Five-year Age Groups Research Articles

Development and justification of a method for presenting radiation risks associated with medical exposure of patients

The practical implementation of radiation protection principles in the medical exposure of patients often tends to fall into one of two extremes: either excessive simplification of the methodology for assessing radiation health detriment, or its excessive complexity. An example of an excessively simplified approach is the assessment of radiation risk to patients using effective dose and radiation damage coefficients (nominal risk coefficients) as presented in Norms of the Radiation Safety NRB-99/2009. An example of an unjustifiably complex approach can be considered Tables 1-2 in MR 2.6.1.0215-20 "Assessment of radiation risk to patients during X-ray diagnostic radiological examinations," which indicate "lifetime risk values of death taking into account harm from reduced quality of life due to cancer of various organs and tissues and genetic effects from medical examinations" for a wide range of medical diagnostic X-ray radiological examinations in five-year age groups of patients. The main shortcomings of the simplified approach can be considered the lack of differences in risk assessment between individuals of different sexes and ages, although the fact of higher radiosensitivity in children compared to adults and in women compared to men can be considered universally recognized. The risk assessment approach proposed in MR 2.6.1.0215-20 addresses these shortcomings. However, in the view of the authors of this study, it offers an unnecessarily detailed picture considering uncertainties inherent in risk assessments at low doses, as well as uncertainties in the method of interpopulation transfer of radiation risk proposed by the International Commission on Radiological Protection. The aim of this study was to develop and justify a simpler and more straightforward method of presenting information on radiation risks associated with medical X-ray radiological examinations, free from the main drawbacks of the two aforementioned methods. To achieve this goal, radiation risks were calculated using two methods (using effective dose and using the risk model of the International Commission on Radiological Protection). A comparative analysis of the calculation results was conducted with estimates presented in Tables 1-2 of MR 2.6.1.0215-20. As a result of the analysis, an original applied method for presenting qualitative characteristics of radiation risks was developed for use in prescribing X-ray radiological examinations and informing patients about potential health risks. The practical outcome of the study is the formation of a table of radiation risks associated with conducting studies on patients from the Russian population, using the developed method of presenting information on radiation risks.

Impact of Bedside Echocardiography in the Management of Critically Ill Pediatric Patients in the Pediatric Intensive Care Unit: A Cross-Sectional Study.

Background Managing critically ill pediatric patients is a challenging responsibility that necessitates effective prioritization and time management. It is important not only to assess the condition of the patient on a continuous and real-time basis but also to assess in a way that will provide vital clues that may help in diagnosis and treatment. Our study aims to investigate the association between echocardiography and clinical systemic examination, to find the association between cardiac dysfunction and pediatric outcomes, and to identify the indications and necessity of echocardiography assessments and therapeutic interventions for patients in the pediatric intensive care unit. Methods This cross-sectional study was conducted in the pediatric intensive care unit (PICU) of the pediatrics department at Datta Meghe Institute of Higher Education and Research, Wardha, India. All critically ill pediatric patients admitted to the PICU underwent echocardiography. The study primarily focused on the indications for echocardiography, the association between systolic and diastolic dysfunction and patient outcomes, and the therapeutic interventions implemented based on the echocardiographic findings. Results The study analyzed 139 subjects aged from one month to 204 months, with the majority in the one- to five-year age group, followed by the 10-15-year age group. Cardiac anomalies were identified in 39 out of 139 cases, and cardiac murmurs were present in 27 cases with an almost equal gender distribution in the infantile age group. Dyspnea, edema, and hepatomegaly were the most common indications for echocardiography. Lasix was the most commonly used antifailure drug used in heart diseases. Sixteen individuals had systolic dysfunction, and eight had diastolic dysfunction, with a mortality rate of 62%. There was a significant association between systolic and diastolic dysfunction and mortality. Conclusion Echocardiography is a valuable asset within the PICU, providing critical insights into cardiac function and hemodynamics. By guiding clinical decision-making, it plays a pivotal role in optimizing care strategies, ultimately leading to improved outcomes for pediatric patients admitted with cardiac conditions. Overall, the study emphasizes the complex nature of pediatric cardiac conditions and the necessity for individualized treatment approaches based on distinct diagnoses and clinical indications.

