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PubMed1998

Current and future hospitalization after heart attack.

OBJECTIVES: This article provides an overview of patients who were hospitalized in 1993/94 because of acute myocardial infarction (AMI) and projects how many AMI patients there could be in the future. DATA SOURCE: The Person-Oriented Information Data Base was used for this analysis. ANALYTICAL TECHNIQUES: Hospital inpatients who had a primary diagnosis of AMI were analyzed, as well as their subsequent hospitalizations for coronary heart disease in the fiscal year. The age-sex specific hospitalization rates were used with population projections to estimate future hospital use. MAIN RESULTS: Of the nearly 45,000 Canadians who were discharged from hospital in 1993/94 with a primary diagnosis of AMI, most (72%) had only one hospital stay within the fiscal year, but 18% had two related stays, and 10% had three or more. AMI patients were hospitalized an average of 14.6 days. The projected number of AMI patients and the number of hospital days used will increase by approximately 36% each decade to the year 2026.

Adult↗
PubMed1974

Aid for family planning in Egypt.

A $5 million credit has been approved by the International Development Association, an affilate of the World Bank, to help finance a population project in Egypt. The project provides for the construction, equipping and furnishing of 22 general health centers, 12 polyclinics, 3 centers for training nursing teachers and 3 centers for in service training. 100 and 50 multipurpose vehicles will be provided to improve mobility of family planning services. Also included are a study on the maintenance of health facilities, 3 evaluation studies of family planning acceptors, an experimental home visiting program to inform and motivate people on family planning, and assistance in the production of health education material useful for family planning information and motivation. Simple demographic facts illustrate the seriousness of the population problem in Egypt. The current population of 35 million will be double by the year 2000 if the present 2.5% annual increase continues. This will put strains on a country whose population density quadrupled during the last century, and which stands to day at 950 persons per square kilometer of habitable land, a density rivalled by only 2 or 3 other countries in the world. The IDA credit will cover about 1/2 of the project's expense. The Egyptian government will finance the local costs.

Africa↗
PubMed1997

Current and projected rates of hip fracture in Canada.

OBJECTIVE: To determine the current values and estimate the projected values (to the year 2041) for annual number of proximal femoral fractures (PFFs), age-adjusted rates of fracture, rates of death in the acute care setting, associated length of stay (LOS) in hospital, and seasonal variation by sex and age in elderly Canadians. DESIGN: Hospital discharge data for fiscal year 1993-94 from the Canadian Institute for Health Information were used to determine PFF incidence, and Statistics Canada population projections were used to estimate the rate and number of PFFs to 2041. SETTING: Canada. PARTICIPANTS: Canadian patients 65 years of age or older who underwent hip arthroplasty. OUTCOME MEASURES: PFF rates, death rates and LOS by age, sex and province. RESULTS: In 1993-94 the incidence of PFF increased exponentially with increasing age. The age-adjusted rates were 479 per 100,000 for women and 187 per 100,000 for men. The number of PFFs was estimated at 23,375 (17,823 in women and 5552 in men), with a projected increase to 88,124 in 2041. The rate of death during the acute care stay increased exponentially with increasing age. The death rates for men were twice those for women. In 1993-94 an estimated 1570 deaths occurred in the acute care setting, and 7000 deaths were projected for 2041. LOS in the acute care setting increased with advancing age, as did variability in LOS, which suggests a more heterogeneous case mix with advancing age. The LOS for 1993-94 and 2041 was estimated at 465,000 and 1.8 million patient-days respectively. Seasonal variability in the incidence of PFFs by sex was not significant. Significant season-province interactions were seen (p < 0.05); however, the differences in incidence were small (on the order of 2% to 3%) and were not considered to have a large effect on resource use in the acute care setting. CONCLUSIONS: On the assumption that current conditions contributing to hip fractures will remain constant, the number of PFFs will rise exponentially over the next 40 years. The results of this study highlight the serious implications for Canadians if incidence rates are not reduced by some form of intervention.

Age Distribution↗
PubMed2006

Detection of density dependence requires density manipulations and calculation of lambda.

