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1.
Front Public Health ; 12: 1341455, 2024.
Article in English | MEDLINE | ID: mdl-38699420

ABSTRACT

Background: Population ageing is inseparable from technological innovation, social progress and the development of human civilization, and constitutes a new element in the development of contemporary human history. Objective: To dynamically analyses the developmental, structural and growth characteristics of population ageing in 31 provincial capitals and municipalities in China, using the data of the fifth national census in 2000 and the seventh national census in 2020. Methods: The development characteristics and spatial and temporal patterns of population aging in the 31 cities were measured using the population aging index growth model, Theil's index, coefficient of variation, population aging index and other analytical methods. Results: (1) From 2000 to 2020, the population aging rate of the 31 central cities generally increased, and the population aging level of the cities showed the characteristics of "East-Central-Northeast-West" to "Northeast-East-Central-West" decreasing. (2) Regional differences in the ratio of old to young are relatively high, while regional differences in the level of population ageing are relatively small. The level of population ageing is classified with the indicators of size structure, family structure and age structure in the first and third quadrants, and with the geographic concentration rate in the second and fourth quadrants. (3) China's population ageing has a T-shaped spatial distribution characteristic pointing along the coast - along the Yangtze Rivers. Conclusion: The 31 central cities are the center of gravity of China's economy and have strong economic power in dealing with the challenges of population ageing, but how to make population ageing compatible with the economy and society, and then promote sustainable population development, is a topic that needs further attention in the study.


Subject(s)
Cities , Population Dynamics , Spatio-Temporal Analysis , China , Humans , Cities/statistics & numerical data , Population Dynamics/trends , Population Dynamics/statistics & numerical data , Aged
2.
Bull Math Biol ; 86(7): 78, 2024 May 22.
Article in English | MEDLINE | ID: mdl-38777934

ABSTRACT

Understanding the propagation of invasive plants at the beginning of invasive spread is important as it can help practitioners eradicate harmful species more efficiently. In our work the propagation regime of the invasive plant species is studied at the short-time scale before a travelling wave is established and advances into space at a constant speed. The integro-difference framework has been employed to deal with a stage-structured population, and a short-distance dispersal mode has been considered in the homogeneous environment and when a road presents in the landscape. It is explained in the paper how nonlinear spatio-temporal dynamics arise in a transient regime where the propagation speed depends on the detection threshold population density. Furthermore, we investigate the question of whether the transient dynamics become different when the homogeneous landscape is transformed into the heterogeneous one. It is shown in the paper how invasion slows down in a transient regime in the presence of a road.


Subject(s)
Ecosystem , Introduced Species , Mathematical Concepts , Models, Biological , Nonlinear Dynamics , Introduced Species/statistics & numerical data , Population Dynamics/statistics & numerical data , Population Density , Computer Simulation , Spatio-Temporal Analysis
3.
Bull Math Biol ; 86(6): 67, 2024 May 03.
Article in English | MEDLINE | ID: mdl-38700758

ABSTRACT

In biology, evolutionary game-theoretical models often arise in which players' strategies impact the state of the environment, driving feedback between strategy and the surroundings. In this case, cooperative interactions can be applied to studying ecological systems, animal or microorganism populations, and cells producing or actively extracting a growth resource from their environment. We consider the framework of eco-evolutionary game theory with replicator dynamics and growth-limiting public goods extracted by population members from some external source. It is known that the two sub-populations of cooperators and defectors can develop spatio-temporal patterns that enable long-term coexistence in the shared environment. To investigate this phenomenon and unveil the mechanisms that sustain cooperation, we analyze two eco-evolutionary models: a well-mixed environment and a heterogeneous model with spatial diffusion. In the latter, we integrate spatial diffusion into replicator dynamics. Our findings reveal rich strategy dynamics, including bistability and bifurcations, in the temporal system and spatial stability, as well as Turing instability, Turing-Hopf bifurcations, and chaos in the diffusion system. The results indicate that effective mechanisms to promote cooperation include increasing the player density, decreasing the relative timescale, controlling the density of initial cooperators, improving the diffusion rate of the public goods, lowering the diffusion rate of the cooperators, and enhancing the payoffs to the cooperators. We provide the conditions for the existence, stability, and occurrence of bifurcations in both systems. Our analysis can be applied to dynamic phenomena in fields as diverse as human decision-making, microorganism growth factors secretion, and group hunting.


