Can Residential Build to Rent provide a profitable low risk investment option?

Purpose : Recently there has been a refocusing on the yields of investment assets. Accordingly, as risks to income yields rise, this research investigates how residential Build to Rent (BtR) may provide an effectively diversified portfolio. Emergence of this new investment sector requires a comparison between the rate of return of (BtR) and other asset classes. We seek to ascertain how BtR can be used by investors to reduce risk and provide diversification benefits within a mixedasset portfolio. Methodology:The research methodology adopted utilised secondary data produced by a reputable research organisation, coupled with personal interviews with major participants within the BtR sector. Findings: Diversification of assets within an investment portfolio reduces the total risk and volatility of an investment portfolio based upon the Markowitz (1952) Modern Portfolio Theory (MPT) model. Analysis of BtR performance against other traditional asset classes including traditional investment property, proved BtR a valuable inclusion, reducing risk and providing valuable returns. Discussion:Limited UK based research material on BtR as an investment option for institutions (and individuals), indicates its relatively short history as an investment option. Accordingly, some reliance was placed upon traditional private residential rental data. Despite this, the BtR investment asset in a mixed asset portfolio proved a source of l

Organ Culture Studies of Pehmphigus Antibodies

The ultrastructural and light microscopic features of acantholysis produced in organ culture were compared with those of human pemphigus lesions. In both, an intraepidermal split was seen and typical suprabasal acantholytic cells were present. These cells contained small bundles of tonofilaments, usually located away from the cell periphery. Desmosomal plaques with inserted tonofilaments frequently remained along the periphery of acantholytic cells and along the upper portion of the periphery of basal cells. The ultrastructural similarity between in vitro and in vivo lesions provides additional evidence to suggest that organ cultures may provide a valid model for studying the dynamics of pemphigus lesion formation

Medical device design in context: a model of user–device interaction and consequences

The practice of evaluating interaction with devices is embedded in disciplines such as human-computer interaction and cognitive ergonomics, including concepts such as affordances, error analysis, skill, rule and knowledge based behaviour and decision making biases. This paper considers the way in which the approach that has been routinely applied to displays and control design within the control and transport domains can be transferred to the context of medical devices. The importance of considering the context in which medical devices are used and implemented is presented, and the need for a systems approach to medical device design is emphasised. Five case studies from medical device control and display design are presented as an aide to developing an understanding of the relationship between device design and resultant behaviours. On the basis of these case studies, four types of mediating factors (catalysts, enablers, facilitators and enhancers) are proposed and a model to describe the link between device design, user, context and consequences is presented

Stigma as a fundamental hindrance to the United States opioid overdose crisis response.

Alexander Tsai and co-authors discuss the role of stigma in responses to the US opioid crisis

Physician antipsychotic overprescribing letters and cognitive, behavioral, and physical health outcomes among people with dementia: a secondary analysis of a randomized clinical trial

Importance Antipsychotics, such as quetiapine, are frequently prescribed to people with dementia to address behavioral symptoms but can also cause harm in this population. Objective To determine whether warning letters to high prescribers of quetiapine can successfully reduce its use among patients with dementia and to investigate the impacts on patients’ health outcomes. Design, Setting, and Participants This is a secondary analysis of a randomized clinical trial of overprescribing letters that began in April 2015 and included the highest-volume primary care physician (PCP) prescribers of quetiapine in original Medicare. Outcomes of patients with dementia were analyzed in repeated 90-day cross-sections through December 2018. Analyses were conducted from September 2021 to February 2024. Interventions PCPs were randomized to a placebo letter or 3 overprescribing warning letters stating that their prescribing of quetiapine was high and under review by Medicare. Main Outcomes and Measures The primary outcome of this analysis was patients’ total quetiapine use in days per 90-day period (the original trial primary outcome was total quetiapine prescribing by study PCPs). Prespecified secondary outcomes included measures of cognitive function and behavioral symptoms from nursing home assessments, indicators of depression from screening questionnaires in assessments and diagnoses in claims, metabolic diagnoses derived from assessments and claims, indicators of use of the hospital and other health care services, and death. Outcomes were analyzed separately for patients living in nursing homes and in the community. Results Of the 5055 study PCPs, 2528 were randomized to the placebo letter, and 2527 were randomized to the 3 warning letters. A total of 84 881 patients with dementia living in nursing homes and 261 288 community-dwelling patients with dementia were attributed to these PCPs. There were 92 874 baseline patients (mean [SD] age, 81.5 [10.5] years; 64 242 female [69.2%]). The intervention reduced quetiapine use among both nursing home patients (adjusted difference, –0.7 days; 95% CI, −1.3 to −0.1 days; P = .02) and community-dwelling patients (adjusted difference, −1.5 days; 95% CI, −1.8 to −1.1 days; P < .001). There were no detected adverse effects on cognitive function (cognitive function scale adjusted difference, 0.01; 95% CI, −0.01 to 0.03; P = .19), behavioral symptoms (agitated or reactive behavior adjusted difference, −0.2%; 95% CI −1.2% to 0.8% percentage points; P = .72), depression, metabolic diagnoses, or more severe outcomes, including hospitalization and death. Conclusions and Relevance This study found that overprescribing warning letters to PCPs safely reduced quetiapine prescribing to their patients with dementia. This intervention and others like it may be useful for future efforts to promote guideline-concordant care

