Wellbeing at the edges of ownership

The test of a well-functioning housing system is the wellbeing of its occupants. It may therefore seem encouraging that in jurisdictions dominated by mortgage-backed home ownership, owner-occupiers traditionally report better physical and mental health than renters. During the 2000s, however, in an era of financial crisis, wellbeing at the edges of ownership came under strain. Using data from two national panel surveys – the survey of Household, Income and Labour Dynamics in Australia, and the British Household Panel Survey (with its successor, Understanding Society) – we track the wellbeing of households who sustained one or more spells of home ownership in the decade to 2010. We estimate log-log regression models of mental wellbeing for each country, documenting (with an appropriate range of controls) the effects of both tenure transitions (between ownership and renting) and some associated financial transactions (anchored on mortgage debt). We find: a wellbeing premium associated with outright ownership and a debt-effect among mortgagors; a wellbeing deficit among those who drop out of owner-occupation, with partial recovery where exit is enduring; and for leavers especially, a wellbeing cost to equity borrowing. Cross-national differences have an institutional explanation, but similarities relating to the character and regulation of mortgage markets are more striking.This work was supported by the Australian Housing and Urban Research Institute (AHURI) under grant number 53011. The HILDA project was funded by the Australian Government Department of Social Services (DSS)

Altered Patterns of Fungal Keratitis at a London Ophthalmic Referral Hospital: An Eight-Year Retrospective Observational Study

PURPOSE: In previous studies of fungal keratitis (FK) from temperate countries, yeasts were the predominant isolates, with ocular surface disease (OSD) being the leading risk factor. Since the 2005–2006 outbreak of contact lens (CL)-associated Fusarium keratitis, there may have been a rise in CL-associated filamentary FK in the United Kingdom. This retrospective case series investigated the patterns of FK from 2007 to 2014. We compared these to 1994–2006 data from the same hospital. DESIGN: Retrospective observational study. METHODS: All cases of FK presenting to Moorfields Eye Hospital between 2007 and 2014 were identified. The definition of FK was either a fungal organism isolated by culture or fungal structures identified by light microscopy (LM) of scrape material, histopathology, or in vivo corneal confocal microscopy (IVCM). Main outcome measure was cases of FK per year. RESULTS: A total of 112 patients had confirmed FK. Median age was 47.2 years. Between 2007 and 2014, there was an increase in annual numbers of FK (Poisson regression, P [ .0001). FK was confirmed using various modalities: 79 (70.5%) by positive culture, 16 (14.3%) by LM, and 61 (54.5%) by IVCM. Seventy-eight patients (69.6%) were diagnosed with filamentary fungus alone, 28 (25%) with yeast alone, and 6 (5.4%) with mixed filamentary and yeast infections. This represents an increase in the proportion of filamentary fungal infections from the pre-2007 data. Filamentary fungal and yeast infections were associated with CL use and OSD, respectively. CONCLUSIONS: The number of FK cases has increased. This increase is due to CL-associated filamentary FK. Clinicians should be aware of these changes, which warrant epidemiologic investigations to identify modifiable risk factors

An investigation of minimisation criteria

Minimisation can be used within treatment trials to ensure that prognostic factors are evenly distributed between treatment groups. The technique is relatively straightforward to apply but does require running tallies of patient recruitments to be made and some simple calculations to be performed prior to each allocation. As computing facilities have become more widely available, minimisation has become a more feasible option for many. Although the technique has increased in popularity, the mode of application is often poorly reported and the choice of input parameters not justified in any logical way

Patient and public involvement in primary care research - an example of ensuring its sustainability

Background The international literature on patient and public involvement (PPI) in research covers a wide range of issues, including active lay involvement throughout the research cycle; roles that patients/public can play; assessing impact of PPI and recommendations for good PPI practice. One area of investigation that is less developed is the sustainability and impact of PPI beyond involvement in time-limited research projects. Methods This paper focuses on the issues of sustainability, the importance of institutional leadership and the creation of a robust infrastructure in order to achieve long-term and wide-ranging PPI in research strategy and programmes. Results We use the case of a Primary Care Research Centre to provide a historical account of the evolution of PPI in the Centre and identified a number of key conceptual issues regarding infrastructure, resource allocation, working methods, roles and relationships. Conclusions The paper concludes about the more general applicability of the Centre’s model for the long-term sustainability of PPI in research

