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

A translational framework for public health research

<p><b>Background</b></p> <p>The paradigm of translational medicine that underpins frameworks such as the Cooksey report on the funding of health research does not adequately reflect the complex reality of the public health environment. We therefore outline a translational framework for public health research.</p> <p><b>Discussion</b></p> <p>Our framework redefines the objective of translation from that of institutionalising effective interventions to that of improving population health by influencing both individual and collective determinants of health. It incorporates epidemiological perspectives with those of the social sciences, recognising that many types of research may contribute to the shaping of policy, practice and future research. It also identifies a pivotal role for evidence synthesis and the importance of non-linear and intersectoral interfaces with the public realm.</p> <p><b>Summary</b></p> <p>We propose a research agenda to advance the field and argue that resources for 'applied' or 'translational' public health research should be deployed across the framework, not reserved for 'dissemination' or 'implementation'.</p&gt

A Geochemical Record of Late- Holocene Hurricane Events From the Florida Everglades

A 5.25- m sediment core SRM- 1 and 45 surface samples from mangrove forests at the Shark River Estuary in the Everglades National Park, Florida, were examined by using X- ray fluorescence and carbon isotopic analyses to study the history of intense hurricane landfall during the Late- Holocene. Significance testing of the surface samples in relation to storm deposits from Hurricane Wilma suggests that elemental concentration of Sr and Cl and the ratio of Cl/Br are the most sensitive indicators for major hurricane events in our study area. The geochemical data sets of core SRM- 1 identified five active periods of intense hurricane activities during the last 3,500 years at ~3,400- 3,000, ~2,200- 1,500, ~1,000- 800, ~600- 300, and ~150 calibrated years before present to present. This is the longest paleohurricane record to date from South Florida. Our results are consistent with the view that intense hurricane activities in South Florida were modulated by Intertropical Convergence Zone (ITCZ) movements, El Niño/Southern Oscillation (ENSO) activities, and North Atlantic Oscillation (NAO) strength. This study contributes to the methodological advancement in paleotempestological studies by demonstrating that geochemical signals, particularly signals of saltwater intrusions, can be preserved in the sediment profiles on millennial time- scale and measured by X- ray fluorescence techniques, thereby enabling more storm records to be produced from otherwise suboptimal sand- limited coastal systems such as the Florida Everglades. More work needs to be done to explore the use of geochemical and stable isotopic analyses in detecting storm signals from sand- limited coastal environments.Plain Language SummaryThis study uses geochemical analyses to detect intense hurricanes that made landfall near the southwest coast of the Florida Everglades from sediment profiles. The geochemical data sets identified five active periods of intense hurricane activities during the last 3,500 years at ~3,400- 3,000, ~2,200- 1,500, ~1,000- 800, ~600- 300, and ~150 years ago. Results from this study agree with previous studies that intense hurricane activities in the western Atlantic Basin were controlled by the position of ITCZ, ENSO activities, and NAO strength.Key PointsThis study demonstrates the use of XRF analysis in detecting major hurricane events in sand- limited coastal systemsFive active hurricane periods were identified at ~3,400- 3,000, ~2,200- 1,500, ~1,000- 800, ~600- 300, and ~150 cal yr BP to presentThis study suggests that intense hurricane activities in the western Atlantic Basin were modulated by ITCZ, ENSO, and NAO activitiesPeer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/156482/2/wrcr24787_am.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/156482/1/wrcr24787.pd

Climate driven life histories: the case of the Mediterranean Storm petrel

Seabirds are affected by changes in the marine ecosystem. The influence of climatic factors on marine food webs can be reflected in long-term seabird population changes. We modelled the survival and recruitment of the Mediterranean storm petrel (Hydrobates pelagicus melitensis) using a 21-year mark-recapture dataset involving almost 5000 birds. We demonstrated a strong influence of prebreeding climatic conditions on recruitment age and of rainfall and breeding period conditions on juvenile survival. The results suggest that the juvenile survival rate of the Mediterranean subspecies may not be negatively affected by the predicted features of climate change, i.e., warmer summers and lower rainfall. Based on considerations of winter conditions in different parts of the Mediterranean, we were able to draw inferences about the wintering areas of the species for the first time

The Role of Ideas in Policy Transfer: The Case of UK Smoking Bans since Devolution

This article explores the relationship between ideas and interests in policy change by examining tobacco control in each country of the United Kingdom (UK). In all four, the moves towards further prohibition reflected international trends, with evidence of policy transfer and the virus-like spread of ideas which has shifted the way that tobacco is framed. However, there are notable differences in the development of policy in each territory. This reinforces conceptions of transfer in which the importation of policy is mediated by political systems. Differences in policy conditions, institutions and ‘windows of opportunity' mean that our conclusions on the role and influence of interest groups, institutions and agenda-setting vary by territory, even within a member state. This suggests that a focus on an ‘idea whose time has come' should be supplemented by careful analysis of the political context in which the idea was articulated and accepted

