Housing security is a likely indicator of loneliness  but there are few studies that focus specifically on the relationship between the two. This paper presents findings from a New Zealand Ageing Well National Science Challenge research programme that presents findings on the impacts of housing and living standards on loneliness and social exclusion. Method: This presentation will provide results from a study of 200+ Māori  aged 50 years and over. Key questions around loneliness and social isolation were co-created with the participants and responses compared with standard international scales to help identify both universal aspects of loneliness and culturally specific aspects. Questions relating to housing security, affordability, living standards and neighbourhood safety were also asked. Regression analysis was used to test the statistical significance of the various relationships between differing aspects of housing and loneliness.The results demonstrate statistically significant relationships between housing quality, affordability, living standards and neighbourhood suitability with both the universal and culturally specific scales of loneliness. Overall greater housing security and quality was shown to be negatively associated with loneliness, which suggests it contributes to the reduction of loneliness.Addressing the quality of social connections has often been seen as the key way to address loneliness. The results of this study suggest housing security and living standards play an important role in people’s perception of loneliness and their experience of it, as well.


This article has been corrected to fix a typo in the first sentence of the Results section:"A total of 177 patient files were reviewed during the study period, of which 87 patients met the inclusion criteria."The correct amount of patients meeting the inclusion criteria was in fact 89, not 87. This sentence has been amended to reflect this. The journal sincerely regrets that this typo was not caught and corrected prior to publication.


Emotional support has been consistently identified as a mechanism through which socioeconomic resources influence mental health outcomes. Despite emerging evidence that compassionate love has a beneficial effect on mental health, its distribution across levels of financial strain and subsequent role in mediating the effect of financial strain on later life mental health have yet to be examined.Based on our nationwide web-based survey of adults aged 50 years and older (n=1751), we conducted a mediation analysis to estimate the direct and indirect effects  of financial strain on depressive symptoms and anxiety.We documented a statistically significant overall effect of financial strain on depressive symptoms  and anxiety . We found a statistically significant path-specific effect  through compassionate love alone on depressive symptoms  and anxiety , but did not find effects for paths through emotional support. There was also a significant direct effect of financial strain on both depressive symptoms and anxiety. Discussion: Our study advances a new line of research by looking at the role of compassionate love in transmitting the effects of financial strain on mental health in later life. Findings suggest that the detrimental effect of financial hardship on mental health operates through its negative effect on the receipt of compassionate love, rather than by its impact on emotional support.


Incorrect corresponding authors were indicated in the published article while the correct version is shown above; Wei Zhang rather than Weilong Liu is the co-corresponding author.The Royal Society of Chemistry apologises for these errors and any consequent inconvenience to authors and readers.


As the number of older incarcerated persons grows, evaluating changes in their physical and mental health over time may be important for appropriate planning and needs assessment. Based on findings from the Aging Inmates’ Suicidal Ideation and Depression Study (Aging INSIDE), we will provide recommendations for assessing both objective and subjective physical function in older incarcerated persons. We will also discuss our experiences with assessing depression and suicidal ideation in this population and describe how the processes for collecting data needed to be modified during the COVID-19 pandemic. Those attending this session will learn about the pros and cons of using face-to-face assessments and mailed surveys to assess physical function and mental health among older persons in the prison setting and will learn how these outcomes may differ between those who have a life sentence versus those expecting to be released from incarceration in late life.


The pandemic further exacerbated racial and ethnic health disparities with BIPOC  communities experiencing significantly higher infection rates and higher hospitalization rates compared to White populations. Underlying medical conditions that disproportionately affect BIPOC populations  and social determinants of health  can account in large part for increased rates of morbidity and mortality. Within the long term services and supports (LTSS) continuum, health disparities exist in both who receives and provides care. The four papers in this Social Research Policy and Practice Presidential Symposium will highlight factors that result in health disparities across the LTSS continuum and propose possible policy and practice solutions to address the disparities. The first paper presented will be an overview of existing nursing home workforce issues that continue to impact disparities in the quality of resident care. The second paper presented examines nursing home resident quality of life disparities from a measurement perspective. The third paper will highlight issues on elder abuse and mistreatment of rural elders, American Indian and Alaskan Natives. The fourth paper will present recommendations from key stakeholders of the RAISE Family Caregiving Advisory Council on how to meet the needs of underrepresented groups  of family caregivers. Policy and practice solutions to reduce disparities will be discussed.


Our public health system is advancing activities to prioritize the health and well-being of older adults and recognizes the importance of policies to support us all as we age. Faculty will discuss national efforts underway to inform and support an age-friendly ecosystem.


Animatronic pets can improve psychosocial outcomes among older adults, but little is known about in-home use by Veterans living with dementia and the perceptions of informal caregivers regarding these tools. This quality improvement project examined the usability and acceptability of animatronic pets by community dwelling Veterans living with dementia from the perspective of informal caregivers. Usability and acceptability were examined through a structured telephone interview with 17 caregivers. Usability was operationalized as frequency of: pet use by the Veteran , and reminders provided by caregivers . Acceptability was defined as perceived benefit  and satisfaction (measured using acceptability tool with close and open-ended response items) as reported by caregivers. Results indicated high usability (71% of Veterans used the pet daily with reminders provided by 30% of caregivers) and acceptability ; Satisfaction: 94% of caregivers would continue to encourage use of the animatronic pet by the Veteran and recommend one to others). Open-ended responses suggest that they may be less satisfying to those who lost a real pet or did not have an affinity for pets earlier in life. Animatronic pets can be used with minimal assistance by Veterans with dementia and are acceptable to informal caregivers. As VA initiatives support provision of these pets, additional research is needed to examine their broader impact on Veterans living with dementia specifically.


