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This article is a response to a piece in this journal, by David Bartram, which questions the validity of a vast literature establishing consistently a U-shaped relationship between age and happiness. There are 618 published studies that find U-shapes in that relationship in 145 countries, and only a handful that do not. Of the 30 countries that Bartram (2023, National Institute Economic Review, 1–15) examines, he finds U-shapes in 18. We show compelling evidence of U-shapes in the remaining dozen countries. Supporting evidence of a U-shape is found in objective measures including deaths of despair, depression, stress and pain that are worst in midlife.
Consensus is growing about the fundamental principles underlying economic policy reforms. In addition, a series of recent comparative studies have increased scholarly understanding of the political conditions necessary for launching such reforms. Yet understanding of the factors that make reforms sustainable over the longer term is far less developed. A wide-ranging and unresolved debate continues over the roles played by institutions, politicians, interest groups, and the popular sectors. The influence of such groups tends to be marginal during the initial implementation of policies, a process involving an insulated group of technocrats. As the reforms proceed, the opposition of different societal groups to specific policies may have some impact but is less critical to the success or failure of the adjustment program than overall economic performance (see Geddes 1995). The primary strength of these groups is retrospective and collective: they can vote reforming governments out of office. Elections—and therefore voter behavior—are critical in sustaining economic reforms over the long term. Voters can reverse economic reform programs, and at times they do. Yet they also can play a major role in making programs more sustainable by legitimating their continuation at the ballot box.
To identify: 1) best practice aged care principles and practices for Aboriginal and Torres Strait Islander older peoples, and 2) actions to integrate aged care services with Aboriginal community-controlled primary health care.
Background:
There is a growing number of older Aboriginal and Torres Strait Islander peoples and an unmet demand for accessible, culturally safe aged care services. The principles and features of aged care service delivery designed to meet the unique needs of Aboriginal and Torres Strait Islander peoples have not been extensively explored and must be understood to inform aged care policy and primary health care planning into the future.
Methods:
The research was governed by leaders from across the Aboriginal community-controlled primary health care sector who identified exemplar services to explore best practice in culturally aligned aged care. In-depth case studies were undertaken with two metropolitan Aboriginal community-controlled services. We conducted semi-structured interviews and yarning circles with 46 staff members to explore key principles, ways of working, enablers and challenges for aged care service provision. A framework approach to thematic analysis was undertaken with emergent findings reviewed and refined by participating services and the governance panel to incorporate national perspectives.
Findings:
A range of principles guided Aboriginal community-controlled aged care service delivery, such as supporting Aboriginal and Torres Strait Islander identity, connection with elders and communities and respect for self-determination. Strong governance, effective leadership and partnerships, Aboriginal and Torres Strait Islander workforce and culturally safe non-Indigenous workforce were among the identified enablers of aged care. Nine implementation actions guided the integration of aged care with primary health care service delivery. Funding limitations, workforce shortages, change management processes and difficulties with navigating the aged care system were among the reported challenges. These findings contribute to an evidence base regarding accessible, integrated, culturally safe aged care services tailored to the needs of Aboriginal and Torres Strait Islander peoples.
Clarifying the relationship between depression symptoms and cardiometabolic and related health could clarify risk factors and treatment targets. The objective of this study was to assess whether depression symptoms in midlife are associated with the subsequent onset of cardiometabolic health problems.
Methods
The study sample comprised 787 male twin veterans with polygenic risk score data who participated in the Harvard Twin Study of Substance Abuse (‘baseline’) and the longitudinal Vietnam Era Twin Study of Aging (‘follow-up’). Depression symptoms were assessed at baseline [mean age 41.42 years (s.d. = 2.34)] using the Diagnostic Interview Schedule, Version III, Revised. The onset of eight cardiometabolic conditions (atrial fibrillation, diabetes, erectile dysfunction, hypercholesterolemia, hypertension, myocardial infarction, sleep apnea, and stroke) was assessed via self-reported doctor diagnosis at follow-up [mean age 67.59 years (s.d. = 2.41)].
Results
Total depression symptoms were longitudinally associated with incident diabetes (OR 1.29, 95% CI 1.07–1.57), erectile dysfunction (OR 1.32, 95% CI 1.10–1.59), hypercholesterolemia (OR 1.26, 95% CI 1.04–1.53), and sleep apnea (OR 1.40, 95% CI 1.13–1.74) over 27 years after controlling for age, alcohol consumption, smoking, body mass index, C-reactive protein, and polygenic risk for specific health conditions. In sensitivity analyses that excluded somatic depression symptoms, only the association with sleep apnea remained significant (OR 1.32, 95% CI 1.09–1.60).
