scholarly journals A Bayesian hierarchical model with integrated covariate selection and misclassification matrices to estimate neonatal and child causes of death

2021 ◽  
Author(s):  
Amy R. Mulick ◽  
Shefali Oza ◽  
David Prieto-Merino ◽  
Francisco Villavicencio ◽  
Simon Cousens ◽  
...  
Keyword(s):  
Random Effects ◽  
Fixed Effects ◽  
Causes Of Death ◽  
National Level ◽  
Selection Procedure ◽  
Statistical Modelling ◽  
Model Parameters ◽  
Covariate Selection ◽  
Country Level ◽  
Nationally Representative

SummaryReducing neonatal and child mortality is a global priority. In countries without comprehensive vital registration data to inform policy and planning, statistical modelling is used to estimate the distribution of key causes of death. This modelling presents challenges given that the input data are few, noisy, often not nationally representative of the country from which they are derived, and often do not report separately on all of the key causes. As more nationally representative data come to be available, it becomes possible to produce country estimates that go beyond fixed-effects models with national-level covariates by incorporating country-level random effects. However, the existing frequentist multinomial model is limited by convergence problems when adding random effects, and had not incorporated a covariate selection procedure simultaneously over all causes. We report here on the translation of a fixed effects, frequentist model into a Bayesian framework to address these problems, incorporating a misclassification matrix with the potential to correct for mis-reported as well as unreported causes. We apply the new method and compare the model parameters and predicted distributions of eight key causes of death with those based on the previous, frequentist model.

scholarly journals Progress against inequalities in mortality: register-based study of 15 European countries between 1990 and 2015

2019 ◽  
Vol 34 (12) ◽  
pp. 1131-1142 ◽  
Author(s):  
Johan P. Mackenbach ◽  
José Rubio Valverde ◽  
Matthias Bopp ◽  
Henrik Brønnum-Hansen ◽  
Giuseppe Costa ◽  
...  
Keyword(s):  
Health Care ◽  
Fixed Effects ◽  
Causes Of Death ◽  
Health Care Expenditure ◽  
European Countries ◽  
Mortality Data ◽  
Factors Associated ◽  
Country Level ◽  
Low Educated ◽  
Inequalities In Mortality

AbstractSocioeconomic inequalities in mortality are a challenge for public health around the world, but appear to be resistant to policy-making. We aimed to identify European countries which have been more successful than others in narrowing inequalities in mortality, and the factors associated with narrowing inequalities. We collected and harmonised mortality data by educational level in 15 European countries over the last 25 years, and quantified changes in inequalities in mortality using a range of measures capturing different perspectives on inequality (e.g., ‘relative’ and ‘absolute’ inequalities, inequalities in ‘attainment’ and ‘shortfall’). We determined which causes of death contributed to narrowing of inequalities, and conducted country- and period-fixed effects analyses to assess which country-level factors were associated with narrowing of inequalities in mortality. Mortality among the low educated has declined rapidly in all European countries, and a narrowing of absolute, but not relative inequalities was seen in many countries. Best performers were Austria, Italy (Turin) and Switzerland among men, and Spain (Barcelona), England and Wales, and Austria among women. Ischemic heart disease, smoking-related causes (men) and amenable causes often contributed to narrowing inequalities. Trends in income inequality, level of democracy and smoking were associated with widening inequalities, but rising health care expenditure was associated with narrowing inequalities. Trends in inequalities in mortality have not been as unfavourable as often claimed. Our results suggest that health care expansion has counteracted the inequalities widening effect of other influences.

Strategies for Survival of the World — Risk Management

2019 ◽  
Vol 10 (4) ◽  
Author(s):  
Jovo Lojanica ◽  
Keyword(s):  
Risk Management ◽  
Native Americans ◽  
National Level ◽  
Country Level ◽  
Management Standards ◽  
Family Level ◽  
Future Challenges ◽  
Iso 31000 ◽  
History Of ◽  
Personal Level

