Total Number Of Deaths Research Articles

Statewide burden of cancer attributable to alcohol use in the United States in the last three decades, projections of deaths to 2040: A benchmarking study.

10575 Background: Cancer stands as the 2nd leading cause of deaths and disability in the United States (US), and among the numerous contributing factors, modifiable risk factors play a significant role in exacerbating this burden. Within the spectrum of cancers, alcohol consumption ranks as the second leading attributable cause of death, as per the Global Burden of Disease Cancer Attributable Risk Factor Study. Methods: Employing the GBD protocol, we conducted an estimation of deaths, disability-adjusted life years (DALYs) attributable to cancer caused by alcohol consumption in the US. This comprehensive analysis was stratified by age, gender, year, and geographical location throughout the US, from 1990 to 2019. To project future trends, we utilized time-series regression techniques to forecast deaths until the year 2040. Results: The total number of cancer-related deaths in the US surged from 19,898 (95%UI: 17,791-22,149) in 1990 to 34,455 (30,542-38,388) in 2019. Concurrently, DALYs increased from 532,533 (480,249-586,646) in 1990 to 854,351 (764,549-949,378) in 2019, and YLLs rose from 501,639 (452,446- 554,400) in 1990 to 802,493 (717,123-891,789) in 2019. The highest annual percentage change (APC) in ASR for mortality was observed in West Virginia, with a 32% increase, followed by Tennessee at 27%. Conversely, the District of Columbia witnessed the most significant decrease, with a 30% reduction from 1990 to 2019. In terms of DALYs rates, the highest increases were observed in West Virginia (27%) and Oklahoma (21%). Males bore a greater overall burden compared to females, with an APC in deaths of 97% vs 40% and an APC in DALYs of 87% vs 26%. The highest number of deaths occurred in the 60-64 age group, with 5,228 cases in 2019, while DALYs reached 154,034 in the same year. Projections indicate that the total number of deaths is expected to increase by 49,230 by the year 2040. Conclusions: In 2019, cancer-related deaths attributed to alcohol use represented 4.42% of all cancer mortality cases. From both a public health and clinician perspective, the study's results highlight the urgent need for comprehensive strategies to address the growing burden of cancer associated with alcohol use. Efforts should focus on prevention, early intervention, and support for individuals struggling with alcohol-related cancer risks. [Table: see text]

Deciphering the global landscape of breast cancer in 38 OECD countries from 1990-2019: A benchmarking global analysis.

1046 Background: Breast Cancer (BC) stands as the primary contributor to disability and the second leading cause of death among countries belonging to the Organization for Economic Cooperation and Development (OECD). A comprehensive cross-country analysis of BC is crucial to monitor the growing burden. Methods: Employing the global burden of disease framework, we have calculated the incidence, prevalence, mortality, disability-adjusted life years (DALYs), and years of life lost (YLL) attributed to BC, categorized by age, gender, year, and geographical location across the 38 OECD member countries. Results: The total number of BC cases has witnessed a notable increase, rising from 5.5 million (95%UI: 5.1-6) in 1990 to 9 million (8.2-9.8) in 2019. BC-related deaths have also risen from 172,148 (164,284-176,147) in 1990 to 214,458 (195,692-226,347) in 2019, while DALYs have increased from 4.6 (4.5-4.8) in 1990 to 5.1 (4.8-5.5) in 2019. The annual percentage change (APC) in incidence has surged by 59% (44-75%) from 1990 to 2019. The highest APC in age-standardized incidence rates was observed in South Korea at 150% (99-205), while the most substantial decrease was recorded in Switzerland at 3%. Regarding death rates, Japan saw an 11% increase, Costa Rica 10%, Mexico 9%, South Korea 8%, and Turkey 4%, whereas the remaining countries witnessed a decrease from 1990 to 2019. In terms of DALY rates, Mexico and Japan experienced a 10% increase, South Korea 5%, Turkey 3%, with the rest showing a decrease from 1990 to 2019. Males bore a higher burden compared to females, with an APC in total incidence of 109% versus 58%, deaths at 73% versus 24%, and DALYs at 57% versus 10% from 1990 to 2019. The highest overall burden was observed in the 70+ age group, while the <70 and <20 age groups exhibited a decreasing trend. The total number of deaths is projected to continue increasing. Conclusions: In 2019, BC accounted for 6.64% of all cancer-related deaths and 7.9% of DALYs among women. Based on these findings, low-resource countries should consider reallocating funding to combat this burden, and public health policymakers need to prioritize surveillance and early screening efforts.

Evaluation of trend and mortality pattern of communicable diseases in a teaching institution in Kerala.

