ABSTRACT
OBJECTIVES: Medical student-run patient navigation (PN) programs enhance healthcare access in underserved communities. This study examines the relationship between patient demographics and PN outcomes in a student-led PN program. METHODS: Patients with moderate or high-risk health concerns were paired with medical students at health fairs. Statistical analysis evaluates program success and demographic influences. RESULTS: Of 444 patients, 66.4% were female, 47.1% Hispanic White, 49.1% spoke English, and 63.7% earned <300% of the federal poverty level. More than half were uninsured and 52.5% achieved navigation goals. Insurance status and risk level significantly predicted PN outcomes, with "other insurance" and high-risk patients being 1.9 and 1.7 times more likely to complete navigation. CONCLUSIONS: The program achieved high completion rates, emphasizing the need for resources such as translators and financial assistance. Risk stratification successfully linked acute cases to resources. Navigation success was consistent, demonstrating the effectiveness of the program across diverse patient groups.
Subject(s)
Patient Navigation , Humans , Female , Male , Florida , Patient Navigation/organization & administration , Adult , Middle Aged , Students, Medical/statistics & numerical data , Health Services Accessibility/statistics & numerical data , Schools, Medical/organization & administration , Medically Uninsured/statistics & numerical data , Young Adult , Program Evaluation , DemographyABSTRACT
The demographical history of France remains largely understudied despite its central role toward understanding modern population structure across Western Europe. Here, by exploring publicly available Europe-wide genotype datasets together with the genomes of 3234 present-day and six newly sequenced medieval individuals from Northern France, we found extensive fine-scale population structure across Brittany and the downstream Loire basin and increased population differentiation between the northern and southern sides of the river Loire, associated with higher proportions of steppe vs. Neolithic-related ancestry. We also found increased allele sharing between individuals from Western Brittany and those associated with the Bell Beaker complex. Our results emphasise the need for investigating local populations to better understand the distribution of rare (putatively deleterious) variants across space and the importance of common genetic legacy in understanding the sharing of disease-related alleles between Brittany and people from western Britain and Ireland.
Subject(s)
Genetics, Population , Humans , France , Genome, Human/genetics , Demography , Genetic Variation , Alleles , Genotype , History, Medieval , EuropeABSTRACT
This cross-sectional study compares the race and ethnicity and gender of images of physicians generated by artificial intelligence (AI) with US physician demographic characteristics.
Subject(s)
Artificial Intelligence , Physicians , Humans , Physicians/statistics & numerical data , Physicians/psychology , Male , Female , Adult , Demography , Middle AgedABSTRACT
The COVID-19 vaccination campaign resulted in uneven vaccine uptake throughout the United States, particularly in rural areas, areas with socially and economically disadvantaged groups, and populations that exhibited vaccine hesitancy behaviors. This study examines how county-level sociodemographic and political affiliation characteristics differentially affected patterns of COVID-19 vaccinations in the state of Indiana every month in 2021. We linked county-level demographics from the 2016-2020 American Community Survey Five-Year Estimates and the Indiana Elections Results Database with county-level COVID-19 vaccination counts from the Indiana State Department of Health. We then created twelve monthly linear regression models to assess which variables were consistently being selected, based on the Akaike Information Criterion (AIC) and adjusted R-squared values. The vaccination models showed a positive association with proportions of Bachelor's degree-holding residents, of 40-59 year-old residents, proportions of Democratic-voting residents, and a negative association with uninsured and unemployed residents, persons living below the poverty line, residents without access to the Internet, and persons of Other Race. Overall, after April, the variables selected were consistent, with the model's high adjusted R2 values for COVID-19 cumulative vaccinations demonstrating that the county sociodemographic and political affiliation characteristics can explain most of the variation in vaccinations. Linking county-level sociodemographic and political affiliation characteristics with Indiana's COVID-19 vaccinations revealed inherent inequalities in vaccine coverage among different sociodemographic groups. Increased vaccine uptake could be improved in the future through targeted messaging, which provides culturally relevant advertising campaigns for groups less likely to receive a vaccine, and increasing access to vaccines for rural, under-resourced, and underserved populations.
