1.  Title: Patterns and trends in adolescents' contraceptive use and discontinuation in developing countries and comparisons with adult women. Author: Blanc AK; Tsui AO; Croft TN; Trevitt JL Source: International Perspectives On Sexual and Reproductive Health. 2009 Jun;35(2):63-71. Abstract: Demographic and Health Survey data from more than 40 countries were used to examine the proportions of 15- to 19-year-old women who are currently married or are unmarried but sexually active; their rates of contraceptive adoption, current use, discontinuation, method switching and contraceptive failure; trends in these indicators; and comparisons with older women. In many countries, the proportion of adolescent women using contraceptives increased substantially over the last two decades. Prevalence among adolescents increased faster than among older women. Greater proportions of adolescents than of older women discontinued using a contraceptive method within a year or experienced contraceptive failure. The authors conclude that expanded demand for contraceptive supplies, services, and information can be expected to challenge the preparedness, capacity, and resources of existing family planning programs and providers. Language: English Keywords: DEVELOPING COUNTRIES | RESEARCH REPORT | DEMOGRAPHIC AND HEALTH SURVEYS | COMPARATIVE STUDIES | ADOLESCENTS, FEMALE | WOMEN | OLDER ADULTS | AGE FACTORS | CONTRACEPTIVE METHOD SWITCHING | CONTRACEPTIVE USAGE | CONTRACEPTIVE EFFECTIVENESS | FAMILY PLANNING PROGRAM EVALUATION | Demographic Surveys | Population Dynamics | Demographic Factors | Population | Studies | Research Methodology | Adolescents | Youth | Population Characteristics | Adults | Contraception | Family Planning | Family Planning Programs Document Number: 342143 |
2.  Peer Reviewed Title: Sexual behavior and drug consumption among young adults in a shantytown in Lima, Peru. Author: Galvez-Buccollini JA; DeLea S; Herrera PM; Gilman RH; Paz-Soldan V Source: BMC Public Health. 2009 Jan 19;9(23):[27] p. Abstract: Risky sexual behaviors of young adults have received increasing attention during the last decades. However, few studies have focused on the sexual behavior of young adults in shantytowns of Latin America. Specifically, studies on the association between sexual behaviors and other risk factors for sexually transmitted infections (STI) and HIV/AIDS transmission, such as the consumption of illicit drugs or alcohol are scarce in this specific context. The study participants were 393 men and 400 women between 18 and 30 years of age, from a shantytown in Lima, Peru. Data were obtained via survey: one section applied by a trained research assistant, and a self-reporting section. Logistic regression was used to estimate associations between use of any illicit drug, high-risk sexual behaviors and reported STI symptoms, adjusting for alcohol consumption level and various socio-demographic characteristics. Among men, age of sexual debut was lower, number of lifetime sexual partners was higher, and there were higher risk types of sexual partners, compared to women. Though consistent condom use with casual partners was low in both groups, reported condom use at last intercourse was higher among men than women. Also, a lifetime history of illicit drug consumption decreased the probability of condom use at last sexual intercourse by half. Among men, the use of illicit drugs doubled the probability of intercourse with a casual partner during the last year and tripled the probability of reported STI symptoms. Drug consumption is associated with high-risk sexual behaviors and reported STI symptoms in a Lima shantytown after controlling for alcohol consumption level. Development of prevention programs for risky sexual behaviors, considering gender differences, is discussed. Language: English Keywords: PERU | RESEARCH REPORT | OLDER ADULTS | RISK FACTORS | RISK BEHAVIOR | DRUG USE AND ABUSE | ALCOHOL USE AND ABUSE | SEX BEHAVIOR | SEXUALLY TRANSMITTED DISEASES | AIDS | HIV INFECTIONS | CONDOM USE | SIGNS AND SYMPTOMS | South America, Western | South America | Latin America | Americas | Developing Countries | Adults | Age Factors | Population Characteristics | Demographic Factors | Population | Biology | Behavior | Reproductive Tract Infections | Infections | Diseases | Viral Diseases | Risk Reduction Behavior Document Number: 329532 |
| 3. Peer Reviewed Title: HIV/AIDS and the health of older people in the slums of Nairobi, Kenya: results from a cross sectional survey. Author: Kyobutungi C; Ezeh AC; Zulu E; Falkingham J Source: BMC Public Health. 2009 May 27;9(1):153. Abstract: ABSTRACT: BACKGROUND: The proportion of older people is increasing worldwide. Globally, it is estimated that older people (those 60 years or older) constitute more than 11% of the population. As the HIV/AIDS pandemic rages in sub-Saharan Africa (SSA), its impact on older people needs closer attention given the increased economic and social roles older people have taken on as a result of increased mortality among adults in the productive age groups. Few studies have looked at older people and their health in SSA or indeed the impact of HIV/AIDS on their health. This study aims to assess the effect of being directly or indirectly affected by HIV/AIDS on the health of older people in two Nairobi slums. METHODS: Data were collected from residents of the Nairobi Urban Health and Demographic Surveillance area, who on 1st October 2006, were 50 years and older. Health status was assessed using the short SAGE (Study on Global AGEing and Adult Health) form and two outcome measures - self-rated health and a composite health score - were generated. To assess HIV/AIDS affected status, respondents were asked: Have you personally been affected by HIV/AIDS? If yes, a follow up question: "How have you been personally affected by HIV/AIDS?" was asked. Ordinal logistic regression was used in models with self-rated health and linear regression in models with the health score. RESULTS: About 18% of respondents reported being affected by HIV/AIDS in at least one way, although less than 1% reported being infected with HIV. Nearly 60% of respondents reported being in good health, 27% in fair health and 14% in poor health. The overall mean health score was 70.6 (SD: 13.9). Females reported worse health outcomes than males. Respondents directly or indirectly affected by HIV/AIDS reported worse health outcomes than those not affected: mean health score: 68.5 and 71.1 respectively (t=3.21), and an adjusted odds ratio of reporting "poor health" of 1.42 (95%CI: 1.12-1.80). CONCLUSION: Poor health outcomes among older people affected by HIV/AIDS highlight the need for policies that target them in the fight against HIV/AIDS if they are to play their envisaged care giving and other traditional roles. Language: English Keywords: KENYA | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | STATISTICAL REGRESSION | KAP SURVEYS | HEALTH SURVEYS | OLDER ADULTS | SLUMS | PERSONS LIVING WITH HIV/AIDS | HEALTH STATUS INDEXES | SEX FACTORS | SELF-PERCEPTION | AIDS | HIV INFECTIONS | HEALTH POLICY | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Data Analysis | Surveys | Sampling Studies | Studies | Health | Adults | Age Factors | Population Characteristics | Demographic Factors | Population | Urbanization | Urban Population Distribution | Population Distribution | Geographic Factors | Viral Diseases | Diseases | Perception | Psychological Factors | Behavior | Policy | Political Factors | Sociocultural Factors Document Number: 341484 |
