Discretion in accounting for pensions under IAS 19:using the ‘magic telescope’?

We use a panel data set of UK-listed companies over the period 2005–2009 to analyse the actuarial assumptions used to value pension plan liabilities under IAS 19. The valuation process requires companies to make assumptions about financial and demographic variables, notably discount rate, price inflation, salary inflation and mortality/life expectancy of plan members/beneficiaries. We use regression analysis to analyse the relationships between these key assumptions (except mortality, where disclosures are limited) and company-specific factors such as the pension plan funding position and duration of pension liabilities. We find evidence of selective ‘management’ of the three assumptions investigated, although the nature of this appears to differ from the findings of US authors. We conclude that IAS 19 does not prevent the use of managerial discretion, particularly by companies whose pension plan funding positions are weak, thereby reducing the representational faithfulness of the reported pension figures. We also highlight that the degree of discretion used reflects the extent to which IAS 19 defines how the assumptions are to be determined. We therefore suggest that companies should be encouraged to justify more explicitly their choice of assumptions.

A magyar öngondoskodás sajátosságai

A magyar nyugdíjrendszerben 1998 óta egymás mellett működik a felosztó-kirovó és a kötelező tőkefedezeti pillér. Ezt a paradigmatikusnak tekintett reformot követően is több változtatás zajlott az elmúlt években, amelyek lényegében a nyugdíjparaméterek módosítására irányultak. Mára a nyugdíjreformról szóló diskurzus világszerte újra általánossá vált. A magyar nyugdíjviták középpontjában nem elsősorban az idősödő népesség növekvő aránya, hanem az alacsony foglalkoztatás és a csekély jogosultságszerzés áll. A hozzászólások ma már nem a felosztó-kirovó versus tőkefedezeti rendszer kérdéskörét érintik. A vitában újra és újra előkerül az öngondoskodás hangsúlyozása. A tanulmány egy felmérés adatain keresztül elemzi az öngondoskodás különböző formáinak elterjedtségét. A kérdőív tanulsága szerint a megkérdezettek jellemzően nem saját maguk hozták meg döntéseiket a vizsgált kérdésekben - a nyugdíjrendszerről és saját várható nyugdíjas élettartamukról korlátozott (és néha téves) ismeretekkel rendelkeznek. Az emberek öngondoskodásának túlhangsúlyozása a szerzők szerint meg nem engedhető optimizmus. /===/ Unfunded and mandatory funded pillars of the Hungarian pension system have been operating simultaneously since 1998. This reform, seen as paradigmatic, has undergone several changes in recent years, designed essentially to alter the pension parameters. Discourse on pension reform has become general again throughout the world. The pension debates in Hungary have focused less on the rising proportion of the elderly than on low employment and eligibility. Contributions to the debate these days are not about the question of an unfunded versus a funded system. The emphasis has repeatedly been on self-provision. The study analyses by means of survey data the extent of the various forms of self-provision. The survey shows that respondents have not typically made decisions of their own on the matter, for which they have limited (and sometimes false) information about the pension system and their life expectancy as pensioners. According to the authors, it is impermissibly optimistic to place excessive emphasis on people’s ability to provide for themselves.

A nemzetgazdasági versenyképesség sportszakmai és gazdasági aspektusai = Sport and economic aspects of competitiveness on national level

