Demographic and geographical trends in chronic lower respiratory diseases mortality in the United States, 1999 to 2020.

Chronic lower respiratory disease (CLRD) related mortality has decreased in the United States due to increasing awareness in the general population and advancing preventative efforts, diagnostic measures, and treatment. However, demographic and regional differences still persist throughout the United States. In this study, we analyzed the temporal trends of demographic and geographical differences in CLRD-related mortality. Data was extracted from the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) database. Using this data, age-adjusted mortality rates per 100,000 people (AAMR), annual percentage change (APC), and average annual percentage changes with 95% confidence intervals (CIs) were assessed. The Joinpoint Regression Program was used to determine mortality trends between 1999 and 2020 based on demographic and regional groups.During this study period, there were 3,064,049 CLRD-related deaths, with most demographics and regional areas showing an overall decreasing trend. However, higher mortality rates were seen in the non-Hispanic White population and rural areas. Interestingly, mortality rates witnessed a decreasing trend for males throughout the study duration compared to females, who only began to show decreases in mortality during the latter half of the 2010s. Using these results, one can target efforts and build policies to improve CLRD-related mortality and reduce disparities in the coming decades.

21st century accelerating neurological deaths in UK and major Western countries: - Demographic and/or multiple-interactive-environmental causes?

OBJECTIVE: We examine whether the rise in neurological death rates over the 21st century are solely explained by the Gompertzian hypothesis. STUDY DESIGN: We examine two data-sets. First, Office of National Statistics (ONS, 2022) for nineteen mortality categories in England/Wales, including Alzheimer's, Dementias and Parkinson's Disease. Secondly, WHO (2020) Combined Neurological Mortality (CNM), from WHO Global mortality categories, Nervous Disease Deaths, and Alzheimer's & Other Dementias. METHODS: Based on ONS data we investigate trends in Age-Standardised Mortality Rates (ASMR) of CNM 2000-2022. Based on WHO data we examine rates of Early Deaths (55-74) and ASMR, for CNM between 2000 and 2015 in the ten Major 'Western' economies: Australia, Canada, France, Germany, Italy, Japan, Netherlands, Spain, UK, and the USA. RESULTS: In England & Wales death rates have increased 348% for Alzheimer's, 235% for Dementias, and 105% for Parkinson's Disease in contrast with falls in most other cause mortality. Early Adults Deaths CNM rates increased in eight countries, an average of 19%. Neurological ASMR rose in every country, averaging 43%, the highest was the UK 95%. CONCLUSION: We reject the Gompertzian hypothesis as an all-encompassing explanation for these marked increases in ASMR. Increases in early adult neurological deaths suggests this cannot be solely explained by an aging population. Furthermore, increases in mortality could be related to an increased prevalence of neurological conditions in this age group. Action is urgently needed to investigate factors - whether environmental, lifestyle or health systems - that could explain these findings.

Modeling potential distribution of newly recorded ant, Brachyponera nigrita using Maxent under climate change in Pothwar region, Pakistan.

Climate change has been discussed as to exert shifts in geographical range of plants, animals or insect species by increasing, reducing or shifting its appropriate climatic habitat. Globally, Pakistan has been ranked at 5th position on the list of countries most vulnerable to climate change in 2020. Climate change has resulted in the losses of biodiversity and alteration in ecosystem as a result of depletion of natural habitats of species in Pakistan as well as in the world. Ants have been regarded as indicators of environmental change and ecosystem processes. Brachyponera nigrita (Emery, 1895) was reported for the first time from Pakistan (Pothwar region). Objective of our studies was to model geographic distribution of newly recorded ant species, B. nigrita based on two representative concentration pathways (RCP) (RCP4.5 and RCP8.5) for 2050s using maximum entropy model (Maxent) in Pakistan. In modeling procedure, 21occurrence records and 8 variables namely Bio4 (Temperature seasonality), Bio8 (Mean temperature of wettest quarter), Bio10 (Mean temperature of warmest quarter), Bio12 (Annual precipitation), Bio13 (Precipitation of wettest month), Bio15 (Precipitation seasonality), Bio17 (Precipitation of driest quarter) and Bio18 (Precipitation of warmest quarter) were used to determine the current and future distributions. Performance of the model was evaluated using AUC (area under curves) values, partial ROC, omission rates (E = 5%) and AICc (Model complexity).The results showed the average AUC value of the model was 0.930, which indicated that the accuracy of the model was excellent. The jackknife test also showed that Bio4, Bio18, Bio17 and Bio15 contributed 98% for the prediction of potential distribution of the species as compared to all other variables. Maxent results indicated that distribution area of B. nigrita under future predicted bioclimatics 2050 (RCP 4.5 and RCP8.5) would be increased in various localities of Pakistan as compared to its current distribution. In Pothwar region, moderately suitable and highly suitable areas of this species would increase by 505.932321km2and 572.118421km2as compared to current distribution under 2050 (RCP 4.5), while under 2050 (RCP 8.5), there would be an increase of 6427.2576km2and 3765.140493km2 respectively in moderately suitable and highly suitable areas of B. nigrita. This species was associated with termites, collembolans and larval stages of different insects. White eggs, creamy white pupae and many workers of this species were observed in a variety of habitats. Unknown nesting ecology, species identification characters supported with micrographs has been given which will help researchers for further ecological studies.

