Indigenous suicide in Brazil, the self-killing of a vulnerable population

Abstract Introduction One of the Sustainable Development Goals is to promote mental health. It is then mandatory to know the death profile of this population and to develop public policies to reduce it. Methods Epidemiological descriptive study regarding the proportion of indigenous deaths according to the variables: age group, year of occurrence, gender, region, municipality and ICD-10 category, in the period 2008 to 2017 in Brazil, using data from the national database DATASUS. Results From 2008 to 2017, there were 5,489 indigenous deaths due to external causes in Brazil, with 1,107 (20.1%) due to self-caused lesions. The annual average was 110.7 cases per year: 100 in 2008, 95 in 2009, 93 in 2010, 97 in 2011, 90 in 2012, 113 in 2013, 117 in 2014, 132 in 2015, 120 in 2016, and 150 in 2017. Regarding causes, strangling/hanging/suffocation were 979 (88.4%), self-intoxication was 31 (2.8%) with other chemicals and 21 (1.8%) with pesticides. Regarding age group, 365 (32.9%) were between 15 to 19 years old, 325 (29.3%) between 20 to 29, 150 (13.5%) between 30 to 39, 131 (11.8%) between 10 to 14, and 136 (12.2%) in other age groups. Regarding gender, 807 (72.9%) were male, 299 (27.0%) were female, and 1 (0.09%) was ignored. Regarding region, the Northern Region had 575 (51.9%) cases and the Central-Western Region had 403 (36.4%) cases. The municipality of São Gabriel da Cachoeira was the one with the highest amount of cases: 132 (12.7%). Conclusions The 50% increase in the amount of deaths by suicide among indigenous people in the analyzed period reveals the infficacy of established public policies in Brazil. The number of deaths among the youth reveals the community trauma of exploration, violence and dignity loss. The Nothern and Central-Western regions had conflicts due to land demarcation and prospecting, which explain the high rates. The reduction of such tragedy demands capacitation of all the public spheres. Key messages Evaluate the aspects that promote it and to propose effective interventions in environments of difficult access and in a historically vulnerable population. Discuss some relevant characteristics among natives who are vulnerable to practicing self-made injuries, in order to make it possible to create new ways to protect this population.

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Sociodemographic Analysis of Neural Tuberculosis in Brazil from 2010 to 2020

10.5327/1516-3180.501 ◽

2021 ◽

Author(s):

Raissa Barreto Lima ◽

Thaís Machado Belitardo de Carvalho ◽

Matheus Campos Ribeiro de Souza ◽

Lara Teixeira de Oliveira ◽

Ana Carolina Pachêco de Menezes Rios ◽

...

Keyword(s):

Information System ◽

Extrapulmonary Tuberculosis ◽

Age Groups ◽

Severe Form ◽

Sociodemographic Characteristics ◽

Age Group ◽

The South ◽

Cross Sectional ◽

Prevention And Health Promotion ◽

Using Data

Background: Neural tuberculosis is an infection of the central nervous system caused by the bacterium Mycobacterium tuberculosis. Bearing in mind that neural tuberculosis is the most severe form of extrapulmonary tuberculosis and results in significant morbidity and mortality rates, it is important to analyze its sociodemographic characteristics in Brazil. Objectives: To describe the sociodemographic characteristics of neural tuberculosis cases in Brazil in the period from 2010 to 2020. Design and Setting: Cross-sectional, retrospective, and descriptive study, carried out using data collected from the Notifiable Diseases Information System (SINAN) and the Hospital Information System (SIH / SUS) of confirmed cases and hospitalizations for neural tuberculosis. Methods: Variables used: region, sex, age group, color/race and year of service. Results: In the period from 2010 to 2020, the number of notified cases of meningoencephalic tuberculosis was 7.451, with mean cases per year of 677.36. The Southeast region was the most affected with 43.8% of the total cases, followed by the South and Northeast regions, with 24.1% and 20.1%, respectively. There was a wide predominance in individuals aged 30-39 years (42.8%) and in the age group 40-59 years (35.9%). The male sex was the most affected with 63.3% of the total. Conclusions: The study shows a predominance of cases in the South and Southeast regions, with a significant prevalence of males and age groups of 20- 59. This could be an alert for new prevention and health promotion strategies for the most affected groups.

