Excess Injury Mortality Among Children in the United States: Comparison of Recent International Statistics

PEDIATRICS ◽  
1990 ◽  
Vol 86 (6) ◽  
pp. 1067-1072
Author(s):  
Bret C. Williams ◽  
Jonathan B. Kotch
Keyword(s):  
Public Transportation ◽  
Motor Vehicle ◽  
The United States ◽  
World Health ◽  
Vulnerable Groups ◽  
Child Injury ◽  
Death Rates ◽  
Childhood Injury ◽  
Injury Mortality ◽  
The Us

Using data from the National Center for Health Statistics and the World Health Organization, child injury death rates in the US were compared to those of Canada, England and Wales, France, Netherlands, and Norway. Except for the 1981 Canadian figure, overall US childhood injury mortality was greater than childhood injury mortality rates of all countries studied during each year from 1980 to 1986. Injury mortality steadily declined in most other countries, whereas the US rate appears to be increasing. Attention to specific causes reveals that much of the difference is explained by motor vehicle injuries and homicide, but in every childhood age group US death rates due to drowning, firearms, homicide, poisoning, and fire are among the highest. Excess US injury mortality is largely attributable to deaths among children younger than 5 and older than 14 years of age, the most vulnerable groups in all countries. Especially high rates among US minorities account for little of the observed differences; for many injuries, the mortality rate of US nonblacks is several times those reported by the comparison nations. Behavioral strategies are inadequate to deal with excess death rates of this magnitude. Limiting exposure through regulation of handguns, greater use of public transportation, and affordable and accessible day care are among the measures that should be implemented.

Population-level analysis of antibiotic use and death rates in beef feedlots over ten years in three cattle-feeding regions of the United States

2021 ◽  
pp. 1-7
Author(s):  
Stephanie C. Rutten-Ramos ◽  
Shabbir Simjee ◽  
Michelle S. Calvo-Lorenzo ◽  
Jason L. Bargen
Keyword(s):  
Death Rate ◽  
Live Weight ◽  
Population Level ◽  
Antibiotic Use ◽  
The United States ◽  
Death Rates ◽  
Cattle Feeding ◽  
The Us ◽  
Rate Ratios ◽  
Beef Feedlots

Abstract OBJECTIVE To assess antibiotic use and other factors associated with death rates in beef feedlots in 3 regions of the US over a 10-year period. SAMPLE Data for 186,297 lots (groups) of finished cattle marketed between 2010 and 2019 were obtained from a database representing feedlots in the central, high, and north plains of the US. PROCEDURES Descriptive statistics were generated. Generalized linear mixed models were used to estimate lot death rates for each region, sex (steer or heifer), and cattle origin (Mexico or the US) combination. Death rate was calculated as the (number of deaths/number of cattle placed in the lot) × 100. Lot antibiotic use (TotalActiveMG/KGOut) was calculated as the total milligrams of active antibiotics assigned to the lot per live weight (in kilograms) of cattle marketed from the lot. Rate ratios were calculated to evaluate the respective associations between lot death rate and characteristics of cattle and antibiotic use. RESULTS Mean death rate increased during the 10-year period, peaking in 2018. Mean number of days on feed also increased over time. Mean TotalActiveMG/KGOut was greatest in 2014 and 2015, lowest in 2017, and moderated in 2018 and 2019. Death rate was positively associated with the number of days on feed and had a nonlinear association with TotalActiveMG/KGOut. Feeding medicated feed articles mitigated death rate. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested a balance between disease prevention and control in feedlots for cattle with various risk profiles. Additional data sources are needed to assess TotalActiveMG/KGOut across the cattle lifetime.

scholarly journals MANAGEMENT OF PUBLIC TRANSPORTATION PERFORMANCE MODEL BASED ON SAFETY TRANSPORTATION, PERIODIC TRANSPORTATION TEST, BEHAVIOR, AND SATISFACTION IN CIREBON CITY.

