scholarly journals Epidemiological Characteristics of Road Traffic Injuries Involving Children in Three Central American Countries, 2012–2015

2020 ◽  
Vol 18 (1) ◽  
pp. 37
Author(s):  
Virginia Núñez-Samudio ◽  
Francisco Mayorga-Marín ◽  
Humberto López Castillo ◽  
Iván Landires
Keyword(s):  
Costa Rica ◽  
Latin American ◽  
Motor Vehicle ◽  
Mortality Rates ◽  
Central American ◽  
Health Concern ◽  
Injury Mortality ◽  
Trends Over Time ◽  
Epidemiological Characteristics ◽  
Over Time

Although motor vehicle collisions (MVCs) are a worldwide public health concern due to their high injury, mortality, and fatality rates, few studies have addressed the epidemiologic behavior of MVCs in Latin American youth. Thus, this study was aimed at describing and comparing the characteristics of MVCs involving 0 to 14-year-olds in Costa Rica, Guatemala, and Panama. A secondary aim was to estimate the crude MVC-related injury, fatality, and mortality rates and their trends over time. We conducted a descriptive, retrospective study using publicly available data for Costa Rica, Panama, and Guatemala between 2012 and 2015. We examined the reported MVC cases and calculated the crude injury, fatality, and mortality rates and their trends over time (α = 0.05). Publicly available data reported 12,020 MVC-related injuries and 431 MVC-related deaths involving 0 to 14-year-olds. The most frequent mechanisms involved 0 to 14-year-olds as passengers or pedestrians in MVCs (>85% of all cases). The highest crude MVC-related injury and mortality rates were reported for Panama (119.35 and 2.14 per 100,000 population, respectively, in 0 to 14-years-olds), while Guatemala had the highest median MVC-related fatality rate (8.84 per 100,000 events; χ2 [2] = 377.8; p < 0.001) with a statistically significant trend increasing over time (r = 0.947; p = 0.027). Although several factors play a role in the prevention of MVCs among 0 to 14-year-olds, we found that Costa Rica was the only country that implemented a policy on child restraint systems resulting in the lowest rates of MVC-related injury, mortality, and fatality. These results could be used by decision makers from the aforementioned Central American countries to develop adequate policies addressing MVC preventative strategies to protect Central American infants and children.

scholarly journals 472 Epidemiology and temporal trends of cardiac device related infective endocarditis

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
M Denes ◽  
A Bence ◽  
T Ferenci ◽  
S Borbas ◽  
Z Som ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
Temporal Trends ◽  
Mortality Rates ◽  
Coagulase Negative Staphylococcus ◽  
Cardiac Device ◽  
Native Valve ◽  
Tertiary Referral Center ◽  
Device Implantation ◽  
Epidemiological Characteristics ◽  
Over Time