Subject(s)
Biological Evolution , Cooperative Behavior , Game Theory , Mathematical Concepts , Models, Biological , Animals , Humans , Spatio-Temporal Analysis , Computer Simulation , Population Dynamics/statistics & numerical data , Feedback
4.
Bull Math Biol ; 86(6): 69, 2024 May 07.
Article in English | MEDLINE | ID: mdl-38714590

ABSTRACT

We unify evolutionary dynamics on graphs in strategic uncertainty through a decaying Bayesian update. Our analysis focuses on the Price theorem of selection, which governs replicator(-mutator) dynamics, based on a stratified interaction mechanism and a composite strategy update rule. Our findings suggest that the replication of a certain mutation in a strategy, leading to a shift from competition to cooperation in a well-mixed population, is equivalent to the replication of a strategy in a Bayesian-structured population without any mutation. Likewise, the replication of a strategy in a Bayesian-structured population with a certain mutation, resulting in a move from competition to cooperation, is equivalent to the replication of a strategy in a well-mixed population without any mutation. This equivalence holds when the transition rate from competition to cooperation is equal to the relative strength of selection acting on either competition or cooperation in relation to the selection differential between cooperators and competitors. Our research allows us to identify situations where cooperation is more likely, irrespective of the specific payoff levels. This approach provides new perspectives into the intended purpose of Price's equation, which was initially not designed for this type of analysis.


Subject(s)
Bayes Theorem , Biological Evolution , Game Theory , Mathematical Concepts , Models, Genetic , Mutation , Selection, Genetic , Computer Simulation , Cooperative Behavior , Competitive Behavior , Population Dynamics/statistics & numerical data , Models, Biological , Humans
5.
Bull Math Biol ; 86(7): 80, 2024 May 27.
Article in English | MEDLINE | ID: mdl-38801489

ABSTRACT

Many commonly used mathematical models in the field of mathematical biology involve challenges of parameter non-identifiability. Practical non-identifiability, where the quality and quantity of data does not provide sufficiently precise parameter estimates is often encountered, even with relatively simple models. In particular, the situation where some parameters are identifiable and others are not is often encountered. In this work we apply a recent likelihood-based workflow, called Profile-Wise Analysis (PWA), to non-identifiable models for the first time. The PWA workflow addresses identifiability, parameter estimation, and prediction in a unified framework that is simple to implement and interpret. Previous implementations of the workflow have dealt with idealised identifiable problems only. In this study we illustrate how the PWA workflow can be applied to both structurally non-identifiable and practically non-identifiable models in the context of simple population growth models. Dealing with simple mathematical models allows us to present the PWA workflow in a didactic, self-contained document that can be studied together with relatively straightforward Julia code provided on GitHub . Working with simple mathematical models allows the PWA workflow prediction intervals to be compared with gold standard full likelihood prediction intervals. Together, our examples illustrate how the PWA workflow provides us with a systematic way of dealing with non-identifiability, especially compared to other approaches, such as seeking ad hoc parameter combinations, or simply setting parameter values to some arbitrary default value. Importantly, we show that the PWA workflow provides insight into the commonly-encountered situation where some parameters are identifiable and others are not, allowing us to explore how uncertainty in some parameters, and combinations of parameters, regardless of their identifiability status, influences model predictions in a way that is insightful and interpretable.


