Factors affecting self-perceived mental health in the general older population during the COVID-19 pandemic: a cross-sectional study.

BACKGROUND: Mental health problems among older people are large public health concerns but often go unrecognized and undertreated. During COVID - 19 several restrictions regarding social contacts were launched, primarily for the old. The objective of this study is to investigate which factors that had the main negative affect on mental health in the older population during the pandemic. METHOD: A cross-sectional cohort study set in Swedish primary care during the pandemic years 2021-2022. The population constitutes of 70-80-years-old, N = 260. Instruments used are Geriatric depression scale 20 (GDS20); Hospital anxiety and depression scale (HADS), and Perceived stress scale 10 (PSS10). Sociodemography and risk factors are explored. Outcome measures are factors independently associated with decreased mental health. Analyses were performed for the group as a whole and with logistic regression models comparing individuals who stated they were mentally affected by the pandemic to individuals who stated they were not. RESULTS: Participants who stated they were mentally affected by the COVID - 19 pandemic reported significantly higher levels of anxiety (p < 0.001), depression (p < 0.001), and stress (p = 0.026) compared to those who stated they were not mentally affected. Explanatory regression models of up to 50% showed that following factors were prominent among individuals who reported a decline in their mental health due to the COVID - 19 pandemic (n = 24); impaired social life (OR 20.29, p < 0.001, CI 4.53-90.81), change in physical activity (OR 5.28, p = 0.01, CI 1.49-18.72), perceived family situation (OR 31.90, p = 0,007, CI 2,53-402.42), mild/moderate and high anxiety (OR 4.94, p = 0.034, CI 1.13-21.60, OR 7.96, p = 0.035, CI 1.16-54.53 respectively), and female gender (OR 6.52, p = 0.029, CI 1.22-34.92). CONCLUSION: Anxiety, family situation, social life and change in physical activity were the main factors influencing the 70-80-years-old's self-perceived mental health during the COVID - 19 pandemic. Long-term effects of social restrictions on mental health in the older population need to be further investigated.

The social life of natural experiments in epidemiology and public health.

Over the twentieth century, the concept of the natural experiment has become increasingly prominent across a variety of disciplines, albeit most consequentially in epidemiology and public health. Drawing on an analysis of the scientific and medical literature, we explore the social life of the natural experiment, tracing its changing use, meaning and uptake to better understand the work done by the concept. We demonstrate how the natural experiment became central to the identity of post-war epidemiology as the discipline professionalised, turned its attention to the prevention of chronic disease and took centre stage in the field of public health. We then turn to its growing significance amid the rise of evidence-based medicine, and the new meanings natural experiments came to take on in the context of concerns about policy and evidence. Finally, we turn to the newest iteration of the natural experiment in the COVID-19 era, which saw an explosion of studies drawing on the term, albeit in ways that reveal more about the underlying politics of health than the method itself. Throughout, we illustrate that the concept of the natural experiment has always been fundamentally social and political and tied to disciplinary claims-making about evidence and what should count as such.

Parental perceptions of social life before and after attending a parent training program for children with complex communication needs: the ComAlong example.

Parent training programs aimed at improving language outcomes for children with complex communication needs have predominantly been evaluated on child-centered outcomes and less often on the impact on social life or parental well-being. This study examined parent perceptions of social life before and after ComAlong, a group intervention providing parents with knowledge and training in responsive communication, environmental-milieu teaching strategies and augmentative and alternative communication (AAC). Parents (N = 467) completed questionnaires during the first and last sessions of ComAlong groups held in Sweden 2012 to 2018. Main outcome measure was change in the Social Life Scale from the Family Impact Questionnaire. Associations between this measure and demographic factors of parents and children were analyzed, along with reported change in parents' use of AAC. Pre-post comparisons revealed small significant positive changes in perceived impact of social life following intervention. The magnitude of the positive change was larger among parents of children with non-syndromic diagnoses and parents of children with autism spectrum disorder or attention deficit hyper activity disorder (ADHD). Differences in social life impact was not associated with parents' gender, language proficiency, age, or educational background. In conclusion, communication-focused parent training programs can have a positive impact on social family life and may thereby influence children's participation.

