Inequality of opportunities in health and death: an investigation from birth to middle age in Great Britain

Objective We assess the existence of unfair inequalities in health and death using the normative framework of inequality of opportunities, from birth to middle age in Great Britain. Methods We use data from the 1958 National Child Development Study, which provides a unique opportunity to observe individual health from birth to the age of 54, including the occurrence of mortality. We measure health status combining self-assessed health and mortality. We compare and statistically test the differences between the cumulative distribution functions of health status at each age according to one childhood circumstance beyond people’s control: the father’s occupation. Results At all ages, individuals born to a ‘professional’, ‘senior manager or technician’ father report a better health status and have a lower mortality rate than individuals born to ‘skilled’, ‘partly skilled’ or ‘unskilled’ manual workers and individuals without a father at birth. The gap in the probability to report good health between individuals born into high social backgrounds compared with low, increases from 12 percentage points at age 23 to 26 at age 54. Health gaps are even more marked in health states at the bottom of the health distribution when mortality is combined with self-assessed health. Conclusions There is increasing inequality of opportunities in health over the lifespan in Great Britain. The tag of social background intensifies as individuals get older. Finally, there is added analytical value to combining mortality with self-assessed health when measuring health inequalities.

Gambaran Faktor Penyebab Ketuban Pecah Dini Pada Ibu Bersalin

One indicator to measure health status is maternal mortality and perinatal mortality. The Indonesian Health Demographic Survey (SDKI) data shows that infant and maternal mortality during childbirth has decreased since 2015 to the first semester of 2017. This study aims to determine the causes of premature rupture of membranes in maternity in the Pontang Community Health Center Working Area in 2018. Population in the study this were all mothers giving birth at Pontang Health Center. The sample was determined using secondary data, namely data obtained from Pontang Public Health Center in 2018 for women who experienced KPD as many as 145 people. The results of the study showed that the majority of mothers who experienced KPD at the age of 20-35 years with a percentage of 83.5%. Most mothers who experience KPD at 37-42 weeks' gestation are 69%. Most of the mothers who experienced KPD at primipara parity were 84 respondents with a percentage of 58%. It is expected that the Puskesmas can provide information on how to prevent premature rupture of the membranes . Keywords: Causing Factors, Labour, Early Rupture of Membranes ABSTRAK Indikator kesehatan suatu negara dapat dilihat dengan salah satu indikatornya adalah dengan angka kematian ibu dan angka kematian perinatal. Data Survey Demografi Kesehatan Indonesia (SDKI) mencatat angka kematian bayi dan ibu saat melahirkan mengalami penurunan hingga semester pertama 2017. Penelitian ini bertujuan untuk mengetahui faktor penyebab ketuban pecah dini pada ibu bersalin di Puskesmas Pontang Tahun 2018. Populasi pada penelitian ini adalah seluruh ibu bersalin di Puskesmas Pontang. sampel ditentukan menggunakan data sekunder yaitu data yang diperoleh dari Puskesmas Pontang tahun 2018 pada ibu bersalin yang mengalami KPD yaitu sebanyak 145 orang. Hasil penelitian menunjukan Sebagian besar ibu yang mengalami KPD pada ibu berumur 20 sampai 35 tahun dengan presentase 83,5%. Sebagian besar ibu yang mengalami KPD pada usia kehamilan 37-42 minggu presentase 69%. Sebagian besar ibu yang mengalami KPD pada paritas primipara 84 responden dengan presentase 58%. Diharapkan pihak Puskesmas mampu memberikan informasi tentang cara pencegahan ketuban pecah dini. Kata Kunci: Faktor Penyebab, Persalinan, Ketuban Pecah Dini.

Regularization method for predicting an ordinal response using longitudinal high-dimensional genomic data

An ordinal scale is commonly used to measure health status and disease related outcomes in hospital settings as well as in translational medical research. In addition, repeated measurements are common in clinical practice for tracking and monitoring the progression of complex diseases. Classical methodology based on statistical inference, in particular, ordinal modeling has contributed to the analysis of data in which the response categories are ordered and the number of covariates (

Frailty Index to Measure Health Status in People with Systemic Sclerosis

Objective.To develop and validate, as a measure of overall health status, a Frailty Index (FI) for patients (n = 1372) in the Canadian Scleroderma Research Group (CSRG) Registry.Methods.Forty-four items were selected from the CSRG database as health deficits and recoded using FI criteria. To test construct validity, we compared measurement properties of the CSRG-FI to other FI, and related it to measures of damage, age, and time since diagnosis. To test criterion validity, we compared the baseline FI to that at last recorded visit and to mortality.Results.The mean CSRG-FI was 0.33 with a sub-maximal limit of 0.67. In patients with diffuse disease, the mean was 0.38(SD 0.14); in patients with limited disease, the mean was 0.31(SD 0.13). The CSRG-FI was weakly (but significantly) correlated with the Rodnan Skin Score (r = 0.28 in people with diffuse disease; 0.18 with limited) and moderately with the Physician Assessment of Damage (r = 0.51 for both limited and diffuse). The risk of death increased with higher FI scores and with higher physician ratings of damage. The area under the receiver operating characteristic curve for the baseline FI in relation to death was 0.75, higher than for other measures (range: 0.57–0.67).Conclusion.The FI quantifies overall health status in people with scleroderma and predicts mortality. Whether the FI might help with decisions about who might best be served by more aggressive treatment, such as bone marrow transplantation, needs to be evaluated.

The Clinical COPD Questionnaire Correlated with BODE Index-A Cross-Sectional Study

The Global initiative for Chronic Obstructive Lung Disease (GOLD) staging has widely used in the stratification of the severity of COPD, while BODE (body mass index, airflow obstruction, dyspnea, and exercise capacity) index was proven superior to FEV1 in predicting mortality, exacerbation and disease severity in patients with COPD. Clinical COPD Questionnaire (CCQ), a questionnaire with ten items categorized into three domains (symptoms, functional state and mental state) was developed to measure health status of COPD patients. However, little is known about the relationship between CCQ score and BODE index. We performed a prospective study with the inclusion of 89 patients who were clinically stable after a 6-week-therapy for COPD symptoms comparing their health status assessed by CCQ, BODE index and GOLD staging. We found that the total CCQ score was correlated with BODE score (P<0.001) and GOLD staging (P<0.001); of three CCQ domains, the functional status correlated the most with BODE index (rS=0.670) and GOLD staging (rS=0.531), followed by symptoms (rS=0.482;rS=0.346, respectively), and mental status (rS=0.340;rS=0.236, respectively). Our data suggest that CCQ is a reliable and convenient alternative tool to evaluate the severity of COPD.