Forecasting the Burden of Cardiovascular Disease and Stroke in the United States Through 2050-Prevalence of Risk Factors and Disease: A Presidential Advisory From the American Heart Association.

BACKGROUND: Cardiovascular disease and stroke are common and costly, and their prevalence is rising. Forecasts on the prevalence of risk factors and clinical events are crucial. METHODS: Using the 2015 to March 2020 National Health and Nutrition Examination Survey and 2015 to 2019 Medical Expenditure Panel Survey, we estimated trends in prevalence for cardiovascular risk factors based on adverse levels of Life's Essential 8 and clinical cardiovascular disease and stroke. We projected through 2050, overall and by age and race and ethnicity, accounting for changes in disease prevalence and demographics. RESULTS: We estimate that among adults, prevalence of hypertension will increase from 51.2% in 2020 to 61.0% in 2050. Diabetes (16.3% to 26.8%) and obesity (43.1% to 60.6%) will increase, whereas hypercholesterolemia will decline (45.8% to 24.0%). The prevalences of poor diet, inadequate physical activity, and smoking are estimated to improve over time, whereas inadequate sleep will worsen. Prevalences of coronary disease (7.8% to 9.2%), heart failure (2.7% to 3.8%), stroke (3.9% to 6.4%), atrial fibrillation (1.7% to 2.4%), and total cardiovascular disease (11.3% to 15.0%) will rise. Clinical CVD will affect 45 million adults, and CVD including hypertension will affect more than 184 million adults by 2050 (>61%). Similar trends are projected in children. Most adverse trends are projected to be worse among people identifying as American Indian/Alaska Native or multiracial, Black, or Hispanic. CONCLUSIONS: The prevalence of many cardiovascular risk factors and most established diseases will increase over the next 30 years. Clinical and public health interventions are needed to effectively manage, stem, and even reverse these adverse trends.

Estimation and probabilistic projection of age- and sex-specific mortality rates across Brazilian municipalities between 2010 and 2030.

BACKGROUND: Mortality rate estimation in small areas can be difficult due the low number of events/exposure (i.e. stochastic error). If the death records are not completed, it adds a systematic uncertainty on the mortality estimates. Previous studies in Brazil have combined demographic and statistical methods to partially overcome these issues. We estimated age- and sex-specific mortality rates for all 5,565 Brazilian municipalities in 2010 and forecasted probabilistic mortality rates and life expectancy between 2010 and 2030. METHODS: We used a combination of the Tool for Projecting Age-Specific Rates Using Linear Splines (TOPALS), Bayesian Model, Spatial Smoothing Model and an ad-hoc procedure to estimate age- and sex-specific mortality rates for all Brazilian municipalities for 2010. Then we adapted the Lee-Carter model to forecast mortality rates by age and sex in all municipalities between 2010 and 2030. RESULTS: The adjusted sex- and age-specific mortality rates for all Brazilian municipalities in 2010 reveal a distinct regional pattern, showcasing a decrease in life expectancy in less socioeconomically developed municipalities when compared to estimates without adjustments. The forecasted mortality rates indicate varying regional improvements, leading to a convergence in life expectancy at birth among small areas in Brazil. Consequently, a reduction in the variability of age at death across Brazil's municipalities was observed, with a persistent sex differential. CONCLUSION: Mortality rates at a small-area level were successfully estimated and forecasted, with associated uncertainty estimates also generated for future life tables. Our approach could be applied across countries with data quality issues to improve public policy planning.

Quantifying the checks and balances of collaborative governance systems for adaptive carnivore management.

