Silvana Nunes de Queiroz, Rosana Baeninger, Ricardo Monteiro de Carvalho
O Nordeste do Brasil é conhecido como uma região de grandes perdas populacionais nas migrações internas. Contudo, a partir dos anos de 1990 constata-se o arrefecimento da emigração interna, conjuntamente com a chegada de migrantes internacionais, em especial no século XXI. Assim, o objetivo deste estudo é analisar a imigração internacional e o perfil dos imigrantes com registros, procedentes dos países de língua portuguesa, residentes nos estados do Nordeste, entre 2010 e 2023. O contexto teórico se baseia no sistema migratório lusófono, nas migrações Sul-Sul e nos espaços-tampões das migrações internacionais no Brasil. A principal fonte de informações é o Sistema de Registro Nacional Migratório (Sis-Migra) do Departamento da Polícia Federal. Os resultados mostram Portugal, Guiné Bissau e Angola como os países com mais imigrantes registrados e residentes no Nordeste, sendo que os estados em destaques são Ceará, Bahia e Pernambuco. Evidencia-se que, no século XXI, a região Nordeste se configura como um espaço-tampão interno das migrações internacionais para países lusófonos, com exceção de Portugal.
Social Sciences, Demography. Population. Vital events
The objective of this article is to make a historical journey of Honduran youth from the 19th century to
the year 2018. Similarly, to contextualize this population from demography, legal and institutional. To
achieve the above, a documentary review of the contributions made by previous research was carried
out, which describes the agreements, legislation and statistical data of the National Institute of Statistics
(ine). Based on the above, it was possible to show that the existing studies on the subject have distanced
themselves from cultural interests and have insisted on employment issues. The latter, together with the
issue of education and security, has been a problem that national youth have historically faced.
The introduction of artificial intelligence in all domains of life is the most transformative process in recent history. It is also a highly dynamic process, and due to the pace of technological development, a very limited legal framework is available to address issues of human rights, ethics, transparency, privacy, safety and accountability. During the last few years, artificial intelligence started to reshape employment processes. Positive aspects of the introduction of AI in the employment process are efficiency and quality in job matching, digitalisation and acceleration of the process, ability to process large data and match job seekers to available vacancy announcements, the alleviation of administrative burdens of employees of employment agencies and giving them strategic and innovative roles. All these are indispensable in present times when demographic challenges in European countries are leading to increased labour migrations and require changes in the recruitment process. The paper explores the current challenges of AI, i.e. how to achieve human-centred values and fairness of AI use during the employment process, preventing algorithmic bias and discriminatory application of AI tools. In order to harness the maximum benefits of AI, we need to develop a regulatory framework that would be enforceable, inclusive and adaptive (OECD), particularly knowing that most AI solutions are privately owned and developed for commercial purposes.
Themba Mutemaringa, Alexa Heekes, Mariette Smith
et al.
Introduction
The Patient Master Index (PMI) plays an important role in management of patient information and epidemiological research, and the availability of unique patient identifiers improves the accuracy when linking patient records across disparate datasets. In our environment, however, a unique identifier is seldom present in all datasets containing patient information. Quasi identifiers are used to attempt to link patient records but sometimes present higher risk of over-linking. Data quality and completeness thus affect the ability to make correct linkages.
Aim
This paper describes the record linkage system that is currently implemented at the Provincial Health Data Centre (PHDC) in the Western Cape, South Africa, and assesses its output to date.
Methods
We apply a stepwise deterministic record linkage approach to link patient data that are routinely collected from health information systems in the Western Cape province of South Africa. Variables used in the linkage process include South African National Identity number (RSA ID), date of birth, year of birth, month of birth, day of birth, residential address and contact information. Descriptive analyses are used to estimate the level and extent of duplication in the provincial PMI.
Results
The percentage of duplicates in the provincial PMI lies between 10% and 20%. Duplicates mainly arise from spelling errors, and surname and first names carry most of the errors, with the first names and surname being different for the same individual in approximately 22% of duplicates. The RSA ID is the variable mostly affected by poor completeness with less than 30% of the records having an RSA ID.
The current linkage algorithm requires refinement as it makes use of algorithms that have been developed and validated on anglicised names which might not work well for local names. Linkage is also affected by data quality-related issues that are associated with the routine nature of the data which often make it difficult to validate and enforce integrity at the point of data capture.
Background
Evidence is limited on the non-medical factors influencing hospital length of stay (LOS) among paediatric inpatients with diabetes, notably potential social and policy correlates. This study aimed to characterize the associations of socioeconomic status and health policy environment with diabetes-attributable LOS to help inform accountability monitoring of a provincial comprehensive diabetes strategy aiming to minimize time in hospital among this high-risk population.