| 4. Title: Erosion of an intrauterine contraceptive device through the bladder wall causing calculus: management and review of the literature. Author: Mustafa M Source: Urologia Internationalis. 2009;82(3):370-1. Abstract: Intrauterine contraceptive devices have been in use for more than 30 years. Although perforation of the uterus by an intrauterine device is not uncommon, intravesical migration with secondary stone formation is a rare complication. A 46-year-old women is described in whom intravesical migration of the intrauterine device was complicated by bladder stone formation. Endoscopic management was applied with an excellent outcome. Language: English Keywords: TURKEY | RESEARCH REPORT | CLINICAL RESEARCH | CASE STUDIES | WOMEN | MIDDLE AGED ADULTS | IUD COMPLICATIONS | UROGENITAL EFFECTS | IUD MIGRATION | PHYSICAL EXAMINATIONS AND DIAGNOSES | IUD, COPPER RELEASING | Europe, Southeastern | Europe | Developing Countries | Research Methodology | Studies | Demographic Factors | Population | Adults | Age Factors | Population Characteristics | IUD | Contraceptive Methods | Contraception | Family Planning | Urogenital System | Physiology | Biology | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 341108 |
| 5. Title: Contraception and women over 40 years of age: mixed-method systematic review. Author: Roberts A; Noyes J Source: Journal of Advanced Nursing. 2009;65(6):1155-1170. Abstract: Aim. This paper is a report of a mixed-method systematic review to identify barriers to, and facilitators of, contraceptive needs and choices of women over 40 years old. Background. Women over 40 years of age who do not want to conceive have specific needs for contraception to prevent unwanted, unplanned and unintended pregnancies prior to menopause. Data sources. Six databases were searched for published and grey literature from September 1997 to September 2007, along with the Cochrane Central Register of Controlled Trials. The Internet, professional networks and hand searching were also used. Review methods. Mixed-method synthesis using Evidence for Policy and Practice Information and Co-ordinating Centre phased design. Findings. Guidelines to inform clinical decision-making were located but did not take account of age-related social factors affecting women's choices or local service availability. Women's access to services and contraceptive choices were influenced by educational level, general awareness of available methods, fear of side effects, women's social standing, religious and cultural beliefs, personal control, and confidentiality. The main factors influencing compliance and continuation rates were knowledge, positive experience and confidence, unacceptable side effects and safety concerns, information, support and advice, and ongoing husband/partner influences. Conclusion. The utility of clinical guidelines could be improved by incorporating socio-cultural factors and women's views. Novel approaches to evidence translation and facilitation are required. Focusing on user-led, age-appropriate services rather than a 'one size fits all' approach could improve the contraceptive choices and outcomes for women over 40 years old. Language: English Keywords: GLOBAL | LITERATURE REVIEW | CLINICAL RESEARCH | CLINICAL TRIALS | WOMEN | MIDDLE AGED ADULTS | DECISION MAKING | CONTRACEPTIVE METHODS CHOSEN | BEST PRACTICES | AGE FACTORS | EDUCATIONAL STATUS | SOCIAL CLASS | RELIGION | CULTURE | CONFIDENTIAL INFORMATION | Research Methodology | Demographic Factors | Population | Adults | Population Characteristics | Behavior | Contraceptive Usage | Contraception | Family Planning | Programs | Organization and Administration | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Sociocultural Factors | Ethics Document Number: 331126 |
| 6. Peer Reviewed Title: The impact of HIV/AIDS on the living arrangements and well-being of elderly caregivers in rural Uganda. Author: Ssengonzi R Source: AIDS Care. 2009 Mar;21(3):309-14. Abstract: As the HIV/AIDS epidemic continues to devastate the sub-Saharan Africa region, the demand for care and support services to persons infected and affected by the disease is proliferating. Currently providing the bulk of this much-needed care and support are elderly persons. However, limited work has been done to examine how such care and support impacts the well-being of elderly caregivers. Using qualitative data from elderly respondents in two Ugandan districts, Kamuli and Luwero, this article examines changes in the household structure and living arrangements of older persons (50 years and above) after they take on caregiving responsibilities for persons suffering from AIDS-related illnesses and orphans and vulnerable children (OVC) affected by HIV/AIDS. The findings show that elderly caregivers face drastic disruptions of living arrangements, including prolonged travels and absences from their homes to care for the sick. There is also a sharp increase in their household size as they take on more OVC. The implications of such changes on the older persons' health and well-being are discussed. Language: English Keywords: UGANDA | RURAL AREAS | RESEARCH REPORT | OLDER ADULTS | PERSONS LIVING WITH HIV/AIDS | ORPHANS AND VULNERABLE CHILDREN | FAMILY AND HOUSEHOLD | CARE AND SUPPORT | LIVING ARRANGEMENTS | INTERVIEWS | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Geographic Factors | Population | Adults | Age Factors | Population Characteristics | Demographic Factors | HIV Infections | Viral Diseases | Diseases | Sociocultural Factors | Health Services | Delivery of Health Care | Health | Residence Characteristics | Population Distribution | Data Collection | Research Methodology Document Number: 341857 |
| 7. Title: Reproductive history, oral contraceptive use, and the risk of ischemic and hemorrhagic stoke in a cohort study of middle-aged Swedish women. Author: Yang L; Kuper H; Sandin S; Margolis KL; Chen Z; Adami HO; Weiderpass E Source: Stroke; A Journal of Cerebral Circulation. 2009 Apr;40(4):1050-8. Abstract: BACKGROUND AND PURPOSE: Controversy persists as to whether oral contraceptive (OC) use and reproductive history play a role in the etiology of stroke, particularly ischemic stroke. Our aim was to investigate this question in a cohort of middle-aged Swedish women. METHODS: The Women's Lifestyle and Health Cohort Study included 49259 Swedish women, aged 30 to 49 years at baseline (1991 to 1992). Participants completed an extensive questionnaire and were traced through linkages to national registries until the end of 2004. RESULTS: Among the 45699 women included in these analyses, there were 285 cases of incident stroke during follow-up (193 ischemic stroke, 72 hemorrhagic stroke, and 20 of unknown origin). Neither ischemic nor hemorrhagic stroke risk was related to OC use, duration, or type of OC use, even among women who were smokers or hypertensive. Though not statistically significant, risk of hemorrhagic stroke was elevated in women who started using OCs after the age of 30 (Hazard Ratio [HR] 2.3, 95% CI=0.8 to 6.8) and women recommended by a doctor to stop using OC for medical reasons (2.1, 0.9 to 5.0) compared with never users. Compared with nulliparous women, parous women had a statistically significant lower risk of hemorrhagic stroke (0.5, 0.2 to 0.8), but similar association was not found for ischemic stroke (0.9, 0.5 to 1.4). CONCLUSIONS: There was no significant association of OC use with ischemic or hemorrhagic stroke, and the parity was associated with reduced risk of hemorrhagic stroke but not with ischemic stroke. Language: English Keywords: SWEDEN | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | COHORT ANALYSIS | FOLLOW-UP STUDIES | WOMEN | MIDDLE AGED ADULTS | PREVALENCE | ORAL CONTRACEPTIVES, SIDE EFFECTS | CEREBROVASCULAR EFFECTS | ORAL CONTRACEPTIVES, CONTRAINDICATIONS | PARITY | RISK FACTORS | Developed Countries | Europe, Northern | Europe | Research Methodology | Studies | Demographic Factors | Population | Adults | Age Factors | Population Characteristics | Measurement | Contraceptive Safety | Safety | Public Health | Health | Physiology | Biology | Fertility Measurements | Fertility | Population Dynamics Document Number: 331084 |
