Thesis (Ph. D.)--University of Hong Kong, 2000. / Includes bibliographical references (leaves 156-187).

Thesis (Ph. D.)--University of Wisconsin--Madison, 1933. / Typescript. Includes bibliographical references (leaves 184-187).

Thesis (M.S. in Manpower Systems Analysis)--Naval Postgraduate School, March 2010. / Thesis Advisor: Henderson, David R. ; Hatch, William D. "March 2010." Author(s) subject terms: Motorcycle safety training, motorcycle accident, motorcycle fatality, motorcycle injury, motorcycle life insurance cost, motorcycle hospitalization cost, military occupational specialty cost. Includes bibliographical references (p. 69-70). Also available in print.

Thesis (M.A.) University of Missouri-Columbia, 2006. / The entire dissertation/thesis text is included in the research.pdf file; the official abstract appears in the short.pdf file (which also appears in the research.pdf); a non-technical general description, or public abstract, appears in the public.pdf file. Title from title screen of research.pdf file (viewed on August 23, 2007) Includes bibliographical references.

Orientador: Iracema Mattos Paranhos Calderon / Coorientador: Maria Rita Garbi Novaes / Banca: Roseli Mieko Yamamoto Nomura / Banca: José Guilherme Cecatti / Resumo: Realizar uma revisão da literatura mundial e nacional sobre mortalidade materna, descrevendo a população vulnerável, os fatores de risco, as causas, as difi culdades para obtenção dos dados e as medidas de prevenção, de forma a subsidiar as ações de saúde. A coleta dos dados foi realizada por meio de pesquisa de artigos nas bases eletrônicas, SCIELLO, PUBMED, LILACS e MEDLINE, além de materiais publicados por organizações mundiais e nacionais. Foram selecionados estudos publicados no periodo de janeiro de 2000 a maio de 2011, utilizando-se os seguintes descritores: "maternal mortality"[MeSH Terms] OR ("maternal"[All Fields] AND "mortality"[All Fields]) OR "maternal mortality"[All Fields], nos idiomas português, inglês e espanhol. Foram selecionados 36 artigos que atendiam aos critérios de inclusão. O óbito materno está diretamente relacionado com as condições de vida da população e apresenta elevada disparidade entre as diversas regiões sócio-econômicas. Embora a mortalidade materna seja o melhor indicador de saúde da população feminina, seus números muitas vezes são apresentados de forma irreal, pela difi culdade da identifi cação dos casos nos registros de óbito. Medidas de prevenção associadas a diagnóstico e tratamento precoces e adequados são fatores benéfi cos na redução desses óbitos maternos. Apesar da tecnologia avançada e do reconhecimento de algumas medidas de prevenção, um grande número de mulheres morre diariamente por complicações no ciclo gravídico-puerperal. É evidente que para a redução desta tragédia é necessário o comprometimento político, social e econômico com a saúde, para promover as reformas necessárias na assistência ao ciclo gravídico-puerperal / Abstract: Accomplishing a review of worldwide and Brazilian literature on maternal mortality, describing the vulnerable population, risk factors, causes, and difficulties in obtaining the data and preventive measures, in order to subsidize health actions. The data collection was accomplished through a search for articles in the electronic data basis SCIELLO, PUBMED, LILACS and MEDLINE, in addition to published materials from worldwide and Brazilian organizations. Studies published between January 2000 and May 2011 have been selected using the following reference: "maternal mortality" [MeSH Terms] OR ("maternal"[All Fields] AND "mortality" [All Fields]) OR "maternal mortality" [All Fields], in Portuguese, English and Spanish languages. 36 articles that fi tted the criteria for inclusion have been selected.. Maternal death is directly related to the quality of life of the population and presents high disparity among the diverse social-economic regions. Even though maternal mortality is the most accurate health indicator for the female population, its numbers many a time are presented in unreal manners, due to the diffi culties in identifying the cases based on obit registries. Preventing measures associated to early diagnosis and proper treatment are benefi cial factors to the decrease of such maternal deaths. In spite of advanced technology and the recognition of some preventive measures, a large number of women decease daily out of complications through the pregnant and puerperal cycle. It is evident that in order to reduce such tragedy, political, social and economical commitment to Health is necessary to promote the needed reforms in the pregnant and puerperal cycle assistance / Mestre

No description available.

