Childhood Health and Differences in Late-Life Health Outcomes Between England and the United States

In this paper we examine the link between retrospectively reported measures of childhood health and the prevalence of various major and minor diseases at older ages. Our analysis is based on comparable retrospective questionnaires placed in the Health and Retirement Study and the English Longitudinal Study of Ageing – nationally representative surveys of the age 50 plus population in America and England respectively. We show that the origins of poorer adult health among older Americans compared to the English trace right back into the childhood years – the American middle and old-age population report higher rates of specific childhood health conditions than their English counterparts. The transmission into poor health in mid life and older ages of these higher rates of childhood illnesses also appears to be higher in America compared to England. Both factors contribute to higher rates of adult illness in the United States compared to England although even in combination they do not explain the full extent of the country difference in late-life health outcomes.

Scaling up from protected areas in England: The value of establishing large conservation areas

Protected areas (PAs) are vital for conserving biodiversity, but many PA networks consist of fragmented habitat patches that poorly represent species and ecosystems. One possible solution is to create conservation landscapes that surround and link these PAs. This often involves working with a range of landowners and agencies to develop large-scale conservation initiatives (LSCIs). These initiatives are being championed by both government and civil society, but we lack data on whether such landscape-level approaches overcome the limitations of more traditional PA networks. Here we expand on a previous gap analysis of England to explore to what extent LSCIs improve the representation of different ecoregions, land-cover types and elevation zones compared to the current PA system. Our results show the traditional PA system covers 6.37% of England, an addition of only 0.07% since 2001, and that it is an ecologically unrepresentative network that mostly protects agriculturally unproductive land. Including LSCIs in the analysis increases the land for conservation more than tenfold and reduces these representation biases. However, only 24% of land within LSCIs is currently under conservation management, mostly funded through agri-environment schemes, and limited monitoring data mean that their contribution to conservation objectives is unclear. There is also a considerable spatial overlap between LSCIs, which are managed by different organisations with different conservation objectives. Our analysis is the first to show how Other Effective Area-Based Conservation Measures (OECMs) can increase the representativeness of conservation area networks, and highlights opportunities for increased collaboration between conservation organisations and engagement with landowners

Directing visual attention during action observation modulates corticospinal excitability

Transcranial magnetic stimulation (TMS) research has shown that corticospinal excitability is facilitated during the observation of human movement. However, the relationship between corticospinal excitability and participants’ visual attention during action observation is rarely considered. Nineteen participants took part in four conditions: (i) a static hand condition, involving observation of a right hand holding a ball between the thumb and index finger; (ii) a free observation condition, involving observation of the ball being pinched between thumb and index finger; and (iii and iv) finger-focused and ball-focused conditions, involving observation of the same ball pinch action with instructions to focus visual attention on either the index finger or the ball. Single-pulse TMS was delivered to the left motor cortex and motor evoked potentials (MEPs) were recorded from the first dorsal interosseous (FDI) and abductor digiti minimi muscles of the right hand. Eye movements were recorded simultaneously throughout each condition. The ball-focused condition produced MEPs of significantly larger amplitude in the FDI muscle, compared to the free observation or static hand conditions. Furthermore, regression analysis indicated that the number of fixations on the ball was a significant predictor of MEP amplitude in the ball-focused condition. These results have important implications for the design and delivery of action observation interventions in motor (re)learning settings. Specifically, providing viewing instructions that direct participants to focus visual attention on task-relevant objects affected by the observed movement promotes activity in the motor system in a more optimal manner than free observation or no instructions

Safety and efficacy of the ChAdOx1 nCoV-19 vaccine (AZD1222) against SARS-CoV-2: an interim analysis of four randomised controlled trials in Brazil, South Africa, and the UK.

BACKGROUND: A safe and efficacious vaccine against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), if deployed with high coverage, could contribute to the control of the COVID-19 pandemic. We evaluated the safety and efficacy of the ChAdOx1 nCoV-19 vaccine in a pooled interim analysis of four trials. METHODS: This analysis includes data from four ongoing blinded, randomised, controlled trials done across the UK, Brazil, and South Africa. Participants aged 18 years and older were randomly assigned (1:1) to ChAdOx1 nCoV-19 vaccine or control (meningococcal group A, C, W, and Y conjugate vaccine or saline). Participants in the ChAdOx1 nCoV-19 group received two doses containing 5 × 1010 viral particles (standard dose; SD/SD cohort); a subset in the UK trial received a half dose as their first dose (low dose) and a standard dose as their second dose (LD/SD cohort). The primary efficacy analysis included symptomatic COVID-19 in seronegative participants with a nucleic acid amplification test-positive swab more than 14 days after a second dose of vaccine. Participants were analysed according to treatment received, with data cutoff on Nov 4, 2020. Vaccine efficacy was calculated as 1 - relative risk derived from a robust Poisson regression model adjusted for age. Studies are registered at ISRCTN89951424 and ClinicalTrials.gov, NCT04324606, NCT04400838, and NCT04444674. FINDINGS: Between April 23 and Nov 4, 2020, 23 848 participants were enrolled and 11 636 participants (7548 in the UK, 4088 in Brazil) were included in the interim primary efficacy analysis. In participants who received two standard doses, vaccine efficacy was 62·1% (95% CI 41·0-75·7; 27 [0·6%] of 4440 in the ChAdOx1 nCoV-19 group vs71 [1·6%] of 4455 in the control group) and in participants who received a low dose followed by a standard dose, efficacy was 90·0% (67·4-97·0; three [0·2%] of 1367 vs 30 [2·2%] of 1374; pinteraction=0·010). Overall vaccine efficacy across both groups was 70·4% (95·8% CI 54·8-80·6; 30 [0·5%] of 5807 vs 101 [1·7%] of 5829). From 21 days after the first dose, there were ten cases hospitalised for COVID-19, all in the control arm; two were classified as severe COVID-19, including one death. There were 74 341 person-months of safety follow-up (median 3·4 months, IQR 1·3-4·8): 175 severe adverse events occurred in 168 participants, 84 events in the ChAdOx1 nCoV-19 group and 91 in the control group. Three events were classified as possibly related to a vaccine: one in the ChAdOx1 nCoV-19 group, one in the control group, and one in a participant who remains masked to group allocation. INTERPRETATION: ChAdOx1 nCoV-19 has an acceptable safety profile and has been found to be efficacious against symptomatic COVID-19 in this interim analysis of ongoing clinical trials. FUNDING: UK Research and Innovation, National Institutes for Health Research (NIHR), Coalition for Epidemic Preparedness Innovations, Bill & Melinda Gates Foundation, Lemann Foundation, Rede D'Or, Brava and Telles Foundation, NIHR Oxford Biomedical Research Centre, Thames Valley and South Midland's NIHR Clinical Research Network, and AstraZeneca

