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PubMedDate not supplied

Working with the elderly: do student nurses care for it?

This study investigates neophyte student nurses' attitudes to working with the elderly through placing them in relation to attitudes to other nursing career options and by exploring student nurses' reasons for such attitudes. The results are based on a questionnaire answered by 610 students from five NSW teaching institutions. The results indicate that nurses rate working with the elderly very poorly, and that this negativity is based on unfavourable stereotypes of aged persons and their care. These findings are placed in the context of projected demographic changes and the pressures these will place on the health care system and its need for nurses qualified in this area of work.

Aged↗

PubMed1990

Naftidrofuryl after acute stroke: a review and a hypothesis.

With demographic change, Western populations are becoming older. The prolonged decline in incidence of stroke, already a very costly illness, may soon reverse. This paper briefly reviews medical treatments of acute stroke that have been popular in the past and finds that they have been generally of little value. The place of naftidrofuryl, a drug with a complex pharmacological profile that includes selective S2-receptor blockade, is discussed in greater detail. Two clinical studies have indicated that, although it may not alter death rate in acute stroke, naftidrofuryl therapy enhances recovery from the disabling effects of cerebral infarction. One important consequence of this is a potentially major reduction in time spent in hospital by stroke patients. Hospital bed occupancy has been identified as a principal component in the cost of stroke to health services. Drug treatments that reduce death rate without improving recovery in survivors have an opposite effect, as has been seen in an important trial of glycerol.

Acute Disease↗

PubMed1992

Diversity in nursing faculty hinges on diversity in nursing students.

In this chapter, I attempted to explicate and highlight some of the interrelationships which exist in higher education between white male and female faculty members from a minority perspective. I discussed the effect of attitudes on the success of minority students and faculty in light of projected demographic changes. I hope that white female faculty members will become more cognizant of how negative attitudes impact upon both their own performance in higher education and also how the inculcation of these attitudes can be transferred to minority faculty members with devastating results. Change is difficult in all spheres of life, but without some modicum of change, life will go on as usual. Minority faculty members and students deserve at the very least a fair chance in the game we call higher education.

Black or African American↗

PubMed1992

[Use of psychopharmaceuticals and commitment in psychiatric admissions of elderly patients with dementia].

Case records of 404 elderly patients (aged 65 years or more) who were admitted for the first time to the Psychiatric Hospital in Aarhus were investigated retrospectively. In 315 patients the diagnoses were senile dementia (290.09) and arteriosclerotic dementia (293.09) according to ICD-8. Information about use of psychotropic drugs before admission and on discharge alive was obtained from the patient case records. In the present study, the use of drugs was not found to be correlated with age, sex and degree of dementia. Significantly fewer committed patients were treated with psychoactive drugs and significantly fewer lived independently in their own homes. Only 42 (13%) patients had a crude psychiatric disorder while 251 (80%) were admitted on account of unacceptable behaviour. 90% of the latter group of patients had been treated with one or more psychoactive drugs on admission. The risks involved in the use of psychoactive drugs are discussed. On account of demographic changes in the Danish population and the recent decrease in psychiatric hospital beds and nursing home beds, it is recommended that the patterns of committed admissions of demented patients to psychiatric hospitals should be followed closely.

Aged↗

PubMed1991

Changing perspectives in the study of the social role of medicine.

The Milbank Quarterly over the past 14 years took the lead in examining inequalities (and their policy implications) arising from stigma and devaluation because of age, disability, mental impairment, and lifestyle as well as socioeconomic disadvantage. It sought to examine alternative models in a context sensitive to the inextricable connections between health and society, their persistence through time, and their link to demographic changes. In focusing on concepts of disease, disability, cultural responses, and ideas of personhood, it brought to health policy considerations a depth of discussion that was visibly absent as our society increasingly became obsessed with containing health care costs. Throughout the years of David Willis's editorship, the Quarterly conveyed a vision of a more equitable health care system sensitive to practical realities but dedicated to moral objectives.

Activities of Daily Living↗

PubMed1991

Historical trends in public general hospitals.

