On demographic aging, inflation, and real wages: some evidence from the Netherlands.
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Demography↗
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Integration of Environmental Assessment into the Regional Development Planning Process of the Galilee
/ The Galilee region on the northern edge of Israel constitutes more than 15% of the state's territory, supplies more than half of its drinking water needs, and is an important recreational resource and destination for Israelis. One of the main objectives of the plan for the Galilee was to devise a regional physical and economic development strategy for the years 1992-2007 that would arrest the trend of emigration of its residents, attract newly arrived immigrants to the region, and at the same time protect natural resources and environmental quality. This paper is limited to discussion of the environmental aspects of the plan. It analyzes spatial concepts for distribution of projected population growth, evaluates environmental impacts of alternative plans, and proposes a decision-making framework and tools for minimizing natural resources loss from development at the local level. Assessment of potential environmental impacts generated quantitative data of natural resources areas. Application of the data in the plan evaluation stage showed that the alternative that concentrated most of the new development in central Galilee was the second-best choice environmentally, but was preferred as the best choice for overall qualities. The planning study offers an alternative environmental impact assessment (EIA) process to the one presently used in Israel by incorporating environmental considerations at the initial plan-making stage and not at the plan-approval stage. It demonstrated that in order to be effective, environmental assessment and land-use planning should be seen as one effort that is integrated from the start and in each stage of the plan-making process.KEY WORDS: Environmental assessment; Development planning; Galilee
Journal Article↗
Sensory nerves impair sympathetic reinnervation and recovery of smooth muscle function.
Neuronal populations projecting to a common target may compete for neurotrophic substances. To determine if competition impairs target reinnervation, we examined the effect of capsaicin-induced sensory denervation on sympathetic nerve ingrowth to the sympathectomized rat superior tarsal smooth muscle. In tarsal muscles with intact sympathetic innervation, capsaicin injection on Day 2 reduced numbers of perimuscular CGRP-ir sensory nerves by 68% at 3-4 months; however, it did not alter dopamine-beta-hydroxylase-ir nerve density, response to nerve stimulation, or tarsal muscle adrenoceptor-mediated contraction. Tarsal muscles denervated by ipsilateral superior cervical ganglionectomy on Postnatal Day 4 were partially reinnervated by fibers from the contralateral ganglion, as noted in previous studies. Sensory denervation by capsaicin improved sympathetic reinnervation, as evidenced by a 174% increase in numbers of DBH-ir nerves and a 62% increase in neurally mediated smooth muscle contraction evoked by electrical stimulation of the contralateral pathway relative to reinnervated muscles of vehicle-injected rats; smooth muscle function was also influenced, as indicated by a decrease toward normal in adrenoceptor sensitivity. Tarsal muscles denervated at 30 days were not reinnervated in either vehicle-injected or capsaicin-treated rats, indicating that sensory denervation does not extend the developmental window during which contralateral reinnervation can occur. Both the vehicle-injected and capsaicin-treated preparations with sustained juvenile sympathectomy showed sensory hyperinnervation as adults; thus, a chronic reduction in competition from sympathetics is a sufficiently powerful stimulus to overcome the decreased nerve density induced by neonatal capsaicin treatment. We conclude that sensory nerves limit the extent of sympathetic reinnervation and functional recovery that can occur following neonatal sympathetic denervation.
Aging↗
Presence of glucocorticoid receptor immunoreactivity in corticotrophin releasing factor and in growth hormone releasing factor immunoreactive neurons of the rat di- and telencephalon.
By means of the indirect immunoperoxidase technique using two-color immunocytochemistry a moderate to strong nuclear glucocorticoid receptor (GR) immunoreactivity was demonstrated in the vast majority of the corticotrophin-releasing factor (CRF)-immunoreactive nerve cells of the parvocellular parts of the paraventricular hypothalamic nucleus, of the septohypothalamic nucleus, of the bed nucleus striae terminalis and of the central and medial amygdaloid nuclei. All the growth hormone-releasing factor (GRF)-immunoreactive nerve cells of the lateral magnocellular part of the arcuate nucleus in its entire rostrocaudal extent showed a moderate GR immunoreactivity. These results and others indicate that glucocorticoids may directly affect all the CRF and GRF cell populations projecting into the median eminence as well as CRF and GRF neurons controlling behavioral and autonomic functions.
Animals↗
Prospective validation of substance abuse severity measures from administrative data.
