates from violent causes (murders) exceeded the corresponding figures of Poland 6,4 times, Sweden – 2,0 times. High levels of socially determined morbidity, adolescence mortality in the post-Soviet period are a consequence of adverse changes in the sociocultural environment.Conclusion. Negative phenomena in the mentally-psychological and somatic health of young people are developing in a state of culture, characterized as “sociocultural destruction”. The latter is due to the processes of marginalization of the population, miscalculations in the areas of state ideology and cultural policies, the destruction and substitution of value orientations, the degradation of morality. The most important task facing the authorities and society is to overcome the factors leading to socio-cultural destruction, strengthening the integrity of the consolidating ethnic group of the cultural system.
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Mitchell, Rachel, Cornelius Ani, James Irvine, Claude Cyr, Ari Joffe, Robin Skinner, Antonia Stang, Sam Wong, Xiaoquan Yao, and Daphne J. Korczak. "109 Near-fatal suicide attempts among Canadian Youth: A CPSP Study." Paediatrics & Child Health 25, Supplement_2 (August 2020): e45-e45. http://dx.doi.org/10.1093/pch/pxaa068.108.
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Abstract Background Suicide is the second leading cause of death among Canadian adolescents. Youth who make near fatal suicide attempts, such as those requiring intensive care unit (ICU) level care, are the closest proxy to those that die by suicide; however, there is limited data on this group. Objectives To evaluate the minimum incidence rate and patterns of presentation of youth (under 18 years of age) admitted to the ICU for medically serious self-inflicted injury. Design/Methods From January 2017 to December 2018, over 2,700 paediatricians/subspecialist members of the Canadian Paediatric Surveillance Program were electronically surveyed on a monthly basis regarding cases of medically serious self-harm. Participants completed a detailed questionnaire about the reported case and descriptive statistics were used for analyses. Results Ninety-four cases (71 female; mean age 15.2 years) of confirmed (n=87) and suspected/probable (n=7) medically serious self-harm were reported. The majority (87%) of cases were reported from 4 out of 13 provinces and territories in Canada (Alberta, British Columbia, Ontario, Quebec). There were 11 deaths by suicide (M>F; p<.05). Medication ingestion was the most common method of self-harm among females (76% F vs. 52% M; p=.03) compared with hanging among males (14% F vs. 39% M; p=.009). More females than males had a prior suicide attempt (62% F vs. 32% M; p=.07) and a history of non-suicidal self-injury (NSSI) (65% F vs. 14% M; p<.05), although only history of NSSI reached significance. More females than males had a past psychiatric diagnosis (77% F vs. 55% M; p=.05), and past use of mental health services (69% F vs. 30% M; p<.001), although only service use reached significance. Half of the youth left evidence of intent (54%) and 33% of parents of included youth were aware that their child was considering suicide. Family conflict was the most common precipitating factor for suicide attempt in both females and males (46%). Conclusion These Canadian findings are consistent with international epidemiologic data that observe a gender paradox of higher rates of suicide attempts in females and greater mental health care engagement but increased suicide mortality in males with decreased involvement with mental health care. This study suggests that family conflict is a potential target for suicide prevention interventions among youth. Future research focusing on gender-specificity in risk factor identification and effectiveness of primary prevention interventions among youth is warranted.
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Pham, Tony, Caitlin Young, Noel Woodford, David Ranson, Carmel M. F. Young, and Joseph E. Ibrahim. "Difference in the characteristics of mortality reports during a heatwave period: retrospective analysis comparing deaths during a heatwave in January 2014 with the same period a year earlier." BMJ Open 9, no. 5 (May 17, 2019): e026118. http://dx.doi.org/10.1136/bmjopen-2018-026118.
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ObjectivesTo describe the characteristics of deaths reported to the Coroners Court of Victoria (CCOV) during Victoria’s last heatwave (14–17 January 2014) and subsequent 4 days (18–21 January) using medicolegal data obtained from both the police investigation report and the pathologist’s report.Design, setting and participantsA single-jurisdiction population-based retrospective analysis of consecutive heat-related deaths (HRDs) reported to the CCOV between 14 and 21 January 2014 with a historical comparison group.Main outcome measuresDescriptive statistics were used to summarise case demographics, causes of death and the types of investigations performed. The cases from 2014 were subgrouped into HRD and non-HRD.ResultsOf the 222 cases during the study period in 2014, 94 (42.3%) were HRDs and 128 (57.7%) were non-HRDs. HRDs were significantly older than non-HRDs (70.5 years: SD=13.8 vs 61.0 years: SD=22.4, t(220)=3.60, p<0.001, 95% CI 4.3 to 14.6). The most common primary cause of death in HRDs was circulatory system disease (n=57, 60.6%), which was significantly higher when compared with non-HRDs (n=39, 30.5%; χ2=20.1, p<0.001, OR 3.5, 95% CI 2.0 to 6.2). HRDs required significantly greater toxicology investigation (89.4% (n=84) vs 71.9% (n=92); χ2=10.9, p<0.001, OR 3.3, 95% CI 1.54 to 7.03) and greater vitreous biochemistry testing (40.4% (n=38) vs 16.4% (n=21); χ2=16.0, p<0.001, OR 3.5, 95% CI 1.9 to 6.5).ConclusionsA heatwave places a significant burden on death investigation services. The inclusion of additional laboratory tests and more detailed circumstantial information are essential if the factors that contribute to HRDs are to be identified.
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Ziker, John P., and Kristin Snopkowski. "Life-History Factors Influence Teenagers’ Suicidal Ideation: A Model Selection Analysis of the Canadian National Longitudinal Survey of Children and Youth." Evolutionary Psychology 18, no. 3 (July 1, 2020): 147470492093952. http://dx.doi.org/10.1177/1474704920939521.
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Suicidality is an important contributor to disease burden worldwide. We examine the developmental and environmental correlates of reported suicidal ideation at age 15 and develop a new evolutionary model of suicidality based on life history trade-offs and hypothesized accompanying modulations of cognition. Data were derived from the National Longitudinal Survey of Children and Youth (Statistics Canada) which collected information on children’s social, emotional, and behavioral development in eight cycles between 1994 and 2009. We take a model selection approach to understand thoughts of suicide at age 15 ( N ≈ 1,700). The most highly ranked models include social support, early life psychosocial stressors, prenatal stress, and mortality cues. Those reporting consistent early life stress had 2.66 greater odds of reporting thoughts of suicide at age 15 than those who reported no childhood stress. Social support of the primary caregiver, neighborhood cohesion, nonkin social support of the adolescent, and the number of social support sources are all associated with suicidal thoughts, where greater neighborhood cohesion and social support sources are associated with a reduction in experiencing suicidal thoughts. Mother’s prenatal smoking throughout pregnancy is associated with a 1.5 greater odds of suicidal thoughts for adolescents compared to children whose mother’s reported not smoking during pregnancy. We discuss these findings in light of evolutionary models of suicidality. This study identifies both positive and negative associations on suicidal thoughts at age 15 and considers these in light of adaptive response models of human development. Findings are relevant for mental health policy.
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John, Nimmy N., Athira Krishnan Krishnan, and H. Doddayya. "A study on knowledge attitude and practices regarding HIV/AIDS among general population in a community of Kottarakkara, Kerala." International Journal Of Community Medicine And Public Health 8, no. 2 (January 27, 2021): 613. http://dx.doi.org/10.18203/2394-6040.ijcmph20210209.
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Background: HIV/AIDS epidemic has emerged as one of the most serious and enormous health problems associated with high morbidity and mortality rate. A prospective questionnaire based observational study was carried out in Kottathala community of Mylom Gramapanchayat, Kottarakkara to analyse the peoples knowledge on HIV/AIDS, as well as attitudes towards HIV patients and actual sex practices for the control or prevention of HIV.Methods: A total of 150 participants were interviewed by using a predesigned questionnaire and responses were reviewed and analysed by using descriptive statistics namely total numbers and percentage.Results: Out of 150 participants females were more (84%) and most of them were under the age group of 18-30 years. Majority of the participants had higher degree of education (51.33%) as they are still youth. The overall participants had a higher degree of knowledge regarding HIV and most of them had a positive attitude towards the HIV patients. Around 84% of participants had history of sexual intercourse but majority of them (46%) never used condoms during sexual intercourse in which, 11.33% only using condom regularly. Most of them were following unsafe sexual practices.Conclusions: This study concludes that the surveyed general populations had high knowledge and attitudes regarding HIV/AIDS and had risky sexual practices.
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Федина, N. Fedina, Ткаченко, T. Tkachenko, Дмитриев, A. Dmitriev, Гудков, and R. Gudkov. "Regional aspects of the epidemiology and clinics of syphilis in children." Journal of New Medical Technologies. eJournal 9, no. 4 (December 8, 2015): 0. http://dx.doi.org/10.12737/16783.
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The purpose of this study was clinical and epidemiological analysis of the incidence of syphilis in children and adolescents in the Ryazan region over a 12 year period. In a retrospective study the authors used the data from regional statistical reports, medical records of newborns, the data on infectious diseases of the Federal State Statistics Service. The analysis of the data for all age groups, including children and pregnant women was carried out. It was noted a substantial reduction in the number of reported cases of syphilis, including among adolescents and youth. The proportion of non-residents and rural residents in the total of patients with syphilis is increasing. In the pediatric population, the leading mode of transmission is vertical (53% of all cases). Among children born from pregnant patients with syphilis, there are 78% of the verified congenital syphilis, and only 5% the classical picture of the disease. It was established a substantial reduction of cases of congenital syphilis, the absence of cases of fetal death and postnatal mortality in recent years. However, the retention of latent forms and late detection of syphilis in pregnant women poses a threat of infection and determines the social significance of the problem. Effective control of congenital syphilis is ensured by the collaboration of obstetriciansgynecologists, dermatologists and neonatologists.
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Drosdowsky, A., K. Gough, M. Grewal, A. Dabscheck, N. Tebbutt, J. Philip, O. Spruyt, M. Michael, and M. Krishnasamy. "Does Care for Australians With Pancreatic Cancer Compare Favourably to a Consensus-Based Standard of Optimal Care?" Journal of Global Oncology 4, Supplement 2 (October 1, 2018): 82s. http://dx.doi.org/10.1200/jgo.18.58800.
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Background: Pancreatic cancer has one of the lowest survival rates of all cancer types, with an incidence to mortality ratio approaching one. People with pancreatic cancer experience a rapid decline in health characterized by pain, nausea, fatigue and weight loss. For most people, the disease is detected at an advanced stage and the focus of treatment is palliative. In Victoria, Australia, knowledge regarding patterns of care for people with pancreatic cancer is out-of-date, but central to quality improvement initiatives targeting unwarranted variations in care and improvement in supports that are consistent with patient preferences. Aim: Our aim was to compare care received by patients with pancreatic cancer with a consensus-based standard representing optimal care to identify deviations from best practice and highlight processes that may improve the quality and safety of care provided. Methods: Eligible patients included those with pancreatic cancer, first treated in 2015, at one of three tertiary hospitals in Victoria, Australia. Once identified, dates and details of events indicated by the optimal care pathway were extracted from the medical record of each patient. Data were summarized using descriptive statistics and process maps: a visualization method that illuminates gaps, duplication, deviations from best practice and processes that may be amenable to improvement. Results: Thirty-two of 165 care pathways have been mapped to date. The nature and timing of care received appears highly variable. Only nine of 32 patients (28%) received all of their cancer care at a single institution; the remainder (n=23, 72%) received care in multiple tertiary and community facilities. Apart from four (13%) emergency presentations, referrals for specialist care came from general/primary practitioners (n=26, 81%). The timeframe for general/primary practitioner investigations ranged from one to 57 days. Once referred to a tertiary setting, most patients (n=23, 72%) were discussed at a multidisciplinary team meeting and received standard therapies. Only four had resectable disease. Nineteen patients (60%) had documented referrals to hospital- or community-based palliative care services. Where observed, deviations from the consensus-based standard tended to be related to the difficult nature of diagnosing pancreatic cancer, and determining appropriate care for patients with an advanced cancer with nonspecific symptoms. Conclusion: Process mapping provided a useful and efficient means of comparing care received with a consensus-based standard; however, the assessment of adherence to optimal timeframes and specific care events was complicated by missing data. Implications for quality improvement activities will be considered in the context of study limitations. We will also emphasize the importance of engaging patients and carers in setting improvement priorities.
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Pawer, Samantha, Fahra Rajabali, Alex Zheng, Ian Pike, Roy Purssell, Atousa Zargaran, and Shelina Babul. "Socioeconomic factors and substances involved in poisoning-related emergency department visits in British Columbia, Canada." Health Promotion and Chronic Disease Prevention in Canada 41, no. 7/8 (August 2021): 211–21. http://dx.doi.org/10.24095/hpcdp.41.7/8.02.
