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BackgroundThe COVID-19 pandemic has drastically changed the lives of countless members of the general population. Older adults are known to experience loneliness, age discrimination, and excessive worry. It is therefore reasonable to anticipate that they would experience greater negative outcomes related to the COVID-19 pandemic given their increased isolation and risk for complications than younger adults. ObjectiveThis study aims to synthesize the existing research on the impact of the COVID-19 pandemic, and associated isolation and protective measures, on older adults. The secondary objective is to investigate the impact of the COVID-19 pandemic, and associated isolation and protective measures, on older adults with Alzheimer disease and related dementias. MethodsA rapid review of the published literature was conducted on October 6, 2020, through a search of 6 online databases to synthesize results from published original studies regarding the impact of the COVID-19 pandemic on older adults. The Human Development Model conceptual framework–Disability Creation Process was used to describe and understand interactions between personal factors, environmental factors, and life habits. Methods and results are reported following the Preferred Reporting Items for Systematic Reviews and Meta-analyses Statement. ResultsA total of 135 records were included from the initial search strategy of 13,452 individual studies. Of these, 113 (83.7%) studies were determined to be of level 4 according to the levels of evidence classification by the Centre for Evidence-Based Medicine. The presence of psychological symptoms, exacerbation of ageism, and physical deterioration of aged populations were reported in the included studies. Decreased social life and fewer in-person social interactions reported during the COVID-19 pandemic were occasionally associated with reduced quality of life and increased depression. Difficulties accessing services, sleep disturbances, and a reduction of physical activity were also noted. ConclusionsOur results highlight the need for adequate isolation and protective measures. Older adults represent a heterogeneous group, which could explain the contradictory results found in the literature. Individual, organizational, and institutional strategies should be established to ensure that older adults are able to maintain social contacts, preserve family ties, and maintain the ability to give or receive help during the current pandemic. Future studies should focus on specific consequences and needs of more at-risk older adults to ensure their inclusion, both in public health recommendations and considerations made by policy makers.

Introduction: Clinical departments at academic medical centers strive to deliver clinical care, provide education and training, support faculty development, and promote scholarship. These departments have experienced increasing demands to improve the quality, safety, and value of care delivery. However, many academic departments lack a sufficient number of clinical faculty members with expertise in improvement science to lead initiatives, teach, and generate scholarship. In this article, we describe the structure, activities, and early outcomes of a program within an academic department of medicine to promote scholarly improvement work. Methods: The Department of Medicine at the University of Vermont Medical Center launched a Quality Program with three primary goals: (a) improve care delivery, (b) provide education and training, and (c) promote scholarship in improvement science. The program serves as a resource center for students, trainees and faculty, offering education and training, analytic support, consultation in design and methodology, and project management. It strives to integrate education, research, and care delivery to learn, apply evidence and improve health care. Results: Over the first 3 years of full implementation, the Quality Program supported an average of 123 projects annually, including prospective clinical quality improvement initiatives, retrospective assessment of clinical programs and practices, and curriculum development and evaluation. The projects have yielded a total of 127 scholarly products, defined as peer‐reviewed publications and abstracts, posters, and oral presentations at local, regional, and national conferences. Conclusions: The Quality Program may serve as a practical model for promoting care delivery improvement, training, and scholarship in improvement science while advancing the goals of a learning health system at the level of an academic clinical department. Dedicated resources within such departments offer the potential to enhance care delivery while promoting academic success for faculty and trainees in improvement science. [ABSTRACT FROM AUTHOR]

This study analyzes the transfer of specialized professional activities from health care workers to patients and their family members in the context of the shift to ambulatory care for acute and chronic illnesses requiring hospitalization. Based on 119 semidirective interviews with patients released from hospital after early discharge and/or with the family members caring for them, and based on 26 focus groups and 9 individual interviews with health care professionals from hospitals and home care agencies in five regions of the province of Quebec, this article raises the issue of the trivialization of professional care which underlies this transfer. This article also examines two stages in this trivialization: the preparation for discharge and the transfer of specialized activities. Theoretical and empirical implications include the need to better understand how health care workers support this transfer through a process of trivialization and the implications of this transfer for patients and their families.

