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Deaths Attributed to Heat, Cold, and Other Weather Events in the United States, 2006–2010

July 31, 2014 Comments off

Deaths Attributed to Heat, Cold, and Other Weather Events in the United States, 2006–2010 (PDF)
Source: National Center for Health Statistics

Objectives—
This report examines heat-related mortality, cold-related mortality, and other weather-related mortality during 2006–2010 among subgroups of U.S. residents.

Methods—
Weather-related death rates for demographic and area-based subgroups were computed using death certificate information. Adjusted odds ratios for weather-related deaths among subgroups were estimated using logistic regression.

Results and Conclusions—
During 2006–2010, about 2,000 U.S. residents died each year from weather-related causes of death. About 31% of these deaths were attributed to exposure to excessive natural heat, heat stroke, sun stroke, or all; 63% were attributed to exposure to excessive natural cold, hypothermia, or both; and the remaining 6% were attributed to floods, storms, or lightning. Weather-related death rates varied by age, race and ethnicity, sex, and characteristics of decedent’s county of residence (median income, region, and urbanization level). Adjustment for region and urbanization decreased the risk of heat-related mortality among Hispanic persons and increased the risk of cold-related mortality among non-Hispanic black persons, compared with non-Hispanic white persons. Adjustment also increased the risk of heat-related mortality and attenuated the risk of cold-related mortality for counties in the lower three income quartiles.

The differentials in weather-related mortality observed among demographic subgroups during 2006–2010 in the United States were consistent with those observed in previous national studies. This study demonstrated that a better understanding of subpopulations at risk from weather-related mortality can be obtained by considering area-based variables (county median household income, region, and urbanization level) when examining weather-related mortality patterns.

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Association between Class III Obesity (BMI of 40–59 kg/m2) and Mortality: A Pooled Analysis of 20 Prospective Studies

July 22, 2014 Comments off

Association between Class III Obesity (BMI of 40–59 kg/m2) and Mortality: A Pooled Analysis of 20 Prospective Studies
Source: PLoS Medicine

Background
The prevalence of class III obesity (body mass index [BMI]≥40 kg/m2) has increased dramatically in several countries and currently affects 6% of adults in the US, with uncertain impact on the risks of illness and death. Using data from a large pooled study, we evaluated the risk of death, overall and due to a wide range of causes, and years of life expectancy lost associated with class III obesity.

Methods and Findings
In a pooled analysis of 20 prospective studies from the United States, Sweden, and Australia, we estimated sex- and age-adjusted total and cause-specific mortality rates (deaths per 100,000 persons per year) and multivariable-adjusted hazard ratios for adults, aged 19–83 y at baseline, classified as obese class III (BMI 40.0–59.9 kg/m2) compared with those classified as normal weight (BMI 18.5–24.9 kg/m2). Participants reporting ever smoking cigarettes or a history of chronic disease (heart disease, cancer, stroke, or emphysema) on baseline questionnaires were excluded. Among 9,564 class III obesity participants, mortality rates were 856.0 in men and 663.0 in women during the study period (1976–2009). Among 304,011 normal-weight participants, rates were 346.7 and 280.5 in men and women, respectively. Deaths from heart disease contributed largely to the excess rates in the class III obesity group (rate differences = 238.9 and 132.8 in men and women, respectively), followed by deaths from cancer (rate differences = 36.7 and 62.3 in men and women, respectively) and diabetes (rate differences = 51.2 and 29.2 in men and women, respectively). Within the class III obesity range, multivariable-adjusted hazard ratios for total deaths and deaths due to heart disease, cancer, diabetes, nephritis/nephrotic syndrome/nephrosis, chronic lower respiratory disease, and influenza/pneumonia increased with increasing BMI. Compared with normal-weight BMI, a BMI of 40–44.9, 45–49.9, 50–54.9, and 55–59.9 kg/m2 was associated with an estimated 6.5 (95% CI: 5.7–7.3), 8.9 (95% CI: 7.4–10.4), 9.8 (95% CI: 7.4–12.2), and 13.7 (95% CI: 10.5–16.9) y of life lost. A limitation was that BMI was mainly ascertained by self-report.

