Demographic Trends Research Articles

Pressure injury incidence measurement as a quality improvement strategy: national trends in Switzerland.

This study sought to determine the risk-adjusted (controlled for patient characteristics) trend in pressure injury (PI) incidence in Switzerland. A secondary data analysis was conducted. The data originated from the national PI quality measurement based on a multicentre cross-sectional design with repeated annual measurements. Descriptive statistics, a Cochran-Armitage trend test and logistic (multilevel) regression modelling were applied. The analysis sample comprised 123,715 patients from 230 hospitals over 10 survey years (2011-2019 and 2022). The incidence of descriptive PI varied in Switzerland between 3.7% and 5.6% over the survey years. No linear trend could be found when patient characteristics were not considered. A non-linear trend was detected when controlling for patient characteristics and the time effect (repeated measurement). This was also reflected in the plotted risk-adjusted incidence, which revealed a decrease followed by a levelling off. When only considering the incidence of PIs rated category 2 and higher, there was also a non-linear decreasing trend when controlling for patient characteristics and time effects. If the incidence per survey year were estimated on the basis of patient characteristics, an increase in the incidence would have been expected. Although patients' risk of developing a PI increased between 2011-2022, the incidence of PIs in Switzerland first decreased and then levelled off. The results indicated that care quality in Swiss hospitals has improved regarding PIs. Nevertheless, in view of demographic trends and increasing staff shortages, it is important to continue to monitor PI incidence and to invest in PI prevention.

Diverse pathways to permanent childlessness in Singapore: A latent class analysis.

The proportions of adults reaching midlife without having children have been rising rapidly across the globe, particularly in Asia. However, little is known about the pathways to permanent childlessness within the region's childless population. This study utilized latent class analysis (LCA) to typologize pathways to childlessness based on dynamic characteristics of multiple life domains (i.e., partnership, education, and occupation) among 489 childless Singaporeans aged 50 and above from a 2022 nationwide survey. Additionally, we utilized multinomial logistic regressions to examine the sociodemographic correlates of pathway profiles and Shannon's entropy index to assess the heterogeneity in pathways to childlessness among successive cohorts. Results revealed five distinct profiles of pathways to childlessness: the Never-Married Semi-Professionals, the Low-Flex Blue-Collars, the Highly Educated Professionals, the Ever-Married Semi-Professionals, and the Flexible Blue-Collars. These pathway profiles were significantly associated with sociodemographic characteristics such as gender and family background. Women's pathways to childlessness were more standardized and heavily influenced by partnership characteristics, compared to those of men. The childless from privileged family background were less likely to follow pathways characterized by disadvantageous education and occupational status. There were also rising trends of voluntary childlessness among married childless individuals and increasing heterogeneity in pathways to childlessness across successive birth cohorts. In sum, our findings are consistent with some of the predictions of the Second Demographic Transition theory, suggesting that Singapore may be experiencing a demographic transition characterized by rising childlessness, decoupling of marriage and childbearing, and de-standardization of the life course.

Religion and Growth

We use the elements of a macroeconomic production function—physical capital, human capital, labor, and technology—together with standard growth models to frame the role of religion in economic growth. Unifying a growing literature, we argue that religion can enhance or impinge upon economic growth through all four elements because it shapes individual preferences, societal norms, and institutions. Religion affects physical capital accumulation by influencing thrift and financial development. It affects human capital through both religious and secular education. It affects population and labor by influencing work effort, fertility, and the demographic transition. And it affects total factor productivity by constraining or unleashing technological change and through rituals, legal institutions, political economy, and conflict. Synthesizing a disjoint literature in this way opens many interesting directions for future research. (JEL E22, I25, J10, N30, O33, O43, Z12)

Shifting Trends in the Epidemiology of Cervical Spine Injuries: An Analysis of 11,822 Patients from the National Electronic Injury Surveillance System over Two Decades.