The health and well-being of older women living alone in the United Kingdom and beyond: a scoping review.

In the United Kingdom (UK), women are more likely to live alone in later life. Social factors such as household composition have been shown to affect health and wellbeing as we age. The health and well-being of older women who live alone are of interest to researchers, care providers, health organizations, and policymakers. This article contributes to the literature by detailing a scoping review, establishing the current evidence in this field. The purpose and context of the review are given. The methodology and resulting data are described. Gaps in the literature and implications for practice and research are given.

Demographic Disparities in Proximity to Certified Stroke Care in the United States.

Background and Purpose: Demographic disparities in proximity to stroke care influence time to treatment and clinical outcome but remain understudied at the national level. This study quantifies the relationship between distance to the nearest certified stroke hospital and census-derived demographics. Methods: This cross-sectional study included population data by census tract from the United States Census Bureau's 2014­2018 American Community Survey, stroke hospitals certified by a state or national body and providing intravenous thrombolysis, and geographic data from a public mapping service. Data were retrieved from March to November 2020. Quantile regression analysis was used to compare relationships between road distance to the nearest stroke center for each census tract and tract-level demographics of age, race, ethnicity, medical insurance status, median annual income, and population density. Results: Two thousand three hundred eighty-eight stroke centers and 71 929 census tracts including 316 995 649 individuals were included. Forty-nine thousand nine hundred eighteen (69%) tracts were urban. Demographic disparities in proximity to certified stroke care were greater in nonurban areas than urban areas. Higher representation of individuals with age ≥65 years was associated with increased median distance to a certified stroke center in nonurban areas (0.51 km per 1% increase [99.9% CI, 0.42­0.59]) but not in urban areas (0.00 km [−0.01 to 0.01]). In urban and nonurban tracts, median distance was greater with higher representation of American Indian (urban: 0.10 km per 1% increase [0.06­0.14]; nonurban: 1.06 km [0.98­1.13]) or uninsured populations (0.02 km [0.00­0.03]; 0.27 km [0.15­0.38]). Each $10 000 increase in median income was associated with a decrease in median distance of 5.04 km [4.31­5.78] in nonurban tracts, and an increase of 0.17 km [0.10­0.23] in urban tracts. Conclusions: Disparities were greater in nonurban areas than in urban areas. Nonurban census tracts with greater representation of elderly, American Indian, or uninsured people, or low median income were substantially more distant from certified stroke care.

The changing health needs of the UK population.

The demographics of the UK population are changing and so is the need for health care. In this Health Policy, we explore the current health of the population, the changing health needs, and future threats to health. Relative to other high-income countries, the UK is lagging on many health outcomes, such as life expectancy and infant mortality, and there is a growing burden of mental illness. Successes exist, such as the striking improvements in oral health, but inequalities in health persist as well. The growth of the ageing population relative to the working-age population, the rise of multimorbidity, and persistent health inequalities, particularly for preventable illness, are all issues that the National Health Service (NHS) will face in the years to come. Meeting the challenges of the future will require an increased focus on health promotion and disease prevention, involving a more concerted effort to understand and tackle the multiple social, environmental, and economic factors that lie at the heart of health inequalities. The immediate priority of the NHS will be to mitigate the wider and long-term health consequences of the COVID-19 pandemic, but it must also strengthen its resilience to reduce the impact of other threats to health, such as the UK leaving the EU, climate change, and antimicrobial resistance.

