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Population trends, issues and implications.

"The aim of the paper is to provide an overview of the population trends in Africa, the critical population issues of the region and their implications, as well as linkages with important social and economic sectors such as education, health, employment, food and nutrition etc. The time frame for the paper is the recent past and the immediate future until 2025 for which United Nations projections are available. The data utilized in the paper are the United Nations Population Projections as assessed in 1988 supplemented by information available from various surveys and studies, particularly the World Fertility Surveys and Demographic and Health Surveys."

Africa↗

Continuing demographic transitions in Asia.

"This article updates the literature survey on demographic trends and policies published in the May 1987 issue of this journal. It reports substantial adjustments in earlier population projections, suggesting slower decline in population growth rates for China and several other Asian countries. It gives an account of recent trends and policies in the Asian-Pacific region, especially China, Vietnam, Indonesia, the Philippines and Singapore."

Asia↗

Effects of fertility and international migration on changing age composition in Canada.

"This paper analyses the prospects for age distribution in Canada through 2036, based on today's age structure and expected trends in fertility and international migration. Simulating these two demographic components at extreme levels shows that tomorrow's aging is already built into the current age distribution, which is heavily marked by the post-war baby boom and the following persistent baby bust, and that neither fertility nor immigration can be seen as effective adjustment mechanisms for the changing age composition of Canada. Population projections using the component method are applied along with an age-specific growth-rate analysis."

Age Distribution↗

The first year as a staff nurse: the experiences of a first cohort of Project 2000 nurses in a demonstration district.

This paper describes the experiences of eight staff nurses who were students in the first cohort of a Project 2000 course in a pilot district during their post-qualification year. A qualitative approach, informed by phenomenological methodology, was adopted in order to present these experiences alongside the meaning attributed to them by the nurses. Taped, focused group discussions, using semi-structured interviews, were analysed. This yielded five themes which describe the structure of these experiences from "coming out of school' through to the acknowledgement and confidence in themselves as a different kind of nurse to those trained on previous traditional courses. The findings suggest that the vision of the United Kingdom Central Council in proposing Project 2000 courses is likely to be realized. These nurses had gained the competent technical and clinical skills expected of any nurse. However, they also displayed skills previously absent in newly-qualified nurses, such as evidence of analytical decision-making and confident interpersonal skills, which are likely to enable them to take an equal place amongst other members of the multi-professional team in the future. Although competent practitioners, the process they had undergone to reach this had, at times, been traumatic. The implications arising from the study are that more attention needs to be paid to the personal and professional development needs of Project 2000 nurses, both at the end of the course and in their first post-qualifying year.

Adaptation, Psychological↗

[The application of Markov chains to demographic projections in smaller geopolitical areas].

"This article deals with the use of Markov chains to project population in smaller geopolitical areas. The method consists of projecting only the relative distribution which, applied to a previous demographic projection, gives figures for the population by subregion. An algorithm is worked out, allowing for an estimate to be made of the transitional probabilities of the chain based on easily available data: the total population residing in two or more regions or states in only two specific moments. Once those probabilities have been determined, the projection of the probabilities and of the relative distribution is direct. This method is applied to the metropolitan zone of Mexico City, for which population and territorial extension are projected." (SUMMARY IN ENG)

Americas↗

EU-project medCERTAIN: Certification and Rating of Trustworthy and Assessed Health Information on the Net.

Med-CERTAIN (MedPICS Certification and Rating of Trustworthy Health Information on the Net, http://www.medpics.org/medcertain/) is a recently launched project funded under the EU Action Plan for safer use of the Internet. It will provide the technical infrastructure for an international system of "quality seals" for Internet health information. Digital "quality seals" may be evaluative metainformation (using standards such as PICS = Platform for Internet Content Selection, now being replaced by RDF/XML) assigned by trusted third-party raters. The project will also enable and encourage self-labelling with descriptive metainformation by web authors. Together these measures will help consumers to identify high-quality information on the Internet. Med-CERTAIN will establish a fully functional demonstrator for a self- and third-party rating system enabling patients and consumers to filter harmful health information and to positively identify and select high quality information. We aim to provide a system allow European citizens to place greater trust in networked information, exemplified in the domain of health information, whilst also making a significant contribution for similar projects with different target domains. The project will demonstrate how PICS-based content rating and filtering technologies can automate and exploit value-adding resource description services. The proposed technology strategy combines a pragmatic use of simple existing technologies for data acquisition with a future-oriented standards policy intended to lead rather than follow the evolution of definitions for information-mediation services.

Europe↗

Peer Review as a QA Tool in Environmental Applications.

Peer Review is commonly applied during the final stage of a project and is used in the science community to determine the soundness of a conclusion and if the quality of information meets the standards of the scientific and technical community. Quality Assurance and Quality Control procedures are most effective when applied to planning, then during the process stage of a project, and during the review of a product. The gold standard for validating the quality of a study's results is comparison with a referenced data set, model, or result (Azouzi, 1999). However, costs can severely limits this approach for many applications. This article proposes an additional means for quality assessment using peer review as a quality assessment tool during the planning, process, and review of a project.

Journal Article↗

Performance indicators in water and sanitation for developing areas.

