Demographic changes in the United States.
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Demography↗
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[Demographic changes in family planning programs].
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Family Planning Services↗
Hip fractures in the elderly: a world-wide projection.
Hip fractures are recognized to be a major public health problem in many Western nations, most notably those in North America, Europe and Oceania. Incidence rates for hip fracture in other parts of the world are generally lower than those reported for these predominantly Caucasian populations, and this has led to the belief that osteoporosis represents less of a problem to the nations of Asia, South American and Africa. Demographic changes in the next 60 years, however, will lead to huge increases in the elderly populations of those countries. We have applied available incidence rates for hip fracture from various parts of the world to projected populations in 1990, 2025 and 2050 in order to estimate the numbers of hip fractures which might occur in each of the major continental regions. The projections indicate that the number of hip fractures occurring in the world each year will rise from 1.66 million in 1990 to 6.26 million by 2050. While Europe and North America account for about half of all hip fractures among elderly people today, this proportion will fall to around one quarter in 2050, by which time steep increases will be observed throughout Asia and Latin America. The results suggest that osteoporosis will truly become a global problem over the next half century, and that preventive strategies will be required in parts of the world where they are not currently felt to be necessary.
Adult↗
Effects of hospital planning reforms on access, costs, efficiency, and quality of care in OECD countries: Systematic review and meta-analysis.
BACKGROUND: Many OECD countries have implemented hospital planning reforms to rising healthcare costs, demographic changes, and concerns about access, efficiency, and quality of care. Despite broad implementation, evidence on effectiveness remains fragmented and country-specific. OBJECTIVE: To synthesize evidence on the effects of hospital planning reforms aross four outcome domains: access, costs, efficiency, and quality of care. METHODS: We conducted a systematic review following Cochrane methodology, searching PubMed and Web of Science (January 2000 - September 2025). Studies were categorized into four intervention types - centralization, minimum volume requirements (MVR), performance-based targets, and governance and ownership restructuring. Risk of bias was assessed using Joanna Briggs Institute checklist for quasi-experimental designs. Where data permitted, random-effects meta-analyses pooled standardized mean differences (SMD) for access and efficiency and risk differences (RD) for quality outcomes. RESULTS: 26 studies from 12 countries were included. Centralization increased patient travel distances and reduced length of stay (SMD -0.09, 95% CI -0.17 to -0.01) and complications (RD -14.52 pp, -25.95 to -3.09), and, jointly with performance-based targets, 30-day readmissions (RD -0.43 pp, -0.65 to -0.22). Mortality effects varied by timepoint and intervention: short-term endpoints were largely non-significant, whereas 90-day mortality was reduced under centralization (RD -0.80 pp, -1.25 to -0.35) and 60-day mortality under MVR (RD -2.00 pp, -2.82 to -1.18). Survival was non-significant throughout. No study examined costs. CONCLUSION: The absence of cost evidence is a critical gap. Substantial heterogeneity reflects variation in reform design and context, underscoring the need to interpret findings by intervention and country conditions.
Humans↗
Ecological determinants of divorce: a structural approach to the explanation of Japanese divorce.
This paper examines the ecological determinants of contemporary Japanese divorce rates on the prefectural level. LISREL and computer-generated graphics are the analytic methods used. The aggregate level of analysis demands the use of the ecological model which posits that demographic changes, economic activities, migration patterns, and the level of urbanization are significant predictors of divorce rate. Our analysis demonstrates that sex ratio, female labor force participation, female in-migration patterns, population increase, and net household income all play a significant role in affecting the divorce rate. Our findings also confirm the well-supported hypothesis that both population density and modernization positively influence modern Japan's divorce rates. The residual analysis also points out that in order to account for the large proportion of the unexplained variance of Japanese divorce, behavioral-related variables and island- or prefecture-specific dimensions need to be included in the ecological model of divorce.
Adolescent↗
The First Highly Contiguous Genome Assembly for the Western Bluebird (Sialia mexicana).
The western bluebird (Sialia mexicana) is a secondary cavity-nesting thrush that has experienced historical population declines, local extirpations, and more recent recoveries associated with nest box programs. Despite these regional successes, recent eBird estimates suggest continued range-wide declines and substantial geographic variation in population trajectories, making this species a useful system for future studies of demographic change, connectivity, and conservation genomics. However, genomic resources for western bluebirds remain limited, and no reference genome currently exists for any species in the genus Sialia. Here, we present the first high-quality de novo reference genome for S. mexicana. Using PacBio HiFi long-read sequencing from an adult female, we generated a highly contiguous, phased 1.3 Gb nuclear assembly with a contig N50 of 24.8 Mb and high BUSCO completeness of 98.3%. We annotated the nuclear genome using transcriptomic and protein evidence, identifying 16,656 protein-coding genes and 26,060 transcripts/protein isoforms. We also assembled a complete ∼16 kb mitochondrial genome from Illumina short-read data. This reference genome provides a foundational resource for future studies of population structure, genetic diversity, connectivity, demographic history, and adaptation in western bluebirds and related taxa.