Estimated Projection of US Cancer Incidence and Death to 2040.

Importance: Coping with the current and future burden of cancer requires an in-depth understanding of trends in cancer incidences and deaths. Estimated projections of cancer incidences and deaths will be important to guide future research funding allocations, health care planning, and health policy efforts. Objective: To estimate cancer incidences and deaths in the United States to the year 2040. Design and Setting: This cross-sectional study's estimated projection analysis used population growth projections and current population-based cancer incidence and death rates to calculate the changes in incidences and deaths to the year 2040. Cancer-specific incidences and deaths in the US were estimated for the most common cancer types. Demographic cancer-specific delay-adjusted incidence rates from the Surveillance, Epidemiology, and End Results Program were combined with US Census Bureau population growth projections (2016) and average annual percentage changes in incidence and death rates. Statistical analyses were performed from July 2020 to February 2021. Main Outcomes and Measures: Total cancer incidences and deaths to the year 2040. Results: This study estimated that the most common cancers in 2040 will be breast (364 000 cases) with melanoma (219 000 cases) becoming the second most common cancer; lung, third (208 000 cases); colorectal remaining fourth (147 000 cases); and prostate cancer dropping to the fourteenth most common cancer (66 000 cases). Lung cancer (63 000 deaths) was estimated to continue as the leading cause of cancer-related death in 2040, with pancreatic cancer (46 000 deaths) and liver and intrahepatic bile duct cancer (41 000 deaths) surpassing colorectal cancer (34 000 deaths) to become the second and third most common causes of cancer-related death, respectively. Breast cancer (30 000 deaths) was estimated to decrease to the fifth most common cause of cancer death. Conclusions and Relevance: These findings suggest that there will be marked changes in the landscape of cancer incidence and deaths by 2040.

Climate change and anthropogenic food manipulation interact in shifting the distribution of a large herbivore at its altitudinal range limit.

Ungulates in alpine ecosystems are constrained by winter harshness through resource limitation and direct mortality from weather extremes. However, little empirical evidence has definitively established how current climate change and other anthropogenic modifications of resource availability affect ungulate winter distribution, especially at their range limits. Here, we used a combination of historical (1997-2002) and contemporary (2012-2015) Eurasian roe deer (Capreolus capreolus) relocation datasets that span changes in snowpack characteristics and two levels of supplemental feeding to compare and forecast probability of space use at the species' altitudinal range limit. Scarcer snow cover in the contemporary period interacted with the augmented feeding site distribution to increase the elevation of winter range limits, and we predict this trend will continue under climate change. Moreover, roe deer have shifted from historically using feeding sites primarily under deep snow conditions to contemporarily using them under a wider range of snow conditions as their availability has increased. Combined with scarcer snow cover during December, January, and April, this trend has reduced inter-annual variability in space use patterns in these months. These spatial responses to climate- and artificial resource-provisioning shifts evidence the importance of these changing factors in shaping large herbivore spatial distribution and, consequently, ecosystem dynamics.

Trends in the epidemiology of inflammatory bowel disease in Colombia by demographics and region using a nationally representative claims database and characterization of inflammatory bowel disease phenotype in a case series of Colombian patients.

ABSTRACT: The incidence of inflammatory bowel disease (IBD) is on the rise in Latin America. The aims of this study were to examine epidemiologic trends of IBD in Colombia by demographics, region, urbanicity, and to describe the IBD phenotype in a large well-characterized Colombian cohort.We used a national database of 33 million adults encompassing 97.6% of the Colombian population in order to obtain epidemiologic trends of IBD using International Classification of Diseases 10codes for adults with ulcerative colitis (UC) and Crohn disease (CD). We calculated the incidence and prevalence of UC and CD from 2010-2017 and examined epidemiologic trends by urbanicity, demographics, and region. We then examined the IBD phenotype (using Montreal Classification), prevalence of IBD-related surgeries, and types of IBD-medications prescribed to adult patients attending a regional IBD clinic in Medellin, Colombia between 2001 and 2017.The incidence of UC increased from 5.59/100,000 in 2010 to 6.3/100,000 in 2017 (relative risk [RR] 1.12, confidence interval (CI) (1.09-1.18), P < .0001). While CD incidence did not increase, the prevalence increased within this period. The Andes region had the highest incidence of IBD (5.56/100,000 in 2017). IBD was seen less in rural regions in Colombia (RR=.95, CI (0.92-0.97), p < .01). An increased risk of IBD was present in women, even after adjusting for age and diagnosis year (RR 1.06 (1.02-1.08), P = .0003). The highest IBD risk occurred in patients 40 to 59 years of age. In the clinic cohort, there were 649 IBD patients: 73.7% UC and 24.5% CD. Mean age of diagnosis in CD was 41.0 years and 39.9 years in UC. UC patients developed mostly pancolitis (43%). CD patients developed mostly ileocolonic disease and greater than a third of patients had an inflammatory, non-fistulizing phenotype (37.7%). A total of 16.7% of CD patients had perianal disease. CD patients received more biologics than UC patients (odds ratio: 3.20, 95% CI 2.19-4.69 P < .001).Using both a national representative sample and a regional clinic cohort, we find that UC is more common in Colombia and is on the rise in urban regions; especially occurring in an older age cohort when compared to Western countries. Future studies are warranted to understand evolving environmental factors explaining this rise.

