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PubMed1987

Testing local level labor force and unemployment projections.

The labor force projections perform well, even for small areas, which suggests that changes in local labor force participation rates can be approximated by national changes. In fact, the mean absolute percent errors are low even when the previously calculated population projections are used. The unemployment projections do not do as well, and using 1980 census labor force data instead of previously calculated labor force projections offers no improvement in the results. A two-step study is needed to determine why the errors are so large. First, the state level changes from 1970 to 1980 should be compared with national changes to determine the difference in unemployment rate changes by race and sex. Second, state level data on the occupational mix should be examined for the relationship between this and the changes in state level unemployment rates by race and sex. It is hypothesized that the first step will show that even state level changes in unemployment rates by race and sex cannot be well approximated by the national changes and the second step will show that some of the variation can be explained by state differences in occupational mix. Further studies should be made to determine how the calculation of national changes affects the results. Changes in labor force participation rates seem to follow trends, and therefore extrapolation may not have much effect on the results. Although using the actual changes in unemployment from 1970 to the latest year available as a proxy for the changes from 1970 to the target year may have a serious detrimental effect on the unemployment projections, if some of the variation in the national changes in race and sex can be explained and some adjustments made, the actual changes may be the best proxy to use.

Black or African American↗
PubMed2002

The projected health care burden of Type 2 diabetes in the UK from 2000 to 2060.

AIMS/HYPOTHESIS: To predict the incidence and prevalence of Type 2 diabetes in the UK, the trends in the levels of diabetes-related complications, and the associated health care costs for the period 2000-60. METHODS: An established epidemiological and economic model of the long-term complications and health care costs of Type 2 diabetes was applied to UK population projections from 2000 to 2060. The model was used to calculate the incidence and prevalence of Type 2 diabetes, the caseloads and population burden for diabetes-related complications, and annual NHS health care costs for Type 2 diabetes over this time period. RESULTS: The total UK population will not increase by more than 3% at any time in the next 60 years. However, the population over 30 will increase by a maximum of 11% by 2030. Due to population ageing, in 2036 there will be approximately 20% more cases of Type 2 diabetes than in 2000. Cases of diabetes-related complications will increase rapidly to peak 20-30% above present levels between 2035 and 2045, before showing a modest decline. The cost of health care for patients with Type 2 diabetes rises by up to 25% during this period, but because of reductions in the economically active age groups, the relative economic burden of the disease can be expected to increase by 40-50%. CONCLUSION/INTERPRETATION: In the next 30 years Type 2 diabetes will present a serious clinical and financial challenge to the UK NHS.

Adult↗
PubMed1999

Prevalence and pattern of epilepsy in India.

PURPOSE: To estimate the prevalence of epilepsy in India by meta-analysis of previously published and unpublished studies and to determine patterns of epilepsy by using community-based studies. METHODS: We attempted to identify as many previously published and unpublished studies as possible on the prevalence of epilepsy in India. The studies were assessed with regard to methods and definitions. The prevalence rates for rural and urban populations and for men and women were calculated with a 95% confidence interval (CI). The studies that provided details on age structure, age-specific rates, and patterns of epilepsy were chosen for meta-analysis. Both crude values and age-standardized prevalence rates were calculated after accounting for heterogeneity. RESULTS: Twenty studies were found involving a sample population of 598,910, among whom 3,207 had epilepsy. This resulted in a crude prevalence of 5.35/1,000. After a correction for heterogeneity due to interstudy variation, the overall prevalence per 1,000 (and its 95% CI) was 5.33 (4.25-6.41); with urban areas at 5.11 (3.49-6.73); rural areas, 5.47 (4.04-6.9); men, 5.88 (3.89-7.87); and women 5.51 (3.49-7.53). After correction for the variability in estimates of heterogeneity, age-standardized rates (from five studies) revealed that the prevalence rates per 1,000 (and the 95% CI), were as follows: overall, 5.59 (4.15-7.03); men, 6.05 (3.79-8.31); women, 5.18 (3.04-7.32); urban, 6.34 (3.43-9.25); rural, 4.94 (3.12-6.76). Urban men and women had a higher prevalence of epilepsy compared with rural ones, however the difference was not statistically significant. Age-specific prevalence rates were higher in the younger age group, with the onset of epilepsy reported mostly in the first three decades of the sample population's lives. The treatment gap (i.e., the percentage of those with epilepsy who were receiving no or inadequate treatment) was more than 70% in the rural areas. CONCLUSIONS: Based on the total projected population of India in the year 2001, the estimated number of people with epilepsy would be 5.5 million. Based on a single study on the incidence of epilepsy, the number of new cases of epilepsy each year would be close to half a million. Because rural population constitutes 74% of the Indian population, the number of people with epilepsy in rural areas will be approximately 4.1 million, three fourths of whom will not be getting any specific treatment as per the present standard.

