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PubMed1993

Demographic and employment shifts: implications for benefits and economic security.

This Issue Brief examines factors affecting the population's age distribution and composition, such as mortality rates, fertility rates, and immigration. In addition, it examines factors affecting labor force composition, such as immigration, increased labor force participation of women, and retirement trends, and discusses the potential impact of these changes on publicly financed programs: Medicare, Medicaid, Social Security, and federal employee retirement systems. The discussion also highlights the implications of these population and labor force changes on employers, employees, and retirees. The elderly population--now 31.8 million, representing 12.6 percent of the population--is projected to experience tremendous growth between 2010 and 2030, when the baby boom generation reaches age 65, rising from 39.7 million, or 13.3 percent of the population, to 69.8 million, or 20.2 percent of the population. Growth in the elderly population has implications for retirement and health care systems. Population projections suggest that the traditionally pyramid-shaped work force, with a proportionately greater number of younger workers than older workers, will be replaced with a more even age distribution. Consequently, significant and continued modifications to benefit packages, such as changes in compensation structures in which earnings automatically rise with age, are likely to occur. Women's labor force participation began to accelerate in the mid-1950s, rising 75 percent among women aged 25-44 in 1991, although there is some indication that this growth may be flattening. With women comprising a greater part of the labor force, employers will be encouraged to develop and implement programs to better accommodate their needs. Increased life expectancy, a decreased percentage of entry level workers, changes in Social Security's normal retirement age from 65 to 67, and employer plans to raise the normal age of retirement or provide incentives to delay retirement, could raise the average age of retirement. However, other factors, such as poor health, other sources of retirement income, and individual preferences for retirement, could still dominate the retirement decision. The combination of increased average life expectancy guaranteeing more years of retirement to finance and rising dependency ratios increases the future cost of Social Security financing. Medicare financing is also an important policy issue because the program is projected to experience financial difficulties in the short term, resulting from explosive health care costs. In addition, Medicaid expenditures are consuming increasing amount of shrinking state budget resources--a large portion of which is used to finance nursing home care for a growing elderly population.

Age Distribution↗
PubMed2004

Distinct expression of phosphorylated N-methyl-D-aspartate receptor NR1 subunits by projection neurons and interneurons in the striatum of normal and amphetamine-treated rats.

N-methyl-D-aspartate (NMDA) receptors are heteromeric assemblies of subunits (NR1 and NR2A-D), and are enriched in the striatum. Receptor phosphorylation has recently been demonstrated on the NR1 subunit at three serine residues, 897, 896, and 890, which appear to correspond to the level of receptor activity. In this study, expression of phospho-specific NR1 subunits at serine 897 (pNR1S897), serine 896 (pNR1S896), or serine 890 (pNR1S890) in neurochemically identified neurons of the adult rat striatum was detected by using double-immunofluorescent labeling or combined in situ hybridization and immunohistochemistry. In both the dorsal and ventral striatum, pNR1S897 was expressed at high levels in projection neurons containing >55% dynorphin (striatonigral) and >90% enkephalin (striatopallidal) and in interneurons that were 100% positive for choline, >90% positive for parvalbumin, and >45% positive for somatostatin (co-containing neuropeptide Y and neuronal nitric oxide synthase). Low levels of pNR1S896 were present in a small portion of projection neurons (<15% for both populations of projection neurons) and were almost lacking in the three types of interneurons. Interestingly, pNR1S890 was exclusively expressed in most parvalbumin-containing interneurons (70-80%). Acute administration of a psychostimulant, amphetamine, increased the number of dynorphin-containing projection neurons and parvalbumin interneurons showing detectable levels of pNR1S896 and pNR1S890, respectively. These results demonstrate the distinct expression of phospho-NR1 subunits in different populations of striatal projection neurons and interneurons at variable levels in normal rats; they also demonstrate that phosphorylation of NR1, at least on serine 896 and 890 sites, is sensitive to drug exposure.

Amphetamine↗
PubMed1998

Fertility, migration, and the ageing of the population--an analysis of the official projections.

