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Straightforward ‘frailty’ exam predicts demise – hospitalization for kidney dialysis clients

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Johns Hopkins researchers report that a ten-moment examination for “frailty” initial built to predict no matter whether the aged can stand up to surgical treatment and other physical anxiety could be practical in examining the increased risk of dying and recurrent hospitalization among the kidney dialysis individuals of any age.

In a review explained in the Journal of the American Geriatrics Society and posted on the net yesterday, the Johns Hopkins investigators said dialysis clients deemed frail by the basic evaluation were a lot more than 2 times as very likely to die inside three a long time, and significantly far more very likely to be hospitalized regularly.

Results of the frailty check, which steps physiological reserve, advise that kidney failure people who submit to the extended and arduous method of mechanical blood cleansing a number of times a 7 days are going through a untimely getting old approach detrimental to their overall health, the scientists say.

“Far more than 600,000 individuals are on dialysis and they have a huge vary of mortality and hospitalization challenges,” says review leader Dorry L. Segev, M.D., Ph.D., an affiliate professor of surgical procedure at the Johns Hopkins College School of Drugs. “But we are not really very good at predicting who is at a lot more-or fewer-chance for hospitalization and loss of life. This evaluation instrument gives us a great deal improved insights into which dialysis patients are at increased hazard, so that their cure can be customized to limit troubles, hospitalizations or demise.”

Dialysis machines do substantially of the operate of broken kidneys, cleansing the blood of waste and extra h2o. Dialysis can’t, on the other hand, totally compensate for the blood tension and fluid regulate roles performed by kidneys, and the body can weaken as it tries to make up for what is lacking, Segev claims.
The only remedy for kidney failure is a kidney transplant.

In the study, frailty was measured applying a 5-stage scale produced at Johns Hopkins. Clients are classified as frail if they meet up with a few or more of the subsequent requirements: shrinking (unintended body weight reduction of ten or a lot more pounds in the earlier yr) weak point (decreased grip toughness as calculated by a hand-held dynamometer) exhaustion (calculated by responses to issues about energy and commitment) decreased bodily action (identified by asking about leisure time and activities) and slowed strolling pace (the time it takes to wander 15 toes).

Segev and his crew enrolled 146 hemodialysis patients concerning January 2009 and March 2010, and followed them as a result of August 2012. At enrollment, 50 p.c of the participants who have been sixty five and more mature, and 35 percent of these under sixty five, had been measured as frail. The three-yr mortality charge for frail individuals was 40 percent, in comparison to 16.two percent for the non-frail.

Of those hospitalized much more than twice in excess of the study period, 43 % were frail, although only 28 percent had been not frail.
“We’re finding out that classes from gerontology can enable us recognize younger individuals with continual disorders,” Segev claims.
Segev, a transplant surgeon and director of medical study for transplant surgical procedure at Johns Hopkins, claims health professionals who are conscious of their patients’ frailty may well pick to look at these individuals extra usually, alter dialysis to a more conservative protocol, or make sure the clients have the social aid desired to make certain they are having their remedies and if not having care of them selves.

Physicians also could recommend physical remedy to all those with low muscle mass mass to support them rebuild their power. “You can consider if you invest quite a few times a week sitting down in a chair hooked up to a device, and the rest of the day recovering, that it would be hard to get in condition and continue to be in condition,” states Mara A.

McAdams-DeMarco, Ph.D., an teacher in the Office of Surgery and the Office of Epidemiology at Johns Hopkins and an additional co-author of the study.

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7 tips for mortgage renewal time

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It is that time of the year for you to renew your mortgage and all you want to do is sign the papers and get done with it. However, you shouldn’t be in a haste to renew your mortgage without doing a little research.

A good fraction of Canadian homeowners—about 27 per cent of them—who carry a mortgage have automated their renewal process, according to a survey by Angus-Reid. While the aim is most likely to avoid any penalties or stress that comes with missing a renewal, this approach can prove costly. Automatically renewing your mortgage means you lose out on great opportunities to save money and take further advantage of any new products and features on your mortgage that may be advantageous to you.

Typically, mortgage renewals occur at the end of your existing mortgage term and the most popular period is usually 5 years—though it can range from 1 to 10 years. Depending on your mortgage type, with a fixed rate mortgage calculator, you can easily estimate your monthly mortgage payment and know how much you’re due on your next payment.

However, before you make your next mortgage payment, here are some important tips that would help you get the most out of your mortgage renewal.

1. Review your current goals

It is possible that your financial needs must’ve changed since you first applied for a mortgage. Therefore, before your sign that renewal slip, you may want to take another look at your financial goals.

For instance, if you’re currently on a five-year fixed mortgage, your renewal would likely come with another five-year fixed mortgage. If you’re certain you would be staying in your home for that amount of time, then renewing it would be great. However, if you have plans of relocating to a different city in a couple of years, then a shorter mortgage term would be best.

Other financial goals that you may want to consider is whether you want to refinance your mortgage or access some equity with Home Equity Line of Credit (HELOC).

