The Great Recession has brought income inequality to the forefront of the American psyche. Parallels have been made between the Great Depression and the Great Recession, and as such, economic history can act as a powerful analytical tool in directing policy. The first essay in Income Inequality during the Great Depression is a qualitative analysis of income transitions from 1929 to 1933 using 33 representative cities as surveyed by the Civil Works Administration. The second essay investigates the welfare effects of income inequality on infant mortality during the Depression. And the third essay on noninfant mortality gives context to the analysis of infant mortality and stillbirths.

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Background Previous measurements of preventable death in hospital do not account for the uncertainty of preventability ratings. Objective To determine the proportion of deaths in hospital that a have high probability of being prevented with high quality care. Methods We created summaries for every death at a tertiary care hospital over 4-months. Four reviewers assigned preventability ratings to each death and latent class analysis was used to classify deaths into high and low preventability categories. Results There were 480 decedents with mean age of 73.9. Inter-rater reliability was poor with an intra-class correlation of 0.14. The best latent class model found that 6.2% (95% CI 0.00 – 15.2%) of deaths had a 31.0% probability of being rated more likely preventable than not by each reviewer. In contrast, 93.8% (95% CI 84.8 - 100.0%) of deaths had a 0.8% probability of being rated more likely preventable than not by each reviewer. The incidence of truly preventable deaths is less than the 6.2% that are deemed possibly preventable. xi Conclusion Very few deaths in hospital are preventable. The low incidence of preventable deaths and low inter-rater reliability means that peer review methodology is only sensitive to large differences in preventable death rate.

This dissertation examines the relation between occupational exposure to the solvent methylene chloride and mortality in a cohort of cellulose fiber production workers. The first paper, entitled The Mortality of Cellulose Fiber Production Workers, presents the main results of the mortality follow-up of the cellulose fiber workers cohort through September 1, 1986. Mortality from neoplastic and non-neoplastic disease among cellulose fiber production workers is compared to that of the U.S. and local (county level) populations, while controlling for the effects of gender, race, calendar period, and age. Mortality from cancers of the lung, breast, and pancreas, and ischemic heart disease was less than expected. Excess mortality was observed for melanoma of the skin, cancer of the buccal cavity and pharynx, tumors of the liver and biliary tract, and accidental deaths. Three deaths from cancer of the bile ducts were observed (3 observed, 0.15 expected, SMR=20). This is the first known report of an association between exposure to methylene chloride and cancer of the bile ducts. [TRUNCATED]

The marginalization index for each municipality in Mexico confirms that the country is characterized by substantial economic inequality. Using this index as a tool to measure inequality in urbanization and data from the Consejo Nacional de Población (CONAPO) and the Instituto Nacional de Estadística y Geografía (INEGI), this work first analyzes observed spatial patterns of the marginalization index. Next, this dissertation analyzes the association between marginalization and mortality patterns inside Mexico. Overall, there is evidence of high marginalization linked to high mortality rates. Factors that might influence marginalization like geographical differences do not seem to influence the relationship between marginalization and mortality. Factors like migration and indigenous population percentages show more relevance in explaining the association between marginalization and mortality as a social causation effect. / text

