Demography as the basis for understanding and predicting range dynamics

Demographic processes and demographic data are increasingly being included in models of the spatio–temporal dynamics of species’ ranges. In this special issue, we explore how the integration of demographic processes further the conceptual understanding and prediction of species’ range dynamics. The 12 papers originate from two workshops entitled ‘Advancing concepts and models of species range dynamics: understanding and disentangling processes across scales’. The papers combine theoretical and empirical evidence for the interplay between environmental conditions, species interactions, demographic processes (births, deaths, dispersal), physiology, and evolution, and they point out promising avenues towards a better understanding and prediction of species’ range dynamics.     

Epidemiology: a developing science

The story of French epidemiology dates back to Daniel Bernoulli (1760), with regard to mathematical epidemiology,and to Pierre-Charles Louis (1838), with regard to 'numerical medicine', the ancestor of the modern evidence-based medicine.This thematic issue samples some of the recent issues of modern epidemiology: biostatisticians have developed a series of specialized techniques to encover the risk factors and to measure the proportion of the disease frequency they can account for (one paper). Epidemiology of chronic diseases is now providing new insights into the tricky relationships between environmental, genetic factors, and diseases (four papers). Epidemiology is not just concerned with diseases. All aspects of human biology and physiology for which a population approach is necessary, are concerned: one paper deals with the case of fecundity and fertility, which are studied by both demographic and epidemiological approaches. One of the roles of epidemiology is to bring rational answers to disputed issues in public health, such as the hazards of postmenopausal hormonal therapy (one paper). Finally, the power of mathematics is increasingly used to understand better the dynamics of infectious diseases (two papers).     

Psychiatric and Medical Symptoms in Binge Eating in the Absence of Compensatory Behaviors

Objective: To explore the extent to which binge eating in the absence of compensatory behaviors (BE) is associated with psychiatric and medical symptoms in men and women and to control for the independent effects of BMI. Research Methods and Procedures: A series of regression models was applied to questionnaire data on 8045 twins, 18 to 31 years old, from a population‐based Norwegian registry. Results: BE was significantly associated with elevated obesity, overweight, symptoms of eating disorders, symptoms of anxiety and depression, panic attacks, depressive episodes, and reduced life satisfaction in both men and women. In women, BE was independently associated with insomnia and early menarche. In men, BE was independently associated with specific phobia, daily smoking, alcohol use, use of pain medication, impairment due to mental health, neck‐shoulder, lower back, and chronic muscular pain, and impairment due to physical health. Both men and women with BE reported higher rates of psychiatric treatment. Discussion: Our results indicate that there is substantial comorbidity between BE and psychiatric symptoms independently of BMI for both men and women. Medical symptoms co‐occur less frequently than previously reported from treatment‐seeking populations in women. Across all domains, the array of symptoms exhibited by men with BE was broader than that observed in women with BE. This observation suggests the importance of considering gender differences in future studies of psychiatric and medical morbidity, binge eating, and obesity.     

A critique of 'countryside biogeography' as a guide to research in human‐dominated landscapes

Proliferation of redundant terms in ecology and conservation slows progress and creates confusion. ‘Countryside biogeography’ has been promoted as a new framework for conservation in production landscapes, so may offer a replacement for other concepts used by landscape ecologists. We conducted a systematic review to assess whether the 'countryside biogeography' concept provides a distinctive framing for conservation in human‐dominated landscapes relative to existing concepts. We reviewed 147 papers referring to countryside biogeography and 81 papers that did not. These papers were divided into categories representing three levels of use of countryside biogeography concepts (strong, weak, cited only) and two categories that did not use countryside biogeography at all but used similar concepts including fragmentation and matrix. We revealed few distinctions among groups of papers. Countryside biogeography papers made more frequent use of the terms 'ecosystem services', 'intensification' and 'land sparing' compared with non‐countryside biogeography papers. Papers that did not refer to countryside biogeography sampled production areas (e.g. farms) less often, and this related to their focus on habitat specialist species for which patch‐matrix assumptions were reasonable. Countryside biogeography offers a conceptual wrapper rather than a distinctive framework for advancing research in human‐modified landscapes. This and similar wrappers such as ‘conservation biogeography’ and ‘agricultural biogeography’ risk creating confusion among new researchers, and can prevent clear communication about research. To improve communication, we recommend using the suite of well‐established terms already applied to conservation in human‐modified landscapes rather than through an interceding conceptual wrapper.     

