Trends in survival of older care home residents in England: a 10-year multi-cohort study

Increases in longevity combined with a policy emphasis on caring for older people in their own homes could have widened or narrowed the survival gap between care home and community-dwelling resident older people. Knowledge of pre-Covid-19 trends in this gap is needed to assess the longer-term impacts of the pandemic. We provide evidence for England on recent trends in 1, 2 and 3-year mortality amongst care home residents aged 65+ compared with similar community-dwelling residents. We use the Clinical Practice Research Datalink, a nationally representative primary care database. For each of the ten years from 2006 to 2015, care home and community-dwelling residents aged 65+ were identified and matched in the ratio 1:3, according to age, gender, area deprivation and region. Cox survival analyses were used to estimate mortality risks for care home residents in comparison with similar community-dwelling people, adjusting for age, gender, area deprivation and region. The study sample consisted of ten overlapping cohorts averaging 5,495 care home residents per cohort. Adjusted mortality risks increased over the study period for care home residents while decreasing slightly for matched community-dwelling residents. The relative risks (RRs) of mortality associated with care home residence were higher for younger ages and shorter follow-up periods, in all years. Over the decade, the RRs increased, most at younger ages and for shorter follow-up periods (e.g. for the age group 65–74 years, 1-year average RR increased by 61% from 5.4 to 8.8, while for those aged 85-94 years and over, 3-year RR increased by 22% from 1.3 to 1.6). Thus the survival gap between older care home and community-dwelling residents has been widening, especially at younger ages. In due course, it will be possible to establish to what extent the Covid-19 pandemic has resulted in further growth in this gap

Interactions between state pension and long-term care reforms: an overview

In April 2016 major reforms to state pensions and long-term care will be implemented in Great Britain and England respectively. Their combined effects have received little attention despite interactions between the two systems. The long-term effects of both sets of reforms will depend on how details of the systems are set in the intervening years, and on how policies in other parts of the welfare system evolve. We will investigate the long-term impacts of alternative ways in which current pensions and long-term care financing reforms may evolve over the next 40 years to ensure that that there is widespread appreciation of the implications of any changes which may have significant long-term effects

Care and State Pension Reform - Interactions between state and pension long-term care reforms: a summary of findings

In April 2016 major reforms to state pensions were implemented in Great Britain. Reforms to the English long-term care financing system were also to be introduced in 2016 but have been postponed until 2020. The state pension reforms replace the existing two-tier state pension system with a single tier pension set just above the minimum income guaranteed through means-tested benefits. It affects only people reaching State Pension age from April 2016. The long-term care reforms introduce a cap on lifetime liability for care costs. To reach the cap, people will need to have eligible care needs for a considerable period, typically at least three years. The primary objective of the state pension reforms is to provide a clearer foundation for private pension saving and reduce reliance on means-tested benefits in retirement by setting the level of the new State Pension (nSP) above the level of the minimum income guaranteed by the means-tested benefit Pension Credit. The long-term care reforms introduce a lifetime limit on individual liability for care costs to provide protection against the risk that care costs could use up nearly all of an individual’s savings. The long-term effects of both sets of reforms will depend on how details of the systems are set in the intervening years, and in particular how components of the systems are adjusted each year – ‘uprated’ – for inflation. This report summarises the findings from a research project which aims to promote informed debate on how the reforms could evolve, highlighting the interactions between the two systems. Amongst other things, the study has analysed the impact of the reforms to 2030 under uprating assumptions consistent with current policy and under alternative uprating assumptions. A separate more detailed Technical Report of the analysis is available

Development of Peptide Targeted PLGA-PEGylated Nanoparticles Loading Licochalcone-A for Ocular Inflammation

