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At least 19 recordsLinked to original sources

Relating changes in life expectancy to changes in mortality.

I address the problem of what can be said of changes in mortality rates, if one knows how life expectancies change. I note a general formula relating life expectancies in different ages to mortality and prove that if mortality changes over time following a proportional-hazard model, then there is a one-to-one correspondence between life expectancy at birth and mortality rates. Extensions and an application of these results to the analysis of mortality change are presented.

Adolescent↗

Changing mortality patterns that led life expectancy in Japan to surpass Sweden's: 1972-1982.

Between 1972 and 1982, Japan caught up to and then surpassed Sweden as the country with the longest life expectancy. The contributions of different causes of death and age groups to life expectancy changes in males during this time period are examined in detail for these two countries. Even though cerebrovascular disease mortality rates remained lower in Sweden over the entire interval, the rapid gain made by Japan relative to Sweden for this cause of death was a prime factor in Japan's ending the period with a higher life expectancy. Important contributions to life expectancy improvement in Japan came from declining mortality rates in those aged 55 and older.

Adolescent↗

Measuring medical cost and life expectancy impacts of changes in cigarette sales.

A change in cigarette sales triggers changes in medical-care costs and in years of life expectancy. Changes in sales result from changes in excise tax policy, agricultural policy, cigarette design, smoking behavior, or anti-smoking laws. The model uses data on medical costs, life expectancy, cigarette price elasticity, and smoking demographics to estimate medical-cost and life-year impacts for any change in cigarette sales. It takes into account the medical costs incurred by quitters over their extra years of life, the asymmetry of impacts for increases and decreases in sales, and the delayed medical effects for ages not yet subject to the health risks of smoking. For example, a 1% decrease in U.S. cigarette sales increases life expectancy in the United States by 1.45 million years and increases medical-care costs by $405 million for ages 25 to 79. This amounts only to $280 in added medical costs for each extra year of life. By generating aggregate health impacts at the margin, the model becomes a valuable tool for evaluating programs that affect smoking.

Adult↗

Past and future life expectancy increases at later ages: their implications for the linkage of chronic morbidity, disability, and mortality.

Recently life expectancy increases have been noted at advanced ages in the United States. This means a more rapid growth of the elderly U.S. population in general, and of the "oldest-old" population in particular. Thus it is of considerable social and health policy interest to forecast the direction and magnitude of future changes in life expectancy at later ages and the changes in the prevalence of health and disability at later ages consequent to the increases in life expectancy. In the analysis, several prior efforts to predict life expectancy changes using standard demographic techniques are reviewed and reasons for the limitations of such efforts suggested. Results show that mortality changes at advanced ages have very different relations to risk factors than at earlier ages. The analysis also shows that linking morbidity, disability, and mortality in a complete projection of population health changes will require the extension of standard demographic methodologies to utilize information from multiple data sources.

Adult↗

Societies in transition: mortality patterns in Pacific Island populations.

The 22 Pacific Island countries and territories are in a state of demographic and epidemiological transition. Mortality data for the period around 1980 were collected from various sources and are presented in this comparative study. Because death registration in many Pacific countries is deficient some data have been adjusted for underenumeration; and some mortality estimates have been calculated by indirect means, using data from censuses or surveys. Cause of death information is affected by diagnostic inaccuracy and often tabulated in broad categories only; in some Pacific countries cause of death data are only available on hospital deaths. The less developed Melanesian malarious countries and the less developed dispersed atoll nations manifest higher mortality, and higher proportional mortality from infectious disease compared with other states. The more developed US-associated states, two New Zealand-associated states, and New Caledonian Europeans all have reasonably low mortality, and relatively high proportional mortality from cardiovascular disease (CVD). Females have longer life expectancy at birth than males in all countries except Vanuatu and the Solomon Islands. The phosphate-rich island of Nauru presents an atypical picture with considerable adult male mortality from diseases associated with modernization.

Adolescent↗

Computational model for insensible water loss from the newborn.

