Tag Archives: Age and Ageing

Frailty: Core Capabilities Framework (Skills for Health)

Posted on February 2, 2019 by Dementia and Elderly Care News

Summary Skills for Health have produced the Frailty Core Capabilities Framework. This framework was commissioned by Health Education England and NHS England, and aims to formalise the skills to provide high quality, holistic, compassionate care and support for persons with … Continue reading →

Posted in Acute Hospitals, Age UK, Commissioning, Community Care, Diagnosis, Falls Prevention, For Carers (mostly), For Doctors (mostly), For Nurses and Therapists (mostly), For Researchers (mostly), For Social Workers (mostly), Guidelines, Integrated Care, Management of Condition, National, NHS England, Non-Pharmacological Treatments, Person-Centred Care, Quick Insights, Standards, UK, Universal Interest | Tagged Active Listening, Adults at Risk of Harm, Age and Ageing, Ageing and Long-Term Care, Ageing Population, Ageing Research, Baroness Sally Greengross (APPG on Dementia), British Geriatric Society, Care and Support Planning, Care for Vulnerable Older People, Care of Frail Older People With Complex Needs, Carers, Causes and Prevention of Frailty, Clinical Frailty Scale: the Rockwood Score, Co-Morbid Physical and Mental Health Conditions, Collaboration, Collaborative Care, Collaborative Working, Commissioning for Older People, Common Problems of Frailty, Community-Based Care for People With Frailty, Comprehensive Geriatric Assessment (CGA), Cumulative Deficit Frailty Model, Cumulative Deficit Model, Edmonton Frail Scale, Electronic Frailty Index, End of Life Care, Families and Carers, Families and Carers as Partners in Frailty Care, Frailty, Frailty Framework of Core Capabilities: Skills for Health, Frailty Index, Frailty Services, Frailty Syndromes, Frailty: Core Capabilities Framework, Frailty: Mapping to Other Frameworks, Gait (Walking) Speed Test, Health Coaching, Health Education England (HEE), HEE: Health Education England, Holistic Approaches, Holistic Assessments, Holistic Care, Holistic Care Assessments, Holistic Needs Assessment, Identification of Frailty, Identifying People Living With Frailty, Identifying Vulnerable People, Improving Care for Frail Older People, Integrated Physical and Mental Health, Involvement of Families and Carers, Long-Term Conditions (LTCs), Long-Term Physical and Mental Health Conditions, Managing Ongoing Physical and Mental Health Conditions, Medication Management, Multi-Morbidities, Multidisciplinary Care, Multidisciplinary Holistic Assessments, Multidisciplinary Teams, Multimorbidity, Older People At Home, Pathways for Frail and Vulnerable People, Patient Activation, People Living With Frailty, Person-Centred Approaches in Healthcare, Personalised Care and Support Planning, Phenotype Model of Frailty, PRISMA 7 Questionnaire, Rockwood Score, Royal College of GPs, Shared Decision-Making, Skills for Care (SfC), Skills for Care and Skills for Health, Skills for Health, Skills for Health (SfH), Targeting Resources on Vulnerable Populations, The Frailty Fulcrum, Time Up and Go (TUG) Test, Vulnerable Adults | Leave a comment

Improving Care for Older People (NHS England / Age UK / PHE / Chief Fire Officer’s Association / JGCR)

Posted on October 14, 2018 by Dementia and Elderly Care News

Summary The guide to Improving Care for Older People, developed by NHS England in partnership with Age UK, Public Health England, and the Chief Fire Officer’s Association, is actually a collection of resources (some dating back several years). This collection … Continue reading →

