Estimated alcohol-caused deaths in Australia, 1990-97

The purpose of the study was to provide updated estimates of alcohol-caused mortality rates in Australia between 1990 and 1997, making adjustments for changes in the prevalence of high-risk alcohol use estimated on the basis of per capita alcohol consumption (PCAC). Deaths wholly and partially attributable to high-risk alcohol consumption were extracted from the Australian Bureau of Statistics Mortality Datafile (1990-1997) and multiplied by specific aetiologicalfractions, which in turn were adjusted by changes in the prevalence of high-risk alcohol use estimated on the basis of annual changes in PCAC. The yearly trends in age-standardized rates of estimated alcohol-caused deaths were compared with those using (i) aetiological fractions unadjusted for changes in PCAC, and (ii) wholly alcohol-caused conditions only (thus requiring no application of aetiological fractions). The age-standardized rates of all alcohol-caused deaths among males aged 15 + years declined from 1990 (4.01110000) to 1993 (3.19/10000) and decreased far more slowly up to 1997 (3.15/10000)-16% overall. For females, these rates declined steadily from 1990 (1.75/10000) to 1997 (1.33/10000)-19% overall. Similar patterns in time trends were noted for estimated alcohol-caused death rates calculated as in (i) and (ii). However, the proportional decreases in rates (21.6%for males; 24. O%for females) would have been underestimated by 16% (males) and 19% (females) if the alcohol aetiological fractions had not been adjusted to take account of the estimated annual changes in the prevalence of high-risk drinking. The declines in estimated alcohol-caused death rates were more pronounced than the 9% decline in PCAC, and were due mainly to decreasing death rates for stroke (men and women), alcoholic liver cirrhosis and road injuries (men only). When aetiological fractions are used to measure temporal trends in estimated alcohol-caused death rates from official mortality statistics, they should account for annual changes in the prevalence of high-risk drinking. Such changes in prevalence can be deduced from yearly fluctuations in PCAC.

The prevalence of work-related deaths associated with alcohol and drugs in Victoria, Australia, 2001 - 6

To describe the presence of alcohol, cannabis and amphetamines in work-related injury deaths in Victoria, 2001–6, an observational study of work-related deaths reported to the State Coroner's Office, Victoria, Australia was conducted. Case and postmortem forensic toxicology data were obtained from the National Coroner's Information System for work-related injury deaths with positive toxicology screens. Over 6 years there were 43 worker deaths in a total of 355 unintentional work-related injury deaths. The coroner mentioned the presence of alcohol/drugs in 22 of the 43 worker deaths with positive toxicology screens. Toxicology screens were positive for alcohol and/or drugs in 79 work-related deaths overall. Overall, alcohol was present in 26 (7%) work-related deaths and cannabis or amphetamines in 20 (6%). Incidents were mainly transport related. Alcohol and/or drugs were present in a significant portion of work-related deaths. Research is needed to determine the relative contribution of alcohol and drugs compared with other contributing factors to work-related deaths.

Accuracy of national mortality codes in identifying adjudicated cardiovascular deaths

Objective: This study investigated the sensitivity and specificity of the national mortality codes in identifying cardiovascular disease (CVD) deaths and documents methods of verification.

Methods: A 12-year retrospective case ascertainment of all ICD-coded CVD deaths was performed for deaths between 1990 and 2002 in the Melbourne Collaborative Cohort Study, comprising 41,528 subjects. Categories of non-CVD codes were also examined. Stratified samples of 750 deaths were adjudicated from a total of 2,230 deaths. Expert panels of cardiologists and neurologists adjudicated deaths.

Results: Of the 750 deaths adjudicated, 582 were verified as CVD [392 coronary heart disease (CHD) and 92 stroke] and 168 non-CVD. Estimated sensitivity and specificity of national mortality codes for identifying specific causes of death were: CHD 74.2% (95% CI: 69.8–78.5%) and 97.6% (96.0–99.2%), respectively; myocardial infarction 59.9% (50.9–69.0%) and 94.2% (92.4–96.0%), respectively; haemorrhagic stroke 58.9% (46.0–71.7%) and 99.8% (99.4–100.0%), respectively and; ischaemic stroke 38.7% (20.5–56.9%) and 99.9% (99.6–100.0%), respectively. Misclassification was most common for deaths with primary ICD codes for endocrine-metabolic and genito-urinary diseases.

Conclusions: National mortality coding under-estimated the true proportion of CHD and stroke deaths in the cohort by 13.6% and 50.8%, respectively.

Ritual power : illuminating the blind spot of births, deaths and marriages in news media research

This article conceptualises the role and place of the newspaper births, deaths and marriages column in Western societies and its relationship to news media. It identifies the births, deaths and marriages notices as a ‘blind spot’ within journalism and media research generated by powerful cultural norms and conventions shaping the field. This is exemplified by the ‘mythical’ divide between political economy and culturalist approaches to media studies that has created a gap where people’s everyday practices or the social value of ‘commercial’ content tends to be overlooked in discussions about news media. Drawing more deeply from cultural studies and scholarship around media power and rituals, the births, deaths and marriages column provides a compelling unique illustration of the ways newspapers – especially at the local level – continue to be perceived as central to the social in this changing media world. A qualitative research project into the future of small commercial newspapers in Australia provides rich data for exploring these key ideas.

Perinatal factors associated with early deaths of preterm infants born in Brazilian Network on Neonatal Research centers

Objective: To evaluate perinatal factors associated with early neonatal death in preterm infants with birth weights (BW) of 400-1,500 g.Methods: A multicenter prospective cohort study of all infants with BW of 400-1,500 g and 23-33 weeks of gestational age (GA), without malformations, who were born alive at eight public university tertiary hospitals in Brazil between June of 2004 and May of 2005. Infants who died within their first 6 days of life were compared with those who did not regarding maternal and neonatal characteristics and morbidity during the first 72 hours of life. Variables associated with the early deaths were identified by stepwise logistic regression.Results: A total of 579 live births met the inclusion criteria. Early deaths occurred in 92 (16%) cases, varying between centers from 5 to 31%, and these differences persisted after controlling for newborn illness severity and mortality risk score (SNAPPE-II). According to the multivariate analysis, the following factors were associated with early intrahospital neonatal deaths: gestational age of 23-27 weeks (odds ratio - OR = 5.0; 95%CI 2.7-9.4), absence of maternal hypertension (OR = 1.9; 95%CI 1.0-3.7), 5th minute Apgar 0-6 (OR = 2.8; 95%CI 1.4-5.4), presence of respiratory distress syndrome (OR = 3.1; 95%CI 1.4-6.6), and network center of birth.Conclusion: Important perinatal factors that are associated with early neonatal deaths in very low birth weight preterm infants can be modified by interventions such as improving fetal vitality at birth and reducing the incidence and severity of respiratory distress syndrome. The heterogeneity of early neonatal rates across the different centers studied indicates that best clinical practices should be identified and disseminated throughout the country.

Adult mortality estimate based on information on age structure of deaths, and application to data for San Felipe around 1787

Includes bibliography