Matrix Metalloproteinase Gene Delivery for Liver Fibrosis

The resolution of advanced liver fibrosis has been recently recognized to be possible, if the causative stimuli are successfully removed. However, whether complete resolution from cirrhosis, the end stage of liver fibrosis, can be achieved is still questionable. Delivery of interstitial collagenases, such as matrix metalloproteinase (MMP)-1, in the liver could be an attractive strategy to treat advanced hepatic fibrosis from the view point that the imbalance between too few interstitial collagenases and too many of their inhibitors is the main obstacle to the resolution from fibrosis. Remodeling of hepatic extracellular matrix by delivered interstitial collagenases also facilitates the disappearance of activated hepatic stellate cells, the main matrix-producing cells in the liver, and promotes the proliferation of hepatocytes. This review will focus on the impact of the gene delivery of MMPs for the treatment of advanced liver fibrosis while discussing other current therapeutic strategies for liver fibrosis, and on the need for the development of a safe and effective delivery system of MMPs

Control of Length and Spatial Functionality of Single-Wall Carbon Nanotube AFM Nanoprobes

Single-wall carbon nanotube (SWNT) nanofibrils were assembled onto conductive atomic force microscopy (AFM) probes with the help of dielectrophoresis (DEP). This process involved the application of a 10 V, 2 MHz, AC bias between a metal-coated AFM probe and a dilute suspension of SWNTs. This exerted a positive dielectrophoretic force onto the nanotubes that caused them to align while precipitating out onto the probe. The gradual removal of the AFM probe away from the SWNT suspension consolidated these nanotubes into nanofibrils with a high degree of alignment as demonstrated with polarization Raman experiments. By varying the pulling speed, immersion time, and concentration of the SWNT suspension, one can tailor the diameter and thus the stiffness of these probes. Precise length trimming of these nanofibrils was also performed by their gradual immersion and dissolution into a liquid that strongly interacted with nanotubes, (i.e., sodium dodecyl sulfate (SDS) solution). Vacuum annealing these nanoprobes at temperature up to 450 degree C further increased their stiffness and rendered them insoluble to SDS and all other aqueous media. Regrowth of a new SWNT nanofibril from the side or at the end of a previously grown SWNT nanofibril was also demonstrated by a repeated dielectrophoretic assembly at the desired immersion depth. These SWNT nanofibril-equipped AFM probes are electrically conductive and mechanically robust for use as high-aspect-ratio electrochemical nanoprobes

Experiences of Self-Management Support Following a Stroke: A Meta-Review of Qualitative Systematic Reviews

Supporting self-management in stroke patients improves psychological and functional outcomes but evidence on how to achieve this is sparse. We aimed to synthesise evidence from systematic reviews of qualitative studies in an overarching meta-review to inform the delivery and development of self-management support interventions.We systematically searched eight electronic databases including MEDLINE, EMBASE and CINAHL for qualitative systematic reviews (published January 1993 to June 2012). We included studies exploring patients', carers' or health care professionals' experiences relevant to self-management support following a stroke, including studies describing the lived experience of surviving a stroke. We meta-synthesised the included review findings using a meta-ethnographic framework.Seven reviews, reporting 130 unique studies, were included. Themes emerging from the reviews were pertinent, consistent and showed data saturation; though explicit mention of self-management support was rare. Our meta-review highlighted the devastating impact of stroke on patients' self-image; the varying needs for self-management support across the trajectory of recovery; the need for psychological and emotional support throughout recovery particularly when physical recovery plateaus; the considerable information needs of patients and carers which also vary across the trajectory of recovery; the importance of good patient-professional communication; the potential benefits of goal-setting and action-planning; and the need for social support which might be met by groups for stroke survivors.The observed data saturation suggests that, currently, no further qualitative research simply describing the lived experience of stroke is needed; we propose that it would be more useful to focus on qualitative research informing self-management support interventions and their implementation. Our findings demonstrate both the on-going importance of self-management support and the evolving priorities throughout the stages of recovery following a stroke. The challenge now is to ensure these findings inform routine practice and the development of interventions to support self-management amongst stroke survivors

A Comprehensive Analysis of the Dynamic Biological Networks in HCV Induced Hepatocarcinogenesis

Hepatocellular carcinoma (HCC) is a primary malignancy of the liver, which is closely related to hepatitis C and cirrhosis. The molecular mechanisms underlying the hepatocarcinogenesis induced by HCV infection remain clarified from a standpoint of systems biology. By integrating data from protein-protein interactions, transcriptional regulation, and disease related microarray analysis, we carried out a dynamic biological network analysis on the progression of HCV induced hepatocarcinogenesis, and systematically explored the potentially disease-related mechanisms through a network view. The dysfunctional interactions among proteins and deregulatory relationships between transcription factors and their target genes could be causes for the occurrence and progression of this disease. The six pathologically defined disease stages in the development and progression of HCC after HCV infection were included in this study. We constructed disease-related biological networks for each disease stage, and identified progression-related sub-networks that potentially play roles in the developmental stage of the corresponding disease and participate in the later stage of cancer progression. In addition, we identified novel risk factors related to HCC based on the analysis of the progression-related sub-networks. The dynamic characteristics of the network reflect important features of the disease development and progression, which provide important information for us to further explore underlying mechanisms of the disease

Archiving primary data: solutions for long-term studies

The recent trend for journals to require open access to primary data included in publications has been embraced by many biologists, but has caused apprehension amongst researchers engaged in long-term ecological and evolutionary studies. A worldwide survey of 73 principal investigators (Pls) with long-term studies revealed positive attitudes towards sharing data with the agreement or involvement of the PI, and 93% of PIs have historically shared data. Only 8% were in favor of uncontrolled, open access to primary data while 63% expressed serious concern. We present here their viewpoint on an issue that can have non-trivial scientific consequences. We discuss potential costs of public data archiving and provide possible solutions to meet the needs of journals and researchers