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PubMed2005

Validity of demographically corrected norms for the WAIS-III.

The diagnostic validity of new demographically corrected WAIS-III norms was investigated using a sample of 100 patients with traumatic brain injury (TBI) and a matched control group from the standardization sample. Demographically corrected norms were compared to traditional age-corrected norms. Although education accounted for incremental variance in WAIS-III factor scores in patients with TBI, above and beyond the effects of injury severity, the demographically corrected norms did not yield statistically different diagnostic classification of individuals with moderate-severe TBI than the traditional norms. In participants with relatively low levels of educational attainment, sensitivity to length of coma was less for demographically corrected norms then for traditional age-corrected norms. Nevertheless, when using a discrepancy between Verbal Comprehension and Processing speed, diagnostic accuracy rates were again similar for both sets of norms. It is concluded that the demographically corrected WAIS-III norms do not offer a clear advantage or disadvantage compared to traditional age-corrected norms in the assessment of patients with TBI who are Caucasian and who have at least a middle school level of education.

Adolescent↗
PubMed2001

The seasonality of live birth is strongly influenced by socio-demographic factors.

The number of births varies markedly by season, but the causes of this variation are not well understood. The proposed explanations include temperature or photoperiod (affecting hormonal concentrations, sperm quality or sexual activity), seasonal variation in pregnancy loss, or cultural factors. In this paper we examined whether birth seasonality is influenced by socio-demographic factors. We used data on all live births registered in the Czech Republic in 1989-1991 (n = 387 496). Differences in the degree of seasonality between socio-demographic groups (defined by maternal age, marital status, education and birth order) were examined by inspection of curves, by comparing coefficients of variations of monthly numbers of births, and by calculating the ratios of the number of births in the 3 peak months (March to May) to the number of births in the 3 lowest months (October to December). We found large differences in the size of the seasonal variation in births by socio-demographic factors. The seasonal variation was highly pronounced in mothers who were 25-34 years old, had higher education, were married, and were pregnant with their second or third child. By contrast, birth seasonality was weak in mothers who were < or =19 years or > or =35 years old, unmarried, had low education, and expected their first or fourth or higher order birth. In a multivariate model, all four socio-demographic variables contributed significantly to seasonal variation. These results suggest that the seasonality of births is, at least in this population, strongly influenced by socio-demographic factors.

Adult↗
PubMed1982

Influence of demographic factors on annual Down's syndrome births in Ohio, 1970-1979, and the United States, 1920-1979.

Because of the high correlation between advanced maternal age and the risk of Down's syndrome, the demographic factors of population age structure and age-specific birth rates are expected to have considerable effect on Down's syndrome births. The principal objective of this research was to clarify the past and present role of dramatic changes in these two demographic factors within the United States in determining the number and incidence of Down's syndrome births, and the percentage of these births to women greater than or equal to 35. The main hypothesis is that demographic events, modified by increasing use of amniocentesis, adequately account for the general trends regarding Down's syndrome births reported in the recent literature, as opposed to other explanations such as environmental factors or a real biologic increase in Down's syndrome births in younger women. The hypothesis was tested using estimates of the annual number of Down's syndrome births in Ohio for 1970-1979, obtained through use of the Lincoln-Peterson Capture-Recapture method of estimating population size. These were compared to predicted N derived from Ohio demographic data and single year maternal age Down's syndrome risk rates from Upstate New York. The two values of N were in statistical agreement in 8 of the 10 years compared, and show an overall incidence of Down's syndrome in Ohio during the 1970s of 1.20. Using USA government demographic data and Ohio 1970-1979 single year maternal age Down's syndrome risk rates, predicted Down's syndrome births were derived for the USA during 1920-1979. The results show a long-term decline over the period in predicted number (6870 to 4232), incidence (2.42 to 1.23), and percentage of Down's syndrome births to women greater than or equal to 35 (64.3 to 23.4). A precipitous decline in all three values was obtained for the 1960s and early 1970s, with an abrupt end to the declines during the mid 1970s. Predicted number of Down's syndrome births rose 10.4% during the last half of the decade from a low of 3835 in 1975, and is expected to continue to rise rapidly throughout the 1980s, principally as a result of the large increase in the number of women moving into the older age categories.