The MD and MS degrees in Britain.

Higher medical degrees--MD and MS--have been awarded at an increased rate since 1980, owing partly to increased numbers of medical graduates and partly to greater career competition. The pass rate has not changed since 1965. Regulations at various universities show substantial differences, particularly in the use of viva voce examinations for failed candidates, in permissible subject matter, and in allowing the submission of previously published papers. As these degrees are important for careers, and are registrable by the General Medical Council, it is suggested that it should issue minimal standards to be observed by all universities.     

Gender differences in traditional Chinese medicine use among adults in Taiwan

Objectives

The increasing use of complementary, alternative medicine (CAM) and traditional Chinese medicine (TCM) has attracted attention. We report on the gender difference in TCM use among the general population in Taiwan in a population-based, cross-sectional study.

Methods

We collected data on socio-demographic factors, lifestyle and health behavior from the 2001 Taiwan National Health Interview Survey. The medical records of interviewees aged 20–69 years were obtained from National Health Insurance claims data with informed consent. The prevalence of TCM use and the average frequency of TCM use were compared between women and men.

Results

Among 14,064 eligible participants, the one-year prevalence of TCM use for women and men was 31.8% and 22.4%, respectively. Compared with men, women had a higher average TCM use frequency (1.55 visits vs. 1.04 visits, p<0.001). This significant difference remained evident after excluding gender-specific diseases (1.43 visits vs. 1.03 visits, p<0.001). The average TCM use frequency was significantly higher in women than in men across all age groups. TCM use correlates differed for women and men. Marital status (odds ratio [OR] = 1.55, 95% confidence interval [CI] = 1.30–1.85), family income and unhealthy lifestyle (OR = 1.50, 95% CI = 1.30–1.74) were factors associated with TCM use in men but not in women.

Conclusions

In Taiwan, women used more TCM services than men and the gender differences in the TCM use profile persisted across age groups.     

Anticonvulsant use and fracture: a case-control study

Objectives:We aimed to investigate fracture risk associated with anticonvulsant use in a population-based sample of men and women.Methods:Data from 1,458 participants (51.8% women) with a radiologically confirmed incident fracture (cases) were compared to 1,796 participants (46.5% women) without fracture (controls). Lifestyle factors, medication use and medical history were self-reported. Associations between anticonvulsant use and fracture were explored using binary logistic regression following adjustment for confounders.Results:In men, fracture cases and controls differed in age, smoking history, education, alcohol use, and gonadal hormone supplementation. In women, fracture cases and controls differed by previous fracture history, alcohol use, physical activity levels and use of anti-fracture agents. After adjustment for age, pooled anticonvulsant use was associated with a 3.4-fold higher risk of fracture in men and a 1.8-fold higher risk in women. Following further adjustments for confounders these patterns persisted; a 2.8-fold higher fracture risk in men and a 1.8-fold higher fracture risk in women.Conclusions:Anticonvulsant use was associated with increased fracture risk, independent of demographic, lifestyle, medical and medication related factors. While further studies exploring potential underlying mechanisms are warranted, regular monitoring of bone health in anticonvulsant users with risk factors may be useful.     

Seed,dispersal, microsite,habitat and recruitment limitation: identification of terms and concepts in studies of limitations

Recently, there is an increase in number of studies concerned with the effect of various types of limitations on species local population size and distribution pattern at the landscape scale. The terminology used to describe these limitations is, however, very inconsistent. Since the different terms often appear in conclusions of the papers, the inconsistency in their use obscures the message of these papers. In this study, we review the current uses of these terms, identify the basic concepts involved in the discussion of a limitation and link the concepts with the currently used terms. Finally, we discuss the experimental approaches used to assess the different types of limitations. We differentiated four basic concepts resulting from the combination of limitation by environment versus ability to grow and spread, and two spatial scales (local and regional scale). The two concepts at each spatial scale are expected to form a gradient of all possible combinations of the two respective types of limitations. In the considerations of various experimental approaches used to assess these limitations, we conclude that sowing experiments, i.e. seed addition into existing populations or seed introduction into unoccupied habitats, are the only reliable types of evidence for the different types of limitations.     