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Oral Contraceptives Provide Protection against Anterior Cruciate Ligament Tears: A National Database Study of 165,748 Female Patients

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967119s00353 ◽

2019 ◽

Vol 7 (7_suppl5) ◽

pp. 2325967119S0035

Author(s):

Steven F. DeFroda ◽

Steven Louis Bokshan ◽

Samantha Worobey ◽

Lauren Ready ◽

Alan H. Daniels ◽

...

Keyword(s):

Clinical Evidence ◽

Cruciate Ligament ◽

Age Groups ◽

National Database ◽

Control Group ◽

Protective Effects ◽

Age Group ◽

Oral Contraceptive Pills ◽

Acl Tear ◽

Chi Squared

Objectives: ACL tears are more prevalent in females than males. One of the factors responsible for this may be the variation in levels of estrogen and progesterone. The purpose of this study was to query a large nationwide database to determine the potentially protective effects of oral contraceptive pills (OCPs) on ACL tears. We hypothesized that females taking OCPs would exhibit ACL tears at lower rates than a matched population of patients not taking OCPs. Methods: The PearlDiver database (www.pearldiverinc.com, Fort Wayne, IN) was queried for all OCP users amongst females aged 15-49. Female experiencing an ACL tear and undergoing surgery (CPT 29888) were compared to a control group of females undergoing surgery for an ACL tear, but not on OCPs. Patients were matched by age and Charlson comorbidity score. Chi-squared testing was used to assess for significant differences in the rate of ACL tears for the OCP and non-OCP users, according to age groups broken down into age intervals of 5 years. Results: There were a total 82,874 patients in both the OCP and non-OCP groups. There were a total of 569 (0.69%) ACL tears in the non-OCP group and 465 (0.56%) in the OCP group (p<0.001). In the non-OCP group, patients aged 15-19 accounted for 29.35% of all ACL tears, whereas, in the OCP group, this same age group only accounted for 13.33% of ACL tears. Among all age groups, the odds ratios for experiencing an ACL tear while on OCP was 0.82 (χ2=0.001, 95% CI 0.72-0.92) (Figure 1) compared to not using OCP. This protective effect was driven primarily by the 15-19 age group (odds ratio 0.37 (χ2<0.001, 95% CI 0.27-0.50)). Conclusion: This investigation utilizing a large national database found that usage of OCPs was associated with an 18% decrease in the risk of ACL tear when compared to a matched population of patients with ACL tears not taking OCPs. These findings were in line with smaller studies which demonstrated similar results. Additionally, it was shown that OCPs were most protective in the 15-19 year old age group, with a 63% reduction in tears in this group. Ongoing randomized trials in patients without ACL tear could help to demonstrate further clinical evidence for OCP usage as a way to modify risk factors for ACL tear. While clinical evidence is limited, there should be strong consideration for OCP usage in elite high school and college aged athletes, especially those who are at risk of ACL tear.

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Tracking the dynamics and allocating tests for COVID-19 in real-time: An acceleration index with an application to French age groups and départements

PLoS ONE ◽

10.1371/journal.pone.0252443 ◽

2021 ◽

Vol 16 (6) ◽

pp. e0252443

Author(s):

Christelle Baunez ◽

Mickael Degoulet ◽

Stéphane Luchini ◽

Patrick A. Pintus ◽

Miriam Teschl

Keyword(s):

