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Exercise keeps our brains healthy – but does cognitive decline lead to physical decline?

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Matthieu Boisgontier’s strategy for keeping fit is a little unorthodox: He buys a chocolate bar – then doesn’t eat it. By training himself to rein in his automatic impulses, he figures he’ll get better at resisting the lure of the couch and getting out the door for his daily half-hour run.

According to new research by Boisgontier, a neuroscientist and health researcher from France recently hired by the University of Ottawa, that strategy may have long-term implications for how his physical and mental capacities decline as he ages – but not necessarily in the way you’d expect.

For years now we’ve been hearing about the power of exercise to keep our brains healthy. Research in both animals and humans has shown that physical activity maintains blood flow to the brain and raises levels of growth factors that promote the formation of new neurons. A study from the Ontario Brain Institute estimated that people who are very physically active are almost 40 per cent less likely to develop Alzheimer’s disease.

But Boisgontier and a colleague from the University of Geneva, Boris Cheval, believe that may be only half the story.

In 2018, they published a study that used EEG brain imaging to explore one of the great riddles of public health: why people fail to exercise regularly even when they know how beneficial it would be. By flashing images of people exercising or lounging in hammocks, they showed that it takes extra neural effort to resist the lure of being sedentary. In other words, we’re wired to be lazy.

Based on those findings, they began to wonder whether declining cognitive function might be a cause, rather than just a consequence, of age-related declines in physical activity.

To test this hypothesis, they analyzed data from more than 100,000 adults between the ages of 50 and 90 in 21 European countries, each of whom had completed cognitive assessments and reported their physical activity levels five times over a 12-year period. The results will be published in the June issue of the journal Health Psychology.

As expected, those with the lowest scores on the cognitive test also tended to get the least exercise. But the most interesting finding was how the scores changed over time: The inexorable declines in cognitive function generally preceded declines in physical activity, suggesting that the former contributed to the latter.

There was also evidence, albeit weaker, that physical declines are followed by cognitive declines. As a result, Boisgontier said, “our results support the idea that cognitive abilities and physical abilities are part of the same circle that can be either a virtuous one or a vicious one.”

The new results join a long-standing debate about the underlying causes of age-related decline, says Emilie Reas, a neuroscientist at the University of California San Diego. It’s possible, for example, that socioeconomic factors or lifestyle changes such as retirement could lead to both physical and cognitive decline in parallel.

“Even if cognitive impairment does limit physical activity, this doesn’t refute the fact that exercise is good for the brain,” she said. “This evidence is quite solid and shouldn’t change the advice to stay active throughout life, especially in older age.”

But if cognitive function itself is a risk factor in that potentially vicious cycle of decline, that suggests other possible counterattacks. Cheval stresses the importance of sustaining cognitively engaging activities such as socializing and reading and modifying the environment to make movement – taking the stairs rather than the elevator, say – a default option that doesn’t require extra cognitive effort.

Boisgontier, meanwhile, has used his don’t-eat-the-chocolate-bar strategy to ingrain the habit of a half-hour daily run. At first, convincing himself to lace up his shoes and get out the door took a lot of mental effort. But eventually, he said, it became automatic. “I don’t really need any brain resources to engage in this physical activity any more” – precisely, he hopes, what will make the habit stick as he gets older.

Alex Hutchinson is the author of Endure: Mind, Body, and the Curiously Elastic Limits of Human Performance. Follow him on Twitter @sweatscience.

Source: – The Globe and Mail

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Why saliva testing for COVID-19 in Canada won't be a panacea for long lineups any time soon – CBC.ca

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Canadians in several provinces face long lines for a swab to help diagnose COVID-19 as school and workplaces open. While new testing technologies could help, doctors say they won’t be a silver bullet. 

The gold standard swab of the nose or throat can be uncomfortable. In contrast, a key promise of saliva tests is that people could collect saliva themselves so that fewer nurses and other health professionals would be needed at assessment centres, as staffing is one of the factors that can drive up wait times.

But that ideal won’t happen immediately. Currently in Canada, both saliva collection and testing remain a research project that regulators are closely evaluating. 

There are three main barriers to overcome before saliva tests roll out widely. 

Gobs of saliva vary in how fluid they can be, so collecting a high-quality sample can be a challenge even for something as non-invasive as spitting into a cup. The next hurdle for scientists is to get accurate and consistent results on the presence of the virus. Finally, clinicians need to determine how well the test results help them to correctly identify those with the disease. 