The historical range and drivers of decline of the Tapanuli orangutan.

The Tapanuli Orangutan (Pongo tapanuliensis) is the most threatened great ape species in the world. It is restricted to an area of about 1,000 km2 of upland forest where fewer than 800 animals survive in three declining subpopulations. Through a historical ecology approach involving analysis of newspaper, journals, books and museum records from the early 1800s to 2009, we demonstrate that historically Pongo tapanuliensis inhabited a much larger area, and occurred across a much wider range of habitat types and at lower elevations than now. Its current Extent of Occurrence is 2.5% and 5.0% of the historical range in the 1890s and 1940s respectively. A combination of historical fragmentation of forest habitats, mostly for small-scale agriculture, and unsustainable hunting likely drove various populations to the south, east and west of the current population to extinction. This happened prior to the industrial-scale forest conversion that started in the 1970s. Our findings indicate how sensitive P. tapanuliensis is to the combined effects of habitat fragmentation and unsustainable take-off rates. Saving this species will require prevention of any further fragmentation and killings or other removal of animals from the remaining population. Without concerted action to achieve this, the remaining populations of P. tapanuliensis are doomed to become extinct within several orangutan generations.

Past and future potential range changes in one of the last large vertebrates of the Australian continent, the emu Dromaius novaehollandiae.

In Australia, significant shifts in species distribution have occurred with the loss of megafauna, changes in indigenous Australian fire regime and land-use changes with European settlement. The emu, one of the last megafaunal species in Australia, has likely undergone substantial distribution changes, particularly near the east coast of Australia where urbanisation is extensive and some populations have declined. We modelled emu distribution across the continental mainland and across the Great Dividing Range region (GDR) of eastern Australia, under historical, present and future climates. We predicted shifts in emu distribution using ensemble modelling, hindcasting and forecasting distribution from current emu occurrence data. Emus have expanded their range northward into central Australia over the 6000 years modelled here. Areas west of the GDR have become more suitable since the mid-Holocene, which was unsuitable then due to high precipitation seasonality. However, the east coast of Australia has become climatically sub-optimal and will remain so for at least 50 years. The north east of NSW encompasses the range of the only listed endangered population, which now occurs at the margins of optimal climatic conditions for emus. Being at the fringe of suitable climatic conditions may put this population at higher risk of further decline from non-climatic anthropogenic disturbances e.g. depredation by introduced foxes and pigs. The limited scientific knowledge about wild emu ecology and biology currently available limits our ability to quantify these risks.

Disruptive Demographics: Their Effects on Nursing Demand, Supply and Academic Preparation.

The nursing profession faces both a labor shortage and a diversity problem. Nine proactive strategies-rooted in the disruptive demographic trends that are transforming our nation-are advanced to address these 2 critical issues.