This article examines utilization trends in Canadian public general hospitals from 1976 to 1986-87. These trends are then compared with a previous period, and with hospital trends in the United States. Findings for this report are based on both provincial and national data. There was an overall decline in the number of hospitals with a decrease in small (1-49 beds) and an increase in large (300+ beds) hospitals. The net result is a 7% increase in the number of beds, though due to the larger population there was a 3% decrease in the bed rate per population. The bed occupancy rate increased from 77% to 83% and the average length of stay also increased. The number of separations increased slightly but rates per population declined. Patient-days per population increased in most provinces and there was a significant increase in long-stay units. Despite general uniformity amongst the provinces there were some notable variations. The trends indicate a reversal of the situation in the 1953-1973 period which was marked by an expansion in the hospital system. Hospitals in the United States showed somewhat similar trends with the exception of length of stay. The trends may be ascribed to factors such as increased efficiency, the development of alternatives to inpatient care, technical improvements, demographic changes and the individuality of the provincial health care systems.

Adult↗

PubMed1991

[Voluntary abortions in 1979-1989--what does their number indicate?].

The number of women aged 15-44 years increased by 110,000 in Norway from 1979 to 1989, while the number of abortions increased by less than 1,900. Adjusting for these demographic changes, the general rate of induced abortion among married women decreased by 17% from 1979 to 1989, while there was no change in the rate of induced abortion among unmarried women. The magnitude of the rate of induced abortion among married women correlates with the accepted rate of failure for copper IUDs, while the magnitude of the rate of induced abortion for unmarried women is lower than the rate of failure for condoms. Among married women the rate of induced abortion in the age groups over 30 years of age has declined throughout the study period. In the other age groups of married women the abortion rate has been relatively constant after 1979. After introduction of self-determined abortion in 1979, the rate of induced abortion for unmarried women under 25 years of age has increased, while only minimal changes have occurred in the rate for older unmarried women. When adjusted for age and marital status, there have been no major changes in the general rate of induced abortion in Norway after introduction of self-determined termination of pregnancy in 1979.

Abortion Applicants↗

PubMedDate not supplied

[Policy on the aged of the Federal government in the 12th legislative period].

Social policy for the elderly requires an analysis of the older generation's living conditions in the Federal Republic of Germany. Personal competence has to be maintained in order to prevent the need for nursing care. The urgent problems resulting from demographic changes in the population structure are met by societal and political institutions.

Aged↗

PubMed1991

Ethnohistory, intertribal relationships, and genetic diversity among Amazonian Indians.

The influence of recent ethnohistorical factors on the microevolution of South American Indians has not been adequately evaluated by population geneticists. This makes difficult a reasonable interpretation of the present genetic structure of these groups. In this article the genetic diversity of 18 tribes of the Amazon and neighboring areas belonging to 3 linguistic groups (Tupi, Carib, and Gê) is analyzed in light of documentary sources about historical events, such as demographic changes, geographic movements, intertribal relationships, and marriage practices, that have taken place since the end of the eighteenth century. The high depopulation rate suffered by the Tupi groups (61.4% on average) is a probable factor conditioning the large intergroup genetic distances in this linguistic stock, for depopulation is a phenomenon associated with random genetic drift caused by a bottleneck effect. On the other hand, the relatively high similarity of the Gê and the Carib shows an association with two main factors: (1) reduced spatial dispersion of the Gê in the recent past, providing adequate conditions for within-stock gene flow, and (2) strong tradition of intergroup contacts among the Carib, frequently followed by genetic admixture and even fusion of groups, as verified for the Wayana and the Aparaí. The patterns of biologic variation of some Tupi tribes (Waiãpi, Emerillon, Parakanã, and Assurini) are better explained by historical and regional contingencies than by linguistic classification.

Bolivia↗

PubMed1991

The incidence of fracture of the proximal femur in two million Canadians from 1972 to 1984. Projections for Canada in the year 2006.