Adolescent↗
PubMed2004

Current and future worldwide prevalence of dependency, its relationship to total population, and dependency ratios.

OBJECTIVE: To estimate the number of people worldwide requiring daily assistance from another person in carrying out health, domestic or personal tasks. METHODS: Data from the Global Burden of Disease Study were used to calculate the prevalence of severe levels of disability, and consequently, to estimate dependency. Population projections were used to forecast changes over the next 50 years. FINDINGS: The greatest burden of dependency currently falls in sub-Saharan Africa, where the "dependency ratio" (ratio of dependent people to the population of working age) is about 10%, compared with 7-8% elsewhere. Large increases in prevalence are predicted in sub-Saharan Africa, the Middle East, Asia and Latin America of up to 5-fold or 6-fold in some cases. These increases will occur in the context of generally increasing populations, and dependency ratios will increase modestly to about 10%. The dependency ratio will increase more in China (14%) and India (12%) than in other areas with large prevalence increases. Established market economies, especially Europe and Japan, will experience modest increases in the prevalence of dependency (30%), and in the dependency ratio (up to 10%). Former Socialist economies of Europe will have static or declining numbers of dependent people, but will have large increases in the dependency ratio (up to 13%). CONCLUSION: Many countries will be greatly affected by the increasing number of dependent people and will need to identify the human and financial resources to support them. Much improved collection of data on disability and on the needs of caregivers is required. The prevention of disability and provision of support for caregivers needs greater priority.

Activities of Daily Living↗
PubMed2004

Assessing development pressure in the Chesapeake Bay watershed: an evaluation of two land-use change models.

Natural resource lands in the Chesapeake Bay watershed are increasingly susceptible to conversion into developed land uses, particularly as the demand for residential development grows. We assessed development pressure in the Baltimore-Washington, DC region, one of the major urban and suburban centers in the watershed. We explored the utility of two modeling approaches for forecasting future development trends and patterns by comparing results from a cellular automata model, SLEUTH (slope, land use, excluded land, urban extent, transportation), and a supply/demand/allocation model, the Western Futures Model. SLEUTH can be classified as a land-cover change model and produces projections on the basis of historic trends of changes in the extent and patterns of developed land and future land protection scenarios. The Western Futures Model derives forecasts from historic trends in housing units, a U.S. Census variable, and exogenously supplied future population projections. Each approach has strengths and weaknesses, and combining the two has advantages and limitations.

Baltimore↗
PubMed1984

Projected use in two general practices of services by the elderly at home.

The proportion of people aged over 70 years in the community will, it is estimated, rise appreciably over the next 10 to 15 years. The impact, however, on different areas and different services will vary greatly. Using county based population projections this paper estimates the likely future demand by elderly people for home services in two contrasting general practices. To maintain services to meet the present demand, increases ranging from +11% to +55%, depending on the area and the service, will be required.

Aged↗
PubMed1992

Characterization of superior cervical ganglion neurons that project to the submandibular glands, the eyes, and the pineal gland in rats.

These studies sought to determine whether the cell bodies of rat superior cervical ganglion neurons projecting to three very different target organs differ in terms of their size, number, location within the ganglion and/or neuropeptide content, and whether these features are altered in response to neonatal deafferentiation of the ganglion. A series of retrograde tracer, immunocytochemical, and double-labeling studies revealed differences in the size, number, location and neuropeptide content of superior cervical ganglion neurons that project to the submandibular salivary glands, eyes, or pineal gland. The mean areas of the cell bodies of neurons projecting to the submandibular gland are largest, those projecting to the eye are smallest, and those projecting to the pineal are intermediate in size. Submandibular gland projecting neurons are found throughout the ganglion, while the eye and pineal projecting populations are localized to the rostral quadrants. The different subpopulations of target organ specific superior cervical ganglion neurons are heterogeneous in their content of vasoactive intestinal peptide-, neuropeptide Y- and somatostatin-like immunoreactivity. A greater percentage of submandibular gland than of pineal projecting neurons display vasoactive intestinal peptide-like immunoreactivity, but there are no differences in the percentage of neurons displaying neuropeptide Y- or somatostatin-like immunoreactivity between the target organ specific groups. Neonatal deafferentiation does not result in changes in the size, number or distribution of target organ specific neurons, or in the percentage of immunoreactive neurons in these populations. In conclusion, these studies provide evidence that the size and distribution of neurons and percentage of peptide-containing neurons in the superior cervical ganglion is related to the target organ innervated, but provides no evidence of exclusive target organ-peptide relationships.

