Population age structures, persistence and flowering cues in Cerberiopsis candelabra (Apocynaceae), a long-lived monocarpic rain-forest tree in New Caledonia

Cerberiopsis candelabra Vieill. is a long-lived, monocarpic (= semelparous) and mass-flowering rain-forest tree, endemic to New Caledonia. Population size structures suggest establishment has been episodic, followed by a recruitment gap that might signal population decline. Here, we use age structures based on tree rings to better assess population dynamics and persistence, and investigate influences of tree size, age and growth rate on flowering. Age structures of populations surveyed in 2007–2008 were unimodal, with establishment over c. 15–81 y, followed by a recruitment gap of c. 23–79 y. Seedling mortality was generally high. High densities of flowering trees or large-scale exogenous disturbances may be necessary for in-situ regeneration. There was no evidence of a simple flowering threshold: flowering in 2017 occurred across a wide range of tree size, age and growth rate. Instead, evidence suggested that size and age at flowering may vary among plants depending on their growth trajectory. Environmental triggers of flowering were not identified by dating tree establishment, but the last three mass-flowering events occurred in years of tropical cyclones. Regeneration and persistence might be facilitated if large-scale disturbances trigger flowering, improving reproductive efficiency by synchronising flowering and linking reproduction with environmental conditions that enhance seedling recruitment.

COVID-19 admission risk tools should include multiethnic age structures, multimorbidity and deprivation metrics for air pollution, household overcrowding, housing quality and adult skills

BackgroundEthnic minorities account for 34% of critically ill patients with COVID-19 despite constituting 14% of the UK population. Internationally, researchers have called for studies to understand deterioration risk factors to inform clinical risk tool development.MethodsMulticentre cohort study of hospitalised patients with COVID-19 (n=3671) exploring determinants of health, including Index of Multiple Deprivation (IMD) subdomains, as risk factors for presentation, deterioration and mortality by ethnicity. Receiver operator characteristics were plotted for CURB65 and ISARIC4C by ethnicity and area under the curve (AUC) calculated.ResultsEthnic minorities were hospitalised with higher Charlson Comorbidity Scores than age, sex and deprivation matched controls and from the most deprived quintile of at least one IMD subdomain: indoor living environment (LE), outdoor LE, adult skills, wider barriers to housing and services. Admission from the most deprived quintile of these deprivation forms was associated with multilobar pneumonia on presentation and ICU admission. AUC did not exceed 0.7 for CURB65 or ISARIC4C among any ethnicity except ISARIC4C among Indian patients (0.83, 95% CI 0.73 to 0.93). Ethnic minorities presenting with pneumonia and low CURB65 (0–1) had higher mortality than White patients (22.6% vs 9.4%; p<0.001); Africans were at highest risk (38.5%; p=0.006), followed by Caribbean (26.7%; p=0.008), Indian (23.1%; p=0.007) and Pakistani (21.2%; p=0.004).ConclusionsEthnic minorities exhibit higher multimorbidity despite younger age structures and disproportionate exposure to unscored risk factors including obesity and deprivation. Household overcrowding, air pollution, housing quality and adult skills deprivation are associated with multilobar pneumonia on presentation and ICU admission which are mortality risk factors. Risk tools need to reflect risks predominantly affecting ethnic minorities.

Bronze Age and Iron Age Archaeology at Thainstone Business Park, Inverurie, Aberdeenshire

Headland Archaeology (UK) Ltd was commissioned by Axiom Project Services to undertake an archaeological excavation in advance of a commercial development at Thainstone Business Park, Aberdeenshire. Excavation identified the remains of a Middle Bronze Age roundhouse and a contemporary urned cremation cemetery. Evidence of Late Bronze Age cremation practices was also identified. A large roundhouse and souterrain dominated the site in the 1st or 2nd century ad. Material culture associated with the Iron Age structures suggested a degree of status to the occupation there.

Justice Across Ages

Justice Across Ages is a book about how we should respond to inequalities between people at different stages of their lives. Age structures our social institutions, relationships, obligations, and entitlements. There is an age for voting, an age for working, and an age when one is expected (and sometimes required) to retire. Each stage of life also corresponds to specific forms of social risks and vulnerabilities. As a result, inequalities between age groups and generations are numerous and multidimensional. And yet, political theorists have spared little time thinking about how we should respond to these disparities. Are they akin to those patterned on gender or race? Or is there something relevantly distinctive about them that mitigates the need for concern? These questions and others are answered in this book and a theory of justice between co-existing generations is proposed. Age structures our lives and societies. It shapes social institutions, roles, and relationships, as well as how we assign obligations and entitlements within them. There is an age for schooling, an age for voting, an age for working, and an age when one is expected (and sometimes required) to retire. Each life-stage also brings its characteristic opportunities and vulnerabilities, which spawn multidimensional inequalities between young and old. How should we respond to these age-related inequalities? Are they unfair in the same way that gender or racial inequalities often are? Or is there something distinctive about age that should mitigate ethical concern? Justice Across Ages addresses these and related questions, offering an ambitious theory of justice between age groups. Written at the intersection of philosophy and public policy, the book sets forth ethical principles to guide a fair distribution of goods like jobs, healthcare, income, and political power among persons at different stages of their life. Drawing on a range of practical cases, the book deploys normative tools to distinguish objectionable instances of inequalities from acceptable ones and in so doing, critically assesses a range of policy remedies. At a time where young people are starkly under-represented in legislatures and subject to disproportionally high unemployment rates, the book moves from foundational theory to the specific policy reforms needed today. As moral and political philosophers have noted, it can be tempting to assume that age-based inequalities are morally trouble free, since over the course of a complete life, a person moves through each age groups. Yet, Justice Across Ages argues that we should resist this assumption. In particular, we should regard with suspicion commonplace and widely tolerated forms of age-based social hierarchy, such as the infantilization of young adults and older citizens, the political marginalization of teenagers and young adults, the exploitation of young workers through precarious contracts and unpaid internships, and the spatial segregation of elderly persons. If we ever are to live in a society where people are treated as equals, we must pay vigilant attention to how age membership can alter our social standing. This position carries important implications for how we should think about the political and moral value of equality, design our social and political institutions, and conduct ourselves in a range of contexts that includes families, workplaces, and schools.

