Trends in survival of older care home residents in England: A 10-year multi-cohort study

Increases in longevity combined with a policy emphasis on caring for older people in their own homes could have widened or narrowed the survival gap between care home and community-dwelling resident older people. Knowledge of pre-COVID-19 trends in this gap is needed to assess the longer-term impacts of the pandemic. We provide evidence for England on recent trends in 1, 2 and 3-year mortality amongst care home residents aged 65+ compared with similar community-dwelling residents. We use the Clinical Practice Research Datalink, a nationally representative primary care database. For each of the ten years from 2006 to 2015, care home and community-dwelling residents aged 65+ were identified and matched in the ratio 1:3, according to age, gender, area deprivation and region. Cox survival analyses were used to estimate mortality risks for care home residents in comparison with similar community-dwelling people, adjusting for age, gender, area deprivation and region. The study sample consisted of ten overlapping cohorts averaging 5495 care home residents per cohort. Adjusted mortality risks increased over the study period for care home residents while decreasing slightly for matched community-dwelling residents. The relative risks (RRs) of mortality associated with care home residence were higher for younger ages and shorter follow-up periods, in all years. Over the decade, the RRs increased, most at younger ages and for shorter follow-up periods (e.g. for the age group 65-74 years, 1-year average RR increased by 61% from 5.4 to 8.8, while for those aged 85-94 years and over, 3-year RR increased by 22% from 1.3 to 1.6). Thus the survival gap between older care home and community-dwelling residents has been widening, especially at younger ages. In due course, it will be possible to establish to what extent the COVID-19 pandemic has resulted in further growth in this gap

Trends in survival of older care home residents in England: A 10-year multi-cohort study

Increases in longevity combined with a policy emphasis on caring for older people in their own homes could have widened or narrowed the survival gap between care home and community-dwelling resident older people. Knowledge of pre-COVID-19 trends in this gap is needed to assess the longer-term impacts of the pandemic. We provide evidence for England on recent trends in 1, 2 and 3-year mortality amongst care home residents aged 65+ compared with similar community-dwelling residents. We use the Clinical Practice Research Datalink, a nationally representative primary care database. For each of the ten years from 2006 to 2015, care home and community-dwelling residents aged 65+ were identified and matched in the ratio 1:3, according to age, gender, area deprivation and region. Cox survival analyses were used to estimate mortality risks for care home residents in comparison with similar community-dwelling people, adjusting for age, gender, area deprivation and region. The study sample consisted of ten overlapping cohorts averaging 5495 care home residents per cohort. Adjusted mortality risks increased over the study period for care home residents while decreasing slightly for matched community-dwelling residents. The relative risks (RRs) of mortality associated with care home residence were higher for younger ages and shorter follow-up periods, in all years. Over the decade, the RRs increased, most at younger ages and for shorter follow-up periods (e.g. for the age group 65–74 years, 1-year average RR increased by 61% from 5.4 to 8.8, while for those aged 85–94 years and over, 3-year RR increased by 22% from 1.3 to 1.6). Thus the survival gap between older care home and community-dwelling residents has been widening, especially at younger ages. In due course, it will be possible to establish to what extent the COVID-19 pandemic has resulted in further growth in this gap

Market concentration, supply, quality and prices paid by local authorities in the English care home market.

We investigate the impact of exogenous local conditions which favor high market concentration on supply, price and quality in local markets for care homes for older people in England. We extend the existing literature in: (i) considering supply capacity as a market outcome alongside price and quality; (ii) taking account of the chain structure of care home supply and differences between the nursing home and residential care home sectors; (iii) using an econometric approach based on reduced form relationships that treats market concentration as a jointly determined outcome of a complex market. We find that areas susceptible to a high degree of market concentration tend to have greatly restricted supply of care home places and (to a lesser extent) a higher average public cost, than areas susceptible to low degree of market concentration. There is no significant evidence that conditions favoring high market concentration affect average care home quality

Acute Malnutrition and Under-5 Mortality, Northeastern Part of India.

We assessed the prevalence of childhood acute malnutrition and under-five mortality rate (U5MR) in Darbhanga district, India, using a two-stage 49-cluster household survey. A total of 1379 households comprising 8473 people were interviewed. During a 90-day recall period, U5MR was 0.5 [95% confidence interval (CI), 0.2-1.4] per 10 000 per day. The prevalence of global acute malnutrition among 1405 children aged 6-59 months was 15.4% (NCHS) and 19.4% (2006 WHO references). This survey suggests that in Darbhanga district, the population is in a borderline food crisis with few food resources. Appropriate strategies should be developed to improve the overall nutritional and health status of children

Higher vertical jumping asymmetries and lower physical performance are indicators of increased injury incidence in youth team-sport athletes