2. Ask for better rates

Before your mortgage renewal is due, your current lender would most likely try to get you to renew early. Typically, you will receive a renewal letter from your lender 6 months and 4 months before your renewal date. While they may offer you a rate that is lower than what you currently pay, it is often not the best rate you can get.

The renewal offer given to you by your lender is often not the best deal and in an increasing rate environment, negotiating your renewal rate is even more important. Signing the renewal letter right away because of some discount offered by your lender might seem tempting but you are potentially losing out on a lot of savings by not considering other available options.

3. Shop early for better rates

Rather than just accepting your current lender’s renewal offer immediately, you can start searching early for other providers and comparing their rates to see which one is most favourable for you. If you begin at least four months before your renewal due date, you will be giving yourself enough time to make a switch, if necessary.

While there are no major penalties if you choose to switch providers, there are some charges incurred that are typically covered by your new mortgage provider. You may not be able to change your mortgage provider until the actual renewal date, but this would give you enough time to find the right product and sort out every required paperwork.

4. Take advantage of a renewal rate hold

A mortgage renewal rate hold allows you to lock in a particular mortgage rate before your renewal is due. Normally, rate hold can last for about 90 to up to 160 days, protecting you from increases in interest rates.

During this time, you can comfortably compare rates months before your renewal date just to find a better deal. If the interest rates increase during your rate hold period, you would have nothing to worry about. Also, should the interest rates decrease, you can still negotiate for a new lower rate with your lender.

5. Switch mortgage lenders

Cutting ties with your current lender can be difficult—at least that’s the impression most lenders give to home buyers. But don’t be afraid of switching lenders, especially when you’ve found a better rate elsewhere.

Remember, getting a better deal on your mortgage can save you few thousands of dollars. Switching providers might mean you have to go through requalification but that is not a problem as long as you begin the process early enough before your renewal date.

6. Add some extra on your principal

If you’re looking for the best time to make a bigger payment on your mortgage, then renewal time is the best since there are no limits on pre-payment.

Making a lump-sum payment can put a huge dent in your mortgage amortization and you would be saving a lot of money on your total interest cost.

7. Consider switching to a broker

If you’re not already using a mortgage broker, then renewal time might be the best time to consider making the switch. According to a study by the Bank of Canada, most homebuyers who used a broker got a much lower mortgage rate than those who used one of the big banks.

Mortgage brokers are a better alternative because they have access to several lenders who offer different competitive rates, unlike the bank. Therefore, if you’re looking to get the best deal on your mortgage, switching to a broker might be a great move.

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3 Money and time-saving mortgage tips

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The path to buying a house isn’t the cheapest nor the easiest. Since the COVID-19 pandemic began last year, there has been several opportunities and challenges for first-time home buyers in the Canadian real estate market.

For some, sudden changes to their lifestyle created better opportunities to improve their savings plan while for others, such plans were halted due to the economic impact of the pandemic and rising home prices in real estate markets across Canada. According to the Canadian Real Estate Association, over 550,000 properties were sold in Canada last year, a new record for the country’s real estate market and a huge boost for the Canadian economy.

If you are a prospective buyer, looking to purchase a home within the year or just planning for the future, having access to the right information, resources and support can be crucial during your home-buying process. Many people—especially first-time home buyers—easily fall into home debt due to a lack of proper research into the market.

There are some important factors to consider in ensuring that your mortgage works best for you by not only saving you time but money. However, before you start searching for a home to buy, you should have a good idea of just how much you’re able to afford for one. 

Checking your credit score using a Canadian mortgage calculator before applying for a mortgage, would give you a realistic price range and equally inform you of your chances of getting your mortgage approved.

Here are some important mortgage tips to help you save time and money while house hunting:

1. Know the penalties on your mortgage

There are several reasons why anyone would want to sell their property. From changes in your financial or marital status to getting transferred to a new location due to either school or work. However, these circumstances could lead to you selling your home and breaking the terms of agreement on your mortgage.

If you’re on a variable-rate mortgage with one of the major banks in Canada, to successfully break your mortgage, you would need to pay about 3 months’ worth of interest. For a fixed-rate mortgage, the cost is much higher than 3 months of interest and there’s also the option of an interest rated differential (IRD). This is typically based on your remaining mortgage balance and current mortgage rates.

To avoid penalties on your mortgage, apply for a portable mortgage that allows you to transfer your existing mortgage to a new property and even combine it with another loan, if necessary. There’s also the option of an assumable mortgage, where you can transfer the mortgage to a qualified buyer instead of breaking it.

2.  Inquire about pre-payment privileges

When buying a home, you need to understand how rising interest rates would affect your mortgage. Without having any pre-payment privileges, the larger portion of your monthly mortgage payment would go towards the interest against the principal—making it harder to complete your mortgage.

Once you have pre-payment privileges, you’re offered enough flexibility to repay a percentage of the principal on your mortgage before the amortization period is over—and without any penalty. In fact, some lenders may even offer you their best rate to avoid giving you the option of pre-payment over a fixed period of time. Therefore, it is important to ask your lender the specific kind of pre-payment privileges you enjoy on your mortgage.

