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Yao L, Yang C, Graff JC, Wang G, Wang G, Gu W. From Reactive to Proactive - The Future Life Design to Promote Health and Extend the Human Lifespan. Adv Biol (Weinh) 2024:e2400148. [PMID: 39037380 DOI: 10.1002/adbi.202400148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 06/11/2024] [Indexed: 07/23/2024]
Abstract
Disease treatment and prevention have improved the human lifespan. Current studies on aging, such as the biological clock and senolytic drugs have focused on the medical treatments of various disorders and health maintenance. However, to efficiently extend the human lifespan to its theoretical maximum, medicine can take a further proactive approach and identify the inapparent disorders that affect the gestation, body growth, and reproductive stages of the so-called "healthy" population. The goal is to upgrade the standard health status to a new level by targeting the inapparent disorders. Thus, future research can shift from reaction, response, and prevention to proactive, quality promotion and vigor prolonging; from single disease-oriented to multiple dimension protocol for a healthy body; from treatment of symptom onset to keep away from disorders; and from the healthy aging management to a healthy promotion design beginning at the birth.
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Affiliation(s)
- Lan Yao
- College of Health management, Harbin Medical University, 157 Baojian Road, Harbin, Heilongjiang, 150081, China
- Department of Orthopedic Surgery and BME-Campbell Clinic, University of Tennessee Health Science Center, Memphis, TN, 38163, USA
| | - Chengyuan Yang
- Department of Orthopedic Surgery and BME-Campbell Clinic, University of Tennessee Health Science Center, Memphis, TN, 38163, USA
| | - J Carolyn Graff
- Department of Health Promotion and Disease Prevention, College of Nursing, University of Tennessee Health Science Center, Memphis, TN, 38163, USA
| | - Guiying Wang
- Department of General Surgery, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, 050011, China
| | - Gang Wang
- Department of Pancreatic and Biliary Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, 150007, China
- Key Laboratory of Hepatosplenic Surgery, Ministry of Education, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, 150007, China
| | - Weikuan Gu
- Department of Orthopedic Surgery and BME-Campbell Clinic, University of Tennessee Health Science Center, Memphis, TN, 38163, USA
- Research Service, Memphis VA Medical Center, 1030 Jefferson Avenue, Memphis, TN, 38104, USA
- Department of Pharmaceutical Sciences, University of Tennessee Health Science Center, 881 Madison Ave, Memphis, TN, 38163, USA
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Yu Z, Dong Y, Chen Y, Aleya L, Zhao Y, Yao L, Gu W. It is time to explore the impact of length of gestation and fetal health on the human lifespan. Aging Cell 2024; 23:e14157. [PMID: 38558485 PMCID: PMC11019132 DOI: 10.1111/acel.14157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 02/20/2024] [Accepted: 03/12/2024] [Indexed: 04/04/2024] Open
Abstract
A recently proposed principal law of lifespan (PLOSP) proposes to extend the whole human lifespan by elongating different life stages. As the preborn stage of a human being, gestation is the foundation for the healthy development of the human body. The antagonistic pleiotropy (AP) theory of aging states that there is a trade-off between early life fitness and late-life mortality. The question is whether slower development during the gestation period would be associated with a longer lifespan. Among all living creatures, the length of the gestation period is highly positively correlated to the length of the lifespan, although such a correlation is thought to be influenced by the body sizes of different species. While examining the relationship between lifespan length and body size within the same species, dogs exhibit a negative correlation between lifespans and body sizes, while there is no such correlation among domestic cats. For humans, most adverse gestational environments shorten the period of gestation, and their impacts are long-term. While many issues remain unsolved, various developmental features have been linked to the conditions during the gestation period. Given that the length of human pregnancies can vary randomly by as long as 5 weeks, it is worth investigating whether a slow steady healthy gestation over a longer period will be related to a longer and healthier lifespan. This article discusses the potential benefits, negative impacts, and challenges of the relative elongation of the gestation period.