To investigate density-dependent population regulation in the perennial bunchgrass Bouteloua rigidiseta, we experimentally manipulated density by removing adults or adding seeds to replicate quadrats in a natural population for three annual intervals. We monitored the adjacent control quadrats for 14 annual intervals. We constructed a population projection matrix for each quadrat in each interval, calculated lambda, and did a life table response experiment (LTRE) analysis. We tested the effects of density upon lambda by comparing experimental and control quadrats, and by an analysis of the 15-year observational data set. As measured by effects on lambda and on N(t+1/Nt in the experimental treatments, negative density dependence was strong: the population was being effectively regulated. The relative contributions of different matrix elements to treatment effect on lambda differed among years and treatments; overall the pattern was one of small contributions by many different life cycle stages. In contrast, density dependence could not be detected using only the observational (control quadrats) data, even though this data set covered a much longer time span. Nor did experimental effects on separate matrix elements reach statistical significance. These results suggest that ecologists may fail to detect density dependence when it is present if they have only descriptive, not experimental, data, do not have data for the entire life cycle, or analyze life cycle components separately.

Biometry↗
PubMed1999

Changes in fertility and family sizes in Europe.

This article describes recent trends in annual fertility rates, and generation measurements of average family size and family size distributions for eight selected European Countries. It compares the changing ages at which mothers are having children and the decline in higher order births, both over time and between countries: The way that variations and changes in annual rates influence generation measurements is also illustrated. Finally, the article compares prevailing annual rates with the long-term fertility assumption included in the most recent population projections for seven countries.

Adolescent↗
PubMed2006

The changing epidemiology of diagnosed prevalent HIV infections in England: greatest impact on the London environs.

Data from the 1997-2004 Surveys of Prevalent HIV Infections Diagnosed were analysed by three geographical areas of residence and treatment to describe the heterogeneous growth of the HIV epidemic in England and provide projections to 2007. Between 1997 and 2004, the number of diagnosed HIV-infected adults resident in England increased by 163% (14,223 to 37,459). Within the 'London environs' the increase was 360% (742 to 3411), within the rest of England 219% (4417 to 14,088) and within London 120% (9064 to 19,960). By 2004, the London environs had the largest proportion of infections acquired through heterosexual sex (and in particular women) and the most recently diagnosed population. Projections indicate over half of diagnosed HIV-infected adults will live outside London by 2007. The epidemiology of diagnosed HIV infection within the London environs is likely to be a predictor of future trends in England overall.

Adolescent↗
PubMed1999

Hip fracture in Hong Kong over the last decade--a comparison with the UK.

BACKGROUND: Hip fracture is a major public health problem in Asia and the UK. The objectives of this study were to describe the trends of hip fracture in Hong Kong over the last decade, and to compare the incidence in Hong Kong with that from the Wessex Health Region of the UK in 1995. METHODS: The number of hip fractures was calculated using hospital discharge records for all public hospitals in Hong Kong in 1991 and 1995. Age-specific incidence rates were then calculated using the mid-year census population for the two years. These rates were presented with previously reported age-specific rates for Hong Kong in 1966 and 1985. These age-specific rates for Hong Kong in 1995 were compared with rates for the Wessex Health Region of the UK. The total number of hip fracture expected in 2010 was calculated by applying the age-specific rates of 1995 to the projected population for 2010. RESULTS: In 1995, a total of 1138 men and 2782 women in Hong Kong fractured their hip. The age-specific rates had remained static from 1985 to 1995, after substantial rise from 1966 to 1985. In 1995, the rates of hip fracture rates were 11/1000 in women and 5/1000 in men who were 70 years and older. These rates were almost identical to those observed in the Wessex Health Region of the UK. CONCLUSION: The age-specific incidence rates of hip fracture had not risen in Hong Kong in the last decade. The incidence of hip fracture in Hong Kong was similar to that in the UK in 1995. The total number of patients with hip fracture in Hong Kong will increase substantially in the future, as a result of the ageing of the population.

Age Distribution↗
PubMedDate not supplied

Method for ascertaining denominators for evaluation of population coverage with pneumococcal vaccine.