Conclusions
Class III obesity is associated with substantially elevated rates of total mortality, with most of the excess deaths due to heart disease, cancer, and diabetes, and major reductions in life expectancy compared with normal weight.

67 Law Enforcement Officer Fatalities Nationwide in First Half of 2014

July 22, 2014 Comments off

67 Law Enforcement Officer Fatalities Nationwide in First Half of 2014
Source: National Law Enforcement Officers Memorial Fund

Today the National Law Enforcement Officers Memorial Fund issued a new report stating that 67 officers have been killed in the line of duty during the first half of 2014—a 31 percent increase over the same period last year.

Of these 67 officers, 26 were killed in traffic-related incidents; 25 were killed by gunfire; and 16 died due to job-related illnesses and other causes.

Key Facts

  • Traffic-related incidents were once again the leading cause of officer fatalities, with 26 officers killed in the first half of 2014—a 37 percent increase over the same period last year.
  • Firearms-related fatalities spiked to 25 in the first half of this year—a 56 percent increase over the first six months of 2013. Investigating suspicious persons or situations was the leading circumstance of fatal shootings, with six officer fatalities; followed by ambushes, with five officer fatalities.
  • Sixteen officers died due to other causes in the first half of 2014, the same as the number reported during the same time last year. Job-related illnesses, such as heart attacks, increased 62 percent in the first half of 2014, with 13 officer fatalities compared to eight during the same period last year.
  • California led all states with eight officer fatalities; followed by Florida, New York, Texas and Virginia each with four peace officer fatalities.

Decline in Drug Overdose Deaths After State Policy Changes — Florida, 2010–2012

July 15, 2014 Comments off

Decline in Drug Overdose Deaths After State Policy Changes — Florida, 2010–2012
Source: Morbidity and Mortality Weekly Report (CDC)

During 2003–2009, the number of deaths caused by drug overdose in Florida increased 61.0%, from 1,804 to 2,905, with especially large increases in deaths caused by the opioid pain reliever oxycodone and the benzodiazepine alprazolam (1). In response, Florida implemented various laws and enforcement actions as part of a comprehensive effort to reverse the trend. This report describes changes in overdose deaths for prescription and illicit drugs and changes in the prescribing of drugs frequently associated with these deaths in Florida after these policy changes. During 2010–2012, the number of drug overdose deaths decreased 16.7%, from 3,201 to 2,666, and the deaths per 100,000 persons decreased 17.7%, from 17.0 to 14.0. Death rates for prescription drugs overall decreased 23.2%, from 14.5 to 11.1 per 100,000 persons. The decline in the overdose deaths from oxycodone (52.1%) exceeded the decline for other opioid pain relievers, and the decline in deaths for alprazolam (35.6%) exceeded the decline for other benzodiazepines. Similar declines occurred in prescribing rates for these drugs during this period. The temporal association between the legislative and enforcement actions and the substantial declines in prescribing and overdose deaths, especially for drugs favored by pain clinics, suggests that the initiatives in Florida reduced prescription drug overdose fatalities.

Association between Class III Obesity (BMI of 40–59 kg/m2) and Mortality: A Pooled Analysis of 20 Prospective Studies

July 10, 2014 Comments off

Association between Class III Obesity (BMI of 40–59 kg/m2) and Mortality: A Pooled Analysis of 20 Prospective Studies
Source: PLoS Medicine

Background
The prevalence of class III obesity (body mass index [BMI]≥40 kg/m2) has increased dramatically in several countries and currently affects 6% of adults in the US, with uncertain impact on the risks of illness and death. Using data from a large pooled study, we evaluated the risk of death, overall and due to a wide range of causes, and years of life expectancy lost associated with class III obesity.