| 8. Title: Progress in introduction of pneumococcal conjugate vaccine--worldwide, 2000-2008. Author: Centers for Disease Control and Prevention (CDC) Source: MMWR. Morbidity and Mortality Weekly Report. 2008 Oct 24;57(42):1148-51. Abstract: Pneumococcal disease is a leading cause of childhood morbidity and mortality globally, causing an estimated 0.7-1.0 million deaths annually among children aged <5 years (1). A pneumococcal conjugate vaccine (PCV) that includes seven pneumococcal serotypes (PCV7) first became available in 2000. Studies in the United States have demonstrated that introduction of universal vaccination with PCV7 resulted in a 77% decrease in invasive pneumococcal disease among children aged <5 years and a 39% decrease in hospital admissions for pneumonia among children aged <2 years (2,3). A similar vaccine with two additional serotypes was highly efficacious against pneumonia and invasive disease in clinical trials in Africa and, in one trial, reduced all-cause mortality among children by 16% (4). Low-income countries, which account for >97% of pneumonia cases in children aged <5 years (5), will benefit most from introduction of PCV. This report summarizes the progress made in introducing PCV7 worldwide. As of August 2008, 26 countries offered PCV7 to all children as part of national immunization programs or had PCV7 in widespread use (i.e., with estimated national coverage >50%); however, none of these countries is a low-income or lower-middle income country. The World Health Organization (WHO) and UNICEF have recognized the safety and effectiveness of PCVs and recommend that these vaccines for young children be included in national immunization programs (1). Overcoming the challenges to global introduction remains an urgent public health priority. (excerpt) Language: English Keywords: MINNESOTA | RESEARCH REPORT | CLINICAL RESEARCH | CASE STUDIES | MEN | OLDER ADULTS | BACTERIAL AND FUNGAL DISEASES | SKELETAL EFFECTS | BLOOD TRANSFUSION | INSECTS | EMBOLISM | SURGERY | COMPLICATIONS | ANTIBIOTICS | United States of America | North America | Americas | Developed Countries | Research Methodology | Studies | Demographic Factors | Population | Adults | Age Factors | Population Characteristics | Infections | Diseases | Physiology | Biology | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Disease Transmission Control | Prevention and Control | Vascular Diseases | Drugs Document Number: 329067 |
| 9. Title: Has the HIV epidemic peaked? Author: Population Council Source: Population Briefs. 2008 Dec;14(2):[2] p. Abstract: The HIV epidemic appears to have stabilized around the world, according to a Population Council Distinguished Scholar and his colleagues. Although the rate of new infections has probably peaked in all world regions, the absolute number of HIV-positive individuals is expected to remain near current levels worldwide, with slower growth in sub-Saharan Africa and declines elsewhere. The epidemic still poses a daunting challenge to public health programs. As a result of continued high rates of population growth and only moderate success of HIV prevention programs, large numbers of adolescents and adults are still likely to become infected. Language: English Keywords: AFRICA, SUB SAHARAN | SUMMARY REPORT | EPIDEMIOLOGY | PREVALENCE | PERSONS LIVING WITH HIV/AIDS | ADOLESCENTS | OLDER ADULTS | HIV TRANSMISSION | HIV INFECTIONS | CHANGES | POPULATION GROWTH | Africa | Developing Countries | Public Health | Health | Measurement | Research Methodology | Viral Diseases | Diseases | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Adults | Social Change | Sociocultural Factors | Population Dynamics Document Number: 331489 |
| 10. Peer Reviewed Title: The epidemiology of dependency among urban-dwelling older people in the Dominican Republic: a cross-sectional survey. Author: Acosta D; Rottbeck R; Rodriguez G; Ferri CP; Prince MJ Source: BMC Public Health. 2008 Aug 13;8:285. Abstract: Demographic ageing, and the health transition will soon lead to large increases in the number of dependent older people in low and middle income countries. Despite its importance, this topic has not previously been studied. A cross sectional catchment area one-phase survey of health conditions, dependency, care arrangements and caregiver strain among 2011 people aged 65 years and over in Santo Domingo, Dominican Republic. 7.1% of participants required much care and a further 4.7% required at least some care. The prevalence of dependency increased sharply with increasing age. Dependent older people were less likely than others to have a pension and much less likely to have paid work, but no more likely to benefit from financial support from their family. Needing much care was strongly associated with comorbidity between cognitive, psychological and physical health problems. However, dementia made the strongest independent contribution. Among those needing care, those with dementia stood out as being more disabled, as needing more care (particularly support with core activities of daily living), and as being more likely to have paid caregivers. Dementia caregivers experienced more strain than caregivers of those with other health conditions, an effect mediated by behavioural and psychological symptoms. Dependency among older people is nearly as prevalent in Dominican Republic as in developed western settings. Non-communicable diseases, particularly dementia are the main contributing factors. Attention needs to be directed towards the development of age-appropriate healthcare, a long-term care policy, and mechanisms for ensuring the social protection of older persons. Language: English Keywords: DOMINICAN REPUBLIC | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | EPIDEMIOLOGY | URBAN AREAS | OLDER ADULTS | DEMOGRAPHIC AGING | HEALTH | DEPENDENCY BURDEN | Caribbean | Americas | Developing Countries | Research Methodology | Public Health | Geographic Factors | Population | Adults | Age Factors | Population Characteristics | Demographic Factors | Population Dynamics | Microeconomic Factors | Economic Factors Document Number: 307986 |
| 11. Title: Do coresidency and financial transfers from the children reduce the need for elderly parents to works in developing countries? Author: Cameron LA; Cobb-Clark D Source: Journal of Population Economics. 2008 Oct;21(4):1007-1033. Abstract: Do elderly parents use coresidence with or financial transfers from children to reduce their own labour supply in old age? This paper is one of only a few studies that seeks to formally model elderly labour supply in the context of a developing country while taking into account coresidency with and financial transfers from children. We find little evidence that support from children-either through transfers or coresidency-substitutes for elderly parents' need to work. Thus, as in developed countries, there is a role for public policy to enhance the welfare of the elderly population. (author's) Language: English Keywords: GLOBAL | DEVELOPING COUNTRIES | INDONESIA | RESEARCH REPORT | ESTIMATION TECHNIQUES | MATHEMATICAL MODEL | OLDER ADULTS | CHILDREN | LIVING ARRANGEMENTS | INTERGENERATIONAL TRANSFERS | DEMOGRAPHIC AGING | LABOR FORCE | Asia, Southeastern | Asia | Research Methodology | Theoretical Models | Adults | Age Factors | Population Characteristics | Demographic Factors | Population | Youth | Residence Characteristics | Population Distribution | Geographic Factors | Microeconomic Factors | Economic Factors | Population Dynamics | Human Resources Document Number: 327975 |