All management standards have requirements for different aspects of improvements on the personal level, family level, company level, in business and life. What is about national level and country level? Is it possible for today’s generations to learn history of nations and of civilizations? If it is — ok, let’s apply it on actual time and people to have less problems and difficulties — especially if is actual in field of risk management. Majority of people are occupied by today’s problems. They don’t consider past and future challenges. People from each country strive for better quality, better and cleaner environment, higher safety etc. historically and today. But could we remember: How did Genghis Khan conquer many regions and how was he defeated? How did Mayas and Aztecs die out? How were Native Americans in North America drastically reduced in numbers? How did the Roman Imperium vanish? How was the Ottoman Imperium established and how it vanished? How many people were killed in the wars in XX century, etc? In all these catastrophic changes risks were not considered in an adequate way. Requirements of risk management — Principles and guidelines — ISO 31000:2009 are very consultative. They could be used on country level, national level, regional level, continental and intercontinental level.

scholarly journals Defining and Quantifying National-Level Targets, Indicators and Benchmarks for Management of Natural Resources to Achieve the Sustainable Development Goals

2019 ◽  
Vol 11 (2) ◽  
pp. 462 ◽  
Author(s):  
Chris Dickens ◽  
Vladimir Smakhtin ◽  
Matthew McCartney ◽  
Gordon O’Brien ◽  
Lula Dahir
Keyword(s):  
Sustainable Development ◽  
Natural Resources ◽  
Sustainable Development Goals ◽  
National Level ◽  
Resource Quality ◽  
The Sustainable Development ◽  
Country Level ◽  
2030 Agenda ◽  
Development Goals ◽  
Global Indicators

The 2030 Agenda for Sustainable Development, the Sustainable Development Goals (SDGs), are high on the agenda for most countries of the world. In its publication of the SDGs, the UN has provided the goals and target descriptions that, if implemented at a country level, would lead towards a sustainable future. The IAEG (InterAgency Expert Group of the SDGs) was tasked with disseminating indicators and methods to countries that can be used to gather data describing the global progress towards sustainability. However, 2030 Agenda leaves it to countries to adopt the targets with each government setting its own national targets guided by the global level of ambition but taking into account national circumstances. At present, guidance on how to go about this is scant but it is clear that the responsibility is with countries to implement and that it is actions at a country level that will determine the success of the SDGs. Reporting on SDGs by country takes on two forms: i) global reporting using prescribed indicator methods and data; ii) National Voluntary Reviews where a country reports on its own progress in more detail but is also able to present data that are more appropriate for the country. For the latter, countries need to be able to adapt the global indicators to fit national priorities and context, thus the global description of an indicator could be reduced to describe only what is relevant to the country. Countries may also, for the National Voluntary Review, use indicators that are unique to the country but nevertheless contribute to measurement of progress towards the global SDG target. Importantly, for those indicators that relate to the security of natural resources security (e.g., water) indicators, there are no prescribed numerical targets/standards or benchmarks. Rather countries will need to set their own benchmarks or standards against which performance can be evaluated. This paper presents a procedure that would enable a country to describe national targets with associated benchmarks that are appropriate for the country. The procedure builds on precedent set in other countries but in particular on a procedure developed for the setting of Resource Quality Objectives in South Africa. The procedure focusses on those SDG targets that are natural resource-security focused, for example, extent of water-related ecosystems (6.6), desertification (15.3) and so forth, because the selection of indicator methods and benchmarks is based on the location of natural resources, their use and present state and how they fit into national strategies.

scholarly journals A random effects population dynamics model based on proportions-at-age and removal data for estimating total mortality

2012 ◽  
Vol 69 (11) ◽  
pp. 1881-1893 ◽  
Author(s):  
Verena M. Trenkel ◽  
Mark V. Bravington ◽  
Pascal Lorance
Keyword(s):  
Population Dynamics ◽  
Random Effects ◽  
Fixed Effects ◽  
Random Effect ◽  
Total Mortality ◽  
Estimation Bias ◽  
Effective Sample Size ◽  
Dynamics Model ◽  
Population Dynamics Model ◽  
Study Parameter

Catch curves are widely used to estimate total mortality for exploited marine populations. The usual population dynamics model assumes constant recruitment across years and constant total mortality. We extend this to include annual recruitment and annual total mortality. Recruitment is treated as an uncorrelated random effect, while total mortality is modelled by a random walk. Data requirements are minimal as only proportions-at-age and total catches are needed. We obtain the effective sample size for aggregated proportion-at-age data based on fitting Dirichlet-multinomial distributions to the raw sampling data. Parameter estimation is carried out by approximate likelihood. We use simulations to study parameter estimability and estimation bias of four model versions, including models treating mortality as fixed effects and misspecified models. All model versions were, in general, estimable, though for certain parameter values or replicate runs they were not. Relative estimation bias of final year total mortalities and depletion rates were lower for the proposed random effects model compared with the fixed effects version for total mortality. The model is demonstrated for the case of blue ling (Molva dypterygia) to the west of the British Isles for the period 1988 to 2011.

