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Introduction: Whether Vitamin D deficiency is linked to development of frailty, independent of other health conditions, is inconclusive. In the British Regional Heart Study we aimed to examine (1) cross sectional (CS) and prospective (PS) associations between Vitamin D levels and frailty; and (2) if these are mediated by conditions linked to low Vitamin D (diabetes, chronic obstructive pulmonary disease and inflammatory markers C-reactive protein & Interleukin-6). Methods: Baseline (2010-2012) Vitamin D in men (71-92y) was categorised as deficiency (<12 ng/ml), insufficiency (12 - < 20 ng/ml) and sufficiency (≥20 ng/ml) states. Frailty, assessed at baseline and follow up (2014) was classified as robust, pre-frail or frail (score 0, 1-2, or ≥3 out of 5 Fried Frailty components respectively). Multinomial regression determined CS & PS relative risk ratios (RRR) of being pre-frail or frail, relative to robust. Adjustments were made for age, BMI, season, smoking, drinking habits, social class, Vitamin D/calcium supplements, mental/physical health and potential mediators. Results: At baseline, 20% of 1494 men were frail and 25% deficient in Vitamin D. Unadjusted RRR of being frail (vs robust) was 3.16 [95% CI 2.16, 4.62] in men with Vitamin D<12ng/ml (reference ≥20ng/ml). Higher RRR persisted even after adjusting for covariates and potential mediating factors, [2.74; 95% CI 1.60, 4.69]. Of 977 men non-frail at baseline, 10% became frail. Men with Vitamin D <12ng/ml (reference ≥20ng/ml) had higher unadjusted RRR of becoming pre-frail [1.47; 95% CI 1.04, 2.09] and frail [2.14 95% CI 1.29, 3.56] (vs robust). While the PS association with pre-frailty was completely attenuated with covariate adjustment, higher RRR for frailty remained even in the fully adjusted model [2.07 95% CI 1.07, 4.00]. Conclusions: Vitamin D <12ng/ml was associated with prevalent & incident frailty in older British men, independent of disease/inflammatory states. Further research exploring Vit D therapy for improving frailty outcomes is needed. [ABSTRACT FROM AUTHOR]

Reports on the court ruling in the case of Nottingham University in England against Simon Fishel for being in breach of his contract with the university while abroad. Establishment of the Nottingham University Research and Treatment Unit in Reproduction (NURTURE) by Dr. Fishel; The lawsuit against Fishel for allegedly gaining secret profits from his own work abroad; Settlement of the court case.

Background: Many studies have suggested that caregiving has a detrimental impact on health. However, these conclusions are challenged by research which finds evidence of a comparative survivorship advantage, as well as work which controls for group differences in the demand for care., Methods: We use a large record linkage study of England and Wales to investigate the mortality risks of carers identified in the 2001 Census. The analysis focuses on individuals aged 35-74 living with others in private households and a distinction is made between those providing 1-19 and 20 or more hours of care per week. Logit models identify differences in carers' health at baseline and postcensal survival is analysed using Cox proportional hazards models., Results: 12.2% of study members reported providing 1-19 h of care and 5.4% reported providing 20 or more hours. While carers were significantly more likely to report poorer health at baseline, survival analyses suggested that they were at a significantly lower risk of dying. This comparative advantage also held when the analyses were restricted to individuals living with at least one person with poor health., Conclusions: The comparative mortality advantage revealed in this analysis challenges common characterisations of carers' health and draws attention to important differences in the way carers are defined in existing analyses. The survival results are consistent with work using similar data for Northern Ireland. However, the study also affords more uniform conclusions about carers' baseline health and this provides grounds for questioning existing hypotheses about the reasons for this advantage.

Objective: We analysed the Trent Hepatitis C cohort to determine standardised mortality ratios in patients infected with hepatitis C virus (HCV), and to identify risk factors and associations with all-cause and liver-related mortality., Design: Cohort study., Setting: Patients with HCV infection attending secondary care within the Trent region of England., Patients: 2285 patients with hepatitis C, followed for 1 year or more., Main Outcome Measures: The death rate in the cohort was compared to that seen in an age- and sex-matched English population. We performed Cox regression analyses to identify factors predictive of all-cause mortality and deaths from liver disease., Results: Standardised mortality ratios in the cohort were three times higher than those expected in the general population of England. The excess deaths were due to liver-related causes and those associated with a drug-using lifestyle. Significant independent predictors of all-cause mortality were age, sex, treatment (protective) and liver biopsy fibrosis. Age, treatment, liver biopsy fibrosis and mean alcohol consumption were predictors of liver-related mortality. HCV was mentioned on 23% of death certificates overall, and on 52% of those of patients dying from a liver-related cause., Conclusions: Our findings demonstrate that the death rate in patients infected with hepatitis C is three times higher than expected. Severity of disease is associated with a worse prognosis, whilst treatment improves outcome, particularly in those who respond. Use of death certificate data on HCV infection for planning purposes will result in considerable under-estimation of the HCV-related disease burden.