Mortality Rate In Elderly Research Articles

Peningkatan Pengetahuan Masyarakat Melalui Edukasi Dalam Pencegahan ISPA Di Desa Cinta Rakyat Kecamatan Percut Sei Tuan

<table width="598" border="1" cellspacing="0" cellpadding="0"><tbody><tr><td valign="top" width="371"><p><strong><em>Abstract </em></strong></p><p align="center"> </p><p><em>Acute respiratory infections are a major cause of infectious disease morbidity and mortality worldwide. According to the World Health Organization, about 4 million people died from acute respiratory infections, 98% of which were caused by lower respiratory tract infections. Infant, child and elderly mortality rates are very high, especially in low- and middle-income countries. efforts to control ARI through health promotion education activities or counseling. Education is carried out with the aim of increasing knowledge and even the community is expected to be able to improve health status. The method in this service activity uses educational methods or counseling based on lecture discussions about ARI. The targets in this activity are mothers who have babies and children. Health problem factors, namely the habit of burning garbage can cause air pollution that comes from burning smoke in the environment and smoking habits.</em><em></em></p></td></tr></tbody></table>

Public Health Measures Enacted by the Norwegian Political Leadership to Protect the Elderly in Response to the SARS-CoV-2 Pandemic Crisis

ABSTRACT The SARS-CoV-2 pandemic crisis is ongoing, and the elderly are still affected by the virus, sometimes with fatal consequences. The political leaders are, inter alia, focussed on protecting citizens, including this vulnerable group. This article aims to describe the response of the Norwegian political leadership, with a focus on the public health measures enacted to protect the elderly during the SARS-CoV-2 pandemic crisis in the years 2020 and 2021. This study has a descriptive qualitative research design using thematic-content analysis as a methodology to evaluate data collected from official documents, national statistics and public health documents from Norway. Statistics show that the elderly mortality rate per 100,000 person-weeks during the first wave of the SARS-CoV-2 pandemic was 2.69 in Norway; during the second wave of the pandemic, it was 1.43. The public health measures the Norwegian political leadership instigated were more effective in containing the crisis when compared to other European countries, and this paper investigates the reasons. The results of our study provide public health policy decision-makers with insights into analytical material showing the usefulness of different measures enacted by the Norwegian government. The Norwegian government’s responses to the crisis, such as the public health measures, restrictions, social consequences for vulnerable groups such as the elderly, as well as cross-government and cross-community cooperation, will need further in-depth analysis.

Collaborative governance in handling covid-19 for elderly social services

In 2050, Indonesia will enter an ageing population of around 21.1% of the total population. Life expectancy has increased significantly despite having a high vulnerability to neglect due to elderly poverty in the COVID-19 pandemic. This condition encourages the need for inclusive service design to promote health and empower ageing in collaborative governance. In this paper, the author presents a study on how collaborative governance interventions in inclusive services for long-term elderly care in the COVID-19 pandemic. As a representation of national strategic research, this research uses research and development designs through interviews, observations, focus group discussions, analysis of elderly data documentation in 2021. The findings show collaborative governance in inclusive services during the COVID-19 pandemic can increase social resilience and empowerment of the elderly. Although, the elderly mortality rate during the COVID-19 pandemic is still high, there is a strengthening of stakeholder participation, social inclusion, and long-term policy support. So, the adoption of collaborative governance in inclusive services can improve the social welfare of the elderly in the long term care post-COVID-19. The implication is that it is necessary to strengthen the role capacity and participation of stakeholders at the local level based on social capital.

The COVID-19 pandemic’s effects on voter turnout

The COVID-19 pandemic has increased the risk of participating in public events, among them elections. We assess whether the voter turnout in the 2020 local government elections in Italy was affected by the COVID-19 pandemic. We do so by exploiting the variation among municipalities in the intensity of the COVID-19 outbreak as measured by the mortality rate among the elderly. We find that a 1 percentage point increase in the elderly mortality rate decreased the voter turnout by 0.5 percentage points, with no gender differences in the behavioural response. The effect was especially strong in densely populated municipalities. We do not detect statistically significant differences in voter turnout among different levels of autonomy from the central government.

Time Trends and Predictions of Suicide Mortality for People Aged 70 Years and Over From 1990 to 2030 Based on the Global Burden of Disease Study 2017.