| 12. Title: The health of aging populations in China and India. Author: Chatterji S; Kowal P; Mathers C; Naidoo N; Verdes E; Smith JP; Suzman R Source: Health Affairs. 2008 Jul-Aug;27(4):1052-63. Abstract: China and India are home to two of the world's largest populations, and both populations are aging rapidly. Our data compare health status, risk factors, and chronic diseases among people age forty-five and older in China and India. By 2030, 65.6 percent of the Chinese and 45.4 percent of the Indian health burden are projected to be borne by older adults, a population with high levels of noncommunicable diseases. Smoking (26 percent in both China and India) and inadequate physical activity (10 percent and 17.7 percent, respectively) are highly prevalent. Health policy and interventions informed by appropriate data will be needed to avert this burden. Language: English Keywords: CHINA | INDIA | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | EVALUATION INDEXES | OLDER ADULTS | MIDDLE AGED ADULTS | PREVALENCE | HEALTH STATUS INDEXES | RISK FACTORS | CHRONIC DISEASES | DEMOGRAPHIC AGING | BIOLOGICAL AGING | TOBACCO USE | FITNESS | Asia, Eastern | Asia | Developing Countries | Asia, Southern | Research Methodology | Quantitative Evaluation | Evaluation | Adults | Age Factors | Population Characteristics | Demographic Factors | Population | Measurement | Health | Biology | Diseases | Population Dynamics | Physiology | Behavior Document Number: 329252 |
| 13. Peer Reviewed Title: Reproductive history and mortality in late middle age among Norwegian men and women. Author: Grundy E; Kravdal O Source: American Journal of Epidemiology. 2008 Feb;167(3):271-279. Abstract: There is growing recognition that reproductive patterns may have long-term health implications, although most evidence is restricted to women. The authors used register data to derive fertility histories for all Norwegian men and women born in 1935-1958. Discrete-time hazard modeling was used to analyze later-life mortality by aspects of reproductive history. A total of 63,312 deaths were observed during 14.5 million person-years of follow-up in 1980-2003, when subjects were aged 45-68 years. Models included detailed information on educational qualifications and marital status. Odds of death relative to those for subjects with two children were highest for the childless (women: odds ratio (OR) = 1.50, 95% confidence interval (CI): 1.43, 1.57; men: OR = 1.35, 95% CI: 1.30, 1.40) and next highest for those with only one child (women: OR = 1.31, 95% CI: 1.26, 1.37; men: OR = 1.20, 95% CI: 1.16, 1.24). Results for the parous showed a positive association between earlier parenthood and later mortality,a reverse association with late age at last birth, and an overall negative association between higher parity and mortality. The similarity of results for women and men suggests biosocial pathways underlying associations between reproductive history and health. The lack of any high-parity disadvantage suggests that in the "family friendly" Norwegian environment, the health benefits of having several children may outweigh the costs. (author's) Language: English Keywords: NORWAY | RESEARCH REPORT | LOGISTIC MODEL | MIDDLE AGED ADULTS | REPRODUCTIVE BEHAVIOR | PARITY | MORTALITY | MORTALITY DETERMINANTS | BIRTH HISTORY | TIME FACTORS | Europe, Northern | Europe | Developed Countries | Mathematical Model | Theoretical Models | Research Methodology | Adults | Age Factors | Population Characteristics | Demographic Factors | Population | Fertility | Population Dynamics | Fertility Measurements | Pregnancy History Document Number: 324323 |
| 14. Peer Reviewed Title: Fertility transition and population ageing in the Asian and Pacific region. Author: Gubhaju B Source: Asia Pacific Population Journal. 2008 Aug;23(2):55-80. Abstract: This paper provides a general overview of population ageing in the context of fertility transition in Asia and the Pacific. Focusing on low-fertility countries, it highlights the implications of low fertility for the ageing process. Indicators of population ageing, such as changes in age structure, potential support ratio and the feminization of the elderly population, are presented to provide a better understanding of the overall situation. As the region is home to over 60 per cent of the global population and has been experiencing a rapid decline in fertility, the absolute size of the older population is a cause for major concern. While the overall population growth rate has been declining over time, the number of older persons is increasing at a faster rate. In addition to the increase in the number of older persons, gender disparity in improvements in life expectancy at birth is likely to result in a much higher percent age of females in the older age groups, particularly in the age group 80 years and older. It is therefore important for countries in the region to recognize the significance of ageing problems and to start formulating policies for the elderly given that it takes several decades for Government old-age pension schemes to mature and to operate at full scale. Language: English Keywords: ASIA | OCEANIA | RESEARCH REPORT | OLDER ADULTS | DEMOGRAPHIC TRANSITION | AGE DISTRIBUTION CHANGES | FERTILITY DECLINE | DEMOGRAPHIC AGING | LIFE EXPECTANCY | Developing Countries | Adults | Age Factors | Population Characteristics | Demographic Factors | Population | Population Dynamics | Age Distribution | Fertility Changes | Fertility | Length of Life | Mortality Document Number: 331308 |
| 15. Title: Manifestations of pulmonary tuberculosis in the elderly: a prospective observational study from north India. Author: Gupta D; Singh N; Kumar R; Jindal SK Source: Indian Journal of Chest Diseases and Allied Sciences. 2008 Jul-Sep;50(3):263-7. Abstract: BACKGROUND: There is scarcity of published literature on manifestations of pulmonary tuberculosis (PTB) among elderly patients in India. The aim of the present study was to compare the clinical, radiological and laboratory manifestations of PTB among young and elderly patients. METHODS: This prospective study involved 100 human immunodeficiency virus (HIV) negative patients with PTB. The demographic, clinical, radiological and laboratory manifestations were compared between young (n=50; under 60 years of age) and elderly (n=50; aged 60 years and above) with PTB. RESULTS: Elderly patients, in comparison to younger patients, tended to be heavier smokers and had more co-morbidities (40% vs 8%; p < 0.05). They presented more frequently with constitutional symptoms (except fever) and less frequently with respiratory symptoms. The mean duration of symptoms and rate of sputum smear-positivity for acid-fast bacilli was similar in both groups. Both the groups were similar with respect to physical examination and chest radiograph findings. Median values of erythrocyte sedimentation rate and total leukocyte count were significantly higher and lower respectively in the elderly patients. CONCLUSIONS: The presentation of PTB in elderly patients differs from that of younger patients by the predominance of constitutional rather than respiratory symptoms. A high index of suspicion is required to make a timely diagnosis of tuberculosis in the elderly. Language: English Keywords: INDIA | RESEARCH REPORT | PROSPECTIVE STUDIES | OLDER ADULTS | TUBERCULOSIS | PULMONARY EFFECTS | RESPIRATORY INFECTIONS | EXAMINATIONS AND DIAGNOSES | Developing Countries | Asia, Southern | Asia | Studies | Research Methodology | Adults | Age Factors | Population Characteristics | Demographic Factors | Population | Infections | Diseases | Physiology | Biology | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 328408 |
