The Importance of Education for Middle- and Old-Age Mortality in Chile: Estimates From Panel Data Linked to Death Records

2021 ◽  
pp. 089826432110274
Author(s):  
Moisés H. Sandoval ◽  
Cássio M. Turra ◽  
Luciana Luz
Keyword(s):  
Formal Education ◽  
Social Protection ◽  
Cox Regression ◽  
Tertiary Education ◽  
Adult Mortality ◽  
Structural Problems ◽  
Hazard Ratios ◽  
Education Levels ◽  
And Gender ◽  
Lower Hazard

Objectives To examine the association between education and mortality by age and gender in Chile. Methods We drew data from 10,147 adults aged 40 years and over from the Chilean Social Protection Survey linked to the national death records. We specify five Cox regression models to estimate the main and interaction effects for education levels, age, sex, and mortality. Results The hazard ratios reduce with increasing education. Secondary and tertiary education levels are associated, respectively, with 34% and 41% lower hazard rates than 0–4 years of schooling. Also, the educational gradient in mortality is significantly weaker at older ages, and it does not differ by gender. Discussion Our findings endorse the negative association of formal education with adult mortality, uncovering Chile’s structural problems despite the economic improvements underway. It also corroborates the importance of novel longitudinal data for mortality analyses in Latin America.

scholarly journals Complementary Chinese Herbal Medicine Therapy Improves Survival of Patients With Pancreatic Cancer in Taiwan: A Nationwide Population-Based Cohort Study

2017 ◽  
Vol 17 (2) ◽  
pp. 411-422 ◽  
Author(s):  
Yi-Ting Kuo ◽  
Hou-Hsun Liao ◽  
Jen-Huai Chiang ◽  
Mei-Yao Wu ◽  
Bor-Chyuan Chen ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Herbal Medicine ◽  
Chinese Herbal Medicine ◽  
Mortality Risk ◽  
Cox Regression ◽  
Population Based ◽  
Hazard Ratio ◽  
Chinese Herbal ◽  
Hazard Ratios ◽  
Lower Hazard

Background: Pancreatic cancer is a difficult-to-treat cancer with a late presentation and poor prognosis. Some patients seek traditional Chinese medicine (TCM) consultation. We aimed to investigate the benefits of complementary Chinese herbal medicine (CHM) among patients with pancreatic cancer in Taiwan. Methods: We included all patients with pancreatic cancer who were registered in the Taiwanese Registry for Catastrophic Illness Patients Database between 1997 and 2010. We used 1:1 frequency matching by age, sex, the initial diagnostic year of pancreatic cancer, and index year to enroll 386 CHM users and 386 non-CHM users. A Cox regression model was used to compare the hazard ratios (HRs) of the risk of mortality. The Kaplan-Meier curve was used to compare the difference in survival time. Results: According to the Cox hazard ratio model mutually adjusted for CHM use, age, sex, urbanization level, comorbidity, and treatments, we found that CHM users had a lower hazard ratio of mortality risk (adjusted HR = 0.67, 95% CI = 0.56-0.79). Those who received CHM therapy for more than 90 days had significantly lower hazard ratios of mortality risk than non-CHM users (90- to 180-day group: adjusted HR = 0.56, 95% CI = 0.42-0.75; >180-day group: HR = 0.33, 95% CI = 0.24-0.45). The survival probability was higher for patients in the CHM group. Bai-hua-she-she-cao (Herba Oldenlandiae; Hedyotis diffusa Spreng) and Xiang-sha-liu-jun-zi-tang (Costus and Chinese Amomum Combination) were the most commonly used single herb and Chinese herbal formula, respectively. Conclusions: Complementary Chinese herbal therapy might be associated with reduced mortality among patients with pancreatic cancer. Further prospective clinical trial is warranted.

scholarly journals Hiring Preferences of Nurseries and Greenhouses in U.S. Southern States

2014 ◽  
Vol 24 (1) ◽  
pp. 107-117
Author(s):  
Benedict C. Posadas ◽  
Patricia R. Knight ◽  
Christine E.H. Coker ◽  
Randal Y. Coker ◽  
Scott A. Langlois
Keyword(s):  
Formal Education ◽  
Age Groups ◽  
The United States ◽  
Hiring Decisions ◽  
Factors Affecting ◽  
Southern States ◽  
Education Levels ◽  
Part Time ◽  
And Gender ◽  
Permanent Workers

