It is uncertain whether Latin America and Caribbean (LAC) countries are approaching a single mortality regime. Over the last three decades, LAC has experienced major public health interventions and the highest number of homicides in the world. However, these interventions and homicide rates are not evenly shared across countries. This study documents trends in life expectancy and lifespan variability for 20 LAC countries, 2000–14. By extending a previous method, we decompose differences in lifespan variability between LAC and a developed world benchmark into cause-specific effects. For both sexes, dispersion of amenable diseases through the age span makes the largest contribution to the gap between LAC and the benchmark. Additionally, for males, the concentration of homicides, accidents, and suicides in mid-life further impedes mortality convergence. Great disparity exists in the region: while some countries are rapidly approaching the developed regime, others remain far behind and suffer a clear disadvantage in population health. 相似文献
Motivated by a breast cancer research program, this paper is concerned with the joint survivor function of multiple event times when their observations are subject to informative censoring caused by a terminating event. We formulate the correlation of the multiple event times together with the time to the terminating event by an Archimedean copula to account for the informative censoring. Adapting the widely used two-stage procedure under a copula model, we propose an easy-to-implement pseudo-likelihood based procedure for estimating the model parameters. The approach yields a new estimator for the marginal distribution of a single event time with semicompeting-risks data. We conduct both asymptotics and simulation studies to examine the proposed approach in consistency, efficiency, and robustness. Data from the breast cancer program are employed to illustrate this research.
To assess the relationship between the duration of the second stage of labour and postpartum anaemia during vaginal birth.
Methods
An observational, analytical retrospective cohort study was performed at the “Mancha-Centro Hospital” (Spain) during the 2013–2016 period. Data were collected from 3437 women who had a vaginal birth. Postpartum anaemia was defined as a haemoglobin level below 11 g/dL at 24 h postpartum. A univariate analysis was used for potential risk factors and a multivariate analysis with binary logistic regression to control for possible confounding factors.
Findings
The incidence of postpartum anaemia was 42.0%. The risk of postpartum anaemia did not increase in nulliparous women whose duration of the second stage of labour exceeded 4 h. Compared with multiparous women who delivered between 0 and 3 h, multiparous women with a duration of the second stage of labour beyond 3 h were at higher risk of postpartum anaemia (OR = 2.43 [1.30–4.52]).
Conclusion
The duration of the second stage of labour beyond 4 h is safe for postpartum anaemia in nulliparous women. However in multiparous women, monitoring should increase if the second stage of labour exceeds 3 h given the increased risk of postpartum anaemia. 相似文献
The purpose of this study was to explore LGBTQ women’s experiences with unwritten or formal dress codes at work. I asked: What are LGBTQ women’s experiences in the workplace with appearance management, and what are LGBTQ women’s experiences navigating the written and unwritten dress codes in the workplace? To answer the research question, interviews were conducted with 24 self-identifying LGBTQ women. Six key themes emerged from the data. Themes included (1) expressed sexual identity in appearance, (2) unwritten dress codes in work environments did not always allow for expression of sexual identity in appearance, (3) motivations for pressure or desire to conceal expression of sexual identity in appearance at work, (4) negotiations of revealing or concealing sexual identity in appearance in the workplace impacted levels of comfort and confidence, (5) verbal and nonverbal negative experiences related to appearance at work, and (6) received compliments about appearance at work. 相似文献
Believing action to reduce the risks of climate change is both possible (self‐efficacy) and effective (response efficacy) is essential to motivate and sustain risk mitigation efforts, according to current risk communication theory. Although the public recognizes the dangers of climate change, and is deluged with lists of possible mitigative actions, little is known about public efficacy beliefs in the context of climate change. Prior efficacy studies rely on conflicting constructs and measures of efficacy, and links between efficacy and risk management actions are muddled. As a result, much remains to learn about how laypersons think about the ease and effectiveness of potential mitigative actions. To bring clarity and inform risk communication and management efforts, we investigate how people think about efficacy in the context of climate change risk management by analyzing unprompted and prompted beliefs from two national surveys (N = 405, N = 1,820). In general, respondents distinguish little between effective and ineffective climate strategies. While many respondents appreciate that reducing fossil fuel use is an effective risk mitigation strategy, overall assessments reflect persistent misconceptions about climate change causes, and uncertainties about the effectiveness of risk mitigation strategies. Our findings suggest targeting climate change risk communication and management strategies to (1) address gaps in people's existing mental models of climate action, (2) leverage existing public understanding of both potentially effective mitigation strategies and the collective action dilemma at the heart of climate change action, and (3) take into account ideologically driven reactions to behavior change and government action framed as climate action. 相似文献
This article highlights three dimensions to understanding children's well‐being during and after parental imprisonment which have not been fully explored in current research. A consideration of ‘time’ reveals the importance of children's past experiences and their anticipated futures. A focus on ‘space’ highlights the impact of new or altered environmental dynamics. A study of ‘agency’ illuminates how children cope within structural, material and social confines which intensify vulnerability and dependency. This integrated perspective reveals important differences in individual children's experiences and commonalities in broader systemic and social constraints on prisoners’ children. The paper analyses data from a prospective longitudinal study of 35 prisoners’ children during and after their (step) father's imprisonment to illustrate the arguments. 相似文献
AbstractThe economic mobility of individuals and households is of fundamental interest. While many measures of economic mobility exist, reliance on transition matrices remains pervasive due to simplicity and ease of interpretation. However, estimation of transition matrices is complicated by the well-acknowledged problem of measurement error in self-reported and even administrative data. Existing methods of addressing measurement error are complex, rely on numerous strong assumptions, and often require data from more than two periods. In this article, we investigate what can be learned about economic mobility as measured via transition matrices while formally accounting for measurement error in a reasonably transparent manner. To do so, we develop a nonparametric partial identification approach to bound transition probabilities under various assumptions on the measurement error and mobility processes. This approach is applied to panel data from the United States to explore short-run mobility before and after the Great Recession. 相似文献
Managing risk in infrastructure systems implies dealing with interdependent physical networks and their relationships with the natural and societal contexts. Computational tools are often used to support operational decisions aimed at improving resilience, whereas economics‐related tools tend to be used to address broader societal and policy issues in infrastructure management. We propose an optimization‐based framework for infrastructure resilience analysis that incorporates organizational and socioeconomic aspects into operational problems, allowing to understand relationships between decisions at the policy level (e.g., regulation) and the technical level (e.g., optimal infrastructure restoration). We focus on three issues that arise when integrating such levels. First, optimal restoration strategies driven by financial and operational factors evolve differently compared to those driven by socioeconomic and humanitarian factors. Second, regulatory aspects have a significant impact on recovery dynamics (e.g., effective recovery is most challenging in societies with weak institutions and regulation, where individual interests may compromise societal well‐being). And third, the decision space (i.e., available actions) in postdisaster phases is strongly determined by predisaster decisions (e.g., resource allocation). The proposed optimization framework addresses these issues by using: (1) parametric analyses to test the influence of operational and socioeconomic factors on optimization outcomes, (2) regulatory constraints to model and assess the cost and benefit (for a variety of actors) of enforcing specific policy‐related conditions for the recovery process, and (3) sensitivity analyses to capture the effect of predisaster decisions on recovery. We illustrate our methodology with an example regarding the recovery of interdependent water, power, and gas networks in Shelby County, TN (USA), with exposure to natural hazards. 相似文献