A mathematical model for predicting insensible water loss from the newborn infant has been developed, and its adjustable parameters have been evaluated using existing data for respiratory and transepidermal water loss components. Subsequently, the model was verified by using an independent set of available data on total insensible loss from naked infants who were not mechanically ventilated and who did not sweat. Under these conditions, the model was capable of correctly predicting the influence of ambient humidity, gestational age, and postnatal age, and in general, the predictions had a precision of +/- 14%, but they tended to underestimate insensible water loss by -16%. The straightforward algebraic form of the model makes it suitable for computerized calculations, which can be readily available at the bedside and quickly updated to account for changes in infant or environmental variables. The model is useful both for anticipating the abnormally large insensible water loss of the premature infant early in life and for computing expected changes in insensible water loss as a result of intentional manipulation of environmental factors, such as incubator temperature or supplemental humidification.

Computer Simulation↗

[3H] thymidine labelling kinetics of peripheral blood lymphocytes in adult thymectomized mice.

The appearance of labelled lymphocytes in the blood of adult thymectomized mice was followed for 21 days after a single injection of [3H] thymidine. The results showed that the expected changes in their life-span resulting from thymic deprivation were not reflected in the kinetics of labelling of these cells with this radioactively-labelled precursor for DNA synthesis. Turnover of DNA and exchange of label between cells must be considered in relation to the results, as had been previously concluded from similar studies of intact mice (Harris, 1975a).

Animals↗

Urinary excretion of chlorpheniramine and pseudoephedrine in humans.

A specific high-pressure liquid chromatographic method for the determination of chlorpheniramine and pseudoephedrine in urine was developed and applied in a urinary excretion study of normal healthy subjects who received a sustained-release dosage form contianing 8 mgof chlorpheniramine maleate and 120 mg of pseudoephedrine hydrochloride. Five subjects received one dose on Day 1, followed by multiple dosing every 12 hr for 7 days without ammonium chloride administration. Four subjects received one dose of the sustained-release dosage form together with ammonium chloride. Urine samples were collected during the 1st day and at steady state. The method is specific and simultaneously determines choorpheniramine, two metabolites (mono- and di-desmethylchlorpheniramine), pseudoephedrine, and norpseudoephedrine. The assay recovery was less than 97% (0.06-3 microgram/ml) for chlorpheniramine maleate and less than 98% (1.5-75 microgram/ml) for pseudoephedrine hydrochloride. Excretion of chlorpheniramine and its two metabolites in urine was enhanced after ammonium chloride administration. At steady state, a change in urine pH from 5.69 to 6.46 resulted in more than a 25% decrease in chlorpheniramine and monodesmethylchlorpheniramine excretion. In spite of expected changes in its biological half-life, the overall amount of unchanged pseudoephedrine excreted in urine was not affected by urine pH, presumably because it is primarily excreted in urine as intact drug.

Chlorpheniramine↗

[Aging in one's occupation: occupational and life's perspectives of elderly male and female employees].

The consequences of social change for the workforce are discussed. In our society of the future we will have to deal with an aging industry as a result of the increasing number of older employees. Furthermore, we expect changes in relation to mandatory retirement in establishing the "Rentenreform 1992" (Retirement age policy). The necessity of intergenerational exchange to avoid "ageism" is explained. The impact of technology on life-long learning and qualifications of older workers is pointed out. Finally, we describe the pluralism of life courses as a characteristic of social change in relation to gender-effects.

Aged↗

Relationship between participant-reported outcomes, residual beta cell function and metabolic parameters in youth with newly diagnosed type 1 diabetes.