scholarly journals Understanding, Choosing, and Unifying Multilevel and Fixed Effect Approaches

2020 ◽  
pp. 1-20
Author(s):  
Chad Hazlett ◽  
Leonard Wainstein
Keyword(s):  
Random Effects ◽  
Fixed Effects ◽  
Multilevel Models ◽  
Standard Errors ◽  
Point Estimate ◽  
Fe Model ◽  
Grouped Data ◽  
Coefficient Estimates ◽  
Political Science Education ◽  
Robust Standard Errors

Abstract When working with grouped data, investigators may choose between “fixed effects” models (FE) with specialized (e.g., cluster-robust) standard errors, or “multilevel models” (MLMs) employing “random effects.” We review the claims given in published works regarding this choice, then clarify how these approaches work and compare by showing that: (i) random effects employed in MLMs are simply “regularized” fixed effects; (ii) unmodified MLMs are consequently susceptible to bias—but there is a longstanding remedy; and (iii) the “default” MLM standard errors rely on narrow assumptions that can lead to undercoverage in many settings. Our review of over 100 papers using MLM in political science, education, and sociology show that these “known” concerns have been widely ignored in practice. We describe how to debias MLM’s coefficient estimates, and provide an option to more flexibly estimate their standard errors. Most illuminating, once MLMs are adjusted in these two ways the point estimate and standard error for the target coefficient are exactly equal to those of the analogous FE model with cluster-robust standard errors. For investigators working with observational data and who are interested only in inference on the target coefficient, either approach is equally appropriate and preferable to uncorrected MLM.

scholarly journals Construction of a demand and capacity model for intensive care and hospital ward beds, and mortality from COVID-19

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Christopher Martin ◽  
Stuart McDonald ◽  
Steve Bale ◽  
Michiel Luteijn ◽  
Rahul Sarkar
Keyword(s):  
Intensive Care ◽  
National Level ◽  
Direct Consequence ◽  
Hospital Ward ◽  
Model Parameters ◽  
Capacity Model ◽  
New Variant ◽  
Pessimistic Scenario ◽  
Demand And Capacity ◽  
Excess Deaths

Abstract Background This paper describes a model for estimating COVID-19 related excess deaths that are a direct consequence of insufficient hospital ward bed and intensive care unit (ICU) capacity. Methods Compartmental models were used to estimate deaths under different combinations of ICU and ward care required and received in England up to late April 2021. Model parameters were sourced from publicly available government information and organisations collating COVID-19 data. A sub-model was used to estimate the mortality scalars that represent increased mortality due to insufficient ICU or general ward bed capacity. Three illustrative scenarios for admissions numbers, ‘Optimistic’, ‘Middling’ and ‘Pessimistic’, were modelled and compared with the subsequent observations to the 3rd February. Results The key output was the demand and capacity model described. There were no excess deaths from a lack of capacity in the ‘Optimistic’ scenario. Several of the ‘Middling’ scenario applications resulted in excess deaths—up to 597 deaths (0.6% increase) with a 20% reduction compared to best estimate ICU capacity. All the ‘Pessimistic’ scenario applications resulted in excess deaths, ranging from 49,178 (17.0% increase) for a 20% increase in ward bed availability, to 103,735 (35.8% increase) for a 20% shortfall in ward bed availability. These scenarios took no account of the emergence of the new, more transmissible, variant of concern (b.1.1.7). Conclusions Mortality is increased when hospital demand exceeds available capacity. No excess deaths from breaching capacity would be expected under the ‘Optimistic’ scenario. The ‘Middling’ scenario could result in some excess deaths—up to a 0.7% increase relative to the total number of deaths. The ‘Pessimistic’ scenario would have resulted in significant excess deaths. Our sensitivity analysis indicated a range between 49,178 (17% increase) and 103,735 (35.8% increase). Given the new variant, the pessimistic scenario appeared increasingly likely and could have resulted in a substantial increase in the number of COVID-19 deaths. In the event, it would appear that capacity was not breached at any stage at a national level with no excess deaths. it will remain unclear if minor local capacity breaches resulted in any small number of excess deaths.

