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This research builds on the recently published paper (Garden, 2022c), which explored through interviews the use of iPads as cameras to enhance Forest School practice. Children's perspectives of the Forest School space captured what was important to them on camera (Garden, 2022c). Working with the same group of 32 Key Stage 2 children selected from two UK primary schools, the research explored the images captured on iPad cameras during the follow-on session. The unstructured interviews explored the children's feelings and meanings associated with the images captured in the Forest School space using Interpretive Phenomenological Analysis (IPA). The photographs can be understood within the themes of 'play with technology', 'soft fascination' and 'place attachment', all of which are inherent in the Forest School ethos. Suggestions for future research include reflections on the ways the capturing of images of Forest School can encourage peer collaboration whilst considering the relative influence of space.

Abstract Objectives The objective of this study is to investigate the association between the use of beta‐adrenergic antagonist atenolol and risk of pathologic upgrade in patients on active surveillance, considering growing literature implicating adrenergic innervation with disease progression mediated through beta‐adrenergic signalling. Patients and Methods Men with low‐risk or favourable intermediate‐risk prostate cancer who were placed on an active surveillance protocol between 2006 and 2020 across three diverse urban hospitals were included. Exposure was duration of atenolol use, and outcome was pathologic grade group upgrading (to GG ≥ 3) on final prostate biopsy. Cox proportional hazard regression models were used to determine the associations between atenolol use and risk of upgrading with time, on a per‐examination basis. Results A total of 467 men with initial GG ≤ 2 were included. Postdiagnosis atenolol use was associated with a decreased risk of pathologic upgrade to GG ≥ 3 on final repeat biopsy (HR 0.81, 95% CI 0.39–0.98). Longer duration of postdiagnosis atenolol use (>2 years) and greater cumulative atenolol dose (>730 defined daily doses) were associated with a more pronounced decreased risk of upgrade to GG ≥ 3 (HR 0.41, 95% CI 0.05–0.88, and HR 0.32, 95% CI 0.15–0.99, respectively). Initiation of atenolol use prior to prostate cancer diagnosis had a slightly greater protective effect than drug initiation postdiagnosis (HR 0.79, 95% CI 0.43–0.98, and HR 0.83, 95% CI 0.30–0.99, respectively). Conclusions Beta‐adrenergic blockade with atenolol use in men on active surveillance is associated with a reduced risk for clinically significant grade group pathologic upgrade.

Some children come to school with a smaller vocabulary than their peers. If children do not have knowledge of the meaning of the words they read in texts, they will fail to comprehend those texts and struggle to keep up with their peers. This is critical because the link between vocabulary and comprehension is very clear (Sticht et al., 1974, as cited in Vadasy & Nelson, 2012). If teachers do not intervene when students are in the early grades, we see that those children who know more words learn additional words more quickly, and subsequently, other children could continue to struggle with reading (Stanovich, 1986). Consequently, some children struggle with reading even more when they enter the upper elementary grades where they can fall into what is referred to as the "fourth-grade slump" when children are beginning to encounter words and word meanings that are increasingly challenging (Chall et al., 1990, p. 1). The author discusses the importance of teaching vocabulary and what vocabulary instruction can look like in the early grades to combat this challenge.

Outdoor pedagogies have gained significant traction in Early Childhood Education over the years and European traditions represent a cultural norm in what is generally referred to as Scandinavian outdoor pedagogies. This small-scale ethnographic research adopted an interpretative methodological approach and afforded opportunities to observe young preschool children engaging in an outdoor, allotment, Garden School in the centre of Oslo Norway. Here we were in the privileged position to capture moments vis a vis the environment, and whilst we acknowledge traditional child led discourses, affiliated with healthy child development, we also envisaged a world where children engaged in post-anthropocentric entanglements with human and non-human kinships.

Forest Schools emerged in the UK in the early 1990s after a group of practitioners developed the Forest School programme following a visit to Denmark. In our recent systematic review of forest school literature in England (Garden and Downes 2021), we proposed that a focus on space in future research to generate new complexities around the broader concepts that allow us to explore hybrid spaces constituted by both classrooms and Forest Schools. This means an examination of the various interactions between children, adults and artefacts that come together to generate existing and new spaces. There is the opportunity to re-conceptualise ideas around the Forest School space through the framing of Massey's (2005) proposition that space is a product of relations-between and that space is always in the process of being made. Thus, children create and 'own' the Forest School space through their inhabitation of it. This paper provides a key contribution to existing knowledge around Forest Schools within outdoor education by examining ways in which new educational spaces can be formed, contested and colonised beyond the classroom.

