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PubMed1991

Demographic changes and local public expenditure in a macroeconomic perspective. Some Norwegian examples.

The impact of demographic aging and changes in the age structure on local government expenditures for social services in Norway is analyzed and projected. "To model the production of the local government sector, we have developed a macro model which reflects the coverage of different services according to demographic characteristics and standards defined as man-hours per client.... The results of a simulation show that demographic changes are of minor importance for local government expenditures in most sectors when compared to changes in standard and coverage rates....Results [also] indicate that a shift in standards and coverages in different client sectors would have rather important effects on the Norwegian economy."

Age Distribution↗
PubMed1989

Projecting household dynamics: a scenario-based microsimulation approach.

2 methods are brought together to estimate and analyze future household structure. Application of a scenario method results in the construction of differing context scenarios. These context scenarios function as alternative societal environments of the future household system. Given these context scenarios and, tentatively derived, general hypotheses relating relevant elements of the context scenarios and household processes, future input parameters of the household model are postulated. Subsequently, microsimulation is used to calculate the future household structure. Emphasis in the article is on methodology, rather than on substantive issues which have a mainly illustrative function.

Developed Countries↗
PubMed2005

Overweight and all-cause mortality in a Swedish rural population: Skaraborg Hypertension and Diabetes Project.

AIMS: To explore the prevalence of overweight in men and women in a Swedish rural community and to examine its associations with all-cause mortality. METHODS: A community-based cohort study. A total of 1,109 men and women aged >or= 40 years participated in a survey of cardiovascular disease (CVD) risk factors in the city of Skara in Skaraborg, Sweden, in 1993-94. Overweight was defined as a BMI >or=25.0 kg m(-2). Vital status was ascertained to 31 December 1999 and sex-specific associations between overweight and mortality were explored. RESULTS: The prevalence of overweight according to the WHO's criteria exceeded 50% in men and 35% in women. In men there was an inverse association between BMI and mortality. Men in the lowest quartile of BMI experienced the highest mortality with 44.1 deaths per 1,000 person-years. The hazard ratio (HR) in the highest quartile was 0.6 (95% CI 0.4-0.9). In women there were no significant differences in mortality between quartiles of BMI. In both men and women with previous CVD the mortality rates decreased with quartiles of increasing BMI. The inverse association between BMI and mortality was confined to elderly men with a history of CVD. CONCLUSION: In both sexes the association between BMI and mortality differed across subgroups of age and of a history of previous CVD. No indication of overweight being negative for longevity was found in this population. Higher age and a history of previous CVD contribute to the excess mortality seen in subjects with low BMI.

Abdominal Fat↗
PubMed2004

Target-specific differences in somatodendritic morphology of layer V pyramidal neurons in rat motor cortex.

Dendritic geometry has been shown to be a critical determinant of information processing and neuronal computation. However, it is not known whether cortical projection neurons that target different subcortical nuclei have distinct dendritic morphologies. In this study, fast blue retrograde tracing in combination with intracellular Lucifer yellow injection and diaminobenzidine (DAB) photoconversion in fixed slices was used to study the morphological features of corticospinal, corticostriatal, and corticothalamic neurons in layer V of rat motor cortex. Marked differences in the distribution of soma, somal size, and dendritic profiles were found among the three groups of pyramidal neurons. Corticospinal neurons were large, were located in deep layer V, and had the most expansive dendritic fields. The apical dendrites of corticospinal pyramidal neurons were thick, spiny, and branched. In contrast, nearly all corticostriatal neurons were small cells located in superficial layer V. Their apical dendritic shafts were significantly more slender, though spiny like those of corticospinal neurons. Corticothalamic neurons, which were located in superficial layer V and in layer VI, had small or medium-sized soma, slender apical dendritic shafts, and dendrites that were largely spine free. This study indicates that, in layer V of rat motor cortex, each population of projection neurons has a unique somatodendritic morphology and suggests that distinct modes of cortical information processing are operative in corticospinal, corticostriatal, and corticothalamic neurons.

Animals↗
PubMed2006

Cameras and community health.

Photography projects are an alternative teaching method that can be easily integrated into community programs with adolescents and children. This article provides a brief review of the use of photography in documenting social and health issues. Two examples of community photography projects with easily ignored populations are described. These projects gave a voice to participants and allowed them to demonstrate their creativity with cameras. An implementation guide is presented to provide concrete suggestions for implementing community photography projects.

Adolescent↗
PubMed1995

Life table analysis of the United States' Year 2000 mortality objectives.

