Optimal interventions of infectious disease

The recent outbreak of novel coronavirus has highlighted the need for a benefit-cost framework to guide unconventional public health interventions aimed at reducing close contact between infected and susceptible individuals. In this paper, we propose an optimal control problem for an infectious disease model, wherein the social planner can control the transmission rate by implementing or lifting lockdown measures. The objective is to minimize total costs, which comprise infection costs, as well as fixed and variable costs associated with lockdown measures. We establish conditions concerning model primitives that guarantee the existence of a straightforward optimal policy. The policy specifies two switching points (Formula presented.), whereby the social planner institutes a lockdown when the percentage of infected individuals exceeds (Formula presented.), and reopens the economy when the percentage of infected individuals drops below (Formula presented.). We subsequently extend the model to cases where the social planner may implement multiple lockdown levels. Finally, numerical studies are conducted to gain additional insights into the value of these controls. © 2023 Wiley Periodicals LLC.

Inclusive and sustainable growth. A mission-driven multi-stakeholder approach

Este documento trata sobre cómo aprender de la experiencia pasada y cómo avanzar hacia las nuevas formas de capitalismo que deben estar en el centro de un sistema impulsado por la misión, en el que los grandes problemas de nuestro tiempo, como la brecha digital, los sistemas sanitarios y el cambio climático sean centrales, y cómo trabajar juntos para abordarlos. Este documento trata sobre cómo diseñar un sistema de producción que sea colectivo, pero sobre todo que distribuya adecuadamente las recompensas, en lugar de la forma disfuncional en que lo hacemos actualmente, que consiste en socializar los riesgos y los costes y privatizar después los beneficios. He tenido el honor de trabajar con responsables políticos de todo el mundo para llevar la noción de reto, propósito e impulso hacia la misión al corazón del diseño de las políticas públicas. Este documento trata también de los cambios sistémicos, de lo que realmente significan, de cómo entendemos la economía, de cómo producir de otra manera.Alternate :This paper is about how to learn from past experience and how to move towards the new forms of capitalism that must be at the heart of a mission-driven system, in which the big issues of our time such as the digital divide, health systems and climate change are central, and how to work together to address them. This paper is about how to design a production system that is collective, but more importantly one that properly distributes the rewards, rather than the dysfunctional way we currently do it, which is to socialise the risks and costs and then privatise the benefits. I have had the honour of working with policy makers around the world to bring the notion of challenge, purpose and mission-drive to the heart of public policy design. This paper is also about systemic change, about what it really means, about how we understand the economy, about how to produce differently.

Exploring epidemic voluntary vaccinating behavior based on information-driven decisions and benefit-cost analysis.

A complex dynamic interplay exists between epidemic transmission and vaccination, which is significantly influenced by human behavioral responses. We construct a research framework combining both the function modeling of the cumulative global COVID-19 information and limited individuals' information processing capacity employing the Gompertz model for growing processes. Meanwhile, we built a function representing the decision to get vaccinated following benefit-cost analysis considered the choices made by people in each scenario have an influence from altruism, free-riding and immunity escaping capacity. Through the mean-field calculation analysis and using a fourth-order Runge-Kutta method with constant step size, we obtain plots from numerical simulations. We found that only when the total number of infectious individuals proves sufficient to reach and exceed a certain level will the individuals face a better trade-off in determining whether to get vaccinated against the diseases based on that information. Besides, authoritative media have a higher decisive influence and efforts should be focused on extending the duration of vaccine protection, which is beneficial to inhibit the outbreaks of epidemics. Our work elucidates that reducing the negative payoff brought about by the free-riding behavior for individuals or improving the positive payoff from the altruistic motivation helps to control the disease in cultures that value social benefits, vaccination willingness is generally stronger. We also note that at a high risk of infection, the decision of vaccination is highly correlated with global epidemic information concerning COVID-19 infection, while at times of lower risk, it depends on the game theoretic vaccine strategy. The findings demonstrate that improving health literacy, ensuring open and transparent information on vaccine safety and efficacy as a public health priority can be an effective strategy for mitigating inequalities in health education, as well as alleviating the phenomenon that immunity escaping abilities is more likely to panic by populations with high levels of education. In addition, prosocial nudges are great ways to bridge these immunity gaps that can contribute to implementing government public health control measures, creating a positive feedback loop.

