Assessing the Will to Live: A Scoping Review Bornet, Marc-Antoine; Bernard, Mathieu; Jaques, Cécile ...
Journal of pain and symptom management,
April 2021, 2021-Apr, 2021-04-00, 20210401, Volume:
61, Issue:
4
Journal Article
Peer reviewed
Open access
The will to live (WTL) is an important factor to consider in the context of providing resource-oriented palliative care. Until now, there has been no major review of the existing research on this ...subject.
The primary objective of this study is to summarize the state of research concerning instruments that assess the WTL. The secondary objective is to explore the theoretical models and psychometric properties of these instruments, in studies where these instruments were initially presented. The tertiary objective is to identify, among all studies where these instruments have been used, the intensity of the WTL, and factors associated with it.
We conducted a scoping review, including studies that were designed to assess the WTL among participants in all settings. Records were systematically searched from seven bibliographic databases with no date limitations up to August 2020.
Of the 3078 records screened, 281 were examined in detail and 111 were included in the synthesis. A total of 25 different instruments quantitatively assessing the WTL are presented. Most are single-question tools and rate intensity. The underlying concepts and psychometric properties are incompletely explained. Lack of crossreferencing is apparent. The intensity of the WTL is high, even among people with significant health impairment, and is frequently associated with different factors, such as resilience and quality of life.
A considerable yet unconnected body of studies assesses the WTL. Its assessment in clinical routine could promote resource-oriented and patient-centered care.
The will to live (WTL) is an important indicator of subjective well-being. It may enable a deeper understanding of the well-being of nursing home residents.
To evaluate the intensity of WTL, its ...association with various factors, and its temporal evolution among residents ≥ 65 years old; we also aimed to compare it with proxy assessments of WTL.
A cross-sectional study was conducted in five nursing homes in Switzerland. Participants with decisional capacity were asked to rate the intensity of their WTL on a single-item numerical rating scale ranging from 0–10. A short-term follow-up was conducted among a sub-sample of 17 participants after three and six weeks. Proxy assessment by residents’ next of kin and professional caregivers was conducted, and inter-rater agreement was calculated.
Data from 103 participants (75.7% women, 87.3 ± 8.0 years) was analyzed. The median intensity of WTL was 8. Higher WTL was significantly associated with better physical mobility and shorter duration of daily care but not with age, gender, pre-admission care setting, or prognosis. Significant independent predictors of WTL were physical mobility and provenance from rehabilitative care. In the short-term follow-up assessment, WTL remained highly stable. Intraclass correlation coefficients were moderate for residents’ next of kin and nurse assistants but poor for physicians and nurses; all proxy assessments underestimated the participants’ WTL.
Nursing home residents expressed a very strong WTL and proxy aents underestimated residents’ WTL. It seems pivotal to proactively communicate with residents about their WTL.
This article is a summary of Professor Arran Stibbe’s ten online lectures on ecolinguistics at Beijing Foreign Studies University. The lecture series begins by asking: Why, from an ecolinguistic ...perspective, do we need new stories to live by? With theoretical insights and practical analyses of a wide range of discourses, it then illustrates how eight types of stories, including ideology, evaluation, erasure, salience, identity, narrative, framing, and metaphor can work cognitively to influence the way people construe reality, in the hope of encouraging people to use language that can inspire them to protect the planet instead of destroying it.
Will-to-live is defined as the psychological expression of one's commitment to life and the desire to continue living. It is an important indicator of subjective wellbeing. This study aimed to assess ...the will-to-live in frail older hospitalized patients and nursing home residents as well as to evaluate its association with physical frailty, tiredness of life, depression and wish-to-die.
Between March and September 2021, we interviewed 186 older adults in six nursing homes and two acute geriatric wards across Belgium. Will-to-live was assessed using a single-item numeric rating scale from 0 to 5. A linear regression analysis was performed to assess the association between will-to-live and frailty (Clinical Frailty Scale) with adjustment for age, gender and setting. Mann-Whitney U test was used to evaluate the association between will-to-live and depression, tiredness of life and wish-to-die.
Mean age was 85 (± 6.2) years. Mean score on the Clinical Frailty Scale was five (± 1.5) and four on the will-to-live (± 1.3). No statistical significant association was found between will-to-live and age (p = 0.991), gender (p = 0.272), setting (p = 0.627) and frailty (p = 0.629). Multiple linear regression showed no significant association with Clinical Frailty Scale (p = 0.660), after adjustment for age, gender and setting. Will-to-live was negatively associated with tiredness of life (p = 0.020) and wish-to-die (p < 0.001), but not with depression (p = 0.186).
