Este artículo de investigación tiene como propósito analizar la constitucionalización del derecho a la seguridad social desde la teoría aristotélica de las causas. El derecho a la seguridad social ha ...sido un derecho que ha sido reconocido en el plano legal como un derecho meramente prestacional, y solo a partir de múltiples avances jurisprudenciales obtuvo reconocimiento iusfundamental. Este artículo desarrolla en primer lugar, las causas del ser como herramientas que permiten comprender cómo el derecho a la seguridad social es un derecho estrechamente ligado a la dignidad de la persona y, en segundo lugar, la necesidad de que el juez en su actividad juridicial utilice la interpretación como instrumento que permita abrir el ámbito iusfundamental de la constitucionalización de este derecho. Así, a partir del método de análisis de datos y fuentes documentales como la Metafísica de Aristóteles, El problema del ser en Aristóteles y, Sentencias de la Corte Constitucional como la T-016 de 2007, la T-881 de 2002 y la T-007 de 2019, entre otras, fue posible concluir que el derecho a la seguridad social es un derecho de raigambre fundamental y debe ser considerado como finalidad última para el ser humano alcanzar su proyecto de vida y el de su familia. En este sentido, uno de los resultados más significativos de esta investigación fue reconocer el criterio de la metagarantía como telhos de la constitucionalización del derecho a la seguridad social para justificar la necesidad de generar desarrollos teóricos constitucionales que enriquezcan la naturaleza jurídica que reviste este derecho.
Unemployment rates in the United States remain near a 25-year high and global unemployment is rising. Previous studies have shown that unemployed persons have an increased risk of death, but the ...magnitude of the risk and moderating factors have not been explored. The study is a random effects meta-analysis and meta-regression designed to assess the association between unemployment and all-cause mortality among working-age persons. We extracted 235 mortality risk estimates from 42 studies, providing data on more than 20 million persons. The mean hazard ratio (HR) for mortality was 1.63 among HRs adjusted for age and additional covariates. The mean effect was higher for men than for women. Unemployment was associated with an increased mortality risk for those in their early and middle careers, but less for those in their late career. The risk of death was highest during the first 10
years of follow-up, but decreased subsequently. The mean HR was 24% lower among the subset of studies controlling for health-related behaviors. Public health initiatives could target unemployed persons for more aggressive cardiovascular screening and interventions aimed at reducing risk-taking behaviors.
► The risk of death for unemployed persons was 63% higher than the risk of death for employed persons. ► The relative mortality risk associated with unemployment was 37% higher for men than for women. ► The relative mortality risk associated with unemployment was significantly lower for workers approaching retirement age (50-65 years of age). ► The relative mortality risk associated with unemployment remained elevated among studies with lengthy follow-up periods, suggesting that becoming unemployed induces a long-term change in the underlying mortaity risk.
The relationship between macronutrients and cardiovascular disease and mortality is controversial. Most available data are from European and North American populations where nutrition excess is more ...likely, so their applicability to other populations is unclear.
The Prospective Urban Rural Epidemiology (PURE) study is a large, epidemiological cohort study of individuals aged 35–70 years (enrolled between Jan 1, 2003, and March 31, 2013) in 18 countries with a median follow-up of 7·4 years (IQR 5·3–9·3). Dietary intake of 135 335 individuals was recorded using validated food frequency questionnaires. The primary outcomes were total mortality and major cardiovascular events (fatal cardiovascular disease, non-fatal myocardial infarction, stroke, and heart failure). Secondary outcomes were all myocardial infarctions, stroke, cardiovascular disease mortality, and non-cardiovascular disease mortality. Participants were categorised into quintiles of nutrient intake (carbohydrate, fats, and protein) based on percentage of energy provided by nutrients. We assessed the associations between consumption of carbohydrate, total fat, and each type of fat with cardiovascular disease and total mortality. We calculated hazard ratios (HRs) using a multivariable Cox frailty model with random intercepts to account for centre clustering.
