Mortality of people over working age in the context of COVID-19 pandemic

Проанализирована смертность лиц старше трудоспособного возраста (женщины 55+ и мужчины 60+) в условиях пандемии COVID-19 для определения потенциальной возможности её предотвращения. Использовали информацию базы данных РФС-ЕМИАС Москвы за 2019, 2020 и 2021 гг. (за периоды до 15 июня). Сделано заключение, что на фоне более корректного учета причин смерти в 2021 г., связанных с инфицированием вирусом SARS-CoV-2, вклад психических расстройств и болезней эндокринной системы в структуру причин смерти лиц старше трудоспособного возраста без учета случаев смерти от COVID-19 превышает показатели 2019 г. Рост смертности от заболеваний этих классов в значительной степени является следствием экзогенного стресса, связанного с пандемией, изоляцией лиц 65 лет и старше в начале пандемии, снижением эффективности их медико-социальной поддержки. Недостатки в организации социальной помощи лицам старших возрастных групп, слабое внедрение новых информационных технологий и носимых электронных устройств в практическую работу здравоохранения, малые масштабы общественных инициатив в области социальной помощи привели к потерям населения, которые могли бы быть предотвращены в период пандемии. The mortality of people over working age (women 55+ and men 60+) was analyzed in the context of COVID-19 pandemic in order to determine the potential for its prevention. The information from the Moscow mortality database for 2019, 2020 and 2021 (up to June 15) was used. Against the background of more correct accounting of death causes associated with SARS-CoV-2 virus infection in 2021, the contributions of mental disorders and endocrine diseases to the structure of death causes (excluding deaths from COVID-19) for people over working age are more than in 2019. The increase in mortality from diseases of these classes is largely a consequence of exogenous stress associated with a pandemic, isolation of people older 64 years and a decrease in the effectiveness of medical care. It was concluded that indirect losses from COVID-19 include avoidable mortality of elderly caused by shortcomings in organization of social assistance for them, the weak introduction of new information technologies and wearable electronic devices into the practical work of health care, small scale of public initiatives in the field of social assistance.

Age-related readjustments of caucasian men’s functional reserves in the North

Цель работы - определение доли лиц, характеризующихся отклонениями физиологических параметров от нормативных диапазонов, и формирование паттернов функциональных резервов у подростков, юношей, мужчин среднего возраста и лиц пожилого возраста. Впервые проведена оценка динамики функциональных резервов на основе отклонений от нормативных референсов некоторых показателей физического развития, сердечно-сосудистой системы, биохимического и микроэлементного профиля, а также характеристик основного обмена и дыхания в онтогенетическом аспекте на основе построения паттернов степени напряжения анализируемых систем у лиц мужского пола, постоянно проживающих на Севере. Дан прогноз возрастного изменения изученных морфофизиологических параметров у лиц пожилого возраста. Результаты исследования показали, что паттерны отклонения анализируемых параметров свидетельствуют о нарастании напряжения функций систем в возрастном аспекте. Это проявляется в кумуляции отклонений в виде возрастных изменений показателей физического развития (увеличение ИМТ), сердечно-сосудистой системы (увеличение доли лиц с высоким нормальным АД и артериальной гипертензией по САД и ДАД), нарастания степени нарушений углеводного обмена (увеличение индекса инсулинорезистентности и гипергликемии натощак), возрастания степени дислипидемии относительно липидного обмена, трансформации нарушений микроэлементного профиля (усилении степени дефицита и возрастного избытка химических элементов). Это наблюдали на фоне снижения основного обмена веществ и показателей функции внешнего дыхания у современных жителей-северян старшего возраста. This study determined proportion of males whose physiological parameters were out of standard ranges and made patterns of their functional reserves to see dynamics in the row of teenagers, young adults, middle-aged adults, older adults. For the first time, dynamics of functional reserves was evaluated based on deviations from standard values existing for physical development, cardiovascular system, biochemical and trace element pictures, as well as characteristics of basic metabolism and breathing in ontogenetic aspect. The evaluation was performed by creating patterns of tension in subjective body systems under the North extremes to make predictive age-related changes older adults morphophysiological indicators. The results the patterns exhibited increasingly dysregulated functioning in the age aspect. That could be seen in age-related stress observed in physical development variables (accelerated body mass index), cardiovascular system (higher proportion of people with high normal blood pressure and arterial hypertension in systolic and diastolic blood pressure), carbohydrate metabolism disorders (higher index of insulin resistance and fasting hyperglycemia), more pronounced dyslipidemia, microelement disorders such as more severe age-related deficiency or excess. Those deviations existed together with worsening in basic metabolism and external respiration function in modern northerners of working age.