COMPENSATING DIFFERENTIALS FOR OCCUPATIONAL HEALTH AND SAFETY RISKS: IMPLICATIONS OF RECENT EVIDENCE

The most enduring measure of how individuals make personal decisions affecting their health and safety is the compensating wage differential for job safety risk revealed in the labor market via hedonic equilibrium outcomes. The decisions in turn reveal the value of a statistical life (VSL), the value of a statistical injury (VSI), and the value of a statistical life year (VSLY), which have both mortality and morbidity aspects that we describe and apply here. All such tradeoff rates play important roles in policy decisions concerning improving individual welfare. Specifically, we explicate the recent empirical research on VSL and its related concepts and link the empirical results to the ongoing examinations of many government policies intended to improve individuals' health and longevity. We pay special attention to recent issues such as the COVID pandemic and newly emerging foci on distributional consequences concerning which demographic groups may benefit most from certain regulations. © 2023 by Emerald Publishing Limited.

The benefits and costs of U.S. employer COVID-19 vaccine mandates.

In 2021, the Biden Administration issued mandates requiring COVID-19 vaccinations for U.S. federal employees and contractors and for some healthcare and private sector workers. These mandates have been challenged in court; some have been halted or delayed. However, their costs and benefits have not been rigorously appraised. This study helps fill that gap. We estimate the direct costs and health-related benefits that would have accrued if these vaccination requirements had been implemented as intended. Compared with the January 2022 vaccination rates, we find that the mandates could have led to 15 million additional vaccinated individuals, increasing the overall proportion of the fully vaccinated U.S. population from 64% to 68%. The associated net benefits depend on the subsequent evolution of the pandemic-information unavailable ex ante to analysts or policymakers. In scenarios involving the emergence of a novel, more transmissible variant, against which vaccination and previous infection offer moderate protection, the estimated net benefits are potentially large. They reach almost $20,000 per additional vaccinated individual, with more than 20,000 total deaths averted over the 6-month period assessed. In scenarios involving a fading pandemic, existing vaccination-acquired or infection-acquired immunity provides sufficient protection, and the mandates' benefits are unlikely to exceed their costs. Thus, mandates may be most useful when the consequences of inaction are catastrophic. However, we do not compare the effects of mandates with alternative policies for increasing vaccination rates or for promoting other protective measures, which may receive stronger public support and be less likely to be overturned by litigation.

Damage Averted: Estimating the Effects of COVID-19 Vaccines on Hospitalizations, Mortality and Costs in Canada

[...]vaccination allowed for a reduction in many preventative public health measures that disrupted the social and economic lives of Canadians. [...]vaccine procurement and administration costs were some $3.7 billion, while the direct savings associated with averted cases and hospitalizations were an estimated $3.3 billion to $5.8 billion, resulting in a net cost-benefit estimate of-$0.4 billion to $2.1 billion, without considering the benefits of saved lives. While comprehensive analysis of the indirect effects of vaccination is beyond the scope of this study, we model the macroeconomic effect of delayed access to vaccines with different lockdown strategies (uniform or differentiated by age group). While this study does not include these indirect effects in the cost-benefit analysis of the public health impact of vaccinations on the broader economy, they represent large and significant positive impacts.

GOVERNMENT DISMISSAL AUTHORITY OF FALSE CLAIMS ACT QUI TAM CLAIMS: AN ANALYSIS OF THE CURRENT POLITICAL AND JUDICIAL DEBATE

