Strata Of Population Research Articles

Trends in Hip Fracture Incidence, Recurrence, and Survival by Education and Comorbidity: A Swedish Register-based Study.

Hip fractures are common and severe conditions among older individuals, associated with high mortality, and the Nordic countries have the highest incidence rates globally. With this study, we aim to present a comprehensive picture of trends in hip fracture incidence and survival in the older Swedish population stratified by education, birth country, and comorbidity level. This study is based on a linkage of several population registers and included the entire population over the age of 60 living in Sweden. We calculated age-standardized incidence rates for first and recurrent hip fractures as well as age-standardized proportions of patients surviving 30 and 365 days through the time period 1998 to 2017. We calculated all outcomes for men and women in the total population and in each population stratum. Altogether, we observed 289,603 first hip fractures during the study period. Age-standardized incidence rates of first and recurrent fractures declined among men and women in the total population and in each educational-, birth country-, and comorbidity group. Declines in incidence were more pronounced for recurrent than for first fractures. Approximately 20% of women and 30% of men died within 1 year of their first hip fracture. Overall, survival proportions remained constant throughout the study period but improved when taking into account comorbidity level. Hip fracture incidence has declined across the Swedish population, but mortality after hip fracture remained high, especially among men. Hip fracture patients constitute a vulnerable population group with increasing comorbidity burden and high mortality risk.

Government and Private Household Debt Relief during COVID-19

We follow a representative panel of US borrowers to study the suspension of household debt payments (debt forbearance) during the COVID-19 pandemic. Between March and October of 2020, loans worth $2 trillion entered forbearance. On average, cumulative payments missed per individual in forbearance during this period were largest for mortgage ($3,200) and auto ($430) borrowers. We estimate that more than 60 million borrowers will miss $70 billion on their debt payments by the end of 2021:Q1. This large amount of debt relief significantly dampened the household debt distress, which can help explain household delinquencies below pre-pandemic levels—a significant difference from other economic crises when delinquencies sharply increased along with unemployment. Forbearance thus may have had potentially large aggregate consequences for house prices and economic activity. Relief flows more to higher income individuals than those receiving stimulus checks, partially due to their higher debt balances: 60% of aggregate forbearance is provided to above median income borrowers. On the other hand, forbearance rates are higher among the more vulnerable populations: individuals with lower credit scores and lower incomes. Borrowers in regions with a higher likelihood of COVID-19 related economic shocks and higher shares of minorities were more likely to obtain debt relief. One third of borrowers in forbearance continued making full payments, suggesting that forbearance acts as a credit line, allowing borrowers to “draw” on payment deferral if needed. More than a quarter of total debt relief was provided by the private sector outside of the government mandates. Exploiting a discontinuity in mortgage eligibility under the CARES Act we estimate that implicit government debt relief subsidies increase the rate of forbearance by about 25%. Government and private relief follow similar patterns across income and creditworthiness, suggesting that borrower self-selection in requesting forbearance is an important determinant of debt relief incidence, and drives the distribution of relief across different population strata. Government relief is provided through private intermediaries, which differ in their propensity to supply relief, with shadow banks less likely to provide forbearance than traditional banks.

Adolescent health literacy: factors effecting usage and expertise of digital health literacy among universities students in Pakistan

BackgroundElectronic health tools are of little use if the intended user lacks the skills to effectively engage them. Engaging eHealth requires a skill set, or literacy, of its own. The present study is an effort to probe the relationship of education and Institution (Independent Variables) with the usage and expertise in eHealth literacy (Dependent Variables) among university students. The research is conducted in 16 Higher Education Commission (HEC) Pakistan’s recognized universities in Lahore. Both male and female students ranging from BS to PhD programs were the focus of the research.MethodsQuantitative data was collected through survey method using stratified random sampling technique. There were different kinds of strata in population i.e. general universities, health sciences universities, engineering universities and animal sciences universities etc. The research encompassed a total of 89,664 students in 16 universities, from which sample size of 1513 was drawn through research advisor table (2006). Proportional allocation formula was used to specify the number of respondents from each university. Non-parametric statistics was used since data was not normally distributed. Kruskal-Wallis H test and Mann-Whitney U test were applied to measure the difference of effect of groups of independent variables on the dependent variables.ResultsThe level of using digital health literacy was not same for all students, as the students of PhD and BS/Masters were significantly different from each other in terms of their usage of digital health literacy. Level of education showed a significant influence on level of expertise in eHealth literacy, confirming that changing the level of education had an effect on level of expertise in digital health literacy, but the size of effect was smaller. MS/MPhil and PhD students were significantly different from each other in their expertise in digital health literacy.ConclusionResults of the study depicted that belonging to different categories of educational levels differently affect the level of usage and that of expertise in digital health literacy among university students.