Amniocentesis↗
PubMed1990

Demographic variables in medical school admission.

Admission committees report that demographic variables, although accurate, reliable, and easily obtained from applicants to medical schools, are only moderately important in their decision making. This may be because the committees are concerned about the validity and legality of using such data as admissions criteria. This essay discusses the research on the validity of demographic variables and the recommendations for their legal use in selecting students for medical school. The relationships of age, gender, size of hometown, parental education, parental occupation, parental income, and marital status to medical school outcomes of preclinical performances, clinical performance, attrition, specialty choice, and practice location are summarized. [Race or ethnic group is discussed in a separate essay in this issue.] Although the authors focus on the predictive value of demographic variables, these variables play a more important role as the moderator variables for other predictors of medical school outcomes. The full value of using demographic variables derives from data obtained in local validity studies. To comply with the equal-protection and due-process requirements, admission officers must assure that the use of demographic information in the admission process is explicit in bulletins given to applicants and is uniformly applied in the evaluation of all applicants.

Adult↗
PubMed1998

Demographic impact of the HIV epidemic in Thailand.

OBJECTIVE: To assess the impact of the HIV epidemic on the demographic development of the Thai population. METHODS: A deterministic mathematical model was used to predict simultaneously epidemiological and demographic processes. Partial differential equations express the relationships between biological, behavioural and demographic variables. The model allows the evaluation of different sexual mixing patterns, variable transmission probabilities and incubation times. Validity analysis was performed by generating antecedent HIV prevalence patterns among military recruits and pregnant women. RESULTS: On the national level in Thailand we predict that the cumulative number of people in Thailand with HIV infection will exceed 1 million by 1999; the number of deaths from AIDS will be 555000 by the year 2000 but will not reach 1 million until after the year 2014. Without the HIV epidemic the population growth rate was estimated at 1.3% per annum until 1995, after which a decline to 0.9% by 2005 is predicted. The HIV epidemic started to affect the population growth rate by 0.026% per year in 1991, and the difference is predicted to rise to about 0.12% per year during the period 1995-2000, to decline to 0.06% in 2005 and then to disappear. In the mid-1990s HIV affected mainly the 15-35-year-old age group, but over time younger and older age groups have been affected as a result of perinatal transmission, and a decline in fertility as well as ageing of the 15-35-year-old birth cohort. Because of HIV, in 2000 there will be 612000 (1%) fewer people than expected and by 2010, 1140000 fewer (1.6%). We predict that the demographic impact of the HIV epidemic in the northern region will follow the same pattern, but with greater severity. Here, the effect on the population growth rate and the population age distribution is likely to be twice as high as at the national level. CONCLUSIONS: It is estimated that 1 million Thais will be infected with HIV by the year 2000 and an almost equal number will have died of AIDS by the year 2014. Although these numbers seem high, their direct and indirect effects on the demographic structure of the Thai population are small. However, at a regional level, for example in the northern region, the effect of the HIV epidemic may be more severe.

Acquired Immunodeficiency Syndrome↗
PubMed2004

Testing the accuracy of demographic estimates in countries with generalized epidemics.

OBJECTIVE: To assess the accuracy of demographic estimates that include the effects of HIV/AIDS on adult mortality. DESIGN: To compare estimates of demographic indicators based on UNAIDS/WHO estimates and projections with newly available estimates based on cohort studies, hospital records, national surveys and other sources of data. METHODS: New information has become available recently from a number of sites in Africa on the ratio of mortality among the HIV-positive and HIV-negative population, the proportion of all adult deaths attributable to AIDS, and the number of orphans. These data are compared with the same indicators calculated from UNAIDS/WHO estimates to assess the accuracy of those estimates. RESULTS: Differences between demographic indicators based on UNAIDS/WHO estimates and study-based estimates are generally within the uncertainty range of the UNAIDS/WHO figures. CONCLUSION: Demographic estimates based on surveillance data and demographic models are close enough to study-based estimates to be useful for advocacy and medium-term planning. However, significant differences do exist that should be taken into account for short-term planning.