Dating back to the Civil War, the False Claims Act (FCA) is a powerful weapon that the U.S. government (government) wields to combat fraud. In particular, the FCA contains "qui tam" provisions wherein a whistleblower, known as a "relator," may bring claims in the government's name and retain a portion of any resultant recoveries. While the FCA allows the government to dismiss a qui tam claim notwithstanding the objections of relator, there is a four-way circuit split on the appropriate standard of review for such motions to dismiss. From 2003 through 2020, the split was only between the Ninth Circuit's Sequoia standard, which requires the government to demonstrate the dismissal is rationally related to a valid governmental objective, and the D.C. Circuit's Swift standard, which confers nearly unfettered deference to the government. The year 2020 ushered in a new era of judicial debate with the Seventh Circuit creating a third standard based on the Federal Rules of Civil Procedure and the First Circuit promulgating an entirely different standard-one that requires the government to provide reasons for dismissal. The First Circuit standard also requires dismissal to be granted unless there is a constitutional infirmity or evidence of fraud. This circuit split was thrust into the spotlight in 2018 when Michael Granston, Director of the Department of Justice (DoJ) Commercial Litigation Branch, Fraud Section, promulgated guidance instructing DoJ attorneys to consider dismissing qui tam cases to curb meritless qui tam cases, conserve government resources, and prevent unfavorable precedents. Senator Charles "Chuck" Grassley (R-Iowa), a life-long whistleblower champion, has publicly criticized these dismissals as pretextual and antithetical to the spirit of the FCA. In October 2021, Senator Grassley proposed an FCA amendment that essentially codifies the Sequoia standard. Shortly before this article was sent to the publisher, the Supreme Court granted certiorari to address this question. This article examines the historical context of the qui tam provisions that ultimately gave rise to the circuit split as well as the DOJ's recent use of its dismissal authority. It further evaluates Senator Grassley's proposed FCA amendment and argues that it does not substantively settle key nuanced issues that continue to drive judicial disagreement. In light of the evolution to a four-way circuit split and the recent increase in judicial divergence, this article argues that the government's dismissal authority is well-suited for Supreme Court intervention. Finally, this article examines why the dismissal authority particularly matters now. With a newly emerging circuit split on whether a denied government motion to dismiss can be appealed and the Coronavirus Aid, Relief, and Economic Security Act (CARES Act) introducing significant opportunities to commit fraud against the government, it is imperative that all FCA litigants have clarity on the contours of the government's dismissal authority.

Can older workers be retrained? Canadian evidence from worker-firm linked data

Our empirical analysis is based on Statistics Canada’s worker-firm matched data set, the 2003 Workplace and Employee Survey (WES). The sample size is substantial: about 4,000 workers over the age of 50 and 12,000 between the ages of 25 and 49. Training was a focus of the survey, which offers a wealth of worker-related and firm-related training variables. We found that the mean probability of receiving training was 9.3 percentage points higher for younger workers than for older ones. Almost half of the gap is explained by older workers having fewer training-associated characteristics (personal, employment, workplace, human resource practices and occupation/industry/region), and slightly more than half by them having a lower propensity to receive training, this being the gap that remained after we controlled for differences in training-associated characteristics. Their lower propensity to receive training likely reflects the higher opportunity cost of lost wages during the time spent in training, possible higher psychological costs and lower expected benefits due to their shorter remaining work-life and lower productivity gains from training, as discussed in the literature. The lower propensity of older workers to receive training tended to prevail across 54 different training measures, with notable exceptions discussed in detail. We found that older workers can be trained, but their training should be redesigned in several ways: by making instruction slower and self-paced;by assigning hands-on practical exercises;by providing modular training components to be taken in stages;by familiarizing the trainees with new equipment;and by minimizing required reading and amount of material covered. The concept of “one-size-fits- all” does not apply to the design and implementation of training programs for older workers.Alternate :Notre analyse empirique est fondée sur l’ensemble des données appariées entre les travailleurs et les entreprises de Statistique Canada, le Workplace and Employee Survey (WES) de 2003. La taille de l’échantillon est importante, environ 4 000 travailleurs de plus de 50 ans et 12 000 qui ont entre 25 et 49 ans. Cette enquête est centrée sur la formation, de sorte qu’elle comporte une multitude de variables sur ce sujet tant pour les travailleurs que pour les entreprises. Notre analyse économétrique a révélé que la probabilité moyenne de recevoir une formation était de 9,3 points de pourcentage plus élevée chez les jeunes que chez les travailleurs plus âgés. Près de la moitié de cet écart peut être attribué au fait que les travailleurs âgés ont moins de caractéristiques associées à la réception de la formation (c’est-à-dire caractéristiques personnelles, d’emploi, du milieu de travail, des pratiques en matière de ressources humaines et de la profession/industrie/région). D’autre part, un peu plus de la moitié de l’écart est attribué au fait qu’ils ont moins tendance à recevoir des formations après avoir pris en compte leurs caractéristiques. Cela reflète probablement un coût d’opportunité plus élevé des salaires perdus pendant la formation et des coûts psychiques possiblement plus élevés pour les travailleurs plus âgés. Comme le révèle la littérature, cela reflète aussi le fait qu’il y a moins d’avantages à former les personnes plus âgées en raison de leur horizon de vie professionnelle plus court et des gains de productivité plus faibles associés à la formation. La faible tendance des travailleurs âgés à recevoir une formation s’exprime dans 54 mesures de la formation, avec quelques exceptions notables. Nous constatons que les travailleurs âgés peuvent être formés, mais cela nécessite une formation conçue pour répondre aux besoins des travailleurs âgés. Ces caractéristiques comprennent une instruction plus lente et auto-rythmée, des exercices pratiques, des composants de formation modulaires qui se construisent par étapes, les familiariser avec de nouveaux équipements et minimiser la lecture requise et la quantité de matériel couvert. Le concept d’uniformité ne s’applique pas à la conception et à la mise en oeuvre de formations pour les travailleurs âgés.