Background: High suicide rate in the elderly is an important global public health problem but has not received the attention it deserves. This study aimed to examine time trends of suicide mortality for people aged 70 years and over by sex, age, and location from 1990 to 2017, and to provide predictions up to 2030.Methods: Using data from the Global Burden of Disease study 2017, we presented elderly suicide mortality changes and compared the patterns for the elderly with that for all ages. We estimated associations between socio-demographic index (SDI) and suicide mortality rates using a restricted cubic spline smoother, and predicted suicide mortality rates up to 2030.Results: In 2017, 118,813 people aged 70 years and over died from suicide, indicating a mortality rate of 27.5 per 100,000, with the highest rates in Eastern Sub-Saharan Africa, Western Sub-Saharan Africa, and Central Sub-Saharan Africa, and for countries and territories, the highest were in South Korea, Zimbabwe, Lesotho, Mozambique, and Senegal. Between 1990 and 2017, suicide mortality rate for the elderly aged 70 years and over decreased globally (percentage change −29.1%), and the largest decreases occurred in East Asia, Southern Latin America, and Western Europe. Nationally, the largest decrease was found in Chile, followed by Czech Republic, Hungary, Turkey, and Philippines. For most countries, the elderly mortality rate was higher than the age-standardized rate, with the largest percentage differences in China and countries in Sub-Saharan Africa. The elderly suicide mortality rate decreased as SDI increased, except for a slight rebound at mid to high SDI. According to projections, 10 out of 195 countries were expected to meet the SDGs indicator of a third reduction by 2030.Conclusions: Variability in suicide mortality rates for the elderly aged 70 years and over by sex, age, region, country, and SDI can guide preventive policies, but causes of the variability need further study. Comprehensive strategies should be adopted to reduce suicide rates and close the gap to the 2030 SDGs.

Insights Into Excess Mortality During the First Months of the COVID-19 Pandemic From a Rural, Demographic Surveillance Site in Bangladesh.

Background: Coronavirus disease 2019 (COVID-19) has spread globally, and the government of each affected country is publishing the number of deaths every day. This official figure is an underestimate as it excludes anybody who did not die in a hospital, who did not test positive, who had a false result, or those who recovered on their own without a test.Objective: This study aimed to measure the community level excess mortality using health and demographic surveillance in a rural area of Bangladesh.Method: The study was conducted in Matlab, in a rural area of Bangladesh, with a Health and Demographic Surveillance System (HDSS) covering a population of 239,030 individuals living in 54,823 households in 142 villages. We examined the mortality in January-April from 2015 to 2020 and compared the mortality in 2020 with the historical trend of 2015–2019. Between 2015 and 2020, we followed 276,868 people until migration or death, whichever occurred first. We analyzed mortality using crude mortality rate ratio (MRR) and adjusted MRR (aMRR) from a Cox proportional hazard model. Mortality was analyzed according to age, sex, and period.Results: During follow-up, 3,197 people died. The mortality rate per 1,000 person-years increased from 10 in 2019 to 12 in 2020. Excess mortality was observed among the elderly population (aged 65 years and above). The elderly mortality rate per 1,000 person-years increased from 80 in 2019 to 110 in 2020, and the aMRR was 1.40 (95% CI: 1.19–1.64). Although an increasing tendency in mortality was observed between 2015 and 2019, it was statistically insignificant.Conclusions: The study reported a 28% increase in excess deaths among the elderly population during the first months of the pandemic. This all-cause mortality estimation at the community level will urge policymakers, public health professionals, and researchers to further investigate the causes of death and the underlying reasons for excess deaths in the older age-group.

The COVID-19 Pandemic's Effects on Voter Turnout

The COVID-19 pandemic has increased the risk of participating in public events, among them elections. We assess whether the voter turnout in the 2020 local government elections in Italy was affected by the COVID-19 pandemic. We do so by exploiting the variation among municipalities in the intensity of the COVID-19 outbreak as measured by the mortality rate among the elderly. We find that a 1 percentage point increase in the elderly mortality rate decreased the voter turnout by 0.5 percentage points, with no gender differences in the behavioural response. The effect was especially strong in densely populated municipalities. We do not detect statistically significant heterogeneous effects between the North and the South or among different levels of autonomy from the central government.

Blurred lines: racial misclassification in death certificates in Brazil.