Subject(s)
COVID-19 , Politics , Socioeconomic Factors , Humans , Indiana , Middle Aged , Adult , COVID-19/prevention & control , COVID-19 Vaccines , Vaccination/statistics & numerical data , Demography , Male , Female , Aged , Young Adult , Adolescent , SARS-CoV-2ABSTRACT
INTRODUCTION: The morbidity and mortality associated with Female Genital Mutilation (FGM) have been clearly documented. Controlling and eventually eradication this practice is very important. Despite a loud call from the WHO and other international organisations, there are extensive nationalities and societies from both developed and developing countries still practising FGM. Understanding the current magnitude and associated factors in Tanzania may bring more light for possible interventions intended to control FGM. This study is timely for this aim. OBJECTIVE: To determine the prevalence of female genital mutilation and its associated factors among adolescent girls and young women in Tanzania. METHODS: Secondary data analysis was conducted on data from the 2022 Tanzanian Demographic and Health Survey. The weighted sample included in this study was 2965 adolescent girls and young women aged 15-24 years. Data analysis was performed using Stata 18.0 software. The strength of the association was assessed using the adjusted odds ratio (aOR) along with its corresponding 95% confidence interval (CI). RESULTS: The overall prevalence of FGM among adolescent girls and young women in Tanzania was 4.9% (95% CI = 3.37, 6.97). The prevalence varied significantly across the zones, ranging from < 1% in both Zanzibar and Southern zones to 19.7% in the Northern zone. Moreover, the results revealed that factors associated with FGM were rural areas (aOR = 2.09, 95% CI = 1.80, 5.44); no education (aOR = 11.59, 95% CI = 4.97, 27.03); poor (aOR = 2.41, 95% CI = 1.20, 4.83); unskilled manuals (aOR = 3.76, 95% CI = 1.97, 7.15); continued FGM (aOR = 3.86, 95% CI = 1.62, 9.18); FGM required by religion (aOR = 8.5, 95% CI = 3.15, 22.96) and watching television at least once a week (aOR = 0.20, 95% CI = 0.70, 1.56) among adolescents and young women in Tanzania. CONCLUSION: Female genital mutilation among adolescent girls and young women aged 15-24 years in Tanzania has decreased slightly between 2015/16 and 2022 from 5.9% to 4.9% respectively. This was mostly associated with education level, place of residence, occupation, wealth index, mass media exposure, attitudes towards FGM. More tailored programs focusing on high prevalence zones targeting adolescent girls and young women are needed to end female genital mutilation by 2030.
Subject(s)
Circumcision, Female , Circumcision, Female/adverse effects , Circumcision, Female/mortality , Circumcision, Female/statistics & numerical data , Tanzania , Prevalence , Demography , Humans , Female , Adolescent , Young Adult , Adult , Risk Factors , Surveys and QuestionnairesABSTRACT
PURPOSE: To determine whether the professional behaviors of radiologic technologists differ based on demographic variables. METHODS: An invitation was sent to 10 000 radiologic technologists to participate in the study. Participants completed the Haynes Scale of Professionalism for Radiologic Technology and answered demographic questions. Kruskal-Wallis tests and analyses of variance were conducted to identify the relationship between demographic variables and professional behaviors. Post hoc analyses were performed to identify differences between groups. RESULTS: A significant difference was identified for the demographic variable of age and the professionalism subscale of quality patient care (P < .001). The demographic variable of years as a technologist had significant differences with the subscales of quality patient care (P = .007), ethical performance (P = .008), personal and professional development (P = .02), and the total professionalism score (P = .01). A significant difference was found for the highest degree and the subscale of quality patient care (P = .007). DISCUSSION: The demographic variables of age, years as a technologist, and highest degree affected the technologist's professional behavior scores. Technologists who were older or had more years of experience had higher professional behavior scores. CONCLUSION: Certain demographic variables can affect the professional behavior of technologists. These results help to highlight the factors that influence the development of professional behaviors.
