Mental and general health at the edges of owner occupation

Purpose The purpose of this paper is to consider one test of a well-functioning housing system – its impact on wellbeing. Exploring one indicator of this, this study aims to track changes in mental and general health across a mix of tenure transitions and financial transactions in three jurisdictions: Australia, the UK and the USA. Design/methodology/approach Using matched variables from three national panel surveys (Household, Income and Labour Dynamics in Australia, British Household Panel Survey/Understanding Society and Panel Study of Income Dynamics) over 17 years (2000–2017) to capture the sweep of the most recent housing cycle, this study adopts a difference-in-difference random-effects model specification to estimate the mental and general health effects of tenure change and borrowing behaviours. Findings There is an enduring health premium associated with unmortgaged owner-occupation. Mortgage debt detracts from this, as does the prospect of dropping out of ownership and into renting. A previously observed post-exit recovery in mental health – a debt-relief effect – is not present in the longer run. In fact, in some circumstances, both mental and general health deficits are amplified, even among those who eventually regain homeownership. Though there are cross-country differences, the similarities across these financialised housing systems are more striking. Practical implications The well-being premium traditionally associated with owner occupation is under threat at the edges of the sector in all three jurisdictions. In this, there is cross-national convergence. There may therefore be scope to introduce policies to better support households at the edges of ownership that work across the board for debt-funded ownership-centred housing systems. Originality/value This paper extends the duration of a previous analysis of the impact of tenure transitions and financial transactions on well-being at the edges of ownership in the UK and Australia. The authors now track households over nearly two decades from the start of the millennium into a lengthy (post-global financial crisis) era of declining housing affordability. This study adds to the reach of the earlier study by adding a general health variable and a third jurisdiction, the USA

Rainfall variability and internal migration: the importance of agriculture linkage and gender inequality

This paper investigates the extent to which exposure to climate volatility can in-fluence individual migration decisions in Vietnam, based on the historical rainfall data from 70 weather stations in Vietnam and the Vietnam Access to Resources House-hold Survey. Utilizing the exogenous variation in the rainfall deviation from the local norms within an individual fixed-effects framework, we uncover the negative associa-tion between rainfall and the probability of individual migration. Individual migration probability drops by 7.5 percentage points when the amount of rainfall relative to the long-run local average doubles. This reduction could potentially be driven by individ-uals who work in the agricultural sector and are less likely to migrate as more rainfall could increase their agricultural incomes. Furthermore, our heterogeneity analyses sug-gest that rainfall shocks could perpetuate gender inequality in Vietnam since women cannot cope with climatic shocks through migration. Policy-makers could shift their focus on flood control and water management in affected areas, where people’s liveli-hoods depend on agriculture, to efficiently address issues related to climate-induced internal migration

Safety and efficacy of fluoxetine on functional outcome after acute stroke (AFFINITY): a randomised, double-blind, placebo-controlled trial

