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PubMed2005

Demographic analysis of post-abortive and interval-administered hormonal contraceptive methods.

OBJECTIVE: To compare, using method type and application time, the demographic characteristics of women using hormonal contraceptive methods administered after abortion or during the interval period with those of intrauterine device (IUD) users. METHODS: The demographic characteristics of women to whom oral contraception (OC), monthly injection, depot medroxyprogesterone acetate (DMPA), or IUD were administered in the post-abortive and interval periods between January 1998 and September 2001 in our clinic, were evaluated with the help of a registration system based on the Microsoft Access software used in our clinic. Demographic characteristics recorded were: age, reproductive expectation, previous contraceptive method, education level, number of live children, number of induced and spontaneous abortuses. RESULTS: A total of 10 500 women were included in the study. Of these, 6601 women had taken a contraceptive method during the interval period, and 3899 women had taken a contraceptive method post-abortion. Only 4.6% of the cases were younger than 20 years, 48.3% were between 21 and 30 years, 37.2% were between 31 and 40 years and 9.9% were 41 years old or over. The DMPA-administered group contained the highest number of women > or = 41 years when compared to other groups (22.8%). In reproductive expectations, 65.8% of the cases wanted no more children; 1.3% wanted to have a baby within a 2-year period whereas 23.7% wanted a child after 2 years. The proportion of women wanting no more children was greatest in the DMPA-administered group (77.3%). No previous use of contraceptive methods was reported by 20.7% of women; 27% were using coitus interruptus. The education level of the women was as follows: 10% had no education, 58.3% had education to primary school level, 23.2% to secondary-high-school level and 2.1% to university level. The group of women who chose OC as their contraceptive method contained the highest proportion of university graduates (6.5%). Only 6.26% of the women had no children. The proportion of women in the DMPA-use group with three or more children was higher compared to that in other groups (33.2%). CONCLUSION: The evaluation of demographic characteristics plays an important role in counseling, and in the efficacy and continued use of contraceptive methods.

Abortion, Spontaneous↗
PubMed2003

The evolution of dispersal under demographic stochasticity.

Temporal and spatial variations of the environment are important factors favoring the evolution of dispersal. With few exceptions, these variations have been considered to be exclusively fluctuations of habitat quality. However, since the presence of conspecifics forms part of an individual's environment, demographic stochasticity may be a component of this variability as well, in particular when local populations are small. To study this effect, we analyzed the evolution of juvenile dispersal in a metapopulation model in which habitat quality is constant in space and time but occupancy fluctuates because of demographic stochasticity. Our analysis extends previous studies in that it includes competition of resources and competition for space. Also, juvenile dispersal is not given by a fixed probability but is made conditional on the presence of free territories in a patch, whereas individuals born in full patches will always disperse. Using a combination of analytical and numerical approaches, we show that demographic stochasticity in itself may provide enough variability to favor dispersal even from patches that are not fully occupied. However, there is no simple relationship between the evolution of dispersal and various indicators of demographic stochasticity. Selected dispersal depends on all aspects of the life-history profile, including kin selection.

Biological Evolution↗
PubMed2004

Comparing demographic, health status and psychosocial strategies of audience segmentation to promote physical activity.

The goal of audience segmentation is to identify population subgroups that are homogeneous with respect to certain variables associated with a given outcome or behavior. When such groups are identified and understood, targeted intervention strategies can be developed to address their unique characteristics and needs. This study compares the results of audience segmentation for physical activity that is based on either demographic, health status or psychosocial variables alone, or a combination of all three types of variables. Participants were 1090 African-American and White adults from two public health centers in St Louis, MO. Using a classification-tree algorithm to form homogeneous groups, analyses showed that more segments with greater variability in physical activity were created using psychosocial versus health status or demographic variables and that a combination of the three outperformed any individual set of variables. Simple segmentation strategies such as those relying on demographic variables alone provided little improvement over no segmentation at all. Audience segmentation appears to yield more homogeneous subgroups when psychosocial and health status factors are combined with demographic variables.

Adolescent↗
PubMed1996

Incidence of HIV-1 infection in adults and socio-demographic characteristics of seroconverters in a rural population in Uganda: 1990-1994.