Abstract Background Infective endocarditis (IE) is a rare, but life-threatening complication of cardiac device implantation. Despite recent preventive strategies, and advances in antimicrobial and surgical treatment, morbidity and mortality rates are still high. Aims The objective of our study was to assess the epidemiological characteristics, temporal tends and mortality rate of cardiac device related IE (CDRIE) in our high-volume, tertiary referral center. Methods retrospective data collection was performed from January 1, 2006 to December 31, 2016. Thirty-day, 6-month and 1-year mortality was estimated, which were compared to left-sided native valve endocarditis (LSNIE). Patients administered between 2006 and 2010 and between 2011 and 2016 were compared to assess temporal trends. Results 465 cases of IE were administered, out of whom 54 patients had CDRIE (39 males [72%], mean age: 55.8 ±19 yrs; 4 VVI, 7 VDD, 7 VVI-ICD, 20 DDD, 5 DDD-ICD and 11 CRT devices; median time since first implantation: 1558 days [IQR: 470 days – 8.6 yrs]). The infection was caused by streptococci in 3 cases (5.5%), Staphylococci were the most prevalent infective agents (70%), S. aureus (SA) in 28 cases (52%, out of whom 10 were MRSA), coagulase negative Staphylococcus in 10 cases (18.5%), blood culture negative cases in 8 patients (15%), and in 5 cases other pathogens were responsible. 266 patients had LSNIE (201 males [75%], mean age: 54.4 ± 15.6 yrs). There was no difference between the two groups in age or in portion of males. Mortality rates were the same in CDRIE group compared to LSNIE group (30-day: 13% vs 13%, 6-month: 20% vs 25%, 1-year: 26% vs 29% and long-term: 44% vs 44%, ns resp.) Patients who died in the CDRIE group (n = 25) were older (64 yrs [IQR:59-71 yrs] vs 52 yrs [IQR: 27-69 yrs], p = 0.02), male sex was less common (52% vs 79%, p = 0.03), had lower ejection fraction (39.6 ±16.6% vs 54.6 ±14.5%, p &lt; 0.001), had worse renal function (GFR: 46.3 ± 15.3 vs 60.2 ± 23.5 ml/min/1.73m2, p = 0.04), shorter time since first device implantation (2.1 yrs [IQR: 1.1-4.8 yrs] vs 6.7 yrs [4.1-12.9 yrs], p = 0.006), and CRT device implantation were more prevalent (32% vs 10%, p &lt; 0.05). Patients admitted before 2011 (n = 22) did not differ from patients admitted after 2011 (n = 32) in terms of age, male gender, concomitant valve infection, pocket infection, or embolic event. The 30-day (0% vs 6%) and the 1-year mortality (18% vs 31%) were the same before and after 2011, but the 6-month mortality was better before 2011 (4.5% vs 31%, p = 0.01). CRT device implantation was more prevalent over time (5% vs 31%, p = 0.01), and SA infection became more frequent (36% vs 63%, p = 0.05) Conclusions During the last decade patients with CDRIE had a same survival as patients with LSNIE, every fourth patient died one year after the diagnosis. Almost three-quarter of the infections were caused by Staphylococci, and the portion of S. aureus infection increased over time.

scholarly journals Field key to the bats of Costa Rica and Nicaragua

2019 ◽  
Vol 100 (6) ◽  
pp. 1726-1749 ◽  
Author(s):  
Heather A York ◽  
Bernal Rodríguez-Herrera ◽  
Richard K Laval ◽  
Robert M Timm ◽  
Kaitlin E Lindsay
Keyword(s):  
Costa Rica ◽  
Taxonomic Diversity ◽  
Central American ◽  
Natural Systems ◽  
Dichotomous Key ◽  
Neotropical Bats ◽  
Taxonomic Changes ◽  
Key Characters ◽  
Over Time

Abstract With more than 1,400 species of bats described worldwide, the order Chiroptera is second only to rodents in ecological and taxonomic diversity. Bats play critically important roles in natural systems as seed and pollen dispersers, predators of invertebrates and vertebrates, and sanguinivores. The Central American countries of Costa Rica and Nicaragua have at least 123 species of bats (in nine families and 66 genera), or nearly 10% of the world's known species. Because of the importance of proper species identification for ecological and systematic studies and conservation efforts, we present a dichotomous key to the bats of this region. Our goal is the positive, in-hand identification of living bats that may be released unharmed after identification. Identifying Neotropical bats and understanding the taxonomic changes that affect the names used for the various species over time can be a challenge. This key includes the 123 species known to occur in Costa Rica and Nicaragua as well as three that are expected to occur in these countries but which have not yet been recorded. We provide illustrations of key characters useful for differentiating bats to species and updated taxonomic notes to assist the reader in assessing the literature. Con más de 1,400 especies de murciélagos descritos en todo el mundo, el orden Chiroptera es el segundo más diverso después de los roedores respecto a taxonomía. Los murciélagos juegan papeles de importancia crítica en los sistemas naturales como dispersores de semillas, polinizadores, depredadores de vertebrados e invertebrados, así como hematófagos. Costa Rica y Nicaragua presentan al menos 123 especies de murciélagos (en 9 familias y 66 géneros), casi el 10% de las especies conocidas en el mundo. Debido a la importancia de la identificación precisa de las especies para los estudios ecológicos, sistemáticos y de conservación, presentamos una clave dicotómica para los murciélagos de esta región. Nuestro objetivo es la identificación correcta con los murciélagos in vivo y que se pueden liberar sin daño después de la identificación. La caracterización de los murciélagos neotropicales y el seguimiento del estatus taxonómico de cada especie puede ser un reto en el proceso de identificación. Esta clave incluye las 123 especies conocidas en Costa Rica y Nicaragua, así como 3 no registradas pero con distribución potencial. Proporcionamos ilustraciones de características claves útiles para diferenciar murciélagos al nivel de la especie y notas taxonómicas actualizadas para ayudar al lector a la identificación.