The amount of money you save by taking advantage of pre-payment privileges is quite substantial. For example, if you took a $300,000 mortgage at a fixed rate of 3.29% over five years and is amortized over 25 years. By making a pre-payment of $2,000 annually, you would save about $21,787 in interest and finish paying off your mortgage almost 4 years faster—assuming the interest rate was fixed throughout the amortization period.

You can always use a mortgage calculator to check much you would be saving by making extra mortgage payments annually.

3.  Know the benefits of making a less than 20% down payment

Typically, when house hunting, the recommended amount of down payment you need to make is 20% of the property cost. However, you mustn’t always pay that high to get the best deal.

Surprisingly, lenders offer the best interest rates to those who want high-ratio mortgage because they have less than the recommended 20% down payment. This because a high-ratio mortgage borrower has a low risk against losses.  

Default insurance makes it a lot cheaper for lenders to easily fund the mortgage loan, allowing them to transfer some of the savings—in form of lower rates—back to the borrower.

It is important to always carry out thorough research before applying for a mortgage to know what the best rates are, if a broker is more advantageous than a bank, or simply how you can get the best credit scores.

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Major housing markets to shine this year and next: Reuters poll

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BENGALURU (Reuters) – The outlook for major global housing markets is brighter than previously thought due to expectations for a broad based economic recovery and easy monetary policy, with only a low risk that a COVID-19 resurgence will derail activity, Reuters polls showed.

Over 100 million people have been infected by the coronavirus, leading to a healthcare crisis and deep economic recessions, but fiscal and monetary stimulus, and the rollout of vaccines, mean the global economy is set to recover this year.[ECILT/WRAP]

While already high unemployment caused by the pandemic is expected to rise further, the Jan. 15-Feb. 1 poll of over 130 property market analysts showed average home prices would rise this year and next in most countries polled.

That compares to largely pessimistic predictions made in September.

An economic rebound, loose monetary policy, government stimulus, pent-up demand and tight inventories were expected to boost housing market activity to varying degrees in Australia, Britain, Canada, Dubai, India and the United States.

“A solid economic recovery bolstered by more fiscal stimulus, still-low mortgage rates, and unmet demand should continue to prop up home sales and construction in 2021,” said Gregory Daco, chief U.S. economist at Oxford Economics.

“We expect some gradual moderation in price growth over the course of 2021 as home sales cool, but sparse inventory will keep a solid floor under home prices.”

Reuters Poll: Major housing markets outlook https://fingfx.thomsonreuters.com/gfx/polling/bdwvkybkqvm/Reuters%20Poll%20-%20Global%20housing%20markets%20outlook%20-%20Feb%202021.PNG

Three-quarters, or 77 of 102 analysts, said in response to an additional question that the risk of a COVID-19 resurgence derailing housing markets this year was low.

Although the U.S. economy on average contracted last year at its sharpest pace since the Second World War due to the pandemic, it had little bearing on housing market activity, an immunity the sector was expected to carry this year.

Despite the recent surge in coronavirus infections and renewed restrictions imposed in the United States, house prices there were forecast to rise over the next two years and activity was expected to continue on a strong course. [US/HOMES]

“The recent COVID-19 surge has not had any noticeable impact, with transactions near record high levels despite record high case growth,” said Brett Ryan, senior U.S. economist at Deutsche Bank.

“Pent-up activity from COVID-19-shutdowns earlier in the year will soon start to wane and transactions will likely normalize. More housing supply will come online as vaccination picks up at the same time that base effects will start to roll off.”

Reuters Poll: Global house prices outlook – Feb 2021 https://fingfx.thomsonreuters.com/gfx/polling/xklpylyqbvg/Reuters%20Poll%20-%20Global%20house%20prices%20outlook%20-%20Feb%202021.PNG

When asked about the primary driver of housing market activity this year, over 55% of respondents, or 57 of 101, chose an economic recovery and easy monetary policy.

Of the remainder, 20 analysts named a desire for more living space and 18 said a successful vaccine rollout, while six chose fiscal stimulus.

Australian and Canadian house prices were expected to rise significantly this year and next, helped by low mortgage rates and massive fiscal spending. [AU/HOMES][CA/HOMES]

When asked what was more likely for housing market activity, 58 of 100 respondents said an acceleration. The others expected a slowdown.

Those views were swayed by a somewhat modest outlook for the British, Dubai and Indian housing markets compared to the rest.

Indian house prices were expected to barely rise this year despite an economic recovery and supportive policies, and Dubai house prices were predicted to fall at a slower pace this year and next compared to the previous poll. [IN/HOMES][AE/HOMES]

British house prices were forecast to flatline this year.[GB/HOMES]

“While we expect a strong start to the year, we expect momentum to wane following the end of the stamp duty (property sales tax) holiday in April. Towards the end of the year the housing market should settle,” said Aneisha Beveridge at estate agents Hamptons International.

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