During follow-up, we documented 5796 deaths and 4784 major cardiovascular disease events. Higher carbohydrate intake was associated with an increased risk of total mortality (highest quintile 5 vs lowest quintile quintile 1 category, HR 1·28 95% CI 1·12–1·46, ptrend=0·0001) but not with the risk of cardiovascular disease or cardiovascular disease mortality. Intake of total fat and each type of fat was associated with lower risk of total mortality (quintile 5 vs quintile 1, total fat: HR 0·77 95% CI 0·67–0·87, ptrend<0·0001; saturated fat, HR 0·86 0·76–0·99, ptrend=0·0088; monounsaturated fat: HR 0·81 0·71–0·92, ptrend<0·0001; and polyunsaturated fat: HR 0·80 0·71–0·89, ptrend<0·0001). Higher saturated fat intake was associated with lower risk of stroke (quintile 5 vs quintile 1, HR 0·79 95% CI 0·64–0·98, ptrend=0·0498). Total fat and saturated and unsaturated fats were not significantly associated with risk of myocardial infarction or cardiovascular disease mortality.
High carbohydrate intake was associated with higher risk of total mortality, whereas total fat and individual types of fat were related to lower total mortality. Total fat and types of fat were not associated with cardiovascular disease, myocardial infarction, or cardiovascular disease mortality, whereas saturated fat had an inverse association with stroke. Global dietary guidelines should be reconsidered in light of these findings.
Full funding sources listed at the end of the paper (see Acknowledgments).
Routinely collected and linked healthcare administrative datasets could be used to monitor mortality among people with hepatitis B (HBV) and C (HCV). This study aimed to evaluate the concordance in ...records of liver‐related mortality among people with an HBV or HCV notification, between data on hospitalization for end‐stage liver disease (ESLD) and death certificates. In New South Wales, Australia, HBV and HCV notifications (1993–2017) were linked to hospital admissions (2001–2018), all‐cause mortality (1993–2018) and cause‐specific mortality (1993–2016) datasets. Hospitalization for ESLD was defined as a first‐time hospital admission due to decompensated cirrhosis (DC) or hepatocellular carcinoma (HCC). Consistency of liver death definition of mortality following hospitalization for ESLD was compared with two death certificate‐based definitions of liver deaths coded among primary and secondary cause‐specific mortality data, including ESLD‐related (deaths due to DC and HCC) and all‐liver deaths (ESLD‐related and other liver‐related causes). Of 63,292 and 107,430 individuals with an HBV and HCV notification, there were 4478 (2.6%) post‐ESLD hospitalization deaths, 5572 (3.3%) death certificate liver disease deaths and 2910 (1.7%) death certificate ESLD deaths. Between 2001 and 2016, among HBV post‐ESLD hospitalization deaths (n = 891), 63% (562) had death certificate ESLD recorded, and 83% (741) had death certificate liver disease recorded. Between 2001 and 2016, among HCV post‐ESLD hospitalization deaths (n = 3587), 58% (2082) had death certificate ESLD recorded, and 87% (3135) had death certificate liver disease recorded. At least one‐third of death certificates with DC and HCC as cause of death had no mention of HBV, HCV or viral hepatitis. Our study identified limitations in estimating and tracking HBV and HCV liver disease mortality using death certificate‐based data only. The optimum data for this purpose is either ESLD hospitalisations with vital status information or a combination of these with cause‐specific death certificate data.
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Kidney stones have been associated with increased risk for end-stage renal disease (ESRD). However, it is unclear whether there is also an increased risk for mortality and if these ...risks are uniform across clinically distinct categories of stone formers.
Historical matched-cohort study.
Stone formers in Olmsted County, MN, between 1984 and 2012 identified using International Classification of Diseases, Ninth Revision codes. Age- and sex-matched individuals who had no codes for stones were the comparison group.
Stone formers were placed into 5 mutually exclusive categories after review of medical charts: incident symptomatic kidney, recurrent symptomatic kidney, asymptomatic kidney, bladder only, and miscoded (no stone).
ESRD, mortality, cardiovascular mortality, and cancer mortality.
Cox proportional hazards models with adjustment for baseline comorbid conditions.