Innovation distinguishes between a leader and a followerThis quote by Steve Jobs has defined the most admired surgeons in our discipline. Innovation fueled by surgical intelligence can expand the reach and performance of surgery beyond what was once considered possible. Endonasal surgery has shepherded skull base surgery into an era in which some of the radical open skull base exposures have been replaced with minimally invasive endonasal corridors, resulting in the concept of operative space being replaced by operative angle.Neurosurgical Focus: Video demonstrates an effort to push the boundaries of endonasal surgery for resection of an intradural lateral brainstem tumor. Although the retromastoid approach would have provided reasonable exposure of this lesion and potentially more aggressive resection while placing the VI nerve at less risk, the authors chose the endonasal route and were able to achieve a good result. In this video, the limitations of microsurgical instrumentation in carrying out intradural microsurgery within lateral trajectories in this operative space are evident. The angles of freedom become progressively more restrictive and challenge the microsurgical prowess of the surgeon to achieve maximal resection.The video titled the “Endoscopic Transnasal Resection of the CP Angle Schwannoma” by Kiyofuji and colleagues in this issue of Pushing the boundaries of minimally invasive surgical approaches at the expense of increased technical difficulty and its yield of resection frequently haunts us. Our ability to resect brainstem lesions via endonasal approaches is at its early stages and requires further evolution of endoscopic microinstrumentation and development of objective selection criteria. Ultimately, the operation is not only about how to get there but also, more importantly, about what to do when you are there. I am thankful to Dr. Kiyofuji and colleagues for their thought-provoking video.


The main challenges after getting started with a podcast will be growth and sustainability. This presentation will focus on promotion tactics for digital health podcasts, including the pros and cons of different hosting platforms and the use of social and academic networks for promotion. The importance of sustainability and consistency for growth will also be discussed, including some practical tips on productivity and team management for content producers.


Physical activity across the life course contributes to physical function and health in later life. Here we characterize a measure of physical activity history, newly implemented in participants of the Baltimore Longitudinal Study of Aging (n = 690). Participants selected one of four levels to describe activity during each decade of life from age ten to the present. Recalled levels of physical activity are positively associated with activity assessed in current and prior decade study visits, suggesting that the recalled estimates are consistent with historic activity. A summary measure based on ranking activity patterns was associated with measures of physical performance, muscle and fat areas quantified from computed tomography images as well as some indicators of homeostatic dysregulation (p <.05). The observed associations suggest that an estimate of physical activity across decades provides complementary information to estimates of current activity and reemphasizes the importance of consistently engaging in physical activity.


The U.S. is experiencing a demographic shift characterized by a significant segment of the population entering older age groups and beginning to require specialized eldercare, however little is known about the influence of demographic characteristics on individuals’ involvement with long-term care institutions. I use data from the Health and Retirement Study and logistic regression models to examine how the identities and resources people bring to the later stages of their lives influence their use of nursing homes. I find that individuals’ levels of human capital – measured through their educational attainment – have the strongest influence on their use of nursing homes, with individuals with college degrees having significant increases in the odds of reporting any nursing home stay and in the expected count of nursing home stays. I posit multiple pathways by which education could increase the likelihood of using institutionalized care, including through the social mobility of other family members as well as the ability to navigate healthcare resources and evaluate eldercare options. This detailed examination of the intersection between older ages, individual characteristics, the accumulation of different kinds of capital over the life course, and the involvement with formal care facilities provides valuable insight into the relationship between individuals and institutions across older ages and can inform policies attempting to prepare the landscape of formal care institutions for the influx of possible consumers.


Community-based health enhancing physical activity (PA) initiatives often lead to important mental health and wellbeing outcomes beyond improvements in physical activity levels. However, identifying what outcomes to measure and how to measure them is a challenge in community-based work. There is a lack of practical guidance on how to strengthen mental health and wellbeing outcomes within the context of PA initiatives. This presentation will share the work on a project with community based practitioners and mental health/physical activity experts which is being led by the HEPA Europe Working Group on HEPA promotion in socially disadvantaged groups, supported by WHO Europe.The presentation will engage participants in discussions around the following questions:What are the most important mental health and wellbeing outcomes of community-based health enhancing physical activity initiatives in Europe, and how can these best  be assessed for evaluation purposes?What are the needs of practitioners  working in communities to promote mental health through physical activity?


In Response: We thank McNamara and colleagues for their commentary (We believe that underestimations of the number of cases in France can be improved by increasing awareness of healthcare professionals through publications describing the risk factors associated with NTM HAI and by triggering clinical and microbiological vigilance through networks and registers. We hope that our article (


Mycobacterium tuberculosis antigens using immunodiagnostic testing. It is recommended that TB exposed children and adolescents and those living with HIV receive TB preventive treatment (TPT) to reduce the risk of progression to TB disease. Several TPT regimens of similar effectiveness and safety are now available and recommended by the World Health Organisation.The burden of tuberculosis (TB) in children and adolescents remains very significant. Several million children and adolescents are infected with TB each year worldwide following exposure to an infectious TB case and the risk of progression from TB infection to tuberculosis disease is higher in this group compared to adults. This review describes the risk factors for TB infection in children and adolescents. Following TB exposure, the risk of TB infection is determined by a combination of index case characteristics, contact features, and environmental determinants. We also present the recently recommended approaches to diagnose and treat TB infection as well as novel tests for infection. The tests for TB infection have limitations and diagnosis still relies on an indirect immunological assessment of cellular immune response to  Mycobacterium (M) tuberculosis complex transmitted by inhaling bacilli contained in droplets expelled by a TB contagious individual : d: d106]: Despite the recent advances in the development of shorter TPT and the pragmatic WHO approach for high TB incidence and resource limited countries to reduce barriers such as chest X-ray to rule out TB disease and TBI testing before TPT initiation, there is still a low uptake of TPT among child contacts and children and adolescents living with HIV . The GloSystematic TB screening of child contacts and children living with HIV including adolescents is essential to early detect and treat those with TB and prevent others from develop TB. This is likely to contribute to reduce the burden of TB. Any innovation that is adapted to the limited resources of most high TB incidence countries will support these efforts but the lack of tools such as chest X-ray and TBI testing should not be a barrier to prescribe TPT to these children. Innovative decentralised, child and adolescent centred approach are also essential to ensure acceptability and access to treatment.