Public Health ◽

Real Time ◽

Age Groups ◽

Population Based ◽

National Average ◽

Health Policies ◽

Age Group ◽

Actual Distribution ◽

Public Health Policies ◽

Using Data

An acceleration index is proposed as a novel indicator to track the dynamics of COVID-19 in real-time. Using data on cases and tests in France for the period between the first and second lock-downs—May 13 to October 25, 2020—our acceleration index shows that the pandemic resurgence can be dated to begin around July 7. It uncovers that the pandemic acceleration was stronger than national average for the [59–68] and especially the 69 and older age groups since early September, the latter being associated with the strongest acceleration index, as of October 25. In contrast, acceleration among the [19–28] age group was the lowest and is about half that of the [69–78]. In addition, we propose an algorithm to allocate tests among French “départements” (roughly counties), based on both the acceleration index and the feedback effect of testing. Our acceleration-based allocation differs from the actual distribution over French territories, which is population-based. We argue that both our acceleration index and our allocation algorithm are useful tools to guide public health policies as France might possibly enter a third lock-down period with indeterminate duration.

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Change and stability: Within-person life satisfaction over a 20-year period using data from the HUNT survey

Scandinavian Journal of Public Health ◽

10.1177/1403494820957439 ◽

2020 ◽

pp. 140349482095743

Author(s):

Frode Lysberg ◽

Tomas Bjerregaard Bertelsen ◽

Cathrine Lysberg ◽

Magnhild Høie ◽

Geir Arild Espnes ◽

...

Keyword(s):

Life Satisfaction ◽

Age Groups ◽

Significant Proportion ◽

Health Study ◽

Age Group ◽

Self Rated Health ◽

Using Data ◽

Prospective Longitudinal ◽

Two Age Groups

Background: The aim of the present study was to investigate within-person life satisfaction (LS) dynamics for two age groups, 20–29 and 30–39 years, from 1984 to 1986 and to follow them over a 20-year period. Methods: Data from 1984 to 2008 were extracted from the large, prospective, longitudinal North-Trøndelag Health Study (HUNT), Norway. This paper includes data from more than 14,500 persons. Data were analysed using logistic regression, and LS dynamics were modelled using gender, time and self-rated health. Results: The analyses revealed that about 20% of people in these age groups had a stable level in LS, also known as set point. Long-term LS change, defined as ⩾2 SDs, was reported for 9% and 6% of people in the youngest and oldest age groups, respectively. A large proportion of more than 70% of people had fluctuations in their LS over a 20-year period. A significant decrease in within-person LS was seen for the age groups from 1984–86 to 1995–97 where a significant increase appeared from 1995–97 to 2006–08. For the initial 20–29 age group, the odds of having a higher score increased by 34%, and for the initial 30–39 age group, the within-person LS increase was 81%. Self-rated health was the most crucial variable influencing within-person LS. Conclusions: These findings suggest that a significant proportion of the responders had a long-term within-person LS change over the 20-year period.

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Driving Comfort Assistance System Considering Two Sensors Data

Acta Mechanica et Automatica ◽

10.2478/ama-2021-0021 ◽

2021 ◽

Vol 15 (3) ◽

pp. 164-168

Author(s):

Stanimir Karapetkov ◽

Hristo Uzunov ◽

Liliana Indrie ◽

Zlatin Zlatev

Keyword(s):

Age Groups ◽

Correlation Method ◽

Principal Component ◽

Sensor Data ◽

Estimation Methods ◽

Age Group ◽

The Road ◽

Use Of Data ◽

Harmful Emissions ◽

Using Data

Abstract In the present work, a system using data from two sensors located next to the driver and to the mass centre of the bus is proposed. Three degrees of discomfort have been used – comfortable, moderately uncomfortable and very uncomfortable. These levels are set out in the questionnaire. A survey was conducted. Respondents were selected between the ages of 14 and 65 and were divided into three age groups – adults, middle-aged and young. Accelerometer systems with MPU-6500 (TDK InvenSense Corp.) sensors are used. A correlation method (CORR) and sequentially improving estimation methods are used for feature selection, which significantly reduce the number of combinations of features obtained. Selected sensor data is entered into feature vectors. These vectors are reduced by principal component analysis. Predictive models have been created that take into account the age of passengers. The use of data from two sensors and separation of the passengers according their age, leads to an increase in the accuracy of predicting passengers discomfort level (DL) of up to 98%. These results can be used to evaluate and guide the vehicle driver in order to improve his driving style. In addition, the simplified interface does not distract the driver from the road conditions. The results obtained can lead to an improvement in the parameters of the transport process, which covers the interest of the carrier related to the efficient use of vehicles, and hence the reduction of fuel consumption and harmful emissions. However, it should be recommended that, when developing systems to ensure comfort of travel, adjustments should be made to suit the age group of passengers carried on public transport buses.