Dr. Mel Krajden, medical director of the public health laboratory at the BC Centre for Disease Control, said health professionals face a quandary in finding the best ways to support a return to school, with all of its formative benefits for students, while protecting the oldest people at highest risk for severe consequences from COVID-19, such as grandparents or parents who are vulnerable because they have other health conditions.

Dr. Mel Krajden, medical director of the public health laboratory at the BC Centre for Disease Control. The Vancouver lab is exploring whether a saline gargle might work better than saliva testing itself. (Ben Nelms/CBC)

Krajden said in his experience, saliva testing works better with COVID-19 patients in hospital than on people living in the community who’ve tried it as part of a research project. His Vancouver lab is working on a simpler approach to collection than the traditional nasal swab using a saline gargle that seems to work in older children. 

On Thursday, British Columbia announced it’s introducing a new mouth rinse, gargle and spit test for students from kindergarten to Grade 12 to make it easier for children and teenagers to check whether they have COVID-19.  But this new test is only offered to school age kids, and only in B.C.

“What we need to be thinking through is what is the best mixture of tests and how are they best supplied?” Krajden said. “You want to have the right balance between convenience and sensitivity.”

Unresolved questions about saliva tests

Health Minister Patty Hajdu said on Wednesday that Health Canada will not approve a test that endangers Canadians’ health because they are inaccurate or offer a false sense of security.

In Canada, the mobile Spartan Cube was recalled because of reliability problems with its swab for the lab-in-a-box PCR test (also known as a polymerase chain reaction test) that was billed as providing results in less than an hour. In the United States, wide-scale problems early on with another PCR test developed by the Centers for Disease Control and Prevention hampered containment efforts.

A different technology, a molecular test launched by Illinois-based Abbott that the company says can deliver positive results in as little as five minutes, was also subject to a recall. It aims to detect the virus during active infection.

The outstanding questions about saliva tests include: How good an alternative could they be to a nasal or throat swab, who would benefit — such as different age groups or those who show symptoms — and when would they be available? 

For governments and clinicians globally and across Canada, the challenge now is to organize all kinds of testing to allow society to function while preventing transmission to those at highest risk of severe consequences.

For the majority of young people, COVID-19 is like a common cold, Krajden said. It’s older adults and those who are vulnerable because of other health conditions that can face serious infection or death.

Policy-makers urged to shift gears

Dr. Larissa Matukas, head of the microbiology division at St. Michael’s Hospital, Unity Health Toronto, said experts and policy-makers need to shift gears to understand where cases are multiplying and shut them down quickly by moving resources, including testing, to where there are signs of concern.

“I’m not sure that’s actually happening right now,” Matukas said.

Dr. Larissa Matukas, head of the microbiology division at St. Michael’s Hospital, Unity Health Toronto, says experts need to understand where cases are multiplying and shut them down quickly by moving resources, including testing, to where there are signs of concern. (Yuri Markarov/Unity Health Toronto)

“We should be shifting to a very aggressive finding of individuals, testing those who are symptomatic or testing those who’ve been in close contact with those who’ve been diagnosed with COVID and then isolating those individuals to really stop all the chains of transmission,” she and her co-authors wrote in an editorial last week in CMAJ

Matukas said the first step is finding cases by improving access to diagnostic nasal or throat swabs or having a health-care professional evaluate symptoms. 

“Unfortunately, there’s been this drive, particularly in Ontario, to reach a particular number of tests per day indiscriminately of who is actually being tested,” she said.

Other, equally important parts of containment have been neglected, Matukas said, such as governments communicating a clear need for all people with symptoms compatible with COVID-19 to get tested immediately and to self-isolate while they wait for the test result.

Dr. David Williams, Ontario’s chief medical officer of health, said Thursday that people who haven’t been in contact with a case, aren’t connected to an outbreak, haven’t received a notification from the COVID Alert app and don’t have symptoms “might want to defer your visit” until the demand for tests falls.

Dr. David Williams, Ontario’s chief medical officer of health, said Thursday that people who haven’t been in contact with a case, aren’t connected to an outbreak, haven’t received a notification from the COVID Alert app and don’t have symptoms might want to delay testing until the demand falls. (Government of Ontario)

‘New technologies are always welcomed’

The level of disease in a particular community also makes a difference in misdiagnosing COVID-19 — another accuracy wrinkle to overcome in adopting quick, at-home saliva-based antigen tests for use in Canada.

“All new technologies are always welcomed,” Matukas said. “They always need to be evaluated in an objective, independent evaluation, and that’s the purpose of not just Health Canada, but that’s my job.”

