Honourable Intentions? Analysing the interests of private equity in the aged care sector

The Australian aged care industry was once dominated by non-profit organisations but recently ownership has changed significantly with the entry of for profit and in particular private equity investment vehicles. This paper provides an overview of the main players and the effects of private equity on the Australian aged care sector. The analysis is framed within the literature which examines the relationship between ownership type and the quality of community services. It also presents a series of case studies which suggest that a change of ownership from non-profit to private equity may have significant consequences for the quality of service provision

Thrombotic and hemorrhagic complications of COVID-19 in adults hospitalized in high-income countries compared with those in adults hospitalized in low-and middle-income countries in an international registry

Background: COVID-19 has been associated with a broad range of thromboembolic, ischemic, and hemorrhagic complications (coagulopathy complications). Most studies have focused on patients with severe disease from high-income countries (HICs). Objectives: The main aims were to compare the frequency of coagulopathy complications in developing countries (low- and middle-income countries [LMICs]) with those in HICs, delineate the frequency across a range of treatment levels, and determine associations with in-hospital mortality. Methods: Adult patients enrolled in an observational, multinational registry, the International Severe Acute Respiratory and Emerging Infections COVID-19 study, between January 1, 2020, and September 15, 2021, met inclusion criteria, including admission to a hospital for laboratory-confirmed, acute COVID-19 and data on complications and survival. The advanced-treatment cohort received care, such as admission to the intensive care unit, mechanical ventilation, or inotropes or vasopressors; the basic-treatment cohort did not receive any of these interventions. Results: The study population included 495,682 patients from 52 countries, with 63% from LMICs and 85% in the basic treatment cohort. The frequency of coagulopathy complications was higher in HICs (0.76%-3.4%) than in LMICs (0.09%-1.22%). Complications were more frequent in the advanced-treatment cohort than in the basic-treatment cohort. Coagulopathy complications were associated with increased in-hospital mortality (odds ratio, 1.58; 95% CI, 1.52-1.64). The increased mortality associated with these complications was higher in LMICs (58.5%) than in HICs (35.4%). After controlling for coagulopathy complications, treatment intensity, and multiple other factors, the mortality was higher among patients in LMICs than among patients in HICs (odds ratio, 1.45; 95% CI, 1.39-1.51). Conclusion: In a large, international registry of patients hospitalized for COVID-19, coagulopathy complications were more frequent in HICs than in LMICs (developing countries). Increased mortality associated with coagulopathy complications was of a greater magnitude among patients in LMICs. Additional research is needed regarding timely diagnosis of and intervention for coagulation derangements associated with COVID-19, particularly for limited-resource settings

No effect of prefrontal transcranial direct current stimulation (tDCS) on food craving, food reward and subjective appetite in females displaying mild-to-moderate binge-type behaviour

Data availability: Data will be made available on request.Supplementary data are available online at: https://www.sciencedirect.com/science/article/pii/S0195666323024595?via%3Dihub#appsec1 .Copyright © 2023 The Authors. Previous work suggests there may be an effect of transcranial direct current stimulation (tDCS) on appetite control in people at risk of overconsumption, however findings are inconsistent. This study aimed to further understand the potential eating behaviour trait-dependent effect of tDCS, specifically in those with binge-type behaviour. Seventeen females (23 ± 7 years, 25.4 ± 3.8 kg m−2) with mild-to-moderate binge eating behaviour completed two sessions of double-blind, randomised and counterbalanced anodal and sham tDCS applied over the right dorsolateral prefrontal cortex at 2.0 mA for 20 min. Subjective appetite visual analogue scales (VAS), the Food Craving Questionnaire-State (FCQ-S), and Leeds Food Preference Questionnaire (LFPQ) were completed pre- and post-tDCS. Participants then consumed a fixed-energy meal, followed by the VAS, FCQ-S and LFPQ. No difference between pre- and post-tDCS scores were found across fullness (p = 0.275, BF10 = 0.040), prospective consumption (p = 0.127, BF10 = 0.063), desire to eat (p = 0.247, BF10 = 0.054) or FCQ-S measures (p = 0.918, BF10 = 0.040) when comparing active and sham protocols. Only explicit liking and wanting for high-fat sweet foods were significantly different between conditions, with increased scores following active tDCS. When controlling for baseline hunger, the significant differences were removed (p = 0.138 to 0.161, BF10 = 0.810 to 1.074). The present data does not support the eating behaviour trait dependency of tDCS in a specific cohort of female participants with mild-to-moderate binge eating scores, and results align with those from individuals with healthy trait scores. This suggests participants with sub-clinical binge eating behaviour do not respond to tDCS. Future work should further explore effects in clinical and sub-clinical populations displaying susceptibility to overconsumption and weight gain.This research was supported by a small grant from the Research England participatory research fund