scholarly journals Maternal education and early childhood education across affluent English-speaking countries

2021 ◽  
pp. 016502542199591
Author(s):  
Robert L. Crosnoe ◽  
Carol Anna Johnston ◽  
Shannon E. Cavanagh
Keyword(s):  
Early Childhood ◽  
Early Childhood Education ◽  
Educational Attainment ◽  
Maternal Education ◽  
Relative Advantage ◽  
Data Sets ◽  
Childhood Education ◽  
Country Level ◽  
English Speaking ◽  
Nationally Representative

Women who attain more education tend to have children with more educational opportunities, a transmission of educational advantages across generations that is embedded in the larger structures of families’ societies. Investigating such country-level variation with a life-course model, this study estimated associations of mothers’ educational attainment with their young children’s enrollment in early childhood education and engagement in cognitively stimulating activities in a pooled sample of 36,400 children ( n = 17,900 girls, 18,500 boys) drawn from nationally representative data sets from Australia, Ireland, U.K., and U.S. Results showed that having a mother with a college degree generally differentiated young children on these two outcomes more in the U.S., potentially reflecting processes related to strong relative advantage (i.e., maternal education matters more in populations with lower rates of women’s educational attainment) and weak contingent protection (i.e., it matters more in societies with less policy investment in families).

scholarly journals Association of bisphenol A with puberty timing: a meta-analysis

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Hui Meng ◽  
Yunping Zhou ◽  
Yunxia Jiang
Keyword(s):  
Bisphenol A ◽  
Confidence Intervals ◽  
Random Effects ◽  
Strong Correlation ◽  
Fixed Effects ◽  
Meta Analysis ◽  
Random Effects Models ◽  
Study Heterogeneity ◽  
The Relationship ◽  
Prevalence Ratios

AbstractObjectivesThe results of existing studies on bisphenol A (BPA) and puberty timing did not reach a consensus. Thereby we performed this meta-analytic study to explore the association between BPA exposure in urine and puberty timing.MethodsMeta-analysis of the pooled odds ratios (OR), prevalence ratios (PR) or hazards ratios (HR) with 95% confidence intervals (CI) were calculated and estimated using fixed-effects or random-effects models based on between-study heterogeneity.ResultsA total of 10 studies involving 5621 subjects were finally included. The meta-analysis showed that BPA exposure was weakly associated with thelarche (PR: 0.96, 95% CI: 0.93–0.99), while no association was found between BPA exposure and menarche (HR: 0.99, 95% CI: 0.89–1.12; OR: 1.02, 95% CI: 0.73–1.43), and pubarche (OR: 1.00, 95% CI: 0.79–1.26; PR: 1.00, 95% CI: 0.95–1.05).ConclusionsThere was no strong correlation between BPA exposure and puberty timing. Further studies with large sample sizes are needed to verify the relationship between BPA and puberty timing.

scholarly journals Dynamic quarantine: a comparative analysis of the Chilean public health response to COVID-19

2020 ◽  
Vol 148 ◽  
Author(s):  
Gonzalo Grebe ◽  
Javier A. Vélez ◽  
Anton Tiutiunnyk ◽  
Diego Aragón-Caqueo ◽  
Javier Fernández-Salinas ◽  
...  
Keyword(s):  
Public Health ◽  
Comparative Analysis ◽  
Transmission Rate ◽  
National Level ◽  
Metropolitan Region ◽  
Public Health Response ◽  
Country Level ◽  
Health Response ◽  
Primary Vector

Abstract In this study, an analysis of the Chilean public health response to mitigate the spread of COVID-19 is presented. The analysis is based on the daily transmission rate (DTR). The Chilean response has been based on dynamic quarantines, which are established, lifted or prolonged based on the percentage of infected individuals in the fundamental administrative sections, called communes. This analysis is performed at a national level, at the level of the Metropolitan Region (MR) and at the commune level in the MR according to whether the commune did or did not enter quarantine between late March and mid-May of 2020. The analysis shows a certain degree of efficacy in controlling the pandemic using the dynamic quarantine strategy. However, it also shows that apparent control has only been partially achieved to date. With this policy, the control of the DTR partially falls to 4%, where it settles, and the MR is the primary vector of infection at the country level. For this reason, we can conclude that the MR has not managed to control the disease, with variable results within its own territory.

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