Mobile shopping apps adoption: a systematic literature review

The study aims to contribute by evaluating and synthesising the findings across various strata of populations in developed and developing countries and by unifying the diverse streams of research into a more coherent and cohesive knowledge entity. The theoretical models and determinants of M-shopping apps adoption intentions and behaviours from selected papers in literature are reviewed to synthesise the findings and identify the gaps and contradictions. Recommendations for future research are made as regards to theoretical approaches, research methodology, anchor constructs, consumer profiles to be researched, and technological and marketing perspectives are to be explored. The research findings in literature are limited by exclusive focus on smartphones, selective geographical regions, theoretical models, consume profiles and methodological approaches and hence not generalisable.

Mobile shopping apps adoption: a systematic literature review

The study aims to contribute by evaluating and synthesising the findings across various strata of populations in developed and developing countries and by unifying the diverse streams of research into a more coherent and cohesive knowledge entity. The theoretical models and determinants of M-shopping apps adoption intentions and behaviours from selected papers in literature are reviewed to synthesise the findings and identify the gaps and contradictions. Recommendations for future research are made as regards to theoretical approaches, research methodology, anchor constructs, consumer profiles to be researched, and technological and marketing perspectives are to be explored. The research findings in literature are limited by exclusive focus on smartphones, selective geographical regions, theoretical models, consume profiles and methodological approaches and hence not generalisable.

Social and investment redistribution – the trend of the future

Russia is going through a stage of becoming accompanied by complex internal problems. They are associated with the development of a legal framework and reconsidering the new type of economy, the negative impact of global crises and evident challenges in the distribution of the money supply. An active social policy of the state is aimed at the population strata in need of support: pensioners, disabled people, children. But the gap between low-income and rich groups is widening, and the middle stratum as a social component has practically disappeared. This situation suggests the need to search for tools to improve the prosperity of the population. Besides, low-efficiency investment systems of large players in the sector with state participation are registered, which requires the search for additional sources of investment and ways of their rational use with proper control. Which, in its turn, will reset the load from the state budget.

Assessment of knowledge and awareness among nursing students of a private medical university towards periodontal health and oral-systemic disease link: a cross-sectional study

Background Health is a global human demand for all strata of population. Oral health plays an essential role to conserve the overall general health. Many systemic conditions have been linked in association with periodontitis, such as preterm low birth weight infants, cardiovascular disease and related events such as angina, myocardial infarction, stroke, respiratory diseases, and diabetes mellitus. Education of oral health is considered to abide an essential prerequisite for oral health-related behavior. This survey was carried out to determine the level of knowledge and awareness about periodontal health and its oral-systemic disease link amongst the nursing students of private medical university. Aim To perceive an understanding among students of nursing college at private university on periodontal health and their knowledge about oral health and link of systemic disease with the help of a questionnaire survey. Patients and methods Three hundred and fifty nursing students were provided with a self-constructed 15 items questionnaire. χ2 test was utilized for individual questions and Kruskal–Wallis test was applied to compare overall periodontal health awareness and awareness about oral-systemic link among students of nursing college. Results and conclusion A total of 350 questionnaires were distributed, out of which all 350 were completed by the students and evaluated for the study with an overall response of questions rate of 97%. The study indicated that 40% of the nursing students were having knowledge about the health of gums and oral hygiene maintenance. Thirty-seven percent were aware about the oral hygiene practices and 23% were familiar about the perio-systemic disease link. But 77% were unaware about the correlation between the periodontal health and systemic diseases.