BACKGROUND: Severity measures for clients in substance abuse treatment programs are becoming increasingly important as funders adopt payment systems linked to agency performance. Recently, two severity measures based on administrative data have been developed. This study validated these measures using prospective data. METHODS: Subjects were participants in the Drug Abuse Treatment Outcomes Study (adult or adolescent components) or the Substance Abuse and Mental Health Services Administration Medicaid Managed Behavioral Healthcare and Vulnerable Populations project (adult or adolescent chemical dependency components). Severity measures were calculated based on data obtained at entry into substance abuse treatment. The baseline severity measures were included along with age, gender, and race/ethnicity in logistic regression models predicting abstinence at follow-up for alcohol use, marijuana use, cocaine use, or heroin use. RESULTS: For adults, the severity measures were highly statistically significant (p<0.001) for all models in both data sets, indicating that adults with higher severity were more likely (and much more likely in many cases) to use alcohol, marijuana, cocaine, or heroin at the follow-up interview than were those with lower severity. For adolescents, the severity measure was highly statistically significant (p<0.001) for marijuana in both data sets and for alcohol in the Medicaid data set. CONCLUSIONS: Baseline severity measures were powerful predictors of abstinence at follow-up. These measures, derived from routinely available electronic records, appear to have noteworthy predictive validity. The severity indicators can be used for administrative purposes such as risk-adjustment when examining treatment agency performance.
Adolescent↗
Anatomical and ontogenetic factors producing variation in HVc neuron number in zebra finches.
The volume of nucleus HVc of the avian song system varies greatly both among and within songbird species, and is positively correlated to song complexity in many species. Moreover, the number of neurons in HVc predicts the ability of individual zebra finches to imitate song accurately. To better understand this brain/behavior relationship, we used the retrograde tracer Fast Blue to assess how specific HVc neuronal subpopulations contribute to variation in overall HVc neuron number in adult male zebra finches. We also investigated whether sibling order predicts the number of HVc neurons and/or yolk levels of testosterone, a hormone that might regulate the development of HVc. We report that total HVc neuron number is consistently and independently predicted by the size of each of its two projection populations, suggesting that the proportional makeup of HVc is tightly regulated at least in male zebra finches. Also, while we failed to detect a significant effect of sibling order on either the number of neurons in HVc or yolk testosterone concentration, we found that clutch of origin made a large contribution to variation in both early hormone levels and HVc neuron number.
Animals↗
Incidence of erectile dysfunction in men 40 to 69 years old: results from a population-based cohort study in Brazil.
OBJECTIVES: To estimate the incidence of erectile dysfunction (ED) in Brazilian men 40 to 69 years old at study entry during an average 2-year follow-up and study the effect of age, socioeconomic status, and medical conditions on the risk of developing ED. METHODS: We analyzed data from a randomly sampled cohort of men living in Salvador, Bahia (Brazil), a racially diverse city with a population of 2.3 million. A total of 602 men completed the baseline interview in 1998 and 501 completed follow-up in 2000. The analysis sample consisted of 428 (83.4%) of 513 men without ED at baseline. The men were interviewed in person, using a standardized questionnaire, and ED was assessed by a single global self-rating question. RESULTS: The crude incidence rate for ED was 65.6 cases per 1000 person-years (95% confidence interval 49.6 to 85.2). The incidence rate increased with age and was 33.3, 53.7, and 189.5 cases per 1000 person-years for men 40 to 49, 50 to 59, and 60 to 69 years old, respectively. The age-adjusted risk of developing new-onset ED was higher for men with lower education, diabetes, hypertension, and benign prostatic hyperplasia. Population projections for men 40 to 69 years old suggest that approximately 68,600 new cases of ED in Bahia and 1,025,600 in Brazil would be expected annually. CONCLUSIONS: The incidence of ED in Brazilian men was 2.5-fold higher than that in the Massachusetts Male Aging Study (26/1000 person-years) and increased with age, lower education, diabetes, hypertension, and benign prostatic hyperplasia.
Adult↗
Left ventricular assist devices and the slippery slope of ageism.
The use of left ventricular assist devices is growing each year, as is the size of the United Network for Organ Sharing cardiac waiting pool. Notably, the geriatric waiting pool (age 65 and older), although small, is growing each year and this growth is predicted to increase as geriatric population projection curves soar. While left ventricular assist devices have clinically proven benefit, their use in geriatric patients raises ethical issues. Where these devices are currently not approved as destination therapy, their use must be reflected upon in conjunction with allograft transplantation. Age-based organ allocation policies could facilitate left ventricular assist devices as a bridge to nowhere for some geriatric patients. Specifically, the extended use of a left ventricular assist device by older patients could, in theory, put them in a position of not being able to get an allograft due to the fact that they have aged while on the waiting list. Unless these devices are approved as destination therapy, or age-based organ allocation policies contain exception clauses, an older person's cardiac dilemma could be confounded as an assist device recipient. Without these measures one might argue the devices themselves should be subject to age-based allocation procedures. Is this the slippery slope of ageism?