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Introduction Canada’s opioid crisis has taken thousands of lives, increasing awareness of poisoning-related injuries as an important public health issue. However, in British Columbia (BC), where overdose mortality rates are the highest in Canada, studies have not yet identified which demographic populations most often visit emergency departments (ED) due to all poisonings, nor which substances are most commonly involved. The aim of this study was to explore these gaps, after developing a methodology for calculating ED visit rates in BC. Methods Poisoning-related ED visit rates during fiscal years 2012/13 to 2016/17, inclusive, were calculated by sex, age group, poisoning substance and socioeconomic status, using a novel methodology developed in this study. ED data were sourced from the National Ambulatory Care Reporting System and population data from Statistics Canada’s 2016 (or 2011) census profiles. Results During the study period, there were an estimated 81 463 poisoning-related ED visits (351.2 per 100 000 population). Infants, toddlers, youth and those aged 20–64 years had elevated risks of poisoning-related ED visits. Rates were highest among those in neighbourhoods with the greatest material (607.8 per 100 000 population) or social (484.2 per 100 000 population) deprivation. Over time, narcotics and psychodysleptics became increasingly common poisoning agents, while alcohol remained problematic. Conclusion A methodology for estimating ED visit rates in BC was developed and applied to determine poisoning-related ED visit rates among various demographic groups within BC. British Columbians most vulnerable to poisoning have been identified, emphasizing the need for efforts to limit drug overdoses and excessive alcohol intoxication to reduce rates of these preventable injuries.
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Dev, Sathish, Timsi Jain, Sivaprakasam P., and Dinesh Raja. "Risk factor assessment and screening for diabetes in field practice area of a private medical college in Thiruvallur district of Tamil Nadu." International Journal Of Community Medicine And Public Health 4, no. 8 (July 22, 2017): 2670. http://dx.doi.org/10.18203/2394-6040.ijcmph20173151.
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Background: Diabetes, which was known to be an epidemic in the urban areas, has been found to be increasing rapidly in the rural areas too as a result of the socioeconomic transitions. Diabetes is no longer only a disease of the elderly but is one of the major causes of morbidity and mortality affecting youth and middle aged people.Methods: Screening camp for diabetes was conducted by the Department of Community Medicine in three different areas in the field practice area of Saveetha Medical College and Hospital viz. Thirumazhisai, Kuthambakkam and Velavedu in Thiruvallur district of Tamil Nadu on 7th April 2016 as a part of World Health Day 2016 celebration. Data was collected using a predesigned interview schedule. Descriptive statistics was calculated using rates, ratios & proportions. Univariate analysis was done using Chi square test to find the association between various factors and diabetes status. A parsimonious regression model was developed to find the predictor variables for diabetes.Results: A total of 188 people aged above 18 years attended the screening camps. Majority of the camp attendees were females (62.2%). Proportion of people having diabetes (already diagnosed plus newly screened) was found to be 18.1% out of which 3.2% were screened positive for diabetes. On regression analysis, Intake of alcohol and perceived stress were found to be significantly associated with diabetes (p<0.05).Conclusions: This study highlights a significant burden of undiagnosed cases of diabetes in the community. This indicates the need for systematic screening and awareness programs to identify the undiagnosed cases in the community and offer early life style modifications, treatment and regular follow up to such individuals.
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Jacob, Aasems, Saurabh Parasramka, Zhonglin Hao, and Eric B. Durbin. "Tobacco still haunting Kentuckians: Adolescent and young adult (AYA) cancer trend from the Kentucky SEER database." Journal of Clinical Oncology 38, no. 15_suppl (May 20, 2020): e13626-e13626. http://dx.doi.org/10.1200/jco.2020.38.15_suppl.e13626.
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e13626 Background: Kentucky has the highest incidence and mortality for AYA cancers in the US. When the incidence of AYA cancers increased 4% between 2012-16 nationally, it was 12.3% in the state of Kentucky. Understanding the burden and factors associated with it may help develop effective risk reduction strategies. Methods: SEER database was used for analyzing population estimates (2012-2016) while records from the NCI-designated cancer center in the state was used to assess current trends and clinicopathologic features. Pearson test was used to estimate correlation and Kaplan-Meier and Cox regression models were used to compare survival outcomes. Results: A total of 5825 AYA patients were identified in the state’s SEER database between 2012-16. A majority (62.4%) were female, from non-Appalachian region (71%) and rural counties (64%). Thyroid, breast, melanoma, cervical and CNS malignancies were the most common. While sarcoma, leukemia and gastric cancer decreased in incidence, breast, melanoma, cervical and colorectal cancer have increased from 2012-2016, similar to a general trend nation-wide. County-wise estimation of cancer incidence showed a significant correlation with prevalence of smoking (Pearson r = 0.34, p < 0.001) independent of educational, employment or economic status. A total of 1129 AYA cancer patients treated between 2016-19 at the Markey Cancer Center were analyzed. Baseline characteristics were similar to statewide trend. About 10% of the cancers were metastatic at diagnosis and 14% died from the disease. Nearly half (44%) of the patients were smokers. Smoking was independently associated with higher risk of death (HR 0.46 95%CI 0.33, 0.64, p < 0.0001) and early cancer recurrence (HR 0.56, 95%CI 0.3, 0.9, p = 0.026). Metastatic disease at diagnosis was also more common among smokers compared to non-smokers. (58% vs 41%, p = 0.002). There was no significant difference in OS or risk of recurrence between rural/urban or Appalachian/Non-Appalachian counties. Conclusions: The high prevalence of smoking (24.3%), especially among youth (14.3%) could be the root of the higher incidence of AYA cancers in the state of KY although multiple socio-economic and geographic factors might be influencing. Second-hand smoke exposure at home is also the highest in the country at 32% with rates as high as 80% in some counties. Awareness about these disturbing statistics is required to set in motion more community and legislative interventions to reduce cancer incidence among the youth.
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Nguyen, Hiep Duc, Merched Azzi, Stephen White, David Salter, Toan Trieu, Geoffrey Morgan, Mahmudur Rahman, et al. "The Summer 2019–2020 Wildfires in East Coast Australia and Their Impacts on Air Quality and Health in New South Wales, Australia." International Journal of Environmental Research and Public Health 18, no. 7 (March 29, 2021): 3538. http://dx.doi.org/10.3390/ijerph18073538.
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The 2019–2020 summer wildfire event on the east coast of Australia was a series of major wildfires occurring from November 2019 to end of January 2020 across the states of Queensland, New South Wales (NSW), Victoria and South Australia. The wildfires were unprecedent in scope and the extensive character of the wildfires caused smoke pollutants to be transported not only to New Zealand, but also across the Pacific Ocean to South America. At the peak of the wildfires, smoke plumes were injected into the stratosphere at a height of up to 25 km and hence transported across the globe. The meteorological and air quality Weather Research and Forecasting with Chemistry (WRF-Chem) model is used together with the air quality monitoring data collected during the bushfire period and remote sensing data from the Moderate Resolution Imaging Spectroradiometer (MODIS) and Cloud-Aerosol Lidar and Infrared Pathfinder Satellite Observation (CALIPSO) satellites to determine the extent of the wildfires, the pollutant transport and their impacts on air quality and health of the exposed population in NSW. The results showed that the WRF-Chem model using Fire Emission Inventory (FINN) from National Center for Atmospheric Research (NCAR) to simulate the dispersion and transport of pollutants from wildfires predicted the daily concentration of PM2.5 having the correlation (R2) and index of agreement (IOA) from 0.6 to 0.75 and 0.61 to 0.86, respectively, when compared with the ground-based data. The impact on health endpoints such as mortality and respiratory and cardiovascular diseases hospitalizations across the modelling domain was then estimated. The estimated health impact on each of the Australian Bureau of Statistics (ABS) census districts (SA4) of New South Wales was calculated based on epidemiological assumptions of the impact function and incidence rate data from the 2016 ABS and NSW Department of Health statistical health records. Summing up all SA4 census district results over NSW, we estimated that there were 247 (CI: 89, 409) premature deaths, 437 (CI: 81, 984) cardiovascular diseases hospitalizations and 1535 (CI: 493, 2087) respiratory diseases hospitalizations in NSW over the period from 1 November 2019 to 8 January 2020. The results are comparable with a previous study based only on observation data, but the results in this study provide much more spatially and temporally detailed data with regard to the health impact from the summer 2019–2020 wildfires.
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SHEVCHUK, P. E. "Probabilistic Demographic Forecasts for Metropolises of Ukraine." Demography and social economy, no. 3 (October 23, 2020): 76–90. http://dx.doi.org/10.15407/dse2020.03.076.
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Uncertainty is an intrinsic characteristic of demographic processes. Th is applies even more to the future. Accurate deterministic forecasts are fundamentally impossible. Th is determines the necessity to quantify the future uncertainty. Th e purpose of this research is to develop probabilistic demographic forecasts for the metropolises of Ukraine and analyze the outcome results. For the fi rst time, probabilistic demographic forecasts have been developed for individual cities of Ukraine. Th e study was carried out using the functional data approach which incorporates wide set of demographical methods and models implemented in several packages of R programming language. Chosen methodology is based entirely on statistics and does not require introducing any additional arbitrary hypotheses. At three cases (namely for fertility in Kyiv, Lviv and Kharkiv) the default method (ARIMA) showed implausible results which could be induced by unreliable current data. In these cases were used random walk model. For Odesa the both models give similar results. It is possible that in this city the underestimation of the departed population is compensated by the underestimation of the arrived, which leads to the relevance of the current fertility rates (namely their denominators) and, consequently, the consistency of the forecast results regardless of the method. Mortality forecasts are consistent with the dynamics of mortality rates being observed and the quality of current data. Th e model captured upward life expectancy trends for Dnipro and Odesa and stagnation for other cities. Th is is also could be caused by denominator inconsistencyfor the latter ones. Computation showed that the population size of Dnipro, Lviv and Kharkiv in 2040 is most likely to be below the population number reached in early 2019. Some chances for population growth remain in Odesa and Kyiv is likely to have a larger population. Th e age distribution of the population in all cities in future looks similar. The number of people over 40 years of age has least uncertainty. At the age of 20 to 40 years, the uncertainty is much higher. Th is is a consequence of the uncertainty of youth migration during the forecast horizon of 2019–2039, because all these cities are powerful educational centres and attract students. In 2040 those who were students in 2020 will reach the age of 40 and can stay in the big city or leave. Uncertainty of the number of persons under 20 is formed from two sources: uncertainty of fertility forecasts and uncertainty of the number of reproductive cohort, i.e. those 20-40-year-olds. It is needed to review these forecasts aft er receiving the results of the closest census.
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Schweisberger, Cintya, Nila Palaniappan, Nicole Wood, Lauren Amos, and Kelsee Halpin. "Hyperglycemia Requiring Insulin Among Pediatric Patients Diagnosed With Hemophagocytic Lymphohistiocytosis." Journal of the Endocrine Society 5, Supplement_1 (May 1, 2021): A451—A452. http://dx.doi.org/10.1210/jendso/bvab048.922.
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Abstract Introduction: Hemophagocytic lymphohistiocytosis (HLH) is a rare, life-threatening disorder marked by massive cytokine release due to macrophage and T-cell activation. Hallmarks of the diagnosis include fever, splenomegaly, cytopenias, hypertriglyceridemia, hypofibrinogemia, and elevations in ferritin and soluble IL-2 receptor. Given HLH is associated with critical illness, elevation in inflammatory markers, and treated with glucocorticoids, the development of hyperglycemia during its course is not unexpected. However, detailed descriptions of the severity of hyperglycemia and strategies in insulin management among HLH patients are lacking. We describe 10 years’ experience at a single tertiary pediatric health center with HLH patients who developed insulin dependent hyperglycemia. Objectives: To describe the demographics, clinical and laboratory findings, treatment regimens, and outcomes for children with HLH treated with insulin due to hyperglycemia. Study Design: Retrospective chart review from 2010 through 2019 of youth 0 to 21 years of age who required insulin therapy during or shortly after a hospitalization where they were diagnosed with HLH using established criteria. Descriptive statistics were used to characterize the population of interest. Results: Of 30 patients diagnosed with HLH, 33% (n=10) required insulin therapy. Half (n=5) were female and half (n=5) male. The mean age was 8.4 years (7.8 months - 17 years). The majority (80%) were non-Hispanic white. Mean BMI at admission was 53rd percentile (5th - 87th percentile). Max serum glucose ranged from 267 to 725 mg/dL (mean 421 mg/dL). Marked inflammation was present (max CRP 2.6 - 44.9 mg/dL, max ferritin 1,091 - 90,219 ng/mL). All were treated with dexamethasone, doses ranging from 5 to 11 mg/m2/day and duration from 2 to 70 days. Most (90%) received parenteral nutrition (PN) with a mean max GIR of 8 mg/kg/min (SD=2.7). Intravenous infusions of regular insulin were used in 80% of patients, though 2 patients were later transitioned to long and short acting subcutaneous insulin. Mean duration of IV insulin therapy was 9.5 days (2–24 days); however, 2 patients died while on IV insulin therapy. The majority (70%) needed insulin within 5 days of starting steroids. Two patients (20%) were treated with subcutaneous insulin only (no IV). Only 1 patient was discharged home on insulin therapy. Mean hospital stay was 60 days (10–202 days). Mortality was 50% (n=5). Conclusions: One-third of pediatric HLH patients required insulin during their hospitalization for severe hyperglycemia likely secondary to multiple factors including glucocorticoid use, parenteral nutrition, inflammation, and severe illness. Insulin is typically started within 5 days of initiating steroid therapy, limited to IV infusions, and often is not needed by the time of discharge. Risk of mortality is very high.