The authors regret that the affiliation details for Mohamad Pezeshki-Modaress were incorrect in the original article. The correct author affiliations are as presented above.The Royal Society of Chemistry apologises for these errors and any consequent inconvenience to authors and readers.


Plants form complex interaction networks with diverse microbiomes in the environment, and the intricate interplay between plants and their associated microbiomes can greatly influence ecosystem processes and functions. The phyllosphere, the aerial part of the plant, provides a unique habitat for diverse microbes, and in return the phyllosphere microbiome greatly affects plant performance. As an open system, the phyllosphere is subjected to environmental perturbations, including global change, which will impact the crosstalk between plants and their microbiomes. In this review, we aim to provide a synthesis of current knowledge of the complex interactions between plants and the phyllosphere microbiome under global changes and to identify future priority areas of research on this topic. Global agricultural production is expected to increase by 70% by 2050 to feed the increasing human population . It has beenreported that organic farming increased fungal alpha diversity in the wheat phyllosphere, compared with conventional management  with increasing surface temperature of 2°C, Aydogan et al. (Sphingomonas spp. and Rhizobium spp.) and enhancement of potentially pathogenic bacteria  in the phyllosphere may indicate that warming increases the potential transmission of pathogens in grassland ecosystems   , warming negatively affected putative fungal pathogens   phyllosphere  showed that rain events did not have a significant effect on the richness or evenness of its phyllosphere bacterial community  showed different abilities in shaping the soil microbiomes.As the outcome of past evolutionary history, the phylogenetic relationship between plant species has been found to be able to interact with climate change to modify plant microbiomes  What are the mechanisms within and across plant hosts that underpin host–microbe interactions? (2) What are the major microbial taxa in the phyllosphere that control or mediate plant performance ? (3) How does the phyllosphere microbiome interact with other plant microbiomes? (4) How can we manage the phyllosphere microbiome to increase plant health and performance in a changing world? (5) How will host and the phyllosphere microbiome evolve in response to global changes, and what impacts will this ecoevolution have on ecosystem functions? Therefore, we argue that advancing our fundamental understanding of the impacts of global changes on the phyllosphere microbiome and related ecosystem functions requires interdisciplinary investigations. We need to shift the focus from the level of community ecology to ecosystem ecology for a better understanding of the mechanisms underlying responses of the ‘holobiont’ (assemblage of a plant and its microbiome living in or around it) to global changes. A systems approach is needed to understand the complex interactions between the phyllosphere microbiome and host fitness, and the ecological functions of these microbes for plant nutrition uptake, growth and survival under global climate change.


Cancer and its treatment often impose physical and psychological consequences. Children with cancer are not only at a risk of adverse events resulting from medical procedures but also severe effects on their social and mental health as a result of its treatment. Depression being one of the most common psychiatric disorders associated with cancer in children and adolescents. The current study aims to provide evidence of an easy and inexpensive intervention that can be used in oncology patients in a low resource setting to help maintain mental health stability in pedriatric patients..To examine the effectiveness of therapeutic group art therapy, in reducing depression scores in children with cancer.The study is quasi experimental, through convinient sampling data of fifteen children in initial stage of thier treatment were selected. They were divided into two groups experimental and controlled through random allocation. Three sessions of forty minutes of group art therapy was given in experimental group, in control normal treatment was provided excluding group art therapy. Childhood Depression Scale (CDI) was used in both group as pre and post test to determine the depression level.The results shows a positive change in the level of depression in experimental group as compared to controlled group.Group art therapy is an effective and inexpensive way of reducing depression level of paediatric leukemia patients that can be used by oncology healthcare centres worldwide with trained mental healthcare professionals in order to maintain positive treatment results of cancer.


The authors regret that an incorrect affiliation was given for co-author Mehdi Bazarganipour in the original article. The correct affiliations are as shown here.The Royal Society of Chemistry apologises for these errors and any consequent inconvenience to authors and readers.


There is a significant problem of unidentified and unaddressed reading disabilities leading to psychiatric problems in children and adolescents because of not having proper tools of assessments in schools. This research proposal can be a revolutionary paradigm in identifying, classifying, modeling, and benefitting children and adolescents with a specific learning disorder (SLD).The objective of the current research proposal is to provide a framework of our reading program and collect data over time as cohorts to reflect the positive outcomes of the reading program.After a reading assessment, students with specific reading disabilities will be registered in the program for 10 weeks. Every student will have reading training and CBT on different days of the week via video conference. Data will be collected retrospectively from the initial cohort and subsequent cohorts will be added to the data collection process for a final analysis when 60 students have completed the program.Initial two weeks of reading training and CBT shows positive and promising results so far.Children need to be screened at a young age for a reading disability before they struggle academically, and develop psychiatric issues later in life.The aim of this research proposal is to help us understand, evaluate and benefit children with Specific Learning Disorder (SLD) with our newly setup reading program at RUSH University Medical Center, Department of Child and Adolescent Psychiatry.


In the originally published article, the provided supplemental figures and tables were erroneously missed in being uploaded to the Supplementary Data file. The figures and tables have now been added to the Supplementary Data file online.