Recovering or threatened carnivore populations are often harvested to minimise their impact on human activities, such as livestock farming or game hunting. Increasingly, harvest quota decisions involve a set of scientific, administrative and political institutions operating at national and sub-national levels whose interactions and collective decision-making aim to increase the legitimacy of management and ensure population targets are met. In practice, however, assessments of how quota decisions change between these different actors and what consequences these changes have on population trends are rare.We combine a state-space population modelling approach with an analysis of quota decisions taken at both regional and national levels between 2007 and 2018 to build a set of decision-making models that together predict annual harvest quota values for Eurasian lynx (Lynx lynx) in Norway.We reveal a tendency for administrative decision-makers to compensate for consistent quota increases by political actors, particularly when the lynx population size estimate is above the regional target. Using population forecasts based on the ensemble of decision-making models, we show that such buffering of political biases ensures lynx population size remains close to regional and national targets in the long term.Our results go beyond the usual qualitative assessment of collaborative governance systems for carnivore management, revealing a system of checks and balances that, in the case of lynx in Norway, ensures both multi-stakeholder participation and sustainable harvest quotas. Nevertheless, we highlight important inter-regional differences in decision-making and population forecasts, the socio-ecological drivers of which need to be better understood to prevent future population declines. Synthesis and applications. Our work analyses the sequence of decisions leading to yearly quotas for lynx harvest in Norway, highlighting the collaborative and structural processes that together shape harvest sustainability. In doing so, we provide a predictive framework to evaluate participatory decision-making processes in wildlife management, paving the way for scientists and decision-makers to collaborate more widely in identifying where decision biases might lie and how institutional arrangements can be optimised to minimise them. We emphasise, however, that this is only possible if wildlife management decisions are documented and transparent.

Forecast of Population Size and Demographic Burden in Russia up to 2100.

The article presents basic approaches to substantiating the hypotheses of fertility, mortality, and migration in Russia in the long term. The main results of the multivariate demographic development of Russia until 2100, which combines 30 different combinations of demographic processes, are analyzed. It is shown that the population will decline under most scenarios, including the most probable medium scenario - up to 137.5 million people by the end of the century. In the short term until the early 2030s, all options show an increase in the demographic load, and in the longer term it alternatively decreases and increases with different intensity time and again. The most favorable scenarios with high fertility and life expectancy and low migration growth put the greatest pressure on the working-age population due to the higher number of births and the elderly in these scenarios.

Demographic drivers of the growth of the number of Aboriginal and Torres Strait Islander people living with dementia, 2016-2051.

OBJECTIVE: To examine the demographic drivers that contribute to the future growth in the population of Aboriginal and Torres Strait Islander peoples living with dementia in Australia. METHODS: Design: Multistate, Indigenous status, cohort component, population projection model. SETTING: National-level, Aboriginal and Torres Strait Islander population. DATA: Data prepared by the Australian Bureau of Statistics on births, deaths, migration and identification change. Australian Institute of Health and Welfare estimates of dementia prevalence alongside estimates from several studies. MAJOR OUTCOME MEASURES: Number of older people living with dementia alongside a decomposition of demographic drivers of growth. RESULTS: By 2051, the relative growth in the number of Aboriginal and Torres Strait Islander peoples aged 50+ with dementia ranges from 4½ to 5½ times (under three prevalence scenarios) its 2016 estimate. Cohort flow (the gradual movement of younger cohorts into the 50+ age group, and the depletion of older cohorts from death, over time) is a key driver of the growth in the number of older people living with dementia. CONCLUSIONS: High growth in the number of people living with dementia poses implications for culturally appropriate care, health-care access and support for Aboriginal and Torres Strait Islander families, carers and their communities.