Life on the edge: A perspective on precarious home ownership in Australia and the UK

This paper focuses on two countries with debt-funded ownership-centred housing systems, Australia and the UK. Financially, there are similarities between these two societies, which have relatively ‘complete’, reasonably well-regulated mortgage markets, had limited exposure to the extremes of subprime, and have been pre-occupied with (and reasonably successful in) restoring ‘business as usual’ in housing and mortgage markets. Institutionally, however, the countries differ from each other, notably with respect to the size and function of the rented sectors. By modelling matched datasets from panel surveys in Australia and the UK, this paper considers how home-buying households in these financially similar, institutionally distinct, countries coped with the ups and downs of housing and mortgage markets in the first decade of the millennium. To address this, we focus on the edges of ownership: that once-stark boundary between owning and renting whose character is often taken for granted, yet which contains important signals about the functioning of housing systems, their link to the wider economy and the well-being of home occupiers. The analysis considers in hitherto unprecedented empirical detail how, why, when, for whom and in what way the edges of ownership proved precarious in the decade to 2010.This work was supported by the Australian Housing and Urban Research Institute (AHURI) under grant number 53011. The paper uses unit record data from the Household, Income and Labour Dynamics in Australia (HILDA) Survey, the British Household Panel Survey (BHPS) and Understanding Society. The HILDA project was initiated and is funded by the Australian Government Department of Social Services (DSS) and is managed by the Melbourne Institute of Applied and Economic and Social Research (MIAESR). The BHPS was originally collected by the ESRC Research Centre on Micro-social Change at the University of Essex and Understanding Society is collected by the Institute of Social and Economic Research at the University of Essex. The findings and views reported in this paper are those of the authors and should not be attributed to AHURI, DSS, MIAESR or the University of Essex

Connected healthcare: Improving patient care using digital health technologies

Now more than ever, traditional healthcare models are being overhauled with digital technologies of Healthcare 4.0 being increasingly adopted. Worldwide, digital devices are improving every stage of the patient care pathway. For one, sensors are being used to monitor patient metrics 24/7, permitting swift diagnosis and interventions. At the treatment stage, 3D printers are currently being investigated for the concept of personalised medicine by allowing patients access to on-demand, customisable therapeutics. Robots are also being explored for treatment, by empowering precision surgery or targeted drug delivery. Within medical logistics, drones are being leveraged to deliver critical treatments to remote areas, collect samples, and even provide emergency aid. To enable seamless integration within healthcare, the Internet of Things technology is being exploited to form closed-loop systems that remotely communicate with one another. This review outlines the most promising healthcare technologies and devices, their strengths, drawbacks, and scopes for clinical adoption

Impact of the growing healthy mhealth program on maternal feeding practices, infant food preferences, and satiety responsiveness: Quasi-experimental study

