Estimating the additional costs of living with a disability in the United Kingdom between 2013 and 2016

In the United Kingdom, more than 20% of the population live with a disability. Past evidence shows that being disabled is associated with functional limitations that often cause social exclusion and poverty. Therefore, it is necessary to analyse the connection between disability and poverty. This paper examines whether households with disabled members face extra costs of living to attain the same standard of living as their peers without disabled members. The modelling framework is based on the standard of living approach which estimates the extra income required to close the gap between households with and without disabled members. We apply an ordered logit regression to data from the Family Resources Survey between 2013 and 2016 to analyse the relationship between standard of living, income, and disability, conditional on other explanatory variables. We find that households with disabled members face considerable extra costs that go beyond the transfer payment of the government. The average household with disabled members saw their weekly extra costs continually increase from £293 in 2013 to £326 in 2016 [2020 prices]. Therefore, the government needs to adjust welfare policies to address the problem of extra costs faced by households with disabled members

Effect of water nanoconfinement on the dynamic properties of paramagnetic colloidal complexes

The anomalous behavior of confined water at the nanoscale has remarkable implications in a number of nanotechnological applications. In this work, we analyze the effect of water self-diffusion on the dynamic properties of a solvated gadolinium-based paramagnetic complex, typically used for contrast enhancement in magnetic resonance imaging. In particular, we examine the effect of silica-based nanostructures on water behavior in the proximity of the paramagnetic complex via atomistic simulations, and interpret the resulting tumbling dynamics in the light of the local solvent modification based on the Lipari-Szabo formalism and of the fractional Stokes-Einstein relation. It is found that the local water confinement induces an increased "stiffness" on the outer sphere of the paramagnetic complex, which eventually reduces its tumbling properties. These model predictions are found to explain well the relaxivity enhancement observed experimentally by confining paramagnetic complexes into porous nanoconstructs, and thus offer mechanistic guidelines to design improved contrast agents for imaging applications

Analysing changes to the flow of public funding within local health and care systems: An adaptation of the System of Health Accounts framework to a local health system in England

Financial flows relating to health care are routinely analysed at national and international level. They have rarely been systematically analysed at local level, despite sub-national variation due to population needs and decisions enacted by local organisations. We illustrate an adaptation of the System of Health Accounts framework to map the flow of public health and care funding within local systems, with an application for Greater Manchester (GM), an area in England which agreed a health and social care devolution deal with the central government in 2016. We analyse how financial flows changed in GM during the four years post-devolution, and whether spending was aligned with local ambitions to move towards prevention of ill-health and integration of health and social care. We find that GM decreased spending on public health by 15%, and increased spending on general practice by 0.1% in real terms. The share of total local expenditure paid to NHS Trusts for general and acute services increased from 70.3% to 71.6%, while that for community services decreased from 11.7% to 10.3%. Results suggest that GM may have experienced challenges in redirecting resources towards their goals. Mapping financial flows at a local level is a useful exercise to examine whether spending is aligned with system goals and highlight areas for further investigation

The relative effects of non-pharmaceutical interventions on wave one Covid-19 mortality: natural experiment in 130 countries

Background: Non-pharmaceutical interventions have been implemented around the world to control Covid-19 transmission. Their general effect on reducing virus transmission is proven, but they can also be negative to mental health and economies, and transmission behaviours can also change voluntarily, without mandated interventions. Their relative impact on Covid-19 attributed mortality, enabling policy selection for maximal benefit with minimal disruption, is not well established due to a lack of definitive methods. Methods: We examined variations in timing and strictness of nine non-pharmaceutical interventions implemented in 130 countries and recorded by the Oxford COVID-19 Government Response Tracker (OxCGRT): 1) School closing; 2) Workplace closing; 3) Cancelled public events; 4) Restrictions on gatherings; 5) Closing public transport; 6) Stay at home requirements (‘Lockdown’); 7) Restrictions on internal movement; 8) International travel controls; 9) Public information campaigns. We used two time periods in the first wave of Covid-19, chosen to limit reverse causality, and fixed country policies to those implemented: i) prior to first Covid-19 death (when policymakers could not possibly be reacting to deaths in their own country); and, ii) 14-days-post first Covid-19 death (when deaths were still low, so reactive policymaking still likely to be minimal). We then examined associations with daily deaths per million in each subsequent 24-day period, which could only be affected by the intervention period, using linear and non-linear multivariable regression models. This method, therefore, exploited the known biological lag between virus transmission (which is what the policies can affect) and mortality for statistical inference. Results: After adjusting, earlier and stricter school (− 1.23 daily deaths per million, 95% CI − 2.20 to − 0.27) and workplace closures (− 0.26, 95% CI − 0.46 to − 0.05) were associated with lower Covid-19 mortality rates. Other interventions were not significantly associated with differences in mortality rates across countries. Findings were robust across multiple statistical approaches. Conclusions: Focusing on ‘compulsory’, particularly school closing, not ‘voluntary’ reduction of social interactions with mandated interventions appears to have been the most effective strategy to mitigate early, wave one, Covid-19 mortality. Within ‘compulsory’ settings, such as schools and workplaces, less damaging interventions than closing might also be considered in future waves/epidemics