Methods and Findings
In a pooled analysis of 20 prospective studies from the United States, Sweden, and Australia, we estimated sex- and age-adjusted total and cause-specific mortality rates (deaths per 100,000 persons per year) and multivariable-adjusted hazard ratios for adults, aged 19–83 y at baseline, classified as obese class III (BMI 40.0–59.9 kg/m2) compared with those classified as normal weight (BMI 18.5–24.9 kg/m2). Participants reporting ever smoking cigarettes or a history of chronic disease (heart disease, cancer, stroke, or emphysema) on baseline questionnaires were excluded. Among 9,564 class III obesity participants, mortality rates were 856.0 in men and 663.0 in women during the study period (1976–2009). Among 304,011 normal-weight participants, rates were 346.7 and 280.5 in men and women, respectively. Deaths from heart disease contributed largely to the excess rates in the class III obesity group (rate differences = 238.9 and 132.8 in men and women, respectively), followed by deaths from cancer (rate differences = 36.7 and 62.3 in men and women, respectively) and diabetes (rate differences = 51.2 and 29.2 in men and women, respectively). Within the class III obesity range, multivariable-adjusted hazard ratios for total deaths and deaths due to heart disease, cancer, diabetes, nephritis/nephrotic syndrome/nephrosis, chronic lower respiratory disease, and influenza/pneumonia increased with increasing BMI. Compared with normal-weight BMI, a BMI of 40–44.9, 45–49.9, 50–54.9, and 55–59.9 kg/m2 was associated with an estimated 6.5 (95% CI: 5.7–7.3), 8.9 (95% CI: 7.4–10.4), 9.8 (95% CI: 7.4–12.2), and 13.7 (95% CI: 10.5–16.9) y of life lost. A limitation was that BMI was mainly ascertained by self-report.

Conclusions
Class III obesity is associated with substantially elevated rates of total mortality, with most of the excess deaths due to heart disease, cancer, and diabetes, and major reductions in life expectancy compared with normal weight.

CPSC Reports Increase in Fireworks-Related Deaths and Injuries in 2013

July 3, 2014 Comments off

CPSC Reports Increase in Fireworks-Related Deaths and Injuries in 2013
Source: Consumer Product Safety Commission

As the nation prepares to celebrate Independence Day, the U.S. Consumer Product Safety Commission (CPSC) urges consumers to celebrate safely. A new CPSC study issued today highlights an increase in the number of fireworks-related deaths and injuries. Device malfunction and improper use are associated with the most injuries.

In 2013, there were eight deaths and an estimated 11,400 consumers who sustained injuries related to fireworks. This is an increase from 8,700 injuries in 2012. Sixty-five percent, or 7,400, of the injuries in 2013 occurred in the 30 days surrounding July 4, 2013. CPSC staff reviewed fireworks incident reports from hospital emergency rooms, death certificate files, news clippings and other sources to estimate deaths, injuries and incident scenarios. Injuries were frequently the result of the user playing with lit fireworks or igniting fireworks while holding the device. Consumers also reported injuries related to devices that malfunctioned or devices that did not work as expected, including injuries due to errant flight paths, devices that tipped over and blowouts.

Contribution of Excessive Alcohol Consumption to Deaths and Years of Potential Life Lost in the United States

June 30, 2014 Comments off

Contribution of Excessive Alcohol Consumption to Deaths and Years of Potential Life Lost in the United States
Source: Preventing Chronic Disease (CDC)

Introduction
Excessive alcohol consumption is a leading cause of premature mortality in the United States. The objectives of this study were to update national estimates of alcohol-attributable deaths (AAD) and years of potential life lost (YPLL) in the United States, calculate age-adjusted rates of AAD and YPLL in states, assess the contribution of AAD and YPLL to total deaths and YPLL among working-age adults, and estimate the number of deaths and YPLL among those younger than 21 years.

Methods
We used the Centers for Disease Control and Prevention’s Alcohol-Related Disease Impact application for 2006–2010 to estimate total AAD and YPLL across 54 conditions for the United States, by sex and age. AAD and YPLL rates and the proportion of total deaths that were attributable to excessive alcohol consumption among working-age adults (20-64 y) were calculated for the United States and for individual states.

Results
From 2006 through 2010, an annual average of 87,798 (27.9/100,000 population) AAD and 2.5 million (831.6/100,000) YPLL occurred in the United States. Age-adjusted state AAD rates ranged from 51.2/100,000 in New Mexico to 19.1/100,000 in New Jersey. Among working-age adults, 9.8% of all deaths in the United States during this period were attributable to excessive drinking, and 69% of all AAD involved working-age adults.