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Determinants of the decline in mortality from acute stroke in England: linked national database study of 795 869 adults

BMJ ◽

10.1136/bmj.l1778 ◽

2019 ◽

pp. l1778 ◽

Cited By ~ 22

Author(s):

Olena O Seminog ◽

Peter Scarborough ◽

F Lucy Wright ◽

Mike Rayner ◽

Michael J Goldacre

Keyword(s):

Acute Stroke ◽

Event Rate ◽

Age Groups ◽

Case Fatality ◽

Mortality Rates ◽

National Database ◽

Age Group ◽

Stroke Mortality ◽

Stroke Event ◽

Event Rates

Abstract Objectives To study trends in stroke mortality rates, event rates, and case fatality, and to explain the extent to which the reduction in stroke mortality rates was influenced by changes in stroke event rates or case fatality. Design Population based study. Setting Person linked routine hospital and mortality data, England. Participants 795 869 adults aged 20 and older who were admitted to hospital with acute stroke or died from stroke. Main outcome measures Stroke mortality rates, stroke event rates (stroke admission or stroke death without admission), and case fatality within 30 days after stroke. Results Between 2001 and 2010 stroke mortality rates decreased by 55%, stroke event rates by 20%, and case fatality by 40%. The study population included 358 599 (45%) men and 437 270 (55%) women. Average annual change in mortality rate was −6.0% (95% confidence interval −6.2% to −5.8%) in men and −6.1% (−6.3% to −6.0%) in women, in stroke event rate was −1.3% (−1.4% to −1.2%) in men and −2.1% (−2.2 to −2.0) in women, and in case fatality was −4.7% (−4.9% to −4.5%) in men and −4.4% (−4.5% to −4.2%) in women. Mortality and case fatality but not event rate declined in all age groups: the stroke event rate decreased in older people but increased by 2% each year in adults aged 35 to 54 years. Of the total decline in mortality rates, 71% was attributed to the decline in case fatality (78% in men and 66% in women) and the remainder to the reduction in stroke event rates. The contribution of the two factors varied between age groups. Whereas the reduction in mortality rates in people younger than 55 years was due to the reduction in case fatality, in the oldest age group (≥85 years) reductions in case fatality and event rates contributed nearly equally. Conclusions Declines in case fatality, probably driven by improvements in stroke care, contributed more than declines in event rates to the overall reduction in stroke mortality. Mortality reduction in men and women younger than 55 was solely a result of a decrease in case fatality, whereas stroke event rates increased in the age group 35 to 54 years. The increase in stroke event rates in young adults is a concern. This suggests that stroke prevention needs to be strengthened to reduce the occurrence of stroke in people younger than 55 years.

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Hospital admissions due to ambulatory care sensitive conditions among children by age group and health region

Revista da Escola de Enfermagem da USP ◽

10.1590/s0080-623420150000100006 ◽

2015 ◽

Vol 49 (1) ◽

pp. 44-53 ◽

Cited By ~ 7

Author(s):

Kelly Holanda Prezotto ◽

Maria Marta Nolasco Chaves ◽

Thais Aidar de Freitas Mathias

Keyword(s):