Cervical spine injuries (CSIs) are heterogeneous in nature and often lead to long-term disability and morbidity. However, there are few recent and comprehensive epidemiological studies on CSI. The objective of this study was to characterize recent trends in CSI patient demographics, incidence, etiology, and injury level. The National Electronic Injury Surveillance System was used to extract data on CSIs from 2002 to 2022. Weighted national estimates of CSI incidence were computed using yearly population estimates interpolated from U.S. census data. Data analysis involved extracting additional information from patient narratives to categorize injury etiology (i.e., fall) and identify CSI level. K-means clustering was performed on cervical levels to define upper versus lower cervical injuries. Appropriate summary statistics including mean with 95% confidence intervals and frequency were reported for age, sex, race, ethnicity, etiology, and disposition. Age between groups was compared using an independent weighted Z-test. All categorical variables were compared using Pearson chi-squared tests with Bonferroni correction for multiple comparisons. Ordinary least squares linear regression was used to quantify the rate of change of various metrics with time. A total of 11,822 patient records met the study criteria. The mean age of patients was 62.4 ± 22.7 years, 52.4% of whom were male and 61.4% of whom were White, 7.4% were Black, 27.8% were not specified, and the remaining comprised a variety of ethnicities. The most common mechanism of CSI was a fall (67.3%). There was a significant increase in the incidence of cervical injuries between 2003 and 2022 (p < 0.001). Unbiased K-means clustering defined upper cervical injuries as C1-C3 and lower cervical injuries as C4-C7. The mean age of patients with upper CSIs was 72.3 ± 19.6, significantly greater than the age of those with lower CSIs (57.1 ± 23.1, p < 0.001). Compared with lower CSI, White patients were more likely to have an upper CSI (67.4% vs. 73.7%; p < 0.001). While Black/African American (7.5% vs. 3.8%) and Hispanic (2.5% vs. 1.0%) patients were more likely to have a lower CSI (p < 0.001). Our study identified a significant increase in the incidence of CSIs over time, which was associated with increasing patient age. Our study detected a pragmatic demarcation of classifying upper injuries as C1-C3 and lower cervical injuries as C4-C7. Upper injuries were seen more often in older, White females who were treated and admitted, and lower injuries were seen more often in young, Black male patients who were released without admission.

Demographical and Regional Trends of HIV-Related Mortality Among Young Adults in the United States From 1999-2020.

BackgroundHIV remains a leading cause of death in the U.S. Previous research has examined mortality patterns among older adults with HIV, revealing regional and demographic disparities. This study aims to assess demographic and regional trends in HIV-related mortality among young adults from 1999 to 2020. MethodologyCDC WONDER database was used to identify young adults aged 15-44 where HIV was mentioned as either underlying or contributory cause of mortality between 1999 and 2020, using the B20-B24 codes from the International Statistical Classification of Diseases and Related Health Problems-10th Revision (ICD-10). Age adjusted mortality rates (AAMRs) per 100,000 population and Annual percentage change (APC) were determined. ResultsThe AAMRs for HIV in young adults consistently declined from 1999-2018, followed by a period of stability from 2018-2020 (APC: 0.5%; 95% CI, -7.4 to 9.0), with 64% deaths occurred in medical facilities. Overall, males had a twice AAMR than females (Female: 2.22, 95% CI 2.19-2.24; Male: 5.19, 95% CI 5.15-5.23). Non-Hispanic (NH) Blacks had seven-fold higher mortality rates than Whites (AAMR 14.88 vs. 2.036). The Southern region experienced three-fold higher mortality compared to the Midwest. Metropolitan adults had a two-fold higher AAMR than non-metropolitan adults. States in the top 90th percentile for HIV-related mortality, including Mississippi, Maryland, Florida, Louisiana, and the District of Columbia, exhibited six times higher mortality compared to states in the bottom 10th percentile, such as North Dakota, Idaho, Wyoming, Montana, and Utah. ConclusionTo address these disparities and ensure continued progress, urgent measures are required.

Letter to the Editor Regarding “Bibliometric Analysis of Publications From 2011–2020 in 6 Major Neurosurgical Journals (Part 1): Geographic, Demographic, and Article Type Trends"

Letter to the Editor Regarding “Bibliometric Analysis of Publications From 2011–2020 in 6 Major Neurosurgical Journals (Part 1): Geographic, Demographic, and Article Type Trends"

Demographic History and English Culture

In England, the period from the late Middle Ages through early modernity was bookended by demographic change. On one edge, there was the Black Death and subsequent plague pandemics, which halved the population, reshaping English society in their wake. On the other, there was the demographic transition of the mid-eighteenth century, which reduced death rates and led to modern family structures. Between these two epochal events, demographic trends shaped English customs and values, and were in turn shaped by them. The articles in this special issue draw on cutting-edge demographic research to offer new interpretations of the effects of plague, patterns of marriage, evolving forms of labor, and the morality of crime and charity, among other subjects. Together, they illustrate how quantitative studies in historical demography can shed light on key transformations in culture and society—and vice versa.

