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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↗

PubMed1989

[Clinico-statistical study of inpatients and autopsied cases in our clinic].

The statistics of clinical observation at Department of Internal Medicine, Nippon Dental University at Niigata from July 1981 to December 1987 (duration 6.5 years) were as follows: Total number of inpatients: 1,238, Total number of death cases: 106. Findings include: 1) Ratio of male patients to female patients 1.34:1.00. Male deceased patients to female deceased patients 1.52:1.00. 2) Average patients number hospitalized per year was 200. The high percentaged of certain advanced aged groups was reflected by the recent demographic changes in the society in general.; in their 60's 46.0%, in their 70's 24.3%, in their 80's 6.7%. In these age groups, female number is tendency to increase the number of male. 3) The diseases of inpatients were mostly due to the digestive tract, which accounted for 60.4% of the total. Of this percentage, 65% was due to hepato-biliary diseases. 4) The death statistics of malignant tumor was 68.9%; Benign diseases being 31.1%. Male patients died from hepatocellar carcinoma, lung cancer, colon cancer and stomach cancer, in descending order. Females died from cancer of the biliary tract, stomach cancer and hepatocellular carcinoma, again, in descending order. 5) 71.7% of all deaths were caused by the digestive tract, in particular, hepatocellular carcinoma, cancer of the biliary tract, liver cirrhosis and primary biliary cirrhosis, all belonging primarily to the hepato-biliary disease group. 6) As a result of 58 autopsies performed for 106 death cases, 32 cases had complete autopsies and 26 cases had partial organ punctures.

Aged↗

PubMed1986

[Handicapped patients in a changing world and rehabilitation concerns].

Rehabilitation medicine is considered one of the most important coordinating disciplines of modern medical intervention. It is the answer to the omissions of medicine in the past in that it turns explicitly toward the consequences of diseases for the quality of life. The social and philosophical movements which have strongly influenced the development of comprehensive medicine are globally outlined. These movements, along with demographic changes, are viewed as the main contributive factors for the development of rehabilitation medicine as a methodologic practical mode of medical intervention, directed at the consequences of disease and trauma as expressed in the terms of impairment, disability, and handicap. The methodology of rehabilitation is outlined, with the rehabilitation medical diagnosis viewed as the indispensable prerequisite and basis for rehabilitation programming in cooperation with the disabled person himself.

Combined Modality Therapy↗

PubMed1988

The role of the family and state in old-age support: the Swedish experience up to 1913.

This paper presents the Swedish experience of caring for the old prior to the welfare state, and focusses on the State's effort to place the responsibility for the aged on the children and kin. If old people were poor and without kin the congregation, e.g. the local community, were responsible for their care and support. The hospitals were built for other groups in society and only the poorhouses were open to the elderly. Pressure on the local community was strongly increased by demographic changes at the turn of the century and the Riksdag was able to unite in passing a law for a State-administered People's Pension 1913.

Aged↗

PubMed1987

Black demographic trends in the 1980s.

Most of the black demographic trends witnessed in the 1970s have continued during the first half of the 1980s, but the pace of demographic change has slowed in some areas and quickened in others. A short summarization of the major trends is provided below; 1. The black population is growing faster than the white population and blacks are becoming a larger share of the total population. 2. Blacks continue to move out of the North and into the South and West. 3. Blacks continue to move out of central cities into suburbs, but blacks are not moving out of central cities as fast as whites and central city populations are becoming increasingly black. 4. The growth rates of preschool-age blacks increased in the 1980s, but the growth rates of the school age and young adult populations declined. 5. The fertility rates of blacks continued to fall and to approach convergence with those of whites, although there still is a significant gap between black and white fertility rates. 6. Teen birthrates for unmarried blacks continued to fall during the first half of the 1980s. 7. Life expectancy for blacks continued to increase during the 1980s, but at a somewhat slower pace than seen during the 1970s. 8. The share of black children living in single parent families continued to grow during the 1980s at a faster rate than seen during the 1970s. 9. The share of black children living with a never-married parent grew much more rapidly in the 1980s than in the 1970s.

Black or African American↗

PubMedDate not supplied

[Phenomenology and psychodynamics of suicidal acts by the elderly].

Worldwide demographic changes will be clearly accompanied by a growing percentage in the world population of human beings in advanced age. People above 64 years will account for 6.6 per cent in the year 2000 and for 9.3 per cent in 2025. Reference is made, in this context, to an expected rise in the incidence of psychic disorders. Old-age suicidality was studied against that background. Special interviews were made with all patients (n = 141) admitted for abortive suicide to the Geropsychiatric Department of Berlin, between 1973 and 1982, with the view to clearing up the phenomenology and psychodynamics of their action. Eighteen women and ten men attempted suicide in a state of paranoid-hallucinative psychosis. Generally known endogenic psychoses were not present. The remaining suicidal attempts were made in the wake of depression primarily for exogenic causes, such as lack of contact and conflict situations, or physical diseases accompanied by severe complaints. Socalled "tough" and "soft" methods had been almost equally used by either sex. The analysis provided relevant information conductive to an expansion of complex attention to aged citizens. Effective action should be taken, in the first place, to cope with their loneliness syndromes.

Aged↗

PubMedDate not supplied

[Homes for the aged and nursing homes in North Rhine-Westphalia].

In the last hundred years demographic change has altered the age composition of the overall population. In particular there was a marked rise in the number of older people (65 years and over). In Germany the proportion of the total population aged 65 years and over increased from 4.6% in 1871 to 15.1% in 1977. The current demographic-geographical situation of the proportion of the aged, homes for the aged and nursing homes in the different districts of North Rhine-Westphalia is presented. Since 1979 there has been an increase of 17,122 in the number of beds available in nursing homes. In North Rhine-Westphalia a total of 49,536 beds in nursing homes were available on 1.9.84, i.e. 2.08 beds per 100 aged (65 years and over), while the intended index is 2.3 beds per 100 aged. The number of places in homes for old people was 58,236 on 1.9.84, i.e. 2.45 places per 100 aged. The intended index (2.80 places per 100 aged) is nearly reached, although the regional differences are considerable.

Aged↗