Conclusions
A history of depression symptoms by early midlife is associated with an elevated risk for subsequent development of several self-reported health conditions. When isolated, non-somatic depression symptoms are associated with incident self-reported sleep apnea. Depression symptom history may be a predictor or marker of cardiometabolic risk over decades.
Using existing data from clinical registries to support clinical trials and other prospective studies has the potential to improve research efficiency. However, little has been reported about staff experiences and lessons learned from implementation of this method in pediatric cardiology.
Objectives:
We describe the process of using existing registry data in the Pediatric Heart Network Residual Lesion Score Study, report stakeholders’ perspectives, and provide recommendations to guide future studies using this methodology.
Methods:
The Residual Lesion Score Study, a 17-site prospective, observational study, piloted the use of existing local surgical registry data (collected for submission to the Society of Thoracic Surgeons-Congenital Heart Surgery Database) to supplement manual data collection. A survey regarding processes and perceptions was administered to study site and data coordinating center staff.
Results:
Survey response rate was 98% (54/55). Overall, 57% perceived that using registry data saved research staff time in the current study, and 74% perceived that it would save time in future studies; 55% noted significant upfront time in developing a methodology for extracting registry data. Survey recommendations included simplifying data extraction processes and tailoring to the needs of the study, understanding registry characteristics to maximise data quality and security, and involving all stakeholders in design and implementation processes.
Conclusions:
Use of existing registry data was perceived to save time and promote efficiency. Consideration must be given to the upfront investment of time and resources needed. Ongoing efforts focussed on automating and centralising data management may aid in further optimising this methodology for future studies.
We examined if and when English-learning 17-month-olds would accommodate Japanese forms as labels for novel objects. In Experiment 1, infants (n = 22) who were habituated to Japanese word–object pairs looked longer at switched test pairs than familiar test pairs, suggesting that they had mapped Japanese word forms to objects. In Experiments 2 (n = 44) and 3 (n = 22), infants were presented with a spoken passage prior to habituation to assess whether experience with a different language would shift their perception of Japanese word forms. Here, infants did not demonstrate learning of Japanese word–object pairs. These findings offer insight into the flexibility of the developing perceptual system. That is, when there is no evidence to the contrary, 17-month-olds will accommodate forms that vary from their typical input but will efficiently constrain their perception when cued to the fact that they are not listening to their native language.
Paleoecological data from the Quaternary Period (2.6 million years ago to present) provides an opportunity for educational outreach for the earth and biological sciences. Paleoecology data repositories serve as technical hubs and focal points within their disciplinary communities and so are uniquely situated to help produce teaching modules and engagement resources. The Neotoma Paleoecology Database provides support to educators from primary schools to graduate students. In collaboration with pedagogical experts, the Neotoma Paleoecology Database team has developed teaching modules and model workflows. Early education is centered on discovery; higher-level educational tools focus on illustrating best practices for technical tasks. Collaborations among pedagogic experts, technical experts and data stewards, centered around data resources such as Neotoma, provide an important role within research communities, and an important service to society, supporting best practices, translating current research advances to interested audiences, and communicating the importance of individual research disciplines.
Individuals who are compromised in their ability to either believe in or plan for their future will make very different valuations of future benefits than will those who have more means and capabilities. These valuations could apply across a wide spectrum, from health care and insurance to investments in education to retirement savings. Data based on time trade-offs and other hypothetical questions will lead to large gaps in contingency valuations which, taken at face value, would lead to regressive outcomes. Individuals who discount the future are unlikely to be responsive to information intended to mitigate risk or to nudges designed to guide behavior away from risky choices. For example, these differential responses result in particular preventive policies having much less than the intended benefit values. Subjective well-being metrics can help circumvent the problem by comparing the reported well-being of individuals who are actually in different arrangements, such as those who have taken up health insurance or not, or in different work arrangements. Still, subjective well-being metrics are a compliment and not a substitute for the standard data that is used in BCA.
In Canada and elsewhere, research policies require researchers to secure consent from a legally authorized representative (LAR) for prospective participants unable to consent. Few jurisdictions, however, offer a clear legislative basis for LAR identification. We investigated Canadian researchers’ practices regarding the involvement of decisionally incapacitated participants and tested whether reported practices were associated with (1) researchers’ understanding of the law on third-party authorization of research and (2) their comfort with allowing a family member to consent on behalf of an incapacitated relative.