Age Factors↗
The impact of stroke on informal carers: a literature review.
Stroke incidence is set to rise in Western societies as population projections predict an increase in the proportion of older people. Most of these stroke survivors are supported by close kin members who play an important role in the rehabilitation and care of this group. The objective of this review was to establish the following: (a) to evaluate the impact of the stroke on the informal carers' quality of life, (b) to identify factors which help carers to cope with their caring role, (c) to evaluate health service provision for stroke carers. A systematic literature search using BIDS-EMBASE, MEDLINE and PSYCHLIT, identified 31 relevant studies. These showed that most studies concentrated on carers' psychological health and the negative impact that the stroke had. Carers ability to cope with the stroke was enhanced both by the use of positive coping strategies and more concrete measures e.g. more stroke information. Furthermore, whilst most carers were generally satisfied with health services, the few interventions directed at improving carer outcomes showed mixed results. The studies reviewed had many limitations; few gave definitions of 'informal' carer and there was a predominant use of cross-sectional studies and non-standardised outcome measures. Future studies should broaden their research question to evaluate quality of life, using standardised measures to do this and employing either a longitudinal or randomised control design to improve the robustness of results. More studies are also needed evaluating the effectiveness of health services on carers' quality of life.
Adaptation, Psychological↗
The recovery from alcohol problems over the life course: the Lundby longitudinal study, Sweden.
The aim of this paper is to 'look behind the statistics' and to study alcohol-related problems over time and to portray the recovery (treated and untreated) from these problems over the life course in a subset of 41 males, defined as DSM-IV alcoholics from the Lundby general population project. The subjects were interviewed with semi-structured interviews by a psychiatrist. There was only minimal attrition. An analysis was made of the distribution of alcohol-related problems among the current alcoholic group compared to the recovered one at follow-up. Due to the limited number of subjects the calculations were mainly descriptive. The dominant problems were medical (64% vs. 25%), mental (45% vs. 17%), family (27% vs. 0%) and work (18% vs. 8%). The overall functioning assessed by the GAF scale implied a change from continuous to transient symptoms and problems in the recovered group. The subjects' attributions of reasons for recovery were social stabilization (84%), treatment (58%), family and peer pressure (58%) and medical complications (33%). It is argued that the qualitative findings might be used to complement the large statistical investigations in order to understand how to link alcohol-related problems and social consequences to the life course studies.
Adult↗
Future trends in breast, cervical, lung, mouth and pharyngeal cancer incidence in Slovenia.
OBJECTIVES: Breast, cervical, lung, mouth and pharyngeal cancers are important public health problems in Slovenia, and in many other Central and South European countries. The aim of this study was to predict the incidence of these cancers in Slovenia up to the year 2009, based on the data of the Cancer Registry of Slovenia for the period 1965-1994 and on the official national population projections for the Republic of Slovenia. METHODS: Age-period-cohort models were applied. In the case of data heterogeneity in lung as well as in mouth and oropharyngeal cancer in males, an additional parameter indicating differences in lifestyle was introduced in the model. RESULTS: After accounting for major site-specific risk factors, we predict in females a steady increase in breast and lung cancer, but no major changes in cervical cancer case-load. In males a steady decrease in the lung cancer case-load is expected throughout the predicted period, while for mouth and pharyngeal cancer a moderate decrease is expected only after the year 2000. CONCLUSION: Despite some uncertainties inherent in cancer incidence predictions, the obtained results are important in setting priorities for national cancer control strategies in Slovenia, especially in further efforts towards primary prevention of lung, mouth and pharyngeal cancer, and in more efficient early detection of breast, cervical, mouth and pharyngeal cancer.
Adult↗
The clinical characteristics of Asian and Caucasian patients on Bradford's Low Vision Register.