Subject(s)
Professionalism , Technology, Radiologic , Humans , Female , Male , Adult , Middle Aged , Surveys and Questionnaires , Demography , Allied Health PersonnelABSTRACT
On October 18, 2019, Chile experienced the most important social upheaval since the country regained democracy in the late 1980s. The "Social Outbreak" surprised economic and political elites and seemed paradoxical to the international community who had often praised Chile as a model of successful development. In this paper, we used structural-demographic theory to analyze the interaction between the overproduction of elites and the stagnation in the relative income of the population as the underlying structural cause of Chilean political instability. This theory was able to predict the three most significant instances of political tension in the recent history of Chile: the crisis of the late 1960s that culminated in the coup d'état of 1973, popular mobilizations during the 1980s, and the recent student mobilizations and social upheaval. Our results suggest that, at least during the period 1938-2019, Chilean sociopolitical dynamics is determined by the same structural drivers.
Subject(s)
Politics , Chile , Humans , Demography , Income , Models, Theoretical , Socioeconomic FactorsABSTRACT
BACKGROUND: Sexually transmitted infections continue to be a significant public health issue on a global scale. Due to their effects on reproductive and child health as well as their role in facilitating the spread of HIV infection, sexually transmitted infections impose a heavy burden of morbidity and mortality in many developing countries. In addition, stigma, infertility, cancer, and an increased risk of HIV are the primary impacts of STIs on sexual and reproductive health. While numerous studies have been conducted in Tanzania to address this specific topic in various settings, the majority of them weren't representative. Therefore, the main objective of this study was to use data from the most recent Tanzania Demographic and Health Survey in order to evaluate the individual and community-level factors associated with sexually transmitted infections among Tanzanian men at the national level. METHODS: The most recent datasets from the Tanzania demographic and health survey were used for secondary data analysis. A total of 5763 men participated in this study. The recent Tanzania demographic and health survey provides data for multilevel mixed effect analysis on the variables that contribute to sexually transmitted infections among men in Tanzania. Finally, the percentage and odd ratio were provided, together with their 95% confidence intervals. RESULT: This study includes a total weighted sample of 5763 men from the Tanzania demographic and health survey. Of the total study participants, 7.5% of men had sexually transmitted infections in the last twelve months. Being married [AOR: 0.531, 95% CI (0.9014, 3.429)] was a factor that reduced the risk of sexually transmitted infections among men. On the other hand, being between the age range of 20 and 24 years [AOR: 6.310, 95% CI (3.514, 11.329)] and having more than one union [AOR: 1.861, 95% CI (1.406, 2.463)] were the factors that increased the risk of sexually transmitted infections among men. CONCLUSIONS: Men's sexually transmitted infections have been associated with individual-level factors. So, the Tanzanian governments and the concerned stakeholders should provide special attention for men whose age range is 20-24 years old. Promoting marriages and limiting the number of sexual partners should be the main strategies to lower the risk of sexually transmitted infections among men in Tanzania.
Subject(s)
Health Surveys , Sexually Transmitted Diseases , Humans , Male , Tanzania/epidemiology , Sexually Transmitted Diseases/epidemiology , Adult , Young Adult , Adolescent , Middle Aged , Sexual Behavior/statistics & numerical data , Risk Factors , Demography , HIV Infections/epidemiologyABSTRACT
BACKGROUND: Advanced maternal-age pregnancy has become a serious public health problem in both developed and developing countries due to adverse birth outcomes for the mother, fetus, or newborn. However, there are limited studies conducted to identify determinants of advanced-age pregnancy in Ethiopia. Therefore, this study aimed to assess individual and community-level determinants of advanced age pregnancy in Ethiopia. METHODS: This study was based on 2016 Ethiopian Demographic and Health Survey data. Three thousand two hundred ninety-two weighted samples of pregnant women were included in this analysis. A multilevel logistic regression model was conducted to assess the determinants of advanced-age pregnancy among the study participants in Ethiopia. RESULTS: maternal age at first birth (AOR = 4.05, 95% CI: 1.77-9.22), level of maternal education [primary education 2.72 times (AOR = 2.27, 95 CI: 1.55-4.76) and secondary and above education (AOR = 5.65, 95% CI: 1.77-17.70)], having a history of alcohol (AOR = 11.8, 95% CI: 5.71-24.42), parity (AOR = 3.22, 95% CI: 2.69-3.84), number of household member (AOR = 1.22, 95% CI: 1.05-1.41), family planning unmet need for spacing of pregnancy (AOR = 4.79, 95% CI: 2.63-8.74), having sons/daughters elsewhere (AOR = 1.89, 95% CI: 1.22-2.94), had higher community poverty level (AOR = 2.37, 95% CI: 1.16-4.85), those had higher community unmet need for family planning (AOR = 5.19, 95% CI: 2.72-9.92) were more likely to have advanced age pregnancy. Whereas Living in an Emerging region (AOR = 0.29, 95% CI: 0.14-0.59) and living in a metropolitan city (AOR = 0.03, 95% CI: 0.03-0.38), were less likely to have advanced age pregnancy. CONCLUSIONS: increased Maternal age at first birth, level of maternal education, history of alcohol drinking, increased number of parity and household members, family planning unmet need for spacing, had sons/daughters elsewhere, had higher community poverty level, those had higher community unmet need for family planning positively, whereas living in the emerging region and living in metropolitan's city was negatively affect advanced age pregnancy. Help women to have informed decision-making and create platforms to women have special care during this age of pregnancy. Empower women on family planning and socioeconomic status.
