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Is there a typical VDT patient? A demographic analysis.

BACKGROUND: The use of video display terminals (VDT) in the workplace is growing rapidly. Visual problems associated with computer use are increasing apace. Recognizing and addressing these needs are vital tasks for the optometric practitioner. This paper examines the demographics, prevalence of symptoms, and other work- and vision-related factors among VDT workers. Understanding the characteristics of a typical patient can aid in developing effective treatment protocols. METHODS: Twenty-two optometrists collected data from 324 patients who work on VDT screens for a minimum of 2 hours per day. A questionnaire was used to collect the data. Along with reporting the patients' dry manifest refraction results, the survey instrument also included a self-report of experienced symptoms. RESULTS: The prototypical patient, based on the total subject population, is a 38-year old, mildly myopic female who uses the computer screen about 5 hours per day. Average total VDT work experience is about 5 years. Most of the patients use full-color screens and sit between 21 and 22 inches away from the screen. A variety of visual symptoms is reported, with eyestrain (65 percent) and headaches (42 percent) being the most common complaints. CONCLUSIONS: Between 75 percent (results of this study) and 88 percent (reported by NIOSH) of patients who use a VDT regularly are likely to be symptomatic. This study has helped to identify the "typical" VDT user and the symptoms this user is most likely to report. The next step is to develop a diagnostic and treatment protocol by which optometrists can prescribe for and potentially prevent these computer-related vision problems.

Adolescent↗

Voiding patterns in patients with post-prostatectomy incontinence: urodynamic and demographic analysis.

PURPOSE: A significant percentage of patients with post-prostatectomy incontinence have been reported to void by Valsalva's maneuver, which is our observation as well. We determine the mechanism of voiding in patients with post-prostatectomy incontinence and correlate this to demographic data, urodynamic parameters and outcome after artificial urinary sphincter implantation, and identify possible risk factors. MATERIALS AND METHODS: Videourodynamic data from 61 consecutive patients with post-prostatectomy incontinence were reviewed to determine voiding patterns. The causes of incontinence were radical prostatectomy in 58 patients and transurethral resection of the prostate followed by radiation therapy in 3. The relationship between voiding patterns and demographic data (age, diabetes mellitus, degree and duration of incontinence, history of radiation therapy or treated bladder neck contracture) as well as urodynamic parameters (bladder capacity, compliance, instability, sensation, leak point pressure and residual urine) were studied. After artificial urinary sphincter implantation outcome was assessed in relation to the voiding patterns. RESULTS: Stress incontinence was present in all patients while concomitant urgency/urge incontinence was present in 48%. Of the patients 43 (70.5%) voided by detrusor contraction (group 1) while the remaining 18 (29.5%) voided by straining (group 2). Mean patient age +/- SD was 70.8 +/- 6.9 and 69.2 +/- 7.2 years, and duration of incontinence was 48 +/- 33 and 46 +/- 30 months in groups 1 and 2, respectively (p >0.05). Also, no significant differences were found between the groups with regard to other demographic data. Delayed first sensation (at volume greater than 140 ml.) was seen in 42.5% and 29.4%, capacity less than 300 ml. in 41.9% and 39%, impaired/poor compliance in 25.6% and 22.2%, bladder instability in 16.3% and 5.6%, abdominal leak point pressure 60 cm. H(2)O or less in 59.4% and 60% and residual urine greater than 50 ml. in 11.6% and 17.6% in groups 1 and 2, respectively (p >0.05). After artificial urinary sphincter implantation 35% and 22.2% of patients used greater than 1 pad a day in groups 1 and 2, respectively. One patient in each group reported difficulty during urination and both patients had no residual urine. CONCLUSIONS: No identifiable demographic or urodynamic risk factors could be detected in association with the strain pattern of voiding in patients with post-prostatectomy incontinence. The absence of a difference in bladder compliance, residual urine volume and outcome after artificial urinary sphincter implantation between detrusor and strain voiders would suggest no increased risk for complications in the strain voiding group.

Aged↗

Who smokes? A demographic analysis of Wisconsin smokers.

CONTEXT: Despite the general decline in prevalence of smoking and actual consumption of cigarettes, there is a heightened concern that this decline has not been uniform throughout the population and that specific subpopulations are adversely affected by tobacco use. OBJECTIVE: To estimate smoking prevalence and cigarette consumption among Wisconsin subpopulations by demographic identifiers, gender, race, age, educational attainment, and income. DESIGN, SETTING AND PARTICIPANTS: We estimated tobacco use among primary sub-populations in Wisconsin in 2003 from the Wisconsin Tobacco Survey. Approximately 8000 interviews were completed via a telephone survey. MAIN OUTCOME MEASURE: Smoking prevalence and tobacco consumption among sub-populations and related policy recommendations. RESULTS: Approximately 20% of the Wisconsin adult population smokes cigarettes. However, the prevalence of smoking is not the same among all population groups. There are also substantial group differences in how many cigarettes people smoke per day. The number of cigarettes smoked is closely tied to the risk of smoking-related illness. The greatest disparities are associated with income and education. People with incomes between 10,000-15,000 dollars per year are more than twice as likely to smoke

Adolescent↗

Street children and political violence: a socio-demographic analysis of street children in Rwanda.