BACKGROUND: To evaluate HIV-1 incidence among adults and socio-demographic risk factors in a rural population in Uganda, a prospective cohort study was carried out. METHODS: All consenting adult residents in a cluster of 15 neighbouring villages of the Masaka District of south-west Uganda have been participating in annual socio-demographic and serological surveys since November 1989. Those who had a negative serostatus when they were first tested and had at least one serostatus assessment during the 4 years of follow-up (1990-1994) have been evaluated for HIV-1 seroconversion. Incidence rates have been calculated per 1000 person-years of observation and socio-demographic characteristics assessed for association with recent seroconversion. RESULTS: At the baseline survey, of 4175 adults with assessable serostatus (79% of all censused adults), 342 (8.2%) were seropositive. During 12588.2 person-years of follow-up 89 seroconversions were identified corresponding to an incidence rate of 7.1 (95% CI: 5.6-8.5). Overall rates were highest in females aged 20-24 years (15.2) and in males aged 20-44 years (11.6). There was a significant interaction between age and sex; the ratio of the rate in females to that in males decreased from 3.3:1 to 0.5:1 with increasing age. Rates for males aged > or = 20 years were four times higher than those for younger males. Other significant socio-demographic correlates with risk included not belonging to the majority tribe, non-Muslim religion and length of stay on compound of less than 10 years. Incidence rates did not show any clear trends with time. CONCLUSION: These findings further emphasize the need for targeted interventions.

Adolescent↗
PubMed1995

Reproducibility of responses to telephone interviews: demographic predictors of discordance in risk factor status.

The reproducibility of responses to the Behavioral Risk Factor Surveillance System questionnaire was examined across the demographic strata used by the Centers for Disease Control and Prevention and state health departments for reporting prevalence estimates (specifically age, sex, income, employment, and marital status), as well as race/ethnicity, which has been previously examined. The authors administered the questionnaire twice, 21-94 days apart, to randomly selected residents of Massachusetts (response rates: first administration, 68% of eligible households; second administration, 68% of persons who completed the first interview). Initial interviews were conducted in March and October 1992. Among 448 respondents to both interviews, group mean distributions of seven demographic characteristics and 19 risk factors were highly consistent across the two interviews. Discordance in individual risk factor status ranged from 1.2% to 21.8% (median, 7.8%) and was symmetric in direction, i.e., as many respondents were considered at increased risk on the basis of the first interview and at low risk on the basis of the second interview as the reverse. Kappas ranged from 0.30 to 0.90 (median, 0.75). Education, household income, and interval between administrations were not associated with prevalence of discordance for any risk factor. Sex, age, race/ethnicity, marital status, and employment status were each predictive of variation in discordance for one or more risk factors, but no consistent effect of any individual demographic characteristic across risk factors was observed. The questionnaire has relatively uniform and generally good reproducibility across all demographic strata used for monitoring the Health Objectives for Year 2000 and other chronic disease surveillance activities.

Adolescent↗
PubMed1996

The impact of demographics, injury severity, and trauma type on the likelihood of survival in child and adolescent trauma patients.

OBJECTIVE: The purpose of this study was to examine the influence of demographics, clinical factors, and injury types on the likelihood of survival. DESIGN: This cross-sectional analysis was restricted to persons younger than 18 years, treated in trauma centers in 1990. MATERIALS: A total of 3,540 individuals from the 1990 Virginia Statewide Trauma Registry was included in the analysis. METHODS AND MEASUREMENTS: The outcome variable was the patient's survival likelihood after injury. The independent variables included Injury Severity Score (ISS), demographics (age, gender, and race), and injury types -- motor vehicle collision (MVC) or gunshot wound (GSW). Correlation coefficients were obtained from the study variables. Logistic regression evaluated the effect of injury severity, controlling for demographics and type of injury. MAIN RESULTS: Three variables (ISS, GSW, and MVC) exerted significant effects of survival. Individuals with more severe injuries were more likely to die than their counterparts. Patients with gunshot wounds and motor vehicle injuries were more likely to die than those who had other injuries. After adjusting for demographics and injury type, injury severity (beta = -0.323) was found to be the most influential predictor of survival. CONCLUSIONS: The overall findings suggest a need for hospitals to collect data routinely for calculating injury severity for the management and treatment of injured patients.

