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An evaluation of nearly-extinct cohort methods for estimating the very elderly populations of australia and new zealand.

ABSTRACT: The rapid growth of very elderly populations requires accurate population estimates up to the highest ages. However, it is recognised that estimates derived from census counts are often unreliable. Methods that make use of death data have not previously been evaluated for Australia and New Zealand. The aim was to evaluate a number of nearly-extinct cohort methods for producing very elderly population estimates by age and sex for Australia and New Zealand. The accuracy of official estimates was also assessed. Variants of three nearly-extinct cohort methods, the Survivor Ratio method, the Das Gupta method and a new method explicitly allowing for falling mortality over time, were evaluated by retrospective application over the period 1976-1996. Estimates by sex and single years of age were compared against numbers derived from the extinct cohort method. Errors were measured by the Weighted Mean Absolute Percentage Error. It is confirmed that for Australian females the Survivor Ratio method constrained to official estimates for ages 90+ performed well. However, for Australian males and both sexes in New Zealand, more accurate estimates were obtained by constraining the Survivor Ratio method to official estimates for ages 85+. Official estimates in Australia proved reasonably accurate for ages 90+ but at 100+ they varied significantly in accuracy from year to year. Estimates produced by Statistics New Zealand in aggregate for ages 90+ proved very accurate. We recommend the use of the Survivor Ratio method constrained to official estimates for ages 85+ to create very elderly population estimates for Australia and New Zealand.

SUBMITTER: Terblanche W

PROVIDER: S-EPMC4388836 | biostudies-literature | 2015

REPOSITORIES: biostudies-literature

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An evaluation of nearly-extinct cohort methods for estimating the very elderly populations of australia and new zealand.

Terblanche Wilma W Wilson Tom T

PloS one 20150407 4

The rapid growth of very elderly populations requires accurate population estimates up to the highest ages. However, it is recognised that estimates derived from census counts are often unreliable. Methods that make use of death data have not previously been evaluated for Australia and New Zealand. The aim was to evaluate a number of nearly-extinct cohort methods for producing very elderly population estimates by age and sex for Australia and New Zealand. The accuracy of official estimates was a ...[more]

PMID: 25849096

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Project description:INTRODUCTION: Older age is associated with higher prevalence of chronic illness and functional impairment, contributing to an increased rate of hospitalization and admission to intensive care. The primary objective was to evaluate the rate, characteristics and outcomes of very old (age >or= 80 years) patients admitted to intensive care units (ICUs). METHODS: Retrospective analysis of prospectively collected data from the Australian New Zealand Intensive Care Society Adult Patient Database. Data were obtained for 120,123 adult admissions for >or= 24 hours across 57 ICUs from 1 January 2000 to 31 December 2005. RESULTS: A total of 15,640 very old patients (13.0%) were admitted during the study. These patients were more likely to be from a chronic care facility, had greater co-morbid illness, greater illness severity, and were less likely to receive mechanical ventilation. Crude ICU and hospital mortalities were higher (ICU: 12% vs. 8.2%, P < 0.001; hospital: 24.0% vs. 13%, P < 0.001). By multivariable analysis, age >/= 80 years was associated with higher ICU and hospital death compared with younger age strata (ICU: odds ratio (OR) = 2.7, 95% confidence interval (CI) = 2.4 to 3.0; hospital: OR = 5.4, 95% CI = 4.9 to 5.9). Factors associated with lower survival included admission from a chronic care facility, co-morbid illness, nonsurgical admission, greater illness severity, mechanical ventilation, and longer stay in the ICU. Those aged >or= 80 years were more likely to be discharged to rehabilitation/long-term care (12.3% vs. 4.9%, OR = 2.7, 95% CI = 2.6 to 2.9). The admission rates of very old patients increased by 5.6% per year. This potentially translates to a 72.4% increase in demand for ICU bed-days by 2015. CONCLUSIONS: The proportion of patients aged >or= 80 years admitted to intensive care in Australia and New Zealand is rapidly increasing. Although these patients have more co-morbid illness, are less likely to be discharged home, and have a greater mortality than younger patients, approximately 80% survive to hospital discharge. These data also imply a potential major increase in demand for ICU bed-days for very old patients within a decade.

