Articles: mortality.
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Historical Article
Health issues and medical care in the Ohio penitentiary, 1833–1907.
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BACKGROUND Pacific mortality rates are traditionally presented for all Pacific people combined, yet there is likely heterogeneity between separate Pacific ethnic groups. We aimed to determine mortality rates for Samoan, Cook Island Māori, Tongan, and Niuean ethnic groups (living in New Zealand). METHODS We used New Zealand Census-Mortality Study (NZCMS) data for 2001-04, for 380,000 person years of follow-up of 0-74 year olds in the 2001-04 cohort for which there was complete data on sex, age, ethnicity (total counts), natality, and household income. ⋯ Our findings, in particular the elevated CVD mortality among Cook Island Māori, appeared robust. CONCLUSIONS To our knowledge, this project is the first time in New Zealand that clear (and marked in the case of CVD) differences in mortality have been demonstrated between different Pacific ethnic groups. Future health research and policy should, wherever possible and practicable, evaluate and incorporate heterogeneity of health status among Pacific people.
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Multicenter Study
Mortality of HIV-infected patients starting potent antiretroviral therapy: comparison with the general population in nine industrialized countries.
Mortality in HIV-infected patients has declined substantially with combination antiretroviral therapy (ART), but it is unclear whether it has reached that of the general population. We compared mortality in patients starting ART in nine countries of Europe and North America with the corresponding general population, taking into account their response to ART. ⋯ In industrialized countries, the mortality experience of HIV-infected patients who start ART and survive the first 6 months continues to be higher than in the general population, but for many patients excess mortality is moderate and comparable with patients having other chronic conditions. Much of the excess mortality might be prevented by earlier diagnosis of HIV followed by timely initiation of ART.
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We describe trends from 1951 to 2006 in inequalities in mortality between the indigenous (Māori) and non-indigenous (non-Māori, mainly European-descended) populations of New Zealand. We relate these trends to the historical context in which they occurred, including major structural adjustment of the economy from the mid 1980s to the mid 1990s, followed by a retreat from neoliberal social and economic policies from the late 1990s onwards. This was accompanied by economic recovery and the introduction of health reforms, including a reorientation of the health system towards primary health care. ⋯ Our results are consistent with a causal association between changing economic inequalities and changing health inequalities between ethnic groups. However, causality cannot be established from a historical analysis alone. Three lessons nevertheless emerge from the New Zealand experience: the lag between changes in ethnic social inequality and ethnic health inequality may be short (<5 years); both changes in the distribution of the social determinants of health and an appropriate health system response may be required to address ethnic health inequalities; and timely monitoring of ethnic health inequalities, based on high-quality ethnicity data, may help to sustain political commitment to pro-equity health and social policies.
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Emerg Med Australas · Dec 2009
Short-term risk of adverse outcome is significantly higher in patients returning an abnormal troponin result when tested in the emergency department.
Describe short-term mortality and hospitalization outcomes in patients undergoing troponin testing in Western Australia tertiary public hospital ED. ⋯ An abnormal ED troponin result appears to be associated with increased risk of subsequent hospitalization and death within 28 days of discharge.