Mortality rate and its determinants among people with dementia receiving home healthcare: a nationwide cohort study.

People with dementia (PwD) who receive home healthcare (HHC) may have distressing symptoms, complex care needs and high mortality rates. However, there are few studies investigating the determinants of mortality in HHC recipients. To identify end-of-life care needs and tailor individualized care goals, we aim to explore the mortality rate and its determinants among PwD receiving HHC. We conducted a retrospective cohort study using a Taiwanese national population database. People with new dementia diagnosis in 2007-2016 who received HHC were included. We calculated the accumulative mortality rate and applied Poisson regression model to estimate the risk of mortality for each variable (adjusted risk ratios, aRR) with a 95% confidence interval (CI). We included 95,831 PwD and 57,036 (59.5%) of them died during the follow-up period (30.5% died in the first-year). Among comorbidities, cirrhosis was associated with the highest mortality risks (aRR 1.65, 95% CI 1.49-1.83). Among HHC-related factors, higher visit frequency of HHC (> 2 versus ≦1 times/month, aRR 3.52, 95% CI 3.39-3.66) and higher level of resource utilization group (RUG, RUG 4 versus 1, aRR = 1.38, 95% CI 1.25-1.51) were risk factor of mortality risk. Meanwhile, HHC provided by physician and nurse was related to reduced mortality risk (aRR 0.79, 95% CI 0.77-0.81) compared to those provided by nurse only. Anticipatory care planning and timely end-of life care should be integrated in light of the high mortality rate among PwD receiving HHC. Determinants associated with increased mortality risk facilitate the identification of high risk group and tailoring the appropriate care goals. Trial registration number: ClinicalTrials.gov Identifier is NCT04250103 which has been registered on 31st January 2020.

A new species of Aclees from Taiwan with notes on other species of the genus (Coleoptera: Curculionidae: Molytinae).

A molecular and morphological analysis of the species of Aclees native to Taiwan allowed for recognition of a new species, that is described here as Aclees aenigmaticus Meregalli Boriani, sp. n. The study also revealed that the species of Aclees that has been introduced into Italy and France has identical morphology and mitochondrial cox-1 gene sequence with specimens of A. taiwanensis from Taiwan. Taiwan is thus assumed to be the country of origin of the specimens introduced into Europe. A key to the species of Aclees present in Taiwan is provided. A lectotype is designated for Aclees foveatus Voss, 1932, and some remarks on A. hirayamai Kôno, 1932 are given. Pagiophloeus visayus Heller, 1929 from the Philippines is transferred to the genus Aclees, comb. n.

Omophorus (Sinomophorus) wallacei: a new weevil from Borneo highlights the enigmatic Ethiopian-Oriental disjunct distribution (Coleoptera, Curculionidae, Molytinae).

In the present study we describe a new species of the genus Omophorus, O. (Sinomophorus) wallacei sp. nov., from Malaysian Borneo. Photographs of habitus and genitalia, a distribution map, and a key for the identification of Omophorus species are included. The definition of the subgenus Sinomophorus is revised and several new diagnostic characters are added. This is the first documented occurrence of Omophorus in Borneo, highlighting its potential diversity in the Oriental region and providing additional evidence of Ethiopian-Oriental disjunction within this genus.