To analyze the agreement between self-reported race and race reported on death certificates for older (≥ 60years) residents of São Paulo, Brazil (from 2000 to 2016) and to estimate weights to correct mortality data by race. We used data from the Health, Well-Being and Aging Study (SABE) and from Brazil's Mortality Information System. Misclassification was identified by comparing individual self-reported race with the corresponding race on the death certificate (n = 1012). Racial agreement was analyzed by performing sensitivity and Cohen's Kappa tests. Multinomial logistic regressions were adjusted to identify characteristics associated with misclassification. Correction weights were applied to race-specific mortality rates. Total racial misclassification was 17.3% (13.1% corresponded to whitening, and 4.2% to blackening). Racial misclassification was higher for self-reported pardos/mixed (63.5%), followed by blacks (42.6%). Official vital statistics suggest highest elderly mortality rates for whites, but after applying correction weights, black individuals had the highest rate (45.85/1000 population), followed by pardos/mixed (42.30/1000 population) and whites (37.91/1000 population). Official Brazilian data on race-specific mortality rates may be severely misclassified, resulting in biased estimates of racial inequalities.

Can Natural Gas Save Lives? Evidence from the Deployment of a Fuel Delivery System in a Developing Country

There has been a widespread displacement of coal by natural gas as space heating and cooking technology in Turkey in the last two decades, triggered by the deployment of natural gas networks. In this paper, we examine the impact of this development on mortality among adults and the elderly. Our research design exploits the variation in the timing of the deployment and the intensity of expansion of natural gas networks at the provincial level using data from 2001 to 2014.The results indicate that the expansion of natural gas services has caused significant reductions in both the adult and the elderly mortality rates. According to our point estimates, a one-percentage point increase in the rate of subscriptions to natural gas services would lower the overall mortality rate by 1.4 percent, the adult mortality rate by 1.9 percent, and the elderly mortality rate by 1.2 percent. These findings are supported by our auxiliary analysis, which demonstrates that the expansion of natural gas networks has indeed led to a significant improvement in air quality.Furthermore, we show that the mortality gains for both the adult and the elderly populations are primarily driven by reductions in cardio-respiratory deaths, which are more likely to be due to conditions caused or exacerbated by air pollution. Finally, our analysis does not reveal any important gender differences in the estimated relationship between the deployment of natural gas networks and mortality.

Patterns of Mortality in the Elderly in Chi Linh, Hai Duong, Vietnam, Period 2004-2012.

ObjectiveThis paper examines the trends of mortality in the elderly people in Chi Linh during period 2004–2012 and identifies a number of factors related to mortality in the elderly.DesignThe longitudinal study method is used. The analyzed data is extracted from database of theDemographic—Epidemiologic Surveillance System (DESS) of Chililab. The data is collected from 7 communes/town of Chi Linh district, Hai Duong province during 2004–2012 with all elderly people. Descriptive statistical analysis and survival analysis using Kaplan Meier survival estimates and Cox regression models were used. The indirect standardization was used to compare between the mortality rate of the elderly in Chi Linh and the rates of those in some reference groups.ResultsMortality rate in elderly tend to decrease over the period 2004–2012. In all the time, mortality rate in elderly men is higher than that in the elderly women. Specific mortality rates by age groups have increased in both males and females. The increase Age specific mortality rates in males is higher than females. Indirect standardized mortality data for the elderly in 2009 in Chi Linh, Vietnam, Canada, the United States of America (USA) showed that elderly mortality rate in Chililab in 2009 was lower than that in elderly of Vietnam (standardized mortality ratio—SMR of elderly in Chililab is only by 75% in comparison with elderly of Vietnam), and also lower than that in elderly people in the US, and Canada. Cox regression analysis (multivariate models) show that with every 1 year older, the risk of death in elderly men increased by 9% and 12% increase in elderly female, for both men and women general risk increased by 10% (p < 0.05). Elderly with higher education levels, elderly with better family economic conditions; elderly living with wife/husband have lower mortality risk than the other counterparts.ConclusionsThe research results suggest some recommendations: Strengthening health care programs for elderly people with low education levels, poor economic conditions, and celibacy groups (the vulnerable groups).

