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Background: Livestock mortality impacts farmer livelihoods and household nutrition. Capturing trends in livestock mortality at localised or national levels is essential to planning, monitoring and evaluating interventions and prog...
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Background: Livestock mortality impacts farmer livelihoods and household nutrition. Capturing trends in livestock mortality at localised or national levels is essential to planning, monitoring and evaluating interventions and programs aimed at decreasing mortality rates. However, livestock mortality data is disparate, and indicators used have not been standardised. This review aims to assess livestock mortality indicator definitions reported in literature, and define the ages where mortality has greatest impact. Methods: A systematic review was conducted, limited to articles focussed on mortality of cattle, sheep and goats. Peer-reviewed articles in Web of Science until year 2020 were assessed for inclusion of age-based definitions for mortality indicators and data on age distribution of mortality. Indicator definitions for each species were collated and similar terms and age groups most targeted were compared. The cumulative distribution of age at mortality was compared across studies graphically where possible; otherwise, age patterns for mortality were collated. Results: Most studies reported mortality risk rather than rate, and there was little agreement between indicator definitions used in the literature. The most common indicators reported were perinatal and neonatal mortality in cattle, and for perinatal, neonatal and pre-weaning mortality indicators for sheep and goats. Direct comparison of age distribution of mortality was only possible for cattle, which found that approximately 80% of all mortalities within the first 12 months had occurred by six months of age. A significant finding of the study is the variation in age groups for which mortality is reported, which impedes the comparison of mortality risk across studies, particularly for sheep and goats. Conclusions: This study demonstrates the importance and value of standardising mortality risk indicators for general use, including a young stock mortality risk indicator measuring mortality in the highest risk period of birth to six months of age in cattle, sheep and goats.
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Abstract Background Anaesthesia related mortality in paediatrics is rare. There are limited data describing paediatric anaesthesia related mortality. This study determined the anaesthesia related mortality at a Tertiary Paediatric...
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Abstract Background Anaesthesia related mortality in paediatrics is rare. There are limited data describing paediatric anaesthesia related mortality. This study determined the anaesthesia related mortality at a Tertiary Paediatric Hospital in Western Australia. Methods A retrospective cohort study of children under‐18?years of age, that died within 30‐days of undergoing anaesthesia at Princess Margaret Hospital (PMH), between 01 January 2001 and 31 March 2015. A senior panel of clinicians reviewed each death to determine whether the death was (i) due wholly to the provision of anaesthesia (ii) due partly to the provision of anaesthesia or (iii) if death was related to the underlying pathology of the patient and anaesthesia was not contributory. Anaesthesia related mortality, 24‐h?and 30‐day mortality as well as predictors of mortality were determined. Results A total of 154,538 anaesthetic events were recorded. There were 198 deaths within 30‐days of anaesthesia. Anaesthesia attributable mortality was 0.19/10,000 with all anaesthesia deaths occuring in patients undergoing cardiothoracic surgery. The 24‐h and 30‐day all‐cause mortality rate was 3.43/10,000 (95% CI 2.57–4.49) and 9.38/10,000 (95% CI 7.92–11.04), respectively. Overall mortality was 12.34/10,000 (95% CI 11.09–14.73) Age less than 1‐year, cardiac surgery, emergency surgery and higher ASA score were all significant predictors of mortality. Conclusion Paediatric anaesthesia related mortality as reflected in this retrospective cohort study is uncommon. Significant risk factors were determined as predictors of mortality.
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Background: The mortality index is a quality metric that measures the ratio of observed mortality to expected mortality among inpatients. Expected mortality is a probability calculation based on documentation of patient risks and ...
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Background: The mortality index is a quality metric that measures the ratio of observed mortality to expected mortality among inpatients. Expected mortality is a probability calculation based on documentation of patient risks and comorbidities. A mortality index of <1.0 represents fewer patients dying while admitted to the hospital than expected. We aimed to decrease the mortality index in our department by 10% in 6 months. Methods: We formed a multidisciplinary team from Gynecologic Oncology, Health Information Management, Office of Performance Improvement, Revenue Operations, Coding and Institutional Compliance. We educated providers on documentation of patient comorbidities, standardized documentation templates, focused coder analysis and in-depth review and discussion as a department of all inpatient deaths. Pre-intervention 8/2017–7/2018 and post-intervention 11/2018–2/2020 outcomes were compared using the Mann Whitney U test. Results: The median mortality index decreased by 44% from 0.84 to 0.47 (p = 0.03). The median expected mortality increased by 37% from 2.94 to 4.02 (p = 0.002). The median number of inpatient deaths, or observed mortalities, was unchanged though there was a non-significant decreasing trend. Conclusions: Inpatient mortality index is an important quality metric that can be improved through education, standardized documentation, focused review and discussion of all inpatient mortalities.
