Paying for Care Costs in Later Life Using the Value in People’s Homes

With the number of U.K. citizens aged 75+ doubling to 10 million by 2040, and with 1.3 million people already receiving social care services in England alone, social care funding is a key public policy challenge. The government has launched a set of reforms designed to get social care funding onto a sustainable footing by establishing a new level for what individuals and the state will pay. The reforms are designed to encourage individuals to explore how best to use their available wealth and assets to meet care costs through a mixed system of local authority and private sector care-funding options. One option is to use the value in the home to bridge the cost between out-of-pocket costs and care home fees. In this article, we consider two new financial arrangements designed to meet the needs of people in different financial circumstances based on releasing equity from the home. These are an equity-backed insurance product and an “equity bank” that lets a person draw down an income from their hom

Measuring the indirect effect: Voter initiatives and legislative production in the American states

Accepted ManuscriptRecent research has identified important policy differences between voter initiative states and pure representative states despite a lack of enough observable voter initiative campaigns to explain the policy differences. This paper investigates the indirect effects of the voter initiative process on legislative production by estimating the number of bill enacted in the American states. The results indicate that legislators in voter initiative states enact more legislation as the difficulty in qualifying a voter initiative for the ballot decreases, as the legislature is less able to alter the effects of successful voter initiatives, and as the average number of voter initiatives that appear on the ballot increases. These results provide some statistical evidence of the indirect effect of the voter initiative and are consistent with the theory that policy differences in voter initiative states are the result of the indirect effect of the voter initiative process.Randolph, G.M. (2010). Measuring the indirect effect: Voter initiatives and legislative production in the American states. Public Finance Review, 38(6), 762-786

A national survey of the availability of intensity-modulated radiation therapy and stereotactic radiosurgery in Canada

<p>Abstract</p> <p>Background</p> <p>The timely and appropriate adoption of new radiation therapy (RT) technologies is a challenge both in terms of providing of optimal patient care and managing health care resources. Relatively little is known regarding the rate at which new RT technologies are adopted in different jurisdictions, and the barriers to implementation of these technologies.</p> <p>Methods</p> <p>Surveys were sent to all radiation oncology department heads in Canada regarding the availability of RT equipment from 2006 to 2010. Data were collected concerning the availability and use of Intensity Modulated Radiation Therapy (IMRT) and stereotactic radiosurgery (SRS), and the obstacles to implementation of these technologies.</p> <p>Results</p> <p>IMRT was available in 37% of responding centers in 2006, increasing to 87% in 2010. In 2010, 72% of centers reported that IMRT was available for all patients who might benefit, and 37% indicated that they used IMRT for "virtually all" head and neck patients. SRS availability increased from 26% in 2006 to 42.5% in 2010. Eighty-two percent of centers reported that patients had access to SRS either directly or by referral. The main barriers for IMRT implementation included the need to train or hire treatment planning staff, whereas barriers to SRS implementation mostly included the need to purchase and/or upgrade existing planning software and equipment.</p> <p>Conclusions</p> <p>The survey showed a growing adoption of IMRT and SRS in Canada, although the latter was available in less than half of responding centers. Barriers to implementation differed for IMRT compared to SRS. Enhancing human resources is an important consideration in the implementation of new RT technologies, due to the multidisciplinary nature of the planning and treatment process.</p

Overcoming the lack of authentic standards for the quantification of biogenic secondary organic aerosol markers

Liquid chromatography coupled to electrospray ionisation high resolution mass spectrometry is an extremely powerful technique for both targeted and non-targeted analysis of organic aerosol. However, quantification of biogenic secondary organic aerosol species (BSOA) is hindered by a lack of commercially available authentic standards. To overcome the lack of authentic standards, this study proposes a quantification method based on the prediction of relative ionisation efficiency (RIE) factors to correct concentrations obtained via calibration using a proxy standard. RIE measurements of 89 commercially available standards were made relative to cis-pinonic acid and coupled to structural descriptors. A regularised random forest predictive model was developed using the authentic standards (R2 = 0.66, RMSE = 0.59). The model was then used to predict the RIE’s of 87 biogenic organic acid markers from α-pinene, limonene and β-caryophyllene without available authentic standards. The predicted RIE’s ranged from 0.27 to 13.5, with a mean ± standard deviation of 4.2 ± 3.9. 25 markers were structurally identified in chamber samples and ambient aerosol filter samples collected in summertime Beijing. The markers were quantified using a cis-pinonic acid calibration and then corrected using the predicted RIE factors. This resulted in the average BSOA concentration decreasing from 146 ng m−3 to 51 ng m−3, respectively. This change in concentration is highlighted to have an impact on the types of average aerosol metrics commonly used to describe bulk composition. This study is the first of its kind to use predicted ionisation efficiency factors to overcome known differences in BSOA concentrations due to the inherent lack of authentic standards in aerosol chemistry

The retirement experiences of elite female gymnasts: Self identity and the physical self

This study explored experiences of retirement from elite sport among a sample of retired female gymnasts. Given the young age at which female gymnasts begin and end their sport careers, particular attention was afforded to the role of identity and the physical self in the process of adaptation. Retrospective, semi-structured interviews were conducted and interview transcripts analyzed using interpretative phenomenological analysis. Analysis indicated that retirement from gymnastics engendered adjustment difficulties for six of the seven participants. Identity loss was particularly salient, and for two gymnasts, physical changes associated with retirement were a further source of distress. The challenge of athletic retirement was intensified because the gymnasts had heavily invested in sport during adolescence, a period demarcated for the pursuit of an identity. Furthermore, their retirement coincided with a time when adolescents typically undergo profound changes physiologically. Practical suggestions to facilitate athletes' disengagement from sport are discussed