Subject(s)
Mathematical Concepts , Models, Biological , Humans , Likelihood Functions , Computer Simulation , Population Dynamics/statistics & numerical data , Workflow , Algorithms
6.
J Math Biol ; 88(6): 70, 2024 Apr 26.
Article in English | MEDLINE | ID: mdl-38668899

ABSTRACT

In this paper, we develop a method of analyzing long transient dynamics in a class of predator-prey models with two species of predators competing explicitly for their common prey, where the prey evolves on a faster timescale than the predators. In a parameter regime near a singular zero-Hopf bifurcation of the coexistence equilibrium state, we assume that the system under study exhibits bistability between a periodic attractor that bifurcates from the singular Hopf point and another attractor, which could be a periodic attractor or a point attractor, such that the invariant manifolds of the coexistence equilibrium point play central roles in organizing the dynamics. To find whether a solution that starts in a vicinity of the coexistence equilibrium approaches the periodic attractor or the other attractor, we reduce the equations to a suitable normal form, and examine the basin boundary near the singular Hopf point. A key component of our study includes an analysis of the long transient dynamics, characterized by their rapid oscillations with a slow variation in amplitude, by applying a moving average technique. We obtain a set of necessary and sufficient conditions on the initial values of a solution near the coexistence equilibrium to determine whether it lies in the basin of attraction of the periodic attractor. As a result of our analysis, we devise a method of identifying early warning signals, significantly in advance, of a future crisis that could lead to extinction of one of the predators. The analysis is applied to the predator-prey model considered in Sadhu (Discrete Contin Dyn Syst B 26:5251-5279, 2021) and we find that our theory is in good agreement with the numerical simulations carried out for this model.


Subject(s)
Extinction, Biological , Food Chain , Models, Biological , Population Dynamics , Predatory Behavior , Animals , Population Dynamics/statistics & numerical data , Ecosystem , Mathematical Concepts , Computer Simulation
7.
J Math Biol ; 88(6): 72, 2024 Apr 28.
Article in English | MEDLINE | ID: mdl-38678110

ABSTRACT

In this work, we formulate a random Wolbachia invasion model incorporating the effects of imperfect maternal transmission and incomplete cytoplasmic incompatibility (CI). Under constant environments, we obtain the following results: Firstly, the complete invasion equilibrium of Wolbachia does not exist, and thus the population replacement is not achievable in the case of imperfect maternal transmission; Secondly, imperfect maternal transmission or incomplete CI may obliterate bistability and backward bifurcation, which leads to the failure of Wolbachia invasion, no matter how many infected mosquitoes would be released; Thirdly, the threshold number of the infected mosquitoes to be released would increase with the decrease of the maternal transmission rate or the intensity of CI effect. In random environments, we investigate in detail the Wolbachia invasion dynamics of the random mosquito population model and establish the initial release threshold of infected mosquitoes for successful invasion of Wolbachia into the wild mosquito population. In particular, the existence and stability of invariant probability measures for the establishment and extinction of Wolbachia are determined.


Subject(s)
Mathematical Concepts , Models, Biological , Mosquito Vectors , Wolbachia , Wolbachia/physiology , Wolbachia/pathogenicity , Animals , Female , Mosquito Vectors/microbiology , Population Dynamics/statistics & numerical data , Cytoplasm/microbiology , Culicidae/microbiology , Male , Computer Simulation , Maternal Inheritance
8.
Glob Health Res Policy ; 9(1): 15, 2024 Apr 29.
Article in English | MEDLINE | ID: mdl-38679749

ABSTRACT

BACKGROUND: The population of China is aging rapidly. However, the long-term trajectories of functionally dependent late middle-aged and older Chinese people are currently absent. The present study aimed to estimate the population size and proportion of late middle-aged and older adults with difficulties and dependence on activities of daily living (ADL) and instrumental activities of daily living (IADL) in China from 2018 to 2048. METHODS: We constructed a dynamic microsimulation model to project the population size and proportions of late middle-aged and older Chinese people who have difficulty and dependence in ADL and IADL from 2018-2048. The model was populated with a representative sample of the target population and allowed individual-level interaction between risk factors, diseases, and health outcomes. Analyses by socioeconomic subgroups were also conducted. RESULTS: Almost 25% and 38% of late middle-aged and older people in China will become ADL- and IADL-dependent by 2048, respectively. Also, 17% of the target population will be severely ADL-disabled by 2048. The inequity in functional status across subgroups by sex, educational level, and urban/rural residency will become substantial. CONCLUSIONS: The numbers and percentages of China's functionally difficult and dependent late middle-aged and older population will increase by magnitudes as of the mid-21st century, the pressure of which is compounded by its disproportionate distribution across subgroups. To alleviate the overwhelming challenge, efforts to improve the functional status of the underserved subpopulation should also be iterated.


