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[Evolution and demographic characteristics of native groups in Canada, 1986-2011].

Population estimates and projections are presented and analyzed for the period 1986-2011 for the Native American population living in Canada. The analysis considers census underenumeration and the impact of recent legislation that increased the number of residents with Native American status by approximately 25 percent. It is concluded that "native groups will continue to grow at a higher rate than the Canadian population as a whole. Comparing the two populations shows a convergence for some demographic characteristics; however, the aging of the native population started much later." (SUMMARY IN ENG AND SPA)

Americas↗

Urban change in the third world: are recent trends a useful pointer to the urban future?

"This paper has three aims. The first is to examine the reliability of the data base for the statistics which are used as the basis for commenting on urban change in 'the Third World'. The second is to explore whether valid generalisations about urban change can be made for the Third World. And the third is to examine the validity of United Nations projections for the Third World's urban future."

Data Collection↗

Visible and ultraviolet-B ocular-ambient exposure ratios for a general population. Salisbury Eye Evaluation Project Team.

PURPOSE: To estimate the numerical value of the ocular-ambient exposure ratio (OAER) (ratio of the facial exposure to that on a horizontal plane) as a function of wavelength band, season, and job category and to establish the effect of various modifiers, such as geography and the use of hats, for use in general population studies. METHODS: Two hundred sixty-four persons within several job categories representing the jobs in our Salisbury, Maryland, population were instrumented with ultraviolet-B (UVB) and visible band sensors for 1 complete day. Studies were done over all four seasons, both with and without hats. RESULTS: OAERs in the UVB wavelength band generally are higher than in the visible (13% versus 6%), display no significant variation with job category, show a seasonal effect (highest in the winter-spring [18%], lowest in the summer [10%], and intermediate in the fall [14%]), and are reduced 34% by the use of hats. In the visible wavelength band, OAERs are affected weakly by job function, although this variation is not significant, display a seasonal effect with three seasons as in the UVB, and are not affected significantly by the use of hats. In neither the UVB nor the visible portions of the spectrum did the authors find an effect on the OAER due to photophobia or eye color. CONCLUSIONS: With the authors' exposure model, the authors have at their disposal a valuable tool for exploring the relation between UVB, UVA, and visible radiation and a number of age-related eye diseases.

Environmental Exposure↗

Cost-effectiveness of recruitment methods in a population-based epidemiological study: the Melbourne Visual Impairment Project.

The cost-effectiveness of five recruitment methods was evaluated to determine the best method of encouraging eligible persons to participate in the Melbourne Visual Impairment Project (a population-based epidemiological study). The evaluation was divided into two phases. Phase 1 included one of two types of initial contact, by direct personal contact or by telephone. Phase 2 involved recruiting residents after an attempt had been made by either the telephone or the doorstep approach, and included a second attempt by a field interviewer, subsequent attempts by senior field staff, and finally, financial incentives. The cost-effectiveness of each method was determined by dividing the approach's cost by the effectiveness ratio. We identified 269 eligible households with 356 eligible residents. An 89 per cent response rate was achieved at the examination centre, comprising 61 per cent from Phase 1 and 28 per cent from Phase 2. Although both recruitment methods in Phase 1 were equally cost-effective, there was a significant difference in the effectiveness of each method in actually recruiting residents. The doorstep method was more costly per attender but was far more effective at 76 per cent recruitment than the telephone method at 47 per cent (P < 0.001). We have demonstrated a practical two-stage approach (the doorstep method in Phase 1 and follow-up strategies in Phase 2) to population-based recruitment involving the middle to elderly age group that should be relevant to many epidemiological studies.

Adult↗

Project Pró-natal: population-based study of perinatal and infant mortality in natal, Northeast Brazil.