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De Santiago, Isabel, Leonor Bacelar Nicolau, Rui Tato Marinho, and José Pereira-Miguel. "Comunicação em Saúde Pública na Prevenção do Consumo Excessivo de Álcool e Drogas na População Escolar de São Tomé e Príncipe: Protocolo Científico." Acta Médica Portuguesa 33, no. 4 (April 1, 2020): 229. http://dx.doi.org/10.20344/amp.13435.
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Introduction: Sao Tome and Principe is an African low-and-middle-income country, where extreme poverty causes major health inequalities. No systematic research has been done on the consumption of alcohol and drugs in Sao Tome and Principe, and only overall statistics are available based on the importation of alcoholic drinks and their distribution among the population. There are also no studies on consumption of alcohol and illicit substances in children and youth and no preventive measures being undertaken. Besides that, manual databases present significant limitations, considering the lack of causes associated with mortality rates (0 - 5 years and > 5), and the difficulty to establish a cause/effect relation between diseases, deaths and life expectancy. No relevant data with burden of life was found in the reports of Centro Nacional de Endemias or the non-governmental, organization Instituto Marques de Valle Flor, a facilitator on healthcare clinical specialties selected on a voluntary basis by doctors from Portuguese hospitals. So, we proposed to provide a first overview of family and housing conditions, and above all, the consumption of alcohol and illegal drugs in young people. Thus, a project, the National Survey on Harmful Consumption of Alcohol and Drugs in Schools of Sao Tome and Principe, will be realized in order to better characterize the situation among children and young students and test public health communication strategies and preventive interventions aimed at this target-population. Interventions were designed taking into consideration local sociocultural realities of target audiences. We considered dialect language, single-parent families (matriarchal structure) and polygamy (mostly) in men and a country and governments led by men (patriarchal structure) and, in which the woman’s role, as Food and Agriculture Organization of the United Nations reports, remains overlooked. Subsequently, we will collect traditional alcohols samples from the two main islands for analysis (at Laboratório de Estudos Farmacêuticos and Laboratório Nacional de Engenharia Civil - Portugal) and to determine heavy metals in the production process and impact on burden of life.Material and Methods: In order to characterise the country’s situation in terms of alcohol and illicit substances consumption a literature review was carried out through a search in several international electronic databases, such as those of the World Health Organization, World Health Organization Africa, United Nation, The Lancet and Lancet Global Health, etc. Available data of the following institutions of Sao Tome and Príncipe was also analyzed: National Institute of Statistics, Ministry of Education, Culture and Training and Ministry of Health and Social Affairs. Several interviews with community and church leaders as well as with members of catholic missions were carried out to better understand the local situation. Following this, a nationwide cross-sectional survey of a sample of 2064 students will be carried out. This will include a questionnaire on socio-demographic characteristics, lifestyles, health behaviors/attitudes, alcohol and illicit substances consumption. Finally, based on the overall diagnosis obtained, some edutainment health communication preventive interventions will be tested in the primary schools of three districts (EDUCA_TURTLE) and on the radio journalists (EDUCA_PRESS). These were evaluated by primary school teachers and by radio journalists.
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Gómez-Sánchez, Pío-Iván Iván. "Personal reflections 25 years after the International Conference on Population and Development in Cairo." Revista Colombiana de Enfermería 18, no. 3 (December 5, 2019): e012. http://dx.doi.org/10.18270/rce.v18i3.2659.
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In my postgraduate formation during the last years of the 80’s, we had close to thirty hospital beds in a pavilion called “sépticas” (1). In Colombia, where abortion was completely penalized, the pavilion was mostly filled with women with insecure, complicated abortions. The focus we received was technical: management of intensive care; performance of hysterectomies, colostomies, bowel resection, etc. In those times, some nurses were nuns and limited themselves to interrogating the patients to get them to “confess” what they had done to themselves in order to abort. It always disturbed me that the women who left alive, left without any advice or contraceptive method. Having asked a professor of mine, he responded with disdain: “This is a third level hospital, those things are done by nurses of the first level”.
Seeing so much pain and death, I decided to talk to patients, and I began to understand their decision. I still remember so many deaths with sadness, but one case in particular pains me: it was a woman close to being fifty who arrived with a uterine perforation in a state of advanced sepsis. Despite the surgery and the intensive care, she passed away. I had talked to her, and she told me she was a widow, had two adult kids and had aborted because of “embarrassment towards them” because they were going to find out that she had an active sexual life. A few days after her passing, the pathology professor called me, surprised, to tell me that the uterus we had sent for pathological examination showed no pregnancy. She was a woman in a perimenopausal state with a pregnancy exam that gave a false positive due to the high levels of FSH/LH typical of her age. SHE WAS NOT PREGNANT!!! She didn’t have menstruation because she was premenopausal and a false positive led her to an unsafe abortion. Of course, the injuries caused in the attempted abortion caused the fatal conclusion, but the real underlying cause was the social taboo in respect to sexuality.
I had to watch many adolescents and young women leave the hospital alive, but without a uterus, sometime without ovaries and with colostomies, to be looked down on by a society that blamed them for deciding to not be mothers. I had to see situation of women that arrived with their intestines protruding from their vaginas because of unsafe abortions. I saw women, who in their despair, self-inflicted injuries attempting to abort with elements such as stick, branches, onion wedges, alum bars and clothing hooks among others. Among so many deaths, it was hard not having at least one woman per day in the morgue due to an unsafe abortion.
During those time, healthcare was not handled from the biopsychosocial, but only from the technical (2); nonetheless, in the academic evaluations that were performed, when asked about the definition of health, we had to recite the text from the International Organization of Health that included these three aspects. How contradictory!
To give response to the health need of women and guarantee their right when I was already a professor, I began an obstetric contraceptive service in that third level hospital. There was resistance from the directors, but fortunately I was able to acquire international donations for the institution, which facilitated its acceptance. I decided to undertake a teaching career with the hope of being able to sensitize health professionals towards an integral focus of health and illness.
When the International Conference of Population and Development (ICPD) was held in Cairo in 1994, I had already spent various years in teaching, and when I read their Action Program, I found a name for what I was working on: Sexual and Reproductive Rights. I began to incorporate the tools given by this document into my professional and teaching life. I was able to sensitize people at my countries Health Ministry, and we worked together moving it to an approach of human rights in areas of sexual and reproductive health (SRH). This new viewpoint, in addition to being integral, sought to give answers to old problems like maternal mortality, adolescent pregnancy, low contraceptive prevalence, unplanned or unwanted pregnancy or violence against women. With other sensitized people, we began with these SRH issues to permeate the Colombian Society of Obstetrics and Gynecology, some universities, and university hospitals. We are still fighting in a country that despite many difficulties has improved its indicators of SRH.
With the experience of having labored in all sphere of these topics, we manage to create, with a handful of colleagues and friend at the Universidad El Bosque, a Master’s Program in Sexual and Reproductive Health, open to all professions, in which we broke several paradigms. A program was initiated in which the qualitative and quantitative investigation had the same weight, and some alumni of the program are now in positions of leadership in governmental and international institutions, replicating integral models. In the Latin American Federation of Obstetrics and Gynecology (FLASOG, English acronym) and in the International Federation of Obstetrics and Gynecology (FIGO), I was able to apply my experience for many years in the SRH committees of these association to benefit women and girls in the regional and global environments.
When I think of who has inspired me in these fights, I should highlight the great feminist who have taught me and been with me in so many fights. I cannot mention them all, but I have admired the story of the life of Margaret Sanger with her persistence and visionary outlook. She fought throughout her whole life to help the women of the 20th century to be able to obtain the right to decide when and whether or not they wanted to have children (3). Of current feminist, I have had the privilege of sharing experiences with Carmen Barroso, Giselle Carino, Debora Diniz and Alejandra Meglioli, leaders of the International Planned Parenthood Federation – Western Hemisphere Region (IPPF-RHO). From my country, I want to mention my countrywoman Florence Thomas, psychologist, columnist, writer and Colombo-French feminist. She is one of the most influential and important voices in the movement for women rights in Colombia and the region. She arrived from France in the 1960’s, in the years of counterculture, the Beatles, hippies, Simone de Beauvoir, and Jean-Paul Sartre, a time in which capitalism and consumer culture began to be criticized (4). It was then when they began to talk about the female body, female sexuality and when the contraceptive pill arrived like a total revolution for women. Upon its arrival in 1967, she experimented a shock because she had just assisted in a revolution and only found a country of mothers, not women (5). That was the only destiny for a woman, to be quiet and submissive. Then she realized that this could not continue, speaking of “revolutionary vanguards” in such a patriarchal environment.
In 1986 with the North American and European feminism waves and with her academic team, they created the group “Mujer y Sociedad de la Universidad Nacional de Colombia”, incubator of great initiatives and achievements for the country (6). She has led great changes with her courage, the strength of her arguments, and a simultaneously passionate and agreeable discourse. Among her multiple books, I highlight “Conversaciones con Violeta” (7), motivated by the disdain towards feminism of some young women. She writes it as a dialogue with an imaginary daughter in which, in an intimate manner, she reconstructs the history of women throughout the centuries and gives new light of the fundamental role of feminism in the life of modern women. Another book that shows her bravery is “Había que decirlo” (8), in which she narrates the experience of her own abortion at age twenty-two in sixty’s France.
My work experience in the IPPF-RHO has allowed me to meet leaders of all ages in diverse countries of the region, who with great mysticism and dedication, voluntarily, work to achieve a more equal and just society. I have been particularly impressed by the appropriation of the concept of sexual and reproductive rights by young people, and this has given me great hope for the future of the planet. We continue to have an incomplete agenda of the action plan of the ICPD of Cairo but seeing how the youth bravely confront the challenges motivates me to continue ahead and give my years of experience in an intergenerational work.
In their policies and programs, the IPPF-RHO evidences great commitment for the rights and the SRH of adolescent, that are consistent with what the organization promotes, for example, 20% of the places for decision making are in hands of the young. Member organizations, that base their labor on volunteers, are true incubators of youth that will make that unassailable and necessary change of generations. In contrast to what many of us experienced, working in this complicated agenda of sexual and reproductive health without theoretical bases, today we see committed people with a solid formation to replace us. In the college of medicine at the Universidad Nacional de Colombia and the College of Nursing at the Universidad El Bosque, the new generations are more motivated and empowered, with great desire to change the strict underlying structures.
Our great worry is the onslaught of the ultra-right, a lot of times better organized than us who do support rights, that supports anti-rights group and are truly pro-life (9). Faced with this scenario, we should organize ourselves better, giving battle to guarantee the rights of women in the local, regional, and global level, aggregating the efforts of all pro-right organizations. We are now committed to the Objectives of Sustainable Development (10), understood as those that satisfy the necessities of the current generation without jeopardizing the capacity of future generations to satisfy their own necessities. This new agenda is based on:
- The unfinished work of the Millennium Development Goals
- Pending commitments (international environmental conventions)
- The emergent topics of the three dimensions of sustainable development: social, economic, and environmental.
We now have 17 objectives of sustainable development and 169 goals (11). These goals mention “universal access to reproductive health” many times. In objective 3 of this list is included guaranteeing, before the year 2030, “universal access to sexual and reproductive health services, including those of family planning, information, and education.” Likewise, objective 5, “obtain gender equality and empower all women and girls”, establishes the goal of “assuring the universal access to sexual and reproductive health and reproductive rights in conformity with the action program of the International Conference on Population and Development, the Action Platform of Beijing”. It cannot be forgotten that the term universal access to sexual and reproductive health includes universal access to abortion and contraception.
Currently, 830 women die every day through preventable maternal causes; of these deaths, 99% occur in developing countries, more than half in fragile environments and in humanitarian contexts (12). 216 million women cannot access modern contraception methods and the majority live in the nine poorest countries in the world and in a cultural environment proper to the decades of the seventies (13). This number only includes women from 15 to 49 years in any marital state, that is to say, the number that takes all women into account is much greater. Achieving the proposed objectives would entail preventing 67 million unwanted pregnancies and reducing maternal deaths by two thirds. We currently have a high, unsatisfied demand for modern contraceptives, with extremely low use of reversible, long term methods (intrauterine devices and subdermal implants) which are the most effect ones with best adherence (14).
