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PubMed1985

On the dynamics of populations with two age groups.

By restricting the number of age groups to two and by introducing continued fractions, the dynamics of populations with deterministically changing vital rates are completely specified at all times. Explicit expressions for the sequence of the product of population projection matrices are given. From these, relative age distribution and reproductive values to any desired accuracy are obtained as functions of the vital rates. Thus, the results given in this paper are stronger than any existing weak ergodic theorems.

Adolescent↗
PubMed1989

Aging and developmental disabilities: interagency planning for an emerging population.

In 1987 the Indiana Task FOrce on Aging and Aged Persons with Developmental Disabilities was formed to address interagency planning and public policy issues related to this newly emerging population. Data were collected from major state agencies now serving either the aged or individuals with developmental disabilities to assess the portion of the population currently receiving services. These data were compared to population projections for 1990. Service needs in health care, residential services, day programming, and other support areas were identified. We discuss direct planning outcomes and indirect process outcomes related to increased interaction among state-agency employees.

Aged↗
PubMed1983

The cell bodies of origin of sympathetic and sensory axons in some skin and muscle nerves of the cat hindlimb.

Cell bodies of sensory and sympathetic axons projecting to skin and skeletal muscle of the cat hindlimb have been labeled retrogradely with horseradish peroxidase (HRP) in order to study location, size, and numbers of the somata of these neurons. HRP was applied to the freshly transected axons of nerves supplying hairy skin (superficial peroneal, SP; sural, Su), hairy and hairless skin of the paw (medial plantar, MP), or skeletal muscle (gastrocnemius-soleus, GS). Serial sections of lumbosacral dorsal root and sympathetic ganglia were studied after standard histochemical processing. Additionally, the numbers of myelinated fibers in the same nerves were determined. All sensory somata and 99.4% of sympathetic cell bodies were located ipsilaterally. Sensory somata were commonly restricted to two adjacent dorsal root ganglia (usually L6-7 for SP, MP; L7-S1 for Su, GS). Although sympathetic somata were more widely distributed rostrocaudally, their maximum frequency always occurred in the segmental ganglia immediately rostral to the sensory outflows, i.e., corresponding to rami communicantes grisei. Dimensions of sympathetic somata varied little between populations projecting to different tissues and were unimodally distributed. The size distributions of sensory somata were characterized by a peak between 10 and 20 microns radius, similar to sympathetic somata, and a varying smaller number of cells ranging up to 60 microns radius. Each nerve had a characteristic distribution profile of afferent somata. A population of very small cells was only present in GS, while the largest sensory somata in GS and MP were bigger than those in SP and Su. Numerical analysis of the data disclosed the characteristic composition of both myelinated and unmyelinated fibers in each nerve studied.

Animals↗
PubMed1987

General plan of the thalamic projections to the prefrontal cortex in the cat.

This study elucidates the general pattern of the thalamocortical neurons which project to the prefrontal cortex (PfC) in the cat, on the basis of the findings obtained using different retrograde labeling techniques in a large number of animals. The injections of the retrograde tracers covered the whole extent of the PfC, and did not invade gray or white matter outside the intended targets. The labeled neurons formed a vertical paramedian band throughout the rostrocaudal extent of the thalamus. This band was densest at the mediodorsal and ventromedial nuclei regions, encroached upon neurons located more medially and laterally, and largely spared the intralaminar nuclei. There were overlaps between neuron populations projecting to different subdivisions of the PfC, or to the PfC and sectors of the motor, insular, limbic and anterior ectosylvian sulcus cortices. However, these projections to separate cortical subdivisions apparently arise from different neuron clusters, with little collateralization of the axons arising from a single thalamocortical neuron. Only the neurons of the ventromedial nucleus, seem to possess somewhat more widespread terminal axons in the cortex.

Amidines↗
PubMedDate not supplied

[Regional aging in Germany].

Elderly people in Germany have a specific regional distribution. Recent regional population projections show that these patterns will change. The most dynamic process of aging will take place in the suburban parts of the large western Germany agglomerations, whereas in eastern Germany aging concentrates in regions with a lower density. There will be a regional deconcentration of elderly people with consequences for the planning of infrastructure.

Aged↗
PubMed2003

Estimating the needs for artesunate-based combination therapy for malaria case-management in Africa.

Because of inadequacies in national health information systems, the volumes of drugs required to support an effective policy transition toward artesunate-based combination therapy (ACT) are unknown for most African countries. A series of national surveys and population projections have been used to estimate the age-structured fever burden among 41 malaria endemic countries in Africa. Under present fever-management guidelines, commodity costs and internationally agreed coverage targets, the financial resources to meet the needs of ACT in most African countries are huge. Between US$1.6 billion and US$3.4 billion per annum must be found to give Africa the chance to consider a drug policy based on ACT. Substantial reductions in these costs would be achieved through more effective targeting of resources--only 20% of drugs would be required to manage fevers among the most at-risk pediatric patient populations. Better diagnostics would also be an important consideration for a new ACT policy in Africa.