This is easily verified by consulting PubMed, a free search engine of biomedical scientific literature online since 1996. By entering “psychology” and “virtual reality” (VR) as search keywords, it is possible to verify a progressive growth in the number of articles in the sector that in a few years it has gone from a few dozen to several hundred articles per year .An important field of application of VR is clinical psychology. The use of computer screen-displayed clinically relevant scenarios for therapy has a limited impact in the field, due to the relatively low ecological validity of these experiences. VR technology offers a solution to this limitation by allowing the opportunity to actively perceiving one's own body within a simulated environment, letting individuals to experience reality-like situations Talking about clinical practice, VR is becoming an increasingly established and widespread method alternative to in-vivo exposition for the treatments of several mental disorders. Recent studies have shown that this approach provides better results compared to traditional therapies for mental disorders Advanced applications of VR for the treatment of anxiety and fear could refer to an integrated human-computer system Insights supporting the importance and efficacy of VR in the clinical field is also provided by research on the rehabilitation of neurological disorders. For example, a recent review article investigating the relevance of VR in stroke rehabilitation found that this technology can be more effective than standard therapies in improving upper limb function and activities of daily living function when used in addition to usual care Finally, VR can be useful for creating experimental settings relevant for the study of clinical symptoms through the involvement of healthy participants. This is the case of Pavlovian conditioning protocols  In conclusion, the current state of the art suggests that the use of VR technology has great potential in boosting clinical practice by promoting therapeutic efficacy, especially when combined with other well established therapeutic methods such as mindfulness and NIBS. The community of clinical psychologists and clinical neuroscientists should look with enthusiasm and genuine interest in VR technology as it could make a difference in psychotherapy and neurorehabilitation.


Rural and remote communities in Australia are characterised by small but widely dispersed populations. This has been proven to be a major hurdle in access to medical care services with screening and treatment goals repeatedly being missed. Telemedicine in ophthalmology provides the opportunity to increase the availability of high quality and timely access to healthcare within. Recent years has also seen the introduction of artificial intelligence (AI) in ophthalmology, particularly in the screening of diseases. AI will hopefully increase the number of appropriate referrals, reduce travel time for patients and ensure timely triage given the low number of qualified optometrists and ophthalmologists. Telemedicine and AI has been introduced in a number of countries and has led to tremendous benefits and advantages when compared to standard practices. This paper summarises current practices in telemedicine and AI and the future of this technology in improving patient care in the field of ophthalmology. However, one of the most targeted diseases is diabetic retinopathy. Despite improvements in diabetic care, diabetic retinopathy remains the leading cause of visual impairment in working‐age adults.2A number of formal telemedicine programs in ophthalmology exist in rural and remote communities across Australia. A recent systematic review of current telemedicine programs in ophthalmology identified five general eye care programs, three emergency care programs and five diseases specific models of care.An program run in Mt Isa, Queensland, allowed for ophthalmologists working in Townsville to remotely assess patients attending the emergency department, who would have otherwise been required to travel significant distances.Lions Outback Vision has provided telemedicine service to rural and remote regions of Western Australia for over a decade. These regions continue to have workforce shortages and telemedicine has enabled increased access for populations dispersed across a vast geographic area.The uptake of telehealth in remote and regional services remains underwhelming given the potential for improving equity in eye care access. The challenges of coordination between outreach optometry and ophthalmology services as well as availability of specialists for on call integration into daily workflow are logistical hurdles.3There are a number of different forms of telemedicine within ophthalmology currently in use, all of which have different logistical and technological requirements Table . The mos4Within Australia and internationally Indigenous people have poorer health and social outcomes compared to their non‐Indigenous counterparts. This includes a shorter life expectancy, increased infant mortality and morbidity and lower educational attainment.Although resources have been committed to improving screening and treatment rates for ophthalmic conditions in Indigenous populations, between 2008–2009 and 2019–2020 screening rates for diabetic retinopathy only increased by 4%.5The COVID‐19 pandemic saw a marked expansion of existing telehealth services and the creation of new of telemedicine programs to maintain both patient and clinician safety. Of great concern during this expansion period was patient safety both from a COVID‐19 perspective and existing chronic health conditions. To minimise the infectious disease risks for both patients and clinicians in Australia, a temporary expansion of Medicare funding for telemedicine during the COVID‐19 pandemic saw the introduction of Medicare benefits to cover the use of audio only consults and the use of telemedicine in metropolitan regions which had previously been unfunded. The lack of funding is often listed as a key reason for a limited uptake of telemedicine. During the COVID‐19 epidemic, ophthalmology saw one of the largest decreases in case volume, with one US study reporting a drop of 81%,Of concern during this period of transition was the effect on patient outcomes and safety. Concerns were raised that deteriorating ocular health would be missed and that both patients and clinicians would fail to engage with a telemedicine service. A number of studies have been conducted in order to address this concern and measure any potential impact that a change in patient care may have had. One large meta‐analysis of just under 1000 primary studies, including one on ophthalmology, found that telemedicine in a number of forms was not inferior to conventional care.6Clinician triage and assessment is still integral to current models of telemedicine in Australia for rural and remote populations Figure . The incThese DLS are able to triage and assess patients for eye diseases and overcome the initial hurdle of accessing a clinician for assessment which has been identified as a barrier particularly in rural areas. This type of artificial intelligence diabetic retinopathy screening model has been trialled in Indigenous communities in Australia. A trial from our group in a number of specialist and primary care clinics including an Aboriginal Medical Service clinic in Western Australia demonstrated that the sensitivity and specificity were above the above that required by Food and Drug Administration sensitivity and specificity endpoints, 96.9  and 87.7 , respectively.Any form of telemedicine is not without its limitations, either in technology and access to clinicians. The introduction of artificial intelligence overcomes the initial hurdle of access to clinicians for screening however these systems are limited by the quality of camera accessible for assessment and the original training image dataset used which tends to be primary of Caucasian descent. This limits the generalisability of artificial intelligence algorithms with area under the curve lower in Aboriginal and Torres Strait Islanders compared to Chinese, Malay and Caucasian populations.7Alongside the benefits of improved and more timely access to care there are economic benefits associated with the use of telemedicine and AI. There is a well‐established evidence base for the cost‐effectiveness of telehealth systems in multiple settings globally.A common theme to these economic analysis is that with greater uptake, the cost‐effectiveness increases. Any new telemedicine program must therefore effectively identify the needs of the population they are serving and integrate into any existing health‐care system in order to maximise the cost benefit both at an individual and government level.8A maldistribution in Australia's eye health clinical workforce means rural and remote populations have chronic issues with eye healthcare access. Therefore, the role of ophthalmologists will be in the management and treatment of surgical management or complex eye diseases. Current telemedicine programs integrate optometrists, nurses and general practitioners; however, further technological advances in ocular imaging and data sharing mean that this can be augmented further and, in some cases, conducted by patients themselves using artificial intelligence.Telemedicine with the addition of artificial intelligence provides many advantages in an aging population with increased healthcare needs, with artificial intelligence screening systems becoming more effective and their integration into telemedicine cheaper. This enhances primary care screening and ensures patients are well triaged for specialist clinician input as required and in an appropriate time frame for optimal visual outcomes.9There are numerous benefits provided by telemedicine ophthalmology programs. These include the increased access to screening and treatment, which is especially important in rural and remote areas which have continue to lag in access and uptake of screening and treatment goals. These telemedicine programs both with and without artificial intelligence enhancements allow for the prompt and early detection of disease, allowing for better patient outcomes. By augmenting screening with integrated artificial intelligence algorithms, further efficiencies may ensure appropriate referrals, reduced travel time and timely triage. A number of studies have already demonstrated the cost effectiveness of telemedicine programs, especially within diabetic retinopathy and these cost savings are likely to increase with the increased expansion and adoption of telemedicine programs. The COVID‐19 pandemic saw the rapid introduction of expanded telemedicine programs in many areas of medicine including ophthalmology. This may serve as an impetus to embrace telemedicine to provide high quality and timely access to healthcare for all Australians no matter their geographic location.


