The informational content of subjective expectations for health service use.

BackgroundThis study aims to evaluate the informational content of people's subjective probability expectations for using various health services.MethodsUsing a sample of 1,528 Australian adults (25-64 years), I compared stated probabilities of visiting various health service providers (hospitals, dentists, optometrists, physiotherapists and related care providers, naturopaths and massage therapists) with past utilization and with predicted utilization estimated out-of-sample. I also estimated whether past utilization and subjective expectations were predicted by the same covariates. Finally, I estimated whether subjective expectations had predictive power for the choice to purchase private health insurance conditional on past utilization and other controls.ResultsSubjective expectations closely reflect patterns of observed utilization, are predicted by the same covariates as observed utilization, and correlate with objective measures of risk. Subjective expectations also add predictive power to models estimating insurance take-up, even after conditioning on prior health care use and other risk factors.ConclusionThe findings are indicative that on average people form quite accurate expectations, and support collecting subjective expectations about health services in household surveys for use in applied research

Retirement, social support and mental well-being: a couple-level analysis.

Social support is increasingly acknowledged as an important resource for promoting well-being. We test whether social support changes around retirement. We also examine whether social support moderates dynamics in mental well-being around retirement and consider both own and spouse's retirement drawing on a unique longitudinal, couple-level data set from Australia. We observe descriptively no effect of own or spouse's retirement on social support. However, those with high social support do experience a small but statistically significant improvement in mental well-being post retirement. Using pension eligibility as an instrument, we find that own retirement causally improves mental well-being for women and by a similar degree for those with low/high social support. We also estimate responses to life satisfaction and find evidence that spill-over benefits from spousal retirement are larger for individuals with low social support

The increasing cost of happiness.

A fundamental question for society is how much happiness does a dollar buy? The accepted view among economists and psychologists is that income has diminishing marginal returns on happiness: money and happiness increase together up to a point after which there is relatively little further gain. In this paper we estimate the relationship between income and subjective wellbeing over a 19-year period focusing on where the greatest change in the marginal return on income occurs and whether this change point has shifted over time. We formally test for the presence of a change point as well as temporal changes in the relationship between income and affective wellbeing (happiness), and income and cognitive wellbeing (life satisfaction), using household economic data from Australia between 2001 and 2019. The results indicate that the change point between affective wellbeing and income has increased over those 19 years faster than inflation (i.e., cost of living). This suggests that inequalities in income may be driving increasing inequities in happiness between the rich and the poor, with implications for health and recent government policy-goals to monitor and improve wellbeing

Psychological, social and cognitive resources and the mental wellbeing of the poor.

Our study takes advantage of unique data to quantify deficits in the psychosocial and cognitive resources of an extremely vulnerable subpopulation-those experiencing housing vulnerability-in an advanced, high-income country (Australia). Groups such as these are often impossible to study using nationally representative data sources because they make up a small share of the overall population. We show that those experiencing housing vulnerability sleep less well, have more limited cognitive functioning, and less social capital than do those in the general population. They are also less emotionally stable, less conscientious, more external, and more risk tolerant. Collectively, these deficits in psychosocial and cognitive resources account for between 24-42% of their reduced life satisfaction and their increased mental distress and loneliness. These traits also account for a large proportion of the gap in mental wellbeing across different levels of housing vulnerability

A Fourier transform infrared trace gas and isotope analyser for atmospheric applications

Concern in recent decades about human impacts on Earth's climate has led to the need for improved and expanded measurement capabilities of greenhouse gases in the atmosphere. In this paper we describe in detail an in situ trace gas analyser based on Fourier Transform Infrared (FTIR) spectroscopy that is capable of simultaneous and continuous measurements of carbon dioxide (CO<sub>2</sub>), methane (CH<sub>4</sub>), carbon monoxide (CO), nitrous oxide (N<sub>2</sub>O) and <sup>13</sup>C in CO<sub>2</sub> in air with high precision. High accuracy is established by reference to measurements of standard reference gases. Stable water isotopes can also be measured in undried airstreams. The analyser is automated and allows unattended operation with minimal operator intervention. Precision and accuracy meet and exceed the compatibility targets set by the World Meteorological Organisation – Global Atmosphere Watch for baseline measurements in the unpolluted troposphere for all species except <sup>13</sup>C in CO<sub>2</sub>. <br><br> The analyser is mobile and well suited to fixed sites, tower measurements, mobile platforms and campaign-based measurements. The isotopic specificity of the optically-based technique and analysis allows its application in isotopic tracer experiments, for example in tracing variations of <sup>13</sup>C in CO<sub>2</sub> and <sup>15</sup>N in N<sub>2</sub>O. We review a number of applications illustrating use of the analyser in clean air monitoring, micrometeorological flux and tower measurements, mobile measurements on a train, and soil flux chamber measurements

A scoping review of psychoeducational interventions for people after transient ischemic attack and minor stroke

