Anticipating the use of life extension technologies : possible pointers from the adoption of assisted reproductive technologies

The first effective life extension technologies might well become available within the next few years. Experts from the University of Queensland, Australia, explore the possible public reaction to these therapies and the ethical and social concerns they raise, drawing on the experience of assisted reproduction technologies

A framework for life cycle cost estimation of a product family at the early stage of product development

A cost estimation method is required to estimate the life cycle cost of a product family at the early stage of product development in order to evaluate the product family design. There are difficulties with existing cost estimation techniques in estimating the life cycle cost for a product family at the early stage of product development. This paper proposes a framework that combines a knowledge based system and an activity based costing techniques in estimating the life cycle cost of a product family at the early stage of product development. The inputs of the framework are the product family structure and its sub function. The output of the framework is the life cycle cost of a product family that consists of all costs at each product family level and the costs of each product life cycle stage. The proposed framework provides a life cycle cost estimation tool for a product family at the early stage of product development using high level information as its input. The framework makes it possible to estimate the life cycle cost of various product family that use any types of product structure. It provides detailed information related to the activity and resource costs of both parts and products that can assist the designer in analyzing the cost of the product family design. In addition, it can reduce the required amount of information and time to construct the cost estimation system.

Are insect frugivores always plant pests? The impact of fruit fly (Diptera: Tephritidae) larvae on host plant fitness

Herbivory is generally regarded as negatively impacting on host plant fitness. Frugivorous insects, which feed directly on plant reproductive tissues, are predicted to be particularly damaging to hosts. We tested this prediction with the fruit fly, Bactrocera tryoni, by recording the impact of larval feeding on two direct (seed number and germination) and two indirect (fruit decay rate and attraction/deterrence of vertebrate frugivores) measures of host plant fitness. Experiments were done in the laboratory, glasshouse and tropical rainforest. We found no negative impact of larval feeding on seed number or germination for three test plants: tomato, capsicum and eggplant. Further, larval feeding accelerated the initiation of decay and increased the final level of fruit decay in tomatoes, apples, pawpaw and pear, a result considered to be beneficial to the fruit. In rainforest studies, native rodents preferred infested apple and pears compared to uninfested control fruit; however, there were no differences observed between treatments for tomato and pawpaw. For our study fruits, these results demonstrate that fruit fly larval infestation has neutral or beneficial impacts on the host plant, an outcome which may be largely influenced by the physical properties of the host. These results may contribute to explaining why fruit flies have not evolved the same level of host specialization generally observed for other herbivore groups.

Exercise for health : a randomized, controlled trial evaluating impact of a pragmatic, translational exercise intervention on quality of life, function and treatment-related side effects following breast cancer

Purpose Exercise for Health was a randomized, controlled trial designed to evaluate two modes of delivering (face-to-face [FtF] and over-the-telephone [Tel]) an 8-month translational exercise intervention, commencing 6-weeks post-breast cancer surgery (PS). Methods Outcomes included quality of life (QoL), function (fitness and upper-body) and treatment-related side effects (fatigue, lymphoedema, body mass index, menopausal symptoms, anxiety, depression and pain). Generalised estimating equation modelling determined time (baseline [5-weeks PS], mid-intervention [6-months PS], post-intervention [12-months PS]), group (FtF, Tel, Usual Care [UC]) and time-by-group effects. 194 women representative of the breast cancer population were randomised to the FtF (n=67), Tel (n=67) and UC (n=60) groups. Results: There were significant (p<0.05) interaction effects on QoL, fitness and fatigue, with differences being observed between the treatment groups and the UC group. Trends observed for the treatment groups were similar. The treatment groups reported improved QoL, fitness and fatigue over time and changes observed between baseline and post-intervention were clinically relevant. In contrast, the UC group experienced no change, or worsening QoL, fitness and fatigue, mid-intervention. Although improvements in the UC group occurred by 12-months post-surgery, the change did not meet the clinically relevant threshold. There were no differences in other treatment-related side-effects between groups. Conclusion This translational intervention trial, delivered either face-to-face or over-the-telephone, supports exercise as a form of adjuvant breast cancer therapy that can prevent declines in fitness and function during treatment and optimise recovery post-treatment.

