Ongoing Input Research Articles

Protocol for the next generation brain health survey on attitudes, understanding, and exposure to brain health risk factors in young adults globally

BackgroundEvidence suggests that risk factors for Alzheimer’s disease and related dementias (ADRD) are at least partially modifiable, and that lifestyle risk accumulates as we age. However, the prevalence and impact of lifestyle-related risk factors in young adulthood (i.e., 18–39 years) remain poorly understood, with some risk factors that are developed in early adulthood being difficult to remove and reverse at midlife. The Next Generation (NextGen) Brain Health Survey is the first of its kind to be designed specifically for young adults, with the aim of exploring attitudes, understanding and exposure to ADRD risk and protective factors in this life stage.MethodsThe NextGen survey is an international, cross-sectional survey of young adults aged 18–39 years. The survey was developed in three phases with ongoing input from public advisors (i.e., young adults from Europe, North America, and Africa). First, we adapted items from existing literature for the target population. Second, we conducted focus groups with young adults to review the items and explore new themes. Third, we piloted the survey in an international network, including brain health researchers, clinicians, and advocacy groups. Feedback was integrated to create the finalized survey.DiscussionThe NextGen survey is conducted online and made available to individuals aged 18–39 years internationally. Results will contribute new knowledge about young adults and ADRD risk exposure before mid-life, including much-needed evidence in populations that are traditionally under-represented in research. Findings will help identify mediators and modifiers of associations between knowledge, attitudes, and risk exposure, and provide the basis for comparison with middle-aged and older populations.

Bioaccumulation in fish (Cyprinodon variegatus) during rejuvenations of a thin active cap over field-aged PCB contaminated sediment: The effect of clean versus contaminated ongoing influx

Repeated addition of activated carbon (AC) via the water column was applied to rejuvenate sorption capacity of thin AC-amended sand caps placed over polychlorinated biphenyl- (PCB) contaminated marine bed sediment receiving ongoing input of sediment (contaminated or clean) in mesocosms. Bioaccumulation of PCBs in sheepshead minnows (Cyprinodon variegatus) from bed sediment was reduced by repeated application of rejuvenating AC when the ongoing input was contaminated. However, when the input sediment was clean, the novel AC addition increased fish uptake of bedded PCBs in the first 60-days of the 90-day experiments. The 79 % increase of bedded PCB bioaccumulation in fish, for clean versus contaminated inputs, was statistically significant (p < 0.05) in experiments where the rejuvenating AC was applied. Equilibrium concentrations in low-density polyethylene (LDPE) passive samplers did not fully explain bioaccumulation. Field implications of this research include setting appropriate temporal expectations of this novel remediation strategy regarding the primary desired effect (i.e., PCB bioavailability reductions).

Obstacles to an Effective Transition to Adult Services for Patients with Hirschsprung Disease.

A growing number of patients with Hirschsprung disease are reaching adulthood, of whom a significant minority will require ongoing input from healthcare providers. In order to ensure patients receive the best care possible, it is essential to transition patients appropriately to adult services. This article describes the unmet need and some of the obstacles to this process and explores potential solutions, drawing on model examples for transitional care.

Research data use in a digital society: a deliberative public engagement.

Sources of public and private data and ways to link them continue to evolve. This offers new opportunities for research, and new reasons for data-holding organisations to form partnerships. While research using these data can be beneficial, there is also a potential for negative consequences for some individuals or groups, including unintended or unanticipated effects. It is important to consult the public on how we might achieve both opportunities to link different types of data for research purposes, and protections against the misuse of data and the possibility of negative consequences. Combining data sources for research was the topic of four days of deliberation held in British Columbia, Canada in late 2019. Public deliberation events bring diverse groups of people together to give direct input to policy makers, through carefully structured in-depth discussion on issues that are controversial and/or a source of public concern. Participants discussed whether data from electronic medical records should be used for research purposes, whether it is acceptable to combine data from public and private sources, who should authorise its use in research, and how a public advisory group on data use might be structured. Over four days, 29 residents of BC developed 17 deliberative conclusions that can be grouped into four broad topic areas: balancing benefit and potential harms when linking data; the protections that are expected to govern use of data; the type of authorisation required; and how the public should be involved in an ongoing way. Overall, the public is very supportive of research as long as oversight and controls are in place, including ongoing input from members of the public. Deliberative conclusions from this event provide essential public input on the use of linked data for research, in particular when those data come from multiple sources. This is important information as policy-makers continue to develop legislation and practices around the use and linkage of both public and private sources of data.