Subject(s)
Activities of Daily Living , China , Humans , Aged , Middle Aged , Male , Female , Aged, 80 and over , Forecasting , Population Dynamics/statistics & numerical data , Computer Simulation
9.
Am Fam Physician ; 109(4): 308-309, 2024 Apr.
Article in English | MEDLINE | ID: mdl-38648825

ABSTRACT

The percentage of U.S. residents 65 years and older was 17% in 2020, and this number is expected to rise due to the aging of the baby boomer generation.1Although life expectancy fell between 2020 and 2021, the proportion of U.S. residents older than 65 years continues to increase.2This age group often has more medical comorbidities and prescription medications, increasing the demand for primary care access. Domestic migration (U.S. residents moving within the country) of this retirement-aged population further strains the primary care workforce in underserved areas.


Subject(s)
Health Services Accessibility , Primary Health Care , Humans , United States , Aged , Aged, 80 and over , Male , Female , Population Dynamics/trends , Population Dynamics/statistics & numerical data , Life Expectancy/trends
10.
Math Biosci ; 372: 109193, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38657944

ABSTRACT

This paper deals with a diffusive population-toxicant model in polluted aquatic environments, with a toxicant-taxis term describing a toxicant-induced behavior change, that is, the population tends to move away from locations with high-level toxicants. The global existence of solutions is established by the techniques of the semigroup estimation and Moser iteration. Based on a detailed study on the properties of the principal eigenvalue for non-self-adjoint eigenvalue problems, we investigated the local and global stability of the toxin-only steady-state solution and the existence of positive steady state, which yields sufficient conditions that lead to population persistence or extinction. Finally, by numerical simulations, we studied the effects of some key parameters, such as toxicant-taxis coefficient, advection rate, and effect coefficient of the toxicant on population growth, on population persistence. Both numerical and analytical results show that a weak chemotaxis effect, a small advection rate of the population, and a weak effect of the toxicant on population growth are favorable for population persistence.


Subject(s)
Population Dynamics , Population Dynamics/statistics & numerical data , Models, Biological , Water Pollutants, Chemical/toxicity , Animals , Mathematical Concepts , Computer Simulation
11.
J Math Biol ; 88(6): 68, 2024 Apr 25.
Article in English | MEDLINE | ID: mdl-38661851

ABSTRACT

The coexistence of multiple phytoplankton species despite their reliance on similar resources is often explained with mean-field models assuming mixed populations. In reality, observations of phytoplankton indicate spatial aggregation at all scales, including at the scale of a few individuals. Local spatial aggregation can hinder competitive exclusion since individuals then interact mostly with other individuals of their own species, rather than competitors from different species. To evaluate how microscale spatial aggregation might explain phytoplankton diversity maintenance, an individual-based, multispecies representation of cells in a hydrodynamic environment is required. We formulate a three-dimensional and multispecies individual-based model of phytoplankton population dynamics at the Kolmogorov scale. The model is studied through both simulations and the derivation of spatial moment equations, in connection with point process theory. The spatial moment equations show a good match between theory and simulations. We parameterized the model based on phytoplankters' ecological and physical characteristics, for both large and small phytoplankton. Defining a zone of potential interactions as the overlap between nutrient depletion volumes, we show that local species composition-within the range of possible interactions-depends on the size class of phytoplankton. In small phytoplankton, individuals remain in mostly monospecific clusters. Spatial structure therefore favours intra- over inter-specific interactions for small phytoplankton, contributing to coexistence. Large phytoplankton cell neighbourhoods appear more mixed. Although some small-scale self-organizing spatial structure remains and could influence coexistence mechanisms, other factors may need to be explored to explain diversity maintenance in large phytoplankton.