ACS Applied Materials & Interfaces,1 which was not cited in this RSC Advances paper. The RSC Advances paper is a valuable and necessary supplement to the publication in ACS Applied Materials & Interfaces and focused on the reduced gas sensing performance of the devices instead of film characterization and film conductive performance.The authors wish to draw the reader’s attention to their previous related study, published in RSC Advances paper, which should be attributed to The authors regret not giving correct attribution to Fig. 1–6 which duplicate data from The Royal Society of Chemistry apologises for these errors and any consequent inconvenience to authors and readers.


To demonstrate the methodology and results for linking measures of neighbourhood walking-friendliness or "walkability" to Canadian health surveys and Canadian health surveys linked to administrative health care records. We linked multiple measures of neighbourhood walkability to hundreds of thousands of 6-digit postal codes of respondents to three large Canadian surveys using geographic information systems and anonymized banks of postal codes.Long term exposure to walkable neighbourhoods was associated with increased reporting of walking for utilitarian purposes. Moving to a high walkable neighbourhood from a low walkable neighbourhood was associated with a full unit decrease in the body mass index of Canadian men over a 12-year follow-up. In a linkage of walkability measures to respondents who wore biosensors for a one-week period in several Canadian cities, we found that neighbourhood walkability was associated with increased reporting of utilitarian walking but not overall physical activity and step counts as measured by biosensors.There is potential for walkable neighbourhoods to influence physical activity and body weight of Canadians which is more evident when individuals are followed for long periods of time.


The assumption that “normal” or typical sexual behavior exists is important for research and practice . The definition of normal sexual behavior is multifaceted, that is why its adequate understanding by students in the course of sexuality requires some effort.The focus of the research was the students’ understanding of complicated normal sexual behavior.24 students  completed adapted and modified questionnaire  consisting 30 items concerning sexual behavior by deciding whether or not they consider each item as normal. Then the evaluations by each student on all items were generalized and discussed and summarized in this general form among all participants.Only 2 items were considered by all students as a normal: concerning sex somewhere other than a bed and masturbation after marriage. Some items were evaluated as normal by the half of participants: fantasizing about a person other than one’s partner during sex; becoming aroused by peeping; dressing of the clothing of the other sex; having rape fantasies. Many items were characterized as normal by less or more than a half of the participants. Trying to answer the question of what elements of sexual behavior can be considered as normal, students aware the ambiguity of these assumptions and observe the variability in the opinions of other participants.Evaluation of different elements of sexual behavior and subsequent group discussion demonstrates for students some difficulties and uncertainty in defining normal sex behavior.No significant relationships.


Advance care planning (ACP) is an important process to enable individuals to make their preferences known in the event of dementia onset. Racial and ethnic minorities have an increased risk of developing dementia. Understanding more about ACP differences by race and dementia status will help improve ACP communication among minority populations. For the current study the 2018 wave of the Health and Retirement Study  to test the relationship between dementia status and ACP and if there were differences by race. Findings indicated that both African Americans and Hispanics are less likely to have completed ACP than non-Hispanic Whites. In unadjusted models, having a dementia diagnosis indicated a lower likelihood of completing ACP; dementia was not significant in the final model when controlling for predisposing and enabling factors. More research on the predisposing and enabling factors that influence ACP among minority and dementia populations is needed.


While we may not be able to predict with certainty whether any particular individual can prevent dementia, we are now able to talk about dementia risk reduction at the population level. The Public Health Center of Excellence on Dementia Risk Reduction reviews and synthesizes the state of the science on modifiable risk factors for cognitive decline and dementia. The Center translates that science into public health action – identifying interventions and best practices to address those risk factors – and develops tools and resources for public health agencies. The Center disseminates this information and works with public health to undertake community-level actions to address risk factors. The Center also works with public health agencies to: (a) address the social determinants of health with respect to dementia risk; (b) build capacity to enable smaller agencies to engage in risk reduction activities; and (c) partner with health systems to advance risk reduction.


The authors regret that the email address was not included for one of the three corresponding authors, Guang-ji Wang. Contact email addresses for all three corresponding authors are presented here.The Royal Society of Chemistry apologises for these errors and any consequent inconvenience to authors and readers.