Both nursing home residents and older hospitalized patients expressed a strong or very strong will-to-live. Will-to-live was not associated with physical frailty as measured by the Clinical Frailty Scale. Nursing home residents with a weak will-to-live were more likely to have depressive symptoms. Most nursing home residents with a wish-to-die had also a low will-to-live, although some residents had both a high will-to-live and wish-to-die.
In the near future, objects have to connect with each other which can result in gathering private sensitive data and cause various security threats and cyber crimes. To prevent cyber crimes, novel ...cyber security techniques are required that can identify malicious Internet Protocol (IP) addresses before communication. One of the best techniques is the IP reputation system used for profiling the behavior of security threats to the cyber–physical system. Existing reputation systems do not perform well due to their high management cost, false-positive rate, consumption time, and considering very few data sources for claiming IP address reputation. To overcome the aforementioned issues, we have proposed a novel hybrid approach based on Dynamic Malware Analysis, Cyber Threat Intelligence, Machine Learning (ML), and Data Forensics. Using the concept of big data forensics, IP reputation is predicted in its pre-acceptance stage and its associated zero-day attacks are categorized via behavioral analysis by applying the Decision Tree (DT) technique. The proposed approach highlights the big data forensic issues and computes severity, risk score along with assessing the confidence and lifespan simultaneously. The proposed system is evaluated in two ways; first, we compare the ML techniques to attain the best F-measure, precision and recall scores, and then we compare the entire reputation system with the existing reputation systems. Our proposed framework is not only cross checked with external sources but also able to reduce the security issues which were neglected by existing outdated reputation engines.
•We have classified malware family using several ML techniques, where DT performs best due to its comprehensive analysis nature.•To demonstrate the malicious behavior of an IP address, we compute the reputation at run time.•The weighted risk score is computed to maintain the updated risk score as IP addresses re-attempt to cause the damage.•The confidence level is computed to assure the maliciousness level of an IP address, and the lifespan of an IP address is computed to forecast the time to live (TTL) period.•With the help of DT, we are also able to reduce the false alarm rate as it returns 2% error rate and 99% F-measure score.
Previous research has shown that will to live is a strong predictor for survival among older people, irrespective of age, gender, and comorbidities. However, research on whether life at age 100 is ...perceived as worth living is limited. The available literature has presented evidence for good levels of positive attitudes and life satisfaction at such an advanced age, but it has also suggested that a longing for death is common. This study aimed to add to the existing data on this matter by exploring centenarians' will to live and the associated factors. The sample comprised 121 centenarians (mean age, 101 years; SD, 1.63 years), 19 (15.7%) of whom were males, from two centenarian studies (PT100). Answers to open questions were analyzed to identify the centenarians' will to live and the reasons behind it. Three groups were created (willing to live longer, not willing to live longer, no clear positioning) and further analyzed in terms of sociodemographic characteristics, health status, social functioning, and well-being. Of the total sample, 31.4% expressed willingness to live longer, 30.6% did not, and 38% presented no clear positioning. The presence of the Catholic religion (God) was referred for centenarians in all three groups. Annoyance, uselessness, loss of meaning, disconnection, and loneliness were the most common justifications for being reluctant to live longer. Positive valuation of life and good self-rated health, followed by having a confidant and reduced pain frequency, were the factors associated with being willing to live longer. The results of the study contribute to the understanding of the psychological functioning of individuals with exceptional longevity, particularly concerning the factors behind willingness to live at such an advanced age.
'Learning To Live Together' (LTLT) has been emphasised in SDG 4.7 and the Delors report, with the latter suggesting it to be one of the four education pillars. LTLT has frequently been used as an ...umbrella-like term leading to difficulties in informing teaching practices and policies. In India, Aurobindo, Dalai Lama, Gandhi, Krishnamurti and Tagore have proposed synergetic ideologies like 'education of the heart'. They founded schools, some more than a century ago, which pursue these goals. This paper develops a conceptual framework for LTLT using teachers' perceptions of LTLT. The paper draws upon a larger multiple embedded case study involving a 10-month-long immersion in the five schools founded by the aforementioned philosophers, as well as ethnographic observations and interviews with 14 teachers and five headteachers. The findings reconceptualise LTLT as LTLT 'Harmoniously' (LTLTH) and builds an interconnected 2D framework with three domains, which are intersected with six dimensions.
To determine whether gonadotropin-releasing hormone (GnRH) antagonist protocol can improve cumulative live birth rates (CLBRs) and shorten the time to live birth (TTLB) in unselected patients ...compared with progestin-primed ovarian stimulation (PPOS).
A propensity score-matched retrospective cohort study design.
Tertiary-care academic medical center.
A total of 6,520 women with infertility aged 20-50 years were included.