COVID19 admission risk tools should include multi-ethnic age structures, multimorbidity and deprivation metrics for air pollution, household overcrowding, housing quality and adult skills

Background-Ethnic minorities account for 34% of critically ill COVID-19 patients despite constituting 14% of the UK population. Internationally, researchers have called for studies to understand deterioration risk factors to inform clinical risk tool development. Methods-Multi-centre cohort study of hospitalised COVID-19 patients (n=3671) exploring determinants of health, including Index of Multiple Deprivation (IMD) sub-indices, as risk factors for presentation, deterioration and mortality by ethnicity. Receiver operator characteristics were plotted for CURB65 and ISARIC4C by ethnicity and area under the curve (AUC) calculated.Results-Ethnic minorities were admitted with higher Charlson Comorbidity Scores than age, sex and deprivation matched controls and from the highest IMD sub-indices of at least one deprivation form: Indoor Living Environment(LE), Outdoor LE, Adult Skills and Wider Barriers to Housing and Services. Admission from the highest sub-indices of these deprivation forms was associated with multilobar pneumonia on presentation and ITU admission. AUC did not exceed 0.7 for CURB65 or ISARIC4C among any ethnicity except ISARIC4C among Indian patients 0.83 (0.73-0.93). Ethnic minorities presenting with pneumonia and low CURB65(0-1) had higher mortality than Caucasians (22.6% vs.9.4%; p<0.001); Africans were at highest risk (38.5%; p=0.006), followed by Caribbean (26.7%; p=0.008), Indian (23.1%; p=0.007) and Pakistani (21.2%; p=0.004).Conclusions-Ethnic minorities exhibit higher multimorbidity despite younger age structures and disproportionate exposure to unscored risk factors: obesity and deprivation. Household overcrowding, air pollution, housing quality and adult skills deprivation are associated with multi-lobar pneumonia on presentation and ITU admission which are mortality risk factors. Risk tools need to reflect risks predominantly affecting ethnic minorities.

Lives Saved from Age-Prioritised COVID-19 Vaccination

BACKGROUND The criteria used to allocate scarce COVID-19 vaccines are hotly contested. While some are pushing just to get vaccines into arms as quickly as possible, others advocate prioritization in terms of risk. OBJECTIVE Our aim is to use demographic models to show the enormous potential of vaccine risk-prioritization in saving lives. METHODS We develop a simple mathematical model that accounts for the age distribution of the population and of COVID-19 mortality. This model considers only the direct live-savings for those who receive the vaccine, and does not account for possible indirect effects of vaccination. We apply this model to the United States, Japan, and Bangladesh. RESULTS In the United States, we find age-prioritization would reduce deaths during a vaccine campaign by about 93 percent relative to no vaccine and 85 percent relative to age-neutral vaccine distribution. In countries with younger age structures, such as Bangladesh, the benefits of age-prioritization are even greater. CONTRIBUTION For policy makers, our findings give additional support to risk-prioritized allocation of COVID-19 vaccines. For demographers, our results show how the age-structures of the population and of disease mortality combine into an expression of risk concentration that shows the benefits of prioritized allocation. This measure can also be used to study the effects of prioritizing other dimensions of risk such as underlying health conditions.

COVID-19 risk stratification tools should incorporate multi-ethnic age structures, multimorbidity and deprivation metrics for air pollution, household overcrowding, housing quality and adult skills

Background-Black Asian and Minority Ethnicity (BAME) patients account for 34% of critically ill COVID-19 patients despite constituting 14% of the UK population. Internationally, researchers have called for studies to understand the risk factors among ethnic subgroups. We explored the extent to which social determinants for health including individual Index of Multiple Deprivation (IMD) sub-indices are risk factors for presentation with multilobar pneumonia, Intensive Therapy Unit (ITU) admission and hospitalised outcomes disaggregated by BAME subgroup.Methods-Multi-centre cohort study of hospitalised COVID-19 patients. Results-BAME patients with pneumonia and low CURB65 scores (0-1) had higher mortality than Caucasians (22.6% vs.9.4%; p<0.001); Africans were at highest risk (38.5%; p=0.006), followed by Caribbean (26.7%; p=0.008), Indian (23.1%; p=0.007) and Pakistani (21.2%; p=0.004). Age, sex, cirrhosis, obesity, Charlson Comorbidity (CCI) scores, presentation with multi-lobar pneumonia and ITU admission were independent mortality risk factors. BAME subgroups were more likely to be admitted with higher CCI scores than age, sex and deprivation matched controls and from the highest IMD sub-indices of at least one deprivation form: Indoor Living Environment (LE), Outdoor LE, Adult Skills and Wider Barriers to Housing and Services. Admission from the highest sub-indices of these deprivation forms was associated with multilobar pneumonia on presentation and ITU admission.Conclusions-BAME subgroups exhibit younger age structures resulting in CURB65 underscoring and disproportionate exposure to unscored risk factors:sex, obesity, multimorbidity and deprivation. Household overcrowding deprivation, air pollution deprivation, housing quality deprivation and adult skills deprivation are associated with multi-lobar pneumonia on presentation and ITU admission. Risk tools need to reflect risk factors predominantly affecting BAME subgroups.