Animals↗
A Million Years of Mammoth Mitogenome Evolution.
The genomic study of specimens dating to the Early and Middle Pleistocene (EP and MP), a period spanning from 2.6 million years ago (Ma) to 126 thousand years ago (ka), has the potential to elucidate the evolutionary processes that shaped present-day biodiversity. Obtaining genomic data from this period is challenging, but mitochondrial DNA, given its higher abundance compared to nuclear DNA, could play an important role to understand evolutionary processes at this time scale. In this study, we report 34 new mitogenomes, including two EP and nine MP mammoth (Mammuthus spp.) specimens from Siberia and North America and analyze them jointly with >200 publicly available mitogenomes to reconstruct a transect of mammoth mitogenome diversity throughout the last million years. We find that our EP mitogenomes fall outside the diversity of all Late Pleistocene (LP) mammoths, while those derived from MP mammoths are basal to LP mammoth Clades 2 and 3, supporting an ancient Siberian origin of these lineages. In contrast, the geographical origin of Clade 1 remains unresolved. With these new deep-time mitogenomes, we observe diversification events across all clades that appear consistent with previously hypothesized MP and LP demographic changes. Furthermore, we improve upon an existing methodology for molecular clock dating of specimens >50 ka, demonstrating that specimens need to be individually dated to avoid biases in their age estimates. Both the molecular and analytical improvements presented here highlight the importance of deep-time genomic data to discover long-lost genetic diversity, enabling better assessments of evolutionary histories.
Animals↗
The challenge of health education for nurses in the 1980s.
As nurses are the largest group of health workers, it is argued that their potential for influence, so far as health education is concerned, is very great. The health problems associated with demographic changes in British society, smoking, alcohol, road accidents, dental decay, mental health and the sexual revolution are focused on; and the health education contribution that nurses (and other health workers) can make to alleviate and prevent these problems is discussed. The important role of 'significant others' is also stressed. Problems associated with general lack of basic biological and health information, and with the physically handicapped, and immigrant groups are also noted with concern and are considered to be particular challenges to nurses. Nurses are urged to develop their social skills, to constantly update their knowledge about British society, and to commit themselves to the aims of health education. It is also argued that they need missionary zeal so that they will take health education to the people in the community at large. The basic tenet of the paper is that health education is part and parcel of the nursing process and, therefore, greater involvement of nurses in health education is a logical and rational extension of their role.
Alcoholism↗
Homoploid Hybrid Speciation in a Marine Pelagic Fish.
Homoploid hybrid speciation (HHS) is an enigmatic evolutionary process where new species arise through hybridisation of divergent lineages without changes in chromosome number. Although increasingly documented in various taxa and ecosystems, convincing cases of HHS in marine fishes have been lacking. This study presents a possible case of HHS in a pelagic marine fish based on comprehensive genomic, morphological, and ecological analyses. Population genomics, species tree estimation, and tests of introgression and admixture identified three sympatric clusters in Megalaspis cordyla in the western Pacific and the admixed nature of one cluster between the others. Moreover, model-based demographic inference favoured a hybrid speciation scenario over introgression for the origin of the admixed cluster. While contemporary gene flow suggested partial reproductive isolation, examination of occurrence data and ecologically relevant morphological characters suggested ecological differences between the clusters, potentially contributing to the reproductive isolation and niche partitioning in sympatry. The clusters are also morphologically distinguishable and thus can be taxonomically recognised as separate species. The hybrid cluster is restricted to the coasts of Taiwan and Japan, where all three clusters coexist. The parental clusters are additionally found in lower latitudes, where they display non-overlapping distributions. Given the geographical distributions, estimated times of species formation, and patterns of historical demographic changes, we propose that the Pleistocene glacial cycles were the primary driver of HHS in this system. We also develop an ecogeographic model of HHS in marine coastal ecosystems, including a novel hypothesis to explain the initial stages of HHS.
Animals↗
Preventable mortality in Mexico: bridging gaps in chronic disease and ageing care.