Forest schools are distinctive outdoor spaces that are often regarded as an alternative to mainstream education. Their increasing popularity in the United Kingdom is often attributed to a perceived decrease in children's outdoor play, due to a concomitant increase in children's use of digital technologies in the home; further compounded by the COVID-19 pandemic. This study explores how iPads can enhance outdoor learning activities. Semi-structured interviews were conducted with 32 Key Stage 2 children selected from two UK primary schools. The interviews explored the experiences and opinions of the children about the role of iPads in the forest school space using Interpretive Phenomenological Analysis (IPA). Findings suggest that Forest School spaces can accommodate new technologies through accommodation of the outdoor environment and technology. Suggestions for future research include the meaningful integration of iPads into Forest School practice while considering the relative influences of space and place.

This qualitative study uses Talanoa methodologies to explore the everyday experiences of Pacific elders travelling around Māngere Central, Aotearoa New Zealand. A suite of street infrastructure changes for walking and cycling took place in the area between 2015 and 2017. While the evidence linking attributes of urban street design to physical activity behaviour is strong, there is little research on the impact of the built environment on Pacific elders’ active mobility. The study seeks to address this knowledge gap by focusing on the impacts of streetscape changes on the active travel and social connectivity of this group of residents. Findings indicate that post-intervention, elders feel significantly safer while walking, with active travel increasing for some. All elders in the study feel that important amenities are now more accessible, with some of significant cultural and social importance. As such, opportunities for social connection appear to have increased. Furthermore, the enhanced look and feel of the local environment is important to the elders interviewed, enhancing feelings of community pride and well-being for some. Further desired changes to support active mobility are discussed, and a logic model highlighting factors theorised to be particularly important for achieving mode shift among Pacific elders is proposed.

Abstract Immune thrombocytopenia (ITP) is the most common acquired primary hemostatic disorder in dogs. Immune thrombocytopenia less commonly affects cats but is an important cause of mortality and treatment‐associated morbidity in both species. Immune thrombocytopenia remains a diagnosis of exclusion for which diagnostic guidelines are lacking. Primary, or non‐associative, ITP refers to autoimmune platelet destruction. Secondary, or associative, ITP arises in response to an underlying disease trigger. However, evidence for which comorbidities serve as ITP triggers has not been systematically evaluated. To identify key diagnostic steps for ITP and important comorbidities associated with secondary ITP, we developed 12 Population Evaluation/Exposure Comparison Outcome (PECO) format questions. These questions were addressed by evidence evaluators utilizing a literature pool of 287 articles identified by the panelists using a structured search strategy. Evidence evaluators, using panel‐designed templates and data extraction tools, summarized evidence and created guideline recommendations that then were integrated by diagnosis and comorbidity domain chairs. The revised PECO responses underwent a Delphi survey process to reach consensus on final guidelines. A combination of panel expertise and PECO responses were employed to develop algorithms for diagnosis of ITP in dogs and cats, which also underwent 4 iterations of Delphi review. Comorbidity evidence evaluators employed an integrated measure of evidence (IME) tool to determine evidence quality for each comorbidity; IME values combined with evidence summaries for each comorbidity were integrated to develop ITP screening recommendations, which also were subjected to Delphi review. Commentary was solicited from multiple relevant professional organizations before finalizing the consensus. The final consensus statement provides clinical guidelines for the diagnosis of, and underlying disease screening for, ITP in dogs and cats. The systematic consensus process identified numerous knowledge gaps that should guide future studies. This statement is a companion manuscript to the ACVIM Consensus Statement on the Treatment of Immune Thrombocytopenia.

