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Results for “Demographers--changes”

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At least 217 records · Page 12Linked to original sources

PubMed1993

[Projection of new cancer diseases to the year 2002--a contribution to health planning in public health by the Saarland cancer registry].

This paper provides projections of incident cases of malignant neoplasms in Saarland, Germany, between 1988 and 2002. The analyses are based on population forecasts by the National Statistical Office and on age-cohort analyses of cancer incidence data from the population-based cancer registry of the Saarland. Due to dramatic demographic changes and increasing age-specific cancer incidence rates, the average yearly number of total incident cases of malignant neoplasms is projected to increase by 63.1% between 1983-1987 and 1998-2002 in men, with the strongest increase projected for colon cancer (+114.6%). In women, a modest increase (+7.1%) is projected for all malignant neoplasms, with stronger increases for colon cancer (+50.1%), lung cancer (+44%) and breast cancer (+27.4%), whereas decreasing annual numbers of cases are projected for cervical cancer (-51.6%), stomach cancer (-18.5%) and endometrial cancer (-10.2%). The results provide a quantitative basis for health care planning in the Saarland. They may also serve as a rough guide for other parts of Germany for which reliable cancer incidence data are not available.

Adolescent↗

PubMed1993

Trends in the community dental service 1980-1990.

The recent past has seen many changes that have had an impact on the dental care of children: for example, demographic changes, changes in the prevalence of dental caries, changes in manpower and changes in the organisation of dental services. The community dental service (CDS) in particular has had a major role to play in the provision of care to many children in this country. An analysis of the statistical returns to the Department of Health for the community dental services in England and Wales for the years 1985-1990 shows that staffing in the CDS has declined from 1,544 (Whole Time Equivalents--WTE) to 1,309 (WTE) in 5 years. The total clinical hours worked has also reduced from 2.02 million to 1.59 million in ten years. Hours spent on administration have increased from 53,490 to 87,091 in the same period. Clinical time spent on treating handicapped adults has increased almost ten fold from 14,644 hours in 1980 to 122,463 hours in 1990. Time devoted to mother and child (pre-school) services in about the same as in 1985. Hours spent on school services have reduced from a peak of almost 2 million in 1985 to 1.38 million in 1989-90. Trends in eight aspects of dental treatment are presented.

Administrative Personnel↗

PubMed1994

From emergency room to morgue: deaths due to undiagnosed perforated peptic ulcers. Report of four cases with review of the literature.

Peptic ulcer perforation is well recognized as a cause of peritonitis and can result in death. Although amenable to surgery, delay in making the correct diagnosis results in increased mortality. Accurate diagnosis has been hindered by demographic changes in the affected population. In recent years, the population at risk has increased. Specifically, a rising incidence has been observed in women, in the elderly, and in patients with previously undiagnosed peptic ulcer disease. Described are four patients with perforated peptic ulcers, three of which were not detected prior to autopsy. In three of the four instances the patient had been observed in and discharged from a hospital emergency room during the 30 h prior to death. In the fourth case, the decedent had been seen in and discharged from the emergency room four times during the month prior to death. In all patients, the presenting historical, physical, and/or radiographic findings were indicative of perforation. The death of a patient within days of a visit to an emergency room should prompt a forensic autopsy. The role of medical examiners in providing quality assurance feedback to emergency rooms located within their jurisdiction is emphasized.

Adult↗

PubMed1994

[Acute myocardial infarction in patients over 70 years of age].

Demographic changes in cardiovascular disease explain the marked increase in the number of myocardial infarctions affecting individuals aged over 70. The prognosis remains poor, with hospital mortality of the order of 30%. The reticence of physicians to use reperfusion techniques (intravenous thrombolysis and coronary angioplasty) is paradoxically considerable. Several studies have nevertheless shown that the benefit/risk ratio of such methods not only persists, but is increased in this age group, which should encourage the widening of their indications. Thorough evaluation of the best management strategy would require a randomised comparative trial, but angioplasty would probably ensure early reperfusion in a larger proportion of elderly patients than thrombolysis, because of the high incidence of contraindications to the latter as well as of cardiogenic shock in this age group.

Age Factors↗

PubMed1994

[Increase in the number of admissions due to heart failure in Dutch hospitals in the period 1980-1992].