As a medical microbiologist, Matukas carefully evaluates every diagnostic test introduced to ensure it meets the performance characteristics patients need in hospital. As part of her evaluation, new technologies are compared with  a standard way of testing as a reference. 

Lab workers need to do the same quality-assurance steps to check tests and equipment from all manufacturers. The goal is to ensure they perform well under real-life conditions, not just optimal ones.

Antigen tests that are used to identify mid-infection as the microbe multiplies, such as rapid tests for strep throat, is another technology under evaluation to help detect people likely infected with COVID-19 in schools, long-term care homes or other high-risk environments.

A laboratory worker shows a prototype of a self-test that will use saliva in a rapid COVID-19 test, which could replace more commonly used swabs, at the University of Liege, Belgium, in August. In Canada, saliva tools are also still being researched. (Yves Herman/Reuters)

Krajden, of the BCCDC, said more data is needed to determine when it makes sense to deploy antigen tests to quickly inform decisions.

Matukas said people living in long-term care will continue to be a priority for diagnostic testing.

Living in an area with a high prevalence of the disease, taking part in certain activities — such as waiting tables, driving a cab or attending a large gathering —  and not using personal protective equipment also contribute to the risk.

On the other hand, scolding people for breakdowns that can’t be controlled could drive some people underground and make it harder to detect cases, Matukas said.

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COVID-19 in B.C.: New and active cases hit record highs, 10 schools report cases, and new gargle test for children – The Georgia Straight

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Unfortunately, new and active COVID-19 case counts continue to climb to new heights in B.C.

There are also two new healthcare outbreaks, six flights and two Metro Vancouver stores confirmed cases, and 10 schools have reported cases.

Meanwhile, a new and more comfortable means of collecting test samples is being introduced in B.C. for children.

At a news conference in Vancouver, B.C. provincial health officer Dr. Bonnie Henry announced some unfortunate news: B.C. set a new record with 165 new cases today (which includes two epi-linked cases). The previous high was 139 cases on September 10.

The number of active cases continues to ascend. At the moment, there are 1,705 active cases (up 91 cases from yesterday’s 1,614 active cases), which is also a new record.

Hospitalized cases are slightly down to 57 people today in hospital (three less patients than yesterday), with 22 of those patients in intensive care units (one less than yesterday).

Of these patients, B.C. Health Minister Dix said that there are 26 in Vancouver Coastal Health, 23 in Fraser Health, seven in Northern Health, and one in Island Health.

The number of people being monitored by public health also continues to decrease—down from 2,966 people yesterday to 2,949 people today.

Unfortunately, one new death was announced, bringing the total number of fatalities to 220 people who have died from COVID-19-related causes during the pandemic.

A total of 5,719 people have recovered from the virus.

During the pandemic, B.C. has recorded a cumulative total of 7,663 cases, which includes 3,937 cases in Fraser Health, 2,714 cases in Vancouver Coastal Health, 489 in Interior Health, 241 in Northern Health, 196 in Island Health, and 85 people who live outside Canada.

Unfortunately, there are two new healthcare outbreaks. Both are in acute care units in Fraser Health, one at Delta Hospital and the other at Peace Arch Hospital in White Rock.

Fraser Health declared the Delta Hospital outbreak on September 16, stating that two patients tested positive in one unit, which has been temporarily closed to admissions. Enhanced cleaning and contact tracing is underway.

Accordingly, there are 16 active outbreaks in healthcare (11 in longterm care facilities and five in acute care facilities), with a total cumulative number of 802 cases (478 residents and 324 staff) involved in healthcare outbreaks during the pandemic.

Meanwhile, Dix also said that B.C. conducted a record number of tests during the pandemic on September 16: a total of 7,674 tests.

B.C. Health Minister Adrian Dix, with provincial health officer Dr. Bonnie Henry
Province of British Columbia

Loblaw has reported two of its stores in the Lower Mainland have staff who have tested positive.

An employee who tested positive last worked at the Westgate Centre location of Shoppers Drug Mart (20395 Lougheed Higway) in Maple Ridge on September 3.

Meanwhile, a staff member at the Real Canadian Superstore (7559 King George Highway) in Surrey, who tested positive, last worked there on September 11.

The B.C. Centre for Disease Control (BCCDC) has added two international and four domestic flights confirmed with COVID-19:

  • September 11: Aeromexico 696, from Mexico City to Vancouver;
  • September 11: Lufthansa 492, from Frankfurt to Vancouver;
  • September 11: Air Canada 8328, from Vancouver to Winnipeg;
  • September 11: WestJet 133, from Calgary to Vancouver;
  • September 12: WestJet 711, Toronto to Vancouver;
  • September 13: WestJet 711, Toronto to Vancouver.