Ambulatory Care ◽

Hospital Admissions ◽

Age Groups ◽

Ambulatory Care Sensitive Conditions ◽

Age Group ◽

Health Region ◽

Unified Health System ◽

Using Data ◽

Ambulatory Care Sensitive ◽

Sensitive Conditions

OBJECTIVE to describe hospital admissions for ambulatory care sensitive conditions in children under five years of age in the State of Paraná, Brazil by condition type, age group and health region. METHOD a temporal ecological study was conducted using data from the Unified Health System Hospital Information System for the period 2000 to 2011. Conditions were grouped in accordance with the list of ambulatory care sensitive conditions in Brazil. RESULTS there was an increase in the rate of admissions for ambulatory care sensitive conditions in all age groups in 50% of the health regions, with a marked increase in children under the age of one. Pneumonia, gastroenteritis and asthma were the main causes of admissions. There was an increase in the proportion of overall admissions accounted for by pneumonia and gastroenteritis. CONCLUSION the increase in admissions reveals the need for actions to improve access to primary healthcare and provide effective treatment of the main ambulatory care sensitive conditions in order to prevent hospital admissions among children.

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Business cycle and mortality in Spain

The European Journal of Health Economics ◽

10.1007/s10198-021-01336-7 ◽

2021 ◽

Author(s):

María Cervini-Plá ◽

Judit Vall-Castelló

Keyword(s):

Business Cycle ◽

Age Groups ◽

Macroeconomic Fluctuations ◽

Age Group ◽

General Terms ◽

Mortality Causes ◽

Using Data ◽

The Impact ◽

Health And Mortality ◽

Transport Accidents

AbstractIn the last couple of decades, there has been a lot of interest on the impact of macroeconomic fluctuations on health and mortality rates. Many studies, for different countries, find that mortality is procyclical. However, studies examining the effects of more recent recessions are less conclusive, finding mortality to be less procyclical, or even countercyclical. In this paper, using data of Spanish provinces from 1999 to 2016, we investigate how this relationship works in the context of a country that is subject to extreme business cycle fluctuations. Furthermore, we analyze the impact of unemployment for different mortality causes and we explore differences by sex, age group and level of education. In general terms, we find mortality to be procyclical so that when the economy is in a recession, mortality falls. When exploring mortality causes, we show that deaths from cardiovascular disease, cancer, senility, transport accidents and homicides are procyclical. By sex, we find procyclicality for both men and women. By age, mortality is procyclical for all age groups; however, the causes of death that result in this procyclical behavior are specific to each age group. By educational level, suicide appears as a countercyclical cause for individuals with intermediate levels of education.

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60 Obesity in Older Adults in the Epic Norfolk Study is Associated with Reduced 20-Year Falls Hospitalization

Age and Ageing ◽

10.1093/ageing/afz164.60 ◽

2019 ◽

Vol 48 (Supplement_4) ◽

pp. iv13-iv17

Author(s):

Sheng Hui Kioh ◽

Mat Sumaiyah ◽

Phyo Myint ◽

Maw Pin Tan

Keyword(s):

Older Adults ◽

Body Height ◽

Age Groups ◽

Age Group ◽

Future Studies ◽

Increased Risk ◽

Risk Of Falls ◽

Using Data ◽

The Relationship

Abstract Background One in three older adults fall each year leading to increased disability, hospitalizations and mortality. Recent studies suggested an increased risk of falls among obese individuals which may correlate with increased rates of falls hospitalizations. However, there is not much information supporting the hypothesis that obesity may influence the risk of falls related hospitalizations. Aims To prospectively investigate whether body mass index (BMI) is a predictor for falls hospitalization by age group in the population of the EPIC-Norfolk Study. Methods Body height and weight were measured at baseline and BMI calculated. Falls hospitalization status over 20 years’ follow-up was ascertained using data linkage with centralized NHS records. Participants were categorized into the four BMI groups: underweight (BMI <18.5kg/m2 ), normal (18.5 ≤ BMI < 25.0 kg/m2), overweight ( 25.0 ≤ BMI < 30.0 kg/m2 ) and obese ( BMI ≥ 30.0kg/m2 ), and according to three age groups ( < 55 years, 55-64 years, ≥ 65 years). Results Data from 25636 individuals, (54.7%) women and (45.3%) men, mean age 59.2 ± 9.3 years, were included. For individuals within the under 55-year age group at baseline, individuals who were overweight (HR = 1.25; 95% CI= 1.01-1.56) and obese (HR = 1.54; 95% CI= 1.17-1.81) were at higher risk of falls hospitalization compared with those with normal BMI. As for individuals aged ≥ 65 years at recruitment, individuals who were obese were less likely to be hospitalized after a fall (HR = 0.85; 95% CI= 0.74 – 0.97) compared to those with normal BMI. Conclusions The relationship between obesity and falls hospitalization over 20 years differed between those aged <55years and 65years, with an increased risk observed for those <55years and reduced risk in those 65years. The underlying rationale for this finding will need to be evaluated in future studies.