scholarly journals Differences in declining mortality rates due to coronary heart disease by neighbourhood deprivation

2018 ◽  
Vol 72 (4) ◽  
pp. 314-318 ◽  
Author(s):  
Daniel Oudin Åström ◽  
Jan Sundquist ◽  
Kristina Sundquist
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Mortality Rates ◽  
Decision Makers ◽  
Neighbourhood Deprivation ◽  
Deprived Neighbourhoods ◽  
Different Types ◽  
Trends Over Time ◽  
Industrialised Countries ◽  
Over Time

BackgroundCardiovascular disease (CVD) is the main cause of death in most industrialised countries, including those in Europe. The mortality rates due to coronary heart disease (CHD), one of the most serious CVD conditions, have been decreasing in most European countries during the last decades. However, whether the trends over time in CHD mortality rates differ depending on neighbourhood deprivation has rarely been investigated.MethodsFor each year of the study period, 1988–2012, in Sweden, age-standardised mortality rates were calculated for three different types of neighbourhoods, characterised by a Neighbourhood Deprivation Index. Joinpoint regression was used to investigate potential changes in age-standardised mortality rates by neighbourhood deprivation and over time.ResultsOver the study period, age-standardised mortality rates due to CHD were consistently the highest in the deprived neighbourhoods and the lowest in the affluent neighbourhoods. We observed a statistically significant overall decline, ranging from 67% to 59%, in the age-standardised CHD mortality rates for each level of neighbourhood deprivation. Furthermore, the decline for the affluent neighbourhoods was significantly higher compared with the decline in the deprived neighbourhoods.ConclusionAge-standardised CHD mortality rates decreased significantly in Sweden between 1988 and 2012. This decline was more pronounced in the affluent neighbourhoods, which indicates that the improvements in prevention and treatment of CHD have not benefited individuals residing in deprived neighbourhoods to an equal extent. Knowledge of time trends in CHD mortality by level of neighbourhood deprivation may help guide decision-makers in the development of appropriate healthcare policies for deprived neighbourhoods.

scholarly journals Detección de gluten en alimentos etiquetados como libres de gluten disponibles en el mercado costarricense

2019 ◽  
Vol 69 (1) ◽  
pp. 42-49
Author(s):  
Jessie Usaga ◽  
Jacqueline Aiello
Keyword(s):  
Costa Rica ◽  
Meat Products ◽  
Costa Rican ◽  
Central American ◽  
Health Concern ◽  
Surveillance Systems ◽  
Three Samples ◽  
International Regulations ◽  
Para Determinar ◽  
Quantifiable Concentration

