ContextModifiable behavioral risk factors are leading causes of mortality in
the United States. Quantifying these will provide insight into the effects
of recent trends and the implications of missed prevention opportunities.ObjectivesTo identify and quantify the leading causes of mortality in the United
States.DesignComprehensive MEDLINE search of English-language articles that identified
epidemiological, clinical, and laboratory studies linking risk behaviors and
mortality. The search was initially restricted to articles published during
or after 1990, but we later included relevant articles published in 1980 to
December 31, 2002. Prevalence and relative risk were identified during the
literature search. We used 2000 mortality data reported to the Centers for
Disease Control and Prevention to identify the causes and number of deaths.
The estimates of cause of death were computed by multiplying estimates of
the cause-attributable fraction of preventable deaths with the total mortality
data.Main Outcome MeasuresActual causes of death.ResultsThe leading causes of death in 2000 were tobacco (435 000 deaths;
18.1% of total US deaths), poor diet and physical inactivity (400 000
deaths; 16.6%), and alcohol consumption (85 000 deaths; 3.5%). Other
actual causes of death were microbial agents (75 000), toxic agents (55 000),
motor vehicle crashes (43 000), incidents involving firearms (29 000),
sexual behaviors (20 000), and illicit use of drugs (17 000).ConclusionsThese analyses show that smoking remains the leading cause of mortality.
However, poor diet and physical inactivity may soon overtake tobacco as the
leading cause of death. These findings, along with escalating health care
costs and aging population, argue persuasively that the need to establish
a more preventive orientation in the US health care and public health systems
has become more urgent.

/pdf/actual-causes-of-death-in-the-united-states-2000-3bff2yf5eo.pdf

Actual causes of death in the United States, 2000.

Transgender and gender non-conforming people face rampant discrimination in every area of life: education, employment, family life, public accommodations, housing, health, police and jails, and ID documents. This data is so shocking that it will change the way you think about transgender people and it should change the way you advocate. The National Transgender Discrimination Survey was conducted by the National Gay and Lesbian Task Force and the National Center for Transgender Equality.

Injustice at Every Turn: A Report of the National Transgender Discrimination Survey

Diabetic ketoacidosis (DKA) and the hyperosmolar hyperglycemic state (HHS) are the two most serious acute metabolic complications of diabetes. DKA is responsible for more than 500,000 hospital days per year (1,2) at an estimated annual direct medical expense and indirect cost of 2.4 billion USD (2,3). Table 1 outlines the diagnostic criteria for DKA and HHS. The triad of uncontrolled hyperglycemia, metabolic acidosis, and increased total body ketone concentration characterizes DKA. HHS is characterized by severe hyperglycemia, hyperosmolality, and dehydration in the absence of significant ketoacidosis. These metabolic derangements result from the combination of absolute or relative insulin deficiency and an increase in counterregulatory hormones (glucagon, catecholamines, cortisol, and growth hormone). Most patients with DKA have autoimmune type 1 diabetes; however, patients with type 2 diabetes are also at risk during the catabolic stress of acute illness such as trauma, surgery, or infections. This consensus statement will outline precipitating factors and recommendations for the diagnosis, treatment, and prevention of DKA and HHS in adult subjects. It is based on a previous technical review (4) and more recently published peer-reviewed articles since 2001, which should be consulted for further information.

View this table:

Table 1 
Diagnostic criteria for DKA and HHS



Recent epidemiological studies indicate that hospitalizations for DKA in the U.S. are increasing. In the decade from 1996 to 2006, there was a 35% increase in the number of cases, with a total of 136,510 cases with a primary diagnosis of DKA in 2006—a rate of increase perhaps more rapid than the overall increase in the diagnosis of diabetes (1). Most patients with DKA were between the ages of 18 and 44 years (56%) and 45 and 65 years (24%), with only 18% of patients <20 years of age. Two-thirds of DKA patients were considered to have type 1 diabetes and …

