Objetivo: Estudar o perfil epidemiológico da mortalidade por Homicídios, Acidentes de Transporte e Suicídios no município de Belo Horizonte e Região Metropolitana, na série histórica de 1980 a 2000. Métodos: O estudo apresenta um desenho ecológico, do tipo série histórica. Os indicadores de mortalidade foram os coeficientes específicos por sexo, idade e gerais padronizados; a mortalidade proporcional; a razão de mortalidade segundo sexo e idade e os incrementos / decrementos percentuais. A população utilizada como padrão foi a de 1980. Os óbitos por Homicídios, Acidentes de Transporte e Suicídios e as estimativas populacionais, segundo o ano calendário, sexo, idade e município de residência foram extraídos da base de dados do DATASUS. No período entre 1980 e 1995, os óbitos foram codificados, segundo a IX Classificação Internacional de Doenças - CID 9ª Revisão, e, a partir de 1996, segundo a CID - 10ª Revisão. A análise de tendência temporal foi desenvolvida no software SPSS para Windows, utilizando-se a técnica de regressão linear simples, com nível de significância (? < 0,05). Resultados: Nas duas regiões geográficas, os indicadores de mortalidade apresentaram maior magnitude para o sexo masculino. A razão de coeficientes específicos de mortalidade apresentou maior magnitude nas faixas etárias entre 20 e 49 anos. Os coeficientes específicos de mortalidade por Homicídios apresentaram maior magnitude na região Metropolitana e os Suicídios e Acidentes de Transporte...

Com o aumento da produção de frangos de corte no Brasil surge a necessidade de otimização do sistema de produção, principalmente devido a um mercado competitivo, sendo necessária a aplicação de recursos de tecnologia que reduzam perdas. Perdas produtivas decorrentes de ondas de calor (OC) são comuns na produção de frangos de corte em clima tropical e a solução é um problema complexo. A previsão precoce destes eventos climáticos com impacto na mortalidade permite reduzir perdas. Bancos de dados zootécnicos e meteorológicos podem conter padrões úteis para a previsão da mortalidade de frangos de corte, possíveis de se extrair por técnicas como a Mineração de Dados. Este trabalho teve por objetivo geral predizer a mortalidade de frangos de corte com um mínimo de 24 horas de antecedência. Os objetivos específicos foram: 1) Caracterizar OC com impacto sobre a mortalidade de frangos de corte; 2) Gerar modelos de previsão aplicável a sistemas de suporte à decisão durante o processo produtivo de frangos de corte prevendo a ocorrência de mortalidade alta em frangos de corte devido a OC; 3) Indicar ações mitigadoras para a amenização do impacto de OC. As OC com impacto na mortalidade de frangos de corte apresentaram características que dependem do tipo construtivo e da idade da ave. A condição mínima para a ocorrência de OC afetando aviários sem climatização foi: temperatura máxima do dia > 32º C; temperatura média do dia > 24º C; Índice de Temperatura e Umidade (ITU) médio > 23º C; Velocidade média do vento _ 1...

Mortality due to chronic diseases has been increasing in all regions of Brazil with corresponding decreases in mortality from infectious diseases. The geographical variation in proportionate mortality for chronic diseases for 17 Brazilian state capitals for the year 1985 and their association with socio-economic variables and infectious disease was studied. Calculations were made of correlation coefficients of proportionate mortality for adults of 30 years or above due to ischaemic heart disease, stroke and cancer of the lung, the breast and stomach with 3 socio-economic variables, race, and mortality due to infectious disease. Linear regression analysis included as independent variables the % of illiteracy, % of whites, % of houses with piped water, mean income, age group, sex, and % of deaths caused by infectious disease. The dependent variables were the % of deaths due to each one of the chronic diseases studied by age-sex group. Chronic diseases were an important cause of death in all regions of Brazil. Ischaemic heart diseases, stroke and malignant neoplasms accounted for more than 34% of the mortality in each of the 17 capitals studied. Proportionate cause-specific mortality varied markedly among state capitals. Ranges were 6.3-19.5% for ischaemic heart diseases...