Afferent Pathways↗
PubMed1988

Projected increases in the number of dementia cases for 29 developed countries: application of a new method for making projections.

A method is described for making projections of increases in dementia cases over a given base year. The method is based on a statistical model relating dementia prevalence to age that is derived from the results of all published prevalence studies. This method was applied to United Nations population projections for 29 developed countries to arrive at expected increases in number of dementia cases in each country for the period 1980 to 2025.

Aged↗
PubMed1993

Static and dynamic models of interdisease competition: past and projected mortality from amyotrophic lateral sclerosis and multiple sclerosis.

Longitudinal Gompertzian analysis is an effective method for determining both the pure probability of death for a given condition and the size of inherently susceptible subpopulations [1]. Gompertzian analysis has been used in this study to provide the parameters necessary to construct a stationary population lifetable (static model) of mortality for amyotrophic lateral sclerosis (ALS) and for multiple sclerosis (MS). The static model demonstrates the relative effect of changing general mortality upon the mortality from each specific disease in a situation where interdisease competition is continuously changing. In order to represent mortality in a real population more closely (where age structure is not the result of mortality rates alone) a dynamic model was constructed for both conditions using the age distributions of the population of England and Wales. The quality of the model was verified by comparison of estimated mortality with historical data from the last three decades. The dynamic model has then been used to estimate mortality from each condition over the next three decades on the basis of population projections made by the Central Statistical Office [2], assuming no major change in the factors which lead to either condition. This analysis demonstrates both the theoretical applicability and practical capabilities of Gompertz-derived mortality models for analysing changing mortality patterns.

Adult↗
PubMed1998

Segment-specific pattern of sympathetic preganglionic projections in the chicken embryo spinal cord is altered by retinoids.

Sympathetic preganglionic neurons exhibit segment-specific projections. Preganglionic neurons located in rostral spinal segments project rostrally within the sympathetic chain, those located in caudal spinal segments project caudally, and those in midthoracic segments project either rostrally or caudally in segmentally graded proportions. Moreover, rostrally and caudally projecting preganglionic neurons are skewed toward the rostral and caudal regions, respectively, of each midthoracic segment. The mechanisms that establish these segment-specific projections are unknown. Here we show that experimental manipulation of retinoid signaling in the chicken embryo alters the segment-specific pattern of sympathetic preganglionic projections and that this effect is mediated by the somitic mesoderm. Application of exogenous retinoic acid to a single rostral thoracic somite decreases the number of rostrally projecting preganglionic neurons at that level. Conversely, disrupting endogenous synthesis of retinoic acid in a single caudal thoracic somite increases the number of rostrally projecting preganglionic neurons at that level. The number of caudally projecting neurons does not change in either case, indicating that the effect is specific for rostrally projecting preganglionic neurons. These results indicate that the sizes of the rostrally and caudally projecting populations may be independently regulated by different factors. Opposing gradients of such factors along the longitudinal axis of the thoracic region of the embryo could be sufficient, in combination, to determine the segment-specific identity of preganglionic projections.

Animals↗
PubMed2005

Trend and area variation in amphetamine prescription usage among children and adolescents in Michigan.

The increased use of stimulant medications for children and teenagers is an ongoing issue of professional and public concern. Unlike methylphenidate, the growth of prescriptions and patterns of utilization of amphetamines for pediatric populations have not been well documented. The study objectives were to describe the trends of amphetamine prescription utilization among pediatric age groups in Michigan and to compare area variations. A population-based computerized data set from the state of Michigan was used to extract all outpatient prescriptions for Schedule II amphetamines dispensed from 1990 to 1997. The prescribing rates by age groups and by counties were computed with the projected population size of corresponding years, and mapped and analyzed with spatial statistical methods. Counties that did not conform to the global spatial dependence pattern in the prescription rate were identified using Moran scatter plot. A total of 236,661 outpatient prescriptions for amphetamines were dispensed in Michigan during the time frame, including less than 1% for methamphetamine, 24.5% for amphetamine, and 74.8% for dextroamphetamine. The prescribing rate was highest among children 10-14 years old (380 prescriptions per 10,000 people) in 1997, followed by children 5-9 years old (253 prescriptions per 10,000). Over the 8-year period, the prescribing rates of amphetamines increased significantly, ranging from 380% for children 2-4 years to 817% for teenagers older than 14 years. The rates among counties ranged from 60 to 1648 per 10,000 children 5-14 years old, with the highest prescribing rates in the northwestern regions of Michigan. Although spatial dependence explained 36% of the variance, the area variations that are unaccounted for are still considerable. In conclusion, there were substantial increases and unexplained area variations in amphetamine usage in Michigan during the study period. Both phenomena require awareness and evaluation from researchers, policy makers, clinicians, and the public.

