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Background climate change is a health emergency. Central to addressing this is understanding the carbon footprint of our daily life and work, in order to reduce it effectively. The coronavirus disease of 2019 (COVID-19) pandemic has brought about rapid change to clinical practice, most notably in use of virtual clinics and personal protective equipment (PPE). Aim to estimate the carbon footprint of a Geriatric Medicine clinic, including the effect of virtual consultation and PPE, in order to inform design of a service that addresses both the health of our patients and our environment. Method data from the Greenhouse Gas Protocol, NHS Carbon Footprint Plus and UK Government were used to estimate the carbon emissions per consultation. Values were calculated for virtual and face-to-face contact and applied to actual clinics both before and during the COVID-19 pandemic. Results the carbon footprint of a face-to-face clinic consultation is 4.82 kgCO2e, most of which is patient travel, followed by staff travel and use of PPE. The footprint of a virtual consultation is 0.99 kgCO2e, most of which is staff travel, followed by data use. Using our hybrid model for a single session clinic reduced our annual carbon footprint by an estimated 200 kgCO2e, roughly equivalent to a surgical operation. Discussion the COVID-19 pandemic has made us deliver services differently. The environmental benefits seen of moving to a partially virtual clinic highlight the importance of thinking beyond reverting to ‘business as usual’—instead deliberately retaining changes, which benefit the current and future health of our community.

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As curiosity grows around the potential of the next wave of technology -Linked Data -and early exemplars emerge exploiting its capabilities, the information world finally has the opportunity to exploit fully the richness of relationships between cultural artefacts. This has considerable potential for academics and students seeking to discover the precise nature of the complex relationship between, say, Homer's Odyssey and James Joyce's Ulysses. However, the ramifications extend beyond academia -a network that seamlessly directs the interested layperson from their current interest to works that are related in a defined way has transformative potential for cultural life.To date, there is no openly available or commercialized resource anywhere which surfaces such relationships. Yet cultural life constantly throws up new examples which need to be made more easily discoverable. There is scarcely a cult television programme these days without its obligatory, knowing references to popular culture and other texts, as viewers of The Simpsons will be aware. And observe the vast popularity, in all media, of the glamourous vampire: Edward Cullen of Twilight and his brethren emerge from complex transformations of the original, monstrous Dracula of Bram Stoker's seminal novel.In the pre-web era, there was only one type of information resource for discovering relationships between texts -the citation index. But these indexes covered only those texts with formal integral references, and even then, the precise relationship between the citing and the cited texts occasionally remained unclear. The advent of the web and BILL HUGHES

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Objectives: To satisfy requirements for continuing professional education, workforce demand for access to large-scale continuous professional education and micro-credential-style online courses is increasing. This study examined the Knowledge Translation (KT) outcomes for a short (2 h) online course about support at night for people living with dementia (Bedtime to Breakfast), delivered at a national scale by the Dementia Training Australia (DTA). Methods: A sample of the first cohort of course completers was re-contacted after 3 months to complete a KT follow-up feedback survey (n = 161). In addition to potential practice impacts in three domains (Conceptual, Instrumental, Persuasive), respondents rated the level of Perceived Improvement in Quality of Care (PIQOC), using a positively packed global rating scale. Results: Overall, 93.8% of the respondents agreed that the course had made a difference to the support they had provided for people with dementia since the completion of the course. In addition to anticipated Conceptual impacts (e.g., change in knowledge), a range of Instrumental and Persuasive impacts were also reported, including workplace guidelines development and knowledge transfer to other staff. Tally counts for discrete KT outcomes were high (median 7/10) and explained 23% of the variance in PIQOC ratings. Conclusions: Online short courses delivered at a national scale are capable of supporting a range of translation-to-practice impacts, within the constraints of retrospective insight into personal practice change. Topics around self-assessed knowledge-to-practice and the value of positively packed rating scales for increasing variance in respondent feedback are discussed.

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