La presencia de gluten en alimentos etiquetados como libres de gluten (LG) representa una preocupación para la salud de pacientes celíacos, y personas intolerantes y sensibles a este conjunto de proteínas. Sin embargo, esto no ha sido estudiado aún en países centroamericanos. Por tanto, se investigó la presencia de gluten en alimentos etiquetados LG, manufacturados en Costa Rica y disponibles en el mercado entre los años 2016 y 2017 para determinar así el cumplimiento de las regulaciones nacionales e internacionales. Se ha estipulado que dichos alimentos deben contener <20 ppm de gluten. Un total de 173 productos fueron analizados por inmunoensayo (tres muestras por producto; cada una de un lote diferente) utilizando el kit ELISA RIDASCREEN®. 60 marcas de productos, de 32 compañías diferentes, fueron evaluadas identificando 15 categorías de alimentos LG: productos horneados, premezclas y harinas, snacks, granos y cereales, salsas, productos cárnicos, productos de origen marino, bebidas, productos lácteos, pastas, chocolates, aceites, tortillas y arepas, jaleas y mermeladas y otros. Una muestra de uno de los productos analizados presentó >20 ppm de gluten. No obstante, al menos una muestra de 49 productos diferentes (28% de los productos analizados) presentó una concentración cuantificable de gluten (>5 ppm) evidenciando una alta variabilidad en los resultados. Esta investigación evidencia el fuerte compromiso de la industria alimentaria costarricense para cumplir la norma que regula la producción de alimentos LG durante el período de estudio, aunque se alerta acerca de la necesidad de implementar mejoras en los sistemas de producción y vigilancia de estos alimentos. The presence of gluten in gluten free (GF) labelled foods represents a serious health concern to celiac patients and persons intolerant or sensitive to this set of proteins. However, this has not yet been studied in Central American countries. Therefore, the presence of gluten in foods labeled LG, manufactured in Costa Rica and available in the market, between 2016 and 2017, was investigated to determine compliance with national and international regulations. It has been stipulated that such foods must contain <20 ppm of gluten. A total of 173 products were analyzed by immunoassay (three samples per product; each from an independent batch), using the ELISA RIDASCREEN® kit. 60 product brands, from 32 different companies, were evaluated and 15 GF food categories were identified: baked products, baking mixes and flours, snacks, grains and cereals, sauces, meat products, seafood, beverages, dairy products, pasta, chocolates, oils, tortillas and arepas, jams and jellies, and others. Only one sample from one of the tested products presented >20 ppm of gluten. However, at least one sample of 49 different products (28% of products tested) presented a quantifiable concentration of gluten (>5 ppm), showing a high variability of results. This research evidences the strong commitment of the Costa Rican food industry to comply with the norm that regulates the production of LG foods during the study period, even though it warns about the need to implement improvements in the production and surveillance systems of these foods.

Escapes from new south wales gaols: placing the risk in perspective

1991 ◽  
Vol 24 (3) ◽  
pp. 204-218 ◽  
Author(s):  
Angela Gorta ◽  
Tony Sillavant
Keyword(s):  
Technical College ◽  
Motor Vehicle ◽  
New South ◽  
New South Wales ◽  
Rare Occurrence ◽  
South Wales ◽  
Trends Over Time ◽  
Detailed Record ◽  
Over Time ◽  
Property Offences

This article seeks to place the risk posed by escapees in perspective by presenting information on escapees from NSW gaols, based on a detailed record study of the 812 prisoners who escaped during the 6 year period, July 1983 to June 1989. Escapes from NSW gaols are a relatively rare occurrence. The majority of escapes (68.4%) occurred from within minimum security institutions. A further 12.3% of escapes refer to prisoners who fall to return on time from an unescorted temporary absence from the gaol, such as day/weekend leave, attendance at technical college or university, etc. Escapees tended to be younger, more likely to be serving sentences for property offences, more likely to be held in minimum security, more likely to have lower security classifications and less likely to be held on remand than prisoners in general. There is no particular point in their sentence when escapees are more likely to escape. While there are variations in patterns of escape or characteristics of escapees from year to year, there are no clear trends over time. The characteristics of escapees determined in this study suggest that reasons exist for escaping other than the presentation of the opportunity. More than one-quarter (28.6%) of the escapees were recaptured on either the day they escaped or the following day. Half (50%) of the escapees were recaptured within 8 days of their escape. The majority of escapees (74.2%) were not convicted of committing any offences whilst at large. Of those who were convicted, offences committed whilst at large are most commonly property offences (74.9%) such as break, enter and steal or larceny of a motor vehicle

Reduction in Stroke After Transient Ischemic Attack in a Province-Wide Cohort Between 2003 and 2015

