Fuel poverty, older people and cold weather: An all-island analysis

Executive Summary This report covers a number of different aspects of fuel poverty and older people. 1. An exploration of existing government survey data from Northern Ireland and the Republic of Ireland with a particular focus on older people and conducting additional targeted analyses where required. 2. An original survey in the Republic of Ireland exploring the lived experience of older people in cold weather. 3. A feasibility study of data logging thermometers placed in the homes of older tenants in local authority accommodation. 4. Analysis of excess winter mortality among older people including a consideration of differences between the two jurisdictions. Older people on the island of Ireland, as in many other countries, experience a ‘dual burden’ in terms of fuel poverty. They are more likely to experience fuel poverty and are also particularly vulnerable to health and social harm as a result of this experience. The numbers of older people vulnerable to ill-effects from cold homes will rise as numbers of people aged 80 and over, and those living with chronic illness or disability, increase. There were significant differences observed between expenditure-based, and subjective (EU-SILC) based fuel poverty indicators, for older people, and between Northern Ireland and Republic of Ireland data. This data required careful interpretation. The higher levels of fuel poverty recorded for older people on the island of Ireland appeared to be driven by all aspects of the fuel poverty model - poor housing condition, energy inefficient housing, rising fuel prices and low income. The majority of older people live in their own home and these homes tend to be older properties which are detached or semi-detached. Older people on the island are over-represented among houses which are in poor condition and which lack central heating in both jurisdictions. Lacking central heating was a more common experience for older people in the Republic of Ireland than in Northern Ireland. Data on energy efficiency measures were not comparable North/South but similar patterns were observed. Older people were less likely than the general population to have attic/loft or wall insulation or double glazing. Older people were also vulnerable from an income point of view. This would seem to be a particular issue in Northern Ireland where rates of income poverty are significantly increasing. In both jurisdictions older people were heavily reliant on social transfers to keep them out of poverty. Coupled with this, there is evidence that many older people are not claiming their full entitlements. Oil dependency was a particular issue in Northern Ireland. Very significant increases were observed in the price of heating oil, as well as electricity and gas in recent years. There was little available research evidence on the relationship between the older consumer and heating oil suppliers

'TaxTrack': Introducing a Democratic Innovation for Taxation

In this article we introduce an input-oriented democratic innovation – that we term ‘TaxTrack’ – which offers individual taxpayers the means to engage with their political economies in three ways. After joining the TaxTrack program, an individual can: (1) see and understand how much, and what types, of taxes they have contributed, (2) see and understand how their tax contributions are, or have been, used, and (3) control what their tax contributions can, or cannot, be spent on. We explain this democratic innovation in two ways. The first is through evocation to prefigure what the innovation could look like in future practise which raises the prospects for both good and problematic outcomes. The second is through formal theory to produce a detailed model of the innovation to assist theory building. We conclude by discussing three interactive outcomes of ‘TaxTrack’ through the democratic innovations literature to establish the beginnings of a theory for the model. This theory tells us that ‘TaxTrack’ can return benefits to its users and the democratic regimes in which they are located but it may also place restrictions on output-oriented innovations like Participatory Budgeting

The Link between Genetic Factors in Children with Febrile Convulsions Appearance

The aim of this research paper is to reflect the link between genetic factors and presenting children with febrile convulsions.Keywords: febrile seizures, genetic factor, the pediatric clinic

The effects of socioeconomic status and indices of physical environment on reduced birth weight and preterm births in Eastern Massachusetts