There is not a single objective among the 17 Objectives of Sustainable Development where contraception does not have a prominent role: from the first one that refers to ending poverty, going through the fifth one about gender equality, the tenth of inequality reduction among countries and within the same country, until the sixteenth related with peace and justice. If we want to change the world, we should procure universal access to contraception without myths or barriers. We have the moral obligation of achieving the irradiation of extreme poverty and advancing the construction of more equal, just, and happy societies.
In emergency contraception (EC), we are very far from reaching expectations. If in reversible, long-term methods we have low prevalence, in EC the situation gets worse. Not all faculties in the region look at this topic, and where it is looked at, there is no homogeneity in content, not even within the same country. There are still myths about their real action mechanisms. There are countries, like Honduras, where it is prohibited and there is no specific medicine, the same case as in Haiti. Where it is available, access is dismal, particularly among girls, adolescents, youth, migrants, afro-descendent, and indigenous. The multiple barriers for the effective use of emergency contraceptives must be knocked down, and to work toward that we have to destroy myths and erroneous perceptions, taboos and cultural norms; achieve changes in laws and restrictive rules within countries, achieve access without barriers to the EC; work in union with other sectors; train health personnel and the community. It is necessary to transform the attitude of health personal to a service above personal opinion.
Reflecting on what has occurred after the ICPD in Cairo, their Action Program changed how we look at the dynamics of population from an emphasis on demographics to a focus on the people and human rights. The governments agreed that, in this new focus, success was the empowerment of women and the possibility of choice through expanded access to education, health, services, and employment among others. Nonetheless, there have been unequal advances and inequality persists in our region, all the goals were not met, the sexual and reproductive goals continue beyond the reach of many women (15). There is a long road ahead until women and girls of the world can claim their rights and liberty of deciding. Globally, maternal deaths have been reduced, there is more qualified assistance of births, more contraception prevalence, integral sexuality education, and access to SRH services for adolescents are now recognized rights with great advances, and additionally there have been concrete gains in terms of more favorable legal frameworks, particularly in our region; nonetheless, although it’s true that the access condition have improved, the restrictive laws of the region expose the most vulnerable women to insecure abortions.
There are great challenges for governments to recognize SRH and the DSR as integral parts of health systems, there is an ample agenda against women. In that sense, access to SRH is threatened and oppressed, it requires multi-sector mobilization and litigation strategies, investigation and support for the support of women’s rights as a multi-sector agenda.
Looking forward, we must make an effort to work more with youth to advance not only the Action Program of the ICPD, but also all social movements. They are one of the most vulnerable groups, and the biggest catalyzers for change. The young population still faces many challenges, especially women and girls; young girls are in particularly high risk due to lack of friendly and confidential services related with sexual and reproductive health, gender violence, and lack of access to services. In addition, access to abortion must be improved; it is the responsibility of states to guarantee the quality and security of this access. In our region there still exist countries with completely restrictive frameworks.
New technologies facilitate self-care (16), which will allow expansion of universal access, but governments cannot detach themselves from their responsibility. Self-care is expanding in the world and can be strategic for reaching the most vulnerable populations. There are new challenges for the same problems, that require a re-interpretation of the measures necessary to guaranty the DSR of all people, in particular women, girls, and in general, marginalized and vulnerable populations. It is necessary to take into account migrations, climate change, the impact of digital media, the resurgence of hate discourse, oppression, violence, xenophobia, homo/transphobia, and other emergent problems, as SRH should be seen within a framework of justice, not isolated.
We should demand accountability of the 179 governments that participate in the ICPD 25 years ago and the 193 countries that signed the Sustainable Development Objectives. They should reaffirm their commitments and expand their agenda to topics not considered at that time. Our region has given the world an example with the Agreement of Montevideo, that becomes a blueprint for achieving the action plan of the CIPD and we should not allow retreat. This agreement puts people at the center, especially women, and includes the topic of abortion, inviting the state to consider the possibility of legalizing it, which opens the doors for all governments of the world to recognize that women have the right to choose on maternity. This agreement is much more inclusive:
Considering that the gaps in health continue to abound in the region and the average statistics hide the high levels of maternal mortality, of sexually transmitted diseases, of infection by HIV/AIDS, and the unsatisfied demand for contraception in the population that lives in poverty and rural areas, among indigenous communities, and afro-descendants and groups in conditions of vulnerability like women, adolescents and incapacitated people, it is agreed:
33- To promote, protect, and guarantee the health and the sexual and reproductive rights that contribute to the complete fulfillment of people and social justice in a society free of any form of discrimination and violence.
37- Guarantee universal access to quality sexual and reproductive health services, taking into consideration the specific needs of men and women, adolescents and young, LGBT people, older people and people with incapacity, paying particular attention to people in a condition of vulnerability and people who live in rural and remote zone, promoting citizen participation in the completing of these commitments.
42- To guarantee, in cases in which abortion is legal or decriminalized in the national legislation, the existence of safe and quality abortion for non-desired or non-accepted pregnancies and instigate the other States to consider the possibility of modifying public laws, norms, strategies, and public policy on the voluntary interruption of pregnancy to save the life and health of pregnant adolescent women, improving their quality of life and decreasing the number of abortions (17).
35
Thị Tuyết Vân, Phan. "Education as a breaker of poverty: a critical perspective." Papers of Social Pedagogy 7, no. 2 (January 28, 2018): 30–41. http://dx.doi.org/10.5604/01.3001.0010.8049.
Full textAbstract:
This paper aims to portray the overall picture of poverty in the world and mentions the key solution to overcome poverty from a critical perspective. The data and figures were quoted from a number of researchers and organizations in the field of poverty around the world. Simultaneously, the information strengthens the correlations among poverty and lack of education. Only appropriate philosophies of education can improve the country’s socio-economic conditions and contribute to effective solutions to worldwide poverty. In the 21st century, despite the rapid development of science and technology with a series of inventions brought into the world to make life more comfortable, human poverty remains a global problem, especially in developing countries. Poverty, according to Lister (2004), is reflected by the state of “low living standards and/or inability to participate fully in society because of lack of material resources” (p.7). The impact and serious consequences of poverty on multiple aspects of human life have been realized by different organizations and researchers from different contexts (Fraser, 2000; Lister, 2004; Lipman, 2004; Lister, 2008). This paper will indicate some of the concepts and research results on poverty. Figures and causes of poverty, and some solutions from education as a key breaker to poverty will also be discussed. Creating a universal definition of poverty is not simple (Nyasulu, 2010). There are conflicts among different groups of people defining poverty, based on different views and fields. Some writers, according to Nyasulu, tend to connect poverty with social problems, while others focus on political or other causes. However, the reality of poverty needs to be considered from different sides and ways; for that reason, the diversity of definitions assigned to poverty can help form the basis on which interventions are drawn (Ife and Tesoriero, 2006). For instance, in dealing with poverty issues, it is essential to intervene politically; economic intervention is very necessary to any definition of this matter. A political definition necessitates political interventions in dealing with poverty, and economic definitions inevitably lead to economic interventions. Similarly, Księżopolski (1999) uses several models to show the perspectives on poverty as marginal, motivation and socialist. These models look at poverty and solutions from different angles. Socialists, for example, emphasize the responsibilities of social organization. The state manages the micro levels and distributes the shares of national gross resources, at the same time fighting to maintain the narrow gap among classes. In his book, Księżopolski (1999) also emphasizes the changes and new values of charity funds or financial aid from churches or organizations recognized by the Poor Law. Speaking specifically, in the new stages poverty has been recognized differently, and support is also delivered in limited categories related to more specific and visible objectives, with the aim of helping the poor change their own status for sustainable improvement. Three ways of categorizing the poor and locating them in the appropriate places are (1) the powerless, (2) who is willing to work and (3) who is dodging work. Basically, poverty is determined not to belong to any specific cultures or politics; otherwise, it refers to the situation in which people’s earnings cannot support their minimum living standard (Rowntree, 1910). Human living standard is defined in Alfredsson & Eide’s work (1999) as follows: “Everyone has the right to a standard of living adequate for the health and well-being of himself and his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control.” (p. 524). In addition, poverty is measured by Global Hunger Index (GHI), which is calculated by the International Food Policy Institute (IFPRI) every year. The GHI measures hunger not only globally, but also by country and region. To have the figures multi-dimensionally, the GHI is based on three indicators: 1. Undernourishment: the proportion of the undernourished as a percentage of the population (reflecting the share of the population with insufficient calorie intake). 2. Child underweight: the proportion of children under age 5 who are underweight (low weight for their age, reflecting wasting, stunted growth or both), which is one indicator of child under-nutrition. 3. Child mortality: the mortality rate of children under 5 (partially reflecting the fatal synergy of inadequate dietary intake and unhealthy environments). Apart from the individual aspects and the above measurement based on nutrition, which help partly imagine poverty, poverty is more complicated, not just being closely related to human physical life but badly affecting spiritual life. According to Jones and Novak (1999 cited in Lister, 2008), poverty not only characterizes the precarious financial situation but also makes people self-deprecating. Poverty turns itself into the roots of shame, guilt, humiliation and resistance. It leads the poor to the end of the road, and they will never call for help except in the worst situations. Education can help people escape poverty or make it worse. In fact, inequality in education has stolen opportunity for fighting poverty from people in many places around the world, in both developed and developing countries (Lipman, 2004). Lipman confirms: “Students need an education that instills a sense of hope and possibility that they can make a difference in their own family, school, and community and in the broader national and global community while it prepare them for multiple life choices.” (p.181) Bradshaw (2005) synthesizes five main causes of poverty: (1) individual deficiencies, (2) cultural belief systems that support subcultures of poverty, (3) economic, political and social distortions or discrimination, (4) geographical disparities and (5) cumulative and cyclical interdependencies. The researcher suggests the most appropriate solution corresponding with each cause. This reflects the diverse causes of poverty; otherwise, poverty easily happens because of social and political issues. From the literature review, it can be said that poverty comes from complex causes and reasons, and is not a problem of any single individual or country. Poverty has brought about serious consequences and needs to be dealt with by many methods and collective effort of many countries and organizations. This paper will focus on representing some alarming figures on poverty, problems of poverty and then the education as a key breaker to poverty. According to a statistics in 2012 on poverty from the United Nations Development Program (UNDP), nearly half the world's population lives below the poverty line, of which is less than $1.25 a day . In a statistics in 2015, of every 1,000 children, 93 do not live to age 5 , and about 448 million babies are stillborn each year . Poverty in the world is happening alarmingly. According to a World Bank study, the risk of poverty continues to increase on a global scale and, of the 2009 slowdown in economic growth, which led to higher prices for fuel and food, further pushed 53 million people into poverty in addition to almost 155 million in 2008. From 1990 to 2009, the average GHI in the world decreased by nearly one-fifth. Many countries had success in solving the problem of child nutrition; however, the mortality rate of children under 5 and the proportion of undernourished people are still high. From 2011 to 2013, the number of hungry people in the world was estimated at 842 million, down 17 percent compared with the period 1990 to 1992, according to a report released by the Food and Agriculture Organization of the United Nations (FAO) titled “The State of Food Insecurity in the World 2013” . Although poverty in some African countries had been improved in this stage, sub-Saharan Africa still maintained an area with high the highest percentage of hungry people in the world. The consequences and big problems resulting from poverty are terrible in the extreme. The following will illustrate the overall picture under the issues of health, unemployment, education and society and politics ➢ Health issues: According a report by Manos Unidas, a non- government organization (NGO) in Spain , poverty kills more than 30,000 children under age 5 