Even in this era of epidemiologic transition communicable disease is still a major public health problem. Surveillance and timely prevention and control activities are the key to the reduction of morbidity and mortality of communicable diseases. Identifying the trend in communicable diseases and pattern of mortality for a period of ten years will be an insight into the ongoing surveillance. In this study we have analysed data from 2013 to 2022 to evaluate the trend and mortality pattern of communicable diseases in a teaching institution in Kerala. A retrospective record-based cross-sectional study conducted at the Department of Community Medicine, Government Medical College, Kottayam. All confirmed communicable disease cases reported from 2013 to 2022 were included in this study except COVID-19-positive cases. The communicable diseases were grouped as: airborne, waterborne, vector-borne, zoonosis, bloodborne diseases and others. SPSS version 20.0 software, Microsoft Word, and Excel were used in data handling and analysis. Total cases reported were 48124. The majority of the morbidity was due to airborne diseases (17585,37%) followed by waterborne diseases (6381, 13%). The total number of deaths reported was 1842. Airborne and zoonotic diseases together accounted for more than 50% of the mortality. Case fatality rate of zoonosis (20.2%) was the highest followed by bloodborne diseases (10.2%). Communicable diseases still continue as a public health problem contributing to morbidity and mortality. Airborne diseases and zoonotic diseases constitute the maximum mortality.

Using a lean management approach in acute ischemic stroke management: a systematic review.

Stroke is the second leading cause of death worldwide with an annual mortality rate of 6.55 million, which accounts for 11.6% of the total number of deaths. Early diagnosis is crucial for improving treatment outcomes. Lean management is an approach originating in the car manufacturing process derived from the Toyota Production System, which healthcare providers have recently adapted. The objective is to examine the use of lean practices in managing AIS in hospital settings. A systematic literature search was performed using MEDLINE and SCOPUS databases, including publications from 1st January 2000 to 20th September 2022. A total of 13 studies fulfilled the predefined inclusion criteria. The recombinant tissue plasminogen activator (rtPA) was used in 11 studies, in 2 studies in combination with mechanical thrombectomy (MT). MT alone was used in the other 2 studies. The value stream mapping was used in all included studies to analyze workflow in acute ischemic stroke (AIS) treatment. Outcome measures include mostly door-to-needle (DTN) time for rtPA treatment and door-to-puncture (DTP) time for mechanical thrombectomy. DTN time was assessed in nine studies and reached statistically significant results in five. DTP was examined in three studies; in two, statistically significant decreases in DTP were observed. Lean management can be a useful method for achieving key performance indicators in AIS, consistent with current guidelines. The results of this systematic literature review show that value stream mapping may improve the process of AIS treatment by reducing in-hospital delays. The field of research that focuses on implementing lean management tools in healthcare is increasing, with more publications appearing in recent years.

Abstract PO5-27-04: The epidemiological profile and lifestyle of non-village indigenous women from Amazonas, Brazil and the likely impact on breast cancer mortality

Abstract Introduction: The high and growing incidence of breast cancer is a reality in almost every continent. However, the low mortality from this neoplasm among indigenous people of Amazonas, Brazil, is an intriguing fact (table 1). Inspite having a lower life expectancy at birth, the magnitude of low mortality is even greater. Indigenous women have gradually integrated into the non-indigenous community, and the reality of low mortality from breast cancer may be at risk of not existing in the future if the justification is in their reproductive epidemiological profile and lifestyle. Objective: This work seeks to find variables that can justify the fact that indigenous women from the Amazon region die less from breast cancer when compared to non-indigenous women. To achieve this, we evaluated reproductive epidemiological factors and lifestyle in non-village indigenous women and compared them with the same data in non-indigenous women. Methods: This is a cross-sectional study consisting of a convenience sample in which all indigenous people treated at the Mastology Outpatient Clinic of the Getúlio Vargas University Hospital of the Federal University of Amazonas were invited to participate from September 2020 to March 2023. There were 126 women: 39 non-village indigenous people who have lived in Manaus for more than 5 years and are integrated into society, 47 non-village indigenous people who live in riverside and interior populations of Amazonas - or in Manaus for less than 5 years - and 40 non-indigenous individuals. A questionnaire in interview format was administered with the objective of evaluating epidemiological and reproductive aspects such as age, education, BMI, menarche, parity, age at first pregnancy, breastfeeding, use of hormonal medications as well as lifestyle factors including smoking, alcohol consumption, dietary habits, physical activity, use of herbs, roots and seeds for therapeutic purposes and practice of religious devotional habits. Results: There was no difference in age, BMI, education, menarche and parity between the interviewed patients, nor in the assessment of the consumption of milk, sugar, fruits, vegetables and legumes, smoking habits, alcohol intake or physical activity between the groups. Indigenous women living in Manaus had a lower age at first pregnancy when compared to non-indigenous women. The variable “breastfeeding time” did not reach statistical significance but demonstrated a very close index (p 0.058) and a tendency to suggest that indigenous people, regardless of their place of residence, breastfeed for a longer duration. Non-indigenous women had a longer history of using hormonal medications when compared to indigenous women living in Manaus. Regarding meat consumption habits, indigenous women living in riverside and interior populations showed higher percentages of sporadic consumption of beef, sporadic consumption of wild animals, and daily consumption of white meat compared to non-indigenous people. On the other hand, non-indigenous women had a higher percentage of never having consumed wild animal meat when compared to the two other groups. Among indigenous women from riverside populations, there was a lower percentage of religious practices. The consumption of herbs, roots or seeds for therapeutic purposes was more commonly observed among indigenous people living in Manaus when compared to non-indigenous people. Conclusion: No epidemiological or lifestyle variables were found in both groups of indigenous people that justify the low mortality from breast cancer in these women. However, although the variable “breastfeeding time” did not reach statistical significance, it demonstrated a very close index (p 0.058) and a tendency to suggest that indigenous people, regardless of their place of residence, breastfeed for a longer duration. This could be a potential explanation for the low mortality from this disease among indigenous women. Table 1: Participation of breast cancer deaths in the total number of deaths in women over 20 years of age in the State of Amazonas Source: prepared by researchers Table 2 - Menarch, parity (childbirth and miscarage), breastfeed, Family history of breast cancer, image exam Table 3: Red and white meat consumption Citation Format: Maria Riselda Vinhote Da Silva, Lilian Cristina De Souza Guimarães, Afonso Nazário, Mariana Guimaraes De Oliveira Castro. The epidemiological profile and lifestyle of non-village indigenous women from Amazonas, Brazil and the likely impact on breast cancer mortality [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO5-27-04.