Acquired Immunodeficiency Syndrome↗
PubMed1998

"The demographics of trauma in 1995" revisited: an assessment of the accuracy and utility of trauma predictions.

OBJECTIVE: In 1987, the article "The Demographics of Trauma in 1995" (DT95) attempted to predict the future needs of trauma centers based on changing population distributions. This article foresaw a relative increase in the number of injuries to the elderly and a relative decrease in total injuries. Based on these predictions, the paper recommended increasing the capabilities of existing trauma centers rather than developing new facilities. We compared these predictions to actual experience to validate this use of demographic data in trauma system planning. METHODS: The predictions of DT95 were compared with the available population and injury data from the U.S. Census Bureau and the Centers for Disease Control and Prevention using age-related cohort analysis. RESULTS: As predicted, the highest-growing segment was the population older than 65 years, which increased 18% to 33.5 million. Also, the rate of injury-related deaths per 100,000 decreased from 61.20 in 1985 to 57.98 in 1995. The number of fatal motor vehicle crashes decreased from 45,958 in 1985 to 43,484 in 1995. Against predictions, the number of firearm deaths in 1994 increased from 31,566 to 35,957. Accurate predictions were thus made for most trauma demographic categories using a combination of census predictions and existing trauma demographic patterns. The increase in firearm deaths, however, was not anticipated using these sources and suggested the potential development of a more violent society. CONCLUSIONS: Demographic projections assist in predicting the number and type of future injuries. Sociologic and economic factors also need to be considered in any predictive determinations of the true demand for trauma centers.

Adolescent↗
PubMed2006

Patients undergoing sinus surgery: constructing a demographic profile.

OBJECTIVES: The objective of this study is to construct an accurate and representative demographic profile of patients undergoing sinus surgery for chronic rhinosinusitis (CRS). This will enable future studies to enroll representative samples so that results can be more easily compared across studies and generalized to the U.S. population. METHODS: The investigators interrogated the databases of the National Survey of Ambulatory Surgery to gather demographic data. Whenever the NSAS provided incomplete characterization, deficiencies were corrected using state-level data provided by the Health care Cost and Utilization Project. The constructed profile was compared with available profiles of patients with CRS and demographic data provided by the U.S. Census Bureau. RESULTS: The demographic profile of patients undergoing sinus surgery is 52.7% female with a mean age of 38.5 years. A total of 93.5% of surgery is performed on an outpatient basis with 78.8% of patients having private insurance sources. No significant difference in occurrence of surgery was found between months of the year or between regions of the country. The constructed race profile is 85.7% white, 5% black, 1.2% Asian/Pacific Islander, 0.2% Native American, and 7.8% other. CONCLUSIONS: A novel integration of national and state databases can be used to create a demographic profile of patients undergoing surgery for CRS. The creation of this profile enables further study of representative populations of patients with CRS and enables thoughtful analysis of the existing literature. The difficulty in creating the profile highlights the need for complete and accurate healthcare information collection by national and state agencies.

Adolescent↗
PubMed2001

Testing demographic models of effective population size.

