Revisiting mortality deceleration patterns in a gamma-Gompertz-Makeham framework

We calculate life-table aging rates (LARs) for overall mortality by estimating a gamma-Gompertz-Makeham (G GM) model and taking advantage of LAR’s parametric representation by Vaupel and Zhang [34]. For selected HMD countries, we study how the evolution of estimated LAR patterns could explain observed 1) longevity dynamics, and 2) mortality improvement or deterioration at different ages. Surprisingly, the age of mortality deceleration x showed almost no correlation with a number of longevity measures apart from e0. In addition, as mortality concentrates at older ages with time, its characteristic bell-shaped pattern becomes more pronounced. Moreover, in a GGM framework, we identify the impact of senescent mortality on shape of the rate of population aging. We also find evidence for a strong relationship between x and the statistically significant curvilinear changes in the evolution of e0 over time. Finally, model-based LARs appear to be consistent with point b) of the “heterogeneity hypothesis” [12]: mortality deceleration, due to selection effects, should shift to older ages as the level of total adult mortality declines

Global Research Priorities to Better Understand the Burden of Iatrogenic Harm in Primary Care: An International Delphi Exercise

There is a need to identify and reach agreement on key foci for patient safety research in primary care contexts and understand how these priorities differ between low-, middle-, and high-income settings. We conducted a modified Delphi exercise, which was distributed to an international panel of experts in patient safety and primary care. Family practice and pharmacy were considered the main contexts on which to focus attention in order to advance patient safety in primary care across all income categories. Other clinical contexts prioritised included community midwifery and nursing in low-income countries and care homes in high-income countries. The sources of patient safety incidents requiring further study across all economic settings that were identified were communication between health care professionals and with patients, teamwork within the health care team, laboratory and diagnostic imaging investigations, issues relating to data management, transitions between different care settings, and chart/patient record com- pleteness. This work lays the foundation for a range of research initiatives that aim to promote a more comprehensive appreciation of the burden of unsafe primary care, develop understanding of the main areas of risk, and identify interventions that can enhance the safety of primary care provision internationall

Hungry Children Age Faster

We analyze how childhood hunger affects human aging for a panel of European individuals. For this purpose, we use six waves of the Survey of Health, Aging, and Retirement in Europe (SHARE) dataset and construct a health deficit index. Results from log-linear regressions suggest that, on average, elderly European men and women developed about 20 percent more health deficits when they experienced a hunger episode in their childhood. The effect becomes larger when the hunger episode is experienced earlier in childhood. In non-linear regressions (akin to the Gompertz-Makeham law), we obtain greater effects suggesting that health deficits in old age are up to 40 percent higher for children suffering from hunger. The wedge of health deficits between hungry and and non-hungry individuals increases absolutely and relatively with age. This implies that individuals who suffered from hunger as children age faster

How We Fall Apart: Similarities of Human Aging in 10 European Countries

We analyze human aging, understood as health deficit accumulation, for a panel of European individuals. For that purpose, we use four waves of the Survey of Health, Aging and Retirement in Europe (SHARE dataset) and construct a health deficit index. Results from log-linear regressions suggest that, on average, elderly European men and women develop about 2.5 percent more health deficits from one birthday to the next. In non-linear regression (akin to the Gompertz-Makeham model), however, we find much greater rates of aging and large differences between men and women as well as between countries. Interestingly, these differences follow a particular regularity (akin to the compensation effect of mortality). They suggest an age at which average health deficits converge for men and women and across countries

Masculine identities and low-paid work: young men in urban labour markets

This article brings together debates about labour market change, work-based identities, growing concerns about the problem of working-class, low-achieving boys and the identification of a contemporary crisis of masculinity. It draws on a longitudinal study of young men in Sheffield and Cambridge - contrasting local labour markets in England - examining the initial workplace experiences of white working-class male school-leavers. Two individual cases are explored in depth, looking at initial working pathways in order to assess the attitudes and actions of young school leavers and their responses to the structural changes in the labour market that have transformed their opportunities compared with both their fathers' generation and their female peers. The implications for theoretical debates about working lives and the trasformation of gender divisions are assessed. Copyright (c) Joint Editors and Blackwell Publishing Ltd 2003.