Two Coupled Harmonic Oscillators on Non-commutative Plane

We investigate a system of two coupled harmonic oscillators on the non-commutative plane \RR^2_{\theta} by requiring that the spatial coordinates do not commute. We show that the system can be diagonalized by a suitable transformation, i.e. a rotation with a mixing angle \alpha. The obtained eigenstates as well as the eigenvalues depend on the non-commutativity parameter \theta. Focusing on the ground state wave function before the transformation, we calculate the density matrix \rho_0(\theta) and find that its traces {\rm Tr}(\rho_{0}(\theta)) and {\rm Tr}(\rho_0^2(\theta)) are not affected by the non-commutativity. Evaluating the Wigner function on \RR^2_{\theta} confirms this. The uncertainty relation is explicitly determined and found to depend on \theta. For small values of \theta, the relation is shifted by a \theta^2 term, which can be interpreted as a quantum correction. The calculated entropy does not change with respect to the normal case. We consider the limits \alpha=1 and \alpha={\pi\over 2}. In first case, by identifying \theta to the squared magnetic length, one can recover basic features of the Hall system.Comment: 15 pages, 1 figur

“Children are precious cargo; we don’t let them take any risks!”: Hearing from adults on safety and risk in children’s active play in schools: a systematic review

BACKGROUND: Understanding determinants of children’s outdoor play is important for improving low physical activity levels, and schools are a key setting for both. Safety concerns shape children’s opportunity to play actively outdoors, therefore, this qualitative evidence synthesis aimed to i) examine adult (e.g., parent, teacher, yard supervisor, principal) perspectives on safety and risk in children’s active play during recess in elementary and/or middle schools, and ii) identify how safety and risk influence playground supervision and decision making in this setting. METHODS: Six electronic databases were systematically searched in March 2021, with an updated search in June 2022. Records were screened against eligibility criteria using Covidence software, and data extraction and synthesis were performed using predesigned coding forms in Microsoft Excel and NVivo. Framework synthesis methodology was employed, guided by a conceptual framework structured on the socio-ecological model (SEM) and affordance theory. RESULTS: From 10,370 records, 25 studies were included that represented 608 adults across 89 schools from nine countries. The synthesis identified 10 constraining and four affording factors that influenced whether school staff were risk-averse or risk tolerant during recess, and, in turn, the degree to which children’s play was managed. Constraining factors stemmed from fears for children’s physical safety, and fear of blame and liability in the event of playground injury, which shaped parent, school staff and institutional responses to risk. Interrelated factors across SEM levels combined to drive risk-averse decision making and constraining supervision. Emerging evidence suggests children’s active play in schools can be promoted by fostering a risk tolerant and play friendly culture in schools through play facilitation training (e.g., risk-reframing, conflict resolution) and engaging stakeholders in the development of school policies and rules that balance benefits of play against potential risks. CONCLUSIONS: Findings show several socio-cultural factors limited the ability of school staff to genuinely promote active play. Future work should seek to foster risk tolerance in schools, challenge the cultural norms that shape parent attitudes and institutional responses to risk in children’s play, and explore novel methods for overcoming policy barriers and fear of liability in schools. TRIAL REGISTRATION: PROSPERO registration: CRD42021238719. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12966-022-01344-7