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PubMed1981

[Demography and the phenomenon of intraspecific competition of Gymnophallidae Morozov, 1955 in the second intermediate hosts (Trematoda, Digenea)].

In Gymnophallidae life-cycle, the primary host is very often a Lamelli-branch, rarely a Prosobranch; the second intermediate host is usually a Pelecypod, rarely a Prosobranch or an Annelid. The first host is generally sedentary; consequently, cercariae are not widely spread. The second intermediate host cannot explore all the environment. These characters are not in favour of the parasite. Adaptation of Gymnophallid cycle consists in a very large cercarial productivity (several millions for only one first host). The recruiting modalities of Gymnophallid larvae by the second intermediate host are not always the same. Two different mechanisms have been discovered. The first one consists of a limited recruiting. The number of metacercariae is not always growing up during the host-life. This number depends on the volume of microhabitat. The top number is reached when microhabitat is saturated. The second one consists of a illimited recruiting. The number of parasites increases during all the second host life. This peculiarity is possible because the metacercariae are permanently carried out of the microhabitat where they had settled. Parasites are indeed progressively surrounded by pallial proliferations and become enclosed inside pockets of host tissues. Thus, microhabitat is always free of parasites and infection can go on. There must be a correlation between the mechanism of the recruitment of Gymnophallid larvae by a given second host and the characteristics of the environment where the life cycle unfolds. In confined environment (almost closed lagoons, brackish ponds) the number of cercariae is very large and the recruitment observed is limited. Then, the host-life is preserved. In wide open stations, where hydrodynamism is important, cercariae are scattered. The recruitment observed is illimited. This peculiarity is probably an adaptative factor permitting concentration of larvae in the second intermediate host.

Animals↗
PubMed1981

[Demography and genetics of a Guaymi Amerindian population of Limoncito, Costa Rica].

A demographic and genetic study of the Guaymi Amerindian population at limoncito, Coto Brus, Costa Rica, showed that 47% of the population is between the ages of 0 and 14 and 35% between 15 and 44. The sex ratio is 91, which is evidence of a greater number of females. Forty percent of the couples come from Panama, but the filial generation (98%) was born in Limoncito. Emigration is very low. The selective potential is relatively high (0.94), with the mortality component predominating. Endogamy and the inbreeding coefficient have high values and polyginy is common. The effective and reproductive size of the population is small. Evolutionary implications of the results are discussed.

Adolescent↗
PubMed1981

Dasherkandi project studies. Demography, morbidity and mortality in a rural community of Bangladesh.

The entire population of Dasherkandi, a village near Dacca city was surveyed. Out of 1181 people 44.2% suffered from organic or psychiatric disorders. 37.7% suffered from physical disorders, 3.6% suffered from psychiatric disorders and another 2.9% suffered from both psychiatric and physical disorders. The common physical disorders were worm infestations, hypertension, peptic ulcer, dental problems and upper respiratory tract infection including flu. Females suffered from psychiatric diseases more than males. The psychiatric morbidity found in the survey differed significantly from those found in other similar surveys. Depressive states were the commonest psychiatric disorder and women suffered four times as frequently as men. Anxiety neurosis was the next common psychiatric problem. Both crude mortality and infant mortality rates (5.75 and 93.20 per thousand respectively) were lower than those of other similar studies. The commonest cause of infant mortality during first one month of life was tetanus in this series. Inspite of the fact that diagnosis was based entirely on clinical findings the morbidity rate was high. It was observed that a high percentage of the people who suffered from psychiatric disorders were due to problems which can be easily tackled under field conditions.

Adolescent↗
PubMed1993

Towards accurate prescribing analysis in general practice: accounting for the effects of practice demography.