Subject(s)
Health Surveys , Maternal Age , Humans , Female , Ethiopia , Pregnancy , Adult , Young Adult , Adolescent , Middle Aged , Socioeconomic Factors , Educational Status , Demography , Logistic Models , ParityABSTRACT
This work studies changes in the demographics of the different spatial units that make up the Andalusia region in Spain throughout the year 2021, with the aim of seeing the progressive recovery of the population after the COVID-19 pandemic. Mobile phone data from Origin-Destination matrices has been used, due to the ease of obtaining updated information quickly and constantly. A methodology has been developed to transform the number of travelers into an estimated population without biases, and an interpolation function has been used to take into account all the data available in the year 2021. Results show a direct link between the demographic changes in Andalusia and the removal of the mobility restrictions caused by the COVID-19 pandemic, with an increase of non-related work mobility and a decrease of static population. Travel distances between home and work places are also affected, with an increase of long trips after the end of the mobility restrictions. In addition, different patterns have been visualized, such as the concentration of commuting in the metropolitan areas of the region during working days, the population growth in rural areas during weekends, or the population displacement to coastal areas in summer.
Subject(s)
COVID-19 , Cell Phone , Travel , COVID-19/epidemiology , Humans , Spain/epidemiology , Travel/statistics & numerical data , SARS-CoV-2/isolation & purification , Pandemics , Population Dynamics , DemographyABSTRACT
OBJECTIVE: Rural location of a patient's primary residence has been associated with worse clinical and surgical outcomes due to limited resource availability in these parts of the US. However, there is a paucity of literature investigating the effect that a rural hospital location may have on these outcomes specific to lumbar spine fusions. METHODS: Using the National Inpatient Sample (NIS) database, we identified all patients who underwent primary lumbar spinal fusion in the years between 2009 and 2020. Patients were separated according to whether the operative hospital was considered rural or urban. Univariable and multivariable regression models were used for data analysis. RESULTS: Of 2,863,816 patients identified, 120,298 (4.2â¯%) had their operation at a rural hospital, with the remaining in an urban hospital. Patients in the urban cohort were younger (Pâ¯< .001), more likely to have private insurance (39.81â¯% vs 31.95â¯%, Pâ¯< .001), and fewer of them were in the first (22.52â¯% vs 43.00â¯%, Pâ¯< .001) and second (25.96â¯% vs 38.90â¯%, Pâ¯< .001) quartiles of median household income compared to the rural cohort. The urban cohort had significantly increased rates of respiratory (4.49â¯% vs 3.37â¯%), urinary (5.25â¯% vs 4.15â¯%), infectious (0.49â¯% vs 0.32â¯%), venous thrombotic (0.57â¯% vs 0.24â¯%, Pâ¯< .001), and neurological (0.79â¯% vs 0.36â¯%) (all Pâ¯< .001) perioperative complications. On multivariable analysis, the urban cohort had significantly increased odds of the same perioperative complications: respiratory (odds ratio[OR]â¯=â¯1.48; 95â¯% confidence interval [CI], 1.26-1.74), urinary (ORâ¯=â¯1.34; 95â¯%CI, 1.20-1.50), infection (ORâ¯=â¯1.63; 95â¯%CI, 1.23-2.17), venous thrombotic (ORâ¯=â¯1.79; 95â¯%CI, 1.32-2.41), neurological injury (ORâ¯=â¯1.92; 95â¯%CI, 1.46-2.53), and localized infection (ORâ¯=â¯1.65; 95â¯%CI, 1.25-2.17) (all Pâ¯< .001). CONCLUSIONS: Patients undergoing lumbar fusions experience significantly different outcomes based on the rural or urban location of the operative hospital.