Adolescent↗
PubMed1975

An examination of the effect of market demographic and competitive characteristics on gross margins of prescription drugs.

This study was carried out to determine the influence of selected demographic and competitive market factors on community pharmacy operations. Data were collected from a panel of pharmacies located in large mid-western city. A sample of 300 prescriptions was obtained from each of the panel pharmacies. From the prescriptions, the gross margins and the addresses of the patrons were determined. A profile of the demographic and competitive factors was determined. Eight research hypotheses were tested. The variables were subjected to regression analysis with per cent markup and dollar markup-on-retail being the dependent variables in each case. The simple regression analysis did reflect a significant relationship between select competitive variables and per cent markup. The stepwise regressions indicated a significant relationship between all demographic and competitive market factors and per cent markup. No significant relationships were found in the simple regression treatment of a dollar markup and the market variables. The stepwise regression routine yielded a nonsignificant relationship between dollar markup and all market variables except income and education. It can be concluded that pricing in this market is reflective of both demographic and competitive market factors of the trading area.

Age Factors↗
PubMed2000

Patient satisfaction with hospital care: effects of demographic and institutional characteristics.

BACKGROUND: There are a growing number of efforts to compare the service quality of health care organizations on the basis of patient satisfaction data. Such efforts inevitably raise questions about the fairness of the comparisons. Fair comparisons presumably should not penalize (or reward) health care organizations for factors that influence satisfaction scores but are not within the control of managers or clinicians. On the basis of previous research, these factors might include the demographic characteristics of patients (eg, age) and the institutional characteristics (eg, size) of the health care organizations where care was received. OBJECTIVES: The goal of this study was to examine the extent to which a patient's satisfaction scores are related to both his/her demographic characteristics and the institutional characteristics of the health care organization where care was received. METHODS: We conducted an analysis of secondary data from the Veterans Health Administration (VHA), US Department of Veterans Affairs. The database contained patient responses to self-administered satisfaction questionnaires and information about demographic characteristics. Additional data from VHA were obtained regarding the institutional characteristics of the hospitals where patients received their care. RESULTS: Among demographic characteristics, age, health status, and race consistently had a statistically significant effect on satisfaction scores. Among the institutional characteristics, hospital size consistently had a significant effect on patient satisfaction scores. CONCLUSIONS: Study results can be interpreted as justifying the need to adjust patient satisfaction scores for differences in patient population among health care organizations. However, from a policy perspective, such adjustments may ultimately create a disincentive for health care organizations to customize their care.

Adult↗
PubMed1994

Tobacco use among American adolescents: geographic and demographic variations.

A previous national study indicated that the South dominated other regions of the United States in tobacco use. Using the results of the Teenage Attitudes and Practices Survey conducted by the National Center for Health Statistics, we examined the geographic and demographic differences of tobacco use among US adolescents. The sample consisted of teenagers in grades 7 through 12 nationwide (N = 6,599). Data were collected through telephone interviewing. The variables included demographics and measures of smoking or use of smokeless tobacco (chewing tobacco/snuff). Results indicated that the overall prevalence rate for smokeless tobacco use was 4.44%, but in the South it was 6.38%. The overall smoking prevalence rate was 13.31%, with no substantial difference among regions. Demographic variables such as sex, ethnicity, education, and poverty levels were also related to tobacco use prevalence. These geographic and demographic variations in tobacco use help target specific regions and populations in greatest need of intervention programs.

Adolescent↗
PubMed2006

Changing demographics of patients with total joint replacement.

There has been a substantial change in the population demographics of patients who potentially will require total joint replacements. We studied data regarding temporal trends in physical condition, life expectancy, education, and other population demographics of individuals most likely to receive total joint replacements. Changes in this population during the last several decades correlate with temporal changes in the prevalence of joint disease and the incidence of total hip and knee replacements. Compared with several decades ago, patients currently receiving total joint replacements are almost 20% heavier, more physically active, three times more likely to have a high school or college education, and live more than 25% longer. Patients needing total joint replacements are more likely to be female, and twice as likely to receive a total knee replacement than a total hip replacement. Treatment choices and outcome expectations are best determined with accurate knowledge of current surgical science and current patient demographics. Therefore, it is important to realize that today's population most likely to receive total joint replacements is demographically different than in the past.