Abstract Management of immune thrombocytopenia (ITP) in dogs and cats is evolving, but there are no evidence‐based guidelines to assist clinicians with treatment decisions. Likewise, the overall goals for treatment of ITP have not been established. Immunosuppressive doses of glucocorticoids are the first line treatment, but optimal treatment regimens beyond glucocorticoids remain uncertain. Additional options include secondary immunosuppressive drugs such as azathioprine, modified cyclosporine, and mycophenolate mofetil, usually selected based on clinician preference. Vincristine, human IV immunoglobulin (hIVIg), and transfusion of platelet or red blood cell–containing products are often used in more severe cases. Splenectomy and thrombopoietin receptor agonists are usually reserved for refractory cases, but when and in which patient these modalities should be employed is under debate. To develop evidence‐based guidelines for individualized treatment of ITP patients, we asked 20 Population Intervention Comparison Outcome (PICO) format questions. These were addressed by 17 evidence evaluators using a literature pool of 288 articles identified by a structured search strategy. Evidence evaluators, using panel‐designed templates and data extraction tools, summarized evidence and created guideline recommendations. These were integrated by treatment domain chairs and then refined by iterative Delphi survey review to reach consensus on the final guidelines. In addition, 19 non‐PICO questions covering scenarios in which evidence was lacking or of low quality were answered by expert opinion using iterative Delphi surveys with panelist integration and refinement. Commentary was solicited from multiple relevant professional organizations before finalizing the consensus. The rigorous consensus process identified few comparative treatment studies, highlighting many areas of ITP treatment requiring additional studies. This statement is a companion manuscript to the ACVIM Consensus Statement on the Diagnosis of Immune Thrombocytopenia in Dogs and Cats.

Value-based healthcare payment models are an alternative insurance payment system that compensates healthcare providers based on their patients’ outcomes rather than the individual services healthcare workers provide. This shift from the current fee-for-service model that predominates our medical system has received renewed popularity and attention within organized medicine such as the American Medical Association. Advocates believe that this new payment model will address many of the unsolved issues in healthcare such as medical waste and unsustainable healthcare costs. In practice, however, this model is plagued with a myriad of unresolved issues of its own. In this commentary, we outline these issues and suggest that the intentions of those advocating for value-based payment models are either misguided or disingenuous. We then offer solutions that preserve our current fee-for-service model while making necessary changes that will benefit both physicians and patients nationwide.

Diversity, Equity, and Inclusion (DEI) initiatives have garnered increasing attention within medical education as there have been increased efforts to diversify the physician workforce among medical students, residents, fellows, and attendings. One way in which programs can improve their DEI initiatives and attract a more diverse pool of applicants is through DEI content on their graduate medical education websites. Prior studies characterizing the content and prevalence of DEI material on residency webpages have shown that dermatology residencies have relatively low levels of DEI content on their websites in which almost ¾ of all programs having no DEI content. Little is known, however, if similar findings are to be expected for the three main dermatology subspecialty fellowship program webpages: Dermatopathology, Pediatric Dermatology, and Micrographic Surgery and Dermatology Oncology. Fellowship programs were identified using the Accreditation Council for Graduate Medical Education’s online database of fellowship programs. Programs were evaluated on a standardized scoring system for five equally weighted criteria: fellowship-specific DEI webpage, DEI commitment statement, DEI initiatives (summer research opportunities for under-represented minorities, DEI council, etc.), link to the institution’s DEI homepage, and information about bias training. The mean score among all programs was 12.5. Pediatric dermatology ranked the highest among all specialties, while Mohs ranked the lowest. A link to the institution’s DEI homepage was the most prevalent factor accounting for 42.1% of all programs collected, whereas information about bias training and fellowship-associated DEI webpage were the least prevalent. The results of this study reveal an overall lack of DEI content across all dermatology subspecialties’ webpages and represent an actionable area of improvement for fellowship directors to increase their DEI efforts to attract a diverse pool of applicants to their program.

Introduction In 2020, the American Osteopathic Association merged its residency programs into one system under the Accreditation Council for Graduate Medical Education (ACGME). The effects of this transition on the ophthalmology match is not fully understood. The purpose of this study is to assess the early impact of the transition to ACGME accreditation on MD, DO, and IMG representation in ophthalmology residency programs.Materials and Methods Information about resident medical degree and resident medical school was gathered from ophthalmology residency program websites from a resident class before and after the Transition. Additionally, the medical degree of residency program directors (PD) was collected to analyze MD vs DO leadership in ophthalmology residency programs and to further stratify resident data to identify any trends in PD preference for different medical graduates.Results Data was obtained for 915 ophthalmology residents in 110 residency programs that met the study’s inclusion criteria. Of these programs, 102 were allopathic with MD leadership, 1 was allopathic with DO leadership, 3 were osteopathic with MD leadership, and 4 were osteopathic with DO leadership. Overall, MD representation increased while DO and IMG representation decreased although not significantly. For both classes analyzed, DO and IMG representation was disproportionately low.Discussion The transition to ACGME accreditation seems to have primarily harmed DO and IMG applicants in the ophthalmology match while benefitting MDs. Various factors such as loss of protected residency positions for DO applicants and the closure of osteopathic ophthalmology residency programs are likely reasons to blame for this decrease in osteopathic representation.