BACKGROUND: Immunization programs may collect numerator data for the estimation of pneumococcal vaccine coverage, but program evaluators do not have appropriate denominator data for estimation of pneumococcal vaccine coverage, particularly among those eligible for vaccine on the grounds of having chronic health conditions. METHODS: We partitioned the Alberta population into 6 mutually exclusive groups, all but one of which met Canadian recommendations for pneumococcal vaccination. Age-sex specific prevalence rates for each group were estimated using data on chronic health conditions from the Alberta over-sample of the 1996 Household component of the National Population Health Survey, from Alberta Health and Wellness rosters of nursing home residents, and from the Alberta Health Care Insurance Plan Stakeholder Registry. We applied these to Alberta Population Projections to estimate the numbers of persons who should be vaccinated. RESULTS: The proportion of persons recommended for vaccination on the grounds of chronic health condition ranged from 1.5% among those aged less than 12 years to 36% among persons aged 80 years or older. The total number of persons recommended for vaccination at mid-year 2000 is estimated to be 638,561 (21.5% of the Alberta population). INTERPRETATION: This methodology provides denominators for the estimation of pneumococcal vaccine coverage and permits monitoring of local and regional progress towards national goals.

Adolescent↗
PubMed1999

Estimating mortality, morbidity and disability due to malaria among Africa's non-pregnant population.

The contribution of malaria to morbidity and mortality among people in Africa has been a subject of academic interest, political advocacy, and speculation. National statistics for much of sub-Saharan Africa have proved to be an unreliable source of disease-specific morbidity and mortality data. Credible estimates of disease-specific burdens are required for setting global and national priorities for health in order to rationalize the use of limited resources and lobby for financial support. We have taken an empirical approach to defining the limits of Plasmodium falciparum transmission across the continent and interpolated the distributions of projected populations in 1995. By combining a review of the literature on malaria in Africa and models of acquired functional immunity, we have estimated the age-structured rates of the fatal, morbid and disabling sequelae following exposure to malaria infection under different epidemiological conditions.

Adolescent↗
PubMed2002

Malthus foiled again and again.

Throughout history, increasing population has driven the need to increase agricultural efficiency, so averting successive 'malthusian' disasters. In the twentieth century, the application of scientific knowledge to agriculture yielded tremendous dividends, enabling cereal yields to increase threefold since 1950. But with the world's population projected to reach nine billion by the middle of this century, new ways must be found to increase yields while preserving natural habitats and biodiversity.

Agriculture↗
PubMed2003

Modeling momentum in gradual demographic transitions.

The analysis of population momentum following a gradual decline in fertility to replacement level provides valuable insights into prospects for future population growth. Here, we extend recent work in the area by applying a new form of the quadratic hyperstable (QH) model, which relates exponentially changing fertility to the resultant exponentiated quadratic birth sequence. Modeling gradual transitions from an initial stable population to an ultimate stationary population indicates that such declines in fertility increase momentum by a product of two factors. The first factor is a previously noted continuation of stable growth for half the period of decline. The second is a not previously appreciated offsetting factor that reflects the interaction between the decline in fertility, the changing age pattern of fertility, and the changing age composition of the population. Numerical examples using both hypothetical and actual populations demonstrate that for declines of any length, the product of the two factors yields momentum values that closely agree with the results of population projections. The QH model can examine monotonic transitions between any two sets of constant vital rates. As a generalization of the fixed-rate stable model, it has great potential value in numerous areas of demographic analysis.

Birth Rate↗
PubMed1994

Connections of the basal telencephalic areas c and d in the turtle brain.