The rapid increase in human longevity has raised important questions about what implications this development may have for the variability of age at death. Earlier studies have reported evidence of a historical trend towards mortality compression. However, the period life table model, commonly used to address mortality compression, produces a compressed picture of mortality as a built-in feature of the model. To overcome this limitation, we base our study on an examination of the durations of exposure, in years of age, of birth cohorts and period life tables to selected short ranges of the death rate observed at old age. Overall, old-age mortality has been decompressing, cohort-wise, since the 1960s. This process may further indicate good prospects for ever-decreasing mortality. In the future, deaths may not be concentrated within a narrow age interval, but will instead become more dispersed, though at ever later ages on average.

Maternal mortality is the leading cause of death among women in Nigeria, especially women aged between 15 and 19 years. This research examines the geography of maternal mortality in Nigeria and the role of cultural and religious practices, socio-economic inequalities, urbanization, access to pre and postnatal care in explaining the spatial pattern. State-level data on maternal mortality rates and predictor variables are presented. Access to healthcare, place of residence and religion explains over 74 percent of the spatial pattern of maternal mortality in Nigeria, especially in the predominantly Muslim region of northern Nigeria where poverty, early marriage and childbirth are at its highest, making them a more vulnerable population. Targeting vulnerable populations in policy-making procedures may be an important strategy for reducing maternal mortality, which would also be more successful if other socio-economic issues such as poverty, religious and health care issues are promptly addressed as well.

Introducción: Diferentes escalas de predicción diagnóstica se vienen recomendando y aplicando en diferentes departamentos de emergencia para predecir ciertos resultados de salud, los cuales pueden apoyar y/o mejorar el manejo de pacientes graves. Entre los más empleados están el qSOFA (quickly- Sepsis-related Organ Failure Assessment), una escala validada por el consenso de sepsis-3; la escala inglesa NEWS (National Early Warning Score) y la escala APACHE II (. Sin embargo, en nuestro medio no se ha evaluado su uso y performance en un servicio de emergencia. Objetivo: Valorar el desempeño diagnóstico de las escalas qSOFA, NEWS y APACHE-II en el departamento de emergencia en el Hospital Edgardo Rebagliati Martins (HNERM). Métodos: Estudio de cohorte retrospectivo realizado en un hospital de alta complejidad. La población de estudio comprendió las admisiones al departamento de emergencia en pacientes con sospecha de sepsis. Asimismo, usando tres escalas: qSOFA, NEWS y APACHE II se calculó la exactitud de la predicción diagnóstica comparándolas entre ellas. Resultados: Se incluyeron 112 pacientes, de los cuales fallecieron 16 (14.29 %). Para predecir mortalidad dentro del hospital, se hallaron áreas bajo las curvas (AUC) para las diferentes escalas. APACHE II ≥17 tuvo una sensibilidad de 87.5% y una especificidad de 78.13% (IC 95%: 0.84 - 0.96) con un AUC de 0.9, qSOFA ≥2 con una sensibilidad de 81.25% y especificidad de 68.75% (IC 95%: 0.63 - 0.87) con un AUC de 0.75 y NEWs ≥7 con una sensibilidad de 62.5% y especificidad de 78.13% (IC 95%: 0.56 - 0.86) con un AUC de 0.71. Conclusiones: Las escalas de puntaje qSOFA, NEWS y APACHE II, son adecuados para la predicción diagnóstica de mortalidad en pacientes con diagnóstico de sepsis y es pertinente su uso en los distintos hospitales del Perú. / Introduction: Different scales of diagnostic prediction are being recommended and applied in different emergency departments to predict certain health outcomes, which can support and / or improve the management of serious patients. Among the most used are the qSOFA (quickly- Sepsis-related Organ Failure Assessment), a scale validated by the sepsis-3 consensus; and the English scale NEWS (National Early Warning Score). However, in our environment, its use and performance have not been evaluated in an emergency service. Objective: To assess the diagnostic performance of the qSOFA, NEWS and APACHE-II scales in the emergency department at the Edgardo Rebagliati Martins Hospital (HNERM). Methods: Retrospective cohort study conducted in a high complexity hospital. The study population included admissions to the emergency department in patients with suspected sepsis. Also, using three scales: qSOFA, NEWS and APACHE II, the accuracy of the prediction was calculated by comparing them. Results: 112 patients were included, of whom 16 died (14.29%). To predict mortality within the hospital, areas under the curves (AUC) were found for the different scales. APACHE II ≥17 had a sensitivity of 87.5% and a specificity of 78.13% (95% CI: 0.84-0.96) with an AUC of 0.9, qSOFA ≥2 with a sensitivity of 81.25% and specificity of 68.75% (95% CI: 0.63 - 0.87) with an AUC of 0.75 and NEWs ≥7 with a sensitivity of 62.5% and specificity of 78.13% (95% CI: 0.56 - 0.86) with an AUC of 0.71. Conclusions: The qSOFA, NEWS and APACHE II score scales are suitable for the diagnostic prediction of mortality in patients diagnosed with sepsis and their use in the different hospitals in Peru is pertinent. / Tesis