Dramatic changes in family life may have altered the structure and quality of social ties to family and friends. However, little is known about whether and how social relationships vary between older adults from different cohorts. Using data from the National Social Life, Health, and Aging Project, we compared social network composition and social support between older adults at ages 57 to 67 from the Silent Generation cohort  and the Baby Boom cohort . Compared with the Silent Generation cohort, the Baby Boom cohort had significantly higher odds of not listing any kin in their core discussion network. There were no cohort differences in proportion of friends in the network. The Baby Boom cohort also reported lower levels of family and friend support than their counterparts. Results suggest that the Baby Boom cohort is more socially disconnected from friends and particularly family compared with the Silent Generation cohort.


Refugees have been shown to be a vulnerable population with increased psychiatric morbidity and lack of access to adequate mental health care. By establishing cooperations between psychosocial centers and psychiatric clinics the state funded project refuKey by NTFN e.V. and DGPPN aims to improve access to and quality of mental health care for traumatized refugees pursuing a stepped-care model.As part of a larger project evaluation study four focus-groups among experts were conducted to explore the impact of refuKey on refugees’ mental health care.Data analysis was conducted using Mayring qualitative content analysis as well as an additional quantitative survey with state refugee reception centers’ employees.The results indicate that refuKey faciliated the access to mental health care for refugees in terms of systematic identification of mental disorders, eased transitions and increased networking between the mental health care institutions and sectors. Planning and implementation of treatment is described as being more coordinated, solution oriented and sustainable due to multiprofessional collaboration and regular use of qualified interpreters. Reduced distress as well as increased transcultural expertise was found for professionals.The persisting barriers for refugees in access to mental health care, especially to psychotherapeutic treatment and the emotional burden for professionals underlines the need for further support and research. The experts highly endorse the continuance of refuKey. Furthermore, they call for expansion of the project in terms of staff and new sites and changes of health policies to guarantee the access to adequate health care for traumatized refugees.No significant relationships.


The authors are retracting “Assessing the Dissemination of COVID-19 Articles Across Social Media With Altmetric and PlumX Metrics: Correlational Study” :e21408) in alignment with COPE guidelines and based on an honest error that invalidates the results.Authors’ statement:We sincerely regret our honest misunderstanding of the Altmetrics variables as it was discussed in our manuscript. As a team that values honest and ethical research, we are grateful to JMIR for bringing this grave error to our attention and appreciate our fellow peers for holding us to the highest standard of research. We strive to uphold integrity in our research and agree with the decision of the editors of JMIR to retract our original manuscript. We look forward to the opportunity to edit our work so our research accurately reflects the intention behind the Altmetrics variables.


Pregnancy is associated with profound changes in pharmacokinetic processes. This is an important - and until recently neglected - area of research since the majority of women take drugs during pregnancy in addition to vitamin and dietary supplements. Recent evidence has emerged that the changes do not only include absorption, distribution and excretion but also drug metabolism, such as modifications in the regulation of hepatic metabolism and conjugation. Oestradiol is known to have an important role in the expression of cytochrome P450 isoenzymes and glucuronosyltransferase that are involved in the metabolism of psychotropic drugs. Recent studies of different psychotropic drug classes have shown that this can result in profound changes of plasma concentrations that commence early in pregnancy and gradually increase towards delivery. In this presentation pregnancy-induced metabolic changes that have been found so far for several psychotropic drugs will be discussed and the question addressed whether and how we should monitor plasma levels in our pregnant patients.No significant relationships.


There are many definitions for polypharmacy used within clinical practice and research and many factors contributing to this problem. Definitions vary from being based on the number of medications the older adult is taking to a more qualitative evaluation of the appropriateness of medication based on the benefit of the drug for a specific problem. For research purposes the definition is more commonly conceptualized as being equivalent to taking five or more medicines. Polypharmacy is noted to be presented in about 40% of older adults living in the community. Limited research has focused specifically on polypharmacy in assisted living settings. In addition to concerns about polypharmacy in assisted living there has also been a focus on the use of psychotropic medication and opioids in these settings as prevalence ranges from 53% to 68%. Although there are not regulations related to decreasing polypharmacy via deprescribing or to decrease use of psychotropics or opioids in assisted living, there are currently major initiatives in geriatrics to focus on these areas. This symposium will provide current data on medication use and polypharmacy among a large sample of 781 assisted living residents from 85 communities across three states and address the impact of a Function Focused Care approach on decreasing polypharmacy and use of psychotropics and opioids. Lastly data will be provided on the value of Deprescribing Networks to help decrease polypharmacy within these settings. The findings from this symposium will provide recommendations for future research as well as guidance for clinical practice.


The largely rural setting of Northern New England offers unique challenges to implementing improved acute care for the growing geriatric population. Northern New England is one of the United States’ most rapidly aging regions, with Vermont and New Hampshire being the second and third oldest US states respectively by median age (U.S. Census 2017). There is a need to expand innovations in geriatric emergency medicine to reach older adults in rural areas such as Northern New England. Dartmouth-Hitchcock Medical Center and the West Health are collaborating on a project leveraging telehealth to extend the reach of a GED to rural hospitals, as well as investigate the opportunities for scaling and sustaining this concept to other rural facilities across Northern New England and throughout the country. This symposium will focus on our experience implementing a hub and spoke model to achieve our goal of improving the care of older adults in rural emergency departments.