The authors combine data from 84 Demographic and Health Surveys from 46 countries to analyze trends and socioeconomic differences in adult mortality, calculating mortality based on the sibling mortality reports collected from female respondents aged 15-49. The analysis yields four main findings. First, adult mortality is different from child mortality: while under-5 mortality shows a definite improving trend over time, adult mortality does not, especially in Sub-Saharan Africa. The second main finding is the increase in adult mortality in Sub-Saharan African countries. The increase is dramatic among those most affected by the HIV/AIDS pandemic. Mortality rates in the highest HIV-prevalence countries of southern Africa exceed those in countries that experienced episodes of civil war. Third, even in Sub-Saharan countries where HIV-prevalence is not as high, mortality rates appear to be at best stagnating, and even increasing in several cases. Finally, the main socioeconomic dimension along which mortality appears to differ in the aggregate is gender. Adult mortality rates in Sub-Saharan Africa have risen substantially higher for men than for women especially so in the high HIV-prevalence countries. On the whole...

Data from three rounds of nationally representative health surveys in India are used to assess the impact of selective mortality on children s anthropometrics. The nutritional status of the child population was simulated under the counterfactual scenario that all children who died in the first three years of life were alive at the time of measurement. The simulations demonstrate that the difference in anthropometrics due to selective mortality would be large only if there were very large differences in anthropometrics between the children who died and those who survived. Differences of this size are not substantiated by the research on the degree of association between mortality and malnutrition. The study shows that although mortality risk is higher among malnourished children, selective mortality has only a minor impact on the measured nutritional status of children or on that status distinguished by gender.

This paper analyzes complementarities between different Millennium Development Goals, focusing on child mortality and how it is influenced by progress in the other goals, in particular two goals related to the expansion of female education: universal primary education and gender equality in education. The authors provide evidence from eight Sub-Saharan African countries using two rounds of Demographic and Health Surveys per country and applying a consistent micro-econometric methodology. In contrast to the mixed findings of previous studies, for most countries the findings reveal strong complementarities between mothers educational achievement and child mortality. Mothers schooling lifts important demand-side constraints impeding the use of health services. Children of mothers with primary education are much more likely to receive vaccines, a crucial proximate determinant of child survival. In addition, better educated mothers tend to have longer birth intervals, which again increase the chances of child survival. For the variables related to the other goals...

The diffusion of cost-effective life saving technologies has reduced infant mortality in much of the developing world. Income gains may also play a direct, protective role in ensuring child survival, although the empirical findings to date on this issue have been mixed. This paper assembles data from Demographic and Health Surveys (DHS) in 59 countries to analyze the relationship between changes in per capita GDP and infant mortality. The authors show that there is a strong, negative association between changes in per capita GDP and infant mortality- in a first-differenced specification the implied elasticity of infant mortality with respect to per capita GDP is approximately -0.56. In addition to this central result, two findings are noteworthy. First, although there is some evidence of changes in the composition of women giving birth during economic upturns and downturns, the observed changes in infant mortality are not a result of mothers with protective characteristics timing fertility to correspond with the business cycle. Second...

Although child mortality rates have declined all across the developing world over the past 40 years, they have declined the most in the Middle East and North Africa region. This paper documents this remarkable experience and shows that it is broad based in the sense that all countries in the Middle East and North Africa experienced significant declines in child mortality over this period and each country did better than most of its comparators. In looking for the sources of the region s performance edge, the paper confirms the importance of such determinants of child mortality as income growth, education stock, public spending on health, urbanization, and food sufficiency. In addition, the paper establishes that the initial level of mortality has a substantial influence on the pace of subsequent child mortality decline. Of these factors, food sufficiency status is found to contribute to the region s performance edge over all developing regions, while the other factors are found to matter to varying degrees in selected pairwise regional comparisons.