Tracer substances were injected into the basal telencephalic areas c and d of the turtle brain. These areas (Acd) have recently been shown to be connected reciprocally with the dorsal spino-medullary region, though the particular subregions involved in these projections remained unclear. We demonstrated that the efferent projections of area d terminate predominantly within or immediately adjacent to the trigeminal nuclear complex and in the high cervical spinal gray. The dendritic domain of the vagus-solitarius complex and the dorsal column nuclear complex might also receive some basal telencephalic efferents. The afferent projections to Acd, on the other hand, arise predominantly in the dorsal column nuclei as defined according to cytoarchitectural and hodological criteria. A few retrogradely labeled cells were found in the vagus-solitarius complex, the principal trigeminal nucleus and the high cervical spinal cord. Numerous labeled cells were found in the dorsolateral isthmo-rhombencephalic tegmentum, especially the n. visceralis secundarius, the n. vestibularis superior and parts of the lateral lemniscal complex. Aminergic cell populations projecting to Acd were the n. raphes inferior and superior, the locus coeruleus, the substantia nigra, pars compacta and the ventral tegmental area. Other meso-diencephalic cell groups were the griseum centrale (including the n. laminaris of the torus semicircularis), the n. interpeduncularis dorsalis, the nucleus of the fasciculus longitudinalis medialis, the nucleus and the nucleus interstitialis of flm, the n. interstitialis commissuralis posterior and then n. caudalis. Several hypothalamic regions, the reuniens complex and the perirotundal region of the thalamus also appeared to project heavily to Acd. Telencephalic areas retrogradely labeled after injection of tracer into Acd and its immediate surroundings were the rostral part of the lateral (olfactory) cortex, adjacent regions of the basal dorsal ventricular ridge and the n. centralis amygdalae, the n. tractus olfactorius lateralis as well as the areas g and h. The data suggest that areas c and d may correlate best with the 'extended' amygdala in mammals; further correlation with structures similar to the ventral striopallidum, however, cannot be excluded. Homostrategies are discussed with regard to the processing of higher-order somatovisceral information in turtles, birds and mammals.

Animals↗
PubMed2006

Demography of central and marginal populations of monkeyflowers (Mimulus cardinalis and M. lewisii).

Every species occupies a limited geographic area, but how spatiotemporal environmental variation affects individual and population fitness to create range limits is not well understood. Because range boundaries arise where, on average, populations are more likely to go extinct than to persist, range limits are an inherently population-level problem for which a demographic framework is useful. In this study, I compare demographic parameters and population dynamics between central and marginal populations of monkeyflowers, Mimulus cardinalis and M. lewisii, along an elevation gradient spanning both species' ranges. Central and marginal populations of both species differed in survival and fecundity. For M. lewisii, these components of fitness were higher in central than in marginal populations, but for M. cardinalis the converse was true. To assess spatiotemporal variation in population dynamics, I used transition matrix models to estimate asymptotic population growth rates (lambda) and found that population growth rates of M. lewisii were highest at the range center and reduced at the range margin. Population growth rates of M. cardinalis were highest at the range margin and greatly reduced at the range center. Life table response analysis decomposed spatiotemporal variation in lambda into contributions from each transition between life stages, finding that transitions from large nonreproductive and reproductive plants to the seed class and stasis in the reproductive class made the largest contributions to spatial differences in lambda. These transitions had only low to moderate sensitivities, indicating that differences in projected population growth rates resulted mainly from observed differences in transition matrix parameters and their underlying vital rates.

Altitude↗
PubMed2003

Number of dementia sufferers in Europe between the years 2000 and 2050.

Several authors have pointed out that in the next few decades dementia will affect a considerably increasing number of the elderly. To our knowledge there exist no calculations of the number of demented persons for the whole European region. We made calculations on the number of dementia cases for the period 2000-2050 based on the population projections of the United Nations. For this purpose, we used the results of several meta-analyses of epidemiological studies. The number of prevalent dementia cases in the year 2000 was 7.1 million. Within the next 50 years, this number will rise to about 16.2 million dementia sufferers. The number of new dementia cases per year will increase from about 1.9 million in the year 2000 to about 4.1 million in the year 2050. Contrarily, the working-age population will considerably decrease during the next 50 years. In the year 2000, 7.1 million dementia cases faced 493 million persons in working-age. This equals a ratio of 69.4 persons in working-age per one demented person. Until the year 2050, this ratio will decrease to only 21.1. Thus, the financial and emotional burden placed by dementia on the working-age population will markedly rise.