worldwide every day, and 11 million children die each year because of poverty. Currently, 42 million people are living with HIV, 39 million of them in developing countries. The Manos Unidas report also shows that 15 million children globally have been orphaned because of AIDS. Scientists predict that by 2020 a number of African countries will have lost a quarter of their population to this disease. Simultaneously, chronic drought and lack of clean water have not only hindered economic development but also caused disastrous consequences of serious diseases across Africa. In fact, only 58 percent of Africans have access to clean water; as a result, the average life expectancy in Africa is the lowest in the world, just 45 years old (Bui, 2010). ➢ Unemployment issues: According to the United Nations, the youth unemployment rate in Africa is the highest in the world: 25.6 percent in the Middle East and North Africa. Unemployment with growth rates of 10 percent a year is one of the key issues causing poverty in African and negatively affecting programs and development plans. Total African debt amounts to $425 billion (Bui, 2010). In addition, joblessness caused by the global economic downturn pushed more than 140 million people in Asia into extreme poverty in 2009, the International Labor Organization (ILO) warned in a report titled The Fallout in Asia, prepared for the High-Level Regional Forum on Responding to the Economic Crisis in Asia and the Pacific, in Manila from Feb. 18 to 20, 2009 . Surprisingly, this situation also happens in developed countries. About 12.5 million people in the United Kingdom (accounting for 20 percent of the population) are living below the poverty line, and in 2005, 35 million people in the United States could not live without charity. At present, 620 million people in Asia are living on less than $1 per day; half of them are in India and China, two countries whose economies are considered to be growing. ➢ Education issues: Going to school is one of the basic needs of human beings, but poor people cannot achieve it. Globally, 130 million children do not attend school, 55 percent of them girls, and 82 million children have lost their childhoods by marrying too soon (Bui, 2010). Similarly, two-thirds of the 759 million illiterate people in total are women. Specifically, the illiteracy rate in Africa keeps increasing, accounting for about 40 percent of the African population at age 15 and over 50 percent of women at age 25. The number of illiterate people in the six countries with the highest number of illiterate people in the world - China, India, Indonesia, Brazil, Bangladesh and Egypt - reached 510 million, accounting for 70 percent of total global illiteracy. ➢ Social and political issues: Poverty leads to a number of social problems and instability in political systems of countries around the world. Actually, 246 million children are underage labors, including 72 million under age 10. Simultaneously, according to an estimate by the United Nations (UN), about 100 million children worldwide are living on the streets. For years, Africa has suffered a chronic refugee problem, with more than 7 million refugees currently and over 200 million people without homes because of a series of internal conflicts and civil wars. Poverty threatens stability and development; it also directly influences human development. Solving the problems caused by poverty takes a lot of time and resources, but afterward they can focus on developing their societies. Poverty has become a global issue with political significance of particular importance. It is a potential cause of political and social instability, even leading to violence and war not only within a country, but also in the whole world. Poverty and injustice together have raised fierce conflicts in international relations; if these conflicts are not satisfactorily resolved by peaceful means, war will inevitably break out. Obviously, poverty plus lack of understanding lead to disastrous consequences such as population growth, depletion of water resources, energy scarcity, pollution, food shortages and serious diseases (especially HIV/AIDS), which are not easy to control; simultaneously, poverty plus injustice will cause international crimes such as terrorism, drug and human trafficking, and money laundering. Among recognizable four issues above which reflected the serious consequences of poverty, the third ones, education, if being prioritized in intervention over other issues in the fighting against poverty is believed to bring more effectiveness in resolving the problems from the roots. In fact, human being with the possibility of being educated resulted from their distinctive linguistic ability makes them differential from other beings species on the earth (Barrow and Woods 2006, p.22). With education, human can be aware and more critical with their situations, they are aimed with abilities to deal with social problems as well as adversity for a better life; however, inequality in education has stolen opportunity for fighting poverty from unprivileged people (Lipman, 2004). An appropriate education can help increase chances for human to deal with all of the issues related to poverty; simultaneously it can narrow the unexpected side-effect of making poverty worse. A number of philosophies from ancient Greek to contemporary era focus on the aspect of education with their own epistemology, for example, idealism of Plato encouraged students to be truth seekers and pragmatism of Dewey enhanced the individual needs of students (Gutex, 1997). Education, more later on, especially critical pedagogy focuses on developing people independently and critically which is essential for poor people to have ability of being aware of what they are facing and then to have equivalent solutions for their problems. In other words, critical pedagogy helps people emancipate themselves and from that they can contribute to transform the situations or society they live in. In this sense, in his most influential work titled “Pedagogy of the Oppressed” (1972), Paulo Freire carried out his critical pedagogy by building up a community network of peasants- the marginalized and unprivileged party in his context, aiming at awakening their awareness about who they are and their roles in society at that time. To do so, he involved the peasants into a problem-posing education which was different from the traditional model of banking education with the technique of dialogue. Dialogue wasn’t just simply for people to learn about each other; but it was for figuring out the same voice; more importantly, for cooperation to build a social network for changing society. The peasants in such an educational community would be relieved from stressfulness and the feeling of being outsiders when all of them could discuss and exchange ideas with each other about the issues from their “praxis”. Praxis which was derived from what people act and linked to some values in their social lives, was defined by Freire as “reflection and action upon the world in order to transform it” (p.50). Critical pedagogy dialogical approach in Pedagogy of the Oppressed of Freire seems to be one of the helpful ways for solving poverty for its close connection to the nature of equality. It doesn’t require any highly intellectual teachers who lead the process; instead, everything happens naturally and the answers are identified by the emancipation of the learners themselves. It can be said that the effectiveness of this pedagogy for people to escape poverty comes from its direct impact on human critical consciousness; from that, learners would be fully aware of their current situations and self- figure out the appropriate solutions for their own. In addition, equality which was one of the essences making learners in critical pedagogy intellectually emancipate was reflected via the work titled “The Ignorant Schoolmaster” by Jacques Rancière (1991). In this work, the teacher and students seemed to be equal in terms of the knowledge. The explicator- teacher Joseph Jacotot employed the interrogative approach which was discovered to be universal because “he taught what he didn’t know”. Obviously, this teacher taught French to Flemish students while he couldn’t speak his students’ language. The ignorance which was not used in the literal sense but a metaphor showed that learners can absolutely realize their capacity for self-emancipation without the traditional teaching of transmission of knowledge from teachers. Regarding this, Rancière (1991, p.17) stated “that every common person might conceive his human dignity, take the measure of his intellectual capacity, and decide how to use it”. This education is so meaningful for poor people by being able to evoking their courageousness to develop themselves when they always try to stay away from the community due the fact that poverty is the roots of shame, guilt, humiliation and resistance (Novak, 1999). The contribution of critical pedagogy to solving poverty by changing the consciousness of people from their immanence is summarized by Freire’s argument in his “Pedagogy of Indignation” as follows: “It is certain that men and women can change the world for the better, can make it less unjust, but they can do so from starting point of concrete reality they “come upon” in their generation. They cannot do it on the basis of reveries, false dreams, or pure illusion”. (p.31) To sum up, education could be an extremely helpful way of solving poverty regarding the possibilities from the applications of studies in critical pedagogy for educational and social issues. Therefore, among the world issues, poverty could be possibly resolved in accordance with the indigenous people’s understanding of their praxis, their actions, cognitive transformation, and the solutions with emancipation in terms of the following keynotes: First, because the poor are powerless, they usually fall into the states of self-deprecation, shame, guilt and humiliation, as previously mentioned. In other words, they usually build a barrier between themselves and society, or they resist changing their status. Therefore, approaching them is not a simple matter; it requires much time and the contributions of psychologists and sociologists in learning about their aspirations, as well as evoking and nurturing the will and capacities of individuals, then providing people with chances to carry out their own potential for overcoming obstacles in life. Second, poverty happens easily in remote areas not endowed with favorable conditions for development. People there haven’t had a lot of access to modern civilization; nor do they earn a lot of money for a better life. Low literacy, together with the lack of healthy forms of entertainment and despair about life without exit, easily lead people into drug addiction, gambling and alcoholism. In other words, the vicious circle of poverty and powerlessness usually leads the poor to a dead end. Above all, they are lonely and need to be listened to, shared with and led to escape from their states. Community meetings for exchanging ideas, communicating and immediate intervening, along with appropriate forms of entertainment, should be held frequently to meet the expectations of the poor, direct them to appropriate jobs and, step by step, change their favorite habits of entertainment. Last but not least, poor people should be encouraged to participate in social forums where they can both raise their voices about their situations and make valuable suggestions for dealing with their poverty. Children from poor families should be completely exempted from school fees to encourage them to go to school, and curriculum should also focus on raising community awareness of poverty issues through extracurricular and volunteer activities, such as meeting and talking with the community, helping poor people with odd jobs, or simply spending time listening to them. Not a matter of any individual country, poverty has become a major problem, a threat to the survival, stability and development of the world and humanity. Globalization has become a bridge linking countries; for that reason, instability in any country can directly and deeply affect the stability of others. The international community has been joining hands to solve poverty; many anti-poverty organizations, including FAO (Food and Agriculture Organization), BecA (the Biosciences eastern and central Africa), UN-REDD (the United Nations Programme on Reducing Emissions from Deforestation and Forest Degradation), BRAC (Building Resources Across Communities), UNDP (United Nations Development Programme), WHO (World Health Organization) and Manos Unidas, operate both regionally and internationally, making some achievements by reducing the number of hungry people, estimated 842 million in the period 1990 to 1992, by 17 percent in 2011- to 2013 . The diverse methods used to deal with poverty have invested billions of dollars in education, health and healing. The Millennium Development Goals set by UNDP put forward eight solutions for addressing issues related to poverty holistically: 1) Eradicate extreme poverty and hunger. 2) Achieve universal primary education. 3) Promote gender equality and empower women. 4) Reduce child mortality. 5) Improve maternal health. 6) Combat HIV/AIDS, malaria and other diseases. 7) Ensure environmental sustainability. 8) Develop a global partnership for development. Although all of the mentioned solutions carried out directly by countries and organizations not only focus on the roots of poverty but break its circle, it is recognized that the solutions do not emphasize the role of the poor themselves which a critical pedagogy does. More than anyone, the poor should have a sense of their poverty so that they can become responsible for their own fate and actively fight poverty instead of waiting for help. It is not different from the cores of critical theory in solving educational and political issues that the poor should be aware and conscious about their situation and reflected context. It is required a critical transformation from their own praxis which would allow them to go through a process of learning, sharing, solving problems, and leading to social movements. This is similar to the method of giving poor people fish hooks rather than giving them fish. The government and people of any country understand better than anyone else clearly the strengths and characteristics of their homelands. It follows that they can efficiently contribute to causing poverty, preventing the return of poverty, and solving consequences of the poverty in their countries by many ways, especially a critical pedagogy; and indirectly narrow the scale of poverty in the world. In a word, the wars against poverty take time, money, energy and human resources, and they are absolutely not simple to end. Again, the poor and the challenged should be educated to be fully aware of their situation to that they can overcome poverty themselves. They need to be respected and receive sharing from the community. All forms of discrimination should be condemned and excluded from human society. When whole communities join hands in solving this universal problem, the endless circle of poverty can be addressed definitely someday. More importantly, every country should be responsible for finding appropriate ways to overcome poverty before receiving supports from other countries as well as the poor self-conscious responsibilities about themselves before receiving supports from the others, but the methods leading them to emancipation for their own transformation and later the social change.