Age-specific colorectal cancer incidence trends in Canada, 1971–2021

IntroductionColorectal cancer (CRC) incidence among adults younger than 50 years has increased in recent decades, leading to some advocating for lowering the age to start CRC screening. Here, we estimate age-specific trends in CRC incidence in Canada and changes in risk by birth cohort. MethodsCRC incidence data from 1971 to 2021 by province, sex, and five-year age group (35−64) were obtained from the National Cancer Incidence Reporting System and the Canadian Cancer Registry. Annual percent changes in age-specific or age-adjusted incidence rates were analyzed with joinpoint regression. Birth cohort effect was estimated with age-period-cohort models and reported as cohort incidence rate ratios (IRRs) with respect to the 1947–51 cohort. ResultsCRC incidence has increased among all age groups under 50 years, with the largest relative increases occurring in the youngest age group (35–39 years). Males and females had similar incidence trends, though males under age 50 had larger increases than females. The birth cohort analysis showed that males born since 1966 have a significantly higher risk than those born at any other time. ConclusionsThese results up to 2021 confirm and update reports that CRC incidence is increasing among adults under age 50 in Canada and that the youngest birth cohorts carry the highest risk. Future studies should assess the effectiveness of CRC screening in younger populations.

Age-sex characteristics of the incidence of melanoma of the skin in the Samara region

Currently, melanoma of the skin is an urgent medical and social problem. In recent decades, there has been an increase in the incidence and prevalence in the world and in the Russian Federation. According to the results of an epidemiological study, an increase in the prevalence and incidence of skin melanoma in the Samara region in 2014–2022 was revealed. An in-depth calculation and analysis of five-year sex and age indicators of the incidence of melanoma of the skin was carried out. It has been established that the incidence rate in women generally prevails over the incidence rate of men in almost every five-year age group. With increasing age (especially in the group of 70 years and older), the incidence becomes higher in both men and women. The fact of a significant increase in the incidence of skin melanoma in 2022 compared to 2014 in young working ages is alarming. The results obtained indicate the need to increase the effectiveness of targeted preventive measures to reduce the prevalence and incidence of skin melanoma, taking into account age and sex characteristics.

Linkage of administrative family court care proceedings and hospital records for mothers in England: linkage accuracy and cumulative incidence of family court care proceedings after a first live birth

IntroductionLinkage of public law family court care proceedings (CP) data to all women giving birth in NHS hospitals in England allows calculation of the cumulative incidence of CP involvement for mothers with first children born. ObjectivesTo assess linkage accuracy and determine the 10-year cumulative incidence of CP after a first live birth (FLB) for population subgroups. MethodNHS England linked records for mothers in Cafcass (Children and Family Court Advisory and Support Service) involved in CP (2007-2021) to all mothers with a delivery in England using Hospital Episode Statistics (HES: 1997-21). We calculated match rates and assessed indirect evidence of potential false positive and missed links. We used survival analyses to estimate cumulative incidence of CP within 10 years overall and for five-year maternal age groups at first live birth. ResultsOf 120,937 mothers involved in CP, 6.6% (n = 8,010) were excluded due to missing postcode or date of birth, or age < 15 or > 50. Of the remaining 112,927 mothers, 92,891 (82.8%) were linked to a HES delivery record. Match rates were lowest for mothers with an ethnic minority background, older at first case, or residing in Greater London, but improved over time. Of 3,572,737 mothers with a FLB, 38,462 had CP involvement. The cumulative incidence of CP at 10 years from FLB was 1.31% (95% Confidence Interval [CI]; 1.29-1.32) overall and highest in mothers aged 15--19 years (6.79%, 95% CI: 6.69-6.89) and those living in the most deprived areas (2.47%, 95% CI: 2.43-2.51). ConclusionOne in 77 of all mothers and one in 15 aged less than 20 at first live birth were involved in CP within 10 years. Linkage error may underestimate the incidence of CP for mothers in London or with an ethnic minority background.