Blindness and visual impairment in Central Europe

Purpose To assess the prevalence and causes of visual impairment and blindness in a Central European country. The findings may have implications for the planning of further research and development of therapies in order to prevent blindness. Setting Department of Ophthalmology, Medical University of Graz, Austria. Design Retrospective, epidemiological study. Methods The database of the Main Confederation of Austrian Social Insurances was searched for patients with visual impairment, legal blindness or deaf-blindness. This database gathers data from patients of all insurance providers in the country who receive care due to visual impairment and blindness. To determine the prevalence of these conditions, the number of all entries recorded in February 2019 was evaluated. Additionally, all new entries between (January 1st,) 2017, and (December 31st,) 2018, were analysed for distinct characteristics, such as sex, the cause of blindness/visual impairment, and age. Since health care allowances can provide a considerable source of income (459.90€-936.90€ per month), good coverage of practically all patients who are blind and visually impaired in the country can be assumed. Results On February 2nd, 2019, 17,730 patients with visual impairments, blindness or deaf-blindness were registered in Austria, resulting in a prevalence of these diagnoses of 0.2% in the country. During the observational period from 2017 to 2018, 4040 persons met the inclusion criteria. Of these, 2877 were female (65.3%), and 1527 were male (34.7%). The mean age was 75.7 ± 18.0 years (median 82). Most patients (n = 3675, 83.4%) were of retirement age, while 729 (16.6%) were working-age adults or minors. In total, an incidence of 25.0 (95% confidence limit (CL) 24.3–25.8) per 100,000 person-years was observed from 2017 to 2018. A higher incidence was observed for females (32.2, 95% CL 31.0–33.3) than for males (17.7, 95% CL 16.8–18.5). Incidences where higher for males in lower age groups (e.g. 10–14 years: rate ratio RR = 2.7, 95% CL 1.1–6.8), and higher for females in higher age groups (e.g. 70–74 years: RR = 0.6, 95% CL 0.5–0.8). In total, the most frequent diagnoses were macular degeneration (1075 persons, 24.4%), other retinal disorders (493 persons, 11.2%) and inherited retinal and choroidal diseases (IRDs) (186 persons, 4.2%). Persons with IRDs were significantly younger compared to persons with macular degeneration or retinal disorders (IRDs: median 57, range 2–96 vs 83, 5–98 and 82, 1–98 years, p<0.001). For persons of retirement age, macular degeneration, other retinal disorders and glaucoma were the three most frequent diagnoses. In contrast, among working-aged adults and children, IRDs were the leading cause of visual impairment and blindness (103 persons, 14.1%). Conclusion These data show that IRDs are the leading cause of blindness and visual impairment in working-aged persons and children in Austria. Thus, these findings suggest to draw attention to enhance further research in the fields of emerging therapies for IRDs.

