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PubMed2006

What is in a cause? Exploring the relationship between genetic cause and felt stigma.

PURPOSE: Concern over stigma as a consequence of genetic testing has grown in response to the recent increase in genetic research and testing resulting from the Human Genome Project. However, whether a genetic or hereditary basis necessarily confers a stigma to a condition remains unexamined. METHODS: We performed a qualitative interview study with 86 individuals with one of four conditions: deafness or hearing loss, breast cancer, sickle cell disease, and cystic fibrosis. The first two groups were divided approximately between people who ascribed their conditions to a genetic or hereditary cause and those who did not. RESULTS: Respondents interpreted genetic or hereditary causes and nongenetic causes in a variety of ways. Subjects with breast cancer reported the most consistently negative interpretation of genetic cause. This response concerned future ill health, not an enduring sense of stigma. Deaf and hard of hearing subjects provided the most consistently positive comments about a genetic or hereditary basis to their condition, casting familial hearing loss as a vital component of group and individual identity. Respondents with sickle cell disease and cystic fibrosis offered similar and positive interpretations of the genetic cause of their condition insofar as it meant their conditions were not contagious. CONCLUSIONS: Although some subjects report feeling stigmatized as a result of their condition, this stigmatization is not uniformly associated with the condition's cause, genetic or otherwise. Instead, stigma emerges from a variety of sources in the context of the lived experience of a particular condition.

Adolescent↗

PubMed1987

On the use of the cause table in handling common cause events in system analysis.

A method is presented for applying the cause table concept to the problem of common cause events. This method can be regarded as an alternative to the approach in which these events are included directly into the system fault trees. In comparison with this approach, the cause table method offers the advantage of simple fault trees, convenient visibility of the contributions of causes, and the ability to truncate the numerical calculation conveniently by aggregating small terms into an "other" category. Generally speaking, the cause table method can be said to handle common causes at the level of arithmetic (i.e., numbers) rather than at the level of algebra (determining cutsets and frequency equations).

Methods↗

PubMedDate not supplied

Cerebral hemorrhagic infarction at autopsy: cardiac embolic cause and the relationship to the cause of death.

In 48 patients dying within 15 days following a supra-tentorial cerebral infarct, the presence of hemorrhagic infarction at autopsy was related to a cardiac embolic cause of the infarct, and to the cause of death. Hemorrhagic infarcts were more common among patients dying from brain herniation than among those dying from a non-cerebral cause. Cardiac embolic strokes were more often hemorrhagic at autopsy than strokes without such cause; this could be explained by a significant higher rate of brain herniation and death after embolic stroke. On the other hand infarcts with extended hemorrhages more often tended to have a cardiac than a non-cardiac cause. These data, together with earlier clinical findings suggest that autopsy studies are biased in relating hemorrhagic infarction almost exclusively to a cardiac embolic cause of stroke, although cardiac emboli may produce more extended hemorrhages.

Adult↗

PubMed2005

Association between fish consumption and all-cause and cause-specific mortality in Japan: NIPPON DATA80, 1980-99.

PURPOSE: Although high consumption of fish may be one of the contributing factors for Japanese longevity, no epidemiological study using Japanese data has tested this hypothesis. SUBJECTS AND METHODS: The relationship between fish consumption and all-cause as well as cause-specific mortality was analyzed using the database of NIPPON DATA80. At baseline in 1980, history, physical, and blood biochemical measurement and a nutritional survey by the food-frequency method were performed in randomly selected community-based subjects aged 30 years and over in Japan. After exclusion of subjects with significant comorbidities at baseline, we followed 3945 men and 4934 women for 19 years. Men and women were analyzed comprehensively. Age- and sex-adjusted and multivariate adjusted relative risk for all-cause or cause-specific mortality was calculated using a Cox proportional hazards model with delayed entry. RESULTS: During 19 years of followup, there were 1745 deaths. Subjects were divided into 5 groups according to fish consumption frequency. The multivariate Cox analyses showed that relative risks for subjects who ate fish more than twice daily compared with those of subjects who ate 1 to 2 times weekly were 0.99 (95% confidence intervals: 0.77-1.27) for all-cause, 1.26 (0.70-2.29) for stroke, 0.92 (0.20-4.23) for cerebral hemorrhage, 1.09 (0.48-2.43) for cerebral infarction, and 0.91 (0.35-2.35) for coronary heart disease mortality. CONCLUSION: Our results did not provide evidence in support of the fish hypothesis, perhaps because the majority of the Japanese subjects in the study ate fish more than the threshold level shown to be beneficial in the previous studies.

