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‘Remarkable’ decline in fertility rates

There has been a remarkable global decline in the number of children women are having, say researche..

There has been a remarkable global decline in the number of children women are having, say researchers.

Their report found fertility rate falls meant nearly half of countries were now facing a "baby bust" – meaning there are insufficient children to maintain their population size.

The researchers said the findings were a "huge surprise".

And there would be profound consequences for societies with "more grandparents than grandchildren".

How big has the fall been?

The study, published in the Lancet, followed trends in every country from 1950 to 2017.

In 1950, women were having an average of 4.7 children in their lifetime. The fertility rate all but halved to 2.4 children per woman by last year.

But that masks huge variation between nations.

The fertility rate in Niger, west Africa, is 7.1, but in the Mediterranean island of Cyprus women are having one child, on average.

In the UK, the rate is 1.7, similar to most Western European countries.

How high does the fertility rate have to be?

The total fertility rate is the average number of children a woman gives birth to in their lifetime (it's different to the birth rate which is the number of children born per thousand people each year).

Whenever a country's rate drops below approximately 2.1 then populations will eventually start to shrink (this "baby bust" figure is significantly higher in countries which have high rates of death in childhood).

At the start of the study, in 1950, there were zero nations in this position.

Prof Christopher Murray, the director of the Institute for Health Metrics and Evaluation at the University of Washington, told the BBC: "We've reached this watershed where half of countries have fertility rates below the replacement level, so if nothing happens the populations will decline in those countries.

"It's a remarkable transition.

"It's a surprise even to people like myself, the idea that it's half the countries in the world will be a huge surprise to people."

Which countries are affected?

More economically developed countries including most of Europe, the US, South Korea and Australia have lower fertility rates.

It does not mean the number of people living in these countries is falling, at least not yet as the size of a population is a mix of the fertility rate, death rate and migration.

It can also take a generation for changes in fertility rate to take hold.

But Prof Murray said: "We will soon be transitioning to a point where societies are grappling with a declining population."

Half the world's nations are still producing enough children to grow, but as more countries advance economically, more will have lower fertility rates.

'We'd rather give our daughter the best of everything'

Rachael Jacobs, 38, of Kent, had her first and only child seven years ago

I'd always focused on my career. When I was pregnant I was still focusing on my career.

I know now that we can survive on what we earn as a family and still go on holiday every year. If we had more than one child we couldn't go on holiday.

We'd rather give our daughter the best of everything than have multiple children that we can just about feed and clothe.

My partner and I are also thinking about the future. We want to be in a position where we can help her financially with university or housing. I don't want to ever have to say that she can't go to a party or have a new Christmas jumper.

Why is the fertility rate falling?

The fall in fertility rate is not down to sperm counts or any of the things that normally come to mind when thinking of fertility.

Instead it is being put down to three key factors:

  • Fewer deaths in childhood meaning women have fewer babies
  • Greater access to contraception
  • More women in education and work

In many ways, falling fertility rates are a success story.

What will the impact be?

Without migration, countries will face ageing and shrinking populations.

Dr George Leeson, director of the Oxford Institute of Population Ageing, says that does not have to be a bad thing, as long as the whole of society adjusts to the massive demographic change.

He told the BBC: "Demography impacts on every single aspect of our lives, just look out of your window at the people on the streets, the houses, the traffic, the consumption, it is all driven by demography.

"Everything we plan for is not just driven by the numbers in the population, but also the age structure and that is changing, so fundamentally we haven't got our heads around it."

He thinks workplaces are going to have to change and even the idea of retiring at 68, the current maximum in the UK, will be unsustainable.

The report, part of the Global Burden of Diseases analysis, says affected countries will need to consider increasing immigration, which can create its own problems, or introducing policies to encourage women to have more children, which often fail.

Report author Prof Murray argues: "On current trends there will be very few children and lots of people over the age of 65 and that's very difficult to sustain global society.

"Think of all the profound social and economic consequences of a society structured like that with more grandparents than grandchildren.

"I think Japan is very aware of this, they're facing declining populations, but I don't think it's hit many countries in the West, because low fertility has been compensated with migration.

"At a global level there is no migration solution," Prof Murray says.

But while the change may challenge societies, it may also have environmental benefits given the impact of our species.

What about China?

China has seen huge population growth since 1950, going from around half a billion inhabitants to 1.4 billion.

But it too is facing the challenge of fertility rates, which stood at only 1.5 in 2017, and has recently moved away from its famous one child policy.

The reason developed countries need a fertility rate of 2.1 is because not all children survive to adulthood and babies are ever so slightly more likely to be male than female.

But in China, the report shows for every 100 girls born there were 117 boys which "imply very substantial sex-selective abortion and even the possibility of female infanticide".

That means even more children need to be born to have a stable population.

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Original Article

BBC

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The organization helping to bring new drugs for rare diseases to market

A research team has reason to celebrate after the Food and Drug Administration granted it approval o..

A research team has reason to celebrate after the Food and Drug Administration granted it approval on Friday to begin a clinical trial for a new pediatric brain cancer drug, one that might have ended up overlooked by pharmaceutical companies.

The lead researcher on the team, Dr. Teresa Purzner has already beat impossible odds. The neurosurgeon and mom of three managed to get the approval in record time and with little money thanks to the help of a team of scientific altruists called SPARK.

The development of new medications in the United States is driven by pharmaceutical companies; researchers at universities rarely bring their discoveries to the bedside. For every 10,000 potential new medicines sitting on laboratory shelves around the country, only one will ever reach patients in need, according to the National Institutes of Health. Why? Because the process can take 10 to 15 years, costing upwards of a billion dollars per drug.