Learning to think spatially : what do students 'see' in numeracy test items?

Learning to think spatially in mathematics involves developing proficiency with graphics. This paper reports on 2 investigations of spatial thinking and graphics. The first investigation explored the importance of graphics as 1 of 3 communication systems (i.e. text, symbols, graphics) used to provide information in numeracy test items. The results showed that graphics were embedded in at least 50 % of test items across 3 year levels. The second investigation examined 11 – 12-year-olds’ performance on 2 mathematical tasks which required substantial interpretation of graphics and spatial thinking. The outcomes revealed that many students lacked proficiency in the basic spatial skills of visual memory and spatial perception and the more advanced skills of spatial orientation and spatial visualisation. This paper concludes with a reaffirmation of the importance of spatial thinking in mathematics and proposes ways to capitalize on graphics in learning to think spatially.

Evaluation of screening tests for predicting older driver performance and safety assessed by an on-road test

A number of tests and test batteries are available for the prediction of older driver safety, but many of these have not been validated against standardized driving outcome measures. The aim of this study was to evaluate a series of previously described screening tests in terms of their ability to predict the potential for safe and unsafe driving. Participants included 79 community-dwelling older drivers (M=72.16 years, SD=5.46; range 65-88 years; 57 males and 22 females) who completed a previously validated multi-disciplinary driving assessment, a hazard perception test, a hazard change detection test and a battery of vision and cognitive tests. Participants also completed a standardized on-road driving assessment. The multi-disciplinary test battery had the highest predictive ability with a sensitivity of 80% and a specificity of 73%, followed by the hazard perception test which demonstrated a sensitivity of 75% and a specificity of 61%. These findings suggest that a relatively simple and practical battery of tests from a range of domains has the capacity to predict safe and unsafe driving in older adults.

Quality of life detriments through self-reported swelling associated with gynaecological cancer

Background and aims: Lower-limb lymphoedema is a serious and feared sequela after treatment for gynaecological cancer. Given the limited prospective data on incidence of and risk factors for lymphoedema after treatment for gynaecological cancer we initiated a prospective cohort study in 2008. Methods: Data were available for 353 women with malignant disease. Participants were assessed before treatment and at regular intervals after treatment for two years. Follow-up visits were grouped into time-periods of six weeks to six months (time 1), nine months to 15 months (time 2), and 18 months to 24 months (time 3). Preliminary data analyses were undertaken up to time 2 using generalised estimating equations to model the repeated measures data of Functional Assessment of Cancer Therapy-General (FACT-G) quality of life (QoL) scores and self-reported swelling at each follow-up period (best-fitting covariance structure). Results: Depending on the time-period, between 30% and 40% of patients self-reported swelling of the lower limb. The QoL of those with self-reported swelling was lower at all time-periods compared with those who did not have swelling. Mean (95% CI) FACT-G scores at time 0, 1 and 2 were 80.7 (78.2, 83.2), 83.0 (81.0, 85.0) and 86.3 (84.2, 88.4), respectively for those with swelling and 85.0 (83.0, 86.9), 86.0 (84.1, 88.0) and 88.9 (87.0, 90.7), respectively for those without swelling. Conclusions: Lower-limb swelling adversely influences QoL and change in QoL over time in patients with gynaecological cancer.

