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The demographics are also more favourable in Austria. In 2015 the dependency ratio – the ratio of over-65s to those aged 20-64 – was 30.3% in Austria and 35.3% in Germany. Nevertheless, demographic trends and the ageing of a country's population can only serve as a rough guide. The key factor for the pension system is the ratio of contributors to beneficiaries. Ultimately, in order to achieve a sustainably funded pension system, the number of people in (well-paid) jobs with mandatory social security contributions needs to be as high as possible. However, this ratio is not included in the OECD report.

However, the European Commission's Ageing Report forecasts that the rise in the ratio of pensioners to contributors in Austria will remain significantly below that in Germany, despite Austria continuing to have a lower statutory retirement age. Bianco Flat Dress Mule Women’s Heels Sandals Silver Silver 91 cheap sale recommend sale best wholesale outlet 100% authentic HzsFEw
In addition to the slightly higher projected rise in employment rates for Austria, this can mainly be put down to the pronounced decline expected to occur in Germany's working age population.

The sharp increase in the number of elderly people as a percentage of the total population means that spending on pensions is set to rise in Austria, too. The European Commission estimates that government pension expenditure in 2013 amounted to 13.9% of GDP. This figure is expected to climb to 14.7% by around 2040. Thereafter, the proportion of GDP spent on pensions is forecast to level off, falling slightly again by 2060. This equates to a 0.5 percentage point rise over the forecast period as a whole. Consequently, the European Commission rates the trend for Austria as "broadly stable". This modest rise is significantly lower than the European Commission's forecast for Germany of a 2.7 percentage point increase to 12.7% of GDP by 2060. cheap sale outlet locations buy online with paypal Clarks Womens Kacia Garnet Boot Taupe Combo Zau4g
Moreover, the figures for Austria include the minimum income payments for pensioners and are based on higher coverage ratios. It is important to bear in mind that these calculations only cover spending on state pensions. In other words, the figures for Germany significantly underestimate the total expenditure, since they do not include private and occupational pensions. sale authentic shop offer cheap online Rieker F6512 Mens Sneakers Brown Eaw0LytO

The fact that civil servants' pensions in Austria were already brought into line with the state pension system regulations several years ago will substantially reduce the burden of funding the future pension system. Of the 13.9% of GDP spent on pensions in 2013, a quarter went to civil servants' pensions. The latest spending forecasts indicate that expenditure on civil servants' pensions will fall from its current level of 3.5% of GDP to just 0.9% by 2060. adidas Womens Element V Core Black/Vapour Grey/White for cheap discount pay with paypal cheap online TtYBCQyzo

Simulations for Germany calculate that changing over to a pension system that encompasses the entire working population would have positive long-term effects. 23 The introduction of compulsory social security contributions for civil servants and the self-employed would allow the net before-tax pension level to be kept at the 2000 level of 52.6% until 2060, while contributions to the state pension scheme would not rise above 26%. On the other hand, failure to implement this reform would result in the pension level falling to around 41% and the contribution rate rising to almost 27.5% by 2060.

An analysis plan or strategy should be developed before any analysis is undertaken to ensure that the modelling is hypothesis-led rather than data-driven. The a priori model-fitting analysis strategy should identify:

the covariates which are to be considered for inclusion in any modelling approach to analysis

the order in which confounding variables are to be considered for inclusion in the model with the intervention variable fitted last (or an ‘intervention × phase’ interaction if pre- and post-measurements have been taken). 14

An example of a model-fitting analysis strategy which could have been used for the URGE data is displayed in Figure 1.

Multilevel modelling was undertaken for the URGE study using the software package MLWin, developed by the Institute of Education in London (Table 2). As outlined above, an a priori model-fitting analysis strategy was developed which identified the order in which covariates were to be included in the model. Only after all covariates were included in the model was the effect of the ‘intervention × phase’ interaction examined. After adjustment for the pre-identified covariates, the interaction remained significant. The effect size estimated from the multilevel model was 0.70 (95% CI: 0.55–0.91). The resulting t -ratio was t = 2.71, P = 0.01. This indicates that when all the data are used in the analysis, the waiting time was on average 30% less in the guideline group compared with the control group (Table 2).

An in-depth discussion of all the available modelling methods is beyond the scope of this article. Researchers should refer to specific texts such as Murray 2 for a general introduction to possible methods, or to Kreft and de Leeuw 15 for discussion of multilevel models. Similarly, a range of statistical software packages are available for the analysis of clustered data sets. A discussion of the more common packages can be found on the multilevel modelling web site: Puma 64288023442 Ladies Safety Shoes Stepper Wns Low S2 HRO SRC Size 8 black/purple black/purple outlet big sale GxTJaf
. For a discussion of generalized estimating equations, readers should refer to Burton et al. 16

These modelling techniques adjust well for clustering and allow adjustment for both cluster level and patient level covariates. These types of analyses are more computationally intensive, however, and require greater statistical expertise both in the execution of the procedures and in the interpretation of the results.