The contribution of second primary cancers to the mortality of patients with a first primary breast cancer

PurposeSecond primary cancers (SPCs) are estimated to affect nearly 5% of patients with breast cancer within 10 years of their diagnosis. This study aimed to estimate the contribution of SPCs to the mortality of patients with a breast first primary cancer (FPC).MethodsA population-based cohort of 17,210 patients with a breast FPC diagnosed between 2000 and 2010 was followed for SPCs (31/12/2015) and vital status (30/06/2021). Patients diagnosed with an SPC (265 synchronous and 897 metachronous, ≤ 1 and > 1 year after the FPC, respectively) were matched (1:3, by five-year age group and year of breast FPC diagnosis) to those without an SPC and alive when the corresponding SPC was diagnosed.ResultsSignificantly higher hazards of death were found among patients with an SPC [hazard ratio of 1.56, 95% confidence interval (CI) 1.29–1.89 for synchronous SPCs; and 2.85, 95%CI 2.56–3.17 for metachronous SPCs] compared to patients with a breast FPC only. Estimates were higher for synchronous lung, stomach, non-Hodgkin lymphoma and breast SPCs, and metachronous liver, stomach, ovary, lung, rectum, corpus uteri, colon, breast, and non-Hodgkin lymphoma SPCs. The 15-year cumulative mortality was 59.5% for synchronous SPCs and 68.7% for metachronous SPCs, which was higher than in patients with a breast FPC only (43.6% and 44.8%, respectively).ConclusionsIn Northern Portugal, patients with an SPC following a breast FPC have a higher mortality compared with patients with a breast FPC only.

The effect of educational attainment on birthrate in Japan: an analysis using the census and the vital statistics from 2000 to 2020

BackgroundIn Japan, difference in birth rates depending on educational attainment has not been investigated. This study aimed to reveal birth rates in Japan depending on the highest level of educational attainment and their trends over the years using nationwide government statistics data.MethodsIndividual-level data from Vital Statistics and the Census from 2000, 2010, and 2020 were used for birth and population data, respectively. Data linkage was conducted for males and females in the Census and fathers and mothers in the Vital Statistics using information about gender, household, nationality, marital status, birth year, birth month, prefecture, and municipality for individuals. The birth rate was calculated by gender, a five-year age group, the highest level of educational attainment achieved, and year. In addition, the slope index of inequality (SII) and relative index of inequality (RII) were calculated to evaluate the degree of inequality in birth rates, depending on the educational attainment.ResultsBirth rates were higher in persons with lower educational attainment compared to those with a higher educational attainment among males and females in their twenties, while they tended to be higher in persons with higher educational attainment among those in their thirties and forties. Additionally, an increase in the birth rate from 2000 to 2020 was the largest in university graduates among males aged 25–49 years and women aged 30–49 years, and a decrease in the birth rate was the smallest in university graduates among males and females aged 20–24 years. As a result, SII and RII increased from 2000 to 2020 among males and females in their thirties and forties.ConclusionsIn conclusion, persons with higher educational attainment tended to have a relatively favorable trend in the birth rate compared with persons with lower educational attainment in recent decades. It suggested that enhanced administrative support for individuals with lower educational attainment or lower socioeconomic status may be required to ameliorate the declining birth rate in Japan.

The state of cancer care in Russia: age and cancer. Features of localization structure, quality of accounting and survival of elderly patients with ZNO (population study). Part 4

In the previous series of articles, we examined in detail the features of the prevalence, the quality of primary registration, the localization structure and survival of patients with malignant neoplasms in various age categories of the Russian population from children and adolescents to middle age (45–59 years). In this study, we will consider all these aspects for the following age category of elderly people. In accordance with the distribution of the age structure recommended by the World Health Organization, the elderly population includes people from 60 to 79 years old. The WHO age classification is not an absolute criterion for classifying a person to a certain age structure, especially for residents of different countries, taking into account their socio-economic characteristics. The elderly age according to the university characteristic is determined by the fact that there is a decrease in vital activity. The specific features of morbidity, mortality and survival of the elderly population of Russia will be considered in detail for each five-year age group of the elderly – 60–64 years, 65–69 years, 70–74 years.

