Using a matrix in life transition research

Life transitions can be planned or can occur unexpectedly. They can cause a major change to a person's life patterns and well-being. Older adulthood is a time for many life transitions as a result of changes in life roles and health status. In this exploratory study, the authors investigate the transition involved in driving cessation for older people. In analyzing and organizing the data, they develop a matrix that incorporated descriptive and temporal factors associated with the transition. This matrix is useful in organizing and communicating the findings as a whole and could be used in describing individual experiences. It might be of use for the organization of qualitative data about other life transitions such as illness, retirement, and the development and adoption of new behaviors.

Is vaccine therapy the future in cancer prevention?

One vaccine designed to prevent cancer by preventing a precursor infection is already in common use, and at least one more is in the latter stages of clinical development. These vaccines are part of a new era of cancer immunoprophylaxis. Several further vaccines are in preclinical and clinical development, targeted at preventing cancer precursor infections, and these should add to our ability to prevent this common human disorder. However, vaccines to prevent cancers not triggered by infection are a more remote prospect, for a variety of reasons.

Making decisions with the future in mind: Developmental and comparative identification of mental time travel

Mechanisms that produce behavior which increase future survival chances provide an adaptive advantage. The flexibility of human behavior is at least partly the result of one such mechanism, our ability to travel mentally in time and entertain potential future scenarios. We can study mental time travel in children using language. Current results suggest that key developments occur between the ages of three to five. However, linguistic performance can be misleading as language itself is developing. We therefore advocate the use of methodologies that focus on future-oriented action. Mental time travel required profound changes in humans' motivational system, so that current behavior could be directed to secure not just present, but individually anticipated future needs. Such behavior should be distinguishable from behavior based on current drives, or on other mechanisms. We propose an experimental paradigm that provides subjects with an opportunity to act now to satisfy a need not currently experienced. This approach may be used to assess mental time travel in nonhuman animals. We conclude by describing a preliminary study employing an adaptation of this paradigm for children. (c) 2005 Elsevier Inc. All rights reserved.

Preventing adolescent depression: An evaluation of the problem solving for life program

This study evaluated the effectiveness of the Problem Solving For Life program as it universal approach to the prevention of adolescent depression. Short-term results indicated that participants with initially elevated depressions scores (high risk) who received the intervention showed a significantly greater decrease in depressive symptoms and increase in life problem-solving scores from pre- to postintervention compared with a high-risk control group. Low-risk participants who received the intervention reported a small but significant decrease in depression scores over the intervention period, whereas the low-risk controls reported an increase in depression scores. The low-risk group reported a significantly greater increase in problem-solving scores over the intervention period compared with low-risk controls. These results were not maintained, however, at 12-month follow-up.

Levels and probable origin of predatory scarring on humpback whales (Megaptera novaeangliae) in east Australian waters

To investigate the incidence of non-lethal predation in Southern Hemisphere whales, more than 3400 fluke-identification photographs from resight histories of 1436 east Australian humpback whales were examined for evidence of predatory markings. Photographs were obtained from 1984 to 1996 at various locations along the east coast of Australia, from northern Queensland to southern New South Wales. Photographs were classified in terms of the level and type of scarring. The possible predator and whether the markings appeared fresh were also noted. In all, 17% of identified east Australian humpbacks possessed some form of predatory scarring, 57% of which was minor and 43% major. Almost all predatory scarring was consistent with that inflicted by killer whales. Only three whales demonstrated an increase in the level of predatory scarring after their first sightings. Two incidents of fresh scarring were recorded, and one fatal killer whale attack on a humpback whale calf was directly observed. The overall level of predatory scarring found in this study is comparable to those found in studies for Northern Hemisphere humpback whales. The low incidence of adult whales showing their first sign of predatory scarring after their initial sighting, and the small number possessing recent scarring, support the idea that east Australian humpback whales experience most predatory attacks early in life.

An economic analysis of life expectancy by gender with application to the United States

This paper presents an economic model to explain the behavior of life expectancy of both sexes. It explicitly examines the relationship between the gender gap in life expectancy and the gender gap in pay. It shows that as the latter narrows over the course of economic development, the former may initially expand but will eventually shrink. Simulation results from our model accord with the behavior of life expectancy for both sexes since the 1940s in the United States. (C) 2003 Elsevier B.V. All rights reserved.

Hospital-based case-control study of bronchiectasis in indigenous children in central Australia

Background: Childhood pneumonia has been reported to be associated with the development of bronchiectasis but there are no case-control studies that have examined this. This study examined the relationship between hospital admission for episode(s) of pneumonia and the risk of radiologically proven bronchiectasis. Methods: A medical record-based case-control study of bronchiectasis in Indigenous children was conducted in Central Australia. Controls (183), matched to cases (61) by gender, age and year of diagnosis, were Indigenous children hospitalized with other conditions. Results: There was a strong association between a history of hospitalized pneumonia and bronchiectasis [odds ratio (OR), 15.2; 95% confidence interval (95% CI) 4.4-52.7]. This was particularly evident in recurrent hospitalized pneumonia (P for trend < 0.01), severe pneumonia episodes with longer hospital stay (P for trend < 0.01), presence of atelectasis (OR 11.9; 95% CI 3.1-45.9) and requirement for oxygen (P for trend < 0.01). The overall number of pneumonia episodes, rather than its site, was associated with bronchiectasis. Although the total number of pneumonia episodes in the first year of life did not increase the risk of bronchiectasis, more severe episodes early in life did. Malnutrition, premature birth and being small for gestational age were more common findings among cases. Breast-feeding appeared to be a protective factor (OR 0.2; 95% CI 0.1-0.7). Conclusions: Although we cannot fully answer the question of why bronchiectasis is much more common in Indigenous children, we have provided strong evidence of an association between bronchiectasis and severe and recurrent pneumonia episodes in infancy and childhood.

