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Inaccurate maternal mortality data has deep implications. In fact, maternal mortality focuses on such a precise portion of the population that even a slight amount of miscoding can produce problematically misleading statistics. Marion MacDorman, a research professor at the University of Maryland’s Population Research Center who passed away earlier this year, conducted a sensitivity analysis in 2017 to study how overreporting maternal deaths (which can happen when death certificates are filled out improperly) might influence mortality rates across different age groups. With just 1 percent of overreporting, maternal death rates among women older than age 40 more than tripled their mortality rate. It doesn’t take much for a small change to have a big impact with this dataset.

Anderson says that the NVSS numbers are effective. At the same time, he recognizes the urgent need to ensure health professionals and policymakers get the most accurate data. “If you’re producing numbers that are sort of wildly incorrect, that could lead you to develop interventions that aren’t needed. Or it could give you sort of a false sense of security, that everything’s fine, when in fact, it’s not,” Anderson says.

Determining a precise maternal mortality rate for the entire country is hard because there are three systems tracking this data—and they operate in different ways.

The variation between these different systems starts, most notably, with how maternal deaths are defined. The National Vital Statistics System (NVSS), run by the CDC, is the country’s official source of maternal mortality data and is used for international comparisons. Maternal mortality, as defined by the World Health Organization and so adopted by the NVSS, is considered as the death of a person while pregnant or within 42 days of birth or termination of pregnancy. It also requires that the cause of death be related to or aggravated by the pregnancy. (Not, for example, from a su***de or an accident.) The Pregnancy Mortality Surveillance System (PMSS) is a broader measurement. It counts pregnancy-related deaths – people who died during or within one year of pregnancy and for reasons that are “from a pregnancy complication, a chain of events initiated by pregnancy, or the aggravation of an unrelated condition by the physiologic effects of pregnancy.” Maternal Mortality Review Committees (MMRCs) are multidisciplinary groups in states and cities that perform comprehensive reviews of deaths among women within a year of the end of a pregnancy. They collect the most detailed data, though they are the newest systems and, at the moment, aren’t as comprehensive as the other systems.

These definitions are important because they shape how data is tracked. Remember the codes that indicate a person’s cause of death? Well, there’s a specific set of codes for anything to do with obstetrics: the “O“ codes. Until 2003, identifying maternal deaths was tricky: States had their own systems and there was no way to consistently track whether the death of a pregnant person happened during pregnancy, a week after, or within the past year—the important distinctions that impact how the NVSS and PMSS systems define it. In 2003, the NVSS system introduced a checkbox on death certificates that offered consistent options for people to denote when someone died and their pregnancy status. But not all states adopted the policy until 2017 and it was still being filled out inconsistently—so the NVSS paused its reporting on maternal mortality rates from 2007 to 2018, when officials felt the data would be cleaner and more consistent.

The NVSS system has made two improvements to the system, one of which is limiting the age range of maternal mortalities to people under age 44, to have less potential data interference. But this distorts the data for older women. “It’s possible we may be underestimating [rates for] older women to some extent and perhaps still overestimating [rates] the younger ages,” says Bob Anderson, chief of the Mortality Statistics Branch at National Center for Health Statistics, which monitors the NVSS system. “But we think that overall we’re getting better information.”

Сузуки-карааге

Словом «сузуки» японцы называют не только машины и мотоциклы, но и рыбу, которую у нас привыкли называть сибасом. В данном случае это сибас во фритюре.

📖 Ингридиенты

✅ Сибас - 1 штука
✅ Вешенки - 130 г
✅ Чеснок - 1 зубчик
✅ Водоросли тосака - 25 г
✅ Зеленый лук - 75 г
✅ Крахмал - 35 г
✅ Сахар - 5 г
✅ Соевый соус - 50 мл
✅ Мирин - 35 мл
✅ Саке - 30 мл
✅ Лимонный сок - 1 столовая ложка
✅ Растительное масло - 1 столовая ложка
✅ Масло для фритюра - 0.5 л
✅ Лимон - 1 кусок
✅ Петрушка - по вкусу
✅ Дайкон - по вкусу
✅ Соль - по вкусу
✅ Молотый черный перец - по вкусу

1 - Для соуса смешать по столовой ложке соевого соуса и лимон­ного сока, 5 мл мирина, сахар и 5 грамм крахмала.
2 - Для маринада смешать оставшийся соевый соус и 30 мл мирина, саке и раздавленный зубчик чеснока.
3 - С сибаса (весом примерно 350 грамм) снять филе и нарезать его тонкими ломтиками. Залить их маринадом и оставить на два часа.
4 - Скелет рыбы обвалять в крахмале, согнуть полумесяцем, зафиксировать деревянной шпажкой и обжарить во фритюре. Промокнуть бумажным полотенцем и выложить на тарелку, подложив для устойчивости нарезанный тонкой соломкой дайкон.
5 - Лук нарезать перьями длиной 5 см, вешенки порвать руками на крупные куски. Быстро обжарить лук и грибы на растительном масле на сильном огне, посолить, поперчить. Выложить на рыбий остов.
6 - Вынуть кусочки сибаса из маринада, обвалять в крахмале и обжарить во фритюре до золотистого цвета. Выложить рыбу на бумажное полотенце, чтобы избавиться от масла, а потом уложить на лук и грибы. Полить соусом, украсить водорослями, лимоном и петрушкой.

#Основныеблюда #Японскаякухня