Using a classic paper by Gottschalk and Mylle to teach the countercurrent model of urinary concentration

Most undergraduates lack the scientific background to read and appreciate much of the primary literature in physiology. Even when the underlying concepts are elegantly simple, the inherent complexity of contemporary papers often makes the work inaccessible to them. However, with a little help, they can be guided to an understanding of the creative thought processes that underlie the research and to appreciate its significance. This is especially true of many classic papers in physiology that often rely on easily comprehensible techniques. Moreover, the American Physiological Society (APS) has invited prominent scientists to select important papers in their fields and to write essays that both put the work into historical context and explain why it is scientifically important. The APS Legacy Project makes these classic papers freely available online. One such paper by Gottschalk and Mylle presents data from a series of micropuncture studies that confirm all of the predictions of the countercurrent exchange model of concentrated urine production (2). The included handout of questions for discovery learning and teaching points suggest ways to use the paper as an instructional resource.     

The Impact of Gender Norms on Condom Use among HIV-Positive Adults in KwaZulu-Natal,South Africa

Critical to preventing the spread of HIV is promoting condom use among HIV-positive individuals. Previous studies suggest that gender norms (social and cultural constructions of the ways that women and men are expected to behave) may be an important determinant of condom use. However, the relationship has not been evaluated among HIV-positive women and men in South Africa. We examined gender norms and condom use at last sex among 550 partnerships reported by 530 sexually-active HIV-positive women (372) and men (158) who had sought care, but not yet initiated antiretroviral therapy in a high HIV-prevalence rural setting in KwaZulu-Natal, South Africa between January 2009 and March 2011. Participants enrolled in the cohort study completed a baseline questionnaire that detailed their socio-demographic characteristics, socio-economic circumstances, religion, HIV testing history and disclosure of HIV status, stigma, social capital, gender norms and self-efficacy. Gender norms did not statistically differ between women and men (p = 0.18). Overall, condoms were used at last sex in 58% of partnerships. Although participants disclosed their HIV status in 66% of the partnerships, 60% did not have knowledge of their partner’s HIV status. In multivariable logistic regression, run separately for each sex, women younger than 26 years with more equitable gender norms were significantly more likely to have used a condom at last sex than those of the same age group with inequitable gender norms (OR = 8.88, 95% CI 2.95–26.75); the association between condom use and gender norms among women aged 26+ years and men of all ages was not statistically significant. Strategies to address gender inequity should be integrated into positive prevention interventions, particularly for younger women, and supported by efforts at a societal level to decrease gender inequality.     

Duration of Last Attack in 998 Fatal Cases of Coronary Artery Disease and its Relation to Possible Cardiac Resuscitation

All the deaths attributed to coronary artery disease and occurring in Belfast during one year were studied.The frequency distributions of the cases by interval of time between onset of the last attack and death are given for those not admitted to hospital, for those admitted to hospital, and for those already in hospital for some other cause of illness.Sixty per cent. of all the deaths occurred outside hospital. This indicates that the problem of cardiac resuscitation in coronary artery disease is to a considerable extent an extra-hospital one.Twenty-seven per cent. of the men and 22% of the women died within 15 minutes, but the median period of survival was 3 hours 30 minutes for men and 6 hours 18 minutes for women.The median time interval from the onset of the attack to sending for medical aid was 1 hour 17 minutes for men and 1 hour 6 minutes for women, and from summoning medical aid to sending for the ambulance 59 minutes for men and 1 hour 26 minutes for women. Ninety-six per cent. of the ambulance journeys to the patient were accomplished in less than 20 minutes.It was found among men, but not among women, that the duration of survival tended to be longer in older patients and in second or subsequent attacks.Of the 596 who did not gain admission to hospital 229 (23% of all the 998 patients) were known to have survived for more than half an hour after the onset of the fatal attack; 182 (18%) survived for more than one hour; and 143 (14%) survived for more than two hours. It is among these that there would appear to be special scope for the cardiac ambulance, providing that medical aid is sought and the ambulance is summoned without delay.     

The anatomy of free paper sessions.

The interaction between speakers, audience, and chairmen was studied by 13 investigators during a medical meeting at which 356 free papers were given before a total audience of 2483 in 48 sessions. A protocol was used to score 21 questions relating to the presentation, 15 to the chairman of the session, and nine to the audience. Many speakers made technical faults in presentation and their use of slides. Most chairmen failed to comply with simple rules of procedure and with the expectations of speakers and audience. The interest of the audience was affected by the performance of speakers and chairman. Speakers should pay more attention to the technique of presentation, and organising committees of medical meetings should provide instructions to both speakers and chairmen.     