Subject(s)
Computer Simulation , Ecosystem , Mathematical Concepts , Models, Biological , Phytoplankton , Population Dynamics , Phytoplankton/physiology , Phytoplankton/growth & development , Population Dynamics/statistics & numerical data , Biodiversity
12.
Neurología (Barc., Ed. impr.) ; 39(1): 10-19, Jan.-Feb. 2024. tab, graf
Article in Spanish | IBECS | ID: ibc-EMG-441

ABSTRACT

Introducción Al realizar una evaluación neuropsicológica, es necesario contar con datos normativos adecuados; la calidad metodológica de los estudios que los proponen garantiza que las conclusiones sean confiables y válidas. Se presentan las características metodológicas del Proyecto Neuronorma Colombia con el fin de analizar sus aportes y limitaciones. Método Se exponen las características de la muestra normativa, los criterios de inclusión y exclusión, el análisis estadístico de los datos, el procedimiento para la obtención de datos normativos y los instrumentos utilizados. Resultados Se presentan algunos perfiles gráficos de ejecución de casos clínicos, a partir de la Unidad de Trabajo Neuronorma, con el fin de ilustrar la interpretación de los resultados obtenidos al evaluar pacientes con la batería Neuronorma Colombia. Discusión y conclusiones Existen ventajas metodológicas del estudio: su carácter multicéntrico y conormalizado y disponer de la Unidad de Trabajo Neuronorma, que permite obtener perfiles gráficos del desempeño del paciente, herramienta fundamental para el diagnóstico y la investigación. Se presentan los hallazgos de investigaciones posteriores realizadas a partir de los datos normativos propuestos, que son evidencia de la utilidad de la batería. Se discute el aporte de este estudio, en el contexto de sus antecedentes inmediatos. (AU)


Introduction Availability of adequate normative data is essential when performing neuropsychological evaluation; good methodological quality of the studies that propose these data ensures that their conclusions are reliable and valid. We present the methodological characteristics of the Neuronorma Colombia Project in order to analyse its contributions and limitations. Method We present the characteristics of the normative sample, inclusion and exclusion criteria, statistical analysis, the procedure for obtaining normative data, and the instruments used. Results We present graphical profiles of patient performance, based on the Neuronorma Work Unit, to illustrate the interpretation of the results obtained when evaluating patients with the Neuronorma Colombia Battery. Discussion and conclusions Our study presents several methodological advantages, such as its multicentre, co-normalised design and the availability of the Neuronorma Work Unit, which allows the creation of graphical profiles of patient performance, a fundamental tool for diagnosis and research. We present the findings of subsequent research based on the proposed normative data, which demonstrate the value of the battery. The contribution of this study is discussed in the context of its immediate background. (AU)


Subject(s)
Humans , Middle Aged , Aged , Aged, 80 and over , Aging , Population Dynamics/statistics & numerical data , Neuropsychology , Colombia
13.
Nature ; 627(8002): 137-148, 2024 Mar.
Article in English | MEDLINE | ID: mdl-38383777

ABSTRACT

Urban life shapes the mental health of city dwellers, and although cities provide access to health, education and economic gain, urban environments are often detrimental to mental health1,2. Increasing urbanization over the next three decades will be accompanied by a growing population of children and adolescents living in cities3. Shaping the aspects of urban life that influence youth mental health could have an enormous impact on adolescent well-being and adult trajectories4. We invited a multidisciplinary, global group of researchers, practitioners, advocates and young people to complete sequential surveys to identify and prioritize the characteristics of a mental health-friendly city for young people. Here we show a set of ranked characteristic statements, grouped by personal, interpersonal, community, organizational, policy and environmental domains of intervention. Life skills for personal development, valuing and accepting young people's ideas and choices, providing safe public space for social connection, employment and job security, centring youth input in urban planning and design, and addressing adverse social determinants were priorities by domain. We report the adversities that COVID-19 generated and link relevant actions to these data. Our findings highlight the need for intersectoral, multilevel intervention and for inclusive, equitable, participatory design of cities that support youth mental health.