Conclusions
Excessive drinking accounted for 1 in 10 deaths among working-age adults in the United States. AAD rates vary across states, but excessive drinking remains a leading cause of premature mortality nationwide. Strategies recommended by the Community Preventive Services Task Force can help reduce excessive drinking and harms related to it.

Lightning Deaths in 2014 in United States

June 27, 2014 Comments off

Lightning Deaths in 2014 in United States
Source: National Weather Service

To date in 2014, there have been 7 lightning fatalities: 4 in Florida, 1 each in Michigan, New Mexico and Texas

Surgery and Neurodevelopmental Outcome of Very Low-Birth-Weight Infants

June 26, 2014 Comments off

Surgery and Neurodevelopmental Outcome of Very Low-Birth-Weight Infants
Source: JAMA Pediatrics

Importance
Reduced death and neurodevelopmental impairment among infants is a goal of perinatal medicine.

Objective
To assess the association between surgery during the initial hospitalization and death or neurodevelopmental impairment of very low-birth-weight infants.

Design, Setting, and Participants
A retrospective cohort analysis was conducted of patients enrolled in the National Institute of Child Health and Human Development Neonatal Research Network Generic Database from 1998 through 2009 and evaluated at 18 to 22 months’ corrected age. Twenty-two academic neonatal intensive care units participated. Inclusion criteria were birth weight 401 to 1500 g, survival to 12 hours, and availability for follow-up. A total of 12 111 infants were included in analyses.

Exposures
Surgical procedures; surgery also was classified by expected anesthesia type as major (general anesthesia) or minor (nongeneral anesthesia).

Main Outcomes and Measures
Multivariable logistic regression analyses planned a priori were performed for the primary outcome of death or neurodevelopmental impairment and for the secondary outcome of neurodevelopmental impairment among survivors. Multivariable linear regression analyses were performed as planned for the adjusted mean scores of the Mental Developmental Index and Psychomotor Developmental Index of the Bayley Scales of Infant Development, Second Edition, for patients born before 2006.

Results
A total of 2186 infants underwent major surgery, 784 had minor surgery, and 9141 infants did not undergo surgery. The risk-adjusted odds ratio of death or neurodevelopmental impairment for all surgery patients compared with those who had no surgery was 1.29 (95% CI, 1.08-1.55). For patients who had major surgery compared with those who had no surgery, the risk-adjusted odds ratio of death or neurodevelopmental impairment was 1.52 (95% CI, 1.24-1.87). Patients classified as having minor surgery had no increased adjusted risk. Among survivors who had major surgery compared with those who had no surgery, the adjusted risk of neurodevelopmental impairment was greater and the adjusted mean Bayley scores were lower.

Conclusions and Relevance
Major surgery in very low-birth-weight infants is independently associated with a greater than 50% increased risk of death or neurodevelopmental impairment and of neurodevelopmental impairment at 18 to 22 months’ corrected age. The role of general anesthesia is implicated but remains unproven.

The moral code in Islam and organ donation in Western countries: reinterpreting religious scriptures to meet utilitarian medical objectives

June 16, 2014 Comments off

The moral code in Islam and organ donation in Western countries: reinterpreting religious scriptures to meet utilitarian medical objectives
Source: Philosophy, Ethics, and Humanities in Medicine

End-of-life organ donation is controversial in Islam. The controversy stems from: (1) scientifically flawed medical criteria of death determination; (2) invasive perimortem procedures for preserving transplantable organs; and (3) incomplete disclosure of information to consenting donors and families. Data from a survey of Muslims residing in Western countries have shown that the interpretation of religious scriptures and advice of faith leaders were major barriers to willingness for organ donation. Transplant advocates have proposed corrective interventions: (1) reinterpreting religious scriptures, (2) reeducating faith leaders, and (3) utilizing media campaigns to overcome religious barriers in Muslim communities. This proposal disregards the intensifying scientific, legal, and ethical controversies in Western societies about the medical criteria of death determination in donors. It would also violate the dignity and inviolability of human life which are pertinent values incorporated in the Islamic moral code. Reinterpreting religious scriptures to serve the utilitarian objectives of a controversial end-of-life practice, perceived to be socially desirable, transgresses the Islamic moral code. It may also have deleterious practical consequences, as donors can suffer harm before death. The negative normative consequences of utilitarian secular moral reasoning reset the Islamic moral code upholding the sanctity and dignity of human life.

