Last Third Of Life Research Articles

Promosi Kesehatan Pelaksanaan Hidup Bersih Dan Sehat Pada Lansia

Each individual must have their own awareness and play an active role in practicing PHBS (Implementation of Clean and Healthy Living) in everyday life. All health behaviors are carried out with awareness so that family or family members can help themselves in the health sector and play a role in activities in the community. The main aim of the PHBS movement is to improve the quality of health through an awareness process which is the beginning of individual contributions in living clean and healthy daily life behavior. The general benefit of PHBS is that it increases people's awareness of wanting to live a clean and healthy life. This is so that people can prevent and overcome health problems. Apart from that, by implementing PHBS the community is able to create a healthy environment and improve the quality of life. This includes the elderly group (elderly). The elderly are an age group that has experienced decline in many aspects, namely physical, psychological and social. The existence of these limitations will greatly affect the ability/independence in implementing PHBS. The lives of aging seniors need to be managed well, emphasizing the concept of active aging, maintaining independence and quality of life in the last third of life.

The aging of the immune system and its implications for transplantation.

By the last third of life, most mammals, including humans, exhibit a decline in immune cell numbers, immune organ structure, and immune defense of the organism, commonly known as immunosenescence. This decline leads to clinical manifestations of increased susceptibility to infections, particularly those caused by emerging and reemerging microorganisms, which can reach staggering levels-infection with SARS-CoV-2 has been 270-fold more lethal to older adults over 80years of age, compared to their 18-39-year-old counterparts. However, while this would be expected to be beneficial to situations where hyporeactivity of the immune system may be desirable, this is not always the case. Here, we discuss the cellular and molecular underpinnings of immunosenescence as they pertain to outcomes of solid organ and hematopoietic transplantation.

Paradoxical aortic stiffening and subsequent cardiac dysfunction in Hutchinson-Gilford progeria syndrome.

Hutchinson-Gilford progeria syndrome (HGPS) is an ultra-rare disorder with devastating sequelae resulting in early death, presently thought to stem primarily from cardiovascular events. We analyse novel longitudinal cardiovascular data from a mouse model of HGPS (LmnaG609G/G609G) using allometric scaling, biomechanical phenotyping, and advanced computational modelling and show that late-stage diastolic dysfunction, with preserved systolic function, emerges with an increase in the pulse wave velocity and an associated loss of aortic function, independent of sex. Specifically, there is a dramatic late-stage loss of smooth muscle function and cells and an excessive accumulation of proteoglycans along the aorta, which result in a loss of biomechanical function (contractility and elastic energy storage) and a marked structural stiffening despite a distinctly low intrinsic material stiffness that is consistent with the lack of functional lamin A. Importantly, the vascular function appears to arise normally from the low-stress environment of development, only to succumb progressively to pressure-related effects of the lamin A mutation and become extreme in the peri-morbid period. Because the dramatic life-threatening aortic phenotype manifests during the last third of life there may be a therapeutic window in maturity that could alleviate concerns with therapies administered during early periods of arterial development.

Lymph nodes as barriers to T‐cell rejuvenation in aging mice and nonhuman primates

In youth, thymic involution curtails production of new naïve T cells, placing the onus of T‐cell maintenance upon secondary lymphoid organs (SLO). This peripheral maintenance preserves the size of the T‐cell pool for much of the lifespan, but wanes in the last third of life, leading to a dearth of naïve T cells in blood and SLO, and contributing to suboptimal immune defense. Both keratinocyte growth factor (KGF) and sex steroid ablation (SSA) have been shown to transiently increase the size and cellularity of the old thymus. It is less clear whether this increase can improve protection of old animals from infectious challenge. Here, we directly measured the extent to which thymic rejuvenation benefits the peripheral T‐cell compartment of old mice and nonhuman primates. Following treatment of old animals with either KGF or SSA, we observed robust rejuvenation of thymic size and cellularity, and, in a reporter mouse model, an increase in recent thymic emigrants (RTE) in the blood. However, few RTE were found in the spleen and even fewer in the lymph nodes, and SSA‐treated mice showed no improvement in immune defense against West Nile virus. In parallel, we found increased disorganization and fibrosis in old LN of both mice and nonhuman primates. These results suggest that SLO defects with aging can negate the effects of successful thymic rejuvenation in immune defense.