Background and Aim: Prostate cancer (PCa) is the leading cancer diagnosis amongst South African men. The incidence of PCa is 68.0 per 100 000 Age Standardized Rate (ASR) and the mortality rates are 27.9 per 100 000 ASR; Globocan 2018. Diagnosis of PCa is based on a combination of digital rectal examination, prostate-specific antigen (PSA) and histology. Several biomarkers have been used to increase the sensitivity and specificity of PSA in distinguishing patients with PCa from those with benign prostatic hyperplasia (BPH). These include fractionated PSA, free/total PSA ratio, −2proPSA, prostate cancer antigen 3 and prostate health index amongst others. Biomarkers are needed to differentiate BPH from PCa due to a lack of specificity of these markers with PSA levels above 4.0 ng/ml. The aim of this study is to investigate gene expression patterns of South African men in 9 PCa and 10 BPH patients in order to distinguish between the two groups. Methods: Ethical approval was obtained (HREC 454/2012). Patients scheduled for transurethral resection of the prostate were recruited from the Western Cape. RNA was extracted from prostate tissue using the AllPrep DNA/RNA/miRNA Universal Kit (Qiagen). Complementary DNA was synthesized from RNA using the SuperScript IV VILO Master Mix (Thermo Fischer Scientific). Gene expression was analyzed with the Human Prostate Cancer RT2 Profiler PCR Array and SYBR Green Master Mix. Data were analyzed with the GeneGlobe RT2 and miScript PCR Array Data Analysis Centre from Qiagen. Results: The cohort included patients from different ethnic groups namely, Caucasians, Mixedand African ancestry. The PCa group has an age range from 56 to 75 years (mean 65) while the BPH group was slight older ranging from 60 to 76 years (mean 68). PSA levels range from 24 to 5000 ng/ml (mean 1252 ng/ml, median 185) for the PCa group and 11 to 58 ng/mL (mean 25 ng/ml, median 22) for the BPH group. The following genes were downregulated 2-fold in the PCa group with p values s <0.05; IGF1, PTEN, GSTP1, SOCS3, EGR3, GPX3, TIMP3, ZNF185, DKK3, PTGS2, FOXO1, ARNTL, TNFRSF10D, CCND1, and DLC1, upregulated genes included; CDH1, MKI67, TMPRSS2, ERG, CDKN2A, FASN, and AR but were not statistically significant. At a fold change threshold of 1.5, the following additional genes were downregulated in the PCa group with p values <0.05; DAXX, EGFR, RASSF1, SOX4, and TIMP2, upregulated genes were ACACA, AR, CDKN2A, ERG and FASN but were also not statistically significant. The study shows similarly differentially expressed genes as seen in international studies. Of note PTEN, MKI67 and FASN which are associated with poor prognosis. EGR3 was downregulated in our study and this has been associated aggressive disease and predict relapse after PCa treatment. This could explain the high mortality demonstrated in South African epidemiological studies. Conclusion: We identified a group of differentially expressed genes that have potential in distinguishing PCa and BPH patients with PSA values above 10 ng/ml. A larger population study is needed to further evaluate the clinical significance of our findings.

The study of the relationship between socioeconomic characteristics and mortality patterns has been a traditional research focus in demography, representing one of the core areas of the discipline. In Latin America, there is an important set of studies that show a significant inverse relationship between socioeconomic status and mortality rates. However, mainly due to limitations in the available data, we know very little about the specific relation between educational attainment and adult mortality. This inverse relationship between educational attainment and mortality rates provides just the tip of the iceberg for a large set of questions: How wide are educational differences in overall adult mortality in Argentina? Does the association between educational attainment and adult mortality vary by age group, gender and region? Are there unique adult mortality patterns by education among specific causes of death? Has the adult mortality differential by education attainment widened or narrowed as education attainment increased between 1991 and 2010? The main objective of this research was to describe and analyze the relationship between educational attainment and adult mortality patterns during the 1991-2010 period in Argentina. The data used in this study come from the Argentinian Mortality Files for the period 1991-2010 and from the 1991, 2001 and 2010 Argentinian Censuses. Results show a clear gradient in the specific mortality rates according to educational groups, for both sexes and for all age groups. The existence and direction of this relationship was as expected; however, the magnitude of educational differences was much higher than what has been found in other countries. The data also exhibited a clear declining trend in mortality inequalities by education as age increased. Educational differences in overall adult mortality did not display an increasing pattern over time. The year 2001, which was characterized by serious economic and social crisis in the country, displayed the highest educational inequalities in mortality in comparison to either 1991 or 2010. The findings of this dissertation are relevant to policy questions about health care and social inequalities in death. / text

Thesis advisor: Sara Moorman / My grandfather passed away four years ago of cancer. Every family member made their way to Cape Cod during his last few days in order to say their good-byes. It was not until the day after the last grandchild said good-bye that my grandfather passed away. We all felt that he wanted to wait so he could say good-bye to all of us. I have talked to many people who have had similar experiences with family members and friends. Some people have held on to see people one last time; others have wanted to make another birthday, while others have wanted to see another holiday that is special to them. In the present study, I explored the death dip, death rise phenomenon. Specifically, I analyzed mortality rates around the New Year’s Day, Christmas, and Pioneer Day. I examined two days before and two days after the holiday within specific cities (Project 1: New York City, Los Angeles, Chicago; Project 2: Salt Lake City, Boise, Little Rock; Project 3: Atlanta, Oklahoma City, New Orleans) within a five-year period (1998-2002). The data observed found a death dip and death rise present for New Year’s in New York City and Chicago. There was not a death dip or death rise observed for Project 2, Project 3, or Los Angeles in Project 1. / Thesis (BA) — Boston College, 2014. / Submitted to: Boston College. College of Arts and Sciences. / Discipline: Sociology Honors Program. / Discipline: Sociology.