When and why does motor preparation arise in recurrent neural network models of motor control?

During delayed ballistic reaches, motor areas consistently display movement-specific activity patterns prior to movement onset. It is unclear why these patterns arise: while they have been proposed to seed an initial neural state from which the movement unfolds, recent experiments have uncovered the presence and necessity of ongoing inputs during movement, which may lessen the need for careful initialization. Here, we modeled the motor cortex as an input-driven dynamical system, and we asked what the optimal way to control this system to perform fast delayed reaches is. We find that delay-period inputs consistently arise in an optimally controlled model of M1. By studying a variety of network architectures, we could dissect and predict the situations in which it is beneficial for a network to prepare. Finally, we show that optimal input-driven control of neural dynamics gives rise to multiple phases of preparation during reach sequences, providing a novel explanation for experimentally observed features of monkey M1 activity in double reaching.

Manipulating attentional priority creates a trade-off between memory and sensory representations in human visual cortex.

People often remember visual information over brief delays while actively engaging with ongoing inputs from the surrounding visual environment. Depending on the situation, one might prioritize mnemonic contents (i.e., remembering details of a past event), or preferentially attend sensory inputs (i.e., minding traffic while crossing a street). Previous fMRI work has shown that early sensory regions can simultaneously represent both mnemonic and passively viewed sensory information. Here we test the limits of such simultaneity by manipulating attention towards sensory distractors during a working memory task performed by human subjects during fMRI scanning. Participants remembered the orientation of a target grating while a distractor grating was shown during the middle portion of the memory delay. Critically, there were several subtle changes in the contrast and the orientation of the distractor, and participants were cued to either ignore the distractor, detect a change in contrast, or detect a change in orientation. Despite sensory stimulation being matched in all three conditions, the fidelity of memory representations in early visual cortex was highest when the distractor was ignored, intermediate when participants attended distractor contrast, and lowest when participants attended the orientation of the distractor during the delay. In contrast, the fidelity of distractor representations was lowest when ignoring the distractor, intermediate when attending distractor-contrast, and highest when attending distractor-orientation. These data suggest a trade-off in early sensory representations when engaging top-down feedback to attend both seen and remembered features and may partially explain memory failures that occur when subjects are distracted by external events.

Paracentral Acute Middle Maculopathy and Risk of Cardiovascular Disease, Stroke, and Death: A Longitudinal Study

To evaluate the risk of acute cardiovascular events (CVE), including cardiovascular diseases, cerebrovascular diseases, and all-cause mortality in patients with paracentral acute middle maculopathy (PAMM). Retrospective cohort study METHODS: We studied 43 individuals with optical coherence tomography -documented PAMM attending Moorfields Eye Hospital between January 2014 and June 2021. We excluded patients with preceding (< 2 years) major adverse cardiac events. We stratified patients by age (<50 years & ≥50 years) and whether associated with retinal vascular diseases (RVD) or isolated (iPAMM). We assessed risk factors, clinical characteristics, and visual prognosis of the patients. CVE risk was estimated using Kaplan-Meier curves, the log-rank test, and Cox proportional hazards regression. In young patients with iPAMM patients (n=12), underlying predisposing factors included six (50%) sickle cell disease and five (41.6%) others, including breakthrough bleeding in pregnancy, migraine, genetic cardiomyopathy, amphetamine use; among those with PAMM+RVD (n=12) one (9%) had a vascular disorder, and four (44.4%) oral contraceptive use. In the older group of 20 patients, 15 (75%) had at least one coronary risk factor. During a median follow-up of 14 months (range 12-54), older subjects with iPAMM had a higher risk of developing CVE than those with PAMM+RVD (p<0.001). Notably, iPAMM displayed a significantly earlier peak in peri-PAMM CVE risk compared to PAMM+RVD (median: 1 month, range 1-40 months vs. 36 months, range 12-54 months). Relative to those with PAMM+RVD, risk of CVE was significantly higher in patients with iPAMM, adjusted for age and sex (hazard ratio: 6.37, 95% Confidence Interval 1.68-24.14, p=0.017). No young patients experienced adverse CVE. At baseline, older iPAMM patients mean best corrected visual acuity of 0.7 (0-1.8) LogMAR, which improved significantly to 0.2 (0-1.30) LogMAR at the latest visit (p=0.033). Young individuals with iPAMM have a higher prevalence of predisposing factors compared to those presenting with combined PAMM+RVD. Older patients with iPAMM had a higher risk of CVE than those with PAMM+RVD, especially in the peri-onset timeframe. This suggests the need for a prompt cardiovascular assessment to rule out systemic etiologies and optimize cardiovascular risk factors, in addition to ongoing ophthalmology input.