Adult↗

PubMed1998

A multicentre study on the causes of death among Italian injecting drug users. AIDS has overtaken overdose as the principal cause of death.

The causes of death among injecting drug users. (IDUs) are still being discussed worldwide. We analysed the causes of death among IDUs attending 26 centres for drug users in North-Eastern Italy from 1985 to 1994. The study of a total number of 1,022 deaths reveals the following: (1) AIDS has become the primary cause of death among IDUs since 1991 and is rising even in an area with a moderate HIV seroprevalence; (2) the mean age of death in AIDS patients proved higher than among patients who died of other causes (which may be due to the long incubation period of AIDS); (3) our data do not reveal higher HIV seroprevalence among IDUs who died of overdose and suicide as opposed to IDUs who died of other causes; (4) the mortality rate in IDUs is significantly higher when compared to that of the general population in the same age group.

Acquired Immunodeficiency Syndrome↗

PubMed2004

Egg consumption, serum cholesterol, and cause-specific and all-cause mortality: the National Integrated Project for Prospective Observation of Non-communicable Disease and Its Trends in the Aged, 1980 (NIPPON DATA80).

BACKGROUND: Because egg yolk has a high cholesterol concentration, limited egg consumption is often suggested to help prevent ischemic heart disease (IHD). OBJECTIVE: We epidemiologically examined the validity of this recommendation. DESIGN: We analyzed the relations of egg consumption to serum cholesterol and cause-specific and all-cause mortality by using the NIPPON DATA80 (National Integrated Project for Prospective Observation of Non-communicable Disease And its Trends in the Aged, 1980) database. At the baseline examination in 1980, a nutritional survey was performed by using the food-frequency method in Japanese subjects aged > or =30 y. We followed 5186 women and 4077 men for 14 y. RESULTS: The subjects were categorized into 5 egg consumption groups on the basis of their responses to a questionnaire (> or =2/d, 1/d, 1/2 d, 1-2/wk, and seldom). There were 69, 1396, 1667, 1742, and 315 women in each of the 5 groups, respectively. Age-adjusted total cholesterol (5.21, 5.04, 4.95, 4.91, and 4.92 mmol/L in the 5 egg consumption categories, respectively) was related to egg consumption (P < 0.0001, analysis of covariance). In women, unadjusted IHD mortality and all-cause mortality differed significantly between the groups [IHD mortality: 1.1, 0.5, 0.4, 0.5, and 2.0 per 1000 person-years, respectively (P = 0.008, chi-square test); all-cause mortality: 14.8, 8.0, 7.5, 7.5, and 14.5 per 1000 person-years, respectively (P < 0.0001, chi-square test)]. In men, egg consumption was not related to age-adjusted total cholesterol. Cox analysis found that, in women, all-cause mortality in the 1-2-eggs/wk group was significantly lower than that in the 1-egg/d group, whereas no such relations were noted in men. CONCLUSION: Limiting egg consumption may have some health benefits, at least in women in geographic areas where egg consumption makes a relatively large contribution to total dietary cholesterol intake.

Adult↗

PubMed2002

All-cause and cause-specific death rates by educational status for two million people in two American Cancer Society cohorts, 1959-1996.

Low socioeconomic status is associated with high mortality, but the extent to which socioeconomic status affects particular diseases and whether socioeconomic status effects have changed over time are uncertain. The authors used education as a marker for socioeconomic status in a study of two large American Cancer Society cohorts (follow-up, 1959-1996). Low education was associated with higher death rates in both cohorts from all causes and most specific causes, except breast cancer and external causes among women. Life expectancy in the more recent cohort was 4.8 years shorter for men and 2.7 years shorter for women for the least versus the most educated. The inverse relation between education and mortality was strongest for coronary heart disease, lung cancer, diabetes, and chronic obstructive pulmonary disease; moderate for colorectal cancer, external causes (men only), and stroke; weak for prostate cancer; and reversed for external causes among women. The direction of a weak gradient for breast cancer differed for those with and without prevalent breast cancer at baseline. Adjustment for conventional risk factors, probable intermediate variables between education and mortality, diminished but did not eliminate the observed educational/mortality gradients. Temporal trends showed increasing mortality differences by education for coronary heart disease, diabetes, and lung cancer for women.

Adult↗

PubMed2003

Increase in deaths caused by HIV infection due to changes in rules for selecting underlying cause of death.