We investigate the extent to which health care has contributed to the decline in mortality rates in Australia over recent decades by examining trends in avoidable mortality between 1968 and 2001. Avoidable mortality refers to deaths from certain conditions that are considered to be largely avoidable given timely and effective health care. Using unit record mortality data, we classified deaths into three avoidable categories: conditions amenable to medical care (‘medical care indicators’ (MCI)), conditions responsive to health policy but that are considered to lack effective treatment once the condition has developed (‘health policy indicators’ (HPI)), and ischaemic heart disease(IHD). ‘Nonavoidable’ deaths included the remaining causes of death. Our findings suggest that the Australian health care system has made substantial contributions to the reduction in mortality over the past three decades. This is shown in the steady decline in avoidable mortality rates with slower declines in nonavoidable mortality rates. Between 1968 and 2001, total avoidable death rates fell around 70% (68.4% in females, 72.2% in males) and nonavoidable rates fell around 34% (34.6% in females, 33.2% in males). Using Poisson regression, the annual declines in avoidable mortality rates were as follows (95% CIs in parentheses): 3.47% (3.44-3.50%) in females and 3.89% (3.86-3.91%) in males. For nonavoidable mortality rates...

Using household survey data, this paper estimates the mortality impact of improved water and sanitation access in order to evaluate the potential contribution of water and sanitation investment toward achieving the child mortality targets defined in Millennium Development Goal 4. The authors find that the average mortality reduction achievable by investment in water and sanitation infrastructure is 25 deaths per 1,000 children born across countries, a difference that accounts for about 40 percent of the gap between current child mortality rates and the 2015 target set in the Millennium Development Goals. According to the estimates, full household coverage with water and sanitation infrastructure could lead to a total reduction of 2.2 million child deaths per year in the developing world. Combining this analysis with cost data for water and sanitation infrastructure, the authors estimate that the average cost per life-year saved ranges between 65 and 80 percent of developing countries' annual gross domestic product per capita. The results suggest that investment in water and sanitation is a highly cost-effective policy option...

This report builds on the World Bank's earlier report on the Millennium Development Goals (MDGs) in India (2004 report number 30266), which highlighted the challenges India faces in meeting a number of the MDGs. The report focuses on the state of Orissa and is organized as follows: the second chapter provides a brief background on Orissa. This is followed by a review of recent trends with infant and child mortality in the state. Chapter 4 introduces a framework for assessing the multitude of factors which have a bearing on infant and child mortality, dividing them into four groups: the individual woman/mother; the family; the community and service provision. Chapter 5 applies the analytical framework to Orissa and this is followed by a chapter 6 which looks at district level patterns. The final chapter of the report pulls it altogether and attempts to answer three questions: what is needed to bring down child mortality rates in Orissa and achieve the 11" Five Year Plan and MDG goal; how well are existing interventions placed to do the job; and where are the gaps and how can they best be filled. The report ends with an outline of a possible multi-sectoral program designed to reduce child mortality in Orissa.

The authors use data from the National Family Health Survey 2005 to present age-specific patterns of child mortality among India's tribal (Adivasi) population. The analysis shows three clear findings. First, a disproportionately high number of child deaths are concentrated among Adivasis, especially in the 1-5 age group and in those states and districts where there is a high concentration of Adivasis. Any effort to reduce child morality in the aggregate will have to focus more squarely on lowering mortality among the Adivasis. Second, the gap in mortality between Adivasi children and the rest really appears after the age of one. In fact, before the age of one, tribal children face more or less similar odds of dying as other children. However, these odds significantly reverse later. This calls for a shift in attention from infant mortality or in general under-five mortality to factors that cause a wedge between tribal children and the rest between the ages of one and five. Third, the analysis goes contrary to the conventional narrative of poverty being the primary factor driving differences between mortality outcomes. Instead...

A number of initiatives that commenced in recent years are geared towards achievement of the fifth millennium development goal (MDG 5: improving maternal health), most notably the launch of the global strategy for women's and children's health in 2010 by the United Nations (UN) Secretary-General. Measuring the MDG 5 target of reducing the maternal mortality ratio (MMR) by three quarters between 1990 and 2015 remains a challenge. Accordingly, the maternal mortality estimation inter-agency group (MMEIG), comprising the World Health Organization (WHO), the United Nations Children's Fund (UNICEF), the United Nations Population Fund (UNFPA), the United Nations Population Division (UNPD), and the World Bank, together with a team at the National University of Singapore and University of California at Berkeley, United States of America, have been working together to generate internationally comparable MMR estimates. The estimates for 2013 presented in this report are the seventh in a series of analyses by the MMEIG to examine the global extent of maternal mortality. Consultations with countries were carried out following the development of the MMR estimates. The purposes of the consultations were: to give countries the opportunity to review the country estimates...