OBJECTIVE: Determination of the trend in the occurrence of hospital admissions because of heart failure in the Netherlands. DESIGN: Descriptive investigation. SETTING: Dutch general and university hospitals. METHOD: Data on hospital admissions because of heart failure from 1980 to 1992, obtained from the National Medical Register, were analysed. Three ICD-9 CM diagnoses were combined (congestive heart failure 428.x, diseases of the heart due to hypertension 402.x and myocardial degeneration 429.I). RESULTS: From 1980 through 1992 the annual number of hospital admissions for heart failure increased by 69%, for both men and women, from 14,441 to 24,368. Age-adjusted admission rates increased by 43% for men, and by 30% for women. The admission rates were strongly age-related, with higher rates in the older age groups. Among men 89% of the patients in 1992 were older than 60 years, and 63% older than 70 years. Among women these figures were 94% and 79%, respectively. During the study period the age-specific admission rates rose in all relevant age groups. The rise was higher in the older age groups. In 1992 the average duration of stay in hospital was 14 days for men and 17 for women. CONCLUSION: Probable causes of the rise in the number of hospital admissions for heart failure were the increasing median age of the population, higher survival rates after acute myocardial infarction and longer survival of persons with heart disease. Demographic changes and medical progress will probably lead to a further rise in morbidity and mortality and of costs of heart failure.

Academic Medical Centers↗

PubMed1994

California's suicide decline, 1970-1990.

From 1970 to 1990 California experienced a 32% decline in suicide, which was particularly pronounced among women, non-whites, the young, and urban dwellers. Suicide declines of over 50% were recorded in San Francisco and Los Angeles, and large decreases occurred in other coastal counties. Additionally, California was the only one of 51 states to show a consistent decline in teenage and young-adult suicide (accompanied by an 88% decrease in teenage drug and other poisoning deaths). Initial investigation of death certification, accident and homicide trends, economic measures, and prevention efforts did not produce an explanation for a suicide decrease of California's magnitude. However, the state does display anomalous trends in certain social measures (reduced divorce, rising non-White population, and rising homicide) that point to multifactorial hypotheses including demographic changes and changed attitudes toward violence. Review of the accuracy of past suicide certification procedures nationally is also indicated.

Adolescent↗

PubMed1993

[Age and sex specific incidence of primary total hip alloplasty in the county of Southern Jutland].

During the 10-year period 1981-90, 1752 primary total hip arthroplasties (THAs) were performed in the county of south Jutland, Denmark. The annual number of THA increased until a steady state level was reached during 1988-90. The age and sex specific incidences were calculated for this period using the population distribution of the County. The age specific incidences were highest in the age-group 70-79 years for both female and males, namely respectively 485 and 410 THAs per 100,000 inhabitants. The overall incidence was 82 THA per 100,000 inhabitants. During the next 30 years, the demand for primary THA in Denmark is expected to increase 32 percent (from 4013 to 5307 THAs) as a consequence of demographic changes.

Adult↗

PubMedDate not supplied

The impact of critical events of the 1980s on core functions for a selected group of local health departments.

Directors of 14 public health departments were surveyed for their perceptions on the impact of 20 critical events of the 1980s on public health performance. The departments were selected in 1979 from among those that were highly regarded by public health experts for exemplary performance, especially with regard to personal health services. The departments were the subjects of intensive case studies in 1979, 1983, and again in 1992. The public health functions that were most benefited in the 1980s were assessment and policy development. The assurance function was equivocally affected. Greatest positive impact was exerted by the acquired immunodeficiency syndrome-human immunodeficiency virus epidemic, by increase in fee income, and by the Institute of Medicine report, "The Future of Public Health." Negative influences, especially on the assurance function were exerted by loss of Federal grants, demographic changes, substance abuse, and economic downturn. Other critical events had equivocal or idiosyncratic effects. Analysis of public health practice according to the functions of assessment, policy development, and assurance appears to have utility for purposes of evaluation and planning.

Data Collection↗

PubMed1976

World developments and trends in social security.

A survey of developments in the social security systems of more than 125 countries from 1971 to 1975 found that most programs are undergoing significant growth. This pattern is reflected primarily by the adoption of additional programs and new provisions designed to raise benefit levels, provide flexibility in retirement practices, expand coverage, and cope with demographic changes, inflationary trends, and growing costs. The new measures tend to extend the role of social security programs through providing a greater proportion of the population with more comprehensive protection and setting higher benefit rates to replace income lost because of old age, disability, sickness, work injury, unemployment, or death.

Age Factors↗

PubMed1993

[Longitudinal socio-gerontologic geronto-epidemiologic study in Hajdúszoboszló (SZOLOVI, 1964-1991)].

