BACKGROUND: There are several reports on underdiagnosis of COPD, while little is known about COPD overdiagnosis and overtreatment. We describe the overdiagnosis and the prevalence of spirometrically defined false positive COPD, as well as their relationship with overtreatment across 23 population samples in 20 countries participating in the BOLD Study between 2003 and 2012. METHODS: A false positive diagnosis of COPD was considered when participants reported a doctor's diagnosis of COPD, but postbronchodilator spirometry was unobstructed (FEV1/FVC > LLN). Additional analyses were performed using the fixed ratio criterion (FEV1/FVC < 0.7). RESULTS: Among 16,177 participants, 919 (5.7%) reported a previous medical diagnosis of COPD. Postbronchodilator spirometry was unobstructed in 569 subjects (61.9%): false positive COPD. A similar rate of overdiagnosis was seen when using the fixed ratio criterion (55.3%). In a subgroup analysis excluding participants who reported a diagnosis of "chronic bronchitis" or "emphysema" (n = 220), 37.7% had no airflow limitation. The site-specific prevalence of false positive COPD varied greatly, from 1.9% in low- to middle-income countries to 4.9% in high-income countries. In multivariate analysis, overdiagnosis was more common among women, and was associated with higher education; former and current smoking; the presence of wheeze, cough, and phlegm; and concomitant medical diagnosis of asthma or heart disease. Among the subjects with false positive COPD, 45.7% reported current use of respiratory medication. Excluding patients with reported asthma, 34.4% of those with normal spirometry still used a respiratory medication. CONCLUSIONS: False positive COPD is frequent. This might expose nonobstructed subjects to possible adverse effects of respiratory medication.

Background The Sustainable Development Goals (SDGs) require household survey programmes such as the UNICEF-supported Multiple Indicator Cluster Surveys (MICS) to enhance data collection to cover new indicators. This study aims to evaluated methods for assessing water quality, water availability, emptying of sanitation facilities, menstrual hygiene management and the acceptability of water quality testing in households which are key to monitoring SDG targets 6.1 and 6.2 on drinking Water, Sanitation and Hygiene (WASH) and emerging issues. Methods As part of a MICS field test, we interviewed 429 households and 267 women age 15-49 in Stann Creek, Belize in a split-sample experiment. In a concurrent qualitative component, we conducted focus groups with interviewers and cognitive interviews with respondents during and immediately following questionnaire administration in the field to explore their question comprehension and response processes. Findings About 88% of respondents agreed to water quality testing but also desired test results, given the potential implications for their own health. Escherichia coli was present in 36% of drinking water collected at the source, and in 47% of samples consumed in the household. Both questions on water availability necessitated probing by interviewers. About one quarter of households reported emptying of pit latrines and septic tanks, though one-quarter could not provide an answer to the question. Asking questions on menstrual hygiene was acceptable to respondents, but required some clarification and probing. Conclusions In the context of Belize, this study confirmed the feasibility of collecting information on the availability and quality of drinking water, emptying of sanitation facilities and menstrual hygiene in a multi-purpose household survey, indicating specific areas to improve question formulation and field protocols. Improvements have been incorporated into the latest round of MICS surveys which will be a major source of national data for monitoring of SDG targets for drinking water, sanitation and hygiene and emerging issues for WASH sector programming.

Introduction: Recent evidence shows that indicators currently used to identify the most vulnerable children in the context of HIV and AIDS (death of one or both parents, presence of a chronically ill parent, and living in a household where in the past 12 months at least one adult died and was chronically ill before he/she died, or co-residence with chronically ill adults in a household) do not consistently identify children and adolescents with poor outcomes across national and epidemic contexts, and therefore call for a re-examination of variables which are more closely associated with child and adolescent vulnerability (Akwara et al. 2010). This analysis, which focuses on two outcomes related to female adolescents and determinants of vulnerability, is part of a broader study that builds on the Akwara et al’s work, aiming to identify key predictors of selected poor developmental outcomes for children and adolescents in the context of HIV and AIDS. It contributes to the global level dialogues on global child and adolescent vulnerability measures that may be used to monitor programme progress, as well as guide resource estimates and targeting of programmes, including HIV and AIDS.

Availability of the perfect sampling frame only exists in developed countries, which covers a very small proportion of the world countries. On the other hand, in developing countries lists of the latest population census counts are generally used as the sampling frame for sample surveys. Therefore, in developing countries surveys which are planned for future periods long after the census date, cannot be representative of the related time period if the same census counts are utilized. Instead, population projections and data adjustment methodologies must be used to provide a representative probability selection of the updated population. This article proposes a population projection and adjustment methodology in order to establish the ideal selection probability for household surveys. The method contains the correction on the differences of the sum of strata and aggregated values. Comparative examples are also provided to clarify the proposed methodology.