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Hoit, G., C. Hinkewich, J. Tiao, V. Porgo, L. Moore, L. Moore, J. Tiao, et al. "Trauma Association of Canada (TAC) Annual Scientific Meeting. The Westin Whistler Resort & Spa, Whistler, BC, Thursday, Apr. 11 to Saturday, Apr. 13, 2013Testing the reliability of tools for pediatric trauma teamwork evaluation in a North American high-resource simulation settingThe association of etomidate with mortality in trauma patientsDefinition of isolated hip fractures as an exclusion criterion in trauma centre performance evaluations: a systematic reviewEstimation of acute care hospitalization costs for trauma hospital performance evaluation: a systematic reviewHospital length of stay following admission for traumatic injury in Canada: a multicentre cohort studyPredictors of hospital length of stay following traumatic injury: a multicentre cohort studyInfluence of the heterogeneity in definitions of an isolated hip fracture used as an exclusion criterion in trauma centre performance evaluations: a multicentre cohort studyPediatric trauma, advocacy skills and medical studentsCompliance with the prescribed packed red blood cell, fresh frozen plasma and platelet ratio for the trauma transfusion pathway at a level 1 trauma centreEarly fixed-wing aircraft activation for major trauma in remote areasDevelopment of a national, multi-disciplinary trauma crisis resource management curriculum: results from the pilot courseThe management of blunt hepatic trauma in the age of angioembolization: a single centre experienceEarly predictors of in-hospital mortality in adult trauma patientsThe impact of open tibial fracture on health service utilization in the year preceding and following injuryA systematic review and meta-analysis of the efficacy of red blood cell transfusion in the trauma populationSources of support for paramedics managing work-related stress in a Canadian EMS service responding to multisystem trauma patientsAnalysis of prehospital treatment of pain in the multisystem trauma patient at a community level 2 trauma centreIncreased mortality associated with placement of central lines during trauma resuscitationChronic pain after serious injury — identifying high risk patientsEpidemiology of in-hospital trauma deaths in a Brazilian university teaching hospitalIncreased suicidality following major trauma: a population-based studyDevelopment of a population-wide record linkage system to support trauma researchInduction of hmgb1 by increased gut permeability mediates acute lung injury in a hemorrhagic shock and resuscitation mouse modelPatients who sustain gunshot pelvic fractures are at increased risk for deep abscess formation: aggravated by rectal injuryAre we transfusing more with conservative management of isolated blunt splenic injury? A retrospective studyMotorcycle clothesline injury prevention: Experimental test of a protective deviceA prospective analysis of compliance with a massive transfusion protocol - activation alone is not enoughAn evaluation of diagnostic modalities in penetrating injuries to the cardiac box: Is there a role for routine echocardiography in the setting of negative pericardial FAST?Achievement of pediatric national quality indicators — an institutional report cardProcess mapping trauma care in 2 regional health authorities in British Columbia: a tool to assist trauma sys tem design and evaluationPatient safety checklist for emergency intubation: a systematic reviewA standardized flow sheet improves pediatric trauma documentationMassive transfusion in pediatric trauma: a 5-year retrospective reviewIs more better: Does a more intensive physiotherapy program result in accelerated recovery for trauma patients?Trauma care: not just for surgeons. Initial impact of implementing a dedicated multidisciplinary trauma team on severely injured patientsThe role of postmortem autopsy in modern trauma care: Do we still need them?Prototype cervical spine traction device for reduction stabilization and transport of nondistraction type cervical spine injuriesGoing beyond organ preservation: a 12-year review of the beneficial effects of a nonoperative management algorithm for splenic traumaAssessing the construct validity of a global disability measure in adult trauma registry patientsThe mactrauma TTL assessment tool: developing a novel tool for assessing performance of trauma traineesA quality improvement approach to developing a standardized reporting format of ct findings in blunt splenic injuriesOutcomes in geriatric trauma: what really mattersFresh whole blood is not better than component therapy (FFP:RBC) in hemorrhagic shock: a thromboelastometric study in a small animal modelFactors affecting mortality of chest trauma patients: a prospective studyLong-term pain prevalence and health related quality of life outcomes for patients enrolled in a ketamine versus morphine for prehospital traumatic pain randomized controlled trialDescribing pain following trauma: predictors of persistent pain and pain prevalenceManagement strategies for hemorrhage due to pelvic trauma: a survey of Canadian general surgeonsMajor trauma follow-up clinic: Patient perception of recovery following severe traumaLost opportunities to enhance trauma practice: culture of interprofessional education and sharing among emergency staffPrehospital airway management in major trauma and traumatic brain injury by critical care paramedicsImproving patient selection for angiography and identifying risk of rebleeding after angioembolization in the nonoperative management of high grade splenic injuriesFactors predicting the need for angioembolization in solid organ injuryProthrombin complex concentrates use in traumatic brain injury patients on oral anticoagulants is effective despite underutilizationThe right treatment at the right time in the right place: early results and associations from the introduction of an all-inclusive provincial trauma care systemA multicentre study of patient experiences with acute and postacute injury carePopulation burden of major trauma: Has introduction of an organized trauma system made a difference?Long-term functional and return to work outcomes following blunt major trauma in Victoria, AustraliaSurgical dilemma in major burns victim: heterotopic ossification of the tempromandibular jointWhich radiological modality to choose in a unique penetrating neck injury: a differing opinionThe Advanced Trauma Life Support (ATLS) program in CanadaThe Rural Trauma Team Development Course (RTTDC) in Pakistan: Is there a role?Novel deployment of BC mobile medical unit for coverage of BMX world cup sporting eventIncidence and prevalence of intra-abdominal hypertension and abdominal compartment syndrome in critically ill adults: a systematic review and meta-analysisRisk factors for intra-abdominal hypertension and abdominal compartment syndrome in critically ill or injured adults: a systematic review and meta-analysisA comparison of quality improvement practices at adult and pediatric trauma centresInternational trauma centre survey to evaluate content validity, usability and feasibility of quality indicatorsLong-term functional recovery following decompressive craniectomy for severe traumatic brain injuryMorbidity and mortality associated with free falls from a height among teenage patients: a 5-year review from a level 1 trauma centreA comparison of adverse events between trauma patients and general surgery patients in a level 1 trauma centreProcoagulation, anticoagulation and fibrinolysis in severely bleeding trauma patients: a laboratorial characterization of the early trauma coagulopathyThe use of mobile technology to facilitate surveillance and improve injury outcome in sport and physical activityIntegrated knowledge translation for injury quality improvement: a partnership between researchers and knowledge usersThe impact of a prevention project in trauma with young and their learningIntraosseus vascular access in adult trauma patients: a systematic reviewThematic analysis of patient reported experiences with acute and post-acute injury careAn evaluation of a world health organization trauma care checklist quality improvement pilot programProspective validation of the modified pediatric trauma triage toolThe 16-year evolution of a Canadian level 1 trauma centre: growing up, growing out, and the impact of a booming economyA 20-year review of trauma related literature: What have we done and where are we going?Management of traumatic flail chest: a systematic review of the literatureOperative versus nonoperative management of flail chestEmergency department performance of a clinically indicated and technically successful emergency department thoracotomy and pericardiotomy with minimal equipment in a New Zealand institution without specialized surgical backupBritish Columbia’s mobile medical unit — an emergency health care support resourceRoutine versus ad hoc screening for acute stress: Who would benefit and what are the opportunities for trauma care?A geographical analysis of the Early Development Instrument (EDI) and childhood injuryDevelopment of a pediatric spinal cord injury nursing course“Kids die in driveways” — an injury prevention campaignEpidemiology of traumatic spine injuries in childrenA collaborative approach to reducing injuries in New Brunswick: acute care and injury preventionImpact of changes to a provincial field trauma triage tool in New BrunswickEnsuring quality of field trauma triage in New BrunswickBenefits of a provincial trauma transfer referral system: beyond the numbersThe field trauma triage landscape in New BrunswickImpact of the Rural Trauma Team Development Course (RTTDC) on trauma transfer intervals in a provincial, inclusive trauma systemTrauma and stress: a critical dynamics study of burnout in trauma centre healthcare professionalsUltrasound-guided pediatric forearm fracture reduction with sedation in the emergency departmentBlock first, opiates later? The use of the fascia iliaca block for patients with hip fractures in the emergency department: a systematic reviewRural trauma systems — demographic and survival analysis of remote traumas transferred from northern QuebecSimulation in trauma ultrasound trainingIncidence of clinically significant intra-abdominal injuries in stable blunt trauma patientsWake up: head injury management around the clockDamage control laparotomy for combat casualties in forward surgical facilitiesDetection of soft tissue foreign bodies by nurse practitioner performed ultrasoundAntihypertensive medications and walking devices are associated with falls from standingThe transfer process: perspectives of transferring physiciansDevelopment of a rodent model for the study of abdominal compartment syndromeClinical efficacy of routine repeat head computed tomography in pediatric traumatic brain injuryEarly warning scores (EWS) in trauma: assessing the “effectiveness” of interventions by a rural ground transport service in the interior of British ColumbiaAccuracy of trauma patient transfer documentation in BCPostoperative echocardiogram after penetrating cardiac injuries: a retrospective studyLoss to follow-up in trauma studies comparing operative methods: a systematic reviewWhat matters where and to whom: a survey of experts on the Canadian pediatric trauma systemA quality initiative to enhance pain management for trauma patients: baseline attitudes of practitionersComparison of rotational thromboelastometry (ROTEM) values in massive and nonmassive transfusion patientsMild traumatic brain injury defined by GCS: Is it really mild?The CMAC videolaryngosocpe is superior to the glidescope for the intubation of trauma patients: a prospective analysisInjury patterns and outcome of urban versus suburban major traumaA cost-effective, readily accessible technique for progressive abdominal closureEvolution and impact of the use of pan-CT scan in a tertiary urban trauma centre: a 4-year auditAdditional and repeated CT scan in interfacilities trauma transfers: room for standardizationPediatric trauma in situ simulation facilitates identification and resolution of system issuesHospital code orange plan: there’s an app for thatDiaphragmatic rupture from blunt trauma: an NTDB studyEarly closure of open abdomen using component separation techniqueSurgical fixation versus nonoperative management of flail chest: a meta-analysisIntegration of intraoperative angiography as part of damage control surgery in major traumaMass casualty preparedness of regional trauma systems: recommendations for an evaluative frameworkDiagnostic peritoneal aspirate: An obsolete diagnostic modality?Blunt hollow viscus injury: the frequency and consequences of delayed diagnosis in the era of selective nonoperative managementEnding “double jeopardy:” the diagnostic impact of cardiac ultrasound and chest radiography on operative sequencing in penetrating thoracoabdominal traumaAre trauma patients with hyperfibrinolysis diagnosed by rotem salvageable?The risk of cardiac injury after penetrating thoracic trauma: Which is the better predictor, hemodynamic status or pericardial window?The online Concussion Awareness Training Toolkit for health practitioners (CATT): a new resource for recognizing, treating, and managing concussionThe prevention of concussion and brain injury in child and youth team sportsRandomized controlled trial of an early rehabilitation intervention to improve return to work Rates following road traumaPhone call follow-upPericardiocentesis in trauma: a systematic review." Canadian Journal of Surgery 56, no. 2 Suppl (April 2013): S1—S42. http://dx.doi.org/10.1503/cjs.005813.
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Andrews, Annie L., Xzavier Killings, Elizabeth R. Oddo, Kelsey A. B. Gastineau, and Ashley B. Hink. "Pediatric Firearm Injury Mortality Epidemiology." Pediatrics 149, no. 3 (February 28, 2022). http://dx.doi.org/10.1542/peds.2021-052739.
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Firearm injury is a leading and preventable cause of death for youth in the United States. The Centers for Disease Control and Prevention web-based injury statistics query and reporting system was queried to examine changes in firearm injury mortality among youth aged 0 to 19 from 2001 to 2019. This includes assessment of overall mortality rates, mortality rates based on intent and race/ethnicity, and the proportion of deaths due to homicide, suicide, and unintentional shootings among different age groups. Regression analysis was used to identify significant differences in mortality rate over time between Black and White youth. Deaths due to firearm injury were compared with deaths due to motor vehicle traffic collisions. In 2019, firearm injuries surpassed motor vehicle collisions to become the leading cause of death for youth aged 0 to 19 years in the United States. Homicide is the most common intent across all age groups, but suicide represents a large proportion of firearm deaths in 10- to 19-year-old youth. In 2019, Black youth had a firearm mortality rate 4.3 times higher than that of White youth and a firearm homicide rate over 14 times higher than that of White youth. For each additional year after 2013, the mortality rate for Black youth increased by 0.55 deaths per 100 000 compared with White youth (time by race interaction effect P < .0001). These data indicate the growing burden of firearm injuries on child mortality and widening racial inequities with Black youth disproportionately affected by firearm violence. This public health crisis demands physician advocacy to reduce these preventable deaths among youth.
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Ritte, Rebecca, Jane Freemantle, Fiona Mensah, and Mary Sullivan. "Visibility in health statistics: a population data linkage study more accurately identifying Aboriginal and Torres Strait Islander Births in Victoria, Australia, 1988-2008." International Journal of Population Data Science 1, no. 1 (April 18, 2017). http://dx.doi.org/10.23889/ijpds.v1i1.234.
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ABSTRACTObjectivesAn accurate picture of infant mortality informs society of its social progress. It is a key indicator of how effective public health policies and programs are in caring for the most vulnerable in our society. Currently, at the population level, Victorian data on Aboriginal and Torres Strait Islander births and deaths are excluded from Australian vital statistics. The Victorian Aboriginal Mortality Study aimed to provide a more complete and accurate population profile of Aboriginal births in Victoria using population data linkage of Victorian statutory and administrative datasets. ApproachTwo population statutory datasets, the Victorian Perinatal Data Collection (VPDC) and Victorian Registry of Births, Deaths and Marriages (RBDM) were linked, using probabilistic matching with mother’s name and surname, child’s date of birth and sex, for all births that occurred in Victoria between 1988 and 2008, inclusive to more accurately ascertain births to mothers and fathers who identified as Aboriginal and/or Torres Strait Islander (hereafter respectfully ‘Aboriginal’).ResultsOver 1.34 million files, reporting births between 1988 and 2008, were linked. However, due to data integrity issues for Indigenous identification prior to 1998, the years between 1999 and 2008 only were used in the development of the birth cohort. Matching the VPDC with the RBDM resulted in identifying an additional 4,333 live births where mother and/or father identified as Aboriginal, representing an 87% increase in the number of births previously recorded as Aboriginal by the VPDC*. The largest increase (186%) in the number of births where mother and/or father identified as Aboriginal births was observed within the Victorian metropolitan areas. ConclusionThis is the first time that the VPDC and RBDM birth data were linked in Victoria. The matched birth information established a more complete population profile of Aboriginal and/or Torres Strait Islander births. These data will provide a more accurate baseline to enhance the Victorian and Australian governments’ ability to plan services, allocate resources and evaluate funded activities aimed at eliminating disparity experienced by Aboriginal and/or Torres Strait Islander peoples. Importantly, it has established a more accurate denominator from which to calculate Aboriginal infant mortality rates for Victoria, Australia.
*Until 2009, the mother’s Indigenous identification only was recorded in the VPDC
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Leske, Stuart, Andrew Garrett, and Jeremy Dwyer. "It Is Official, They Are Different – Discrepancies Between National Statistical Agency and Register-Based State Suicide Mortality Statistics in Australia." Crisis, November 29, 2022. http://dx.doi.org/10.1027/0227-5910/a000889.