Preventable mortality remains a critical public health challenge in Mexico, with 819 672 deaths recorded in 2024. Of these, 37.21% in the general population were attributed to ischaemic heart disease (IHD) and diabetes mellitus. We analyse Instituto Nacional de Estadística y Geografía mortality data to assess disparities in cardiovascular mortality across age groups, sex and geographical regions, and to identify key gaps in Mexico's preventive care strategies. Age-standardised mortality rates (ASMRs) reveal persistently elevated cardiovascular mortality in northern states, including Chihuahua, Coahuila, Durango and Nuevo León, and in southeastern states, including Veracruz, Tabasco, Campeche and Yucatán. The burden is highly concentrated among older adults and geographically clustered in specific high-risk regions. These patterns reflect structural gaps in prevention, early detection and access to adequate care rather than unavoidable demographic change. Obesity, diabetes and hypertension form a pathophysiological triad that synergistically exacerbates cardiovascular disease through shared mechanisms and comorbidities. Despite substantial global declines in IHD mortality over the past two decades, Mexico continues to experience elevated and regionally extreme cardiovascular mortality, highlighting a failure to translate established global evidence into national practice. Drawing on evidence-based interventions implemented in comparable health systems, we propose seven scalable strategies: (1) expanding access to health services in underserved regions, (2) integrating preventive health programmes within primary care, (3) developing structured physical activity initiatives, (4) establishing a geriatric care framework, (5) promoting community-based nutrition and wellness programmes, (6) advancing gender-sensitive cardiovascular prevention across adulthood and ageing and (7) implementing school-based health education programmes. These interventions could substantially reduce cardiovascular mortality, lower healthcare costs and improve long-term population health outcomes in Mexico.
Humans↗
Hip arthroplasty in Jutland, Denmark. Age and sex-specific incidences of primary operations.
During the 10-year period 1981-90, 1752 primary total hip arthroplasties were performed in the County of South Jutland, Denmark. The annual number increased to a steady state during 1988-90. In this period, the incidence was highest in the age group 70-79 years for both women and men, with 485 and 410 arthroplasties per 100,000 inhabitants, respectively; the overall incidence was 82 per 100,000 inhabitants. During the next 30 years, the demand for primary hip arthroplasties in Denmark is expected to increase because of demographic changes.
Adult↗
The effects of zero population growth on the incidence of cleft lip and palate in Western Australia.
A total of 613 cases of cleft lip, cleft palate, and combinations of both (CLP(P)) has been ascertained in the period from 1958 to 1975 in Western Australia. Near-total ascertainment of cases during this period was obtained from multiple sources. There has been a significant decline in the total incidence and the cleft lip and palate (CLP) incidence in males. The hypothesis is presented that these changes are linked to the changing fertility pattern throughout Australia (as technological improvements are made in the simplicity and efficacy of birth control), and abortion (as social attitudes change); and as the birthrate drops towards zero population growth (ZPG). The paper presents two critical observations: (i) the link between CLP(P) incidence, and demographic changes; (ii) in differing behaviour of cleft lip (CL) and CLP, which were previously regarded as linked conditions.
Australia↗
Fertility and family planning in Thailand: results from two rounds of a national study.
The Longitudinal Study of Social, Economic, and Demographic Change was undertaken during the late 1960s to provide detailed national information on behavior and attitudes related to fertility and family planning in Thailand. Results from the second round of the study indicate that the practice of family planning increased substantially in both rural and urban areas during the three-year interval between the two rounds. During this period, marital fertility registered a decline in the urban areas. This was a result of a small rise in fertility among Bangkok-Thonburi women combined with a sharp decline in fertility among provincial urban women. Because the National Family Planning Program was officially begun at the time of the first round, its role in the increase in contraceptive use is examined. Although the study shows that the desired number of children is substantially below the actual number of children Thai womenhave by the end of their reproductive years, the desired number of children is still well above the number usually considered ideal in developed countries. Nonetheless, changes in reproductive behavior appear to reflect the impact of modernization on Thai society. In urban areas, marital fertility is only moderately high and a substantial proportion of couples practice family planning. Of particular importance over the remainder of the decade will be the reproductive behavior of rural women, who constitute an extremely high proportion of the Thai female population.
Adolescent↗
Overview of contemporary families.
Perceptions and definitions of the term family have always been varied and complex. Hence, an overview of contemporary families is presented here from several perspectives. First, families as they have been perceived by nursing and social science theorists are reviewed. Demographic changes in the family over the last two decades are then presented, followed by an examination of issues faced by families as they change over time. Finally, families as they exist within varying cultural and social contexts are discussed. Emphasis is placed on the need for health care providers to be flexible in defining and working with individual patients and their families.
Critical Care↗
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↗
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↗
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↗
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↗