Posted in Age UK, Commissioning, Community Care, For Carers (mostly), For Doctors (mostly), For Nurses and Therapists (mostly), For Researchers (mostly), For Social Workers (mostly), Integrated Care, Management of Condition, Mental Health, National, NHS, NHS England, Non-Pharmacological Treatments, Person-Centred Care, Personalisation, Practical Advice, Public Health England, Quick Insights, UK, Universal Interest | Tagged Active Ageing, Active and Healthy Ageing, Age and Ageing, Age-Friendly Housing, Age-Related Hearing Loss (ARHL), Ageing Population, Ageing Population Carer Support, Ageing Society, Ageing Well, Ageing Well and Supporting People Living With Frailty (NHS England), Ageing Well With Technology, Amenable Mortality, Avoidable Harm, Avoidable Hospital Admissions, Avoidable Mortality, Avoidable Premature Mortality, Avoidable Rehospitalisations, Bladder Problems, Burden on Caregivers, Care for Vulnerable Older People, Care Home Admission Delay, Care in an Ageing Society, Care of Frail Older People With Complex Needs, Caregiver Assessments, Caregiver Burden, Caregivers, Caregiving (Carers), Carer Awareness, Carer Experience, Carer Fatigue, Carer Isolation, Carer Organisations, Carer Support, Carer Support Services, Carer's Needs, Carer’s Perspective, Carers Strategy, Carers Trust, Carers UK Adviceline, Carers' Assessments, Carers’ Benefits, Carers’ Health and Wellbeing, Caring and Family Finances, Caring into Later Life, Case Finding and Risk Stratification, Chief Fire Officers Association, Chief Fire Officers Association (CFOA), Chief Fire Officers Association: Ageing Safely Strategy, Cognitive Impairment, Cold Homes, Collaboration, Collaborative Commissioning, Collaborative Models of Delivery, Collaborative Working, Collaborative Working in Local Communities, Community Care Assessments, Community Response Intervention Teams, Community Risk Intervention, Community Risk Intervention Team (CRIT), Community Volunteering, Community-Based Services, Complex Needs, Consensus Statement on Improving Health and Wellbeing (2015), Consent to Share Information, Cooking Arrangements, Coping With Stress, Culture Change in Health and Care, Delivering Better Health and Care Outcomes, Dementia-Friendly Housing, Design Principles for Safe and Well Visits, Determinants of Health, Electronic Frailty Index, electronic Frailty Index (eFI), Emily Holzhausen: Director of Policy and Public Affairs at Carers UK, Falls Prevention, Falls Reduction, Falls Risk Assessment Tool (FRAT), Family Caregivers, Family Carers, Feeling Under the Weather (Campaign), Fire and Rescue Service Delivering Home Modifications, Fire and Rescue Services (FRS), Fire and Rescue Services (FRS): Health Ambassadors, Fire and Rescue Services Act (2004), Fire and Rescue Services Checks on Older People, Fire and Rescue Services Checks on People With Long Term Health Conditions, Fire as a Health Asset: Consensus, Fire Safety Check Programmes, Fires, Frail Older People, Frailty, Frailty Identification and Frailty Care, Frailty Services, Frailty Syndromes, FRS Volunteers, Geriatric Care and Research Organisation (GeriCaRe), Greater Manchester FRS Community Risk Intervention Teams (CRITs), Guide to Healthy Ageing, Happiness and Wellbeing, Health and Care of Older People, Health and Social Care Integration, Health and Wellbeing, Healthy Ageing, Healthy Ageing Conference 2018 (India), Healthy Ageing in India, Healthy Caring Guide, Healthy Feet, Hearing, Hearing Loss, Hoarding, Home Adaptations, Home Modifications, Home Safety, Home Security, Hydration and Nutrition, Identification of Frailty, Identification of Frailty (Routine Screening), Identifying People Living With Frailty, Identifying Vulnerable People, Impact of Caring on Carers, Improving Care for Frail Older People, Improving Care for Older People (NHS England), Improving General Practice, Improving Lives of Carers, Improving Quality in General Practice, Improving the Quality of Care in General Practice, Inappropriate Hospital Admissions, Independence, Independence at Home, Independent Living, Independent Living At Home, India, India (State of Odisha), Informal Caregiving, Informal Carers, Information Needs of Carers, Information Technology, Integrated and Community-Based Care, Integrated Home and Community Care Services, Integrated Prevention Approaches, Integration of Health and Care, Integration of Health and Social Care, Journal of Geriatric Care and Research (JGCR), Keep Warm Keep Well, LGA: Local Government Association, Lifestyle Risk Factors, Links Between Mental Health and Fire Risk, Local Government Association: LGA, Local Government Authority: Beyond Fighting Fires, Local Health and Care Services, Loneliness, Loneliness and Social Isolation, Long Term Health Conditions, Long-Term Care (LTC), Long-Term Care and Support, Long-Term Conditions, Long-Term Conditions (LTCs), Maintaining Independence, Maintaining Relationships, Mental Health Needs of Carers, Mental Wellbeing, Mental Wellbeing and Older People, Mobile Technology, Multi-Agency Integration, Multi-Agency Working, Multi-Disciplinary Working, Multi-Morbidity, Needs of Carers, NHS England Risk Stratification Guidance, Older Community-Dwelling Adults, Older People At Home, Older People With Complex Needs, Older People: Independence and Mental Wellbeing, Opportunities to Treat Patients Without Hospital Admission, Partnership and Collaboration, Partnership Working, Partnership(s) Between NHS and Fire Service, Pathways for Frail and Vulnerable People, Patient Targeting and Risk Stratification, People Living With Frailty, Personalised Care and Support Planning Handbook, PHE: Public Health England, Portable Heaters and Open Fires, Potentially Modifiable Socio-Environmental Risk Factors, Preparations for Winter, Preventable Hospital Admissions, Prevention, Prevention Agenda, Primary Care, Provision of Risk Appropriate Domestic Fire Detection and Warning, Public Health England (PHE), Recognising and Managing Frailty in Primary Care, Reducing Unplanned Hospitalisation, Regaining Independence, Rehospitalisations, Risk and Protective Factors for Mental Wellbeing, Risk of Nursing Home Admission, Risk Stratification, Social Media, Support for Carers, Support for People with Complex Needs, Supporting Health Wellbeing and Independence, Sustainable Caring, Targeted Screening, Targeting Resources on Vulnerable Populations, Treating Patients Without Hospital Admission, Unpaid Caregivers (Carers), Unpaid Carers, Unplanned Hospital Admissions, Unplanned Hospitalisation, Urinary Incontinence, Urinary Infections, Use of Social Media, Vaccination Programmes, Visual Impairment, Voluntary and Community Sector, Voluntary Sector, Warm Homes, Winter Friends | Leave a comment