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.Background: Air pollution and social characteristics have been shown to affect indicators of health. While use of spatial methods to estimate exposure to air pollution has increased the power to detect effects, questions have been raised about potential for confounding by social factors.Methods: A study of singleton births in Eastern Massachusetts was conducted between 1996 and 2002 to examine the association between indicators of traffic, land use, individual and area-based socioeconomic measures (SEM), and birth outcomes ( birth weight, small for gestational age and preterm births), in a two-level hierarchical model.Results: We found effects of both individual ( education, race, prenatal care index) and area-based ( median household income) SEM with all birth outcomes. The associations for traffic and land use variables were mainly seen with birth weight, with an exception for an effect of cumulative traffic density on small for gestational age. Race/ethnicity of mother was an important predictor of birth outcomes and a strong confounder for both area-based SEM and indices of physical environment. The effects of traffic and land use differed by level of education and median household income.Conclusion: Overall, the findings of the study suggested greater likelihood of reduced birth weight and preterm births among the more socially disadvantaged, and a greater risk of reduced birth weight associated with traffic exposures. Results revealed the importance of controlling simultaneously for SEM and environmental exposures as the way to better understand determinants of health.This work is supported by the Harvard Environmental Protection Agency (EPA) Center, Grants R827353 and R-832416, and National Institute for Environmental Health Science (NIEHS) ES-0002

Socioeconomic differentials in the immediate mortality effects of the national Irish smoking ban

This article has been made available through the Brunel Open Access Publishing Fund.Background: Consistent evidence has demonstrated that smoking ban policies save lives, but impacts on health inequalities are uncertain as few studies have assessed post-ban effects by socioeconomic status (SES) and findings have been inconsistent. The aim of this study was to assess the effects of the national Irish smoking ban on ischemic heart disease (IHD), stroke, and chronic obstructive pulmonary disease (COPD) mortality by discrete and composite SES indicators to determine impacts on inequalities. Methods: Census data were used to assign frequencies of structural and material SES indicators to 34 local authorities across Ireland with a 2000–2010 study period. Discrete indicators were jointly analysed through principal component analysis to generate a composite index, with sensitivity analyses conducted by varying the included indicators. Poisson regression with interrupted time-series analysis was conducted to examine monthly age and gender-standardised mortality rates in the Irish population, ages ≥35 years, stratified by tertiles of SES indicators. All models were adjusted for time trend, season, influenza, and smoking prevalence. Results: Post-ban mortality reductions by structural SES indicators were concentrated in the most deprived tertile for all causes of death, while reductions by material SES indicators were more equitable across SES tertiles. The composite indices mirrored the results of the discrete indicators, demonstrating that post-ban mortality decreases were either greater or similar in the most deprived when compared to the least deprived for all causes of death. Conclusions: Overall findings indicated that the national Irish smoking ban reduced inequalities in smoking-related mortality. Due to the higher rates of smoking-related mortality in the most deprived group, even equitable reductions across SES tertiles resulted in decreases in inequalities. The choice of SES indicator was influential in the measurement of effects, underscoring that a differentiated analytical approach aided in understanding the complexities in which structural and material factors influence mortality

Global, regional, and national burden of mortality associated with short-term temperature variability from 2000-19: a three-stage modelling study

BACKGROUND: Increased mortality risk is associated with short-term temperature variability. However, to our knowledge, there has been no comprehensive assessment of the temperature variability-related mortality burden worldwide. In this study, using data from the MCC Collaborative Research Network, we first explored the association between temperature variability and mortality across 43 countries or regions. Then, to provide a more comprehensive picture of the global burden of mortality associated with temperature variability, global gridded temperature data with a resolution of 0.5 degrees x 0.5 degrees were used to assess the temperature variability-related mortality burden at the global, regional, and national levels. Furthermore, temporal trends in temperature variability-related mortality burden were also explored from 2000-19. METHODS: In this modelling study, we applied a three-stage meta-analytical approach to assess the global temperature variability-related mortality burden at a spatial resolution of 0.5 degrees x 0.5 degrees from 2000-19. Temperature variability was calculated as the SD of the average of the same and previous days' minimum and maximum temperatures. We first obtained location-specific temperature variability related-mortality associations based on a daily time series of 750 locations from the Multi-country Multi-city Collaborative Research Network. We subsequently constructed a multivariable meta-regression model with five predictors to estimate grid-specific temperature variability related-mortality associations across the globe. Finally, percentage excess in mortality and excess mortality rate were calculated to quantify the temperature variability-related mortality burden and to further explore its temporal trend over two decades. FINDINGS: An increasing trend in temperature variability was identified at the global level from 2000 to 2019. Globally, 1 753 392 deaths (95% CI 1 159 901-2 357 718) were associated with temperature variability per year, accounting for 3.4% (2.2-4.6) of all deaths. Most of Asia, Australia, and New Zealand were observed to have a higher percentage excess in mortality than the global mean. Globally, the percentage excess in mortality increased by about 4.6% (3.7-5.3) per decade. The largest increase occurred in Australia and New Zealand (7.3%, 95% CI 4.3-10.4), followed by Europe (4.4%, 2.2-5.6) and Africa (3.3, 1.9-4.6). INTERPRETATION: Globally, a substantial mortality burden was associated with temperature variability, showing geographical heterogeneity and a slightly increasing temporal trend. Our findings could assist in raising public awareness and improving the understanding of the health impacts of temperature variability. FUNDING: Australian Research Council, Australian National Health & Medical Research Council

