Excess Mortality Related to Chikungunya Epidemics in the Context of Co-circulation of Other Arboviruses in Brazil

AbstractChikungunya is an emerging arbovirus that reached the Western Hemisphere at the end of 2013. Studies conducted in Indie Ocean and India suggest that many of deaths associated with chikungunya cannot be recognized by passive surveillance system. The occurrence of these deaths can be inferred by an increase in the overall mortality observed during chikungunya epidemics. To evaluate the mortality associated with chikungunya epidemics in Brazil, we studied monthly mortality by age group comparing the pre-chikungunya period with the chikungunya epidemic period in the most affected states of Brazil. We obtained official data from National System of Notifiable Diseases (SINAN) and Mortality Information System (SIM), both maintained by the Ministry of Health. It was possible to identify a significant increase in all-cause mortality rate during chikungunya epidemics, there was no similar mortality in previous years, even during dengue epidemics. We estimated an excess of 4,842 deaths in Pernambuco during the chikungunya epidemics (51.4/100,000 inhabitants), the most affected age groups were the elderly and under 1 year of age, the same pattern occurred in all states. Further studies at other sites are needed to confirm the association between increased mortality and chikungunya epidemics. If these findings are confirmed, it will be necessary to revise guidelines to recognize the real mortality associated with chikungunya and to improve therapeutic approaches and protective measures in the most vulnerable groups.

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Metagenomic Profiles of the Intestinal Virome of Long-Livers

KnE Life Sciences ◽

10.18502/kls.v7i1.10116 ◽

2022 ◽

Author(s):

Elizaveta V. Starikova ◽

Ksenia M. Klimina ◽

Anastasia O. Eudokimova ◽

Ksenia A. Yeruslanova ◽

Denis A. Gudkov ◽

...

Keyword(s):

Microbial Community ◽

Gut Microbiome ◽

Age Groups ◽

The Elderly ◽

Viral Metagenomics ◽

Viral Diversity ◽

Human Intestine ◽

Health It ◽

Beneficial Bacteria ◽

Keywords Aging

The microbial community of the human intestine is important for maintaining human health. It has been reported that the gut microbiome changes with age, and it can be enrichedwith certain beneficial bacteria while also losing certain commensal bacteria.Little is known about the gut virome of long-livers. Our research aimed to extract, sequence and analyze the viral fraction of long-livers’ gut microbiota in comparison with those of young adults and the elderly. We were thereby able to characterize the gut virome profiles and viral diversity of three age groups. Keywords: aging, gut microbiome, viral metagenomics, bacteriophages

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Utilization of Secondary Eye Care Services in Western Kenya

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16183371 ◽

2019 ◽

Vol 16 (18) ◽

pp. 3371

Author(s):

Hillary K Rono MMed ◽

David Macleod ◽

Andrew Bastawrous ◽

Emmanuel Wanjala ◽

Michael Gichangi ◽

...

Keyword(s):

Incidence Rate ◽

Age Groups ◽

Unmet Need ◽

The Elderly ◽

Vulnerable Groups ◽

Age Group ◽

Attendance Rates ◽

Care Providers ◽

Eye Care ◽

Care Services

Background: Eye care provision is currently insufficient to meet the population’s eye health needs in Kenya. Many people remain unnecessarily visually impaired or at risk of becoming so due to treatable or preventable conditions. A lack of access and awareness of services are key barriers, in large part due to their being too few eye care providers in the health system for this unmet need. Methods: A hospital-based, retrospective analysis of patients who attended Kitale eye unit, Trans Nzoia County, Kenya from 1st January 2013 to 31st December 2015. Age and sex standardized hospital attendance rates by residence, age group, and sex were calculated for Trans Nzoia county and each subcounty. The changing trends in attendance rates were estimated by calculating the difference between base year and last year. Incidence rate ratios for attendance for each age-group, sex, and residence were estimated using a multivariable regression model. Results: 20,695 patients from the county were seen in Kitale Eye Unit in 2013, 2014 and 2015. In that period, 8.3% had either uncorrected refractive error, cataracts or glaucoma, the priority VISION2020 diseases, and 61.0% had allergic or other conjunctivitis or normal eyes, which could potentially be managed at primary eye care. During the study period, overall average annual attendance rate increased from 609 to 792 per 100, 000 population, incidence rate ratio (IRR) 1.30 (95% confidence interval (CI) 1.26–1.35). Attendance rates increased more in females than males (34.7% vs. 25.1%, respectively), IRR 1.07 (1.04–1.10). Attendance rates increased with increasing age, (highest among the elderly compared to the young). We found that in extreme age groups (>75 years and <15years) females were less likely to attend than males and there was reduced utilization from those based furthest from the hospital. Conclusion: Specialist eye services are heavily utilized by people with conditions that could be managed at the primary health care level. Barriers to accessing eye services were distance and gender, especially among the most vulnerable groups (young and the elderly). Integration of primary and secondary eye care services could lower barriers to essential eye care services to the population whilst lowering pressure on the limited specialist services by ensuring more appropriate utilization.

