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PubMed1991

A profile of Alexandra.

In this article publications on the demography and environmental and health status of Alexandra Township are reviewed and a demographic survey carried out in 1990 is reported. The demographic data presented in the article describe the age, sex and ethnic profile of the population. It also describes the health and disease status, provides some vital statistics, describes the health services and discusses the implications for the development of appropriate health care strategies. Approximately 19% of the population live in informal dwellings or shelters, 14% in the newly upgraded areas and 67% in old Alexandra. Mean household occupancy was 4.04 with a male/female (m/f) ratio of 0.86. It was 3.08 in informal dwellings (m/f = 1.11), 4.30 in the newly upgraded areas (m/f = 0.74) and 4.28 for Old Alex (m/f = 0.82). Old Alex had the highest proportion of inhabitants aged over 60 years. On average females have been resident in Alexandra for 16.8 years and males for 14.9 years.

Adolescent↗
PubMed1989

[Approach to the acceptability of the capitation fee system by the population in 3 integrated health centers of the Liège region].

Capitation payment developed rapidly in the Liège area. The 1983 regulations were adopted by an existing health centre (Seraing) and two new health centres financed on capitation basis were created (Ougrée, Liège). It is now possible to distinguish amongst the theoretical factors those who had significant impact on the speed of growth. This is thus a kinetics study. The factors taken into consideration are, on demand side: demographic, sociographic, cultural, economic; and on supply side: quantity, quality of supply (diversity: age, sex, culture), organization of permanent care. The temporary conclusion is that demography of demand and quality of supply seem to be dominant factors for the kinetics. Viability of a health centre depends strongly of growth kinetics. There is a provisional instrument for creation of new health centres and their success.

Belgium↗
PubMed1978

A medical information system for ambulatory care, research, and curriculum in an army family practice residency: 51,113 patient problems.

Over a 16-month period, the Family Practice Residency at Madigan Army Medical Center coded 51,113 ambulatory problems using the International Classification of Health Problems in Primary Care (ICHPPC) coding scheme. The demography of this defined active duty, retired, and dependent population is described as well as the rank order of the major diagnostic categories and top 25 individual diagnoses. A plot of the major diagnostic categories seen by month over a 16-month period is presented. Comparisons between similar curves are made. Physician compliance to coding approached 75 percent and an average of 1.42 problems were dealt with (coded) per visit. Fifty percent of all patient problems recorded fell into 25 descriptive diagnoses. Ninety percent of all patient problems recorded fell into 163 descriptive diagnoses. These data compare favorably to the Virginia study. Comparison of the top 25 patient problems also revealed similarities between this and the Virginia study. Difficulties arise in comparing data because of the differences in coding schemes (RCGP vs ICHPPC). A universally adopted code for all family practice and ambulatory care research would help in overcoming this problem.

Adolescent↗
PubMedDate not supplied

Epidemiologic survey of juvenile chronic arthritis in France. Comparison of data obtained from two different regions.

An epidemiologic survey of JCA was carried out in two regions of France, the western part of Paris and Brittany, differing in terms of geological background and demography. The prevalence was 0.77 and 0.100% and the incidence 0.019 and 0.013%, respectively. The type of onset, the course of the disease, the immunological data and the degree of final disability were similar in both regions. These data were compared to other studies and the factors of possible discrepancy analysed.

Adolescent↗
PubMed1984

The analysis of linkages in demographic theory.

Many seemingly different questions that arise in the analysis of population change can be phrased as the same technical question: How, within a given demographic model, would variable y change if the age- or time-specific function f were to change arbitrarily in shape and intensity? At present demography lacks the machinery to answer this question in analytical and general form. This paper suggests a method based on modern functional calculus for deriving closed-form expressions for the sensitivity of demographic variables to changes in input functions or schedules. It uses this "linkage method" to obtain closed-form expressions for the response of the intrinsic growth rate, birth rate, and age composition of a stable population to arbitrary marginal changes in its age patterns of fertility and mortality. It uses it also to obtain expressions for the transient response of the age composition of a nonstable population to time-varying changes in the birth sequence, and to age-specific fertility and mortality patterns that change over time. The problem of "bias" in period vital rates is also looked at.

Adult↗
PubMed1982

[Electrophoretic alpha 1-antitrypsin variation in the Swiss population].