For affected row information, visit the BCCDC webpage for public exposures.

Anyone at these locations or on these flights should monitor themselves for 14 days after the date of visit or flight date. If you develop symptoms, immediately self-isolate and contact 811 for testing information.

As announced yesterday, provincial health authorities have begun reporting potential exposure incidents at schools.

Fraser Health reported eight exposure events in schools.

One was at an exposure incident at Delta Secondary on September 11.

Two were at private schools: Khalsa School (elementary school at Old Yale Road location) on September 1 and 4, and Khalsa Secondary School in Surrey on September 9 and 10.

Five incidents were at public schools in Surrey:

  • Johnson Height Secondary from September 8 to 11;
  • Panorama Ridge Secondary on September 8;
  • Sullivan Heights Secondary on September 8;
  • William Watson Elementary on September 10;
  • Princess Margaret Secondary on September 11.

Interior Health listed Stanley Humphries Secondary School in Castlegar had one student on September 11 who has tested positive.

Northern Health listed École Frank Ross Elementary in Dawson Creek with an exposure event from September 10 to 11.

There weren’t any exposure incidents at schools reported in Island Health or Vancouver Coastal Health.

Video of Mouth rinse and gargle COVID-19 test for school-aged children

A new made-in-B.C. method of collecting samples for testing—one of the first of its kind in the world—is being introduced for testing school-aged children.

As an alternative to collecting samples from the nose with swabs, children and youth swish and gargle sterile salt water before spitting it into a tube, or by using a swab to collect a sample from their nose.

The nose swab is used for younger children or those who are unable to follow the swish, gargle, and spit instructions.

The BCCDC adds that children can practice at home how to swish, gargle, and spit.

Henry said that this new method will be more efficient because it doesn’t take as long to do as the nasal swab test.

However, due to limited supplies, she said they are focussing on children because “we know right now it’s going to be very critical for children if they start showing symptoms of COVID-19 and they’re in a school setting, many of them will need to get tested so it’s a way to try and facilitate that and make that easier right now.”

She said that this collection method needs to be done at a health centre assessment centre. In addition, she explained that the test itself remains the same but this is a different means of collecting samples.

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Fourth staff member at Fellowes High School tests positive for COVID-19 – The Cold Lake Sun

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The Renfrew County and District Health Unit has ordered the closure of Fellowes High School due to a COVID-19 outbreak involving three staff members. A fourth staff member tested positive Thursday.

Tina Peplinskie / jpg, PM

The Renfrew County District Health Unit has confirmed a fourth staff member from Fellowes High School has tested positive for COVID-19.

RCDHU had deemed this person a probable case which factored into the decision to close the school on Sept. 16. This individual did not have any further exposures beyond the classes that have already been identified for testing and the staff member who became symptomatic last week has not been at school this week, according to a release issued Thursday evening.

The good news is that RCDHU has received negative test results for some staff and for all but two of the students in the original class that was exposed to the staff cases; these two tests have yet to be reported.

This afternoon RCDHU tested 98 individuals, 83 staff and 15 students. Almost all the staff from the school was tested along with most of the students considered to be at highest risk. There will be further testing tomorrow, for the remaining staff and students that could not attend today.

RCDHU will continue to update the school community and the public daily. In the meantime, RCDHU asks everyone to rigorously observe public health precautions as follows:

  • Limit your social activities and keep your bubble small.
  • Practice physical distancing (maintaining 2 metre distance).
  • Wear a mask when physical distancing cannot be maintained.
  • Clean your hands frequently with soap and water or an alcohol-based hand rub.
  • Cover your mouth and nose with a tissue when you cough or sneeze, then clean your hands.
  • If you don’t have a tissue, sneeze or cough into your sleeve and then clean your hands.
  • Avoid touching your eyes, nose or mouth, unless you have just cleaned your hands. • If you are ill, stay home.
  • Avoid contact with people who are sick.
  • Get your flu shot.
  • Use the COVID Alert App.

For all other information, visit RCDHU’s website at https://www.rcdhu.com/novelcoronavirus-covid-19-2/ or call 613-735-8654. For COVID-19 testing dates and times visit the Renfrew County Virtual Triage Assessment Centre (RCVTAC) website at www.rcvtac.ca for the testing schedule or call RCVTAC at 1- 844-727-6404 to book an appointment for testing.

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