AIMS/HYPOTHESIS: Clinical trials of interventions to preserve beta cell function in new-onset type 1 diabetes frequently employ participant-reported outcome measures (PROMs). However, the expected changes in PROMs scores immediately following diagnosis and their association with residual beta cell function, metabolic markers and continuous glucose monitoring (CGM) are unclear. METHODS: Repeated PROMs including Paediatric Quality of Life Inventory diabetes module (PedsQL) and hypoglycaemia fear survey (HFS) were recorded from participants aged 10-18 years with newly diagnosed type 1 diabetes and their parents in two clinical trials: CLOuD (N=97, hybrid closed loop [HCL] vs multiple daily injections [MDI]) and USTEKID (N=72, ustekinumab immunotherapy vs placebo). Scores were compared with serial mixed meal-stimulated C-peptide levels (AUC C-peptide), HbA1c and CGM data. RESULTS: PedsQL and HFS scores for children/adolescents and their parents showed wide variation between individuals but did not change substantially within individuals over the first 48 months from diagnosis. Baseline scores were highly predictive of scores at 12-48 months (p<0.001). PedsQL scores were higher (better) in those reported by children/adolescents than by their parents (p<0.01). In contrast, HFS scores were higher in parents than children (p<0.001), indicating more fear. Strong correlations were observed between child and parent scores (p<0.001). No significant improvement in these scores was detected following intervention (ustekinumab or HCL). Meta-analysis revealed modest but statistically significant associations between HbA1c and PedsQL (&#x3b2;(std)=-0.11; 95% CI -0.20, -0.03) and HFS (&#x3b2;(std)=0.11; 95% CI 0.00, 0.21), and between CGM time in range and PedsQL (&#x3b2;(std)=0.14; 95% CI 0.03, 0.26) but not HFS (&#x3b2;(std)=-0.05; 95% CI -0.16, 0.06). Beta cell function (AUC C-peptide) was strongly associated with HbA1c (&#x3b2;(std)=-0.29; 95% CI -0.39, -0.20) and CGM time in range (&#x3b2;(std)=0.41; 95% CI 0.30, 0.52). Higher beta cell function showed a trend towards better PedsQL (&#x3b2;(std)=0.11; 95% CI -0.03, 0.25) and lower HFS (&#x3b2;(std)=-0.05; 95% CI -0.17, 0.07) but this did not reach statistical significance. CONCLUSIONS/INTERPRETATION: PedsQL and HFS scores changed little during the first 48 months after diagnosis of type 1 diabetes. These scores showed modest but statistically significant associations with measures of glucose management (HbA1c and CGM time in range), whereas the relationships with residual beta cell function (C-peptide) were weaker and did not reach significance. The modest size of these effects suggests current PROMs capture only limited aspects of the clinical benefit associated with beta cell preservation. Future research should incorporate psychometric instruments that are specifically adapted for young people using modern diabetes technologies and undergoing disease-modifying therapy, to ensure outcomes are meaningfully represented in early-stage type 1 diabetes trials.

Adolescent↗

Measuring function and health status in rheumatic disease clinical trials.

We have summarized the limitations of traditional outcome measures in rheumatology, reviewed the growing field of measures emphasizing the patient's perception of improvement, and provided guidelines for choosing a specific instrument for a clinical trial. Newer measures have measurement properties equal to or surpassing traditional measures, but no one ADL or quality-of-life instrument can be used to assess outcome in every situation as no one test can indicate success of a treatment in a chronic disease. An instrument needs to be judged by the following criteria: Is it metrically sound? Does it fit the socio-demographic characteristics of the target population? Does it measure the specific changes which are likely to be affected by the treatment? Will it capture or measure the expected changes?

Arthritis, Rheumatoid↗

Effects of coronary risk reduction on the pattern of mortality.

Control of coronary risk factors is associated with lower age-specific risks, but people will then live longer, with increased exposure to the higher mortality rates of the elderly. Expected changes in pattern of mortality, based on the 15-year follow-up of men in the Whitehall study, have been calculated. Non-smokers live longer than smokers, but death (when it comes) is more likely to be due to heart attack and less likely to be due to cancer. By contrast a lower level of plasma cholesterol, which is also associated with longer life, is expected to reduce the lifetime risk of fatal heart attack, its place then being taken by a typical mixture of other causes of death.

Age Factors↗

The development of migration expectations: changes throughout the lifecourse.

This research examines how the relative influence of factors that determine an individual's expectations of moving varies throughout the lifecourse. Factors representing personal characteristics, ties to origin, and ties to potential destinations were used to discriminate between expected migrants and nonmigrants in three population subgroups representing different stages of life. These subgroups included a general adult population, a preretirement population, and an elderly population. The results indicate that personal characteristics are most influential among preretirement persons, ties to origin are most influential among the general and elderly populations, and ties to potential destinations are influential among all population subgroups.

Adult↗