Adolescent↗
PubMed2004

A national census of care home residents.

BACKGROUND: the medical and dependency characteristics of UK care home residents have not been well described. This undermines care commissioning, development and regulation. Data to inform policy and practice are needed. OBJECTIVE: to survey the dependency and clinical diagnoses of 16,043 people resident in the 244 care homes distributed across the UK managed by the largest provider of care in the UK. RESULTS: (i) Return rate of 97% (15,483 returns suitable for analysis). (ii) 25% were 'residential' and 75% in 'nursing' care. (iii) Medical morbidity and associated disability rather than non-specific frailty and social needs had driven admission in over 90% of residents. (iv) More than 50% of residents had dementia, stroke or other neurodegenerative disease. (v) Overall, 76% of residents required assistance with their mobility or were immobile. 78% had at least one form of mental impairment and 71% were incontinent. 27% of the population were immobile, confused and incontinent. (vi) Considerable overlap in dependency between residential and nursing care observed: only 40% of those in residential care were ambulant without assistance and 46% were incontinent. CONCLUSIONS: the practicality of acquiring information on care home residents has been demonstrated. The care needs of people in care homes are largely determined by progressive chronic diseases. A single assessment and commissioning at the point of entry to care services is unlikely to address changing needs. Alternatives to institutional long-term care should only be considered in the context of current resident profiles, the practicality of providing alternative models and likely projected population needs.

Aged↗
PubMed1997

Recent upturn in mortality in rural Zimbabwe: evidence for an early demographic impact of HIV-1 infection?

OBJECTIVES: To describe recent mortality trends in rural Zimbabwe and to assess the impact of HIV-1 infection. METHOD: Comparative, cross-sectional, retrospective, demographic survey with 1-year follow-up. Parallel HIV-1 surveillance. Comparison of results with 1992 national census and vital registration data and results from mathematical model-based population projections. SETTING AND PARTICIPANTS: Residents of 929 (745 revisited in 1995) households in two rural areas of Manicaland Province, Zimbabwe, with contrasting HIV-1 prevalence: Honde and Rusitu valleys. Subjects gave information on parental survival for 2320 resident children. Female residents aged 13-49 years (n = 1237) provided information on birth histories and child survival. Consenting women attending local antenatal clinics (n = 487) provided blood samples for HIV-1 screening and demographic information. MAIN OUTCOME MEASURES: HIV-1 prevalence in pregnant women; per capita death registration rates; incidence of parental death for children aged under 8 years; infant mortality and age-specific death probabilities. RESULTS: HIV-1 prevalence was high in each study area. Death registration and age-specific mortality have begun to rise. The largest increases were seen in the area of higher HIV-1 prevalence (Honde) and among younger adults, particularly men. Incidence of parental death was observed to be rising. Increases in registered deaths were concentrated among HIV-1-associated causes. CONCLUSIONS: The observed increases in mortality by age, sex and cause of death were consistent with those expected early in a severe HIV-1 epidemic, on the basis of mathematical model projections and observations elsewhere in Africa. Further rises in mortality, particularly among women and young children, and consequent increases in orphanhood, are to be expected in rural areas of Zimbabwe.

Adolescent↗
PubMed1987

Dynamics of populations with changing rates: generalization of the stable population theory.

A general and complete exposition of the dynamics of populations with changing vital rates is given in the discrete time formulation. Results obtained are stronger than Lopez's or Hajnal's. In addition to the proof of existence of limits, an explicit expression for the age distribution is obtained by considering forward products of population projection matrices, while an explicit expression for the generalized reproductive values is obtained by considering backward products. The forward and backward characteristic equations respectively determine the forward and backward growth rates. The relative age distribution is compared to the alternative expression of Y.J. Kim (1986, Demography 23 (3), 451-461), which is the discrete version of S.H. Preston and A.J. Coale (1982, Pop. Index 48 (2), 217-259).

Aging↗
PubMed1984

Integrated population and employment projections for national-regional planning in the Federal Republic of Germany.

"The concepts, methodological approach, assumptions and results of a long-term forecast for 88 federal planning regions in West Germany are presented and discussed. It is emphasized that population and employment projections for policy consultation purposes must be of an intermediate complexity in order to remain transparent and reconstructable. To facilitate the interpretation of the forecasting results, a typology of the planning regions along the dimension of forecasted labour market developments is presented." It is found that "rural peripheral regions with employment problems stemming mainly from demographic factors and old industrial regions with severe labour market imbalances caused by structural change are...the actual and future problem regions in West Germany."

