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health

“First of its Kind” Research on the Practice and Promise of Seniors’ Campuses of Care

Innovative model brings together a full continuum of supports and care where seniors live along with valuable social connections that have proven critical during the COVID-19 pandemic.

Toronto, ON, Nov. 03, 2020 (GLOBE NEWSWIRE) — At a time when there has never been a greater urgency to find better ways to maintain the health, well-being and safety of vulnerable seniors, newly released research from AdvantAge Ontario highlights a “made in Ontario” model that has been operating successfully in communities across the province for decades.

Campuses of care (also commonly referred to as seniors’ villages) are settings that “co-locate” a mix of community-based health and social supports, along with different types of housing and long-term care beds, in one location.

“Campuses offer a sustainable and innovative solution for a new generation of seniors’ care,” says Jane Sinclair, Chair of the AdvantAge Ontario Board of Directors. “They bring services, supports and care together in one setting, which is incredibly valuable. But more importantly they are vibrant, age-friendly communities that promote friendships, social inclusion, mutual support, and positive aging.”

AdvantAge Ontario initiated a multi-year, province-wide research study of campuses of care supported by a Canadian Institutes of Health Research (CIHR) Health Systems Impact Fellowship and with in-kind contributions from the Institute for Health Policy, Management and Evaluation (IHPME) at the University of Toronto. The final report, recently published by BMC Geriatrics and titled, “Seniors’ Campus Continuums: Local Solutions for Broad Spectrum Seniors’ Care,” is the first academic research of its kind on campuses.

“This is tremendously exciting. Not-for-profit and municipal long-term care providers were early pioneers of the campus model, and this research has generated much-needed, evidence-based knowledge to guide the development of future campuses,” adds Lisa Levin, CEO of AdvantAge Ontario.

The Association’s research identified many important advantages offered by campuses, including built-in opportunities for providers and community partners working alongside each other to communicate, collaborate, and share expertise and resources. This promotes more integrated, person-centred care that avoids unnecessary long-term care placements and hospital admissions and ensures quicker discharges when hospitalization does occur.

Moreover, by building “critical mass,” campuses become attractive partners for municipalities, businesses, faith organizations, schools and universities to access new resources, create new opportunities for on-campus and off-campus communities, encourage volunteerism, and train new generations of care workers, clinicians, and researchers.

The Association has also released an Executive Brief based on this research, titled “Campuses of Care: Supporting People, Sustaining Care Systems in Ontario”, which is intended for policy-makers, providers and others who are planning to build, scale-up or spread campuses of care.

“The COVID-19 pandemic and the terrible toll it has taken on long-term care adds greater urgency to discussions on how to keep residents safe and healthy and to ensure that we have viable options for the vast majority of Ontario’s seniors who wish to continue to live as independently as possible for as long as possible,” says Levin. “Campuses are uniquely equipped not only to respond but also to lead the creation of new and

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health

What kind of mask should you wear to vote in-person on Election Day?

While more than 94 million people have voted already in the 2020 presidential election, amounting to more than 67% of 2016’s overall turnout of 138 million votes, voters who plan to cast their ballot in-person are doing so as coronavirus cases continue to surge nationwide. 

“Face the Nation” moderator Margaret Brennan spoke with former Food and Drug Administration Commissioner Dr. Scott Gottlieb last week for insight on just what masks work best and are safest for those looking to vote on Election Day. 

Gottlieb said when it comes to masks that afford you the protection you need from others during the COVID-19 pandemic, it’s quality that matters.


Gottlieb warns of “dangerous tipping point” a…

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“A cloth mask may be 10% to 30% protective. A surgical mask, a level-two or level-three surgical mask, procedure mask, maybe about 60% effective. An N95 mask or an equivalent like a KN95 mask, which is the Chinese equivalent, or what we call an FFP2 mask, which is a European equivalent to an N95, that could be 90 to 95% protective,” Gottlieb said. 

“If you want to mask to afford you a level of protection, wear a higher quality mask. If you only can get a cloth mask, thickness matters and cloth masks with polyester in them and a combination of polyester and cotton do better,” he added.   

Gottlieb explained that masks largely serve two purposes: “One is to protect other people from you. So if you’re asymptomatic or pre-symptomatic, if you have a mask on, you’re less likely to expel respiratory droplets that can infect other people. The other purpose is to provide you some measure of protection if, in fact, you’re around people who are infected.”

His recommendation comes as the spread of the virus is accelerating in dozens of states, including across the Midwest and the Great Lakes region, while 15 states have a positivity rate above 10%. There is an expanding epidemic in all 50 states, he told “Face the Nation” on Sunday.

Gottlieb has also been optimistic that measures to protect those who choose to vote in-person would be taken seriously, but ultimately everyone has a personal responsibility to protect themselves. 

“I think when you go out to vote, the voting places are taking precautions. They’re sequencing people carefully. They’re cleaning the voting stations in between voters. Their lines are going to be long, but they’re going to take precautions inside those settings. And I think when people go out to vote, if they wear a high quality mask, they can adequately protect themselves,” he said on October 18.

“The biggest risk are the settings where we’re not on guard, where we let our guard down, where we are not taking those kinds of precautions. So I think you can vote safely, even in places where there’s high prevalence. But you’re going to need to be careful,” he added.

Since the outset of the pandemic, there have been more than 9.2 million coronavirus cases in the U.S., and the death

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health

First-of-Its Kind Guideline on Lipid Monitoring in Endocrine Diseases

Endocrine diseases of any type — not just diabetes — can represent a cardiovascular risk and patients with those disorders should be screened for high cholesterol, according to a new clinical practice guideline from the Endocrine Society.

