The changing incidence of childhood epilepsy in Finland

INTRODUCTION

to investigate the childhood epilepsy incidence, population trends, associated factors, and validate the national population registers.

METHODS

a comprehensive comparative analysis of childhood epilepsy in the population during two distinct time intervals using medical records, appropriate national medical and population registers, and two random samples for control.

RESULTS

In 1961-1964, the average incidence of epilepsy was 38/100,000 and during 1991-2000 65.9 (95 % CI 59.6 to 72.2) and 65.6/100,000 person-years after adjustment for the European Standard Population. This increase was significant (p<0.0001) as was a decline (p<0.003) from 1991 to 1995 to 1996-2000. The decline in incidence for girls occurred at a younger age compared to boys. Epilepsy cases associated with prenatal and perinatal factors were 50 % lower in 1991-2000 than in 1961-1964, especially related to asphyxia, infections, pre-eclampsia, and imminent abortion. The national Register for Healthcare independently identified 94.5 % of relevant cases (University Hospital alone 81.2 %, and Drug Register alone 74.3 %).

DISCUSSION

Over the past five decades, the incidence rate of childhood epilepsy has exhibited a dynamic pattern, with a notable increase until the 1990's, followed by a stabilization at an incidence rate of approximately 60-70 per 100,000 person-years. Our findings, in line with other recent Finnish research, support a significant decrease in incidence since the mid-1990's. The underlying reasons for the increase and decrease remain unclear. Finnish national registers for epilepsy have established themselves as highly dependable resources for conducting epidemiological research.

CONCLUSION

Childhood epilepsy incidence in Finland is similar to other industrialized countries, but there are signs of a declining trend emerging.

Fair concordance between Google Trends and Danish ornithologists in the assessment of temporal trends in Danish bird populations highlights the informational value of big data

The ongoing depletion of natural systems and associated biodiversity decline is of growing international concern. Climate change is expected to exacerbate anthropogenic impacts on wild populations. The scale of impact on ecosystems and ecosystem services will be determined by the impact on a multitude of species and functional groups, which due to their biology and numbers are difficult to monitor. The IPCC has argued that surveillance or monitoring is critical and proposed that monitoring systems should be developed, which not only track developments but also function as "early warning systems." Human populations are already generating large continuous datasets on multiple taxonomic groups through internet searches. These time series could in principle add substantially to current monitoring if they reflect true changes in the natural world. We here examined whether information on internet search frequencies delivered by the Danish population and captured by Google Trends (GT) appropriately informs on population trends in 106 common Danish bird species. We compared the internet search activity with independent equivalent population trend assessments from the Danish Ornithological Society (BirdLife Denmark/DOF). We find a fair concordance between the GT trends and the assessments by DOF. A substantial agreement can be obtained by omitting species without clear temporal trends. Our findings suggest that population trend proxies from internet search frequencies can be used to supplement existing wildlife population monitoring and to ask questions about an array of ecological phenomena, which potentially can be integrated into an early warning system for biodiversity under climate change.

Temporal trends of land-use favourability for the strongly declining little bustard: assessing the role of protected areas

The little bustard (Tetrax tetrax) is a steppe bird strongly and negatively influenced by agricultural intensification in Europe. Here, we use the little bustard as a model species to examine how favourability (relative occurrence likelihood of a species based on environmental characteristics, such as habitat availability) varies regionally with degree of protection in north-western Spain. The Natura2000 network is one of the main biodiversity conservation tools of the European Union, aiming to protect areas hosting species of conservation concern from unfavourable land-use changes. The network covers many landscapes across the continent, including farmland. Additionally, we examine the relationship between trends in land-use favourability and little bustard population trends over a decade in the Nature Reserve of Lagunas de Villafáfila, a protected area also in the Natura2000 network where active and intense management focused on steppe bird conservation is carried out. Favourability was much greater in Villafáfila than in both protected areas with lower degree of protection and in non-protected areas. Land-use favourability increased slightly between 2011 and 2020 both in and out of protected areas, whereas little bustard populations declined sharply in that period, even in Villafáfila. Spatial variations in little bustard abundance within Villafáfila depended on social attraction (increasing with the number of neighbouring males) but not significantly on small-scale variations in land-use favourability. These results suggest that land-use management in Natura2000 areas needs to be more conservation-focused, favouring natural and seminatural habitats and traditional farming practices to improve land-use favourability for little bustards and other steppe birds. Additional factors, such as field-level agricultural management or social interaction variables that may cause an Allee effect, should be incorporated in little bustard favourability models to improve their use in conservation planning.

Forced intercourse in America: a pandemic update

BACKGROUND

Measures of forced intercourse from the U.S. National Center for Health Statistics (NCHS) indicate high prevalence among U.S. women, which is likely to produce unintended pregnancies. However, NCHS did not measure forced intercourse during the pandemic, limiting knowledge of recent prevalence rates.