Burden of Total and Cause-Specific Mortality Related to Tobacco Smoking among Adults Aged ≥45 Years in Asia: A Pooled Analysis of 21 Cohorts

June 13, 2014 Comments off

Burden of Total and Cause-Specific Mortality Related to Tobacco Smoking among Adults Aged ≥45 Years in Asia: A Pooled Analysis of 21 Cohorts
Source: PLoS Medicine

Background
Tobacco smoking is a major risk factor for many diseases. We sought to quantify the burden of tobacco-smoking-related deaths in Asia, in parts of which men’s smoking prevalence is among the world’s highest.

Methods and Findings
We performed pooled analyses of data from 1,049,929 participants in 21 cohorts in Asia to quantify the risks of total and cause-specific mortality associated with tobacco smoking using adjusted hazard ratios and their 95% confidence intervals. We then estimated smoking-related deaths among adults aged ≥45 y in 2004 in Bangladesh, India, mainland China, Japan, Republic of Korea, Singapore, and Taiwan—accounting for ~71% of Asia’s total population. An approximately 1.44-fold (95% CI = 1.37–1.51) and 1.48-fold (1.38–1.58) elevated risk of death from any cause was found in male and female ever-smokers, respectively. In 2004, active tobacco smoking accounted for approximately 15.8% (95% CI = 14.3%–17.2%) and 3.3% (2.6%–4.0%) of deaths, respectively, in men and women aged ≥45 y in the seven countries/regions combined, with a total number of estimated deaths of ~1,575,500 (95% CI = 1,398,000–1,744,700). Among men, approximately 11.4%, 30.5%, and 19.8% of deaths due to cardiovascular diseases, cancer, and respiratory diseases, respectively, were attributable to tobacco smoking. Corresponding proportions for East Asian women were 3.7%, 4.6%, and 1.7%, respectively. The strongest association with tobacco smoking was found for lung cancer: a 3- to 4-fold elevated risk, accounting for 60.5% and 16.7% of lung cancer deaths, respectively, in Asian men and East Asian women aged ≥45 y.

Conclusions
Tobacco smoking is associated with a substantially elevated risk of mortality, accounting for approximately 2 million deaths in adults aged ≥45 y throughout Asia in 2004. It is likely that smoking-related deaths in Asia will continue to rise over the next few decades if no effective smoking control programs are implemented.

Place and Cause of Death in Centenarians: A Population-Based Observational Study in England, 2001 to 2010

June 6, 2014 Comments off

Place and Cause of Death in Centenarians: A Population-Based Observational Study in England, 2001 to 2010
Source: PLoS Medicine

Background
Centenarians are a rapidly growing demographic group worldwide, yet their health and social care needs are seldom considered. This study aims to examine trends in place of death and associations for centenarians in England over 10 years to consider policy implications of extreme longevity.

Methods and Findings
This is a population-based observational study using death registration data linked with area-level indices of multiple deprivations for people aged ≥100 years who died 2001 to 2010 in England, compared with those dying at ages 80-99. We used linear regression to examine the time trends in number of deaths and place of death, and Poisson regression to evaluate factors associated with centenarians’ place of death. The cohort totalled 35,867 people with a median age at death of 101 years (range: 100–115 years). Centenarian deaths increased 56% (95% CI 53.8%–57.4%) in 10 years. Most died in a care home with (26.7%, 95% CI 26.3%–27.2%) or without nursing (34.5%, 95% CI 34.0%–35.0%) or in hospital (27.2%, 95% CI 26.7%–27.6%). The proportion of deaths in nursing homes decreased over 10 years (−0.36% annually, 95% CI −0.63% to −0.09%, p = 0.014), while hospital deaths changed little (0.25% annually, 95% CI −0.06% to 0.57%, p = 0.09). Dying with frailty was common with “old age” stated in 75.6% of death certifications. Centenarians were more likely to die of pneumonia (e.g., 17.7% [95% CI 17.3%–18.1%] versus 6.0% [5.9%–6.0%] for those aged 80–84 years) and old age/frailty (28.1% [27.6%–28.5%] versus 0.9% [0.9%–0.9%] for those aged 80–84 years) and less likely to die of cancer (4.4% [4.2%–4.6%] versus 24.5% [24.6%–25.4%] for those aged 80–84 years) and ischemic heart disease (8.6% [8.3%–8.9%] versus 19.0% [18.9%–19.0%] for those aged 80–84 years) than were younger elderly patients. More care home beds available per 1,000 population were associated with fewer deaths in hospital (PR 0.98, 95% CI 0.98–0.99, p<0.001).

