The effects of health changes on projections of health service needs for the elderly population of the United States

The 1982–1994 National Long-Term Care Surveys indicate an accelerating decline in disability among the U.S. elderly population, suggesting that a 1.5% annual decline in chronic disability for elderly persons is achievable. Furthermore, many risk factors for chronic diseases show improvements, many linked to education, from 1910 to the present. Projections indicate the proportion of persons aged 85–89 with less than 8 years of education will decline from 65% in 1980 to 15% in 2015. Health and socioeconomic status trends are not directly represented in Medicare Trust Fund and Social Security Administration beneficiary projections. Thus, they may have different economic implications from projections directly accounting for health trends. A 1.5% annual disability decline keeps the support ratio (ratio of economically active persons aged 20–64 to the number of chronically disabled persons aged 65+) above its 1994 value, 22:1, when the Hospital Insurance Trust Fund was in fiscal balance, to 2070. With no changes in disability, projections indicate a support ratio in 2070 of 8:1—63% below a cash flow balance.

Induced intensification: Agricultural change in Bangladesh with implications for Malthus and Boserup

Bangladesh is dominated by a small-holder agrarian economy under extreme stress. Production shortfalls, increasing economic polarization, and chronic malnutrition are persistent, but major famine has been diverted in part by significant growth in agriculture. This recent history is open to both Malthusian and Boserupian interpretations—a history we explore here through a test of the induced intensification thesis of agricultural change. This thesis, framed by variations in the behavior of small-holders, has grown from a simple demand-production relationship to a consideration of the mediating influences on that relationship. The induced intensification thesis is reviewed and tested for 265 households in 6 villages in Bangladesh from 1950–1986. A time-series analysis of an induced intensification model provides relatively high levels of explained variance in cropping intensity (frequency and land productivity) and also indicates the relative impacts of household class, environment, and cropping strategies. On average, the small-holders in question kept pace with the demands on production, although important class and village variations were evident and the proportion of landless households increased. These results, coupled with evidence that agricultural growth involved intensification thresholds, provide clues about Malthusian and Boserupian interpretations of Bangladesh, and suggest that small-holder agriculture there is likely to continue on a “muted” path of growth.

Economic evaluation and randomised controlled trial of extracorporeal membrane oxygenation: UK collaborative trial

Objective: To compare the resource implications and short term outcomes of extracorporeal membrane oxygenation and conventional management for term babies with severe respiratory failure.

Initiation process of earthquakes and its implications for seismic hazard reduction strategy.

For the average citizen and the public, "earthquake prediction" means "short-term prediction," a prediction of a specific earthquake on a relatively short time scale. Such prediction must specify the time, place, and magnitude of the earthquake in question with sufficiently high reliability. For this type of prediction, one must rely on some short-term precursors. Examinations of strain changes just before large earthquakes suggest that consistent detection of such precursory strain changes cannot be expected. Other precursory phenomena such as foreshocks and nonseismological anomalies do not occur consistently either. Thus, reliable short-term prediction would be very difficult. Although short-term predictions with large uncertainties could be useful for some areas if their social and economic environments can tolerate false alarms, such predictions would be impractical for most modern industrialized cities. A strategy for effective seismic hazard reduction is to take full advantage of the recent technical advancements in seismology, computers, and communication. In highly industrialized communities, rapid earthquake information is critically important for emergency services agencies, utilities, communications, financial companies, and media to make quick reports and damage estimates and to determine where emergency response is most needed. Long-term forecast, or prognosis, of earthquakes is important for development of realistic building codes, retrofitting existing structures, and land-use planning, but the distinction between short-term and long-term predictions needs to be clearly communicated to the public to avoid misunderstanding.