Population Demography

ORIGINAL RESEARCH Open AccessThe epidemiology of medical emergency contactsoutside hospitals in Norway - a prospectivepopulation based studyErik Zakariassen1,2*, Robert Anders Burman1, Steinar Hunskaar1,3AbstractIntroduction: There is a lack of epidemiological knowledge on medical emergencies outside hospitals in Norway.The aim of the present study was to obtain representative data on the epidemiology of medical emergenciesclassified as “red responses” in Norway.Method: Three emergency medical dispatch centres (EMCCs) were chosen as catchment areas, covering 816 000inhabitants. During a three month period in 2007 the EMCCs gathered information on every situation that wastriaged as a red response, according to The Norwegian Index of Medical Emergencies (Index). Records fromground ambulances, air ambulances, and the primary care doctors were subsequently collected. InternationalClassification of Primary Care - 2 symptom codes (ICPC-2) and The National Committee on Aeronautics (NACA)Score System were given retrospectively.Results: Total incidence of red response situations was 5 105 during the three month period. 394 patients wereinvolved in 138 accidents, and 181 situations were without patients, resulting in a total of 5 180 patients. Thepatients’ age ranged from 0 to 107 years, with a median age of 57, and 55% were male. 90% of the red responseswere medical problems with a large variation of symptoms, the remainder being accidents. 70% of the patientswere in a non-life-threatening situation. Within the accident group, males accounted for 61%, and 35% were agedbetween 10 and 29 years, with a median age of 37 years. Few of the 39 chapters in the Index were used, A10“Chest pain” was the most common one (22% of all situations). ICPC-2 symptom codes showed that cardiovascular,syncope/coma, respiratory and neurological problems were most common. 50% of all patients in a sever situation(NACA score 4-7) were > 70 years of age.Conclusions: The results show that emergency medicine based on 816 000 Norwegians mainly consists of medicalproblems, where the majority of the patients have a non-life-threatening situation. More focus on the emergencysystem outside hospitals, including triage and dispatch, and how to best deal with “everyday” emergency problemsis needed to secure knowledge based decisions for the future organization of the emergency system.IntroductionPersons in need of acute medical assistance are sup-posed to come in contact with the emergency care sys-tem by calling a three digits emergency number (113) toan emergency medical dispatch centre (EMCC). The 19EMCCs are responsible for alarming the out-of-hospitalsemergency resources like ambulances services (groundand air) and primary care doctors on-call.For all calls to an EMCC, trained nurses use The Nor-wegian Index of Medical Emergencies (Index) [1] toclassify the medical problem into one of three differentlevels of response; green, yellow and red, the latter indi-cating immediate need of help (potentially or a manifestlife-threatening situation). When an emergency situationis classified as red, there will be transmitted a simulta-neous radio alarm from the EMCC to doctors on-calland the ambulances in the relevant area.Even though emergency medicine is considered animportant part of the health care system, little is knownabout the incidence and management of medical* Correspondence: Population Demography Population Demography Bởi: OpenStaxCollege Populations are dynamic entities Populations consist all of the species living within a specific area, and populations fluctuate based on a number of factors: seasonal and yearly changes in the environment, natural disasters such as forest fires and volcanic eruptions, and competition for resources between and within species The statistical study of population dynamics, demography, uses a series of mathematical tools to investigate how populations respond to changes in their biotic and abiotic environments Many of these tools were originally designed to study human populations For example, life tables, which detail the life expectancy of individuals within a population, were initially developed by life insurance companies to set insurance rates In fact, while the term “demographics” is commonly used when discussing humans, all living populations can be studied using this approach Population Size and Density The study of any population usually begins