Conclusions
Centenarians are more likely to have causes of death certified as pneumonia and frailty and less likely to have causes of death of cancer or ischemic heart disease, compared with younger elderly patients. To reduce reliance on hospital care at the end of life requires recognition of centenarians’ increased likelihood to “acute” decline, notably from pneumonia, and wider provision of anticipatory care to enable people to remain in their usual residence, and increasing care home bed capacity.

Do Unto Others: Doctors’ Personal End-of-Life Resuscitation Preferences and Their Attitudes toward Advance Directives

June 4, 2014 Comments off

Do Unto Others: Doctors’ Personal End-of-Life Resuscitation Preferences and Their Attitudes toward Advance Directives
Source: PLoS ONE

Objective
High-intensity interventions are provided to seriously-ill patients in the last months of life by medical sub-specialists. This study was undertaken to determine if doctors’ age, ethnicity, medical sub-specialty and personal resuscitation and organ donation preferences influenced their attitudes toward Advance Directives (AD) and to compare a cohort of 2013 doctors to a 1989 (one year before the Patient Self Determination Act in 1990) cohort to determine any changes in attitudes towards AD in the past 23 years.

Design
Doctors in two academic medical centers participated in an AD simulation and attitudes survey in 2013 and their responses were compared to a cohort of doctors in 1989.

Outcomes
Resuscitation and organ donation preferences (2013 cohort) and attitudes toward AD (1989 and 2013 cohorts).

Results
In 2013, 1081 (94.2%) doctors of the 1147 approached participated. Compared to 1989, 2013 cohort did not feel that widespread acceptance of AD would result in less aggressive treatment even of patients who do not have an AD (p<0.001, AUC = 0.77); had greater confidence in their treatment decisions if guided by an AD (p<.001, AUC = 0.58) and were less worried about legal consequences of limiting treatment when following an AD (p<.001, AUC = 0.57). The gender (p = 0.00172), ethnicity (χ2 14.68, DF = 3,p = .0021) and sub-specialty (χ2 28.92, p = .004, DF = 12) influenced their attitudes towards AD. 88.3% doctors chose do-not-resuscitate status and wanted to become organ donors. Those less supportive of AD were more likely to opt for “full code” even if terminally ill and were less supportive of organ donation.

Conclusions
Doctors' attitudes towards AD has not changed significantly in the past 23 years. Doctors' gender, ethnicity and sub-specialty influence their attitudes towards AD. Our study raises questions about why doctors continue to provide high-intensity care for terminally ill patients but personally forego such care for themselves at the end of life.

New Report: Every Bicyclist Counts

May 28, 2014 Comments off

New Report: Every Bicyclist Counts
Source: League of American Bicyclists

A terrible string of fatal bike crashes in the Tampa area in late 2011 and early 2012 left the local bike community reeling.

As they shared each awful tragedy with us, we too felt frustrated and powerless. We also realized how little we really knew about the circumstances of serious crashes between bikes and cars, and how woefully inadequate (and late) the available data was at the national level.

For a 12-month period, we set about the grim task of tracking and documenting every fatal traffic crash involving a bicyclist captured by relevant internet search terms. We also wanted to offer a place to remember the victims and raise the hope that their deaths would at least inform efforts to prevent such tragedies in the future.

The result was the Every Bicyclist Counts initiative: everybicyclistcounts.org

We owe a huge debt of gratitude to Elizabeth Kiker for compiling much of this data and to the Ride of Silence and Ghost Bike programs that offer so much comfort to the friends and families of bicyclists killed on the road — and a vital outlet for the outrage felt by everyone that rides a bike when they hear of these needless deaths.

