Nitric oxide and oxidative stress in cardiovascular aging

The long-standing free radical theory of aging, which attributes cellular pathology to the relentless accumulation of reactive oxygen species (ROS), remains attractive but controversial. Emerging insights into the molecular interactions between ROS and reactive nitrogen species (RNS) such as nitric oxide suggest that, in biological systems, one effect of increased ROS is the disruption of protein S-nitrosylation, a ubiquitous posttranslational modification system. In this way, ROS may not only damage cells but also disrupt widespread signaling pathways. Here, we discuss this phenomenon in the context of the cardiovascular system and propose that ideas regarding oxidative stress and aging need to be reevaluated to take account of the balance between oxidative and nitrosative stress.     

Decentralization, aging policy, and the age of Clinton

This article examines the recent trends in decentralization and their implications for aging policy in the Clinton presidency. It first discusses a decade-long trend toward decentralizing policy and then examines some recent federal enactments that promote more discretion by state and local policymakers, suggesting that these may set the framework for aging policy during most of Clinton's first term. A basic premise of the discussion is, however, that the degree of flexibility varies with the policy area being analyzed-housing, transportation, health and social services--and whether these are "old" (pre-1980s) or "new" (post-1980s) policies. It concludes with the suggestion that a dual-centered, shared federal-state solution may provide the best approach to the premier issue in aging policy today-long-term care.     

An ‘unholy alliance’ of existential proportions: Negotiating discourses with men's experiences of cancer and aging

Little is understood about how experiencing cancer and aging together can disrupt people's socio-personal worlds and lead to existential questions about identity, life ambiguity, and death. Toward this end, we interpreted the metaphors that three aging men with cancer used in a focus group to describe their existential concerns. We also considered how two dominant cultural discourses around cancer and aging, generally referred to as discourses of “progress” and “decline”, figured into the participants' meanings. Finally, we compared the men's attitudes toward cancer and aging to dominant ideas about how men respond to these life events. Through interpretative phenomenological analysis, informed by critical phenomenology, we came to three conclusions. First, the men's interpretations of cancer and aging shared similar existential themes of tragedy and transcendence. Second, these existential concerns were informed by dominant discourses of cancer and aging, in that they followed the culturally constructed trajectories of decline and progress, respectively. The men's metaphors point to a negotiation of these two discourses. A third and related point is that the men predominantly contradicted gendered assumptions about dealing with life adversity but in some ways repeated them. This research indicates that people interpret cancer and aging in somewhat shared ways, via dominant cultural discourses, but also in individual ways depending on personal life histories. As discourses and life histories seem to influence how people make sense of aging life with cancer, it may be useful to be aware of these contexts when providing psycho-social care to aging cancer patients.     

Issues of Motivation – Vassa/Equiano and Carretta's Critique of the Evidence

This article offers an analysis of the written record of an oral statement of grievances delivered in 1798 by George II, king and principal chief of the Afro-Indian Miskitu nation, before Antonio de Echeverría, the senior officer in command of the small Spanish settlement of Río Tinto. Containing 44 articles and extending over four days, George's protest is used here as a lens through which to examine the ways in which the Miskitu exploited their occupation of a strategically vital borderland between British and Spanish empires in Central America and the Caribbean to protect their autonomy, and extract advantage from the Europeans who competed for their loyalty. In discussing the wider context and the circumstances that gave rise to the 1798 events from an indigenous perspective, it also throws new light on the processes and experiences that entangled Britons, Spaniards and Miskitu over the decades from the 1770s to 1800.     

Managing unforeseen events in anesthesia: collective trade-off between "understanding" and "doing"

This study aims to describe how anesthesia teams handle unforeseen events that may affect the patients' health. More precisely, it investigates the mechanisms of decisions made by anesthesia teams to manage unthought-of situations, i.e. situations that have not been foreseen as "possible" ones before their occurrence. An empirical study, based on the analysis of simulated situations, was conducted in a pediatric anesthesia service of a university hospital in France. The results highlighted three ways of managing unthought-of situations (determined management, cautious management and overwhelmed management). They support the hypothesis of a collective cognitive trade-off, whereby teams would behave as virtual operators, with their own collective trade-off between "understanding" and "doing". The discussion of the results questions the assessment criteria, the safety perspectives we adopt and the possible ways to improve the management of unforeseen situations.     