Tanulmányunk a gazdasági versenyképességgel, kiemelten annak nemzetgazdasági szintű vetületével és a sport esetében történő értelmezésével foglakozik. A gazdasági versenyképesség esetén kiemelten kezeljük az IMD és a WEF versenyképességi rangsorait, a sport esetén pedig szétválasztjuk a hivatásos és a szabadidősportot. A hivatásos sport esetén bemutatjuk a sportszakmai versenyképességet indikáló és a sportszakmai versenyképességre hatással lévő gazdasági és társadalmi mutatókat egyaránt. Összehasonlítási csoportot képeztünk, amelyben Magyarország és a környező országok szerepelnek és a komparatív elemzés kiterjed a gazdasági és a sportszakmai versenyképességre, valamint a sportszakmai versenyképességre ható gazdasági és társadalmi tényezőkre egyaránt. A sportszakmai versenyképességet az olimpiai érmek számával és azok pontértékével mérjük, amit az olimpiák teljes történelmére és az elmúlt 20 év különböző szakaszaira egyaránt vizsgálunk, míg a gazdasági és társadalmi tényezőket csak a mondanivalónk szempontjából legrelevánsabb évekre, az új évezredre vizsgálunk. A hivatásos sporttal kapcsolatos versenyképességi kérdésekből azt a következtetést vontuk le, hogy Magyarország történelmi sportszakmai eredményességének fenntartását a jelen gazdasági és társadalmi tényezők nem igazolják, sőt az elmúlt időszak visszaesését támasztják alá és a Londoni olimpián való szereplésünkkel kapcsolatban inkább az összehasonlítási csoporton belüli további visszacsúszást, mintsem az eredmény javulását támogatják. A tanulmányban azt állítjuk, hogy egyéni, vállalati és makrogazdasági versenyképességet is javíthat a szabadidősport. Mikro szinten, majd makrogazdasági szinten elemeztük a szabadidősport hatásait, valamint próbáltunk választ keresni arra a kérdésre, hogy hogyan válhat az egyén, a vállalat és végső célként a gazdaság versenyképesebbé a fizikai aktivitás által. A kevesebb betegség és egészségügyi kiadás, vagy éppen a kedvezőbb várható élettartami mutatók mellett termelékenység-növekedés, a versenyképességi rangsorokban pedig előkelőbb helyezések érhetők el. ______ Our paper tackles the concept of competitiveness in the national level and interprets it also in the field of sport as well. In the economics field we focus on the competitiveness rankings of IMD and WEF and in the sport field we differentiate between professional and leisure sport. In the case of professional sport we introduce the measures of sport competitiveness and its influencing economic and social factors as well. We have made a peer group which contains Hungary and its neighboring countries and the comparative study tackles the sport competitiveness and the influencing economic and social factors as well. We measure sport competitiveness with the Olympic medal count and the medals point value, which is counted in the whole Olympic history, and different phases of the last 20 years. The economic and social factors are compared only in the new millennia as this is the most relevant time frame of this study. From the competitiveness analysis of professional sport we concluded that the maintenance of Hungary’s historical sport successes is not proved by nowadays economic and social factors, however they support the past years decline. These factors also indicate that in London (2012)we would rather slip one more position back in the peer group, than rise again from our ashes. In our opinion leisure sport could enhance the competitiveness of individuals, companies, and economy also. We analysed the effects of leisure sport on the microeconomic and macroeconomic level, and tried to find answer to that question how could be individuals, companies, and economy more competitive through leisure sport. Besides less illness and health care expenditures, longer life expectancy, productivity growth, countries could be well placed in competitiveness’ rankings.

Demográfiai hatások és implicit hozamok kapcsolata a nyugdíjrendszerekben = The relationship of demographic effects and implicit returns in pension systems

E tanulmány központi témája a nyugdíjrendszerek implicit hozama. Az együtt élő nemzedékek figyelembevételével felépülő nyugdíjmodellekben kétféle implicit hozamot különböztetünk meg. A hosszmetszeti implicit hozamot valamely adott nemzedékhez tartozó, különböző években esedékes pénzáramlások alapján, a keresztmetszeti implicit hozamot pedig több, különböző nemzedék adott évben jellemző pénzáramlásai alapján számíthatjuk ki. A hosszmetszeti és keresztmetszeti implicit hozamok értékeit és a közük lévő összefüggéseket a tőkefedezeti, a névleges egyéni számlás és a hagyományos felosztó-kirovó nyugdíjrendszerek egyszerű elméleti modelljeiben hasonlítjuk össze. A számításokhoz használt modellkeret fontos eleme a várható élettartam figyelembevétele. Az eredmények azt mutatják, hogy a maximális és a várható élettartam eltérésekor a hosszmetszeti és a keresztmetszeti implicit hozamok közötti összefüggések még egyszerű elméleti modellben is meglehetősen összetettek lehetnek. ____ The focus of this study is on the implicit returns of pension systems. Two types are analysed using an overlapping generations model: the calculation of longitudinal\" return is based on cash flows in different years belonging to a given generation, while cross-section\" implicit return is calculated in a given year with cash flows of multiple generations. Values and relationships of longitudinal and cross-section implicit returns are compared in simple theoretical models of fully funded\", notional defined-contribution\" and traditional pay-as-you-go\" pension systems. An important element of the theoretical model is the inclusion of an assumption about life expectancy. Model results point to the complexity of the relation between longitudinal and cross-section implicit returns, if expected and maximum life expectancy differ. The study maps and introduces these complex relationships.