Project description:BackgroundPodiatry enrolments at Australian and New Zealand universities have decreased by 17.3% since 2015, which threatens the profession's sustainability and the health and wellbeing of Australian and New Zealand people and communities. Reasons for this decline remain unclear due to insufficient evidence on factors influencing career choices. The overarching aim of this study was to identify motivators and barriers for studying podiatry in Australia and New Zealand.MethodsThis study used a convergent mixed methods design. Students enrolled in (i) podiatry and (ii) relevant non-podiatry health, sport or science programs at nine Australian and one New Zealand university, were invited to participate in an online survey. First-year podiatry students were also invited to participate in an online workshop. Quantitative data were analysed using descriptive statistics and linear/logistic regression models. Three independent assessors used inductive thematic analysis for the qualitative data.ResultsOverall, 278 podiatry students (mean age 24.9 ± 8.5 years, 65.1% female) and 553 non-podiatry students (mean age 24.8 ± 8.2 years, 75.4% female; 32.2% from physiotherapy and 29.1% from occupational therapy) responded to the survey. Interest in a health-related career, wanting to make a difference to people's health, and opportunity to care for people from different backgrounds/age groups were key motivating factors among podiatry students. Barriers to studying podiatry were encountered by 28.1% of podiatry students. Thematic analysis identified seven themes concerning career choice, which are as follows: (i) awareness of profession and scope of practice; (ii) stereotypes and negative perceptions of the profession; (iii) awareness of career pathways; (iv) job prospects and earning potential; (v) working with people and building relationships; (vi) podiatry is not the first preference; and (vii) barriers which limit student enrolment.ConclusionsThere are a variety of factors that motivate and influence students to study podiatry, however, altruistic reasons are most highly rated. Allied health students have limited understanding of the scope of practice and career opportunities in podiatry. Additionally, the podiatry profession often faces negative stereotypes. Further work is required to reverse the negative stereotypes and perceptions of podiatry and build knowledge of the profession's scope of practice, career pathways/opportunities, job prospects and earning potential.

Project description:BackgroundSurfers play a critical role in coastal drowning prevention, conservatively estimated to make as many rescues as beach lifeguards. The Surfer Rescue 24/7 (SR24/7) program is a coastal safety intervention in Australia and New Zealand that teaches surfers safe rescue skills and promotes prevention activities. This multi-part, mixed-methods study aimed to evaluate the impact of the SR24/7 program.MethodsThe study consisted of three parts employing quantitative and qualitative methods: a retrospective survey of course participants, in-depth interviews with course participants who had conducted rescues, and an analysis of self-reported skills confidence ratings before and after the program.ResultsTriangulated results from the three study components indicated that after the course, participants exhibited high levels of satisfaction with their experience in the program and would encourage others to attend, were more observant and aware of safety concerns while surfing, had a better understanding of ocean conditions and hazards, learned new rescue techniques and skills, grasped important course concepts related to their own personal safety, and improved their confidence in responding to an emergency situation. Several participants had conducted rescues in real life and indicated that the course was effective in providing them with the baseline knowledge and skills to keep safe while helping others in the ocean. This study also provides new insight on the role of surfers in coastal safety, specifically that surfers are engaged in a range of prevention activities before rescue is required.ConclusionsDespite persistent challenges in combating coastal drowning rates, the SR24/7 program is an effective intervention that helps save lives. Importantly, this study provides evidence that the course successfully equips surfers with techniques to act responsibly and safely. Expanding coastal safety focus and resources towards surfers, an often-overlooked demographic in beach safety strategies, could substantially enhance community-level capacity to prevent and respond to ocean emergencies.

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An evaluation of nearly-extinct cohort methods for estimating the very elderly populations of australia and new zealand.

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An evaluation of nearly-extinct cohort methods for estimating the very elderly populations of australia and new zealand.

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