Evolution of star formation in the UKIDSS Ultra Deep Survey Field - I. Luminosity functions and cosmic star formation rate out to z = 1.6

We present new results on the cosmic star formation history in the Subaru/XMM–Newton Deep Survey (SXDS)–Ultra Deep Survey (UDS) field out to z = 1.6. We compile narrowband data from the Subaru Telescope and the Visible and Infrared Survey Telescope for Astronomy (VISTA) in conjunction with broad-band data from the SXDS and UDS, to make a selection of 5725 emission-line galaxies in 12 redshift slices, spanning 10 Gyr of cosmic time. We determine photometric redshifts for the sample using 11-band photometry, and use a spectroscopically confirmed subset to fine tune the resultant redshift distribution. We use the maximum-likelihood technique to determine luminosity functions in each redshift slice and model the selection effects inherent in any narrow-band selection statistically, to obviate the retrospective corrections ordinarily required. The deep narrow-band data are sensitive to very low star formation rates (SFRs), and allow an accurate evaluation of the faint end slope of the Schechter function, α. We find that α is particularly sensitive to the assumed faintest broad-band magnitude of a galaxy capable of hosting an emission line, and propose that this limit should be empirically motivated. For this analysis, we base our threshold on the limiting observed equivalent widths of emission lines in the local Universe. We compute the characteristic SFR of galaxies in each redshift slice, and the integrated SFR density, ρSFR. We find our results to be in good agreement with the literature and parametrize the evolution of the SFR density as ρSFR ∝ (1 + z)4.58 confirming a steep decline in star formation activity since z ∼ 1.6. Keywords: surveys – galaxies: evolution – galaxies: formation – galaxies: high-redshift – galaxies: star formation – cosmology: observations

Cosmological parameters from the clustering of AGN

We attempt to put constraints on different cosmological and biasing models by combining the recent clustering results of X-ray sources in the local ($z\le 0.1$) and distant universe ($z\sim 1$).Comment: 9 pages, 3 figures, to be published in the proceedings of the ''2nd Hellenic Cosmology Workshop'', Athens 2001, eds, Manolis Plionis & Spiros Kotsaki

Cancer Cachexia: Traditional Therapies and Novel Molecular Mechanism-Based Approaches to Treatment

The complex syndrome of cancer cachexia (CC) that occurs in 50% to 80% cancer patients has been identified as an independent predictor of shorter survival and increased risk of treatment failure and toxicity, contributing to the mortality and morbidity in this population. CC is a pathological state including a symptom cluster of loss of muscle (skeletal and visceral) and fat, manifested in the cardinal feature of emaciation, weakness affecting functional status, impaired immune system, and metabolic dysfunction. The most prominent feature of CC is its non-responsiveness to traditional treatment approaches; randomized clinical trials with appetite stimulants, 5-HT3 antagonists, nutrient supplementation, and Cox-2 inhibitors all have failed to demonstrate success in reversing the metabolic abnormalities seen in CC. Interventions based on a clear understanding of the mechanism of CC, using validated markers relevant to the underlying metabolic abnormalities implicated in CC are much needed. Although the etiopathogenesis of CC is poorly understood, studies have proposed that NFkB is upregulated in CC, modulating immune and inflammatory responses induce the cellular breakdown of muscle, resulting in sarcopenia. Several recent laboratory studies have shown that n-3 fatty acid may attenuate protein degradation, potentially by preventing NFkB accumulation in the nucleus, preventing the degradation of muscle proteins. However, clinical trials to date have produced mixed results potentially attributed to timing of interventions (end stage) and utilizing outcome markers such as weight which is confounded by hydration, cytotoxic therapies, and serum cytokines. We propose that selective targeting of proteasome activity with a standardized dose of omega-3-acid ethyl esters, administered to cancer patients diagnosed with early stage CC, in addition to a standard intervention with nutritionally adequate diet and appetite stimulants, will alter metabolic abnormalities by downregulating NFkB, preventing the breakdown of myofibrillar proteins and resulting in increasing serum protein markers, lean body mass, and functional status