The influence of perception of forgetting and gender, ethnicity, and closeness on likelihood of caregiving

As life expectancy increases, the population of older adults is increasing rapidly. The caregiving of older parents by adult children has become a normative experience. Much of the gerontological literature has examined the caregiving experience, particularly in terms of the stresses involved. However, research is only beginning to examine the factors which motivate adult children to begin caregiving. The research described here examined how an elderly parent's memory behavior might influence caregiving decisions. In addition, gender, ethnicity, and parent-adult child closeness were examined to explore how these individual difference variables might influence those caregiving decisions.^ Participants read one of two vignettes describing a social visit with an elderly widow (target). In the vignette, the elderly target experiences several instances of forgetting. The vignettes depicted forgetting behavior established in pilot work as normal or serious. The normal forgetting vignette did not arouse concern and the serious forgetting vignette did arouse concern when the middle-aged participants imagined their mothers in the role of the vignette target. Participants rated their likelihood of engaging in eight caregiving behaviors if their mothers behaved like the vignette target. They also rated their closeness with their own mothers.^ Multivariate analyses of variance indicated main effects for vignette type, gender, ethnicity, and attachment. The likelihood of caregiving was higher when forgetting was more serious and when participants were female, Hispanic, and were highly attached to their mothers. Interaction effects showed that gender differences decreased with increased seriousness of forgetting, and ethnic differences were only significant for the normal forgetting condition.^ Multiple regression analyses indicated that attachment was the most significant predictor of likelihood of caregiving. Gender and ethnicity predicted specific caregiving behaviors. Females were more likely to engage in phoning and cooking, and Hispanics were more likely to engage in visiting and suggesting mother move in. ^

Diferenciais de mortalidade adulta por nível de escolaridade no Brasil e regiões

The study of mortality by various differentials has been an important tool to guide public health policies, due to better describing the events of deaths in a population. This research aims to seek disparities in mortality according to educational level, sex and adulthood in large Brazilian regions and consequently for Brazil as a whole. A vast literature has shown that people with more education tend to have lower risk of death. Studies on inequalities in mortality by level of education in Brazil are still very specific and has still known very little about Brazil about mortality according to educational level, due to lack of information about the well-filled school in the records of deaths arising from the Mortality Information System (MIS) of the Ministry of Health. This data source has shown improvement in the coverage of sub reports in the last decade, however, it has still perceived negligence in completing the question regarding schooling of death (about 30% of registered deaths in 2010 to Brazil, Given this scenario, this work contributes to the national literature on the behavior of adult mortality differentials having as proposed, using data from the new variable mortality of the 2010 Census (CD 2010), assuming the characteristics of education of the head the household for deaths occurring in the same. It is therefore considered that the probability of mortality is homogeneous within the household. Events of deaths were corrected only for the records come from households where the head possessed levels of schooling and Instruction Elementary Education No Incomplete and Primary Education and Secondary Education Complete Incomplete through the Generations Extinct Adjusted method. With deaths already corrected, probabilities of death were calculated between 15 and 60 years life, as well as tables by sex and level of education to all regions of Brazil. No que se refere às probabilidades de morte por idade, nas idades entre 15 e 60 anos as maiores probabilidades seguem um gradiente, maior probabilidade para os menos escolarizados. Results corroborate the literature, the more educated the population is, the greater the life expectancy. In all Brazilian regions, life expectancy of the female population is greater than that of men at all levels of schooling. With respect to probabilities of death by age between the ages of 15 and 60 years the most likely follow a gradient, most likely to the least educated. At older ages (from 70 years), this behavior has presented another pattern, the lowest level of education has the lowest odds in the regions, North, Northeast, South and Midwest, except in the Southeast region