Systematic Review of Falls Reduction Interventions for Older Adults Recently Discharged From Hospital (Age and Ageing)

Posted on May 22, 2018 by Dementia and Elderly Care News

Summary A joint Australian and American review has examined the evidence concerning the effectiveness of falls prevention interventions for community-dwelling older adults discharged recently from hospitals. Twelve falls prevention interventions were considered. Home exercise interventions were not found to be … Continue reading →

Posted in Commissioning, Community Care, Falls, Falls Prevention, For Carers (mostly), For Nurses and Therapists (mostly), For Researchers (mostly), For Social Workers (mostly), Integrated Care, International, Management of Condition, Non-Pharmacological Treatments, Person-Centred Care, Personalisation, Quick Insights, Systematic Reviews, Universal Interest | Tagged Age and Ageing, Australia, Centre for Functioning and Health Research: Metro South Health, Centre for Medical Research: University of Western Australia, Cholecalciferol Therapy, College of Medicine: University of Florida, Curtin University, Curtin University (Perth), Department of Geriatric Medicine: University of Western Australia, Exercise Regimens, Exercise Therapy, Faculty of Health Science: Curtin University, Faculty of Health: Queensland University of Technology, Faculty of Medicine Nursing and Health Science: Monash University, Fall Prevention Strategies for Discharged Patients, Falls Prevention, Falls Prevention for Community-Dwelling Older Adults, Falls Prevention for Older Adults Recently Discharged From Hospital, Falls Prevention Programmes, Falls Reduction, Geriatric Research Education and Clinical Center (GRECC), Healthscope and La Trobe Centre for Sport and Exercise Medicine Research: La Trobe University, Home Exercise Interventions, Home Hazard Modifications, Home Modifications, Housing Adaptations, Institute for Health Research: University of Notre Dame Australia, Journal of Geriatric Care and Research (JGCR), La Trobe University (Victoria Australia), Malcom Randall VA Medical Center: Geriatric Research Education and Clinical Center (GRECC), Metro South Health (Brisbane), Monash University: Melbourne, Nutritional Supplementation, Post-Discharge Assessment and Support, Post-Discharge Support, Post-Discharge Support for Older Adults, Queensland University of Technology, Royal Perth Hospital Unit: University of Western Australia, School of Medicine and Pharmacology: University of Western Australia, School of Occupational Therapy and Social Work: Curtin University, School of Physiotherapy and Exercise Sciences: Curtin University, School of Physiotherapy: University of Notre Dame Australia, School of Public Health and Social Work: Queensland University of Technology, Systematic Reviews and Meta-Analyses, United States, University of Florida, University of Notre Dame (Australia), University of Western Australia, USA, Western Australia, Western Australian Centre for Health and Ageing: University of Western Australia | Leave a comment