Techno-economic analysis of a solar thermal plant for large-scale water pasteurization

Water pasteurization has the potential to overcome some of the drawbacks of more conventional disinfection techniques such as chlorination, ozonation and ultraviolet radiation treatment. However, the high throughput of community water systems requires energy-intensive processes, and renewable energy sources have the potential to improve the sustainability of water pasteurization plants. In case of water pasteurization by solar thermal treatment, the continuity of operation is limited by the intermittent availability of the solar irradiance. Here we show that this problem can be addressed by a proper design of the plant layout, which includes a thermal energy storage system and an auxiliary gas boiler. Based on a target pasteurization protocol validated by experiments, a complete lumped-component model of the plant is developed and used to determine the operating parameters and size of the components for a given delivery flow rate. Finally, we report an economic analysis of the proposed plant layout, which allows its optimization for different scenarios based on two design variables, namely the solar multiple and the duration of the thermal energy storage. Based on the analyzed cases, it is found that the proposed plant layouts may yield a unit cost of water treatment ranging from ≈32 EUR-cents m-3 to ≈25 EUR-cents m-3

Techno-economic analysis of a solar thermal plant for large-scale water pasteurization

Water pasteurization has the potential to overcome some of the drawbacks of more conventional disinfection techniques such as chlorination, ozonation and ultraviolet radiation treatment. However, the high throughput of community water systems requires energy-intensive processes, and renewable energy sources have the potential to improve the sustainability of water pasteurization plants. In case of water pasteurization by solar thermal treatment, the continuity of operation is limited by the intermittent availability of the solar irradiance. Here we show that this problem can be addressed by a proper design of the plant layout, which includes a thermal energy storage system and an auxiliary gas boiler. Based on a target pasteurization protocol validated by experiments, a complete lumped-component model of the plant is developed and used to determine the operating parameters and size of the components for a given delivery flow rate. Finally, we report an economic analysis of the proposed plant layout, which allows its optimization for different scenarios based on two design variables, namely the solar multiple and the duration of the thermal energy storage. Based on the analyzed cases, it is found that the proposed plant layouts may yield a unit cost of water treatment ranging from ≈32 EUR-cents m−3 to ≈25 EUR-cents m−3

Deep-sea reverse osmosis desalination for energy efficient low salinity enhanced oil recovery

The decrease in the oil discoveries fuels the development of innovative and more efficient extraction processes. It has been demonstrated that Enhanced Oil Recovery (EOR, or tertiary recovery technique) offers prospects for producing 30 to 60% of the oil originally trapped in the reservoir. Interestingly, oil extraction is significantly enhanced by the injection of low salinity water into oilfields, which is known as one of the EOR techniques. Surface Reverse Osmosis (SRO) plants have been adopted to provide the large and continuous amount of low salinity water for this EOR technique, especially in offshore sites. In this article, we outline an original solution for producing low salinity water for offshore EOR processes, and we demonstrate its energy convenience. In fact, the installation of reverse osmosis plants under the sea level (Deep-Sea Reverse Osmosis, DSRO) is found to have significant potential energy savings (up to 50%) with respect to traditional SRO ones. This convenience mainly arises from the non-ideality of reverse osmosis membranes and hydraulic machines, and it is especially evident - from both energy and technological point of view - when the permeate is kept pressurized at the outlet of the reverse osmosis elements. In perspective, DSRO may be a good alternative to improve the sustainability of low salinity EOR

The role of care home fees in the public costs and distributional effects of potential reforms to care home funding for older people in England

In England, Local Authorities (LAs) contribute to the care home fees of two-thirds of care home residents aged 65+ who pass a means test. LAs typically pay fees below those faced by residents excluded from state support. Most proposals for reform of the means test would increase the proportion of residents entitled to state support. If care homes receive the LA fee for more residents, they might increase fees for any remaining self-funders. Alternatively, the LA fee might have to rise. We use two linked simulation models to examine how alternative assumptions on post-reform fees affect projected public costs and financial gains to residents of three potential reforms to the means test. Raising the LA fee rate to maintain income per resident would increase the projected public cost of the reforms by between 22% and 72% in the base year. It would reduce the average gain to care home residents by between 8% and 12%. Raising post-reform fees for remaining self-funders or requiring pre-reform self-funders to meet the difference between the LA and self-funder fees, reduces the gains to residents by 28-37%. For one reform, residents in the highest income quintile would face losses if the self-funder fee rises. © 2012 Cambridge University Press