This work describes workers’ socioeconomic characteristics and evaluates the determinants of workers hiring decisions among 215 randomly selected wholesale nurseries and greenhouses located in eight selected southern states in the United States. The participating nurseries and greenhouses employed on average 5.40 permanent workers per horticulture operation or 2.27 permanent workers per acre under cultivation. Participating nurseries and greenhouses hired an average 2.38 part-time workers per horticulture operation or 0.80 part-time workers per acre placed under production. Empirical models were estimated to determine the significant factors affecting hiring decisions by this industry. Hiring decision models covered age groups, racial backgrounds, formal education levels, and gender. Analysis of the decision-making process involving the employment of hired workers among the participating wholesale nurseries and greenhouses provided insights into the hiring decisions in the industry. The hiring decisions by demographic characteristics serve as benchmarks for assessing impacts of regulations affecting the industry in the near future. About 1.9% of all the establishments employed more than 50 permanent and part-time workers and 1.4% employed more than 50 permanent workers.

Association of reperfusion success and emboli in new territories with long term mortality after mechanical thrombectomy

2021 ◽  
pp. neurintsurg-2021-017422
Author(s):  
Morin Beyeler ◽  
Loris Weber ◽  
Christoph C Kurmann ◽  
Eike Immo I Piechowiak ◽  
Pascal J Mosimann ◽  
...  
Keyword(s):  
Mechanical Thrombectomy ◽  
Cox Regression ◽  
Survival Times ◽  
Vital Status ◽  
Hazard Ratios ◽  
Significant Difference ◽  
Lower Hazard ◽  
Long Term Mortality

BackgroundThe degree of reperfusion is the most important modifiable predictor of 3 month functional outcome and mortality in ischemic stroke patients treated with mechanical thrombectomy. Whether the beneficial effect of reperfusion also leads to a reduction in long term mortality is unknown.MethodsPatients undergoing mechanical thrombectomy between January 2010 and December 2018 were included. The post-thrombectomy degree of reperfusion and emboli in new territories were core laboratory adjudicated. Reperfusion was evaluated according to the expanded Thrombolysis in Cerebral Infarction (eTICI) scale. Vital status was obtained from the Swiss population register. Adjusted hazard ratios (aHRs) using time split Cox regression models were calculated. Subgroup analyses were performed in patients with borderline indications.ResultsOur study included 1264 patients (median follow-up per patient 2.5 years). Patients with successful reperfusion had longer survival times, attributable to a lower hazard of death within 0–90 days and for >90 days to 2 years (aHR 0.34, 95% CI 0.26 to 0.46; aHR 0.37, 95% CI 0.22 to 0.62). This association was homogeneous across all predefined subgroups (p for interaction >0.05). Among patients with successful reperfusion, a significant difference in the hazard of death was observed between eTICI2b50 and eTICI3 (aHR 0.51, 95% CI 0.33 to 0.79). Emboli in new territories were present in 5% of patients, and were associated with increased mortality (aHR 2.3, 95% CI 1.11 to 4.86).ConclusionSuccessful, and ideally complete, reperfusion without emboli in new territories is associated with a reduction in long term mortality in patients treated with mechanical thrombectomy, and this was evident across several subgroups.

scholarly journals Instrumental variable analysis using offspring BMI in childhood as an indicator of parental BMI in relation to mortality

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kim Blond ◽  
David Carslake ◽  
Line Klingen Gjærde ◽  
Dorte Vistisen ◽  
Thorkild I. A. Sørensen ◽  
...  
Keyword(s):  
Instrumental Variable ◽  
School Health ◽  
Cox Regression ◽  
Adult Mortality ◽  
Instrumental Variable Analysis ◽  
Hazard Ratios ◽  
Copenhagen School ◽  
Low Bmi ◽  
Conventional Models ◽  
Variable Analysis

AbstractChildhood BMI shows associations with adult mortality, but these may be influenced by effects of ill health in childhood on BMI and later mortality. To avoid this, we used offspring childhood BMI as an instrumental variable (IV) for own BMI in relation to mortality and compared it with conventional associations of own childhood BMI and own mortality. We included 36,097 parent–offspring pairs with measured heights and weights from the Copenhagen School Health Records Register and register-based information on death. Hazard ratios (HR) were estimated using adjusted Cox regression models. For all-cause mortality, per zBMI at age 7 the conventional HR = 1.07 (95%CI: 1.04–1.09) in women and 1.02 (95%CI: 0.92–1.14) in men, whereas the IV HR = 1.23 (95%CI: 1.15–1.32) in women and 1.05 (95%CI: 0.94–1.17) in men. Per zBMI at age 13, the conventional HR = 1.11 (95%CI: 1.08–1.15) in women and 1.03 (95%CI: 0.99–1.06) in men, whereas the IV HR = 1.30 (95%CI: 1.19–1.42) in women and 1.15 (95%CI: 1.04–1.29) in men. Only conventional models showed indications of J-shaped associations. Our IV analyses suggest that there is a causal relationship between BMI and mortality that is positive at both high and low BMI values.