Relationships between appetite and quality of life in hemodialysis patients

The aim of this paper was to investigate the association between appetite and Kidney-Disease Specific Quality of Life in maintenance hemodialysis patients. Quality of Life (QoL) was measured using the Kidney Disease Quality Of Life survey. Appetite was measured using self-reported categories and a visual analog scale. Other nutritional parameters included Patient-Generated Subjective Global Assessment (PGSGA), dietary intake, body mass index and biochemical markers C-Reactive Protein and albumin. Even in this well nourished sample (n=62) of hemodialysis patients, PGSGA score (r=-0.629), subjective hunger sensations (r=0.420) and body mass index (r=-0.409) were all significantly associated with the Physical Health Domain of QoL. As self-reported appetite declined, QoL was significantly lower in nine domains which were mostly in the SF36 component and covered social functioning and physical domains. Appetite and other nutritional parameters were not as strongly associated with the Mental Health domain and Kidney Disease Component Summary Domains. Nutritional parameters, especially PGSGA score and appetite, appear to be important components of the physical health domain of QoL. As even small reductions in nutritional status were associated with significantly lower QoL scores, monitoring appetite and nutritional status is an important component of care for hemodialysis patients.

Colour and Camp Bring Shakespeare’s As You Like It to Life

As You Like It By Shakespeare. La Boite Theatre Company, Brisbane, February 24. DURING the past three years, La Boite Theatre Company has started each season with a modern adaptation of a Shakespearean favourite. This time, director David Bertold's choice is not a tragedy but As You Like It, a comedy about love's twists and turns in which a strong female figure, Rosalind, takes the leading role...

Engaging Noemi Lakmeier's living installations : the ethics of embarrassment

In Exercise in Losing Control (2007) and We Are for You Because We are Against Them (2010), Austrian-born artist Noemi Lakmaier represents Otherness – and, in particular, the experience of Otherness as one of being vulnerable, dependent or visibly different from everyone else in a social situation – by placing first herself then a group of participants in big circular balls she calls ‘Weebles’. In doing so, Lakmaier depicts Otherness as an absurd, ambiguous or illegible element in otherwise everyday ‘living installations’ in which people meet, converse, dine and connect with spectators and passersby on the street. In this paper I analyse the way spectators and passersby respond to the weeble-wearers. Not surprisingly, responses vary – from people who hurry away, to people who try to talk to the weeble-wearer, to people who try to kick or tip the weeble to test its reality. The not-quite-normal situation, and the visibility of the spectators in the situation, asks spectators to rehearse their response to corporeal differences that might be encountered in day-to-day life. As the range of comments, confrontations and struggles show, the situation transfers the ill-at-ease, embarrassed and awkward aspects of dealing with corporeal difference from the disabled performer to the able spectator-become-performer. In this paper, I theorise some of the self-conscious spectatorial responses this sort of work can provoke in terms of an ethics of embarrassment. As the Latin roots of the word attest, embarrassment is born of a block, barrier or obstacle to move smoothly through a social or communicative encounter. In Lakmaier’s work, a range of potential blocks present themselves. The spectators’ responses – from ignoring the weeble, to querying the weeble, to asking visual, verbal or physical questions about how the weeble works, and so on – are ways of managing the interruption and moving forward. They are, I argue, strategies for moving from confusion to comprehension, or from what Emmanuel Levinas would call an encounter with the unknown to back into the horizon of the known, classified and classifiable. They flag the potential for what Levinas would call an ethical face-to-face encounter with the Other in which spectators and passersby may unexpectedly find themselves in a vulnerable position.

Living a life with a physical impairment in Taiwan : "It is more than just the impairment"

