Search

Abstract Background Electronic health records (EHRs) data provide an opportunity to collect patient information rapidly, efficiently and at scale. National collaborative research networks, such as PEDSnet, aggregate EHRs data across institutions, enabling rapid identification of pediatric disease cohorts and generating new knowledge for medical conditions. To date, aggregation of EHR data has had limited applications in advancing our understanding of mental health (MH) conditions, in part due to the limited research in clinical informatics, necessary for the translation of EHR data to child mental health research. Methods In this cohort study, a comprehensive EHR-based typology was developed by an interdisciplinary team, with expertise in informatics and child and adolescent psychiatry, to query aggregated, standardized EHR data for the full spectrum of MH conditions (disorders/symptoms and exposure to adverse childhood experiences (ACEs), across 13 years (2010–2023), from 9 PEDSnet centers. Patients with and without MH disorders/symptoms (without ACEs), were compared by age, gender, race/ethnicity, insurance, and chronic physical conditions. Patients with ACEs alone were compared with those that also had MH disorders/symptoms. Prevalence estimates for patients with 1+ disorder/symptoms and for specific disorders/symptoms and exposure to ACEs were calculated, as well as risk for developing MH disorder/symptoms. Results The EHR study data set included 7,852,081 patients

Background: Electronic health records (EHRs) data provide an opportunity to collect patient information rapidly, efficiently and at scale. National collaborative research networks, such as PEDSnet, aggregate EHRs data across institutions, enabling rapid identification of pediatric disease cohorts and generating new knowledge for medical conditions. To date, aggregation of EHR data has had limited applications in advancing our understanding of mental health (MH) conditions, in part due to the limited research in clinical informatics, necessary for the translation of EHR data to child mental health research. Methods: In this cohort study, a comprehensive EHR-based typology was developed by an interdisciplinary team, with expertise in informatics and child and adolescent psychiatry, to query aggregated, standardized EHR data for the full spectrum of MH conditions (disorders/symptoms and exposure to adverse childhood experiences (ACEs), across 13 years (2010–2023), from 9 PEDSnet centers. Patients with and without MH disorders/symptoms (without ACEs), were compared by age, gender, race/ethnicity, insurance, and chronic physical conditions. Patients with ACEs alone were compared with those that also had MH disorders/symptoms. Prevalence estimates for patients with 1+ disorder/symptoms and for specific disorders/symptoms and exposure to ACEs were calculated, as well as risk for developing MH disorder/symptoms. Results: The EHR study data set included 7,852,081 patients < 21 years of age, of which 52.1% were male. Of this group, 1,552,726 (19.8%), without exposure to ACEs, had a lifetime MH disorders/symptoms, 56.5% being male. Annual prevalence estimates of MH disorders/symptoms (without exposure to ACEs) rose from 10.6% to 2010 to 15.1% in 2023, a 44% relative increase, peaking to 15.4% in 2019, prior to the Covid-19 pandemic. MH categories with the largest increases between 2010 and 2023 were exposure to ACEs (1.7, 95% CI 1.6–1.8), anxiety disorders (2.8, 95% CI 2.8–2.9), eating/feeding disorders (2.1, 95% CI 2.1–2.2), gender dysphoria/sexual dysfunction (43.6, 95% CI 35.8–53.0), and intentional self-harm/suicidality (3.3, 95% CI 3.2–3.5). White youths had the highest rates in most categories, except for disruptive behavior disorders, elimination disorders, psychotic disorders, and standalone symptoms which Black youths had higher rates. Median age of detection was 8.1 years (IQR 3.5–13.5) with all standalone symptoms recorded earlier than the corresponding MH disorder categories. Conclusions: These results support EHRs' capability in capturing the full spectrum of MH disorders/symptoms and exposure to ACEs, identifying the proportion of patients and groups at risk, and detecting trends throughout a 13-year period that included the Covid-19 pandemic. Standardized EHR data, which capture MH conditions is critical for health systems to examine past and current trends for future surveillance. Our publicly available EHR-mental health typology codes can be used in other studies to further advance research in this area. [ABSTRACT FROM AUTHOR]