The state of cancer care in Russia: age and cancer. Features of the localization structure, quality of accounting and survival of patients with malignant neoplasms of senile age and centenarians (population study). Part 5.

In accordance with the World Health Organization (WHO) standard, the elderly population is defined as individuals aged 75 to 89, while long-livers are those aged 90 and older. According to the United Nations, long-livers are individuals who have reached 100 years of age. In the preceding four messages, we explored the specific detailed localization structure of morbidity, mortality, and survival in pediatric, adolescent, young adult, middle-aged, and elderly populations. However, the analysis of these characteristics for individuals in the elderly and long-liver categories is conducted for the first time. Old age is the period of human life characterized by the loss of the body's ability to sustain the species, deterioration of mental capacities, and decline in bodily functions. It represents an age range for individuals nearing the expected life span. Gerontologists are concerned with medical research into the aging process, while diseases affecting the elderly and old age fall under the purview of geriatrics. The discipline of gerontology deals with the technologies for supporting an aging society. The elderly and older adult populations are more susceptible to diseases and injuries. They face economic challenges related to retirement, loneliness, and ageism – age-based discrimination. The WHO's definition of "elderly" encompasses three five-year age groups, including long-livers: - 75-79 years – early old age - 80-84 years – advanced old age - 85-89 years – late old age - 90 years and older – long-livers. We will attempt to examine the specific localization characteristics and the potential effectiveness of specialized oncological care for each of these age groups. Emphasis will also be placed on the quality of primary patient registration whenever possible.

Global burden of young-onset Alzheimer's disease and other dementias: a secondary analysis of the global burden of disease study, 2019.

To describe the global burden of young-onset Alzheimer's disease and other dementias by world region and income through a secondary analysis of the Global Burden of Disease Study 2019. This is a descriptive cross-sectional ecological study. Data by sex and five-year age groups from 40 to 64 years were extracted from the Global Burden of Disease Study results tool. We performed a descriptive analysis of prevalence, incidence, deaths, disability-adjusted life years, years of life lost, and years lived with disability. In 2019, young-onset Alzheimer's disease and other dementias presented a prevalence of 2.67 cases and an incidence of 0.44 per 1,000 inhabitants globally. It carried a significant burden, resulting in 1.16 disability-adjusted life years per 1,000 inhabitants, primarily due to years of life lost, and to a lesser extent due to years lived with disability. East Asia & the Pacific, Latin America & the Caribbean, and North America are the most affected regions. Burden rates are consistently higher among women; no gradient was observed by country income. Smoking was the most relevant risk factor, presenting a broad difference by country income level. The global burden of young-onset Alzheimer's disease and other dementias may reshape healthcare requirements and the societal impact of dementias, and its understanding is relevant to inform decisions related to service offerings and research agendas.

ТЕНДЕНЦИИ ТРУДОВОЙ ЗАНЯТОСТИ ПЕНСИОНЕРОВ В РАЗРЕЗЕ ЗАНЯТИЙ И ВИДОВ ЭКОНОМИЧЕСКОЙ ДЕЯТЕЛЬНОСТИ В 2017–2022 ГГ.

The purpose of the study is to analyze and evaluate trends in the employment process of pensioners in 2017 (before the reform) and 2022. The subject of the study is data on distribution by occupation (according to the All-Russian Classifier of Occupations-2014) and by type of economic activity of pensioners over working age by five-year age groups. The study used the method of dynamic and categorical comparison of employment characteristics of persons over working age. In the course of the study, the following tasks were solved: 1) general employment trends of working people over working age were determined; 2) employment trends of men and women of retirement age were identified; 3) features of employment dynamics by gender and age were established. An attempt was made to assess the contribution of previous pension generations (who were already old-age pensioners in 2017) to the change in indicators as a whole. Data indicate a steady decline in the number of workers of retirement age engaged in unskilled labor. The share of employed older workers in management positions is gradually declining. The most noticeable changes are occurring in the employment structure of men of retirement age, as their share among highly qualified specialists is declining. At the same time, the share of women in this category increased by 4 percentage points. There is a reduction in the share of older workers in organizations and enterprises with significant state participation and their flow into the sphere of trade and services. As a result of the study, a scientifically based conclusion was made that to level out the described negative processes, it is advisable (taking into account the difference in life expectancy of men and women) to reduce the retirement age limit for men.