Reported increases in the number of fractures of the proximal femur in Europe are greater than can be explained by demographic changes alone. This trend was assessed in Canada by examining hospital discharge records from the provinces of Saskatchewan and Manitoba from 1972 to 1984. The annual number of first fractures of the proximal femur in persons older than 50 years of age increased 59.7% in women and 42.2% in men during this time period. In most of the five-year age groups the percentage of increase in the number of fractures exceeded the percentage of increase in population of that age group. Annual age-specific incidences (by five-year age groups) increased exponentially with age, doubling every six years, and reached a maximum value of 4% in women older than 90 years of age. Annual age-adjusted incidences increased significantly over the study period in men and women. For the whole of Canada in 1987, it is estimated that there were 13,193 first fractures of the proximal femur in women and 4610 in men, and that in the year 2006 these will rise to 22,922 and 7846, respectively. The actual increase will be considerably greater if the age-specific incidences continue to increase as they have from 1972 to 1984. The gradual decline in physical activity, which contributes to bone loss, may be one etiological factor of this trend during the last half century.

Age Factors↗

PubMed1991

Genetic population structure of Italy. I. Geographic patterns of gene frequencies.

The diversity of spatial patterns of 61 allele frequencies for 20 genetic systems (15 loci) in Italy is presented. Blood antigens, enzymes, and proteins were analyzed. The total number of data points over all systems and localities was 1119. We used homogeneity tests, one-dimensional and directional spatial correlograms, and SYMAP interpolated surfaces. The data matrices were reduced by clustering techniques to reveal the principal patterns. Only a few allele frequency surfaces are strongly correlated across loci. All systems but one (ADA) exhibit significant heterogeneity in allele frequencies among the localities. Significant spatial patterns are shown by 27 of the 61 surfaces. Only one pattern (cde; system 4.19) is clinal; another (PGM1) exhibits a pure isolation by distance pattern; the others show long-range differentiation in addition to the short-distance decline of autocorrelation expected under isolation by distance. There is a marked decline in overall genetic similarity with distance for most variables. The 27 spatially significant alleles in Italy are also significantly patterned in Europe, but in all but 2 cases the country-wide and continent-wide patterns differ. The Italian patterns are due to forces specific to Italy. Differential selection for alleles associated with malaria is still evident. Whereas short-range differentiation can with malaria is still evident. Whereas short-range differentiation can be explained by isolation by distance, long-range differentiation appears to be due to demographic changes in certain populations that may be maintained by physical and linguistic isolation.

Gene Frequency↗

PubMedDate not supplied

Implications for human health of global ecological changes.

Comparatively little attention has been given to the health implications of global ecological changes on human health, with the exception of concern over ozone depletion leading to an increased frequency of ultraviolet irradiation-induced skin cancer and cataracts. The implications for human health of five large-scale ecological disruptions were explored: climate change (greenhouse effect), ozone depletion, acid precipitation, transregional pollution, and demographic changes. Limitations of presently available data and the uncertainty of current interpretations of apparent trend is emphasized. Rigorous assessment of the effects of these changes and the response required from public health professionals is needed. This overview provides a point of departure.

Acid Rain↗

PubMed1990

[20th anniversary of the Federal Society of Rehabilitation--retrospect-outlook].

The impetus for founding the Bundesarbeitsgemeinschaft für Rehabilitation BAR (Federal Rehabilitation Council) had been the will of the social partners that the coordination found to be indispensable in the rehabilitation field should be brought about and safeguarded in the long run while preserving the rights of self-government. Founded February 6, 1969 as a voluntary association of all branches of the social protection system, the Federal Rehabilitation Council already in 1970 presented principles for harmonization of services and benefits as well as for cooperation among the rehabilitation administrations involved, pointing out perspectives for benefitting from the advantages of the structured system and overcoming its disadvantages. In retrospect, it is notably the harmonization agreements (Gesamtvereinbarungen) concluded at BAR-level and the various standards presented that document its successful work. Voluntarily agreed on by the various rehabilitation administrations, these rules and regulations for harmonization are fully in line with the legislator's intentions in this respect, and are recognized to have obviated governmental action. The range of future tasks of the Federal Rehabilitation Council will in particular be moulded by the changing disease spectrum on account of the increase of chronic conditions as well as by demographic changes due to a growing number of old people. Both factors require new approaches in the field of integration of disabled persons, ranging from increased efforts to implement community-based rehabilitation, to needs-based concepts in psychosocial counselling. Like in other areas, research and teaching will have to come to an even closer dialogue with practice in rehabilitation, too.