Trabalho e saúde: análise da relação entre condições de trabalho e motivação no emprego e suas interfaces com a saúde dos profissionais nos hospitais públicos

Health results from the interaction of biological, social, economic, political and cultural factors. Under this perspective, we aim to analyze the relationship among working in public emergency hospitals and the health-sickness of the professionals who work there. We are based in a quantitative and qualitative research, in which 240 health professionals (doctors, nurses, social workers, psychologists, dentists, nutritionists, audiologists, physiotherapists and occupational therapists) answered a survey. All of them recognize the importance of work to guarantee favorable conditions to good health. However, they highlight its physical and mental wear effects on workers like stress, absence of a healthy life-style, high blood pressure, musculoskeletal, gastrointestinal and sleep disorders. It becomes urgent to face this reality, to enhance professionals' health and, consequently, the quality of user’s assistance, since the illness of health workers is strongly correlated with the existing health model in society.

Development of an instrumented customizable total knee prosthesis for experimental tests.

Total knee arthroplasty (TKA) has revolutionized the life of millions of patients and it is the most efficient treatment in cases of osteoarthritis. The increase in life expectancy has lowered the average age of the patient, which requires a more enduring and performing prosthesis. To improve the design of implants and satisfying the patient's needs, a deep understanding of the knee Biomechanics is needed. To overcome the uncertainties of numerical models, recently instrumented knee prostheses are spreading. The aim of the thesis was to design and manifacture a new prototype of instrumented implant, able to measure kinetics and kinematics (in terms of medial and lateral forces and patellofemoral forces) of different interchangeable designs of prosthesis during experiments tests within a research laboratory, on robotic knee simulator. Unlike previous prototypes it was not aimed for industrial applications, but purely focusing on research. After a careful study of the literature, and a preliminary analytic study, the device was created modifying the structure of a commercial prosthesis and transforming it in a load cell. For monitoring the kinematics of the femoral component a three-layers, piezoelettric position sensor was manifactured using a Velostat foil. This sensor has responded well to pilot test. Once completed, such device can be used to validate existing numerical models of the knee and of TKA and create new ones, more accurate.It can lead to refinement of surgical techniques, to enhancement of prosthetic designs and, once validated, and if properly modified, it can be used also intraoperatively.

« Utilisation des services de santé chez les personnes âgées : association avec la maladie chronique et l’incapacité »