“The simple recommendation to check a lipid panel in patients with endocrine diseases and calculate cardiovascular risk may be practice changing because that is not done routinely,” Connie Newman, MD, chair of the Endocrine Society committee that developed the guideline, told Medscape Medical News.

“Usually the focus is on assessment and treatment of the endocrine disease, rather than on assessment and treatment of atherosclerotic cardiovascular disease risk,” said Newman, an adjunct professor of medicine in the Department of Medicine, Division of Endocrinology, Diabetes & Metabolism, at the New York University Grossman School of Medicine in New York City.

Whereas diabetes, well-known for its increased cardiovascular risk profile, is commonly addressed in other cardiovascular and cholesterol practice management guidelines, the array of other endocrine diseases are not typically included.

“This guideline is the first of its kind,” Newman said.

“The Endocrine Society has not previously issued a guideline on lipid management in endocrine disorders (and) other organizations have not written guidelines on this topic.” 

“Rather, guidelines have been written on cholesterol management, but these do not describe cholesterol management in patients with endocrine diseases such as thyroid disease (hypothyroidism and hyperthyroidism), Cushing’s syndrome, acromegaly, growth hormone deficiency, menopause, male hypogonadism, and obesity,” she noted.

But these conditions carry a host of cardiovascular risk factors that may require careful monitoring and management.

“Although endocrine hormones, such as thyroid hormone, cortisol, estrogen, testosterone, growth hormone, and insulin, affect pathways for lipid metabolism, physicians lack guidance on lipid abnormalities, cardiovascular risk, and treatment to reduce lipids and cardiovascular risk in patients with endocrine diseases,” she explained.

Vinaya Simha, MD, an internal medicine specialist at the Mayo Clinic, in Rochester, Minnesota, agrees that the guideline is notable in addressing an unmet need.

Recommendations that stand out to Simha include the suggestion of adding eicosapentaenoic acid (EPA) ethyl ester to reduce the risk of cardiovascular disease in adults with diabetes or atherosclerotic cardiovascular disease who have elevated triglyceride levels despite statin treatment.

James L. Rosenzweig, MD, an endocrinologist at Hebrew SeniorLife, in Boston, Massachusetts, agrees this is an important addition to an area that needs more guidance.

“Many of these clinical situations can exacerbate dyslipidemia and some also increase the cardiovascular risk to a greater extent in combination with elevated cholesterol and/or triglycerides,” he told Medscape Medical News

“In many cases, treatment of the underlying disorder appropriately can have an important impact in resolving the lipid disorder. In others, more aggressive pharmacological treatment is indicated,” he said.

“I think that this will be a valuable resource, especially for endocrinologists, but it can be used as well by providers in other disciplines.”  

Key Recommendations for Different Endocrine Conditions

The guideline, published in the Journal of Clinical Endocrinology & Metabolism, details those risks and provides evidence-based recommendations on their

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fitness

Boutique fitness as we know it is dead, a new kind is taking its place

  • The COVID-19 pandemic has thrown the previously-booming boutique fitness industry into crisis, with studios struggling to pay rent as classes remain closed or at limited capacity.
  • Consumers are increasingly pivoting to digital and at-home fitness as companies like Peloton and Mirror, already successful pre-pandemic, have been booming. 
  • Experts say the coronavirus exposed existing vulnerabilities in the boutique fitness industry, but the market for premium in-person fitness experiences will likely adapt and survive through the pandemic. 
  • Visit Business Insider’s homepage for more stories.

When Flywheel Sports, the revolutionary spin class with a cult following, announced it was permanently closing its doors in September, other studios saw an ominous sign in the world of boutique fitness.

“When it’s as big as Flywheel, that’s when it really gets noticed. That’s exemplifying what’s going to happen over the next 6 months,” said Amanda Freeman, founder of SLT a pilates studio with locations in several states, including New York and New Jersey.

Flywheel was once widely lauded as a paragon of success, expanding to 42 studios since its founding in 2014. In March, the company laid off 98% of its staff. Flywheel declared bankruptcy September 15, joining the ranks of fitness corporations like Gold’s Gym and New York Sports Club parent company Town International Sports, which have had to permanently shutter locations and liquidate assets in response to pandemic-induced closures.

Six months into the pandemic, the boutique fitness industry is now facing a crisis. 

The business of small, often exclusive or luxury spaces, group exercise classes, and typically a specialization (such as high-intensity interval training, or HIIT, barre, spin, or pilates), has boomed in the past decade.

“The big success was built on that idea that you could have an experience with an individual rockstar trainer or the brand identity and community,” said Jared Kaplan, owner and founder of Studio 26, once called the “WeWork” of fitness, providing a co-working space for fitness professionals. 

“People really identified with the experience they were having rather than being a cog in a big box gym, whether that was a dark class with pumping music or a really serene, meditative studio.”

But that highly successful model of home-away-from-home studios with showers, saunas, and luxe changing rooms may be a thing of the past. Instagram-worthy ambience, amenities, and a trainer that remembers your name may not be enough to entice exercisers back into the studio, given evidence that the virus spreads more easily indoors. 

To compete with the at-home fitness industry that’s booming during the pandemic, boutique fitness has to also adapt to meet clients where they are now, which is increasingly at home. And under intense economic and social pressure, studios that are unable or unwilling to change rapidly may not survive at all. 

Even prior to COVID-19, the industry was being squeezed by platforms like ClassPass, which offered subscribers credits to attend multiple studios, rather than faithfully subscribing to one. While boutique studios typically charge a premium per-class fee, ClassPass leveraged lower prices by helping to fill

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