To date, the literature looking at the association between injury-risk factors and actual injury incidence in young elite team-sports athletes is scarce. The main objective of the present study was to examine how modifiable factors may affect injury incidence. Eighty-one young elite team-sports athletes (age: u-14 to u-18) performed the countermovement jump (CMJ), a single leg CMJ (SLCMJ), the one-legged hop test (OLHT), a 30 m sprint test, the v-cut test, a repeated sprint ability and the 30-15 intermittent fitness test during the pre-season period. Inter-limb asymmetries were calculated for SLCMJ and OLHT. Injuries were recorded prospectively for the entirety of the 2017-2018 season. Comparison of injury and non-injury data was carried out using a two-way analysis of variance (ANOVA). Results of the ANOVA according to injury showed significant differences in CMJ (p = 0.01), SLCMJ on the lowest performing limb (p = 0.03) and SLCMJ asymmetry (< 0.001). Sex*injury interaction was significant from CMJ (p = 0.018) and 30-15 IFT (p = < 0.001). In conclusion, the current study indicated that athletes with greater inter-limb asymmetries, less vertical jump capacity and lower intermittent aerobic fitness had a greater predisposition to injury. Therefore, monitoring CMJ, aerobic performance and inter-limb asymmetries is recommended given their sensitivity to detect significant differences between injured and healthy youth athletes

Could GLUT12 be a Potential Therapeutic Target in Cancer Treatment? A Preliminary Report

Background: Recent studies proposed GLUT12 to be a major glucose transporter involved in the glycolytic metabolism of cancer cells. Methods: GLUT12 expression was determined by immunohistochemistry in a selection of cancer cell lines and a tumour spheroid model. Results: GLUT12 expression was high in A549 and RH-36; low in HT29; and absent in NB-EB cancer cell lines. GLUT12 expression was located in the necrotic centre of HT29 spheroids, which is characterised by anaerobic metabolism. Conclusion: The data supports the involvement of GLUT12 in the glycolytic metabolism of cancer cells and therefore, its potential as a novel therapeutic target for cancer treatment

Acquired Cold Urticaria: Clinical Features, Particular Phenotypes, and Disease Course in a Tertiary Care Center Cohort

BACKGROUND: Data about special phenotypes, natural course, and prognostic variables of patients with acquired cold urticaria (ACU) are scarce. OBJECTIVES: We sought to describe the clinical features and disease course of patients with ACU, with special attention paid to particular phenotypes, and to examine possible parameters that could predict the evolution of the disease. METHODS: This study was a retrospective chart review of 74 patients with ACU who visited a tertiary referral center of urticaria between 2005 and 2015. RESULTS: Fourteen patients (18.9%) presented with life-threatening reactions after cold exposure, and 21 (28.4%) showed negative results after cold stimulation tests (classified as atypical ACU). Nineteen patients (25.7%) achieved complete symptoms resolution at the end of the surveillance period and had no subsequent recurrences. Higher rates of atypical ACU along with a lower likelihood of achieving complete symptom resolution was observed in patients who had an onset of symptoms during childhood (P < .05). In patients with atypical ACU, shorter disease duration and lower doses of antihistamines required for achieving disease control were detected (P < .05). Age at disease onset, symptom severity, and cold urticaria threshold values were found to be related to disease evolution (P < .05). LIMITATIONS: This study was limited by its retrospective nature. CONCLUSIONS: The knowledge of the clinical predictors of the disease evolution along with the clinical features of ACU phenotypes would allow for the establishment of an early and proper therapeutic strategy

Fabrication of optical waveguides in RbTiOPO4 single crystals by using different techniques

M.A. Butt, M.C. Pujol, R. Solé, A. Ródenas, G. Lifante, M. Aguiló, F. Díaz, S. N. Khonina, R. V. Skidanov and Payal Verma, "Fabrication of optical waveguides in RbTiOPO4 single crystals by using different techniques", XIII International Scientific and Technical Conference on Optical Technologies in Telecommunications,SPIE 9807 (26 March, 2016): doi: 10.1117/12.2231368. One print or electronic copy may be made for personal use only. Systematic reproduction and distribution, duplication of any material in this paper for a fee or for commercial purposes, or modification of the content of the paper are prohibitedProceedings of XIII International Scientific and Technical Conference on Optical Technologies in Telecommunications Conference (Ufa, Russian Federation)In this work, we have demonstrated the use of different technologies to fabricate straight channel waveguides, S-bend waveguides, Y-splitter and Mach -Zehnder (MZ) structures on RbTiOPO 4 crystals and its isomorphs. We used reactive ion etching (RIE), inductively coupled plasma-RIE (ICP-RIE), femtosecond pulse laser micro-fabrication and ion diffusion techniques to structure these crystals. Computer simulations have been carried out and compared with the optical characterization of the waveguides which are in agreement with each other.This work is supported by the Ministry of Education and Science of the Russian Federation, Russian Science Foundation (grant No. 14-19-00114), Spanish Government under Projects MAT2011-29255-C02-02, TEC2014-55948-R, MAT2013-47395, C4-4-R/1-R and by the Catalan Authority under Project 2014SGR135