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The current researchers carried out a large online survey on 18 March 2020 and unintentionally provided a 'snap shot' of how the British population was responding in the early stages of the Covid‐19 pandemic. This paper aims to investigate the relationship between loneliness and mental health at the early stages of the global crisis. This cross‐sectional study was carried out using Prolific, an online participant recruitment platform that allowed 1608 responses in just 2 hr. Participants completed measures of Personal Well‐being, Psychological Distress, Flourishing and Loneliness. Numerous associations between loneliness and mental health were found. A multiple regression found that 43% of the variance in loneliness can be accounted for by age, psychological distress and flourishing. Responses were also categorised into three groups: the non‐lonely (n = 311), averagely lonely (n = 1054) and the severely lonely (n = 243), with analysis indicating that poorer well‐being was associated with increased loneliness. Due to the cross sectional nature of this research, determining the direction of causality is not possible. It remains uncertain whether increased loneliness negatively impacted on mental health, whether poor mental health lead to increased loneliness, or both in fact. Current findings suggest that severely lonely individuals may be particularly vulnerable to psychological distress and that individuals with poor mental health may be especially prone to loneliness. Individuals experiencing loneliness and/or poor mental health will almost certainly need additional support during and beyond the pandemic. [ABSTRACT FROM AUTHOR]

Comorbidity has been found to be significantly related to increased levels of mortality, decreased functional status and quality of life, increasing dependence on health services and an increased risk of mental and social problems. Previous research into comorbidity has mainly focused on identifying the most common groupings of illnesses found among elderly healthcare users. In contrast, this paper pools data from the Health Survey for England from 2008 to 2012 to form a representative sample of individuals in private households in England to explore the risk of comorbidity among the general population; and to take account of not only the demographic but also the socioeconomic and area-level determinants of comorbidity. Using a multinomial logistic model, this research confirms that age and gender are significant predictors of cardiovascular disease, diabetes and obesity, whether examined singly or in any comorbidity combination. Across the seven possible disease combinations, the odds ratios are lowest for those individuals with a high income (6 of 7), home-owning (5 of 7), degree educated (7 of 7) and living in the least deprived area (6 of 7), when controlling for demographic and smoking characteristics. The important influence of socioeconomic factors associated with comorbidity risk indicates that healthcare policy needs to move from a focus on age profiles to take better account of individual and local area socioeconomic circumstances. [ABSTRACT FROM AUTHOR]

Abstract: Many patients find using medicines burdensome. This paper reports the types of issues people experience with medicines, using a validated measure of medicines burden, and the factors associated with high burden. The cross‐sectional study involved patients presenting prescriptions at pharmacies or awaiting appointments at GP practices or outpatient clinics, during October 2015 to December 2016. Adults using at least one regular medicine were asked to complete the Living with Medicines Questionnaire V3 (LMQ‐3). The LMQ‐3 contains 41 statements rated on a 5‐point scale (strongly agree to strongly disagree), with higher scores indicating greater burden, plus a visual analogue scale for self‐reporting of overall perceived burden (VAS‐burden). For a subsample, access to their medication record was requested, facilitating calculation of the complexity of their medicine regimen using the Medicine Regimen Complexity Index (MRCI). Of 1,888 questionnaires distributed, 684 were returned (36.2%) and medication records obtained for 163. The median number of medicines respondents reported using was 4 (range 1 to 26). Two‐thirds (418; 67.0%) used medicines more than once daily, 67 (10.1%) required assistance with medicines and 189 (28.3%) paid a prescription charge. LMQ‐3 scores showed a strong positive relationship with VAS‐burden scores (r = .547; p < 0.001). LMQ‐3 and VAS‐burden scores were lower in older age groups, but both increased with increasing number of medicines and dosing frequency. LMQ‐3 score was positively related to MRCI score (n = 163; r = .217; p = 0.005), whereas VAS‐burden was not. Older respondents reported lower burden in most domains. Higher numbers and frequency of medicines, paying prescription charges, needing support and deprivation increased burden across multiple domains. Factors strongly associated with high LMQ‐3 scores were: needing support, high dosing frequency and unemployment. Interventions seeking to reduce medicines burden should consider targeting individuals who need support with using medicines, use at least four medicines, more than twice daily and/or pay prescription charges. [ABSTRACT FROM AUTHOR]