Psychological and social challenges of patients with locally advanced and metastatic gastrointestinal stromal tumours (GIST) on long-term treatment with tyrosine kinase inhibitors: a qualitative study with patients and medical oncologists.

PURPOSE: Tyrosine kinase inhibitors (TKIs) have revolutionized the treatment of locally advanced and metastatic gastrointestinal stromal tumours (GISTs). Patients are experiencing prolonged survival but often at the expense of their health-related quality of life. It is not only the physical side effects that impact GIST patients' daily lives but also the psychological and social challenges they have to deal with. This qualitative study aimed to explore the psychological and social life challenges of GIST patients with locally advanced and metastatic disease on ≥ 5 years TKI treatment. METHODS: Semi-structured interviews with 15 locally advanced and/or metastatic GIST patients and 10 medical oncologists with experience of delivering care to this specific patient group were conducted. Thematic analysis was used to interpret the data. RESULTS: Psychological challenges expressed by participants concerned fears, scanxiety, negative change in emotion and mood, doubts about their treatment and follow-up, living with uncertainty, lack of understanding from others or healthcare professionals, and constantly being reminded of their illness. Challenges regarding social health included financial difficulties, challenges in relationships, concerns about fertility and parenting, work, and impact on social activities. CONCLUSION: The reported psychological and social challenges can significantly hamper the overall quality of life of GIST patients. Some challenges were clearly underreported and hardly recognized by medical oncologist, as they may tend to focus on the physical side effects and clinical outcomes of treatment. Therefore, it is essential to take the patient's perspective into account in research and clinical practice to ensure optimal care for this patient group.

Scoping review of the association between bacterial vaginosis and emotional, sexual and social health.

BACKGROUND: Bacterial vaginosis (BV) is a condition that, if symptomatic, is characterized by discharge and odor, with high recurrence rates even when treated. This study aims to review what literature exists on the association between BV and the emotional, sexual, and social health of women. METHODS: MEDLINE, Embase and Web of Science databases were searched from inception until November 2020. Studies reporting an association between women's emotional, sexual and/or social health and symptomatic BV in a qualitative and/or quantitative manner were included. Selected studies were divided in three categories, i.e. reporting on the emotional, sexual and/or social association. All studies were critically evaluated and discussed. RESULTS: Sixteen studies were included. Concerning emotional health, we found eight studies that calculated the association between stress and BV, in four this was statistically significant. Four qualitative studies on emotional health showed that the severity of the symptoms influenced the impact on women's lives. All studies on sexual health reported that many women experienced an impact on their relationship and sexual intimacy. Results for social life ranged from no association found to most of the study population showing avoidance behavior. CONCLUSION: This review shows that symptomatic BV can be associated with diminished emotional, sexual, and social health, but there is too little evidence to state the extent of this association.

Using the Product Social Impact Life Cycle Assessment (PSILCA) database for product comparison: Confetti case study.

Purpose: Social Life Cycle Assessment (S-LCA) is a methodology that can help companies administer their supply chain and promote both social responsibility and sustainability through the assessment of both positive and negative social and socio-economic aspects of products during their entire life cycle. Here, a case study was performed to test an S-LCA database as a comparative assessment tool of two products, i.e. the traditional almond sugared confetti and Tenerelli sugared almonds, made by the same company. Methods: The S-LCA case study was carried out by using the Product Social Impact Life Cycle Assessment (PSILCA) database, for the two products on openLCA software. Results and discussion: The risk assessment helped to identify the most affected impact categories and which product influences the most on them as well as the categories on which the foreground processes have the greatest impact. For both the analysed products, the category "Contribution of the sector to economic development" is marginally affected. Overall, the production of Confetti entails higher medium risk hours regarding some categories (e.g. "Public sector corruption", "Promoting social responsibility", "Migration flows"), whilst for others, it is the Tenerelli that affect the most (e.g. "Biomass consumption", "Trade unionism"), depending on the different inputs used. Finally, the results are not very influenced by foreground processes, and the social risks are therefore related to upstream processes for both products. Conclusions: The comparison can become more useful for products of the same or similar functions and the same audience but of different inputs and therefore different supply chains. Indeed, it could be useful for decision-making with the aim of selecting between various possible options the one that entails lower social risks.