The relative effects of non-pharmaceutical interventions on wave one Covid-19 mortality: natural experiment in 130 countries

Background Non-pharmaceutical interventions have been implemented around the world to control Covid-19 transmission. Their general effect on reducing virus transmission is proven, but they can also be negative to mental health and economies, and transmission behaviours can also change voluntarily, without mandated interventions. Their relative impact on Covid-19 attributed mortality, enabling policy selection for maximal benefit with minimal disruption, is not well established due to a lack of definitive methods. Methods We examined variations in timing and strictness of nine non-pharmaceutical interventions implemented in 130 countries and recorded by the Oxford COVID-19 Government Response Tracker (OxCGRT): 1) School closing; 2) Workplace closing; 3) Cancelled public events; 4) Restrictions on gatherings; 5) Closing public transport; 6) Stay at home requirements (‘Lockdown’); 7) Restrictions on internal movement; 8) International travel controls; 9) Public information campaigns. We used two time periods in the first wave of Covid-19, chosen to limit reverse causality, and fixed country policies to those implemented: i) prior to first Covid-19 death (when policymakers could not possibly be reacting to deaths in their own country); and, ii) 14-days-post first Covid-19 death (when deaths were still low, so reactive policymaking still likely to be minimal). We then examined associations with daily deaths per million in each subsequent 24-day period, which could only be affected by the intervention period, using linear and non-linear multivariable regression models. This method, therefore, exploited the known biological lag between virus transmission (which is what the policies can affect) and mortality for statistical inference. Results After adjusting, earlier and stricter school (− 1.23 daily deaths per million, 95% CI − 2.20 to − 0.27) and workplace closures (− 0.26, 95% CI − 0.46 to − 0.05) were associated with lower Covid-19 mortality rates. Other interventions were not significantly associated with differences in mortality rates across countries. Findings were robust across multiple statistical approaches. Conclusions Focusing on ‘compulsory’, particularly school closing, not ‘voluntary’ reduction of social interactions with mandated interventions appears to have been the most effective strategy to mitigate early, wave one, Covid-19 mortality. Within ‘compulsory’ settings, such as schools and workplaces, less damaging interventions than closing might also be considered in future waves/epidemics

po 237 the pro oncogenic transcription factor stat3 regulates ca2 release and apoptosis from the endoplasmic reticulum via interaction with the ca2 channel ip3r3

Introduction Signal Transducer and Activator of Transcription (STAT) 3 is an oncogenic transcription factor found constitutively activated in several tumours, where it exerts its functions both as a canonical transcription factor and as a non-canonical regulator of energy metabolism and mitochondrial functions. These two activities rely on different post-translational activating events; the phosphorylation on Y705 is involved in nuclear activities, while that on S727 is relevant for mitochondrial functions. Mitochondrial STAT3 increases aerobic glycolysis and decreases ROS production, partly by interacting with the Electron Transfer Complexes (ETC). Material and methods By means of cell fractionations, we tested STAT3 localization to the Endoplasmic Reticulum (ER) in breast cancer cell lines dependent or not on STAT3 activity. We then measured Ca2+ release and apoptotic response in the same cells. The physical interaction between inositol 1,4,5-trisphosphate receptor type 3 (IP3R3) and STAT3 was demonstrated by co-IP either of the endogenous proteins or of their truncated/mutated forms, while STAT3 role in the degradation of IP3R3 was tested by serum starvation and refeeding experiments, followed by WB. Results and discussions We describe here the previously undetected abundant localization of STAT3 also to the ER. In this cellular compartment IP3R3, a Ca2+ channel that allows Ca2+ release from the ER and the mitochondrial associated membranes (MAMs) in response to IP3, regulates the balance between mitochondrial activation and Ca2+-triggered apoptosis. We observed that STAT3 within the ER physically interacts with IP3R3 and, via its phosphorylation on S727, it down-regulates Ca2+ release and apoptosis. Indeed, STAT3 silencing enhances both ER Ca2+ release and sensitivity to apoptosis following oxidative stress in STAT3-dependent mammary tumour cells, correlating with increased IP3R3 levels. In line with this, basal-like breast tumours, which frequently display constitutively active STAT3, show an inverse correlation between IP3R3 and STAT3 protein levels. Conclusion Our results indicate that S727-phosphorylated STAT3 contribute to mammary tumour aggressiveness, also by localising to the ER and regulating Ca2+ fluxes. STAT3-mediated enhanced IP3R3 degradation leads to decreased Ca2+ release and thus to resistance to apoptosis. This new non-canonical STAT3 role appears to be particularly relevant in basal-like breast cancers, adding a new mechanisms through which STAT3 exerts its well established pro-oncogenic anti-apoptotic role