Complicaciones en los pacientes quemados

Introducción: La lesión por quemadura es uno de los eventos más traumáticos y devastadores que puede sufrir un ser humano. Este evento térmico produce profundas alteraciones en los mecanismos sistémicos de defensa del huésped. Las complicaciones en grandes quemados comienzan en la fase inmediata de la inflamación producida tras sufrir la agresión térmica. Las complicaciones en los pacientes quemados se han asociado con un mal pronóstico, con una alta morbilidad y mortalidad. Objetivo: Describir las complicaciones en los pacientes quemados. Métodos: Se realizó un estudio descriptivo, retrospectivo, de corte transversal para describir las complicaciones en los pacientes quemados que ingresaron en la sala de Caumatología del Hospital Universitario Manuel Ascunce Domenech de la ciudad Camagüey en el período comprendido desde enero de 2021 hasta febrero de 2022. Se estudiaron 32 pacientes en quienes se tuvieron en cuenta las variables: índice de gravedad, complicaciones generales, las complicaciones hidroelectrolíticas y acido básicas, así el estado al egreso de los pacientes. Resultados: Hubo un predominio de pacientes con complicaciones en aquellos lesionados con insulto térmico severo, presentes en 24 pacientes para un 75 %. La infección de la lesión por quemaduras, la hiperglucemia, la anemia y los estados de deshidratación fueron las complicaciones que mayormente se presentaron en los pacientes estudiados. La totalidad de los fallecidos fueron del grupo de pacientes que presentaron complicaciones, ocho pacientes para un 25 %. Conclusiones: La infección de las quemaduras es la principal complicación del paciente quemado. La mayoría de los pacientes de esta serie egresaron vivos.

Introduction: Burn injury is one of the most traumatic and devastating events that a human being can suffer. This thermal event produces profound alterations in the host's systemic defense mechanisms. Complications in major burns begin in the immediate phase of inflammation produced after suffering thermal aggression. Complications in the burned patients are associated with a bad prognosis with a high morbility and mortality. Objective: To decribe the complications in burned patient. Methods: A descriptive, retrospective, cross-section study was carried out to determine the complications in the burned patients that were admitted in the service of Caumatology, of the Universitary Hospital Manuel Ascunce Domenech in Camagüey city between January, 2021 and February, 2022. 32 patients were studied and the following variables were evaluated: severity rate, general complications, and acid-basic and hydroelectrolytic complications, as well as the state at discharge of the patients. Results: There was a predominance of patients with complications, in those injured persons with thermic harsh insult, present in 24 patients for 75 %. The infection of the injury for burns, the hyperglycemia, the anemia and the states of dehydration were the complications that largely showed up in the studied patients. All of the dead persons belonged to patient's group that had complications, eight patients showed (25 %). Conclusions: The infection of the burns continues to be the main complication of the burned patient. Most of the patients in this series were discharged alive.

Well beyond the 60s? The impact of a pandemic on the growth of the older population / Muito além dos 60? Impacto de uma pandemia na dinâmica de crescimento da população idosa

Contrary to expectations that the first decades of the 21st century would experience an increase in lived time, the 2020s cast doubts on the future of old age. The Brazilian population is expected to increase until 2030, when it will reach its maximum, with a total of approximately 215 million inhabitants. A trend of population decline was already in progress and had already been documented, but the pandemic accelerated this process. This study describes a set of projections for the older Brazilian population. The projections were elaborated using the main components method, whose advantages are the possibility of separately projecting the behavior of the three demographic variables (fertility, mortality, and migrations) and obtaining results disaggregated by sex and age groups. Birth data for 2018, 2019, and 2020 suggest a 3.51 and 5.28% decrease in total births between 2018 and 2019 and 2019 and 2020, respectively. Preliminary data for 2021, which indicate the continuation of this trend between 2020­2021, show a 2.32% reduction in the number of births. The hypotheses raised for the mortality patterns, if proven to be accurate, suggest a life expectancy of 72.8 years for men and 76.2 years for women at the final period of the projection, resulting in gains of 4.6 and 2.0 years, respectively. Despite these gains, the levels obtained in 2019, pre-pandemic, would be reached by the male population only between 2035 and 2040.