The Pró-Natal project is a collaborative initiative that aims to improve maternal and infant health in a deprived community in Natal, Northeast Brazil. To assess the perinatal and infant mortality in this population of 40,000, we have collected over a 2-year period a consecutive series of 39 autopsy examinations on deaths under 1 year of age. During this period there were 2212 live births in the study population. The 14 perinatal deaths are described using the Wrigglesworth classification, and the 25 infant deaths, using a clinicopathological system. The contribution of normally formed stillbirths was small (14%), which probably reflects the underreporting of stillbirths in this community. The most common cause of death in the live births was complications of prematurity (43%). Specific causes (22%) of perinatal deaths were predominantly infections, including one case of congenital syphilis. Perinatal asphyxia was diagnosed in 14%, and there was one case (7%) of a chromosome abnormality. Infant deaths were predominantly due to respiratory (45%) and gastrointestinal infections (28%), with chronic malnutrition as an underlying cause in 80% of cases. Prenatal care could theoretically have prevented three of the perinatal deaths, and a further six deaths could have been avoided by improved management of labor and the immediate neonatal period. Prevention of malnutrition and improved treatment of acute infections would contribute to a reduction in infant mortality in this population. The Pró-Natal project will use these data to design preventative interventions to reduce perinatal and infant mortality in this community.

Autopsy↗

Function and visual impairment in a population-based study of older adults. The SEE project. Salisbury Eye Evaluation.

PURPOSE: The Salisbury Eye Evaluation (SEE) project investigates the impact of vision on functional status in a population-based sample of elderly persons. The prevalence of self-reports of functional status and the association with visual acuity loss are described. METHODS: A random sample of men and women 65 to 84 years of age from Salisbury, Maryland were recruited for home interviews and clinic examinations. Of the eligible sample, 78% responded to the home questionnaire and 65% responded to the questionnaire and the clinic examination. Binocular visual acuity of each person was measured using ETDRS charts and protocols. Questions were asked concerning activities of daily living, instrumental activities of daily living, physical function, social interaction, and activities of daily vision. Analyses of the association of presenting visual acuity worse than 20/40 with the measures of function were carried out and adjusted for age, race, and sex. RESULTS: All measures of functional status showed a decline with age; women and blacks were more likely to report difficulties. The age-adjusted proportions of those with visual impairment were not significantly different between men and women (7.2% versus 6.7%; P = 0.60). Black persons had almost twice the rate (10.4%) of white persons (5.6%; P < 0.001). Age, race, gender, and visual impairment were all significantly related to declines in functional status in multivariate models. CONCLUSIONS: Data on functional status in the project population were similar to national data and confirmed higher rates of disability in women and blacks. Binocular visual acuity worse than 20/40 appeared to have an impact on all the self-report measures of functional status. Further analyses on the interaction of vision with other comorbid conditions on function status clearly are indicated.

Activities of Daily Living↗

Migration theories and behavioural models.

"This review presents a probabilistic formulation of the decision making process, leading to a rigorous treatment of migration behaviour for projection purposes....Aggregate-level models may be applied to migration flows for which the objectively measured characteristics of areas of department and destination act as subjectively measured characteristics and stimuli....Individual-level models use event history methods of analysis to introduce a great variety of characteristics of the subject on the decision to move. They lead to projections using microsimulation models. A further step is taken in integrating macro- and microbehavioural models. The use of aggregate and individual characteristics simultaneously leads to more efficient and sophisticated projection models: the factors affecting behaviour at the micro-level cannot be inferred from aggregate studies and conversely."

Behavior↗

Sensitivity analysis in a multidimensional demographic projection model with a two-sex algorithm.

"Formulas are derived for the effect that a slight change in the occurrence/exposure rate of the multidimensional projection model has on the elements of the population vector. The projection model classifies the population by sex, age, and marital status. The model includes a two-sex algorithm in order to ensure consistency between numbers of male and female marriages, number of divorces for the two sexes, and new widows (widowers) and deceased spouses. The sensitivity functions and elasticities are applied to data from the Netherlands for the period 1980-1984. The results indicate that marriage market mechanisms, in particular competition and substitution effects, are reasonably well modelled."

Age Distribution↗

A violence-prevention and evaluation project with ethnically diverse populations.

The purpose of this paper is to describe some of the challenges encountered and lessons learned while providing and evaluating a violence-prevention program for and with ethnically diverse populations in child care settings. The paper discusses Safe Start, a violence prevention education program for child care staff and parents, and the evaluation of the program. Safe Start was designed to include culturally relevant content to increase cultural awareness for child care staff and parents from diverse ethnic backgrounds. The evaluation project enrolled child care centers with families representing the ethnically diverse communities in which they were located. Violence prevention research involving children from diverse ethnic backgrounds presents new methodologic challenges, but also provides new opportunities for creative, novel methods. This paper describes some of the challenges encountered with curriculum development, staff recruitment, instrument selection, and data collection procedures.