Life cycle assessment of animal-based foods and plant-based protein-rich alternatives: a socio-economic perspective.

BACKGROUND: Extensive research shows that replacing animal protein with plant-based protein in the diet would strongly alleviate the environmental impact of the food system. However, much less attention has been given to the socio-economic considerations of dietary transitions. This study analyses the socio-economic performance of innovative legume-based food prototypes, developed in the Protein2Food research project, and conventional animal-based products (chicken meat and dairy milk). We implement a social life cycle assessment (sLCA) to quantify and compare their potential socio-economic impacts along the entire life cycle. RESULTS: Findings from this analysis show that legume-based prototypes and their respective animal-based counterparts have, overall, a comparable socio-economic performance. Looking at the disaggregated life cycle stages, socio-economic hotspots (points of most negative impacts) were mainly identified at the production stage in legume-based products. Farm-level net margin and profitability are low when compared with their animal equivalents. However, at the processing stage, there are socio-economic gains for plant-based products regarding lower unemployment rates. Finally, at the consumption stage, there are mixed results. Plant-based products show worse protein affordability but better nutritional contents (lower saturated fat and cholesterol) than their animal counterparts. CONCLUSIONS: To improve socio-economic performance of legume-based foods, greater emphasis should be placed upon developing improved processing technologies and supply chains. This would broaden the supply of sustainable protein-rich food options and make these products more economically attractive. The research illustrates that policies should be targeted to the different stages of the food value chain to optimize the development of innovative plant-based foods. © 2021 The Authors. Journal of The Science of Food and Agriculture published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.

Applying social life cycle assessment to evaluate the use phase of mobility services: a case study in Berlin.

Purpose: The main purpose of this S-LCA case study is to analyse social impacts of the use phase of mobility services is a holistic way, taking into account positive as well as negative impacts. The use phase plays an important role for the assessment of services, which is why this study exclusively focuses on the use phase assessment. That way, this study aims to contribute to answer the question whether mobility services can improve quality of life in cities. Methods: For the analysis, seven different mobility options were chosen in the city of Berlin, Germany, including free-floating car sharing, e-scooter sharing, S-Bahn, subway, tram, bus and the car in private ownership. For the analysis, five stakeholder groups that are outlined in the S-LCA Guidelines (UNEP 2020) were taken into account: Local Community, Consumer, Worker, Value Chain Actors and Society. For a detailed analysis of all relevant aspects, 37 indicators were analysed, out of which 23 are quantitative and 14 are qualitative. For data collection, several different data sources were used, including publicly available data e.g. from statistics as well as own data from interviews. Results and discussion: For comparability, all results are displayed on a 5-point scale from - 2 to + 2, in line with the Handbook (Goedkoop et al. 2018) and the S-LCA Guidelines (UNEP 2020). For some indicators, the results of the case study are as expected, for example regarding impacts on air quality. For other indicators, however, the results are specific for the analysed mobility services in Berlin and therefore give new insights and reveal new aspects, as for example in the case of job creation for the local community. The main challenge of this S-LCA case study was data availability and data quality, which is why assumptions and simplifications had to be made, especially regarding space occupancy and the allocation of common infrastructure. Conclusions: This S-LCA case study provides a holistic assessment of the use phase of mobility services, taking into account five stakeholder categories and their respective social impacts. The study illustrates specific results for the city of Berlin, showing positive as well as negative social impacts of mobility services and outlines a procedure for further studies. That way, this case study contributes to answer the overlying question whether mobility services can improve quality of life in cities. Supplementary information: The online version contains supplementary material available at 10.1007/s11367-022-02051-y.