The tendencies of the demographic changes in Hungary, the trend and pace of the expected development of the age distribution and social stratification anticipated even in the early sixties that the problem of the ageing population (of the agriculture) would raise to national level and a considerable part of its consequent tasks will be the share of the national health care. So began in 1964 in Hajdúszoboszló a social gerontological-geroepidemiological study of those who were 60 and over and had agricultural profession. This study was developed into a longitudinal one (in the years 1986, 1990, 1991 and 1993), and is being continued even today.

Aged↗

PubMed1993

Schistosomiasis mansoni in Burundi: progress in its control since 1985.

Described is the evolution of the schistosomiasis control programme in Burundi since 1985. A single round of selective population chemotherapy was carried out in the Rusizi Plain and the Bugesera focus from 1985 to 1990. The prevalences and intensities of infection as well as the number of symptomatic cases detected in general health services decreased considerably. Annual sample surveys in the treated areas showed, however, that these improvements were rapidly reversed by reinfection of the demographically changing population. Since repeated selective population chemotherapy was not sustainable in the long term, a primary health care approach was adopted. In areas with good access to basic health services, approximately 10% of all schistosomiasis cases now receive treatment annually through this approach. Yearly selective chemotherapy in primary schools in suburban Bujumbura reduced the prevalence of schistosomal infection among pupils from 23% to 9% over the period 1984-90, and this programme has now been extended to highly endemic areas in Imbo-Sud. Focal snail control produced disappointing results, and emphasis has therefore shifted towards health education and environmental control of transmission.

Adolescent↗

PubMed1993

Transportation needs of the elderly population.

All evidence suggests that the elderly population of today and tomorrow will continue to depend on the private car to give them freedom, independence, and choice--as do younger travellers. Given the demographic changes in the United States, it seems very unlikely that other modes or options can provide anywhere near the level of mobility that the elderly want or need. Almost three fourths of those over age 65 will live in suburban or rural places after the turn of the century, places where transit and para-transit options are inherently impractical or costly. These elderly individuals will have made choices about doctors, hospitals, friends, and social and recreational options based on their lifelong access to the car. When they can no longer drive or receive rides, their mobility will drop and they may have to make drastic changes in their whole life network to be able to access just a few necessary services. Those concerned with the use of medical services by the elderly population must focus not only on transportation but on the other variables that create the need for a car. Transportation needs are clearly linked to where and how medical and social services are made available, so medical agencies must recognize the changing demographics of the elderly population by locating and programming their services accordingly. Medical and human service agencies will have to make an effort to make their programs accessible to the elderly population rather than simply locating their facilities where they please and assuming that elderly persons or transportation planners will somehow deal with the resulting loss of mobility.

Adult↗

PubMed1995

Controversies about the clinical assessment of benign prostatic hyperplasia.

Benign prostatic hyperplasia (BPH) is a common disorder which places a considerable burden on older men and health care expenses. With advances in medical technologies and the foreseeable demographic changes in the Western world, the financial and epidemiological impact of this chronic disease is expected to increase further. The management of BPH is controversial, and this article critically reviews the clinical applicability and validity of the various measures available for assessment. Few objective modalities are indicated in the routine evaluation of BPH. There is a poor correlation between objective and subjective indicators and both measures reveal a substantial variation over time. This fluctuation is mainly attributed to the natural history of the disease. The clinical value of combining objective and subjective parameters into an analytic process seems small. Disagreements about the clinical value of BPH assessment modalities have caused inconsistent practices and consequently provision of changeable health care quality. Patients seek urological counseling and relief because of burden of illness. Quality care is provided by clinicians being perceptive to patients' preferences. Provision of quality care does not inevitably generate increasing health service expenses.

Humans↗

PubMed1996

[Evaluation of symptoms in patients with benign prostatic hyperplasia].

Benign prostatic hyperplasia (BPH) is the most common cause of voiding dysfunction in elderly men. With the age related demographic changes in the western world, the epidemiological and economical burden of BPH is anticipated to increase. BPH is clinically diagnosed on a variety of more or less well defined symptomatic, macroscopical, and physiological criteria, whereas the histological diagnosis is straightforward. Yet, no symptom is specific for BPH and numerous other diseases have to be considered when a patient presents with symptoms of bladder outlet obstruction. A BPH questionnaire is useful when weighing the pros and cons for intervention. Furthermore, a symptom index represents a valuable indicator for the quality of care provided. Through the last decades a number of BPH questionnaires have been introduced. This article scrutinizes various BPH indices and provides an introduction to the prerequisites of clinical questionnaires.