Overall, 65 of 6,984 (0.93%) stone formers and 102 of 28,044 (0.36%) non–stone formers developed ESRD over a mean follow-up of 12.0 years. After adjusting for baseline hypertension, diabetes mellitus, dyslipidemia, gout, obesity, and chronic kidney disease, risk for ESRD was higher in recurrent symptomatic kidney (HR, 2.34; 95% CI, 1.08-5.07), asymptomatic kidney (HR, 3.94; 95% CI, 1.65-9.43), and miscoded (HR, 6.18; 95% CI, 2.25-16.93) stone formers, but not in incident symptomatic kidney or bladder stone formers. The adjusted risk for all-cause mortality was higher in asymptomatic kidney (HR, 1.40; 95% CI, 1.18-1.67) and bladder (HR, 1.37; 95% CI, 1.12-1.69) stone formers. Chart review of asymptomatic and miscoded stone formers suggested increased risk for adverse outcomes related to diagnoses including urinary tract infection, cancer, and musculoskeletal or gastrointestinal pain.
The higher risk for ESRD in recurrent symptomatic compared with incident symptomatic kidney stone formers suggests that stone events are associated with kidney injury. The clinical indication for imaging in asymptomatic stone formers, the correct diagnosis in miscoded stone formers, and the cause of a bladder outlet obstruction in bladder stone formers may explain the higher risk for ESRD or death in these groups.
•Developing an integrated SPM-MP model for two-stage cascade processes.•Taking into account the random failure of machines.•Considering the possibility of occurring multiple assignable causes.
This ...study develops an integrated model of statistical process monitoring and maintenance policy (MP) for a two-stage cascade process, involving two machines in series where the output of one stage affects the next stage. Instead of a single assignable cause (AC) affecting the quality characteristic, this production process experiences multiple ACs to more precisely simulate real conditions. Traditional and Hotelling’s T2 charts cannot detect the specific stage in which a shift occurs; therefore, this study employs a Cause-selecting control chart. The possibility of equipment failure and system stoppage are considered, with the process failure mechanism following a Weibull distribution. Depending on the conditions affecting the process or equipment, four MPs are considered to acheive the system’s initial condition, resulting in sixteen defined scenarios. The goal is to determine decision variables by minimizing a cost function subject to some statistical measures. This economic-statistical design can improve statistical and/or economic measures. However, it creates a more complex problem. Due to this complexity, a particle swarm optimization algorithm is used for optimization. The proposed model is implemented for a system that produces cotton yarn, with fiber length and skein strength are as the outputs of the first and second stages, respectively. Comparisons with two models validate the proposed model’s performance in cost reduction. A sensitivity analysis is performed for further investigations. The results indicate significant cost savings of the proposed model.
•Epistemic uncertainty and CCFs are synthesized in reliability analysis of MSSs•D-S evidence theory is used to express the epistemic uncertainty in system•A modified β factor parametric model is ...introduced to model the multiple CCF groups•Developed method is shown to be efficient and practical.
With the increasing complexity and size of modern advanced engineering systems, the traditional reliability theory cannot characterize and quantify the complex characteristics of complex systems, such as multi-state properties, epistemic uncertainties, common cause failures (CCFs). This paper focuses on the reliability analysis of complex multi-state system (MSS) with epistemic uncertainty and CCFs. Based on the Bayesian network (BN) method for reliability analysis of MSS, the Dempster-Shafer (DS) evidence theory is used to express the epistemic uncertainty in system through the state space reconstruction of MSS, and an uncertain state used to express the epistemic uncertainty is introduced in the new state space. The integration of evidence theory with BN which called evidential network (EN) is achieved by adapting and updating the conditional probability tables (CPTs) into conditional mass tables (CMTs). When multiple CCF groups (CCFGs) are considered in complex redundant system, a modified β factor parametric model is introduced to model the CCF in system. An EN method is proposed for the reliability analysis and evaluation of complex MSSs in this paper. The reliability analysis of servo feeding control system for CNC heavy-duty horizontal lathes (HDHLs) by this proposed method has shown that CCFs have considerable impact on system reliability. The presented method has high computational efficiency, and the computational accuracy is also verified.
We estimated the effects of education on mortality and causes of death in Norway. We identified causal effects by exploiting the staggered implementation of a school reform that increased the length ...of compulsory education from seven to nine years. The municipality-level education data were combined with complete records of all deaths from 1960 to 2015 from the Norwegian Cause of Death Registry. These data covered the entire life span of persons aged 16–64.