AIM: To analyse the clinical characteristics of patients on the Bradford Low Vision Register with regards to the type (partially sighted or blind), sex, race, causes and age at registration. METHODS: All the data were obtained from the Morley Street Resource Centre, which keeps records of all registrations in the Bradford Metropolitan District. Information including postcode, date of birth, age, gender, ethnic group, degree, date of registration, cause of registration and age at registration were entered into a database. RESULTS: Of all registrations, 64% were blind and 36% were partially sighted. Asians were younger at registration and there were a significantly lower number of females compared to Caucasians. When data were analysed for the different age groups, in the older group of over 65 years, Asians showed significantly more diabetic retinopathy (26.1%) compared to Asians (7.8%), while Caucasians demonstrated significantly more glaucoma (C: 29.3%; A: 17.4%). In the younger age group (<30 years), the leading causes for Asians were retinitis pigmentosa and nystagmus while for Caucasians it was congenital cataracts and optic atrophy. The proportion of Asians registered was significantly lower than expected from the projected population estimates in Bradford. CONCLUSIONS: The study indicates significant differences in the clinical profiles of the two racial groups. The data do not follow the predictions from published population estimates, with Asians, especially females, being under-represented in the register.
Adult↗
Sampling design, response rates, and analysis weights for the National Human Exposure Assessment Survey (NHEXAS) in EPA region 5.
For the Phase I field test of the National Human Exposure Assessment Survey (NHEXAS) in U.S. Environmental Protection Agency (EPA) Region 5, this paper presents the survey sampling design, the response rates achieved, and the sample weighting procedure implemented to compensate for unit nonresponse. To enable statistically defensible inferences to the entire region, a sample of about 250 members of the household population in EPA Region 5 was selected using a stratified multistage probability-based survey sampling design. Sample selection proceeded in four nested stages: (1) sample counties; (2) area segments based on Census blocks within sample counties; (3) housing units (HUs) within sample segments; and (4) individual participants within sample households. Each fourth-stage sample member was asked to participate in 6 days of exposure monitoring. A subsample of participants was asked to participate in two rounds of longitudinal follow-up data collection. Approximately 70% of all sample households participated in household screening interviews in which rosters of household members were developed. Over 70% of the sample subjects selected from these households completed the Baseline Questionnaire regarding their demographic characteristics and potential for exposures. And, over 75% of these sample members went on to complete at least the core environmental monitoring, including personal exposures to volatile organic compounds (VOCs) and tap water concentrations of metals. The sample weighting procedures used the data collected in the screening interviews for all household members to fit logistic models for nonresponse in the later phases of the study. Moreover, the statistical analysis weights were poststratified to 1994 State population projections obtained from the Bureau of the Census to ensure consistency with other statistics for the Region.
Adolescent↗
Implementation of health facilities in a new city.
A new city is under construction in a developing country. The town will be organized in modules, and the population projection is established till the 90s. The ratio of medical personnel to inhabitants is fixed according to health policy criteria. The primary care system should be composed of a set of health centres which are identical with regard to equipment and personnel. The problem is to determine the number--and thus the size--of the health centres, and their location. The solution depends on two opposing factors: the total construction cost, which is increasing with the number of centres, and the walking distance for the patient, which is decreasing with the number of centres. For a given critical distance, we find--using techniques of location theory in network--the smallest number of centres that will ensure that all inhabitants are located within the critical distance. A Fortran program in which the sensitivity of the solution is studied as a function of the given critical distance is developed.
Catchment Area, Health↗
Economic-demographic modeling with endogenously determined birth and migration rates: theory and prospects.
"The standard demographic approach to population forecasting consists of extrapolating into the future carefully measured birth, death, and migration rates. An alternative is to forecast changes in those rates on the basis of social science theories. In this paper the prospects for incorporating those theories into forecasting models are assessed. The paper has two parts, the first devoted to fertility and the second to migration. Each contains a description of the demographic methods currently used by the US Bureau of the Census followed by a comprehensive review of the theoretical foundations for forecasting and an assessment of the prospects for doing so."
Americas↗
Geodemographics in practice: developments in North America.
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Americas↗
Divisions of general practice: a status review.
This paper looks at the emergence of divisions of general practice in Australia. Divisions are local groups of general practitioners working to integrate general practice into the wider health system and to explore opportunities for improving service delivery, teaching and research. There are now 116 divisions of general practice, covering over 95 per cent of the Australian population. Projects and infrastructure funding was approximately $35 million in 1994-95. Divisions have enabled general practitioners to retain their autonomy while responding to a government health reform process which depends on their participation. They are a uniquely Australian solution to the problems confronting general practice in the 1990s, bridging the gap that previously existed between individual general practitioners and the health system as a whole. The Divisions and Projects program is being evaluated using a variety of methods which allow feedback into the program in a timely way. The program thus remains sensitive to new strategies and directions, either from the general practitioners themselves or from other stakeholders.
Accreditation↗