by determining how many individuals of a particular species exist, and how closely associated they are with each other Within a particular habitat, a population can be characterized by its population size (N), the total number of individuals, and its population density, the number of individuals within a specific area or volume Population size and density are the two main characteristics used to describe and understand populations For example, populations with more individuals may be more stable than smaller populations based on their genetic variability, and thus their potential to adapt to the environment Alternatively, a member of a population with low population density (more spread out in the habitat), might have more difficulty finding a mate to reproduce compared to a population of higher density As is shown in [link], smaller organisms tend to be more densely distributed than larger organisms Art Connection 1/10 Population Demography Australian mammals show a typical inverse relationship between population density and body size As this graph shows, population density typically decreases with increasing body size Why you think this is the case? Population Research Methods The most accurate way to determine population size is to simply count all of the individuals within the habitat However, this method is often not logistically or economically feasible, especially when studying large habitats Thus, scientists usually study populations by sampling a representative portion of each habitat and using this data to make inferences about the habitat as a whole A variety of methods can be used to sample populations to determine their size and density For immobile organisms such as plants, or for very small and slow-moving organisms, a quadrat may be used ([link]) A quadrat is a way of marking off square areas within a habitat, either by staking out an area with sticks and string, or by the use of a wood, plastic, or metal square placed on the ground After setting the quadrats, researchers then count the number of individuals that lie within their boundaries Multiple quadrat samples are performed throughout the habitat at several random locations All of this data can then be used to estimate the population size and population density within the entire habitat The number and size of quadrat samples depends on the type of organisms under study and other factors, including the density of the organism For example, if sampling daffodils, a m2 quadrat might be used whereas with giant redwoods, which are larger and live much further apart from each other, a larger quadrat of 100 m2 might be employed This ensures that enough individuals of the species are counted to get an accurate sample that correlates with the habitat, including areas not sampled 2/10 Population Demography A scientist uses a quadrat to measure population size and density (credit: NPS Sonoran Desert Network) For mobile organisms, such as mammals, birds, or fish, a technique called mark and recapture is often used This method involves marking a sample of captured animals in some way (such as tags, bands, paint, or other body markings), and then releasing them back into the environment to allow them to mix with the rest of the population; later, a new sample is collected, including some individuals that are marked (recaptures) and some individuals that are unmarked ([link]) Mark and recapture is used to measure the population size of mobile animals such as (a) bighorn sheep, (b) the California condor, and (c) salmon (credit a: modification of work by Neal Herbert, NPS; credit b: modification of work by Pacific Southwest Region USFWS; credit c: modification of work by Ingrid Taylar) Using the ratio of marked and unmarked individuals, scientists determine how many individuals are in the sample From this, calculations are used to estimate the total population size This method assumes that the larger the population, the lower the percentage of ...RESEARCH Open AccessHigh blood pressure, antihypertensive medicationand lung function in a general adult populationEva Schnabel1,2*, Stefan Karrasch3,4,5, Holger Schulz1,3,5, Sven Gläser6, Christa Meisinger7,11, Margit Heier7,11,Annette Peters8,11, H-Erich Wichmann1,8, Jürgen Behr5,9, Rudolf M Huber5,10and Joachim Heinrich1, forfor the Cooperative Health Research in the Region of Augsburg (KORA) Study GroupAbstractBackground: Several studies showed that blood pressure