"As we move through the demographic transition, an older age structure is inevitable but future possible scenarios vary.... The paper analyses nine different population projections produced by the ABS [Australian Bureau of Statistics], four in 1996 and five in 1998. The highest projection...adds an extra ten million people by the year 2051 while the lowest...adds none."

Age Distribution↗
PubMed1995

Outcomes of a risk-reduction intervention with high-risk populations: the Harlem AIDS project.

Many studies of interventions with high-risk populations have reported reductions in risk behaviors. To assess effectiveness of interventions, data are also needed on the characteristics of subjects lost to follow-up, and on follow-up risk behaviors for subjects who were not participants in the intervention. This paper reports on a study conducted in Harlem, New York, recruiting 1,770 injection drug users (IDUs) and sex partners of IDUs, randomly assigned to two interventions. Repeated-measures analyses for the two intervention groups and those who participated in no intervention indicated that all groups reported significant reductions in risk behaviors, with no group effect. Comparisons of those followed-up and not followed-up indicate that those followed-up were less likely to: be homeless, be Latinos, and to use "shooting galleries." The discussion focuses on the need to assess outcomes for all types of participants, and to distinguish the impact of interventions from other explanations for behavior changes.

Acquired Immunodeficiency Syndrome↗
PubMed2003

The San Daniele 2 Project: protocol description and population characteristics.

In 1990 we studied the prevalence and determinants of carotid atherosclerosis in an Italian general asymptomatic population (630 males and 718 females aged 18-99 years) living in the San Daniele district of the Friuli-Venezia Giulia Region. The global prevalence of subclinical carotid atherosclerosis was 25.4% in men and 26.4% in women. We considered intima-media thickness, non-stenotic plaque (< 40%), and stenotic plaque (> 40%). In the multiple logistic regression, the cross-sectional analysis of subjects aged 40 years showed a positive significant association between plaques/stenosis and age (p < 0.001), systolic blood pressure (p < 0.01), cigarette smoking (p < 0.0001), and the protective effect of high-density lipoprotein cholesterol (p < 0.037). In 2002 we decided to re-examine the initial cohort with the following objectives: prospectively evaluating the modifications of the previous carotid findings, their relationship with known and less documented cardiovascular risk factors and the predictive power of those variations on incident coronary and cerebrovascular events. We plan to evaluate the association of carotid plaque and carotid intima-media thickness with the genetic polymorphisms involved in atherosclerosis in survivors and finally to study the incidence and the determinants of atrial fibrillation in a general population. In this paper, we will describe the methodology of the screening and the cohort population characteristics. We have compared the San Daniele Project survivor cohort's characteristics to the current general population of the same age living in the Friuli-Venezia Giulia Region so as to extend the study's conclusions to the whole regional population.

Adolescent↗
PubMed1985

The household-composition matrix as a notion in multiregional forecasting of population and households.

"The household-composition matrix has been used in the past for single-region projection of population and households; here the application is expanded to multiregional projection of population and households. Geographic regions of residence are considered as household categories, and a household-composition matrix is constructed to indicate average numbers of persons by age per household, for each of the regions considered." The method is illustrated using data for the city of Edmonton, Canada. Changes over time due to population aging and to observed patterns of household mobility are considered. "These patterns are listed as six possible household mobility types, which in turn, are viewed as constraints within which population growth takes place. With the assumption that external net-migration to the regions, as a whole, is known for a projected period, an iterative procedure is offered to estimate future population by age and region, as well as future number and average size of households by region."

Age Distribution↗
PubMed1978

[The estimated risk of coronary heart disease in four working population groups: the Rome Project of Coronary Heart Disease Prevention (author's transl)].