| 16. Peer Reviewed Title: Circumstances of women's first birth may be linked to their health during middle age. Author: Hollander D Source: Perspectives on Sexual and Reproductive Health. 2008 Mar;40(1):57. Abstract: Once women reach late middle age, their mortality and disease risks may be related to their early childbearing history, according to analyses of data from the Health and Retirement Study (HRS), which conducts periodic surveys to track participants' health, socioeconomic circumstances and family structure. Among U.S. women who were born in 1931-1941 and lived until at least the early 1990s, those who had first given birth as teenagers had elevated odds of dying between 1994 and 2002; they also were more likely than others to have had heart disease, lung disease or cancer by 1994. Women who had had a nonmarital first birth appeared to be at risk of early mortality, but the association lost significance when midlife socioeconomic status was taken into account. HRS participants were first interviewed in 1992, when they were 51-61 years of age, and are reinterviewed every two years. The data set includes information on women before they gave birth, at the time of their first birth and during midlife. To assess the relationship between childbearing history and mortality in late middle age, the analyst examined data for 1994-2002, which were linked to national mortality statistics. Assessment of a variety of diseases was based on data from the 1994 survey. (excerpt) Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | HEALTH SURVEYS | EPIDEMIOLOGIC METHODS | WOMEN | MIDDLE AGED ADULTS | FIRST BIRTH | WOMEN'S HEALTH | RISK FACTORS | MORTALITY DETERMINANTS | ADOLESCENT PREGNANCY | DISEASES | PREVALENCE | Developed Countries | North America | Americas | Health | Research Methodology | Demographic Factors | Population | Adults | Age Factors | Population Characteristics | Pregnancy History | Fertility Measurements | Fertility | Population Dynamics | Biology | Mortality | Reproductive Behavior | Measurement Document Number: 325200 |
| 17. Peer Reviewed Title: Aging and health of the elderly in rural Bangladesh. Author: Khan MM; Matin MA Source: Journal of Family Welfare. 2008 Jun;54(1):92-99. Abstract: Aging is quite a new topic in Bangladesh and the concern for the elderly is a low priority for the government. Literature has not emerged as yet; however, this will become a challenge for the nation in the near future. This study may not reveal the true picture of the rural elderly; however, it provides some insight of the indicators regarding the health status of rural elderly, which may be used in formulating effective primary policy strategy and to tackle the consequences of aging in the near future. Further studies are required to validate the results found herein and to cope with the enormous changes presently going on in social, cultural and economic arenas in Bangladesh. Thus, proper attention of population scientists and immediate intervention of government is necessary to conduct extensive research to know about the elderly and related problems to eradicate its consequences in Bangladesh. (excerpt) Language: English Keywords: BANGLADESH | RESEARCH REPORT | RURAL POPULATION | DEMOGRAPHIC AGING | OLDER ADULTS, 80 AND OVER | HEALTH STATUS INDEXES | PSYCHOLOGICAL FACTORS | HEALTH POLICY | Developing Countries | Asia, Southern | Asia | Population Characteristics | Demographic Factors | Population | Population Dynamics | Older Adults | Adults | Age Factors | Health | Behavior | Policy | Political Factors | Sociocultural Factors Document Number: 340189 |
| 18. Title: The impact of future demographic trends in Europe, 2005 -- 2050. Author: Kupiszewski M; Bijak J; Nowok B Source: Finnish Yearbook of Population Research. 2008;43:147-183. Abstract: The objective of the paper is to examine the future of populations within the Council of Europe member states, identify the main trends and discuss their policy implications. The analysis focuses on the impact that future demographic trends will have on the following social domains: education, the labour market, health care and care of the elderly and social protection. The study aims to be policy-oriented and to provide an overview of future demographic trends for 2005-2050 in the Council of Europe member states, as well as presenting an analysis related to selected policies and an interpretation of these trends. The analysis of population dynamics in the coming 45 years is based on the United Nations population projection of 2005. (author's) Language: English Keywords: EUROPE | RESEARCH REPORT | DEMOGRAPHIC ANALYSIS | POPULATION | OLDER ADULTS | LABOR FORCE | POPULATION FORECAST | DEMOGRAPHIC IMPACT | SOCIAL POLICY | EDUCATION | EMPLOYMENT | POPULATION DYNAMICS | DEMOGRAPHY | QUALITY OF HEALTH CARE | SOCIAL PROTECTION | Developed Countries | Research Methodology | Adults | Age Factors | Population Characteristics | Demographic Factors | Human Resources | Economic Factors | Estimation Techniques | Policy | Political Factors | Sociocultural Factors | Macroeconomic Factors | Social Sciences | Science | Health Services Evaluation | Program Evaluation | Programs | Organization and Administration Document Number: 326071 |
| 19. Peer Reviewed Title: Mortality of the elderly is still exceedingly high at diagnosis of AIDS despite favourable outcomes after highly active antiretroviral therapy in Recife, Brazil. Author: Lacerda HR; Kitner D Source: International Journal of STD and AIDS. 2008 Jul;19(7):450-454. Abstract: This study aimed to compare the outcome of an elderly group of AIDS patients with that of a younger group and their features at the time of the diagnosis of AIDS. We evaluated 58 patients aged .60 years and 114 aged 20-39 years, followed for 35.3 months. There was an obvious delay in diagnosing the elderly as they had more AIDS-defining diseases at diagnosis and their most frequent opportunistic infection was pulmonary tuberculosis. Mortality at the time of the diagnosis of AIDS was four times higher in the elderly (24.1% versus 6.1%, P< 0.001). However, when comparing only those submitted to highly active antiretroviral therapy, there was a similar frequency of favourable outcomes; 76.9% in the elderly against 83.1% in the young (P = 0.455). Mean CD4 lymphocyte was 438 cells/mm3 at the end of follow up in the young when compared with 442 cells/mm3 in the elderly (P = 0.945). The types of antiretroviral schema and the number of antivirals per patient were similar in both groups. (author's) Language: English Keywords: BRAZIL | RESEARCH REPORT | CLIENTS | OLDER ADULTS | AGE FACTORS | AIDS | TUBERCULOSIS | HIV TESTING | ANTIRETROVIRAL THERAPY | TREATMENT | DEATH RATE | MORTALITY | Developing Countries | South America, Eastern | South America | Latin America | Americas | Program Activities | Programs | Organization and Administration | Adults | Population Characteristics | Demographic Factors | Population | HIV Infections | Viral Diseases | Diseases | Infections | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | HIV | Population Dynamics Document Number: 327875 |
| 20. Peer Reviewed Title: Patterns and correlates of sexual activity and condom use behavior in persons 50-plus years of age living with HIV/AIDS. Author: Lovejoy TI; Heckman TG; Sikkema KJ; Hansen NB; Kochman A; Suhr JA; Garske JP; Johnson CJ Source: AIDS and Behavior. 2008 Nov;12(6):943-956. Abstract: This study characterized rates of sexual activity and identified psychosocial and behavioral correlates of sexual activity and condom use in a metropolitan sample of 290 HIV-infected adults 50-plus years of age. Thirty-eight percent of participants were sexually active in the past three months, 33% of whom had at least one occasion of anal or vaginal intercourse that was not condom protected. Rates and correlates of sexual activity and condom use differed between gay/bisexual men, heterosexual men, and heterosexual women. In the past three months, 72% of heterosexual men were sexually active compared to only 36% of gay/bisexual men and 21% of heterosexual women. However, among sexually active persons, only 27% of heterosexual men reported inconsistent condom use compared to 37% of gay/bisexual men and 35% of heterosexual women. As the number of older adults living with HIV/AIDS in the U.S. continues to increase, age-appropriate secondary risk-reduction interventions are urgently needed. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | CONTRACEPTIVE PREVALENCE SURVEYS | MIDDLE AGED ADULTS | PERSONS LIVING WITH HIV/AIDS | URBAN POPULATION | HOMOSEXUALS | BISEXUALS | HETEROSEXUALS | CONDOM USE | SEX BEHAVIOR | RISK BEHAVIOR | HIV INFECTIONS | SEX FACTORS | CONTRACEPTIVE PREVALENCE | Developed Countries | North America | Americas | Family Planning Surveys | Family Planning | Adults | Age Factors | Population Characteristics | Demographic Factors | Population | Viral Diseases | Diseases | Behavior | Risk Reduction Behavior | Contraceptive Usage | Contraception Document Number: 322728 |