Overall survival in patients who received checkpoint inhibitors after completing tebentafusp in a phase 3 randomized trial of first-line metastatic uveal melanoma.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 9526-9526
Author(s):  
Marlana Orloff ◽  
Richard D. Carvajal ◽  
Alexander Noor Shoushtari ◽  
Joseph J. Sacco ◽  
Max Schlaak ◽  
...  
Keyword(s):  
Cox Regression ◽  
Checkpoint Inhibitors ◽  
Meta Analysis ◽  
Analysis Data ◽  
Cell Receptor ◽  
First Line ◽  
Kaplan Meier ◽  
Hazard Ratios ◽  
Exploratory Data ◽  
And Gender

9526 Background: Tebentafusp (tebe) is a bispecific consisting of an affinity-enhanced T cell receptor fused to an anti-CD3 effector that can redirect T cells to target gp100+ cells. Tebe significantly improved OS compared to investigator’s choice (IC) in first line (1L) mUM [NCT03070392]. In a phase (ph) 2 study of tebe in 2L+ mUM (NCT02570308), several checkpoint inhibitor (CPI) refractory pts who were retreated with CPI after tebe achieved durable clinical benefit [1]. We therefore evaluated clinical outcomes of post-tebe CPI in patients treated on the ph3 trial of tebe versus investigator’s choice (IC) [NCT03070392]. Methods: In the ph3 trial, 378 HLA-A*02:01+ 1L mUM pts were randomized 2:1 to tebe (n=252) or IC (n=126) [pembrolizumab (82%), ipilimumab (12%) or dacarbazine (6%)]. No crossover to tebe was permitted, investigators were free to choose subsequent therapy, and there was no re-randomization at time of subsequent therapy. This analysis was conducted on the first interim analysis (data extracted Nov-2020). When pts received more than one subsequent therapy, the first was used in these analyses. Medians and 1-yr OS from the start of post-study therapy are obtained from standard Kaplan-Meier analyses; hazard ratios (HR) are from Cox regression models adjusted for age and gender. Results: 106/252 (42%) tebe pts received ≥ 1 subsequent therapy: 35% CPI, 9% chemo, 6% liver directed therapy (LDT), 6% other. 55/126 (44%) of IC pts received ≥ 1 subsequent therapy: 21% CPI, 10% chemo, 12% LDT, 10% other. Median time to first subsequent therapy was longer for tebe pts at 5.2 mo vs. IC pts at 3.8 mo. The median duration from start of first subsequent CPI to end date was longer in the prior tebe pts at 4 mo vs prior IC pts at 2.8 mo. From the start of any first subsequent therapy, prior tebe pts had longer OS compared to prior IC pts, HR 0.67 (95% CI 0.42, 1.07). Most of the subsequent therapy was CPI, and the OS benefit was also seen in this subset, HR 0.62 (95% CI 0.34, 1.14). For prior tebe pts, the median and 1-yr OS rates from start of any first subsequent therapy were 13 mo and 53% and from start of first subsequent CPI were 16 mo and 63%. Both were higher than the sequence of IC followed by any therapy (11 mo and 44%), IC followed by CPI (9 mo and 47%) and a recent meta-analysis of 2L+ mUM (7 mo and ̃35% 1-yr OS rate). Conclusions: Pts who progressed on tebe and then received CPI had better OS compared to pts who progressed on IC and then received CPI. Further analysis will explore whether confounding factors are influencing this effect. These exploratory data suggest that tebe, relative to IC, may improve outcomes to subsequent CPI. (1)Yang J. et al. ASCO 2019, J . Cli n Oncol 37:15_suppl, 9592. Clinical trial information: NCT03070392.

scholarly journals Relative risk of functional dyspepsia in patients with sleep disturbance: a population-based cohort study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Hsu-Han Su ◽  
Fung-Chang Sung ◽  
Kai-Liang Kao ◽  
Shu-Chin Chen ◽  
Chen-Ju Lin ◽  
...  
Keyword(s):  
Cohort Study ◽  
Sleep Disturbance ◽  
Functional Dyspepsia ◽  
Cox Regression ◽  
Large Population ◽  
Population Based ◽  
Administrative Dataset ◽  
Hazard Ratios ◽  
Increased Risk ◽  
And Gender