Aged↗

PubMed1996

[Why do elderly couples use ambulatory nursing care?].

More than one million people in Germany are in need of home care and elderly caregiving wives and their caretaking husbands are an important group in the society. Demographical changes with a shift to more elderly people in relation to younger people will further increase the importance of this group. Home care service organisations play an important role in supporting these couples, but they are still rarely made use of. To optimize the support that can be rendered by home care services, information is needed on what influences the decision of elderly couples to use or not to use such services. A set of data from an earlier study about the situation of more than 300 couples aged 60 years or older is used to determine influencing factors in bivariate and multivariate analysis. The theoretical framework is a behavioural model of service use. The need for care measured by loss of function in activities of daily living turns out to be the most important factor influencing the use of home service organisations. Other variables such as e.g. disability of caregivers play a minor role. It seems that home care services are used as a kind of "last resort" if there is no other way to handle the situation. In trying to optimize home care services, the different values of factors influencing their use should be considered. It is important to take into consideration that those who solicit home care aid wish to retain their autonomy at the same time.

Activities of Daily Living↗

PubMedDate not supplied

Diagnostic yield of upper gastrointestinal endoscopy in relation to age and gender: a study of 10112 Saudi patients.

BACKGROUND/AIMS: The availability of fiberoptic endoscopy has made it relatively easy to evaluate symptoms of upper gastrointestinal disorders with a significant degree of accuracy. MATERIALS AND METHODS: To determine the pattern of upper gastrointestinal lesions in the Saudi population with particular reference to the influence of age and gender, 10,112 patients were studied. RESULTS: No abnormal findings were detected in 26.9%. The frequency of ulcer lesions was 13.7% while non-ulcer, mucosal inflammation was diagnosed with a frequency of 33.7%. In the young (less than 20 years of age), the most common lesion was duodenal ulcer or duodenitis, whereas in the elderly (above 60 years of age), esophagitis, hiatus hernia and esophageal varices were the most frequently diagnosed. The highest mean ages were observed in the group of patients with gastric and esophageal cancers (mean ages of 58.8 and 65.1 years, respectively). There was no gender-related differences with regard to the mean age of patients in all the diagnostic categories. CONCLUSIONS: This study provides baseline data on the age distribution of major upper gastrointestinal diseases among the Saudi population. The peculiarities of upper gastrointestinal endoscopic findings in advanced age are clarified. The influence of demographic changes on the pattern of these diseases in Saudi Arabia can be evaluated against our findings in the future.

Age Factors↗

PubMed1995

Changing demographics: past and future demands for early childhood programs.

This article provides a historical analysis of how demographic changes in the organization of American family life from the mid-1800s to the present have shaped the demand for programs to complement the efforts of families to educate and care for their children. The author asserts that the United States is in the midst of a second child care revolution. The first occurred in the late 1800s, when families left farming to enable fathers to take jobs in urban areas and when compulsory free public schooling was established for children age six and above. The second has developed over the past 55 years as the proportion of children under six living in families with two wage earners or a single working parent has escalated and propelled more and more young children into the early childhood care and education programs discussed throughout this journal issue. Looking to the future, the author sees indications that the demand for early childhood care and education programs will continue to grow while the needs of the children to be served will become increasingly diverse. To meet these dual pressures, the author argues that public funding for early childhood programs--like funding for public schools--is justified by the value such programs have for the broader society.

Adolescent↗

PubMed1995

[Women in the medical profession in Israel].

This paper describes the current status of women physicians in Israel at various stages in their professional careers: in medical school, in the medical specialties and in academia. In the past, as in most western countries, medicine in Israel was regarded as a man's profession. The last decade has seen major demographic changes: the proportion of women entering medical school is now similar to that of men, and as a result of immigration from the former Soviet Union, the percentage of women physicians is approaching the level in eastern European countries. Recent findings show an increase in women in all specialty areas. However, they are concentrated in the lower status strata and in primary care, occupying the base of the academic pyramid. It appears that when objective criteria are employed, such as for admission to medical school and licensing examinations, women and men have similar levels of achievement. However, when subjective criteria are used, such as in admission to residency training, gender-based differences in distribution in the medical specialties are apparent. We suggest implementing objective standards for acceptance for residency training which should help equalize the status of women in the Israeli medical establishment.

Emigration and Immigration↗