2020 ◽  
pp. 1-9
Author(s):  
Ryan Wang ◽  
Arunima Kapoor ◽  
Patrice Lindsay ◽  
Cristina Goia ◽  
Amy Y. X. Yu ◽  
...  
Keyword(s):  
Transient Ischemic Attack ◽  
Mortality Rates ◽  
Canadian Institute ◽  
Trends Over Time ◽  
Level 1 ◽  
Ischemic Attack ◽  
Event Rates ◽  
Linear Regressions ◽  
Over Time

ABSTRACT: Background: Improvements in management of transient ischemic attack (TIA) have decreased stroke and mortality post-TIA. Studies examining trends over time on a provincial level are limited. We analyzed whether efforts to improve management have decreased the rate of stroke and mortality after TIA from 2003 to 2015 across an entire province. Methods: Using administrative data from the Canadian Institute for Health Information’s (CIHI) databases from 2003 to 2015, we identified a cohort of patients with a diagnosis of TIA upon discharge from the emergency department (ED). We examined stroke rates at Day 1, 2, 7, 30, 90, 180, and 365 post-TIA and 1-year mortality rates and compared trends over time between 2003 and 2015. Results: From 2003 to 2015 in Ontario, there were 61,710 patients with an ED diagnosis of TIA. Linear regressions of stroke after the index TIA showed a significant decline between 2003 and 2015, decreasing by 25% at Day 180 and 32% at 1 year (p < 0.01). The 1-year stroke rate decreased from 6.0% in 2003 to 3.4% in 2015. Early (within 48 h) stroke after TIA continued to represent approximately half of the 1-year event rates. The 1-year mortality rate after ED discharge following a TIA decreased from 1.3% in 2003 to 0.3% in 2015 (p < 0.001). Interpretation: At a province-wide level, 1-year rates of stroke and mortality after TIA have declined significantly between 2003 and 2015, suggesting that efforts to improve management may have contributed toward the decline in long-term risk of stroke and mortality. Continued efforts are needed to further reduce the immediate risk of stroke following a TIA.

Costa Rica’s Historical Development and New Age of Progress

2020 ◽  
Author(s):  
Adam Golob
Keyword(s):  
Costa Rica ◽  
Latin American ◽  
National Level ◽  
The United States ◽  
Costa Rican ◽  
Gay Marriage ◽  
Central American ◽  
Lost Decade ◽  
The Right ◽  
Party Dominance

Costa Rica has historically faced many of the same challenges as its Central American neighbors, but to a less dramatic extent. This has put the country on a unique path of political and economic development. Even today, it outperforms its neighbors, often including its more developed neighbors, like the United States, in essential measurements of human development, happiness, lack of corruption, and economics. Many Costa Rican scholars have concluded that the nation benefitted from its time as a colonial outcast and from a lack of exploitable resources like gold and silver. The common misbelief that Costa Rica was settled without the destruction of natives, that the country gained a peaceful independence, and that it somehow avoided all the pitfalls of Latin American development is now met with resistance, and a better understanding of Costa Rican history has emerged. Although Costa Rican development has not been without its complications, issues, and bloody epochs, it has been far less extreme and far more open to change, democracy, and progress. Costa Rica was able to gain a semi-peaceful independence, form a strong republic, and endure the “lost decade” better than many other countries in the region. Since 2008, this tiny country has progressed rapidly. It joined CAFTA-DR, elected its first female president, ended 70 years of two-party dominance, survived national-level scandal, legalized gay marriage, and elected a progressive leftist president in 2018 despite a global shift to the right for political leaders. Yet along with progress comes continued struggles. Costa Rica faces new challenges in the 21st century. In the new millennium, it confronts issues of social injustice, rising crime rates, economic dependency on international monetary institutions, corruption, and human rights, to name a few.