Subject(s)
Cities , City Planning , Mental Health , Surveys and Questionnaires , Adolescent , Child , Humans , Young Adult , Cities/statistics & numerical data , Mental Health/statistics & numerical data , Mental Health/trends , Population Dynamics/statistics & numerical data , Population Dynamics/trends , Urbanization/trends , Built Environment/statistics & numerical data , Built Environment/trends , City Planning/methods , Employment , Social Behavior
14.
Neurología (Barc., Ed. impr.) ; 39(1): 10-19, Jan.-Feb. 2024. tab, graf
Article in Spanish | IBECS | ID: ibc-229824

ABSTRACT

Introducción Al realizar una evaluación neuropsicológica, es necesario contar con datos normativos adecuados; la calidad metodológica de los estudios que los proponen garantiza que las conclusiones sean confiables y válidas. Se presentan las características metodológicas del Proyecto Neuronorma Colombia con el fin de analizar sus aportes y limitaciones. Método Se exponen las características de la muestra normativa, los criterios de inclusión y exclusión, el análisis estadístico de los datos, el procedimiento para la obtención de datos normativos y los instrumentos utilizados. Resultados Se presentan algunos perfiles gráficos de ejecución de casos clínicos, a partir de la Unidad de Trabajo Neuronorma, con el fin de ilustrar la interpretación de los resultados obtenidos al evaluar pacientes con la batería Neuronorma Colombia. Discusión y conclusiones Existen ventajas metodológicas del estudio: su carácter multicéntrico y conormalizado y disponer de la Unidad de Trabajo Neuronorma, que permite obtener perfiles gráficos del desempeño del paciente, herramienta fundamental para el diagnóstico y la investigación. Se presentan los hallazgos de investigaciones posteriores realizadas a partir de los datos normativos propuestos, que son evidencia de la utilidad de la batería. Se discute el aporte de este estudio, en el contexto de sus antecedentes inmediatos. (AU)


Introduction Availability of adequate normative data is essential when performing neuropsychological evaluation; good methodological quality of the studies that propose these data ensures that their conclusions are reliable and valid. We present the methodological characteristics of the Neuronorma Colombia Project in order to analyse its contributions and limitations. Method We present the characteristics of the normative sample, inclusion and exclusion criteria, statistical analysis, the procedure for obtaining normative data, and the instruments used. Results We present graphical profiles of patient performance, based on the Neuronorma Work Unit, to illustrate the interpretation of the results obtained when evaluating patients with the Neuronorma Colombia Battery. Discussion and conclusions Our study presents several methodological advantages, such as its multicentre, co-normalised design and the availability of the Neuronorma Work Unit, which allows the creation of graphical profiles of patient performance, a fundamental tool for diagnosis and research. We present the findings of subsequent research based on the proposed normative data, which demonstrate the value of the battery. The contribution of this study is discussed in the context of its immediate background. (AU)


Subject(s)
Humans , Middle Aged , Aged , Aged, 80 and over , Aging , Population Dynamics/statistics & numerical data , Neuropsychology , Colombia
15.
Article in Russian | MEDLINE | ID: mdl-37427507

ABSTRACT

The article considers the process of population aging, which is evidently specific in economically developed countries for last quarter of the XX century. The increasing of population size older than able-bodied age in urban and rural population in the Irkutsk Oblast that is demonstrated by aging coefficient dynamic. In all studied territories increasing of this coefficient is revealed that characterizes transition of aging process in most areas of residence of urban and rural population to the level of III-IV stages (old and deeply old population). The dynamics of average age indicator is characterized by its stabilization at the level of stage II as aging population. The pensionary load on urban and rural population is increasing and it is higher in rural population. The increasing of this indicator is reflected in transformation of aging population (stage II) to old and deeply old population (stage III-IV). In most areas, coefficient of longevity is characterized by its increase in urban and rural population. The heterogeneity of aging differences between urban and rural population is smoothing out.