Regulatory T (Treg) cells are essential for the maintenance of immunological tolerance, yet the molecular components required for their maintenance and effector functions remain incompletely defined. Inactivation of VPS34 in Treg cells led to an early, lethal phenotype, with massive effector T cell activation and inflammation, like mice lacking Treg cells completely. However, VPS34-deficient Treg cells developed normally, populated the peripheral lymphoid organs and effectively supressed conventional T cells in vitro. Our data suggest that VPS34 is required for the maintaining normal numbers of mature Treg. Functionally, we observed that lack of VPS34 activity impairs cargo processing upon transendocytosis, that defective autophagy may contribute to, but is not sufficient to explain this lethal phenotype, and that loss of VPS34 activity induces a state of heightened metabolic activity that may interfere with metabolic networks required for maintenance or suppressive functions of Treg cells.

Interactions between excitatory and inhibitory neurons are critical to computations in cortical circuits but their organization is difficult to assess with standard electrophysiological approaches. Within the medial entorhinal cortex, representation of location by grid and other spatial cells involves circuits in layer 2 in which excitatory stellate cells interact with each other via inhibitory parvalbumin expressing interneurons. Whether this connectivity is structured to support local circuit computations is unclear. Here, we introduce strategies to address the functional organization of excitatory-inhibitory interactions using crossed Cre- and Flp-driver mouse lines to direct targeted presynaptic optogenetic activation and postsynaptic cell identification. We then use simultaneous patch-clamp recordings from postsynaptic neurons to assess their shared input from optically activated presynaptic populations. We find that extensive axonal projections support spatially organized connectivity between stellate cells and parvalbumin interneurons, such that direct connections are often, but not always, shared by nearby neurons, whereas multisynaptic interactions coordinate inputs to neurons with greater spatial separation. We suggest that direct excitatory-inhibitory synaptic interactions may operate at the scale of grid cell clusters, with local modules defined by excitatory-inhibitory connectivity, while indirect interactions may coordinate activity at the scale of grid cell modules.

Abstract Background Cachexia is prevalent in gastrointestinal cancers and worsens patient outcomes and chemotherapy compliance. We examined to what extent registered gastrointestinal cancer chemotherapy clinical trials record measures and related symptoms of cachexia as outcomes, and whether these were associated with trial characteristics. Methods Four public trial registries (2012–2022) were accessed for Phase II and/or III randomized controlled pancreatic, gastric, and colorectal cancer chemotherapy trial protocols. Trial outcome measures of overall survival and toxicity/side effects, and those related to cachexia [physical activity, weight/body mass index (BMI), dietary limitations, caloric intake, lean muscle mass] and symptoms (appetite loss, diarrhoea, pain, fatigue/insomnia, constipation, nausea, vomiting, and oral mucositis) were extracted, along with the number and types of performance status and patient‐reported outcomes (PROs) tools. Data were summarized descriptively. Chi‐square tests examined associations between outcomes and trial characteristics (cancer type, trial location, funding source, PROs tools, and commencement year). Statistical significance was set at P

Objective We sought to describe the long-term prognosis for a population-based cohort of people with hypercapnic respiratory failure (HRF) and the associations between underlying diagnoses and the risks of death and rehospitalisation.Methods We performed a historical cohort study of all persons with HRF in the Liverpool local government area in New South Wales, Australia, in the 3-year period from 2013 to 2015. Cohort members were identified using arterial blood gas results from Liverpool Hospital demonstrating pH ≤7.45 and PaCO2 >45 mm Hg within 24 hours of presentation. Linked health data were obtained from statewide registries with a minimum follow-up period of 6 years. The primary outcomes were time to death from any cause and the standardised mortality ratio (SMR) which compares the observed to the expected number of deaths in the same population. Secondary outcomes were time to rehospitalisation and the associations between death and/or hospitalisation and underlying diagnoses.Results The cohort comprised 590 adults aged between 15 and 101 years. Overall, 415 (70.3%) participants died in the follow-up period. Among those who survived the index admission, the probability of survival at 1, 3 and 5 years was 81%, 59% and 45%, respectively. The overall SMR was 9.2 (95% CI 7.6 to 11.0), indicating a near 10-fold risk of death than otherwise expected for age. Most (91%) survivors experienced rehospitalisation, with median (IQR) time to readmission of 3.9 (1.2–10.6) months. Congestive cardiac failure and neuromuscular disease were associated with an increased risk of death, whereas chronic obstructive pulmonary disease and sleep disordered breathing increased the risk of rehospitalisation.Conclusions HRF is associated with poor survival and high risk of rehospitalisation in the 5 years following an index event. The underlying disease appears to have some influence on overall survival and subsequent hospitalisations.