and lung function are associated. Additionally, apotential effect of antihypertensive medication, especially beta-blockers, on lung function has been discussed.However, side effects of beta-blockers have been investigated mainly in patients with already reduced lungfunction. Thus, aim of this analysis is to determine whether hypertension and antihypertensive medication have anadverse effect on lung function in a general adult population.Methods: Within the population-based KORA F4 study 1319 adults aged 40-65 years performed lung function testsand blood pressure measurements. Additionally, information on anthropometric measurements, medical historyand use of antihypertensive medication was available. Multivariable regression models were applied to study theassociation between blood pressure, antihypertensive medication and lung function.Results: High blood pressure as well as antihypertensive medication were associated with lower forced expiratoryvolume in one second (p = 0.02 respectively p = 0.05; R2: 0.65) and forced vital capacity values (p = 0.01respectively p = 0.05, R2: 0.73). Furthermore, a detailed analysis of antihypertensive medication pointed out thatonly the use of beta-blockers was associated with reduced lung function, whereas other antihypertensivemedication had no effect on lung function. The adverse effect of beta-blockers was significant for forced vitalcapacity (p = 0.04; R2: 0.65), while the association with forced expiratory volume in one second showed a trendtoward significance (p = 0.07; R2: 0.73). In the same model high blood pressure was associated with reducedforced vital capacity (p = 0.01) and forced expiratory volume in one second (p = 0.03) values, too.Conclusion: Our analysis indicates that both high blood pressure and the use of beta-blockers, but not the use ofother antihypertensive medication, are associated with reduced lung function in a general adult population.BackgroundHypertension is an increasingly important public healthchallenge worldwide and it is one of the major causesfor morbidity and mortality [1]. Thus, the National HighBlood Pressure Education Program reports that the glo-bal burden of hypertension is approximately 1 billionindividuals and that more than 7 million deaths per yearmay be attributable to hypertension [2].Moreover, hypertension has been linked to multipleother diseases including cardiac, cerebrovascular, renaland eye diseases [3]. Beside the well-established associa-tion between hypertension and vascular comorbidities,several studies showed that blood pressure and lung func-tion are associated [4-9]. It could be demonstrated thathigher forced vital capacity (FVC) is a negative predictorof developing hypertension [7,8]. Moreover, some studiesfound an association between reduced pulmonary func-tion, including both low FVC and low forced expiratoryvolume in one second (FEV1), and hypertension [5,9,6].Furthermore,thereareanumber of publications dis-cussing the controversial Int. J. Med. Sci. 2011, 8 http://www.medsci.org 68 IInntteerrnnaattiioonnaall JJoouurrnnaall ooff MMeeddiiccaall SScciieenncceess 2011; 8(1):68-73 â Ivyspring International Publisher. All rights reserved. Research Paper Two-year Outcome of Turkish Patients Treated with Zotarolimus Versus Paclitaxel Eluting Stents in an Unselected Population with Coronary Artery Disease in the Real World: A Prospective Non-randomized Registry in Southern Turkey Davran ầiỗek1,, Hasan Pekdemir2, Cevahir Haberal1, Nihat Kalay3, Sỹleyman Binici4, Hakan Altay4, Haldun Mỹderrisolu5 1. Bakent University School of Medicine, Department of Cardiology, Antalya; 2. nửnỹ University School of Medicine, Department of Cardiology, Malatya; 3. Erciyes University School of Medicine, Department of Cardiology, Kayseri; 4. Bakent University School of Medicine, Department of Cardiology, Adana; 5. Bakent University School of Medicine, Department of Cardiology, Ankara. Corresponding author: Dr. Davran Cicek, Bakent University School of Medicine, Department of Cardiology, Alanya/Antalya/Turkey. Tel: +90 532 3336466, Fax: +902425115563. E-mail: davrancicek@mynet.com Received: 2010.06.18; Accepted: 2011.01.01; Published: 2011.01.08 Abstract Background: Our purpose was to investigate the clinical outcomes of Zotarolimus- and Paclitaxel-eluting stents in Turkish patients with coronary artery disease (CAD). In general, the outcome of drug-eluting stent (DES) placement has a proven efficacy