Data and methods
This retrospective population-based study drew on multiple linked administrative and geospatial databases among all children aged 18 and under with a diabetes-related hospitalization in the province of New Brunswick, Canada, during the four-year period following implementation of an insulin pump funding program. Multiple linear regression was used to assess the role of access to the public insulin pump resourcing scheme and relative neighbourhood deprivation as predictors of days spent in acute care, controlling for age, sex, and place of residence.
Results
Among the paediatric inpatient population (N=386), 21% had accessed social resources made available through the insulin pump funding policy and 42% resided in the most materially deprived neighbourhoods. Diabetes-related hospital stays averaged 3.87 days. Paediatric inpatients having accessed resources through the social insurance policy spent significantly fewer days in hospital (1.34 days less [95% CI: 0.63--2.05]) than those who had not, all else being equal. Observed differences in LOS by neighbourhood socioeconomic deprivation were not found to be statistically significant in the multivariate analysis.
Conclusion
Findings from this context of universal medical coverage suggested that public policy for supplemental financing of assistive technologies among children with diabetes may be associated with reduced burden to the hospital system. The causes of socioenvironmental disparities in LOS require further investigation to inform interventions to mitigate preventable patient-level variations in hospital-based health outcomes.
Mortality in Algeria has declined significantly since the country declared its independence in 1962. This trend has been accompanied by improvements in data quality and changes in estimation methodology, both of which are scarcely documented, and may distort the natural evolution of mortality as reported in official statistics. In this paper, our aim is to detect these methodological and data quality changes by means of the visual inspection of mortality surfaces, which represent the evolution of mortality rates, mortality improvement rates and the male-female mortality ratio over age and time. Data quality problems are clearly visible during the 1977–1982 period. The quality of mortality data has improved after 1983, and even further since the population census of 1998, which coincided with the end of the civil war. Additional inexplicable patterns have also been detected, such as a changing mortality age pattern during the period before 1983, and a changing pattern of excess female mortality at reproductive ages, which suddenly appears in 1983 and disappears in 1992.
The best nutrition for babies is breast milk. Breast milk should be given exclusively without any additions in the first six months. According to previous research, a woman’s age at marriage will affect the practice of exclusive breastfeeding to their babies, as young mothers are often not ready to have and care for babies. The work status of mothers also has a large impact on exclusive breastfeeding practices. The goal of this study was to discover the correlation between age at marriage and the work status of mothers with exclusive breastfeeding practices. This research was an observational study with the subjects being 94 mothers of children aged 0-5 years in Ngringinrejo Village, Kalitidu District, Bojonegoro Regency from 3 July to 9 August, 2019. This study used data from the professional placement activity or Praktik Kerja Lapangan (PKL) conducted by the students of the public health study program of Airlangga University. The outcome of this research showed that there was no meaningful relationship between the age of marriage of mothers and practices of exclusive breastfeeding (p-value = 0.973) and there is also no statistical relationship between the work status of mothers and exclusive breastfeeding practices (p-value = 0.276). However, it was discovered that mothers who gave exclusive breastfeeding were mostly not working, and mothers who did not breastfeed exclusively were mostly in employment. The conclusion of this research is the absence of a correlation between age at marriage and the work status of mothers with exclusive breastfeeding.
José Marcos Pinto da Cunha, Luiz Antonio Chaves de Farias, Alberto Augusto Eichman Jakob
Resumo O presente estudo tem dois objetivos principais: discutir os impactos, consequências e respostas demográficas do processo de expansão e estruturação de grandes aglomerações urbanas, com especial enfoque no caso do município de Praia Grande/SP na Região Metropolitana da Baixada Santista (RMBS); e examinar, com mais detalhes, as nuances da mobilidade populacional e, em particular, das modalidades migratórias (e suas características), como elementos importantes da peculiar inserção regional do referido município enquanto “periferia simultânea" de duas regiões metropolitanas. A partir do uso exaustivo dos dados censitários, em especial dos Censos Demográficos de 2000 e 2010, analisam-se o crescimento e a expansão territorial de Praia Grande, enfatizando, em nível intramunicipal, o papel das distintas modalidades de migração (intrametropolitana e inter-regional). Além disso, procura-se associá-las a diferentes motivações a partir de um olhar detalhado para o perfil sociodemográfico dos fluxos estabelecidos. Como principais resultados do trabalho, observou-se que o papel de Praia Grande enquanto área de expansão metropolitana da RMBS se encontra lastreado pelos crescentes fluxos migratórios intrametropolitanos provenientes do polo regional, realidade esta que igualmente pode ser vista em outros contextos metropolitanos. No entanto, enquanto peculiaridade de seu processo de ocupação e inserção regional, parte majoritária dessa migração é originária de fora da RMBS, mais precisamente do município de São Paulo, centro de outra importante área de metropolitana, fato que contribui para caracterizar Praia Grande como uma “periferia com dois centros”.