International evidence indicates that older people with frailty are more likely to access social care services, compared to nonfrail older people. There is, however, no robust evidence on costs of social care provided for community‐dwelling older people living with frailty in their own homes. The main objective of this study was to examine the relationship between community‐dwelling older people living with frailty, defined using the cumulative deficit model, and annual formal social care costs for the 2012–2018 period. A secondary objective was to estimate formal social care spending for every 1% reduction in the number of older people who develop frailty over 1 year. Secondary analysis of prospective cohort data from two large nationally representative community‐based cohort studies in England was performed. Respondents aged ≥75 were used in the main analysis and respondents aged 65–74 in sensitivity testing. We used regression tree modelling for formal social care cost analysis including frailty, age, gender, age at completing education and living with partner as key covariates. We employed a minimum node size stopping criteria to limit tree complexity and overfitting and applied 'bootstrap aggregating' to improve robustness. We assessed the impact of an intervention for every 1% decrease in the number of individuals who become frail over 1 year in England. Results show that frailty is the strongest predictor of formal social care costs. Mean social care costs for people who are not frail are £321, compared with £2,895 for individuals with frailty. For every 1% of nonfrail people not transitioning to frailty savings of £4.4 million in annual expenditures on formal social care in England are expected, not including expenditure on care homes. Given considerably higher costs for individuals classed as frail compared to nonfrail, a successful intervention avoiding or postponing the onset of frailty has the potential to considerably reduce social care costs. [ABSTRACT FROM AUTHOR]

Objectives: To identify differences and similarities in HbA1c levels and patterns regarding age and gender in eight high‐income countries. Subjects: 66 071 children and adolescents below18 years of age with type 1 diabetes for at least 3 months and at least one HbA1c measurement during the study period. Methods: Pediatric Diabetes Quality Registry data from Austria, Denmark, England, Germany, Norway, Sweden, the United States, and Wales were collected between 2013 and 2014. HbA1c, gender, age, and duration were used in the analysis. Results: Distribution of gender and age groups was similar in the eight participating countries. The mean HbA1c varied from 60 to 73 mmol/mol (7.6%‐8.8%) between the countries. The increase in HbA1c between the youngest (0‐9 years) to the oldest (15‐17 years) age group was close to 8 mmol/mol (0.7%) in all countries (P <.001). Females had a 1 mmol/mol (0.1%) higher mean HbA1c than boys (P <.001) in seven out of eight countries. Conclusions: In spite of large differences in the mean HbA1c between countries, a remarkable similarity in the increase of HbA1c from childhood to adolescence was found. [ABSTRACT FROM AUTHOR]

The Care Act 2014 allows eligible people with care and support needs to access funding directly from local authorities in England. Such funds may be used to employ care workers. Others may employ care workers using their own or family resources. This study explores the working relationships, views and experiences of General Practitioner (GP) about older people's directly employed care workers (DECWs). Qualitative interviews were conducted with 20 GPs in England, identified by convenience sampling of research networks and snowballing methods. Data were analysed thematically. Three overarching themes were identified: (a) anxieties about the identity of the DECW, and their relationship to their employer; (b) experiences of relationship‐based care, and; (c) tasks carried out by DECWs. Identity mattered because DECWs can appear as an unknown participant in consultations, raising questions about consent, and prompting thoughts about elder abuse. Uncertainty about identity made documentation of DECWs' details in electronic medical records and care plans problematic. Case examples of relational care illustrated the benefits of reciprocity between older person and their employee who sometimes provided continuity of care and care co‐ordination for their employer. Participants were alert to the risks of exploitation and insecurity for DECWs whose tasks were thought to span household and personal care, transport assistance and health‐related activities. The involvement of DECWs in maintaining older people's health raises questions about the support they receive from health professionals. In conclusion DECWs are well placed to monitor older people's health, provide continuity of care and undertake certain healthcare tasks. GPs envisaged such workers as potentially valuable assets in community‐based care for an ageing population. They called for skills training for this workforce and the development of protocols for delegation of health tasks and safeguarding of vulnerable older people. Older people employing care workers and those advising or supporting them should address communications with health providers in employment contracts and job descriptions. [ABSTRACT FROM AUTHOR]

This article examines the thresholds at which provision of unpaid care affects employment in England. Previous research has shown that providing care for 20 or more hours a week has a negative effect on employment. The present article explores the impact of a lower threshold and asks whether provision of care for 10 or more hours a week has a negative effect on employment. The article focuses on women and men aged between 50 and State Pension Age (60 for women, 65 for men). The study uses data from the first four waves of the English Longitudinal Study of Ageing (ELSA), collected in 2002/2003, 2004/2005, 2006/2007 and 2008/2009. Across these waves, there are 17 123 people aged 50-59/64 years, of whom 9% provide unpaid care to an adult. Using logistic regression analysis of the longitudinal data, the study finds that employed women in their fifties who start providing care for <10 hours a week are significantly more likely to remain in employment one wave later than similar women who have not started to provide care. In contrast, employed women in their fifties who start providing care for 10 or more hours a week are significantly less likely to remain in employment one wave later than similar women who have not started to provide care. Employed men aged between 50 and State Pension Age, who provide care for 10 or more hours a week at the beginning of the period have a significantly reduced employment rate one wave later than those who do not provide care. The study therefore suggests that carers' employment may be negatively affected when care is provided at a lower intensity than is generally estimated in England. This has important implications for local authorities, who have a duty to provide services to carers whose employment is at risk. [ABSTRACT FROM AUTHOR]