AbstractIncreased prevalence of sleep disorders has been found in patients with functional dyspepsia; however, direction of causality remains unclear. Our aim was to compare the risk of incident functional dyspepsia between patients with and without sleep disturbance from a large population-based sample. Utilizing a nation-wide health insurance administrative dataset, we assembled an 11-year historic cohort study to compare subsequent incidence of diagnosed functional dyspepsia between adult patients with any diagnosis of sleep disturbance and age- and gender-matched controls. Hazard ratios adjusted for other relevant comorbidities and medications were calculated using Cox regression models. 45,310 patients with sleep disorder and 90,620 controls were compared. Patients with sleep apnea had a 3.3-fold (95% confidence interval: 2.82 ~ 3.89) increased hazard of functional dyspepsia compared with controls. This increased risk persisted regardless of previously diagnosed depression coexisted. Sleep disturbance was associated with an increased risk of subsequent functional dyspepsia. Potential mechanisms are discussed.

Model Pembinaan Remaja Putus Sekolah Terlantar di Provinsi Lampung (Studi Pada Uptd Pelayanan Sosial Bina Remaja (PSBR) Raden Intan Lampung

2020 ◽  
Vol 2 (2) ◽  
pp. 231-241
Author(s):  
Maulita Daniar Anom ◽  
◽  
Novita Tresiana ◽  
Intan Fitri Meutia ◽  
◽  
...  
Keyword(s):  
Youth Development ◽  
Formal Education ◽  
Social Protection ◽  
Development Program ◽  
Rehabilitation Program ◽  
Drop Out ◽  
Structured Interviews ◽  
Youth Development Program ◽  
Coaching Activities ◽  
Out Of School

Education is a mandatory thing that must be obtained for every child. However, not all children are able to get education due to several factors, one of which is the economic condition of the family which causes them to drop out of school. Guidance for neglected drop-out teenagers is an action that is taken to overcome one of the social problems, which is neglected teenagers who have dropped out of school with the purpose of directing their personality, abilities and skills through non-formal education. This research was conducted at UPTD PSBR Raden Intan Lampung. The purpose of this research is to describe and analyze how the models and coaching programs are carried out to overcome neglected dropout teenagers.The method used in this research is descriptive with a qualitative approach with the use of data collection techniques, such as: structured interviews, documentation and observation. The data analysis technique used in this study was data reduction, data presentation and drawing conclusions, and for data validity techniques are the extension of observations and triangulation. Based on the research results, it shows that the model that is used as a reference in the implementation of coaching activities for neglected dropouts teenagers is the Youth Development Program (YDP) Model which has 3 approaches, that are: Institutional Based, Family Based and Community. The conclusion of this research is based on the analysis, namely the Youth Development Program (YDP) Model which is the reference applied through 4 programs by the UPTD PSBR Raden Intan Lampung, that are Social Rehabilitation Program, Social Security Program, Social Empowerment Program and the last Social Protection Program with the hope that this effort can solve the problem of neglected dropouts teenagers, especially in Lampung Province.

Fracture Risk in Patients with Myasthenia Gravis: A Population-Based Cohort Study

2021 ◽  
pp. 1-8
Author(s):  
Charles Kassardjian ◽  
Jessica Widdifield ◽  
J. Michael Paterson ◽  
Alexander Kopp ◽  
Chenthila Nagamuthu ◽  
...  
Keyword(s):  
Myasthenia Gravis ◽  
Lower Risk ◽  
Cox Regression ◽  
Large Population ◽  
Population Based ◽  
Osteoporosis Prevention ◽  
Inception Cohort ◽  
Hazard Ratios ◽  
Multiple Covariates ◽  
Region Of Residence

Background: Prednisone is a common treatment for myasthenia gravis (MG), and osteoporosis is a known potential risk of chronic prednisone therapy. Objective: Our aim was to evaluate the risk of serious fractures in a population-based cohort of MG patients. Methods: An inception cohort of patients with MG was identified from administrative health data in Ontario, Canada between April 1, 2002 and December 31, 2015. For each MG patient, we matched 4 general population comparators based on age, sex, and region of residence. Fractures were identified through emergency department and hospitalization data. Crude overall rates and sex-specific rates of fractures were calculated for the MG and comparator groups, as well as rates of specific fractures. Adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox regression. Results: Among 3,823 incident MG patients (followed for a mean of 5 years), 188 (4.9%) experienced a fracture compared with 741 (4.8%) fractures amongst 15,292 matched comparators. Crude fracture rates were not different between the MG cohort and matched comparators (8.71 vs. 7.98 per 1000 patient years), overall and in men and women separately. After controlling for multiple covariates, MG patients had a significantly lower risk of fracture than comparators (HR 0.74, 95% CI 0.63–0.88). Conclusions: In this large, population-based cohort of incident MG patients, MG patients were at lower risk of a major fracture than comparators. The reasons for this finding are unclear but may highlight the importance osteoporosis prevention.

