The impact of the COVID-19 pandemic on transfers between long-term care and emergency departments across Alberta

Abstract Background Long-term care (LTC) was overwhelmingly impacted by COVID-19 and unnecessary transfer to emergency departments (ED) can have negative health outcomes. This study aimed to explore how the COVID-19 pandemic impacted LTC to ED transfers and hospitalizations, utilization of community paramedics and facilitated conversations between LTC and ED physicians during the first four waves of the pandemic in Alberta, Canada. Methods In this retrospective population-based study, administrative databases were linked to identify episodes of care for LTC residents who resided in facilities in Alberta, Canada. This study included data from January 1, 2018 to December 31, 2021 to capture outcomes prior to the onset of the pandemic and across the first four waves. Individuals were included if they visited an emergency department, received care from a community paramedic or whose care involved a facilitated conversation between LTC and ED physicians during this time period. Results Transfers to ED and hospitalizations from LTC have been gradually declining since 2018 with a sharp decline seen during wave 1 of the pandemic that was greatest in the lowest-priority triage classification (CTAS 5). Community paramedic visits were highest during the first two waves of the pandemic before declining in subsequent waves; facilitated calls between LTC and ED physicians increased during the waves. Conclusions There was a reduction in number of transfers from LTC to EDs and in hospitalizations during the first four waves of the pandemic. This was supported by increased conversations between LTC and ED physicians, but was not associated with increased community paramedic visits. Additional work is needed to explore how programs such as community paramedics and facilitated conversations between LTC and ED providers can help to reduce unnecessary transfers to hospital

Effect of age, sex and aerobic exercise on cerebrovascular regulation in older adults: Results from the Brain in Motion Study

Background: By 2024, 20% of Canada’s population will be 65 and older. Aging is associated with progressive declines in cerebrovascular and cognitive function and an increased prevalence of age-related diseases such as Alzheimer’s Disease (AD). Physical activity has been associated with improvements in cerebrovascular function and cognitive performance, and may help to prevent and/or delay AD. However, the underlying time-course by which enhanced physical activity may be protective for brain health and differences between men and women is poorly understood. Objective: To determine the influence of age and sex on the cerebrovascular responses to submaximal exercise and euoxic hypercapnia in older adults. Furthermore, this study assessed the effects of a 6-month aerobic exercise intervention on cerebrovascular measures and evaluated outcomes after three and six months of exercise. Design: 202 participants aged 66.5 ± 6.5 years (mean ± SD, 101 females) completed the aerobic exercise intervention. Measurements took place pre-, mid- and post-intervention including demographic information, maximal aerobic capacity (VO2max) and cerebrovascular function. Linear mixed models adjusted for covariates were used to measure the physiological responses to submaximal exercise and euoxic hypercapnia pre-intervention and the changes in middle cerebral artery peak blood flow velocity (VP), mean arterial pressure (MAP) and cerebrovascular resistance (CVRi) and conductance (CVCi) indices after three and six months of aerobic exercise. Results: Pre-intervention, both age and sex were significant predictors of VP (p=0.002; p<0.010), CVRi (p<0.001; p=0.029), and CVCi (p<0.001; p=0.004) during exercise. Compared to rest, acute exercise led to increases in VP, CVRi and MAP and decreases in CVCi (p<0.001). Three months of aerobic exercise led to increases in VP (p=0.005) and CVCi (p=0.021) and decreases in CVRi (p=0.002) in women only, with no further changes observed after an additional three months of exercise. Conclusion: Male sex and increasing age were associated with lower VP, CVCi and higher CVRi. Three months of aerobic exercise led to improvements in cerebrovascular measures in women that were maintained in the latter three months of the intervention in healthy, older adults. Such results have important implications for the role of physical activity in improving health outcomes and the differences observed with aging and sex

Electric and steric factors affecting the formation of aluminum complexes

2-苯氧基乙醇與AlX3反應生成高產率的五配位雙體產物[(u-OCH2CH2OPh) AlX2]2(1, X=Cl; 2, X=Br) 錯化合物1屬於斜方晶系,Pbca空間群,錯化合 物2結晶於空間群, 但是當2-苯氧基乙醇與Al(Bui)3 反應卻是生成一個四 配位雙體的產物[(u-O(CH2)2OPh)Al(Bui)2]2 (3), 錯化合物3 屬於三斜 晶系,空間群P-1, 當2-苯氧基乙醇與一當量Et2AlCl反應,得到產物[(u-O( CH2)2OPh)Al(Et)0.75(Cl)1.25]2 (4), 錯化合物4 的結晶於單斜晶系的 空間群P21/c, 而當2-甲氧基苯醇與AlR3反應產生高產率四配位的雙體產 物[(u-OCH2C6H4OMe)AlR2]2 (5, R=Me; 6, R=Bui), 錯化合物6為空間群 P-1,包含電子及立體兩個效應,影響了氧,氧-雙官能基配位基鉗合到鋁原 子中心的能力,而產生四配位或五配位的鋁烷氧化合