The object of this study was to develop a more accurate method of analysing prescribing patterns in general practice than is currently provided by prescribing analysis and cost (PACT) data. In particular it was hoped to be able to develop a system to predict accurately both the prescribing activity related to practice population age-sex distributions, and the related prescribing activity in the individual therapeutic groups used in PACT reports. Data from the Vamp research data bank were combined with mean prescription costs from the Prescription Pricing Authority and the patient age-sex profile of each practice. The estimated cost of prescribing for each practice in each therapeutic group was derived, and subsequently compared with the PACT data. Large variations were found between predicted patterns and PACT 'averages' for both overall costs, and within therapeutic groups. This was most noticeable where a practice's age-sex profile varied markedly from the family health services authority mean age-sex distribution. Comparison of data for the different therapeutic groups showed the largest differential between the predicted patterns and PACT averages to be in the drugs for the cardiovascular system. Audit requires a baseline against which to measure, change and re-evaluate performance and this system of analysis provides a more accurate baseline against which to measure a practice's prescribing habits. Subsequent evaluation will provide a judgement of the quality of that prescribing. A practice population's age-sex structure is such a fundamental determinant of the practice's prescribing patterns that some modification of the current PACT weighting system should be undertaken so as to reflect more accurately average prescribing in different age groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1996

The changing profile of homozygous beta-thalassemia: demography, ethnicity, and age distribution of current North American patients and changes in two decades.

BACKGROUND: The age of patients with homozygous beta-thalassemia is increasing because of better treatment and decreased births. A countering influence is immigration of ethnic groups with a high prevalence of thalassemia. METHODS: a questionnaire sent to 48 North American centers requested information about current patients with homozygous beta-thalassemia: age, clinical severity, and ethnicity. An 83% response was obtained. Twelve reference hospitals that participated in similar surveys in 1972 and 1984 were included. RESULTS: Five hundred eighteen patients with homozygous beta-thalassemia represent most North American patients. Four hundred forty-three (86%) of these had transfusion-dependent thalassemia major (TM); 75 (14%) had thalassemia intermedia (TI). Sixty-two percent were of Greek and Italian ancestry. There were approximately equal numbers of patients with TM in 5-year intervals between 0 and 25 years of age. Thereafter, the numbers of patients fell sharply. The mean age (+/- SD) of the patients with TM was 16.1 +/- 9.2 years. Striking differences were seen in Italian and Greek patients compared with those of other ancestries. Sixty-six percent of the 271 Italian and Greek patients with TM were older than 16 years of age, whereas 77% of the 172 patients of other ethnic groups with TM were younger than 15 years of age. The mean age of the 75 patients with TI was greater than that of the patients with TM. Seventy-three percent of African-American patients had TI, compared with 0% of Southeastern Asian patients. Comparisons of patients with TM from the 12 reference hospitals for two decades show increasing mean ages of TM patients (1973, 11.4 +/- 6.7 years; 1985, 14/2 +/- 7.3 years; and 1993, 16.1 +/- 9.2 years). CONCLUSIONS: There are probably only 750 to 1000 patients with homozygous beta-thalassemia in North America. Only about 15 to 20 new cases are diagnosed each year. The increasing mean age and age distribution indicate that modern therapies are effective, but immigration of non-Mediterranean ethnic groups with thalassemia has resulted in more, younger patients. TM is increasingly becoming a disease of young adults.

Adolescent↗
PubMed1996

Genetic studies in Medzev, an isolate in south-eastern Slovakia. 1. History, demography, marriage patterns.

In Medzev, a village located in South-Eastern Slovakia, the secular variation of two indices of genetic isolation has been studied. It could be seen that this village was highly isolated till the beginning of the 20th century. Both indices show a tendency to increase in the first five decades of this century. For the entire period from 1766-1950 the coefficient of inbreeding estimated by the method of isonymy was found to be F = 0.0074 with different ratios of random (Fr) and non-random (Fn) components in particular periods. The coefficient of inbreeding estimated from the ecclesiastical dispensations for marriages comes to F = 0.0019. The genetic significance of the changes in the population structure of this village will be analyzed in further studies.