Due to practical difficulties in obtaining direct genetic estimates of effective sizes, conservation biologists have to rely on so-called 'demographic models' which combine life-history and mating-system parameters with F-statistics in order to produce indirect estimates of effective sizes. However, for the same practical reasons that prevent direct genetic estimates, the accuracy of demographic models is difficult to evaluate. Here we use individual-based, genetically explicit computer simulations in order to investigate the accuracy of two such demographic models aimed at investigating the hierarchical structure of populations. We show that, by and large, these models provide good estimates under a wide range of mating systems and dispersal patterns. However, one of the models should be avoided whenever the focal species' breeding system approaches monogamy with no sex bias in dispersal or when a substructure within social groups is suspected because effective sizes may then be strongly overestimated. The timing during the life cycle at which F-statistics are evaluated is also of crucial importance and attention should be paid to it when designing field sampling since different demographic models assume different timings. Our study shows that individual-based, genetically explicit models provide a promising way of evaluating the accuracy of demographic models of effective size and delineate their field of applicability.

Alleles↗
PubMed2002

Benefits and costs of mutualism: demographic consequences in a pollinating seed-consumer interaction.

Interspecific interactions can affect population dynamics and the evolution of species traits by altering demographic rates such as reproduction and survival. The influence of mutualism on population processes is thought to depend on both the benefits and costs of the interaction. However, few studies have explicitly quantified both benefits and costs in terms of demographic rates; furthermore there has been little consideration as to how benefits and costs depend on the demographic effects of factors extrinsic to the interaction. I studied how benefits (pollination) and costs (larval fruit consumption) of pollinating seed-consumers (senita moths) affect the reproduction of senita cacti and how these effects may rely on extrinsic water limitation for reproduction. Fruit initiation was not limited by moth pollination, but survival of initiated fruit increased when moth eggs were removed from flowers. Watered cacti produced more flowers and initiated more fruit from hand-pollinated flowers than did unwatered cacti, but fruit initiation remained low despite excess pollen. Even though water, pollination and larvae each affected a component of cactus reproduction, when all of these factors were included in a factorial experiment, pollination and water determined rates of reproduction. Counter-intuitively, larval fruit consumption had a negligible effect on cactus reproduction. By quantifying both benefits and costs of mutualism in terms of demographic rates, this study demonstrates that benefits and costs can be differentially influential to population processes and that interpretation of their influences can depend on demographic effects of factors extrinsic to the interaction.

Animals↗
PubMed2000

Socio-demographic correlates of screening intention for colorectal cancer.

OBJECTIVE: To assess the relationship between socio-demographic factors and screening intention for colorectal cancer (CRC). METHODS: A cross-sectional survey of a random sample of 884 Queenslanders aged 40-80 years was conducted using a computer-assisted telephone interviewing system. The factors measured included socio-demographic characteristics, personal history of CRC, knowledge of others with CRC and perceived symptom status. Chi-squared and Monte Carlo estimates of Fisher Exact Tests were performed to determine the associations between socio-demographic factors and screening intention. In multivariate analyses, multinomial logistic regression (MNLR) was utilised to examine potential determinants of screening intention. RESULTS: 77.5% (95% CI 74.0%-80.7%) of the respondents indicated their intention to participate in CRC screening if it were recommended by their doctor or health authorities. The likelihood ratio chi-squared tests in the MNLR analyses show that age (chi(df = 6)2 = 15.0; p = 0.02), education (chi(df = 8)2 = 19.4; p = 0.01), perceived symptom status (chi(df = 4)2 = 22.9; p = 0.00), sex (chi(df = 2)2 = 4.5; p = 0.11), income (chi(df = 14)2 = 19.6; p = 0.14) and personal history of CRC (chi(df = 2)2 = 4.3; p = 0.12) were potential determinants of screening intention. Other socio-demographic factors, including country of birth, private health insurance status, Socio-economic Index for Areas, and Rural and Remote Areas Classification codes, were not associated with screening intention. CONCLUSIONS AND IMPLICATIONS: The results indicate that a variety of socio-demographic factors are associated with screening intention and need to be considered in the future development of a population-based screening program for CRC.

Adult↗
PubMed2001

Demographers and the study of mortality: scope, perspectives, and theory.