Purpose: Our purpose was to develop a clinically intuitive and easily understandable scoring method using statistical metrics to visually determine the quality of a radiation treatment plan. Methods and Materials: Data from 111 patients with head and neck cancer were used to establish a percentile-based scoring system for treatment plan quality evaluation on both a plan-by-plan and objective-by-objective basis. The percentile scores for each clinical objective and the overall treatment plan score were then visualized using a daisy plot. To validate our scoring method, 6 physicians were recruited to assess 60 plans, each using a scoring table consisting of a 5-point Likert scale (with scores ≥3 considered passing). Spearman correlation analysis was conducted to assess the association between increasing treatment plan percentile rank and physician rating, with Likert scores of 1 and 2 representing clinically unacceptable plans, scores of 3 and 4 representing plans needing minor edits, and a score of 5 representing clinically acceptable plans. Receiver operating characteristic curve analysis was used to assess the scoring system's ability to quantify plan quality. Results: Of the 60 plans scored by the physicians, 8 were deemed as clinically acceptable; these plans had an 89.0th ± 14.5 percentile value using our scoring system. The plans needing minor edits or deemed unacceptable had more variation, with scores falling in the 62.6nd ± 25.1 percentile and 35.6th ± 25.7 percentile, respectively. The estimated Spearman correlation coefficient between the physician score and treatment plan percentile was 0.53 (P < .001), indicating a moderate but statistically significant correlation. Receiver operating characteristic curve analysis demonstrated discernment between acceptable and unacceptable plan quality, with an area under the curve of 0.76. Conclusions: Our scoring system correlates with physician ratings while providing intuitive visual feedback for identifying good treatment plan quality, thereby indicating its utility in the quality assurance process.

Blockages in sewers and drains often result in overflows and flooding that cause significant environmental pollution and public health risks, particularly in hospitals, where the consequences can be catastrophic. Due to their low “visibility”, sewers and drains are inherently difficult to monitor and maintain, resulting in a reactive management approach whereby maintenance or repair is carried out only after a system failure has occurred. This paper investigates the feasibility of applying the reflected wave technique, a unique sonar-like monitoring approach capable of identifying changes in the geometry of closed-pipe conduits, as a means of proactive system monitoring. The technique uses a 10 Hz sinusoidal air pressure wave which is transmitted into the drainpipe. When the pressure wave encounters a system boundary, a reflection is generated which alters the measured test pressure response. Analysis of the reflections generated by a changed system boundary, such as the formation of a blockage, can provide information related to the location of that boundary within the system. An experimental setup was developed to simulate a horizontal drain using standard pipework of 100 mm diameter and 70 m length. The technique was able to detect applied blockages with cross-sectional coverage of 30% and 75%, and lengths ranging from 30 mm to 3000 mm. Accuracy was improved when the pressure sensor was positioned closer to the blockage. When the sensor was 3.4 m from the blockage, location estimates were very accurate (−2% to 3% error). At a 14 m distance from the blockage, the error increased to between 4% and 33%. The accuracy of blockage detection and location improved with increasing blockage cross-sectional area and length. Overall, the reflected wave technique could provide a potentially continuous monitoring solution for blockage detection in sewers and drains.

This paper draws on the breadth of Forest School research literature spanning the past ten years in order to categorise theorisations across the papers. As Forest Schools in the UK are still a fairly recent development research is still limited in quantity and can lack theorisation at a broader level of abstraction. The systematic literature review draws largely on the framework produced by the Evidence for Policy and Practice Information and Co-ordinating Centre (EPPI-Centre) ([2019b]. What is a Systematic Review? Accessed: 13 August 2020. http://eppi.ioe.ac.uk/cms/Default.aspx?tabid=67). The paper highlights a set of overarching themes for Forest School research as well as providing a conceptual map representing three distinct contexts: early years, special education needs and disability, and formal education. In addition, a set of more abstract themes emerged from work associated with the Forest School space.