OBJECTIVE: The aims were: (1) to examine the profile of African street children and to assess the link between street children in Africa and political violence; (2) to undertake a systematic examination of causal factors of street children in postgenocide Rwanda; and (3) to situate this analysis in the context of the socio-cultural and political impact of the genocide on Rwandan communities. METHOD: Observational mapping examined the profile and activities of Rwandan street children. Structured interviews were carried out with 290 children in four regional towns to obtain information on socio-demographic, familial, educational background, causal factors surrounding street life involvement, psychological well-being, and relationship to the street. Focus group discussions and key informant interviews examined the relationship between street children and the broader Rwandan society. RESULTS: Street children in Rwanda were predominantly adolescent boys, almost half of whom were homeless (42%), with a high proportion of orphaned children or children who had lost at least one parent. Two variables predicted homelessness: child's guardian and reason for being in street. Qualitative accounts of children conveyed the impact of death of family members, repatriation, imprisonment of parents, and poverty on their lives. CONCLUSIONS: The analysis highlighted the need for community based support for children in alternative guardianship care and for policies to support the reintegration of male youths in postconflict welfare strategies as prevention strategies for street migration.

Adolescent↗

Comparison of health risk prevalence reported in a health risk appraisal and predicted through demographic analysis.

BACKGROUND: The purpose of this study was to determine if the Healthier People Health Risk Appraisal and the RiskPlan Report, two different methods for measuring health risks of an employee population, produce the same estimates of health risk prevalence. METHODS: The prevalence of each of seven risk factors, directly measured by the Healthier People Health Risk Appraisal and predicted by the RiskPlan Report using demographic and normative data, were compared for a group of 239 employees participating in a voluntary health screening. Further, the 239 participants and 426 nonparticipants were compared with respect to demographic factors gleaned from personnel records, and risk factor prevalence derived from the RiskPlan Report. RESULTS: Significant differences were found in the prevalence of six of the seven risk factors measured by the Healthier People Health Risk Appraisal and predicted by the RiskPlan Report. Also, risk factor prevalence predicted by the RiskPlan Report was not significantly different in the participants and nonparticipants although three critical sociodemographic variables were significantly different. DISCUSSION: The results suggest that the prevalence of health risks based on normative data and the demographic profile of a population are not similar to those directly measured, and some doubt is raised about predicting health risks based on these data.

Adolescent↗

Pediatric facial fractures: a demographic analysis outside an urban environment.

This study reviews all pediatric facial fractures treated operatively at the C.S. Mott Children's Hospital of the University of Michigan over a 5-year period. Previous series of pediatric facial fractures have been collected at large urban centers and may not be representative of all practice environments. Our institution is a level 1 trauma center that serves a patient population primarily from suburban and rural regions throughout the state. Referral and practice patterns at our institution gave us an important opportunity to analyze differences in patient care and management secondary to venue, and challenge the assumptions made by studies collected at large urban centers. We reviewed 80 fractures in 62 patients. Patient age ranged from 2 to 18 years old with the majority of patients (58%) between 15 and 18 years old. Most fractures resulted from motor vehicle accidents (43%) and there were no firearm injuries. Fracture sites included the mandible (38%), the frontonasoethmoid region (35%), the midface (17%), and the orbit (10%). Only two operative complications were reported. There were no cervical spine injuries. Median patient age was higher and mechanism of injury differed in our study compared with urban studies. Rapid changes in the health care delivery system and the emergence of managed care demand accurate demographic updates for the efficient allocation of valuable resources. Our results showed important differences with previous studies and imply that assumptions and analysis of the care of pediatric facial fractures based solely on data collected at large urban centers may be too parochial, and therefore subsequent health care decisions of resource allocation arrived at without respect to practice environment could be erroneous.

Adolescent↗

Mismatch between occupation and schooling: a prevalence measure, recent trends and demographic analysis.

This paper deals with the mismatch between occupation and schooling attainment, the imbalance between occupation-specific demand for labor and schooling-level-specific labor supply. A framework for measuring the prevalence of mismatch is given, and a simple index derived from it gives plausible results and robust inferences about differentials and time trend. This approach can be applied to existing data, yields comprehensive and current social indicators, and can be used with a minimum number of assumptions. Trends for the U.S. labor force over the 1969-1980 interval are examined. Results show that there has been a dramatic and general increase in mismatch prevalence. Various demographic explanations of mismatch trends are examined.

Adult↗

[Diagnostic expressions and causes of death. Some reflections on their utilization in the demographic analysis of mortality].

The author discusses "the main difficulties that arise from the use of the diagnostical expressions used to report [causes of death].... From an interdisciplinary point of view, the work stresses the need to study in depth the causal explanation of mortality. It favours the creation of interpretative schemes showing the causal associations, direct or otherwise, between the determinants of good or bad health and the mortality problems as revealed in the death causes." (SUMMARY IN ENG AND FRE)

Cause of Death↗