Demographers have for a long time adopted an empirical approach to the study of the levels and trends of mortality, fertility, and population size. They depend for their analyses on data, usually collected until recent times by government and often for other purposes. Modern demography had its origins in Britain in the second half of the seventeenth century. The major focus of demographers has usually been on mortality, although fertility studies predominated in the 1960s and 1970s. Mortality decline in the West only became certain in the late nineteenth century. Until the 1960s the fastest mortality declines were for the young, but an unheralded mortality decline among the old thereafter became important. The world, especially in economically advanced countries, is faced with an increasingly high proportion of old people, explained largely, not by mortality decline, but by fertility decline. Explanations for the mortality transition place different emphases on the role of modern medicine, better nutrition, and behavioral and social change, particularly rising levels of education. Even among the old, at least until 85 years of age, there are wide differentials in mortality by educational level. Analysts have divided the mortality transition into stages: (1) high, pretransitional mortality, (2) early transitional mortality with the decline explained by the conquest of infectious disease, and (3) late transitional mortality largely attributable to degenerative disease. Some have now added stage (4), the reduction or delay in death from degenerative causes. Attempts have been made to effect the convergence of demographic and epidemiological approaches to the analysis of mortality, and they have been more successful in the case of medical demographic than in social demographic approaches.

Adult↗
PubMed2003

Effects of demographic and health variables on Rasch scaled cognitive scores.

OBJECTIVES: To determine whether demographic and health variables interact to predict cognitive scores in Asset and Health Dynamics of the Oldest-Old (AHEAD), a representative survey of older Americans, as a test of the developmental discontinuity hypothesis. METHODS: Rasch modeling procedures were used to rescale cognitive measures into interval scores, equating scales across measures, making it possible to compare predictor effects directly. Rasch scaling also reduces the likelihood of obtaining spurious interactions. Tasks included combined immediate and delayed recall, the Telephone Interview for Cognitive Status (TICS), Series 7, and an overall cognitive score. RESULTS: Demographic variables most strongly predicted performance on all scores, with health variables having smaller effects. Age interacted with both demographic and health variables, but patterns of effects varied. DISCUSSION: Demographic variables have strong effects on cognition. The developmental discontinuity hypothesis that health variables have stronger effects than demographic ones on cognition in older adults was not supported.

Age Factors↗
PubMed2002

[Reforms and demographic crisis].

During reformation years all basic medical and demographic indices have undergone negative changes in Russia. Since 1992 there has been a steady-state decrease in the population due to the fact that mortality rates are extremely greater than birth ones. In 2001, the Russian population reduced in number by nearly a million. The birth rates are twice less than that requires for a simple reproduction of generations. Extremely high death rates remain among the population, in able-bodied males. The main reasons for the demographic crisis are the negative consequences of the implemented reforms rather than the transition from traditional to the new present-day reproduction of the population. It is problematic now to correct the situation via active migration of Russian-speaking persons. This requires enormous funds to provide comers with jobs and dwelling. It is unreal to diminish annual departure of 100 thousand persons, mainly young educated professionals from the country, though it is joust not only a demographic, but a strategic problem. In 2001 there was a some rise in birth rates. But this is the most illusive way of solving the demographic crisis. Just in the USSR, the high educational level of the population, the socioeconomic emancipation of females and progress in medicine gave rise to the transition to the present-day reproduction of the population, which is characterized by low birth and death rates. So the population is unlikely to be replenished by high birth rates. The main way of overcoming the demographic crisis is to reduce mortality and not to allow young people to die prematurely. For this it is necessary to know the biological mechanisms responsible for extremely high mortality. It is most likely to be due to breakdown in the dynamic stereotype of higher nervous performance, as stated by I. P. Pavlov. Today it is insufficient to control alcoholism, traumatism, and smoking by healthy lifestyle propaganda in order to reduce death rates in Russian. All these disasters took place after the Great Patriotic War, but an aspiration for long and happy life was prevalent in the consciousness of the people who has won the war. At present, neither the whole able-bodied population nor all young people have an internal aim at living long. To overcome this tragic gap in the consciousness requires primarily a great working motivation.

