O24 10 YEARS PARTICIPATING IN THE HERNIAMED-REGISTRY: REFLECTING ON RESULTS OF THE PAST HELPS US TO SHAPE THE FUTURE

Aim Between 01/2011 and 12/2020 5,068 AWR-patients at our department (tertiary referral center) – 884 (17.4%) incisionals. Over this 10-years period considerable changes (patients characteristics, surgical techniques, results) were analyzed. Material and Methods Herniamed® offers an internet-based registry-platform to document all kinds of abdominal wall repairs on a voluntary basis since 2009. Demographic data, interventional details and outcomes are documented using the EHS-classification-system. Follow-up is standardized and sheduled for 10 years. Results Up to 54.7% of patients (in 2020) show at least one risk factor (diabetes, smoking ….), in contrast to the age pyramid patients >70 years are decreasing (47.2% in 2011 down to 29.3% in 2020), share of ASA III/IV is initially increasing (up to 42.9% in 2017) with a constant decrease after 2017 to 25.3% in 2020. Emergent cases are increasing (6.9% in 2011 up to 10.8% in 2019). Recurrent hernia repairs stays almost constant at median 21.7%. After 2015 we decided – for various reasons - not to routinely apply the laparoscopic IPOM-technique (with an interim ratio of up to 46.2%) – with a post-OP complication rate of median 23.3% anymore. From 2016 onwards we performed an increasing number of „other techniques“ (E-MILOS, E-TEP, ….) up to 36% in 2020 instead. Conclusions By analysing trends we recognized that patients show increasing numbers of risk factors and ASA-scores which led us to implement a prehabilitational strategy in clinical routine. However rate of post-OP complication is still high representing AWR as demanding in many aspects. A temporary cessation of MIS did not led to an extensive increase in post-OP wound complications.

Rural practitioner vignette

This chapter describes the Cape Breton Regional Municipality (CBRM) as a beautiful region of approximately 2,400 square kilometres located on Cape Breton Island in the eastern part of Nova Scotia. It talks about the characterization of Cape Breton Island by both an aging and declining population hundreds as young adults have migrated out of the region for educational and work opportunities. It also analyzes the shift in the shape of the CBRM's age pyramid as there have been fewer young people and far more people in the older age cohorts. The chapter elaborates how the CBRM is increasingly challenged to identify initiatives and programs that will effectively accommodate and support an aging population, as it is among the poorest municipalities in Nova Scotia. It points out the CBRM's active transportation strategy, which has been supported by the municipal council and has resulted in far better infrastructure for walking and cycling in the region.

Trends and factors of the demographic development of Tver oblast in the 20th — early 21st centuries

The article summarizes the reproductive and migration development of one of the most demographically-disadvantaged regions of Russia — Tver oblast, where depopulation has been taking place for more than 50 years. Thus, in 30 years, from January 1989 to January 2019, the population of Tver oblast, as well as its population in working age, decreased by 1.3 times, the number of women of the most active reproductive age (20-39 years) — by 1.5 times. The factors of this negative process are substantiated in the article. First, during the War of 1941-1945 this territory was occupied for three years and became the site of some of the bloodiest battles of this war, including the Battle of Rzhev. Second, from the region in the pre-revolutionary and post-war Soviet times actively went the settlement of the rear and suburban regions, first of all, North European and Asian Russia. Third, the region is on the way between the two main migration recipients («magnets») of Russia — the Moscow and Leningrad macroregions, and its population is steadily decreasing due to outflow to two capitals. The article reveals the extent of demographic, including migration, losses of the region in the later Soviet and post-Soviet times. The circle of the closest migration partners of Tver oblast and the nature of population exchange with them are identified. Changes in the direction and closeness of the region's migration links over the past fifty years have been investigated. The origin of structural waves in the sex-age pyramid of Tver oblast for a century has been substantiated. It is argued to what demographic structural and socio-economic consequences such development of the region has led to. It is concluded about the place and prospects of Tver oblast and its population in modern market economy Russia.

Integrated Approaches in Economics of Contracting and Knowledge Management

Knowledge management (KM) in the space sector is a particularly interesting study owing to the specific characteristics of lack of patenting and recording of information associated with security considerations, as well as the sectoral age pyramid and the obsolescence of equipment that results in significant KM transaction costs and loss of information. Coupled with the custom-made nature that is typical of space projects, the analysis in this paper focuses on contractual mechanisms that incorporate transfer of KM within and beyond a project’s life-cycle and the implications for specific types of contracts that are typically used -mostly in procurement. This leads to incentives for contractors to enhance also inter-firm transfer of knowledge and develop the management tools that will sustain virtual skills of past project teams. The paper shows that this approach can result in significant benefits for all stakeholders, despite challenges associated with potential transaction costs in contracting and lack of standards and relevant experience in usage of such mechanisms. Finally, a critique of the industry tradition of cost and performance assessments prior to end of lifetime is emerging.

Statistical Study of Demographic Indicators of Tula region

The article assesses the dynamics of the main demographic indicators of the Tula region: birth rate, mortality, natural increase and decrease for 2000–2018, presents the age pyramid of the population, estimates the coefficient of demographic load, and analyzes the main reasons for the increase in the burden on the working-age population. It is established that the demographic situation in the Tula region, as in most other regions of Russia, remains quite tense, and is characterized by complex processes in the development of the population, which is associated with high mortality and low fertility. Methods of analysis, synthesis, deduction and induction, methods of graphical analysis were used in the preparation of the article. The methodological basis was the data of the Federal state statistics service and normative documents. The authors based on the analysis of the main normative documents regulating the activities of the authorities and management in the field of demographic situation management at the municipal level, and statistical data, justified the need to introduce measures to improve the demographic situation in the Tula region, the introduction of additional mechanisms to encourage families to give birth to children by increasing guaranteed social benefits to families.