in randomized trials. However, the difference in efficacy between the Zotarolimus and Paclitaxel-eluting stents in unselected Turkish patients is controversial. Therefore, we investigated the clinical outcomes of these two drug-eluting stents in the real-world. Methods: We created a registry and prospectively analyzed data on a consecutive series of all patients who presented to our institution with symptomatic coronary artery disease between February 2005 and March 2007 and who were treated with the zotarolimus- o r t h e paclitaxel-eluting stent. The follow-up period was approximately two years. The primary end-point was major cardiac events, and the secondary end-point was definite stent thrombosis. Informed consent was obtained from all subjects, and the study protocol was approved by the local ethical committee. Results: In total, 217 patients were treated with either the zotarolimus-eluting stent (n = 116) or the paclitaxel-eluting stent (n = 101). The lesions in the 2 arms of the study were treated similarly by conventional technique. At 24-month follow-up the paclitaxel-eluting stent group showed significantly higher non-Q wave myocardial infarction (2.6% vs 5.9%, p: 0.02), Q wave myocardial infarction (1.7% vs 5.9%, p: 0.049), coronary artery binding graft surgery (2.6% vs 6.9%, p: 0.002), and late stent thrombosis (1.7% vs 3.9%, p: 0.046). Conclusions: Zotarolimus-eluting stents demonstrated better clinical outcomes than Pac-litaxel-eluting stents in a daily routine practice of coronary intervention in an unselected Turkish population. Key words: coronary artery disease, drug-eluting stent, major Int. J. Med. Sci. 2010, 7 http://www.medsci.org 391 IInntteerrnnaattiioonnaall JJoouurrnnaall ooff MMeeddiiccaall SScciieenncceess 2010; 7(6):391-394 © Ivyspring International Publisher. All rights reserved Research Paper Prevalence of Overactive Bladder, its Under-Diagnosis, and Risk Factors in a Male Urologic Veterans Population Wellman W Cheung1, William Blank1, Dorota Borawski1, William Tran1, Martin H Bluth2 1. SUNY Downstate Medical School, Department of Urology, Brooklyn, NY, USA 2. Wayne State University School of Medicine, Department of Pathology , Detroit, MI, USA  Corresponding author: Wellman W Cheung, MD, SUNY Downstate Medical Center, Departments of Urology and Ob-stetrics/Gynecology, 450 Clarkson Avenue, Brooklyn, NY 11230. Email: wellman.cheung@downstate.edu Received: 2010.04.04; Accepted: 2010.09.09; Published: 2010.11.12 Abstract Purpose: We assess the prevalence of overactive bladder (OAB) a n d i t s r i s k f actors i n a m a l e urologic veterans population. Materials and Methods: Validated self-administered question-naire was prospectively given. Results: Among 1086 patients, OAB was present in 75%, of which 48% had not been diagnosed/treated. The risk of OAB increased with age. OAB was not associated with BMI, smoking, race, diabetes, CHF, and COPD. Conclusions: The pre-valence of OAB in this population is under-diagnosed and under-treated. Key words: overactive bladder, OAB, incontinence, male, urology, veterans INTRODUCTION Recent international population and non-population studies reported overactive bladder (OAB) in 10-17% of the adult population, depending on sex.1,2,3,4 In the U.S., a population-based study re-ported that 16.0% of men and 16.9% of women expe-rienced OAB.5 No study has examined the prevalence of OAB in the urologic population, which is expected to be much higher. Some studies have reported asso-ciation of OAB with age (men and women), body mass index - BMI (female), menopause (female), con-stipation (female), episiotomy (female), and beer consumption (men). 2, 6,7,8 In this prospective cohort study, we assess the prevalence of OAB in urologic male veterans popula-tion, the need for OAB screening, and risk factors for OAB. METHODS An IRB-approved self-administered question-naire on urinary symptoms was given to male pa-tients who visited the general urology outpatient clinic at a Veterans Administration hospital in Brooklyn, NY. It included questions on lower urinary tract symptoms (LUTS) with 0-5 point scale and on quality of life with 0-6 (best to worst) point scale (based on a modified validated Overactive Bladder 8-question Screener (OAB-V8)9). Questions on LUTS included urinary frequency (2 questions), urgency (2), nocturia (1), incontinence (2) and emptying (1). The questionnaire also included medical and surgical