Subject(s)
Population Dynamics , Rural Population , Urban Population , Aged , Aged, 80 and over , Humans , Population Dynamics/statistics & numerical data , Rural Population/statistics & numerical data , Russia , Urban Population/statistics & numerical data
16.
Child Dev ; 94(5): e264-e278, 2023.
Article in English | MEDLINE | ID: mdl-37132154

ABSTRACT

Moving is common during middle childhood, but links between move type and children's development are less well understood. Using nationally-representative, longitudinal data (2010-2016) of ~9900 U.S. kindergarteners (52% boys, 51.48% White, 26.11% Hispanic/Latino, 10.63% Black, 11.78% Asian/Pacific Islander), we conducted multiple-group fixed-effects models estimating associations of within- and between-neighborhood moves, family income, and children's achievement and executive function, testing whether associations persisted or varied by developmental timing. Analyses suggest important spatial and temporal dimensions of moving during middle childhood: between-neighborhood moves had stronger associations than within-neighborhood moves, earlier moves benefited development whereas later moves did not, and associations persisted with significant effect sizes (cumulative Hedges' g = -0.09-1.35). Research and policy implications are discussed.


Subject(s)
Population Dynamics , Residence Characteristics , Child , Female , Humans , Male , Achievement , Asian/psychology , Asian/statistics & numerical data , Executive Function , Pacific Island People/psychology , Pacific Island People/statistics & numerical data , Residence Characteristics/statistics & numerical data , White/psychology , White/statistics & numerical data , Hispanic or Latino/psychology , Hispanic or Latino/statistics & numerical data , Black or African American/psychology , Black or African American/statistics & numerical data , Educational Status , Social Determinants of Health/ethnology , Social Determinants of Health/statistics & numerical data , Population Dynamics/statistics & numerical data
17.
Brasília; CONASS; 2023. 110 p. ilus.
Monography in Portuguese | LILACS, CONASS, CNS-BR | ID: biblio-1538280