The Impact of COVID-19 on the Clinical Practices, Working Environment, and Social Life of Intensivists in Non-COVID ICU.

Purpose: Enlightening the changes in the usual clinical practices, working environment, and social life of Intensivists working in noncoronavirus disease intensive care units (non-COVID ICU) during the COVID pandemic. Materials and methods: Observational cross-sectional study for Indian intensivists working in non-COVID ICUs conducted between July and September 2021. A 16-question online survey consisting of the work and social profile of the participating intensivists, changes in the usual clinical practices, working environment, and impact on their social life was administered. For the last three sections, intensivists were asked to compare pandemic times to prepandemic times (pre-mid-March 2020). Results: The number of invasive interventions performed by intensivists working in the private sector with lesser clinical experience (<12 years) were significantly less as compared to the government sector (p = 0.07) and clinically experienced (p = 0.07). Intensivists without comorbidities performed significantly lesser number of patient examinations (p = 0.03). The cooperation from healthcare workers (HCWs) decreased significantly with lesser experienced intensivists (p = 0.05). Leaves were significantly reduced in case of private sector intensivists (p = 0.06). Lesser experienced intensivists (p = 0.06) and intensivists working in the private sector (p = 0.06) spent significantly lesser time with family. Conclusion: Coronavirus disease-2019 (COVID-19) affected the non-COVID ICUs as well. Young and private sector intensivists were affected due to less leaves and family time. HCWs need proper training for better cooperation during the pandemic time. How to cite this article: Ghatak T, Singh RK, Kumar A, Patnaik R, Sanjeev OP, Verma A, et al. The Impact of COVID-19 on the Clinical Practices, Working Environment, and Social Life of Intensivists in Non-COVID ICU. Indian J Crit Care Med 2022;26(7):816-824.

Age and sex influence social interactions, but not associations, within a killer whale pod.

Social structure is a fundamental aspect of animal populations. In order to understand the function and evolution of animal societies, it is important to quantify how individual attributes, such as age and sex, shape social relationships. Detecting these influences in wild populations under natural conditions can be challenging, especially when social interactions are difficult to observe and broad-scale measures of association are used as a proxy. In this study, we use unoccupied aerial systems to observe association, synchronous surfacing, and physical contact within a pod of southern resident killer whales (Orcinus orca). We show that interactions do not occur randomly between associated individuals, and that interaction types are not interchangeable. While age and sex did not detectably influence association network structure, both interaction networks showed significant social homophily by age and sex, and centrality within the contact network was higher among females and young individuals. These results suggest killer whales exhibit interesting parallels in social bond formation and social life histories with primates and other terrestrial social mammals, and demonstrate how important patterns can be missed when using associations as a proxy for interactions in animal social network studies.

Response to the COVID-19 Outbreak in Urban Settings in China.