Years of Life Lost Due to Premature Mortality in Northern Iran: A Cross-sectional Study

Background: Years of life lost (YLL) is commonly used to determine the social and economic burden of loss due to premature mortality. The present study estimated YLL based on general mortality groups in Golestan Province, Iran, in 2018. Methods: In this cross-sectional study, by referring to the province death registration system information and using standard expected years of life lost (SEYLL) of the World Health Organization (WHO), YLL was calculated due to premature mortality based on general mortality groups in ICD-10 (international classification of diseases 10th revision). Results: The total number of deaths in Golestan Province was 8543 in 2018. The overall YLL due to premature mortality was 129838 years, of which 57.4% occurred among men. The major causes of YLL due to premature mortality (YLL%) were diseases of the circulatory system (I00-I99) (32.3%), external causes (V01-Y89) (17.3%), certain conditions originating in the perinatal period (P00-P96) (14.5%), and cancers (C00-D48) (13.9%). After diseases of the circulatory system, the most common cause of YLL due to premature mortality is external causes (22.9%) among men and cancers (16.2%) among women. In general, the highest YLL rate occurred due to circulatory system diseases (22.5 per 1000 people). Conclusion: According to the results of our study, most years of life lost in both sexes are related to diseases of the circulatory system, followed by external causes of morbidity and mortality. Therefore, it is important to pay attention to the diseases of the circulatory system and its causes, as well as external causes of morbidity and mortality.

Epidemiologic Features and Risk Factors for Crimean-Congo Hemorrhagic Fever in Dhi Qar Province, Iraq.

Crimean-Congo hemorrhagic fever virus (CCHFV) is endemic in Iraq, where recurrent epidemics have been constantly observed during the last five years. The present study aimed to determine the factors associated with Crimean-Congo hemorrhagic fever (CCHF) cases in Dhi Qar province during the year 2022. A test-negative case-control design was used to analyze 621 CCHF patients, of which 162 were confirmed and 459 were suspected cases. To identify the confirmed and suspected cases, reverse transcriptase polymerase chain reaction (RT-PCR) was used. Suspected patients whose PCR test results were negative were selected as the control group. Data on potential risk factors for CCHF were collected as existing data for previous years for the same geographical locations in Dhi Qar province. Logistic regression analyses were used to determine the correlation between probable risk factors and confirmed CCHF cases. The incidence rate of CCHF was 6.8% per 100,000 people. The total number of deaths was 48 for patients with a case fatality rate of 7.7%. The patients' ages ranged from one year to 65 years, with an overall mean ± SD of 36.08 ± 18.29 years. A total of 98.2% of the patients were between 15 and 65 years of age; 58% of the reported patients were male, and the male-to-female ratio was 1.4:1. Additionally, contact with raw meat, animal contact, and tick bite had the highest percentages for CCHF positivity cases. Male gender, high-risk jobs like housewives, health staff, shepherds, butchers, animal dealers, slaughterhouse workers, veterinary staff, and farmers, tick bites, and contact with raw meat were statistically significant predictors for increasing CCHF incidence in Dhi Qar province during the year 2022.