Политический террор и правое движение (на примере Владимирской губернии)

The article examines the street confrontation of October 1905 which went down in history as Jewish pogroms. The source base of the work comprises the documents of the police department deposited in the State Archive of Vladimir Oblast and the materials from periodicals of various political leanings. After the publication of the Manifesto of the 17th of October, 1905, in the streets of Russian cities, the revolutionary demonstrations whose participants viewed the Manifesto as a signal for a decisive assault on the autocracy clashed with the patriotic manifestations held by those who wanted to defend their familiar world. The defiant behavior of opposition supporters who preached their political ideals and in doing so insulted national and religious feelings of the conservative strata of population provoked street excesses, which then turned into bloody clashes. The situation was aggravated by the inaction of the local authorities who had not received timely instructions from St Petersburg and showed confusion during the first “days of freedom.” Thus, the pogroms of October 1905 which took place outside the Pale of Settlement were directed not so much against the Jews as against the revolutionaries (a considerable part of them were Jews). Contrary to the idea prevailing in historiography that the clashes of October 1905 were organized, the pogroms arose spontaneously. Neither the government, which was prostrate, nor the right-wing parties, the numerical composition of which in Russia at that time was measured by several thousand people, initiated or organized those events. In October 1905, there were no monarchist organizations in Vladimir Governorate at all. However, the supporters of autocracy are responsible for two political murders which occurred after the pogroms in November–December 1905. In Ivanovo-Voznesensk the crowd infuriated with the events of recent months tore to pieces a revolutionary woman who was transporting weapons, and in the village of Undol workers killed an agitator who called for the overthrow of autocracy. After the foundation of monarchist organizations in Vladimir Governorate, street clashes between the opponents and the supporters of autocracy gradually died down because the monarchists got an opportunity to defend their political convictions in a more civilized form. Although the conflicts between persons of opposite political views continued for some time, they were more like domestic quarrels and had no victims. Both sides were equally responsible for those incidents.

Small-scale spatial distribution of COVID-19-related excess mortality

Mortality due to massive events like the COVID-19 pandemic is underestimated because of several reasons, among which the impossibility to track all positive cases and the inadequacy of coding systems are presumably the most relevant. Therefore, the most affordable method to estimate COVID-19-related mortality is excess mortality (EM). Very often, though, EM is calculated on large spatial units that may entail different EM patterns and without stratifying deaths by age or sex, while, especially in the case of epidemics, it is important to identify the areas that suffered a higher death toll or that were spared. We developed the Stata COVID19_EM.ado procedure that estimates EM within municipalities in six subgroups defined by sex and age class using official data provided by ISTAT (Italian National Statistics Bureau) on deaths occurred from 2015 to 2020. Using simple linear regression models, we estimated the mortality trend in each age-and-sex subgroup and obtained the expected deaths of 2020 by extrapolating the linear trend. The results are then displayed using choropleth maps. Subsequently, local autocorrelation maps, which allow to appreciate the presence of local clusters of high or low EM, may be obtained using an R procedure that we developed.•We focused on estimating excess mortality in small-scale spatial units (municipalities) and in population strata defined by age and sex.•This method gives a deeper insight on excess mortality than summary figures at regional or national level, enabling to identify the local areas that suffered the most and the high-risk population subgroups within them.•This type of analysis could be replicated on different time frames, which might correspond to successive epidemic waves, as well as to periods in which containment measures were enforced and for different age classes; moreover, it could be applied in every instance of mortality crisis within a region or a country.

Territorial features of consumer behavior in the medical services market

Expansion of the commercial medical service market in Russia is a risk factor that promotes social inequality. In remote rural areas, social infrastructure, in particular the healthcare system, has been degrading. As a result, patients have widely taken to the use of commercial medical services. In this situation, such behavioral models are demonstrated not only by well-off, but even by needy rural and small-town residents. In this context, research on the formation mechanisms of user practices in the commercial medical service market in remote rural areas and smaller towns gains more relevance. The objective of the study is to assess the behavior of people in the Republic of Karelia (Russia) as users of commercial services. Methodologically, the study employed the household approach and statistical data analysis methods: factor and discriminant analyses. We demonstrate that the active use of commercial medical services by poor population strata is a necessity-driven activity caused by the absence or low availability of free services of this sort, or their low quality at the local level. The findings can help in decision-making on upgrading the social policy in healthcare.