Knowledge and Use Value of Plant Species in a Rarámuri Community: A Gender Perspective for Conservation

We used a quantitative ethnobotanical approach to analyze factors influencing the use value of plant species among men and women of the Rarámuri people in Cuiteco, Chihuahua, Mexico. We constructed a use value index (UV) combining the use frequency (U) and the quality perception (Q) of useful plant species by local people. We identified all plant species used by the Rarámuri and classified them into 14 general use categories. We interviewed 34 households in the village to compare men and women’s knowledge on the five main general use categories (and on their respective subcategories and specific uses), to document how they practice gathering activities and to calculate scores of plants UV. A total of 226 useful plant species were identified, but only 12% of them had high UV scores for the 42 specific uses defined. When the overall knowledge of plant species was examined, no significant differences were detected between men and women, but significant differences were identified in general use categories such as medicinal plants, plants for construction and domestic goods, but not in plants used as food and firewood. We identified a division of labor in gathering activities associated with gender, with women mainly gathering medicinal and edible plants and being involved in preparing medicines and food, whereas men were primarily gathering and using plants for manufacturing domestic goods, firewood, and building materials. Plant species UV associated to gender were significantly different between men and women at the level of specific uses in the general category of domestic goods and building. Frequency of use is highly associated with plant species quality perception.     

Complementary medicine in the primary care setting: Results of a survey of gender and cultural patterns in Israel

Objective: The purpose of this study was to examine the use of complementary and alternative medicine (CAM) in a primary care practice in Israel to determine prevalence and patterns of use.Methods: Trained research assistants invited all patients attending the administrative, medical, pharmaceutical, or nursing services of 7 clinics in urban and rural areas of northern Israel over a 16-month period, from April 1, 2005, through August 1, 2006, to complete a 13-item written questionnaire about CAM use and beliefs about CAM safety and efficacy. CAM was defined as therapies often referred to as alternative, complementary, natural, or folk/traditional medicine, and which are not usually offered as part of the medical treatment in the clinic, including herbal medicine, Chinese medicine (including acupuncture), homeopathy, folk and traditional remedies, dietary/nutritional therapy (including nutritional supplements), chiropractic, movement/manual healing therapies (including massage, reflexology, yoga, and Alexander and Feldenkrais techniques), mind-body techniques (including meditation, guided imagery, and relaxation), energy and healing therapies, and other naturopathic therapies. The Pearson χ² test and multivariate logistic regression were used to assess univariate associations with the odds ratios of CAM use among Arab and Jewish women. A t test was performed to determine whether there were any differences in the continuous variables between the 2 groups.Results: Of 3972 consecutive patients who received the questionnaire, 3447 responded; 2139 respondents (62%) were women. Of the female respondents, 2121 reported their religion (1238 respondents [58%] self-identified as being Arab, and 883 [41.6%] as being Jewish). Compared with men, more women used CAM during the previous year (46.4% vs 39.4%; P < 0.001). Women were more likely to use CAM and to be interested in receiving CAM at primary care clinics. Arab women reported less CAM use than Jewish women but were more interested in experiencing CAM, had a higher degree of confidence in CAM efficacy and safety, and more frequently supported the integration of CAM practitioners in primary care clinics.Conclusions: In this study, women visiting primary care clinics in northern Israel used CAM more often than men did. Arab women reported less use of CAM than did Jewish women but also reported greater confidence in CAM efficacy and safety.     

Differences in abuse reported by female and male Canadian medical students.

OBJECTIVE: To assess differences between male and female medical students concerning their experiences of abuse during training in a large Canadian medical school. DESIGN: Voluntary, anonymous cross-sectional survey of first- and fourth-year medical students during February 1991. SETTING: University of Toronto School of Medicine. PARTICIPANTS: Of 396 first- and fourth-year students surveyed after one of their regular classes, 347 (117 women, 230 men) completed the questionnaire. INTERVENTION: A 165-item, multiple-choice questionnaire concerning experiences of verbal or emotional abuse, sexual harassment and physical abuse, completed within 30 minutes. MAIN OUTCOME MEASURES: Differences between male and female respondents in abuse experiences before and during medical training, the relation between abuse before and during training, and the psychologic and behavioural effects of abuse during training. RESULTS: The experiences of the male and female respondents differed mainly in regard to sexual harassment: 42% (49/117) of the women and 11% (25/230) of the men reported sexual harassment before entering medical school (p < 0.0001); 46% (54/117) and 19% (43/230) respectively reported sexual harassment during medical training (p < 0.0001); and women who reported sexual harassment were the only respondents for whom a significant relation was found between abuse before and during training (p < 0.043). The women were more distressed than the men by all forms of abuse. A significant relation was shown between male students who reported experiencing abuse during medical training and mistreating patients (p < 0.0001). CONCLUSION: Female students'' experiences of sexual harassment differed from those of their male counterparts. As well, the female students'' reactions to and ways of coping with all types of abuse differed from those of the male students.     