Trends and disparities in American Indian/Alaska Native unintentional injury mortality from 1999 to 2016

2020 ◽  
pp. injuryprev-2020-043951
Author(s):  
William C Kerr ◽  
Yu Ye ◽  
Edwina Williams ◽  
Nina Mulia ◽  
Cheryl J Cherpitel
Keyword(s):  
New York ◽  
American Indian ◽  
Alaska Native ◽  
Motor Vehicle ◽  
Unintentional Injury ◽  
Mortality Rates ◽  
Situational Factors ◽  
Drug Poisoning ◽  
Alcohol Poisoning ◽  
Injury Mortality

IntroductionAlcohol and drug use are significant problems in the US, and American Indian/Alaska Native (AI/AN) communities and individuals are known to be among the most affected. This study evaluates disparities in unintentional injury mortality causes since 1999.MethodsAnalyses in 2020 of unintentional injury mortality rate disparities between AI/ANs and white population over the 1999–2016 period with attention to motor vehicle crashes, alcohol poisoning, drug poisoning and all other cause types. Rates in each of the 10 states with the largest AI/AN populations were also investigated to account for geographical concentration.ResultsMotor vehicle mortality rates declined for both AI/AN and white groups, but a large racial disparity was maintained. Conversely, poisoning mortality rates rose substantially in both groups, with a jump in rates in 2007 due to a coding change, resulting in a large disparity that was maintained through 2016. Comparison of alcohol and drug poisonings showed that the AI/AN alcohol poisoning rate was about eight times the white rate, whereas drug poisoning rates were similar. For ‘all other’ unintentional injuries, the highest rates were seen for AI/AN men, with rates generally rising over the study period. State-specific analyses found substantial variation in AI/AN rates, with few or no disparities in New York and Texas.ConclusionsResults indicate substantial and persisting disparities in unintentional injury mortality, with especially large differences in alcohol poisoning. The absence of disparities in New York and Texas suggest the importance of situational factors.

scholarly journals Unintentional injury mortality and external causes in Canada from 2001 to 2007

2013 ◽  
Vol 33 (2) ◽  
pp. 95-102 ◽  
Author(s):  
Y Chen ◽  
F Mo ◽  
QL Yi ◽  
Y Jiang ◽  
Y Mao
Keyword(s):  
Mortality Rate ◽  
Motor Vehicle ◽  
Unintentional Injury ◽  
Mortality Rates ◽  
Vital Statistics ◽  
Motor Vehicle Crashes ◽  
Vehicle Crashes ◽  
Female Ratio ◽  
Injury Mortality ◽  
External Causes

Introduction To understand the distribution pattern and time trend of unintentional injury mortalities is crucial in order to develop prevention strategies. Methods We analyzed vital statistics data from Canada (excluding Quebec) for 2001 to 2007. Mortality rates were age- and sex-standardized to the 2001 Canadian population. An autoregressive model was used for time-series analysis. Results Overall mortality rate steadily decreased but unintentional injury mortality rate was stable over the study period. The three territories had the highest mortality rates. Unintentional injury deaths were less common in children than in youths/adults. After 60, the mortality rate increased steadily with age. Males were more likely to die of unintentional injury, and the male/female ratio peaked in the 25- to 29-year age group. Motor vehicle crashes, falls and poisoning were the three major causes. There was a substantial year after year increase in mortality due to falls. Deaths due to motor vehicle crashes and drowning were more common in summer months, and deaths caused by falls and burns were more common in winter months. Conclusion The share of unintentional injury among all-cause mortality and the mortality from falls increased in Canada during the period 2001 to 2007.

scholarly journals Suicide Mortality in the Americas – Regional Report 2015-2019

2021 ◽  
Keyword(s):  
Risk Factors ◽  
Mortality Rates ◽  
Suicide Mortality ◽  
Fourth Edition ◽  
Country Level ◽  
Specific Risk ◽  
Trends Over Time ◽  
Gender Specific ◽  
Over Time ◽  
Risk Factors For Suicide

This report provides updated data on suicide in the Region of the Americas and is issued every five years, this being the fourth edition. In addition to including analysis similar to previous reports (suicide according to age, sex, as well as methods used), this report includes an expanded set of analysis on risk factors for suicide in the Americas: the analysis of the annual age-standardized gender-specific suicide morality rate trends over time by country and sub-region and to identify points of inflection, and evaluates the association of specific risk factors on country-level suicide mortality rates.

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