© Catherine Georgina Russell, Elizabeth Denney-Wilson, Rachel A Laws, Gavin Abbott, Miaobing Zheng, Sharyn J Lymer, Sarah Taki, Eloise-Kate V Litterbach, Kok-Leong Ong, Karen J Campbell. Background: Infancy is an important life stage for obesity prevention efforts. Parents’ infant feeding practices influence the development of infants’ food preferences and eating behaviors and subsequently diet and weight. Mobile health (mHealth) may provide a feasible medium through which to deliver programs to promote healthy infant feeding as it allows low cost and easy access to tailored content. Objective: The objective of this study was to describe the effects of an mHealth intervention on parental feeding practices, infant food preferences, and infant satiety responsiveness. Methods: A quasi-experimental study was conducted with an mHealth intervention group (Growing Healthy) and a nonrandomized comparison group (“Baby's First Food"). The intervention group received access to a free app with age-appropriate push notifications, a website, and an online forum that provided them with evidence-based advice on infant feeding for healthy growth from birth until 9 months of age. Behavior change techniques were selected using the Behaviour Change Wheel framework. Participants in both groups completed three Web-based surveys, first when their infants were less than 3 months old (baseline, T1), then at 6 months (time 2, T2), and 9 months of age (time 3, T3). Surveys included questions on infant feeding practices and beliefs (Infant Feeding Questionnaire, IFQ), satiety responsiveness (Baby Eating Behaviour Questionnaire), and infant’s food exposure and liking. Multivariate linear regression models, estimated using maximum likelihood with bootstrapped standard errors, were fitted to compare continuous outcomes between the intervention groups, with adjustment for relevant covariates. Multivariate logistic regression adjusting for the same covariates was performed for categorical outcomes. Results: A total of 645 parents (Growing Healthy: n=301, Baby's First Food: n=344) met the eligibility criteria and were included in the study, reducing to a sample size of 546 (Growing Healthy: n=234, Baby's First Food: n=312) at T2 and a sample size of 518 (Growing Healthy: n=225, Baby's First Food: n=293) at T3. There were approximately equal numbers of boy and girl infants, and infants were aged less than 3 months at baseline (Growing Healthy: mean 7.0, SD 3.7 weeks; Baby's First Food: mean 7.9, SD 3.8 weeks), with Growing Healthy infants being slightly younger than Baby's First Food infants (P=.001). All but one (IFQ subscale “concerns about infant overeating or becoming overweight” at T2) of the measured outcomes did not differ between Growing Healthy and Baby's First Food. Conclusions: Although mHealth can be effective in promoting some health behaviors and offers many advantages in health promotion, the results of this study suggest that design and delivery characteristics needed to maximize the impact of mHealth interventions on infant feeding are uncertain. The sensitivity of available measurement tools and differences in baseline characteristics of participants may have also affected the results

Pro-inflammatory cytokines play a key role in the development of radiotherapy-induced gastrointestinal mucositis

Background: Mucositis is a toxic side effect of anti-cancer treatments and is a major focus in cancer research. Pro-inflammatory cytokines have previously been implicated in the pathophysiology of chemotherapy-induced gastrointestinal mucositis. However, whether they play a key role in the development of radiotherapy-induced gastrointestinal mucositis is still unknown. Therefore, the aim of the present study was to characterise the expression of pro-inflammatory cytokines in the gastrointestinal tract using a rat model of fractionated radiotherapy-induced toxicity. Methods: Thirty six female Dark Agouti rats were randomly assigned into groups and received 2.5 Gys abdominal radiotherapy three times a week over six weeks. Real time PCR was conducted to determine the relative change in mRNA expression of pro-inflammatory cytokines IL-1β, IL-6 and TNF in the jejunum and colon. Protein expression of IL-1β, IL-6 and TNF in the intestinal epithelium was investigated using qualitative immunohistochemistry. Results: Radiotherapy-induced sub-acute damage was associated with significantly upregulated IL-1β, IL-6 and TNF mRNA levels in the jejunum and colon. The majority of pro-inflammatory cytokine protein expression in the jejunum and colon exhibited minimal change following fractionated radiotherapy. Conclusions: Pro-inflammatory cytokines play a key role in radiotherapy-induced gastrointestinal mucositis in the sub-acute onset setting.Zhi Yi Ong, Rachel J. Gibson, Joanne M. Bowen, Andrea M. Stringer, Jocelyn M. Darby, Richard M. Logan, Ann S.J. Yeoh, Dorothy M. Keef

Biodegradable zinc-containing mesoporous silica nanoparticles for cancer therapy

Triple-negative breast cancers are extremely aggressive with limited treatment options because of the reduced response of the cancerous cells to hormonal therapy. Here, monodispersed zinc-containing mesoporous silica nanoparticles (MSNPs-Zn) were produced as a tuneable biodegradable platform for delivery of therapeutic zinc ions into cells. We demonstrate that the nanoparticles were internalized by cells, and a therapeutic dose window was identified in which the MSNPs-Zn were toxic to breast cancer cells but not to healthy epithelial (MCF-10a) cells or to murine macrophages. A significant reduction in the viability of triple negative MDA-MB-231 and MCF-7 (ER+) breast cancer cells was seen following 24 h exposure to MSNPs-Zn. The more aggressive MDA-MB-231 cells, with higher metastatic potential, were more sensitive to MSNPs-Zn than the MCF-7 cells. MSNPs-Zn underwent biodegradation inside the cells, becoming hollow structures, as imaged by high-resolution transmission electron microscopy. The mesoporous silica nanoparticles provide a biodegradable vehicle for therapeutic ion release inside cells