Трудовые ресурсы в условиях военной опасности как ключевой фактор повышения промышленного потенциала

The article examines the problem of mobilising the industrial potential of Russia in terms of the growing military danger during SMO under decrease in the demographic and labour potential of the Russian Federation. The authors emphasize the effective involvement of labour resources is a key element for development of the industrial potential. Those are necessary to counter the increasing escalation of the military conflict and the desire of Western countries for military and political defeat of Russia. However, the reduction of labour potential and the aging of the population can cause serious socio-economic and political problems. A liberal approach to migration poses long-term threats to the State. Unregulated migration processes will inevitably cause an increase in unemployment, a decrease in the share Russian nation itself, loss of national identity, social tension, and cultural, ethnic, and religious conflicts. It requires a thorough systematised approach and effective monitoring of demographic trends. The state should find a balance between attracting labour from outside and increasing its own labour resources. It also should provide the rational use of existing labour resources.

Temporal Trends in Takotsubo Syndrome: Results From the International Takotsubo Registry

BackgroundThe perception of takotsubo syndrome (TTS) has evolved significantly over the years, primarily driven by increased recognition of acute complications and mortality. ObjectivesThis study aimed to explore temporal trends in demographic patterns, risk factors, clinical presentations, and outcomes in patients with TTS. MethodsPatients diagnosed with TTS between 2004 and 2021 were enrolled from the InterTAK (International Takotsubo) registry. To assess temporal trends, patients were divided into 6 groups, each corresponding to a 3-year interval within the study period. ResultsOverall, 3,957 patients were included in the study. There was a significant demographic transition, with the proportion of male patients rising from 10% to 15% (P = 0.003). Although apical TTS remained the most common form, the diagnosis of midventricular TTS increased from 18% to 28% (P = 0.018). The prevalence of physical triggers increased from 39% to 58% over the years (P < 0.001). There was a significant increase in 60-day mortality over the years (P < 0.001). However, a landmark analysis excluding patients who died within the first 60 days showed no differences in 1-year mortality (P = 0.150). ConclusionsThis study of temporal trends in TTS highlights a transition in patients demographic with a growing prevalence among men, increasing recognition of midventricular TTS type, and increased short-term mortality and rates of cardiogenic shock in recent years. This transition aligns with the rising prevalence of physical triggers, as expression of increased recognition of TTS in association with acute comorbidities.

Gender and adolescent sexual and reproductive health and rights in West and Central Africa: New evidence and emerging gaps.

The West and Central Africa (WCA) region is a natural resource-rich, 24-country, contiguous area with a population of nearly 500 million people. The median age for the region is currently 18 years and approximately one-third of its population is aged between 10 and 24 years. If current demographic trends in the region persist, its population will reach 1.5 billion by 2050. At that time, WCA will not only have the largest number of young people globally, but it will also be the only part of the world whose population of young people will continue to increase1. Many countries in the region are also or have recently been involved in armed conflicts, which have devastated infrastructure, displaced people, stifled development, and more importantly, resulted in myriad deaths and morbidities.

Labor force and macroeconomic projections overview and highlights, 2023–33

Projections from the U.S. Bureau of Labor Statistics continue to be influenced by demographic trends. These trends are projected to result in subdued labor force and employment growth over the 2023–33 projections period. This slower growth also affects gross domestic product (GDP), which is projected to grow at a modest annual rate of 1.9 percent through the 2023–33 projections period. Additionally, the labor force, employment, and GDP have recovered since the 2020 recession induced by the COVID-19 pandemic. This rebound leaves less room for growth as the economy was at or near full employment in 2023.