2020 ◽  
Vol 4 (2) ◽  
Author(s):  
Herry Hermawan
Keyword(s):  
Public Transportation ◽  
User Satisfaction ◽  
Human Error ◽  
Motor Vehicle ◽  
Performance Model ◽  
Urban Transport ◽  
World Health ◽  
Urban Systems ◽  
Intelligence Agency ◽  
National Police

The development of cities in Indonesia is marked by the high number of commuters (commuters) who travel between the main city and the surrounding city or district (hinterland) or between regions within a city due to an increase in population, population activities, types of services, and the relative functioning of the economy national and regional level of a country..       Transportation problems and challenges are multi-dimensional between transportation systems and urban systems, both operational, management and policy aspects. Urban transport policies that care about sustainable development in developing countries are very complex, but can be studied especially in the public transportation system because it is more possible when compared to private transport at this time.       In Indonesia, the number of motorized vehicles is increasing every year. The addition of that number in 2012 reached 10,036 million units, resulting in the population recorded in the Indonesian National Police increased 12% to 94.292 million units compared to only 84.19 million in 2011 (Kurniawan, 2013). Based on data from the National Police also stated that in 2012 there were 109,038 accident cases with 27,441 people died. Different data from the Coordinating Ministry for Economic Affairs and People's Welfare of the Republic of Indonesia states that motorcycle rider accidents have reached 120,226 times or 72% of all traffic accidents in a year. Most accident cases occur in people with lower middle economic level as motorcycle and public transportation users (State Intelligence Agency, 2013).       As released by WHO (World Health Organization), of all accidents that occur on the highway, the human error factor (human error) has the highest contribution, reaching between 80-90 percent compared to the factor of vehicle vehicle improperities ranging from 5-10 percent, as well as due to damage to road infrastructure by 10-20 percent (DG Hubdat, 2010). Vehicle facilities that often occur are less than 1 millimeter of tire grooves resulting in vehicle skid or tire breaks, brakes failing, metal fatigue resulting in broken vehicle parts, worn equipment not replaced, and various other causes. This is very much related to the technology used and the care done to the vehicle. One of the government's efforts to improve road safety is through safety vehicle action programs such as compliance with vehicle operations, organizing periodic and type test repair procedures, handling overloading, vehicle scrapping, and developing motor vehicle design that aims to improve vehicle safety technology (DG Hubdat, 2013).Keywords:Transportation Performance, User Satisfaction.

scholarly journals Is COVID-19 the end of US hegemony? Public bads, leadership failures and monetary hegemony

2020 ◽  
Vol 96 (5) ◽  
pp. 1281-1303 ◽  
Author(s):  
Carla Norrlöf
Keyword(s):  
United States ◽  
Public Goods ◽  
The United States ◽  
World Health ◽  
The Public ◽  
The Us ◽  
Us Hegemony ◽  
Health Organization ◽  
Public Bads ◽  
The Relationship

Abstract COVID-19 is the most invasive global crisis in the postwar era, jeopardizing all dimensions of human activity. By theorizing COVID-19 as a public bad, I shed light on one of the great debates of the twentieth and twenty-first centuries regarding the relationship between the United States and liberal international order (LIO). Conceptualizing the pandemic as a public bad, I analyze its consequences for US hegemony. Unlike other international public bads and many of the most important public goods that make up the LIO, the COVID-19 public bad not only has some degree of rivalry but can be made partially excludable, transforming it into more of a club good. Domestically, I demonstrate how the failure to effectively manage the COVID-19 public bad has compromised America's ability to secure the health of its citizens and the domestic economy, the very foundations for its international leadership. These failures jeopardize US provision of other global public goods. Internationally, I show how the US has already used the crisis strategically to reinforce its opposition to free international movement while abandoning the primary international institution tasked with fighting the public bad, the World Health Organization (WHO). While the only area where the United States has exercised leadership is in the monetary sphere, I argue this feat is more consequential for maintaining hegemony. However, even monetary hegemony could be at risk if the pandemic continues to be mismanaged.

scholarly journals Probiotic Products in Canada with Clinical Evidence: What Can Gastroenterologists Recommend?

