Why is capital so immobile internationally?: Possible explanations and implications for capital income taxation

Capital Movements;Income Tax;Information;Open Economy

The treatment of hypertension in people with dementia: a multi-centre prospective observational cohort study

ObjectivesTo describe the treatment of hypertension in people with dementia and collate evidence on adverse health events whilst on treatment.DesignA multicenter prospective observational cohort study.Setting and participantsPeople with documented diagnoses of hypertension and dementia were recruited through memory clinics and general practice from 8 sites in the United Kingdom.MethodsThe cohort was recruited between July 2013 and October 2014. Participants underwent face-to-face, standardized assessment of blood pressure (BP), activities of daily living, cognitive function, and medication use. Follow-up was by monthly telephone interview for 6 months to collate data on adverse health events.Results181 participants were recruited and 177 followed up; 126 (70%) were female, mean age was 82 [standard deviation (SD) 6.3] years, median Mini-Mental State Examination score was 23 [interquartile range (IQR) 18-26] and mean BP was 141/78 (SD 22/12) mmHg. Antihypertensive drugs were prescribed in 157 (87%). Participants were prescribed a median of 1 (IQR 1-2) antihypertensive medication. Angiotensin-converting enzyme inhibitors and/or angiotensin receptor blockers were the most frequently prescribed antihypertensives in 63% of participants. Target BP was achieved in 58% (95% confidence interval 49%-64%). Increasing number of antihypertensives was not associated with lower systolic or diastolic BP, or with a higher proportion of patients attaining target BP. Participants had 214 falls, 3 had a fracture, 3 developed symptomatic heart failure, 4 had cerebrovascular events, and 8 died.Conclusions/ImplicationsIn this population of people with mild dementia, participants were treated with standard antihypertensive medications in a similar proportion to the general population, with a similar proportion achieving target BP. The rate of adverse health events was higher than in randomized controlled trials of antihypertensives and raises reservations about the assumptions underpinning antihypertensive treatment in people with dementia. These findings may help inform clinical decision making

Flux-quantum-modulated Kondo conductance in a multielectron quantum dot

We investigate a lateral semiconductor quantum dot with a large number of electrons in the limit of strong coupling to the leads. A Kondo effect is observed and can be tuned in a perpendicular magnetic field. This Kondo effect does not exhibit Zeeman splitting. It shows a modulation with the periodicity of one flux quantum per dot area at low temperatures. The modulation leads to a novel, strikingly regular stripe pattern for a wide range in magnetic field and number of electrons.Comment: 4 pages, 5 figure

Alternative approach to b−>sγb->s \gamma in the uMSSM

The gluino contributions to the $C'_{7,8}$ Wilson coefficients for $b->s \gamma$ are calculated within the unconstrained MSSM. New stringent bounds on the $\delta^{RL}_{23}$ and $\delta^{RR}_{23}$ mass insertion parameters are obtained in the limit in which the SM and SUSY contributions to $C_{7,8}$ approximately cancel. Such a cancellation can plausibly appear within several classes of SUSY breaking models in which the trilinear couplings exhibit a factorized structure proportional to the Yukawa matrices. Assuming this cancellation takes place, we perform an analysis of the $b->s \gamma$ decay. We show that in a supersymmetric world such an alternative is reasonable and it is possible to saturate the $b->s \gamma$ branching ratio and produce a CP asymmetry of up to 20%, from only the gluino contribution to $C'_{7,8}$ coefficients. Using photon polarization a LR asymmetry can be defined that in principle allows for the $C_{7,8}$ and $C'_{7,8}$ contributions to the $b->s \gamma$ decay to be disentangled. In this scenario no constraints on the ``sign of $\mu$'' can be derived.Comment: LaTeX2e, 23 pages, 7 ps figure, needs package epsfi

“Don’t let the trial kill the intervention”: How can researchers and care home teams implement complex intervention trials in care homes?

There is a need for a context-specific sustainable model for conduct of high-quality research in care homes Implementation of research interventions in care homes needs co-design, good relationships, understanding the context and funding A framework can provide the basis to build trust between researchers, care home residents, families and staff

Development and Validation of Quality of Life Measurement Tools Used in Older Peoples’ Care Homes: a scoping review protocol