Within four middle-aged population groups enrolled in the Rome Project of Coronary Heart Disease Prevention, a theoretic estimation of coronary heart disease (CHD) incidence in 5 years has been made on the basis of some risk factors (age, systolic blood pressure, serum cholesterol, smoking habit, physical activity at work, body mass index), employing four different solutions of the multiple longistic function (MLF) derived from previous population studies and a simple risk score adopted by the WHO European Collaborative Group to which this study belongs. The use of different MLF solutions provides rather different levels of estimated incidence, but the ranking and the relative risk between population groups are substancially constant and little dependent on the different solutions. Moreover, an acceptable similarity has been found in terms of estimated risk between the pool of the treatment and that of the control population groups (ratio between 0.97 and 1.09). A reasonable hypothesis indicates that in the absence of preventive action the annual incidence of severe CHD (hard criteria) should be around 6 per 1,000. The estimation of the relative risk within single population groups allows to identify strata of people with different risk, which suggests, again in the absence of any preventive action, a concentration of 25-30% of all new cases of disease in a 10% of the population and about 40-45% in a 20% of the same.

Adult↗
PubMed1999

Localization of estrogen-receptive neurons projecting to the GnRH neuron-containing rostral preoptic area of the ewe.

Estrogen exerts important feedback effects upon the biosynthetic and secretory behavior of gonadotropin-releasing hormone (GnRH) neurons to control reproductive functioning. The mechanism of estrogen action upon these neurons is unclear and seems likely to involve the transsynaptic regulation of GnRH neurons. The objective of the present study was to identify the estrogen-receptive neural populations which project to the general vicinity of the GnRH perikarya in the rostral preoptic area and diagonal band of Broca (rPOA/DBB) of the ewe. Intact breeding-season ewes received an injection of the retrograde tracer fluorogold (FG) into the rPOA/DBB, and their hypothalami and brainstems examined for the presence of FG and estrogen receptor alpha (ERalpha) immunocytochemistry. Retrogradely labeled neurons were identified principally within the lateral septum (LS), lamina terminalis, bed nucleus of the stria terminalis, POA, arcuate nucleus (ARN), ventromedial nucleus (VMN) and median eminence. Smaller numbers of FG-immonoreactive cells were found in the caudal brainstem where they resided mostly in the ventrolateral medulla (VLM). Dual-labeled cells exhibiting both FG and ERalpha staining were prominent in the POA, LS and at all rostrocaudal levels of the VMN and ARN. Small numbers of dual-labeled cells were found in the VLM. These observations indicate that a number of distinct ERalpha-expressing neural populations project to the rPOA/DBB where the majority of the GnRH perikarya are found in the ewe. Although it is not possible to determine the direct connectivity of these projections with GnRH neurons, the findings provide an initial neuroanatomical framework through which the transsynaptic actions of estrogen on ovine GnRH neurons may be tested.

Animals↗
PubMed1995

Cardiovascular risk factors in the former communist countries. Analysis of 40 European MONICA populations.

MONICA Project findings provide a unique opportunity to compare cardiovascular disease (CVD) risk factor levels in a large number of populations living in different political systems. 15 European communist populations had significantly higher age-standardized mortality for age groups 35-64 years from all causes, from CVD and stroke than 25 democratic MONICA populations. The prevalence of systolic and diastolic hypertension in males and females, prevalence of smoking in males and prevalence of overweight in females were significantly higher in communist MONICA populations. In these populations there was tendency to lower prevalence of hypercholesterolemia. In simple and multiple regression analysis hypertension and smoking prevalence had the highest relation with CVD mortality in men; hypertension and overweight prevalence had the highest relation with CVD mortality in women. The combination of 'classical' CVD risk factors could explain only part of differences observed. In communist Europe there was high consumption of spirits, low consumption of fruits and extremely low intake of citrus fruits. Instead of exaggerated anti-cholesterol propaganda emphasis should be given to the prevention of antioxidant deficiencies by the increase of fruit and vegetable consumption and to the decrease in salt, spirit and cigarette consumption in former communist countries.

Adult↗
PubMed1998

Methodology of quality improvement projects for the Texas Medicare population.