2008 ◽  
Vol 22 (2) ◽  
pp. 169-175 ◽  
Author(s):  
Gregor Reid ◽  
Kingsley Anukam ◽  
Tara Koyama
Keyword(s):  
United States Of America ◽  
Clinical Evidence ◽  
Health Benefit ◽  
The United States ◽  
World Health ◽  
Therapeutic Effects ◽  
The Us ◽  
Health Organization ◽  
Health Canada

Probiotics, defined as ‘live microorganisms, which when administered in adequate amounts, confer a health benefit on the host’, are finally becoming an option for gastroenterologists in Canada, after being available for many years in Japan, Europe and the United States of America. Unfortunately, Health Canada and the US Food and Drug Administration have not controlled the use of the term ‘probiotic’ or put into place United Nations and World Health Organization guidelines. The net result is that a host of products called ‘probiotics’ are available but are not truly probiotic. The aim of the present review was to discuss the rationale for probiotics in gastroenterology, and specifically examine which products are options for physicians in Canada, and which ones patients might be using. It is hoped that by clarifying what probiotics are, and the strengths and limitations of their use, specialists will be better placed to make recommendations on the role of these products in patient care. In due course, more clinically documented probiotics will emerge, some with therapeutic effects based on a better understanding of disease processes.

Phase I Study of Clofarabine (JC0707) in Adult Japanese Patients with Acute Myeloid Leukemia (AML)

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 4295-4295
Author(s):  
Takahiro Yamauchi ◽  
Tatsuya Suzuki ◽  
Kiyoshi Ando ◽  
Tadashi Nagai ◽  
Kazuhiko Kakihana ◽  
...  
Keyword(s):  
Acute Myeloid Leukemia ◽  
Phase I ◽  
Myeloid Leukemia ◽  
The United States ◽  
World Health ◽  
Plasma Samples ◽  
Newly Diagnosed ◽  
The Us ◽  
Grade 3 ◽  
Acute Myeloid

Abstract Abstract 4295 Background and Purpose: Although cytarabine plus anthracycline (7+3 or 7+5) regimens are commonly used for induction therapy in patients (pts) with acute myeloid leukemia (AML) and there have been improvements in the treatment of AML in younger adults, there is no standard of care in pts with relapsed or refractory (R/R) AML. Treatment options for older pts and those with R/R disease remain limited. Clofarabine (JC0707) is a purine nucleoside analog approved in the United States (US) and European Union for the treatment of pediatric pts with R/R acute lymphocytic leukemia (ALL). In a phase II study from the US, single-agent clofarabine showed activity and acceptable toxicity in pts ≥ 60 years with untreated AML and adverse prognostic factors (Kantarjian, J Clin Oncol 2010;28:549–55). The purpose of this phase I open-label, multi-center study is to assess the safety, tolerability, and pharmacokinetics of clofarabine monotherapy in elderly Japanese pts with newly diagnosed AML for whom standard induction chemotherapy is unlikely to be of benefit or Japanese adult pts with R/R AML. Method: Adult pts (20–74 years) with R/R AML according to World Health Organization (WHO) criteria and elderly pts (60–74 years) with newly diagnosed AML were eligible to participate. Additional inclusion criteria included Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 2 and no prior hematopoietic stem cell transplant. The study utilized a standard 3 + 3 dose escalation method; 3 pts enrolled in each dosing cohort, 3 additional pts were added to cohorts where dose-limiting toxicities (DLTs) were observed. The maximum tolerated dose (MTD) was defined as the dose level below that for which 2 DLTs were observed. Based on prior clinical trials in the US, pts were to be treated with clofarabine 20 mg/m2/day (IV over 1 hr), 30 mg/m2/day, or 40 mg/m2/day for one 5 day cycle in cohorts 1, 2 and 3, respectively. Pts with evidence of hematologic response after one cycle could receive up to a maximum of 3 cycles. The primary endpoints of this study were MTD, safety, and pharmacokinetic (PK) parameters. Result: Until June 2011, 14 pts were enrolled and treated in this trial: cohort 1 (n=3), cohort 2 (n=6), and cohort 3 (n=5). Bioanalytical determination of clofarabine concentrations in plasma samples showed an increased concentration with increased dosage. No DLTs were noted in cohort 1 (20 mg/m2). Among the first 3 pts in cohort 2 (30 mg/m2), only 1 patient experienced DLT (reversible, grade 4 elevated ALT). Additionally, 2 pts in cohort 3 (40 mg/m2) experienced DLTs (grade 3 elevated ALT [n=1]; grade 3 elevated amylase [n=1]). Thus, the MTD was determined to be 30 mg/m2. Preliminary safety and efficacy data are available for 9 of these pts and presented herein. Overall, the most common all cause, non-hematologic toxicities were nausea and headache (89% each), rash and elevated ALT and AST (78% each), malaise (56%), pneumonia and hypokalemia (44% each), and elevated bilirubin and vomiting (33% each). Grade 3 or 4 toxicities were primarily hematologic and infectious occurring in 89% and 67% of patients, respectively. Only one patient developed a treatment-related serious adverse event (SAE) (herpes zoster). There were no AE related deaths and no patients discontinued therapy as a result of an AE. Two patients achieved complete remission (CR) and 2 patients achieved CR without platelet recovery (CRp), for an overall response rate (ORR) of 44% (Table 1). Additionally, plasma samples were obtained from all patients for PK evaluation; plasma concentration data from all 14 patients will be presented. Conclusion: Clofarabine monotherapy was well tolerated at doses up to 30mg/m2 and showed preliminary evidence of activity with 44% ORR in elderly newly diagnosed AML or adult Japanese pts with R/R AML, warranting further investigations. Disclosures: Off Label Use: Clofarabine (JC0707) is an investigational agent in Japan; this abstract assesses its use in adult AML patients. Ewesuedo:Sanofi Oncology: Employment. Tabata:Genzyme (a Sanofi company): Employment.