Touch Helps Hearing: Evidence From Continuous Audio-Tactile Stimulation.

Identifying target sounds in challenging environments is crucial for daily experiences. It is important to note that it can be enhanced by nonauditory stimuli, for example, through lip-reading in an ongoing conversation. However, how tactile stimuli affect auditory processing is still relatively unclear. Recent studies have shown that brief tactile stimuli can reliably facilitate auditory perception, while studies using longer-lasting audio-tactile stimulation yielded conflicting results. This study aimed to investigate the impact of ongoing pulsating tactile stimulation on basic auditory processing. In experiment 1, the electroencephalogram (EEG) was recorded while 24 participants performed a loudness-discrimination task on a 4-Hz modulated tone-in-noise and received either in-phase, anti-phase, or no 4-Hz electrotactile stimulation above the median nerve. In experiment 2, another 24 participants were presented with the same tactile stimulation as before, but performed a tone-in-noise detection task while their selective auditory attention was manipulated. We found that in-phase tactile stimulation enhanced EEG responses to the tone, whereas anti-phase tactile stimulation suppressed these responses. No corresponding tactile effects on loudness-discrimination performance were observed in experiment 1. Using a yes/no paradigm in experiment 2, we found that in-phase tactile stimulation, but not anti-phase tactile stimulation, improved detection thresholds. Selective attention also improved thresholds but did not modulate the observed benefit from in-phase tactile stimulation. Our study highlights that ongoing in-phase tactile input can enhance basic auditory processing as reflected in scalp EEG and detection thresholds. This might have implications for the development of hearing enhancement technologies and interventions.

The benefits and drawbacks of writing a thesis as an English major student

To graduate from most colleges, English majors are required to complete a research paper, also called a diploma paper. However, when writing a diploma paper in their last year of study, English language learners discover several advantages and disadvantages. This article sought to determine the advantages and disadvantages of writing a Bachelor of Arts thesis for English majors upon completion of their studies, as well as the extent to which composition classes provided during the final semester aid them. As part of this study, eight additional university students participated in a focus group, and thirty-one students were invited to complete a questionnaire. The findings indicate that writing a thesis allows you to follow your interests, get ongoing input from your mentor, and build your portfolio with well-written work that the committee members will study. Nevertheless, there are also some drawbacks that students face while writing a paper, such as managing information, the use of generalizations, and not having enough time to write it. Finally, this study suggests that having a course that prepares students to write a thesis at the end of their studies is beneficial to students as it mentors them and teaches a step-by-step writing thesis. Keywords: Composition course; diploma paper; English majors; thesis.

Designing the Food and Lifestyle Information Program (FLIP) culinary nutrition intervention for adults with mild-to-moderate intellectual disability.

People with intellectual disability have diverse needs and experience higher rates of diet-related chronic disease such as type 2 diabetes compared to people without disability. However, they are infrequently included in development and implementation of interventions to address diet-related chronic disease. The present study describes the process to plan, develop and refine the Food and Lifestyle Information Program (FLIP) culinary nutrition intervention for adults with mild-to-moderate intellectual disability. The project was initiated by a disability service provider and was guided by the Cook-Ed™ model and inclusive research principles. Initially the disability service provider and academic research team members co-designed pre-program consultation and pilot studies, and draft program resources. Pre-program consultation explored paid disability support worker (n = 10) perceptions of cooking and food skills, nutrition priorities and optimal program format, which guided further program drafting. Program resources and pilot study design were further developed and refined with co-researchers with lived experience of intellectual disability who attended a pre-pilot and then pilot study sessions as remunerated co-facilitators. Key characteristics of the FLIP intervention arising from pre-program consultation included providing cooking task instruction in small steps, enabling participant choice in program activities, promoting an inclusive and social atmosphere, and providing paper-based resources. FLIP intervention co-design was enabled through ongoing input from the disability service provider and people with lived experience of intellectual disability. Evaluation of FLIP feasibility, acceptability and preliminary effectiveness to improve diet-related health is underway.