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Using data from national surveys conducted within the scope of the Eurostat project titled Push and Pull Factors of International Migration, analyses are presented using different definitions (narrow versus wide) of household membership in migrant-sending countries (Egypt, Ghana, Morocco, Senegal and Turkey) to see if different definitions are helpful in identifying and increasing the number of migrants who are or was a part of those households. When broad definition was used, the increase in the international migrant members was especially considerable in recent and current migrant households. The findings demonstrated that it was possible to trace an important number of international migrants back in their country of origin and to collect data using proxy interviews. However, it was still impossible to survey emigrants who left the country as a household, those who were not expected to return to the household, those belonging to some dissolved households, or those who died.

This study aims at providing information on various aspects of adolescent fertility in Turkey. Data collected from women aged 15-19 in the 1998 Turkish Demographic and Health Survey was used with the aim of 1) identifying levels patterns and determinants of adolescent fertility 2) identifying individual cultural and contextual characteristics of adolescent fertility and 3) providing policy recommendations on adolescent fertility in Turkey. The findings are also compared with findings from the other countries in the Middle East and Near Asia region. (authors)

Older populations are expanding not only in developed countries but in developing countries as well. With rapidly decreasing mortality and fertility levels the proportion of the elderly is expected to rise in Turkey; from 5.5 percent in 2000 to 8.6 percent in 2025. Using data from the latest 1998 Turkish Demographic and Health Survey this study gives a comprehensive description of the social economic demographic and residential characteristics of the elderly in Turkey. The elderly consist mostly of females are less urbanised and have less education. Households with elderly are more likely to have a lower level of income compared to all households in the country. The findings also suggested that the elderly population still holds and needs to be around their immediate families either within the same household or within a very close territory. (authors)

This article describes the population structure in Turkey over the past 70 years and presents population projections for the period 1990-2025. Demographic patterns and economic development vary widely within Turkey. Population increased from 13 million to about 60 million during 1923-95. The annual population growth rate was 2.2%. Turkey is one of the 20 most populous countries of the world. The government of Turkey maintained a pronatalist policy until the mid-1960s. The Population Planning Law of 1965 allowed limited imports of contraceptives. In 1983 the law was revised and liberalized to allow abortion up to the 10th gestation week and voluntary surgical sterilization. Past high fertility and growth rates are evident in the young population age structure. In the early 1990s the crude birth rate was about 25/1000. Contraceptive prevalence in 1993 was 63% of total married women in reproductive ages, but only 34.5% relied on effective methods. Withdrawal was the most popular method. Over 66% of women in 1993 reported a desire to stop childbearing, and 14% desired a delay in childbearing. Ideal family size was 2.4 children. The total fertility rate in 1993 was 2.7 children compared to 3.4 in 1988. Infant mortality declined to 53/1000 in the early 1990s. Maternal mortality was 132/1000 live births. Life expectancy was 63 years for males and 68 years for females. 51.4% of the population was urban in 1993. Net in-migration is expected until 2010. Population, under the medium variant, is expected to reach 66 million in 2000 and 87 million in 2025. Under the low variant and a fertility rate decline to 1.58 by 2025, population would reach about 84 million by 2025. Although Turkey remains different from European Union (EU) countries in socioeconomic and demographic profiles, Turkey is a middle-income country and offers the EU an important human resource.

The Turkish Demographic and Health Survey (TDHS), conducted in 1993, provided data on the magnitude of malnutrition in a sample of 3152 preschool children from five geographical regions, and on its causal and conditioning factors. Stunting was found to be the dominant form of malnutrition (21 per cent). Altogether 10 per cent of children were underweight and 3 per cent were wasted. There were urban-rural (16 v. 27 per cent, P < 0.001) and regional differences (highest in the East 38 per cent, lowest in the West and North 10 and 14 per cent, respectively; P < 0.001) in the rate of stunting. Among the most important conditioning factors were too early introduction of supplementary foods, mother's educational level, mother's work area, person who takes care of children while mother is at work, birth rank of children, birth spacing, number of children in an individual family, family size, and mother's welfare and hygiene indices. The need for an intersectoral approach for the development of remedial programs to reduce the effect of these factors and for periodic assessment of nutritional status of preschool children is stressed.

Referring to a 1992 study by Freedman and Blanc, the author of this paper states that during the 15-year period between 1965-70 and 1980-85 the fertility rate in developing countries dropped by 30% and reports that in Turkey the drop for the same period was around 46%, based on analysis using data from a 1988 Turkish Population and Health Survey. Using the same data, the author looks at what women consider the ideal age for marriage; bearing their first and last children and the ideal intervals between pregnancies, by region; settlement type; level of education and age groups. These ideals are examined to determine their effect on fertility rates, and it is found that women both get married and give birth to their first child sooner than they would prefer. It is also observed that the interval between births is shorter than women would wish. According to the study, Turkish women would like to have an average of 2.1 children, although the actual figure is higher. It is also noted that, on the average, women would like to have their last child at age 30 and would like to prevent pregnancy after this age. However, many women, despite this wish, do not actually use modern birth control techniques. It is therefore concluded that by increasing the awareness and availability of effective modern family planning, there is potential to further reduce Turkey's fertility rates.