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We aimed to describe emergency department (ED) care transition interventions delivered to older adults with cognitive impairment, identify relevant patient-centered outcomes, and determine priority research areas for future investigation.Systematic scoping review.ED patients with cognitive impairment and/or their care partners.Informed by the clinical questions, we conducted systematic electronic searches of medical research databases for relevant publications following published guidelines. The results were presented to a stakeholder group representing ED-based and non-ED-based clinicians, individuals living with cognitive impairment, care partners, and advocacy organizations. After discussion, they voted on potential research areas to prioritize for future investigations.From 3848 publications identified, 78 eligible studies underwent full text review, and 10 articles were abstracted. Common ED-to-community care transition interventions for older adults with cognitive impairment included interdisciplinary geriatric assessments, home visits from medical personnel, and telephone follow-ups. Intervention effects were mixed, with improvements observed in 30-day ED revisit rates but most largely ineffective at promoting connections to outpatient care or improving secondary outcomes such as physical function. Outcomes identified as important to adults with cognitive impairment and their care partners included care coordination between providers and inclusion of care partners in care management within the ED setting. The highest priority research area for future investigation identified by stakeholders was identifying strategies to tailor ED-to-community care transitions for adults living with cognitive impairment complicated by other vulnerabilities such as social isolation or economic disadvantage.This scoping review identified key gaps in ED-to-community care transition interventions delivered to older adults with cognitive impairment. Combined with a stakeholder assessment and prioritization, it identified relevant patient-centered outcomes and clarifies priority areas for future investigation to improve ED care for individuals with impaired cognition, an area of critical need given the current population trends.

The triphenyl oxinates of the group 14 elements (M = Si, Ge, Sn, and Pb) contain the 8-hydroxyquinoline ligand (HO x ), which can function in either a bidentate or monodentate fashion. The compounds Ph 3 MO x were prepared by reaction of the triphenylmetal chloride with HO x in the presence of an HCl scavenger triethylamine or, sodium acetate, and in the case of lead, with the sodium salt of 8-hydroxyquinoline. The interaction of the nitrogen with the central atom was studied through the use of the NMR chemical shifts of the central metal atom and the 15 N atom of the ligand. The chemical shifts of the central metal provided evidence that the triphenylgermanium and silicon oxinates are uncoordinated while the triphenyltin and lead oxinates are five-coordinate. These conclusions are confirmed by molecular modeling, 15 N chemical shifts and the metal– 13 C one bond coupling constants at the ipso carbon. The NMR data provides evidence that the strength of the interaction of the nitrogen with the metal increases from silicon and germanium to lead. Two peaks in the 5-coordinate region of the 207 Pb NMR spectra can be rationalized with the postulate that strong interaction with lead produces two geometrical isomers. Two peaks were also present in the 5-coordinate region of the 119 Sn NMR spectra at low temperatures indicating a rapid exchange between the two geometrical isomers at room temperature.