Introduction There is a high prevalence of frailty and cognitive impairment within care home population. These wide-ranging experiences and needs impact on residents’ quality of life. Therefore, measuring Quality of Life (QOL) in residents as part of routine practice could help inform care decisions. This review aims to describe how QOL tools used in care homes have been developed, to describe the extent to which these are grounded in the care home experience, the extent to which the concerns of residents, families and staff are addressed by existing tools, and/or the extent to which these remain unaddressed.Method This review will follow the Joanna Briggs Institute (JBI) guidelines for conducting scoping reviews. All published literature will be searched using bibliographic databases (MEDLINE, EMBASE, PsychINFO, CINAHL, and COSMIN database of systematic review of outcome measurement instruments) and grey literature will be searched using OpenGrey and social care online databases.Studies will be selected for inclusion based on population- individuals aged 65 years and above; concept- all QOL tools both generic and dementia-specific used in care homes regardless of the context they have been developed for; and context- care homes- both residential and nursing homes with or without dementia care in any country. Also, reference lists of reviews and included studies will be carried out to identify additional relevant studies. Only papers written in English will be included. Conference abstracts, editorial and commentary articles will be excluded. Articles will be independently screened (at both title/abstract and full text stages) for eligibility by two reviewers. Any disagreement will be resolved by a third reviewer. Data will be extracted, summarised descriptively and presented in a tabular form under categories that represent the review’s objectives. This will include the theoretical frameworks/conceptual models, stakeholder involvement, tool content, intended use of the tool, validation and strengths and limitations of the tool. Discussion A key strength of this review is using a scoping review methodology which is appropriate for the review question because it will provide a descriptive and broad overview on the development of QOL tools used in care homes. Potential limitations include limiting the searches to only studies published in English

Risk of incident dementia and cognitive impairment in patients with chronic obstructive pulmonary disease (COPD): A large UK population-based study

Background: Although cognitive impairment and dementia are common comorbidities in patients with chronic obstructive pulmonary disease (COPD), estimates of incidence following a diagnosis of COPD are inconclusive. Objective: To determine the incidence of cognitive impairment and dementia in people with and without a COPD diagnosis. Methods: A population-based study using UK General Practice (GP) health records from The Health Improvement Network database was conducted. Patients with confirmed COPD diagnosis, ≥40 years old, were matched to up to four subjects without a COPD diagnosis by age, sex and GP practice. Cox proportional hazards models were used to assess the incidence rates of cognitive impairment and dementia. Results: Of patients with COPD (n = 62,148), 9% developed cognitive impairment, compared with 7% of subjects without COPD (n = 230,076), p < 0.001. The incidence of cognitive impairment following COPD diagnosis was greater than in subjects without COPD following index date (adjusted Hazard Ratio (aHR), 1.21; 95% CI: 1.16 ─ 1.26, p < 0.001). The coded incidence of either cognitive impairment or dementia was also greater in patients with COPD following adjustment for confounders (aHR: 1.13, 95% CI: 1.09 ─ 1.18, p < 0.001). Coded incident dementia alone was not different between patients with COPD and subjects without COPD (aHR, 0.91, 95% CI: 0.83 ─ 1.01, p = 0.053). Conclusion: Despite the increased incidence of cognitive impairment in patients with COPD, incidence of dementia was not as frequently recorded in patients with COPD. This raises the concern of undiagnosed dementia and emphasises the need for a systematic assessment in this population

Anti-Kondo resonance in transport through a quantum wire with a side-coupled quantum dot

An interacting quantum dot side-coupled to a perfect quantum wire is studied. Transport through the quantum wire is investigated by using an exact sum rule and the slave-boson mean field treatment. It is shown that the Kondo effect provides a suppression of the transmission due to the destructive interference of the ballistic channel and the Kondo channel. At finite temperatures, anti-resonance behavior is found as a function of the quantum dot level position, which is interpreted as a crossover from the high temperature Kondo phase to the low temperature charge fluctuation phase.Comment: 4 pages Revtex, 3 eps figure

Closing the UK care home data gap - methodological challenges and solutions

UK care home residents are invisible in national datasets. The COVID-19 pandemic has exposed data failings that have hindered service development and research for years. Fundamental gaps, in terms of population and service demographics coupled with difficulties identifying the population in routine data are a significant limitation. These challenges are a key factor underpinning the failure to provide timely and responsive policy decisions to support care homes. In this commentary we propose changes that could address this data gap, priorities include: (1) Reliable identification of care home residents and their tenure; (2) Common identifiers to facilitate linkage between data sources from different sectors; (3) Individual-level, anonymised data inclusive of mortality irrespective of where death occurs; (4) Investment in capacity for large-scale, anonymised linked data analysis within social care working in partnership with academics; (5) Recognition of the need for collaborative working to use novel data sources, working to understand their meaning and ensure correct interpretation; (6) Better integration of information governance, enabling safe access for legitimate analyses from all relevant sectors; (7) A core national dataset for care homes developed in collaboration with key stakeholders to support integrated care delivery, service planning, commissioning, policy and research. Our suggestions are immediately actionable with political will and investment. We should seize this opportunity to capitalise on the spotlight the pandemic has thrown on the vulnerable populations living in care homes to invest in data-informed approaches to support care, evidence-based policy making and research