The Hospital Frailty Risk Score: a Simpler Method of Screening for Frailty and Patients at Greater Risk (Lancet)

Posted on May 5, 2018 by Dementia and Elderly Care News

Summary The Hospital Frailty Risk Score is a risk score designed for the identification of older people at risk of harm or adverse outcomes in hospitals. It is based on standard diagnostic codes from the International Statistical Classification of Diseases … Continue reading →

Posted in Acute Hospitals, Commissioning, Delirium, Diagnosis, For Doctors (mostly), For Nurses and Therapists (mostly), For Researchers (mostly), Health Foundation, Integrated Care, International, Management of Condition, Models of Dementia Care, NHS, Nuffield Trust, Person-Centred Care, Quick Insights, Statistics, UK, Universal Interest | Tagged Academic Geriatric Medicine: University of Southampton, Adults at Risk of Harm, Age and Ageing, Ageing and Long-Term Care, Ageing Population, Ageing Research, Amenable Mortality, Avoidable Hospital Admissions, Avoidable Mortality, Avoidable Premature Mortality, Avoidable Rehospitalisations, Cardiff University, Care for Vulnerable Older People, Care of Frail Older People With Complex Needs, Charlson Comorbidity Index, College of Life Sciences: University of Leicester, Commissioning for Older People, Count-Based Multimorbidity Measures, Data Analytics Team: Health Foundation, Department of Business Intelligence: Manchester University NHS Foundation Trust, Department of Geriatric Medicine: Lyon Teaching Hospital, Department of Health Policy: London School of Economics, Department of Health Sciences: University of Leicester, Department of Public Health: Cardiff University, Diagnostic Codes, Electronic Care Record (ECR), Electronic Care Records, Electronic Health Records, Electronic Health Records (EHRs), Frailty, Frailty Status at Admission to Hospital, France, Fried and Rockwood Scales, Fried Phenotype, Hospital Frailty Risk Score, ICD-10 Codes, Identification of Frailty, Identification of Frailty (Routine Screening), Identifying People Living With Frailty, Identifying Vulnerable People, Improving Care for Frail Older People, Institute for Ageing: Newcastle University, International Classification of Diseases (ICD), International Statistical Classification of Diseases and Related Health Problems (ICD-10), Lancet, London School of Economics, Lyon Teaching Hospital, Manchester University NHS Foundation Trust, Morbidity and Wellbeing, Multimorbidity Measures, Newcastle University, Optimising Acute Frailty, Patient Targeting and Risk Stratification, Risk Assessment, Risk Evaluation, Risk Stratification, Rockwood Frailty Index, Screening For Frailty, Screening for Frailty (in Hospitals), Targeted Screening, Targeting Resources on Vulnerable Populations, University of Leicester, University of Southampton, Vulnerable Adults, World Health Organization's (WHO) International Classification of Diseases: Tenth Revision (ICD-10) | Leave a comment

Screening For Frailty: as Easy as eFI? (NHS England / Age and Ageing)

Posted on September 20, 2016 by Dementia and Elderly Care News

Summary The “electronic Frailty Index (eFI)” is discussed, by NHS England’s National Clinical Director for Older People and Person Centred Integrated Care, as a validated tool which might assist in the proactive identification, diagnosis and management of frailty. Potentially, the … Continue reading →

