The Caregiver Support Ratio in Europe: Estimating the Future of Potentially (Un)Available Caregivers

The caregiver support ratio (CSR) is defined as the number of potential caregivers aged 45–64 years, the most common caregiving age range, for each person aged 80+, the subgroup of older adults most at risk of needing long-term services and support. This study uses data from the CENSUS HUB database and from the UN database to calculate the current (last year available: 2011) and projected (2020, 2030, 2040 and 2050) CSR for a group of European countries. Mediterranean countries, France, Belgium, and Sweden presented the lowest CSR (5:1) in 2011. The countries with the highest CSR were Slovakia (9:1) and Ireland, Poland, Cyprus, and Malta (8:1). The estimated CSR is expected to progressively decline from 6:1 (2011) to 2:1 (2050) for all countries. Although differences in the CSR exist between countries, the number of people aged 45–64 who are available to care for each person aged 80+ will decrease uniformly in the coming decades. Cross-national challenges for gerontological social policies and healthcare provision are expected due to the increasing demand for long-term care among the oldest population.

The Environmental-Economic Performance of a Poblano Family Milpa System: An Emergy Evaluation

The family milpa system (FMS) is of great importance to food security and the livelihoods of rural families in Mexico. However, the performance of the system can be compromised due to inappropriate agricultural practices. Therefore, a suitable evaluation strategy is required to identify the best management of resources. Nonetheless, at present, there is no holistic understanding around the nature–society interface that allows us to predict the global behavior of the FMS. Thus, this study assesses the global performance of a Poblano FMS through emergy-based indices. The emergy evaluation was carried out by accounting for the available energy of different qualities used in the system, which were subsequently converted to one kind of energy (solar emjoules). The percentage of renewable emergy (%Ren) used in the system was 72.16%. The emergy self-support ratio (ESR) showed that 74% of the emergy used came from free local resources. The emergy investment ratio (EIR) of 0.36 indicated that the emergy use was efficient. The emergy yield ratio (EYR) was 3.78, which in terms of net emergy (NE), was equivalent to a gain of 1.35 × 1016 sej ha−1 y−1. The environmental loading ratio (ELR) was 0.39, which indicated a low potential environmental impact. The emergy sustainability index (ESI) was high (9.80) compared to other agricultural systems. The performance of the FMS is superior compared to other agricultural systems, including ecologic and recycling systems. However, the use of resources is not optimum and needs to be improved to reach maximum empower.

Effects of Masai Barefoot Technology Footwear Compared with Barefoot and Oxford Footwear on Gait

Background Shoes, with their biomechanical features, affect the human body and function as clothing that protects the foot. This study aimed to investigate the effects of Masai Barefoot Technology (MBT) shoes on gait in healthy, young individuals compared with bare feet and classic stable shoes. Methods The study was conducted in 67 healthy females aged 18 to 30 years. All volunteers walked barefoot, in Oxford shoes, and in MBT shoes and were evaluated in the same session. Kinematic gait analyses were performed. The three performances were compared using repeated-measures analysis of variance to study the variance in the groups themselves, and the Friedman and Wilcoxon paired two-sample tests were used for the intragroup comparisons. Results We found that the single support time and the swing phase ratio increased during walking in MBT shoes compared with walking in stable shoes, whereas the double support ratio, stride length, cadence, gait speed, loading response ratio, and preswing phase ratio decreased. However, it was found that the step and stride length, step width, and gait speed increased and the preswing phase extended during walking in stable shoes compared with walking barefoot. Conclusions These results support the hypothesis that MBT shoes facilitate foot cycles as they reduce the loading response and the preswing and stance phase ratios.

Rhythmic Sensory Stimulation on Gait in Patients With Chronic Stroke

Background: Patients with stroke suffer from impaired locomotion which exhibit unstable walking with increased gait variability. Rhythmic sensory stimulation is one approach for improving the gait of persons with stroke, Parkinson’s disease, or the elderly. However, the effects of this approach on the gait of patients with chronic stroke are unclear. This study was conducted to identify the effects of rhythmic sensory stimulation on the gait of patients with chronic stroke. Methods: Twenty 20 older adults with stroke (mean age ± SD, 72.10 ± 7.15 years; female/male, 8/12) and twenty age- and gender-matched healthy controls (mean age ± SD, 72.65 ± 6.93 years; female/male, 8/12) walked 60 m under four conditions: (1) normal walking with no stimulation, (2) walking with rhythmic auditory stimulation (RAS), (3) walking with rhythmic somatosensory stimulation (RSS), and (4) walking with rhythmic combined stimulation (RCS: RAS + RSS). RAS was applied through an earphone in the ear of each participant, while RSS was applied through a haptic device on the wrist of the participant. RCS was applied simultaneously via an earphone and haptic device. The gait performance (i.e., mean gait speed, stride length, gait cycle, cadence, stance ratio, swing ratio, and double support ratio) and gait variability (i.e., coefficient of variation (CV) value of stride length, gait cycle, stance ratio, swing ratio, and double support ratio) were evaluated. Results: Gait performance in the stroke group was significantly improved in walking with RAS, RSS, and RCS compared to normal walking with no stimulation (P < 0.008). Gait variability was significantly decreased in the RAS, RSS, and RCS conditions compared to that during normal walking (P < 0.008). The gait performance and variability in the healthy control group were not significantly different under the RAS, RSS, or RCS conditions compared to those under normal walking (P > 0.008). Conclusions: Rhythmic sensory stimulation is effective in improving the gait of patients with chronic stroke, regardless of the type of rhythmic stimuli, compared to healthy controls. Trial registration: This study was approved by the Bioethics Committee (IRB-2019-04-003-001), and all participants provided written informed consent.