| 21. Title: An aging world - demographics and challenges [editorial] Author: Lunenfeld B Source: Gynecological Endocrinology. 2008 Jan;24(1):1-3. Abstract: The world has seen enormous changes over the past century, including historically unprecedented declines in mortality rates and increases in population, followed by equally unprecedented declines in fertility rates. This century will see a new set of demographic challenges, including a mix of falling fertility rates alongside persisting worldwide population growth, and the subsequent aging of populations in both developing and developed countries. The 20th century was the century of population growth; the 21st century will go into the history books as the century of aging. A holistic approach to this new challenge of the 21st century will necessitate a quantum leap in multidisciplinary and internationally coordinated research efforts, supported by a new partnership between industry and governments, philanthropic and international organizations. This collaboration we hope will enrich us with a better understanding of healthy aging, permit us to help to improve quality of life, prevent the preventable, and postpone and decrease the pain and suffering of the inevitable. (author's) Language: English Keywords: GLOBAL | CRITIQUE | INTERDISCIPLINARY STUDIES | OLDER ADULTS | POPULATION | DEMOGRAPHIC AGING | FERTILITY RATE | QUALITY OF LIFE | POPULATION PROJECTION | FERTILITY DECLINE | LIFE EXPECTANCY | ENVIRONMENTAL PROTECTION | LIFE STYLE | RISK REDUCTION BEHAVIOR | PREVENTIVE MEDICINE | Adults | Age Factors | Population Characteristics | Demographic Factors | Population Dynamics | Birth Rate | Fertility Measurements | Fertility | Social Welfare | Economic Factors | Estimation Techniques | Research Methodology | Fertility Changes | Length of Life | Mortality | Natural Resources | Environment | Behavior | Medicine | Health Services | Delivery of Health Care | Health Document Number: 324751 |
| 22. Title: Early life exposure and its effects on health in the Puerto Rican elderly population. Author: McEniry M; Palloni A; Davila AL; Garcia Gurucharri A Source: Madison, Wisconsin, University of Wisconsin-Madison, Center for Demography and Ecology, 2008. 49 p. (CDE Working Paper No. 2008-01) Abstract: Season of birth may help disentangle the effects on health of early life exposure to poor nutrition and infectious diseases from effects associated with other childhood conditions. Using data from 60 to 74 year old Puerto Ricans who lived in rural areas during childhood (n=1459), we estimated effects of exposure to poor nutrition and infectious diseases during late gestation on the probability of (a) chronic conditions (diabetes, heart disease, obesity), (b) decreased functionality (limitation in at least one ADL and IADL), and (c) poor self-reported health controlling for childhood health and SES and knee height. Findings: (1) strong associations between exposure and heart disease; (2) virtually no attenuation of effects of self-reported childhood health with controls for exposure; (3) no association between exposure and diabetes, obesity, functionality, poor health. Conclusions: timing of birth may reveal conditions experienced perinatally which affect adult heart disease, but there is little evidence of similar effects on adult diabetes and obesity. (author's) Language: English Keywords: PUERTO RICO | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | OLDER ADULTS | FETUS | SEASONAL VARIATION | CHILDBIRTH | INFANT NUTRITION | COMMUNICABLE DISEASES | CHILD HEALTH | CHRONIC DISEASES | HEALTH | HEART DISEASES | OBESITY | DIABETES | Caribbean | Americas | Developed Countries | Research Methodology | Adults | Age Factors | Population Characteristics | Demographic Factors | Population | Pregnancy | Reproduction | Population Dynamics | Pregnancy Outcomes | Nutrition | Infections | Diseases | Body Weight | Physiology | Biology Document Number: 325667 |
| 23. Title: Cortical atrophy and white matter hyperintensities in HIV: the Hawaii Aging with HIV Cohort Study. Author: McMurtray A; Nakamoto B; Shikuma C; Valcour V Source: Journal of Stroke and Cerebrovascular Diseases. 2008 Jul-Aug;17(4):212-7. Abstract: BACKGROUND: As many human immunodeficiency virus (HIV)-seropositive individuals are now living longer after infection because of highly active antiretroviral therapy, aging-related manifestations of cerebral small-vessel ischemic vascular disease, such as brain white matter hyperintensities (WMHs), are becoming increasingly important in this population. GOALS: This study was designed to determine the relationship between WMHs and cortical volumes in HIV-seropositive individuals. MATERIALS AND METHODS: Voxel-based morphometry was used to compare cortical volumes among 62 HIV-seropositive individuals participating in the Hawaii Aging with HIV Cohort Study, 30 with moderate WMHs and 32 with minimal or no WMHs. RESULTS: Presence of moderate WMHs was associated with decreased cortical volumes in the frontal lobes bilaterally. CONCLUSION: These findings suggest that age-related WMHs are associated with reduced frontal gray matter volumes in HIV-seropositive individuals, supporting the hypothesis that the frontal lobes may have greater susceptibility to the effects of small-vessel ischemic vascular disease. Language: English Keywords: HAWAII | RESEARCH REPORT | COHORT ANALYSIS | OLDER ADULTS | PERSONS LIVING WITH HIV/AIDS | HIV INFECTIONS | VASCULAR DISEASES | BIOLOGICAL AGING | Developed Countries | United States of America | North America | Americas | Research Methodology | Adults | Age Factors | Population Characteristics | Demographic Factors | Population | Persons Living With HIV/AIDS | Viral Diseases | Diseases | Physiology | Biology Document Number: 328567 |
| 24. Peer Reviewed Title: Evaluation of the WHO criteria for antiretroviral treatment failure among adults in South Africa. Author: Mee P; Fielding KL; Charalambous S; Churchyard GJ; Grant AD Source: AIDS. 2008 Oct 1;22(15):1971-7. Abstract: OBJECTIVE: To assess the performance of WHO clinical and CD4 cell count criteria for antiretroviral treatment (ART) failure among HIV-infected adults in a workplace HIV care programme in South Africa. DESIGN: Cohort study. METHODS: We included initially ART-naive participants who remained on first-line therapy and had an evaluable HIV viral load result at the 12-month visit. WHO-defined clinical and CD4 cell count criteria for ART failure were compared against a gold standard of virological failure. RESULTS: Among 324 individuals (97.5% men, median age 40.2, median starting CD4 cell count and viral load 154 cells/mul and 47,503 copies/ml, respectively), 33 (10.2%) had definite or probable virological failure at 12 months, compared with 19 (6.0%) and 40 (12.5%) with WHO-defined CD4 and clinical failure, respectively. CD4 criteria had a sensitivity of 21.2% and a specificity of 95.8% in detecting virological failure, and clinical criteria had sensitivity of 15.2% and specificity of 88.1%. The positive predictive value of CD4 and clinical criteria in detecting virological failure were 36.8 and 12.8%, respectively. Exclusion of weight loss or tuberculosis failed to improve the performance of clinical criteria. CONCLUSION: WHO clinical and CD4 criteria have poor sensitivity and specificity in detecting virological failure. The low specificities and positive predictive values mean that individuals with adequate virological suppression risk being incorrectly classified as having treatment failure and unnecessarily switched to second-line therapy. Virological failure should be confirmed before switching to second-line therapy. Language: English Keywords: SOUTH AFRICA | RESEARCH REPORT | EVALUATION | COHORT ANALYSIS | MIDDLE AGED ADULTS | PERSONS LIVING WITH HIV/AIDS | WORKPLACE | HIV INFECTIONS | TREATMENT | ANTIRETROVIRAL THERAPY | BODY WEIGHT | TUBERCULOSIS | ANTIRETROVIRAL DRUGS | MONITORING | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Adults | Age Factors | Population Characteristics | Demographic Factors | Population | Persons Living With HIV/AIDS | Viral Diseases | Diseases | Employment | Macroeconomic Factors | Economic Factors | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | HIV | Physiology | Biology | Infections Document Number: 329335 |