Determinants of Adherence to ADA Type II Diabetes Mellitus Guidelines: Implications for Longevity

The aim of this study was to identify the differences in terms of demographics, socioeconomic status and overall levels of morbidity-related health burden between population strata characterized by high levels of adherence to American Diabetes Association screening guidelines and their low-adherence counterparts. Factor analysis was used to create a single continuous measure of adherence which was stratified and analyzed using the Cox proportional hazards model to identify adherence levels associated with protective effects for mortality. Based on the results, the entire population of Health and Retirement Study respondents newly diagnosed with diabetes mellitus, type II was then stratified into four levels of adherence – excellent, sufficient, insufficient, poor – based on the strength of the protective effect associated with that level of the adherence factor and compared. Mortality in the group associated with excellent adherence was 41 to 57 percentage points lower than among their counterparts. High levels of adherence were associated with White and Hispanic race, low morbidity burden, high education and economic status, and low levels of functioning limitations. Based on race-specific survival function estimates we found that the life expectancy at age 65 of an individual newly diagnosed with type II diabetes mellitus could be improved from 14.97 to 19.64 years for whites, 13.36 to 19.58 years for African Americans and 14.92 to 21.28 for Hispanics if average adherence levels are increased to the highest levels observed in our study. Finally, we found that adherence levels were improving over the 1991-2015 period suggesting successful diabetes awareness efforts.

Determinants of the household electricity consumption efficiency of an ageing population: Evidence for the EU-28

This paper explores the determinants of household electricity consumption efficiency of an ageing population. The analysis is pursued for the 28 member states of the European Union between 2005 and 2016. These determinants are evaluated through the employment of the econometric method Fractional Regression Model. Results indicate that the share of renewables in heating and cooling, the government expenditures in housing and community and the housing cost burden below 60% for people aged 65 and over, are the main drivers that impulse the efficiency levels positively. On the other hand, the old age dependency ratio, and the housing cost burden above 60% for people aged 65 and over, affect the efficiency levels negatively. The main contribution of the study is to underline the relevance of the socio-economic household characteristics of an ageing population strata in explaining the residential electricity consumption efficiency.

Mixed logistic regression in genome-wide association studies

BackgroundMixed linear models (MLM) have been widely used to account for population structure in case-control genome-wide association studies, the status being analyzed as a quantitative phenotype. Chen et al. proved in 2016 that this method is inappropriate in some situations and proposed GMMAT, a score test for the mixed logistic regression (MLR). However, this test does not produces an estimation of the variants’ effects. We propose two computationally efficient methods to estimate the variants’ effects. Their properties and those of other methods (MLM, logistic regression) are evaluated using both simulated and real genomic data from a recent GWAS in two geographically close population in West Africa.ResultsWe show that, when the disease prevalence differs between population strata, MLM is inappropriate to analyze binary traits. MLR performs the best in all circumstances. The variants’ effects are well evaluated by our methods, with a moderate bias when the effect sizes are large. Additionally, we propose a stratified QQ-plot, enhancing the diagnosis of p values inflation or deflation when population strata are not clearly identified in the sample.ConclusionThe two proposed methods are implemented in the R package milorGWAS available on the CRAN. Both methods scale up to at least 10,000 individuals. The same computational strategies could be applied to other models (e.g. mixed Cox model for survival analysis).

Time trends in the relation between the achieved education and the cardiovascular risk factors prevalence and control in general population and in persons with coronary heart disease