Primer coronariaintervenció ST-elevációs infarktusban

Összefoglaló. Bevezetés: Heveny myocardialis infarctusban a szívizommentés sikere, a beteg életkilátása nagymértékben függ a panasz kezdete és az elzáródott koszorúér rekanalizálása között eltelt ischaemiás időtől. Jelenleg az ér nyitása optimális esetben minden betegnél koszorúér-intervencióval történik. Célkitűzés: Annak vizsgálata, hogy öt év alatt mennyit változtak az ischaemiás idő összetevői, és miben változott az elzáródott ér nyitásának módszere ST-elevációs myocardialis infarctus (STEMI) miatt végzett primer coronariaintervencióban. Módszer: 2014. 01. 01. és 2018. 12. 31. között 1663, STEMI miatt koszorúér-intervencióval kezelt betegnél (1173 férfi és 490 nő) vizsgáltuk évenkénti bontásban a panasztól a koszorúér nyitásáig eltelt idő összetevőit és a 30 napos halálozást. Eredmények: Öt év alatt a panasztól az első egészségügyi kontaktusig medián 2:53 vs. 2:10 óra (p = 0,0132), ettől az intervenciós centrumba történt felvételig medián 1:17 vs. 1:03 óra (p = 0,009), a felvételtől a ballon nyitásáig medián 0:31 vs. 0:29 óra (p = ns) telt el. A panasztól a ballon nyitásáig eltelt idő (medián 5:29 vs. 4:07 óra, p = 0,0001) rövidült, döntően 2014 és 2015 között. A gyógyszerkibocsátó stent beültetése 15%-ról 96%-ra nőtt. A vizsgált években a légzés/keringés támogatás aránya 8,2–10,6–13,9–7,6–8,4, a 30 napos halálozásé 4,1–6,8–11,1–7,4–5,7% volt; a két érték korrelációt mutat (p = 0,827). Következtetés: Öt év alatt a panasztól az első egészségügyi kontaktusig és a kórházi beszállításig eltelt idő rövidült, de az Európai Kardiológiai Társaság ajánlásához képest hosszú; a kórházi felvételtől a ballon nyitásáig eltelt idő megfelelő. A négy órán belüli reperfúzió a betegek közel felében valósult meg. Az intervenciós centrumba való gyorsabb bekerülés javíthatna az eredményen. Orv Hetil. 2021; 162(13): 497–503. Summary. Introduction: In acute myocardial infarction, the heart muscle salvage, the patient’s life expectancy is highly dependent on the elapsed ischaemic time from the onset of complaint to target vessel recanalisation. Nowadays, target vessel recanalisation is performed with coronary intervention in all patients in optimal case. Objective: To examine how the components of ischemic time and the opening procedure of the occluded coronary have changed over five years in primary intervention done in acute ST-elevation myocardial infarction (STEMI). Method: Authors studied data of 1663 (1173 male and 480 female) STEMI patients in annual breakdowns treated with coronary intervention between 01. 01. 2014 and 31. 12. 2018, time from complaint to coronary artery opening, details of intervention and 30 days mortality rate. Results: During the five years, time intervals were as follows: from onset of complaint to first medical contact: median 2:53 vs. 2:10 hours (p = 0.0132), from this to admission in the interventional centre: median 1:17 vs. 1:03 hours (p = 0.009), from hospital admission to balloon opening: median 0:31 vs. 0:29 hours (p = ns). In total, the complaint to balloon opening time (median 5:29 vs. 4:07 hours, p = 0.0001) diminished, decisively from 2014 to 2015. Ratio of drug-eluting stent implantation increased from 15% to 96%. In the investigated years, the need of respiratory and/or circulatory device support ratio was 8.2–10.6–13.9–7.6–8.4, 30-day mortality rate between 4.1–6.8–11.1–7.4–5.7%; these two values showed a correlation (p = 0.827). Conclusion: The time from complaint to first medical contact and transfer to hospital against the significant decrease is still longer than the recommendation of the European Society of Cardiology. The time from hospital admission to balloon opening is adequate. Reperfusion within four hours was achieved in half of the patients in total. Faster hospitalization may improve results. Orv Hetil. 2021; 162(13): 497–503.

