Publications
Background
Meta-analyses have shown that preexisting mental disorders may increase serious Coronavirus Disease 2019 (COVID-19) outcomes, especially mortality. However, most studies were conducted during the first months of the pandemic, were inconclusive for several categories of mental disorders, and not fully controlled for potential confounders. Our study objectives were to assess independent associations between various categories of mental disorders and COVID-19-related mortality in a nationwide sample of COVID-19 inpatients discharged over 18 months and the potential role of salvage therapy triage to explain these associations.
Methods and findings:
We analysed a nationwide retrospective cohort of all adult inpatients discharged with symptomatic COVID-19 between February 24, 2020 and August 28, 2021 in mainland France. The primary exposure was preexisting mental disorders assessed from all discharge information recorded over the last 9 years (dementia, depression, anxiety disorders, schizophrenia, alcohol use disorders, opioid use disorders, Down syndrome, other learning disabilities, and other disorder requiring psychiatric ward admission). The main outcomes were all-cause mortality and access to salvage therapy (intensive-care unit admission or life-saving respiratory support) assessed at 120 days after recorded COVID-19 diagnosis at hospital. Independent associations were analysed in multivariate logistic models. Of 465,750 inpatients with symptomatic COVID-19, 153,870 (33.0%) were recorded with a history of mental disorders. Almost all categories of mental disorders were independently associated with higher mortality risks (except opioid use disorders) and lower salvage therapy rates (except opioid use disorders and Down syndrome). After taking into account the mortality risk predicted at baseline from patient vulnerability (including older age and severe somatic comorbidities), excess mortality risks due to caseload surges in hospitals were +5.0% (95% confidence interval (CI), 4.7 to 5.2) in patients without mental disorders (for a predicted risk of 13.3% [95% CI, 13.2 to 13.4] at baseline) and significantly higher in patients with mental disorders (+9.3% [95% CI, 8.9 to 9.8] for a predicted risk of 21.2% [95% CI, 21.0 to 21.4] at baseline). In contrast, salvage therapy rates during caseload surges in hospitals were significantly higher than expected in patients without mental disorders (+4.2% [95% CI, 3.8 to 4.5]) and lower in patients with mental disorders (−4.1% [95% CI, −4.4; −3.7]) for predicted rates similar at baseline (18.8% [95% CI, 18.7-18.9] and 18.0% [95% CI, 17.9-18.2], respectively). The main limitations of our study point to the assessment of COVID-19-related mortality at 120 days and potential coding bias of medical information recorded in hospital claims data, although the main study findings were consistently reproduced in multiple sensitivity analyses.
Conclusions:
COVID-19 patients with mental disorders had lower odds of accessing salvage therapy, suggesting that life-saving measures at French hospitals were disproportionately denied to patients with mental disorders in this exceptional context.
We revisit fertility regulation in Tunisia by examining the role of the extended family. As marriage is the exclusive acknowledged childbearing context, we examine fertility analysis in Tunisia through the sequence: woman’s marriage age, post-marriage delay in the first use of contraception, and past and current contraceptive use. We trace the family socio-economic influences that operate through these decisions.
We prove a new minimization theorem in weighted graphs endowed with a quasi-metric distance, which improves the graphical version of the Ekeland variational principle discovered recently (Alfuraidan and Khamsi in Proc Am Math Soc 147:5313–5321, 2019). As a powerful application in behavioral sciences, we consider how to improve the quality of life in the context of the work–family balance problem, using the recent variational rationality approach of stay and change human dynamics (Soubeyran in Variational Rationality, a Theory of Individual Stability and Change: Worthwhile and Ambidextry Behaviors. Preprint. GREQAM, Aix Marseille University, 2009; Soubeyran in Variational Rationality. The Resolution of Goal Conflicts Via Stop and Go Approach-Avoidance Dynamics. Preprint. AMSE, Aix-Marseille University, 2021).
This article investigates the impact of European Central Bank policies on credits considering financial and banking fragmentation. Using European data from the past decade, we estimate SVAR models to analyze the regional impact of conventional and unconventional measures on price and volume indicators of fragmentation. The risk-taking channel is studied using GVAR models to document the national consequences of this fragmentation. We find that unconventional measures increase credit in peripheral countries. Monetary policies alleviate fragmentation, but mostly in terms of price dispersion rather than credit volume. Finally, unconventional measures imply a rebalancing of European bank assets in favor of foreign currency denominated-assets.
This paper has two parts. The mathematical part provides generalized versions of the robust Ekeland variational principle in terms of set-valued EVP with variable preferences, uncertain parameters and changing weights given to vectorial perturbation functions. The behavioural part that motivates our findings models the formation and stability of a partnership in a changing, uncertain and complex environment in the context of the variational rationality approach of stop, continue and go human dynamics. Our generalizations allow us to consider two very important psychological effects relative to ego depletion and goal gradient hypothesis.
