Medical studies are concluding that optimists really do have something to be cheerful about. Coincidental links between optimism and improved general health have been found by researchers. Recently, a Yale University psychologists' study of 660 volunteers aged 50 and above was published. It found that thinking positively about ageing adds an average of seven years to a person's life. The team, led by Dr Becca Levy, suggests that having an optimistic attitude can bolster the will to live, though they admit that they cannot explain it fully.

Another American research team, however, says they have identified a physical mechanism behind the phenomenon. Their eight-year study of 670 men aged about 63 found that the optimists had significantly better lung function than men who were more pessimistic. This is the first study to show such a link. The research team at Brigham & Women's Hospital and Harvard Medical School believes that attitude somehow strengthens the immune system, and that adopting a more positive outlook may reverse physical decline. ‘Preliminary studies on heart patients suggest that by changing a person's outlook, you can improve their mortality risk,’ says Dr Rosalind Wright.

The role of optimism in good health has long been noted but often sidelined. Sigmund Freud, the influential psychologist, equated optimism with ignorance, and from 1970 to 2000 there were 46,000 psychology papers on depression and only 40 on joy.

Part of that negativity may be blamed on optimists themselves. They are not necessarily fun to have around, says Brice Pitt, the Emeritus Professor of the Psychiatry of Old Age at Imperial College, London. ‘Optimists tend to be insufferable people. Always jolly, always up, and, frankly, they have a hopelessly rosy outlook,’ he says. ‘Depressive people see things as they really are, and that is a disadvantage from an evolutionary point of view. Optimism is a piece of evolutionary equipment that has carried us a long way through millennia of setbacks.’

Studies show that optimists do better than pessimists in work, school and sports; suffer less depression, achieve more goals, respond better to stress and fight disease better. Among people aged from their mid-nineties into their hundreds, researchers generally fail to find consistencies in diet or exercise (and some still smoke). What the super-aged do tend to share, however, is a positive, optimistic outlook.

Toshihiko Maruta, of the Mayo Institute, headed an earlier American medical study to find a link between optimism and longevity. Her study found that optimists live about 19 per cent longer than people with grim outlooks. ‘It tells us that mind and body are linked and that attitude has an impact on the final outcome: death,’ she says. That simple message might have far more effect than exhortations to eat fresh fruit and warnings to stay out of the sun.

Despite the benefits of unprecedented material wealth, the World Health Organisation estimates that depression is soon to become the second leading cause of disability. Popular wisdom blames this on our frenetically busy society. According to social forecasters at the Henley Centre, while people in developed countries are 65 per cent better off financially today than they were 15 years ago, there is no evidence that they are any more content with their lives. While much of this is down to the perception among many of being rushed and pressured for time and space, it is the perception, not the reality, that counts, they say.

The Henley researchers found that if people think they have enough time, space or money, they feel more relaxed about life, regardless of how much of these things they actually have. ‘In terms of money, some of the people who “feel” wealthiest, and some of those who “feel” poorest, actually have almost the same amount of money at their disposal. Their attitudes and behaviour patterns, however, are different from one another,’ says Chad Wallens, a researcher.

Few studies have tried to ascertain the proportion of optimists in the world. But a 1995 nationwide survey conducted in the USA for the American magazine Adweek found that about half the population counted themselves as optimists, with women slightly more apt than men (53 per cent versus 48 per cent) to identify themselves thus. That attitude drops, however, to less than a third of people between the ages of 55 and 64, which supports research showing that men, in particular, tend to become more irritable as they get older, Lynn Myers, a psychotherapist, points out.

However, too much optimism can be a bad thing. ‘You can be what is called a cock-eyed optimist, the sort of person who smokes but is convinced they will never get lung cancer.’ Curiously, though, the Brigham & Women's Hospital study found that optimism was linked to improved lung function even after smoking was taken into account.

Myers is sceptical about whether there is a simple way that people can become optimistic in order to improve their health chances. ‘I certainly would not suggest that there is anything like “six easy lessons to change your outlook”. But if you can lower your anxiety levels, it tends to make you more optimistic. Conversely, people who are highly anxious tend to be pessimistic,’ she says.