With the increasing popularity of the cluster randomized trial, it is important that researchers be aware of the implications of adopting such a design. Cluster RCTs are more complex to undertake than patient randomized trials in that they require increased sample sizes, with associated recruitment issues, and the analysis of these trials is not so straightforward. Cluster trials are the gold standard design for some interventions, however, and it is important that researchers have the information to design and analyse them appropriately.

In NSTE-ACS patients, there is no interaction between the effect of myocardial revascularization and diabetic status [ 62 , 63 , 69 ]. In both the FRISC-2 and TACTICS-TIM118 trials [ 62 , 69 ], an early invasive strategy was associated with improved outcomes; in TACTICS-TIM118 [ 69 ], the magnitude of the benefit in diabetic patients was greater than in non-diabetics.

In STEMI patients, the PCAT-2 [ 112 ] collaborative analysis of 19 RCTs showed a similar benefit of primary PCI over fibrinolytic treatment in diabetic and non-diabetic patients. The odds ratio (OR) for mortality with primary PCI was 0.49 for diabetic patients (95%CI 0.31–0.79). Late PCI in patients with a completely occluded coronary artery after STEMI past the acute stage offered no benefit over medical therapy alone, both in diabetic and non-diabetic patients [ 90 ].

All RCTs have shown higher rates of repeat revascularization procedures after PCI, compared with CABG, in diabetic patients [ 29 ]. A recent meta-analysis on individual data from 10 RCTs of elective myocardial revascularization [ 29 ] confirms a distinct survival advantage for CABG over PCI in diabetic patients. Five-year mortality was 20% with PCI, compared with 12.3% with CABG (OR 0.70, 95%CI 0.56–0.87), whereas no difference was found for non-diabetic patients; the interaction between diabetic status and type of revascularization was significant. The AWESOME trial [ 113 ] randomized high-risk patients (one-third with diabetes) to PCI or CABG. At 3 years, there was no significant difference in mortality between PCI-treated and CABG-treated diabetic patients. Finally, in diabetic patients from the SYNTAX trial [ 4 ], the MACCE rate at 1 year was twice as high with PCI using paclitaxel-eluting stent (PES), compared with CABG, a difference driven by repeat revascularization.

Though admittedly underpowered, the CARDia trial [ 114 ] is the only trial reported to date that was specifically designed to compare PCI using BMS (31%) or DES (69%) with CABG in diabetic patients. At 1 year, the combined incidence of death, MI, or stroke was 10.5% in the CABG arm and 13.0% in the PCI arm (HR 1.25, 95%CI 0.75–2.09). Repeat revascularization was 2.0% vs. 11.8%, respectively ( P ≪ 0.001).

Besides RCTs, registry data, such as the New York registry [ 34 ], show a trend to improved outcomes in diabetic patients treated with CABG compared with DES (OR for death or MI at 18 months 0.84, 95% CI 0.69–1.01).

A large collaborative network meta-analysis has compared DES with BMS in 3852 diabetic patients [ 115 ]. Mortality appeared significantly ( P = 0.02) higher with DES compared with BMS when the duration of DAPT was ≪6 months (eight trials); in contrast, no difference in mortality and the combined endpoint death or MI was found when DAPT duration was ≥6 months (27 trials). Whatever the duration of DAPT, the need for repeat TVR was considerably less with DES than BMS [OR 0.29 for sirolimus-eluting stent (sES); 0.38 for PES], similar to the restenosis reduction observed in non-diabetic patients. There are no robust data to support the use of one DES over another in patients with diabetes.

30. “Ya’ll don’t want me to win. I’m tryna follow dreams, you want me to follow trends.” – Kendrick Lamar

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5 months ago


Jan 23, 2018


Joe Kleckner

Andy Frisella is a serial entrepreneur, motivator, and host of the hugely successful MFCEO podcast where he has interviewed legends such as Gary Vaynerchuk and Lewis Howes . Andy got his start 17 years ago with a small supplement distribution company. Since then it has grown into a $100 million per year business. Andy has certainly had to endure a lot on his journey to success. Along the way, he has picked up wisdom far beyond the years of anyone else.