Ethnicity↗
PubMed1996

[Demography and effects of chronic renal insufficiency in Ile-de-France].

In order to assess the incidence of chronic renal failure (CRF) and the demographic characteristics of affected patients, a prospective, multicenter epidemiologic study was conducted with the cooperation of all nephrology and dialysis units in the Ile-de-France district, the total population of which is 10660000 inhabitants (source: national census, march 1990). Included were patients with a plasma creatinine (Pcr) concentration > or = 200 mumol/l referred during the one-year period from July 1, 1991 until June 30, 1992. The overall response rate was 98.5%. A total of 2775 adult patients were recorded, including 1780 males (64%) with a mean (+/- SD) age of 58.1 +/- 16.3 years and a mean Pcr of 447 +/- 214 mumol/l, and 995 females (36%) with a mean age of 59.2 +/- 16.4 years and a mean Pcr of 425 +/- 185 mumol/l. Age of patients was < 40 in 16%, 40-59 in 31%, 60-74 in 34% and > or = 75 years in 19%. Pcr was 200-399 mumol/l in 54%, 400-599 mumol/l in 25%, 600-799 mumol/l in 12% and > or = 800 mumol/l in 9%. The overall incidence of CRF was 260/million population/year, twice higher in males than in females (348 vs 179/10(6)/year, p < 0.001). Incidence of CRF dramatically rose with age in both genders, with figures as high as 1124 and 356/10(6)/year respectively in male and female patients aged > or = 75 years, vs 288 and 151/10(6)/year in patients aged < 40 years. A sequential evaluation was performed in a representative sample of 251 patients with initial Pcr > or = 300 mumol/l. End-stage renal failure (ESRF) was reached within one year in 99% of patients with PCr > 600, 49% with Pcr 500-599, 24% with PCr 400-499 and 11% with PCr 300-399 mumol/l. Based on these figures, the predicted incidence of ESRF within one year of referral was 864 out of the 2775 patients, an estimated annual incidence of 81 patients per million population. In conclusion, this prospective study affords the first direct information on the incidence of chronic renal failure and the demographic characteristics of patients with CRF in the Ile-de-France district. Due to the design of the study conducted only in nephrology units, the estimated figure of 81 new patients per million population per year reaching ESRF is a minimal evaluation. In view of the relentless aging of population in France, an incidence of at least 100 ESRF patients per million population per year is to be expected in the next future.

Adult↗
PubMed1997

The demography, clinical manifestations and natural history of human immunodeficiency virus (HIV) infection in an older population in Singapore.

In this retrospective study, we report 43 cases (41 males and 2 females) of human immunodeficiency virus (HIV) infection in the Singapore population aged 50 years and above at first presentation. We found an increasing proportion of these older individuals among our HIV-seropositive patients; from 4.8% in 1991 to 16.7% by mid-1996. The mean age at presentation was 59.2 years (range 50 to 75 years). They were mainly heterosexuals (93%) and the majority (79.1%) were previously or currently married. Thirty-six (83.7%) patients had multiple sexual exposures to commercial sex workers. Nearly all had acquired the infection through the sexual route. The majority (76.7%) were symptomatic at presentation. Common clinical presentations were weight loss (72%), respiratory symptoms (60%) and oral candidiasis (56%). More than half (58.1%) of the patients had acquired immunodeficiency virus (AIDS) at the time of first presentation with a low median CD4 count of 17 cells/mm3. Pneumocystis carinii pneumonia and tuberculosis were the common AIDS-defining diseases. Survival in patients presenting with AIDS (median survival 3 months) is poorer compared to younger HIV-seropositive patients (< 50 years; median survival 1 year). No increase in age-related infection or malignancy was seen. Common causes of death were pneumonia and septicaemia. Physicians should consider HIV infection in older patients particularly when he/she presents with unexplained weight loss, respiratory symptoms and oral candidiasis. A history of high-risk sexual behaviour must be sought in all patients, including the elderly.