Neonicotinoid retention and transport in a maize cropping system with contour prairie strips

Conservation areas established in agricultural fields can provide habitat for native organisms, but they also have the potential to accumulate and expose organisms to insecticides. Prairie strips are zones of cropland that have been converted to native prairie vegetation. Prairie strips increase biodiversity and reduce nutrient runoff, but they may also accumulate insecticides that endanger visiting organisms or facilitate the movement of insecticides across the landscape. In a study of paired catchments with ongoing neonicotinoid inputs, we measured the impact of prairie strips (10 % of cropland) on the accumulation and movement of the neonicotinoid insecticide clothianidin (CLO) into surface soil, deep soil, plant tissue, and groundwater across multiple slope positions during three phases of a maize growing season. While CLO accumulates in maize leaf tissue midseason following neonicotinoid application, we did not find evidence that prairie plant species in prairie strips accumulate CLO at concentrations lethal to pollinator insects. We also found that downslope soils contained the highest CLO concentrations in both catchments, showing that prairie strips did not eliminate downslope insecticide runoff. Our study adds to the existing literature examining prairie strip effects on downslope agrochemical transport, showing that when prairie strips are planted in cropland with ongoing neonicotinoid inputs, they can provide safe, low-insecticide habitat for visiting organisms amidst their other services, but may not reduce offsite insecticide runoff.

A multiscale sensorimotor model of experience-dependent behavior in a minimal organism

To survive in ever-changing environments, living organisms need to continuously combine the ongoing external inputs they receive, representing present conditions, with their dynamical internal state, which includes influences of past experiences. It is still unclear in general, however 1) how this happens at the molecular and cellular levels and 2) how the corresponding molecular and cellular processes are integrated with the behavioral responses of the organism. Here, we address these issues by modeling mathematically a particular behavioral paradigm in a minimal model organism, namely chemotaxis in the nematode C. elegans. Specifically, we use a long-standing collection of elegant experiments on salt chemotaxis in this animal, in which the migration direction varies depending on its previous experience. Our model integrates the molecular, cellular, and organismal levels to reproduce the experimentally observed experience-dependent behavior. The model proposes specific molecular mechanisms for the encoding of current conditions and past experiences in key neurons associated with this response, predicting the behavior of various mutants associated with those molecular circuits.

Crop Suggestive System through Soil Property Characterization using IoT

The emergence of Internet of Things (IoT) technology has brought about a significant transformation in multiple sectors, including agriculture, by facilitating data- driven decision-making and real-time monitoring. In this work, we present a novel Internet of Things (IoT) agricultural suggestion system that uses soil property characterization to enable accurate crop management and selection. Our technology seeks to help farmers optimize agricultural yields while minimizing resource usage and environmental impact by combining IoT sensors with modern data analytics. Our system's primary feature is the installation of Internet of Things (IoT) sensors throughout fields to continuously collect data on important soil attributes. These characteristics include salinity, pH values, temperature, moisture content, nutrient concentrations, and organic matter content. This data is wirelessly transmitted by the sensors to a cloud platform or centralized database, where it is thoroughly analyzed. One of the many difficulties facing modern agriculture is choosing crops optimally to maximize yields while minimizing environmental effect. Conventional crop selection techniques sometimes rely on manual soil testing or broad suggestions, which produces less than ideal results and inefficiencies. A novel method using the Internet of Things (IoT) is suggested to address this: a Crop Suggestive System using Soil Property Characterization (CSS-SPC). Using Internet of Things sensors, this system continuously monitors and analyzes soil parameters in real-time, giving farmers customized crop recommendations depending on the unique conditions of their property. Crop rotations, soil amendments, and irrigation schedule optimization are made possible for farmers through smooth planning and decision-making that ismade possible by integration with current farm management systems. Farmers' ongoing input on the effectiveness ofsuggested crops guarantees the system's accuracy and continued applicability