Feasibility and sustainability of working in different types of jobs after total hip arthroplasty: analysis of longitudinal data from two cohorts

ObjectivesTo investigate the rates of return to work and workability among working-age people following total hip arthroplasty (THA).MethodsParticipants from the Geneva Arthroplasty Registry and the Clinical Outcomes for Arthroplasty Study aged 18–64 years when they had primary THA and with at least 5 years’ follow-up were mailed a questionnaire 2017–2019. Information was collected about preoperative and post-THA employment along with exposure to physically demanding activities at work or in leisure. Patterns of change of job were explored. Survival analyses using Cox proportional hazard models were created to explore risk factors for having to stop work because of difficulties with the replaced hip.ResultsIn total, 825 returned a questionnaire (response 58%), 392 (48%) men, mean age 58 years, median follow-up 7.5 years post-THA. The majority (93%) of those who worked preoperatively returned to work, mostly in the same sector but higher rates of non-return (36%–41%) were seen among process, plant and machine operatives and workers in elementary occupations. 7% reported subsequently leaving work because of their replaced hip and the risk of this was strongly associated with: standing >4 hours/day (HR 3.81, 95% CI 1.62 to 8.96); kneeling/squatting (HR 3.32, 95% CI 1.46 to 7.55) and/or carrying/lifting ≥10 kg (HR 5.43, 95% CI 2.29 to 12.88).ConclusionsIt may be more difficult to return to some (particularly physically demanding) jobs post-THA than others. Rehabilitation may need to be targeted to these types of workers or it may be that redeployment or job change counselling are required.

Incidence of outbreak-associated COVID-19 cases by industry in Ontario, Canada, 1 April 2020–31 March 2021

ObjectivesThe objective of our study was to estimate the rate of workplace outbreak-associated cases of COVID-19 by industry in labour market participants aged 15–69 years who reported working the majority of hours outside the home in Ontario, Canada.MethodsWe conducted a population-based cross-sectional study of COVID-19 workplace outbreaks and associated cases reported in Ontario between 1 April 2020 and 31 March 2021. All outbreaks were manually classified into two-digit North American Industry Classification System codes. We obtained monthly denominator estimates from the Statistics Canada Labour Force Survey to estimate the incidence of outbreak-associated cases per 100 000 000 hours among individuals who reported the majority of hours were worked outside the home. We performed this analysis across industries and in three distinct time periods.ResultsOverall, 12% of cases were attributed to workplace outbreaks among working-age adults across our study period. While incidence varied across the time periods, the five industries with the highest incidence rates across our study period were agriculture, healthcare and social assistance, food manufacturing, educational services, and transportation and warehousing.ConclusionsCertain industries have consistently increased the incidence of COVID-19 over the course of the pandemic. These results may assist in ongoing efforts to reduce transmission of COVID-19 by prioritising resources, as well as industry-specific guidance, vaccination and public health messaging.

Sex features of cutaneous microvasculature in healthy working-age people

Aim. To study sex characteristics of cutaneous microvascular structure and function in a cohort of healthy working-age people without cardiovascular diseases.Material and methods. The study included 35 healthy men (42±4 years) and 34 women (41 ±5 years). The cardiovascular system was assessed in all patients. The microcirculatory bed of the skin was investigated by the following non-invasive methods: 1) computerized video capillaroscopy; 2) laser Doppler flowmetry; 3) photoplethysmography.Results. According to computerized video capillaroscopy in men, compared with women, there was a smaller number of both functioning capillaries (78 vs 86 capillaries/mm2, respectively (p<0,05)) and their total number (100 vs 120 capillaries/mm2, respectively (p<0,001)). Against the background of a decrease in capillary density in men, there was a higher skin interstitial hydration — 113 vs 96 gm (p<0,005) in men than in women. At the level of precapillary arterioles, where humoral tone regulation prevails. Laser Doppler flowmetry revealed lower pulse amplitude in men than in women — 0,87 vs 1,02 pf, respectively (p<0,05), which indicates a lower arterial blood inflow to exchange microvessels. Against this background, the constrictor response of precapillary arterioles to a sympathetic nervous system stimulation in men is higher than in women — 45% vs 40%, respectively (p<0,05). At the level of large arterioles, where neural tone regulation prevails, photoplethysmography revealed lower augmentation index standardized at a heart rate in men (-4,6 vs 1,7%, respectively, p<0,05), which indicates lower rigidity of muscular vessels in men.Conclusion. In working-age healthy people, sex differences are noted at all cutaneous microvascular levels, which must be taken into account when planning studies.