Adult↗
PubMed2003

Voiding patterns in patients with post-prostatectomy incontinence: urodynamic and demographic analysis.

PURPOSE: A significant percentage of patients with post-prostatectomy incontinence have been reported to void by Valsalva's maneuver, which is our observation as well. We determine the mechanism of voiding in patients with post-prostatectomy incontinence and correlate this to demographic data, urodynamic parameters and outcome after artificial urinary sphincter implantation, and identify possible risk factors. MATERIALS AND METHODS: Videourodynamic data from 61 consecutive patients with post-prostatectomy incontinence were reviewed to determine voiding patterns. The causes of incontinence were radical prostatectomy in 58 patients and transurethral resection of the prostate followed by radiation therapy in 3. The relationship between voiding patterns and demographic data (age, diabetes mellitus, degree and duration of incontinence, history of radiation therapy or treated bladder neck contracture) as well as urodynamic parameters (bladder capacity, compliance, instability, sensation, leak point pressure and residual urine) were studied. After artificial urinary sphincter implantation outcome was assessed in relation to the voiding patterns. RESULTS: Stress incontinence was present in all patients while concomitant urgency/urge incontinence was present in 48%. Of the patients 43 (70.5%) voided by detrusor contraction (group 1) while the remaining 18 (29.5%) voided by straining (group 2). Mean patient age +/- SD was 70.8 +/- 6.9 and 69.2 +/- 7.2 years, and duration of incontinence was 48 +/- 33 and 46 +/- 30 months in groups 1 and 2, respectively (p >0.05). Also, no significant differences were found between the groups with regard to other demographic data. Delayed first sensation (at volume greater than 140 ml.) was seen in 42.5% and 29.4%, capacity less than 300 ml. in 41.9% and 39%, impaired/poor compliance in 25.6% and 22.2%, bladder instability in 16.3% and 5.6%, abdominal leak point pressure 60 cm. H(2)O or less in 59.4% and 60% and residual urine greater than 50 ml. in 11.6% and 17.6% in groups 1 and 2, respectively (p >0.05). After artificial urinary sphincter implantation 35% and 22.2% of patients used greater than 1 pad a day in groups 1 and 2, respectively. One patient in each group reported difficulty during urination and both patients had no residual urine. CONCLUSIONS: No identifiable demographic or urodynamic risk factors could be detected in association with the strain pattern of voiding in patients with post-prostatectomy incontinence. The absence of a difference in bladder compliance, residual urine volume and outcome after artificial urinary sphincter implantation between detrusor and strain voiders would suggest no increased risk for complications in the strain voiding group.

Aged↗
PubMed2005

Informed consent in sinus surgery: link between demographics and patient desires.

OBJECTIVE: To evaluate and understand differences in expectations according to patient demographics during the informed consent process for functional endoscopic sinus surgery (FESS). STUDY DESIGN: Multi-institutional, cross-sectional survey design. METHODS: Anonymous surveys were administered to patients in two tertiary academic centers with a chief complaints relating to "allergy and sinus" problems. Patients completed and eight-item questionnaire that assessed demographics and the nature and level of risks that patients wished to be informed of before FESS. Univariate and multivariate analyses were performed to assess for differences in patient desires related to FESS risks according to demographics. RESULTS: Three hundred eighty-nine completed surveys were analyzed. Younger patients (P = .049), white patients (P = .0026), and more educated patients (P = .0033) wished to know about complications at the lowest risks levels (lowest incidence), regardless of severity. With regards to specific complications, black patients and patients with less formal education were less interested in being informed about the potential risks of orbital complications, cerebrospinal fluid leak, or possible need for revision surgery. Multivariate analysis confirmed that race, education, age were independently significant factors in determining response. CONCLUSION: Demographic-related differences exist in patient's desires and expectations in the informed consent process for a sinus procedure. Physicians should be aware of these differences when counseling patients about sinus surgery. More research is needed to elucidate the factors that underlie the observed differences.

