Multidimensional preventive home visit programs for community-dwelling older adults: a systematic review and meta-analysis of randomized controlled trials

BACKGROUND: Multidimensional preventive home visit programs aim at maintaining health and autonomy of older adults and preventing disability and subsequent nursing home admission, but results of randomized controlled trials (RCTs) have been inconsistent. Our objective was to systematically review RCTs examining the effect of home visit programs on mortality, nursing home admissions, and functional status decline. METHODS: Data sources were MEDLINE, EMBASE, Cochrane CENTRAL database, and references. Studies were reviewed to identify RCTs that compared outcome data of older participants in preventive home visit programs with control group outcome data. Publications reporting 21 trials were included. Data on study population, intervention characteristics, outcomes, and trial quality were double-extracted. We conducted random effects meta-analyses. RESULTS: Pooled effects estimates revealed statistically nonsignificant favorable, and heterogeneous effects on mortality (odds ratio [OR] 0.92, 95% confidence interval [CI], 0.80-1.05), functional status decline (OR 0.89, 95% CI, 0.77-1.03), and nursing home admission (OR 0.86, 95% CI, 0.68-1.10). A beneficial effect on mortality was seen in younger study populations (OR 0.74, 95% CI, 0.58-0.94) but not in older populations (OR 1.14, 95% CI, 0.90-1.43). Functional decline was reduced in programs including a clinical examination in the initial assessment (OR 0.64, 95% CI, 0.48-0.87) but not in other trials (OR 1.00, 95% CI, 0.88-1.14). There was no single factor explaining the heterogenous effects of trials on nursing home admissions. CONCLUSION: Multidimensional preventive home visits have the potential to reduce disability burden among older adults when based on multidimensional assessment with clinical examination. Effects on nursing home admissions are heterogeneous and likely depend on multiple factors including population factors, program characteristics, and health care setting.

Scrabbling Mice, a Visit from Hades and Thoughts of Death. The Autobiography of Lucas Forcart-Respinger, a Merchant from Basel (1789–1869)

Der Beitrag legt offen, wie Lucas Forcart-Respinger, ein Angehöriger der Basler oberen Schichten, in seinem Selbstzeugnis sich mit dem Thema "Tod und Sterben" auseinandersetzt. Dabei zeigt sich, dass der einem pietistisch-"erweckten" Milieu zugehörige Autor im Vergleich mit anderen Basler Selbstzeugnissen des späten 18. und frühen 19. Jahrhunderts die unterschiedlichsten Facetten des Themenkomplexes beleuchtet: Jenseitsvorstellungen, Gespensterglaube, Todesfälle Verwandter, Selbsttötung, Scheintod und Lebendigbestattung. Insbesondere kennzeichnet eine starke Orientierung auf den eigenen Tod den Text. Auch die traditionelle Vorstellung der "artes moriendi" ist greifbar.

International real business cycles : a re-visit

It is well known that several quantitative properties of international real business cycle models with are at odds with the data. First, the cross-country correlations are much higher for consumption than for output, while in the data the opposite is true (the BKK puzzle). Second, cross-country correlations of employment and investment are negative, while in the data they are positive. This paper quantitatively shows that preferences with a zero income effect on labor supply help generate a correct cross-country correlation in employment even without any restrictions on financial markets. In a bond economy, a zero income effect in labor supply, combined with time-to-build investment, can generate a positive cross-country correlation in investment, and the BKK puzzle is also resolved when the inter-temporal elasticity of substitution in labor supply is low.

Sancti Gregorij Magni ... Liber moraliu[m] in beatu[m] Iob : singulari sagacitate consummataq[ue] opera per capitula distinctus ... : in cuius calce sententiaru[m] Sacre Scripture ... index ... / que omnia visit, castigauit ... frater Ioannes Lagrenus ...

Pie de imp. tomado del colofón en 3s3v

John Lovell and Jeremiah Allen's statement regarding their visit to Nathan Prince, accompanying Edward Holyoke, July 12, 1742

Lovell and Allen accompanied Holyoke to Nathan Prince's lodging in Boston, to personally inform him that the Board of Overseers had voted for his dismissal and that his belongings had been removed from his chamber and were being stored in town until he chose to claim them.