Demography↗
PubMed1989

Distribution of uncrossed axons along the course of the optic nerve and chiasm of rodents.

The distribution of the ipsilaterally projecting population of retinofugal axons has been analyzed following injections of horseradish peroxidase (HRP) into the optic tract of adult hamsters and rats to determine whether the topographical segregation of the cells of origin seen in the retina is maintained by their axons throughout the course of the optic nerve and chiasm. Axons are limited to a roughly appropriate topographic location within the intraorbital course of the nerve but this organization changes at levels progressively closer to the optic chiasm. Immediately rostral to the chiasm labelled profiles are found dispersed across most of the cross-sectional area of the nerve. This dispersal is maintained within the region of the optic chiasm where a complex rearrangement of ipsilaterally projecting axons takes place. The results show that axons are not retinotopically organized along the entire length of the optic nerve. The order of axons changes along the course of the nerve and in the optic chiasm. The change seen within the intracranial course may indicate a chronotopic re-sorting of axons prior to the optic tract where the organization of axons has previously been interpreted as a map of time of axon arrival.

Animals↗
PubMed1983

Improving the accuracy of migration age detail in multiple-area population forecasts.

Population projections are often required for many geographical areas, and must be prepared with maximal computer and minimal analytical effort. At the same time, realistic age detail forecasts require a flexible means of treating age-specific net migration. This report presents a migration projection technique compatible with these constraints. A simplified version of Pittenger's model is used, where future migration patterns are automatically assigned from characteristics of historical patterns. A comparative test of age pattern accuracy for 1970-1980 indicates that this technique is superior to the commonly used plus-minus adjustment to historical rates.

Adolescent↗
PubMed2004

Progress toward poliomyelitis eradication--Nigeria, January 2003-March 2004.

Since the 1988 World Health Assembly resolution to eradicate poliomyelitis, three World Health Organization (WHO) regions (Americas, Western Pacific, and European) have been certified polio-free, and the number of countries where polio is endemic has decreased from 125 in 1988 to six in 2003 (Afghanistan, Egypt, India, Niger, Nigeria, and Pakistan). In 2003, Nigeria, the most populous country of the African continent (2003 population projected from 1991 census report: 125 million), reported 355 wild poliovirus (WPV) cases, accounting for 45% of cases reported globally and >80% of cases reported from the African Region (AFR). This report summarizes progress toward polio eradication in Nigeria during January 2003-March 2004. The findings indicate the urgent need to implement high-quality supplementary immunization activities (SIAs) in Nigeria to interrupt ongoing WPV transmission.

Adolescent↗
PubMed1996

Cancer in Northern Ireland by 2002.

An estimate of cancer deaths and incidence for the years 1997 and 2002, taking account of current trends and population projections for Northern Ireland is presented below. These numbers will be of value to those planning services and, in particular, for those implementing the report "Cancer Services - Investing for the Future". Cancer deaths are expected to rise by almost 13% to 4056 by the year 2002. Marked rises are expected in the number of deaths from cancer of the lung, oesophagus, kidney, bladder and prostate with smaller rises in deaths from breast and pancreatic cancer. The fall in stomach cancer is expected to continue as is the trend of lower deaths from cervical cancer. Deaths from cancer of the colon and rectum are expected to remain static. Estimates of cancer incidence currently and for the years 1997 and 2002 are also included. The impact of tobacco use by the population, which poses a current and future serious threat to public health is highlighted.

Aged↗
PubMed1997

Urologic manpower issues for the 21st century: assessing the impact of changing population demographics.

OBJECTIVES: To evaluate the impact of changing population demographics on urologic staffing over the coming decades. METHODS: A model was constructed using data obtained from the U.S. Bureau of the Census for population projections; clinical studies to assess the percentages of men with symptomatic benign prostatic hyperplasia (BPH) and those undergoing prostatectomy; the American Medical Association regarding numbers and annual percent change of practicing urologists; and the American Urological Association regarding numbers of physicians completing residency training programs. Sensitivity analyses were performed varying both the rate of surgical intervention for symptomatic BPH and the annual increase in the number of practicing urologists. RESULTS: Regardless of variations in the surgical rate to as low as 4%, the average number of transurethral resections of the prostate gland/surgical interventions for BPH per urologist will increase by the year 2020 when compared with the known basepoint value obtained for 1990. Additionally, even with an annual net increase of 200 urologists per year, by 2020, the rapidly expanding population over 65 years of age will nearly offset even such a large increase in the number of practicing urologists. CONCLUSIONS: The greatest factor concerning future urologic staffing issues will be the changing population demographics. The need for urologic services will continue to rise. An oversupply of urologists can be avoided as long as the net increase does not exceed an average of 200 urologists annually.