Cohort consumption in the Russian Federation

The current demographic situation in both developed and developing countries is characterized by an aging population. From an economic perspective, this phenomenon holds practical significance for studying anticipated changes in the structure of state budget revenues and expenditures, as well as alterations in the overall consumption of goods and services. This paper investigates the spending patterns of different generations in the Russian Federation. In foreign literature, there is an observed increase in consumption with each successive generation compared to its predecessor. This trend is commonly attributed to declining fertility rates, the accumulation of capital by one generation, and its subsequent transfer to the next. Consequently, the younger generation tends to possess more capital than their forebears. The level of consumption across generations is also influenced by the life expectancy of the population; an extension of healthy life expectancy enables individuals to remain active in the workforce beyond retirement age. Utilizing data from the Russian Longitudinal Monitoring Survey (RLMS), HSE conducts cohort consumption estimates for the years 2000-2020, categorized into five-year age groups. The study results indicate an increase in consumption levels beyond the age of 50 for cohorts born between 1930 and 1955. Conversely, for cohorts born between 1960 and 1999, the consumption levels below the age of 50 remained relatively unchanged.

Changing Trends in Sickle Cell Disease-Related Mortality in the United States over Four Decades

Introduction: Sickle cell disease (SCD) causes significant morbidity and early mortality. The Cooperative Study of Sickle Cell Disease estimated median life expectancy for individuals with SCD at 42 years for males and 48 years for females in the early 1990s. However, this calculation was made prior to now standards-of-care in SCD, including routine transcranial doppler screening, pneumococcal prophylaxis, and the introduction of the primary disease-modifying therapy hydroxyurea and the widespread use of chronic blood transfusion. Over the last thirty years, with expanded access to disease modifying therapies, increased evidence exists for the preservation of organ function and less frequent acute vaso-occlusive pain. It remains unclear whether the introduction of these therapies has affected overall SCD-related mortality or the specific causes of death of those with SCD in the United States, particularly in the last decade when the use of hydroxyurea has expanded most significantly. Methods: We used the US mortality statistics for 1979-2020 available publicly through the CDC WONDER database (http://wonder.cdc.gov), which is a compilation of county, state, and national-level mortality statistics derived from death certificates, including age category at death, sex, race, ethnicity, year of death, underlying cause of death, and additional contributing causes using ICD-9 codes for 1979-1998 (282.6 sickle cell anemia- all SCD genotypes were included under one code in ICD-9) and ICD-10 codes for 1999-2020 (D57.0 sickle cell anemia with crisis; D57.1 sickle cell anemia without crisis; D57.2 double heterozygous sickling disorders; D57.8 other sickle cell disorders). We searched the SCD ICD-10 codes listed as underlying cause of death by five-year age groups for Black individuals and all ethnicities, (from Hamideh and Alvarez, Pediatric Blood and Cancer 2013) and compared the crude death rates overall and for each age group to those of 1999-2009. We also searched using the SCD ICD-10 codes included in “the multiple causes of death” to determine the 15 most common ICD categories of death in each 10-year period. Results: For the period 2010-2020, 5272 Black (Hispanic & non-Hispanic) individuals died in the United States with the underlying cause of death listed as one of the ICD-10 SCD codes (see Figure 1A for a map of the crude mortality rate distribution). The crude mortality rate was 1.1 per 100,000 Black individuals, which was significantly lower than the period 1999-2009 (crude rate 1.2 per 100,000, p < 0.0001) (Figure 1B). Of note, similar to prior trends, there is a significant increase in mortality rate in the 15-19 year age group versus 20-24 years (0.9 per 100,000 to 1.4 per 100,000, p < 0.0001) corresponding with the age of transition to adult centers. The mean age at death for all genotypes for 2010-2020 was 43 years (females: 44 years, males: 41 years) versus 39 years for 1999-2009 (females: 40 years, males: 38 years). For the period 2010-2020, 61% of cases listed SCD as the primary cause of death without specificity or proximal cause; for the other 39% of cases when an underlying cause of death was noted, cardiovascular disease was the most common (28%), followed by accidents (7%), cerebrovascular disease (7%), malignancy (6%), septicemia (4.8%), and renal disease (3.8%). The fifteen most common causes of death accounted for 90% of underlying causes of death listed in the SCD population. Conclusion: The sickle cell disease-related mortality rate has significantly declined over the last 40 years, including in the period 1999-2020, corresponding with the introduction of disease modifying therapies, improved SCD care, and decreased infant mortality. This overall improvement, however, provides contrast to the enduring sharp increase in mortality in the young adult years. This demonstrates the critical need to improve the transition process from pediatric to adult care and to emphasize the need for additional support for young adults after they transition to adult SCD care.