Introdução e objetivos: As infecções respiratórias estão entre as mais importantes causas de morbimortalidade no mundo. A sua alta incidência tem relevante impacto nos óbitos, como também na sobrecarga do sistema de saúde e absenteísmo no trabalho e escola Todas as faixas etárias são acometidas, porém, as mais afetadas são as crianças e os idosos. Também são particularmente susceptíveis os imunocomprometidos e os portadores de doenças crônicas em geral. Os vírus são os agentes responsáveis pela maior parte das infecções respiratórias, os principais vírus causadores de infecções respiratórias são o influenza A e B e o Vírus Sincicial Respiratório (VSR). Estes vírus têm comportamento biológicos distintos e o conhecimento de como estes vírus afetam a saúde da população é fundamental para embasar as ações de prevenção, profilaxia e tratamento de pacientes permitindo uma alocação adequada de recursos em quantidade e tempo adequados. No Brasil, no ano 2000, para monitorar a ocorrência destes vírus foi implantada a vigilância de síndromes gripais SIVEP-GRIPE, que através de 128 unidades sentinelas distribuídas em todas as regiões do país coletam semanalmente amostras de secreção de nasofaringe por semana de pacientes com síndromes gripais. Neste trabalho estudamos o impacto do influenza na mortalidade no estado de São Paulo...

A mortalidade no país apresenta tendência de queda e, em consequência, a expectativa de vida ao nascer (e0) se amplia. Todavia, estas mudanças não se manifestam uniformemente em todas as idades, causas de morte e em ambos os sexos. Estudos que analisam as desigualdades sociais indicam ainda que o declínio da mortalidade não atinge todos os segmentos socioeconômicos da população com a mesma força e ritmo. Diante destas considerações, o objetivo deste estudo foi avaliar os efeitos da redução da mortalidade no aumento da e0, bem como analisar as desigualdades sociais no tempo médio de vida e nos coeficientes de mortalidade no município de Campinas. Os resultados desta tese são apresentados em três capítulos. No primeiro, Expectativa de vida ao nascer: impacto das variações na mortalidade por idade e causas de morte no município de Campinas, São Paulo, Brasil, foram analisadas as contribuições de grupos etários e causas de morte no aumento da e0 entre 1991, 2000 e 2005. Foram construídas tábuas de mortalidade e aplicado o método de Pollard para mensurar os efeitos da variação da mortalidade na evolução da e0. O crescimento da mortalidade por causas externas, entre 1991/2000, ocasionou redução de 1,1 ano...

Background: Inflammatory bowel disease (IBD), including Crohn's disease (CD) and ulcerative colitis (UC) is perceived to harbor significant morbidity but limited excess mortality, thought to be driven by colon cancer, compared with the general population. Recent studies suggest mortality rates seem higher than previously understood, and there are emerging threats to mortality. Clinicians must be up to date and able to clearly convey the causes of mortality to arm individual patients with information to meaningfully participate in decisions regarding IBD treatment and maintenance of health. Methods: A MEDLINE search was conducted to capture all relevant articles. Keyword search included: “inflammatory bowel disease,” “Crohn's disease,” “ulcerative colitis,” and “mortality.” Results: CD and UC have slightly different causes of mortality; however, malignancy and colorectal cancer–associated mortality remains controversial in IBD. CD mortality seems to be driven by gastrointestinal disease, infection, and respiratory diseases. UC mortality was primarily attributable to gastrointestinal disease and infection. Clostridium difficile infection is an emerging cause of mortality in IBD. UC and CD patients have a marked increase in risk of thromboembolic disease. With advances in medical and surgical interventions...