As a result, the number of new medications approved by the FDA has remained stagnant at about 31 per year over the past 10 years. The majority of these medications are similar to already existing ones, and many target diseases for which there are large markets — like hypertension and high cholesterol — and therefore, a return on investment.

Enter SPARK, a non-profit program created in partnership between Stanford University and volunteers from the biotechnology, pharmaceutical, and investment industries, which helps academic researchers bring their discoveries to patients. Since its founding, SPARK has given special consideration to projects typically neglected by pharmaceutical companies, including rare diseases and diseases affecting children.

Purzner put her neurosurgery practice on pause to study medulloblastoma, a type of childhood brain cancer. Compared to diseases like hypertension and high cholesterol, which affect millions of Americans, medulloblastoma is rare, affecting only 250 to 500 children every year.

“Theres something especially poignant about seeing children —beautiful, wonderful, innocent things — and seeing the impact of the therapies we are giving them. The medications, the radiation therapies impact their cognition, their quality of life and their ability to function as independent adults in the future,” Purzner said in an interview with ABC News.

Purzner had a clear goal: to find a targeted therapy that could shut down the basic biochemical pathway responsible for the development of this cancer, and she did. She tested the potential drug in mice with good results, and she just received FDA approval to test it in clinical trials, which she will do through the Pediatric Brain Tumor Consortium. She did it all in five years and for a price tag of $500,000.

“To get from my initial findings in the lab to the point where the Pediatric Brain Tumor Consortium picked it up for clinical trials would have never happened without the help of SPARK… they gave me a clear pathway and made me believe it was possible,” said Purzner.

Every year, SPARK provides 10 teams with funding and expert mentorship to promote efficient and cost-effective drug development. (more…)

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Widowed father works with congresswoman on legislation to prevent maternal deaths

Sitting in the hospital room, mother and newborn baby were sound asleep.

“I was overjoyed. I reme..

Sitting in the hospital room, mother and newborn baby were sound asleep.

"I was overjoyed. I remember thinking my family is complete," Charles Johnson told ABC News.

But then he looked down and saw his wife Kiras catheter turn pink and then red with blood.

April 12, 2016 was supposed to be a joyous day for the Johnson family, but it turned into a "nightmare."

Ten hours later, Kira Johnson died as a result of internal bleeding following a cesarean section.

Now, two years later, Johnson is raising two children on his own and advocating to rectify the country's maternal health policies and regulations to prevent anyone else from sharing the same tragedy. Johnson took to Capitol Hill to share his wife's story before members of Congress, working alongside a congresswoman who experienced her own personal difficulties during pregnancy.

Charles and Kira Johnson welcomed their first son Charles V. in 2014. He was delivered via C-section. Two years later, the Johnson family relocated from Atlanta to Los Angeles and learned they were expecting their second baby boy.

"Kira and I had always wanted two boys," Johnson said. "I was excited."

The Johnsons decided to have Langston delivered at Cedars Sinai medical center, a non-profit hospital that is currently ranked as the eighth best hospital in the country by U.S. News and World Report.

Charles Johnson said his wife was in exceptional health and that she took all the necessary prenatal measures to ensure their second child would be born healthy. Since their first son was born via C-section, the doctor suggested the same for their second. (more…)

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States look to breathalyze convicted drunk drivers to reduce fatalities

This story is from Kaiser Health News

On Jan. 1, California joined the majority of states that ha..

This story is from Kaiser Health News

On Jan. 1, California joined the majority of states that have laws requiring drivers with drunken-driving convictions to install breathalyzers in vehicles they own or operate.

Researchers, public health advocates and political leaders believe these laws are helping reduce alcohol-related road deaths.

The gadgets, known as ignition interlock devices, are mounted on the steering wheel of a vehicle and prevent it from starting if the drivers blood-alcohol reading is above a predetermined level.

In California, the breathalyzers are mandatory only for repeat offenders. Five other states — Georgia, Indiana, Massachusetts, Montana and Ohio — have similar laws. Thirty-two states and D.C. require the devices even for first-time offenders.

The advent of such laws across the United States in the past 15 years has been accompanied by some good news: Deaths involving drunken driving are only about half of what they were in the early 1980s, though they have ticked back up in recent years. The long-term decline is largely attributable to greater public awareness, stricter seat belt enforcement and the establishment in 2000 of a nationwide legal blood-alcohol threshold of 0.08 percent — far below the 0.15 percent standard commonly used before then.

State Sen. Jerry Hill (D-San Mateo), the author of the California law, said breathalyzers in cars will make roads safer than under the current law, which generally relies on license restrictions and suspensions.

“Weve seen people on a suspended license continue to drive and continue to cause destruction,” said Hill, who lost his best friend to drunken driving in the 1980s.

There is some evidence that the breathalyzers have an impact. Nationally, from 2006 to 2016, ignition-locking breathalyzers prevented 2.3 million attempts to drive by people with a blood-alcohol level at or above 0.08 percent — the legal threshold for driving under the influence — according to a 2017 report by the advocacy group Mothers Against Drunk Driving.

Emma McGinty, an associate professor at the Johns Hopkins Bloomberg School of Public Health, found that laws requiring interlocks for all DUI offenders were associated with a 7 percent drop in the rate of fatal crashes caused by drunken drivers. Another study found that laws covering all offenders were associated with 15 percent fewer alcohol-related fatalities compared with states that have less stringent laws. (more…)

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