Patients underwent either the GnRH antagonist protocol (n = 5,004) or PPOS (n = 1,516) on the basis of the assessment of the attending physicians. One-to-one propensity score matching was performed with a caliper of 0.02. Women who were not matched were excluded from the analyses.
The CLBR of which the ongoing status had to be achieved within 22 months from the day of ovarian stimulation and TTLB.
Each group comprised 1,424 couples after propensity score matching, and the baseline demographic characteristics of the couples after matching were comparable between the 2 groups. The cycle cancellation rate was significantly lower in the GnRH antagonist group than in the PPOS group (12.9% vs. 19.6%). The implantation rate, clinical pregnancy rate, ongoing pregnancy rate, and live birth rate per transfer were comparable between the 2 groups. However, CLBRs after 1 complete IVF cycle were significantly higher in the GnRH antagonist group than in the PPOS group (36.0% vs. 32.2%; Risk ratio = 1.12; 95% confidence interval CI, 1.01-1.24). The average TTLB was significantly shorter in the GnRH antagonist group than in the PPOS group (9.3 months vs. 12.4 months). Using the Kaplan-Meier analysis, the cumulative incidence of ongoing pregnancy leading to live birth was significantly higher in the GnRH antagonist group than in the PPOS group (85.1% vs. 66.1%, Log-rank test). A Cox proportional hazard model revealed that women who underwent the antagonist protocol were 2.32 times more likely to achieve a live birth than those who used PPOS (hazard ratio HR = 2.32; 95% CI, 1.91-2.83). Subgroup analysis revealed that women who used the antagonist protocol were more likely to achieve a live birth than women who used PPOS across the 3 antral follicle count (AFC) strata (AFC ≤ 5, AFC 6-15, and AFC > 15), 2 age strata (<35 and ≥35 years), and first cycle or repeated cycle. The difference was greatest among women whose AFC was ≤5 and who were aged ≥35 years, effectively becoming smaller in the group with high ovarian reserve and younger age.
In unselected women undergoing IVF, the GnRH antagonist protocol was associated with a higher CLBR and a shorter TTLB compared with PPOS.
TTL model for an LRU-based similarity caching policy Ben Mazziane, Younes; Alouf, Sara; Neglia, Giovanni ...
Computer networks (Amsterdam, Netherlands : 1999),
March 2024, 2024-03-00, Volume:
241
Journal Article
Peer reviewed
Similarity caching allows requests for an item to be served by a similar item. Applications include recommendation systems, multimedia retrieval, and machine learning. Recently, many similarity ...caching policies have been proposed, like SIM-LRU and its generalization RND-LRU, but the performance analysis of their hit ratio is still wanting. In this paper, we show how to extend the popular time-to-live approximation in classic caching to similarity caching. In particular, we propose a method to estimate the hit ratio of the similarity caching policy RND-LRU. Our method, the RND-TTL approximation, introduces the RND-TTL cache model and then tunes its parameters in such a way as to mimic the behavior of RND-LRU. The parameter tuning involves solving a fixed point system of equations for which we provide an algorithm for numerical resolution and sufficient conditions for its convergence. Our approach for approximating the hit ratio of RND-LRU is evaluated on both synthetic and real-world traces.
OBJECTIVEThe Will-to-Live Scale (WTLS) is used to measure the will to live in older adults; however, there is no Spanish version. The objective of the study was to translate the WTLS into Spanish, ...assess its internal structure, reliability, and the correlates between WTLS and life satisfaction, resilience, and depression in older Peruvian adults. METHODThe participants were 235 Peruvian older adults (M=72.69, SD=6.68), evaluated between March to May 2019, selected through non-probability sampling. The WTLS, the Satisfaction with Life Scale (SWLS), the Brief Resilient Coping Scale (BRCS) and the Patient Health Questionnaire-2 (PHQ-2) were administered. Data analysis included reliability by internal consistency and structural equation models, specifically confirmatory factor analysis (AFC), to test the one-dimensional solution of the WTLS and the convergent validity of the WTLS at the latent level, by specifying a four-factor model (will to live, life satisfaction, resilience and depression). RESULTSCronbach's alpha coefficient and the composite reliability index obtain values of .93 and .94, respectively. The one-dimensional structure of the WTLS was fitted to the data (χ2(5)=10,067, P=.073, CFI=.999, RMSEA=.066, SRMR=.014) and showed positive associations with the SWLS (ρ=.82), and BRCS (ρ=.86), as well as negative associations with the PHQ-2 (ρ=-.66). CONCLUSIONThe WTLS in Spanish presents evidence of validity and reliability to measure the will to live in Peruvian older adults.
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