The scientific study at hand takes a look at the changes in demography over the last 30 years in the ethnographic region of "Moţilor Land" trying to establish if a balance has been reached. There are several important demographic risks that affect this region. First, there is the rapid depopulation of the area that was triggered by three factors: by the isolation of the people in the "Moţilor Land" which was amplified during the 1990s after the destruction of the railway that connected Câmpeni with the periphery of the mountain zone, by the economic crisis experienced by the region due to the collapse of the mining activities and not the least by the lack in many localities of minimal utilities like schools, commercial units, electricity, telephone lines, fact due especially to the numerous settlements per commune and to the difficult mountainous terrain. Other important risk factors are the demographic aging and the feminization of the population. These are the result of the continuous reduction of birth rate over a long period of time and of the previous migrations, especially after the 1966 when numerous people, especially young males, left the mountain villages for the cities where jobs became available due to the intense industrial development during the 1970s and 1980s in Romania. [ABSTRACT FROM AUTHOR]

Starting from the definition of demographic risk as a dangerous socialphenomenon for a people and for society as a whole, this article aims to present the most significant and quantified risks for female population: the ageing, the reduction of the generation of fertile age, the unemployment. The study emphasizes some very sensitiveindicators in the assessment of the risks such as: the index of feminization specific for the age groups of 15-59 years and over 60 years, and also the maternal death. If in the case of natural risks, the forecasts have a very relative character, the demographics risks can be avoided, can be kept under control, their prevention being possible.

WORK AND FAMILY ARE THE TWO MAJOR SCENES FOR ADULTS, EXISTING EVER SINCE THE BEGINNING OF MANKIND, BUT HIGHLY ANALYZED IN THE LAST YEARS DUE TO SOCIAL, ECONOMIC AND DEMOGRAPHIC CHANGE. THE IMPORTANCE OF STUDYING THE RELATIONSHIP BETWEEN FAMILY LIFE AND WORK ISSUES IS DETERMINED BY THE NEGATIVE EFFECTS OF POOR MANAGING OF THE TWO ROLES ON ONE SIDE FOR THE INDIVIDUAL HUMAN BEING (PHYSIC - SOMATIC, PSYCHIC AND BEHAVIOR MANIFESTATIONS), FOR THE ORGANIZATION ON THE OTHER HAND (ABSENTEEISM, LOW PRODUCTIVITY, HIGH COSTS GENERATED BY ILLNESS, PERSONNEL FLUCTUATION AND TURN-OVER) AND FOR THE SOCIETY AS A WHOLE. PREVIOUS RESEARCH IDENTIFIED A NEGATIVE RELATIONSHIP BETWEEN WORK-FAMILY CONFLICT AND JOB SATISFACTION (JONES AND BUTLER, 1980; PLECK, STAINES AND GOLD, 1980, KOPLEMAN ET AL. 1983; AHMAD, 1996). IN SOLVING THIS EQUATION BECOMES OBVIOUS THE NEED TO ADDRESS THE CONFLICT BETWEEN WORK AND PERSONAL LIFE IN ORDER TO BALANCE THE TWO. [ABSTRACT FROM AUTHOR]

Modernisation of society has reflected itself in people's professional structure, in economic and professional profile diversification, in higher territorial mobility (migration), in birth rate decrease and in less numerous families, in religious pluralism, and in the educated ones' diversified structure. The Land of Nasaud (a region in Bistri͕a-Năsăud County, in the north of Romania) offers an example of the regional impact of some factors such as unsuccessful Romanian social and economic practices or the promise of a better life and of a more grateful society to those who work, to be found only abroad. The changes characteristic of the people's demographic behaviour in the Land of Nasaud, far from being watched with calm or with bitterness, they surely are the source of much worry. The statistical data of the last 17 years point out a negative trend for the future of the region: the human resource diminishes and loses some of its attributes. [ABSTRACT FROM AUTHOR]