Abstract 2026: Assessing The Global Burden And Trends Of Stroke Attributable To Smoking In 38 Oecd Countries From 1990 To 2019: A Benchmarking Analysis

Introduction: Stroke has remained a 2 nd leading cause of both mortality and disability among cardiovascular diseases (CVD) on a global scale. Smoking is responsible for 12.27% of CVD-related deaths in countries belonging to the Organization for Economic Cooperation and Development (OECD). Method: Using Global burden of disease tool, we analyzed deaths, disability adjusted life years (DALYs), years lived with disability (YLDs) due to Stroke attributable to Smoking by age, sex, year and location across the 38 OECD countries. Results: The total number of deaths attributed to smoking-related strokes saw a notable reduction of 45% (with a 95% uncertainty interval of 42-48%), while DALYs decreased by 41% (with a range of 38-44%). However, YLDs showed a marginal 1% decrease (with a range of 2-5%). Regarding age-standardized rates, Latvia recorded the highest death rate in 2019 at 12.42 deaths per 100,000 person-years, followed by Hungary with 9.72 deaths. Conversely, Australia had the lowest rate at 1.97 deaths, while the United States reported 4.45 deaths per 100,000 person-years. In terms of specific age groups, the 80-84 age group witnessed the highest number of deaths, with 16,069 fatalities, while the 60-64 age group had the highest DALYs, totaling 392,824 in 2019. Over the past three decades, males consistently bore a greater burden compared to females. Conclusion: From a public health policy perspective, the significant decline in smoking-related stroke deaths and DALYs signals the success of anti-smoking efforts, yet the varying rates among countries underscore the need for tailored strategies. Clinicians should take heed of the enduring higher burden in males, emphasizing early intervention and smoking cessation counseling, especially for vulnerable age groups. Integrating prevention and smoking cessation programs into stroke care is pivotal to further mitigating smoking's impact on stroke outcomes.

Abstract 1011: Evolving Burden Of Aortic Aneurysm Attributable To High Systolic Blood Pressure In 204 Countries And Territories From 1990-2019: A Comprehensive Global Assessment

Introduction and Background: High blood pressure (HBP) is a major risk factor contributing to cardiovascular disease. Understanding the global burden of aortic aneurysms (AA) attributable to HBP is crucial for healthcare professionals, researchers, policymakers, and public health experts. Method: Using Global Burden of Disease tool, we estimated deaths, disability adjusted life years (DALYs) due to AA attributable to HBP by age, sex, year across the 204 countries and territories from 1990-2019. The results were employed in absolute counts and age-standardized rate (per 100,000 person years). Results: The study observed a notable increase in the total number of deaths due to AA attributable to HBP, rising from 36,629 in 1990 (95%[UI]: 28,841-44,353) to 59,880 in 2019 (46,691-72,639). Similarly, disability-adjusted life years (DALYs) escalated from 782,721 (629,321-944,867) in 1990 to 1,241,450 (1,015,874-1,468,103) in 2019. The most significant annual percentage change (APC) in the unadjusted death rate was recorded in the high-income Asia Pacific region, with an increase of 181%, followed by a 125% increase in the DALY rate in East Asia during the period from 1990-2019. In 2019, India, Japan, Russia, China, the United States, and Brazil accounted for 49.86% of the total global deaths. The highest mortality was seen in individuals aged 75-79 years, while the highest DALYs were observed in the 65-69 year age group. Over the past three decades, males have shown higher rates of death and disability compared to females. Conclusion: The study shows a marked global increase in both deaths and disability from AA attributable to HBP from 1990-2019, with significant regional disparities and a higher impact on older males, emphasizing the need for targeted healthcare strategies.

Abstract 2025: Evolving Burden Of Peripheral Artery Disease Attributable To Smoking In 38 Oecd Countries From 1990-2019: Global, Regional, National Variations, Age Dynamics, And Implications For Global Health