A 1,408 km bicycle tour with prostate cancer patients—results of a pilot study

Negative psychological and physical effects of prostate cancer and its medical treatment may persist many years after diagnosis. The influence of a long cycling tour on rehabilitative or health-related effects with prostate cancer patients has not yet been studied. In practice, physicians and therapists rarely recommend cycling to prostate cancer. In May 2010, eight prostate cancer patients rode their bikes for over 1,408 km from Cologne to Marseille within 5 weeks. Endurance test, blood examinations (prostate-specific antigen (PSA), total testosterone, interleukin-6, oxidative stress, and antioxidant capacity) and quality of life questionnaires were completed before and after the tour. All eight subjects reached Marseille. Significant improvements could be observed in physical performance and certain quality of life scores (p?=?0.008), as well as a reduction of total testosterone (p?=?0.19). PSA levels did not change. This pilot study suggests that long bicycle tours with prostate cancer patients are feasible. Due to the missing control group and the small sample size, the results of this pilot study are limited.     

A life course approach: research orientations and future challenges

The need to study lifelong changes in health and functioning has resulted in increasing emphasis on a life course approach in different fields of inquiry. The aim of this approach is to explore how biological, psychological, and social risk factor trajectories, acting across the entire life course, influence age-related diseases, functional decline, and disability. The importance of the first years of life upon later development and adult characteristics was generally recognized already in the first half of the twentieth century, but it was not until the 1990s that different strands of medical and social research converge in the field of life course epidemiology, in which epidemiological processes are approached using different models such as biological programming, critical periods, pathways, and accumulation. The biological programming model holds that organ development in utero and early infancy determines the maximum functional capacity that an individual can attain and influences the development of certain chronic diseases later in life. The critical period model extends the idea to include child development and key social transitions over the entire life course. The pathway model focuses on the cumulative effect of life events along the developmental trajectories, with early advantage or disadvantage setting a person on a pathway to a later etiologically important exposure. The accumulation model describes the underlying social, behavioral, and biological processes that drive the impact of the life course on health. The growing focus on life course determinants of aging also has implications for studies of long-term changes in physical activity and their role in determining both gains and losses of health and functioning with aging. A life course approach presents great challenges for the continued development of testable theoretical models and effective study design and analysis.     

Status variations in stress exposure: implications for the interpretation of research on race, socioeconomic status, and gender

Life events checklists have been the predominant method for estimating variations in stress exposure. It is unknown, however, whether such inventories are equally meaningful for estimating differences in exposure between men and women, African Americans and whites, and those in lower and higher socioeconomic categories. In this paper, we employ a wider range of measures of stress--recent life events, chronic stressors, lifetime major events, and discrimination stress--to examine the extent to which these dimensions collectively yield conclusions about status variations in stress exposure that are similar to or different from estimates based only on a life events checklist. Our analyses of data collected from 899 young men and women of African American and non-Hispanic white ancestry suggest that status differences in exposure to stress vary considerably by the measure of stress that is employed. Although women are more exposed to recent life events than men, males report more major events and discrimination stress than females. Our results also reveal that life event measures tend to substantially under-estimate differences between African Americans and non-Hispanic whites in exposure to stress. A similar pattern also holds for socioeconomic status. When stress is more comprehensively estimated, level of exposure profoundly affects ethnic differences in depressive symptomatology, accounting for almost half of the difference by socioeconomic status but contributing little to the explanation of the gender difference in distress. The implications of these findings for the debate over the relative mental health significance of exposure and vulnerability to stress are discussed.     

Constructing deservingness: federal welfare reform,supplemental security income,and elderly immigrants

On August 22, 1996, President Clinton signed the welfare reform law that ended eligibility for all immigrants to federal means tested entitlements. Poor elderly immigrants on Supplemental Security Income were specifically targeted. This article documents how the print media responded to these policy changes. The following are the major research questions: (1) How were older immigrants on Supplemental Security Income portrayed in the print media before and after federal welfare reform? (2) Who was involved in the print media coverage of older immigrants on Supplemental Security Income before and after federal welfare reform? (3) What types of statements were made by those involved in the print media coverage of older immigrants on Supplemental Security Income, before and after federal welfare reform? The approach used was an in-depth content analysis of newspaper articles from major U.S. newspapers. The findings demonstrate that older immigrants were constructed as "undeserving" in news articles prior to the passage of the federal welfare reform bill. However, after the passage of the federal welfare reform bill the coverage of older immigrants on Supplemental Security Income started to change, and older immigrants were portrayed as "deserving." In advancing aging policy for poor, vulnerable elderly, such as elderly immigrants, advocates, health and social service providers can play an influential role in bringing their voices to the print media.     