The aim of this research topic is to give the opportunity for clinicians and researchers from around the world to contribute with their experience and knowledge around challenges and solutions in the sphere of translational research in neuromuscular diseases (NMD). This is with reference to study design, outcome measures and what we have learnt from both successful trials and those that did not meet their primary endpoints. Resulting publications around this topic offer exciting and valuable insight which we hope can help guide future clinical trials as well as clinical practice. Lessons learned will benefit those developing research methodology to help improve trial outcomes and therefore clinical care for patients with neuromuscular diseases.Duong et al.). Traditionally, assessments have been performed in person with direct contact with the research subject. Recent global events have created additional pressures for industry in delivering face to face consultations. A number of industry sponsors quickly introduced amendments to their study protocols to enable remote evaluations. There may be many complications when utilizing a scale initially validated to be performed in person through a remote platform which may potentially impact the scale validity. Here a global network of physiotherapists report on methods for adapting current practices to accommodate remote testing and considerations for remote evaluations . Insight from these two manuscripts may provide valuable knowledge for considerations in study design and set up.Many factors may contribute to clinical trials not meeting their primary endpoint. One of the identified reasons is the lack of robust data to support the validity of a measure and poor-quality data collection. Significant efforts have been made to ameliorate these issues and one manuscript has provided a framework to guide the learning process for clinical outcome assessments (COAs) for use in both clinics and clinical trials. The process of teaching and learning COAs is necessary to maximize reliability of the measure and validity of the data collected. Evaluators involved in collecting data must do so in a standardised manner and must use clinical judgement and knowledge to accurately perform and score the COA. This manuscript is a consensus-based guideline to assist in the required training that must be employed for study start up for all evaluators regardless of experience . And finally, but not insignificantly are the implications of the use of social media in and around clinical trials. Can they be a force for good as well as perhaps their more usually perceived negative impact? In this paper they provide an overview of the guidance that has been published and muse the pros and cons of the use of social media in trials for rare disease (Nelson and Iannaccone). The knowledge based on past experiences may be extremely valuable as we continue to advance clinical trials and clinical care for patients with NMD.Prior experience in clinical trials has provided us another important tool for moving the field forward in these rare diseases. For example, in the last three decades, several compounds have been assessed preclinically and within clinical studies for their ability to restore functional dystrophin levels or to modify pathways involved in Duchenne muscular dystrophy (DMD) pathophysiology. However, there has been a significant attrition rate of early and late phase trials. Here they present data from 16 compounds that failed to complete clinical development, despite positive results in the early phases of development . The autThe success of a clinical trial in the rare disease community may be based on many factors. The manuscripts within this issue have touched on some of the aspects that researchers must take into consideration. Furthermore, we must also remember that clinical outcome assessments utilised in clinical trials need to be robust measures  based up


At a time of growing enrollment among adult learners, student bodies are increasingly age diverse. Identifying and reducing age-related bias on campus may be multipurpose in supporting those who experience ageism while promoting professional skills to combat ageism in students' future careers. The extant literature has primarily focused on ageism in the workplace and ageism experienced by faculty and staff in higher education while less has focused on ageism experienced by adult students and the possible disruption this creates to feeling included as part of the campus community. We present data from a mixed methods study of adult learners assessing the extent to which they experience and are impacted by age-related bias on campus. Data are used to justify faculty and student training to improve intergenerational contact in the classroom and beyond under the broader umbrella of DEI initiatives.


In the second phase, semi-structured interviews will be conducted via selective sampling to record participant opinions, experiences and expectations of using cancer-related health services.We expect to identify and explain important personal barriers and facilitators related to the use of cancer screening and treatment offers. Further interviews with stakeholders in cancer healthcare, such as physicians, nurses and self-help groups will be conducted to complement data from the service-providers’ point of view. The results will be analyzed with behavioral and sociocultural theories to gain a deeper understanding of perceived and experienced barriers in accessing cancer care in Germany and to formulate recommendations for prospective targeted approaches and interventions.Our findings will be useful for facilitating knowledge transfer and policy dissemination to increase public awareness about cancer offers and improve participation rates. The results will be also used to develop an interprofessional teaching module in the medical curriculum as well as prepare and implement advanced training courses for medical professionals certified by the State Medical Association.This study is funded by Strube Stiftung Stuttgart.


Chorioretinitis is a serious ocular complication of congenital syphilis (CS) that can cause permanent vision loss. While antibiotic use and public awareness have helped dramatically reduce the incidence of syphilis in the twentieth century, the US incidence of syphilis has more than tripled from 2000 to 2018 [The Stanford University Network for Diagnosis of Retinopathy of Prematurity (SUNDROP) study is a telemedicine screening platform for retinopathy of prematurity (ROP) used by member hospitals that lack access to quaternary pediatric retina specialists. The SUNDROP platform has been used in expanded indications beyond ROP to provide hospitals with pediatric retinal screening including the transmission of retinal images in infants with known or suspected CS. We retrospectively analyzed the SUNDROP database to examine a more recent incidence of chorioretinitis among cases of CS. This index study was conducted in accordance with the Health Insurance Portability and Accountability Act and the tenets of the Declaration of Helsinki and with local approval of the Institutional Board Review (IRB 8572).Thirty-seven confirmed and seven probable cases of CS were identified from 2015 to 2020 following Centers for Disease Control case definitions . An addiThese preliminary findings suggest that even as the incidences of CS have risen, chorioretinitis remains a rare complication. While these results are specific to CS in neonates, they are consistent with a recent study that found hospital admissions for syphilitic uveitis have not increased despite a growing incidence of admissions for syphilis . Althoug


Building a health data pipeline is an opportunity not only to review the efficiency of data flows and organisational processes but also to guarantee that the resulting data system incorporates data protection and fairness principles by design. This session will cover some key aspects of data protection and the principles of data fairness and ethics:Transparency, simplicity and fairnessThe importance of a diverse team with diverse expertiseKeeping the business objectives in mind and purpose limitationCompliance with data protection directives (GDPR)


After this article was published, similarities were noted between this article  and submIn response to queries about these concerns, the corresponding author provided the underlying data in The authors commented on aspects of how data were collected and analyzed for this study, but overall their responses did not fully resolve the concerns.PLOS ONE Editors issue this Expression of Concern to notify readers of the unresolved concerns discussed above, and to provide the data and updated figure received from the authors.The S1 File(ZIP)Click here for additional data file.