Subject(s)
Databases, Factual , Hospitals, Rural , Hospitals, Urban , Lumbar Vertebrae , Postoperative Complications , Spinal Fusion , Humans , Spinal Fusion/adverse effects , Male , Hospitals, Rural/statistics & numerical data , Female , Middle Aged , Aged , Lumbar Vertebrae/surgery , Postoperative Complications/epidemiology , United States/epidemiology , Adult , Treatment Outcome , Inpatients , DemographyABSTRACT
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.
Subject(s)
Mortality , Humans , United States/epidemiology , Male , Female , Middle Aged , Aged , Chronic Disease/mortality , Mortality/trends , Adult , Demography/trends , Respiratory Tract Diseases/mortality , Aged, 80 and over , Young Adult , Time FactorsABSTRACT
Understanding the factors influencing species range limits is increasingly crucial in anticipating migrations due to human-caused climate change. In the boreal biome, ongoing climate change and the associated increases in the rate, size, and severity of disturbances may alter the distributions of boreal tree species. Notably, Interior Alaska lacks native pine, a biogeographical anomaly that carries implications for ecosystem structure and function. The current range of lodgepole pine (Pinus contorta var. latifolia) in the adjacent Yukon Territory may expand into Interior Alaska, particularly with human assistance. Evaluating the potential for pine expansion in Alaska requires testing constraints on range limits such as dispersal limitations, environmental tolerance limits, and positive or negative biotic interactions. In this study, we used field experiments with pine seeds and transplanted seedlings, complemented by model simulations, to assess the abiotic and biotic factors influencing lodgepole pine seedling establishment and growth after fire in Interior Alaska. We found that pine could successfully recruit, survive, grow, and reproduce across our broadly distributed network of experimental sites. Our results show that both mammalian herbivory and competition from native tree species are unlikely to constrain pine growth and that environmental conditions commonly found in Interior Alaska fall well within the tolerance limits for pine. If dispersal constraints are released, lodgepole pine could have a geographically expansive range in Alaska, and once established, its growth is sufficient to support pine-dominated stands. Given the impacts of lodgepole pine on ecosystem processes such as increases in timber production, carbon sequestration, landscape flammability, and reduced forage quality, natural or human-assisted migration of this species is likely to substantially alter responses of Alaskan forest ecosystems to climate change.
Subject(s)
Pinus , Pinus/physiology , Alaska , Climate Change , Models, Biological , Seedlings , Demography , Animals , EcosystemABSTRACT
An understanding of thermal limits and variation across geographic regions is central to predicting how any population may respond to global change. Latitudinal clines, in particular, have been used to demonstrate that populations can be locally adapted to their own thermal environment and, as a result, not all populations will be equally impacted by an increase in temperature. But how robust are these signals of thermal adaptation to the other ecological challenges that animals commonly face in the wild? Seasonal changes in population density, food availability, or photoperiod are common ecological challenges that could disrupt patterns of thermal tolerance along a cline if each population differentially used these signals to anticipate future temperatures and adjust their thermal tolerances accordingly. In this study, we aimed to test the robustness of a cline in thermal tolerance to simulated signals of seasonal heterogeneity. Experimental animals were derived from clones of the Australian water flea, Daphnia carinata, sampled from nine distinct populations along a latitudinal transect in Eastern Australia. We then factorially combined summer (18 h light, 6 h dark) and winter (6 h light, 18 h dark) photoperiods with high (5 million algal cells individual-1 day-1) and low (1 million algal cells individual-1 day-1) food availabilities, before performing static heat shock assays to measure thermal tolerance. We found that the thermal tolerances of the clonal populations were sensitive to both measures of seasonal change. In general, higher food availability led to an increase in thermal tolerances, with the magnitude of the increase varying by clone. In contrast, a switch in photoperiod led to rank-order changes in thermal tolerances, with heat resistance increasing for some clones, and decreasing for others. Heat resistance, however, still declined with increasing latitude, irrespective of the manipulation of seasonal signals, with clones from northern populations always showing greater thermal resistance, most likely driven by adaptation to winter thermal conditions. While photoperiod and food availability can clearly shape thermal tolerances for specific populations, they are unlikely to overwhelm overarching signals of thermal adaptation, and thus, observed clines in heat resistance will likely have remained robust to these forms of seasonal heterogeneity.