ABSTRACT

Os sistemas de atenção à saúde se deparam, em escala planetária, com um grave problema estrutural determinado pela fragmentação do cuidado que se explica pela natureza singular da transição da saúde. Essa transição compõe-se de dois movimentos interconectados: a transição das condições de saúde e a transição dos sistemas de saúde. A transição das condições de saúde dá-se no contexto dos sistemas de atenção em duas dimensões principais: a transição demográfica e a transição epidemiológica. A transição demográfica já se completou nos países desenvolvidos e está se dando de forma muito profunda e rápida nos países em desenvolvimento, entre eles o Brasil, como mostram os dados recente do censo. O resultado dessa transição é que a proporção de pessoas idosas vem aumentando rapidamente, levando ao incremento exponencial das condições crônicas e pressionando os custos dos sistemas de atenção à saúde. A outra transição contextual é a epidemiológica, que se expressa no crescimento relativo das condições crônicas na carga de doenças. No Brasil, as doenças crônicas já representam mais de 70% dessa carga. Se considerarmos o conceito de condições crônicas, que engloba todas as condições que exigem dos sistemas de atenção à saúde uma ação proativa, contínua e integrada em redes - o que inclui a atenção à pessoa idosa -, esse percentual chega a aproximadamente 80% da carga total doenças. Como consequência, pode-se estimar que mais de 75% dos gastos do SUS são por condições crônicas. Por outro lado, a transição dos sistemas de atenção à saúde expressa em suas culturas e seus modelos de gestão e de financiamento dá-se de forma lenta e superficial. Essa brecha entre a transição das condições de saúde e a transição dos sistemas de atenção à saúde rompe o princípio fundamental do postulado que indica que deve haver uma coerência entre essas duas formas de transição. Isso leva a uma ruptura que constitui a crise medular dos sistemas de atenção à saúde, que não conseguem se adaptar, oportunamente, ao crescimento das condições crônicas. O resultado é que temos hoje, no Brasil e em todo o mundo, uma incoerência entre uma situação de saúde de tripla carga de doenças, com predomínio relativo forte das condições crônicas e uma resposta social dada por sistemas de atenção à saúde fragmentados, que foram desenvolvidos na metade do século passado. Ou seja, temos um descompasso entre uma situação de saúde do século XXI, sendo respondida por um sistema de atenção à saúde do século XX, que se volta relativamente para a atenção aos eventos agudos. O sistema fragmentado vigente se caracteriza por ser organizado por componentes, por níveis hierárquicos e para a atenção aos eventos agudos, para os indivíduos, de forma reativa, com ênfase em ações curativas, reabilitadoras e no cuidado profissional e sem um ente de coordenação dos fluxos de pessoas, produtos e informações. Esses sistemas fragmentados fracassaram totalmente no enfrentamento das condições crônicas. Pesquisa recente sobre a hipertensão arterial feita por 1200 estudos populacionais e com uma amostra de mais de 1 milhão de pessoas em vários países do mundo mostrou que de cada 100 pessoas menos de 10 delas estavam em tratamento e com a pressão arterial controlada. Não é diferente no Brasil em que estudos evidenciaram que de cada 100 pessoas com diabetes apenas 13 estavam em tratamento e com a glicemia controlada. A conclusão é clara: há que se superar a fragmentação do cuidado para restabelecer a coerência entre a situação de saúde com forte predomínio de condições crônicas e os sistemas de atenção à saúde público e privado em nosso País. Essa mudança não é trivial porque a implica enfrentar a fragmentação do cuidado que é, segundo a teoria da complexidade, um problema perverso (wicked problem). Esses problemas não são meramente complicados ou técnicos e não podem ser resolvidos pela simples aplicação da lógica ou do poder computacional ou pelos programas de melhoria da qualidade, requerendo intervenções amplas de reimaginação, que convocam soluções em redes e inovações disruptivas. Ou seja, impõe-se um movimento de transição do sistema fragmentado para a organização das redes de atenção à saúde que se caracterizam por: um contínuo de atenção, um equilíbrio entre os eventos agudos e as condições crônicas, um foco numa população, uma construção dos sujeitos como agentes de sua saúde, uma ação proativa, um cuidado integrado (promoção, prevenção, cura, reabilitação e paliação), uma ênfase no cuidado interdisciplinar e uma coordenação pela atenção primária.


Subject(s)
Humans , Aged , Aged, 80 and over , Primary Health Care , Population Dynamics/statistics & numerical data , Multimorbidity , Social Vulnerability , Brazil/epidemiology
19.
PLoS One ; 17(2): e0263704, 2022.
Article in English | MEDLINE | ID: mdl-35134092

ABSTRACT

Automation and population aging are two major forces that will shape the nature of works in the future. However, it is not clear how these forces will interact with each other and affect the labor market. This paper examines the interaction effects of computerization and population aging on the labor market. We found that computerization and population aging have large and statistically significant effects on employment growth but not earnings growth. Also, their interaction terms are statistically significant only for employment growth but not for earnings growth.


Subject(s)
Automation/economics , Employment/trends , Population Dynamics/trends , Automation/ethics , Automation/statistics & numerical data , Employment/economics , Humans , Income , Models, Economic , Models, Theoretical , Occupations , Population Dynamics/statistics & numerical data , Social Class , Socioeconomic Factors , Time Factors
20.
In. Fernández Seco, Alberto Ernesto; Cintra Cala, Duniesky. Envejecimiento saludable en Cuba. La Habana, Editorial Ciencias Médicas, 2022. , ilus, tab.
Monography in Spanish | CUMED | ID: cum-78523
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