METHODS

We use multiple nationally-representative, cross-sectional surveys representing the U.S. population from 2011 to 2022 to document these trends. This includes measures from the National Survey of Family Growth, the Panel Study of Income Dynamics Transition into Adulthood Supplement, and the American Family Health Study (AFHS) to provide population estimates of forced intercourse.

RESULTS

Reports of forced intercourse remained high during the pandemic, with more than 25% of U.S. females over 40 reporting lifetime forced intercourse in the AFHS (number of females in AFHS: 1,042). There was a significant increase among females aged 24-28 (p < 0.05) and rates are highest for those who did not complete college. Among females 24-28, 32.5% (S.E. = 5.7%) with less than 4 years of college reported forced intercourse, a significantly (p < 0.05) higher rate than among those with a higher level of education.

CONCLUSIONS

Rates of forced intercourse among U.S. women remained high during the pandemic, increasing significantly in early adulthood. This exposure to forced intercourse is likely to produce an increase in unintended pregnancies and other sexual, reproductive, and mental health problems.

Demographics and Oral Health Care Utilization for Older Adults

The population of older adults is projected to increase dramatically as Baby Boomers continue to reach age 65 into 2029. This article discusses key shifts in this demographic, including changes in overall health status and living arrangements, that can aid in defining older adults and their medical needs. It also highlights the changes in dental use patterns and the increase in demand for comprehensive dental services for older adults in recent years. The article focuses on the fact that oral health contributes to overall health and the dental workforce must be prepared to treat older adults in their practices.

Impact on emergency and elective hospital-based care in Scotland over the first 12 months of the pandemic: interrupted time-series analysis of national lockdowns

OBJECTIVES

COVID-19 has resulted in the greatest disruption to National Health Service (NHS) care in its over 70-year history. Building on our previous work, we assessed the ongoing impact of pandemic-related disruption on provision of emergency and elective hospital-based care across Scotland over the first year of the pandemic.

DESIGN

We undertook interrupted time-series analyses to evaluate the impact of ongoing pandemic-related disruption on hospital NHS care provision at national level and across demographics and clinical specialties spanning the period 29 March 2020-28 March 2021.

SETTING

Scotland, UK.

PARTICIPANTS

Patients receiving hospital care from NHS Scotland.

MAIN OUTCOME MEASURES

We used the percentage change of accident and emergency attendances, and emergency and planned hospital admissions during the pandemic compared to the average admission rate for equivalent weeks in 2018-2019.

RESULTS

As restrictions were gradually lifted in Scotland after the first lockdown, hospital-based admissions increased approaching pre-pandemic levels. Subsequent tightening of restrictions in September 2020 were associated with a change in slope of relative weekly admissions rate: -1.98% (-2.38, -1.58) in accident and emergency attendance, -1.36% (-1.68, -1.04) in emergency admissions and -2.31% (-2.95, -1.66) in planned admissions. A similar pattern was seen across sex, socioeconomic status and most age groups, except children (0-14 years) where accident and emergency attendance, and emergency admissions were persistently low over the study period.

CONCLUSIONS

We found substantial disruption to urgent and planned inpatient healthcare provision in hospitals across NHS Scotland. There is the need for urgent policy responses to address continuing unmet health needs and to ensure resilience in the context of future pandemics.

Trends and characteristics of hospitalisations from the harmful use of opioids in England between 2008 and 2018: Population-based retrospective cohort study

Objective

To examine the trends and characteristics of opioid-related hospital admissions in England over 10 years, and its burden for the National Health Service and public finances.

Design

Patient-level data from the Hospital Episode Statistics database to examine all opioid-related hospitalisations from 2008 to 2018, stratified by type of opioid admission and patient demographics.

Setting

All National Health Service hospitals in England.

Participants

Patients hospitalised from the harmful use of opioids.

Main outcome measures

The number of opioid-related hospitalisations, length of stay, in-hospital mortality, 30-day readmission rate and treatment costs.

Results

Opioid-related hospitalisations increased by 48.9%, from 10,805 admissions in 2008 to 16,091 admissions in 2018, with total treatment costs of £137 million. The growth in opioid-related hospitalisations was 21% above the corresponding rate for all other emergency admissions in England. Relative changes showed that hospitalisations increased most for individuals older than 55 years (160%), those living in the most affluent areas of England (93.8%), and suffering from four co-morbidities (627.6%) or more. Hospitals reduced mean patient length of stay from 2.8 days to 1.1 days over 10 years. Mean in-hospital mortality was 0.4% and mean 30-day readmission risk was 16.6%.

Conclusion

Opioid use is an increasing public health concern in England, though hospitalisation and mortality rates are less pronounced than in other countries. There are concerns about significant rises in hospitalisations from older, less deprived and sicker population groups. Our findings should prompt policymakers to go beyond monitoring mortality statistics when assessing the impacts of harmful use of opioids.