Subject(s)
Daphnia , Seasons , Animals , Daphnia/physiology , Climate Change , Hot Temperature , Thermotolerance , Demography , Models, BiologicalABSTRACT
Livestock keepers who operate on a small scale in the United Kingdom are often described as either smallholders or hobby farmers; however, this is not always the case. There is another distinct population in Scotland. The crofting system promotes the preservation of a way of life that is significant to the cultural heritage of Scotland, whilst at the same time utilising and maintaining marginal land that could otherwise be deemed of very low productive value. We developed two cross-sectional questionnaire surveys to gather descriptive data about individuals from two populations (crofters and smallholders) who kept sheep and/or cattle. Our aim was to explore demographics, animal health, husbandry, and biosecurity practices of these two communities, including how they may interact with other livestock sectors. Most respondents in each population kept sheep, with far fewer keeping cattle. There was a distinct geographical difference in the approximate location of respondents' holdings. Movement of sheep was often local, temporary, and exempt from reporting to national databases. Visits from the vet were infrequent, but the vet remained an important source of animal health advice, alongside peer networks. The information from these surveys is valuable because policy decisions taken with predominantly larger, commercial-scale enterprises in mind also frequently apply to small-scale enterprises, even though these smaller enterprises may not have the same opportunity to influence those decisions or implement the requirements. Aspects of agricultural activity and food production at the scale explored in these surveys - including plurality of employment and diversification away from purely agricultural activities - are relevant to the United Nations Sustainable Development Goals of sustainable cities and communities, zero hunger and life on land. In this context, competent authorities should support this type of context-sensitive agriculture, alongside seeking to maintain animal health and welfare standards at the highest possible level on a national scale. Our surveys contribute to improved understanding of how these enterprises function and therefore will support policy makers when considering the breadth of keepers and circumstances affected by rules and regulations governing agriculture.
Subject(s)
Animal Husbandry , Sheep Diseases , Animals , Scotland , Cattle , Sheep , Animal Husbandry/methods , Cross-Sectional Studies , Sheep Diseases/prevention & control , Sheep Diseases/epidemiology , Surveys and Questionnaires , Cattle Diseases/prevention & control , Cattle Diseases/epidemiology , Demography , Female , Humans , MaleABSTRACT
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.
Subject(s)
Nervous System Diseases , Humans , Aged , Nervous System Diseases/mortality , Nervous System Diseases/epidemiology , Middle Aged , United Kingdom/epidemiology , Male , Female , Cause of Death/trends , Demography/trends , Parkinson Disease/mortality , Parkinson Disease/epidemiology , Adult , Australia/epidemiology , Aged, 80 and overABSTRACT
PURPOSE: The quality of radiotherapy auto-segmentation training data, primarily derived from clinician observers, is of utmost importance. However, the factors influencing the quality of clinician-derived segmentations are poorly understood; our study aims to quantify these factors. METHODS: Organ at risk (OAR) and tumor-related segmentations provided by radiation oncologists from the Contouring Collaborative for Consensus in Radiation Oncology data set were used. Segmentations were derived from five disease sites: breast, sarcoma, head and neck (H&N), gynecologic (GYN), and GI. Segmentation quality was determined on a structure-by-structure basis by comparing the observer segmentations with an expert-derived consensus, which served as a reference standard benchmark. The Dice similarity coefficient (DSC) was primarily used as a metric for the comparisons. DSC was stratified into binary groups on the basis of structure-specific expert-derived interobserver variability (IOV) cutoffs. Generalized linear mixed-effects models using Bayesian estimation were used to investigate the association between demographic variables and the binarized DSC for each disease site. Variables with a highest density interval excluding zero were considered to substantially affect the outcome measure. RESULTS: Five hundred seventy-four, 110, 452, 112, and 48 segmentations were used for the breast, sarcoma, H&N, GYN, and GI cases, respectively. The median percentage of segmentations that crossed the expert DSC IOV cutoff when stratified by structure type was 55% and 31% for OARs and tumors, respectively. Regression analysis revealed that the structure being tumor-related had a substantial negative impact on binarized DSC for the breast, sarcoma, H&N, and GI cases. There were no recurring relationships between segmentation quality and demographic variables across the cases, with most variables demonstrating large standard deviations. CONCLUSION: Our study highlights substantial uncertainty surrounding conventionally presumed factors influencing segmentation quality relative to benchmarks.