Introduction and Background: Peripheral artery disease (PAD) ranks as the 11th leading cause of mortality and disability in countries within the Organization for Economic Cooperation and Development (OECD). Smoking is recognized as a leading risk factor for PAD, and its impact on the prevalence and outcomes of PAD has significant public health implications. Method: Using Global Burden of Disease framework, Deaths, disability adjusted life years (DALYs), years lived with disability (YLDs) due to stroke attributable to Smoking were analyzed by age, sex, year and location across the 38 OECD Countries from the last 3 decades. Results: From 1990 to 2019, the total number of deaths increased from 7,226 to 10,738, and Disability-Adjusted Life Years (DALYs) rose from 191,915 to 238,577. In 2019, the United States had the highest number of deaths (3,596) and DALYs (83,073). Hungary had the highest age-standardized mortality rate in 2019 (1.7 deaths per 100,000 person-years). The 80-84 age group had the most deaths (2,233), while the 70-74 age group had the highest DALYs (45,947) in 2019. Over the past three decades, males consistently had a higher burden, with an annual percentage change in deaths of 50% compared to 45% for females, and a 32% change in DALYs for males compared to 12% for females. Conclusion: The findings highlight the urgent need for public health efforts to address the increasing burden of peripheral artery disease (PAD), particularly focusing on smoking cessation and tailored interventions for high-risk groups. Clinicians should prioritize early detection and patient counseling to mitigate PAD risk factors, especially among males with a consistently higher burden.

An immuno-epidemiological model with waning immunity after infection or vaccination

In epidemics, waning immunity is common after infection or vaccination of individuals. Immunity levels are highly heterogeneous and dynamic. This work presents an immuno-epidemiological model that captures the fundamental dynamic features of immunity acquisition and wane after infection or vaccination and analyzes mathematically its dynamical properties. The model consists of a system of first order partial differential equations, involving nonlinear integral terms and different transfer velocities. Structurally, the equation may be interpreted as a Fokker-Planck equation for a piecewise deterministic process. However, unlike the usual models, our equation involves nonlocal effects, representing the infectivity of the whole environment. This, together with the presence of different transfer velocities, makes the proved existence of a solution novel and nontrivial. In addition, the asymptotic behavior of the model is analyzed based on the obtained qualitative properties of the solution. An optimal control problem with objective function including the total number of deaths and costs of vaccination is explored. Numerical results describe the dynamic relationship between contact rates and optimal solutions. The approach can contribute to the understanding of the dynamics of immune responses at population level and may guide public health policies.

The efficacy and safety of the novel combination lenvatinib and pembrolizumab in endometrial cancer: A systematic review and single-arm meta-analysis

ObjectiveEndometrial carcinoma is the most widespread gynecological cancer, with increasing morbidity and mortality. Pembrolizumab, a monoclonal antibody that targets PD1 receptor tumors, is approved for patients with microsatellite instability-high (MSI-H) solid tumors. Many clinical trials and observational studies have been conducted to assess the safety and efficacy of Lenvatinib and Pembrolizumab combination therapy in the setting of endometrial cancer. However, results have been inconsistent, and current data is based on a heterogeneous population. The primary objective was to assess the safety and efficacy of Lenvatinib plus Pembrolizumab for endometrial cancer. Data sourcesThe search was conducted from inception from four databases; PubMed, Google Scholar, the Cochrane Library, and ClinicalTrials.gov. The electronic database search was conducted from inception to August 20, 2023. Study eligibility criteriaWe considered randomized controlled trials and single-arm observational studies, i.e. cohort, case-control and cross-sectional studies. MethodologyWe performed a single-arm meta-analysis, involving 7 studies having a total of 495 patients with endometrial cancer were eventually included which had the following outcomes: Complete response, Partial response, Progression-free survival, stable disease, progressive disease, safety outcomes, Adverse events, and the total number of deaths. ResultsOur results showed that 88.6 % of the patients were positive for non-MSI-H/pMMR tumors (95 % CI = 0.825–0.927) whereas 6.5 % (95 % CI = 3.8–9.8 %) of the patients for MSI-H/dMMR tumors. The pooled objective response of endometrial cancer patients treated with Lenvatinib and Pembrolizumab was 36.5 % (95 % CI = 0.258–0.471), the pooled estimate of complete and partial response was 47 % (95 % CI = 0.024–0.070) and 31.3 % (95 % CI = 0.230–0.396). 38.2 % patients had stable disease (95 % CI = 0.329–0.435) and 24.0 % patients had progressive disease (95 % CI = 0.103–0.378). The pooled median progression-free survival was 5.97 (95 % CI 5.43–7.63) months and, whereas the median overall survival was 17.19 months (95 % CI 15.34–19.31). All grade adverse events occurred in 85 % and Grade 3 or worse adverse events occurred in 39 % of patients during the therapy whereas death occurred in 23.8 % during the treatment. ConclusionThe results of this meta-analysis concludes that although the combined treatment of a Lenvatinib and Pembrolizumab had a PFS and OS that was inferior to the standard therapy used to treat advanced and recurrent endometrial cancer, it is still a novel treatment and shows potential for further research with a greater sample size.