CONTEXT: Brazilian infant and child mortality levels are not compatible with the country's economic potential. In this paper, we provide a description of levels and trends in infant mortality due to perinatal causes and malformations and assess the likely impact of changing intermediate-level determinants, many of which are amenable to direct interventions through the health or related sectors. TYPE OF STUDY: Review paper. METHODS: Two main sources of mortality data were used: indirect mortality estimates based on censuses and surveys, and rates based on registered deaths. The latter were corrected for under-registration. Combination of the two sources of data allowed the estimation of cause-specific mortality rates. Data on current coverage of preventive and curative interventions were mostly obtained from the 1996 Demographic and Health Survey. Other national household surveys and Ministry of Health Statistics were also used. A thorough review of the Brazilian literature on levels, trends and determinants of infant mortality led to the identification of a large number of papers and books. These provided the background for the analyses of risk factors and potential interventions. RESULTS: The indirect infant mortality rate estimate for 1995-97 is of 37.5 deaths per thousand live births...

Demographers have for a long time adopted an empirical approach to the study of the levels and trends of mortality, fertility, and population size. They depend for their analyses on data, usually collected until recent times by government and often for other purposes. Modern demography had its origins in Britain in the second haft of the seventeenth century. The major focus of demographers has usually been on mortality, although fertility studies predominated in the 1960s and 1970s. Mortality decline in the West only became certain in the late nineteenth century. Until the 1960s the fastest mortality declines were for the young, but an unheralded mortality decline among the old thereafter became important. The world, especially in economically advanced countries, is faced with an increasingly high proportion of old people, explained largely, not by mortality decline, but by fertility decline. Explanations for the mortality transition place different emphases on the role of modern medicine, better nutrition, and behavioral and social change, particularly rising levels of education. Even among the old, at least until 85 years of age, there are wide differentials in mortality by educational level. Analysts have divided the mortality transition into stages: (1) high...

OBJECTIVE: The Russian mortality crisis of the early 1990s attracted considerable attention, but information on possible covariates of mortality is lacking, and concerns have been raised about the validity of official mortality data. To help elucidate the determinants of mortality, we examined whether indirect demographic techniques could be used to study mortality in countries such as the Russian Federation, where mortality data are inadequate, using input data independent from official vital statistics. METHODS: A national sample of the population was interviewed (n = 1600, response rate = 67%). Participants who had ever been married (82% of the sample) were asked about the date of birth and vital status of their first spouse. Spousal mortality was then estimated indirectly for the 531 men and 710 women for whom valid data were available. FINDINGS: The estimated risk of death between the ages of 35-69 years was 57% for male spouses and 17% for female spouses. Corresponding figures derived from national data for 1990 were 52% and 25% for the Russian Federation, and 31% and 20% for the United Kingdom. According to spouses' reports, 38% of their husbands died from cardiovascular disease, 22% from cancer, and 14% from injuries and accidents. Mortality of male spouses was inversely related to the education level of their wives...

Objective Comparing cervical cancer mortality rates in Colombian departments, as well as in urban and rural areas and examining the potential causes of any differences. Methodology This was an ecologic study. Mortality due to cervical cancer was estimated from data collected between 2005 and 2008 by the Colombian National Statistics Bureau (DANE).This included overall mortality in Colombia, mortality by department and mortality by rural and urban area. DANE provided theunder-recording indicator for mortality by departments and the unmet basic needs index. Spearman correlation coefficient was estimated for average mortality by department, unmet basic needs and under-recording variables. Results The overall annual mortality rate from 2005 to 2008 due to cervical cancer in Colombia ranged from 10 to 11.1 per 100,000 females. Mortality reported in urban areas was higher than in rural areas (10.3-11.7 cf 7.6-8.7). The lowest average mortality was reported from the Chocó department (4.7) and the highest from Meta (18.2). An inverse correlation was found between average mortality by department and unmet basic needs. The ‘under-reporting' indicator had an inverse correlation with mortality, meaning that departments having recording issues also reported lower mortality rates. Conclusions Health systems must adopt strategies designed to improve information systems for supporting decision-making and optimise the use of health resources...