There is a move throughout the developed world to introduce benchmarking techniques to the management of water and sanitation systems. The indicators that are being considered for benchmarking purposes tend to cover a broad band of activities that are part of the scope of management of large organisations. Most of the lists that have been prepared do not really cater for the implementation and operation of small rural schemes. The greatest need is the implementation of sustainable schemes for this category of consumer. The implementation of a rural water and sanitation scheme involves the negotiation in the initial stages with the local community representatives of what the community wants and how it will be provided and operated. This may have to be preceded by a period of empowerment so that the negotiations can be conducted by informed people. At the conclusion of the negotiations a business plan can be prepared that should be implemented in association with the community. The project is at this stage mainly in the control of a professional engineer, responsible for the technical interpretation of the business plan and the management of the construction phase. Finally, after commissioning, a water service provider will be responsible for the operation, management and maintenance of the scheme on a sustainable basis. The key actions and activities are identified and performance criteria defined. As communication at the beginning of the project is a critical component, the success of this is confirmed by examination and discussion as to how much has in fact been communicated and understood correctly. Other performance indicators for the operational phase are derived from the conventional ones used in the developed world. Finally, it is important that the participants, do not see the measurement of performance as a threatening situation, but rather a stepping stone to improvement of not only performance, but also of subsequent reward.

Benchmarking↗

Risk perception during information system development in non-profit health care organizations.

The perception of risk exposure among design team members during the early phases of information system development projects can provide valuable strategic information for clinical organizations. To develop a typology of perceived risks during information system development projects in health care, interviews were performed with key team members from a specialist clinic, primary health care, and an informatics research group, during the requirements specification. Phenomenological data analysis and secondary integration of the results in available theories were performed. System objectives, the user requirements definition procedure, the communication pattern between design team members and project management were found to be perceived as the main risk areas. In the secondary analysis, the technical factors, identified as preventing a maximization of the use of the resources, were lack of informatics knowledge among economic decision makers and differences between customers and suppliers regarding their views on the nature of system design. During the implementation of a given strategy, decision makers may consider the requests of their own sponsors in the first place and maximize the use of the project resources in the second place. Informatics knowledge plays a key role in risk perception during the development of an information system in health care. Political considerations by team members are important to take into regard, since these may influence technical and economic decisions.

Humans↗

Design of Genetics Home Reference: a new NLM consumer health resource.

The authors have developed the Genetics Home Reference, a consumer resource that addresses the health implications of the Human Genome Project. The research results made possible by the Human Genome Project are being made available increasingly in scientific databases on the Internet, but, because of the often highly technical nature of these databases, they are not readily accessible to the lay public. The authors' goal is to provide a bridge between the clinical questions of the public and the richness of the data emanating from the Human Genome Project. The Genetics Home Reference currently focuses on single gene or polygenic conditions that are also topics on MEDLINEplus, the National Library of Medicine's primary consumer health site. As knowledge of genetics expands, the interrelationships between genes and diseases will continue to unfold, and the site will reflect these developments.

Computer Systems↗

Statistical graduation in local demographic analysis and projection.

"This paper considers parametric graduation for mortality, fertility and migration with particular reference to the development of parameterized local and regional demographic projections. Parametric graduations facilitate comparisons of demographic schedules across many areas and across time points--a feature which can be used to advantage in making forecasts of the three demographic components and thus in setting the assumptions for projections. Particular methodological issues raised are the questions of parsimony in fit and...of overdispersion in relation to binomial or Poisson assumptions. The analysis is illustrated with cross-sectional material for the 32 London boroughs and with time series at the level of Greater London."

Demography↗

Rescuing the emergency--multiple expertise and IT in the emergency field.

OBJECTIVES: The rapid growth, both in technical and social approaches to the innovation phenomenon in health care suggests that profound changes are occurring. The focus of the project was to evaluate these changes through the case study of the French emergency field. METHODS: The consequences of information technology implementations in the Emergency Services are presented as models to investigate the importance of technical expertise, with both the involvement of all the stakeholders from the beginning of the design and the test of the new tool in real settings. RESULTS AND CONCLUSION: A new form of work resulted for the management of the crisis, which questioned the status of the actors and their actions, and the characteristics of the protocols of rescue. The outcome of this project was a new model built for the rescue of the emergency field which encompasses alternative forms of expertise.

Cooperative Behavior↗

1993-based subnational population projections for England.

The populations of the shire counties and Greater London are projected to increase in population between 1993 and 2001. In contrast the populations of the metropolitan counties are expected to remain fairly static. This article gives details of the 1993-based subnational population projections for local authority areas within England.

Adolescent↗

Telehomecare: quality, perception, satisfaction.

The aim of this study was to demonstrate that telehomecare linking homebound patients with their home health-care nurses over the plain old telephone system (POTS) provides high-quality, clinically useful, and patient satisfactory interactions. Congestive heart failure, chronic obstructive pulmonary disease, and chronic wound-care patients receiving skilled home nursing care were randomized into control (standard home health care, HHC) and two intervention (standard care plus video conferencing/Internet access; the above plus physiological monitoring) groups. Virtual visits (VVs), consisting of two-way audio and video interactions between the central site HHC nurse and the subject at home, were compared for technical quality and clinical usefulness by the HHC nurses who performed the VVs. Subject perception of telehomecare and satisfaction with their HHC were assessed over the course of the project. There were a total of 567 virtual and 1,057 actual visits conducted for the 53 subjects completing the study. The technical quality of VVs were rated at 94.7%. They were considered to be as useful as actual visits in 90.7% of cases. Subject telehomecare perception increased after experiencing the process. All subjects were satisfied with their HHC; satisfaction increased with an increasing level of telehomecare intervention. Subjects receiving physiological monitoring and video conferencing/Internet access in addition to standard care were most satisfied with their care. VVs can be conducted over POTS. Patients can use telehomecare with moderate levels of training. These programs can provide timely and quality home health nursing care with VVs augmenting traditional home visits.

Aged↗