Refusing to Sing: Gender,Kinship and Patriliny in Macedonia

The issue of whether formal kinship structures and sentiments reflect the reality of social relations was of particular concern to specialists at the height of the kinship debates in the 1960s and 1970s, as it continues to be in some contemporary studies. So too, the classifications ‘patrilineal’ or ‘matrilineal’ have clearly been shown to be problematic given that there are multiple levels of discourse and relational and ideational realities in any given society. For many contemporary kinship specialists in fact no simple correlation can be made between type of descent system and actual social relations, especially relations between men and women. However, some anthropologists continue to argue that patrilineal kinship systems are somehow indicative of control or domination by men or, put inversely, of women's lack of power and authority. It is argued in this paper that even where the formal kinship structures and ideological discourses are dominated by agnation as appears to be the case in south Slav societies generally, and Macedonian in particular, this is not automatically mirrored in gender relations between men and women. In short, there is a long leap from patriliny to patriarchy.     

Relationship between Body Mass Index and the Use of Healthcare Services in Australia

Objective: To examine the relationship between body mass index (BMI) and the use of medical and preventive health services. Research Methods and Procedures: This study involved secondary analysis of weighted data from the Australian 1995 National Health Survey. The study was a population survey designed to obtain national benchmark information about a range of health‐related issues. Data were available from 17,033 men and 17,174 women, ≥20 years or age. BMI, based on self‐reported weight and height, was analyzed in relation to the use of medical services and preventive health services. Results: A positive relationship was found between BMI and medical service use, such as medication use, visits to hospital accident and emergency departments (for women only); doctor visits, visits to a hospital outpatient clinics; and visits to other health professionals (for women only). A negative relationship was found in women between BMI and preventive health services. Underweight women were found to be significantly less likely to have Papanicolaou smear tests, breast examinations, and mammograms. Discussion: This research shows that people who fall outside the healthy weight range are more likely to use a range of medical services. Given that the BMI of industrialized populations appears to be increasing, this has important ramifications for health service planning and reinforces the need for obesity prevention strategies at a population level.     

Relationships in Canada between mortality from tumours of the gastrointestinal tract and marital status.

The mortality from tumours of the gastrointestinal tract in the Canadian population in 1970-72 was 16% higher in single than in married men (on the basis of age-adjusted rates), 25% higher in widowed men and 28% higher in divorced men. All these differences were unlikely to be due to chance. The rates were 4% higher for single women, 14% higher for widows and 22% higher for divorced women, compared with the married. The differences for single and divorced women were not significant. Substantial excess mortality was found in the unmarried for tumours of the mouth, pharynx and esophagus, and rectum; for tumours of the stomach and colon the excess was small or nonexistent. This variation between sites suggests that systematic errors in the census data used as denominators are not responsible for the high mortality for the unmarried from certain tumours. The effect is found in conditions for which treatment can have made little difference (e.g., a 75% excess mortality for tumours of the esophagus in single men compared with married) and in conditions for which differences in the use of medical facilities may have been important (e.g., a 44% excess mortality for tumours of the rectum in widowers).     

Sex differences in ischemic heart disease and heart failure biomarkers

Since 1984, each year, more women than men die of ischemic heart disease (IHD) and heart failure (HF), yet more men are diagnosed. Because biomarker assessment is often the first diagnostic employed in such patients, understanding biomarker differences in men vs. women may improve female morbidity and mortality rates.Some key examples of cardiac biomarker utility based on sex include contemporary use of “unisex” troponin reference intervals under-diagnosing myocardial necrosis in women; greater use of hsCRP in the setting of acute coronary syndrome (ACS) could lead to better stratification in women; and greater use of BNP with sex-specific thresholds in ACS could also lead to more timely risk stratification in women.Accurate diagnosis, appropriate risk management, and monitoring are key in the prevention and treatment of cardiovascular diseases; however, the assessment tools used must also be useful or at least assessed for utility in both sexes. In other words, going forward, we need to evaluate sex-specific reference intervals or cutoffs for laboratory tests used to assess cardiovascular disease to help close the diagnostic gap between men and women.