Analysis of Characteristics of Health Status Based on Assessment of Cognitive Function in the Elderly in Indonesia

Introduction: Various challenges will arise due to the increase in elderly people yearly. In Indonesia, the effect of the demographic transition can be seen in the low birth and death rates, and the rise in life expectancy is indirectly the way to increase the number of the elderly; from sharing the problems that arise among the elderly, one of the things that need to be concerned is how to maintain cognitive function so that the elderly can maintain their health status. Objectives: to determine the relationship between characteristics and the health status of the elderly based on the results of cognitive function assessment. Methods: This study is a type of observational analytical research using a cross-sectional study design and was carried out in Gowa Regency, South Sulawesi Province, Indonesia, from August to December 2023, involving 64 older adults with the criteria of elderly people who are 60-75 years old, do not have mental disorders and can read and write. Cognitive function uses the Montreal Cognitive Assessment Indonesia version (MoCA-Ina) and is a variable to be analyzed. Results: There was a significant relationship between sex p&lt;0.030, age p&lt;0.027, education level p&lt;0.001, occupation p&lt;0.045, prayer activity p&lt;0.001 with cognitive function, while marital status was not related to cognitive function p&gt;0.193. Conclusion: The characteristics of the elderly in this study are related to health status based on the value of cognitive function in the elderly.

Spatiotemporal heterogeneity of the association between socioeconomic development and health policy attention: a geographically and temporally weighted regression modeling study in China.

Health policy attention (HPA) refers to the extent of attention given by governments to health issues in public policy and is generally influenced by socioeconomic development. This study aimed to examine the spatiotemporal heterogeneity and clustering of the associations between socioeconomic factors and HPA. Longitudinal study. This study examined the spatiotemporal heterogeneity of the association between public and provincial government attention, economic development, and demographic transition and HPA by using geographically and temporally weighted regression (GTWR). Word2Vec machine learning technology was utilized to calculate HPA data in 323 cities and independent variable data was collected in each city in China over the period of 2018-2021. The results showed that there is a substantial overall rise in HPA levels throughout China following the COVID-19 pandemic. Furthermore, the GTWR results revealed significant spatiotemporal heterogeneity in the associations between HPA and public and provincial government attention, economic development, and demographic transition, particularly in the context of COVID-19. The impact of provincial government attention on HPA decreased from the capital of the political center outward, while the impact of public financial investment decreased in less developed cities during the pandemic. It was only cities with high levels of aging are more likely to receive greater HPA. The finding highlighted the remarkable spatial and temporal variations in the associations between the variables and HPA across different regions in China, emphasizing the need for region-specific policies to strengthen the focus on health by municipal governments.

Land use land cover change in the African Great Lakes Region: a spatial–temporal analysis and future predictions

The African Great Lakes Region has experienced substantial land use land cover change (LULCC) over the last decades, driven by a complex interplay of various factors. However, a comprehensive analysis exploring the relationships between LULCC, and its explanatory variables remains unexplored. This study focused on the Lake Kivu catchment in Rwanda, analysing LULCC from 1990 to 2020, identifying major variables, and predicting future LULC scenarios under different development trajectories. Image classification was conducted in Google Earth Engine using random forest classifier, by incorporating seasonal composites Landsat images, spectral indices, and topographic features, to enhance discrimination and capture seasonal variations. The results demonstrated an overall accuracy exceeding 83%. Historical analysis revealed significant changes, including forest loss (26.6 to 18.7%) and agricultural land expansion (27.7 to 43%) in the 1990–2000 decade, attributed to political conflicts and population movements. Forest recovery (24.8% by 2020) was observed in subsequent decades, driven by Rwanda’s sustainable development initiatives. A Multi-Layer Perceptron neural network from Land Change Modeler predicted distinct 2030 and 2050 LULC scenarios based on natural, socio-economic variables, and historical transitions. Analysis of explanatory variables highlighted the significant role of proximity to urban centers, population density, and terrain in LULCC. Predictions indicate distinct trajectories influenced by demographic and socio-economic trends. The study recommends adopting the Green Growth Economy scenario aligned with ongoing conservation measures. The findings contribute to identifying opportunities for land restoration and conservation efforts, promoting the preservation of Lake Kivu catchment’s ecological integrity, in alignment with national and global goals.Graphical

The last days of Aporia crataegi (L.) in Britain: Evaluating genomic erosion in an extirpated butterfly.

