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PubMed2003

Cross-national determinants of quality of life from six longitudinal studies on aging: the CLESA project.

BACKGROUND AND AIMS: The Comparison of Longitudinal European Studies on Aging (CLESA) Project, here presented for the first time, is a collaborative study involving five European and one Israeli longitudinal study on aging. The aim of this paper is to describe the methodology developed for the harmonization of data and the creation of a Common Data Base (CDB), and to investigate the distribution of some selected common variables among the six countries. The design of each study is briefly introduced and the methodology leading to the harmonization of the common variables is described. METHODS: The study base includes data from five European countries (Finland, Italy, the Netherlands, Spain, Sweden) and Israel, for older people aged 65-89 living both in the community and in institutions (total, 11557 subjects). For two age classes (65-74 and 75-84), the prevalence ratios or the mean values of the following selected variables are provided: a) sociodemographic variables; b) health habits; c) health status; d) physical functioning; e) social networks and support; and f) health and social services utilization. RESULTS: Statistically significant differences were found between most of the investigated characteristics across the CLESA countries, with very few exceptions. While some of the differences found may be due to cultural variations, others require further investigation and should be encompassed in the main framework of the Project, which is to identify predictors of hospitalization, mortality, institutionalization and functional decline. CONCLUSIONS: A common data base is available for the study of the aging process in five European and one Israeli population. These data provide a unique opportunity to identify common risk factors for mortality and functional decline and increase our understanding of country-specific exposures and vulnerability.

Aged↗
PubMedDate not supplied

Predictors of mortality: an international comparison of socio-demographic and health characteristics from six longitudinal studies on aging: the CLESA project.

PURPOSE: Multiple factors contribute to mortality in the elderly, but the extent to which traditional factors contribute independently to mortality in different countries is not known. Our objective is to determine the differential impact of socio-demographic variables, selected diseases, health habits and disability on all-cause mortality, among older people living in five European countries and Israel. METHODS: From six longitudinal studies on aging (TamELSA-Tampere (Finland), CALAS-Israel, ILSA-Italy, LASA-Netherlands, AL-Leganés (Spain), SATSA-Sweden), a harmonized common database was created in the context of the CLESA Project (Cross-national determinants of quality of life and health services for the elderly). A common five-year follow-up was used. RESULTS: The highest mortality rate was found in Tampere among females (98.7%) and in Israel among males (108.3%), whereas the lowest was observed in Leganés for males (72.3%) and in The Netherlands for females (44.6%). In multivariate models, some predictors were homogeneously, significantly distributed across the six countries, including older age (HR = 1.57) and male sex (HR = 1.60) among the socio-demographic variables; smoking status (HR = 1.15) and alcohol consumption (HR = 0.81) among the health habits variables; presence of heart disease (HR = 1.34), diabetes (HR = 1.46), cancer (HR = 1.93), respiratory disease (HR = 1.19), and disability (HR = 2.92) among the health status variables. Marital status, education, and drug use did not have homogeneous effects in the six countries. DISCUSSION: This large international study shows that multiple factors contribute to increased risk of all cause mortality among older people and that most risk factors are similar across countries. Disability, age greater than 80 years, cancer and male sex were identified as the strongest common risk factors of mortality.

Aged↗
PubMed2003

Monitoring health inequalities: life expectancy and small area deprivation in New Zealand.

BACKGROUND: Socioeconomic and ethnic inequalities in health are of great concern, and life expectancy provides a readily understood means of monitoring such inequalities. The objectives of this study are to (1) measure life expectancy by socioeconomic deprivation and ethnicity, and (2) describe trends in the deprivation gradient in life expectancy since the mid-1990s. METHODS: Three years of national mortality data have been combined with mid-point population denominators to produce life tables within nationally determined levels of small area deprivation (NZDep96) for three ethnic group: European, Mäori and Pacific peoples. This process has been repeated for the periods 1995-97, 1996-98, 1997-99 and 1998-2000. RESULTS: There was a strong relationship between increasing small area deprivation and decreasing life expectancy. Through the mid- to late 1990s, males living in the most deprived small areas in New Zealand experienced life expectancies at birth approximately nine years less than their counterparts living in the least deprived areas; for females the corresponding difference was under seven years.Mäori and Pacific life expectancies at birth were lower than those of Europeans at each level of deprivation.Over the study period (1995-2000) the gradient in life expectancy across deprivation deciles remained stable. CONCLUSION: Small area deprivation analyses of life expectancy could be repeated routinely at regular intervals, which would provide a useful approach to monitoring trends in socioeconomic, geographic, ethnic and gender inequalities in mortality.