The COVID-19 outbreak in China was devastating and spread throughout the country before being contained. Stringent physical distancing recommendations and shelter-in-place were first introduced in the hardest-hit provinces, and by March, these recommendations were uniform throughout the country. In the presence of an evolving and deadly pandemic, we sought to investigate the impact of this pandemic on individual well-being and prevention practices among Chinese urban residents. From March 2-11, 2020, 4607 individuals were recruited from 11 provinces with varying numbers of COVID-19 cases using the social networking app WeChat to complete a brief, anonymous, online survey. The analytical sample was restricted to 2551 urban residents. Standardized scales measured generalized anxiety disorder (GAD), the primary outcome. Multiple logistic regression was conducted to identify correlates of GAD alongside assessment of community practices in response to the COVID-19 pandemic. We found that during the COVID-19 pandemic, the recommended public health practices significantly (p < 0.001) increased, including wearing facial mask, practicing physical distancing, handwashing, decreased public spitting, and going outside in urban communities. Overall, 40.3% of participants met screening criteria for GAD and 49.3%, 62.6%, and 55.4% reported that their work, social life, and family life were interrupted by anxious feelings, respectively. Independent correlates of having anxiety symptoms included being a healthcare provider (aOR = 1.58, p < 0.01), living in regions with a higher density of COVID-19 cases (aOR = 2.13, p < 0.01), having completed college (aOR = 1.38, p = 0.03), meeting screening criteria for depression (aOR = 6.03, p < 0.01), and poorer perceived health status (aOR = 1.54, p < 0.01). COVID-19 had a profound impact on the health of urban dwellers throughout China. Not only did they markedly increase their self- and community-protective behaviors, but they also experienced high levels of anxiety associated with a heightened vulnerability like depression, having poor perceived health, and the potential of increased exposure to COVID-19 such as living closer to the epicenter of the pandemic.

Profiles of subjective health among people living alone: a latent class analysis.

BACKGROUND: Living alone has increased globally and especially in Finland where 45% of all households are single occupancy. Epidemiological research has found that living alone a risk factor for a wide range of adversities related to quality of life but the rapidly-changing demographics of people living alone calls for a more detailed investigation of their subjective health status. METHODS: Using a cross-sectional survey sent for a random sample of Finnish residents in single-person households (n = 884), we explored with latent class analysis whether the respondents form different health profiles based on the three health dimensions defined by the World Health Organization: physical, social, and mental well-being. The identified groups were then compared in terms of demographic characteristics with the χ2 test and quality of life using linear regression models. Sensitivity analyses were run using more refined, manual 3-step BCH method. RESULTS: Four distinct health profiles were found: Languishing (4%), Managing (35%), Healthy (30%), and Flourishing (31%). The groups differed in most socio-demographic aspects such as marital and employment status, but not in terms of geographic location or gender (apart from group Languishing that contained more men). Controlling for these socio-demographic differences, all groups showed different average levels of perceived quality of life to the expected direction. CONCLUSIONS: Our findings suggest that people living alone are indeed a very heterogeneous group in terms of subjective health. Instead of seeing living alone as a mere risk for low quality of life, concept of living alone should be understood more broadly both in public discussion and scientific research.

Social life characteristics in relation to adherence to the Mediterranean diet in older adults: findings from the Hellenic Longitudinal Investigation of Aging and Diet (HELIAD) study.

OBJECTIVE: The present study aimed to explore the associations between social life and adherence to a healthy dietary pattern, the Mediterranean diet (MD), in a population-representative cohort of older people. DESIGN: Cross-sectional study. Adherence to the MD was evaluated by an a priori score; tertiles of the score, indicating low, medium and high adherence, were used in the analyses. Social life was assessed by a questionnaire evaluating participation in leisure-time activities and the number of social contacts; primary occupation was also recorded and job characteristics were further explored. SETTING: Community-dwelling older adults. PARTICIPANTS: Adults from the Hellenic Longitudinal Investigation of Aging and Diet (HELIAD) study (n 1933; age range 65-99 years). RESULTS: Each unit increase in the number of social contacts/month and in the frequency score of intellectual, social and physical activities was associated with a 1·6, 6·8, 4·8 and 13·7 % increase in the likelihood of a participant being in the high MD adherence group, respectively. The analysis by age group revealed that younger elderly participants had a 1·4, 8·4 and 11·3 % higher likelihood to be in the high adherence group for each unit increase in the number of social contacts/month and in the frequency score of engagement in intellectual and physical activities, respectively. Similar associations were found for older elderly participants with high compared with low MD adherence, except for the intellectual activities. CONCLUSIONS: The present results suggest that high MD adherence is associated with good social life, suggesting a clustering of health-promoting lifestyle factors in older adults.