Links between bed occupancy, deaths and costs

British Journal of Healthcare ManagementVol. 21, No. 11 Money MattersLinks between bed occupancy, deaths and costsRod JonesRod JonesSearch for more papers by this authorRod JonesPublished Online:14 Nov 2015https://doi.org/10.12968/bjhc.2015.21.11.544AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References Ekamper P, Van Poppel F, Van Duin C, Garssen J (2009) 150 years of temperature-related excess mortality in the Netherlands. Demographic Research 21: 385–426. Crossref, Google ScholarJones R (2013) Do recurring outbreaks of a type of infectious immune impairment trigger cyclic changes in the gender ratio at birth? Biomedicine International 4(1): 26–39 Google ScholarJones R (2014a) Unexpected single-year-of-age changes in the elderly mortality rate in 2012 in England and Wales. Brit J Med Medical Res 4(16): 3196–207. doi: https://doi.org/10.9734/BJMMR/2014/9072 Crossref, Google ScholarJones R (2014b) Infectious-like spread of an agent leading to increased medical admissions and deaths in Wigan (England), during 2011 and 2012. Brit J Med Medical Res 4(28): 4723–41. doi: https://doi.org/10.9734/BJMMR/2014/10807 Crossref, Google ScholarJones R, Beauchant S (2015) Spread of a new type of infectious condition across Berkshire in England between June 2011 and March 2013: Effect on medical emergency admissions. Brit J Med Medical Res 6(1): 126–48 Crossref, Google ScholarJones R (2015a) A previously uncharacterized infectious-like event leading to spatial spread of deaths across England and Wales: Characteristics of the most recent event and a time series for past events. Brit J Med Medical Res 5(11): 1361–80 Crossref, Google ScholarJones R (2015b) Unexpected and disruptive changes in admissions associated with an infectious-like event experienced at a hospital in Berkshire, England around May of 2012. Brit J Med Medical Res 6(1): 56–76. doi: https://doi.org/10.9734/BJMMR/2015/13938 Crossref, Google ScholarJones R (2015c) Recurring outbreaks of an infection apparently targeting immune function, and consequent unprecedented growth in medical admission and costs in the United Kingdom: a review. Brit J Med Medical Res 6(8): 735–70. doi: https://doi.org/10.9734/BJMMR/2015/14845 Crossref, Google ScholarJones R (2015d) Are emergency admissions contagious? BJHCM 21(5): 227–35 Google ScholarJones R (2015e) Unexpected increase in deaths from Alzheimer's, dementia and other neurological disorders in England and Wales during 2012 and 2013. J Neuroinfectious Dis 6: 172. doi: https://doi.org/10.4172/2314-7326.1000172 Crossref, Google ScholarJones R (2015f) A time series of infectious-like events in Australia between 2000 and 2013 leading to extended periods of increased deaths (all-cause mortality) with possible links to increased hospital medical admissions. Int J Epidemiologic Res 2(2): 53–67 Google ScholarJones R (2015g) Small area spread and step-like changes in emergency medical admissions in response to an apparently new type of infectious event. FGNAMB 1(2): 42–54. doi: https://doi.org/10.15761/FGNAMB.1000110 Google ScholarJones R (2015h) Deaths and international health care expenditure. BJHCM 21(10): 491–93 Google ScholarJones R (2015i) Simulated rectangular wave infectious-like events replicate the diversity of time-profiles observed in real-world running 12 month totals of admissions or deaths. FGNAMB 1(3) (in press) Google ScholarJones R (2015j) A ‘fatal’ flaw in hospital mortality models: How spatiotemporal variation in all-cause mortality invalidates hidden assumptions in the models. FGNAMB 1: (in press) Google ScholarJones R (2015k) Infectious-like spread of an agent leading to increased medical hospital admission in the North East Essex area of the East of England. FGNAMB 1 (in press) Google ScholarJones R (2015l) Trends in demand for urgent care. J Paramed Pract 7(10) (in press) Link, Google ScholarJones R (2016) Is cytomegalovirus involved in recurring periods of higher than expected death and medical admissions, occurring as clustered outbreaks in the northern and southern hemispheres? Brit J Med Medical Res 11(2): 1–31. doi: https://doi.org/10.9734/BJMMR/2016/20062 Crossref, Google ScholarOliver D (2014) Preventing hospital admission: we need evidence based policy rather than ‘policy based evidence’. BMJ 349: g5538. https://doi.org/http://dx.doi.org/10.1136/bmj.g5538 Crossref, Google Scholar FiguresReferencesRelatedDetailsCited byA Machine Learning Solution for Bed Occupancy Issue for Smart Healthcare Sector13 January 2022 | Automatic Control and Computer Sciences, Vol. 55, No. 6 2 November 2015Volume 21Issue 11ISSN (print): 1358-0574ISSN (online): 1759-7382 Metrics History Published online 14 November 2015 Published in print 2 November 2015 Information© MA Healthcare LimitedPDF download