Child↗

The supply of renal physicians: an analysis of data from the American Medical Association Physician Masterfile.

This study uses data from the American Medical Association (AMA) Physician Masterfile to describe current demographic trends among physicians specializing in adult and pediatric nephrology. The analysis shows that renal physicians are younger than the physician population as a whole. Compared with other specialty groups, renal physicians are less likely to be in patient-care activities and are more likely to be in research. In recent years, the population of renal physicians has grown at a much faster rate than the rest of the physician population. A projection analysis indicates that the adult nephrologist population will more than double in size between 1987 and 2010. Among adult nephrologists, the number of women is expected to grow much faster than the number of men. Rapid growth is expected in the older age categories, whereas the number of adult nephrologists 35 years of age and younger is expected to decrease slightly.

Adult↗

Evaluation of white-tailed deer (Odocoileus virginianus) as natural sentinels for Anaplasma phagocytophilum.

Anaplasma phagocytophilum, the causative agent of human granulocytotropic anaplasmosis, can infect white-tailed deer (WTD; Odocoileus virginianus), and this species is a crucial host for adult Ixodes scapularis, the primary vector of A. phagocytophilum. The goal of this study was to determine the geographic distribution of A. phagocytophilum among WTD across a 19 state region and to evaluate the utility of WTD as natural sentinels. Serologic testing using the indirect fluorescent antibody (IFA) assay was conducted on WTD serum samples and molecular and xenodiagnostic tests were performed to confirm serologic results. The surveillance system was assessed through examination of vital attributes including WTD age and gender associations with serologic status, sample size adequacy for accurate infection status classification, and presence of the vector, I. scapularis. Six hundred thirty-three of 2,666 (24%) WTD in 17 states tested positive for antibodies (>or=128) when tested by IFA assay. Testing for p44 and/or 16S rRNA gene targets identified 73 (16%) PCR positive WTD among 458 animals tested, all of which originated from seropositive populations. Attempts to culture A. phagocytophilum from WTD were unsuccessful; however, xenodiagnostic mice inoculated with blood from 3 WTD became infected. Seroprevalence did not differ by deer age or gender; however, WTD<or=0.75 years old had a higher prevalence of PCR positivity. Using seroprevalence data, a sample size of 6-9 animals per population was projected to be adequate for identifying seropositive populations. The presence of I. scapularis was significantly associated with A. phagocytophilum antibodies in WTD. Collectively, the results of this study demonstrate that WTD would be suitable natural sentinels for this emerging zoonotic pathogen.

Age Distribution↗

The effect of increased consumer demand on fees for aesthetic surgery: an economic analysis.

Economic theory dictates that changes in consumer demand have predictable effects on prices. Demographics represents an important component of demand for aesthetic surgery. Between the years of 1997 and 2010, the U.S. population is projected to increase by 12 percent. The population increase will be skewed such that those groups undergoing the most aesthetic surgery will see the largest increase. Accounting for the age-specific frequencies of aesthetic surgery and the population increase yields an estimate that the overall market for aesthetic surgery will increase by 19 percent. Barring unforeseen changes in general economic conditions or consumer tastes, demand should increase by an analogous amount. An economic demonstration shows the effects of increasing demand for aesthetic surgery on its fees. Between the years of 1992 and 1997, there was an increase in demand for breast augmentation as fears of associated autoimmune disorders subsided. Similarly, there was increased male acceptance of aesthetic surgery. The number of breast augmentations and procedures to treat male pattern baldness, plastic surgeons, and fees for the procedures were tracked. During the study period, the supply of surgeons and consumer demand increased for both of these procedures. Volume of breast augmentation increased by 275 percent, whereas real fees remained stable. Volume of treatment for male pattern baldness increased by 107 percent, and the fees increased by 29 percent. Ordinarily, an increase in supply leads to a decrease in prices. This did not occur during the study period. Economic analysis demonstrates that the increased supply of surgeons performing breast augmentation was offset by increased consumer demand for the procedure. For this reason, fees were not lowered. Similarly, increased demand for treatment of male pattern baldness more than offset the increased supply of surgeons performing it. The result was higher fees. Emphasis should be placed on using these economic relationships to expand the demand for aesthetic surgery.

Fees, Medical↗