Aging issues: unanswered questions in marital and family therapy literature

Researchers have reviewed couple and family therapy journals to determine the extent to which issues concerning older populations are addressed. In an effort to extend previous work, we conducted content analyses of 957 articles published in three of the leading marital and family therapy journals between 1997 and 2006. From the articles, 27 (2.8%) mentioned aging or included older adults in their sample. Results indicate that the number of articles emphasizing older adults has not substantially increased. While this result has been substantiated by other researchers in previous years, a new finding in this study concerns the quality of articles on aging issues. The articles reviewed in this study indicated a greater focus on aging issues and addressing issues during this life cycle stage.     

“The risk of age”? Early detection test,prostate cancer and practices of self

Drawing on Rose and Novas’s concept of “biological citizenship” and Michel Foucault's "practices of self", this paper reflects on how men become agents of their own therapeutic regimens, and yet internalise messages of risk and practices of self within early detection of prostate cancer discourses in the late 20th century. In doing so, it traces the ways in which concepts of age, gender and risk converge at the problematic site of prostate cancer and preventative health strategies, both of the state and the medical profession. Analysing how insecurities have simultaneously resulted in over-promoting and over-diagnosing risk, thereby blurring the lines between normal and pathological states of health and aging, the paper finishes with a critical discussion on how men have adopted self-surveying and attuned themselves to risk discourses. Suggestions are made for future research on comparative gender studies on embodied concepts of self and cancer screening and the relation between differential aging, risk management and the concept of the body.     

Stem cell aging and cancer

Stem cells are capable of self-renewal, differentiation into various lineages, and proliferation; thus, they play critical roles in the functioning and maintenance of many biological systems. However, these unique qualities of stem cells also make them more vulnerable to mutations as the organism ages. The biggest risk factor in cancer development is age, and most scientists believe that cancers partly result from a buildup of mutations in different cell types over time. This accumulation of mutations takes place over the course of a person's lifetime, during which repeated rounds of cell division result in editing errors in the DNA. Genetic alterations can cause changes in the signaling pathways controlling proliferation, differentiation, and apoptosis. In the case of stem cells, such mutations would be passed on to all of the stem cell's progeny, ultimately resulting in a pool of stem cells that feeds neoplastic formation. Studies aiming to identify and characterize these putative cancer stem cells and to understand how they arise will shed light on the process of stem cell aging and its role in cancer.     

Public Policy and Poverty Among the Oldest Old

In neglecting to acknowledge the heterogeneity of our aging population, we encourage policies that meet the needs of the majority of older people but discount the needs of those characterized by lifelong poverty. The overall economic well-being of the "oldest old," historically the poorer cohort among the age%: is anticipated to improve over the next 50 years. This improvement will increase the economic gap between the majority of the aged and a minority who will carry their existing poverty into old age. Economic protection for the "always-poor" can be improved and intergenerational stress reduced if we identify now those with a high probability of poverty in old age and develop policies in the 1990s aimed at meeting their future needs.     

“It's really overwhelming”: Parent and service provider perspectives of parents aging out of foster care

Rates of pregnancy and parenthood among current and former foster youth are two to three times higher than non-foster youth peers. Repeat pregnancies among young mothers aging out of foster care also occur at higher rates than peers not involved with the child welfare system. Furthermore, mothers aging out of foster care demonstrate high levels of parenting stress and risk for child maltreatment. Indeed, this population is in significant need of help; however, beyond anecdotal evidence, little is known about the needs and day-to day experiences of this population. In order to tailor interventions to meet the needs of parents aging out, the perspectives of stakeholders must be taken into account. Using qualitative data gathered from separate small group interviews with parents aging out and service providers, this study examined participants' perceptions of parents' daily experiences, strengths, and needs. Findings indicated that parents aging out face overwhelming adversity and stress with little outside financial, emotional, or parenting support from family or friends. Yet, parents also expressed motivation to be good parents, resilience, and the desire to gain effective parenting skills. Although similar themes arose among parent and provider interviews, perceptions differed. Parents expressed hope and optimism in providing for their children while providers expressed systemic failure in preparing parents for independent living. Based on these findings, we conclude that parenting interventions specific to parents aging out may need to address three fundamental and key components: basic needs, social support, and effective parenting techniques.     