Role of oxidative stress in age-associated chronic kidney pathologies

The kidneys exhibit age-associated deterioration in function via a loss of 20% to 25% kidney mass, particularly from the renal cortex and increased fibrosis. Oxidative stress has been found to mediate age-associated renal cell injury and cell death, particularly apoptosis. Oxidative stress results from an imbalance between the levels of free radicals generated during aerobic metabolism, inflammation, and infection and the safe breakdown of these species by endogenous and exogenous scavengers. Other factors may influence these pathologies. For example, growth hormone and caloric restriction have been shown to influence life span, although neither method of prolonging life is likely to find general acceptance in humans. Some genetic knockout models offer promise; for example, knockout of the p66 isoform of the Shc gene in mice increases life span by 30%, but appetite, size, and fertility are retained. Whether the increase in life span is via increased kidney health is not yet clear, but decreasing the age-related renal pathologies will no doubt aid in increasing life span and health in general. This review looks at the role and modulation of factors that influence life span, in particular modulation of oxidative stress, with particular relevance to age-related renal pathologies. (C) 2005 by the National Kidney Foundation, Inc.

Lifetime cover in private insurance markets

In the last few decades, private health insurance rates have declined in many countries. In countries and states with community rating, a major cause is adverse selection. In order to address age-based adverse selection, Australia has recently begun a novel approach which imposes stiff penalties for buying private insurance later in life, when expected costs are higher. In this paper, we analyze Australiarsquos Lifetime Cover in the context of a modified version of the Rothschild-Stiglitz insurance model (Rothschild and Stiglitz, 1976). We allow empirically-based probabilities to increase by age for low-risk types. The model highlights the shortcomings of the Australian plan. Based on empirically-based probabilities of illness, we predict that Lifetime Cover will not arrest adverse selection. The model has many policy implications for government regulation encouraging long-term health coverage.

A simple lifestyle score predicts survival in healthy elderly men

Background. Although improvements in life expectancy have been attributed in part to the adoption or a more prudent lifestyle, few studies have examined the association of lifestyle with survival, using several lifestyle factors simultaneously, in a healthy elderly population. Methods. We investigated the association of health related behaviors with mortality in 7989 men aged 65 to 83 years participating in a population-based trial in Perth, Western Australia, by calculating a lifestyle score as a simple tally of flow many or eight prudent behaviors each individual followed. Results. Invitations to screening produced a corrected response of 70.5%. Out of a possible score of 8.46% of men had a score of less than 5. Within 5 years, a total of 703 men (9%) had died from any cause. The hazard ratio in men with a low lifestyle score was 1.3 [95% confidence interval (CI): 1.1-1.5] compared with men with a score of 5 or more. Conclusions. Lifestyle remains an important predictor of mortality even in old age. Survival in older men without a history of cardiovascular disease can potentially be enhanced by promoting a healthy lifestyle. © 2004 Elsevier Inc, All rights reserved.

The effect of life expectancy on fertility, saving, schooling and economic growth: theory and evidence

We construct a simple growth model where agents with uncertain survival choose schooling time, life-cycle consumption and the number of children. We show that rising longevity reduces fertility but raises saving, schooling time and the growth rate at a diminishing rate. Cross-section analyses using data from 76 countries support these propositions: life expectancy has a significant positive effect on the saving rate, secondary school enrollment and growth but a significant negative effect on fertility. Through sensitivity analyses, the effect on the saving rate is inconclusive, while the effects on the other variables are robust and consistent. These estimated effects are decreasing in life expectancy. Copyright The editors of the Scandinavian Journal of Economics 2005.

Strong and weak lifespan extension: What is most feasible and likely?

Recent advances in biomedical science indicate that it may eventually be possible to intervene in the biological process of human ageing. This paper overviews the current state of the science of lifespan extension and promising future directions. It is uncertain whether 'strong' lifespan extension - the extension of human life beyond the maximum 122 years so far observed - will become a reality. It is more likely that cumulative effects of numerous scientific and biomedical advances in the treatment of common disease will produce 'weak' lifespan extension - the extension of average life expectancy. The practical application of molecular, genetic and nanomaterials research may also lead to advances in life expectancy. It is not too early to begin to consider the policy implications of either form of lifespan extension.

Successful use of recombinant factor VII in massive hemoptysis due to community-acquired pneumonia

Recombinant activated factor VII (rFVIIa) is a powerful hemostatic agent developed for use in hemophilia. It has been used increasingly in life-threatening hemorrhage in a variety of other settings in which conventional medical or surgical therapy is unsuccessful. This report describes the successful use of rFVIIa for pulmonary hemorrhage due to a focal bleeding source in a regional hospital where bronchial artery embolization or surgery were not available. rFVIIa may be a useful temporizing measure in the unstable patient with pulmonary hemorrhage without coagulopathic bleeding when conventional treatment. is not immediately available.