DSM-5 Clinical/legal Challenges Regarding the USA's Death Penalty

2016 ◽  
Vol 33 (S1) ◽  
pp. S458-S458
Author(s):  
L. French
Keyword(s):  
Mental Retardation ◽  
Death Penalty ◽  
The United States ◽  
World Health ◽  
Diagnostic And Statistical Manual ◽  
Dsm 5 ◽  
The Us ◽  
Icd 10 ◽  
The Usa ◽  
Competing Interest

IntroductionIn May 2013, the American Psychiatric Association (APA) published the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) in order to bring America's clinical professionals in concert with the World Health Organization's (WHO) international classifications, notably the ICD-10-CM. This effort was met with considerable resistance and changes were delayed until November 2015. Major social-cultural differences between the United States and its European and other North American partners (Canada and Mexico) poses challenges in critical forensic areas such as the clinical/legal assessment of death qualified offenders – a status unique to the USA.Objective/aimsTo articulate the clinical/legal differences between the previous DSM's (III; III-R; IV) and the DSM-5 and how the new language provides greater ambiguity in defining the mental status requirements for Mens Rea – competence to understand one's actions.MethodsPresent the major legal issues surrounding the US death penalty and brought before the US Supreme Court including: Furman v. Georgia (1972); Greg v. Georgia (1976); Jared v. Texas (1976); Proffit v. Florida (1976); Adkins v. Virginia (2002); Roper v. Simmons (2005); Miller v. Alabama (2012): … and legislative actions such as Rosa's Law (Public Law 111-256; 2010).Results/conclusionsAdvocacy groups pushed Rosa's Law to mental retardation with – intellectual and developmental disability. This change is reflected in the DSM-5 whereby mental retardation (MR) was once relegated to axis II, is now classified under intellectual disabilities (ID) given the impression that it is a transitory (correctable) and not a fix (organ disability) clinical condition.Disclosure of interestThe author has not supplied his declaration of competing interest.

scholarly journals The COVID States Project #75: Attitudes toward COVID-19 boosters before and after Omicron

2021 ◽  
Author(s):  
Roy H. Perlis ◽  
Matthew Baum ◽  
Kristin Lunz Trujillo ◽  
David Lazer ◽  
Alauna Safarpour ◽  
...  
Keyword(s):  
District Of Columbia ◽  
The United States ◽  
World Health ◽  
Vaccine Hesitancy ◽  
Dominant Form ◽  
The Us ◽  
Before And After ◽  
Control And Prevention ◽  
Health Organization ◽  
To Receive