Trends in death and end-of-life costs in the UK

British Journal of Healthcare ManagementVol. 20, No. 6 Money MattersTrends in death and end-of-life costs in the UKRod JonesRod JonesSearch for more papers by this authorRod JonesPublished Online:24 Jun 2014https://doi.org/10.12968/bjhc.2014.20.6.298AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References Bardsley M, Georghiou T, Dixon J (2010) Social care and hospital use at the end of life. The Nuffield Trust, London: www.nuffieldtrust.org.uk/sites/files/nuffield/social_care_and_hospital_use-full_report_081210.pdf (accessed 28 May 2014) Google ScholarJones R (2012a) Volatile inpatient costs and implications to CCG financial stability. BJHCM 18(5): 251–8 Google ScholarJones R (2012b) End of life care and volatility in costs. BJHCM 18(7): 374–81 Google ScholarJones R (2012c) Diagnoses, deaths and infectious outbreaks. BJHCM 18(10): 539–48 Google ScholarJones R (2013a) Could cytomegalovirus be causing widespread outbreaks of chronic poor health. In: Shoja M, ed. Hypotheses in Clinical Medicine. Nova Science Publishers Inc, New York, NY: 37–79 Google ScholarJones R (2013b) An unexplained increase in deaths during 2012. BJHCM 19(5): 248–53 Google ScholarJones R (2013c) Recurring outbreaks of a subtle condition leading to hospitalization and death. Epidemiology: Open Access 4(3): 137. Available from: www.hcaf.biz/2013/2161-1165-3-137.pdf Google ScholarJones R (2013d) Is the demographic shift the real problem? BJHCM 19(10): 509–11 Google ScholarJones R (2013e) Trends in elderly diagnoses: links with multi-morbidity. BJHCM 19(11): 553–58 Google ScholarJones R (2013f) Do recurring outbreaks of a type of infectious immune impairment trigger cyclic changes in the gender ratio at birth? Biomedicine International 4(1): 26–39 Google ScholarJones R (2013g) A recurring series of infectious-like events leading to excess deaths, emergency department attendances and medical admissions in Scotland. Biomedicine International 4(2): 72–86 Google ScholarJones R (2013h) Analysing excess winter mortality: 2012/13. BJHCM 19(12): 601–5 Google ScholarJones R (2014a) What is happening in unscheduled care? Journal of Paramedic Practice 5(2): 60–2 Link, Google ScholarJones R (2014b) Increased deaths in 2012: which conditions? BJHCM 20(1): 45–7 Google ScholarJones R (2014c) Infectious-like spread of an agent leading to increased medical hospital admission in the North East Essex area of the East of England. Biomedicine International 5(1): (in press) Google ScholarJones R (2014d) Unexpected and semi-permanent increase in emergency medical admissions: admission threshold or infectious-like spread? British Journal of Medicine and Medical Research (in press) Google ScholarJones R (2014e) Unexpected single-year-of-age changes in the elderly mortality rate in 2012 in England and Wales. British Journal of Medicine and Medical Research 4(16): 3196–7 Crossref, Google ScholarJones R (2014f) A previously uncharacterized infectious-like event leading to spatial spread of deaths across England and Wales: Characteristics of the most recent event and a time series for past events. OA Medicine (submitted) Google ScholarJones R, Beauchant S (2014) Spread of a new type of infectious condition across Berkshire in England between June 2011 and March 2013: Effect on medical emergency admissions. OA Medicine (submitted) Google ScholarJones R, Goldeck D (2014) Unexpected and unexplained increase in death due to neurological disorders in 2012 in England and Wales: Is cytomegalovirus implicated? Medical Hypotheses 83(1): 25–31. http://www.sciencedirect.com/science/article/pii/S0306987714001650 Google Scholar FiguresReferencesRelatedDetails 2 June 2014Volume 20Issue 6ISSN (print): 1358-0574ISSN (online): 1759-7382 Metrics History Published online 24 June 2014 Published in print 2 June 2014 Information© MA Healthcare LimitedPDF download

Association of Human Mortality with Air Pollution of Hong Kong

In this study, we attempted to investigate the general statistical association of air pollution with the cardiovascular and respiratory mortality of the elderly in Hong Kong. Based on six years of measurements including the major air pollutant concentrations (PM10, SO2, NO, NO2, O3, CO), ambient temperature, and mortality (respiratory, cardiovascular) between 2005 and 2010, correlation analysis was carried out in annual, monthly and weekly time scales. From an annual perspective, it was found that the air pollution species may pose a constant effect on the respiratory and the cardiovascular mortality during the studied period since the elderly mortality rates and the air pollution annual concentrations show obvious constant trends. From a monthly time scale, it was found that NO2 and CO have high positive cross correlation with the respiratory mortality of the following 1 to 2 months. In addition, PM10 and CO also have similar delayed influence on the cardiovascular mortality. Among these four pollutants, only CO was found to exhibit high statistical association in the weekly time scale and it is most related to the cardiovascular mortality of the week after next. Therefore, it was concluded that the effect of air pollution on the elderly mortality of Hong Kong should be cumulative. This study implies that the establishment of weekly or monthly air quality indices is necessary for health implications.