Two Swiss populations (population 1: Switzerland, n = 1041; population 2: population of the mountain village of Törbel, n = 273) have been phenotyped in the Pi-system (alpha 1-antitrypsin system) by isoelectrofocusing (pH 4-6 and 4-5, Ampholine plates). 20 Pi-phenotypes have been detected, which are genetically determined by at least 9 alleles. In population 1 (Switzerland) 17 Pi-phenotypes have been found, among them the relatively rare Pi-phenotypes Pi M1T, Pi M1F, Pi M1I, Pi M2S, Pi M2I, Pi M3M3, Pi M3F, Pi SS, Pi SF, Pi SZ and Pi ZZ. The detection of the PiT-allele and of the clinically relevant phenotype Pi ZZ in this population requires a special interest. The relatively isolated population 2 (Törbel) in the Swiss Alps seems to be characterized by a lower number of Pi-phenotypes and by an increased frequency of the PiE-allele compared to the whole Swiss population. Detailed data about the demography and the history of this population strengthen the hypothesis that in particular genetic drift (founder principle) and isolation are responsible for this significant distribution of the Pi-phenotypes.

Demography↗
PubMed1982

A macrosimulation approach to the investigation of natural fertility.

This paper is part of a long-term investigation known as the Mormon Historical Demography Project. It examines the capability of a simulation model, originally proposed by John Bongaarts (1976), to fit the natural fertility pattern which characterized the mid-nineteenth century Mormon population. Application of this model permits estimates to be made of the historical timing and age-incidence of fertility limitation. A sensitivity analysis of the model's parameters demonstrates that simple changes in the model's proximate determinants of fertility, excluding contraceptive practices, would be insufficient to account for later transition effects. Thus the results successfully capture the dynamics underlying the Mormon natural fertility pattern as well as offer a framework for future modeling of the transition away from natural fertility.

Adolescent↗
PubMedDate not supplied

[A model of the population growth of the Earth].

Of all global problems world population growth is the most significant one. World population drives all other global issues--of food and energy, resources and the environment. Although demographic data in a quantitative way does express the net result of our economic, social and cultural development, methods of demography can hardly suggest a more general, synergistic, approach to the study of long term growth. To describe this process in its past and project it into the foreseeable future a mathematical model is worked out. It treats the world population as an entity, seen as an open and evolving dynamic system. The approach is phenomenological and growth over very many generations is assumed to be self-similar. This invokes scaling and mathematically is expressed by a power law. Comparison with population data leads to a consistent description of growth by a hyperbolic growth curve valid from the Paleolithic up to the middle of this century. In terms of kinetics the growth rate is proportional to the square of the total number of people, rather than their number, as in the case of exponential growth. Thus nonlinear quadratic rate describes the sum outcome of all mechanisms that contribute to our growth and development in a collective interactive process. Taken without limits this pattern is divergent in the distant past and present, when it describes the population explosion. These singularities are cut off by introducing a characteristic time of 42 years,--the effective human life span--as the microscopic time constant in this phenomenology. The model gives an estimate of the beginning of human evolution congruent to 4.4 million years ago and of the total number of people who ever lived: congruent to 100 billion. In the scope of the model large scale cycles defined by history and anthropology are shown to be uniformly spaced in time on a logarithmic scale, expressing an inherent periodicity. On this scale, as we go into the past the rate of growth decreases when, finally in the early Paleolithic any appreciable change would take a million years to happen. As we approach the present this progression of cycles with the consequent compression of the time scale is now terminated by the demographic transition. This is seen as a singular epoch in all human development when the basic mode of world population growth is to change.(ABSTRACT TRUNCATED AT 400 WORDS)

Demography↗
PubMed1995

[Genetic-demographic study of mountain populations from Dagestan and their migrants to the lowlands. Comparison of basic parameters of fitness].

Results of a total genetic demography study of females of postreproductive age from both parts of "splits" highland isolates of Dagestan, highlanders, and migrants to lowlands are described. The components of natural selection that were related to differential mortality and differential fertility were estimated in the highlanders and the migrants using Crow indices. Offsprings of female migrants were characterized by a higher prenatal (spontaneous abortions and still-births) and a lower prereproductive mortality. These differences may be accounted for by two mechanisms: (1) the effects of changing marital structure (female migrants are more exogamous) and (2) better medical care for the children of migrants compared to those living in highland auls (settlements), which are still difficult to access. It was demonstrated that mortality of probands' children before reproductive age, as well as the proportion of their close genetic relatives that died within five years after resettling, increased with an increase in the level of individual inbreeding in women examined (probands). These data allow us to suggest that the drastic increase revealed in mortality of the highlanders during the first years after resettling may be partially attributed to high levels of inbreeding and heterozygosity; these, in turn, decrease the individual's nonspecific resistance to new ecological factors. Fertility and prenatal mortality appeared to increase and decrease, respectively, with an increase in the inbreeding level.