Abstract Background Achieved education is the most consistent and powerful socioeconomic status index and the differences in cardiovascular mortality (CV) according to achieved education in the Czech Republic are over a long period among most pronounced in Europe. Higher prevalence of CV risk factors in less educated is the major factor behind their higher CV morbidity and mortality. Purpose To analyse the changes in prevalence and control of CV risk factors according to achieved education in general population and in patients with stable CHD and their impact on CV mortality. Methods Based on data of 15 590 persons from 7 cross sectional epidemiological surveys carried through the Czech MONICA and post-MONICA project in 1985–2018 in identical 6 districts of the Czech Republic (general population) and on data of 2129 patients from 5 independent descriptive surveys of the Czech EUROASPIRE study in 1995–2018 (patients with stable CHD) time trends of major CV risk factors and their control in respondents with basic, secondary and university education were compared. Results The persons from general population as well as patients with CHD with higher education had consistently lower BMI and lower prevalence of obesity, the differences increased in due time (p<0,001), the prevalence of obesity increased in all educational strata (p<0,001). The total and non-HDL cholesterol were higher in lower educational population strata (p<0,01), but not in CHD patients, there was a very pronounced continuous decrease in all educational strata (p<0,001 for trend). Population systolic and diastolic blood pressures and prevalence of hypertension were higher in men and women with basic education (p<0,01) and decreased during the analysed period (p<0,001). In CHD patients the blood pressure was higher only in women. The prevalence of smoking was higher in men with basic education and decreased in all educational strata (p<0,0001), in women the prevalence of smoking increased in women with basic and decreased in women with secondary and university education (p<0,0001), in CHD patients the prevalence of smoking was lower and did not differ according to education. Prevalence of diabetes and of sedentary life style increased and was more prevalent in general as well as in CHD population in persons with lower education. Conclusion CV risk gradient in general population and in CHD patients decreased with level of education achieved, was present during the whole analysed period and became more pronounced in the 2016–18 survey. The education based differences were more pronounced in factors influenced by lifestyle (BMI, smoking) and less in factors influenced also by medical therapies (blood pressure, cholesterol levels). The impact on CV mortality is to be expected more pronounced in general CV prevention and less in already treated population. Observation of healthy life style remains a basic problem in CV prevention, particularly in persons with elementary education. Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): Agency for Medical Research, Ministry of Health of the Czech Republic

Assessing the knowledge, attitudes and practices regarding COVID-19 and homoeopathy among the citizens of Delhi and national capital region, India: a cross-sectional online survey

Background: Delhi and NCR of India is densely populated with access to an integrated health care delivery system, with a promoted preventive homoeopathic medicine for flu like illnesses. To assess knowledge, attitudes and practices to this unanticipated situation and infectious disease pandemic of COVID-19 continues to be a global and public health challenge.Methods: A survey was conducted. An online cross-sectional survey was conducted in a sample of the residents of Delhi and NCR using a self-prepared pilot-tested structured format. The obtained data was analysed using descriptive and inferential statistics.Results: 925 people completed the survey with 55.5% of the study group being females. Mean knowledge score obtained was 7.57±1.41 while mean attitude score was 3.27±1.31. Majority of the respondents (86%) had an adequate knowledge about the disease in general and were optimistic about recovery from the disease. Gender had negligible impact on the average knowledge score, while the score differed significantly with education and occupation. In the absence of an available vaccine, 29.47% respondents considered prophylactic potential of homoeopathy.Conclusions: Results reveal adequate knowledge and practices in the educated residents but below average mean attitude score. Public has welcomed the governmental initiative of homoeopathic prophylactic, and their belief in its therapeutic potential furthers the studies to determine its role as an adjuvant. Further extensive cross-sectional surveys to cover various strata of population are required to assess the widespread pattern of KAP in the general population.

Первая в РСФСР: Ирбитская ярмарка в 1922 г.

The study aims to examine the processes of preparing and holding the first Soviet fair in 1922 in Irbit (Yekaterinburg province), as well as to assess its effectiveness with regard to goals set by the authorities. Scientific novelty of the research lies in the fact that the 1922 Irbit Fair is considered as a nationwide landmark historic event representing the beginning of transition to a new format of dialogue with the society by the Bolshevik government. As a result of the study, it has been proved that the Irbit Fair added a much greater political effect to power decisions on current economic issues, made it possible to unearth routine economic problems involving the entrepreneurial population strata in their resolution.

Virtual Modeling of User Populations and Formative Design Parameters

Human variability related to physical, cognitive, socio-demographic, and other factors can contribute to large differences in human performance. Quantifying population heterogeneity can be useful for designers wishing to evaluate design parameters such that a system design is robust to this variability. Comprehensively integrating human variability in the design process poses many challenges, such as limited access to a statistically representative population and limited data collection resources. This paper discusses two virtual population modeling approaches intended to be performed prior to in-person design validation studies to minimize these challenges by: (1) targeting recruitment of representative population strata and (2) reducing the candidate design parameters being validated in the target population. The first approach suggests the use of digital human models, virtual representations of humans that can simulate system interaction to eliminate candidate design parameters. The second approach suggests the use of existing human databases to identify relevant human characteristics for representative recruitment strata in subsequent studies. Two case studies are presented to demonstrate each approach, and the benefits and limitations of each are discussed. This paper demonstrates the benefit of modeling prior to conducting in-person human performance studies to minimize resource burden, which has significant implications on early design stages.