Long-term cycles in admissions for neurological conditions

British Journal of Healthcare ManagementVol. 20, No. 4 Money MattersLong-term cycles in admissions for neurological conditionsRod JonesRod JonesSearch for more papers by this authorRod JonesPublished Online:14 May 2014https://doi.org/10.12968/bjhc.2014.20.4.192AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View articleReferencesFerrari C, Tarelli R (2011) Parkinson's disease and systemic inflammation. Parkinson's Disease doi: https://doi.org/10.4061/2011/436813 Google ScholarRussell P, Banerjee S, Watt Jet al. (2013) Improving the identification of people with dementia in primary care: evaluation of the impact of primary care dementia coding guidance on identified prevalence. BMJ Open 3(12): e004023 Crossref, Google ScholarJones R (2013a) Could cytomegalovirus be causing widespread outbreaks of chronic poor health. In: Shoja M, ed. Hypotheses in Clinical Medicine. Nova Science Publishers Inc, New York, NY: 37–79. Available at: www.hcaf.biz/2013/CMV_Read.pdf (accessed 26 March 2014) Google ScholarJones R (2013b) Recurring outbreaks of a subtle condition leading to hospitalization and death. Epidemiology: Open Access 4(3): 137 Google ScholarJones R (2013c) Do recurring outbreaks of a type of infectious immune impairment trigger cyclic changes in the gender ratio at birth? Biomedicine International 4(1): 26–39 Google ScholarJones R (2013d) A recurring series of infectious-like events leading to excess deaths, emergency department attendances and medical admissions in Scotland. Biomedicine International 4(2): 72–86 Google ScholarJones R (2013e) What every GP needs to know about financial risk in commissioning. General Practice Online. Available at: www.priory.com/family_medicine/GP_commissioning_risk.htm (accessed 26 March 2014) Google ScholarJones R (2014a) Infectious-like spread of an agent leading to increased medical hospital admission in the North East Essex area of the East of England. Biomedicine International 5(1): in press Google ScholarJones R (2014b) What is happening in unscheduled care? Journal of Paramedic Practice 5(2): 60–62 Link, Google ScholarJones R (2014c) Unexpected and semipermanent increase in emergency medical admissions: admission threshold or infectious-like spread? Public Health (submitted) Google ScholarJones R (2014d) Unexpected single-year-of-age changes in the elderly mortality rate in 2012 in England and Wales. British Journal of Medicine and Medical Research 4(16): 3196–207 Crossref, Google ScholarJones R, Beauchant S (2014e) Spread of a new type of infectious condition across Berkshire in England between June 2011 and March 2013: Effect on medical emergency admissions. Public Health (submitted) Google ScholarJones R, Goldeck D (2014f) Unexpected and unexplained increase in death due to neurological disorders in 2012 in England and Wales: Is cytomegalovirus implicated? Med Hypotheses (in press) Google Scholar FiguresReferencesRelatedDetails 1 April 2014Volume 20Issue 4ISSN (print): 1358-0574ISSN (online): 1759-7382 Metrics History Published online 14 May 2014 Published in print 1 April 2014 Information© MA Healthcare LimitedPDF download

