Closing the life expectancy gap: An ecological study of the factors associated with smaller regional health inequalities in post-reunification Germany.

Regional health inequalities are rising globally. The case of German reunification offers a unique opportunity to explore how such inequalities can be reduced, or even eliminated: following reunification, a long-standing life expectancy gap between East and West Germany was closed for women and markedly reduced for men in less than 15 years. We used data from official national statistics covering the period 1994-2020 for 15 regions in East and West Germany.

Is it possible to identify populations experiencing material disadvantage in primary care? A feasibility study using the Clinical Practice Research Database.

Background: Material disadvantage is associated with poor health, but commonly available area-based metrics provide a poor proxy for it. We investigate if a measure of material disadvantage could be constructed from UK primary care electronic health records.

Methods: Using data from Clinical Practice Research Datalink Aurum (May 2022) linked to the 2019 English Index of Multiple Deprivation (IMD), we sought to (1) identify codes that signified material disadvantage, (2) aggregate these codes into a binary measure of material disadvantage and (3) compare the proportion of people with this binary measure against IMD quintiles for validation purposes.

"Successful" ageing in later older age: A sociology of class and ageing in place.

Supporting people to 'age in place' - to live independently at home and remain connected to the community - is an international policy priority. But the process of ageing in place is mediated in a socio-cultural context where neoliberal tropes of successful ageing reproduce a pervasive model about 'ageing well' by elevating ideals of individualised choice and self-governance. Based on two waves of qualitative interviews and interim observations, we employ a Bourdieusian logic to explore the ramifications of this context on the experiences of 46 people in later older age (80+) ageing in place in North East England.

Automatic identification of ablation targets in persistent atrial fibrillation: Initial experience with a new mapping tool.

Introduction: Strategies beyond pulmonary vein isolation (PVI) in persistent atrial fibrillation (persAF) are debated. A novel mapping tool provides algorithmic detection of ablation targets based on electrogram (EGM) properties specific to stable localized rotational activations.

Methods: The mapping tool was used on 31 patients (20 de novo).

Assessing the extent and determinants of socioeconomic inequalities in epilepsy in the UK: a systematic review and meta-analysis of evidence.

Background: Socioeconomic inequalities in epilepsy incidence and its adverse outcomes are documented internationally, yet the extent of inequalities and factors influencing the association can differ between countries. A UK public health response to epilepsy, which prevents epilepsy without widening inequalities, is required. However, the data on UK epilepsy inequalities have not been synthesised in a review and the underlying determinants are unknown.

'It's where I belong': what does it mean to age in place from the perspective of people aged 80 and above? A longitudinal qualitative study (wave one).

Background: Most people want to remain at home as they age. Ageing in place - remaining at home and connected to the community - is a national and international policy priority; however, to better understand how policy might be implemented, a more nuanced understanding is required about older adults' lived experiences of ageing in place, especially the experiences of those aged 80 and above.

Objective: To describe and explore the social processes which enable ageing in place from the perspective of community-dwelling older people (80+).

Characteristics of older unpaid carers in England: a study of social patterning from the English Longitudinal Study of Ageing.

Background: A growing number of older people provide unpaid care, but contemporary research evidence on this group is limited.

Aim: This study aims to describe the characteristics of older people who provide unpaid care and how these vary by socioeconomic position.

Methods: Using recent information from the English Longitudinal Study of Ageing (ELSA wave 9, 2019), we analysed cross-sectional data on 1,282 unpaid carers aged ≥50.

Demographic, health, physical activity, and workplace factors are associated with lower healthy working life expectancy and life expectancy at age 50.

Although retirement ages are rising in the United Kingdom and other countries, the average number of years people in England can expect to spend both healthy and work from age 50 (Healthy Working Life Expectancy; HWLE) is less than the number of years to the State Pension age. This study aimed to estimate HWLE with the presence and absence of selected health, socio-demographic, physical activity, and workplace factors relevant to stakeholders focusing on improving work participation. Data from 11,540 adults in the English Longitudinal Study of Ageing were analysed using a continuous time 3-state multi-state model.

Synchrotron-based x ray fluorescence ghost imaging.

X ray fluorescence ghost imaging (XRF-GI) was recently demonstrated for x ray lab sources. It has the potential to reduce the acquisition time and deposited dose by choosing their trade-off with a spatial resolution while alleviating the focusing constraints of the probing beam. Here, we demonstrate the realization of synchrotron-based XRF-GI: we present both an adapted experimental setup and its corresponding required computational technique to process the data.

Associations Between Local Area Deprivation and Physical Activity Participation in People with Cognitive Impairment in the North East of England.

Background: Promoting physical activity, such as habitual walking behaviors, in people with cognitive impairment may support their ability to remain independent with a good quality of life for longer. However, people with cognitive impairment participate in less physical activity compared to cognitively unimpaired older adults. The local area in which people live may significantly impact abilities to participate in physical activity.

Is polypharmacy associated with difficulty taking medicines in people aged ≥85 living at home? Findings from the Newcastle 85+ Study.

It is unclear whether polypharmacy is associated with difficulty taking medications amongst people aged ≥85 living at home. This is despite the projected decline in availability of family carers, who may support independent living. Using Newcastle 85+ Study data and mixed-effects modelling, we investigated the association between polypharmacy and difficulty taking medications amongst 85-year-olds living at home, over a 10-year time period.

Mask design, fabrication, and experimental ghost imaging applications for patterned X-ray illumination.