Objective: To provide updated data on the incidence, types, and demographics of laryngoceles in the adult population. Methods: We searched the medical archives of our institute for computed tomography (CT) studies acquired between January 1, 2007 and December 31, 2017 in which the term "laryngocele" appeared in the radiology reports. Two of the authors reviewed relevant images for the presence, type, distribution, and laterality of true laryngoceles. Demographic and clinical data were extracted from medical records and the incidence was calculated. Results: Laryngoceles were detected in 53 out of the 79 893 patients with relevant CT data, which equates to an incidence of 151 per 2.5 million (0.06:1000) patients per year. The male:female ratio was 3:1, average age was 60 (±18) years, and incidence peaked among patients in the sixth decade of life. Nine patients (17%) had known laryngeal cancer; however, the majority of the cohort did not have follow up clinic visits. Conclusion: Our study demonstrates that the incidence of laryngoceles is much greater than previously reported. In most cases, the diagnosis of a laryngocele was an incidental radiological finding. Male gender predilection and age at presentation are in agreement with previous reports. Association of laryngoceles with laryngeal cancer could not be calculated due to low rates of follow ups. Level of Evidence: 3. [ABSTRACT FROM AUTHOR]

Soybean (Glycine max (L.) Merr.) was domesticated in China and ihe greatest genetic diversity for this species is found in Asia. In contrast, in North America, soybean cultivars trace back to a small number of plant introductions from Asia and genetic diversity is typically quite limited. The purpose of this work was to measure and compare the genetic diversity in two sets of soybean lines. The first set (termed 'local') was composed of 100 lines used in a private breeding program in Quebec. The second set (termed 'exotic') was composed of 200 lines from elsewhere in the world (but mostly from Asia) and included a few lines of Glycine soja, the wild progenitor of cultivated soybean. Almost all the genotypes belonged to maturity groups between 000 and II. A total of 39 microsatellites (SSRs) were used to genotype the two collections. The number of alleles per locus was almost twice as great in the exotic set compared with the local set. Also, the number of 'unique' alleles, i.e., those uniquely present in one set and absent in the other, was almost fivefold greater (191 vs. 37) in a subset of 108 exotic lines with good adaptation than among the local set. A genetic distance matrix, a UPGMA cluster analysis, and a principal coordinate analysis were conducted based on the SSR data. These analyses all indicated that the exotic set was much more diverse and formed a clearly distinct group from the local set. Interestingly, some of the lines showing the best adaptation to local conditions were quite distinctive in terms of their genotype and could potentially contribute useful novel genetic variation within the breeding program. Key words; Glycine max, genetic diversity, microsatellites, germplasm, genetic breeding. Le soja (Glycine max (L.) Merr.) a ete domestique en Chine et e'est en Asie qu'on retrouve la plus grande diversity genetique au sein de cette espece. En Amerique du Nord, les cultivars de soja proviennent d'un petit nombre d'introductions de l'Asie et leur diversite genetique est typiquement tres limitee. L'objectif de cette etude etait de mesurer et de comparer la diversite genetique au sein de deux collections de cultivars de soja. La premiere collection (dite << locale >>) etait composee de 100 lignees utilisees dans un programme de selection prive au Quebec. La deuxieme collection (dite << exotique >>) etait composee de 200 lignees de partout dans le monde (la plupart de l'Asie) et incluait quelques lignees de Glycine soja, l'aneetre sauvage du soja cultive. Presque tous les genotypes appartenaient aux groupes de maturite de 000 a II. An total, trente-neuf microsatellites (SSR) ont ete employes pour le genotypage des deux collections. Le nombre d'alleles par locus s'est avere presque deux fois plus grand dans la collection exotique par rapport a la collection locale. De plus, le nombre d'alleles << uniques >>, i.e. ceux presents dans une collection mais pas dans l'autre, etait cinq fois plus grand (191 vs 37) dans une sous-collection de 108 lignees exotiques bien adaptees que dans la collection locale. Une matrice de distance genetique, une analyse de groupement UPGMA et une analyse de coordonnees principales ont ete faites sur les donnees SSR. Toutes ces analyses indiquent que la collection exotique etait plus diverse et formait un groupe bien distinct de la collection locale. Fait interessant, certaines lignees parmi les mieux adaptees aux conditions locales etaient tres distinctes des lignees locales au niveau genotypique et pourraient s'averer une source de variation genetique nouvelle et utile dans le cadre de programmes d'amelioration. Mots-cles: Glycine max, diversite genetique, microsatellites. germoplasme, amelioration genetique., Introduction Cultivated soybean, Glycine max (L.) Merr. (2n = 2x = 40), is an important member of the family Papilionaceae and a close relative of Glycine soja, its wild progenitor. [...]