Adaptation, Physiological↗
PubMedDate not supplied

[The epidemiological transition of chronic and degenerative diseases in Mexico].

Mexico during the last decades has achieve an important development, therefore the frequency of most of the transmissible diseases dropped and an increase in frequency has been noticed in regard the chronic non-transmissible diseases of multifactorial etiology. Diagnosis and management in those cases require a great effort in fields such as internal medicine and surgery, as well as a substantial portion of resources assigned to biomedical research. Chronic and degenerative diseases have a sound impact on health economy, need medical decisions with population impact and justify an epidemiological approach in the national health service. Life expectancy reached 69 years by 1990, there is a proportional increase in adults and older person in our population, increasing urbanization and a epidemiological transition which results in a different picture of mortality in Mexico, now heart diseases, malignant neoplasia and diabetes mellitus are 3 of the 5 leading causes of death. Morbidity is not as easy to define because lack of consistent data, however, there is no doubt in regard the important role played by chronic and degenerative diseases in it. General education and health promotion as well as a changing behaviour at issues such as nutrition, physical exercise and avoiding unhealthy habits should be encouraged because its obvious value as preventive measures. After long years of heavy work we are facing a changing mexico in terms of demography and epidemiology, which requires the concern of all health professionals in order to achieve a different epidemiological picture through health education, promotion and behaviour in the whole population, it is necessary not only to live longer, we must have a superior quality of life.

Chronic Disease↗
PubMed1994

Women with chronic physical disabilities: correlates of their long-term psychosocial adaptation.

The main purpose of the present study was to examine the accountability of demography, disability status, and internal resources to the long-term psychosocial adaptation of women with chronic physical disabilities. Eighty-eight married women, with orthopaedic, neurological and internal chronic diseases, completed questionnaires dealing with demographic and disability characteristics, sense of coherence, and personal and familial adaptation. The results indicate that sense of coherence and socioeconomic index, rather than disability status variables, account significantly for the explained variance of adaptational outcome.

Activities of Daily Living↗
PubMed1977

Spline interpolation of demographic data.

There are many problems in demography involving the smoothing or interpolation of data. Usually a solution is obtained by fitting a polynomial or a suitable model curve. Often, however, fitting a spline proves to be a simple recourse. Splines, were invented nearly 30 years ago and have been shown to have desirable properties. Although spline functions are by no means unknown to demographers, no simple and direct explanation of their application exists. We hope to remedy this deficiency with this expository piece.

Demography↗
PubMedDate not supplied

HIV/AIDS in the context of culture: selection of ethnocultural communities for study in Canada.

This article reports on the methodology used to select six ethnocultural communities invited to participate in subsequent phases of the project on HIV/AIDS in the context of culture in Canada. Selection was based on quantitative data on demography, qualitative assessment of ethnocultural cohesion; and quantitative data and qualitative data of exposure to risk for sexually transmitted disease. A principle of partnership insured that the final selection was completed by interaction between the investigators and the National Advisory Committee representing ethnocultural communities in Canada. The six communities asked to participate in Phase II of the study were: in Montreal, the Latin American and the Arabic-speaking communities; in Toronto, the English-speaking Caribbean communities and communities from the Horn of Africa; in Vancouver, the Chinese and the South Asian communities. The results are significant for the future both of research on ethnicity in Canada and of control of HIV and AIDS.

Acquired Immunodeficiency Syndrome↗
PubMed1997

What demographers can learn from fruit fly actuarial models and biology.

Historically demographers have viewed the results of actuarial studies of nonhuman species, particularly those on invertebrates such as fruit flies, as largely irrelevant to investigations on human populations. In this paper I present life table data from large scale studies on the Mediterranean fruit fly, and show that they provide important insights into fundamental aspects of mortality relevant to human populations: the trajectory of mortality at older ages, sex mortality differentials, the concept of maximal life span, and demographic heterogeneity and selection. An overriding theme of the paper is the need for demographers to acquire a heightened awareness of new developments in biology including areas such as evolutionary ecology, experimental demography, and molecular medicine.