A.
At some time in their lives, nearly all New Zealanders will have to attend an after-hours clinic following an emergency or accident. On entering the consulting room, the patient is faced with a barrage of questions. The first ones relate to the current episode, and are followed by more general enquiries. Do you have any allergies? Are you on any medications? And so on.

But imagine a different scenario. The patient walks into the consulting room and there on the healthcare professional's computer screen is his or her medical record in its entirety: allergies, medications, test results and everything else. To some, it's amazing that this isn't happening already. After all, individuals can track their bank accounts, phone records and countless other transactions online, so why can't they track their health? Ian McCrae, Orion Health's CEO, says that it's understandable if health often falls behind other sectors in its adoption of information technology (IT). It might be, he argues, because of concerns about patient privacy, but also because health care is just so complicated.

B.
The irony is, New Zealand started out being ahead of the game. The backbone of any health IT system is having a unique identifier for each patient, and New Zealand's national health index (NHI) number system was introduced in 1993, before most other countries in the world. Innovation then slowed for some years, but in 2011 the earthquake in Canterbury, which affected thousands of people, was a catalyst for health IT in that region of the country. Suddenly, many people couldn't be seen by their usual doctor and many health records were inaccessible.

An existing plan for an electronic shared record was fast-tracked, and within six months a basic system, HealthOne, was up and running. By 2013, clinicians in the hospital emergency department were able to see all relevant medical information about patients. Dr Nigel Millar, Chief Medical Officer for the Canterbury region, says within days doctors were telling him the information had already revolutionised the way they worked.

C.
This idea, known as a ‘patient portal’, is now in operation in other parts of the country, including the capital Wellington. With a mobile app, patients can remain connected to their patient portal on their mobile device, allowing for added flexibility. However, there's a lot of complacency in medicine, according to Dr Richard Medlicott. He says that innovative IT systems have the potential to radically change health care delivery, because they will free doctors from routine administrative tasks and instead allow them to focus on diagnosis and patient care, which is where their skills are really needed.

But he admits there is some way to go in the adoption of shared care records, and also in changing the mindset of some doctors who are resistant to change. A good example of technology in use comes from Australia, where the National Home Doctor Service has brought back a service that was becoming infrequent: the home visit. The after-hours service uses an app to arrange an on-call doctor who will visit patients at home to provide on-the-spot healthcare.

D.
A key part of the health IT picture is maintaining a dialogue and exchange of ideas between healthcare professionals, according to Kate Reid, a director at Orion Health. Reid says this is critical, but it's not easy because there are so many different agencies that are sometimes in competition. Another issue, Reid says, is that there are many information systems that are being trialled today. However, these trials are not big enough to determine if they could ever work at a national level.

One area where cooperation in health IT really could deliver benefits is in disease prevention and early intervention, says Reid. ‘We've got innovations and technology that could be reaching at-risk people right now,’ she argues, but the infrastructure is not in place to allow funding to be shifted from treatment to prevention. Scott Arrol, CEO of New Zealand Health IT, says that advances are coming, they're just not arriving as fast as everybody would like.

E.
While IT is extremely important to a functioning health system, there are other areas where New Zealand technologies are improving health care. Dr Hong Sheng Chiong, for example, has adapted a smartphone camera for medical use. The examination kit combines a phone adapter and app, allowing users to examine the eye with minimal training.

Another innovation is the Clever MedKit, an intelligent first aid kit. It separates different items like band-aids and ice packs and orders replacements when necessary, making it particularly helpful in today's busy offices. In a separate field, the use of pre-made ceramic fittings which can be placed over a broken tooth in a single sitting reduces the cost of treatment. Dr Adam Doudney came up with the idea before it was developed by researchers at the technology company Rhondium.

Another idea is the Silhouette system, which offers a way to easily monitor wounds. It allows practitioners to detect small differences in wound size by collecting accurate images and data. Finally, the Auckland Bioengineering Institute is helping those wishing to keep fit or rehabilitate from injury. When placed on the body, their special sensor moves with the wearer and measures the amount of movement, before the data is transmitted to the user's mobile or tablet. It'll be fascinating to see how these and other technologies transform medicine over the years to come.