Posted in Commissioning, Community Care, Diagnosis, For Doctors (mostly), For Nurses and Therapists (mostly), For Researchers (mostly), For Social Workers (mostly), Integrated Care, Management of Condition, National, NHS, NHS England, Non-Pharmacological Treatments, Person-Centred Care, Quick Insights, Statistics, Systematic Reviews, UK, Universal Interest | Tagged Academic Unit of Elderly Care and Rehabilitation: University of Leeds, Age and Ageing, Ageing and Long-Term Care: Projections, Ageing Population, Ageing Research, Amenable Mortality, Avoidable Hospital Admissions, Avoidable Mortality, Avoidable Premature Mortality, Avoidable Rehospitalisations, BMJ Open, BMJ Publishing Group Ltd, Bradford, British Geriatrics Society, Care for Vulnerable Older People, Care Home Admission Delay, Care of Frail Older People With Complex Needs, Centre for Reviews and Dissemination: University of York, Charlson Comorbidity Index, Commissioning for Older People, Connected Bradford, Connected Health Cities, Count-Based Multimorbidity Measures, Cumulative Deficit Frailty Model, Cumulative Deficit Model, Deficits Contained in eFI Calculations, Disease Counts, Dr Martin Vernon: Consultant Geriatrician and Associate Head of Division for Medicine and Community Services for Central Manchester, Dr Martin Vernon: National Clinical Director for Older People and Integrated Care, Dr Martin Vernon: NCD for Older People and Integrated Person Centred Care, Dublin, Effectiveness Matters, Electronic Frailty Index, electronic Frailty Index (eFI), Electronic Health Records, Electronic Health Records (EHRs), Faculty of Health Studies: University of Bradford, Frail Older People, Frailty, Frailty Identification and Frailty Care, Frailty Services, Frailty Syndromes, Functional Decline, General Practice, General Practices, General Practitioners, GP Assessment, Guidance on Supporting Routine Frailty Identification and Frailty Care Through the GP Contract 2017/2018, Holistic Medical Reviews (Automated Electronic Heuristics), Holistic Medical Reviews by GPs, HRB Centre for Primary Care Research: Royal College of Surgeons in Ireland (RCSI), Identification of Frailty, Identification of Frailty (Routine Screening), Identifying People Living With Frailty, Identifying Vulnerable People, Improving Care for Frail Older People, Improving General Practice, Improving Quality in General Practice, Improving the Quality of Care in General Practice, Inappropriate Hospital Admissions, Independence at Home, Institute of Applied Health Research: University of Birmingham, Ireland, John Young: Academic Unit of Elderly Care and Rehabilitation at University of Leeds, Long-Term Care and Support, Long-Term Conditions (LTCs), Maintaining Independence, Medication Counts, Mortality in Older People, Mortality Morbidity and Wellbeing, Multimorbidity Measures, Older Community-Dwelling Adults, Older People At Home, Opportunities to Treat Patients Without Hospital Admission, Pathways for Frail and Vulnerable People, People Living With Frailty, Point-of-Care Screening, Population Health Sciences Division: Royal College of Surgeons of Ireland (RCSI), Preventable Hospital Admissions, Primary Care, Professor John Young, Professor John Young: Former National Clinical Director for Integration and Frail Elderly at NHS England, Rapid Screening, Recognising and Managing Frailty in Primary Care, Reducing Unplanned Hospitalisation, Rehospitalisations, ResearchOne (TPP Leeds West Yorkshire), ResearchOne Health and Care Database, ResearchOne Primary Care Database, Risk of Nursing Home Admission, Routine Primary Care Electronic Health Record Data, Royal College of Surgeons of Ireland (RCSI), RxRisk-V, Screening, Screening For Frailty, Screening Tests, Selected Conditions Counts, Shakespeare: Seven Ages of Man, Staying Independent, Supporting Older People Living With Frailty in the Community, Supporting People With Hospital Admissions, Supporting Vulnerable People, SystmOne (TPP Leeds West Yorkshire), SystmOne Electronic Health Record System, Targeted Screening, Targeting Resources on Vulnerable Populations, The Health Improvement Network (THIN) Databases, THIN Database, Toolkit for General Practice in Supporting Older People Living With Frailty (NHS England), TPP SystmOne Clinical System, Treating Patients Without Hospital Admission, University of Leeds, University of York, Unnecessary Hospital Admissions, Unplanned Hospital Admissions, Unplanned Hospitalisation, Validation of electronic Frailty Index (eFI), Vulnerable Adults, West Yorkshire, Yorkshire and Humber AHSN Improvement Academy | Leave a comment

Future of UK Ageing Population Report (Government Office for Science)

Posted on July 22, 2016 by Dementia and Elderly Care News

Summary A Government Office for Science report has assembled a range of evidence about the older population, in the attempt to identify trends and make projections of likely relevance for the UK government and others developing policies for an ageing … Continue reading →

Improving Integration of Carer Support: Toolkit To Assist Identification and Assessment of Carer Health and Wellbeing (NHS England)