/pdf/hyperglycemic-crises-in-adult-patients-with-diabetes-22pudyi5y7.pdf

Hyperglycemic Crises in Adult Patients With Diabetes

T here is a high school dropout epidemic in America. Each year, almost one third of all public high school students – and nearly one half of all blacks, Hispanics and Native Americans – fail to graduate from public high school with their class. Many of these students abandon school with less than two years to complete their high school education. This tragic cycle has not substantially improved during the past few decades when education reform has been high on the public agenda. During this time, the public has been almost entirely unaware of the severity of the dropout problem due to inaccurate data. The consequences remain tragic. The decision to drop out is a dangerous one for the student. Dropouts are much more likely than their peers who graduate to be unemployed, living in poverty, receiving public assistance, in prison, on death row, unhealthy, divorced, and single parents with children who drop out from high school themselves. Our communities and nation also suffer from the dropout epidemic due to the loss of productive workers and the higher costs associated with increased incarceration, health care and social services. Given the clear detrimental economic and personal costs to them, why do young people drop out of high school in such large numbers? Almost every elementary and middle school student reports ambitions that include high school graduation and at least some college. Why are so many dreams cut short? And what steps should be taken to turn the tide? In an effort to better understand the lives and circumstances of students who drop out of high school and to help ground the research in the stories and reflections of the former students themselves, a series of focus groups and a survey were conducted of young people aged 16-25 who identified themselves as high school dropouts in 25 different locations throughout the United States. These interviews took place in large cities, suburbs and small towns with high dropout rates. A primary purpose of this report is to approach the dropout problem from a perspective that has not been much considered in past studies – that of the students themselves. These efforts were designed to paint a more in-depth picture of who these young people are, why they dropped out of high school, and what might have helped them complete their high school education. We wanted to give their stories and insights a voice, …

/pdf/the-silent-epidemic-perspectives-of-high-school-dropouts-4h10o2g975.pdf

The Silent Epidemic Perspectives of High School Dropouts

This report presents trends in national estimates of mean weight, height, and body mass index (BMI) from the National Health Examination and the National Health and Nutrition Examination Surveys between 1960 and 2002. The tables included in this report present data for adults by sex, race/ethnicity, and age group and for children by sex and year of age. Mean weight and BMI have increased for both sexes, all race/ethnic groups, and all ages. Among adults, mean weight increased more than 24 pounds. Although not as dramatically, mean height has also increased for most ages and for both males and females.

http://mreed.umtri.umich.edu/mreed/documents/nchs_2004_obesity.pdf

Mean body weight, height, and body mass index, United States 1960-2002.

The national center for health statistics

We developed a distribution-free, nonparametric statistical test (the permutation-rank test) for verifying the exiscence of significant peaks in power spectral ordinates calculated on noisy, short, time series. In this paper, we demonstrate the application of the test in the case of periodic series generated by the in numero perturbation of the amplitude of a cosine wave of known, single, constant frequency. The test was able to detect the underlying oscillation when it was amplitude-corrupted by noise generated by a standard uniform distribution, with a noise-to-signal ratio of 1 or less.

A permutation test for periodicities in short, noisy time series

Chance and necessity: An essay on the natural philosophy of modern biology by Jacques Monod

Publisher Summary This chapter discusses the basic concepts of system biology and system physiology. The central concept of system physiology is that an arrangement of biological components, coupled, connected, and interacting, has properties beyond the sum of those to be found in the components individually. Therefore, systems physiology is the science of the static, quasi-static, and dynamic properties of components. The properties of a system of connected components depend on (1) the nature of the components individually, (2) the nature of the individual connections and coupling relations, and (3) the arrangement of components and the paths of communication among them. By definition, these system properties lie outside the scope of molecular biology and represent the province of systems physiology, in which the structural integrity of components is accepted and the dissolution of structure is minimized. Systems physiology poses the questions and sets the goals for analytical biology generally. It is characterized by its point of view, by the kinds of questions it asks, and by the kinds of answers it seeks rather than by the level of organization at which a study is made.

F. Eugene Yates

Papers

The national center for health statistics

A permutation test for periodicities in short, noisy time series

Chance and necessity: An essay on the natural philosophy of modern biology by Jacques Monod

Systems Biology as a Concept