With implementation of the (ICD-10), for U.S. vital statistics in 1999, the criteria for selecting HIV infection as the underlying cause of death were expanded. To estimate the effect of ICD-10 rules on the number of deaths attributed to HIV infection, we applied a simplified version of ICD-10 rules to data on causes of death from all U.S. death certificates for 1998 (previously classified by rules of the 9th revision of ICD [ICD-9]) and calculated the resulting increase in deaths for which HIV infection was selected as the underlying cause. Of the 17,186 deaths in 1998 with any mention of HIV infection on the death certificate, ICD-10 rules selected HIV infection as the underlying cause for 15,145, which was 1,719 (13%) more than the 13,426 for which it had been selected by ICD-9 rules. The proportional increase differed by demographic group, being less among non-Hispanic blacks (9%) and Hispanics (13%) than among non-Hispanic whites (18%). Thus, comparison of deaths attributed to HIV infection in 1999 or later with those in 1998 or earlier should take into account the changes in ICD rules for selecting the underlying cause of death.

Adolescent↗

PubMed2005

[Cause of death: from primary disease to direct cause of death].

Following the death of a patient, the treating physician in the Netherlands is required to fill out two forms. Form A, which is the certificate of death and Form B, which is used by the Statistics Netherlands to compile data on causes ofdeath. The latter form often poses difficulty for the physician with respect to the primary cause of death. This applies particularly to cases of sudden death, which account for one third of all deaths in the Netherlands. As a result, the statistical analyses appear to lead to an incorrect representation of the distribution of causes of death. A more thorough investigation into the primary cause of death is desirable, if necessary, supported by a request for an autopsy. The primary cause of death is to be regarded as the basic disease from which the cascade of changes ultimately leading to death originated.

Autopsy↗

PubMed1996

Protocol for writing cause-of-death statements for deaths due to natural causes.

The purpose of this article is to describe a protocol that provides suggestions and guides the clinical practice of writing cause-of-death statements for death certificates, autopsy reports, and other medical documents. The 16 members of the Autopsy Committee of the College of American Pathologists (CAP), Northfield, Ill, were appointed by the CAP officers based on demonstrated interest and expertise in autopsy performance and reporting. The committee perceived a need for specific instructions aimed at promoting consistency, accuracy, and completeness when writing cause-of-death statements. Development of a protocol was supported by CAP after approval by the CAP board of governors. The framework for the protocol was based on recommendations of the National Center for Health Statistics, Hyattsville, Md, with additional concepts added by the autopsy committee. The protocol for writing cause-of-death statements for natural causes is expected to foster consistency, accuracy, and completeness in the writing of cause-of-death statements. The quality of individual death certificates, autopsy reports, and national mortality data may improve through protocol usage. Application of the protocol principles should impose no ongoing costs at any user level because no new products or personnel are required for its application.

Autopsy↗

PubMed1996

Mortality trends by cause of death in England and Wales 1980-94: the impact of introducing automated cause coding and related changes in 1993.

This article describes the implementation of a computerised system for coding the cause of death from death registrations in England and Wales since the beginning of 1993, and the impact this has had on national cause of death statistics. Overall the automated system has been effective and reliable at deriving ICD-9 codes for the underlying cause of death and other conditions mentioned on the certificate. Automation increases the consistency and international comparability of cause of death coding. However, it has led to discontinuities in time trends between 1992 and 1993, which are explored here. The largest effect was related to expected changes in the application of ICD-9 selection rule 3. However there were other effects which were not expected. The automated system does not deal adequately with external causes of death, which are certified after coroner's inquest, and ONS has reverted to coding these clerically. Lessons for the implementation of ICD-10 for mortality have been learnt.

Adolescent↗

PubMed2002

Are within-individual causes of delinquency the same as between-individual causes?

BACKGROUND: Previous studies of the causes of delinquency have been based on between-individual correlations. This paper aims to study the causes of delinquency by comparing within-individual and between-individual correlations of risk factors with delinquency. METHOD: A total of 506 boys in the oldest sample of the Pittsburgh Youth Study were followed up in seven data waves between ages 13.8 and 17.8 on average. RESULTS: Poor parental supervision, low parental reinforcement and low involvement of the boy in family activities were the most important causes of delinquency according to forward-lagged within-individual correlations. Poor housing was positively related to delinquency for boys living in bad neighbourhoods but not for boys living in good neighbourhoods. CONCLUSIONS: Forward-lagged within-individual correlations provide more valid information about the causes of delinquency than do between-individual correlations. Peer delinquency was the strongest correlate of delinquency according to between-individual correlations but was not a cause of delinquency according to forward-lagged within-individual correlations.