Licochalcone-A is a natural compound with anti-inflammatory properties. However, it possesses low water solubility, making its application for the treatment of ocular inflammation difficult. To overcome this drawback, biodegradable nanoparticles incorporating Licochalcone-A have been developed. Additionally, to avoid fast clearance and increase cellular internalization into the ocular tissues, PLGA nanoparticles have been functionalized using PEG and cell penetrating peptides (Tet-1 and B6). To optimize the formulations, a factorial design was carried out and short-term stability of the nanoparticles was studied. Moreover, morphology was also observed by transmission electron microcopy and in vitro drug release was carried out. Ocular tolerance of the formulations was ensured in vitro and in vivo and anti-inflammatory therapeutic efficacy was also assessed. Surface functionalized nanoparticles loading Licochalcone-A were developed with an average size below 200 nm, a positive surface charge, and a monodisperse population. The formulations were non-irritant and showed a prolonged Licochalcone-A release. Despite the fact that both Licochalcone-A Tet-1 and B6 functionalized nanoparticles demonstrated to be suitable for the treatment of ocular inflammation, B6 targeted nanoparticles provided greater therapeutic efficacy in in vivo assays. Keywords: Licochalcone-A; nanoparticles; ocular inflammation; cell-penetrating peptides; PLG

A monoclonal antibody that specifically recognizes m6A nucleoside

A hybridoma against the nucleoside m6A has been obtained from mouse spleen. This hybridoma was named H65 and it secretes monoclonal antibodies anti-m6A. The competition assays showed that the monoclonal antibody was highly specific for m6A nucleoside.This work was supported by PGC grant no PB92-0004. C. Codony was recipient of a fellowship from PGC.Peer Reviewe

A second-step splicing activity is conserved from yeast to human

We describe a defective HeLa nuclear extract which is particularly deficient in step 2 of splicing reaction. With this extract we have studied the conservation of a second-step activity from yeast to human cells. We detected a S. cerevisiae second-step splicing activity that allows restoration of step 2 of the defective HeLa nuclear extract, which indicates that yeast purified fraction has a second-step activity that is conserved from yeast to human cells. The activity is a yeast UsnRNP protein(s) since it is purified with anti-tri-methylguanosine by immunoaffinity columns.This work was supported by PGC Grant No. PB92-0004 and an Alexander von Humboldt Foundation grant. C. Codony was the recipient of a fellowship from PGC; R.B. Cicarelli was the recipient from a fellowship from CAPES and Spanish MEC; A. Khaouja was the recipient of a fellowship from the Moroccan government.Peer Reviewe

The impact of postponement of reforms to long-term care financing in England

The delay in the introduction of a lifetime cap on spending on long-term care will result in single and widowed homeowners with modest incomes who need care now or in the near future having to use up twice as much of their capital to pay for their care

Antibodies to yeast Sm motif 1 cross-react with human Sm core polypeptides

Two regions common to all UsnRNP core polypeptides have been described: Sm motif 1 and Sm motif 2. Rabbits were immunized with a 22 amino-acid peptide containing one segment of Sm motif 1 (YRGTLVSTDNYFNLQL-NEAEEF, corresponding to residues 11-32) from yeast F protein. After immunization, the rabbit sera contained antibodies that not only reacted specifically with the peptide from yeast F protein but also cross-reacted with Sm polypeptides from mammals; that is, with purified human U I snRNPs. The results suggest that the peptide used and human Sm polypeptides contain a common feature recognized by the polyclonal antibodies. A large collection of human systemic lupus erythematosus sera was assayed using the yeast peptide as an antigen source. Seventy per cent of systemic lupus erythematosus sera contain an antibody specificity that cross-reacts with the yeast peptide.his work was supported by PGC grant no. PB92-0004 and PETRI no. 94-0186. R.B. Cicarelli was the recipient of a fellowship from CAPES and Spanish MEC; D. Bahia was the recipient first of a MUTIS fellowship and later of a CNPq fellowship. A. Khaouja was recipient of a fellowship from the Moroccan government. We also thank Martí Cullell for revising this manuscript.Peer Reviewe