Current rates of habitat degradation and climate change are causing unprecedented declines in global biodiversity. Studies on vertebrates highlight how conservation genomics can be effective in identifying and managing threatened populations, but it is unclear how vertebrate-derived metrics of genomic erosion translate to invertebrates, with their markedly different population sizes and life histories. The Black-veined White butterfly (Aporia crataegi) was extirpated from Britain in the 1920s. Here, we sequenced historical DNA from 17 specimens collected between 1854 and 1924 to reconstruct demography and compare levels of genomic erosion between extirpated British and extant European mainland populations. We contrast these results using modern samples of the Common Blue butterfly (Polyommatus icarus); a species with relatively stable demographic trends in Great Britain. We provide evidence for bottlenecks in both these species around the period of post-glacial colonization of the British Isles. Our results reveal different demographic histories and Ne for both species, consistent with their fates in Britain, likely driven by differences in life history, ecology and genome size. Despite a difference, by an order of magnitude, in historical effective population sizes (Ne), reduction in genome-wide heterozygosity in A. crataegi was comparable to that in P. icarus. Symptomatic of A. crataegi's disappearance were marked increases in runs-of-homozygosity (RoH), potentially indicative of recent inbreeding, and accumulation of putatively mildly and weakly deleterious variants. Our results provide a rare glimpse of genomic erosion in a regionally extinct insect and support the potential use of genomic erosion metrics in identifying invertebrate populations or species in decline.

Australian medical practitioners: trends in demographics and regions of work 2013-2022.

ObjectiveThis study aimed to examine changes in the demographics and regions of work of Australian doctors over a period of 9years.MethodsA retrospective study of Australian Health Practitioner Regulation Agency (AHPRA) registration data was performed. Data were sourced from the Health Workforce Dataset Online Data Tool which was derived from annual registration data from AHPRA for 2013-2022. The demographic factors analysed were gender, age, and origin of qualification. Regions of work were defined using the Modified Monash (MM) model.ResultsThe number of registered doctors increased from 82,408 in 2013 to 111,908 in 2022 but mean hours worked per week decreased from 41 to 39 leading up to 2020. Trends in age and origin of qualification remained stable, but the proportion of female workers increased from 38.5% in 2013 to 44.5% in 2022. While female hours per week (~37) were consistent from 2013 to 2020, male hours per week decreased from 43 to 41. The number of registrations and total full-time equivalent (FTE) outcomes increased consistently in metropolitan (MM1) and rural (MM2-5) regions but did not increase for remote and very remote (MM6-7) regions.ConclusionThe Australian medical workforce both grew and changed between 2013 and 2022. An overall decrease in mean hours worked appears to be driven by a decline in hours worked by male workers and the increased proportion of female workers. While increased gender parity and a decrease in hours worked per week were positive outcomes, a lack of growth in the medical workforce was noted in remote and very remote regions of Australia.

A Comprehensive Review on Acanthamoeba Keratitis: An Overview of Epidemiology, Risk Factors, and Therapeutic Strategies.

Acanthamoeba keratitis (AK) is a rare but severe corneal infection caused by the free-living amoeba, Acanthamoeba, which is ubiquitously present in the environment. This condition predominantly affects contact lens wearers but can also occur in non-lens users, particularly those exposed to contaminated water or with compromised immune systems. AK is characterized by progressive corneal inflammation, epithelial defects, and ulceration, which can lead to significant visual impairment or blindness if not promptly diagnosed and treated. This review aims to provide a comprehensive overview of AK by synthesizing current knowledge on its epidemiology, risk factors, pathophysiology, clinical manifestations, diagnostic approaches, and therapeutic strategies. The review also highlights preventive measures and public health strategies to reduce the incidence of this debilitating condition. A detailed examination of existing literature was conducted, focusing on the global incidence of AK, demographic trends, and various risk factors such as contact lens use, environmental exposures, and immunity status. The review also delves into the pathophysiology of Acanthamoeba infection, the host immune response, and the challenges in distinguishing AK from other forms of infectious keratitis. Therapeutic strategies, including medical and surgical interventions, are analyzed, along with emerging treatments. The global incidence of AK has increased, particularly among contact lens users, due to poor hygiene practices and environmental exposures. Early diagnosis remains challenging, often leading to delayed treatment and poorer outcomes. Biguanides and diamidines are the mainstays of medical therapy, with surgical options considered in advanced cases. Emerging therapies, such as photodynamic therapy and antimicrobial peptides, show promise in enhancing treatment outcomes.AK poses a significant threat to ocular health due to its potential for severe visual impairment and the complexities associated with its diagnosis and treatment. Early recognition, appropriate management, and public health initiatives focused on prevention are crucial for improving patient outcomes. Ongoing research and a collaborative approach among healthcare providers are essential to advancing the understanding and management of AK.