Examining the effects of voluntary avoidance behaviour and policy-mediated behaviour change on the dynamics of SARS-CoV-2: A mathematical model

BackgroundThroughout the SARS-CoV-2 pandemic, policymakers have had to navigate between recommending voluntary behaviour change and policy-driven behaviour change to mitigate the impact of the virus. While individuals will voluntarily engage in self-protective behaviour when there is an increasing infectious disease risk, the extent to which this occurs and its impact on an epidemic is not known. MethodsThis paper describes a deterministic disease transmission model exploring the impact of individual avoidance behaviour and policy-mediated avoidance behaviour on epidemic outcomes during the second wave of SARS-CoV-2 infections in Ontario, Canada (September 1, 2020 to February 28, 2021). The model incorporates an information feedback function based on empirically derived behaviour data describing the degree to which avoidance behaviour changed in response to the number of new daily cases COVID-19. ResultsVoluntary avoidance behaviour alone was estimated to reduce the final attack rate by 23.1%, the total number of hospitalizations by 26.2%, and cumulative deaths by 27.5% over 6 months compared to a counterfactual scenario in which there were no interventions or avoidance behaviour. A provincial shutdown order issued on December 26, 2020 was estimated to reduce the final attack rate by 66.7%, the total number of hospitalizations by 66.8%, and the total number of deaths by 67.2% compared to the counterfactual scenario. ConclusionGiven the dynamics of SARS-CoV-2 in a pre-vaccine era, individual avoidance behaviour in the absence of government action would have resulted in a moderate reduction in disease however, it would not have been sufficient to entirely mitigate transmission and the associated risk to the population in Ontario. Government action during the second wave of the COVID-19 pandemic in Ontario reduced infections, protected hospital capacity, and saved lives.

Suicide prevention project with young people in the Rocinha slum in Rio de Janeiro

IntroductionThe 2019 WHO report on suicide warned of a serious public health problem. It was found that suicide is a serious problem for global public health, causing approximately 703 thousand deaths every year. Self-extermination is among the leading causes of death worldwide, with more deaths than from malaria, HIV/AIDS, breast cancer, war and homicide. More than one in every 100 deaths (1.3%) in 2019 were the result of suicide.Suicide is the fourth leading cause of death in older adolescents (15–19 years). Risk factors are multifaceted and include harmful use of alcohol, which includes abuse during childhood, stigma against seeking help, barriers to accessing care and means of suicide.The total number of deaths due to self-extermination registered in the adolescent population in the period from 2016 to 2021 was 6,588. According to the WHO director-general, “attention to suicide prevention is even more important now, after many months of living with the pandemic and many of the risk factors, such as loss of employment, financial stress and social isolation, still very present.” Therefore, suicide prevention work with young adolescents in Rocinha, one of the largest slums in Rio de Janeiro, is extremely important, given the increase in suicide rates and mental health problems in this age group. This approach must be thoughtful, culturally sensitive, and involve a range of strategies to address the complex issues affecting adolescents in the community. The Community of Rocinha was chosen to host this prevention project.ObjectivesCreate a preventive event by surveying participants’ opinions, integrating, welcoming and deconstructing stigmas about suicide.MethodsThis study investigated, in a population of 140 young adolescents with cultural differences in a theater class, their level of knowledge regarding relevant information about suicide. A structured questionnaire was presented and answered before and after a lecture, resulting in a class at the end, carried out by the young participants themselves. The scenes were filmed and a film produced. This dynamic process also included the distribution of a shirt alluding to the fact, making the participants multiplier references.ResultsThe results of the lecture showed a significant improvement in mental health awareness and willingness to seek help among young people, totaling a 20% increase in knowledge.ConclusionsStudents attended the event in significant numbers, taking into account that the slum had a curfew due to armed conflict. The results of the lecture showed a significant improvement in mental health awareness and willingness to seek help among young people, totaling a 20% increase in knowledge. The young people reported a feeling of support and belonging to the community, highlighting the importance of the debate in a final lecture given by them.Disclosure of InterestNone Declared

Effect of calorie labelling in the out-of-home food sector on adult obesity prevalence, cardiovascular mortality, and social inequalities in England: a modelling study