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Age-Stratified Risk of Cerebral Venous Sinus Thrombosis After SARS-CoV-2 Vaccination

Neurology ◽

10.1212/wnl.0000000000013148 ◽

2021 ◽

pp. 10.1212/WNL.0000000000013148

Author(s):

Katarzyna Krzywicka ◽

Anita van de Munckhof ◽

Mayte Sánchez van Kammen ◽

Mirjam R Heldner ◽

Katarina Jood ◽

...

Keyword(s):

Sinus Thrombosis ◽

Absolute Risk ◽

Age Groups ◽

Cerebral Venous Sinus Thrombosis ◽

Venous Sinus ◽

Age Group ◽

Background Rate ◽

Venous Sinus Thrombosis ◽

The Absolute ◽

Using Data

Background and ObjectivesCerebral Venous Sinus Thrombosis (CVST) as a part of the thrombosis and thrombocytopenia syndrome is a rare adverse drug reaction of SARS-CoV-2 vaccination. Estimated background rate of CVST with thrombocytopenia is 0.1 per million per month. We assessed the age-stratified risk of CVST with and without thrombocytopenia after SARS-CoV-2 vaccination.MethodsWe estimated the absolute risk of CVST with and without thrombocytopenia within 28 days of first dose of four SARS-CoV-2 vaccinations, using data from the European Medicines Agency’s EudraVigilance database (until 13 June 2021). As a denominator, we used data on vaccine delivery from 31 European countries. For 22.8 million adults from 25 countries, we estimated the absolute risk of CVST after the first dose of ChAdOx1 nCov-19 per age category.ResultsThe absolute risk of CVST within 28 days of first dose vaccination was 7.5 (95%CI 6.9-8.3), 0.7 (95%CI 0.2-2.4), 0.6 (95%CI 0.5-0.7) and 0.6 (95%CI 0.3-1.1) per million of first doses of ChAdOx1 nCov-19, Ad26.COV2.S, BNT162b2 and mRNA-1273, respectively. The absolute risk of CVST with thrombocytopenia within 28 days of first dose vaccination was 4.4 (95%CI 3.9-4.9), 0.7 (95%CI 0.2-2.4), 0.0 (95%CI 0.0-0.1) and 0.0 (95%CI 0.0-0.2) per million of first doses of ChAdOx1 nCov-19, Ad26.COV2.S, BNT162b2 and mRNA-1273, respectively. In recipients of ChAdOx1 nCov-19, the absolute risk of CVST, both with and without thrombocytopenia, was the highest in the 18-24 years age group (7.3 per million, 95%CI 2.8-18.8 and 3.7 per million, 95%CI 1.0-13.3, respectively). The risk of CVST with thrombocytopenia in ChAdOx1 nCov-19 recipients was the lowest in the age group≥70 years (0.2, 95%CI 0.0-1.3). Age <60 compared to ≥60 was a predictor for CVST with thrombocytopenia (incidence rate ratio 5.79; 95%CI 2.98-11.24, p<0.001).DiscussionThe risk of CVST with thrombocytopenia within 28 days of first dose vaccination with ChAdOx1 nCov-19 was higher in younger age groups. The risk of CVST with thrombocytopenia was slightly increased in patients receiving Ad26.COV2.S, compared with the estimated background risk. The risk of CVST with thrombocytopenia was not increased in recipients of SARS-CoV-2 mRNA vaccines.

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