Diverging destinies: How children are faring under demographic transition

India reached the replacement level of fertility in 2020. However, the journey of fertility transition is unconventional and heterogeneous within the country and across the different socio-economic groups. The fertility transition is considered to be faster than its socio-economic and health transition in several states. Thus, it has been presumed that the returns to fertility decline are heterogeneous across the states and population sub-groups. Our specific hypothesis is that although rich and poor, and educated and un-educated, everyone had significantly contributed to the fertility decline in response to family planning policies, only those socio-economically better-off have been investing relatively more in their children compared to the poor, and this has led to diverging destinies for children. We tested this supposition using a macro-level panel dataset (1992–2021), fixed and random effects, and IV regression models. The results confirm that child health care and outcomes have diverged while fertility declined from 1992 to 2021. These results are sustained in multiple robustness checks. While fertility is declining with highly state-sponsored family planning programmes, the persistent socio-economic inequalities are leading to unequal progress in health outcomes for children in India.

Demographic trends and disparities in mortality related to coexisting heart failure and diabetes mellitus among older adults in the United States between 1999 and 2020: A retrospective population-based cohort study from the CDC WONDER database

BackgroundHeart Failure (HF) and Diabetes Mellitus (DM) often coexist, and each condition independently increases the likelihood of developing the other. While there has been concern regarding the increasing burden of disease for both conditions individually over the last decade, a comprehensive examination of mortality trends and demographic and regional disparities needs to be thoroughly explored in the United States (US). MethodsThis study analyzed death certificates from the CDC WONDER database, focusing on mortality caused by the co-occurrence of HF and DM in adults aged 75 and older from 1999 to 2020. Age-adjusted mortality rates (AAMRs) and annual percent changes (APCs) were computed and categorized by year, gender, race, census region, state, and metropolitan status. ResultsA total of 663,016 deaths were reported in patients with coexisting HF and DM. Overall, AAMR increased from 154.1 to 186.1 per 100,000 population between 1999 and 2020, with a notable significant increase from 2018 to 2020 (APC: 11.30). Older men had consistently higher AAMRs than older women (185 vs. 135.4). Furthermore, we found that AAMRs were highest among non-Hispanic (NH) American Indian or Alaskan natives and lowest in NH Asian or Pacific Islanders (214.4 vs. 104.1). Similarly, AAMRs were highest in the Midwestern region and among those dwelling in non-metropolitan areas. ConclusionsMortality from HF and DM has risen significantly in recent years, especially among older men, NH American Indian or Alaska Natives, and those in non-metropolitan areas. Urgent policies need to be developed to address these disparities and promote equitable healthcare access.

How the radical right reshapes public opinion: the Sweden Democrats’ local mobilisation, 2002–2020

This study enhances our understanding of the long-term impact of radical right parties (RRPs) on public opinion by examining the local mobilisation of the Sweden Democrats (SD) over the past two decades. Drawing on extensive local-level data from Sweden’s 290 municipalities (2002–2020), merged with survey data, the study reveals that the gradual establishment of RRPs in local politics alters voters’ policy preferences, increasing the salience of immigration. The study further shows that the SD’s local presence reshapes societal divides, leading individuals to increasingly sort their ideological views according to their positions on immigration, while reducing the prominence of economic redistribution issues. Consequently, public attention shifts away from traditional economic-redistributive conflicts towards immigration-related concerns. These findings have significant implications, suggesting that the local establishment of RRPs reconfigures public perceptions of political conflict from the grassroots level, independent of demographic trends, external crises, and even RRPs’ national leadership.