Historical trends in breast cancer presentation among women in Pakistan from join-point regression analysis.

Breast cancer prevalence in Pakistan is among the highest in Asian countries. Recent changes in the temporal trends of breast cancer are largely unknown and examination of these trends can provide a direction in national planning for future health programs. The aim of this study was to examine recent changes in breast cancer incidence in Pakistan. A total of 9,771 diagnosed breast cancer women were registered from 2004 to 2015 in three hospitals of Karachi. Join-point regression analysis was applied to assessing the age-standardized breast cancer presentation trends for each five-year age group. Age-specific average annual percentage changes were also calculated to assess the proportion of women with increased or decreased incidence of breast cancer. Age-standardized rates of breast cancer steadily increased from 24.7 per 100,000 in 2004, to 45.4 per 100,000 in 2015. The analytical trend based on the join-point model showed an average percentage increase breast cancer prevalence of 5.4 (95% CI = 3.1, 7.8). Significantly higher prevalence rates were identified among women aged 40-44 years and 65-69 years with an average percentage change of 18.5 (95% CI = 2.3, 37.2) and 14.3 (95% CI = 2.2, 27.9) respectively in the four years from 2011 to 2015. The findings indicate the trend in age-standardized prevalence increased significantly in all age groups with noticeably larger increases observed among older and post-menopausal women from 2011 to 2015. The results warrant the need for more targeted interventions to high-risk groups and a sound foundation for cancer control program planning and policy development in Pakistan to reduce the increasing incidence of breast cancer.

Hepatitis B infection status among South Africans attending public health facilities over a five-year period: 2015 to 2019.

Hepatitis B, a potentially life-threatening viral infection of the liver, remains a global public health concern despite the availability of effective vaccines for over three decades. The aim of our study was to provide national data on active hepatitis B infections in the public health sector of South Africa. We conducted retrospective analyses on national laboratory data over the period 2015 to 2019. We identified 176,530 cases who tested positive for HBsAg (active infection) with a test positivity rate of 9.02%. Of these active infections, 11,355 (6.43%) were found to be chronically infected. We linked 24,839 (14.07%) and 2,461 (21.67%) HBeAg positive results to all active HBV infections and identified chronic infections respectively. Clearance of HBsAg was observed in 5,569 cases, inclusive of clearance in 135 chronic cases. Active HBV infections were significantly higher in men than women over the five years (p < 0.0001). Among individuals who were vaccine-eligible as infants (0 to 19 years old), we observed 4,981 active HBV infections, including 1,131 infections under five years old, majority of which (65.78%) were under one year old. In the under five-year age group, the HBsAg population positivity rate was 0.02% and test positivity rate was 4.83%. Among all women with active HBV infections (78,935), 85.17% were of reproductive age and of these, 13.73% were HBeAg positive. Without a birth dose of the HBV vaccine, lack of routine HBsAg screening at antenatal care, and HBsAg and HBeAg prevalence among women of reproductive age, it is likely that the majority of cases under five years old were vertically infected. Optimal HBV vaccine coverage, inclusive of a birth dose, is key to eliminating horizontal and vertical transmission of HBV. Early identification of HBV chronicity through real time data analysis is fundamental in reducing the risk of liver cirrhosis and hepatocellular carcinoma.