As florestas subtropicais têm um papel importante nos serviços ecossistêmicos, embora pouco se conheça sobre a sua dinâmica e funcionamento, especialmente na porção sul da Mata Atlântica. A dinâmica florestal é frequentemente avaliada pela variação líquida da biomassa de árvores. Essa dinâmica de biomassa é influenciada por processos demográficos nas comunidades, os quais correspondem ao crescimento (de sobreviventes), recrutamento e mortalidade de indivíduos. Avaliamos a influência de fatores bióticos (atributos funcionais de plantas e a estrutura inicial da floresta) e fatores abióticos (variáveis do solo) sobre a dinâmica de biomassa de uma floresta subtropical, em um intervalo de 18 anos. Também avaliamos o efeito dos processos demográficos sobre a mudança de biomassa líquida da floresta. O estudo foi realizado no sul do Brasil, em uma área de transição entre a Floresta com Araucária e a Floresta Estacional, sem registro de distúrbio há pelo menos 60 anos, mas com histórico anterior de corte seletivo de madeira. Os levantamentos foram realizados em 1999 e em 2017, em 24 parcelas permanentes de 500 m2 cada, mensurando todos os indivíduos com CAP > 30 cm. Atributos funcionais foliares, de densidade de madeira e altura potencial foram obtidos para todas as espécies. Modelos lineares foram utilizados para avaliar o efeito de atributos funcionais (considerando valores médios da comunidade inicial (CWM= ‘community-weighted mean’) e a diversidade funcional (FD)), da estrutura inicial (área basal no tempo inicial) e de variáveis do solo sobre as variáveis resposta (taxa anual de crescimento, recrutamento e mortalidade). Modelos lineares também foram utilizados para avaliar o efeito dos processes demográficos (taxa de crescimento, recrutamento e mortalidade) e incremento em biomassa (biomassa de sobreviventes + recrutas) sobre a variação líquida de biomassa na comunidade. Observamos um efeito positivo do CWM da altura máxima sobre o crescimento de sobreviventes, e um efeito negativo do CWM do conteúdo de fósforo foliar, do FD de conteúdo de matéria seca foliar (LDMC) e da FD da altura máxima. A biomassa de recrutados teve um efeito positivo do pH e negativo do K do solo, enquanto a mortalidade foi positivamente associada à estrutura inicial da comunidade. Observamos ainda que a mudança líquida de biomassa desta floresta teve influência significativa da mortalidade e do incremento total (biomassa de sobreviventes + recrutados). Comunidades com indivíduos mais altos e com atributos relacionados à conservação de recursos em média crescem mais, enquanto que o menor crescimento teve relação com comunidades funcionalmente mais diversas em termos de LDMC e altura, potencialmente associado a espécies de sub-bosque. Solos menos ácidos permitiram o maior recrutamento, enquanto que a alta concentração de K limitou o recrutamento. Comunidades com maior cobertura inicial apresentaram maior mortalidade de espécies no período. Este trabalho traz importantes resultados sobre a dinâmica de florestas subtropicais, demonstrando que as características iniciais da comunidade, tanto bióticas quanto abióticas, tiveram influência no incremento e/ou perda em biomassa deste ecossistema num período de quase duas décadas. / Subtropical forests play an important role on ecosystem services, but the drivers of biomass dynamics and ecosystem functioning specially at the southern portion of Mata Atlântica are poorly understood. The forest dynamics is often evaluated by tree net biomass change, which is underlied by the community demographic processes. These demographic processes correspond to the growth of survival trees, recruitment and mortality. Here we evaluated the influence of biotic factors (plant functional traits and the initial forest structure) and abiotic factors (soil variables) on biomass dynamics of a subtropical forest in an interval of 18 years. We also evaluated the effect of demographic processes on the net biomass change of the forest. This study was carried out in a subtropical forest in southern Brazil and the region is characterized by the Atlantic forest s.l, in a transitional area between Araucaria and Seasonal forest. The study area corresponds to a protected area (Chapecó National Forest) that did not suffer disturbance since at least 60 years but had some selective logging before. The forestry inventories were realized in 1999 and 2017, in 24 permanent plots with 500 m2 each one. All the individuals with circumference at breast height > 30 cm were measured, identified and tagged. Leaf functional traits, wood density and maximum height were obtained for all species. We performed linear models to evaluate the effect of functional traits (following the mean values of initial community, community-weighted mean (CWM) and functional trait diversity (FD)), initial forest structure (community basal area in initial time) and soil variables, on the response variables (annual rate of growth of survival, recruits and mortality). Linear models were also used to evaluate the effect of tree demographic processes (biomass growth of survival, recruits, mortality and biomass increment (growth of survival + recruits)) on the net biomass change. We observed a positive effect of CWM and FD of maximum height, FD of leaf dry matter content (LDMC) and a negative of CWM of leaf nitrogen content on the growth of survivors. The biomass of recruits had a negative effect of soil K content, and a positive effect of soil pH. Biomass mortality was positive related to the initial forest structure. The net biomass change was negatively influenced by the biomass mortality and positively related to the biomass increment. Communities with taller individuals in mean and traits related to resources conserving grew more. The lower growth was related to more diverse communities in terms of LDMC and maximum height, probably associated to understory species. Less acid soils allowed more recruitment, and high availability of soil K limited the recruitment. Communities with more initial tree cover had more mortality along the time. This work provided important results about the biomass dynamics in subtropical forests, showing that biotic and abiotic community initial characteristics influenced the gain or loss of biomass of this ecosystem in a period of almost two decades.