Contrariando expectativas de que as primeiras décadas do século XXI seriam um tempo de expansão do tempo vivido, os anos 2020 apontam dúvidas com relação ao futuro da velhice. A população brasileira deverá crescer até 2030, quando se projeta que atingirá o seu máximo, com um total de aproximadamente 215 milhões de habitantes. Uma tendência de redução populacional já era documentada e estava em curso, mas a pandemia acelerou o seu movimento. Este artigo apresenta um conjunto de projeções para a população brasileira e idosa. Para a sua elaboração, utilizamos o método das componentes, cujas vantagens são: (a) projetar, isoladamente, o comportamento de cada uma das três variáveis demográficas ­ fecundidade, mortalidade e migrações ­ e (b) obter resultados desagregados por sexo e grupos de idade. Os dados de nascimentos para 2018, 2019 e 2020 apontam para uma diminuição deste total de 3,51% entre 2018 e 2019 e de 5,28% entre 2019 e 2020. Os dados preliminares de 2021, que apontam para uma continuação dessa tendência entre 2020 e 2021 demonstram redução de 2,32% no número de nascimentos. As hipóteses feitas para os padrões de mortalidade, se verificadas, apontam para uma expectativa de vida de 72,8 e 76,2 anos no final do período da projeção, o que resultaria em ganhos de 4,6 e 2,0 anos, para homens e mulheres, respectivamente. Apesar desses ganhos, os níveis obtidos em 2019, pré-pandemia, seriam alcançados pelos homens entre 2035 e 2040.

O impacto demográfico e seus diferenciais por sexo nos custos assistenciais da saúde suplementar no Brasil / The demographic impact and its differentials by gender on the health care costs of supplementary health in Brazil

Resumo Introdução As consequências do processo de Transição Demográfica afetam a demanda por saúde e, por conseguinte, o setor de saúde suplementar. Objetivo Examinar as consequências futuras do envelhecimento populacional e dos ganhos em longevidade, diferenciados por sexo, nos custos assistenciais das operadoras de planos de saúde. Para tanto, utilizaram-se os dados disponibilizados pela Agência Nacional de Saúde Suplementar (ANS) e pelo Instituto Brasileiro de Geografia e Estatística (IBGE). Método Utilizou-se o modelo de padronização, entre 2016 e 2045, variando apenas a estrutura etária populacional. Resultados Os resultados indicam que o processo de envelhecimento populacional é mais acentuado para a população feminina e mais intenso entre os beneficiários dos planos individuais/familiares se comparados aos dos planos coletivos. As internações e os exames complementares permanecerão os mais onerosos entre os itens assistenciais. Em relação aos impactos da longevidade, constatou-se que os maiores gastos esperados de usuários com mais de 59 anos de idade até a morte são com as internações e entre as mulheres, nos planos individuais/familiares. Conclusão O envelhecimento populacional e aumento de longevidade, principalmente para mulheres, vão impactar os custos dos planos de saúde, com maior intensidade os individuais/familiares. A saúde suplementar precisa se preparar para os desafios demográficos impostos aos custos futuros, buscando políticas capazes de minimizá-los.

Abstract Background The consequences of the Demographic Transition process affect the demand for health, including the private health sector. Objective To examine the consequences of population aging and the longevity gains, gender differentials, in the healthcare costs of healthcare operators. Data from The National Regulatory Agency for Private Health Insurance and Plans (Agência Nacional de Saúde Suplementar (ANS)) and the Brazilian Institute of Geography and Statistics (Instituto Brasileiro de Geografia e Estatística (IBGE)) were used for this purpose. Method The standardization model has been used between 2016 and 2045, varying only the population age structure. Results The results indicate that the population aging process is more accentuated for the female population and more intense among the beneficiaries of individual/family plans compared to collective plans. The hospitalization and complementary examinations showed the highest absolute monetary values between care items, for both types of plans, in all years analyzed. The findings of the impacts of longevity, the expected costs for the users of the last age group will be higher for hospitalizations, especially among women and with individual / family plans. Conclusion Population aging and increased longevity, especially for women, will impact the costs of health plans, with greater intensity for individual / family members. Supplementary health needs to prepare for the demographic challenges imposed by future costs by pursuing policies that can minimize them.