State of oncological care in Russia: age and cancer. Features of the localization structure, quality of recording, and survival of young adults with malignant neoplasms (clinical-population study). Part 2.

In the first part of our clinical-population study, we present the results of assessing the effectiveness of anti-cancer measures conducted in Russia among children and adolescents. In this study, we focus on the prevalence and structure of oncological diseases, the quality of accounting, and the survival of primary patients in the "young adults" age group. To address the set tasks, we selected two groups for research: the entire Russia for calculating the incidence, mortality, and quality of accounting for patients, as well as the entire Northwest Federal District for calculating the survival of cancer patients. According to the WHO classification, young population is considered to be the age group from 18 to 44 years, i.e. after the adolescent period and up to 45 years. The main goal of our study is to investigate the specifics of the localization structure of oncological diseases for different age groups of the population, and the main reports present data for five-year age groups. In the future, we will analyze the features of the localization structure of oncopathology by five-year age intervals, starting from the age group of 20-24 years. This is of particular importance, as our previous study of the adolescent group (15-19 years old) did not reveal significant differences in the structure and survival of patients aged 15-17 years.

The impact of the National Shingles Vaccination Program on the epidemiology of herpes zoster among adults ≥ 60 years in Victoria, Australia.

In November 2016, Australia recommended herpes zoster (HZ) vaccination for adults aged ≥ 60 years and implemented a National Shingles Vaccination Program (NSVP) offering free HZ vaccination to adults aged 70-79 years. This study investigated trends in HZ epidemiology among Victorian adults aged ≥ 60 years and the impact of the NSVP in this population. We conducted epidemiological analyses of routinely collected HZ surveillance data for Victorian adults aged ≥ 60 years who were notified as having a HZ illness or vaccination between 2012 and 2021. Annual incidence rates are presented for vaccinations, case notifications, emergency department presentations, hospitalisations and deaths by five-year age groups. Age-specific incidence rate ratios are calculated comparing the period prior to (1 January 2012 to 31 October 2016) and following (1 November 2016 to 31 December 2021) NSVP implementation. HZ vaccination rates were highest among those eligible to receive free vaccination (70-79 years), but appear to have plateaued across all age groups and remained below full coverage. Incidence rate ratios showed a statistically significant increase (p < 0.01) in HZ notifications across all age-groups. Emergency presentations and hospitalisations showed a statistically significant decline (p < 0.05) among the 70-79 year old age groups; however, these rates remained consistent or increased among other age groups for whom vaccination is recommended. Mortality rates declined, particularly among those aged 85+ years. HZ continues to cause significant disease among the older adult population in Victoria. The findings of this study suggest the NSVP has led to some changes in the epidemiology of HZ among the 70-79 years old age group in Victoria; however, there is less evidence that it has influenced other age groups for whom vaccination is recommended. An evaluation of the NSVP and epidemiology of HZ at a national level is required to identify strategies to improve vaccination coverage among the target populations.

Sexual abuse during childhood and all-cause mortality into middle adulthood: an Australian cohort study.

To compare mortality from all causes, internal causes (eg, cancers, circulatory and respiratory system diseases), and external causes (eg, suicide, accidents, assault) among people who were sexually abused during childhood with mortality for the general population. Historical cohort study. 2759 people (2201 women, 79.8%) who had experienced medically assessed contact sexual abuse in Victoria while aged 16 years or younger during 1964-1995, as recorded in Victorian Institute of Forensic Medicine records. Mortality rate, based on linked National Death Index data (1980-2020), by five-year age group; sex- and age-standardised mortality ratios; comparison of rates with age- and sex-adjusted rates for the general Victorian population (incident rate ratio [IRR]). We included 115 deaths of people under 50 years of age in our analysis (4.2% of people sexually abused as children; 79 women, 36 men); 56 deaths were attributed to external, 56 to internal causes (cause of death information missing in three cases). In each age group from 15-19 years, the mortality rates for people sexually abused as children were higher than for the general population; age- and sex-standardised all-cause mortality ratios were highest for people aged 25-29 years (men: 16.5; 95% confidence interval [CI], 11.0-22.0; women: 19.2; 95% CI, 14.3-24.2). The age- and sex-adjusted mortality rate for people sexually abused as children was higher than in the general population for all-cause (IRR, 8.25; 95% CI, 5.92-11.5), internal cause (IRR, 5.92; 95% CI, 3.89-9.01), and external cause deaths (IRR, 12.6; 95% CI, 9.61-16.6); the differences in external cause mortality were greater for people who had experienced penetrative (IRR, 14.9; 95% CI, 10.9-20.5) than for those who had experienced non-penetrative sexual abuse as children (IRR, 8.92; 95% CI, 5.35-14.9). Sexual abuse during childhood is associated with higher mortality rates into mid-adulthood. Preventing child sexual abuse and intervening early to reduce the damage it inflicts is not only essential for the welfare of the child, but could also help reduce avoidable deaths later in life.