Aged↗
PubMed1999

By the numbers.

Any statement about the ability of the specialty to meet the future demand for orthodontic care based merely on a ratio of the projected number of orthodontists to the projected population is an oversimplification. Still, some inferences can be drawn from the data presented in this article. To be as prudent as possible, we will limit the scope of the discussion to the next 10 years. 1. It seems likely that the annual number of orthodontic graduates will remain about the same. 2. Considering the slow increase in the average age of orthodontists, the death rate will increase slightly, but not significantly. 3. The average annual number of retirees will be somewhere between 125 (the current rate) and 359 (the maximum projected by the JCO Retirement Survey). 4. The above assumptions would leave no less than 7,500 practicing orthodontists in the United States in 10 years. 5. The number of children age 9-17 will increase by 5-10%. In a worst-case scenario, could 7,500 orthodontists meet the orthodontic demand 10 years from now? The 1997 JCO Orthodontic Practice Study reported the annual median number of case starts to be 180. Multiplied by 9,000 orthodontists, that would equal 1,620,000 case starts. If we project a 10% increase in demand, there could be 1,782,000 case starts 10 years from now--an average of 238 starts per year for 7,500 orthodontists. Respondents to the Practice Studies have consistently indicated that they could handle 50 additional case starts with no increase in staff or facilities, which would mean current orthodontists could accommodate an average of 230 case starts. Moreover, orthodontic productivity is likely to increase due to delegation and improved technology. In conclusion, even if the sharp increase in the number of annual retirements anticipated in the JCO Retirement Survey turns out to be correct, it seems unlikely that it will affect the ability of the specialty to accomplish its mission in the foreseeable future.

Dentists↗
PubMed2000

Expression of the netrin-1 receptor, deleted in colorectal cancer (DCC), is largely confined to projecting neurons in the developing forebrain.

Axon guidance mechanisms are crucial to the development of an integrated nervous system. One family of molecules that may be important in establishing axonal connectivity in mammals is the Netrins, and their putative receptors DCC (deleted in colorectal cancer), Neogenin, and Unc-5. Knockout and mutational analyses of some of these genes have shown that they are critically involved in the development of several specific pathways in the developing brain. However, previous expression analyses of these genes have largely been confined to the developing spinal cord. In the present study, we analyzed the expression of DCC in the developing mouse forebrain. We found that DCC protein is expressed in specific axonal populations projecting from the developing olfactory bulb, neocortex, hippocampus, and epithalamus/habenular complex. In the developing olfactory bulb and neocortex, DCC expression is particularly evident during the targeting phase of axon outgrowth and is then rapidly downregulated. As predicted from the knockout and mutational analyses of this gene, DCC is expressed in axonal commissures, in particular the corpus callosum, hippocampal commissure, and the anterior commissure. In addition, we found that DCC is expressed in the habenular commissure, the fasciculus retroflexus, and the stria medularis. Therefore, this analysis implicates a function for DCC in additional axonal guidance systems not predicted from the knockout and mutational analyses.

Animals↗
PubMedDate not supplied

[Increasing life expectancy--effects on the care of the aged?].

This contribution represents data from two population projections which--in contrast to other studies and official documents--do not maintain mortality at a constant level, but shows some consequences of mortality trends until the year 2000.

Aged↗
PubMed1984

Forecasting cancer trends to optimize control strategies.

Population projections and age-stratified cancer rates were used to forecast the trends for cancer occurrence for the United States during the coming decades: A progressive increase in the number of new cases is already predetermined by the high birth rate that occurred during the middle part of the century, and it will lead to nearly a doubling in the number of cases in about 4 decades. The demographic circumstances that determine the per capita costs of cancer are likely to worsen, because expected population trends will produce a deteriorating per capita economic base. Furthermore, the high costs of emerging treatment technologies are likely to magnify the deterioration ever further. Development of methods for cancer trend forecasting can provide a sound and accurate foundation for planning a comprehensive national strategy for optimal partitioning of research resources between the need for development of new treatments and the need for new research directed toward primary preventive measures.

Adolescent↗