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The Effects of Significant International Sports Events on Hungarian Suicide Rates

Crisis ◽

10.1027/0227-5910/a000352 ◽

2016 ◽

Vol 37 (2) ◽

pp. 148-154 ◽

Cited By ~ 2

Author(s):

Karoly Bozsonyi ◽

Peter Osvath ◽

Sandor Fekete ◽

Lajos Bálint

Keyword(s):

Significant Relationship ◽

Olympic Games ◽

Arima Model ◽

Age Groups ◽

The Elderly ◽

Intervention Analysis ◽

Middle Aged ◽

Sports Events ◽

Sport Events ◽

The Olympic Games

Abstract. Background: Several studies found a significant relationship between important sport events and suicidal behavior. Aims: We set out to investigate whether there is a significant relationship between the raw suicide rate and the most important international sports events (Olympic Games, FIFA World Cup, UEFA European Championship) in such an achievement-oriented society as the Hungarian one, where these sport events receive great attention. Method: We examined suicide cases occurring over 15,706 days between January 1, 1970, and December 31, 2012 (43 years), separately for each gender. Because of the age-specific characteristics of suicide, the effects of these sport events were analyzed for the middle-aged (30–59 years old) and the elderly (over 60 years old) generations as well as for gender-specific population groups. The role of international sport events was examined with the help of time-series intervention analysis after cyclical and seasonal components were removed. Intervention analysis was based on the ARIMA model. Results: Our results showed that only the Olympic Games had a significant effect in the middle-aged population. Neither in the older male nor in any of the female age groups was a relationship between suicide and Olympic Games detected. Conclusion: The Olympic Games seem to decrease the rate of suicide among middle-aged men, slightly but significantly.

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Older workers in the Russian labor market: Trends in employment reallocation

Voprosy Ekonomiki ◽

10.32609/0042-8736-2019-11-5-34 ◽

2019 ◽

pp. 5-34

Author(s):

Anna L. Lukyanova ◽

Rostislav I. Kapeliushnikov

Keyword(s):

Older Workers ◽

Service Sector ◽

Age Groups ◽

The Elderly ◽

Education And Health ◽

Job Opportunities ◽

Intellectual Labor ◽

Market Trends ◽

Trade Education ◽

The One

The paper analyzes changes in job opportunities of older workers in Russia in the period 2005—2017. The study uses the data from the Russian Labor Force Survey conducted by Rosstat. Changes in the occupational and industrial composition of elderly workers follow the trends pursued by other age groups: employment shifts from low- to high-skilled occupations, from physical to intellectual labor, and from material production to the service sector. We find a stronger polarization among older workers as their occupational structure is biased in favor of, on the one hand, the most and, on the other hand, the least qualified types of jobs. Employment of the elderly has fallen sharply in agriculture and manufacturing with a significant increase in trade, education, and health. Although the employment structure of older workers is generally more “traditionalist”, recent decades have witnessed its transformation in “progressive” directions, similarly to other age groups. These findings suggest that the legislated increase in the state retirement age is not likely to give rise to sizeable unemployment among the elderly. Most of them will be able to work in the occupations and industries previously dominated by young and prime-age workers.

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ACUTE KIDNEY INJURY IN ELDERLY PATIENTS

Wiadomości Lekarskie ◽

10.36740/wlek201908109 ◽

2019 ◽

Vol 72 (8) ◽

pp. 1466-1472

Author(s):

Grażyna Kobus ◽

Jolanta Małyszko ◽

Hanna Bachórzewska-Gajewska

Keyword(s):

Acute Kidney Injury ◽

Renal Failure ◽

Acute Renal Failure ◽

Elderly Patients ◽

Older Patients ◽

Age Groups ◽

Kidney Injury ◽

The Elderly ◽

Younger Patients ◽

Common Cause

Introduction: In the elderly, impairment of kidney function occurs. Renal diseases overlap with anatomic and functional changes related to age-related involutionary processes. Mortality among patients with acute renal injury is approximately 50%, despite advances in treatment and diagnosis of AKI. The aim: To assess the incidence of acute kidney injury in elderly patients and to analyze the causes of acute renal failure depending on age. Materials and methods: A retrospective analysis included medical documentation of patients hospitalized in the Nephrology Clinic during the 6-month period. During this period 452 patients were hospitalized in the clinic. A group of 77 patients with acute renal failure as a reason for hospitalization was included in the study. Results: The prerenal form was the most common cause of AKI in both age groups. In both age groups, the most common cause was dehydration; in the group of patients up to 65 years of age, dehydration was 29.17%; in the group of people over 65 years - 43.39%. Renal replacement therapy in patients with AKI was used in 14.29% of patients. In the group of patients up to 65 years of age hemodialysis was 16.67% and above 65 years of age. -13.21% of patients. The average creatinine level in the group of younger patients at admission was 5.16 ± 3.71 mg / dl, in the group of older patients 3.14 ± 1.63 mg / dl. The size of glomerular filtration GFR in the group of younger patients at admission was 21.14 ± 19.54 ml / min, in the group of older patients 23.34 ± 13.33 ml / min. Conclusions: The main cause of acute kidney injury regardless of the age group was dehydration. Due to the high percentage of AKI in the elderly, this group requires more preventive action, not only in the hospital but also at home.