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Affiliation(s)
- Zhuo Yu
- Heilongjiang Academy of Traditional Chinese MedicineHarbinChina
| | - Yushan Dong
- Graduate School of Heilongjiang University of Chinese MedicineHarbinHeilongjiangChina
| | - Yuhan Chen
- Guang'anmen Hospital, China Academy of Chinese Medical SciencesBeijingChina
| | - Lotfi Aleya
- Chrono‐Environnement Laboratory, UMR CNRS 6249Bourgogne Franche‐Comté UniversityBesançon CedexFrance
| | - Yinhuan Zhao
- Department of Rheumatism, Shanghai Traditional Chinese Medicine Integrated HospitalShanghai University of Traditional Chinese MedicineShanghaiChina
| | - Lan Yao
- College of Health Management, Harbin Medical UniversityHarbinHeilongjiangChina
- Department of Orthopedic Surgery and BME‐Campbell ClinicUniversity of Tennessee Health Science CentreMemphisTennesseeUSA
| | - Weikuan Gu
- Department of Orthopedic Surgery and BME‐Campbell ClinicUniversity of Tennessee Health Science CentreMemphisTennesseeUSA
- Research Lt. Col. Luke WeathersJr. VA Medical CenterMemphisTennesseeUSA
- Department of Pharmaceutical SciencesUniversity of Tennessee Health Science CenterMemphisTennesseeUSA
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Mrema S, Okumu F, Schellenberg J, Fink G. Associations between the use of insecticide-treated nets in early childhood and educational outcomes, marriage and child-bearing in early adulthood: evidence from a 22-year prospective cohort study in Tanzania. Malar J 2023; 22:134. [PMID: 37098566 PMCID: PMC10127494 DOI: 10.1186/s12936-023-04560-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 04/13/2023] [Indexed: 04/27/2023] Open
Abstract
BACKGROUND The effectiveness of insecticide-treated nets (ITNs) in preventing malaria in young children is well established. However, the long-term effects of early childhood ITN use on educational outcomes, fertility, and marriage in early adulthood are not well understood. METHODS This study uses 22 years of longitudinal data from rural Tanzania to investigate the associations between early life ITN use and educational attainment, fertility and marriage in early adulthood. Unadjusted and adjusted logistic regression models were used to estimate the associations between early life ITN use and early adult outcomes (education, childbearing, and marriage), controlling for potential confounders, such as parental education, household asset quintiles, and year of birth. Analyses were conducted separately for men and women. RESULTS A total of 6706 participants born between 1998 and 2000 were enrolled in the study between 1998 and 2003. By 2019 a total of 604 had died and a further 723 could not be found, leaving 5379 participants who were interviewed, among whom complete data were available for 5216. Among women, sleeping under a treated net at least half of the time during early childhood ["high ITN use"] was associated with a 13% increase in the odds of completing primary school (adjusted odds ratio (aOR) 1.13 [0.85, 1.50]) and with a 40% increase in the odds of completing secondary school (aOR 1.40 [1.11, 1.76]) compared with women sleeping less frequently under ITNs in early life (< age 5 years). Among men, high ITN use was associated with a 50% increase in the odds of completing primary school (aOR 1.50 [1.18, 1.92]) and a 56% increase in the odds of completing secondary school (aOR 1.56 [1.16, 2.08]) compared to men with low ITN use in early life. Weaker associations were found between ITN use in early life and both adolescent childbearing (aOR 0.91 [0.75, 1.10]) and early marriage (aOR 0.86 [0.69, 1.05]). CONCLUSION This study found that early life use of ITNs was strongly associated with increased school completion in both men and women. More marginal associations were found between early-life ITN use and both marriage and child-bearing in early adulthood. ITN use during early childhood may have long-term positive effects on educational attainment in Tanzania. However, further research is needed to understand the mechanisms behind these associations and to explore the broader impacts of ITN use on other aspects of early adult life.
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Affiliation(s)
| | | | | | - Günther Fink
- Swiss Tropical and Public Health Institute and University of Basel, Kreuzstrasse 2, Allschwil, 4123, Basel, Switzerland.