Engaging older people in healthy and active lifestyles: a systematic review

ABSTRACTIn 2002, the World Health Organization emphasised the concept of active ageing to manage and increase the last third of life. Although many efforts have been made to optimise treatment management, less attention has been paid to health promotion initiatives. To date, few shared guidelines exist that promote an active life in healthy older targets. To fill this gap, we conducted a systematic review to map health promotion interventions that targeted an active and healthy ageing among older citizens. Articles containing the key term active ageing and seven synonyms were searched for in the electronic databases. Because we were interested in actions aimed to promote healthier lifestyles, we connected the string with the term health. A total of 3,918 titles were retrieved and 20 articles were extracted. Twelve of the 20 studies used group interventions, five interventions targeted the individual level and three interventions targeted the community level. Interventions differed for the health focus of the programmes, which ranged from physical activity interventions to social participation or cognitive functioning. Most of the studies aimed to act on psychological components. The review suggests that different interventions promoted for active ageing are effective in improving specific healthy and active lifestyles; however, no studies were concerned directly with a holistic process of citizen health engagement to improve long-term outcomes.

Marriage, Social Networks, and Health at Older Ages.

Social relationships in older adulthood have strong connections to health and wellbeing. Connections with social network members and with spouses and long-term partners in particular, have an especially important impact on health. We highlight recent research from the National Social Life, Health, and Aging Project (NSHAP), a nationally representative, longitudinal study of aging in America, to describe the different ways health is produced in social contexts. We first discuss how social network characteristics and marital relationships influence health outcomes and sexuality, and then move on to recent findings about the ways health shapes an individual’s social world. We find that features of a social network, apart from simply its size, have strong effects on health behaviors, and that changes in network composition are associated with changes in health. We show that marriage is uniquely protective against damaging biological processes, and that the quality of a marriage influences health and well-being in nuanced ways. Finally we find that health status is associated with the ability to manage one's social network, and that health status affects the quality of one's marriage. We focus our discussion on new data from Wave 2 that enables researchers to explore how changes in social networks and partner relationships affect health and well-being during the last third of life.

Challenges of Caring

Congregational expectations for care in the last third of life create challenges for church professionals. The last third of life is typically long and complex as people are living long and dying sicker. Current social and church demographics create new demands for and limits on caring; for some church professionals, the personal demands for caring pose a particular challenge. Four strategies may help: conversations sustained over time, shared congregational rituals and experiences, living “as if,” and political hospitality.

Youth unemployment: A public health problem set to worsen if older people work longer

In 2012 the coalition government decided to increase the retirement age and reform public sector pensions.1 The logic behind this is that increased life expectancy makes payouts under the old terms unsustainable for the public purse. I believe this move is misguided for several reasons. Life spans have indeed increased, but a longer old age does not automatically mean a healthier one. We, more than anyone, can testify to the burden of chronic illness in an ageing population, and the escalating consumption of healthcare resources during the last third of life.2 Vital functions such as eyesight, memory, and agility decline during middle age, well before evolving to hard diagnoses such as macular degeneration, dementia, or arthritis. While there are many older people who wish to work beyond usual retirement age, this should be voluntary. Surely the most potent argument against making it compulsory is that it will exacerbate one of the most under-rated scourges of our time: the ticking time bomb of youth unemployment. The soubriquet NEET describes young adults not in employment, education, or training. The NEET population in the UK was around 13% in 2004,3 and since that year, well …

Leaving Analysis and Moving Beyond Pain

As an analyst and an analysand, we explore reasons for not “doing” psychoanalysis in the last third of life when our own experience became sufficiently intense to make self-exploration through pain undesirable. For the analyst, self-knowledge was inseparable from the therapeutic process: she discovered and created her selves in therapeutic relationships, which meant living in the pain of others. The analysand needed to know whether she could reinvent her life, after one of its lengthiest and most complex phases had ended. The analyst decided to turn away from a primary focus on the therapeutic other in order to commit herself to being alive with more pleasure. The analysand decided that she did not need to go back in order to move forward. For both, it was the formation of a new relationship in the last third of life that created the environment for mutual recognition and libratory self-discovery.