Educational Differences in Cycling: Evidence from German Cities

Cycling is an environmentally sustainable social practice that contributes to liveable cities and provides affordable and healthy transport. People with lower education could particularly benefit from cycling, as they tend to fare worse regarding finances and health. However, in bivariate analyses, those with lower education cycle less. This article discusses the social meaning of cycling and investigates whether the education–cycling association holds after accounting for (1) confounders and (2) factors that determine decision leeway between different transport modes. I analyse approximately 80,000 short-distance trips (0.5–7.5 km) reported by 28,000 working-age individuals from cities in Germany using multilevel linear probability regression models. Results support that higher education systematically and substantially increases the propensity to cycle. This education gap implies major untapped potential for environmental sustainability, that current pro-cycling policies in cities disproportionally favour the highly educated and that cycling patterns contribute to inequalities in finances and health.

The Impacts of Population Aging on China’s Economy

The Chinese economy had an extraordinary average GDP growth rate of 8.50 percent from 1980 to 2018. However, the implementation of one-child policy in the late 1970s has depressed the total fertility rate to below the replacement rate since 1992. China thus experienced an increasing composition of older populations in the past three decades, which puts pressure on Chinese economic growth and makes its eye-catching economic growth potentially unsustainable. This study develops an overlapping generations (OLG) model to investigate the impacts of this demographic transition in the Chinese economy. This study conducts six policy reform exercises to examine measures that could improve the sustainability of fiscal and pension systems. The simulation results indicate that a mild tax increase on either wage income or consumption does not improve the fiscal stance but creates distortionary effects on saving and consumption behaviors. Of the pension reform measures considered, the combination of extending the mandatory retirement age and cutting the replacement ratio offers the most significant improvement to pension sustainability. However, increasing the contribution rate of the working-age population has the least effect on pension sustainability and a noticeable distortionary effect on the consumption ratio and saving rate.

Patient and caregiver socioeconomic burden of first-line systemic therapy for advanced gastroesophageal adenocarcinoma

Aim: This study assessed the work productivity and financial impact of advanced gastroesophageal adenocarcinomas, comprising gastric, esophageal and gastroesophageal junction cancers, on patients of working age and their caregivers. Patients & methods: A multicenter medical chart review and surveys of patients with advanced gastroesophageal adenocarcinoma and their caregivers was conducted in France, Germany, the UK, China, Japan and the USA. Results: Across differing regions, the study highlighted the impact of cancer on patients’ ability to work, to function normally and on their wellbeing, as well as the economic burden placed on patients and their caregivers. Conclusion: Advanced gastroesophageal adenocarcinomas have a significant impact on patients’ and caregivers’ well-being and are associated with reduced work productivity, and income loss.

The Mediating Role of Age Productivity on Human Resources Development, Health Infrastructure, and Proverty Level

Poverty is a classic problem in many regions in Indonesia, including the Bengkulu Province. There are several causes of poverty case in Bengkulu, three of which are low human resources, inadequate rural health infrastructure, and less productive population with productive working age. The purpose of the study is to examine 1) the influence of human resources management, health infrastructure, and productive age partially on poverty in Bengkulu Province, and 2) the influence of human resources, health infrastructure respectively through mediation of productive age on poverty in Bengkulu Province. This study uses a quantitative descriptive approach using secondary data. The research population is all districts/cities in Bengkulu Province totalling 9 districts and 1 city in 2010 – 2019. This study uses saturated sampling. The data was then processed and analyzed using SEM-PLS. The results of the study show that human resources proxied by the Human Development Index (HDI) had a positive effect on the poverty level, health infrastructure had no effect on the poverty level, productive age had no effect on the poverty level, productive age was not a mediating variable between resources and the poverty level, so that cannot be used as a mediating variable, and productive age does not mediate the effect of health infrastructure on poverty levels in Bengkulu Province.