Picture Fuzzy Benefit/Cost Analysis in Digital Transformation for an IT Firm

With the coronavirus disease (COVID-19) pandemic, it has been seen that the importance of IT companies and digitalization investments has accelerated. Engineering economics techniques are frequently used in investments and provide use among alternatives. Although benefit/cost analysis is one of the important engineering economic techniques, it is seen that it is widely used in the literature. Engineering economics analyzes are made based on the opinions and experiences of experts. While human thoughts can contain uncertainty, these uncertainties should also be taken into account in the investment evaluation. Fuzzy sets come to the fore in the literature to eliminate the uncertainty in human opinions. Fuzzy sets represent human thoughts through membership functions. Since fuzzy sets were proposed in 1965, fuzzy sets have extended to their extensions. Some of these extensions are type 2 fuzzy sets, spherical fuzzy sets, hesitant fuzzy sets, q-rung fuzzy sets, picture fuzzy sets, Pythagorean fuzzy sets, fermatean fuzzy sets, circular intuitionistic fuzzy sets, decomposed fuzzy sets and etc. When the studies on the benefit/cost analysis method, which is one of the engineering economics approaches, are examined, it is seen that it is used with fuzzy sets and their extensions. In this study, benefit/cost analysis is extended with picture fuzzy sets, and the extended model is applied in the digital transformation investment assessment for an information technology. Future suggestions and recommendations are given in conclusion section. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.

Advance Market Commitments (AMC) model application for Colombian purchase strategy of COVID-19 vaccines.

This research estimated the optimal size and composition of the portfolio, and its benefit-cost ratio, of COVID-19 vaccines that Colombia should negotiate as a price-taking country. The Advance Market Commitments (AMC) mathematical model was applied using the parameters from the Colombian context and from a literature review. The findings indicate that the optimal portfolio of Colombia should include 13 vaccines, mainly from two platforms: i) RNA and ii) inactivated virus. The benefit-cost ratio was always greater than one in the baseline scenario and after performing many sensitivity analyses on parameters such as the percentage of the population at risk, the price per treatment, and the herd immunity threshold, among others. In a context of high uncertainty, the best decision - with high benefit - is to anticipate the negotiation processes with the providers of COVID-19 vaccines, which will generate positive economic and health impacts.

Well-being costs of perceived job insecurity: Mediating role of financial satisfaction, subjective healthiness and institutional trust

The fear of losing the current job or not finding a new job significantly affects an individual’s well-being. However, perceived job insecurity also affects an individual’s financial satisfaction, subjective healthiness, and trust in institutions - determinants of subjective well-being. This research explores the direct and indirect effects of perceived job insecurity on the life satisfaction of the full-time employed and unemployed people within a serial mediation analysis framework. Using the World Values Survey (6th wave) dataset, we estimated the effects in aggregate and disaggregated (by the income level of countries) samples. Regarding unemployed people, results display the almost equal contribution of direct and indirect channels. In contrast, the dominance of indirect impact channels is more considerable in the case of individuals employed full-time. In disaggregated samples, no significant impact is detected in low-income and upper-middle-income class members, while the effects are significant and economically meaningful for lower-middle-income and high-income countries. Non-pecuniary costs exceed pecuniary costs. The primary mediating factor is satisfaction with a household’s financial situation, especially in high-income countries. The availability of unemployment insurance benefits can partially compensate well-being costs of perceived job insecurity. Nevertheless, governments need to enhance labour market efficiency to diminish both unemployed and full-time employed individuals’ perceived job insecurity, which would improve societal welfare in the end.