Attitude to Health↗
PubMed1992

Demographics, affect, and adolescents' health behaviors.

Considerable research has established that a relationship exists between demographics, emotions, and physical health complaints. Much less is known about the association between demographics, affect, and actual health behaviors, particularly in youngsters. Accordingly, this paper presents findings on the relationship between affect, demographics, and health-related lifestyle among 139 public high school students, a population generally believed to be at high risk for the development of detrimental health habits. Covariation between affect, health practices, and demographics was examined using stepwise multiple regression analyses which revealed distinctive demographic and affective correlates of different health behaviors. The implications of these results are discussed and directions for future research are noted.

Adolescent↗
PubMed2005

Socio-demographic and geographic indicators and distribution of tuberculosis in Hong Kong: a spatial analysis.

OBJECTIVE: To determine the socio-demographic and geographic indicators responsible for the distribution and transmission of tuberculosis (TB) in Hong Kong using geographical information system (GIS) technology. MATERIALS AND METHODS: All patients with bacteriologically proven TB over a period of 3 years (May 1999-April 2002) residing within Hong Kong Island were studied. Molecular characterisation of their sputum isolates by IS6110-based restriction fragment length polymorphism (RFLP) technique was performed. Socio-demographic data were derived from the 2001 Hong Kong population census. Geographic coordinates of patients' addresses were linked to the GIS; large street block groups (LSBGs) were the units of analysis. RESULTS: Of 2387 patients with bacteriologically confirmed TB, 2332 had valid addresses distributed in 430 LSBGs in Hong Kong Island. Of the five socio-demographic indicators studied, significant correlations were found between the rate of TB in an LSBG and low educational attainment, elderly population and low-income household, but not population density or unemployment. The five socio-demographic indicators were not different between LSBG with clustered cases and those with unique cases. CONCLUSION: Low educational attainment, old age and poverty were significant determinants of the rate of TB in different parts of Hong Kong, while none of the socio-demographic indicators was related to disease transmission.

Aged↗
PubMed1991

[The quality of demographic development in Czechoslovakia from the European viewpoint].

Forty years of a totalitarian regime imply economic, cultural and moral devastation. Statistical analyses reveal, however, also demographic devastation in particular in the sphere of health and social aspects. This means that the basic indicators of the quality of demographic development in Czechoslovakia during the last 25 years are remarkably close to the indicators of the former socialist system and that they deteriorate and lag behind when compared with other countries, in particular developed industrial countries. This trend can be also called "balkanization" because Czechoslovakia which belonged before the war among the eight most highly developed industrial countries dropped at the end of the eighties to the level of demographic indicators of Bulgaria, Jugoslavia, Hungary, Roumania etc. In the submitted investigation the authors demonstrate these facts based on the analysis of selected coefficients of quality of the demographic development such as infant mortality, specific mortality of the male and female population aged 55-59 years and the mean life expectancy of men and women at birth, on the background of the general European demographic situation. For analyses only the latest data published by UNO were used.

Adult↗
PubMed1989

[The development of drug utilization with special reference to demographic factors].

Possible influences of demographic changes in the Federal Republic of Germany on future expenditures for medication have been investigated using population models from the Federal Statistical Office and data concerning the structure of current drug expenditures of the health insurance system. In addition the former contribution of demographic changes to the development of drug expenditures has been estimated using retrospective analysis. The study demonstrates that a constant supply with medicines would require an increase of expenses of 0.6% per year until 2,000 AD due to demographic changes, assuming other conditions remain constant. Development since 1957, however, shows that demographic influences are of relatively low importance for the development of total drug expenditures. During the last decade the total growth of costs for medicines was 6 times higher than that which would have been expected due to demographic changes alone. Further comparisons with the growth rate of the gross national product (GNP) demonstrate that since 1975 growth of drug expenditures parallels growth of GNP. The price indices for pharmaceutical products and for cost of living developed in a parallel way during the same period of time.

Age Factors↗