England implemented a menu calorie labelling policy in large, out-of-home food businesses in 2022. We aimed to model the likely policy impact on population-level obesity and cardiovascular disease mortality, as well as the socioeconomic equity of estimated effects, in the adult population in England. For this modelling analysis, we built a comparative assessment model using two scenarios: the current implementation scenario refers to actual deployment only in large (≥250 employees), out-of-home food businesses, whereas the full implementation scenario refers to deployment in every out-of-home food business. We compared each scenario with a counterfactual: the scenario in which no intervention is implemented (ie, baseline). For both scenarios, we modelled the impact of the policy through assumed changes in energy intake due to either consumer response or product reformulation by retailers. We used data from the Office for National Statistics and the National Diet and Nutrition Survey 2009-19, and modelled the effect over 20 years (ie, 2022-41) to capture the long-term impact of the policy and provided mid-period results after 10 years. We used the Monte Carlo approach (2500 iterations) to estimate the uncertainty of model parameters. For each scenario, the model generated the change in obesity prevalence and the total number of deaths prevented or postponed. The current implementation scenario was estimated to reduce obesity prevalence by 0·31 percentage points (absolute; 95% uncertainty interval [UI] 0·10-0·35), which would prevent or postpone 730 cardiovascular disease deaths (UI 430-1300) of the 830 000 deaths (UI 600 000-1 200 000) expected over 20 years. However, the health benefits would be increased if calorie labelling was implemented in all out-of-home food businesses (2·65 percentage points reduction in obesity prevalence [UI 1·97-3·24] and 9200 cardiovascular disease deaths prevented or postponed [UI 5500-16 000]). Results were similar in the most and the least deprived socioeconomic groups. This study offers the first modelled estimation of the impact of the menu calorie labelling regulation on the adult population in England, although we did not include a cost-effectiveness analysis. Calorie labelling might result in a reduction in obesity prevalence and cardiovascular disease mortality without widening health inequalities. However, our results emphasise the need for the government to be more ambitious by applying this policy to all out-of-home food businesses to maximise impact. European Research Council.

Senility deaths in aged societies: The case of Japan.

Senility is now the third largest cause of death in Japan, comprising 11.4% of the total number of deaths in 2022. Although senility deaths were common in the period before the Second World War, they declined sharply from 1950 to 2000 and then increased up to the present. The recent increase is more than what we could expect from an increasing number of very old persons or the increasing number of deaths at facilities. The senility death description in the death certificate is becoming poorer, with 93.8% of them only with a single entry of "senility". If other diseases are mentioned, those are again vague diseases or conditions. Senility, dementia and Alzheimer's disease, sequelae of cerebrovascular disease, and heart failure are the largest causes of death in which senility is mentioned in the death certificate. The period from senility onset to death is often described within a few months, but it varies. In some cases, the deceased's age was written out of a conviction that the ageing process starts from birth. As senility is perceived differently among the certifying doctors, a standardised protocol to certify the senility death is needed. On the other hand, senility death is the preferred cause of death and many people do not wish to receive invasive medical examinations before dying peacefully. Together with other causes of death related to frailty, there would be a need to capture senility as a proper cause of death, not just as a garbage code, in the aged, low-mortality population.

Qualitative Analysis of Factors Influencing Compliance with Medication in Pregnant Women and Suffering Families Tuberculosis: Application of Theory Health Belief Model

Tuberculosis (TB) has contributed 25% of the total number of deaths. It is estimated that 98% of deaths due to TB occur in developing countries. So the success of treating TB really depends on the patient's compliance with taking medication, especially in groups at risk of contracting TB such as pregnant women. Compliance is greatly influenced by various factors and is very dependent on behavior. One of the most popular theories in explaining behavior is the health belief model. The aimed of this research is to explore the factors influencing compliance with medication in pregnant women with tuberculosis using theory of health belief model. This research is a qualitative analysis using a health belief model approach. This research will be conducted in the work area of the Cimarga Community Health Center in December 2023. Data collection was carried out using in-depth interviews with researchers using the triangulation method. There were 4 main informants, 2 triangulators, and 4 supporting informants. The approach used is perception of vulnerability, severity and perception of benefits The result of this research are: (1) perceived susceptibility shows that the majority of respondents who adhere to taking medication are aware that this disease is serious and after they are infected, this makes them afraid that people around them such as parents and fetuses will also be infected. (2) Perceived benefits can be measured in the context of TB treatment behavior in pregnant women by asking about improvements in symptoms and perceived changes in physical condition during the treatment process. (3) The perception of severity begins to be felt when the disease begins to cause symptoms and family members become infected quickly. Moreover, those infected are mothers who are pregnant.

SARS-CoV-2 Pandemic: A Comparison Between the Epidemiological Situation in Greece and Romania.