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Abstract. Background: In Australia, most state-based suicide registers now publicly release suicide mortality data alongside those the Australian Bureau of Statistics (ABS) releases annually. Aims: This study compared ABS’s recorded suicides with three state-based suicide registers (Queensland, Victoria, and Tasmania). We compared their case definitions and coding approaches to assist users in choosing the most suitable data source and interpret differences between sources. Method: We collated the number of suicides by year of registration and occurrence (2006–2020). We compared the scope and coding of suicides between ABS and the registers using publicly available suicide reports and data releases. Results: The ABS’s annual suicide numbers are similar to (and in Tasmania exceed) the numbers reported by state-based registers. The ABS year of occurrence data diverges substantially from the Victoria and Queensland register data in 2020, perhaps attributable to ongoing ABS revision processes. Minimal overlap exists between the case definitions and coding practices of the ABS and registers. Limitations: This is not an individual-level concordance study. Conclusion: Despite different case definitions and coding practices, the two sources produced largely consistent data. They have complementary strengths: timeliness (suicide register data) and enabling cross-jurisdictional comparisons (ABS data).
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Paratz, E., L. Rowsell, J. Ball, D. Zentner, S. Parsons, N. Morgan, T. Thompson, et al. "Economic impact of sudden cardiac arrest." European Heart Journal 41, Supplement_2 (November 1, 2020). http://dx.doi.org/10.1093/ehjci/ehaa946.3542.
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Abstract Background Each year, there are approximately 5,000 out-of-hospital cardiac arrests (OHCAs) in the state of Victoria, Australia (population 6.4 million, state healthcare budget AUD$2.9 billion / €1.8billion). Mortality from OHCA approaches ninety percent. High mortality rates and survivors not returning to work is likely to have an adverse effect on the Victorian economy but this has not been previously investigated. Purpose To model the economic impact of OHCA mortality and survivors not returning to work. Methods Data on all OHCAs transported by Ambulance Victoria from July 2017- June 2018 in Victoria, Australia was collected, including age, gender, survival to hospital, survival to discharge, and survival to 12 months. Cases were excluded if arrest was precipitated by trauma, exsanguination, overdose, terminal illness, hanging, SIDS, electrocution, sepsis, respiratory causes, drowning, or neurological causes. Pre-arrest employment status of patients was modelled using the Australian Bureau of Statistics Economic Security dataset, which provides contemporary employment rates for gender-matched five-year cohorts for Australians aged 15–79 years. For survivors to 12 months, pre-arrest and post-arrest work status were confirmed. Economic impact was then calculated to a five year horizon utilizing a Markov model with probabilistic sensitivity analysis. Results 4,934 arrests meeting the inclusion criteria were transported by Ambulance Victoria in twelve months, of whom 4,639 were determined to be cardiac arrests without any exclusion criteria as a precipitant. 695 patients survived to hospital (15.0%), and 325 to discharge (7.0%). At 12 months, 303 patients were alive (6.5% of overall cases, 93.2% of those discharged from hospital). Economic modelling of age and gender-matched data indicated that 1516 patients (35%) would have been employed pre-cardiac arrest, but only 216 survivors (4.7%) would be employed at five years post-arrest. Using Markov modelling incorporating estimated earnings and the pre-determined value of a statistical life, the annual economic burden of cardiac arrest approximated AUD$4 billion (€2.5 billion) at a five-year horizon. Conclusion The annual economic impact of cardiac arrest in Victoria, Australia is approximately AUD$4 billion (€2.5 billion) in a five-year horizon. As the annual Victorian state budget for all healthcare is AUD$2.93 billion (€1.8 billion), our data suggests that the economic impact of cardiac arrest is under-appreciated. Therefore, research in this area and providing state-of-the-art care for all cardiac arrest patients should be a healthcare priority. Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): NHMRC/NHF Postgraduate Scholarship, RACP JJ Billings Scholarship
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Tilstra, Andrea M., Iliya Gutin, Nathan T. Dollar, Richard G. Rogers, and Robert A. Hummer. "“Outside the Skin”: The Persistence of Black–White Disparities in U.S. Early-Life Mortality." Demography, November 11, 2022. http://dx.doi.org/10.1215/00703370-10346963.
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Abstract Research on Black–White disparities in mortality emphasizes the cumulative pathways through which racism gets “under the skin” to affect health. Yet this framing is less applicable in early life, when death is primarily attributable to external causes rather than cumulative, biological processes. We use mortality data from the National Vital Statistics System Multiple Cause of Death files and population counts from the Surveillance, Epidemiology, and End Result Program to analyze 705,801 deaths among Black and White males and females, ages 15–24. We estimate age-standardized death rates and single-decrement life tables to show how all-cause and cause-specific mortality changed from 1990 to 2016 by race and sex. Despite overall declines in early-life mortality, Black–White disparities remain unchanged across several causes—especially homicide, for which mortality is nearly 20 times as high among Black as among White males. Suicide and drug-related deaths are higher among White youth during this period, yet their impact on life expectancy at birth is less than half that of homicide among Black youth. Critically, early-life disparities are driven by preventable causes of death whose impact occurs “outside the skin,” reflecting racial differences in social exposures and experiences that prove harmful for both Black and White adolescents and young adults.
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Ritte, Rebecca, Jane Freemantle, Fiona Mensah, Mary Sullivan, Sue Chang, and Anne Read. "Using population data linkage to make the invisible, visible: patterns and trends in mortality for Victorian born Aboriginal compared with non-Indigenous Victorian infants." International Journal of Population Data Science 1, no. 1 (April 18, 2017). http://dx.doi.org/10.23889/ijpds.v1i1.237.
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ABSTRACTObjectivesThe disparity between the infant mortality rates of Aboriginal and Torres Strait Islander (forthwith respectfully ‘Aboriginal’) and non-Aboriginal populations in Australia is well documented. However, major public health initiatives and campaigns aimed particularly at halving the Aboriginal infant mortality rate are hindered by the lack of comprehensive and accurate data. To date, infant and child mortality rates for Victorian born Aboriginal children have not been reported in national statistics. The aim of Victorian Aboriginal Child Mortality Study was to accurately measure the patterns and trends of Aboriginal infant mortality and to report the disparities between Aboriginal and non-Aboriginal infants born in Victoria, Australia between 1999 and 2008 inclusive. ApproachWe used best practice methodologies to link total population data and comprehensive mortality case review to classify and code the deaths to determine, for the first time, all-cause and cause-specific mortality for Aboriginal and non- Aboriginal infants born in Victoria from 1999 to 2008.ResultsBetween 1999 and 2009, Aboriginal infants were twice as likely to die in in the first year of life as non-Aboriginal infants. Infant cumulative mortality rates (CMR) were higher among Aboriginal births (9.1/1000 livebirths in 1999-2003 and 9.4/1000 livebirths in 2004-2008) than non- Aboriginal births (4.7/1000 livebirths in 1999-2003 and 4.5/1000 livebirths in 2004-2008). For Aboriginal infants there was an observed decrease in the rate of neonatal deaths, and conversely an increase in the postneonatal CMR (from 2.2/1000 livebirths in 1999-2003 and 3.8/1000 livebirths in 2004-2008). Among Aboriginal infants there was an increase in deaths attributed to prematurity (3.1/1000 livebirths in 1999-2003 and 4.3/1000 livebirths in 2004-2008) and sudden infant death syndrome (SIDS) (1.0/1000 livebirths in 1999-2003 and 1.7/1000 livebirths in 2004-2008). There were significantly more potentially preventable deaths among Aboriginal infants than in non-Aboriginal infants [infection (0.6/1000 Aboriginal livebirths vs 0.2/1000 non-Aboriginal livebirths, RR 2.5 95%CI 1.1-5.6) injury (0.6/1000 Aboriginal livebirths vs 0.1/ 1000 non-Aboriginal livebirths, RR 5.8 95%CI 2.5-13.5), and SIDS (1.4/1000 Aboriginal livebirths vs 0.28/1000 non-Aboriginal livebirths, RR 5.0 95%CI 2.9-8.6)]. ConclusionThis is the first time that all-cause and cause-specific mortality rates for Victorian born Aboriginal and non-Indigenous infants have been reported. The observed increasing disparities between Aboriginal and non- Indigenous infants, especially due to preventative causes, such as infection, injury and SIDS, in the post neonatal period, demand immediate action in partnership with Aboriginal communities. Collaborative action must focus on both access to primary health care and better living conditions.
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"Firearms and Adolescents." Pediatrics 89, no. 4 (April 1, 1992): 784–87. http://dx.doi.org/10.1542/peds.89.4.784.
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Firearms play a major role in childhood morbidity and mortality in the United States, especially among adolescents. The American Academy of Pediatrics is committed to reducing firearm death and injury of children and youth and has published policy statements on handgun control (1985),1 "toy" firearms (1987),2 and "Firearm Injuries Affecting the Pediatric Population" (1992).3 The purpose of this statement is to identify major firearm issues that specifically address adolescents. Reducing injuries and deaths from firearms is an essential priority for adolescent health. Of all firearm deaths among children from birth to age 19 years, 80% occur in older youths aged 10 to 19 years. Firearms are involved in 70% of teen homicide and 63% of teen suicide. Firearms are the second beading cause of death (after motor vehicle accidents) among all teenagers aged 15 to 19 years.4,5 Risk factors for firearm death seem particularly related to age, as rates of firearm violence peak in bate adolescence (ages 15 to 24 years) and decrease in young adulthood (ages 25 to 34 years).6 Therefore, special characteristics of adolescent development must be considered in designing effective countermeasures to prevent injury and death. ADOLESCENT MORTALITY AND MORBIDITY The statistics on firearm death and injury in adolescents emphasize the severity of the problem. Mortality Firearms account for 20% of deaths among all older youth, with almost 3200 US youths aged 15 to 19 years fatally shot each year.4 In the last 20 years, the rate of firearm deaths among teenagers has increased 75%, from 10.1/100 000 to 17.7/100 000.4
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EVERETT, ESTELLE M., LAUREN E. WISK, and LILY CHAO. "979-P: Risk Factors for Hyperosmolar Hyperglycemic State in Youth-Onset Type 2 Diabetes." Diabetes 71, Supplement_1 (June 1, 2022). http://dx.doi.org/10.2337/db22-979-p.
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Background: The prevalence of youth-onset type 2 diabetes (T2D) has been rising. There is a paucity of data on the risk factors for hyperosmolar hyperglycemic state (HHS) compared to diabetic ketoacidosis (DKA) in this population. Methods: We used the national Kids’ Inpatient Database to identify pediatric admissions for DKA and HHS among those with T2D in years 2006, 2009, 2012, and 2016. Admissions were identified using ICD codes. We used descriptive statistics to summarize baseline characteristics and used Chi-squared test and logistic regression to evaluate factors associated with admissions for HHS compared to DKA in unadjusted and adjusted models. Results: We found 6,8admissions for hyperglycemic emergencies in youth with T2D, of which 9.8% were due to HHS and 90.2% were for DKA. These admissions occurred mostly in youth 16-20 years old (70%) , females (52%) , who were non-White (Black 29%, Hispanic 17%) with public insurance (46%) and from the lowest income quartile (39.4%) . Most hospitalizations occurred in urban areas (82%) , southern US (47%) in private (58%) , large hospitals (61%) . In adjusted models, there was increased odds for HHS compared to DKA in males (OR 1.84, 95%CI 1.47-2.30) and those of Black race compared to those of White race (1.69, 95%CI 1.25-2.28) . There was no significant difference between those admitted for HHS compared to DKA with regards to age, other racial-ethnic groups, insurance payer, income, hospital region, size or ownership. In patients admitted with HHS compared to DKA, severity of illness (54% vs. 12.9% with major illness; p<0.001) and mortality were significantly higher (1.8% vs. 0.2%, p<0.001) . Conclusion: While DKA represents most admissions for hyperglycemic emergencies among youth-onset T2D, those admitted for HHS had higher severity of illness and mortality. Male gender and Black race were associated with HHS admission compared to DKA. Additional studies are needed to understand the drivers of these risk factors. Disclosure E.M.Everett: None. L.E.Wisk: None. L.Chao: None. Funding National Institute of Diabetes and Digestive and Kidney Diseases (K01DK116932, L40DK129996)
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Stefanac, Nina, Sarah Hetrick, Carol Hulbert, Matthew J. Spittal, Katrina Witt, and Jo Robinson. "Are young female suicides increasing? A comparison of sex-specific rates and characteristics of youth suicides in Australia over 2004–2014." BMC Public Health 19, no. 1 (October 28, 2019). http://dx.doi.org/10.1186/s12889-019-7742-9.