history, demographic data, BMI, medications and visit diagnosis. OAB-V8 total score that was equal to or greater than 6 for men was defined as OAB positive. Subse-q u e n t questionnaires from the same patient were ex-cluded. To determine the relationship between OAB and other factors (age, BMI, smoking, race, diabetes, hypertension, congestive heart failure, chronic ob-structive pulmonary disease, diuretic medications and hepatitis), covariates were first individually eva-luated using the chi-square test. Int. J. Med. Sci. 2010, 7 http://www.medsci.org 191IInntteerrnnaattiioonnaall JJoouurrnnaall ooff MMeeddiiccaall SScciieenncceess 2010; 7(4):191-196 â Ivyspring International Publisher. All rights reserved Research Paper Efficacy of Sirolimus-Eluting Stents Compared With Paclitaxel-Eluting Stents in an Unselected Population With Coronary Artery Disease: 24-Month Outcomes of Patients in a Prospective Non-randomized Registry in South-ern Turkey Davran ầiỗek1, Hasan Pekdemir2, Nihat Kalay3 , Sỹleyman Binici4, Hakan Altay4, Haldun Mỹderrisolu5 1. Bakent University School of Medicine, Department of Cardiology, Antalya, Turkey; 2. nửnỹ University School of Medicine, Department of Cardiology, Malatya, Turkey; 3. Erciyes University School of Medicine, Department of Cardiology, Kayseri, Turkey; 4. Bakent University School of Medicine, Department of Cardiology, Adana, Turkey; 5. Bakent University School of Medicine, Department of Cardiology, Ankara, Turkey Corresponding author: Davran Cicek, Bakent University School of Medicine, Department of Cardiology, Alanya/Antalya/Turkey, Tel: +90 532 3336466, Fax: +902425115563. E-mail: davrancicek@mynet.com Received: 2010.04.27; Accepted: 2010.06.04; Published: 2010.06.10 Abstract Background: The efficacy of drug-eluting stents has been shown in randomized trials, but some controversy exists regarding which stent sirolimus-eluting or paclitaxel-eluting is more effective in unselected Turkish patients. Therefore, we investigated the clinical outcomes of patients who were treated with one type of these drug-eluting stents in the real world. Methods: We created a registry and prospectively analyzed data on a consecutive series of all patients who presented to our institution with symptomatic coronary artery disease between February 2005 and March 2007 and who were treated with the sirolimus- or the paclitaxel-eluting stent. The follow-up period after stent implantation was approximately 24 months. The primary end point was a major cardiac event, and the secondary end point was stent thrombosis. Informed consent was obtained from all subjects, and the study protocol was approved by the local ethical committee. Results: In total, 204 patients were treated with either the sirolimus-eluting stent (n = 103) or the paclitaxel-eluting stent (n = 101). The lesions in the 2 arms of the study were treated similarly by conventional technique. At 24-month follow-up, patients who received the pac-litaxel-eluting stent showed significantly higher rates of nonQ-wave myocardial infarction (1.9% vs 5.9%; P: .002), target vessel revascularization (1.9% vs 4.9%; P: .002), coronary artery bypass graft surgery (1.9% vs 6.9%; P: .001), and late stent thrombosis (1.9% vs 3.9%, P: .002). Conclusions: Patients who received the sirolimus-eluting stent showed better clinical outcomes compared with those who had the paclitaxel-eluting-stent. Key words: coronary artery disease, drug-eluting stent, major adverse cardiac event, stent throm-bosis. INTRODUCTION Because of their association with decreased in-cidents of restenosis and repeat intervention, the siro-limus-eluting stent (SES)1 and the paclitaxel-eluting stent (PES)2 have been shown to be superior to the bare-metal stent. Along with the accumulation of clinical experiences, drug-eluting stents increasingly have been used for more complex ... Rebecca Wood) Demography While population size and density describe a population at one particular point in time, scientists must use demography to study the dynamics of a population Demography. .. the population size (N) using the following equation: (number marked first catch x total number of second catch) =N number marked second catch 3/10 Population Demography Using our example, the population. . .Population Demography Australian mammals show a typical inverse relationship between population density and body size As this graph shows, population density typically