The Texas Medical Foundation, the quality improvement organization for the state of Texas, develops local quality improvement projects for the Medicare population. These projects are developed as part of the Health Care Quality Improvement Program undertaken by the Health Care Financing Administration. The goal of a local quality improvement project is to collaborate with providers to identify and reduce the incidence of unintentional variations in the delivery of care that negatively impact outcomes. Two factors are critical to the success of a quality improvement project. First, as opposed to peer review that is based on implicit criteria, quality improvement must be based on explicit criteria. These criteria represent key steps in the delivery of care that have been shown to improve outcomes for a specific disease. Second, quality improvement must be performed in partnership with the health care community. As such, the health care community must play an integral role in the design and evaluation of a quality improvement project and in the design and implementation of the resulting quality improvement plan. Specifically, this article provides a historical perspective for the transition from peer review to quality improvement. It discusses key steps used in developing and implementing local quality improvement projects including topic selection, quality indicator development, collaborator recruitment, and measurement of performance/improvement. Two Texas Medical Foundation projects are described to highlight the current methodology and to illustrate the impact of quality improvement projects.

Angina Pectoris↗
PubMed2004

[School-based education strategies to promote fruit and vegetable consumption: the Pro Children Project].

Available population data suggest that a high proportion of European children and young people eat less fruit and vegetables than desirable. School based health promotion strategies fostering healthy eating practices and regular physical activity has the potential for a major impact on health and wellbeing during childhood and later stages in life. The aim of Pro-Children project is to estimate the consumption of fruit and vegetables as well as its main determinants among 11 year old European children and their families. It also aims to develop and assess the effectiveness of a school-based intervention program to promote adequate consumption levels of fruit and vegetables among school children. In the first phase of the project, cross-sectional studies were carried out on random population samples in nine European countries. The study protocol included assessment of fruit and vegetable consumption and a questionnaire to ascertain key determinants. A school-based intervention program was designed based on the Attitude, Social Influence and Self-Efficacy model (ASE). Theoretically similar but culturally relevant interventions were designed to be tested in Norway, The Netherlands and Spain during two school years. Each intervention site follows-up 10 intervention schools implementing the program and 10 control schools. Intervention planning and design followed an intervention mapping procedure. Key behaviours and determinants to be addressed through the intervention were identified in order to develop a matrix of educational objectives. The provision of fruit and vegetables in the school is an outstanding element. Program activities include guided classroom activities, computer tailored messages for children, activities to be completed at home with the family and family targeted specific actions. Additionally, optional components for community reinforcement include mass media, school health services participation and implication of grocery stores in the project. Despite cultural and social diversity, common school-based strategies to increase fruit and vegetable consumption among children are feasible across Europe. Understanding specific situations will enhance implementation and gain support.

Child↗
PubMed1994

Spatial-dynamic population systems: analysis and projection.

"In this paper a set of more-detailed multiregional population accounts is proposed to specify more realistically the exposure time of populations at risk for various components of population change. The concepts of population-time at risk and forward demographic rates based on the initial population are discussed. The relations of the forward demographic rates defined in this paper with the occurrence-exposure demographic rates are discussed. A more precise and straightforward multiregional population model is developed on the basis of forward demographic rates. The model is also expressed in the familiar matrix form of multiregional, cohort-survival models." Some applications of the model are made to data for China.

Asia↗
PubMed1995

Project document drafted to revitalize population education.

In the pipeline is the recently developed draft project document aimed at revitalizing and strengthening the population education in the country. It is now under review and approval. To reactivate the population education program, the project calls for the issuance of an Executive Order by the Department of Education, Culture and Sports to create a national Population Education Center and the establishment of 15 Regional Population Education Offices and 133 population education desks at the divisional level. This institutional network will ensure the nationwide implementation of population education program. It will also update and revise some existing curricula and develop new teaching/learning materials for kindergarten, elementary and university level as well as packages for learners and fieldworkers of nonformal education. The first baseline activities to accomplish this are to review the existing curricula for population education messages from kindergarten to grade 11 and university level as well as a survey to determine population learning needs of pupils and teachers from kindergarten to university level. The project will also go into training and re-training of project staff, trainers at national and regional levels, 2000 new teachers and 1000 formerly trained teachers and 17 documentation/library assistants. Strengthening of its Documentation Center and setting up to an information network will also be undertaken. Thus, by the end of the project, it is envisaged that about half a million students and 2500 educators would have increased their knowledge and developed positive attitudes towards population-related concepts.