Diverses publications soulignent l'augmentation de l'espérance de vie et avec elle, le vieillissement mondial de la population. Ce processus se poursuivra à l'avenir, ainsi que son influence sur l’incidence et la prévalence de l'incapacité. Chez les personnes âgées, l’incapacité, les maladies chroniques et leur association constituent un sujet important dans le domaine de la santé publique en raison de l'effet qu'ils ont sur la demande des services de santé. Le but de ce mémoire est d’examiner quelle est la contribution respective des maladies chroniques et de l'incapacité dans l'utilisation des services de santé chez les personnes âgées et de leur interaction. Il s’agit de savoir si l'association entre la maladie chronique et l'utilisation des services de santé est modifiée par l’incapacité prenant en compte les caractéristiques de l'individu et son environnement. Ce travail est basé sur le modèle comportemental proposé par Andersen et Newman et le modèle du processus d’incapacité de Verbrugge et Jette. Pour répondre à l’objectif, nous utilisons les données du projet de recherche “ FRéLE ” (Fragilité, une étude longitudinale de ses expressions), réalisé durant la période 2010 -2013 auprès d’un échantillon de 1643 personnes âgées vivant dans la communauté au Québec. L’incapacité est évaluée à l’aide de deux indicateurs : les AVQ et les AVD. Les maladies chroniques sont mesurées par l’indice fonctionnel de comorbidité (IFC). La dépression est évaluée selon les critères de l’échelle de dépression gériatrique (EDG). L’état cognitif est mesuré par l'évaluation cognitive de Montréal (MoCA). Les facteurs de prédisposition comportent l’âge, le sexe, l’ethnicité et le niveau scolaire. Les facteurs facilitateurs incluent le revenu et le réseau social, ce dernier étant mesure par la présence ou non d’une personne de soutien et son lien avec la personne âgée. Divers modèles de régression sont adoptés pour identifier les facteurs statistiquement significatifs du modèle comportemental d’Andersen et Newman et du modèle du processus d’incapacité de Verbrugge et Jette. Nos résultats ont montré que, si le rôle des prédicteurs de l’utilisation varie en fonction du type de services de santé utilisé, l’utilisation s’accroît principalement avec le nombre de maladies chroniques. En ce qui concerne l’interaction entre la maladie chronique et l’incapacité, nos résultats ont révélé que l’interaction n’est statistiquement significative pour aucun des services analysés. Compte tenu de la diversité et les besoins de la population âgée, caractérisée par une prévalence élevée de maladies chroniques et d'incapacités, l’étude des facteurs impliqués dans l'utilisation des services de santé sera utile pour la mise en œuvre d’une offre de services, plus conforme aux besoins de cette population

JNK regulates Fas receptor mediated apoptosis in prostate cancer cell lines

Prostate Cancer is a disease that primarily affects elderly men. The incidence of prostate cancer has been progressively increasing in the western world over the last two decades. Life expectancy and diet are believed to be the main factors contributing to this increase in prevalence. Prostate cancer is a slowly progressing disorder and patients often live for over 10 years after initially being diagnosed with prostate cancer. However, patients with hormone refractory prostate cancer have a poor prognosis and generally do not survive for longer than 2 or 3 years. Hormone refractory prostate cancer is responsible for over 200,000 deaths each year and current chemotherapeutic regimens are only useful as palliative agents. The long-term survival rate is poor and chemotherapy does not significantly increase this. Cell lines derived from hormone refractory tumours usually display elevated resistance to many cytotoxic drugs. The Fas receptor is a membrane bound protein capable of binding to a ligand called Fas ligand. Engagement of Fas receptor with Fas ligand results in clustering of Fas receptor on the plasma membrane of cells. A number of proteins responsible for initiating apoptosis are recruited to the plasma membrane and are activated in response to elevated local concentrations. This series of events initiates a proteolysis cascade and that culminates in the degradation of structural and enzymatic processes and the repackaging of cellular constituents within membrane bound vesicles that can be endocytosed and recycled by surrounding phagocytic cells. The Fas receptor is believed to be a key mechanism by which immune cells can destroy damaged cells. Consequently, resistance to Fas receptor mediated apoptosis often correlates with tumour progression. It has been reported that prostate cancer cell lines display elevated resistance to Fas receptor mediated apoptosis and this correlates with the stage of tumour from which the cell lines were isolated. JNK, a stress-activated protein kinase, has been implicated both with increased survival and increased apoptosis in prostate cancer. Elevated endogenous JNK activity has been demonstrated to correlate with prostate cancer progression. It has been shown that endogenous JNK activity increases the expression of anti-apoptotic proteins and can increase the resistance of prostate cancer cell lines to chemotherapy. In addition, elevated endogenous JNK activity is required for improved proliferation and transformation of a number of epithelial tumours. However, prolonged JNK activation in response to cytotoxic stimuli can increase the sensitivity of cells to apoptosis. Prolonged JNK activity appears to induce the expression of a separate set of genes responsible for promoting apoptosis. Our group has recently shown that activation of JNK by chemotherapeutic drugs can sensitise DU 145 prostate carcinoma cells to Fas receptor mediated apoptosis. In order toidentify novel targets for treating hormone refractory prostate cancer we have investigated the role of JNK in Fas receptor mediated apoptosis. We have demonstrated that prolonged JNK activation is defective in DU 145 cells in response to Fas receptor activation alone. Co-administering anisomycin, a JNK agonist, greatly enhances the ability of DU 145 cells to undergo apoptosis by increasing the rate of Caspase 8 cleavage. We also investigated the role of endogenous JNK activity in Fas receptor mediated.