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Introduction: This article is presenting the overall situation of maternal and neonatal health in Bangladesh in comparison to other South Asian countries. Bringing down the maternal mortality ratio from 569 to 143 was the target f...
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Introduction: This article is presenting the overall situation of maternal and neonatal health in Bangladesh in comparison to other South Asian countries. Bringing down the maternal mortality ratio from 569 to 143 was the target for Bangladesh which was achieved up to 176 per 100,000 live births by 2015 but the target as per the Millennium Development Goal 5 was not fulfilled yet and remained as a challenge. Besides, the improvement in reducing the neonatal mortality rate during 1993-2014 shows a national level decline from 52 to 28 per 1000 live births, which is almost half during this period with a percentage change of about 46% and so more care is needed here also. Objectives and Methods : The manuscript has three objectives: to present the trends of maternal and neonatal mortality, to explain the maternal and neonatal mortality rate by background characteristics and the causes of maternal and neonatal deaths in Bangladesh on the basis of South Asian perspective. The main source of data collection and analysis was the secondary sources, from different journals and project reports published between the years 2001 to May 2018. Main Text: In Bangladesh, 35% maternal deaths occurred as indirect causes and 9% causes of deaths are still remaining unidentified. In addition, hemorrhage (31%) and pre-eclampsia-eclampsia (20%) are found two vital causes of maternal deaths with two more causes which are due to obstructed labor (7%), and termination of pregnancy (1%). It is found that Bangladesh has shown a great improvement in maternal mortality ratio by reducing maternal mortality to 176 in 2015 from 569 deaths per 100,000 live births in 1990, with an increase of 69% as progress. On the other hand, it is found that 43% of neonatal deaths in Bangladesh occurred due to birth asphyxia, 24% due to neonatal pneumonia, 22% due to prematurity, 5% due to sepsis, 0.2% due to meningitis and encephalitis, 0.1% due to congenital malformation and 5% causes are still remain undetermined. While comparing the situation to other South Asian countries, it is seen that the causes of neonatal deaths by prematurity are in the highest position that causes 29.7%, 43.8%, 30.8% and 39.3% deaths and birth asphyxia is in the second highest position that causes 22.9%, 18.9%, 23.4% and 20.9% deaths in Bangladesh, India, Nepal and Pakistan respectively. Conclusion: This paper will support health researchers and medical anthropologist for further studies and specifically for the health-policy makers and corresponding authorities to take necessary actions for overcoming the obstacles of improving maternal and neonatal health situation in Bangladesh.
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We develop a Gaussian process (GP) framework for modeling mortality rates and mortality improvement factors. GP regression is a nonparametric, data-driven approach for determining the spatial dependence in mortality rates and join...
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We develop a Gaussian process (GP) framework for modeling mortality rates and mortality improvement factors. GP regression is a nonparametric, data-driven approach for determining the spatial dependence in mortality rates and jointly smoothing raw rates across dimensions, such as calendar year and age. The GP model quantifies uncertainty associated with smoothed historical experience and generates full stochastic trajectories for out-of-sample forecasts. Our framework is well suited for updating projections when newly available data arrives, and for dealing with "edge" issues where credibility is lower. We present a detailed analysis of GP model performance for US mortality experience based on the CDC (Center for Disease Control) datasets. We investigate the interaction between mean and residual modeling, Bayesian and non-Bayesian GP methodologies, accuracy of in-sample and out-of-sample forecasting, and stability of model parameters. We also document the general decline, along with strong age-dependency, in mortality improvement factors over the past few years, contrasting our findings with the Society of Actuaries (SOA) MP-2014 and -2015 models that do not fully reflect these recent trends.
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The President: Welcome everybody. Tonight, Professor Sir Brian Jarman, OBE, has very kindly agreed to speak to us. Brian has enjoyed a brilliant career and has the unusual mix of skills being both an academic and a man who can fin...