Five-Year Forecasting Deaths Caused by Traffic Accidents in Fars Province of Iran.

OBJECTIVE: The aim of study was to conduct a time-based analysis to utilize the obtained knowledge for forecasting the trend of accidents in the future. METHODS: The present study, which was conducted as a cross-sectional research, investigated deaths from traffic accidents in Fars Province during a five-year period from 2013 to 2018. The pseudo-regression model of Spline was used to predict the increase in mortality rate by 2021. RESULTS: The forecasted values indicated a decline in deaths from traffic accidents by 2021. A total of 8020 records of accidents leading to death were included in the study. The mean mortality rate from traffic accidents in the province was approximately estimated to be 33.7 per 100,000 populations. More than half of the people who died (52.36%) were in a car, 25.57% were motorcycle riders, and 19.93% were pedestrians. The highest rate of deaths was observed in the age group of 16 to 25 years old (21.5%). The data indicated a reduction in the rate of death among car riders and pedestrians and an increase in the number of deaths among motorcycle riders. The trend of deaths occurred outside the city had been increasing while the trend of deaths occurred inside the city had been decreasing. CONCLUSION: The present regulations are only able to reduce a small number of deaths each year. In order to achieve a downward trend in mortality with a steeper pace, it is necessary to design and implement more intelligent standards, not merely the stricter ones.

Stochastic Forecasting of Labor Supply and Population: An Integrated Model.

This paper presents a stochastic model to forecast the German population and labor supply until 2060. Within a cohort-component approach, our population forecast applies principal components analysis to birth, mortality, emigration, and immigration rates, which allows for the reduction of dimensionality and accounts for correlation of the rates. Labor force participation rates are estimated by means of an econometric time series approach. All time series are forecast by stochastic simulation using the bootstrap method. As our model also distinguishes between German and foreign nationals, different developments in fertility, migration, and labor participation could be predicted. The results show that even rising birth rates and high levels of immigration cannot break the basic demographic trend in the long run. An important finding from an endogenous modeling of emigration rates is that high net migration in the long run will be difficult to achieve. Our stochastic perspective suggests therefore a high probability of substantially decreasing the labor supply in Germany.

Population forecasting with endogenous migration: an application to trans-Tasman migration.

"This article focuses on forecasting migration between Australia and New Zealand (trans-Tasman migration), which is largely visa-free and therefore resembles internal migration. Net trans-Tasman migration is a major component of New Zealand population change and is embedded in this article in a Bayesian or unrestricted vector autoregression (VAR) model, which includes foreign and domestic economic variables. When time series of net migration are available, this approach provides a useful input into forecasting population growth in the short run in the absence of major policy changes. This conclusion applies equally to interregional migration and to unrestricted international migration between economically integrated nations."

[Population forecasts 1998-2050]. / Bevolkingsprognose 1998-2050.

PIP: "The medium variant of the new Netherlands population forecasts for the period 1998-2050 projects that population size will increase to a maximum of 17.4 million around 2035.... In the new population forecasts population growth is higher due to higher numbers of births and lower numbers of deaths. Even though net migration will be lower than in the previous forecasts, this will only partly offset the higher natural growth. The main cause of the higher projection of population growth is that the new forecasts are based on assumptions about emigration rates, distinguished by age, sex and country of birth, rather than on absolute numbers of emigrants." (EXCERPT)^ieng

[Population statistics] as of January 1, 1998.

PIP: In thousands, Thailand's total population as of January 1, 1998, was 60,763, of which 30,363 were male and 30,400 were female. 19,127 live in urban areas and 41,636 live in rural areas. 11,363 live in the northern region, 20,720 to the northeast, 8021 in the South, 13,550 centrally, and 7109 in the Bangkok metropolis. 16,375 were under age 15, 39,282 aged 15-59, and 5106 aged 60 and over. There were 15,728 women of reproductive ages 15-44. Crude birth and death rates per 1000 population were 17.3 and 6.5, respectively, with an overall natural growth rate of 1.1%. Infant mortality was 25.0/1000 live births. Male and female life expectancies at birth were 66.6 and 71.7 years, respectively. Further life expectancies at age 60 for males and females were 20.3 and 23.9 years, respectively. The rate of total fertility per woman was 1.98, with a contraceptive prevalence rate of 72.2%.^ieng

[The Immigration and Naturalization Service and demographic forecasts]. / De Immigratie- en Naturalisatie Dienst en demografische prognoses.