Unexpected changes in outpatient first attendance

British Journal of Healthcare ManagementVol. 20, No. 3 Money MattersUnexpected changes in outpatient first attendanceRod JonesRod JonesSearch for more papers by this authorRod JonesPublished Online:27 Mar 2014https://doi.org/10.12968/bjhc.2014.20.3.142AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View articleReferencesBaylis D Bartlett D Patel H Roberts H (2013) Understanding how we age: insights into inflammaging. Longevity & Healthspan 2: 8 Crossref, Google ScholarJones R (2013a) Could cytomegalovirus be causing widespread outbreaks of chronic poor health. Hypotheses in Clinical Medicine 37–79. EdsM Shojaet al.. New York: Nova Science Publishers Inc. Available from: http://www.hcaf.biz/2013/CMV_Read.pdf (accessed 5 February 2014) Google ScholarJones R (2013b) Recurring outbreaks of a subtle condition leading to hospitalization and death. Epidemiology: Open access 4(3): 137 Google ScholarJones R (2013c) A recurring series of infectious-like events leading to excess deaths, emergency department attendances and medical admissions in Scotland. Biomedicine International 4(2): in press Google ScholarJones R (2014a) Infectious-like spread of an agent leading to increased medical hospital admission in the North East Essex area of the East of England. Biomedicine International 5(1): in press Google ScholarJones R (2014b) Roles for cytomegalovirus in infection, inflammation and autoimmunity. In: Shoenfeld Y, Rose NR, eds. Infection and Autoimmunity. Elsevier, Amsterdam Google ScholarJones R (2014c) What is happening in unscheduled care? Journal of Paramedic Practice 5(2): in press Google ScholarJones R (2014d) Unexpected and semipermanent increase in emergency medical admissions: admission threshold or infectious-like spread? Public Health, submitted. Google ScholarJones R (2014e) Unexpected single-year-of-age changes in the elderly mortality rate in 2012 in England and Wales. British Journal of Medicine and Medical Research, submitted. Crossref, Google ScholarJones R, Beauchant S (2014f) Spread of a new type of infectious condition across Berkshire in England between June 2011 and March 2013: Effect on medical emergency admissions. Public Health, submitted. Google ScholarWorld Health Organization (2010) International Statistical Classification of Diseases and Related Health Problems 10th Revision. Available at: http://apps.who.int/classifications/icd10/browse/2010/en (accessed 13 December 2013) Google Scholar FiguresReferencesRelatedDetailsCited byUnexpected and unexplained increase in death due to neurological disorders in 2012 in England and Wales: Is cytomegalovirus implicated?Medical Hypotheses, Vol. 83, No. 1 1 March 2014Volume 20Issue 3ISSN (print): 1358-0574ISSN (online): 1759-7382 Metrics History Published online 27 March 2014 Published in print 1 March 2014 Information© MA Healthcare LimitedPDF download

Unexpected Single-year-of-age Changes in the Elderly Mortality Rate in England and Wales During 2012

Aims: To evaluate single-year-of-age specificity in deaths in England and Wales associated with a large, unexpected and unexplained increase in 2012. To demonstrate that this type of event has occurred previously across the entire UK. To demonstrate that infectious-like spread at a regional level in England may be involved. Study Design: Longitudinal study of annual (calendar year) deaths (all-cause mortality) in the United Kingdom and England and Wales using publically available statistics available from the Office for National Statistics (ONS). Place and Duration of Study: United Kingdom, England & Wales, local authorities within England & Wales covering a variety of time spans designed to illustrate various key points. Methodology: Deaths between 1974 and 2012 in the United Kingdom. Live population and deaths for residents of England and Wales and of English local authorities. Calculation of single-year-of-age death rates in 2011 and 2012 which are the years before and after the large and unexpected increase in deaths. Results: A recurring series of infectious-like events can be demonstrated which prior to 2000 had been largely assumed to be due to influenza epidemics. The event in 2012 shows specificity for the elderly particularly above age 75, which is somewhat expected given increased susceptibility to the environment as we age. The single year of age mortality rate shows saw tooth behavior for deaths in 2011 and even more exaggerated saw tooth behavior is seen in the difference between 2011 and 2012. Similar saw tooth behavior is seen in the difference between single-year-of-age standardized admissions Original Research Article British Journal of Medicine & Medical Research, 4(16): 3196-3207, 2014 3197 via the emergency department in England between 2008 and 2012. The infectious spread across England behind this phenomenon is illustrated at regional level and probably results in a 40% underestimation of the saw tooth behavior. Conclusion: The saw tooth behavior is known to be associated with what is called ‘original antigenic sin’. Hence the saw tooth behavior appears to indicate that the unexpected high elderly mortality in 2012 was due to an outbreak of an infectious agent which has multiple strains. This behavior confirms the results of other studies investigating simultaneous increase in medical admissions to hospital during the time that the deaths increase. The ubiquitous herpes virus, cytomegalovirus may be involved, although at the moment this virus provides a prototype for the sort of immune modulating agent that may be responsible. The use of five year age bands to age standardize mortality and medical admission rates may be subject to misleading outcomes where the periodicity behind these outbreaks and their cumulative effect on immune mediated responses is out of synchrony with the basic saw tooth behavior seen in both mortality and admission rates. This has major implication to the calculation of hospital standardized mortality rates (HSMR).