Persons with Disabilities↗

PubMed1990

A scarce professional: the geropsychiatric clinical nurse specialist.

The purpose of this paper is threefold: (1) to provide detailed data to substantiate the urgent need for geropsychiatric clinical-nursing specialists (GCNSs), (2) to suggest curricula content areas for GCNSs, and (3) to discuss potential topics for research on mental health and the aged. The GCNS is a rare professional; therefore, rationale is provided for the need for increasing the quantity and the quality of GCNSs. The demographic changes are emphasized in this paper, and a wide array of research topics for nurse researchers are suggested. One area needing further research is reminiscence therapy.

Curriculum↗

PubMed1990

Age-dependent sexual behaviour amongst male homosexuals and the transmission dynamics of HIV-1.

The paper describes the development of an age-structured model of the transmission dynamics of HIV-1 in a male homosexual population with age-dependent rates of sexual partner acquisition, and explores the properties of the model by means of numerical methods. Age-dependency in rates of sexual partner change acts to increase the initial growth rate of the epidemic and raises the equilibrium level of endemic infection in the population when compared with the prediction of a model without age structure but with identical initial overall population mean rate of partner acquisition. In addition, age-dependency in sexual activity acts to induce demographic changes in the population where the younger more sexually active males represent an increasing proportion of the population as the epidemic develops over time. One consequence of this is an increase in the overall population mean rate of sexual partner change as a direct result of the mortality induced by AIDS in the older less sexually active classes who acquired infection at a younger age. The results are discussed in relation to the interpretation of current patterns of HIV-1 spread and the acquisition of quantitative information on sexual behaviour.

Adolescent↗

PubMed1990

American conceptions of infant development from 1955 to 1984: what the experts are telling parents.

The efforts of the child development movement to understand development and the factors influencing it have been the basis of 2 interrelated tasks: the scientific study of children, and the dissemination of this knowledge to parents. Content analysis is used to assess the extent to which psychological theories and research about infants have been communicated to parents from 1955 to 1984 in 2 popular publications, the Infant Care manual and Parents magazine. Results indicated that there is not a singular relation between what experts know and what is communicated to parents. Information reflecting scientific advances about the biological components of infant development (perception, cognition, and temperament) have been most accurately communicated to parents, whereas discussions of the mother-infant relationship, child care, feeding, and fathers appeared to be related to the broader cultural context and demographic changes over the past thirty years. This study reveals an interaction between science and culture in our theories of infant development and child rearing.

Child Development↗

PubMed1979

Health implications of increased coal use in the Western States.

The National Energy Plan proposed by President Carter provides for the rapid development of coal resources in the United States, particularly in the West. The potential consequences for health of this development were considered by the Advisory Committee on Health and Environmental Effects of Increased Coal Utilization, reporting to the Department of Energy. Their report recommended rigid adherence to pertinent existing regulations, improved environmental monitoring, expanded research in selected relevant topics and development of procedures for selecting the sites of new coal-fired power plants. Although the report was a major exercise in technology assessment, it is fundamentally a cautious document that proposes no new solutions or approaches. A review of occupational and community health problems associated with coal mining and coal utilization suggests that lessons from past experiences, especially in Appalachia, cannot be applied to the West uncritically. The two regions are fundamentally different in scale, topography and social development. In the West, future problems related to coal are likely to derive from unknown risks associated with coal processing technologies, land reclamation and water quality at the sites of power generation, and extensive social and demographic changes at centers of industrial activity that may have secondary effects on health. Additional considerations should supplement the recommendations of the Advisory Committee report.

Coal↗

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↗