Tendências atuais em restauração evidenciam a importância de propiciar o retorno das funções ecossistêmicas e ecológicas. Porém muitas áreas possuem baixo potencial para reestabelecimento de processos ecológicos devido à perda da resiliência, o que faz da restauração ecológica um processo desafiador. Para o sucesso das atividades propostas, é essencial que no decorrer do projeto os sistemas sejam capazes de retomar sua trajetória sucessional e dinâmica temporal, sem necessidade de futuras intervenções humanas. O objetivo desta tese foi avaliar os processos iniciais de restauração ecológica em áreas degradadas por mineração de carvão, através da análise de trajetórias sucessionais envolvendo: (1) taxas de crescimento e mortalidade de mudas nativas introduzidas e sua relação com atributos funcionais de plantas; (2) chuva de sementes associada, ou não, ao uso de poleiros artificiais e sua relação com regenerantes de espécies lenhosas; e (3) regeneração natural e sua relação com fatores abióticos e bióticos. Mudas de espécies nativas introduzidas sob condições limitantes (devido ao alto nível de impacto) apresentaram diferentes performances e relações com atributos, por vezes distintas do esperado para espécies sob condições naturais. A limitação de sementes nas áreas em restauração pode ser, potencialmente, reduzida pelo uso de poleiros artificiais, aumentando especialmente sementes de espécies não-pioneiras e zoocóricas. No entanto, não foi verificada relação entre a chuva de sementes e a taxa de recrutamento. Fatores abióticos, relacionados à composição química do solo, e fatores bióticos, como a presença de gramíneas exóticas, foram as variáveis com maior influência negativa sobre a regeneração natural. Este estudo evidencia a possibilidade do retornar do processo de sucessão natural em áreas de mata ciliar que foram profundamente alteradas por mineração de carvão, em um tempo relativamente curto. Entretanto, recomendamos o uso de objetivos realísticos e intermediários, bem como monitoramentos detalhados nas fases iniciais. / In current projects of ecological restoration, the return of ecosystem functions and natural processes is an important aim. However, many areas have lost their resilience due the high damage they have been submitted to, and this makes the ecological restoration a challenging process. For the success of the proposed activities, it is essential that during the project, the ecosystem can return to its successional trajectory without necessity of strong human intervention in the future. The goal of this thesis was to evaluate the initial processes of ecological restoration in areas severally degraded by coal mining, through analyses of successional trajectories regarding: (1) growth and mortality rates of planted samplings and their relationship to functional traits; (2) seed rain, associated or not, to perches and its relationship to natural regeneration of woody species; and (3) natural regeneration of woody species and its relationship to abiotic and biotic variables. Planted saplings under limited conditions (due the high impact of mining) showed to have distinct performance and trait relationships, somewhat different to the expected for species under natural conditions. The study indicates that the limitation of seeds in areas under ecological restoration can be reduced by the use of perches, increasing especially the number of seeds of non-pioneer and zoocoric species. Nevertheless, we did not found a relation between seed rain and recruitment rate. Soil chemistry (abiotic variable) and the cover of exotic grasses (biotic variable) were the variables with the strongest negative impact on natural regeneration. We conclude that it is possible to return to successional processes in areas of riparian forest severely damaged by coal mining activities in a relatively short time, but recommend the use of realistic, intermediate restoration goals and detailed monitoring in early restoration phases.