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Abstract Background Australian mortality statistics suggest that young female suicides have increased since 2004 in comparison to young males, a pattern documented across other Western high-income countries. This may indicate a need for more targeted and multifaceted youth suicide prevention efforts. However, sex-based time trends are yet to be tested empirically within a comprehensive Australian sample. The aim of this study was to examine changes over time in sex-based rates and characteristics of all suicides among young people in Australia (2004–2014). Methods National Coronial Information System and Australian Bureau of Statistics data provided annual suicide counts and rates for 10–24-year-olds in Australia (2004–2014), stratified by sex, age group, Indigenous status and methods. Negative binomial regressions estimated time trends in population-stratified rates, and multinomial logistic regressions estimated time trends by major suicide methods (i.e., hanging, drug poisoning). Results Between 2004 and 2014, 3709 young Australians aged 10–24 years died by suicide. Whilst, overall, youth suicide rates did not increase significantly in Australia between 2004 and 2014, there was a significant increase in suicide rates for females (incident rate ratio [IRR] 1.03, 95% confidence interval [CI] 1.01 to 1.06), but not males. Rates were consistently higher among Aboriginal/Torres Strait Islander youth, males, and in older (20–24-years) as compared to younger (15–19 years) age groups. Overall, the odds of using hanging as a method of suicide increased over time among both males and females, whilst the odds of using drug-poisoning did not change over this period. Conclusions We showed that suicide rates among young females, but not young males, increased over the study period. Patterns were observed in the use of major suicide methods with hanging the most frequently used method among both sexes and more likely among younger and Aboriginal/Torres Strait Islander groups. Findings highlight the need to broaden current conceptualizations of youth suicide to one increasingly involving young females, and strengthen the case for a multifaceted prevention approach that capitalize on young females’ greater help-seeking propensity.
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Rao, Chaitra, M. Parvathi, and K. Ravi. "Clinical Profile and Outcomes of COVID-19 Patients with MalignancyA Cross-sectional Study." JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH, 2022. http://dx.doi.org/10.7860/jcdr/2022/54947.16185.
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Introduction: Patients with history of past or active malignancy are at increased risk of contracting the virus and developing Coronavirus Disease 2019 (COVID-19) related complications. With the global prevalence of cancer and the high transmissibility of Severe Acute Respiratory Syndrome Corona Virus 2 (SARSCoV-2), an understanding of the disease course of COVID-19 and factors influencing clinical outcomes in patients with cancer is necessary and is largely unknown. Aim: To study the laboratory characteristics of patients with malignancy and COVID-19 infection and to evaluate the outcomes in terms of clinical features, severity of infection and mortality of patients with malignancy and COVID-19 infection. Materials and Methods: The present study was a crosssectional study conducted at Victoria Hospital, Bangalore Medical College and Research Institute, Bangalore, Karnataka, India after obtaining Institutional Ethical Committee (IEC) clearance, involving 72 subjects with COVID-19 infection. The duration of the study was from April-November 2020. Demographic details and data were collected in patients with active or previous malignancy and COVID-19 illness based on Indian Council of Medical Research (ICMR) criteria. Clinical outcome of the patients was measured based on need for Intensive Care Unit (ICU) admission, oxygen therapy and mortality. Descriptive statistics of the explanatory and outcome variables were calculated by mean, Standard Deviation (SD), median and Interquartile Range (IQR) for quantitative variables, frequency and proportions for qualitative variables. Inferential statistics like Chi-square test was applied for qualitative variables. Results: The mean age of the subjects was 52.10±14.512 years with 29 males, 43 females. Among 72 patients with malignancy, patients were classified as mild (23), moderate (22) and severe (27) according to ICMR case type respectively. Among the total patients, 21 (29.2%) were asymptomatic and 51 (70.8%) were symptomatic with 26 (36.1%) symptomatic patients having severe disease. Also, 30 (41.7%) had requirement of O2 and 28 (38.9%) were admitted to ICU. Most common was solid organ (66) lung carcinoma (13), breast (10), compared to haematological malignancies (6). A total of 22 (30.6%) patients had mortality with most common complication being Acute Respiratory Distress Syndrome (ARDS) (20.8%) followed by sepsis (4.2%). Conclusion: The results of present study revealed higher mortality and increased inflammatory markers in patients with severe COVID-19 infection and malignancy.
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Jiang, Heng, Michael Livingston, Robin Room, Yong Gan, Dallas English, and Richard Chenhall. "Can public health policies on alcohol and tobacco reduce a cancer epidemic? Australia's experience." BMC Medicine 17, no. 1 (November 27, 2019). http://dx.doi.org/10.1186/s12916-019-1453-z.
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Abstract Background Although long-term alcohol and tobacco use have widely been recognised as important risk factors for cancer, the impacts of alcohol and tobacco health policies on cancer mortality have not been examined in previous studies. This study aims to estimate the association of key alcohol and tobacco policy or events in Australia with changes in overall and five specific types of cancer mortality between the 1950s and 2013. Methods Annual population-based time-series data between 1911 and 2013 on per capita alcohol and tobacco consumption and head and neck (lip, oral cavity, pharynx, larynx and oesophagus), lung, breast, colorectum and anus, liver and total cancer mortality data from the 1950s to 2013 were collected from the Australian Bureau of Statistics and Cancer Council Victoria, the WHO Cancer Mortality Database and the Australian Institute of Health and Welfare. The policies with significant relations to changes in alcohol and tobacco consumption were identified in an initial model. Intervention dummies with estimated lags were then developed based on these key alcohol and tobacco policies and events and inserted into time-series models to estimate the relation of the particular policy changes with cancer mortality. Results Liquor licence liberalisation in the 1960s was significantly associated with increases in the level of population drinking and thereafter of male cancer mortality. The introduction of random breath testing programs in Australia after 1976 was associated with a reduction in population drinking and thereafter in cancer mortality for both men and women. Meanwhile, the release of UK and US public health reports on tobacco in 1962 and 1964 and the ban on cigarette ads on TV and radio in 1976 were found to have been associated with a reduction in Australian tobacco consumption and thereafter a reduction in mortality from all cancer types except liver cancer. Policy changes on alcohol and tobacco during the 1960s–1980s were associated with greater changes for men than for women, particularly for head and neck, lung and colorectum cancer sites. Conclusion This study provides evidence that some changes to public health policies in Australia in the twentieth century were related to the changes in the population consumption of alcohol and tobacco, and in subsequent mortality from various cancers over the following 20 years.
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Pollock, Nathaniel J., Li Liu, Margo M. Wilson, Charlene Reccord, Nicole D. Power, Shree Mulay, Yordan Karaivanov, and Lil Tonmyr. "Suicide in Newfoundland and Labrador, Canada: a time trend analysis from 1981 to 2018." BMC Public Health 21, no. 1 (July 2, 2021). http://dx.doi.org/10.1186/s12889-021-11293-8.
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Abstract Background The suicide rate in Canada decreased by 24% during the past four decades. However, rates vary between provinces and territories, and not all jurisdictions experienced the same changes. This study examined suicide rates over time in the province of Newfoundland and Labrador. Methods We used cross-sectional surveillance data from the Canadian Vital Statistics Death Database to examine suicide rates in Newfoundland and Labrador from 1981 to 2018. We calculated annual age-standardized suicide mortality rates and used joinpoint regression to estimate the average annual percent change (AAPC) in suicide rates overall and by sex, age group, and means of suicide. Results From 1981 to 2018, 1759 deaths by suicide were recorded among people in Newfoundland and Labrador. The age-standardized suicide mortality rate increased more than threefold over the study period, from 4.6 to 15.4 deaths per 100,000. The suicide rate was higher among males than females, and accounted for 83.1% of suicide deaths (n = 1462); the male-to-female ratio of suicide deaths was 4.9 to 1. The average annual percent change in suicide rates was higher among females than males (6.3% versus 2.0%). Age-specific suicide rates increased significantly for all age groups, except seniors (aged 65 or older); the largest increase was among youth aged 10 to 24 years old (AAPC 3.5; 95% CI, 1.6 to 5.5). The predominant means of suicide was hanging/strangulation/suffocation, which accounted for 43.8% of all deaths by suicide. Conclusions The suicide rate in Newfoundland and Labrador increased steadily between 1981 and 2018, which was in contrast to the national rate decline. The disparity between the provincial and national suicide rates and the variations by sex and age underscore the need for a public health approach to prevention that accounts for geographic and demographic differences in the epidemiology of suicide.
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Gumà, Jordi, and Amans Blanes. "Diferencias entre mujeres y hombres en la asociación entre la salud autopercibida y la mortalidad en las edades adultas en Europa." Empiria. Revista de metodología de ciencias sociales, no. 39 (January 12, 2018). http://dx.doi.org/10.5944/empiria.39.2018.20880.
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Objetivo: Explorar el patrón por edad de la relación entre el indicador de salud autopercibida y la mortalidad en las edades posteriores a la juventud (35-79) para hombres y mujeres en seis países europeos con trayectorias de morbilidad diferenciadas: Alemania, Francia, España, Italia, Polonia y Hungría. Métodos y datos: Descripción de los patrones tanto de la prevalencia de mala salud autopercibida como de la diferencia entre las transformaciones logarítmicas de las probabilidades de morir y de la prevalencia de mala salud en los años 2005 y 2009. Los datos proceden de la encuesta sobre Condiciones de Vida en la Unión Europea (EU-SILC) para la salud autopercibida, y de la Human Mortality Database (HMD) para la mortalidad. Resultados: Ambos indicadores muestran un patrón creciente por edad aunque el valor relativo de este incremento no es igual para la mortalidad y para la mala salud. La prevalencia de mala salud autopercibida aumenta con la edad con una intensidad menor que la mortalidad en ambos sexos en todos los países analizados. Este cambio en la relación entre ambos indicadores con la edad muestra valores similares entre mujeres y hombres, menos en el caso de Polonia y Hungría. Conclusiones: El cambio en la relación entre salud percibida y mortalidad con la edad se explicaría mediante la normalización por parte del individuo de la propia morbilidad. El diferente cambio en esta relación entre mujeres y hombres parece deberse a mayores niveles de desigualdad de género en aquellos países donde se observa esta diferencia, aunque estos resultados deberán comprobarse futuros trabajos.Goal: To explore the age pattern of the relationship between self-perceived health and mortality at ages beyond youth (35-79) for men and women in six European countries with different with different patterns of morbidity: Germany, France, Spain, Italy, Poland and Hungary. Methods and data sources: Descriptive analysis of the patterns of both the prevalence of poor self-perceived health and the difference between the logarithmic transformations of the mortality probabilities and the prevalence of poor health in 2005 and 2009. The data about self-perceived health come from the European Union statistics on income and living conditions (EU-SILC), whereas mortality data come from Human Mortality Database (HMD). Results: Both indicators show a growing pattern by age though the relative value of this increase is not equal in mortality and poor self-perceived health. Poor self-perceived health prevalence rises by age with a lower intensity than mortality for both sexes in all the analysed countries. This change by age in the relationship between both health outcomes shows similar values for women and men, with the exception of Poland and Hungary. Conclusions: The change in the relationship by age between self-perceived health and mortality would be explained by the process of standardization of individual’s morbidity. Different age changes between sexes seem to be related with higher levels of gender inequalities in countries where this difference is observed, though this must be confirmed in future research.
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Varghese, B., M. Beaty, P. Bi, and J. Nairn. "Heatwave-related morbidity in Australia: Effect modification by Individual and Area-level factors." European Journal of Public Health 31, Supplement_3 (October 1, 2021). http://dx.doi.org/10.1093/eurpub/ckab164.630.
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Abstract Background Heatwaves are associated with increases in mortality, emergency department visits, and hospital admissions. However, evidence regarding heatwave impacts on general practice (GP) visits is limited. The objectives of this study were to quantify the impact of heatwaves on GP visits in Australia and identify the individual and area-level factors that modify the heatwave-GP visits association. Methods Warm-season (October-March) GP visits data (2011-2016) were obtained from the Australian Bureau of Statistics. Using a case-crossover approach we assessed the effect of heatwaves (defined using Excess Heat Factor) on GP visits at the Statistical Area Level 2 (SA2) spatial unit (reflecting suburbs), as well as effect modification by individual and area-level factors. Results are reported as percent increase in GP visits during severe/extreme heatwaves compared with non-heatwaves. Results Nationally, GP visits increased by 4% (95%CI: 3-4%) during severe/extreme heatwaves. But impacts varied with the highest effect observed in Canberra (16.4%; 95%CI:15.4-17.4%), Adelaide (14.9%; 95%CI: 14.3-15.4%), and regional Victoria (13.5%; 95%CI: 13-14%). A gradient of impact was found within locations, for example, vulnerable SA2s nationally were featured by a higher proportion of populations with no air-conditioning, low income, limited English proficiency, living alone, and a prevalence of diabetes and circulatory diseases. Individual-level factors included those: living alone, with limited English proficiency, with diabetes, hypertension and using anti-coagulants and diuretic medications. Conclusions Heatwaves increase GP visits in Australia, with impacts varied between locations and populations, affecting certain areas and individuals disproportionately. Our results using an individual and area-level linked data suggest that local area and individual vulnerabilities should be incorporated when developing place-based interventions combating heatwave-health impacts. Key messages Heatwaves increase GP visits in Australia, but with spatial variability across and within locations. Individual and area-level factors contribute to heatwave-vulnerability.