AIDS-Related Opportunistic Infections↗
PubMed2000

Access to physician treatment for a mental disorder: a regional analysis.

BACKGROUND: This study examined (1) disparities in the proportion of persons who accessed a physician for treatment of a diagnosed mental disorder across 17 health regions in Alberta, Canada, and (2) the extent to which regional disparities in physician access could be explained by differences in regional demographies, population needs, or physician supply. METHODS: The study illustrates the use of ecological comparisons for regional health system performance evaluations. Regional characteristics were aggregated from four sources of data: the health insurance registry file (population denominators and regional demographies), physician claims data (treatment access), census data (social indicators of population need), and the medical directory of the College of Physicians of Surgeons (physician supply). RESULTS: Regional variability in needs-adjusted measures of access to physician-based treatment services were comparatively small (varying by a factor of 1.6). Models containing adjustments for demography, need, and physician supply explained 41% of regional variation in access. Of the total variation explained, physician supply explained a smaller proportion (39%) in comparison to social demography and needs (61%). Few large regional imbalances were noted when needs-adjusted and supply-adjusted estimates were compared. Only two areas appeared to be underserviced in comparison to their local needs, reflecting approximately 6% of the provincial population. CONCLUSIONS: While all three study factors proved important, findings support the broad conclusion that social demography and social risk (a proxy for need) will remain the key determinants predicting access to physician services for treatment of mental disorders in publicly funded health systems.

Adult↗
PubMed2000

Adaptive explanation in socio-ecology: lessons from the Equidae.

Socio-ecological explanations for intra- and interspecific variation in the social and spatial organization of animals predominate in the scientific literature. The socio-ecological model, developed first for the Bovidae and Cervidae, is commonly applied more widely to other groups including the Equidae. Intraspecific comparisons are particularly valuable because they allow the role of environment and demography on social and spatial organization to be understood while controlling for phylogeny or morphology which confound interspecific comparisons. Feral horse (Equus caballus Linnaeus 1758) populations with different demography inhabit a range of environments throughout the world. I use 56 reports to obtain 23 measures or characteristics of the behaviour and the social and spatial organization of 19 feral horse populations in which the environment, demography, management, research effort and sample size are also described. Comparison shows that different populations had remarkably similar social and spatial organization and that group sizes and composition, and home range sizes varied as much within as between populations. I assess the few exceptions to uniformity and conclude that they are due to the attributes of the studies themselves, particularly to poor definition of terms and inadequate empiricism, rather than to the environment or demography per se. Interspecific comparisons show that equid species adhere to their different social and spatial organizations despite similarities in their environments and even when species are sympatric. Furthermore, equid male territoriality has been ill-defined in previous studies, observations presented as evidence of territoriality are also found in non-territorial equids, and populations of supposedly territorial species demonstrate female defence polygyny. Thus, territoriality may not be a useful categorization in the Equidae. Moreover, although equid socio-ecologists have relied on the socio-ecological model derived from the extremely diverse Bovidae and Cervidae for explanations of variation in equine society, the homomorphic, but large and polygynous, and monogeneric Equidae do not support previous socio-ecological explanations for relationships between body size, mating system and sexual dimorphism in ungulates. Consequently, in spite of the efforts of numerous authors during the past two decades, functional explanations of apparent differences in feral horse and equid social and spatial organization and behaviour based on assumptions of their current utility in the environmental or demographic context remain unconvincing. Nevertheless, differences in social cohesion between species that are insensitive to intra- and interspecific variation in habitat and predation pressure warrant explanation. Thus, I propose alternative avenues of inquiry including testing for species-specific differences in inter-individual aggression and investigating the role of phylogenetic constraints in equine society. The Equidae are evidence of the relative importance of phylogeny and biological structure, and unimportance of the present-day environment, in animal behaviour and social and spatial organization.

Adaptation, Physiological↗