Adolescent↗

PubMed2001

Endopolygalacturonase is essential for citrus black rot caused by Alternaria citri but not brown spot caused by Alternaria alternata.

Alternaria citri, the cause of Alternaria black rot, and Alternaria alternata rough lemon pathotype, the cause of Alternaria brown spot, are morphologically indistinguishable pathogens of citrus: one causes rot by macerating tissues and the other causes necrotic spots by producing a host-selective toxin. To evaluate the role of endopolygalacturonase (endoPG) in pathogenicity of these two Alternaria spp. pathogens, their genes for endoPG were mutated by gene targeting. The endoPGs produced by these fungi have similar biochemical properties, and the genes are highly similar (99.6% nucleotide identity). The phenotypes of the mutants, however, are completely different. An endoPG mutant of A. citri was significantly reduced in its ability to cause black rot symptoms on citrus as well as in the maceration of potato tissue and could not colonize citrus peel segments. In contrast, an endoPG mutant of A. alternata was unchanged in pathogenicity. The results indicate that a cell wall-degrading enzyme can play different roles in the pathogenicity of fungal pathogens. The role of a cell wall-degrading enzyme depends upon the type of disease but not the taxonomy of the fungus.

Alternaria↗

PubMed2002

Determining probable causes of ecological impairment in the Little Scioto River, Ohio, USA: part 1. Listing candidate causes and analyzing evidence.

The Little Scioto River in north-central Ohio, USA, is considered to be biologically impaired based on the results of fish and invertebrate surveys. The causes for these impairments were evaluated by means of a formal method. Two of the impairments identified on the stream reach were characterized in detail to support the causal assessment. A list of six candidate causes was developed that included habitat alteration, polycyclic aromatic hydrocarbon contamination, metals contamination, low dissolved oxygen, ammonia toxicity, and nutrient enrichment. Evidence for the causal evaluation was developed with data from the site that associated each candidate cause with the biological responses. Evidence was also developed that drew on data from other locations and laboratory studies, including comparisons of site exposures with screening values and criteria. The formal method increased the transparency of the assessment; candidate causes were clearly listed and the pathways by which they may have produced effects were shown. Analysis of the evidence maximized the utility of available data, which were collected as part of monitoring and research programs rather than to specifically support a causal assessment. This case study illustrates how the stressor identification method can be used to draw conclusions from available data about the most likely causes of impairment and to show what additional studies would be useful.

Animals↗

PubMed1991

Causes of death in a cohort of 50,465 young men--validity of recorded suicide as underlying cause of death.

We studied causes of death in a cohort of all young males (n = 50,465) conscripted for military service in 1969-70. Six hundred eighty three deaths occurred in the cohort during the follow-up through 1983. Injury-related deaths accounted for 75% of all deaths. Of these, 38% were definite suicides, 10% undetermined suicides and 30% motor vehicle accidents. The validity of officially recorded causes of death was studied by scrutinizing all death certificates (n = 683) and forensic reports, including police reports, toxicological and histological data, from a sample (n = 322) of deaths with unclear circumstances. Of 161 officially recorded suicides (E950-959), only one case was reevaluated into poisoning, "undetermined" (E980). Of 47 cases officially recorded "undetermined" (E980-989), 9 were reevaluated into definite suicide (E950-959) although we believe that this is still an underestimation of "true" suicide cases. An alcohol concentration of more than 0.1 g% was found in 45% of all violent deaths (E800-999), 34% of all suicides and 60% of all "undetermined" deaths. We conclude that the causes of death in most cases of injury related death in young age are recorded with high accuracy. Reevaluation of recorded deaths from "undetermined" causes revealed a number of definite suicides, although the "true" number of suicides is difficult to assess even after close scrutiny of the information available.

Accidents↗

PubMed2025

High-fat and low-fat fermented milk and cheese intake, proteomic signatures, and risk of all-cause and cause-specific mortality.