One additional year of education caused a reduction in mortality of about 10% for men. The effect was negligible for women. For men, a large part of the effect was due to fewer accidental deaths. We suggest two explanations for this finding. First, there are differences in risk-taking behaviour between people with a high level of education and those with a low level. Second, more education leads to upward occupational mobility. This mobility is mainly from occupations for which the risk of accidents is high to occupations for which the risk is low. Our results supported the fundamental cause theory. This is because education had a stronger effect on mortality for causes of death that are preventable than for causes of death that are not preventable. More education had no effect on the probability of dying of diseases that were amenable to medical intervention only. This gives some support to our results that patients are treated equally, independent of their level of education. This may be due to the large public involvement in financing and provision of health services.
•Education had a fairly strong causal effect on mortality.•The effect of education on mortality was mainly for men.•For men, a large part of the effect was due to fewer accidental deaths.•Education had a causal effect on causes of death that could be prevented.•Education had no effect on mortality for causes of death that were amenable to medical intervention.
Anemia and acute heart failure (AHF) frequently coexist. Several published studies have investigated the association of anemia with all‐cause mortality and all‐cause heart failure events in ...AHF patients, but their findings remain controversial. This study is intended to evaluate the relationship between anemia and AHF. We systematically searched PubMed, Medline, the Cochrane Library, Embase, and Elsevier's ScienceDirect databases until July 30, 2023, and selected prospective or retrospective cohort studies to evaluate anemia for AHF. A total of nine trials involving 29 587 AHF patients were eventually included. Pooled analyses demonstrated anemia is associated with a higher risk of all‐cause heart failure event rate (OR: 1.82, 95% CI: 1.58−2.10, p < .01) and all‐cause mortality, both for short‐term (30 days) all‐cause mortality (OR: 1.91, 95% CI: 1.31−2.79, p < .01) and long‐term (1 year) all‐cause mortality (OR: 1.72, 95% CI: 1.27−2.32, p < .01). The evidence from this meta‐analysis suggested that anemia may be an independent risk factor for all‐cause mortality and all‐cause heart failure events in patients with AHF and might emphasize the importance of anemia correction before discharge.
A total of nine trials involving 29 587 acute heart failure patients were eventually included. Pooled analyses demonstrated anemia is associated with a higher risk of all‐cause heart failure event rate (OR: 1.82, 95% CI: 1.58−2.10, p < .01) and all‐cause mortality, both for short‐term (30 days) all‐cause mortality (OR: 1.91, 95% CI: 1.31−2.79, p < .01) and long‐term (1 year) all‐cause mortality (OR: 1.72, 95% CI: 1.27−2.32, p < .01).
Introduction
The impact of conditions that partly or indirectly contribute to drinking‐related mortality is usually underestimated. We investigate all alcohol‐related multiple (underlying and ...contributory) causes of death and compare mortality distributions in countries with different levels and patterns of drinking.
Method
Analysis of population‐level mortality data for persons aged 20 and over in Austria, Czechia, Poland and Spain. Age‐standardised death rates and standardised ratios of multiple to underlying cause were calculated for alcohol‐related causes of death.
Results
Multiple‐cause mortality ranged from 20 to 58 deaths per 100,000 for men and from 5 to 16 per 100,000 for women. Liver diseases were the most common underlying and multiple causes, but mental and behavioural disorders were the second or third, depending on country and sex, most prevalent multiple mentions. Two distinct age patterns of alcohol‐related mortality were observed: in Czechia and Poland an inverted‐U distribution with a peak at the age of 60–64, in Austria and Spain a distribution increasing with age and then levelling off for older age groups.
Discussion and Conclusion
The importance of alcohol‐related conditions that indirectly impact mortality can be re‐assessed with the use of contributory mentions. The multiple‐cause‐of‐death approach provides convergent results for countries characterised by similar patterns of alcohol consumption. Multiple‐cause mortality was almost double the level of mortality with alcohol as the underlying cause, except in Poland. Mental and behavioural disorders were mostly certified as contributory to other, non‐alcohol‐related underlying causes of death.
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