Cognitively intact residents were receiving significantly more medications (median (IQR) 13 (10-16)) than those with mild to moderate (10 (7-13)) or severe (9 (7-12)) cognitive impairment (p less then  0.001). Overall, 82% of residents received at least one anticholinergic/sedative medication and 26.9% were exposed to one or more PIM, although the proportions of those receiving such medications were not significantly different across the groups. Of 7658 medications residents were taking daily, 21.3% and 11.7% were classified as symptom control and preventive medications respectively with no significant difference among the groups in their use. CONCLUSION Our findings highlight the need for optimising prescribing in RACF residents, with particular attention to medications with anticholinergic effects. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.AIM This study aimed to determine the clinical and biochemical variables associated with change in HbA1c in patients with type 2 diabetes who start sodium-glucose linked transporter (SGLT) inhibitor therapy. METHODS We performed a prospective cohort study (ACTRN12616000833460) of 48 adults with type 2 diabetes (18 female, 38 male) who attended a tertiary hospital diabetes clinic. Fasting serum and urine samples, collected during clinic visits prior to and at 1, 12 and 24 weeks after commencing SGLT inhibitor treatment, were analysed for HbA1c, electrolytes, urea, creatinine and glucose. RESULTS After 12 weeks, SGLT inhibitor therapy was associated with respective median (97% CI) decreases in weight, blood pressure, HbA1c and urine albumin/creatinine ratio of 3.0 (1.7 to 3.4) kg, 8 (2 to 16)/4 (3 to 9) mmHg, 6 (3 to 14) mmol/mol and 0.69 (0.18 to 1.8) mg/mmol. These effects persisted to 24 weeks. Urinary frequency and genitourinary infection were common adverse effects. Baseline HbA1c and eGFR independently predicted ΔHbA1c at 12 weeks whereas only baseline HbA1c independently predicted ΔHbA1c at 24 weeks. Urinary fractional glucose excretion and change in fasting glucose one week after starting SGLT inhibitor did not contribute to prediction of glycaemic response. CONCLUSIONS SGLT inhibitor therapy in a hospital clinic setting was associated with clinical improvements comparable to those observed in clinical trials but with higher incidence of genitourinary side effects. Baseline HbA1c and eGFR, but not urine fractional glucose excretion, predicted glycaemic response. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.Papers on sexual selection often highlight the incredible diversity of sexually selected traits across animals. Yet, few studies have tried to explain why this diversity evolved. Animals use many different types of traits to attract mates and outcompete rivals, including colours, songs, and horns, but it remains unclear why, for example, some taxa have songs, others have colours, and others horns. Here, we first conduct a systematic survey of the basic diversity and distribution of different types of sexually selected signals and weapons across the animal Tree of Life. Based on this survey, we describe seven major patterns in trait diversity and distributions. We then discuss 10 unanswered questions raised by these patterns, and how they might be addressed. One major pattern is that most types of sexually selected signals and weapons are apparently absent from most animal phyla (88%), in contrast to the conventional wisdom that a diversity of sexually selected traits is present across animals. Furthermore, most trait diversity is clustered in Arthropoda and Chordata, but only within certain clades. Within these clades, many different types of traits have evolved, and many types appear to have evolved repeatedly. By contrast, other major arthropod and chordate clades appear to lack all or most trait types, and similar patterns are repeated at smaller phylogenetic scales (e.g. within insects). Although most research on sexual selection focuses on female choice, we find similar numbers of traits (among sampled species) are involved in male contests (44%) and female choice (55%). Overall, these patterns are largely unexplained and unexplored, as are many other fundamental questions about the evolution of these traits. We suggest that understanding the diversity of sexually selected traits may require a shift towards macroevolutionary studies at relatively deep timescales (e.g. tens to hundreds of millions of years ago). © 2020 Cambridge Philosophical Society.Despite growing concern over socioeconomic inequality in health, few studies have focused on health inequality among older adults. https://www.selleckchem.com/products/ugt8-in-1.html The present study examined the independent and joint effects of socioeconomic status (SES) and family functioning on mental health and subjective well-being and explored the gender differences in such relations. Representative survey data on older adults (N = 1,432) were drawn from the third wave of the Hong Kong Panel Study of Social Dynamics conducted in 2015. Descriptive analyses and ordinary least-squares regressions were conducted for data analysis. The results demonstrate that receipt of means-tested welfare payments was associated with more severe mental distress and lower life satisfaction; living in private (as opposed to public or subsidised) housing was associated with better mental health; whereas holding investments and larger residence size were related to higher life satisfaction. Moreover, greater family functioning predicted better mental health and greater subjective well-being and mitigated the detrimental effects of low SES. Gender differences were observed concerning the effects of different predictors. The findings could inform the development of health-promotion services sensitive to gender and socioeconomic differences and facilitate integration of individual- and family-level services for older adults. © 2020 John Wiley & Sons Ltd.The purposes of this study were to describe the hypertensive population and therapeutic management of hypertension in adults between 18 and 74 years of age in France in 2015. Esteban survey is a cross-sectional survey with a clinical examination conducted in a representative sample of French adults aged 18-74 years between 2014 and 2016. Esteban was entirely public-funded. Blood pressure (BP) was measured during clinical examination with a standardized protocol, and pharmacological treatment was collected through the exhaustive Système National des Données de Santé (SNDS) database. Hypertension was defined by systolic BP (SBP)> 140 mm Hg, diastolic BP (DBP)> 90 mm Hg or treatment with BP-lowering drugs. The therapeutic control of treated hypertensive patients was defined by SBP  less then  140 mm Hg and DBP  less then  90 mm Hg. Adherence to drug treatment was defined as more than 80% of days covered by BP-lowering drug per year. The prevalence of hypertension was 31.3%. 74.7% of aware hypertensive participants taking an antihypertensive drug, and 57.