This UK focussed theoretical paper builds on Harper's (2017. "Outdoor Risky Play and Healthy Child Development in the Shadow of the "Risk Society": A Forest and Nature School Perspective." "Child & Youth Services" 38 (4): 318-334) work in Canadian Forest Schools and the role that Forest Schools play in education by including outdoor risky play. It considers the conceptualisation of a risk-averse Western society, with a focus on healthy childhood development, and the childhood risks within Forest School that are present yet arguably small. There is the opportunity to re-conceptualise ideas around risk within the Forest School space through the framing of Massey's (2005. "For Space." London, UK: Sage Publications] proposition that space is a product of relations-between and that space is always in the process of being made. Thus, children create and 'own' the Forest School space through their inhabitation of it. Children's well-being and the value of risk in their lives can be understood as a fluid, dynamic and relational process within their geographies. Conclusions include a value that risk-taking has within the Forest School space. The implications of Beck's risk society, its ongoing influence on societal beliefs and practices, inducing practitioners' fear of litigation over accidents and injury are highlighted.

Purpose: MR-guided radiotherapy (MRgRT) has the advantage of utilizing high soft tissue contrast imaging to track daily changes in target and critical organs throughout the entire radiation treatment course. Head and neck (HN) stereotactic body radiation therapy (SBRT) has been increasingly used to treat localized lesions within a shorter timeframe. The purpose of this study is to examine the dosimetric difference between the step-and-shot intensity modulated radiation therapy (IMRT) plans on Elekta Unity and our clinical volumetric modulated arc therapy (VMAT) plans on Varian TrueBeam for HN SBRT. Method: Fourteen patients treated on TrueBeam sTx with VMAT treatment plans were re-planned in the Monaco treatment planning system for Elekta Unity MR-Linac (MRL). The plan qualities, including target coverage, conformity, homogeneity, nearby critical organ doses, gradient index and low dose bath volume, were compared between VMAT and Monaco IMRT plans. Additionally, we evaluated the Unity adaptive plans of adapt-to-position (ATP) and adapt-to-shape (ATS) workflows using simulated setup errors for five patients and assessed the outcomes of our treated patients. Results: Monaco IMRT plans achieved comparable results to VMAT plans in terms of target coverage, uniformity and homogeneity, with slightly higher target maximum and mean doses. The critical organ doses in Monaco IMRT plans all met clinical goals; however, the mean doses and low dose bath volumes were higher than in VMAT plans. The adaptive plans demonstrated that the ATP workflow may result in degraded target coverage and OAR doses for HN SBRT, while the ATS workflow can maintain the plan quality. Conclusion: The use of Monaco treatment planning and online adaptation can achieve dosimetric results comparable to VMAT plans, with the additional benefits of real-time tracking of target volume and nearby critical structures. This offers the potential to treat aggressive and variable tumors in HN SBRT and improve local control and treatment toxicity.

Summary: Background & Aims: Currently, there is lack of universal consensus on the use of effective malnutrition screening tools. Although malnutrition, frailty and physical disability are interrelated and associated with mortality in older people, there is a paucity of research in care home settings. With a high co-prevalence of these conditions, understanding their interconnectedness can provide a holistic view of an older person's health condition. The purpose of this study was to examine the prevalence of malnutrition (and risk) frailty and physical disability among care home residents using different methods, as well as the associations between markers of malnutrition (MUST and MNA-SF), physical function (Barthel Index, BI), frailty (Edmonton Frailty Scale, EFS), and all-cause mortality in care home residents. Methods: In Lincoln, UK, 508 residents from care homes underwent screening for malnutrition (MNA-SF and MUST), frailty (EFS), and physical function (BI) as part of standard comprehensive geriatric assessment (CGA) between November 2015 and January 2018. Prevalence of conditions were assessed and MNA-SF, MUST, EFS, and BI-specific survival in each category were compared using Kaplan-Meier survival analysis (KMSA) with log-rank test. Multivariable analyses were conducted using the Cox proportional hazard model to identify prognostic factors that were statistically significant in care home residents. Results: There was significant discordance between malnutrition risk measured by MUST and MNA-SF. The percentage of patients ‘at risk’/‘medium risk’ and ‘malnourished’/‘high risk’ was 25.3%/49.9% for MNA and for 19.6%/31.57% for MUST. The prevalence of frailty measured by EFS was high with the percentage of residents with severe frailty being 70.9%. Only 8.6% of patients were functionally independent. The association between malnutrition risk (MUST) and mortality was not significant. MNA-SF appeared to be a better tool at predicting mortality in older care home residents (p