Economic incentives for the wildlife trade and costs of epidemics compared across individual, national, and global scales

The wildlife trade drives biodiversity loss and zoonotic disease emergence, and the health and economic impacts of COVID‐19 have sparked discussions over stricter regulation of the wildlife trade. Yet regulation for conservation and health purposes is at odds with the economic incentives provided by this multibillion‐dollar industry. To understand why the wildlife trade persists despite associated biodiversity and global health threats, we used a benefit–cost approach using simple calculations to compare the economic benefits of the wildlife trade at the individual, national, and global scales to the costs of COVID‐19, severe acute respiratory syndrome (SARS), and Ebola disease across scenarios of epidemic frequency. For COVID‐19, benefits of the wildlife trade outweigh costs at individual scales, but costs far exceed benefits at national and global scales, particularly if epidemics were to become frequent. For SARS and Ebola, benefits outweigh costs at all scales, except if Ebola‐like epidemics were to become frequent. The wildlife trade produces net benefits for people who depend on wildlife for food and income but incurs net costs on stakeholders at larger scales from increased epidemic risk. While our analysis omits a variety of costs and benefits that are difficult to quantify and contrast, our analysis is meant to illustrate the distributional outcomes across stakeholder groups that could result from increased wildlife trade regulation. Importantly, the feasibility of trade regulatory policies will depend on how these benefits and costs compare across groups and would therefore need to involve accessible and attractive alternative sources of food and livelihoods for those who depend on the wildlife trade. [ FROM AUTHOR] Copyright of Conservation Science & Practice is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Small matching grants for women entrepreneurs: lessons from the past recession

During the economic slowdown caused by the financial crisis in 2008, grants for entrepreneurs were made available to support economic development. Whether such a policy instrument is effective for business development is a highly relevant question in the aftermath of the COVID-19. We evaluate the causal effects of small business development matching grants using a quasi-experimental approach. The grants were exclusively targeted to women entrepreneurs and provided during the recession after the financial crisis. Our findings demonstrate an increase in bank loans and a positive impact on turnover, value-added, capital, employment, and overall factor productivity for more experienced women entrepreneurs. As the grants are too small to have direct economic effects or indirect effects via the certification effect, they alleviate time and information constraints of women entrepreneurs. The cost-benefit analysis shows an increase in value-added that outweighs the scheme-related costs.Plain English SummaryThis study evaluates the effect of small public grants for women entrepreneurs. Grants were used for childcare and business consultancy costs to alleviate time and information constraints of women entrepreneurs. Benefiting from these grants resulted in higher bank loans. The women entrepreneurs on average invested more money in capital and had better performance measures like turnover and value-added. The effect was particularly evident among more experienced women entrepreneurs. The cost-benefit analysis shows grant-induced increase in value-added outweighs the scheme-related costs. The study implies small public grants for women entrepreneurs increase small firms’ growth, and these grants are in addition a cost-effective policy tool.

The Cost Benefit Analysis of Commercial 100 MW Solar PV: The Plant Quaid-e-Azam Solar Power Pvt Ltd

The energy crisis in Pakistan has crippled the country’s economy with an energy shortfall reaching up to 6000 MW. Fortunately, Pakistan lies close to the Sun Belt and therefore receives very high irradiation. To this end, in the beginning of 2014 the Pakistani government sanctioned a solar photovoltaic project namely Quaid-e-Azam Solar Park which was rated at 1000 MW. In this study, a cost benefit analysis for the Quaid-e-Azam Solar Park has been developed. The model uses RETScreen software. In fact, a literature review pointed out that most of the previous research work with reference to cost benefit analysis for solar projects has been mainly carried out on smaller power plants. The outcome of the study shows promising results with the simple payback period coming out at 5.6 years. Furthermore, this analysis can serve as guideline for future solar photovoltaic projects in Pakistan and can help in the development and utilization of the huge solar potential of the country, thus aiding in the reduction of energy shortage. In its proposal, our research is unique and innovative in the Pakistani context. The results aim to serve as a guideline for decision makers and researchers interested in this topic.