Background: Psychoeducation can provide information and support to cope with the physical and emotional effects of a health condition. This scoping review aimed to identify the evidence regarding psychoeducational interventions for people after a Transient Ischaemic Attack (TIA) and minor stroke. Methods: This review was conducted in accordance with the PRISMA Extension for Scoping Reviews. Three electronic databases (MEDLINE, Embase, PsycINFO) were searched for articles on interventions related to psychoeducational support post TIA and minor/mild stroke. Search retrieved 3722 articles. Three reviewers independently screened titles, abstracts, full-texts, and then extracted data for included studies. Study quality was assessed using the JADAD scale. TIDieR checklist was used to describe interventions. Results: Fifteen RCTs were included. Twelve studies were of high quality (JADAD score ≥2), two were low quality. A total of 1500 participants were recruited across the studies. Definition of TIA and minor stroke were unclear, leading to the exclusion of several studies. Various interventions were included, including education/psychoeducation (n=4); exercise and lifestyle advice (n=3); telephone-based education/counselling (n=3); secondary prevention education (n=1); motivational interviewing (n=2); self-management (n=2). Interventions were inconsistently described, with information missing about who delivered it and tailoring. Conclusions: Definitions of stroke severity are not adequately reported. There are variety of interventions including education about a range of stroke-specific topics. Many interventions are not adequately defined, thus making it difficult to determine if the aim was to provide information or support to promote self-management and wellbeing post TIA/minor stroke. There is a need for a more in-depth systematic review to develop a clear definition of psychoeducation

Pigmentation plasticity enhances crypsis in larval newts: Associated metabolic cost and background choice behaviour

In heterogeneous environments, the capacity for colour change can be a valuable adaptation enhancing crypsis against predators. Alternatively, organisms might achieve concealment by evolving preferences for backgrounds that match their visual traits, thus avoiding the costs of plasticity. Here we examined the degree of plasticity in pigmentation of newt larvae (Lissotriton boscai) in relation to predation risk. Furthermore, we tested for associated metabolic costs and pigmentation-dependent background choice behaviour. Newt larvae expressed substantial changes in pigmentation so that light, high-reflecting environment induced depigmentation whereas dark, low-reflecting environment induced pigmentation in just three days of exposure. Induced pigmentation was completely reversible upon switching microhabitats. Predator cues, however, did not enhance cryptic phenotypes, suggesting that environmental albedo induces changes in pigmentation improving concealment regardless of the perceived predation risk. Metabolic rate was higher in heavily pigmented individuals from dark environments, indicating a high energetic requirement of pigmentation that could impose a constraint to larval camouflage in dim habitats. Finally, we found partial evidence for larvae selecting backgrounds matching their induced phenotypes. However, in the presence of predator cues, larvae increased the time spent in light environments, which may reflect a escape response towards shallow waters rather than an attempt at increasing crypsisFinancial support was provided by the Spanish Ministry of Science and Innovation (MICINN), Grant CGL2012-40044 to IGM, and by the Universidad Autónoma de Madrid, Short Stay Grant to NPC. Additional financial support was provided by the MICINN, Grant CGL2015-68670-R to NP

Molecular evolution of vertebrate sex-determining genes

Y-linked Dmy (also called dmrt1bY) in the teleost fish medaka, W-linked Dm-W in the African clawed frog (Xenopus laevis), and Z-linked Dmrt1 in the chicken are all sex chromosome-linked Dmrt1 homologues required for sex determination. Dmy and Dm-W both are Dmrt1 palalogues evolved through Dmrt1 duplication, while chicken Dmrt1 is a Z-linked orthologue. The eutherian sex-determining gene, Sry, evolved from an allelic gene, Sox3. Here we analyzed the exon–intron structures of the Dmrt1 homologues of several vertebrate species through information from databases and by determining the transcription initiation sites in medaka, chicken, Xenopus, and mouse. Interestingly, medaka Dmrt1 and Dmy and Xenopus Dm-W and Dmrt1 have a noncoding-type first exon, while mouse and chicken Dmrt1 do not. We next compared the 5′-flanking sequences of the Dmrt1 noncoding and coding exons 1 of several vertebrate species and found conservation of the presumptive binding sites for some transcription factors. Importantly, based on the phylogenetic trees for Dmrt1 and Sox3 homologues, it was implied that the sex-determining gene Dmy, Dm-W, and Sry have a higher substitution rate than thier prototype genes. Finally, we discuss the evolutionary relationships between vertebrate sex chromosomes and the sex-determining genes Dmy/Dm-W and Sry, which evolved by neofunctionalization of Dmrt1 and Sox3, respectively, for sex determining function. We propose a coevolution model of sex determining gene and sex chromosome, in which undifferentiated sex chromosomes easily allow replacement of a sex-determining gene with another new one, while specialized sex chromosomes are restricted a particular sex-determining gene

PIK3CA dependence and sensitivity to therapeutic targeting in urothelial carcinoma

Background Many urothelial carcinomas (UC) contain activating PIK3CA mutations. In telomerase-immortalized normal urothelial cells (TERT-NHUC), ectopic expression of mutant PIK3CA induces PI3K pathway activation, cell proliferation and cell migration. However, it is not clear whether advanced UC tumors are PIK3CA-dependent and whether PI3K pathway inhibition is a good therapeutic option in such cases. Methods We used retrovirus-mediated delivery of shRNA to knock down mutant PIK3CA in UC cell lines and assessed effects on pathway activation, cell proliferation, migration and tumorigenicity. The effect of the class I PI3K inhibitor GDC-0941 was assessed in a panel of UC cell lines with a range of known molecular alterations in the PI3K pathway. Results Specific knockdown of PIK3CA inhibited proliferation, migration, anchorage-independent growth and in vivo tumor growth of cells with PIK3CA mutations. Sensitivity to GDC-0941 was dependent on hotspot PIK3CA mutation status. Cells with rare PIK3CA mutations and co-occurring TSC1 or PTEN mutations were less sensitive. Furthermore, downstream PI3K pathway alterations in TSC1 or PTEN or co-occurring AKT1 and RAS gene mutations were associated with GDC-0941 resistance. Conclusions Mutant PIK3CA is a potent oncogenic driver in many UC cell lines and may represent a valuable therapeutic target in advanced bladder cancer