Background Trials of fluoxetine for recovery after stroke report conflicting results. The Assessment oF FluoxetINe In sTroke recoverY (AFFINITY) trial aimed to show if daily oral fluoxetine for 6 months after stroke improves functional outcome in an ethnically diverse population. Methods AFFINITY was a randomised, parallel-group, double-blind, placebo-controlled trial done in 43 hospital stroke units in Australia (n=29), New Zealand (four), and Vietnam (ten). Eligible patients were adults (aged ≥18 years) with a clinical diagnosis of acute stroke in the previous 2–15 days, brain imaging consistent with ischaemic or haemorrhagic stroke, and a persisting neurological deficit that produced a modified Rankin Scale (mRS) score of 1 or more. Patients were randomly assigned 1:1 via a web-based system using a minimisation algorithm to once daily, oral fluoxetine 20 mg capsules or matching placebo for 6 months. Patients, carers, investigators, and outcome assessors were masked to the treatment allocation. The primary outcome was functional status, measured by the mRS, at 6 months. The primary analysis was an ordinal logistic regression of the mRS at 6 months, adjusted for minimisation variables. Primary and safety analyses were done according to the patient's treatment allocation. The trial is registered with the Australian New Zealand Clinical Trials Registry, ACTRN12611000774921. Findings Between Jan 11, 2013, and June 30, 2019, 1280 patients were recruited in Australia (n=532), New Zealand (n=42), and Vietnam (n=706), of whom 642 were randomly assigned to fluoxetine and 638 were randomly assigned to placebo. Mean duration of trial treatment was 167 days (SD 48·1). At 6 months, mRS data were available in 624 (97%) patients in the fluoxetine group and 632 (99%) in the placebo group. The distribution of mRS categories was similar in the fluoxetine and placebo groups (adjusted common odds ratio 0·94, 95% CI 0·76–1·15; p=0·53). Compared with patients in the placebo group, patients in the fluoxetine group had more falls (20 [3%] vs seven [1%]; p=0·018), bone fractures (19 [3%] vs six [1%]; p=0·014), and epileptic seizures (ten [2%] vs two [<1%]; p=0·038) at 6 months. Interpretation Oral fluoxetine 20 mg daily for 6 months after acute stroke did not improve functional outcome and increased the risk of falls, bone fractures, and epileptic seizures. These results do not support the use of fluoxetine to improve functional outcome after stroke

Rainfall variability and internal migration: The importance of agriculture linkage and gender inequality

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 link.This paper investigates the extent to which individual migration decisions in Vietnam can be driven by climate change, based on the historical rainfall data from 70 weather stations in Vietnam and the Vietnam Access to Resources Household Survey. Utilizing the exogenous variation in the rainfall deviation from the local norms within an individual fixed-effects framework, we uncover the negative association between rainfall and the probability of individuals decision to migrate. We find that doubling the amount of precipitation relative to the long-run local average reduces the probability of migration by 7.5 percent. This result could potentially be driven by individuals who work in the agriculture sector and could have experienced an increase in income as high precipitation could lead to high yield. Furthermore, our heterogeneity analyses suggest rainfall shocks could perpetuate gender inequality in Vietnam as women are less likely to migrate when being affected by climate change. Policymakers could shift their focus to flood control and water management in affected areas, where people's livelihoods depend on agriculture, to efficiently address issues related to climate-induced internal migration. Keywords: Climate change, Rainfall, Migration, Gender inequality, Vietnam

Rainfall variability and internal migration: the importance of agriculture linkage and gender inequality

This paper investigates the extent to which individual migration decisions in Vietnam can be driven by climate change, based on the historical rainfall data from 70 weather stations in Vietnam and the Vietnam Access to Resources Household Survey. Utilizing the exogenous variation in the rainfall deviation from the local norms within an individual fixed-effects framework, we uncover the negative association between rainfall and the probability of individual’s decision to migrate. We find that doubling the amount of precipitation relative to the long-run local average reduces the probability of migration by 7.5 percent. This result could potentially be driven by individuals who work in the agriculture sector and could have experienced an increase in income as high precipitation could lead to high yield. Furthermore, our heterogeneity analyses suggest rainfall shocks could perpetuate gender inequality in Vietnam as women are less likely to migrate when being affected by climate change. Policymakers could shift their focus to flood control and water management in affected areas, where people’s livelihoods depend on agriculture, to efficiently address issues related to climate-induced internal migration

Engineering Stress in Thin Films: An Innovative Pathway Toward 3D Micro and Nanosystems

Transformation of conventional 2D platforms into unusual 3D configu-rations provides exciting opportunities for sensors, electronics, optical devices, and biological systems. Engineering material properties or control-ling and modulating stresses in thin films to pop-up 3D structures out of standard planar surfaces has been a highly active research topic over the last decade. Implementation of 3D micro and nanoarchitectures enables unprecedented functionalities including multiplexed, monolithic mechanical sensors, vertical integration of electronics components, and recording of neuron activities in 3D organoids. This paper provides an overview on stress engineering approaches to developing 3D functional microsystems. The paper systematically presents the origin of stresses generated in thin films and methods to transform a 2D design into an out-of-plane configu-ration. Different types of 3D micro and nanostructures, along with their applications in several areas are discussed. The paper concludes with cur-rent technical challenges and potential approaches and applications of this fast-growing research direction