Over the course of the project we documented 628 fatal bike crashes, a high percentage of the official number of such fatalities recorded by federal authorities.

Wait times for health care in Canada may be linked to increase in female death rates

May 27, 2014 Comments off

Wait times for health care in Canada may be linked to increase in female death rates
Source: Fraser Institute

Canada’s growing wait times for health care may have contributed to the deaths of 44,273 Canadian women between 1993 and 2009, concludes a new study released today by the Fraser Institute, an independent, non-partisan Canadian public policy think-tank.

The study, The Effect of Wait Times on Mortality in Canada, examines the relationship between mortality rates and lengthy wait times for medically necessary care in Canada. As wait times between referral (from a general practitioner) and treatment increase, finds the study, so does the rate of female mortality.

Physicians, Medical Ethics, and Execution by Lethal Injection

May 21, 2014 Comments off

Physicians, Medical Ethics, and Execution by Lethal Injection
Source: Journal of the American Medical Association

In an opinion dissenting from a Supreme Court decision to deny review in a death penalty case, Supreme Court Justice Harry Blackmun famously wrote, “From this day forward, I no longer shall tinker with the machinery of death.” In the wake of the recent botched execution by lethal injection in Oklahoma, however, a group of eminent legal professionals known as the Death Penalty Committee of The Constitution Project has published a sweeping set of 39 recommendations that not only tinker with, but hope to fix, the multitude of problems that affect this method of capital punishment.

Many of the recommendations this committee makes with regard to legal and administrative reforms appear worthwhile and reasonable. Their final recommendation, however, concerns the role of the medical profession in performing lethal injection. It states: “Jurisdictions should ensure that qualified medical personnel are present at executions and responsible for all medically-related elements of executions.”

In particular, the recommendation specifies that “Execution team members…are licensed, practicing doctors, nurses or emergency medical technicians who are responsible for performing functions in their day-to-day practice that are similar to those they will perform at the execution.” Regardless of this committee’s recommendations, physician participation in capital punishment is an ethical dilemma that the profession of medicine must address.

Racial/Ethnic Disparities in Fatal Unintentional Drowning Among Persons Aged ≤29 Years — United States, 1999–2010

May 20, 2014 Comments off

Racial/Ethnic Disparities in Fatal Unintentional Drowning Among Persons Aged ≤29 Years — United States, 1999–2010
Source: Morbidity and Mortality Weekly Report (CDC)

In the United States, almost 4,000 persons die from drowning each year (1). Drowning is responsible for more deaths among children aged 1–4 years than any other cause except congenital anomalies (2). For persons aged ≤29 years, drowning is one of the top three causes of unintentional injury death (2). Previous research has identified racial/ethnic disparities in drowning rates (3,4). To describe these differences by age of decedent and drowning setting, CDC analyzed 12 years of combined mortality data from 1999–2010 for those aged ≤29 years. Among non-Hispanics, the overall drowning rate for American Indians/Alaska Natives (AI/AN) was twice the rate for whites, and the rate for blacks was 1.4 times the rate for whites. Disparities were greatest in swimming pools, with swimming pool drowning rates among blacks aged 5–19 years 5.5 times higher than those among whites in the same age group. This disparity was greatest at ages 11–12 years; at these ages, blacks drown in swimming pools at 10 times the rate of whites. Drowning prevention strategies include using barriers (e.g., fencing) and life jackets, actively supervising or lifeguarding, teaching basic swimming skills and performing bystander cardiopulmonary resuscitation (CPR). The practicality and effectiveness of these strategies varies by setting; however, basic swimming skills can be beneficial across all settings.

