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Background: Although long-term management of psoriasis is paramount, this approach is challenging in clinical practice. In the recent PSO-LONG trial, a fixed-dose combination of betamethasone dipropionate (BD) and calcipotriol (Cal) foam applied twice a week on non-consecutive days for 52 weeks (proactive treatment) reduced the risk of relapse. However, the role of Cal/BD foam in the long-term management of psoriasis needs further clarifications. The ProActive Management (PAM) program, a nationwide Italian project, aims at reaching a consensus on the role of proactive management of psoriasis. Methods: A steering committee generated some statements through the nominal group technique (NGT). The statements were voted by an expert panel in an adapted Delphi voting process. Results: Eighteen statements were proposed, and the majority of them (14/18) reached a consensus during the Delphi voting. The need to provide long-term proactive topical treatment to reduce the risk of relapse for the treatment of challenging diseases sites or in patients where phototherapy or systemic therapies are contraindicated/ineffective was widely recognized. A consensus was reached about the possibility to associate the proactive treatment with systemic and biological therapies, without the need for dose intensification, thus favoring a prolonged remission. Moreover, the proactive treatment was recognized as more effective than weekend therapy in increasing time free from relapses. Approaches to improve adherence, on the other hand, need further investigation. Conclusions: The inclusion in guidelines of a proactive strategy among the effective treatment options will be a fundamental step in the evolution of a mild-moderate psoriasis therapeutic approach.

Insight into the future of the world population is key for policy planning. At present, several organisations engage in developing global long-term population projections and provide varied results in terms of projected population size and structures. This diversity demonstrates that there is a need to reflect on the ingredients that feed into the projections. For this reason, the JRC, IIASA and the UN Population Division launched a survey where experts were asked to assess the validity and relevance of alternative arguments about the forces that could shape future fertility, mortality, and migration trends in the country of their choice. The results of the survey highlight that experts almost unanimously support the roles played by urbanisation, reductions in child mortality, greater educational attainment, and employment opportunities for women in decreasing fertility in high fertility countries. At the same time, life expectancy is expected to continue increasing across world regions, with the most significant improvements projected by experts in current 'low mortality' countries. Experts on migration mostly agree that climate change will lead to a rise in immigration. However, there is less agreement on the forces driving emigration. As a broad conclusion, the expert opinions seem to indicate that demographic challenges of the future do not necessarily have demographic solutions, and will instead necessitate improved adaptive capacities among all societies.

The recent debate on population dynamics and climate change has highlighted the importance of assessing and quantifying disparities in populations’ vulnerability and adopting a forward-looking manner when considering the potential impacts of climate change on different communities and regions. In this article, we overlay demographic projections based on the Shared Socioeconomic Pathways and climate change projections derived from the Representative Concentration Pathways. We focus on populations that are likely to be the most exposed to climate change in the future, namely, African populations in a comparative global context. First, we estimate the share of populations living in rural areas, who would be more dependent on agriculture, as one of the economic sectors mostly affected by climate change. Second, we explore how climate change would worsen the condition of populations living below the poverty line. Finally, we account for low levels of education, as further factors limiting people’s adaptation ability to increasingly adverse climate circumstances. Our contribution to the literature on population, agriculture, and environmental change is twofold. Firstly, by mapping the potential populations exposed to climate change, in terms of declining agricultural yields, we identify vulnerable areas, allowing for the development of targeted strategies and interventions to mitigate the impacts, ensure resilience, and protect the population living in the most affected areas. Secondly, we assess differentials in the vulnerability of local populations, showing how African regions would become among one of the most exposed to climate change by the end of the century. The findings support the targeting of policy measures to prevent increased vulnerability among already disadvantaged populations.

This report analyses the effect of the Russian Invasion on the longer-term future of Ukraine?s population size and structure. The qualitative scenarios spanning a range of possible migration futures are translated into quantitative population projections using a multistate population model which shows the evolution of the size and age-sex composition of Ukraine?s population up to 2052. Under the most pessimistic scenario of Long war, low return scenario we project a decline of 30 of the population. The difference of in population decline across the four considered migration scenarios matches the uncertainty in the UN projections suggesting that migration will be similarly important as fertility and mortality in driving population change in Ukraine following the war.

Across the European Union (EU) Local Administrative Units (LAUs), populations are experiencing persisting differences in their age structures that can only be interpreted accounting for migration and mobility components. Yet, in the absence of census data, migration patterns of local populations are not available from EU-official statistics. To fill the gaps, we firstly combine census data with statistics available from the National Statistical Institutes of the EU-Member Sates in a harmonised database on age-specific population structures, covering all EU-LAUs for the period 2011−2019. Secondly, we apply model life tables to assess changes by cohort over the intercensal period and provide estimates of age-specific net migration rates at LAU levels. The analysis reveals how migration dynamics vary along demographic patterns and to what extent differences are related to the degree of urbanisation and territorial characteristics (distance from city centres, remoteness, population change, GDP per-capita and poverty level) across the EU municipalities.

Background. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has been associated with adverse maternal and neonatal outcomes, yet uptake of SARS-CoV-2 vaccines during pregnancy and lactation has been slow. As a result, millions of pregnant and lactating women and their infants remain susceptible to the virus. Methods. We measured spike-specific immunoglobulin G (anti-S IgG) and immunoglobulin A (anti-S IgA) in serum and breastmilk (BM) samples from 3 prospective mother-infant cohorts recruited in 2 academic medical centers. The primary aim was to determine the impact of maternal SARS-CoV-2 immunization vs infection and their timing on systemic and mucosal immunity. Results. The study included 28 mothers infected with SARS-CoV-2 in late pregnancy (INF), 11 uninfected mothers who received 2 doses of the BNT162b2 vaccine in the latter half of pregnancy (VAX-P), and 12 uninfected mothers who received 2 doses of BNT162b2 during lactation. VAX dyads had significantly higher serum anti-S IgG compared to INF dyads (P, .0001), whereas INF mothers had higher BM:serum anti-S IgA ratios compared to VAX mothers (P = .0001). Median IgG placental transfer ratios were significantly higher in VAX-P compared to INF mothers (P, .0001). There was a significant positive correlation between maternal and neonatal serum anti-S IgG after vaccination (r = 0.68, P = .013), but not infection. Conclusions. BNT161b2 vaccination in late pregnancy or lactation enhances systemic immunity through serum anti-S immunoglobulin, while SARS-CoV-2 infection induces mucosal over systemic immunity more efficiently through BM immunoglobulin production. Next-generation vaccines boosting mucosal immunity could provide additional protection to the mother-infant dyad. Future studies should focus on identifying the optimal timing of primary and/or booster maternal vaccination for maximal benefit. © The Author(s) 2022. Published by Oxford University Press on behalf of the Infectious Diseases