Various related compounds of hexaphenylbenzene are examined, which usually engage in hydrogen bonding and hence give rise to numerous hydrogen-bonded molecular crystals. The results show that the number of hydrogen bonds and the percentage of volume accessible to the guests are found to be highest in such complexes, which demonstrates the importance of maintaining a consistent molecular shape while determining the properties.

This study examines the norms and values associated with care to disabled and frail aging parents, in particular those with regard to the sharing of responsibilities for care between families and formal services, and this within three age cohorts in Quebec, Canada. It is based on a telephone interview of 1,315 people. Factor analysis yielded four factors: (1) family responsibility; (2) uncompromising family obligations; (3) acceptance of services; (4) distrust of services. Analyses of the data indicate that all three age cohorts consider that families have responsibilities for their aging family members, at the same time that they score very high on the acceptance of service scale. This article discusses these seemingly paradoxical results and their implications for aging policy. doi:10.1300/J031v18n03_05 [Article copies available for a fee from The Haworth Document Delivery Service: 1-800-HAWORTH. E-mail address: Website: [c]2006 by The Haworth Press, Inc. All rights reserved.] KEYWORDS. Eldercare, family responsibility, formal services, caregiving, values

This study analyzes the transfer of specialized professional activities from health care workers to patients and their family members in the context of the shift to ambulatory care for acute and chronic illnesses requiring hospitalization. Based on 119 semidirective interviews with patients released from hospital after early discharge and/or with the family members caring for them, and based on 26 focus groups and 9 individual interviews with health care professionals from hospitals and home care agencies in five regions of the province of Quebec, this article raises the issue of the trivialization of professional care which underlies this transfer. This article also examines two stages in this trivialization: the preparation for discharge and the transfer of specialized activities. Theoretical and empirical implications include the need to better understand how health care workers support this transfer through a process of trivialization and the implications of this transfer for patients and their families. Keywords: home care; hospital discharge; ambulatory care; caregivers

Objectives: In 2018, the ACGME (Accreditation Council for Graduate Medical Education) made a change to the maximum permissible number of consecutive nights a resident trainee can be on “night float,” from six to seven nights. To our knowledge, although investigators have studied overall discrepancy rates and discrepancy rates as a function of shift length or perceived workload of a particular shift, no study has been performed to evaluate resident-faculty discrepancy rates as a quality/performance proxy, to see whether resident performance declines as a function of the number of consecutive nights. Our hypothesis is that we would observe a progressive increase in significant overnight resident – attending discrepancies over the 7 days’ time. Methods: A total of 8,488 reports were extracted between 4/26/2019 to 8/22/2019 retrospectively. Data was obtained from the voice dictation system report server. Exported query was saved as a .csv file format and analyzed using Python packages. A “discrepancy checker” was created to search all finalized reports for the departmental standard heading of “Final Attending Report,” used to specify any significant changes from the preliminary interpretation. Results: Model estimates varied on different days however there were no trends or patterns to indicate a deterioration in resident performance throughout the week. There were comparable probabilities throughout the week, with 2.17% on Monday, 2.35% on Thursday and 2.05% on Friday. Conclusions: Our results reveal no convincing trend in terms of overnight report discrepancies between the preliminary report generated by the night float resident and the final report issued by a faculty the following morning. These results are in support of the ACGME’s recent change in the permissible number of consecutive nights on night float. We did not prove our hypothesis that resident performance on-call in the domain of report accuracy would diminish over seven consecutive nights while on the night float rotation. Our results found that performance remained fairly uniform over the course of the week. [ABSTRACT FROM AUTHOR]