Psychotherapy with Lesbian,Gay, Bisexual,and Transgender Older Adults

A small literature has addressed psychotherapy with lesbian, gay, bisexual, and transgender (LGBT) samples over the past two decades. Older adults have also been investigated in a growing number of psychotherapy research studies. However, psychotherapy specifically with LGBT older adults has not received adequate investigation. This review relies on converging lines of research to provide an integrated discussion of evidence-based psychological treatments (EBTs) with current research and clinical observations in the field of gerontology and suggests ways in which these topics can inform psychotherapy practice with LGBT older adults. We summarize current research on aging in several areas of practical interest to psychotherapists seeking to apply EBTs in their work with LGBT older adults. These areas include: adult development, coping, stigmatization, social context, and the effects of cohort membership. The results of these studies belie stereotypes regarding both the aging process, in general, and more specifically LGBT older adulthood, with significant implications for the practice of psychotherapy. EBTs are adaptable to a variety of issues encountered in later life by LGBT older adults, and these modifications to therapeutic technique are addressed throughout.     

Aging cartilage and osteoarthritis--what's the link?

Cartilage aging can contribute to the development of osteoarthritis (OA), the most common cause of chronic pain and disability in older adults. Articular cartilage is a unique tissue from the perspective of aging in that the cells (chondrocytes) and the majority of the extracellular matrix proteins experience little turnover, resulting in a tissue that must withstand years of use and can also accumulate years of aging-associated changes. Accumulation of advanced glycation end products (AGEs) occurs in cartilage, and the potential role of AGEs in the development of OA is being investigated. An age-associated reduction in growth factor signaling and an increase in oxidative stress may also play an important role in the age-OA connection. Further elucidation of mechanisms that affect chondrocyte function with aging should lead to novel interventions designed to slow the aging process in cartilage with the goal of preventing age-associated OA.     

Inside insulin signaling, communication is key to long life

In a recent Nature paper, Tatar and colleagues show that inhibition of insulin/insulin-like growth factor (IGF) signaling specifically in the adipose tissue of Drosophila melanogaster retards organismal aging, increases resistance to oxidative stress, augments lipid deposition, and restricts insulin signaling in peripheral tissues by a cell-non-autonomous mechanism. Consistent with recent work in the worm, these results suggest that insulin/IGF signaling itself may mediate communication among various tissues to influence organismal longevity.     

ARTICLE POPULARITY

This paper briefly examines the causes and consequences of article popularity. Tracing subsequent citations to nearly 6,000 articles published during 1974-76 reveals that most articles are cited rarely, if ever. Over 90% are cited fewer than 20 times over the ensuing 6 years, whereas only 3/10ths of 1% are cited over 100 times. Regression analysis demonstrates that author reputation, article length, and quality of publishing journal are strong determinants of article popularity.
The relative importance of various economics journals, though not their rankings, is sensitive to inclusion of "hit" articles; the differential impact of a journal may be more closely approximated by its ability to attract a significant proportion of the "hit parade" of articles.     

Private lives and public programs: an Australian longitudinal study of the elderly

Major late life events, reported in the Dubbo longitudinal study of older Australians, are used to examine the interaction of private lives with public programs. First, the data indicate strong supportive effects of publicly funded income, health, and aged care programs in reducing family burdens from major life changes. In particular, financial crises were rarely mentioned, directly or indirectly, as major threats. Next, the central role of informal social support in these events is demonstrated, first, as in previous studies, family support was responsive to risky events and to aging itself. Also, in new findings, one-third of surviving elderly respondents coped with the burdens of family crises as a substantial proportion of the "major" life changes that occurred over 13 years of the study. Within the security and support provided by the Australian welfare system, and with strong social networks, families with older persons in the Dubbo study manage multiple, major life changes. With rapid population aging, the development of more, and more easily accessible, services for a growing population of older people is a priority. The critical challenge will be to harmoniously grow public financing, private funding, and informal caregiving to deal with the growing burden arising from an aging society.     

Pathways into Bankruptcy: Accumulating Disadvantage and the Consequences of Adverse Life Events

This study combines theories of accumulating disadvantage and economic insecurity using the event of bankruptcy to investigate how certain adverse life events jointly affect inequality. I analyze National Longitudinal Survey of Youth data from 1985 through 2008 to highlight the complexities of financial hardship in the path to bankruptcy. By applying hybrid mixed effects models to parse out within‐ and between‐person variation, I show that, in the case of bankruptcy, financial hardship unfolds over a specific series of events, which can lead to the accumulation of disadvantage connected to changes in employment, marital, and health statuses. I find that bankruptcy results from people's recent experiences of illness and marital dissolution, but not always directly from employment disruption. The effects of job loss on bankruptcy become more apparent as these events accumulate over time and limit wealth creation. The timing of events and their relationship with net worth also influence when a person will file for bankruptcy. As a whole, my findings demonstrate how adverse events and financial hardship lead to bankruptcy through multiple pathways.