| 25. Peer Reviewed Title: Adult education and child nutrition: The role of family and community. Author: Moestue H; Huttly S Source: Journal of Epidemiology and Community Health. 2008 Feb;62(2):153-159. Abstract: It is well established that mothers' education has positive effects on child nutrition in developing countries. Less explored is the effect exerted by the education of other individuals-mothers' friends, neighbours and family. The objectives were to examine independent effects of mothers', fathers' and grandmothers' education on child height-forage and weight-for-age z-score, and the role of community-level maternal literacy over and above parental education and other individual-level factors. Cross-sectional data were analysed for 5692 children from Andhra Pradesh State in India and Vietnam sampled within "sites" (20 from each country) and then within "communities" (31 from Vietnam and 102 from India). Multilevel regression analysis was undertaken to account for confounders and geographical clustering of observations. Child nutrition is positively and independently associated with mothers', fathers' and grandmothers' education. The association with grandmothers' education was statistically significant in the India sample only and was stronger for boys: the adjusted mean difference in height-for-age z-scores between boys living with an educated grandmother and those not was 0.64 (95% CI 0.29 to 0.99, p less than 0.001). In the Vietnam sample, child nutrition was associated with the proportion of literate mothers in the community, adjusting for parental education and other confounders (height 0.81, 95% CI 0.29 to 1.31, p=0.002). The results imply that an individual-level perspective may fail to capture the entire impact of education on child nutrition, and support a call for a widening of focus of nutrition policy and programmes from the mother-child pair towards the broader context of their family and community. (author's) Language: English Keywords: INDIA | VIETNAM | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | PARENTS | OLDER ADULTS | MIDDLE AGED ADULTS | CHILD HEALTH | EDUCATIONAL STATUS | EDUCATION | CHILD NUTRITION | LITERACY | ANTHROPOMETRY | IMPACT | Developing Countries | Asia, Southern | Asia | Asia, Southeastern | Research Methodology | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Adults | Age Factors | Population Characteristics | Demographic Factors | Population | Health | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Nutrition | Measurement | Communication Document Number: 323621 |
| 26. Peer Reviewed Title: Labour migration and change in older people's living arrangements: the case of Kanchanaburi Demographic surveillance system (KDSS), Thailand. Author: Qin M; Punpuing S; Guest P; Prasartkul P Source: Population, Space and Place. 2008;14:419-432. Abstract: This study involves an investigation of changes in older people's living arrangements in the context of a 4-round panel design from the Kanchanaburi Demographic Surveillance System (KDSS), Thailand. The respondents were 2320 persons aged 60 and above, who were co-residing with family members in addition to, or other than, their spouse at the time of the first round of the census. Survival analysis is used to interpret the data. Results indicate that labour migration plays an important role in changes in the living arrangements of older people. Migration increases the risk of living alone. Other demographic and socio-economic factors of importance include the marital status of older people, economic security, household assets, household size, and household members living nearby. The paper concludes by discussing policy implications of the findings. Language: English Keywords: THAILAND | RESEARCH REPORT | OLDER ADULTS | LABOR MIGRATION | LIVING ARRANGEMENTS | CHANGES | DEMOGRAPHIC FACTORS | Developing Countries | Asia, Southeastern | Asia | Adults | Age Factors | Population Characteristics | Population | Migration | Population Dynamics | Residence Characteristics | Population Distribution | Geographic Factors | Social Change | Sociocultural Factors Document Number: 328738 |
| 27. Peer Reviewed Title: Are social inequalities in mortality in Britain narrowing? Time trends from 1978 to 2005 in a population-based study of older men. Author: Ramsay SE; Morris RW; Lennon LT; Wannamethee SG; Whincup PH Source: Journal of Epidemiology and Community Health. 2008;62:75-80. Abstract: The objective was to examine whether social inequalities in all-cause and coronary heart disease (CHD) mortality in Britain have reduced between 1978 and 2005. The design of the study was a prospective study of a socioeconomically representative population. The setting for the study was 24 British towns. The participants used were 7735 Men, aged 40-59 years at recruitment in 1978-1980 and followed up until 2005 through the National Health Service Central Register (164 120 person-years). The main outcome measures were relative hazards and absolute risk differences for all-cause and CHD death comparing manual with non-manual social classes, calculated for different calendar periods. 3009 Deaths from all causes (1003 from CHD) occurred during follow-up. The overall hazard ratio (manual versus non-manual) was 1.56 (95% CI 1.45 to 1.69, p < 0.001) for all-cause mortality and 1.54 (95% CI 1.35 to 1.76, p < 0.001) for CHD mortality. The relative difference between these social groups tended to increase over time. The overall relative increase in hazard ratio comparing manual with non-manual groups over a 20-year calendar period was 1.22 (95% CI 0.83 to 1.80, p=0.31) for all-cause mortality and 1.75 (95% CI 0.89 to 3.45, p=0.11) for CHD mortality. The absolute difference in probability of survival to age 65 years between nonmanual and manual groups fell from 29% in 1981 to 19% in 2001 for all-cause mortality and from 17% to 7% for CHD mortality. Relative differences in all-cause and CHD mortality between manual and non-manual social class groups persisted and may have increased during this period. Absolute differences in mortality between these social groups decreased as a result of falling overall mortality rates. Greater effort is needed to reduce social inequalities in all-cause and CHD mortality in the new millennium. (author's) Language: English Keywords: UNITED KINGDOM | RESEARCH REPORT | LONGITUDINAL STUDIES | PROSPECTIVE STUDIES | EPIDEMIOLOGIC METHODS | MEN | OLDER ADULTS | INEQUALITIES | TIME FACTORS | SOCIAL CLASS | MORTALITY DETERMINANTS | MORTALITY CHANGES | DIFFERENTIAL MORTALITY | CAUSES OF DEATH | HEART DISEASES | Developed Countries | Europe, Western | Europe | Studies | Research Methodology | Demographic Factors | Population | Adults | Age Factors | Population Characteristics | Socioeconomic Factors | Economic Factors | Population Dynamics | Socioeconomic Status | Mortality | Diseases Document Number: 323232 |