Guest editorial

[...]some call the field data analytics. [...]modeling is a key component of the analytics field. In particular, the methodology is useful to deal with inaccurate judgment and different perceptions. [...]the model assigns risk levels to each model input.

Benefit-Cost Ratios of Continuing Routine Immunization During the COVID-19 Pandemic in Africa

Disruptions in routine immunization caused by COVID-19 put African countries with large vaccine-preventable disease burdens at high risk of outbreaks. Abbas et al. (2020) showed that mortality reduction from resuming immunization outweighs excess mortality from COVID-19 caused by exposure during immunization activities. We leverage these estimates to calculate benefit-cost ratios (BCRs) of disrupted immunization and apply cost of illness (COI) and value of statistical life-year (VSLY) approaches to estimate the cost of excess child deaths from eight vaccine-preventable diseases. BCRs were computed for each country, vaccine, and Expanded Program on Immunization visit. Secondary estimates that include the cost of providing immunization are presented in scenario analysis. Suspended immunization may cost $4949 million due to excess mortality using the COI approach, or $34,344 million using the VSLY approach. Likewise, excess COVID-19 deaths caused by exposure from immunization activities would cost $53 and $275 million using the COI and VSLY approaches, respectively. BCRs of continuing routine immunization are 94:1 using COI and 125:1 using VSLY, indicating that the economic costs of suspending immunization exceed that of COVID-19 deaths risked by routine immunization. When including the costs of providing routine immunization during the COVID-19 pandemic, the BCRs are 38:1 and 97:1 using the COI and VSLY approaches, respectively.

Time Reallocation and the Cost and Benefit of School Closures during an Epidemic

School closures are an important public health intervention during epidemics. Yet, the existing estimates of policy costs and benefits overlook the impact of human behavior and labor market conditions. We use an integrated assessment framework to quantify the public health benefits and the economic costs of school closures based on activity patterns derived from the American Time-Use Survey (ATUS) for a pandemic like COVID-19. We develop a policy decision framework based on marginal benefits and costs to estimate the optimal school closure duration. The results suggest that the optimal school closure depends on how people reallocate their time when schools are closed. Widespread social distancing behavior implemented early and for a long duration can delay the epidemic for years, buying time for the development of pharmaceutical interventions and yielding substantial net benefits. Conversely, school closure, with behavior targeted to adjust only to the school closure, is unlikely to provide substantial delay or sufficient net benefits to justify closing schools for pathogen control.

This Paper Attacks a Strawman but the Strawman Wins: A reply to van Basshuysen and White

We reply to van Basshuysen and White’s criticism of our paper. We argue that they have misconstrued what our original claims were. Nevertheless, we maintain that their arguments against the position they incorrectly attribute to us fail.

Do the Benefits of COVID-19 Policies Exceed the Costs? Exploring Uncertainties in the Age-VSL Relationship.

Numerous analyses of the benefits and costs of COVID-19 policies have been completed quickly as the crisis has unfolded. The results often largely depend on the approach used to value mortality risk reductions, typically expressed as the value per statistical life (VSL). Many analyses rely on a population-average VSL estimate; some adjust VSL for life expectancy at the age of death. We explore the implications of theory and empirical studies, which suggest that the relationship between age and VSL is uncertain. We compare the effects of three approaches: (1) an invariant population-average VSL; (2) a constant value per statistical life-year (VSLY); and (3) a VSL that follows an inverse-U pattern, peaking in middle age. We find that when applied to the U.S. age distribution of COVID-19 deaths, these approaches result in average VSL estimates of $10.63 million, $4.47 million, and $8.31 million. We explore the extent to which applying these estimates alters the conclusions of frequently cited analyses of social distancing, finding that they significantly affect the findings. However, these analyses do not address other characteristics of COVID-19 deaths that may increase or decrease the VSL estimates. Examples include the health status and income level of those affected, the size of the risk change, and the extent to which the risk is dreaded, uncertain, involuntarily incurred, and outside of one's control. The effects of these characteristics and their correlation with age are uncertain; it is unclear whether they amplify or diminish the effects of age on VSL.