A set of non-configurable transversely-displaced masks has been designed and fabricated to generate high-quality X-ray illumination patterns for use in imaging techniques such as ghost imaging (GI), ghost projection, and speckle tracking. The designs include a range of random binary and orthogonal patterns, fabricated through a combination of photolithography and gold electroplating techniques. We experimentally demonstrated that a single wafer can be used as an illumination mask for GI, employing individual illumination patterns and also a mixture of patterns, using a laboratory X-ray source.

Geography Influences Susceptibility to SARS-CoV-2 Serological Response in Patients With Inflammatory Bowel Disease: Multinational Analysis From the ICARUS-IBD Consortium.

Background: Beyond systematic reviews and meta-analyses, there have been no direct studies of serological response to COVID-19 in patients with inflammatory bowel disease (IBD) across continents. In particular, there has been limited data from Asia, with no data reported from India. The ICARUS-IBD (International study of COVID-19 Antibody Response Under Sustained immunosuppression in IBD) consortium assessed serological response to SARS-CoV-2 in patients with IBD in North America, Europe, and Asia.

Designing formative assessments to improve anatomy exam performance.

Formative assessments are primarily used as a tool to gauge learning throughout an anatomy course. They have also been demonstrated to improve student mastery and exam performance, although the precise nature of this relationship is poorly understood. In this study, it is hypothesized that formative assessment questions targeting higher cognitive levels, integrating topics from multiple lessons, and including visuospatial elements will increase student exam performance.

The impact of long-term conditions on disability-free life expectancy: A systematic review.

Although leading causes of death are regularly reported, there is disagreement on which long-term conditions (LTCs) reduce disability-free life expectancy (DFLE) the most. We aimed to estimate increases in DFLE associated with elimination of a range of LTCs. This is a comprehensive systematic review and meta-analysis of studies assessing the effects of LTCs on health expectancy (HE).

Paleo-biodegradation and hydrocarbon mixing in a major hybrid petroleum reservoir.

Some of the parental material for hydrocarbons produced from low-permeability reservoirs in Western Canada corresponds to thermal products from biodegraded oil. This has been proved by the occurrence of framboidal pyrite, which is often formed during microbial sulfate reduction (MSR). In addition, the identified pyrite framboids are associated with the presence of phosphorus (P).

National Early Warning Scores Following Emergency Hospital Transfer: Implications for Care Home Residents.

Objective: Care home residents have high rates of hospital admission. The UK National Early Warning Score (NEWS2) standardizes the secondary care response to acute illness. However, the ability of NEWS2 to predict adverse health outcomes specifically for care home residents is unknown.

The association between multimorbidity and mobility disability-free life expectancy in adults aged 85 years and over: A modelling study in the Newcastle 85+ cohort.

Background: Mobility disability is predictive of further functional decline and can itself compromise older people's capacity (and preference) to live independently. The world's population is also ageing, and multimorbidity is the norm in those aged ≥85. What is unclear in this age group, is the influence of multimorbidity on (a) transitions in mobility disability and (b) mobility disability-free life expectancy (mobDFLE).

Vascular disease and apathy symptoms in the very old: A cross-sectional and longitudinal meta-analysis of individual participant data.

Objectives: Previous findings suggest a vascular foundation underlying apathy, but transdiagnostic and prospective evidence on vascular apathy is scarce. This study examines the association between vascular disease and the presence and development of apathy symptoms in the very old.

Methods: Four cohorts of the Towards Understanding Longitudinal International older People Studies (TULIPS)-consortium were included in a two-staged, individual participant data meta-analysis using generalized linear mixed models.

Does polypharmacy shape dependency transitions in the very old? Findings from the Newcastle 85+ Study.

Background: helping older people to maintain their independence, and identifying risk factors that compromise this, is of high importance. Polypharmacy is common in the very old (aged ≥ 85) but whether it can shape transitions in dependency in this fastest growing subpopulation is unclear.

Methods: using Newcastle 85+ Study data and multi-state modelling, we investigated the association between each additional medication prescribed and the progression of and recovery from dependency states, over 10 years (age 85-95).

Factors associated with unmet need for support to maintain independence in later life: a systematic review of quantitative and qualitative evidence.

Background: populations are considered to have an 'unmet need' when they could benefit from, but do not get, the necessary support. Policy efforts to achieve equitable access to long-term care require an understanding of patterns of unmet need. A systematic review was conducted to identify factors associated with unmet need for support to maintain independence in later life.

Investigating the impact on mental wellbeing of an increase in pensions: A longitudinal analysis by area-level deprivation in England, 1998-2002.

In 1997 approximately two million people aged 60 years or over were living poverty in the UK. In 1999 the UK Government raised real pension incomes of low-income pensioners by around a third through the introduction of the Minimum Income Guarantee (MIG). This study explores the implications of this change for pensioners' mental wellbeing with a focus on differences by area level deprivation in England.

A versatile microtomography system to study in situ the failure and fragmentation in geomaterials.

This article describes a microtomography experimental platform enabling in situ micro-mechanical study of failure and fragmentation in geomaterials. The system is based on an original high-pressure triaxial flow cell, which is fully integrated into a custom built microtomography scanner equipped with a laboratory x-ray source. The design of the high-precision mechanical apparatus was informed by the concurrent development of advanced tomographic reconstruction methods based on helical scanning and of algorithms correcting for hardware inaccuracies.