Mean age and body mass index at type 2 diabetes diagnosis: Pooled analysis of 56 health surveys across income groups and world regions.

Screening for type 2 diabetes mellitus (T2DM) targets people aged 35+ years and those with overweight/obesity. With mounting evidence on young-onset T2DM and T2DM patients with lean phenotypes, it is worth revising the screening criteria to include younger and leaner adults. We quantified the mean age and body mass index (BMI; kg/m2 ) at T2DM diagnosis in 56 countries. Descriptive cross-sectional analysis of WHO STEPS surveys. We analysed adults (25-69 years) with new T2DM diagnosis (not necessarily T2DM onset) as per fasting plasma glucose ≥126 mg/dL measured during the survey. For people with new T2DM diagnosis, we summarized the mean age and the proportion of each five-year age group; also, we summarized the mean BMI and the proportion of mutually exclusive BMI categories. There were 8695 new T2DM patients. Overall, the mean age at T2DM diagnosis was 45.1 years in men and 45.0 years in women; and the mean BMI at T2DM diagnosis was 25.2 in men and 26.9 in women. Overall, in men, 10.3% were 25-29 years and 8.5% were 30-34 years old; in women, 8.6% and 12.5% were 25-29 years and 30-34 years old, respectively. 48.5% of men and 37.3% of women were in the normal BMI category. A non-negligible proportion of new T2DM patients were younger than 35 years. Many new T2DM patients were in the normal weight range. Guidelines for T2DM screening may consider revising the age and BMI criteria to incorporate young and lean adults.

Contribution of specific age groups and classes of death causes &#x0D; to the life expectancy of the population of the Novosibirsk Region

Introduction. Life expectancy is an important public health criterion. An assessment of its trend, taking into account the contribution of individual causes of death, makes it possible to form a healthcare strategy at the regional level. &#x0D; The purpose of the investigation was to study the contribution of individual age groups and leading classes of death causes to the trend of the life expectancy for 2005–2020, the elimination reserves of the life expectancy of the population of the Novosibirsk Region in 2020. &#x0D; Material and methods. The calculations were based on mortality rates by gender, five-year age groups, and causes of death from the Russian Database on Fertility and Mortality of the Center for Demographic Research of the Russian Economic School. The methods of constructing brief tables of mortality, linear approximation, and the method of components were used to calculate the contribution of spesific age groups and causes of death to the trend of the life expectancy and its elimination reserves. &#x0D; Results. The increase in life expectancy in the Novosibirsk region during the study period took place in 2 stages. In 2005-2009 the growth of the indicator was largely ensured by reducing the mortality of people of working age, especially men, from external causes. Further increase in life expectancy in 2009–2019 associated with a decrease in mortality of people older than working age, in particular women from diseases of the circulatory system. In 2020, the coronavirus pandemic contributed to a decline in the life expectancy for men to the level of 2015, and for women until 2011.&#x0D; Limitations. Territorial, temporary. The trend in the life expectancy of men and women of the Novosibirsk Region for 2005–2020 was studied.&#x0D; Conclusion. When developing federal, regional socio-demographic programs, and planning the work of the healthcare system, it is necessary to take into account the identified features of the trend of mortality, life expectancy, and reserves for its increase. Particular attention should be paid to increasing the availability of medical care and programs for the health-saving behaviour spesific of the population.