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Veras H. Wrong place, wrong time: The long-run effects of in-utero exposure to malaria on educational attainment. ECONOMICS AND HUMAN BIOLOGY 2022; 44:101092. [PMID: 34923211 DOI: 10.1016/j.ehb.2021.101092] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 11/23/2021] [Accepted: 12/03/2021] [Indexed: 06/14/2023]
Abstract
This paper investigates the long-term relationship between early life exposure to malaria and human capital accumulation in Brazil. The identification strategy relies on exogenous variation in the risk of malaria outbreaks in different states and seasons of the year to identify in utero exposure according to the timing and location of birth. I find consistent negative treatment effects of in utero exposure to malaria on educational attainment. The effects are stronger for exposure during the first trimester of pregnancy than during other periods of gestation. Effective anti-malaria policies can, thus, be an important factor contributing to reducing the educational inequality by targeting pregnant women, especially those in their first months of gestation.
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Affiliation(s)
- Henrique Veras
- Department of Economics and Business, Centre College, Crounse Hall 417, 1600 W Walnut St, Danville, KY 40422, USA.
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Cirera L, Castelló JV, Brew J, Saúte F, Sicuri E. The impact of a malaria elimination initiative on school outcomes: Evidence from Southern Mozambique. ECONOMICS AND HUMAN BIOLOGY 2022; 44:101100. [PMID: 34922211 DOI: 10.1016/j.ehb.2021.101100] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 10/08/2021] [Accepted: 12/09/2021] [Indexed: 06/14/2023]
Abstract
Despite the significant improvements achieved over the last ten years, primary education attainment in Mozambique is still low. Potential reasons acting from the demand perspective include ill health, among other factors. In Mozambique, ill health is still largely linked to malaria, which is a leading cause of outpatient contacts, hospital admissions and death, particularly among under-five and school-aged children. Despite this, in Mozambique and more generally, in malaria endemic countries, the identification and measurement of how improved malaria indicators may contribute to better school outcomes remains largely unknown. In particular, there is a low understanding of the extent to which better health translates immediately into school indicators, such as absenteeism and grades. In this study, we exploit the first year of a malaria elimination initiative implemented in Magude district (Southern Mozambique) that started in 2015, as a quasi-experiment to estimate the impact of malaria on selected primary school outcomes. While malaria was not eliminated, its incidence drastically dropped. We use as control a neighbouring district (Manhiça) with similar socio-economic and epidemiological characteristics. By employing a difference-in-differences (DiD) approach, we examine whether the positive health shock translated into improved school outcomes. Using information from school registers, we generated a dataset on school attendance and grades for 9,848 primary-school students from 9 schools (4 in the treated district and 5 in the control district). In our main specification, a repeated cross-section analysis, we find that the elimination initiative led to a 28% decrease in school absenteeism and a 2% increase in students' grades. Our results are robust across different specifications, including a panel DiD individual fixed effects estimate on a sub-sample of students. These findings provide evidence on the negative impact of malaria on primary education attainment and suggest remarkable economic benefits consequent to its elimination.
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Affiliation(s)
- Laia Cirera
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Judit Vall Castelló
- Department of Economics & Institut D'economia De Barcelona (IEB), Universitat de Barcelona, Spain; Centre for Research in Health and Economics (CRES), Universitat Pompeu Fabra, Barcelona, Spain
| | - Joe Brew
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain; Vrije Universiteit, Amsterdam, The Netherlands
| | - Francisco Saúte
- Centro de Investigação em Saúde de Manhiça (CISM), Manhiça, Mozambique
| | - Elisa Sicuri
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain; LSE Health, Department of Health Policy, London School of Economics and Political Science, London, UK.