BACKGROUND: The US Year 2000 mortality objectives are model standards cast as targeted changes in age-adjusted cause-specific death rates. This research centred on the projected impact of such changes on life expectancy and the mortality toll for each sex. METHODS: A computer simulation was conducted using single decrement, multiple decrement and cause-elimination life table techniques, together with a decomposition procedure. RESULTS: Male and female life expectancy at birth was projected to increase by 1.71 and 1.51 years, respectively, between the designated 1987 baseline and 2000. The leading beneficiaries would be those aged 65 and older, followed by those aged 45-64, and infants. Declines in coronary heart disease, stroke and injury death rates would most influence the projected life expectancy changes, irrespective of sex. Approximately 782,000 male deaths and 730,000 female deaths would be averted under Year 2000 assumptions. CONCLUSIONS: Life expectancy would be a useful summary measure to incorporate into official evaluations of the Year 2000 mortality objectives. Targeting of excess male mortality in the US and other highly industrialized nations is recommended.

Adolescent↗
PubMed1993

[A method for determining the denominator in general practice--results of a pilot study].

In countries with fee for service billing and direct access to specialist care the general practitioner does not know key figures of the population he serves. As the role of general practice in health-service-research, quality assurance activities and the construction of sentinel-networks is becoming more important, valid methods to determine the denominator are needed. Results from five practices suggest that yearly contact groups should be used as a common denominator for general practice in our health care system. For certain groups of patients (e. g. the elderly > 60 yrs.) even quarterly contact groups can give sufficient information to forecast the yearly contact group.

Adolescent↗
PubMed2002

Development of a prototype system for statewide asthma surveillance.

OBJECTIVES: We developed and evaluated a statewide and community-level asthma surveillance system. METHODS: Databases and measures included a community prevalence survey, hospital admissions data, emergency department/outpatient clinic visit records, and a physician survey of diagnosis and treatment practices. We evaluated the system in 5 Maine communities varying in population and income. RESULTS: Asthma hospitalizations were high in the rural/low-socioeconomic-status communities studied, although diagnosed asthma was low. Males were more likely than females to experience asthma symptoms, although they were less likely to have been diagnosed with asthma or to have used hospital-based asthma care. CONCLUSIONS: Databases were useful for estimating asthma burden and identifying service needs as well as high-risk groups. They were less useful in estimating severity or in identifying environmental risks.

Adolescent↗
PubMed1989

Dynamic aspects of the LHRH system associated with ovulation in the little brown bat (Myotis lucifugus).

Adult female bats were collected from natural roosting sites in pre-ovulatory and post-ovulatory conditions. LHRH neurones of these animals were examined using light and electron microscopic immunocytochemistry, and LHRH tissue contents were measured by radioimmunoassay. Comparisons between the two groups of bats revealed that the number of LHRH perikarya detected immunocytochemically, as well as hypothalamic LHRH content, were significantly reduced in post-ovulatory animals. Distributions of immunoreactive perikarya were, however, strikingly similar in both groups. The reduction in immunoreactive cell number observed after ovulation was therefore not restricted to an anatomically defined subset of neurones, but was evident throughout the population. The projection of LHRH-immunoreactive fibres that extend into the pituitary neural lobe in this species also exhibited changes related to endocrine condition. Morphometric indices of fibre density in the neural lobe were significantly reduced in post-ovulatory bats, as was LHRH content of the lower infundibular stalk and neural lobe. Fine structural study of perikarya revealed complex anatomical interactions between LHRH-immunopositive elements, especially in post-ovulatory bats. These interactions included direct apposition of perikarya, as well as more elaborate networks involving various combinations of perikarya and large- and small-caliber processes. These changes in the LHRH system associated with ovulation suggest reduction of stored peptide within perikarya and depletion from terminals within the lower infundibular stem and neural lobe. Parallel reductions in hypothalamic and neural lobe LHRH content during the periovulatory period support the hypothesis that the neural lobe component of the system contributes to control of gonadotrophin secretion in this species. Finally, increased complexity of anatomical contact between components of the LHRH system may be related to activation of this cell population in spring.

Animals↗
PubMed1995

[Cohort analysis of population distribution change in Japan: processes of population concentration in the Tokyo region and its future].

"This paper aims at analyzing the relationships between net-migration and the transition of population distribution from the perspective of cohort analysis. The article consists of three parts: (1) review of...previous studies...; (2) evaluation of the transition of population distribution in Japan...; (3) presentation of a new projection method, where a basic concept of a new method for regional population projection and the preliminary trial for the Tokyo Region are discussed." (SUMMARY IN ENG)

Asia↗
PubMed2003

Characteristics associated with alcohol consumption in Germany.