Mindfulness and Emotional Intelligence: A Study on Millennials on Hospitality

In software development, dependability and quality are critical. A Bug Tracking System (BTS) designed specifically for large-scale software projects is introduced in this significant project with the goal of streamlining bug tracking, reporting, detection, and resolution. The system provides secure authentication, a backend database that is reliable, and an easy-to-use web interface. Using cutting-edge web technologies, it offers critical features including automated notifications, progress tracking, severity assignment, and thorough bug reporting together with user-friendly interfaces for a range of user roles. Tools for data visualization help identify defect patterns and monitor projects. The project follows best practices recommended by the industry for requirements analysis, design, implementation, testing, and deployment, and it solicits ongoing input. The result is a thorough BTS that addresses defect management difficulties. Thorough testing and assessment in comparison to standards confirms its efficacy. This approach could have a big impact on software development, improving user satisfaction and quality. Furthermore, issues with bug tracking are covered, including distributed team communication, scalability, and automation balancing. Proposals for strategies to address these issues are grounded in scholarly research and professional opinions. This summary highlights the critical role that bug tracking systems play in contemporary software development, making it an invaluable tool for researchers, practitioners, and teams looking to improve bug tracking procedures and raise the caliber and effectiveness of the software development lifecycle. Keywords— Bug Tracking System, Software Development, Defect Management, Quality Assurance, Automation, Collaboration, Large-scale Projects.

The EV antibody database: An interactive database of curated antibodies for extracellular vesicle and nanoparticle research

Antibodies are critical tools for research into extracellular vesicles (EVs) and other extracellular nanoparticles (ENPs), where they can be used for their identification, characterization, and isolation. However, the lack of a centralized antibody platform where researchers can share validation results thus minimizing wasted personnel time and reagents, has been a significant obstacle. Moreover, because the performance of antibodies varies among assay types and conditions, detailed information on assay variables and protocols is also of value. To facilitate sharing of results on antibodies that are relevant to EV/ENP research, the EV Antibody Database has been developed by the investigators of the Extracellular RNA Communication Consortium (ERCC). Hosted by the ExRNA Portal (https://exrna.org/resources/evabdb/), this interactive database aggregates and shares results from antibodies that have been tested by research groups in the EV/ENP field. Currently, the EV Antibody Database includes modules for antibodies tested for western Blot, EV Flow Cytometry, and EV Sandwich Assays, and holds 110 records contributed by 6 laboratories from the ERCC. Detailed information on antibody sources, assay conditions, and results is provided, including negative results. We encourage ongoing expert input and community feedback to enhance the database's utility, making it a valuable resource for comprehensive validation data on antibodies and protocols in EV biology.

Leadership and Challenges: A Phenomenological Exploration of Teacher-Principals in the Philippines

This qualitative study employed a descriptive phenomenological approach to explore the experiences of school principals who also serve as teachers in Leyte and Southern Leyte, Philippines. Thirty school heads, selected based on experience, marital status, and willingness to participate, provided insights through a Pre-Survey form and semi-structured interviews. Thematic analysis (Colaizzi's method) revealed challenges in teaching strategies, behavior management, technology integration, and parental communication, while strategic management skills included prioritization, planning, and stress management. Findings have implications for policy development, professional development programs, and curriculum design, benefiting scholars, practitioners, and policymakers. The study highlights the unique experiences of teacher-principals, contributing to scholarly dialogue on educational leadership. Recommendations emphasize ongoing strategic management training, self-assessment, and collaborative input. By exploring innovative teaching strategies and sharing insights, teacher-principals can enhance collective educational knowledge. This study offers valuable perspectives on educational leadership, guiding policies and practices for a more effective and responsive educational system.

The structural analysis of the farming systems resilience after the Covid-19 pandemic in West Timor, Indonesia

Although Indonesia has recorded good performance in its national economic development, especially in the agriculture sector during the Covid-19 pandemic, the impact of the pandemic on farming and food systems has not been evaluated yet. This study has evaluated the resilience of the two dominant existing farming systems in West Timor, i.e. (i) wetland farming system and (ii) dryland farming system. This research aims to understand the resilience of farming after the Covid-19 pandemic and to develop strategic policies that could be adopted to increase the resilience of the farming system in West Timor. A quantitative analysis using the Structural Equation Modelling (SEM) was employed to evaluate the relationship and impact of the following seven generic aspects: labour movement, sustainability, economy, socio- culture, output markets, input markets, farming system resilience, and 27 reflective indicators. The analysis shows that dryland farming systems are more resilient than wetland farming systems. It might be understood from the size of the regression coefficient, as the impact of exogenous construct variables of the environment, socioculture, input, and output on the resilience of dryland farming systems is more significant than on wetlands. Economic performance rather than labour movement factors will create better resilience of farming systems for wetland or dryland after the Covid-19 pandemic. Finally, the economic recovery process and the ongoing input supply mechanism after the Covid-19 pandemic have increased the resilience of the dryland food system more than the resilience of the wetland farming system.

