RESULTS About 25.7% of older adults, representative of 11.0 million people nationwide, reported having three or more cumulative SDoH risk factors. These older adults were more likely to have functional limitations (eg, activities of daily living) and less likely to report their general health as “very good” or “excellent” than those with two or fewer cumulative SDoH risk factors (P  less then  .001 for each). Each additional cumulative SDoH risk factor was associated with increased odds of not having a usual source of care (adjusted odds ratio = 1.57; 95% confidence interval = 1.09-2.27). CONCLUSION The SDoH index score may be a useful tool to predict access to care and quality of care in older adults. © 2020 The American Geriatrics Society.Environmental adaptation of crops is essential for reliable agricultural production and an important breeding objective. Genebanks provide genetic variation for the improvement of modern varieties, but the selection of suitable germplasm is frequently impeded by incomplete phenotypic data. We address this bottleneck by combining a Focused Identification of Germplasm Strategy (FIGS) with core collection methodology to select soybean (Glycine max) germplasm for Central European breeding from a collection of >17,000 accessions. By focussing on adaptation to high-latitude cold regions, we selected an “environmental precore” of 3,663 accessions using environmental data and compared the Donor opulation of Environments (DPE) in Asia and the Target Population of Environments (TPE) in Central Europe in the present and 2070. Using single nucleotide polymorphisms, we reduced the precore into two diverse core collections of 183 and 366 accessions to serve as diversity panels for evaluation in the TPE. Genetic differentiation between precore and non-precore accessions revealed genomic regions that control maturity, and novel candidate loci for environmental adaptation, demonstrating the potential of diversity panels for studying adaptation. Objective-driven core collections have the potential to increase germplasm utilization for abiotic adaptation by breeding for a rapidly changing climate, or de novo adaptation of crops to expand cultivation ranges. © 2020 The Authors. Plant, Cell & Environment published by John Wiley & Sons Ltd.This open label, parallel-group study investigated the pharmacokinetics and safety of a single oral 2-mg dose of the novel selective progesterone receptor modulator vilaprisan in participants with impaired renal function compared with age, weight, sex, and race matched controls with normal renal function. Systemic exposure (area under the plasma concentration-time curve [AUC]) and maximum observed concentrations (Cmax ) were compared among 9 participants with moderate renal impairment and matched controls by ANOVA. An additional 4 participants, each with severe renal impairment or normal renal function, contributed to a linear regression analysis exploring any monotone relationship between individual variables and the estimated glomerular filtration rate. The geometric mean AUC was increased by a factor of 1.35 in renally impaired participants compared to normal controls (not statistically significant least squares mean, 1.346; 90% confidence interval, 0.918-1.973). Cmax was similar in participants with moderate renal impairment and normal renal function (least squares mean, 1.026; 90% confidence interval, 0.779-1.351). Considering the overall variability, there was no correlation between renal function (estimated glomerular filtration rate) and Cmax or AUC of vilaprisan. Single oral administration of vilaprisan 2 mg was well tolerated by all participants, both men and women and irrespective of renal function. The incidence of treatment-emergent adverse events was similar across all groups. Results from this study do not indicate that a dose adjustment will be necessary for vilaprisan when treating patients up to moderate renal impairment. © 2020 The Authors. Bcl2 inhibitor The Journal of Clinical Pharmacology published by Wiley Periodicals, Inc. on behalf of American College of Clinical Pharmacology.AIM AND OBJECTIVES To develop knowledge about homecare professionals’ observational competence in early recognition of deterioration in frail older patients. BACKGROUND The number of frail older patients in homecare has been rising, and these patients are at higher risk of deterioration and mortality. However, studies are scarce on homecare professionals’ recognition and response to clinical deterioration in homecare. DESIGN This study applies an explorative, qualitative, mixed-methods design. METHODS The data were collected in two homecare districts in 2018 during 62 hours of participant observation, as well as from six focus group interviews. The data were subjected to qualitative content analyses. The Standards for Reporting Qualitative Research (SRQR) checklist was used to report the results. RESULTS The data analyses revealed two main themes and five sub-themes related to homecare professionals’ observational practices. The first main theme entailed patient-situated assessment of changes in patients’ clinical condition, i.e., the homecare professionals’ recognised changes in patients’ physical and mental conditions. The second theme was the organisational environment, in which planned, practical tasks and collaboration and collegial support were emphasised. CONCLUSIONS The homecare professionals in the two districts varied in their ability to recognise signs of patient deterioration. Their routines are described in detailed work plans, which seemed to affect assessment of their patients’ decline. RELEVANCE FOR CLINICAL PRACTICE The results can inform homecare services on how homecare professionals’ observational competence and an appropriate organisational system are essential in ensuring early detection of deterioration in frail older patients. This article is protected by copyright. All rights reserved.OBJECTIVES To evaluate the diagnostic yield of non-invasive prenatal diagnosis (NIPD) for FGFR3-related skeletal dysplasias and assess the accuracy of referrals based on sonographic findings to inform guidelines for referral. METHODS We retrospectively reviewed laboratory and referral records from 2012-2018 to ascertain all NIPD tests performed using our next generation sequencing panel to detect FGFR3 mutations. We calculated the diagnostic yield of the test overall and when sub-divided according to the phenotypic features identified on ultrasound before testing. Pregnancy outcomes were ascertained wherever possible from referring centres. RESULTS Of 335 tests, 261 were referred because of sonographic findings, of which 80 (31.3%) had a mutation. The diagnostic yield when short limbs were the only abnormal sonographic feature reported was 17.9% (30/168), increasing to 48.9% (23/47) in the presence of one, and 82.6% (19/23) in the presence of two or more characteristic features in addition to short limbs. CONCLUSIONS Accurate sonographic phenotyping can maximise the diagnostic yield of NIPD in fetuses suspected to have FGFR3-related skeletal dysplasias.