OBJECTIVE: Knowledge about predictors of alcohol intake in Germany is scarce. The purpose of this study was to analyze the association of sociodemographic and lifestyle characteristics and quality of life with alcohol consumption among German adults. METHOD: Analyses are based on cross-sectional data of the German adult population derived from the representative German National Health Interview and Examination Survey 1998 and the integrated German Nutrition Survey. In total, 1,925 women and 1,615 men, 18 to 79 years old, were included. Multiple linear regression analyses of alcohol intake were used to identify predictors of alcohol consumption. The analyses of drinkers were performed separately for women and men. RESULTS: Among women, alcohol consumption was associated with age, socioeconomic status, household size, smoking status, physical activity, use of soft drugs, body mass index, pregnancy and general health perception. The highest alcohol consumption was observed for women of middle age with high socioeconomic status. Among men, age, socioeconomic status, smoking status, physical activity, use of soft drugs, vegetarian diet, contentment with family or neighbors/friends, social functioning and physical functioning were associated with alcohol consumption, with age and smoking being the most important predictors. CONCLUSIONS: A variety of factors, including newly analyzed factors describing lifestyle and quality of life, are jointly associated with the higher alcohol consumption of German women and men. These findings may be valuable to focus health promotion projects on population groups with higher alcohol intake and, therefore, higher risk for harmful alcohol effects.

Adolescent↗
PubMed1995

The public health implications of the increasing predominance of Schistosoma mansoni in Egypt: a pilot study in the Nile delta.

Over the past twenty years, Schistosoma mansoni has apparently replaced Schistosoma haematobium as the more prevalent species of schistosomiasis in the Nile delta. In this paper we show that this change has profound implications for public health strategies, in particular the provision and utilization of diagnostic and treatment services for the Egyptian rural population, and for health education programmes. The processes of providing and seeking treatment for the two forms of schistosomiasis are quite distinct as they have different signs and symptoms and are diagnosed in stool and urine samples respectively. In two Nile delta villages, where S. mansoni has almost completely replaced S. haematobium, we found that health services were geared primarily to S. haematobium, and hence many cases of S. mansoni remain undiagnosed and untreated. One reason for this is that health unit staff and local people lacked detailed knowledge of the two forms of schistosomiasis, indicating the need for health education.

Egypt↗
PubMed1993

HIV serosurveillance in Papua New Guinea.

To determine human immunodeficiency virus-1 (HIV-1) prevalence in low- and high-risk populations in Papua New Guinea (PNG), anonymous unlinked serosurveillance was conducted in government-administered antenatal and sexually transmitted disease (STD) clinics at six sites beginning in June 1989. Although 3 of 1233 samples were HIV positive in a pilot study, none of 7948 samples was HIV positive during the first full year of serosurveillance (June 1989--May 1990). HIV-infected people are also identified in PNG through clinical diagnostic testing. Although underreporting is probably substantial, 45 HIV-infected people had been identified in PNG (population 3.6 million) through diagnostic testing between 1987 and the end of the first serosurveillance year (May 1990). In view of the steadily emerging clinical problem of acquired immune deficiency syndrome (AIDS) in PNG, the negative results of serosurveillance required explanation. Three possibilities are proposed: 1) the sample size chosen could fail to detect a case 5% (or more) of the time under the likely conditions of this survey; 2) the populations chosen for surveillance may not, yet, be those in which HIV is circulating at this early stage of the epidemic in PNG; and 3) laboratory error could account for some false negative results. The first two of these, alone or in combination, are most likely. Limited surveillance continued in PNG in 1991 and 1992. By June of 1992, 5 of an additional 6035 serosurveillance samples had tested positive. All 5 were among 2000 samples from a single site, the Port Moresby STD Clinic.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

Introduction of a population-based vascular registry: validity of data and limitations of registration. The Finnvasc Study Group.