How animals distribute themselves in space: energy landscapes of Antarctic avian predators

BACKGROUND

Energy landscapes provide an approach to the mechanistic basis of spatial ecology and decision-making in animals. This is based on the quantification of the variation in the energy costs of movements through a given environment, as well as how these costs vary in time and for different animal populations. Organisms as diverse as fish, mammals, and birds will move in areas of the energy landscape that result in minimised costs and maximised energy gain. Recently, energy landscapes have been used to link energy gain and variable energy costs of foraging to breeding success, revealing their potential use for understanding demographic changes.

METHODS

Using GPS-temperature-depth and tri-axial accelerometer loggers, stable isotope and molecular analyses of the diet, and leucocyte counts, we studied the response of gentoo (Pygoscelis papua) and chinstrap (Pygoscelis antarcticus) penguins to different energy landscapes and resources. We compared species and gentoo penguin populations with contrasting population trends.

RESULTS

Between populations, gentoo penguins from Livingston Island (Antarctica), a site with positive population trends, foraged in energy landscape sectors that implied lower foraging costs per energy gained compared with those around New Island (Falkland/Malvinas Islands; sub-Antarctic), a breeding site with fluctuating energy costs of foraging, breeding success and populations. Between species, chinstrap penguins foraged in sectors of the energy landscape with lower foraging costs per bottom time, a proxy for energy gain. They also showed lower physiological stress, as revealed by leucocyte counts, and higher breeding success than gentoo penguins. In terms of diet, we found a flexible foraging ecology in gentoo penguins but a narrow foraging niche for chinstraps.

CONCLUSIONS

The lower foraging costs incurred by the gentoo penguins from Livingston, may favour a higher breeding success that would explain the species' positive population trend in the Antarctic Peninsula. The lower foraging costs in chinstrap penguins may also explain their higher breeding success, compared to gentoos from Antarctica but not their negative population trend. Altogether, our results suggest a link between energy landscapes and breeding success mediated by the physiological condition.

Demographics and Oral Health Care Utilization for Older Adults

The population of older adults is projected to increase dramatically as Baby Boomers continue to reach age 65 into 2029. This article discusses key shifts in this demographic, including changes in overall health status and living arrangements, that can aid in defining older adults and their medical needs. It also highlights the changes in dental use patterns and the increase in demand for comprehensive dental services for older adults in recent years. The article focuses on the fact that oral health contributes to overall health and the dental workforce must be prepared to treat older adults in their practices.

Demographics in Rural Populations

This article reviews key population trends affecting rural American health. The article explains the role of demography in defining and studying rural health using example data from the 2014 to 2018 American Community Survey. Specific trends, including depopulation, aging, racial/ethnic diversification, socioeconomic status, and health characteristics found in rural areas, are highlighted. Insights are offered into how population trends, changing age and sex structures, and socioeconomic distributions have implications for rural health care practitioners and surgeons. Several areas and opportunities to address current and future rural health needs are identified.

Do population trends in adolescent electronic cigarette use coincide with changes in prevalence of cigarette smoking?

Adolescents who initiate electronic cigarette (EC) use without having ever used tobacco are more likely than those that have not initiated EC use to try cigarette smoking over time. However, whether rates of EC use coincide with cigarette smoking rates at the population level remains unknown. This study aimed to compare trends in ever, current, and daily use of EC and cigarette smoking among adolescents in Iceland from 2015 to 2018. We analyzed four waves of pooled cross-sectional population-based school survey data with students enrolled in the 8th, 9th and 10th grades in the national Icelandic school system (n = 42,440, boys = 50.1%). Response rates ranged between 83.3% and 86.0%. Findings for 8th, 9th, and 10th grade students, and the combined sample, revealed a consistent pattern: prevalence of cigarette smoking either remained unchanged or decreased minimally over the study period. In the combined sample rates of ever smoking remained between 9 and 10% during the entire study period, whereas the prevalence of daily cigarette smoking was around 1%. The use of EC increased 2- to 3-fold in all age groups. Ever use increased from 12% to roughly 30% in the combined group and daily use increased from about 2% to 6% during the same period. We conclude that the prevalence of adolescent cigarette smoking in Iceland remained mostly unchanged between the years 2015 and 2018, whereas EC use increased exponentially during the same period. The prevalence of EC use now far outweighs cigarette smoking in 8th–10th grade youth in Iceland.

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Trends in adolescent e-cigarette use and cigarette smoking, 2015–2018, is reported.

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Cigarette smoking remained mostly unchanged during the study period.

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E-cigarette use increased exponentially in all age groups during the study period.

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E-cigarette use now far outweighs cigarette smoking among youth in Iceland.