Journal Article↗
PubMed2006

Coronary arteries: imaging, reconstruction, and fluid dynamic analysis.

Atherosclerosis is the underlying cause of most cardiovascular-related deaths in industrialized nations. Determining the etiology of atherosclerosis and detecting lesions in the early stages of the disease for possible pharmacological or mechanical intervention have been challenges facing cardiovascular researchers. In addition to genetic and environmental factors, the formation and growth of atheroma have been linked to the complex fluid dynamics and mass transport in these arterial segments. This article reviews the current state of affairs in imaging modalities and image processing techniques that allow the visualization and morphologically realistic reconstruction of coronary arterial geometry to aid in the diagnosis and treatment of coronary artery disease (CAD). In addition, studies pertaining to our current understanding of the complex flow dynamics in the coronary arteries and the relationship between fluid-induced stresses on the initiation and growth of the atherosclerotic lesions are also reviewed. The article concludes with a brief discussion on possible future directions of research that will advance our knowledge of this challenging problem.

Animals↗
PubMed2000

Dependent convergence: the importation of technological hazards by semiperipheral countries.

This article complements the substantial body of literature produced over the last three decades on the export of hazards from developed countries to developing countries. After reviewing the central arguments proposed by this literature, the authors add to the debate by focusing on the role of national actors in the importation of these hazards, based on the experience of late 1970s' developments in the petrochemical industry in Brazil. The Brazilian case indicates that social struggles and/or interactions among actors in developing and developed nations determine to what extent hazardous technologies are imported without environmental controls and to what extent their hazardous effects are controlled by these nations. This study suggests that the future development of a more inclusive theory of export-import of hazardous technologies and products should take into account the dialectical relationship established between social actors internal to the exporting and importing countries.

Brazil↗
PubMed1970

CMA's proposal for a voluntary, universally available Health Benefits Program. A socio-economic report of the Bureau of Research and Planning, California Medical Association.

The May 4, 1970 issue of the American Medical News contains an article on a report released in April by the British Medical Association following a two-year study of the British National Health Service. Although the BMA study is oriented to the specific program as it has evolved in Great Britain since 1946, its main thrust is in the development of a system of voluntary health insurance which would provide for greater consumer choice, based upon nationally determined guidelines and regulations. BMA's recommendations would have the NHS utilize a combination of tax-supported and voluntary-supported mechanisms in providing medical services to various segments of the population, based upon categories of illness and income levels. Since the BMA proposal as reported in the AMA News parallels in some respects the one approved by the CMA House of Delegates and submitted to the AMA House of Delegates for its consideration, the reader will be interested in seeing the concept for a Voluntary Universally Available Health Benefits Program, independently developed by the California Medical Association. It is interesting to note that the CMA proposal attempts to avoid many of the problems with which the NHS has been identified, and at the same time would establish a single, coherent, integrated approach for development over the next decade, incorporating public programs into a unified system of medical care which utilizes the multiplicity of voluntary health insurance approaches and mechanisms.

California↗
PubMed1994

Explaining immigrant naturalization.

"Prior research on immigrant naturalization has focused mainly on the effects of immigrants' adaptation experiences and demographic characteristics on their propensity to naturalize. This article proposes a broader analytical framework which incorporates immigrants' individual characteristics and larger social contexts in the country of origin and the country of destination to explain the likelihood of citizenship acquisition. The framework is tested for a cohort of recent immigrants, using the PUMS data from the 1980 U.S. census. The results show that economic, political, social, cultural and geographical conditions in the country of origin, and immigrants ethnic communities and urban concentration in the country of destination, to a large extent influence immigrants' propensity for naturalization and that, net of the contextual factors, many of the immigrants' adaptation and demographic characteristics are also significant predictors of citizenship acquisition."

Acculturation↗