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A new medical Internet system in healthcare: innovation of Telegeriatrics and healthcare demands of older patients of different age groups (Preprint)

10.2196/preprints.24676 ◽

2020 ◽

Author(s):

Yu Gong ◽

Jianyuan Zhou

Keyword(s):

Cardiovascular Diseases ◽

General Practitioners ◽

Older Patients ◽

Metabolic Diseases ◽

Treatment Plan ◽

Age Groups ◽

The Elderly ◽

Diagnosis And Treatment ◽

World Health ◽

New Model

BACKGROUND Healthcare for older patients is a worldwide challenge for public health system. A new medical Internet system in healthcare which is a new model of telegeriatrics system has been established. The key innovation is the new telegeriatrics system was conducted jointly by general practitioners in the Community Health Service Center and specialists in university teaching hospital. Unlike the typical telemedicine that has been practiced in other countries, the new model provides a solution for the key issues in telemedicine where a doctor is unable to conduct a direct physical examination and the associated potential diagnostic error. OBJECTIVE This study is to introduce the operation mechanism of the new Telegeriatrics system and analyze healthcare demands of older patients in different age groups applying the new Telegeriatrics system. METHODS 472 older patients (aged≥60) were enrolled and divided into the young older group (aged 60 to 74), the old older group (aged 75 to 89) and the very old group (aged≥90) according to the age stratification of World Health Organization. Proportion of the top 10 diseases of older patients of different age groups was analyzed. RESULTS The process of older patients’ diagnosis and treatment made by specialist and general practitioners formed a closed loop. It ensures the timeliness and effectiveness of diagnosis and treatment of older patients. The treatment effect can be observed by general practitioners and specialist can adjust the treatment plan in time. In this study, it was found that older patients in different age groups have different healthcare demands. Coronary heart disease and type 2 diabetes mellitus were found to be the main diseases of the older patients and the young older patients as well as the old older patients applying Telegeriatrics. CONCLUSIONS The new telegeriatrics system can provide convenient and efficient healthcare services for older patients and overcome the disadvantage of currently used models of telegeriatrics. Older patients in different age groups have different medical care demands. Cardiovascular diseases and metabolic diseases have become the main diseases of the elderly applying the new Telegeriatrics system. Healthcare policy makers should invest more medical resources to the prevention of cardiovascular diseases and metabolic diseases in the elderly.

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Big Data Driven Clinical Informatics & Surveillance (BDD_CIS) – A Multimodal Database Focused Clinical, Community, and Multi-Omics Surveillance Plan for COVID-19: A study Protocol (Preprint)

10.2196/preprints.24504 ◽

2020 ◽

Author(s):

Bankole Olatosi ◽

Jiajia Zhang ◽

Sharon Weissman ◽

Zhenlong Li ◽

Jianjun Hu ◽

...

Keyword(s):

Big Data ◽

South Carolina ◽

Data Science ◽

Age Groups ◽

The Elderly ◽

The United States ◽

Data Sources ◽

Patient Registries ◽

Multiple Partner ◽

Multimodal Data

BACKGROUND The Coronavirus Disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus (SARS-CoV-2) remains a serious global pandemic. Currently, all age groups are at risk for infection but the elderly and persons with underlying health conditions are at higher risk of severe complications. In the United States (US), the pandemic curve is rapidly changing with over 6,786,352 cases and 199,024 deaths reported. South Carolina (SC) as of 9/21/2020 reported 138,624 cases and 3,212 deaths across the state. OBJECTIVE The growing availability of COVID-19 data provides a basis for deploying Big Data science to leverage multitudinal and multimodal data sources for incremental learning. Doing this requires the acquisition and collation of multiple data sources at the individual and county level. METHODS The population for the comprehensive database comes from statewide COVID-19 testing surveillance data (March 2020- till present) for all SC COVID-19 patients (N≈140,000). This project will 1) connect multiple partner data sources for prediction and intelligence gathering, 2) build a REDCap database that links de-identified multitudinal and multimodal data sources useful for machine learning and deep learning algorithms to enable further studies. Additional data will include hospital based COVID-19 patient registries, Health Sciences South Carolina (HSSC) data, data from the office of Revenue and Fiscal Affairs (RFA), and Area Health Resource Files (AHRF). RESULTS The project was funded as of June 2020 by the National Institutes for Health. CONCLUSIONS The development of such a linked and integrated database will allow for the identification of important predictors of short- and long-term clinical outcomes for SC COVID-19 patients using data science.