Lachlan L Dalli, Joosup Kim, Dominique A Cadilhac
et al.
Introduction
Despite being recommended in clinical guidelines for secondary prevention of stroke, there are limited real-world data on outcomes associated with use of statins post-stroke.
Objectives and Approach
We aimed to investigate the association between statin use and cardiovascular mortality post-stroke. We conducted a retrospective cohort study using prospectively collected data from the Australian Stroke Clinical Registry (2010-2014), linked with national medication dispensing and mortality data. We observed adult patients with first-ever ischaemic stroke or transient ischaemic attack (TIA) for 1-year following hospital discharge, or until their date of death, whichever occurred first. Statin use, defined as having an available statin dispensing, was assessed daily and treated as a time-varying exposure to account for patients who discontinued or reinitiated statins during follow-up. Multivariable, competing-risks regression, with non-cardiovascular death as the competing risk, was used to investigate the association between statin use and 1-year cardiovascular mortality.
Results
Among 8363 patients discharged following first-ever ischaemic stroke or TIA (48% aged ≥75 years, 45% female, 20% TIA, median length-of-stay 5 days), 945 died within 1 year, with 763 deaths being cardiovascular-related. The proportion of statin users was 65% at 90 days, 64% at 180 days, and 62% at 1 year. Groups least likely to be statin users at 1-year were women (odds ratio [OR]: 0.75; 95% CI: 0.67-0.85), patients aged <65 years (OR: 0.80; 95% CI: 0.69-0.92), and those discharged directly home (OR: 0.77; 95% CI: 0.67-0.88). Compared to non-use, use of statins was associated with a reduced risk of cardiovascular mortality within 1 year overall (sub-distribution hazard ratio [SHR]: 0.40; 95% CI: 0.34-0.46), and in sub-groups of patients with TIA, severe stroke, and advanced age.
Conclusion / Implications:
Our preliminary data provide evidence of survival benefits associated with post-stroke statin use. Interventions to improve medication adherence may assist in reducing post-stroke mortality.
El objetivo de este artículo es analizar las transformaciones en la proveeduría laboral de los hogares familiares suscitadas entre 2005 y 2017, es decir cuántos y cuáles miembros están colaborando, y sus relaciones con el cambio de la estructura por edad de la población. La fuente de datos es la Encuesta Nacional de Ocupación y Empleo, para el segundo trimestre de esos años. Los principales resultados muestran que ha aumentado el número de proveedores laborales por hogar, principalmente en las parejas sin hijos. Por otro lado, aunque la participación económica del jefe de hogar sigue siendo importante, se incrementó sustantivamente la presencia de hogares en los que las cónyuges colaboran con su sostenimiento económico. Para ambos años, la participación de hijos y otros miembros se encuentra en mayor medida en los hogares monoparentales con hijos y en los ampliados.
Social Sciences, Demography. Population. Vital events
Se analizan las actitudes de padres de familia sobre la igualdad de género en los roles y liderazgos familiares en los sectores urbano-populares de Tijuana, México. Se usa la Encuesta a Padres de Familia con Hijos en Escuelas Secundarias en Tijuana, B.C., 2015, con información para 2 560 padres con hijos e hijas en escuelas secundarias públicas. Se estiman cuatro índices sobre la igualdad de género en el rol materno, los roles domésticos y los liderazgos familiares, y se crean modelos de regresión logística. Los hallazgos indican la coexistencia de un gran valor asignado al rol de la maternidad en la vida de las mujeres, así como actitudes moderadamente entusiastas a favor de la igualdad de género en los roles domésticos, pero menos entusiastas respecto de compartir e intercambiar los liderazgos familiares. El nivel educativo de los padres muestra ser la única variable estadísticamente significativa en su asociación con los cuatro índices considerados.
Human settlements. Communities, Demography. Population. Vital events
ABSTRACT
Objectives
Electronic healthcare records (EHR) are the main data sources that facilitate epidemiology research. Routinely collected data such as primary and secondary care are now easily linked to produce novel and high impact research. There are, however, rich data locked in the free text of clinical letters that are not otherwise translated into EHRs. It is highly desirable to be able to extract this information to strengthen the body of information in existing EHRs.