Environmental characteristics of older people attending physical medicine and rehabilitation outpatient clinics.

OBJECTIVE: A residential environment refers to the physical and social characteristics in a neighbourhood. The physical characteristics include interior housing qualities, exterior neighbourhood characteristics, and the accessibility of essential facilities and services outside the neighbourhood. Older adults especially may be vulnerable to the negative impacts of the residential environment. The aim of this study is to elucidate the problems ageing people face in their neighbourhoods, buildings and public areas. METHODS: The study group consisted of a total of 1,001 people over the age of 65 who were admitted to physical medicine and rehabilitation clinics in Turkey and consented to participate. A questionnaire covering demographic, social and environmental information was used. RESULTS: Of the study group, 58.6% was living in an apartment building, but only 23.6% of these buildings had an elevator, and the stairs were inconvenient in 46.7% of the buildings. Only 49% of the elderly people went for a walk regularly. The most frequent complaint about the hospitals, community health centres and other public areas was the inappropriate restroom conditions. Eighty-six percent of the study group were not members of an organization, a foundation or a group, and 73.6% did not have personal hobbies. CONCLUSIONS: The layouts of buildings and surroundings are inappropriate for older people, and the opportunities for them to participate in social activities are limited. Health and social programmes and governmental and local policies for older people are needed, and public awareness about this issue should be raised.

The social life of data points: Antecedents of digital technologies.

Recent technological advances such as microprocessors and random-access memory have had a significant role in gathering, storing and processing digital data, but the basic principles underpinning such data management were established in the century preceding the digital revolution. This paper maps the emergence of those older technologies to show that the logic and imperative for the surveillance potential of more recent digital technologies was laid down in a pre-digital age. The paper focuses on the development of the data point from its use in punch cards in the late 19th century through its manipulation in ideas about correlation to its collection via self-completion questionnaires. Some ways in which medicine and psychology have taken up and deployed the technology of data points are used as illustrative exemplars. The paper concludes with a discussion of the role of data points in defining human identity.

Effect of stress on human biology: Epigenetics, adaptation, inheritance, and social significance.

I present a brief introduction to epigenetics, focused primarily on methylation of the genome and various regulatory RNAs, modifications of associated histones, and their importance in enabling us to adapt to real and changing environmental, developmental, and social circumstances. Following this is a more extensive overview of how it impacts our inheritance, our entire life (which changes as we age), and how we interact with others. Throughout, I emphasize the critical influence that stress, of many varieties exerts, via epigenetic means, on much of how we live and survive, mostly in the brain. I end with a short section on multigenerational transmission, drugs, and the importance of both social life and early life experiences in the development of adult diseases. There will be nothing about cancer. Although epigenetics is critical in that field, it is a whole different cobweb of complications (some involving stress).

First Postpubertal Male Same-Sex Sexual Experience in the National Health and Social Life Survey: Current Functioning in Relation to Age at Time of Experience and Partner Age.

This study used an important data set to examine long-term adjustment and functioning in men, who as adolescents had sexual experiences with men. The data came from the National Health and Social Life Survey, which used a national probability sample (Laumann, Gagnon, Michael, & Michaels, 1994). Three perspectives were considered, which offered different predictions. From the "child sexual abuse" (CSA) paradigm, which dominates clinical, legal, and lay views, expected was robust evidence for poorer adjustment, given that intense harm is assumed to be intrinsic. From the "mainstream psychological" perspective, derived from the CSA paradigm but more scientifically based, poorer adjustment was also expected, but with less magnitude, given that minor-adult sex is seen as posing a serious risk of harm, which may not universally apply. From the "relevant-empirical" perspective, which infers response to male adolescent-adult same-sex sex from relevant prior empirical research (as opposed to clinical cases or the female experience), expected was little or no evidence for poorer adjustment. Results supported the relevant-empirical perspective. Compared to several control groups (i.e., men whose first postpubertal same-sex sex was as men with other men; men with no postpubertal same-sex sexual experience or child-adult sex), men whose first postpubertal same-sex sex was as adolescents with men were just as well adjusted in terms of health, happiness, sexual functioning, and educational and career achievement. Results are discussed in relation to cultural influences, other cultures, and comparative data from primates.