scholarly journals Poverty and survival from COVID-19 in Mexico

2020 ◽  
Author(s):  
Rebeca Olivia Millán-Guerrero ◽  
Ramiro Caballero-Hoyos ◽  
Joel Monárrez-Espino
Keyword(s):  
Cox Regression ◽  
Secondary Data ◽  
Multidimensional Poverty ◽  
Preventive Strategy ◽  
Poverty Level ◽  
Factors Affecting ◽  
Extreme Poverty ◽  
Lower Survival ◽  
Hazard Ratios ◽  
Poverty And Inequality

Abstract Background Recent evidence points to the relevance of poverty and inequality as factors affecting the spread and mortality of the COVID-19 pandemic in Latin America. This study aimed to determine whether COVID-19 patients living in Mexican municipalities with high levels of poverty have a lower survival compared with those living in municipalities with low levels. Methods Retrospective cohort study. Secondary data was used to define the exposure (multidimensional poverty level) and outcome (survival time) among patients diagnosed with COVID-19 between 27 February and 1 July 2020. Crude and adjusted hazard ratios (HR) from Cox regression were computed. Results Nearly 250 000 COVID-19 patients were included. Mortality was 12.3% reaching 59.3% in patients with ≥1 comorbidities. Multivariate survival analyses revealed that individuals living in municipalities with extreme poverty had 9% higher risk of dying at any given time proportionally to those living in municipalities classified as not poor (HR 1.09; 95% CI 1.06–1.12). The survival gap widened with the follow-up time up to the third to fourth weeks after diagnosis. Conclusion Evidence suggests that the poorest population groups have a lower survival from COVID-19. Thus, combating extreme poverty should be a central preventive strategy.

scholarly journals Individuals with familial hypercholesterolemia have increased risk of re-hospitalization after acute myocardial infarction compared with controls

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
K Svendsen ◽  
H.W Krogh ◽  
J Igland ◽  
G.S Tell ◽  
L.J Mundal ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Familial Hypercholesterolemia ◽  
Cox Regression ◽  
Public Institution ◽  
University Hospital ◽  
Funding Source ◽  
Hazard Ratios ◽  
Increased Risk ◽  
University Of Oslo

Abstract Background and aim We have previously reported that individuals with familial hypercholesterolemia (FH) have a two-fold increased risk of acute myocardial infarction (AMI) compared with the general population. The consequences of having an AMI on re-hospitalization and mortality are however less known. The aim of the present study was to compare the risk of re-hospitalization with AMI and CHD and risk of mortality after incident (first) AMI-hospitalization between persons with and without FH (controls). Methods The original study population comprised 5691 persons diagnosed with FH during 1992–2014 and 119511 age and sex matched controls randomly selected from the general Norwegian population. We identified 221 individuals with FH and 1947 controls with an incident AMI registered in the Norwegian Patient Registry (NPR) or the Cardiovascular Disease in Norway Project during 2001–2017. Persons with incident AMI were followed until December 31st 2017 for re-hospitalization with AMI or coronary heart disease (CHD) registered in the NPR, and for mortality through linkage to the Norwegian Cause of Death Registry. Risk of re-hospitalization was compared with sub-hazard ratios (SHR) from competing risk regression with death as competing event, and mortality was compared using hazard ratios (HR) from Cox regression. All models were adjusted for age. Results Risk of re-hospitalization was 2-fold increased both for AMI [SHR=2.53 (95% CI: 1.88–3.41)] and CHD [SHR=1.82 (95% CI: 1.44–2.28)]. However, persons with FH did not have increased 28-day mortality following an incident AMI (HR=1.05 (95% CI: 0.62–1.78), but the longer-term (>28 days) mortality after first AMI was increased in FH [HR=1.45 (95% CI: 1.07–1.95]. Conclusion This study yields the important finding that persons with FH have increased risk of re-hospitalization of both AMI and CHD after incident AMI. These findings call for more intensive follow-up of individuals with FH after an AMI. Funding Acknowledgement Type of funding source: Public Institution(s). Main funding source(s): University of Oslo and Oslo University Hospital

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