PURPOSE: This study aimed to examine the associations between the intake of high- and low-fat fermented dairy (cheese and fermented milk), their proteomic profiles, and mortality risk. METHODS: This cohort study included 25,187 participants (mean age 57.7 years, 60.9% females). Fermented dairy intake was assessed by a modified diet history method. In a random subset of this cohort (n = 4359), we constructed proteomic signatures for fermented dairy intake using 136 candidate plasma proteins. RESULTS: During 23.5 years of follow-up, 9742 participants died. High-fat cheese (> 20% fat) intake was inversely associated with risk of all-cause mortality (HR for an increment of 20 g/day, 0.97; 95% CI, 0.96-0.99, P < 0.001) and cardiovascular disease mortality (HR, 0.96; 95% CI, 0.93-0.99, P = 0.006). Low-fat cheese intake showed an inverse association with all-cause mortality (HR, 0.98; 95% CI, 0.96-1.00, P = 0.047). Low-fat fermented milk intake was inversely associated with all-cause mortality (HR for an increment of 250 g/day, 0.91; 95% CI, 0.85-0.97, P = 0.006), while high-fat fermented milk (> 2.5% fat) showed null association. A total of 42, 26, 0, and 39 proteins were identified for the signature of high-fat cheese, low-fat cheese, high-fat fermented milk, and low-fat fermented milk, respectively. Inverse associations with all-cause mortality were observed for all three signatures with identified proteins. The identified proteins were involved in biological pathways related to immune response and inflammation. CONCLUSION: Our study indicated that consuming high-fat cheese, low-fat cheese, and low-fat fermented milk was linked to survival benefits. Plasma proteins improve our understanding of the health effects of fermented dairy.

Humans↗

PubMed2006

Intakes of 4 dietary lignans and cause-specific and all-cause mortality in the Zutphen Elderly Study.

BACKGROUND: Plant lignans are converted to enterolignans that have antioxidant and weak estrogen-like activities, and therefore they may lower cardiovascular disease and cancer risks. OBJECTIVE: We investigated whether the intakes of 4 plant lignans (lariciresinol, pinoresinol, secoisolariciresinol, and matairesinol) were inversely associated with coronary heart disease (CHD), cardiovascular diseases (CVD), cancer, and all-cause mortality. DESIGN: The Zutphen Elderly Study is a prospective cohort study in which 570 men aged 64-84 y were followed for 15 y. We recently developed a database and used it to estimate the dietary intakes of 4 plant lignans. Lignan intake was related to mortality with the use of Cox proportional hazards analysis. RESULTS: The median total lignan intake in 1985 was 977 microg/d. Tea, vegetables, bread, coffee, fruit, and wine were the major sources of lignan. The total lignan intake was not related to mortality. However, the intake of matairesinol was inversely associated with CHD, CVD, and all-cause mortality (P </= 0.05 for all) and cancer (P = 0.06). Multivariate-adjusted rate ratios (95% CI) per 1-SD increase in intake were 0.72 (0.53, 0.98) for CHD, 0.83 (0.69, 1.00) for CVD, 0.86 (0.76, 0.97) for all-cause mortality, and 0.81 (0.65, 1.00) for cancer. CONCLUSIONS: Total lignan intake was not associated with mortality. The intake of matairesinol was inversely associated with mortality due to CHD, CVD, cancer, and all causes. We cannot exclude the possibility that the inverse association between matairesinol intake and mortality is due to an associated factor, such as wine consumption.

Aged↗

PubMed2001

Urban cause-specific socioeconomic mortality differences. Which causes of death contribute most?

BACKGROUND: Cause-specific information on socioeconomic differences in health is necessary for a rational public health policy. At the local level, the Municipal Health Service studies these differences in order to support the authorities in policy making. METHODS: Mortality data of the under 65 age group in The Hague were analysed (1982-1991) at residential area level. RESULTS: Causes of death with a high socioeconomic gradient among males were: homicide, chronic liver disease, 'other' external causes of injury, diabetes, bronchitis, emphysema and asthma, and motor vehicle accidents; and among females: diabetes, ischaemic heart disease, 'other' diseases of the circulatory system, signs, symptoms and ill-defined conditions, malignant neoplasm of cervix, and 'other' diseases. Main contributors to the mortality differences between the highest and lowest socioeconomic quartiles among males were: ischaemic heart disease (17.3%), 'other' diseases of the circulatory system (10.2%), signs, symptoms and ill-defined conditions (9.0%), 'other' external causes of injury (8.6%), and chronic liver disease (7.2%); and among females: ischaemic heart disease (25.5%), 'other' diseases (20.1%), signs, symptoms and ill-defined conditions (18.6%), 'other' diseases of the circulatory system (11.0%), and diabetes (9.1%). Among females the contributions of malignant neoplasms of breast (-16.3%) and colon (-5.5%) and suicide (-4.3%) were negative. CONCLUSIONS: The diseases that are the main contributors to urban socioeconomic mortality differences can be influenced by public health policy.

Adolescent↗