Age Distribution↗
PubMed1997

How frailty models can be used for evaluating longevity limits: taking advantage of an interdisciplinary approach.

In this paper we discuss an approach to the analysis of mortality and longevity limits when survival data on related individuals with and without observed covariates are available. The approach combines the ideas of demography and survival analysis with methods of quantitative genetics and genetic epidemiology. It allows us to analyze the genetic structure of frailty in the Cox-type hazard model with random effects. We demonstrate the implementation of this strategy to survival data on Danish twins. We then evaluate the resulting lower bounds for biological limits of human longevity. Finally, we discuss the limitations of this approach and directions of further research.

Aged↗
PubMed1997

Diversity and critical forces in dental education.

Critical issues that affect dental education and the connection between science and practice include the community, managed patient care, public skepticism and fiscal support, and shifting demography in patterns of oral disease as well as the background of students entering the dental profession. During the past several decades, there have been major shifts in the patterns of oral disease, most recently described in results of the NHANES III dental survey. The diversity and background of students entering the dental profession have changed dramatically as well, and present estimates of change in U.S. population are no less volatile. Funding for dental education in constant dollars is decreasing nationally, with declining support from state and federal sources and a much greater reliance on clinical and development income. Recent recommendations by the Institute of Medicine and Pew Health Commission and reactions to those recommendations by representative dental organizations-particularly the American Dental Association, American Association of Dental Schools, and the American Association of Dental Examiners-have significant implications for the structure of dental education. All of these factors are tempered by the emergence of managed patient care and the implications of that environment to increasing the level of academic excellence of students, improving the quality of care delivered to patients, and enhancing the scholarly contributions of faculty. These forces may represent an opportunity to maintain a well-documented national excellence in oral health care, expand the educational options to meet student demand and interest, increase the biological and behavioral background of our graduates, and explore new educational approaches to preclinical and clinical training.

Adolescent↗
PubMed1998

A prospective review of laparoscopic cholecystectomy in Brunei.

Brunei has a small population and a unique medical setup: The number of laparoscopic cholecystectomies (LCs) performed in our institution represents the total number of cases performed in this country. A prospective analysis of all the LCs performed in Brunei is presented. All 220 LCs performed between February 1, 1992, and November 30, 1996, were prospectively recorded on a detailed protocol. Analyses were made with respect to preoperative patient demography, intraoperative complications, and postoperative morbidity and mortality. Symptomatic gallstone disease was found to be common among the ethnic Nepalese population. In this series, nine patients required conversion to open surgery (4%). Acute cholecystitis comprised 21% of cases, and the mean operating time was longer in these cases (144.1 min) than in elective cases (101.2 min; P = 0.002). The overall morbidity was 5% with one ductal injury (0.5%). The mortality rate in this series was 0.5%. Our results of LC are favorable and comparable with those of published series. We conclude that LC has been successfully introduced into our institution. This study also represents an unofficial audit of the state of development of LC in Brunei.

Acute Disease↗
PubMed1997

[Epidemiological transition in Latin America: a comparison of four countries].

BACKGROUND: In the last decade, Latin America has experienced important transformations in its health conditions, due to demographic changes and a rapid urbanization process. AIM: To analyze socioeconomic, demographic and epidemiological changes in Chile, Guatemala, Mexico and Uruguay and relate them to the different stages in the demographic and epidemiological transition of these countries. MATERIAL AND METHODS: Data was obtained from official information of local and international organizations such as Pan-American Health Organization, United Nations, Latin American Center for Demography (CELADE) and World Bank. RESULTS: Guatemala is in a pre-transition stage with a high proportion of communicable diseases as causes of death (61%) as compared with Mexico (22%), Chile (13%) and Uruguay (7%). Mexico is in a prolonged transition situation and Chile is close to Uruguay in a post-transitional stage. Despite decreasing rates of mortality, the proportion of deaths represented by chronic diseases and injuries has increased to over 30% in all countries, except Uruguay. Adjusted mortality rates for cardiovascular diseases are lower in Latin American countries, as compared to Canada. However, excepting Guatemala, there are differences in the pattern of cardiovascular disease, with a higher mortality due to cerebrovascular and a lower mortality due to coronary artery diseases. CONCLUSIONS: An increment in non communicable diseases is expected for the next decades in Latin America. Analysis of demographic and epidemiological transition is crucial to define health policies and to adequate health systems to the new situations.

Chile↗