Posted on May 19, 2016 by Dementia and Elderly Care News

Summary NHS England, in cooperation with numerous partners, has produced a new “Integrated Approach to Identifying and Assessing Carer Health and Wellbeing” toolkit. This is the latest component of their ongoing Commitment to Carers. The toolkit includes a template Memorandum … Continue reading →

Posted in Carers UK, Charitable Bodies, Commissioning, Community Care, For Carers (mostly), For Nurses and Therapists (mostly), For Researchers (mostly), For Social Workers (mostly), Integrated Care, Local Interest, Management of Condition, Models of Dementia Care, National, NHS, NHS England, Non-Pharmacological Treatments, Patient Care Pathway, Person-Centred Care, Personalisation, Practical Advice, Quick Insights, Standards, UK, Universal Interest | Tagged 5YFV: NHS Five Year Forward View, Access to Primary Care, Adult Carers in England: Quality of Life, Adult Social Care, Age and Ageing, Ageing Population, Ageing Population Carer Support, Association of Directors of Adult Social Services (ADASS), Balancing Work With Caring, BAME Carers, Burden on Caregivers, Care in an Ageing Society, Caregiver Assessments, Caregiver Support, Caregivers, Caregiving (Carers), Carer Awareness, Carer Awareness Training in Health and Social Care, Carer Experience, Carer Fatigue, Carer Health and Wellbeing, Carer Inclusion, Carer Isolation, Carer Organisations, Carer Satisfaction, Carer Support, Carer Support Services, Carer's Needs, Carer’s Independence, Carer’s Needs Assessment, Carer’s Perspective, Carers, Carers for People with Dementia, Carers From BAME (Black Asian and Minority Ethnic) Communities, Carers Leave, Carers Strategy, Carers Toolkit (NHS England), Carers Week, Carers’ Breaks, Carers’ Health and Wellbeing, Caring for Carers, Collaboration for Coordinated Care, Commissioning for Carers, Commissioning for Carers Principles, Commitments to Carers: NHS England 2014, Dr Mahiben Maruthappu: NHS England's NHS Innovation Accelerator (NIA), Dr Mahiben Maruthappu: Senior Fellow to the Chief Executive of NHS England, Emily Holzhausen: Director of Policy and Public Affairs at Carers UK, Family Caregivers, Family Carers, Family Carers' Legal Rights, Flexible Hours for Carers, Health and Wellbeing Boards (HWBs), Health and Wellbeing of Adult Carers, Helen Leadbitter: Operational Programme Manager at the Children’s Society, Improving Carer Health and Wellbeing, Informal Caregiving, Informal Carers, Information and Advice, Information and Signposting Services, Information and Support for Carers, Information Needs of Carers, Integrated Approach to Identifying and Assessing Carer Health and Wellbeing (NHS England Toolkit), Joint Health and Wellbeing Strategy (JHWS), Listening to Carers, Local Authority and Social Care, Local Authority Commissioners, Long Term Health Conditions, Long-Term Conditions (LTCs), Memorandum Of Understanding (MOU), Military Carers and Military Young Carers, Needs of Carers, Neil Churchill: National Director of Patient Experience (NHS England), NHS and Social Care, NHS England Commitment to Carers: Priority 1: Raising the Profile of Carers, NHS England Commitment to Carers: Priority 2: Education Training and Information, NHS England Commitment to Carers: Priority 3: Service Development, NHS England Commitment to Carers: Priority 4: Person Centred Well Co-ordinated Care, NHS England Commitment to Carers: Priority 5: Primary Care, NHS England Commitment to Carers: Priority 6: Commissioning Support, NHS England Commitment to Carers: Priority 6b: Partnership Links, NHS England's Five Year Forward View (2014), NHS England's Patient Experience Team, NHS England’s Commitment to Carers, NHS England’s Responsibility to Carers, Partnership Links, Professor David Croisedale-Appleby OBE: Chair of the Standing Commission on Carers, Raising the Profile of Carers, Standing Commission on Carers, Support for Carers, Template Memorandum of Understanding, Thinking Carer Across the Local Health and Social Care System, Undervalued Hidden Workforce, Unpaid Caregivers (Carers), Unpaid Carers, Valuing Carers, Working and Caring, Working Carers, Working Together to Support Carers, Young Carers | Leave a comment

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