Safety and efficacy of the ChAdOx1 nCoV-19 vaccine (AZD1222) against SARS-CoV-2: an interim analysis of four randomised controlled trials in Brazil, South Africa, and the UK

Background A safe and efficacious vaccine against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), if deployed with high coverage, could contribute to the control of the COVID-19 pandemic. We evaluated the safety and efficacy of the ChAdOx1 nCoV-19 vaccine in a pooled interim analysis of four trials. Methods This analysis includes data from four ongoing blinded, randomised, controlled trials done across the UK, Brazil, and South Africa. Participants aged 18 years and older were randomly assigned (1:1) to ChAdOx1 nCoV-19 vaccine or control (meningococcal group A, C, W, and Y conjugate vaccine or saline). Participants in the ChAdOx1 nCoV-19 group received two doses containing 5 × 1010 viral particles (standard dose; SD/SD cohort); a subset in the UK trial received a half dose as their first dose (low dose) and a standard dose as their second dose (LD/SD cohort). The primary efficacy analysis included symptomatic COVID-19 in seronegative participants with a nucleic acid amplification test-positive swab more than 14 days after a second dose of vaccine. Participants were analysed according to treatment received, with data cutoff on Nov 4, 2020. Vaccine efficacy was calculated as 1 - relative risk derived from a robust Poisson regression model adjusted for age. Studies are registered at ISRCTN89951424 and ClinicalTrials.gov, NCT04324606, NCT04400838, and NCT04444674. Findings Between April 23 and Nov 4, 2020, 23 848 participants were enrolled and 11 636 participants (7548 in the UK, 4088 in Brazil) were included in the interim primary efficacy analysis. In participants who received two standard doses, vaccine efficacy was 62·1% (95% CI 41·0–75·7; 27 [0·6%] of 4440 in the ChAdOx1 nCoV-19 group vs71 [1·6%] of 4455 in the control group) and in participants who received a low dose followed by a standard dose, efficacy was 90·0% (67·4–97·0; three [0·2%] of 1367 vs 30 [2·2%] of 1374; pinteraction=0·010). Overall vaccine efficacy across both groups was 70·4% (95·8% CI 54·8–80·6; 30 [0·5%] of 5807 vs 101 [1·7%] of 5829). From 21 days after the first dose, there were ten cases hospitalised for COVID-19, all in the control arm; two were classified as severe COVID-19, including one death. There were 74 341 person-months of safety follow-up (median 3·4 months, IQR 1·3–4·8): 175 severe adverse events occurred in 168 participants, 84 events in the ChAdOx1 nCoV-19 group and 91 in the control group. Three events were classified as possibly related to a vaccine: one in the ChAdOx1 nCoV-19 group, one in the control group, and one in a participant who remains masked to group allocation. Interpretation ChAdOx1 nCoV-19 has an acceptable safety profile and has been found to be efficacious against symptomatic COVID-19 in this interim analysis of ongoing clinical trials

Differences in the measurement and structure of wealth using alternative data sources: the case of the UK

In this paper, we identify methodological differences and similarities in the measurement of wealth using survey data constructed for different purposes in the U.K. and separately for England. The focus of the paper is on two prominent surveys in the U.K.: the English Longitudinal Survey of Ageing (ELSA) and the British Household Panel Survey (BHPS). We find conceptual differences in the measurement of financial assets and debt. At the same time, striking similarities exist in the measurement of non-financial assets. For the most part, many differences arise in the tails of the distributions of wealth. Comparable definitions of overall wealth in the surveys lead us to find a 10% and 3% difference in mean and conditional median of total net worth, respectively. Reassuring is the fact that inequality results carried out with the two surveys support one another and quantile regression shows that the distribution of total net worth across demographic groups is similar in the two surveys.Wealth; measurement; BHPS; ELSA

House Price Volatility and the Housing Ladder

This paper investigates the effects of housing price risk on housing choices over the life-cycle. Housing price risk can be substantial but, unlike other risky assets which people can avoid, the fact that most people will eventually own their home creates an insurance demand for housing assets early in life. The authors' contribution is to focus on the importance of home ownership and housing wealth as a hedge against future house price risk for individuals moving up the ladderÑpeople living in places with higher housing price risk should own their first home at a younger age, should live in larger homes, and should be less likely to refinance. These predictions are tested and shown to hold using panel data from the United States and Great Britain.