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PubMed1983

Doctors, disease and demography--changing patterns.

Over the past century major shifts have occurred in causes of morbidity and mortality in the population. Improved environmental conditions and control of infectious diseases have led to the emergence of the "new epidemics" of the so-called societal diseases. At the same time, the population has aged significantly in demographic terms. The major challenges facing health care services now require significant reorientation in thinking, especially in terms of objectives, definition of roles, allocation of resources and planning for the future. This paper explores some of the challenges, the competing interests involved, and the economic, social and political context in which these issues have emerged proposes a model for seeking resolution.

Australia↗

PubMed2002

Unintentional gun injuries, firearm design, and prevention: what we know, what we need to know, and what can be done.

The public health community has long recognized unintentional gun injuries as a public health issue. In 1998 in the United States, 866 people died from unintentional gunshot wounds, resulting in a crude death rate of 0.32 per 100,000. Unintentional gun deaths have been declining since at least 1920, yet the reasons for this downward trend are not understood. Possible explanations, such as changes in gun ownership and demography, changes in access to guns among population subgroups, safety practices, and artifactual influences are discussed. Intervention strategies for reducing the risk of unintentional gun injury are also discussed.

Accident Prevention↗

PubMed2002

Workload and stress in consultant medical microbiologists and virologists: a questionnaire survey.

AIMS: To document demography, changing workload patterns, job satisfaction, morale, and prevalence of stress and psychological morbidity among UK consultant medical microbiologists and virologists. METHOD: A questionnaire survey of all identified UK practising consultant medical microbiologists and virologists (n= 464). RESULTS: Among 367 respondents (79%), there were 33 virologists and at least 89 single handed consultants. Over half the respondents (58%) were working a 1 : 1 or 1 : 2 on call rota during the week and a similar proportion (51%) at weekends. Of all consultants (including those working part time), 56% were working more than 48 hours weekly. Working more than 48 hours weekly, and being on call 1 : 1 or 1 : 2 at weekends, were both independently associated with increased psychological morbidity. Those on call 1 : 1 or 1 : 2 at weekends were also more likely to have low or very low morale. Female consultants were more likely to have higher stress scores. More than half of the respondents (208 of 363; 57%) were making active financial provision to retire early, and 198 of 363 (55%) did not intend to work beyond the age of 60. CONCLUSIONS: The long hours worked by many consultant microbiologists and virologists are in breach of the European Working Time Directive and are associated with a higher degree of psychological morbidity. For most consultants, the frequency of on call commitments is demanding and job satisfaction and morale have deteriorated. Urgent action is needed, particularly to support those working more than 48 hours each week and those on call at weekends 1 : 1 or 1 : 2. However, a major expansion of the consultant establishment cannot be achieved rapidly, and will be slowed further if early retirements become more frequent.

Adult↗

PubMed1993

Issues in the demography of Mongolian nomadic pastoralism.

"Taking a historical perspective this paper examines the ecological and political influences on Mongolian demography. Changes in political policy, domestic economy, health services, venereal diseases and shortages of men are considered in examining the unusual pattern of very low fertility, followed by a rise in the 1950s and 1960s and a gradual fertility decline, even in the absence of modern contraception. It is concluded that the lack of simultaneity between major political and demographic changes suggest that there are no direct responses to policy, despite the strong pronatalist stance, but that health services, particularly in the realms of venereal disease treatment, have had a major influence on Mongolian demographic patterns. The indirect consequences of government policy--education, health services in rural areas, rapid urbanisation--appear to have a stronger influence than the pronatalism, and ironically have led to rapid fertility decline."

Asia↗

PubMed2003

[Study on the changes of demography and behavioral characteristics of drug users in Beijing].

OBJECTIVE: To understand the demography changes and behaviors in drug users. METHOD: Self-reported questionnaires was used and longitudinal investigation was conducted in one of the detoxication centers in Beijing in 1998 and 2000. Drug users were randomly chosen. RESULTS: Results showed that age of drug users tend to become younger with the numbers of drug users aged below 25, increased from 18.7% in 1998 to 28.2% in 2000. Majority of drug users remained males, but the proportion of females seemed to increase. Distribution of occupation showed that the largest increase fell among individual enterprisers, from 15.2% in 1998 to 25.9% in 2000. With educational back-ground, the proportion of lower than elementary education level, including illiterate, increased. Fifty percent of drug users were unmarried which increased from 40.8% in 1998 to 53.2% in 2000. Needle sharing was quite common, 16.5% in 1998 and 11.9% in 2000, but the decrease was not statistically significant (P > 0.05). Fifty-seven point three percent of the injecting drug users did not have constant partners to share equipments. Proportion of extra-marriage sexual practice increased from 12.5% in 1998 to 27.5% in 2000, and significant difference (Chi-square = 12.50, P < 0.001). Multiple partners in extra-married drug users was also found (mean = 2). Compared to 1998, condom use during every sexual practice increased in 2000, but 47.7% drug users still never used condom. CONCLUSION: In summary, as the quick increase of drug users, sharing of injecting equipment and high-risk sexual behavior, including multiple partners and unprotected sex, were quite common, with the possibility of HIV epidemic in drug users.

Adult↗

PubMed1991

The event history approach in demography.

"In the present paper, we shall examine...changes in the field of demography, by following the progression from period analysis to cohort analysis. We shall discuss the hypotheses underlying each of these approaches and show how their distance from actual human behaviour could lead to mistaken or incomplete conclusions. We shall then show how event history analysis can solve these problems and we shall define the hypotheses implied by this new approach. Finally, we shall come back to the complimentarity of the different social sciences."

Behavior↗

PubMed1982