Asia↗
PubMed1993

The conformations of cyclic (1-->2)-beta-D-glucans: application of multidimensional clustering analysis to conformational data sets obtained by Metropolis Monte Carlo calculations.

Sets containing up to 1.3 x 10(6) energetically accessible conformations of linear (1-->2)-beta-D-glucan oligosaccharides were obtained by Metropolis Monte Carlo (MMC) calculations performed with the GEGOP (GEometry of GlycOProteins) program. Quantitative analyses of the data sets (which were expressed in terms of the glycosidic dihedral angle coordinates) were obtained by two different clustering methods: (i) the three-distance hierarchical clustering method (3-DM), published by Jure Zupan, and (ii) a nonhierarchical clustering method (Population-Density Projection, PDP) which, through a segmentation analysis of two-dimensional projections of the population-density surface, establishes a partitioning of conformational space into a set of "cluster regions", followed by a clustering step where each conformation of the data set is assigned to one of these regions. Computer programs (MCLUST and PDPCLUST) were developed to perform the 3-DM and PDP analyses, respectively. The two types of analysis provided very similar sets of conformational families (clusters), which could be expressed as combinations of distinct conformations of the glycosidic torsional angles (phi, psi) centered at (50 degrees, 10 degrees) for conformation A, (40 degrees, 160 degrees) for conformation B, (55 degrees, -160 degrees) for conformation B', and (170 degrees, 10 degrees) for conformation C. The analysis provided the populations of the families, along with relative rates for transitions between families. Examination of the frequencies of the A, B, and C glycosidic bond conformations with respect to their relative positions in the sequence revealed the tendency of the (1-->2)-beta-D-glucan to adopt conformational repeating structures of the general form [AnB], where n = 3 or 6. These repeating structures combine in an energetically cooperative fashion to give low-energy cyclic conformations having, for example C5 symmetry [AAAB]5 for the eicosamer, and C3 symmetry [AAAAAAB]3 for the heneicosamer.

Carbohydrate Conformation↗
PubMed2003

[The role of vitamins and minerals supplementation in nutrition of urban and rural population--Pol-MONICA Project].

The assessment of nutritional supplement usage was studied in randomly selected population samples-1329 men and women from Warsaw and 1398 from former Tarnobrzeg voivodeship respectively. The use of vitamins/minerals supplement was reported by 20% men and 28% women from Warsaw and 8% and 17% from former Tarnobrzeg voivodeship respectively. Use of supplements was more frequent among persons with university education, full-time employment and people taking other medicines. The role of supplement usage was different in cases of minerals and vitamins. Calcium and magnesium were used in the doses not sufficient (5-15% total intake) to eliminate the risk of deficiency. Vitamins were taken in amounts much higher (40-80% total intake) than Recommended Dietary Allowances (RDAs). Among 6-19% people, doses of vitamins A and E 10-times exceeded the RDAs.

Adult↗
PubMedDate not supplied

Evidence for calcitonin gene-related peptide contacts on a population of lamina I projection neurons.

Using double-labeling techniques, we evaluated small diameter primary afferent input, as indicated by calcitonin gene-related peptide-immunoreactive varicosities, to a population of lamina I projection neurons in the rat lumbar spinal cord. About one third of the lamina I neurons labeled after injections of a retrograde tracer into the region surrounding the brachium conjunctivum received contacts from immunoreactive varicosities. Significantly fewer immunoreactive varicosities were in apposition to fusiform neurons than pyramidal or flattened neurons. A positive correlation was found between the size of the retrogradely labeled neuron and the number of contacts received. This study demonstrates that a known population of nociceptive lamina I neurons received direct input from presumed nociceptive primary afferents.

Afferent Pathways↗