With increasing numbers of persons living with dementia and their higher rates of hospitalizations, it is necessary to ensure they receive appropriate and effective acute care; yet, acute care environments are often harmful for persons with dementia. There is a lack of dementia education for acute health care providers in Canada. Scotland presently delivers a dementia education program for health care providers, known as the Scottish National Dementia Champions Programme. The objective of this Policy and Practice Note is to present the collaborative work of Scottish experts and Canadian stakeholders to adapt the Dementia Champions Programme for use in Canada. This work to date includes: (a) an environmental scan of Canadian dementia education for acute health care providers; (b) key informant interviews; and, (c) findings from a two-day planning meeting. The results of this collaborative work can and are being used to inform the next steps to develop and pilot a Canadian dementia education program.

Health technology assessment (HTA) is commonly used to guide evidence-informed decisions to optimize resource use, prioritize policies, and support countries to achieve universal health coverage. Producing HTAs requires time, scientific expertise, and political commitment, but these are not available in all settings – especially in low- and middle-income countries (LMIC) where HTA processes may be less institutionalized. Transferring and adapting existing HTAs to local settings may offer a solution while reducing duplication efforts. This scoping review aims to provide an overview of tools, methods, approaches, and considerations which can aid HTA transfers. We systematically searched (from 2005 to 2020) six databases and, using predefined inclusion criteria, included twenty-two studies. Data extraction followed a structured process, while synthesis was more iterative. We identified a common approach for HTA transfers. It follows the de novo process of undertaking original HTAs, but with additional steps to assess relevance (applicability), quality, and transferability, as well as steps to adapt parameters where necessary. The EUnetHTA Adaptation Toolkit was the only tool that provided guidance for adapting multiple HTA domains. Other tools were specific to systematic reviews (n = 1) or economic evaluations (n = 12), where one provided guidance for systematic reviews of economic evaluations. Eight papers reported transferring an HTA, with only one transferring to an LMIC. Finally, we reported issues that may facilitate or hinder transferability. In conclusion, we identified fourteen transfer approaches in the form of guidance or checklists, but harmonized and pragmatic guidance for HTA transfers to suit settings with limited HTA capacity seems warranted.

The evolution of midwater sediment plumes associated with deep-sea mining activities is investigated in the passive-transport phase using a simplified advection–diffusion-settling model. Key metrics that characterize the extent of plumes are defined based on a concentration threshold. Namely, we consider the volume flux of fluid that ever exceeds a concentration threshold, the furthest distance from and maximum depth below the intrusion where the plume exceeds the threshold, and the instantaneous volume of fluid in excess of the threshold. Formulas are derived for the metrics that provide insight into the parameters that most strongly affect the extent of the plume. The model is applied to a reference deep-sea mining scenario around which key parameters are varied. The results provide some sense of scale for deep-sea mining midwater plumes, but more significantly demonstrate the importance of the parameters that influence the evolution of midwater plumes. The model shows that the discharge mass flow rate and the concentration threshold play an equal and opposite role on setting the extent of the plume. Ambient ocean turbulence and the settling velocity distribution of particles play a lesser yet significant role on setting the extent, and can influence different metrics in opposing ways.

We develop and investigate an advection–diffusion-settling model of deep-sea mining collector plumes, building on the analysis of midwater plumes in Part 1. In the case of collector plumes, deposition plays a predominant role in controlling the mass of sediment in suspension, and thus on setting the extent of the plume. We first discuss the competition between settling, which leads to deposition, and vertical turbulent diffusion, which stretches the plume vertically and reduces deposition. The time evolution of the concentration at the seabed is found to be a highly nonlinear function of time that depends non-trivially on the ratio of diffusion to settling time scales. This has direct implications for the three extent metrics considered, namely the instantaneous area of the seabed where a deposition rate threshold is exceeded, the furthest distance from the discharge where the plume exceeds a concentration threshold and the volume flux of fluid in the water column that ever exceeds a concentration threshold. Unlike the midwater plume, the particle velocity distribution of the sediment has the greatest influence on the extent metrics. The turbulence levels experienced by the plume also markedly affects its extent. Expected variability of turbulence and particle settling velocity yields orders of magnitude changes in the extent metrics.

In this prospective, longitudinal study, we examined the risk factors for severe acute respiratory coronavirus virus 2 (SARS-CoV-2) infection among a cohort of chronic hemodialysis (HD) patients and healthcare personnel (HCPs) over a 6-month period. The risk of SARS-CoV-2 infection among HD patients and HCPs was consistently associated with a household member having SARS-CoV-2 infection.

My first encounter with David Wiggins’ thought occurred a few weeks before I took my undergraduate final examinations in Oxford in 1971. In Blackwell's Bookshop I came across a slim blue volume Identity and Spatio-Temporal Continuity. I purchased it and read it cover-to-cover the same day. It was immediately clear that this was contemporary writing in a different league from anything I had previously read on the topic.