Who Am I Now? Using Life Span Theories in Psychotherapy in Late Adulthood

Although academic and clinical psychology do not often embrace, lifespan developmental constructs and theories can enrich the process of psychotherapy. Particularly in the last third of life, when social institutions and societal expectations provide less guidance and constraint, access to understandings about the lifespan may be especially useful. A life structure model of 20-year eras and periods of stability and evaluation/transformation can bring structure when life appears amorphous. Recognition of the ways that people of different ages experience time, and lifetime, can increase empathy and promote client's understanding of their own changes. Three dimensions of development—the ethic of care, the acquisition of integrity, and the building of an individuated and mature ego—can bring increased depth, vitality, fullness, and enjoyment to the last third of life. Therapists' ability to detect and articulate their client's developmental needs and process can enhance the work and further client's growth.

Less Time Ahead, More Behind: Being a Psychotherapist in the Last Third of Life

For those of us in the last third of life, there is less time ahead and more time behind. The greater proximity to death can lead not only to expansions of the self but to a profoundly revelatory lowering of defenses: it can allow us to acknowledge reality in a way not before possible. The recognition that “life is short” leads to a pruning of activities. The accumulation of years behind us increases perspective and offers a greater sense of the whole. We have ever more “ages inside us,” allowing empathy with ever more patients of different (actual and internal) ages. We are more pragmatic, self-regulated, integrated, simply human. There is greater freedom from the rules. The psychotherapy profession, by its very nature, encourages these and other emotional transformations through aging.

The Therapist's Illness As an Opportunity in the Clinical Hour

Our subjective experience of aging will have an impact on the cocreation of the therapeutic relationship. As therapists enter the last third of life, they need to anticipate possible disruptions to their practice due to increased physical vulnerability, and they need to plan for these disruptions. This may require confronting narcissistic defenses and denial. Professional resources are available to assist with the pragmatic steps needed for continuity of patient care. Viewing her clinical work through the lens of intersubjective theory, the author shares her own experience with a life-threatening illness. She describes the impact it had on her relationship with one patient and how it was possible for the patient to find considerable therapeutic value in her response to the therapist's illness. The therapist's clinical decision to self-disclose information about her diagnosis is considered from an intersubjective perspective.

An Annotated Bibliography on the Intersection of Aging, Spirituality, Religion and Ministry Practices

This annotated bibliography is designed to introduce both scholars and practitioners to the range of sources that address the intersection between religion, spirituality, aging and ministry by and for those in the last third of life. The inclusion of several annotated bibliographies in this source has allowed less concern that, in a limited list, key sources will be left out. Because the focus of this theme issue is on the transition we are experiencing and will continue to experience in ministry with senior adults, a few sources about the baby boomers are included as well.

Sour Finding on Popular Sweetener: Increased Cancer Incidence Associated with Low-Dose Aspartame Intake

More than 20 years have elapsed since aspartame was approved by regulatory agencies as an artificial sweetener. But scientists draw conclusions on carcinogenicity based on the evidence available at the time, and new research out of the European Ramazzini Foundation of Oncology and Environmental Sciences bolsters recent calls for reconsideration of regulations governing aspartame’s widespread use in order to better protect public health, particularly that of children [EHP 114:379–385; Soffritti et al.]. The researchers added aspartame to the standard diet of Sprague-Dawley rats, using dosages designed to simulate a wide range of human intakes. Each rat was observed from 8 weeks of age until death. This is in contrast with earlier studies that typically sacrificed animals between 104 and 110 weeks of age, corresponding to about two-thirds of a rat’s lifespan (in humans, approximately 80% of cancer diagnoses are made in the last third of life, after age 55). Deceased animals were examined for microscopic changes in various organs and tissues, enabling a comprehensive assessment of aspartame’s carcinogenic potential. A total of 1,800 rodents were included, far more than in previous studies. Aspartame-fed females showed significant evidence of lymphomas/leukemias and of carcinomas of the renal pelvis and ureter. The effect on the renal pelvis was much more evident when carcinomas were combined with atypical preneoplastic lesions. The researchers also observed an insignificant increase in incidence of malignant schwannomas of the peripheral nerves in males, as well as hyperplasia of the olfactory epithelium in males and females. Lesions of the kidney and olfactory epithelium are extremely rare in this strain of rats and therefore merit special attention. The carcinogenic effects were evident at daily doses as low as 400 parts per million, equivalent to an assumed daily human intake of 20 milligrams per kilogram body weight (mg/kg). This dosage is much less than the acceptable daily intake for humans, with current limits set at 50 mg/kg in the United States and 40 mg/kg in Europe. Surveys of aspartame intake in the United States and Europe from 1984 to 1992 showed that consumers typically consumed 2–3 mg/kg daily, with small children and women of child-bearing age consuming slightly more, at 2–5 mg/kg daily. The public health implications of these findings may be substantial, since aspartame is used in about 6,000 products, and more than 200 million people regularly consume aspartame through foods, beverages, drugs (such as chewable vitamins), and hygiene products (such as toothpaste). Because the study did not take into account in utero and perinatal exposures, the authors point to this as a salient direction for future research, given that children and pregnant and breastfeeding women are among the major consumers of aspartame.