PIP: "The Immigration and Naturalisation Service of the Netherlands is a government institution with the authority to decide which persons are allowed immigration into the Netherlands. Its decisions are not only of importance to the potential immigrants themselves, but also to organizations responsible for enforcing the jurisdiction. In order to perform such tasks in a fair and efficient manner, forecasts of immigrants, in particular forecasts of asylum seekers, are indispensable." (EXCERPT)^ieng

K-12 enrollment forecasting: merging methods and judgment.

"This article describes an enrollment forecasting process in which technical experts and local community stakeholders [in Oregon] worked together to produce data that were cost-efficient and yet accurate enough to serve as the basis for sound decisions. The large school district that employed this process gained valuable insights to guide its attendance zone and facilities planning decisions, and also created a group of key communicators to ensure community understanding and support."

Combining probabilistic and subjective assessments of error to provide realistic appraisals of demographic forecast uncertainty: Alho's approach.

"With increasing interest in forecast uncertainty, there is an evolving concern with assessing the degree of certainty we can attach to uncertainty itself. This concern is the subject of recent work by Juha Alho.... I examine [his] approach systematically and draw general conclusions about its efficacy. Suggestions for improvement are made."

[Population forecasts 1997-2003: more births]. / Bevolkingsprognose 1997-2003: meer geboorten.

PIP: "The new [Netherlands] population forecasts differ in three respects from the previous forecasts published one year ago. 1. The forecast period is limited to 1997-2003, whereas the previous forecasts covered the period until 2050.... 2. The observed population on 1 January 1997 is 7 thousand higher than the forecasts published one year ago. 3. The assumption of the total fertility rate (TFR) in the period 1997-2002 is revised in an upward direction...." (EXCERPT)^ieng

[Regional differences in population]. / Regionale verschillen in bevolking.

PIP: "The majority of the Dutch population lives in western and central regions of the Netherlands. According to the 1997 regional population forecasts...this situation will not change significantly in the years to come.... In the medium variant of the regional forecasts, almost all...regions will experience positive population growth in the period up to 2030.... Ageing will occur in most of the...regions, especially in the peripheral areas." (EXCERPT)^ieng

[Probability distribution of population forecasts]. / Kansverdeling van de bevolkingsprognose.

PIP: "On the basis of assumptions on the probability distribution of future fertility, life expectancy and net migration, the probability distribution of the future size and age structure of the population [of the Netherlands] can be calculated.... The calculations are based on three main assumptions.... On the basis of these assumptions it can be calculated that the probability of the population size in 2010 lying between 15.8 million and 17.2 million is 90%." (EXCERPT)^ieng

[The Twenty-eighth Conference of the Czech Demographic Society "Present Trends and Formulae of Demographic Behavior--Europe and Ourselves" (May 20, 1998)]. / XXVIII. konference Ceske Demograficke Spolecnosti "Soucasne trendy a vzorce demografickeho chovani--Evropa a my" (20. Kveten 1998).

PIP: This is a collection of brief papers from a 1998 conference on population dynamics in Europe. Papers are included on demographic developments in Eastern and Western Europe from 1950 to 1990; current trends of demographic behavior; the second demographic transition; the Czech Republic within the context of European demographic developments; macroeconomic development in Central and Eastern Europe from 1990 to 1997; the socioeconomic status of young people in the Czech Republic and Western Europe; family size and household earnings from 1988 to 1996; and possible future scenarios.^ieng