MSc (Med), Population-Based Field Epidemiology, Faculty of Health Sciences, University of the Witwatersrand / Background Improvements in the health status of children have resulted in a substantive reduction in under-five mortality by two-thirds between 1960 and 1990. However this reduction is favourable for children after the first year in life, with little decrease in the neonatal period. Every year, about 4 million children die within the first 28 days of life, the first week (0-7 days) posing the highest risk. The Fourth Millennium Development Goal emphasises a reduction in child mortality by two-thirds by 2015, however this goal cannot be met because neonatal deaths continue to increase. It is therefore important to make available information on risk factors and the main causes of death that exist at a community level so that appropriate health policies are devised to reduce the mortality burden faced by neonates. Objective The study investigates the relationship between household and maternal socio-demographic characteristics with neonatal mortality in the Kassena-Nankana District from 2001 to 2005. The specific objectives were; (1) To calculate the neonatal mortality rates in the Kassena-Nankana District from 2001 to 2005, (2) To determine the causes of neonatal death for years 2003 to 2005, and (3) To assess the association of household characteristics and maternal socio-demographic characteristics with neonatal deaths in the Kassena-Nankana District from 2001 to 2005. Methods Data from Navrongo DSS in Ghana was used for the analysis. A total of 19 340 live births born from 15 224 households were registered between 1st January 2001 to 31st December 2005. Of these 551 died before the 28th day after birth. The outcome, neonatal mortality was coded as a binary variable and took values 1 if the child died and 0 if the child survived. Neonatal mortality rates were calculated by dividing the total number of deaths for a particular year by the total number of live births for that year, multiplied by 1000. Cause of death data were collected using neonatal specific verbal autopsies. Cause-specific neonatal mortality rates were calculated using physician coding to a list of cause of deaths based on the 9th International Classification for Diseases (ICD). Using the mother‟s household characteristics and assets ownership, a wealth index was constructed as proposed by Filmer and Pritchett to estimate socio-economic status. Chi-square (x2) test at 5% significant level was also done to compare the maternal socio-demographic and neonatal characteristics by neonatal mortality. Logistic regression models were fitted to assess the association between (i) neonatal mortality and socio-economic status (SES) and (ii) between neonatal mortality and maternal as well as neonatal risk factors, while adjusting for potential confounders. Health equity was measured using the concentration index (CI) and the poorest-poor ratio (PPR). Results: The overall neonatal mortality rate for the whole study period was 29 per 1000 live births. Most deaths (65.9%) occurred outside the health facility and most occurred in the early neonatal period (0-7 days). Infectious diseases (n=98, 33.2%), birth injuries (n=28, 9.5%) and prematurity (n=29, 9.8%) were the main causes of neonatal deaths. In the multivariate analysis maternal characteristic that showed an association with mortality were place of residence, SES, birth order and the type of birth outcome. Such that children who died were more often from the rural areas compared to in the urban areas (AOR=2.24 95% CI=1.16-4.34 P=0.016). Children who died were more often from a multiple birth outcome compared to those from a single birth outcome (AOR=0.20 95% CI=0.14-0.28 P<0.0001). SES was found to be protective against neonatal mortality (AOR=0.70 95% CI= 0.51–0.96 P=0.026). By birth order, children who died were more often from the 1st birth order compared to children of birth orders; 2-3 (AOR=0.60 95% CI=0.44-0.81 P=0.001), 4-5 (AOR=0.56 95% CI=0.38-0.84 P=0.005) and 6+ birth order (AOR=0.50 95% CI=0.31-0.8 P=0.005). A measure of health equity gave a C.I of -0.07 and PPR of 1.29 implying that neonatal mortality was high amongst the poorest households than the better ones. Conclusion The study showed that neonatal mortality was high in the rural areas and in the poorest households. Efforts to alleviate the burden of neonatal mortality at a community level should focus on improving living standards for poorest in the community. Also educating women on child health care and making them aware of high risk pregnancy age-groups will help minimize risky pregnancies which in turn will reduce neonatal deaths.