Evolution of ST-Elevation Acute Myocardial Infarction Prevalence by Gender Assessed Age Pyramid Analysis—The Piramyd Study

Introduction: Recent studies reported a decrease in the incidence of acute myocardial infarction. This favorable evolution does not extend to young women. The interaction between gender, risk factors and myocardial infarction incidence remains controversial. Objective: To compare the evolution of the age pyramid of patients with ST-elevation myocardial infarction (STEMI) according to gender. Methods: Data from patients with STEMI managed in pre-hospital settings prospectively collected in the greater Paris area. Evolution of patient demographics and risk factors was investigated. Results: 28,249 patients with STEMI were included in the registry between 2002 and 2014, 21,883 (77%) males and 6,366 (23%) females. The sex ratio did not significantly vary over the study period (p = 0.4). Median patient age was 60.1 years (51.1–73.0) and was significantly different between males and females, respectively 57.9 (50.0–68.3) vs. 72.9 years (58.3–82.2) (p = 0.0004). The median age of males significantly (p = 0.0044) increased from 57.6 (50.1–70.0) in 2002 to 58.1 years (50.5–67.8) in 2014. The median age of females significantly (p = 0.0006) decreased from 73.7 (57.9–81.8) to 69.6 years (57.0–82.4). The median gap between the age of men and women significantly (p = 0.0002) decreased, from 16.1 to 11.5 years. Prevalence of risk factors was unchanged or decreased except for hypertension which significantly increased in males. The rate of STEMI without reported risk factors increased in both males and females. Conclusion: The age of STEMI onset significantly decreased in females, whereas it significantly increased in males. The prevalence of risk factors decreased in males, whereas no significant variation was found in females.

Trends of Cardiovascular Disease Mortality in Relation to Population Aging in Greece (1956 - 2015)

Background: Demographic dynamics and decreasing trends in mortality from chronic diseases are major contributors to the phenomenon of population aging. The purpose of the present study was to examine the association between cardiovascular disease (CVD) mortality and demographic indicators, in Greece the past 60 years. Methods: Life Expectancy at birth (LE), population age structure, fertility rates (TFR) and all-cause, CVD mortality rates were retrieved (data provided by the Hellenic Statistical Authority, 1956-2015). In order to test the research hypothesis time-series analysis was conducted. Results: Increasing trends in LE and in the older age (>65 or >80 years) groups’ share and declining trends in TFR were recorded. CVD mortality, after an upward course, showed decreasing trends during 1988–2009, accounting for the 96% and 97% increment in LE in men and women respectively. However, newer records (2010-2015) show a new upward trend. The declining trends in TFR were highly associated with the shifts towards the upper part of the population age pyramid. Conclusion: Population aging is a historically unprecedented event that cannot be avoided, deterred or alleviated. Its negative effects act cumulatively with the recent increases in cardiovascular mortality, especially in the light of the ongoing economic crisis which is expected to further exacerbate the existing contrasts. A possible way to successfully cope with the new demographic realities is to unlock an, up till now largely overlooked, opportunity named “healthy aging”.

ПІДГОТОВКА МАЙБУТНІХ СОЦІОЛОГІВ ДО КОМП’ЮТЕРНОГО АНАЛІЗУ ДЕМОГРАФІЧНИХ ПРОЦЕСІВ І СТРУКТУР

In the modern era of digital globalization, it is becoming more and more important to train sociology students in the field of demographics and demographic statistics based not only on demographic theories but also on the practical application of the new computer tools and technologies, databases and Internet services. The article analyzes the capabilities of modern computer tools for the analysis of demographic processes and structures in training sociology students; substantiates the use of the R environment as a tool for analysis and graphical representation of demographic data. It presents the idea of teaching students to perform computer analysis of demographic data using a combination of Excel spreadsheets, SPSS statistical package, R environment illustrated by two examples. The first example concerns building and comparing the gender-age pyramid of the population of Ukraine at different years and includes searching for the relevant data, building the pyramid using standard diagram building Excel tools, using SPSS tools (Chart Builder, Histogram, Population Pyramid), and using pyramid package of R environment. The second example relates to calculation of childcare and grandparent care load coefficients, visualizing their dynamics, and includes an introduction to the demographic passport of Ukraine. The article presents the developed methodological support for teaching sociology students to perform demographic data analysis, including presentation-lectures on the fundamental principles of work in R and R Studio environment, laboratory works (theory summary, detailed operative instructions, control questions, tasks for students ‘ independent work); data packages attached to every assignment. The author has analyzed the didactic capabilities of the free Gapminder service that includes the list of the tools titled `Play with Data`, bubble chart, maps, ranking, trends, age pyramids. This provides colorful and dynamic data visualization for chosen demographic criteria (depending on the research objectives) by countries and continents over time that stimulates the students to conduct additional scientific research.

8. Population pyramids and projections

‘Population pyramids and projections’ describes a key concept within demography—the population pyramid. The age pyramid represents the distribution of a population by age and sex. It comprises a pair of bar graphs joined in the centre and traditionally resembling an Egyptian pyramid. The vertical axis records age, with young at the base and old at the top, and the bars coming off the axis to the right represent females and to the left males. The demographic behaviour of individuals is affected by their age, the time period in which they are living, and their shared cohort experience. Different methods of population projections to foresee population futures are also outlined.