Mortality Risk and Survival in the Aftermath of the Medieval Black Death

May 17, 2014 Comments off

Mortality Risk and Survival in the Aftermath of the Medieval Black Death
Source: PLoS ONE

The medieval Black Death (c. 1347-1351) was one of the most devastating epidemics in human history. It killed tens of millions of Europeans, and recent analyses have shown that the disease targeted elderly adults and individuals who had been previously exposed to physiological stressors. Following the epidemic, there were improvements in standards of living, particularly in dietary quality for all socioeconomic strata. This study investigates whether the combination of the selective mortality of the Black Death and post-epidemic improvements in standards of living had detectable effects on survival and mortality in London. Samples are drawn from several pre- and post-Black Death London cemeteries. The pre-Black Death sample comes from the Guildhall Yard (n = 75) and St. Nicholas Shambles (n = 246) cemeteries, which date to the 11th–12th centuries, and from two phases within the St. Mary Spital cemetery, which date to between 1120-1300 (n = 143). The St. Mary Graces cemetery (n = 133) was in use from 1350–1538 and thus represents post-epidemic demographic conditions. By applying Kaplan-Meier analysis and the Gompertz hazard model to transition analysis age estimates, and controlling for changes in birth rates, this study examines differences in survivorship and mortality risk between the pre- and post-Black Death populations of London. The results indicate that there are significant differences in survival and mortality risk, but not birth rates, between the two time periods, which suggest improvements in health following the Black Death, despite repeated outbreaks of plague in the centuries after the Black Death.

FBI Releases 2013 Preliminary Statistics for Law Enforcement Officers Killed in the Line of Duty

May 12, 2014 Comments off

FBI Releases 2013 Preliminary Statistics for Law Enforcement Officers Killed in the Line of Duty
Source: Federal Bureau of Investigation

Preliminary statistics released today by the FBI show that 27 law enforcement officers were feloniously killed in the line of duty in 2013, a decrease of more than 44 percent when compared to the 49 officers killed in 2012. By region, 15 officers died as a result of criminal acts that occurred in the South, six officers in the West, four officers in the Midwest, and two in the Northeast.

By circumstance, seven officers were killed as a result of ambushes (four during unprovoked attacks and three due to entrapment/premeditated situations). Five officers died from injuries inflicted as a result of answering disturbance calls (three of which were domestic disturbances), and five officers were engaged in tactical situations. Three officers sustained fatal injuries while they were investigating suspicious persons or circumstances, three were conducting traffic pursuits or stops, and three officers were responding to robberies in progress or pursuing robbery suspects. One officer was killed as a result of an investigative activity.

Offenders used firearms in 26 of the 27 felonious deaths. These included 19 incidents with handguns, five incidents with rifles, and two incidents with shotguns. One victim officer was killed with a vehicle used as a weapon.

Nineteen of the slain officers were confirmed to be wearing body armor at the times of the incidents. Six of the officers fired their own weapons, and three officers attempted to fire their service weapons. Two victim officers had their weapons stolen; one officer was killed with his own weapon.

Potentially Preventable Deaths from the Five Leading Causes of Death — United States, 2008–2010

May 12, 2014 Comments off

Potentially Preventable Deaths from the Five Leading Causes of Death — United States, 2008–2010
Source: Morbidity and Mortality Weekly Report (CDC)

In 2010, the top five causes of death in the United States were 1) diseases of the heart, 2) cancer, 3) chronic lower respiratory diseases, 4) cerebrovascular diseases (stroke), and 5) unintentional injuries (1). The rates of death from each cause vary greatly across the 50 states and the District of Columbia (2). An understanding of state differences in death rates for the leading causes might help state health officials establish disease prevention goals, priorities, and strategies. States with lower death rates can be used as benchmarks for setting achievable goals and calculating the number of deaths that might be prevented in states with higher rates. To determine the number of premature annual deaths for the five leading causes of death that potentially could be prevented (“potentially preventable deaths”), CDC analyzed National Vital Statistics System mortality data from 2008–2010. The number of annual potentially preventable deaths per state before age 80 years was determined by comparing the number of expected deaths (based on average death rates for the three states with the lowest rates for each cause) with the number of observed deaths. The results of this analysis indicate that, when considered separately, 91,757 deaths from diseases of the heart, 84,443 from cancer, 28,831 from chronic lower respiratory diseases, 16,973 from cerebrovascular diseases (stroke), and 36,836 from unintentional injuries potentially could be prevented each year. In addition, states in the Southeast had the highest number of potentially preventable deaths for each of the five leading causes. The findings provide disease-specific targets that states can use to measure their progress in preventing the leading causes of deaths in their populations.

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