Adolescent↗
PubMed2003

HIV and population dynamics: a general model and maximum-likelihood standards for east Africa.

In high-prevalence populations, the HIV epidemic undermines the validity of past empirical models and related demographic techniques. A parsimonious model of HIV and population dynamics is presented here and fit to 46,000 observations, gathered from 11 East African populations. The fitted model simulates HIV and population dynamics with standard demographic inputs and only two additional parameters for the onset and scale of the epidemic. The underestimation of the general prevalence of HIV in samples of pregnant women and the fertility impact of HIV are examples of the dynamic interactions that demographic models must reproduce and are shown here to increase over time even with constant prevalence levels. As a result, the impact of HIV on population growth appears to have been underestimated by current population projections that ignore this dynamic.

Adolescent↗
PubMed1994

A simulation of the transmission of HIV and AIDS in regional populations within the United Kingdom.

"The spread of HIV-1 in the United Kingdom is simulated by a model which integrates behavioural and epidemiological processes within a multi-regional population projection framework and represents the spatial heterogeneities in the distribution of HIV which have significant effects on transmission patterns. Analyses determine the significance of different parameters in contributing to prediction uncertainty and highlight the importance of behavioural change and international population movements."

Acquired Immunodeficiency Syndrome↗
PubMed1985

The organization of the ipsi- and contralateral claustrocortical system in rat with notes on the bilateral claustrocortical projections in cat.

The organization of the claustrocortical system was investigated in rat by means of cortical injections of either lectin-conjugated horseradish peroxidase or retrograde fluorescent tracers. The latter were also employed in cat. Evans Blue, Fast Blue, True Blue, Nuclear Yellow and Diamidino Yellow were used in different combinations and were injected, uni- or bilaterally, in different cortical fields. Cells retrogradely labeled from each cortical injection were observed in the ipsi- and contralateral claustrum. Anterogradely labeled terminals were also seen in the claustra of both sides in the horseradish peroxidase experiments. The topographic and quantitative study of the distribution of labeled neurons showed a topographic organization of the rat's claustrocortical system, although a certain degree of overlap of the cell populations projecting to frontal and occipital fields was also evident. Four types of branched claustrocortical neurons were observed in the double labeling experiments: neurons branching ipsilaterally (A) or contralaterally (B) to anterior and posterior cortical fields; neurons branching bilaterally to homotopic (C) or heterotopic (D) cortical fields. Each population of branched neurons was equivalent to a different percent value of the total labeled cell populations; the percent value decreased from type A to type D. Type C branched neurons were also identified in the claustrofrontal system of the cat. The intricate organization of the claustral-ascending projections suggests that the nucleus is involved in different cortical activities and that its efferents may also provide the substrate of a powerful subcortical mechanism of interhemispheric communication.

Animals↗
PubMedDate not supplied

[Population dynamics in Serbia--present status and problems at the end of the 20th century].

INTRODUCTION: Population changes in Serbia in the last hundred years were very intensive in all fields of demographic development. They were positive, because the movement trend was basically up-to-date and as such responded to the needs and requirements of the problems in regard to population time. However, what was the intensity of these changes? What kinds of problems does Serbia face at the end of the 20th century? Methodology In order to establish precise data and isolate basic problems the following components were analyzed: fertility, mortality and population growth, age and ethnic distribution, migrations and spatial distribution. Data were taken from official vital statistics, censuses, censuses of people from the territory of former Yugoslavia, population projections and secondary analysis of relevant scientific findings. RESULTS: Serbia is faced with a number of problems in almost all segments of demographic development at the end of the 20th century. This primarily includes dual types of reproduction, open depopulation and fast population growth, reversible mortality trends of certain age-sex groups, a large number of refugees, pronounced emigration, especially of young and educated people, and greater or smaller distortions in the territorial distribution and in the development of certain subpopulations. DISCUSSION: Changes in population of Serbia have been intensive in all areas of demographic development giving it to a lesser or greater extent characteristics of contemporary population of developed countries. These changes, however, were either slow or began later, or too intensive and elemental, causing a series of distortions in the population development. CONCLUSION: The existence of demographic problems poses numerous questions. The basic one is to what extent do demographic distortions slow down the development of a country as a whole; how may the extreme differences in the population fertility levels represent a source of conflict, crises and instability, to questions concerning solutions and probabilities of strong political response. However, there is no dilemma that a population policy is necessary.