Effect of Different Types of Organic Manure on Oil and Fatty Acid Accumulation and Desaturase Gene Expression of Oilseed Flax in the Dry Areas of the Loess Plateau of China

In order to understand the mechanism of action of oil and fatty acid accumulation and desaturase gene expression in how oilseed flax responds to different fertilization conditions, a three-factor split-plot experiment was conducted to investigate the accumulation trends of oil and fatty acids. The results revealed that soluble sugar (SS) and sucrose (SUC) contents decreased, and the starch (ST) content increased gradually with the grain development and maturity of oilseed flax. The application of sheep manure promoted the accumulation of nonstructural carbohydrates in the grains. Soluble sugar (SS) and sucrose (SUC) contents were negatively correlated with the oil content. Compared with chemical fertilizer, organic manure decreased the total saturated fatty acid but increased the unsaturated fatty acid. Organic manure significantly upregulated the expression of various genes, and fad2a gene expression was higher with the 5.8 t ha−1 chicken manure treatment. The 25 t ha−1 sheep manure treatment was more conducive to the expression of fad3a and fad3b genes and promoted the accumulation of linolenic acid (LIN), and the LIN content increased by 0.64–3.90% compared with other treatments. Consequently, an ongoing anthropogenic sheep manure input may impact the regulation of grain oil quality and yield per unit area.

Single-shot liposomal bupivacaine in place of rectus sheath catheters to provide non-opiate analgesia after laparotomy: a quality improvement project to reduce the need for ongoing nursing input

Opioid-sparing pain management is an integral component of enhanced recovery after colonic and rectal surgery. In our hospital, rectus sheath catheters (RSCs) are routinely placed during emergency laparotomy for colorectal...

Overcoming structural inequity in healthcare for people living with substance use issues and mental illness.

Structural stigma arbitrarily limits the opportunities and/or constrains the right of persons with lived and living experience of mental health problems and illnesses and/or substance use (PWLLE). While it often occurs unknowingly, it creates inequities embedded in the fabric of our social institutions, organizations, and our shared ways of thinking and acting. In health care, structural stigma exists in the laws, policies, practices, and models of care that deprioritize, dehumanize, and fail to treat PWLLE as equitably as those with physical health concerns. Such unfairness leads to overall poorer healthcare access, less availability of evidence-based services, and lower quality of care for these individuals, whether their concerns relate to physical health, mental health, and/or substance use.&#x0D; In 2019, the Mental Health Commission of Canada (MHCC) set out on a multi-year project to examine structural stigma in health-care settings and develop tools and approaches for dismantling it. Through this work, the MHCC has published a literature review, produced a conceptual framework for dismantling structural stigma in health systems, and co-developed a measure with PWLLE to assess structural stigma in different healthcare settings and contexts. A major part of this work includes engaging with PWLLE and health leaders to better understand the priorities and strategies for successfully addressing structural stigma within the health system. &#x0D; The presentation will showcase one such engagement project, known as the Champions and Changemakers project. The goal was to learn and work with champions within the Canadian health system (health providers, leaders, and decision makers, PWLLE, other stakeholders) who were implementing innovations to enhance the equity of care for PWLLE- including changes to service delivery, models of care, training models, as well as policy, advocacy and leadership and power-sharing structures. Through this collaboration process, we expanded knowledge of the key ingredients and processes for structural change (features, strategies, context, mechanisms, outcomes), and co-designed an implementation guide that can be used to provide guidance to others interested in reducing structural stigma within their own organizations. The collaboration and co-design process involved several group and one-on-one interviews and stakeholder meetings, facilitated participatory workshops with all stakeholders, and ongoing input, feedback, and review from all stakeholders in the building of the guide.&#x0D; &#x0D; In addition to the knowledge products and relationship building that came from this project, the other main impact is that the MHCC is now working to build a sustainable community of practice to promote and support ongoing work and efforts in addressing structural stigma in the Canadian healthcare context.&#x0D; Learning Objectives:&#x0D; &#x0D; Describe and understand Structural Stigma and how it creates inequity in healthcare for PWLLE;&#x0D; Demonstrate an understanding of key elements of select promising practices that support improved access to- and quality of- health care for PWLLE;&#x0D; Identify opportunities to disrupt and dismantle structural stigma, and;&#x0D; Understand the next steps to continue to address mental health and substance use-related structural stigma in health-care settings.&#x0D; &#x0D; Audience: Health-care leaders, administrators, providers, policymakers, people with lived and living experience and their caregivers and/or family of choice.