Recognizing that the protection conferred by COVID-19 vaccines may wane over time, the US Centers for Disease Control and Prevention (CDC) has encouraged adults in the United States to receive booster shots that can augment their immunity to the virus. While the Biden administration sought to encourage all adults to receive boosters, the CDC initially authorized the shots only for higher-risk individuals. Subsequently, authorization was broadened to all adults, although only higher-risk individuals were encouraged to pursue boosters. Most recently, after substantial criticism, the CDC changed its language to encourage all adults to receive boosters.But regardless of the language, are US adults sufficiently convinced to seek booster shots? Will the same factors that contributed to COVID-19 vaccine hesitancy and vaccine resistance impact booster shots? The answers may have profound public health implications as the US enters the season during which respiratory viruses typically have the greatest impact, and the highly-transmissible Omicron variant rapidly becomes the dominant form of COVID-19, after being labeled a variant of concern by the World Health Organization on November 26th.Between November 3rd and December 3rd, 2021, the COVID States Project asked 22,277 adults in all 50 US states and the District of Columbia about their attitudes and behaviors regarding COVID-19. In particular, we asked about whether people are vaccinated or intend to be vaccinated, and whether they had sought booster shots or intend to seek a booster shot. In this brief report, we examine attitudes toward COVID-19 booster shots, and whether they differ across particular groups of people. Since the survey was ongoing when news about Omicron emerged in the US, we also take an initial look at whether these attitudes have begun to shift along with perceptions of the threat posed by COVID-19 subsequent to the November 26th announcement.

International Use of the AMA Guides® to the Evaluation of Permanent Impairment

2020 ◽  
Vol 25 (2) ◽  
pp. 3-8
Author(s):  
Mohammed I. Ranavaya ◽  
Christopher R. Brigham
Keyword(s):  
United States ◽  
New Zealand ◽  
Middle East ◽  
Southern Africa ◽  
Motor Vehicle ◽  
The United States ◽  
World Health ◽  
Personal Injury ◽  
Workers Compensation ◽  
Fourth Edition

Abstract Since its inception more than six decades ago, the AMA Guides to the Evaluation of Permanent Impairment, (AMA Guides), has become internationally accepted as a global benchmark and is used in the United States, Canada, certain European countries, the Middle East, Australia, New Zealand, and Southern Africa, as well as by the United Nations. When the AMA Guides, Sixth Edition, adopted the terminology and conceptual framework of disablement developed by the World Health Organization, this paradigm shift let to an increase in the worldwide influence and use of the AMA Guides. In the United States, the AMA Guides is used primarily in state and federal workers’ compensation systems and sometimes in automobile casualty and personal injury arenas. Most workers’ compensation jurisdictions across Canada use the AMA Guides formally by statute or regulation, or they accept its use informally as a standard tool to rate impairment. In Australia, the AMA Guides is used in both federal and individual state or territory compensation schemes for personal injuries that arise from work, as well as motor vehicle accidents (a table presents uses of the AMA Guides in Australian jurisdictions). New Zealand uses the AMA Guides, Fourth Edition, and the ACC User Handbook to the AMA “Guides to the Evaluation of Permanent Impairment,” Fourth Edition. The AMA Guides is used in Hong Kong to evaluate all types of damages for personal injury claims and also is referenced in Southern Africa, Europe, and countries in the Middle East.

Comparing the COVID-19 Responses in Cuba and the United States

2021 ◽  
Vol 111 (12) ◽  
pp. 2186-2193
Author(s):  
Mary Anne Powell ◽  
Paul C. Erwin ◽  
Pedro Mas Bermejo
Keyword(s):  
United States ◽  
Death Rate ◽  
Health Inequities ◽  
The United States ◽  
Death Rates ◽  
Excess Death ◽  
Future Studies ◽  
Effective Strategies ◽  
The Us ◽  
Case Rate

The purpose of this analytic essay is to contrast the COVID-19 responses in Cuba and the United States, and to understand the differences in outcomes between the 2 nations. With fundamental differences in health systems structure and organization, as well as in political philosophy and culture, it is not surprising that there are major differences in outcomes. The more coordinated, comprehensive response to COVID-19 in Cuba has resulted in significantly better outcomes compared with the United States. Through July 15, 2021, the US cumulative case rate is more than 4 times higher than Cuba’s, while the death rate and excess death rate are both approximately 12 times higher in the United States. In addition to the large differences in cumulative case and death rates between United States and Cuba, the COVID-19 pandemic has unmasked serious underlying health inequities in the United States. The vaccine rollout presents its own set of challenges for both countries, and future studies can examine the comparative successes to identify effective strategies for distribution and administration. (Am J Public Health. 2021;111(12):2186–2193. https://doi.org/10.2105/AJPH.2021.306526 )

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