Demography↗
PubMed1990

Evaluation of UNICEF/Arab Republic of Egypt/WHO schistosomiasis Control Project in Beheira Governorate.

We evaluated the UNICEF/Government of Egypt/WHO Schistosomiasis Control project in 2 districts of Beheira Governorate of the Nile Delta during 3 weeks in February 1988. The project, begun in 1983, was focused on reducing prevalence, intensity, and morbidity due to schistosomiasis by providing diagnosis and treatment with praziquantel to schoolchildren. Schools were visited twice. Following the completion of the school surveys, the program was extended into the community. Chemotherapy was delivered by mobile and static teams. The evaluation indicated that, with respect to accuracy of diagnosis, record-keeping, and coverage of targeted populations, project tasks were performed exceedingly well by highly motivated, well-supervised mobile teams. Static teams in rural health centers were less successful in providing diagnosis and chemotherapy to village populations. We resurveyed 6 randomly selected schools to assess the impact of chemotherapy. Overall, the prevalence of Schistosoma mansoni infection was reduced from 60.3% to 24.8% between the first and second surveys (approximately 1 year apart) and was still lower (41.1%) than initial levels up to 3 years after the last treatment with praziquantel. The percentages of those with greater than or equal to 34 S. mansoni eggs/slide using the Kato-Katz technique showed a marked and prolonged decrease (17.1% to 0.3% to 2.2%). The prevalence of S. haematobium infection dropped from 37.6% to 5.5% and was still 9.9% at the time of the evaluation. The percentages of those with greater than or equal to 50 S. haematobium eggs/10 ml urine dropped less dramatically (17% to 4.4% to 11.9%). Mobile teams conducting vigorous chemotherapy programs targeted at schoolchildren can have long-lasting benefits in terms of prevalence and intensity.

Child↗
PubMed2004

Diagnostic cardiac catheterization and revascularization rates for coronary heart disease.

BACKGROUND: Despite evidence of regional variation across North America, there have been no comprehensive studies of cardiac procedure rates for coronary heart disease in Canada. OBJECTIVES: To use available administrative data and a survey of catheterization facilities to examine regional and demographic variations in cardiovascular procedure rates. METHODS: A survey of all cardiac catheterization facilities in Canada was conducted, and the procedure counts from these facilities were used to determine provincial catheterization rates from 1997/1998 to 2001/2002. Procedure counts for 1997/1998 to 1999/2000 for coronary artery bypass graft (CABG) surgery and percutaneous coronary intervention (PCI) were provided by the Canadian Institute for Health Information and used to calculate revascularization procedure rates. Population projections provided by Statistics Canada were used as denominators for calculating the rates, and direct standardization was used to obtain age- and sex-adjusted rates. RESULTS AND CONCLUSIONS: The crude rate of cardiac catheterization in Canada increased from 359.9 to 471.5 per 100,000 population across the five years studied. There was considerable variation in revascularization procedure rates across health regions and provinces. Between 1997/1998 and 1999/2000, there was little increase in the rate of CABGs performed in Canada but a marked increase in the rate of PCIs. For both CABG and PCI, rates were higher for men than women, and highest in the 65- to 74-year-old age category. This study provides a valuable 'snapshot' of cardiac procedure use rates but indicates a clear need for more comprehensive collection of cardiac care data in Canada.

Adult↗
PubMed1998

A modified model for projecting age-structured populations in random environments.

A discrete-time age-structured population model with vital rates linked to a stochastic environmental process was developed as a generalization of an existing model by making the explicit link between variability in the vital rates and variability in the environment more flexible. This modified model uses biologically relevant probability distributions for the vital rates, and allows for temporal autocorrelation and an arbitrary covariance structure between vital rates. Through simulations, the properties of the projected population in the short-term were investigated and compared to analytical approximations. The distribution of the total population size did not quickly approach lognormality under all conditions. Furthermore, the sensitivity of the vital rates to the environmental process had a strong effect on the variance and distribution of the projected population size. These results suggest that short-term projections need to be carried out through simulation methods, as the analytical approximations technically apply only to the long-run asymptotic behavior. Techniques for parameter estimation were considered; recommendations depend on the form of the data available. The approach described allows the empirical calculation of the probability distribution for predicted population size, a quantity relevant to the use of formal decision analysis in natural resource management.

Age Factors↗