This thesis is concerned with understanding what it is like to live with a physical impairment in Taiwan. Constructionism was used as the epistemological stance to guide the study and Heideggerian interpretive phenomenology was used as the theoretical perspective. Information was gained through a series of in-depth interviews with seven Taiwanese adults with a physical impairment living in the community. They were recruited from Yunlin and Tainan Counties in Taiwan. Study participants were seen as research partners who had expertise in understanding disability, and the researcher was seen as a learner. Grounded theory principles were used to develop the theory "it is more than just the impairment" from the information provided by the participants. According to their descriptions of how they lived their lives, participants are grouped into three clusters. These are ‘fortress ladies’, ‘social networkers’ and ‘the mind man’. The grounded theory developed portrays their lives, providing a vivid picture of living a life with a physical impairment in Taiwan. The study’s findings contribute to three main areas. First, as an occupational therapist and with my growing understanding of disability learned from the study participants, I recognize the agency of people with an impairment and their expertise in disability. Thus, I argue the need for health professionals to build alliances with them, and suggest ways to achieve such a relationship. Second, I propose the developed conceptual framework is suitable for exploring lived experience in other research areas; I discuss the implications of the subtle interactions between impaired people’s body and mind; I also present three impressive lived experiences provided by study participants as exemplars of the findings, and these form the foundation for discussion. Finally, the development of "it is more than just the impairment" provides a basis from which to theorize disability in a more holistic way.

Examining the health related quality of life of people with end stage kidney disease living in Hanoi, Vietnam

Background: The prevalence of end-stage kidney disease (ESKD) patients is increasing in Vietnam; however, the impact of ESKD and its treatment on a person’s quality of life (QOL) is not well understood. Objective: This research sought to examine the association between monthly income, comorbidity, length of time on dialysis, social support and health-related quality of life (HRQOL) among Vietnamese ESKD patients. Method: Using a descriptive design, 95 patients who were receiving haemodialysis (HD) and peritoneal dialysis (PD) from one hospital in Hanoi, were conveniently sampled. Results: ESKD patients reported having a moderate level of HRQOL. Factors associated with QOL were social support (r= .268, p<.05), comorbid health conditions (r= –.185, p<.05), and length of time on dialysis (r= .182, p<.05). However, monthly income was not significantly related to HRQOL (p>.05). Conclusion: The results seem to indicate that ESKD patients in Vietnam have a high level of support from family members, friends and significant others. There was also a negative impact of comorbid conditions on the QOL of these patients. Based on the results of this study, nurses ought to develop nursing interventions which will lead to a better QOL for patients, and further research into the QOL for ESKD patients in Vietnam is warranted.

A longitudinal study of health-related quality of life, fatigue and physical activity in chronic kidney disease patients

This study assessed the health-related quality of life (HRQoL), fatigue and physical activity levels of 28 persons with chronic kidney disease (CKD) on initial administration of an erythropoietin stimulating agent, and at 3 months, 6 months and 12 months. The sample comprised of 15 females and 13 males whose ages ranged from 31 to 84 years. Physical activity was measured using the Human Activity Profile (HAP): Self-care, Personal/Household work, Entertainment/Social, Independent exercise. Quality of life was measured using the SF-36 which gives scores on physical health (physical functioning, role-physical, bodily pain and general health) and mental health (vitality, social functioning, role-emotional and emotional well-being). Fatigue was measured by the Fatigue Severity Scale (FSS). Across all time points the renal sample engaged in considerably less HAP personal/household work activities and entertainment/social activities compared to healthy adults. The normative sample engaged in three times more independent/exercise activities compared to renal patients. One-way Repeated measures ANOVAs indicated a significant change over time for SF-36 scales of role physical, vitality, emotional well-being and overall mental health. There was a significant difference in fatigue levels over time [F(3,11) = 3.78, p<.05]. Fatigue was highest at baseline and lowest at 6 months. The more breathlessness the CKD patient reported, the fewer activities undertaken and the greater the reported level of fatigue. There were no significant age differences over time for fatigue or physical activity. Age differences were only found for SF-36 mental health at 3 months (t=-2.41, df=14, p<.05). Those younger than 65 years had lower emotional well-being compared to those aged over 65. Males had poorer physical health compared to females at 12 months. There were no significant gender differences on mental health at any time point. In the management of chronic kidney disease, early detection of a person’s inability to engage in routine activities due to fatigue is necessary. Early detection would enable timely interventions to optimise HRQoL and independent exercise.