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Over 40% of 10th grade students have tried e-cigarettes and 10% are daily users.

General population estimates of the association between college experience and the odds of forced intercourse

Sexual assault on college campuses is a pervasive problem, recently receiving increased scientific and policy attention. However, the high focus on college student experience ignores general population prevalence, trends, and differences between those with college experience and those without. We analyze measures from the National Survey of Family Growth (NSFG) to provide a general population view of experiences with forced intercourse. Forced intercourse is a common experience in the U.S. population, has remained stable in recent years, and varies greatly by gender, age and race. The odds of forced intercourse are also significantly higher among those with less than four years of college. This ubiquitous public health problem is not limited to college campuses. Measures from the NSFG are an important resource for understanding population rates of (and trends in) forced intercourse, providing information to guide interventions and better target scientific investigation.

Trends in Volunteer Mentoring in the United States: Analysis of a Decade of Census Survey Data

Over the past decade, considerable resources have been devoted to recruiting volunteer mentors and expanding mentoring programs. It is unclear whether these efforts have helped to counter the broader national trends of declining volunteer rates. The current study uses data from the Volunteering Supplement of the Current Population Survey (CPS), sponsored by the U.S. Census Bureau and U.S. Bureau of Labor Statistics, to explore population-level trends in mentoring over the past decade. Results suggest that mentoring rates have remained relatively stable over the past decade, but that the population of mentors has changed somewhat in terms of age, ethnicity, educational background, and region of the United States. In addition, certain sectors of the mentor population show higher rates of attrition from 1 year to the next. Findings have important implications for the development of recruitment, training, and mentor support practices within mentoring organizations, as well as policies designed to meet the needs of at-risk youth in the U.S.

Adolescent adaptation before, during and in the aftermath of the Great Recession in the USA

This study examines the impact of the "Great Recession" (from December 2007 to June 2009) on 8th and 10th graders in the USA, using annual nationally representative data from the Monitoring the Future study. Historical changes in youth adjustment (self-esteem, depressed mood, risk taking, aggression and property crime), school achievement (grade point average [GPA], time spent on homework and educational expectations) and structured and unstructured activities (volunteering, employment, sports and evenings out for fun) were examined between 1991 and 2014. Overall, there were only slight changes in mean levels of adjustment, achievement and most youth activities. However, the percentage of youth working during the school year did decline during the Great Recession. Several longer-term trends were also evident, though not directly tied to the Great Recession. These include an increase in GPA, a decrease in time spent on homework, rising educational expectations and more time spent volunteering. Future work should assess how the shift to unpaid work activities (e.g. volunteering and internships) among youth is impacting the transition from school to work in the contemporary economy, and whether the Great Recession had deleterious impacts for younger children or among youth whose parents lost work or had their homes foreclosed.

Count trends for migratory Bald Eagles reveal differences between two populations at a spring site along the Lake Ontario shoreline

The recovery of Bald Eagles (Haliaeetus leucophalus), after DDT and other organochlorine insecticides were banned in the United States, can be regarded as one of the most iconic success stories resulting from the Endangered Species Act. Interest remains high in the recovery and growth of the Bald Eagle population. Common to evaluating growth and recovery rates are counts at nesting sites and analyses of individuals fledged per season. But this is merely one snapshot that ignores survival rates as eagles grow to maturity. By analyzing indices from migration counts, we get a different snapshot better reflecting the survival of young birds. Different populations of Bald Eagles breed at different sites at different times of the year. Typical migration count analyses do not separate the populations. A separation of two distinct populations can be achieved at spring count sites by taking advantage of the tendency for northern summer breeding birds to migrate north in spring earlier than southern winter breeding birds who disperse north later in spring. In this paper I analyze migratory indices at a spring site along Lake Ontario. The analysis shows that eagles considered to be primarily of the northern summer breeding population showed an estimated growth rate of 5.3 ± 0.85% (SE) per year with 49% of eagles tallied in adult plumage, whereas the migrants considered to be primarily of the southern breeding population had an estimated growth rate of 14.0 ± 1.79% with only 22% in adult plumage. Together these results argue that the populations of southern breeding Bald Eagles are growing at a substantially higher rate than northern breeding eagles. These findings suggest that aggregate population indices for a species at migration counting sites can sometimes obscure important differences among separate populations at any given site and that separating counts by time period can be a useful way to check for differences among sub-populations.

Our current geriatric population: demographic and oral health care utilization

This article describes the rapidly growing geriatric population in the United States. Current and emerging living arrangements include the subgroups of older adults who live at home, retirement villages, assisted living facilities, various levels of nursing homes, and hospice care. The degree of isolation and social connection is discussed and the need for dental care has been summarized from the literature. Demographic trends imply a substantial increase in both the need and demand for dental care by the senior age groups. A proposal to integrate oral health and dental care with primary care is provided.