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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↗

PubMed1990

Variability of hypertension-related mortality in the United States, 1968-1986.

There has been recent interest in trying to understand the way demographic changes and population structure affect disease rates in the Unites States. We analysed mortality data for 1968 to 1986 to examine how ageing and a changing population structure have affected hypertension mortality rates in the United States. Multiple-cause-of-death data were used with census projections to estimate age-adjusted, reported-prevalence-at-death rates for hypertension. For the period 1970 to 1986, we found considerable geographic diversity, including an eightfold difference in the range of hypertension mortality by state (from 11.4 in Hawaii to 82.3 in the District of Columbia). Substantial differences appeared in age-adjusted rates by race; an average twofold excess among blacks was observed throughout the period. The largest race difference in 1986 was observed in Florida, where the reported-prevalence-at-death rate was 3.2 times greater among blacks (112.2 per 100,000) than among whites (34.7 per 100,000). When we allow for discontinuities in coding between ICD-8 and ICD-9, the states will appear to be relatively stable with regard to both age-adjusted rate and relative rank. Age-adjusted, reported-prevalence-at-death rates for blacks also show geographic variability and suggest that factors other than genetics play an important role in the contribution of hypertension to mortality in the United States.

Black People↗

PubMed1986

[Medical and social aspects of the psychological health of the elderly].

As a consequence of falling birth-rates and increasing life expectancy, the absolute and relative number of the elderly has been considerably growing in all industrial countries during the last hundred years. According to the findings of a field study carried out among inhabitants of the City of Mannheim, well in concordance with the results of comparable investigations undertaken in rural and urban areas of other countries, about a quarter of the individuals aged over 65 are mentally ill. Under the assumption of unchanged age-related morbidity rates, the absolute number of elderly persons suffering from mental illness more than doubled in the Federal Republic of Germany between 1950 and 1980, due to demographical changes only. The quantitatively most important risk factor for psychiatric morbidity in old age, especially for psycho-organic syndromes, seem to be physical illness and handicaps. Environmental factors determining the microsocial milieu of the elderly seem to influence the frequency of depressive syndromes, as was shown by a study carried out in homes for the elderly in New York, Mannheim and London. Also in old age, belonging to the lower socioeconomic stratum - as a macrosocial factor - correlates with increased rates for psychiatric morbidity as a whole, as it does with poor physical health and increased mortality. However, this correlation is significant only for the group of psycho-organic syndromes. In functional syndromes it is hardly marked. It can be assumed that to a large part, unfavourable socioeconomic conditions mainly have an indirect impact on psychiatric morbidity by way of higher rates of those somatic diseases leading to psychiatric sequelae, e.g. cardiovascular diseases. Events of losses and social isolation in a sense of experienced loneliness accompanied by a lack of contact enlarge the risk of developing psychiatric disturbances, in particular depressive syndromes, and also the risk of somatic diseases and suicides. Since coping resources of the individual also often decrease in old age, this phase of life shows specific mental health risks which should be counteracted as long as possible by medical and social care on the levels discussed before.

Aged↗

PubMed1989

[Evolution of mortality by causes (1960-1982)].

Mortality from all causes has decreased in Chile by 50% from 1960 to 1982. Median age of death increased from 28 to 66 years. Reduction in mortality rate was greater for those under 15 years of age, mostly due to a decrease in mortality from digestive, respiratory, infectious and neonatal diseases. In contrast, only 16% reduction was observed in mortality for the 65 and over age group. This may be due to a relative increase in mortality from cardiovascular diseases in the older age group. Multiple factors are involved in the improvement of these health indexes, such as changes in socio-economic conditions, health delivery policies and demographic change of the population.

Adolescent↗

PubMed1989

Impact of public health on human genetics.

It is often thought that the incidence of genetic disease is rising, because improved medical care is increasing the survival, and therefore the cumulative number of affected people. This examination of the genetic implications of recent demographic change in Europe suggests that the incidence of genetic disease is in fact falling, for several reasons, most of which are indirect consequences of improved primary care. There seems to be no evidence that improved care for the handicapped will have long-term deleterious effects on the human gene pool.

Consanguinity↗

PubMed1989

Stability and change in an urban homeless population.

Few studies have produced the over-time observational data needed to draw valid conclusions about changes in urban homeless populations during the 1980s. One place for which such data exist is Nashville, Tennessee. An ongoing series of enumerations lends little support to Nashvillians' perception that the number of homeless in their city is growing rapidly. Enumeration results also (1) contradict expectations regarding the rise of "new homeless" groups and (2) show two types of spatial redistribution--from indoor to outdoor and core to peripheral locations--to be under way. The applicability of the enumeration methodology to other communities is discussed, as are the discrepancies between purported and measured demographic changes in homelessness.

Demography↗

PubMed1989

Home care nursing: professional and political issues.

Concern for quality, cost, and access dominate the health care system in the eighties. State and national actions, demographic changes, and technological advances are converging to create many changes in the home care delivery system. Knowledgeable nurses can influence the evolution of home care services to assure that patients receive appropriate acute and long term home care services. Concern for quality care, changing patient needs, and availability of care are the major issues facing home care nursing in the eighties, and will continue to be into the nineties. Reimbursement policies of third party payers, medicare/medicaid regulations, state licensing, employer benefit programs, state health programs, home health care providers, professional/trade associations, and consumer advocacy groups are some of the key forces reshaping the practice of home health nurses. Knowledge of these factors will enable nurses to influence effectively the design of institutional and governmental policies which affect the care nurses deliver to patients at home.

Acquired Immunodeficiency Syndrome↗

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↗