Pengembangan Model dan Metode Perhitungan Bonus Demografi

Previously research on bonus demographic measurement is still only focused on one model, namely dependency ratio which coverage two methods namely Cheung et al and Adioetomo. This research was carried out in East Lombok Regency and consist of two models, namely dependency ratio model and economic lifetime model. Dependency ratio model which coverage four methods namely Cheung et al, Adioetomo, Komine & Kabe, and Golini. Meanwhile economic lifetime model which coverage two methods namely support ratio and ratio of lifecycle pension wealth to total labour income. The aimed of this research is to determine model and method of bonus demographic measurement. This research used descriptive quantitative method. Based on the data analysis the results obtained that model that developed for measurement of demographic bonus is only dependency ratio model, meanwihle economic lifetime model isn’t developed yet. Refer to the fourth method of dependency ratio model, three methods have been developed namely Cheung et al, Adioetomo, Komine and Kabe, meanwhile Golini hasn’t been developed yet. Based on Cheung et al method East Lombok Timur Regency has been achieved demographic bonus between 2035 and 2045, but based on Adioetomo method between 2020 and 2045 has not been achieved demographic bonus yet and based on Komine and Kabe method will be achieved demographic bonus between 2020 and 2045. Keywords: demographic bonus, dependency ratio, economic lifetime

Pension reform 2019: determinants, consequences, alternatives

The paper addresses, mostly with demographic tools, the rationale and consequences of the reform of Russia’s distributive pension system. Contrary to official assertions, mortality conditions do not warrant an increase of the pension age. The reference to a rapidly falling demographic support ratio as a rationale of the reform’s urgency is misleading. A rapid and large increase in the retirement age will considerably reduce the obligations of the Pension Fund of Russia, yet this will be far from enough to balance its budget. The reform creates a fundamentally new and difficult to implement task of ensuring the right to employment of persons deprived of the right to a pension. To the extent that this task can be accomplished, the Pension Fund of Russia and the State budget will be supplemented with additional revenues. At the same time, to the extent that this task remains unresolved, a social group of elderly people who are deprived of income will arise and continue to grow. For a limited time their life will be supported by unemployment benefits. Russia possesses large-scale alternative resources for resolving the pension problem, which consist, among other things, in increasing the collection of pension contributions, labor productivity and employment of the population, as well as in developing funded forms of pension insurance.

Metal-wood crane beam calculation

Objective. The development of structures and calculation of metal-wood crane beams are associated with specific difficulties. The article discusses the methods of calculation and design of metal-wood crane beams. In this case, an algorithm is described that allows designing systems that are rational in terms of material consumption. Methods. As an example, a metal-wood beam with a span of 12 m is used, which is supported by overhead cranes with a load capacity of 30 tf. The operation of a metal-wood crane beam was compared with a glue laminate crane beam without reinforcement. The reinforcement elements are "discarded" and replaced with elasto-yielding supports to calculate a glue laminate beam reinforced with metal elements (or a metal-wood beam). The flexibility of these supports is taken into account using the elastic support ratio r, which is determined depending on the stiffness of the supports, and the force in the metal elements is derived from the nodes balance. Result. In both variants of loading metal-wood crane beams, it was shown that the greatest bending moment occurred when the bridge wheel was located above the elastic support. Conclusion. It is rational to use a metal-wood crane beam when operating bridge cranes with a lifting capacity of up to 30 tf; metal-wood crane beams are recommended to be designed with spans up to 12 m; the comparison of glue laminate crane beams with metal-wood beams showed that metal-wood beams were 40-55% more efficient.

The effect of education on the demographic dividend: an analysis of the Brazilian case

The demographic dividend has aroused interest among demographers and economists because it is seen as a window of oportunity for the economic development of countries that have experienced a demographic transition. There are reasons to question the sole virtuosity of the pure demographic dividend in economic growth. Crespo-Cuaresma et al. (2014) found that educational expansion has an important role in economic gains during the demographic dividend. To verify these results for the Brazilian case, we performed a decomposition exercise of economic support ratio (ESR), an alternative to demographic dependency ratio, to analyze the first demographic dividend. A simulation, applied for the period from 1970 to 2100 considering three scenarios of educational expansion, shows that educational expansion was and will be responsible for a big share of the economic gains of the Brazilian demographic dividend period, outperforming the change in age structure effect. In addition, an increase in a work-age population with post-secondary education appears to potentialize these results.