Engineering Route for Stretchable, 3D Microarchitectures of Wide Bandgap Semiconductors for Biomedical Applications

Wide bandgap (WBG) semiconductors have attracted significant research interest for the development of a broad range of flexible electronic applications, including wearable sensors, soft logical circuits, and long-term implanted neuromodulators. Conventionally, these materials are grown on standard silicon substrates, and then transferred onto soft polymers using mechanical stamping processes. This technique can retain the excellent electrical properties of wide bandgap materials after transfer and enables flexibility; however, most devices are constrained by 2D configurations that exhibit limited mechanical stretchability and morphologies compared with 3D biological systems. Herein, a stamping-free micromachining process is presented to realize, for the first time, 3D flexible and stretchable wide bandgap electronics. The approach applies photolithography on both sides of free-standing nanomembranes, which enables the formation of flexible architectures directly on standard silicon wafers to tailor the optical transparency and mechanical properties of the material. Subsequent detachment of the flexible devices from the support substrate and controlled mechanical buckling transforms the 2D precursors of wide band gap semiconductors into complex 3D mesoscale structures. The ability to fabricate wide band gap materials with 3D architectures that offer device-level stretchability combined with their multi-modal sensing capability will greatly facilitate the establishment of advanced 3D bio-electronics interfaces.</p

Twelve-Month Outcomes of the AFFINITY Trial of Fluoxetine for Functional Recovery After Acute Stroke: AFFINITY Trial Steering Committee on Behalf of the AFFINITY Trial Collaboration

Background and Purpose: The AFFINITY trial (Assessment of Fluoxetine in Stroke Recovery) reported that oral fluoxetine 20 mg daily for 6 months after acute stroke did not improve functional outcome and increased the risk of falls, bone fractures, and seizures. After trial medication was ceased at 6 months, survivors were followed to 12 months post-randomization. This preplanned secondary analysis aimed to determine any sustained or delayed effects of fluoxetine at 12 months post-randomization. Methods: AFFINITY was a randomized, parallel-group, double-blind, placebo-controlled trial in adults (n=1280) with a clinical diagnosis of stroke in the previous 2 to 15 days and persisting neurological deficit who were recruited at 43 hospital stroke units in Australia (n=29), New Zealand (4), and Vietnam (10) between 2013 and 2019. Participants were randomized to oral fluoxetine 20 mg once daily (n=642) or matching placebo (n=638) for 6 months and followed until 12 months after randomization. The primary outcome was function, measured by the modified Rankin Scale, at 6 months. Secondary outcomes for these analyses included measures of the modified Rankin Scale, mood, cognition, overall health status, fatigue, health-related quality of life, and safety at 12 months. Results: Adherence to trial medication was for a mean 167 (SD 48) days and similar between randomized groups. At 12 months, the distribution of modified Rankin Scale categories was similar in the fluoxetine and placebo groups (adjusted common odds ratio, 0.93 [95% CI, 0.76–1.14]; P =0.46). Compared with placebo, patients allocated fluoxetine had fewer recurrent ischemic strokes (14 [2.18%] versus 29 [4.55%]; P =0.02), and no longer had significantly more falls (27 [4.21%] versus 15 [2.35%]; P =0.08), bone fractures (23 [3.58%] versus 11 [1.72%]; P =0.05), or seizures (11 [1.71%] versus 8 [1.25%]; P =0.64) at 12 months. Conclusions: Fluoxetine 20 mg daily for 6 months after acute stroke had no delayed or sustained effect on functional outcome, falls, bone fractures, or seizures at 12 months poststroke. The lower rate of recurrent ischemic stroke in the fluoxetine group is most likely a chance finding. REGISTRATION: URL: http://www.anzctr.org.au/ ; Unique identifier: ACTRN12611000774921