Yateras frente a la COVID-19: 386 días de silencio epidemiológico / Yateras versus COVID-19: 386 days of epidemiological silence

Introducción: No hay un reporte en la literatura científica que analice las causas que permitieron al municipio Yateras ser el único en Cuba en no tener pacientes diagnosticados con COVID-19 entre el 11 de marzo de 2020, fecha del primer reporte en el país, y el 2 de abril de 2021 en que se diagnosticó el primer paciente con la enfermedad. Objetivo: Caracterizar aspectos sociodemográficos de la población del municipio Yateras de la provincia de Guantánamo, en Cuba, durante este período en el cual no se diagnosticaron casos confirmados de la COVID-19. Métodos: Se realizó un estudio descriptivo, retrospectivo y transversal en el período comprendido entre el 11 de marzo de 2020 y el 2 de abril de 2021. El universo lo constituyó la población censada en ese período. Se estudiaron la edad, sexo, características de las viviendas, clasificación de la población según grupos dispensariales y otras condiciones que determinan la vulnerabilidad de los pobladores. Resultados: El 47,1 por ciento de la población fue vulnerable a la pandemia. El 98,8 por ciento presentó alguna comorbilidad o factor de riesgo, sobre todo el antecedente de hipertensión arterial sistémica en 2192 pobladores. El 10,7 por ciento de las viviendas se calificaron como hacinadas y 54,2 por ciento presentaba condiciones inadecuadas. Conclusiones: La mayor proporción de los pobladores de Yateras es vulnerable a la COVID-19, pero las particularidades sociodemográficas de esta población no determinaron el período de silencio epidemiológico que caracterizó al territorio, lo que se supone se debió al control y cumplimiento estricto de un sistema de medidas dirigidas al enfrentamiento de esta enfermedad, mediatizado por la actitud responsable y solidaria de la comunidad yaterana en el logro de esta finalidad(AU)

ABSTRACT Introduction: No report is available in the scientific literature analyzing the reasons why Yateras is the only municipality in Cuba without any COVID-19 patient from 11 March 2020, when the first case was reported in the country, until 2 April 2021, when the first case was diagnosed in the municipality. Objective: Characterize sociodemographic features of the population of the municipality of Yateras, province of Guantánamo, Cuba, during the period when no confirmed COVID-19 cases were diagnosed. Methods: A descriptive cross-sectional retrospective study was conducted in the period extending from 11 March 2020 to 2 April 2021. The study universe was the census-registered population in that period. The variables analyzed were age, sex, household conditions, population classification according to dispensary groups, and other conditions determining the vulnerability of the population. Results: Of the population studied, 47.1 percent was vulnerable to the pandemic. 98.8 percent had some sort of comorbidity or risk factor, mainly an antecedent of systemic arterial hypertension in 2192 inhabitants. 10.7 percent of the households were classified as overcrowded and 54.2 percent had inadequate conditions. Conclusions: A large number of Yateras residents are vulnerable to COVID-19. However, the sociodemographic features of this population did not determine the period of epidemiological silence characterizing the territory, which is thought to have been due to the control and strict compliance with a system of measures aimed at facing the disease, alongside the responsible, supportive attitude of the community toward the achievement of this goal(AU)

La inmigración internacional reciente en la Ciudad de Buenos Aires / Recent international immigration in the City of Buenos Aires

En un nuevo contexto de la migración en la Ciudad de Buenos Aires, el presente informe tiene como objetivo analizar las características sociodemográficas de los principales orígenes que integran el conjunto de inmigrantes externos y que, como se mencionó, presentan particularidades en su composición y antigüedad de residencia en la Ciudad, considerando asimismo desde una perspectiva comparativa a los residentes nacidos en el país. Para este informe se explotaron los datos de la última Encuesta Anual de Hogares disponible correspondiente a 2019 que releva la Dirección General de Estadística y Censos sobre la base de una muestra probabilística de viviendas y hogares residentes en CABA y que contiene preguntas específicas sobre el lugar de nacimiento y el año desde que la persona reside en forma continua, que permiten identificar la antigüedad y cohortes de inmigrantes. (AU)

Superposition of COVID-19 waves, anticipating a sustained wave, and lessons for the future.

The 2019 coronavirus (COVID-19), also known as SARS-CoV-2, is highly pathogenic and virulent, and it spreads very quickly through human-to-human contact. In response to the growing number of cases, governments across the spectrum of affected countries have adopted different strategies in implementing control measures, in a hope to reduce the number of new cases. However, 5 months after the first confirmed case, countries like the United States of America (US) seems to be heading towards a trajectory that indicates a health care crisis. This is in stark contrast to the downward trajectory in Europe, China, and elsewhere in Asia, where the number of new cases has seen a decline ahead of an anticipated second wave. A data-driven approach reveals three key strategies in tackling COVID-19. Our work here has definitively evaluated these strategies and serves as a warning to the US, and more importantly, a guide for tackling future pandemics. Also see the video abstract here https://youtu.be/gPkCi2_7tWo.