Here are some of his best quotes :

1. “Lots of people wanting everything and doing nothing.” – Andy Frisella

2. “99% of people let others opinions and beliefs keep them from ever living the life they want.” – Andy Frisella

3. “This is about legacy. This is about service. This is about giving far more than you take. This is about inspiring the warrior attitude and taking responsibility for your life. This is about picking eachother up.” – Andy Frisella

4. “There are no super-humans, just humans, and what one man can do, another can do.” – Andy Frisella

5. “Your mind focus are far more powerful than you could ever comprehend.” – Andy Frisella

6. “Quit feeling sorry for yourself, make shit happen.” – Andy Frisella

7. “Instead of thinking how hard your journey is, think how great your story will be.” – Andy Frisella

8. “You are where you are because of you.” – Andy Frisella

9. “Live for the weekends and that’s all you’ll ever have.” – Andy Frisella

10. “Yes, finding success is going to require you to make sacrifices and be uncomfortable.” – Andy Frisella

11. “When you say ‘no’ most of the time you are saying ‘yes’ to the progression of yourself and those around you” – Andy Frisella

12. “What you’re doing in the short term to make yourself comfortable is killing your potential.” – Andy Frisella

13. “There’s a lot of healthy shit that comes from believing in yourself.” – Andy Frisella

14. “If you don’t believe youre the shit, nobody else will either.” – Andy Frisella

15. “History forgets whiners, but remembers winners.” – Andy Frisella

16. “Easy never pays well.” – Andy Frisella

17. “Make sure the people who bet against you lose.” – Andy Frisella

18. “Being a leader who lets shit slide, isn’t being a leader at all.” – Andy Frisella

19. “It’s not luck, it’s not magic, it’s not circumstances. It’s developing a great plan and executing on it, day in and day out until the visions in your head become your reality.” – Andy Frisella

20. “Accepting responsibility even when it’s not your fault and fixing the problem; you will have unlimited income potential in your life.” – Andy Frisella

21. “There’s something you’re good at, you’re just not putting value on it.” – Andy Frisella

22. “‘I deserve’ is the most whiny, cry baby phrase in the english language.” – Andy Frisella

23. “There is no ‘what it’, if you do the work on a worth plan the result will be there.” – Andy Frisella

24. “If you do the work and you make a plan it will f*cking happen.” – Andy Frisella

25. “You don’t have to define yourself by one kind of life…you can live in any world you want.” – Andy Frisella

Check out these epic quotes from Elliott Hulse

26. “Real success is not defined by what you accomplish It is defined by how you are helping others accomplish.” – Andy Frisella

27. “Don’t let the constant pursuit of and drive for success keep you from appreciating and being grateful for what you have now.” – Andy Frisella

28. “Dream so big everyone thinks you’re crazy, no matter what they think about it. The only person that limits you stares back at you in the mirror every single day.” – Andy Frisella

29. “Nothing great is given, it’s earned.” – Andy Frisella

30. “What you think about, dream about, talk about and focus on will become your life.” – Andy Frisella

31. “Nobody who you wanna be floats through the day.” – Andy Frisella

32. “Don’t be an asshole to yourself.” – Andy Frisella

33. “You know why you are so far from where you want to be? Because you think too small…you do now and you always have.” – Andy Frisella

34. “The biggest mistake you can make in life is thinking you have all the time in the world.” – Andy Frisella

35. “You gotta do the work…and gotta produce a result.” – Andy Frisella

36. “Honest gratitude for what you have is one of the biggest accelerators for future success.” – Andy Frisella

37. “But at the end of the day, success is about resilience and grit .” – Andy Frisella

38. “Put your head down for the next 10 years and get yourself a Lamborghini or two…” – Andy Frisella

39. “Don’t even let that 2nd place shit tough your skin…losing is contagious.” – Andy Frisella

40. “Free your mind to dream huge. Free your heart to believe its possible.” – Andy Frisella

41. “Be brave enough to go after what you really want. Be strong enough to pick people up and bring them to you.” – Andy Frisella

42. “The only thing relevant to your success is your actions.” – Andy Frisella

43. “Everything you see, touch, or use in your daily life started as just a single thought.” – Andy Frisella

44. “You can’t cut down a tree with a single swing of an axe.” – Andy Frisella

45. “Don’t worry about the people who aren’t happy for you. Guaranteed they are miserable f*cks anyway.” – Andy Frisella

46. “The problem with society is nobody drinks from the skulls of their enemies anymore.” – Andy Frisella

47. “Big dreams don’t cost any more than little ones.” – Andy Frisella

48. “All great things come with sacrifice.” – Andy Frisella

49. “Successful people all do one thing that you don’t do…they live with intent in every action that they take.” – Andy Frisella

50. “The reason people don’t succeed is because they don’t do the work.” – Andy Frisella

51. “Inside of every self-made man is a poor kid who followed his dreams.” – Andy Frisella

Which quote motivated you the most? Comment below!

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