| 28. Peer Reviewed Title: Health insurance and cervical cancer screening among older women in Latin American and Caribbean cities. Author: Reyes-Ortiz CA; Velez LF; Camacho ME; Ottenbacher KJ; Markides KS Source: International Journal of Epidemiology. 2008 Aug;37(4):870-878. Abstract: The purpose of this study is to describe the prevalence of Papanicolaou (Pap) smear use for cervical cancer screening and to estimate A cross-sectional study using data from the Health, Well-Being and Aging in Latin America and the Caribbean Study (SABE). The sample includes 6357 women aged 60 and older from seven cities. The outcome was reporting a Pap smear for cervical cancer screening during the previous 2 years. Main independent variable was health care insurance. Covariates were demographic or socioeconomic variables, medical conditions and functional status. Prevalence of Pap smear use across the seven cities ranged from 21% in Bridgetown to 45% in Mexico City. In a multivariate analysis of the combined sample, without Havana that has universal health care insurance, women with public insurance (OR 0.55, 95% CI 0.43-0.71) or with no insurance (OR 0.23, 95% CI 0.15-0.34) were less likely to have a Pap smear compared with women with private insurance. Also, women with no insurance were less likely to have a Pap smear (OR 0.40, 95% CI 0.30-0.54) compared with women with any health insurance. In general, the prevalence of Pap smear use was lower than that reported for Hispanic populations in the United States. Overall, lack of health insurance or having public health insurance determined lower odds for having a Pap smear for cervical cancer screening. (author's) Language: English Keywords: LATIN AMERICA | CARIBBEAN | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | CANCER | SCREENING | HEALTH INSURANCE | PAP SMEAR | WOMEN | MIDDLE AGED ADULTS | OLDER ADULTS | Americas | Developing Countries | Research Methodology | Neoplasms | Diseases | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Financial Activities | Economic Factors | Laboratory Examinations and Diagnoses | Demographic Factors | Population | Adults | Age Factors | Population Characteristics Document Number: 327853 |
| 29. Peer Reviewed Title: Sex and the city: Differences in disease- and disability-free life years, and active community participation of elderly men and women in 7 cities in Latin America and the Caribbean. Author: Rose AM; Hennis AJ; Hambleton IR Source: BMC Public Health. 2008 Apr 21;8:127. Abstract: The world's population is ageing, and four of the top 10 most rapidly ageing developing nations are from the region of Latin America and the Caribbean (LAC). Although an ageing population heralds likely increases in chronic disease, disability-related dependence, and economic burden, the societal contribution of the chronically ill or those with disability is not often measured. We calculated country-specific prevalences of 'disability' (difficulty with at least one activity of daily living), 'disease' and 'co-morbidity' (presence of at least one, and at least two, of seven chronic diseases/conditions, respectively), and 'active community engagement' (using five levels of community participation, from less than weekly community contact to voluntary or paid work) in seven LAC cities. We estimated remaining life expectancy (LE) with and without disability, disease and co-morbidity, and investigated age, sex, and regional variations in disability-free LE. Finally, we modeled the association of disease, co-morbidity and disability with active community participation using an ordinal regression model, adjusted for depression. Overall, 77% of the LAC elderly had at least one chronic disease/condition, 44% had comorbidity and 19% had a disability. The proportion of disability-free LE declined between the youngest (60-64 years) and the eldest (90 years and over) age-groups for both men (from 85% to 55%) and women (from 75% to 45%). Disease-free and co-morbidity-free LE, however, remained at approximately 30% and 62%, respectively, for men (20% and 48% for women), until 80-84 years of age, then increased. Only Bridgetown's participants had statistically significantly longer disability-free LE than the regional average (IRR=1.08; 95%CI 1.05-1.10; p less than 0.001). Only Santiago's participants had disability-free LE which was shorter than the regional average (IRR=0.94; 95%CI 0.92-0.97; p less than 0.001). There was 75% active community participation overall, with more women than men involved in active help (49% vs 32%, respectively) and more men involved in voluntary/paid work (46% vs 25%, respectively). There was either no, or borderline significance in the association between having one or more diseases/conditions and active community engagement for both sexes. These associations were limited by depression (odds ratio [OR] reduced by 15-17% for men, and by 8-11% for women), and only remained statistically significant in men. However, disability remained statistically significantly associated with less community engagement after adjusting for depression (OR=0.58, 95%CI 0.49-0.69, p less than 0.001 for women and OR=0.50, 95%CI 0.47-0.65, p less than 0.001 for men). There is an increasing burden of disease and disability with older age across the LAC region. As these nations cope with resulting social and economic demands, governments and civic societies must continue to develop and maintain opportunities for community participation by this increasingly frail, but actively engaged group. (author's) Language: English Keywords: LATIN AMERICA | CARIBBEAN | RESEARCH REPORT | PREVALENCE | OLDER ADULTS | DEMOGRAPHIC AGING | COMMUNITY PARTICIPATION | LIFE EXPECTANCY | DISEASES | MORBIDITY | DEPENDENCY BURDEN | Americas | Developing Countries | Measurement | Research Methodology | Adults | Age Factors | Population Characteristics | Demographic Factors | Population | Population Dynamics | Organization and Administration | Length of Life | Mortality | Microeconomic Factors | Economic Factors Document Number: 326237 |
| 30. Peer Reviewed Title: The exceptionally high life expectancy of Costa Rican nonagenarians. Author: Rosero-Bixby L Source: Demography. 2008 Aug;45(3):673-691. Abstract: Robust data from a voter registry show that Costa Rican nonagenarians have an exceptionally high life expectancy. Mortality at age 90 in Costa Rica is at least 14% lower than an average of 13 high-income countries. This advantage increases with age by 1% per year. Males have an additional 12% advantage. Age-90 life expectancy for males is 4.4 years, one-half year more than any other country in the world. These estimates do not use problematic data on reported ages, but ages are computed from birth dates in the Costa Rican birth-registration ledgers. Census data confirm the exceptionally high survival of elderly Costa Ricans, especially males. Comparisons with the United States and Sweden show that the Costa Rican advantage comes mostly from reduced incidence of cardiovascular diseases, coupled with a low prevalence of obesity, as the only available explanatory risk factor. Costa Rican nonagenarians are survivors of cohorts that underwent extremely harsh health conditions when young, and their advantage might be just a heterogeneity in frailty effect that might disappear in more recent cohorts. The availability of reliable estimates for the oldest-old in low- income populations is extremely rare. These results may enlighten the debate over how harsh early-life health conditions affect older-age mortality. (author's) Language: English Keywords: COSTA RICA | RESEARCH REPORT | OLDER ADULTS, 80 AND OVER | LIFE EXPECTANCY | HEALTH | HETEROGENEITY | MORTALITY DETERMINANTS | DATA QUALITY | ESTIMATION TECHNIQUES | VALIDITY | MORTALITY | SEX FACTORS | Central America | Latin America | Americas | Developing Countries | Older Adults | Adults | Age Factors | Population Characteristics | Demographic Factors | Population | Length of Life | Population Dynamics | Data Analysis | Research Methodology | Measurement Document Number: 327989 |
 |
||
 |
Information & Knowledge for Optimal Health (INFO) Project 111 Market Place Suite 310, Baltimore, MD 21202 Phone: 410-659-6300 Fax: 410-659-6266 Security & Privacy Policy |  |