The evolution of residual stress in the thermally grown oxide on Pt diffusion bond coats in TBCs

The evolution of residual stress in the thermally grown oxide (TGO), formed on bond coats (BC) produced by diffusion of Pt into a Ni-based superalloy, has been studied as a function of thermal cycling using photo-luminescence piezo-spectroscopy through the yttria-stabilised zirconia (YSZ) thermal barrier coating. The luminescence spectra were analysed in terms of a high stress and a low stress contribution to the residual stress sampled at a single analysis point (approx. 20 μm in size); the low stress contribution being caused by either local TGO fractures or interfacial delamination The mean compressive residual stress increases during the first two thirds of the lifetime due to gradual stiffening of the non-planar TGO as it thickens and becomes more resistant to bending. In the last third of life the mean stress tends to decrease due to relaxation by increasingly numerous local damage events. This is more pronounced as a dramatic increase in the parameters that quantify the extent of the low stress contributions. Spatial mapping of the low stress contributions shows that they are isolated at first, but become more numerous towards the end of life and coalesce into larger regions of damage a few hundred μm in size. Eventual spallation is by unstable delamination at the BC/TGO interface and the stored elastic energy released is between 40 and 80 J m −2. The lifetime is governed by the growth of the local damage regions until one (probably near an edge) reaches a critical size above which it propagates in a highly unstable way over most of the interface.

Ageing in irradiated and unirradiated germfree ICR mice

The life span and incidence of disease were studied in germfree, conventional, and barrier ICR mice which had not been exposed to X-irradiation and in germfree and conventional male mice of the same strain which had been exposed to 600–900 R of X-radiaiton at 12 weeks of age. Unirradiated germfree mice had an increased survival rate in the middle one-third of the life span if those dying with cecal volvulus were omitted from the sample, but the difference disappeared in the last third of life. Irradiation of germfree mice resulted in life-shortening of approximately 275 days when mice dying of diseases other than thymic lymphoma and cecal volvulus were compared. The germfree mice resembled the mice raised in contaminated environments in the development f lymphatic leukemia, reticulum-cell sarcoma, and solid tumors of various sites. Glomerulosclerosis was observed in all groups of mice, but its incidence and severity were lower in unirradiated germfree mice. Irradiation of germfree male mice raised the severity of glomerulosclerosis to that seen in contaminated mice. Miscellaneous lesions common to conventional mice (i.e. amyloidosis, uterine hypertrophy and ovarian cysts) were seen in germfree mice, but inflammatory lesions associated with infectious microorganisms (such as otitis media, abscesses, and ulcerative dermatitis) were seen only in mice raised in microbially contaminated environments. Cecal volvulus and severe distention of the gall bladder were noted only in germfree mice. The general similarity of widely diverse pathological lesions between germfree and conventional mice suggests that the absence of a detectable microbial flora and fauna alters ageing processes and late somatic effects of radiation relatively little.

MEDIAN PERINEAL PROSTATECTOMY: TOTAL REMOVAL OF THE PROSTATE GLAND, SIX CASES.

There are so many different methods of treating prostatics that one is forced to the conclusion that the subject is in an evolutionary stage. I venture the assertion that every surgeon of experience has often been disappointed with many of the procedures he had employed. It is true that every case is more or less a special one, having individual features and combined phenomena of its own, but when we consider the radical treatment, that is, total prostatectomy, it should not take us very long to establish one method as the safest and best. The era of giving permanent relief to over 25 per cent. of the male population in the last third of life began in 1887, with first, Belfield of Chicago, and then McGill of Leeds, England. They did a partial and then as they improved their technique, complete suprapubic extirpation of the prostate gland. At the present