Introduction Since the onset of the SARS-CoV-2 pandemic, there seems to be scarce data targeting the comparison of epidemiological data among different countries. In an attempt to reveal and characterize the epidemiological profile in the Balkan peninsula,a cross-sectional study has been conducted, aiming to retrospectively collect all the existing information regarding the SARS-CoV-2 pandemic over a period of three years, starting from March 2020 until March 2023. The comparative analysis of the epidemiological features and the main indicators between Romania and Greece can generate a good overview of the factors that can influence public healthand create an adequate system of measures to limit the COVID-19 pandemic in the area. A retrospective comparative study aiming to detect and associate the main indicators determining the evolution of the SARS-CoV-2 pandemic data with the control measures adopted in Romania and Greece was performed. Methods Publicly available data were obtained from official sources such as the World Health Organization, the European Centre for Disease Control, the Romanian and Greek Ministries of Health,and the Romanian National Centre for Surveillance and Control of Communicable Diseases. The reported number of cases, in total and in conjunction with the age distribution, total number of deaths, and vaccination coverage, from the onset of the pandemic in March 2020 until March 2023, were collected. All officially reported cases of COVID-19 were included in this analysis. Reports with missing or incomplete values regarding the timeframe, age distribution, and vaccination status were excluded. Results During the timeframe of the study, from March 2020 until March 2023, Greece reported a higher number of confirmed SARS-CoV-2 cases as compared to Romania (5,910,103 cases and 3,352,356 cases, respectively).Still, in terms of the overall death toll, Romania recorded a higher mortality rate than Greece during the pandemic (67.773 deathsvs.36.372 deaths). Concerning both cumulative incidence rates and the 14-day case notification rate per 100.000 inhabitants, it is evident that Romania exhibited greater numbers throughout the course of the pandemic. Although it is not clearly stated, the compulsory vaccination ofelderly people that was set as a high priority in Greece may have contributed to the above results. In terms of the 14-day death notification rate per 100.000 inhabitants in 2020 and 2021, Romania showed a higher rate than Greece, while Greece reported a greater rate in 2022 and up until March 2023. Between 2020 and 2023, Greece presented both a higher number of vaccinated individualsand a higher vaccination coverage with two doses (7,034,695 individuals, 70% of the general population), as compared to Romania (6,467,804 individuals, 33.68% of the general population, p<0.0001). Conclusions Despite the similar restrictions and preventive actions adopted by Romania and Greece, some of the epidemiological data between the two countries tends to differ. It must not be ignoredthatevery nation should be considered a unique entity with distinct features, including individuals, customs, and policies, rather than being categorized with other countries based on geographic proximity or regionalization.

MEMORABLE BOOKS OF PROVINCES AS A SOURCE FOR STUDYING THE MORTALITY OF THE ORTHODOX POPULATION OF BELARUS IN THE SECOND HALF OF THE 19TH CENTURY

The article presents the results of the analysis of statistical data published in the Memorable Books of Belarusian provinces for 1858 – 1864. It has been established that the statistical data on mortality in the Memorable Books of Vitebsk province for 1862 – 64 are not reliable and are characterised by significant undercounting of child mortality. The peak of mortality in all cases occurs in early childhood. The share of child deaths in the total number of deaths is higher in rural areas than in urban areas. In both urban and rural areas, boys under 5 years of age have higher mortality rates than girls. In adulthood, differences in male and female mortality patterns in urban and rural areas begin to emerge. In rural areas, there is a slight increase in the number of deaths of women of reproductive age compared to men. In urban areas, the opposite situation is observed, the mortality rate of men of working age significantly exceeds the female mortality rate.

Abstract WMP101: Global Burden of Stroke Attributable to High BMI in 38 OECD Countries From 1990-2019: A Benchmarking Systematic Analysis

Background: The global burden of stroke remains a significant public health challenge, with high body mass index (BMI) emerging as a notable and modifiable risk factor in Organization for Economic Co-operation and Development (OECD) countries. Method: Using Global burden of disease tool, deaths and disability adjusted life years due to Stroke attributable to High BMI were assessed by age, sex, year across the 38 OECD countries from 1990-2019. Result: The total number of deaths saw a decline from 148,031 (95%UI 85,206-219,328) in 1990 to 143,105 (95%UI: 85,383-209,533) in 2019. The annual percentage change (APC) in the total number of DALYs exhibited a decrease of 1% between 1990-2019. Notably, the most substantial increase in APC for deaths was observed in Turkey at 129%, followed by Mexico at 95% from 1990-2019. Conversely, Estonia displayed the most significant decrease in APC at 63%. In relation to DALYs, Turkey experienced the highest APC at 99%, followed by Costa Rica at 85% from 1990-2019. In 2019, the age group of 75-79 exhibited the highest number of deaths (22,709) while the age group of 65-69 had the highest DALYs (553,284). In terms of gender differences, males observed a 5% increase in APC for deaths, whereas females witnessed a 10% decrease in APC from 1990-2019. Conclusion: The global burden of stroke attributable to high BMI in OECD countries highlights the urgent need for comprehensive strategies to address the intertwined challenges of obesity and stroke. Efforts to prevent and manage obesity, coupled with targeted interventions to mitigate stroke risk factors, hold the promise of reducing the human, societal, and economic toll of this prevalent and debilitating condition.