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France

10.1093/oso/9780198807032.003.0006 ◽

2018 ◽

Author(s):

Philippe Askenazy ◽

Bruno Palier

Keyword(s):

Income Inequality ◽

Labour Market ◽

Rapid Growth ◽

Household Income ◽

General Trend ◽

Age Groups ◽

Wage Growth ◽

The Elderly ◽

Wage Setting ◽

Rich Countries

This chapter describes France as apparently one of the few rich countries to have avoided a significant increase in income inequality in recent decades. However, stable average inequalities mask an asymmetric trend of income between age groups, the elderly improving their situation while the young see theirs worsening. Furthermore, it shows that behind this relatively still surface, a general trend of precarization of more and more ordinary workers is occurring. The importance of wage-setting processes and of regulation of the labour market is brought out, together with the way the tax and transfer systems have operated, in restraining the forces driving inequality upwards. Wage growth, while limited, has thus been reasonably uniform across the distribution and together with the redistributive system have kept household income inequality within bounds. However, in response to high unemployment both regulatory and tax–transfer systems have served to underpin the very rapid growth in precarious working over the last decade, representing a very serious challenge for policy.

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A Pharmacological Analysis of the Activity and Failure of the Medical Treatment of High-Grade Osteosarcoma

Medicina ◽

10.3390/medicina57020141 ◽

2021 ◽

Vol 57 (2) ◽

pp. 141

Author(s):

Alessandro Comandone ◽

Antonella Boglione ◽

Tiziana Comandone ◽

Fausto Petrelli

Keyword(s):

Bone Cells ◽

Age Groups ◽

The Elderly ◽

New Drugs ◽

High Grade ◽

Secondary Resistance ◽

Orthopedic Surgeons ◽

Close Cooperation ◽

High Grade Osteosarcoma ◽

Effective Drugs

Osteosarcomas (OSs) are a group of neoplasms originating from bone cells, usually presenting in three specific age groups: children, young adults, and the elderly. High-grade OS is an extremely malignant tumor mainly due to evolution into metastatic disease, usually in the lungs. Survival of these patients has improved since the 1980s thanks to close cooperation between oncologists, oncological surgeons and orthopedic surgeons. Unfortunately, no progress has been made in the last 30 years and new, more effective drugs are needed. This article reviews the biological and pharmacological basis of the treatment of OS. Models of clinical pharmacology of the active drugs, toxic effects and reasons for primary and secondary resistance to old and new drugs are discussed.

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Estimation of Excess Mortality and Years of Life Lost to COVID-19 in Norway and Sweden between March and November 2020

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18083913 ◽

2021 ◽

Vol 18 (8) ◽

pp. 3913

Author(s):

Martin Rypdal ◽

Kristoffer Rypdal ◽

Ola Løvsletten ◽

Sigrunn Holbek Sørbye ◽

Elinor Ytterstad ◽

...

Keyword(s):

Excess Mortality ◽

Age Groups ◽

Years Of Life Lost ◽

Regressive Model ◽

Epidemic Period ◽

All Cause Mortality ◽

Auto Regressive ◽

Expected Mortality ◽

Auto Regressive Model ◽

Excess Deaths

We estimate the weekly excess all-cause mortality in Norway and Sweden, the years of life lost (YLL) attributed to COVID-19 in Sweden, and the significance of mortality displacement. We computed the expected mortality by taking into account the declining trend and the seasonality in mortality in the two countries over the past 20 years. From the excess mortality in Sweden in 2019/20, we estimated the YLL attributed to COVID-19 using the life expectancy in different age groups. We adjusted this estimate for possible displacement using an auto-regressive model for the year-to-year variations in excess mortality. We found that excess all-cause mortality over the epidemic year, July 2019 to July 2020, was 517 (95%CI = (12, 1074)) in Norway and 4329 [3331, 5325] in Sweden. There were 255 COVID-19 related deaths reported in Norway, and 5741 in Sweden, that year. During the epidemic period of 11 March–11 November, there were 6247 reported COVID-19 deaths and 5517 (4701, 6330) excess deaths in Sweden. We estimated that the number of YLL attributed to COVID-19 in Sweden was 45,850 [13,915, 80,276] without adjusting for mortality displacement and 43,073 (12,160, 85,451) after adjusting for the displacement accounted for by the auto-regressive model. In conclusion, we find good agreement between officially recorded COVID-19 related deaths and all-cause excess deaths in both countries during the first epidemic wave and no significant mortality displacement that can explain those deaths.

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