The Swansea Collaborative in Analysis of NLP Research (SCANR) group at Swansea University has been established to evaluate the usage of Natural Language Processing platforms for obtaining new clinical data.
To use Clix Enrich to extract SNOMED concepts from a variety of clinical free texts and produce EHRs from the extraction process.
Approach
SNOMED concepts contain common items of interest such as diagnosis, medication and symptoms, as well as contextual concepts such as historical reference and negation. Clix Enrich uses the SNOMED dictionary to encode clinical free text (pre-co-ordinated) and find contextually correct SNOMED concepts (post co-ordinated). We used Clix Enrich to extract meaningful clinical terms from MS and Epilepsy consultant letters, as well as presenting complaint fields from a Welsh Emergency Department (ED).
Results
We tailored Clix Enrich to extract a wide variety of clinical terms from each source (fourty texts per source) and validated the extraction accuracy with clinical experts in each domain. Clix Enrich was able to accurately extract the correct diagnosis for MS, Epilepsy and ED attendance (100%, 95% and 80%), dosage and frequency of anti-epileptic medication and MS modifying therapy (90%, 100%) and EDDS score (94%). We note a probable source of discrepancy in extraction accuracy between letter sources in the frequency of abbreviated terms, particularly within the presenting complaint field of the ED sample.
Conclusion
Clix Enrich can be used to accurately extract SNOMED concepts from clinical letters. The resulting datasets are readily available to link to existing EHRs, and can be linked to EHRs that adopt the SNOMED coding structure, or backward compatible hierarchies. Clix Enrich comes with out-of-the-box extraction methods but the optimum way to extract the correct information would be to build in custom queries, thus requiring clinical expertise to validate extraction.
Abstract This article describes an explosion in the availability of individual-level population data. By 2018, demographic researchers will have access to over 2 billion records of accessible microdata from over 100 countries, dating from 1703 to the present. Another 2 to 4 billion records will be available through restricted-access data enclaves. These new resources represent a new kind of data that will enable transformative research on demographic and economic change and the spatial organization of society.
Rare long distance dispersal events are thought to have a disproportionate impact on the spread of invasive species. Modelling using integrodifference equations suggests that, when long distance contacts are represented by a fat-tailed dispersal kernel, an accelerating wave of advance can ensue. Invasions spreading in this manner could have particularly dramatic effects. Recently, various authors have suggested that demographic stochasticity disrupts wave acceleration. Integrodifference models have been widely used in movement ecology, and as such a clearer understanding of stochastic effects is needed. Here, we present a stochastic non-linear one-dimensional lattice model in which demographic stochasticity and the dispersal regime can be systematically varied. Extensive simulations show that stochasticity has a profound effect on model behaviour, and usually breaks acceleration for fat-tailed kernels. Exceptions are seen for some power law kernels, K(l)∝|l|-β with β<3, for which acceleration persists despite stochasticity. Such kernels lack a second moment and are important in 'accelerating' phenomena such as Lévy flights. Furthermore, for long-range kernels the approach to the continuum limit behaviour as stochasticity is reduced is generally slow. Given that real-world populations are finite, stochastic models may give better predictive power when long-range dispersal is important. Insights from mean-field models such as integrodifference equations should be applied with caution in such circumstances.
BackgroundDemographic and socioeconomic changes such as increasing urbanization, migration, and female education shape population health in many low- and middle-income countries. These changes are rarely reflected in computational epidemiological models, which are commonly used to understand population health trends and evaluate policy interventions. Our goal was to create a “backbone” simulation modeling approach to allow computational epidemiologists to explicitly reflect changing demographic and socioeconomic conditions in population health models.MethodsWe developed, evaluated, and “open-sourced” a generalized approach to incorporate longitudinal, commonly available demographic and socioeconomic data into epidemiological simulations, illustrating the feasibility and utility of our approach with data from India. We constructed a series of nested microsimulations of increasing complexity, calibrating each model to longitudinal sociodemographic and vital registration data. We then selected the model that was most consistent with the data (i.e., greater accuracy) while containing the fewest parameters (i.e., greater parsimony). We validated the selected model against additional data sources not used for calibration.ResultsWe found that standard computational epidemiology models that do not incorporate demographic and socioeconomic trends quickly diverged from past mortality and population size estimates, while our approach remained consistent with observed data over decadal time courses. Our approach additionally enabled the examination of complex relations between demographic, socioeconomic and health parameters, such as the relationship between changes in educational attainment or urbanization and changes in fertility, mortality, and migration rates.ConclusionsIncorporating demographic and socioeconomic trends in computational epidemiology is feasible through the “open source” approach, and could critically alter population health projections and model-based evaluations of health policy interventions in unintuitive ways.