Nonhuman primates across sub-Saharan Africa are infected with the yaws bacterium Treponema pallidum subsp. pertenue

Dear Editor, The bacterium Treponema pallidum (TP) causes human syphilis (subsp. pallidum; TPA), bejel (subsp. endemicum; TEN), and yaws (subsp. pertenue; TPE) (1). Although syphilis has reached a worldwide distribution (2), bejel and yaws have remained endemic diseases. Bejel affects individuals in dry areas of Sahelian Africa and Saudi Arabia, whereas yaws affects those living in the humid tropics (1). Yaws is currently reported as endemic in 14 countries, and an additional 84 countries have a known history of yaws but lack recent epidemiological data (3,4). Although this disease was subject to global eradication efforts in the mid-20th century, it later reemerged in West Africa, Southern Asia, and the Pacific region (5). New large-scale treatment options triggered the ongoing second eradication campaign, the goal of which is to eradicate yaws globally by 2020 (5). References: (1) Giacani, L. & Lukehart, S.A. The endemic treponematoses. Clin. Microbiol. Rev. 27, 89–115 (2014). (2) Arora, N. et al. Origin of modern syphilis and emergence of a pandemic Treponema pallidum cluster. Nat. Microbiol. 2, 16245 (2016). (3) Marks, M. Yaws: towards the WHO eradication target. Trans. R Soc. Trop. Med. Hyg. 110, 319–320 (2016). (4) World Health Organization. Eradication of yaws: procedures for verification and certification of interruption of transmission (World Health Organization, Geneva, 2018). (5) Asiedu, K., Fitzpatrick, C. & Jannin, J. Eradication of yaws: historical efforts and achieving WHO’s 2020 target. PLoS Negl. Trop. Dis. 8, e3016 (2014)

Intraspecies Transmission of BASE Induces Clinical Dullness and Amyotrophic Changes

The disease phenotype of bovine spongiform encephalopathy (BSE) and the molecular/ biological properties of its prion strain, including the host range and the characteristics of BSE-related disorders, have been extensively studied since its discovery in 1986. In recent years, systematic testing of the brains of cattle coming to slaughter resulted in the identification of at least two atypical forms of BSE. These emerging disorders are characterized by novel conformers of the bovine pathological prion protein (PrPTSE), named high-type (BSE-H) and low-type (BSE-L). We recently reported two Italian atypical cases with a PrPTSE type identical to BSE-L, pathologically characterized by PrP amyloid plaques and known as bovine amyloidotic spongiform encephalopathy (BASE). Several lines of evidence suggest that BASE is highly virulent and easily transmissible to a wide host range. Experimental transmission to transgenic mice overexpressing bovine PrP (Tgbov XV) suggested that BASE is caused by a prion strain distinct from the BSE isolate. In the present study, we experimentally infected Friesian and Alpine brown cattle with Italian BSE and BASE isolates via the intracerebral route. BASE-infected cattle developed amyotrophic changes accompanied by mental dullness. The molecular and neuropathological profiles, including PrP deposition pattern, closely matched those observed in the original cases. This study provides clear evidence of BASE as a distinct prion isolate and discloses a novel disease phenotype in cattle

Mechanism of Assembly of the Dimanganese-Tyrosyl Radical Cofactor of Class Ib Ribonucleotide Reductase: Enzymatic Generation of Superoxide Is Required for Tyrosine Oxidation via a Mn(III)Mn(IV) Intermediate

Ribonucleotide reductases (RNRs) utilize radical chemistry to reduce nucleotides to deoxynucleotides in all organisms. In the class Ia and Ib RNRs, this reaction requires a stable tyrosyl radical (Y•) generated by oxidation of a reduced dinuclear metal cluster. The Fe[superscript III][subscript 2]-Y• cofactor in the NrdB subunit of the class Ia RNRs can be generated by self-assembly from Fe[superscript II][subscript 2]-NrdB, O[subscript 2], and a reducing equivalent. By contrast, the structurally homologous class Ib enzymes require a Mn[superscript III][subscript 2]-Y• cofactor in their NrdF subunit. Mn[superscript II][subscript 2]-NrdF does not react with O[subscript 2], but it binds the reduced form of a conserved flavodoxin-like protein, NrdI[subscript hq], which, in the presence of O[subscript 2], reacts to form the Mn[superscript III][subscript 2]-Y• cofactor. Here we investigate the mechanism of assembly of the Mn[superscript III][subscript 2]-Y• cofactor in Bacillus subtilis NrdF. Cluster assembly from Mn[superscript II][subscript 2]-NrdF, NrdI[subscript hq], and O[subscript 2] has been studied by stopped flow absorption and rapid freeze quench EPR spectroscopies. The results support a mechanism in which NrdI[subscript hq] reduces O[subscript 2] to O[subscript 2]•– (40–48 s[superscript –1], 0.6 mM O[subscript 2]), the O[subscript 2]•– channels to and reacts with Mn[superscript II][subscript 2]-NrdF to form a Mn[superscript III]Mn[superscript IV] intermediate (2.2 ± 0.4 s[superscript –1]), and the Mn[superscript III]Mn[superscript IV] species oxidizes tyrosine to Y• (0.08–0.15 s[superscript –1]). Controlled production of O[subscript 2]•– by NrdI[subscript hq] during class Ib RNR cofactor assembly both circumvents the unreactivity of the Mn[superscript II][subscript 2] cluster with O[subscript 2] and satisfies the requirement for an “extra” reducing equivalent in Y• generation.National Institutes of Health (U.S.) (Grant GM81393)United States. Dept. of Defense (National Defense Science and Engineering Graduate (NDSEG) Fellowships