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The President: Welcome everybody. Tonight, Professor Sir Brian Jarman, OBE, has very kindly agreed to speak to us. Brian has enjoyed a brilliant career and has the unusual mix of skills being both an academic and a man who can find practical solutions to problem.After completing his first degree at Cambridge, his National Service with the Royal Artillery gave him the opportunity to assist in planning the Allied Nuclear Defence Strategy in Western Europe. Fortunately for us, after gaining PhD in geophysics at Imperial and working for Shell, at 31 he decided to change career and study medicine. He obtained a degree in medicine from Imperial College, where of course he achieved first class honours, went to Harvard as a clinical fellow and then returned to the UK and worked as a GP for 28 years.
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Background There is evidence that low‐level alcohol use, drinking 1 to 2 drinks on occasion, is protective for cardiovascular disease, but increases the risk of cancer. Synthesizing the overall impact of low‐level alcohol use on...
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Background There is evidence that low‐level alcohol use, drinking 1 to 2 drinks on occasion, is protective for cardiovascular disease, but increases the risk of cancer. Synthesizing the overall impact of low‐level alcohol use on health is therefore complex. The objective of this paper was to examine the association between frequency of low‐level drinking and mortality. Methods Two data sets with self‐reported alcohol use and mortality follow‐up were analyzed: 340,668 individuals from the National Health Interview Survey (NHIS) and 93,653 individuals from the Veterans Health Administration (VA) outpatient medical records. Survival analyses were conducted to evaluate the association between low‐level drinking frequency and mortality. Results The minimum risk drinking frequency among those who drink 1 to 2 drinks per occasion was found to be 3.2 times weekly in the NHIS data, based on a continuous measure of drinking frequency, and 2 to 3 times weekly in the VA data. Relative to these individuals with minimum risk, individuals who drink 7 times weekly had an adjusted hazard ratio (HR) of all‐cause mortality of 1.23 ( p ?<?0.0001) in the NHIS data, and individuals who drink 4 to 7 times weekly in the VA data also had an adjusted HR of 1.23 ( p ?=?0.01). Secondary analyses in the NHIS data showed that the minimum risk was drinking 4 times weekly for cardiovascular mortality, and drinking monthly or less for cancer mortality. The associations were consistent in stratified analyses of men, women, and never smokers. Conclusions The minimum risk of low‐level drinking frequency for all‐cause mortality appears to be approximately 3 occasions weekly. The robustness of this finding is highlighted in 2 distinctly different data sets: a large epidemiological data set and a data set of veterans sampled from an outpatient clinic. Daily drinking, even at low levels, is detrimental to one's health.
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Background: The government of the United Republic of Tanzania has initiated the Integrated Management of Childhood Illness program to improve the health and wellbeing of children. Methods: Tanzania's under-five mortality rate is s...
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Background: The government of the United Republic of Tanzania has initiated the Integrated Management of Childhood Illness program to improve the health and wellbeing of children. Methods: Tanzania's under-five mortality rate is still 1.7 times higher than the world average and, in order to achieve its Millennium Development Goal 4 target, its annual reduction rate is quite low at 2.2. The main aim of the study is to examine under-five mortality combined with the Data from the Tanzania Demographic and Health Survey 2008 data was used. Odds ratios for infant and under-five mortality were estimated using logistic regression; crude and adjusting models were adopted. Results: Mortality cases (18.3%) have been reported to children born with an interval of <24 months. Mothers with no education reported 14.6%, primary education mothers reported 11.1% and higher education reported only 5.3% (P<0.001). Therefore, maternal education plays is a major role on fertility and infant and under-five mortality behavior. Conclusion: Maternal education also influences a mother's behavior in her usage of available health services to improve the health of the children. Further in-depth analysis is immensely needed in this situation.
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Important pregnancy outcomes include stillbirth and neonatal mortality, long-term neurologic handicap, and maternal mortality. Research conducted with the support of NICHD and other agencies in the last four decades has provided u...
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Important pregnancy outcomes include stillbirth and neonatal mortality, long-term neurologic handicap, and maternal mortality. Research conducted with the support of NICHD and other agencies in the last four decades has provided us with the ability to substantially improve many of these outcomes. In fact, in recent years, in the U.S. and other developed countries, childbirth has become a relatively safe undertaking for the mothers, and the vast majority of infants are born healthy and survive. In many developing countries, the risk of each of the adverse outcomes mentioned above is increased 10- to 100-fold compared to U.S. rates, with many of the differences explained by inadequately organized healthcare systems and low levels of health expenditures. At present, we have the knowledge to substantially reduce adverse pregnancy outcomes throughout the world; so far we have not had the will.
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