Subject(s)
Bayes Theorem , Benchmarking , Radiation Oncologists , Humans , Benchmarking/methods , Female , Radiotherapy Planning, Computer-Assisted/methods , Neoplasms/epidemiology , Neoplasms/radiotherapy , Organs at Risk , Male , Radiation Oncology/standards , Radiation Oncology/methods , Demography , Observer VariationABSTRACT
Limited literature exists on chloramphenicol's clinical use. In this retrospective, single-center case-series, we examined 183 chloramphenicol-treated and 81 piperacillin-tazobactam-treated medical patients. Chloramphenicol recipients were older, more debilitated, cognitively impaired, and penicillin allergic, while increased need for inotropics, higher leukocyte count, and higher creatinine levels were notable in the piperacillin-tazobactam group. Pneumonia was the most common indication, with no mortality difference between groups. While acknowledging its antimicrobial activity and potential benefit in specific conditions such as pneumonia, further clinical studies are needed to assess the role of chloramphenicol in the setting where other alternatives are available.
Subject(s)
Anti-Bacterial Agents , Chloramphenicol , Humans , Chloramphenicol/therapeutic use , Retrospective Studies , Anti-Bacterial Agents/therapeutic use , Male , Aged , Female , Middle Aged , Aged, 80 and over , Hospitalization/statistics & numerical data , Treatment Outcome , Piperacillin, Tazobactam Drug Combination/therapeutic use , Adult , DemographyABSTRACT
Introduction: For many infectious diseases, women are at higher risk and have a more severe disease course than men for many reasons, including biological differences, social inequalities, and restrictive cultural norms. The study focuses on infections with human papillomaviruses (HPV) in the form of cervical cancer as a gender-specific disease. The main goal is to evaluate cervical tumour incidence trends in the Czech female population in the HPV vaccination period 2012-2020 in relation to selected demographic, socioeconomic, and geographic indicators. Methods: This is a retrospective ecological study. Data from publicly available databases about the incidence and mortality of cervical tumours (C53 Malignant neoplasm of cervix uteri, D06 Carcinoma in situ of cervix uteri according to ICD 10) and HPV vaccination rate were analysed and compared with demographic, socioeconomic and territorial data. Associations were searched using correlation analysis. Results: There was a decreasing trend in the incidence of cervical cancer in the observed period. Regarding cervical tumours (C53, D06) and malignant neoplasm of cervix uteri incidence (C53), the decrease was approximately 11 and 20%, respectively. Differences between regions were observed in incidences and vaccination rates. Based on correlation analysis, indicators connected with urban/rural aspects, such as a share of urban population and population density, were statistically significant. The indicators related to higher cervical cancer incidence are the high unemployment rate of women, the high number of divorces, the high number of abortions, the high share of the urban population, the high number of students, and the high number of women with only primary education. On the other hand, the indicators related to lower cervical cancer incidence are the high gross domestic product (GDP), the high average gross monthly wage per employee, the high employment rate of women, the higher average age of mothers at birth, and the high number of women with tertiary education. Conclusion: Results underline the problem of economically disadvantaged regions and families. Increasing vaccination rates, promoting regular screening for cervical cancer, and supporting awareness in the population, especially in regions with higher incidence rates, should be priorities for public health efforts.