« Utilisation des services de santé chez les personnes âgées : association avec la maladie chronique et l’incapacité »

Diverses publications soulignent l'augmentation de l'espérance de vie et avec elle, le vieillissement mondial de la population. Ce processus se poursuivra à l'avenir, ainsi que son influence sur l’incidence et la prévalence de l'incapacité. Chez les personnes âgées, l’incapacité, les maladies chroniques et leur association constituent un sujet important dans le domaine de la santé publique en raison de l'effet qu'ils ont sur la demande des services de santé. Le but de ce mémoire est d’examiner quelle est la contribution respective des maladies chroniques et de l'incapacité dans l'utilisation des services de santé chez les personnes âgées et de leur interaction. Il s’agit de savoir si l'association entre la maladie chronique et l'utilisation des services de santé est modifiée par l’incapacité prenant en compte les caractéristiques de l'individu et son environnement. Ce travail est basé sur le modèle comportemental proposé par Andersen et Newman et le modèle du processus d’incapacité de Verbrugge et Jette. Pour répondre à l’objectif, nous utilisons les données du projet de recherche “ FRéLE ” (Fragilité, une étude longitudinale de ses expressions), réalisé durant la période 2010 -2013 auprès d’un échantillon de 1643 personnes âgées vivant dans la communauté au Québec. L’incapacité est évaluée à l’aide de deux indicateurs : les AVQ et les AVD. Les maladies chroniques sont mesurées par l’indice fonctionnel de comorbidité (IFC). La dépression est évaluée selon les critères de l’échelle de dépression gériatrique (EDG). L’état cognitif est mesuré par l'évaluation cognitive de Montréal (MoCA). Les facteurs de prédisposition comportent l’âge, le sexe, l’ethnicité et le niveau scolaire. Les facteurs facilitateurs incluent le revenu et le réseau social, ce dernier étant mesure par la présence ou non d’une personne de soutien et son lien avec la personne âgée. Divers modèles de régression sont adoptés pour identifier les facteurs statistiquement significatifs du modèle comportemental d’Andersen et Newman et du modèle du processus d’incapacité de Verbrugge et Jette. Nos résultats ont montré que, si le rôle des prédicteurs de l’utilisation varie en fonction du type de services de santé utilisé, l’utilisation s’accroît principalement avec le nombre de maladies chroniques. En ce qui concerne l’interaction entre la maladie chronique et l’incapacité, nos résultats ont révélé que l’interaction n’est statistiquement significative pour aucun des services analysés. Compte tenu de la diversité et les besoins de la population âgée, caractérisée par une prévalence élevée de maladies chroniques et d'incapacités, l’étude des facteurs impliqués dans l'utilisation des services de santé sera utile pour la mise en œuvre d’une offre de services, plus conforme aux besoins de cette population

‘I don’t think I’d be frightened if the statins went’: a phenomenological qualitative study exploring medicines use in palliative care patients, carers and healthcare professionals

Background

Cabazitaxel for hormone-relapsed metastatic prostate cancer previously treated with a docetaxel-containing regimen (review of TA255)

Prostate cancer is the most common cancer amongst men in the England and currently affects ~40,000 people around 6,000 of whom suffer from metastatic disease. Overall patients with metastatic disease have a life expectancy of less than 24 months and a poor prognosis.

Docetaxel was the first agent to show survival benefit in metastatic Hormone Refractory Prostate Cancer (mHRPC) and since approval by NICE in 2006 (TA101) has for many years been the mainstay of treatment.

To appraise the clinical and cost effectiveness of cabazitaxel within its marketing authorisation for treating hormone-relapsed metastatic prostate cancer previously treated with a docetaxel-containing regimen.