A
According to game theory, our chances of success in negotiations are based on the choices of others. Computer models have been developed to work out how events will unfold as people and organizations act in what they perceive to be their own best interests. Numerical values are placed on the goals, motivations, and influence of players, and likely options are considered. Game theory software then evaluates the ability of each of those players to influence others, and hence predicts the course of events.

B
Although many individuals would feel uncomfortable having a computer make decisions for them, many organizations run such computer simulations for law firms, companies, and governments. But feeding software with accurate data on all the players involved is especially tricky for political matters. Reinier van Oosten of Decide, a Dutch firm that models political negotiations, notes that predictions may become unreliable when people unexpectedly give in to ‘non-rational’ emotions such as hatred, rather than pursuing what is apparently in their best interests. However, sorting out people's motivations is much easier when making money is the main object. Accordingly, modeling behavior using game theory is proving especially useful when applied to economics.

C
Using game theory software to model auctions can be very lucrative. Consulting firms are entering the market to help clients design profitable auctions, or to win them less expensively. In 2006, in the run-up to an online auction of radio-spectrum licenses by America's Federal Communications Commission, Dr Paul Milgrom, a consultant and Stanford University professor in the United States, customized his game theory software to assist a consortium of bidders. He was apprehensive at first, but the result was a triumph.

When the auction began, Milgrom's software tracked competitors' bids to estimate their budgets for the 1,132 licenses on offer. Crucially, the software estimated the secret values bidders placed on specific licenses and determined that certain big licenses were being overvalued. Milgrom's clients were then directed to obtain a collection of smaller, less expensive licenses instead. Two of his clients paid about a third less than their competitors for an equivalent amount of spectrum, saving almost $1.2 billion. Such a saving makes one wonder why everyone isn't using game theory software. And, if they were, how would that affect the game?

D
PA Consulting, a British firm, designs models for software based on game theory to help its clients solve specific problems in areas from pharmaceuticals to the production of television shows. British government agencies have asked PA Consulting to build models to test scenarios that address how many of a type of business should be allowed to operate in a particular area.

A simple example: if two competing ice-cream sellers share a long beach, they will set up stalls back-to-back in the middle and stay put, explains Dr Stephen Black, a modeler for PA. Unfortunately for potential customers at the far ends of the beach, each seller prevents the other from relocating—no other spot would be closer to more people. Introduce a third seller, however, and the stifling equilibrium is broken as relocations and pricing changes energize the market.

By studying a chain of events such as this, software designers can assess the effect of change and see the patterns in possible outcomes that may occur. As a result, the use of modeling makes clients more inclined to look at future repercussions when making business decisions, Black says.

E
Where is all this heading? Alongside the increasingly elaborate modeling software, there are also efforts to develop software that can assist in negotiation and mediation. Two decades ago, Dr Clara Ponsati, a Spanish academic, came up with a clever idea.

She accepted that, as negotiators everywhere know, the first side to disclose the maximum amount that it is willing to pay loses considerable bargaining power. Without leverage, it can be pushed backward in the bargaining process by a clever opponent. But if neither side reveals the concessions it is prepared to make, negotiations can become very slow or collapse. However, difficult negotiations can often be pushed along by neutral mediators, especially if they are entrusted with the secret bottom lines of all parties.

Ponsati's idea was that if a human mediator was not trusted, affordable, or available, a computer could do the job instead. Negotiating parties would update the software with the confidential information on their bargaining positions after each round of talks. Once positions on both sides were no longer mutually exclusive, the software would be used to split the difference and propose an agreement.

Ponsati, now head of the Institute of Economic Analysis at the Autonomous University of Barcelona in Spain, says such “mediation machines” could be employed to push negotiations forward by unlocking information that would otherwise be withheld from an opponent.

F
Could mediation which has been achieved using software based on game theory spread from auction bids and utility pricing to resolving political and military disputes? Today's game theory software is not yet sufficiently advanced to mediate between warring countries. But one day opponents on the brink of war might be tempted to use it to exchange information without having to engage in conflict.

According to some game theorists, opponents could learn how a war would turn out, skip the fighting, and strike a deal. Over-optimistic, perhaps—but game theorists do have rather an impressive track record when it comes to predicting the future.