Adolescent↗
PubMed2006

Surveillance of the colorectal cancer disparities among demographic subgroups: a spatial analysis.

OBJECTIVE: The literature suggests that colorectal cancer mortality in Texas is distributed inhomogeneously among specific demographic subgroups and in certain geographic regions over an extended period. To understand the extent of the demographic and geographic disparities, the present study examined colorectal cancer mortality in 15 demographic groups in Texas counties between 1990 and 2001. METHODS: The Spatial Scan Statistic was used to assess the standardized mortality ratio, duration and age-adjusted rates of excess mortality, and their respective p-values for testing the null hypothesis of homogeneity of geographic and temporal distribution. RESULTS: The study confirmed the excess mortality in some Texas counties found in the literature, identified 13 additional excess mortality regions, and found 4 health regions with persistent excess mortality involving several population subgroups. CONCLUSION: Health disparities of colorectal cancer mortality continue to exist in Texas demographic subpopulations. Health education and intervention programs should be directed to the at-risk subpopulations in the identified regions.

Black People↗
PubMed2005

Genetic analysis reveals demographic fragmentation of grizzly bears yielding vulnerably small populations.

Ecosystem conservation requires the presence of native carnivores, yet in North America, the distributions of many larger carnivores have contracted. Large carnivores live at low densities and require large areas to thrive at the population level. Therefore, if human-dominated landscapes fragment remaining carnivore populations, small and demographically vulnerable populations may result. Grizzly bear range contraction in the conterminous USA has left four fragmented populations, three of which remain along the Canada-USA border. A tenet of grizzly bear conservation is that the viability of these populations requires demographic linkage (i.e. inter-population movement of both sexes) to Canadian bears. Using individual-based genetic analysis, our results suggest this demographic connection has been severed across their entire range in southern Canada by a highway and associated settlements, limiting female and reducing male movement. Two resulting populations are vulnerably small (< or =100 animals) and one of these is completely isolated. Our results suggest that these trans-border bear populations may be more threatened than previously thought and that conservation efforts must expand to include international connectivity management. They also demonstrate the ability of genetic analysis to detect gender-specific demographic population fragmentation in recently disturbed systems, a traditionally intractable yet increasingly important ecological measurement worldwide.

Animal Migration↗
PubMed2004

Demographic factors, denture status and oral health-related quality of life.

OBJECTIVES: This study investigated the association between denture status, demographic factors, and oral health-related quality of life (OHRQoL). METHODS: OHRQoL was measured using the German version of the Oral Health Impact Profile (OHIP-G, 53 items), which was administered in a personal interview to 2050 subjects (60% of eligible subjects responded) 16-79 years of age in a national survey. Median regression was used to analyze the influence of denture status (no, removable, complete dentures), age, gender, education (less than 10 years of schooling, 10-12 years, more than 12 years), and residential area (rural, urban) on the OHIP-G summary score. RESULTS: In bivariable analyses, compared to the base category, the OHIP-G median increased 8.0 U for subjects with removable dentures, 20.0 U for subjects with complete dentures, 1.7 U for each 10-year age period, 2.0 U for men, 3.0 U for less than 10 years of schooling (compared to > or =10 years.), and 1.0 U for urban areas (P < 0.05 for all effects except for residential area). In the multivariable analysis, compared to subjects without dentures, subjects with removable dentures had a 7.5 (95% CI: 5.2-9.8) higher OHIP-G median and subjects with complete dentures had a 18.5 (95% CI: 14.7-22.4) higher median when demographic variables were controlled. No demographic variables were statistically significant except for residential area (P = 0.04). CONCLUSIONS: Denture status was a stronger predictor for impaired OHRQoL than demographic variables and rendered age and education almost negligible in their influence on OHRQoL.

Adolescent↗
PubMed2005

Genetic structure of the cyclic fossorial water vole (Arvicola terrestris): landscape and demographic influences.

