The use of communities of practice (CoP) to support the application of knowledge in improved geriatric care practice is not widely understood. This case study’s aim was to gain a deeper understanding of the knowledge-to-action (KTA) processes of a CoP focused on environmental design, to improve how persons with dementia find their way around in long-term care (LTC) homes. Qualitative data were collected (key informant interviews, observations, and document review), and analysed using emergent coding. CoP members contributed extensive knowledge to the KTA process characterized by the following themes: team dynamics, employing a structured process, technology use, varied forms of knowledge, and a clear initiative. The study’s CoP effectively synthesized and translated knowledge into practical tools to inform changes in practice, programs, and policy on dementia care. More research is needed on how to involve patients and caregivers in the KTA processes, and to ensure that practical application of knowledge has financial and policy support

Financial inclusion depends on providing adjusted services for citizens with disclosed vulnerabilities. At the same time, the financial industry needs to adhere to a strict regulatory framework, which is often in conflict with the desire for inclusive, adaptive, and privacy-preserving services. In this article we study how this tension impacts the deployment of privacy-sensitive technologies aimed at financial inclusion. We conduct a qualitative study with banking experts to understand their perspectives on service development for financial inclusion. We build and demonstrate a prototype solution based on open source decentralized identifiers and verifiable credentials software and report on feedback from the banking experts on this system. The technology is promising thanks to its selective disclosure of vulnerabilities to the full control of the individual. This supports GDPR requirements, but at the same time, there is a clear tension between introducing these technologies and fulfilling other regulatory requirements, particularly with respect to “Know Your Customer.” We consider the policy implications stemming from these tensions and provide guidelines for the further design of related technologies.

Background: Electronic hand hygiene monitoring systems (EHHMSs) are being increasingly utilized to improve hand hygiene outcomes. Following the implementation of an EHHMS at a large, academic medical center, an interdisciplinary team developed a web-based survey to gather information on employee’s perceptions and behaviors surrounding the EHHMS. Methods: In total, 1,273 complete responses were collected. Responses were analyzed using Stata version 16 statistical software with 2-tailed tests and .05 significance level. Multivariate logistic regression models were constructed to examine factors associated with negative perceptions of the EHHMS and of wearing the EHHMS radiofrequency identification (RFID) badge. Supporting qualitative analysis was performed using Atlas.ti version 9 software. Results: The general sentiment toward the monitoring system was neutral (38%) to negative (37%). The same was true for respondents’ sentiments toward wearing the RFID badge. Of respondents who interact with the system, 48% feel that the system does not capture hand hygiene data accurately. The EHHMS had limited influence on employee’s hand hygiene habits: 27% significant influence and 54% little-to-no influence. Respondents of younger age, those employed as a registered nurse, scientist, physician, or master’s level clinician, and those working at the satellite hospital were significantly more likely to have negative perceptions of the EHHMS. Negative perceptions were also significantly more likely among respondents familiar with the institution’s hand hygiene policy and those who had a negative opinion of seeing the hand hygiene data of others. Negative perceptions of the EHHMS RFID badge were significantly more likely among respondents of younger age, those employed as a registered nurse, scientist, physician, or master’s level clinician, those working at the satellite hospital, and those with a negative perception of seeing the hand hygiene data of others. Employment in a role providing direct patient care and those employed at the institution for >1 year were also significantly more likely to have a negative perception. Conclusions: Negative and neutral opinions dominate perceptions of the EHHMS considered in this analysis. Respondents expressed concerns with accuracy of the EHHMS data collection. The system’s limited influence is likely a result of limited familiarity, limited performance feedback, and employee frustration and concerns. These findings provide opportunities for improvement in future implementation of EHHMS. Based on these results, implementation of EHHMS would be best be supported by coordinated backing from administration and leadership, advanced planning and education, and frequent, effective communication. Additional research and evaluation are required to optimize implementation of electronic hand hygiene monitoring systems, with the goal of improving hand hygiene outcomes.

Funding: None

Disclosures: None

COVID-19 has disproportionally impacted older adults, and has highlighted many issues, including extreme deficiencies in Canadian long-term care homes and gaps in home and community care services for older adults. In recent years, there has been a push towards better patient and family engagement in health system research, and with the onset of the pandemic, engaging older adults in research and policy planning is more important than ever. In this article, we describe the Seniors Helping as Research Partners (SHARP) approach to engagement with older adults as an example of how partnerships that engage older adults in the development of research aims and processes can help to ensure that future research meets the needs of older adults. SHARP members highlighted a number of areas for future COVID-19 research such as improvements to long-term care, enhancing access to home and community care, and a focus on aging and social isolation.