Social participation and heat-related behavior in older adults during heat waves and on other days.

BACKGROUND: High indoor temperatures require behavioral adaptation, especially among vulnerable older adults. There are uncertainties as to the degree to which people adapt to these challenging conditions. OBJECTIVE: The aim of this study was to describe the degree of adaptation of social participation and other heat-related behavior with respect to higher indoor temperatures. METHODS: In this study 81 residents from 10 sheltered living facilities (84% women, mean age 80.9 years) were visited every 4 weeks from May to October 2015 and additionally during 2 heat waves in July and August 2015. The indoor temperature, drinking and clothing and social participation were documented. Baseline documentation of gait speed and residential area were used to create subgroups of people with high or low gait speed and with facility location in a garden city/suburb or city/city center. RESULTS: Social participation and clothing decreased with -4.53 in the World Health Organization participation score units (95% confidence interval CI -5.32; -3.74) and -0.41 for clothing units (95% CI -0.46; -0.37) and volume of drinking increased (0.65 l/day; 95% CI 0.52; 0.77) per increase of indoor temperature by 10 °C. The negative association between indoor temperature and social life participation was stronger if functional capacity was low or if the facility was located in the city/city center. Not all older adults displayed temperature-related adaptive behavior. CONCLUSION: For older adults the negative association between indoor temperature and social life participation was stronger in the city/city center or if their functional capacity was low. Frequent personal contact and motivation of those who are frail might be helpful to support their adaptive behavior of drinking and clothing during heat stress.

Waste-to-energy: A review of life cycle assessment and its extension methods.

This article proposes a comprehensive review of evaluation tools based on life cycle thinking, as applied to waste-to-energy. Habitually, life cycle assessment is adopted to assess environmental burdens associated with waste-to-energy initiatives. Based on this framework, several extension methods have been developed to focus on specific aspects: Exergetic life cycle assessment for reducing resource depletion, life cycle costing for evaluating its economic burden, and social life cycle assessment for recording its social impacts. Additionally, the environment-energy-economy model integrates both life cycle assessment and life cycle costing methods and judges simultaneously these three features for sustainable waste-to-energy conversion. Life cycle assessment is sufficiently developed on waste-to-energy with concrete data inventory and sensitivity analysis, although the data and model uncertainty are unavoidable. Compared with life cycle assessment, only a few evaluations are conducted to waste-to-energy techniques by using extension methods and its methodology and application need to be further developed. Finally, this article succinctly summarises some recommendations for further research.

Sexuality in Older Couples: Individual and Dyadic Characteristics.

Sexuality is a key component of health and functioning that changes with age. Although most sexual activity takes place with a partner, the majority of research on sexuality has focused on individuals. In this paper, we focused on the sexual dyad. We proposed and tested a conceptual model of the predictors of partnered sexual activity in older adulthood. This model began with the personality of each of the partners, which affects individuals' views of sex and characteristics of the partnership, which in turn affected sexual expression in the couple. We measured a key feature of personality, Positivity, which reflected the individual's tendency to present his or herself positively in social situations. This trait, we posited, increased frequency of sex through increased desire for sex, and the subjective importance of sex to each member of the couple. In this model, Positivity also impacted characteristics of the relationship that promoted dyadic sexual behavior. These processes differed for men and women in the model. We tested this model with data from the National Social Life, Health and Aging Project, which conducted personal interviews with both partners in 940 American dyads (average male age 72; average female age 69). We found that couples in which the husbands' (but not wives') were high in Positivity show higher levels of sexual activity, and that this association was partially mediated by dimensions of relationship quality, but more so by individual factors such as thinking about sex and believing sex is important.