Structure and change in causes of death: An international summary

Abstract Model patterns of the cause structure of mortality at different levels were established for males and females, based on data for 165 national populations. These patterns suggest that the cause of death most responsible for mortality variation is influenza/bronchitis, followed by 'other infectious and parasitic diseases', respiratory tuberculosis, and diarrhoeal disease. Together, these causes typically account for about 60 per cent of the change in level of mortality from all causes combined. Their respective contributions have not depended in an important way on the initial level of mortality. These results - especially tbe importance of the respiratory and diarrhoeal diseases - imply that past accounts may have over-emphasized the role in mortality decline of specific and well-defined infectious diseases and their corresponding methods of control. There is strong statistical support for the suggestion that most of the remainder of mortality variation should be ascribed to changes in cardio-vascular diseases, but that methods of cause-of-death assignment in high-mortality populations have often obscured the importance of these diseases. When death rates from 'other and unknown' causes are held constant, changes in cardio-vascular disease account for about one-quarter of the decline in mortality from 'all causes'.Although the causal factors are poorly established, corroborative results have been demonstrated cross-sectionally in the United States. The composition of the group of populations most deviant from the structural norms is apparently dominated by differentials in the mode of assigning deaths to cardio-vascular disease. However, when broad groups of regions or periods are distinguished, more subtle differences emerge. Controlling mortality level for all causes combined, diarrhoeal diseases are significantly higher in non-Western populations and southern/eastern Europe than in overseas Europe or northern/western Europe. These differences are probably related to standards of nutrition and personal hygiene, but may also reflect climatic factors. Much higher cardio-vascular mortality in overseas European populations than in non-Western populations at similar overall levels probably reflects variation in habits of life. Regional differences in death rates from violence, maternal mortality, respiratory tuberculosis and influenza/pneumonia/bronchitis are briefly noted and commented upon. Cause-of-death structures at a particular level of mortality display some important changes over time. Respiratory tuberculosis and 'other infectious and parasitic diseases' have tended to contribute less and less to a certain level of mortality. They have in part been 'replaced' by diarrhoeal disease, specifically in non-Western populations. These developments reflect an accelerating rate of medical and public health progress against the specific infectious diseases, and a disappointing rate of progress against diarrhoeal disease. Western and non-western populations have shared to approximately the same extent in the accelerating progress against infectious diseases, and developments during the post-war period are more appropriately viewed as an extension of prior trends rather than as radical departures therefrom. For males, cardio-vascular disease and cancer have significantly increased their contribution to a particular level of mortality, while no such tendency is apparent for females. These developments may be related to changes in personal behaviour and in environmental influences whose differential impact on the sexes has been demonstrated in epidemiological studies. Although we have avoided an explicit treatment of age by having recourse at the outset to standardization, certain of the results are apparently reflected in studies of age patterns of mortality. The joint occurrence in non-Western populations and Southern/Eastern populations of exceptionally high death rates from diarrhoeal disease may explain why the 'South' age-pattern, with it high death rates between ages one and five, is often the most accurate referent for use in Latin America and Asia. The fact that the list of populations with the least deviation cause structure is almost exclusively confined to members of the 'West' group of Coale and Demeny may account for the lack of persistent deviation in this group's age patterns. Finally, tbe increasing importance of cardio-vascular disease and neoplasms in cause-of-death structures for males but not females is probably associated with the changing age patterns of male mortality noted by Coale and Demeny.     

Teenage boys and girls in West Germany

In 1970 the Institute for Sex Research at the University of Hamburg conducted a study of 302 males and 300 females aged 16-17. By age 16, 92% of the boys and 50% of the girls had experienced masturbation, 35% of the boys and 30% of the girls had experienced coitus. In the year before the study, 50% of the girls had an orgasm often or always during coitus. Boys achieved 80% of their orgasms through masturbation, 6% through petting, and 14% through coitus. The girls achieve 1/3 of their orgasms through each of these patterns. 18% of the boys and 6% of the girls had had at least 1 homosexual experience. About 70% of the respondents used contraception regularly. 40% to 50% used oral contraceptives and 20%-30% used condoms. The attitudes towards premarital coitus have become more permissive in the last 10 years, but the majority are still in favor of love and fidelity, and are oriented towards marriage.     

Self-help housing in urban Colombia; alternatives for the production and distribution of building materials

Building materials account for a high percentage of the non-land cost of self-help housing. Few studies, however, have examined the use of building materials by self-help builders and the practicalities of producing and distributing the materials in an alternative manner. This paper discusses the nature of construction by self-help in the intermediate-sized Colombian city of Pereira, focusing in particular on the building materials used, and examines various attempts to reduce the cost of building-materials for self-help builders. It is concluded that projects which aim to introduce alternative building materials or retail outlets for self-help builders, need to consider the nature of construction by self-help and the operation of the building-materials market, if they are to have any chance of success.     

Informal shelter providers: Low income households sheltering the homeless

Despite the important role they play in preventing homelessness, those who shelter people who can not afford housing of their own have been neglected by researchers. This study examines the characteristics of these low income informal shelter providers. While informal shelter providers were similar to a comparison group of low income households that did not shelter others, there were also significant differences between the two groups. Informal shelter providers were more much more likely to live in single family dwellings, they were more likely to be long-term residents of the community, they were more likely to have experienced homelessness themselves, and they devoted a disproportionate share of their incomes to housing.     

The office of scientific integrity investigations: The importance of data analysis

Certified Public Accountants serve as independent auditors of financial statements. They perform information‐integrity testing for the economy and society, adding creditability to financial statements prepared by organizations’ management. Investors, creditors, and others rely on these financial statements and the audit report to make business decisions. Auditing work involves gathering evidence (research) and forming an opinion (reporting results) about the “fairness”; of financial statements according to regulatory, legal, and professional rules. As researchers, auditors are subject to a complex network of mechanisms to promote accountability in their work. These mechanisms exist at environmental, professional, and audit‐firm levels. They combine to influence the judgments of individual auditors.     

Soft Regionalism in Action: Examining Voluntary Regional Councils’ Structures,Processes and Programs

In the United States, the voluntary regional council is the dominant organizational form used by local, state and federal agencies to address regional issues. However, research addressing the details of their operations including their structures, processes and programs has been limited. This article reports on a survey of thirty of these regional councils that are located in large metropolitan areas. The findings indicate that these councils reflect a form of “soft regionalism.” Primarily, they facilitate, coordinate and energize, but they don’t have the more expansive capabilities of consolidations, regional governments and annexations.     

A decision support methodology for strategic planning in maritime transportation

This paper presents a decision support methodology for strategic planning in tramp and industrial shipping. The proposed methodology combines simulation and optimization, where a Monte Carlo simulation framework is built around an optimization-based decision support system for short-term routing and scheduling. The simulation proceeds by considering a series of short-term routing and scheduling problems using a rolling horizon principle where information is revealed as time goes by. The approach is flexible in the sense that it can easily be configured to provide decision support for a wide range of strategic planning problems, such as fleet size and mix problems, analysis of long-term contracts and contract terms. The methodology is tested on a real case for a major Norwegian shipping company. The methodology provided valuable decision support on important strategic planning problems for the shipping company.