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Brick K, Cooper JL, Mason L, Faeflen S, Monmia J, Dubinsky JM. Training-of-Trainers Neuroscience and Mental Health Teacher Education in Liberia Improves Self-Reported Support for Students. Front Hum Neurosci 2021; 15:653069. [PMID: 34220469 PMCID: PMC8249721 DOI: 10.3389/fnhum.2021.653069] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 05/14/2021] [Indexed: 12/25/2022] Open
Abstract
Education programs have been central to reestablishing social norms, rebuilding public educational institutions, and addressing public attitudes toward mental illness in Liberia following a protracted civil war and the Ebola epidemic. The aim of this study was to determine if a program combining an understanding of neuroscience with mental health literacy content could increase teachers’ awareness of students’ mental health issues and produce changes in teacher attitudes and classroom practices. A tiered Training-of-Trainers approach was employed. The first workshop trained 24 Liberian secondary science teachers in the neurobiology of learning, memory, emotions, stress and adolescent brain development. A Leadership Team formed from eight of the Tier I participants then adapted the curriculum, added in more mental health literacy content and led four Tier II workshops and four follow-up Refresher sessions. Participants completed a neuroscience knowledge test and surveys assessing stigma, general perceptions of people with mental illness, and burnout. A subset of Tier II teachers participated in a structured interview at the Refresher time point. Teachers in both tiers acquired basic neuroscience knowledge. Tier I, but not Tier II teachers significantly improved their surveyed attitudes toward people with mental illness. No changes were found in overall teacher burnout. Despite these survey results, the interviewed Tier II teachers self-reported behavioral changes in how they approached their teaching and students in their classrooms. Interviewees described how they now understood social and emotional challenges students might be experiencing and recognized abnormal behaviors as having a biopsychosocial basis. Teachers reported reduced use of verbal and corporal punishment and increased positive rewards systems, such as social and emotional support for students through building relationships. Refresher discussions concurred with the interviewees. In contrast to previous teacher mental health literacy programs which did not bring about a change in helping behaviors, this pilot program may have been successful in changing teacher knowledge and self-reported behaviors, improving teacher–student relationships and decreasing harsh discipline. The combination of basic neuroscience concepts with training on how to recognize mental health issues and refer students should be investigated further as a strategy to promote teacher mental health literacy.
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Affiliation(s)
- Kara Brick
- Carter Center Mental Health Program, Monrovia, Liberia.,Peace Corps Liberia, Monrovia, Liberia
| | | | - Leona Mason
- Carter Center Mental Health Program, Monrovia, Liberia
| | | | - Josiah Monmia
- Carter Center Mental Health Program, Monrovia, Liberia
| | - Janet M Dubinsky
- Department of Neuroscience, University of Minnesota, Minneapolis, MN, United States
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Yoder - van den Brink HN. Reflections on "Building Back Better" Child and Adolescent Mental Health Care in a Low-Resource Postemergency Setting: The Case of Sierra Leone. Front Psychiatry 2019; 10:758. [PMID: 31736794 PMCID: PMC6834689 DOI: 10.3389/fpsyt.2019.00758] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Accepted: 09/20/2019] [Indexed: 12/30/2022] Open
Abstract
Over the past three decades, Sierra Leone has experienced two major humanitarian crises: an armed conflict (1991-2002) and an Ebola virus disease outbreak (2014-2015). In addition to these country-wide crises, the capital Freetown experienced a mudslide affecting thousands of people in 2017. In response to these emergencies, donors and aid organizations showed an increased interest in supporting and implementing mental health and psychosocial support interventions. Despite these efforts, the mental health infrastructure of the country remains frail. Specifically, systemic improvements in the implementation of evidence-based mental health care for children and adolescents appear to be lacking. In this article, the Interactive Systems Framework for Dissemination and Implementation is used as a tool to analyze issues related to the development of a sustainable, contextually relevant child and adolescent mental health-care delivery system. The author draws on her long-term experience as a child mental health specialist in Sierra Leone. Observations and hypotheses are tested and supplemented by formal and informal reports and national and international literature. The three systems described by the Interactive Systems Framework are explored in the context of Sierra Leone: (1) Synthesis and Translation, (2) Support, and (3) Delivery. Interaction between the three Systems is discussed as critical to the successful dissemination and implementation of interventions. Ample attention is given to contextual factors that are believed to be paramount to the development of child and adolescent mental health care in Sierra Leone. The article concludes with a reflection on the usefulness of the Interactive Systems Framework in the dissemination and implementation of child and adolescent mental health-care interventions in low-resource, postemergency settings. It is suggested that, in addition to funding and policies, the child and adolescent mental health system in Sierra Leone could benefit from the development of contextually relevant interventions, improvement of capacity-building efforts, and acknowledgment of the role of community-based practitioners in the delivery of services. Local mental health experts, especially those trained in child and adolescent mental health, should be empowered to work together with culturally competent expatriate professionals to improve child and adolescent mental health care in Sierra Leone.
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Affiliation(s)
- Hélène N.C. Yoder - van den Brink
- Department of Sociology and Anthropology, Institute for Social Science Research (AISSR), University of Amsterdam, Amsterdam, Netherlands
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