Age Factors↗
PubMed2006

Secular trends in incidence of atrial fibrillation in Olmsted County, Minnesota, 1980 to 2000, and implications on the projections for future prevalence.

BACKGROUND: Limited data exist on trends in incidence of atrial fibrillation (AF). We assessed the community-based trends in AF incidence for 1980 to 2000 and provided prevalence projections to 2050. METHODS AND RESULTS: The adult residents of Olmsted County, Minnesota, who had ECG-confirmed first AF in the period 1980 to 2000 (n=4618) were identified. Trends in age-adjusted incidence were determined and used to construct model-based prevalence estimates. The age- and sex-adjusted incidence of AF per 1000 person-years was 3.04 (95% CI, 2.78 to 3.31) in 1980 and 3.68 (95% CI, 3.42 to 3.95) in 2000. According to Poisson regression with adjustment for age and sex, incidence of AF increased significantly (P=0.014), with a relative increase of 12.6% (95% CI, 2.1 to 23.1) over 21 years. The increase in age-adjusted AF incidence did not differ between men and women (P=0.84). According to the US population projections by the US Census Bureau, the number of persons with AF is projected to be 12.1 million by 2050, assuming no further increase in age-adjusted incidence of AF, but 15.9 million if the increase in incidence continues. CONCLUSIONS: The age-adjusted incidence of AF increased significantly in Olmsted County during 1980 to 2000. Whether or not this rate of increase continues, the projected number of persons with AF for the United States will exceed 10 million by 2050, underscoring the urgent need for primary prevention strategies against AF development.

Adult↗
PubMedDate not supplied

A physician workforce planning model applied to Canadian anesthesiology: assessment of needs.

PURPOSE: A human resource planning model for anesthesiology is described. METHODS: The model uses 'per capita' expenditure for anesthesiologists in Quebec, as a measure of clinical services provided to different age/gender groups. The future demand for anesthesia services is calculated as the product of 'per capita' expenditure and the population projections to a future date. Future demand was converted into full-time equivalent (FTE) providers required, by dividing by the annual 'units of service' optimally delivered by one FTE anesthesiologist. The pattern of age/gender (demographic) consumption of anesthesia services in Quebec was compared with data from Ontario to validate its use in a planning model. The model was then applied to all provinces and territories. RESULTS: The 'per capita' expenditures on anesthesia services in Quebec and Ontario showed a regular pattern. Using the model, the estimated 1999 demand for FTE anesthesiologists to provide clinical services in Quebec is 546 and 669 for 2016. When non-clinical demands were included, we estimated that Quebec's total demand will increase to approximately 730 FTEs in 2016. Similar estimates are made for all provinces. The population increase anticipated is 17.9% but the increase in FTE demand in Canada is 30.9%. CONCLUSION: The model showed that the cause of the increased FTE demand for anesthesiologists is a combination of increased population and its demographic composition. The relative impact of each of these factors varies in different provinces. Effective specialty-specific planning models can be designed but they need ongoing committed resources and personnel for their usefulness to be maximized.

Adolescent↗
PubMed2005

Cancer incidence and mortality in Europe, 2004.

BACKGROUND: There are no recent estimates of the incidence and mortality from cancer at a European level. Those data that are available generally refer to the mid-1990s and are of limited use for cancer control planning. We present estimates of the cancer burden in Europe in 2004, including data for the (25 Member States) European Union. METHODS: The most recent sources of incidence and mortality data available in the Descriptive Epidemiology Group at IARC were applied to population projections to derive the best estimates of the burden of cancer, in terms of incidence and mortality, for Europe in 2004. RESULTS: In 2004 in Europe, there were an estimated 2,886,800 incident cases of cancer diagnosed and 1,711,000 cancer deaths. The most common incident form of cancer was lung cancer (13.3% of all incident cases), followed by colorectal cancer (13.2%) and breast cancer (13%). Lung cancer was also the most common cause of cancer death (341,800 deaths), followed by colorectal (203,700), stomach (137,900) and breast (129,900). CONCLUSIONS: With an estimated 2.9 million new cases (54% occurring in men, 46% in women) and 1.7 million deaths (56% in men, 44% in women) each year, cancer remains an important public health problem in Europe, and the ageing of the European population will cause these numbers to continue to increase even if age-specific rates remain constant. To make great progress quickly against cancer in Europe, the need is evident to make a concerted attack on the big killers: lung, colorectal, breast and stomach cancer. Stomach cancer rates are falling everywhere in Europe and public health measures are available to reduce the incidence and mortality of lung cancer, colorectal cancer and breast cancer.

Adolescent↗