Substantial progress has been made in the standardization of nomenclature for paediatric and congenital cardiac care. In 1936, Maude Abbott published her Atlas of Congenital Cardiac Disease, which was the first formal attempt to classify congenital heart disease. The International Paediatric and Congenital Cardiac Code (IPCCC) is now utilized worldwide and has most recently become the paediatric and congenital cardiac component of the Eleventh Revision of the International Classification of Diseases (ICD-11). The most recent publication of the IPCCC was in 2017. This manuscript provides an updated 2021 version of the IPCCC.

The International Society for Nomenclature of Paediatric and Congenital Heart Disease (ISNPCHD), in collaboration with the World Health Organization (WHO), developed the paediatric and congenital cardiac nomenclature that is now within the eleventh version of the International Classification of Diseases (ICD-11). This unification of IPCCC and ICD-11 is the IPCCC ICD-11 Nomenclature and is the first time that the clinical nomenclature for paediatric and congenital cardiac care and the administrative nomenclature for paediatric and congenital cardiac care are harmonized. The resultant congenital cardiac component of ICD-11 was increased from 29 congenital cardiac codes in ICD-9 and 73 congenital cardiac codes in ICD-10 to 318 codes submitted by ISNPCHD through 2018 for incorporation into ICD-11. After these 318 terms were incorporated into ICD-11 in 2018, the WHO ICD-11 team added an additional 49 terms, some of which are acceptable legacy terms from ICD-10, while others provide greater granularity than the ISNPCHD thought was originally acceptable. Thus, the total number of paediatric and congenital cardiac terms in ICD-11 is 367. In this manuscript, we describe and review the terminology, hierarchy, and definitions of the IPCCC ICD-11 Nomenclature. This article, therefore, presents a global system of nomenclature for paediatric and congenital cardiac care that unifies clinical and administrative nomenclature.

The members of ISNPCHD realize that the nomenclature published in this manuscript will continue to evolve. The version of the IPCCC that was published in 2017 has evolved and changed, and it is now replaced by this 2021 version. In the future, ISNPCHD will again publish updated versions of IPCCC, as IPCCC continues to evolve.

Enrichment of the heavy rare earth elements (HREE) in carbonatites is rare as carbonatite petrogenesis favours the light (L)REE. We describe HREE enrichment in fenitized phonolite breccia, focusing on small satellite occurrences 1–2 km from the Songwe Hill carbonatite, Malawi. Within the breccia groundmass, a HREE-bearing mineral assemblage comprises xenotime, zircon, anatase/rutile and minor huttonite/thorite, as well as fluorite and apatite.

A genetic link between HREE mineralization and carbonatite emplacement is indicated by the presence of Sr-bearing carbonate veins, carbonatite xenoliths and extensive fenitization. We propose that the HREE are retained in hydrothermal fluids which are residually derived from a carbonatite after precipitation of LREE minerals. Brecciation provides a focusing conduit for such fluids, enabling HREE transport and xenotime precipitation in the fenite. Continued fluid–rock interaction leads to dissolution of HREE-bearing minerals and further precipitation of xenotime and huttonite/thorite.

At a maximum Y content of 3100 µg g−1, HREE concentrations in the presented example are not sufficient to constitute ore, but the similar composition and texture of these rocks to other cases of carbonatite-related HREE enrichment suggests that all form via a common mechanism linked to fenitization. Precipitation of HREE minerals only occurs where a pre-existing structure provides a focusing conduit for fenitizing fluids, reducing fluid – country-rock interaction. Enrichment of HREE and Th in fenite breccia serves as an indicator of fluid expulsion from a carbonatite, and may indicate the presence of LREE mineralization within the source carbonatite body at depth.

This article explores innovative praxis in Environmental and Sustainability Education (ESE) in four preservice teacher education programmes in Canada. ESE is finding its way into teacher education in a variety of innovative and interdisciplinary ways, as both part of mainstream programmes and in their co-curricular margins. Using a case study approach, each case builds on unique connections to Indigenous education, art education, cultural learning or educational gardening, which supports a variety of differing aspects in relation to ESE. These cases share a common theme of building relationships at the heart of ESE teaching and learning in the mainstream and the margins of the academy. Brought together through a Canadian network of faculty, researchers, policy-makers and community educators that was formed in 2016, these cases demonstrate a deep commitment and imaginative capacity for embedding ESE in Canada’s teacher education systems.