Polypharmacy and inappropriate medication use in patients with dementia: an underresearched problem

Multimorbidity and polypharmacy are increasingly prevalent across healthcare systems and settings as global demographic trends shift towards increased proportions of older people in populations. Numerous studies have demonstrated an association between polypharmacy and potentially inappropriate prescribing (PIP), and have reported high prevalence of PIP across settings of care in Europe and North America and, as a consequence, increased risk of adverse drug reactions, healthcare utilisation, morbidity and mortality. These studies have not focused specifically on people with dementia, despite the high risk of adverse drug reactions and PIP in this patient cohort. This narrative review considers the evidence currently available in the area, including studies examining prevalence of PIP in older people with dementia, how appropriateness of prescribing is assessed, the medications most commonly implicated, the clinical consequences, and research priorities to optimise prescribing for this vulnerable patient group. Although there has been considerable research effort to develop criteria to assess medication appropriateness in older people in recent years, the majority of tools do not focus on people with dementia. Of the limited number of tools available, most focus on the advanced stages of dementia in which life-expectancy is limited. The development of tools to assess medication appropriateness in people with mild-to-moderate dementia or across the full spectrum of disease severity represents an important gap in the research literature and is beginning to attract research interest, with recent studies considering the medication regimen as a whole, or misprescribing, overprescribing or underprescribing of certain medications/medication classes including anticholinergics, psychotropics, antibiotics and analgesics. Further work is required in development and validation of criteria to assess prescribing appropriateness in this vulnerable patient population, to determine prevalence of PIP in large cohorts of people with the full spectrum of dementia variants and severities and to examine the impact of PIP on health outcomes.

Mortalidade por câncer de boca e condição sócio-econômica no Brasil

Chronic non-communicable diseases represent a major public health problem, requiring more effective investigation and control by government agencies. The aim of this study was to correlate the mortality rate for oral cancer in Brazilian State capitals from 1998 to 2002 with socioeconomic factors collected in the 2000 census, using an ecological study design. Data were obtained from the Mortality Information System from 1998 to 2002. Social factors were taken from the Brazilian Human Development Atlases. After data collection, statistical analysis was performed using Pearson's correlation index. The findings included positive and significant correlations among the socioeconomic indicators (Municipal Human Development Index - MHDI, MHDI-income, MHDI-education, MHDI-life expectancy, and per capita income), and negative and significant correlations with the socioeconomic indicators Gini Index and infant mortality. Despite the study’s limitations and probable underreporting in less developed State capitals, the study found significant statistic correlations between the selected socioeconomic indicators and the oral cancer mortality rate___________________________RESUMO As doenças crônico-degenerativas representam um grande problema de saúde pública, necessitando de levantamento e controle mais efetivos destas enfermidades por parte dos órgãos públicos. O objetivo deste estudo foi correlacionar os índices de mortalidade por câncer oral nas capitais do Brasil no período de 1998 a 2002 com indicadores sócio-econômicos do Censo Demográfico de 2000 , por meio de um estudo do tipo ecológico. Os dados foram extraídos do Sistema de Informação de Mortalidade (Ministério da Saúde/DATASUS), para os anos de 1998-2002. Os indicadores sócio-econômicos foram obtidos a partir do Atlas do Desenvolvimento Humano no Brasil. Após coleta dos dados, a análise estatística foi realizada usando-se o índice de correlação de Pearson. Observaram-se corre- lações positivas e significativas entre os indicadores sócio-econômicos (Índice de Desenvolvimento HumanoMunicipal – IDH-M, IDH-M renda, IDH-M educação, IDH-M longevidade e renda per capita), e correlação negativa e significante para os indicadores sócio-econômicos índice de Gini e mortalidade infantil. Apesar das limitações do estudo e da provável problemática de sub-registros nas capitais menos desenvolvidas, o presente trabalho encontrou correlações estatisticamente significantes entre os indicadores sócio-econômicos selecionados e o índice de mortalidade por câncer oral