A study was performed to assess the validity of the data in a nationwide vascular registry, Finnvasc, initiated in 1991. Data recorded during the first year were of 3507 procedures (immediate reoperations were excluded); 2436 (69 per cent) were surgical and 1071 (31 per cent) endovascular in nature. The Finnvasc data were compared with 2325 hospital records and re-registration of a random sample of 233 patients treated during October 1991 in nine centres was also carried out. In all, 21 per cent of patients from hospitals participating in Finnvasc were not registered and so it was calculated that about 4500 vascular procedures, 3125 surgical and 1375 endovascular, were performed in Finland in 1991. This represents an average of 900,625 and 275 procedures per million population per year respectively. The non-registration rate in October was 17 per cent. Apart from operation classification, and function and patency at 1 month, all simple binary and code data at re-registration were in agreement in at least 92 per cent of cases; checklist and numerical data did not show such good conformity. During the first year of the registry many data were either missing or inadequately recorded, emphasizing the need for cross-validation and re-registration of a random sample of cases. Furthermore, the non-uniformity of coding between hospital records and the Finnvasc registry illustrated deficiencies in the current coding system.

Finland↗
PubMed1994

Hypertensive disorders of pregnancy in southwestern Navajo Indians.

BACKGROUND: The Navajos are the largest Native American tribe. They, like other Native Americans, appear to be in an "epidemiologic transition" and are accordingly experiencing increased rates of hypertension, diabetes, and obesity. METHODS: A retrospective chart review of all pregnancies in 1991 at the Crownpoint Indian Health Service Facility in Crownpoint, NM, was conducted to determine the prevalence of hypertensive disorders of pregnancy in this Navajo population. RESULTS: Seventy-five (12.6%) of 594 pregnancies were associated with a hypertensive disorder. There were 18 individuals who developed gestational hypertension and 10 individuals with chronic hypertension that persisted during pregnancy. There were 46 women (7.7%) who developed preeclampsia and one woman (0.3%) who developed eclampsia. Eight women (1.4%) with chronic hypertension developed superimposed preeclampsia during pregnancy. Thus, 12.3% of these pregnancies in Navajo women were associated with the development of, or worsening, hypertension, and there was a prevalence of preeclampsia of 9.1%. CONCLUSION: The Navajos exhibit a high prevalence of pregnancy-related hypertension and preeclampsia.

Adolescent↗
PubMed1999

Small steps, great strides. Local groups take on health care's toughest issues--slowly but surely.

Three of the major issues affecting health care today are global in nature: poverty, violence and the aging of the American population. In the absence of a concerted national effort to deal with them, communities across the country are experimenting with their own local solutions. The Valencia County Coalition in New Mexico, for instance, is breaking down the barriers between low-income residents and the state's Medicaid managed care program. Another example: The DeKalb Medical Center in Decatur, Ga., opened a unit to treat elderly patients' acute medical problems and keep them functional so they can go straight home from the hospital rather than to subacute or skilled nursing care.

Aged↗
PubMed2003

Comparison of multiple environmental factors for asthmatic children in public housing.

Nine families of a public housing development in Boston were enrolled in a pilot asthma intervention program designed to gather dense environmental data and generate hypotheses about the relative importance of different contaminants and the viability of interventions. Despite formidable challenges working with this inner-city population, the project team succeeded in gaining active support for the project by forming a partnership with a community-based organization and by building positive relationships between the field team and the residents. Families were provided with physical interventions such as air filters, industrial cleaning and mattress covers to each apartment. Indoor temperature was high and relative humidity low during winter. Insulation of exposed steam pipes did not lower temperature. Cockroach, mouse and pet antigen levels were variable and frequently high in settled dust. Viable fungal spore levels were variable and high in some apartments. Dust-mite allergen levels were below the level of concern. Industrial cleaning led to transient reduction in mouse and cockroach antigen burden. Mattress and pillow covers lowered dust-mite antigen in bedrooms, but not living rooms. Nitrogen dioxide (NO2) levels exceeded ambient concentrations due to use of gas stoves and concentrations of particulate matter with aerodynamic diameter <2.5 microm (PM2.5) were above ambient levels because of smoking. Air filtering systems did not reduce PM levels. Several volatile organic compounds (VOCs) were above adverse risk concentrations. We hypothesize that our findings are consistent with a multifactorial model for exacerbation of asthma in this population and that no single problem dominates.

Adolescent↗
PubMed1991

When the baby boom grows old: impacts on Canada's public sector.

The authors discuss the dependency burden that is expected to result from demographic aging in Canada. "The estimated size of the burden depends on projections of demographic change, economic growth, and structural aspects of the major age-sensitive public-sector programmes. The burdens are analysed for 2016 and 2036, the period when demographic aging may be expected to have its most adverse impacts on old-age dependency ratios and public-sector programme costs. Contrary to many popularly expressed concerns, demographic aging is not the most important factor in determining future public-sector costs and revenues. Rather, aspects of the design and management of public-sector programmes represent the greatest area of uncertainty."

Age Factors↗