Methods:
We surveyed researchers in aging from four Canadian provinces about their practices with prospective participants deemed incapable of consent, their understanding of relevant law, and comfort with family consent for research purposes. Understanding and comfort were measured with research vignettes that briefly described hypothetical studies in which an adult who lacks the capacity to consent was invited to participate.
Results:
Many respondents reported soliciting consent from a family member (45.7% for low-risk studies and 10.7% for serious risks studies), even in jurisdictions where such authority is uncertain at law. Researchers’ tendency to solicit family consent was associated with their comfort in doing so, but not with their understanding of the law on substitute consent for research.
Conclusions:
Findings underscore the need to clarify who may authorize an incapacitated adult's participation in research. Meanwhile, people should inform their relatives of their desire to participate or not in research in the event of incapacity, given researchers’ tendency to turn to family for consent, even where not supported by law.
Many species respond to risks and benefits of dispersal that vary over the short term through condition-dependent dispersal. We used wind tunnels to investigate how abiotic factors, spiderling age, and indicators of environmental quality affect aerial dispersal behaviour of spiderlings in Dolomedes triton (Walckenaer) (Araneae: Pisauridae), a denizen of temporary habitats. More than half of all spiderlings exhibited preballooning, ballooning, or spanning behaviours. Warm temperatures (>22.5 °C) and low wind speeds (<2.0 m/second) increased aerial dispersal. Aerial dispersal behaviour increased significantly until 5 days after hatch, after which it decreased, coinciding with the onset of active hunting by spiderlings. In contrast, cues about ambient food availability (egg sac number and food limitation of the mother) and potential resource competition or risk of cannibalism (conspecific density) did not affect aerial dispersal propensity. Offspring from different females ballooned in different proportions, except at the peak of dispersal, but a female's reproductive output and propensity of her offspring to balloon were uncorrelated. Thus, it appears that spiderlings of D. triton adopt a fixed strategy of high dispersal rate under optimal abiotic conditions, rather than reducing dispersal in response to cues about local food availability or conspecific density.
Background: Dementia research often requires the participation of people with dementia. Obtaining informed consent is problematic when potential participants lack the capacity to provide it. We investigated comfort with proxy consent to research involving older adults deemed incapable of this decision, and examined if comfort varies with the type of proxy and the study's risk-benefit profile.
Methods: We surveyed random samples of five relevant groups (older adults, informal caregivers, physicians, researchers in aging, and Research Ethics Board members) from four Canadian provinces. Respondents were presented with scenarios involving four types of proxies (non-assigned, designated in a healthcare advance directive with or without instructions specific to research participation, and court-appointed). Given a series of risk-benefit profiles, respondents indicated whether they were comfortable with proxy consent to research for each scenario.
Results: Two percent of the respondents felt proxy consent should never be allowed. In all groups, comfort depended far more on the risk-benefit profile associated with the research scenario than with type of proxy. For research involving little or no risk and potential personal benefits, over 90% of the respondents felt comfortable with substitute consent by a designated or court-appointed proxy while 80% were at ease with a non-assigned proxy. For studies involving serious risks with potentially greater personal benefits, older adults and informal caregivers were less comfortable with proxy consent.
Conclusions: A large majority of Canadians are comfortable with proxy consent for low-risk research. Further work is needed to establish what kinds of research are considered to be low risk.
A group of 94 nondemented patients self-referred to an outpatient memory clinic for memory difficulties were studied to determine the incidence of single versus multi-domain mild cognitive impairment (MCI) using Petersen criteria. Fifty-five community dwelling normal controls (NC) participants without memory complaints also were recruited. Tests assessing executive control, naming/lexical retrieval, and declarative memory were administered. Thirty-four patients exhibited single-domain MCI, 43 patients presented with multi-domain MCI. When the entire MCI sample (n = 77) was subjected to a cluster analysis, 14 patients were classified with amnesic MCI, 21 patients with dysexecutive MCI, and 42 patients were classified into a mixed/multi-domain MCI group involving low scores on tests of letter fluency, “animal” fluency, and delayed recognition discriminability. Analyses comparing the three cluster-derived MCI groups versus a NC group confirmed the presence of memory and dysexecutive impairment for the amnesic and dysexecutive MCI groups. The mixed MCI group produced lower scores on tests of letter fluency compared with the amnesic MCI and NC groups and lower scores on tests of naming and memory compared with the NC group. In summary, multi-domain MCI is quite common. These data suggest that MCI is a highly nuanced and complex clinical entity. (JINS, 2010, 16, 84–93.)