Six Ways Population Change Will Affect the Global Economy

New estimates of economic flows by age combined with population projections show that in the coming decades (1) global GDP growth could be slower by about 1 percentage point per year, declining more sharply than population growth; (2) GDP will shift toward sub-Saharan Africa more than population trends suggest; (3) living standards of working-age adults may be squeezed by high spending on children and seniors; (4) changing population age distribution will raise living standards in many lower-income nations; (5) changing economic life cycles will amplify the economic effects of population aging in many higher income economies; and (6) population aging will likely push public debt, private assets, and perhaps productivity higher. Population change will have profound implications for national, regional, and global economies.Center on the Economics and Demography of Aging/[5P30AGO12839-24]/CEDA/Estados UnidosWilliam and Flora Hewlett Foundation/[2013-9306]//Estados UnidosWilliam and Flora Hewlett Foundation/[2017-4778]//Estados UnidosInternational Development Research Centre/[107451]/IDRC/Estados UnidosEuropean Union’s Seventh Framework Program/[613247]/FP7/Unión EuropeaUnited Nations Development Account/[1617AO]/UNDP/Estados UnidosUCR::Vicerrectoría de Investigación::Unidades de Investigación::Ciencias Sociales::Centro Centroamericano de Población (CCP

Estimación (1980-2017) y proyección (2018-2100) de la población económicamente activa de Costa Rica. Informe metodológico

La identificación de las tendencias pasadas y la proyección a futuro de la población económicamente activa (PEA) del país son necesarias para la planificación de sus recursos humanos y la formulación de las políticas de empleo. Estas tendencias y su proyección son también insumos esenciales para los estudios de los futuros contribuyentes a la seguridad social, incluido el sistema de pensiones. En Costa Rica no existen proyecciones oficiales ni análisis de tendencias de la PEA. El Centro Latinoamericano y Caribeño de Demografía (CELADE) de la CEPAL realizó en el 2017 proyecciones en esta materia para los países latinoamericanos y del Caribe (CELADE, 2017); sin embargo, estos datos tienen un uso limitado en el caso costarricense ya que las estimaciones no son completamente compatibles con las proyecciones oficiales de población (INEC & CCP, 2013). Además, las estimaciones de CELADE no especifican ni los supuestos ni la metodología que se utiliza. Otra limitación de esta fuente de información es que los indicadores se proyectan hasta el 2050, lo cual es un periodo insuficiente para análisis de largo plazo, tales como los estudios actuariales del sistema de pensiones que llegan al año 2100 y más. Dado el vacío de información expuesto anteriormente, este documento propone una metodología para estimar series detalladas de la PEA de Costa Rica entre 1980 a 2017 y su proyección del 2018 al 2100. Este estudio incluye también la desagregación de la PEA en asalariados o no. Todos los análisis son desagregados por sexo y por edad en años simples. Este informe está dividido en cuatro secciones. La primera describe las fuentes de información utilizadas. La segunda parte detalla la metodología con tres subsecciones: modelo predictivo, los efectos o resultados del modelo propuesto, y los supuestos para realizar la proyección. El tercer apartado presenta los resultados de la proyección. Finalmente se incluye una discusión de los resultados y la metodología.UCR::Vicerrectoría de Investigación::Unidades de Investigación::Ciencias Sociales::Centro Centroamericano de Población (CCP)UCR::Vicerrectoría de Docencia::Ciencias Sociales::Facultad de Ciencias Económicas::Escuela de EstadísticaUCR::Vicerrectoría de Investigación::Unidades de Investigación::Ciencias Sociales::Instituto de Investigación en Ciencias Económicas (IICE

Syphilis in pregnancy: knowledge of pregnant and puerperous women / Sífilis na gestação: conhecimento de gestantes e puérperas

Objetivo: identificar o conhecimento de gestantes e puérperas acerca da sífilis. Método: pesquisa descritiva, com abordagem qualitativa. A coleta de dados ocorreu por meio de instrumento semiestruturado, entre abril a julho de 2021, com 18 gestantes/puérperas com diagnóstico de sífilis na gestação. As respostas foram gravadas e transcritas na íntegra, sendo utilizado para análise a técnica do Discurso do Sujeito Coletivo. Resultados: identificou-se três ideias centrais: 1) Conhecimento sobre a sífilis, 2) Buscando conhecimento sobre a sífilis e 3) Falsa prevenção. O conhecimento das participantes mostrou-se conflitante, pois algumas apresentaram algum conhecimento e outras nenhum, sendo que todas deveriam ter sido orientadas sobre a doença. Considerações finais: identificou-se uma falha no atendimento ofertado nos serviços de saúde. Assim, estratégias voltadas à educação em saúde devem ser incentivadas e implementadas no acompanhamento de pré-natal, ofertando a promoção e prevenção da saúde, a fim de reduzir os casos de sífilis na gestação.

Two-year outcomes after transcatheter or surgical aortic-valve replacement.

BACKGROUND: The Placement of Aortic Transcatheter Valves (PARTNER) trial showed that among high-risk patients with aortic stenosis, the 1-year survival rates are similar with transcatheter aortic-valve replacement (TAVR) and surgical replacement. However, longer-term follow-up is necessary to determine whether TAVR has prolonged benefits. METHODS: At 25 centers, we randomly assigned 699 high-risk patients with severe aortic stenosis to undergo either surgical aortic-valve replacement or TAVR. All patients were followed for at least 2 years, with assessment of clinical outcomes and echocardiographic evaluation. RESULTS: The rates of death from any cause were similar in the TAVR and surgery groups (hazard ratio with TAVR, 0.90; 95% confidence interval [CI], 0.71 to 1.15; P=0.41) and at 2 years (Kaplan-Meier analysis) were 33.9% in the TAVR group and 35.0% in the surgery group (P=0.78). The frequency of all strokes during follow-up did not differ significantly between the two groups (hazard ratio, 1.22; 95% CI, 0.67 to 2.23; P=0.52). At 30 days, strokes were more frequent with TAVR than with surgical replacement (4.6% vs. 2.4%, P=0.12); subsequently, there were 8 additional strokes in the TAVR group and 12 in the surgery group. Improvement in valve areas was similar with TAVR and surgical replacement and was maintained for 2 years. Paravalvular regurgitation was more frequent after TAVR (P<0.001), and even mild paravalvular regurgitation was associated with increased late mortality (P<0.001). CONCLUSIONS: A 2-year follow-up of patients in the PARTNER trial supports TAVR as an alternative to surgery in high-risk patients. The two treatments were similar with respect to mortality, reduction in symptoms, and improved valve hemodynamics, but paravalvular regurgitation was more frequent after TAVR and was associated with increased late mortality. (Funded by Edwards Lifesciences; ClinicalTrials.gov number, NCT00530894.)

A proposal for a new PhD level curriculum on quantitative methods for drug development

This paper provides an overview of “Improving Design, Evaluation and Analysis of early drug development Studies” (IDEAS), a European Commission–funded network bringing together leading academic institutions and small‐ to large‐sized pharmaceutical companies to train a cohort of graduate‐level medical statisticians. The network is composed of a diverse mix of public and private sector partners spread across Europe, which will host 14 early‐stage researchers for 36 months. IDEAS training activities are composed of a well‐rounded mixture of specialist methodological components and generic transferable skills. Particular attention is paid to fostering collaborations between researchers and supervisors, which span academia and the private sector. Within this paper, we review existing medical statistics programmes (MSc and PhD) and highlight the training they provide on skills relevant to drug development. Motivated by this review and our experiences with the IDEAS project, we propose a concept for a joint, harmonised European PhD programme to train statisticians in quantitative methods for drug development