Should mortality data for the elderly be collected routinely in emergencies? The practical challenges of age-disaggregated surveillance systems

Data on the elderly are rarely collected in humanitarian emergencies. During a refugee crisis in South Sudan, Médecins Sans Frontières developed a prospective mortality surveillance system collecting data for those aged ≥50 years and found that the elderly were dying at five times the rate of those aged 5–49 years. Practical and ethical issues arose. Were reported ages accurate? Since no baseline exists, what does the mortality rate mean? Should programmatic changes be made without evidence that these would reduce the elderly mortality rate? We outline issues to be addressed to enable informed decisions on response to elderly populations in emergency settings.

The Impact of Caregiver Support on Mortality Following Burn Injury in the Elderly

Advances in burn care have decreased mortality in the past 20 years, but affecting elderly mortality rates (>65 years) remain challenging. This study evaluates the impact of home caregiver support on elderly burn patients' mortality. The authors retrospectively reviewed patients aged 65 and older admitted to their burn center from July 1995 to October 2004. Patient demographics, Injury Severity Score, TBSA, and patients' primary caregiver were collected. The outcomes were mortality, disposition, and length of stay and these were evaluated using univariate and subsequently multivariate regression. Significance was calculated at P ≤ .05. A total of 112 patients were included in the analysis. The mean age was 76±8. Male patients constituted 47%, whereas 53% were female patients, and mean TBSA was 21±16%. Thirty patients' primary caregiver was a spouse, for 38 it was a child, and 44 had no caregiver. Fifty-eight patients survived (51.7%), and 54 patients died (48.3%). Only 21% of the survivors had a child as their primary caregiver; however, 48% of the nonsurvivors had a child as the primary caregiver (P ≤ 0.05). On multivariate analysis, age, TBSA, and child as primary caregiver were all independent predictors of mortality. Having a child as a caregiver provided the largest impact, with an odds ratio of 4.4 (95% confidence interval, 1.2-15.62; P = .02).

Air temperature-related human health outcomes: Current impact and estimations of future risks in Central Italy

The association between air temperature and human health is described in detail in a large amount of literature. However, scientific publications estimating how climate change will affect the population's health are much less extensive. In this study current evaluations and future predictions of the impact of temperature on human health in different geographical areas have been carried out. Non-accidental mortality and hospitalizations, and daily average air temperatures have been obtained for the 1999–2008 period for the ten main cities in Tuscany (Central Italy). High-resolution city-specific climatologic A1B scenarios centered on 2020 and 2040 have been assessed. Generalized additive and distributed lag models have been used to identify the relationships between temperature and health outcomes stratified by age: general adults (<65), elderly (aged 65–74) and very elderly (≥75). The cumulative impact (over a lag-period of 30days) of the effects of cold and especially heat, was mainly significant for mortality in the very elderly, with a higher impact on coastal plain than inland cities: 1°C decrease/increase in temperature below/above the threshold was associated with a 2.27% (95% CI: 0.17–4.93) and 15.97% (95% CI: 7.43–24.51) change in mortality respectively in the coastal plain cities. A slight unexpected increase in short-term cold-related mortality in the very elderly, with respect to the baseline period, is predicted for the following years in half of the cities considered. Most cities also showed an extensive predicted increase in short-term heat-related mortality and a general increase in the annual temperature-related elderly mortality rate. These findings should encourage efforts to implement adaptation actions conducive to policy-making decisions, especially for planning short- and long-term health intervention strategies and mitigation aimed at preventing and minimizing the consequences of climate change on human health.

Recessions and seniors’ health, health behaviors, and healthcare use: Analysis of the Medicare Current Beneficiary Survey

A number of studies report that U.S. state mortality rates, particularly for the elderly, decline during economic downturns. Further, several prior studies use microdata to show that as state unemployment rates rise, physical health improves, unhealthy behaviors decrease, and medical care use declines. We use data on elderly mortality rates and data from the Medicare Current Beneficiary Survey from a time period that encompasses the start of the Great Recession. We find that elderly mortality is countercyclical during most of the 1994–2008 period. Further, as unemployment rates rise, seniors report worse mental health and are no more likely to engage in healthier behaviors. We find suggestive evidence that inpatient utilization increases perhaps because of an increased physician willingness to accept Medicare patients. Our findings suggest that either elderly individuals respond differently to recessions than do working age adults, or that the relationship between unemployment and health has changed.