Purpose The authors characterize the conditions under which a country may eventually split and when it splits within an infinite horizon multi-stage differential game. Design/methodology/approach In contrast to the existing literature, the authors do not assume that after splitting, players will adopt Markovian strategies. Instead, the authors assume that while the splitting country plays Markovian, the remaining coalition remains committed to the collective control of pollution and plays open-loop. Findings Within a full linear-quadratic model, the authors characterize the optimal strategies. The authors later compare with the outcomes of the case where the splitting country and the remaining coalition play both Markovian. The authors highlight several interesting results in terms of the implications for long-term pollution levels and the duration of coalitions under heterogenous strategies as compared to Markovian behavior. Originality/value In this paper, the authors have illustrated the richness of the simplications of enlarging the set of strategies in terms of the emergence of coalitions, their duration and the implied welfare levels per player. Varying only three parameters (the technological gap, pollution damage and coalition payoff share distribution across players), the authors have been able to generate, among other findings, quite different rankings of welfare per player depending on whether the remaining coalitions after split play Markovian or stay precommited to the pre-splitting period decisions.
Considering optimal non-linear income tax problems when the social welfare function only depends on ranks as in Yaari (Econometrica 55(1):95–115, 1987) and weights agreeing with the Lorenz quasi-ordering, we extend the analysis of Simula and Trannoy (Am Econ J Econ Policy, 2021) in two directions. First, we establish conditions under which bunching does not occur in the social optimum. We find a sufficient condition on individual preferences, which appears as a reinforcement of the Spence-Mirrlees condition. In particular, the marginal dis-utility of gross income should be convex, but less convex the higher the productivity. We also show that, for all productivity distributions with a log-concave survival function, bunching is precluded under the maximin, Gini, and “illfare-ranked single-series Ginis”. Second, we turn to a discrete population setting, and provide an “ABC” formula for optimal marginal tax rates, which is related to those for a continuum of types found in Simula and Trannoy (2021), but remain essentially distinct.
Under income-differentiated mortality, poverty measures suffer from a selection bias: they do not count the missing poor (i.e., persons who would have been counted as poor provided they did not die prematurely). The Pre-Industrial period being characterized by an evolutionary advantage (i.e., a higher number of surviving children per household) of the non-poor over the poor, one may expect that the missing poor bias is substantial during that period. This paper quantifies the missing poor bias in Pre-Industrial societies, by computing the hypothetical headcount poverty rates that would have prevailed provided the non-poor did not benefit from an evolutionary advantage over the poor. Using data on Pre-Industrial England and France, we show that the sign and size of the missing poor bias are sensitive to the degree of downward social mobility.
In pharmaceutical studies, the Quality by Design (QbD) approach is increasingly being implemented to improve product development. Product quality is tested at each step of the manufacturing process, allowing a better process understanding and a better risk management, thus avoiding manufacturing defects. A key element of QbD is the construction of a Design Space (DS), i.e., a region in which the specifications on the output parameters should be met. Among the various possible construction methods, Designs of Experiments (DoE), and more precisely Response Surface Methodology, represent a perfectly adapted tool. The DS obtained may have any geometrical shape; consequently, the acceptable variation range of an input may depend on the value of other inputs. However, the experimenters would like to directly know the variation range of each input so that their variation domains are independent. In this context, we developed a method to determine the “Proven Acceptable Independent Range” (PAIR). It consists of looking for all the hyper polyhedra included in the multidimensional DS and selecting a hyper polyhedron according to various strategies. We will illustrate the performance of our method on different DoE cases.
Background
Numeracy, or the ability to understand and use numbers, has been associated with obtaining better health and financial outcomes. Studies in high-income countries suggest that low numeracy is associated with older age—perhaps especially among individuals with lower education. Here, we examined whether findings generalize to the rest of the world.
Methods
Gallup surveyed >150,000 participants for the 2019 Lloyd’s Register Foundation World Risk Poll, from 21 low-income, 34 lower-middle income, 42 upper-middle income, and 43 high-income countries. Low numeracy was operationalized as failing to correctly answer, “Is 10% bigger than 1 out of 10, smaller than 1 out of 10, or the same as 1 out of 10?”
Results
Regressions controlling for participants’ education, income, and other characteristics found that, worldwide, low numeracy was associated with older age, lower education, and their interaction. Findings held in each country-income category, although low numeracy was more common in low-income countries than in high-income countries.
Limitations
Age differences may reflect cohort effects and life span–developmental changes.
Discussion
Low numeracy is more common among people who are older and less educated. We discuss the need for education and interventions outside of the classroom.
Highlights
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We analyzed a global survey conducted in 21 low-income, 34 lower-middle income, 42 upper-middle income, and 43 high-income countries.
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Low numeracy was associated with older adult age, even after accounting for age differences in education.
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Low numeracy was more common in older people with lower education.