Genetic structure can be strongly affected by landscape features and variation through time and space of demographic parameters such as population size and migration rate. The fossorial water vole (Arvicola terrestris) is a cyclic species characterized by large demographic fluctuations over short periods of time. The outbreaks do not occur everywhere at the same time but spread as a wave at a regional scale. This leads to a pattern of large areas (i.e. some hundreds of km2), each with different vole abundances, at any given time. Here, we describe the abundance and genetic structures in populations of the fossorial water vole. We use the data to try to understand how landscape and demographic features act to shape the genetic structure. The spatial variability of vole abundance was assessed from surface indices, collected in spring 2002 (April) in eastern central France. Genetic variability was analysed using eight microsatellite loci at 23 localities sampled between October 2001 and April 2002. We found some congruence between abundance and genetic structures. At a regional scale, the genetic disruptions were associated with both sharp relief and transition between an area of low abundance and another of high abundance. At a local scale, we observed a variation of the isolation-by-distance pattern according to the abundance level of vole populations. From these results we suggest that the dispersal pattern in cyclic rodent populations varies throughout the demographic cycle.

Animals↗
PubMed2006

Demographic spatial genetic structure of the Neotropical tree, Jacaranda copaia.

We used genotypes from six microsatellite loci and demographic data from a large mapped forest plot to study changes in spatial genetic structure across demographic stages, from seed rain to seedlings, juveniles, and adult diameter classes in the Neotropical tree, Jacaranda copaia. In pairwise comparisons of genetic differentiation among demographic classes, only seedlings were significantly differentiated from the other diameter classes; F(ST) values ranged from 0.006 to 0.009. Furthermore, only seedlings showed homozygote excess suggesting biparental inbreeding in the large diameter reproductive adults. We found very low levels of relatedness in the first distance class of trees, 1-26 cm diameter (F(ij) = 0.011). However, there was a 5- to 10-fold rise in relatedness in the smallest distance class, from the smallest to the largest tree diameter classes (F(ij) = 0.110 for individuals > 56 cm diameter). A variety of non-mutually exclusive mechanisms have been invoked perviously to explain such a pattern, including natural selection, history, or nonequilibrium population dynamics. The long-term demographic data available for this species allow us to evaluate these mechanisms. Jacaranda is a fast-growing, light-demanding species with low recruitment rates and high mortality rates in the smaller diameter classes. It successfully regenerates only in large light gaps, which occur infrequently and stochastically in space and time. These factors contribute to the nonequilibrium population dynamics and observed low genetic structure in the small size classes. We conclude that the pattern of spatial genetic transitions in Jacaranda is consistent with overlapping related generations and strong but infrequent periods of high recruitment, followed by long periods of population decline.

Bignoniaceae↗
PubMed1999

Associations between alcohol related hospital admissions and alcohol consumption in Victoria: influence of socio-demographic factors.

OBJECTIVE: To examine the cross-sectional ecologic associations between apparent per-capita alcohol consumption, alcohol-related hospital admission rates, and the distributions of socio-demographic factors for people residing in 76 Local Government Areas (LGAs) in Victoria, during the 1995-1996 fiscal year. METHOD: Visitor-adjusted per-capita alcohol consumption was obtained from wholesale sales data from the Liquor Licensing Commission Victoria. Alcohol-related hospital admission rates were extracted from the Victorian Inpatient Minimum Dataset, and adjusted by the appropriate aetiologic fractions. Summary socio-demographic measures were derived from the 1996 Census. Their associations were analysed using multiple linear regression. RESULTS: Per-capita alcohol consumption ranged from 4 to 14 litres absolute alcohol/year and alcohol-related hospital admission rates ranged from 5 to 25 per 10,000 residents/year (external-cause diagnoses) and 8-37 per 10,000 residents/year (disease diagnoses). Higher levels of per-capita consumption were associated with higher admission rates (r = 0.45 for external cause diagnoses, r = 0.66 for disease diagnoses, and r = 0.70 for all diagnoses), each per-capita increase of one litre/year corresponding to increased admission rates of 0.6, 1.5 and 2.1 per 10,000 person-years, respectively. Further adjustments by summary socio-demographic measures reduced, but did not modify, the associations between per-capita consumption and admission rates. CONCLUSIONS AND IMPLICATIONS: Summary measures of sales-based per-capita alcohol consumption and socio-demographic environments may provide useful indicators of alcohol-related morbidity in Victorian communities.

Alcohol Drinking↗