Theoretical-Practical And Epistemological Review Of Political Linguistics

Political text and discourse is a combination of perceiving the life in terms of conceptual-discourse methods, standards of scientific researches and activities. The primary form of analyzing a text identifies hidden factors of its political and ideological objectives as they reflect socio-political changes turning to setting the target for investigating, evaluating and selecting. This can help clearly define epistemic-linguistic problems and the frame of the tasks in developing national idea. Currently, the prosperity of Uzbekistan has its reflection on the development of the Uzbek language and its application in people’s lives. Language is the basis of political life, hence, political thinking remains unchanged unless national language develops. In this view, it’s essential to investigate argumentative issues of the essence of political linguistics, the interrelation, the main idea that determines the notion of political discourse in terms of political-philosophical aspects. For this reason, the article mainly focuses on political language and its peculiar features. Political language constitutes different spheres of a culture, interpretation of the lexis delivered during propaganda and political events within various strata of population, as well as timeliness to strengthen the link with population. Political linguistics

Burden of Healthcare-Associated Infections in Italy: Disability-Adjusted Life Years

Abstract Background Healthcare-Associated Infections (HAIs) significantly increase adverse clinical outcomes and healthcare costs. In 2016 Italy participated in the second European Centre for Disease Prevention and Control (ECDC) Point Prevalence Survey (PPS) of HAIs and antimicrobial use in acute care hospitals. The aim of this study was to estimate the burden of the 5 most common HAIs in Italy, by evaluating incidence, attributable deaths, Years of Life Lost (YLL), Years Lived with Disability (YLD) and Disability-Adjusted Life-Years (DALYs). Methods National PPS data were used to establish sex- and age-specific incidence of Healthcare-associated Pneumonia (HAP), HA Urinary tract infections (HA UTI), HA Bloodstream Infections (HA BSI) excluding neonatal BSI, Surgical Site Infections (SSI), HA Clostridium Difficile infections (HA CDI). Patients' life expectancy was adjusted according to the severity of underlying conditions using the McCabe score. Following the methodology from the Burden of Communicable Diseases in Europe (BCoDE)-project, an adapted version of the disease models of the BCoDE toolkit was used. Results An overall yearly incidence of 643434 new cases of HAI in Italy was estimated. The aggregate burden of the 5 HAIs was 426411.98 DALYs (86731.03 YLD + 339680.96 YLL), corresponding to 702.53 DALYs per 100000 total population. HA BSI and HAP had the highest burden with respectively 253868.22? and 126038.26 DALYs. The population strata with the highest burden were the ones with McCabe Score 1 for every considered HAI. The age groups with the highest burden were 70-74 for male and 45-49 for female patients. In total, 56% of DALYs were attributable to men and 44% to women. Conclusions This nation-wide study found a significant burden of disease due to HAIs in Italy. Results of this study could be used to guide policy-makers in the implementation of measures aiming to reduce the impact of HAIs. Key messages This study estimated the burden of 5 HAIs in Italy was 426411.98 DALYs (86731.03 YLD + 339680.96 YLL according to 2016 PPS data. Considering the significant burden of HAIs found in this study, infection prevention and control measures should be a Public Health priority in Italy.

The Social Consequences of Innovations in Public Administration

The role of innovations as a key factor in public administration development and state functions transformation remains so far insufficiently studied. The research objective is to study social consequences of applying innovative technologies in public administration, while analyzing state functions dynamics as influenced by developing innovations. Main research methods are the universal philosophical method of scientific knowledge; analysis, synthesis, comparative legal and systematic methods. Mainstreaming of innovative technologies in public administration creates conditions for emerging and developing new state functions - ensuring innovative security and overcoming inequalities in information society associated with limited accessibility of innovations for certain population strata. In line with global trends, the implementation of basic state functions is closely linked with the innovative development function and ensuring national innovative security thereby creating conditions for implementing other state functions. That said, account should also be taken of using innovative technologies in public administration poses certain risks to human rights, and therefore, the development of innovations should only be the material basis for achieving the primary goal of the state - ensuring and protecting human rights and freedoms. Our research results demonstrate dynamics and nature of state functions in today’s world with development and implementation of innovations.