The synthesis of chalcones as anticancer prodrugs and their bioactivation in CYP1 expressing breast cancer cells

The file attached to this record is the author's final peer reviewed version. The Publisher's final version can be found by following the DOI linkAbstract: Background: Although the expression levels of many P450s differ between tumour and corresponding normal tissue, CYP1B1 is one of the few CYP subfamilies which is significantly and consistently overexpressed in tumours. CYP1B1 has been shown to be active within tumours and is capable of metabolising a structurally diverse range of anticancer drugs. Because of this, and its role in the activation of procarcinogens, CYP1B1 is seen as an important target for anticancer drug development. Objectives: To synthesise a series of chalcone derivatives based on the chemopreventative agent DMU-135 and investigate their antiproliferative activities in human breast cancer cell lines which express CYP1B1 and CYP1A1. Method: A series of chalcones were synthesised in yields of 43-94% using the Claisen-Schmidt condensation reaction. These were screened using a MTT assay against a panel of breast cancer cell lines which have been characterised for CYP1 expression. Results: A number of derivatives showed promising antiproliferative activities in human breast cancer cell lines which express CYP1B1 and CYP1A1, while showing significantly lower toxicity towards a non-tumour breast cell line with no CYP expression. Experiments using the CYP1 inhibitors acacetin and -naphthoflavone provided supporting evidence for the involvement of CYP1 enzymes in the bioactivation of these compounds. Conclusions: Chalcones show promise as anticancer agents with evidence suggesting that CYP1 activation of these compounds may be involved

Occupational exposure to dusts and risk of renal cell carcinoma

Background: Occupational exposures to dusts have generally been examined in relation to cancers of the respiratory system and have rarely been examined in relation to other cancers, such as renal cell carcinoma (RCC). Although previous epidemiological studies, though few, have shown certain dusts, such as asbestos, to increase renal cancer risk, the potential for other occupational dust exposures to cause kidney damage and/or cancer may exist. We investigated whether asbestos, as well as 20 other occupational dust exposures, were associated with RCC risk in a large European, multi-center, hospital-based renal case-control study.Methods: General occupational histories and job-specific questionnaires were reviewed by occupational hygienists for subject-specific information. Odds ratios (ORs) and 95% confidence intervals (95% CIs) between RCC risk and exposures were calculated using unconditional logistic regression. Results: Among participants ever exposed to dusts, significant associations were observed for glass fibres (OR: 2.1; 95% CI: 1.1-3.9), mineral wool fibres (OR: 2.5; 95% CI: 1.2-5.1), and brick dust (OR: 1.5; 95% CI: 1.0-2.4). Significant trends were also observed with exposure duration and cumulative exposure. No association between RCC risk and asbestos exposure was observed. Conclusion: Results suggest that increased RCC risk may be associated with occupational exposure to specific types of dusts. Additional studies are needed to replicate and extend findings. © 2011 Cancer Research UK All rights reserved