Background: A large healthcare system in Georgia implemented an enhanced electronic infection surveillance system that is incorporated into the electronic medical record (EMR). Prior to the implementation of this electronic infection surveillance system, the infection prevention (IP) team performed healthcare-associated infection (HAI) surveillance through a locally created system that did not interface with their EMR. Each HAI identified undergoes a robust analysis for opportunities depending on the infection type by manual abstraction from the EMR, which is stored in a spreadsheet. One disadvantage of this spreadsheet is that only 1 person can enter data at a time. The coronavirus disease 2019 (COVID-19) pandemic has presented many challenges for healthcare facilities including shifting resources from HAI prevention programs. These programs include the investigations performed to identify risk factors that can aid in preventing future infections. Due to the necessity to increase efficiency in the current pandemic, the IP team proposed using technology to automate our HAI investigation process. Method: The IP team and the business intelligence (BI) team met to determine whether data completed in the electronic infection surveillance system could flow into an interactive data visualization software that is currently used for other HAI prevention dashboards. The existing spreadsheet was reviewed to select variables essential for HAI investigations and for which the data existed in the EMR. The BI team worked to find the correct data tables within the EMR so that the data could automatically refresh daily in the data visualization software. Result: The BI team was able to correctly identify variables used in the previously manual HAI investigation process within the EMR to interface with the data visualization software. This automation of investigations allows quick analysis of trends and areas of opportunity to prevent future HAIs. Conclusion: This utilization of technology can be applied to other healthcare facilities with similar software systems to streamline IP workflows. The automation of quickly and efficiently recognizing areas of opportunity allows IPs more time to facilitate the prevention of HAIs in other ways.Funding: NoDisclosures: None


The last decade has seen a remarkable resurgence of interest in psychedelic drugs such as psilocybin (from magic mushrooms) LSD and DMT (dimethyl tryptamine – the active ingredient of ayahuasca). This has been driven by the discovery that these psychedelics all act agonists of 5-HT2A receptors. Human imaging studies have revealed this action leads to profound alterations in brain measures of activity particularly in terms of increased entropy of EEG MEG and fMRI signals and reduced within-network, but increased between-network, connectivity. In addition they all can increase synaptic growth and brain plasticity. These findings not only explain the subjective nature of the psychedelic experience but also have implications for the treatment of internalising disorders such as depression addiction anorexia and OCD that are characterised by increased within network connectivity especially of the default mode network. Subsequent trials, particularly of psilocybin, in these disorders has revealed significant clinical benefits from even just a single administration. A number of companies have now been set up to extend these discoveries with regulatory-level trials that could result in market authorisations within a few years. My talk will explore these brain mechanisms and clinical data and discuss the potential place of psychedelic medicine in the future of psychiatry.I am an advisor to Compass pathways and Beckley Psytec two companies that are developing psychedelics for depression and other psychiatric indications. Several members of my research group receive support from these companies and also from Small Pharma.


Although the primary goal of self-directed programs providing long term services and supports (LTSS) is to maximize choice and control for service recipients, such programs may also benefit family caregivers by compensating them for providing supportive services. This study draws on qualitative data from research supporting the RAISE Family Caregiver Advisory Council, finding that family caregivers themselves see the expansion of self-directed programs as a policy priority due to their need for financial security. The request for compensation was the strongest finding, with respondents highlighting the incompatibility of work with caregiving and their inability to rely on the existing paid workforce due to supply and quality issues; the consequences of this loss of earned income were reported as severe. Ultimately, respondents saw payment for providing care as an issue of fairness. This evidence supports the policy case for expanding access to self-directed programs that permit the employment of family caregivers.


Frontiers in Psychology on Environmental, Social, and Corporate Governance (ESG) and Sustainability. After a thorough blind review procedure, we are pleased to announce that 19 articles have been selected for publication in the Research Topic. We believe that all of these articles address important aspects of ESG in this Research Topic according to the background detailed below.Welcome to this Research Topic of We are currently witnessing dramatic changes in the business environment  when they recall altruistic anxieties associated with COVID-19. Considering ESG also mediated the moderating effects. By introducing the nature of COVID-19 fears as a critical factor, this study made a worthwhile contribution to the literature on pro-environmental behavior.The fifth paper by Lee and Jeong confirmed that the compatibility and authenticity of social responsibility activities affect a firm's brand trust, thereby improving corporate sustainability management. The results of this study provided strategic implications for the performance of social responsibility activities necessary for the continuous growth of firms and for building brand trust.The sixth paper by Qing and Jin investigated whether CSR can affect sustainability through the economic and social performance of social enterprises (SEs). It also attempted to verify the moderating role of innovativeness in the relationship between CSR and SE performance. The results suggest that, while CSR can improve sustainability through economic and social performance, innovativeness has no moderating effect on the relationship between CSR and SE performance.The seventh paper by Bae et al. presented a new theoretical perspective on the relationship between the strength of environmental regulations and foreign direct investment (FDI), which is currently attracting increased scholarly attention. We argue through this new perspective that we should observe the strength of environmental regulations, which has been overlooked by previous literature, and the distance between countries in the FDI relationship. This will make it possible to obtain fresh insights and new ideas regarding the relationship described above.The eighth paper by Wang and Liu addressed two important research questions: “how may various types of green innovation strategies matter in explaining the variation of firm performance?” and “how may various types of green innovation strategies interact with supply chain risks in illustrating firm performance variation?” Using primary data collected from a sample of 337 firms in China, the study uncovered that the effects of green innovation strategies were statistically significant in elucidating the heterogeneity of firm performance, and their interactions with supply chain risks were also noteworthy and economically important.The ninth paper by Wang and Teng was motivated to address two major research questions: “what contributes to the development of supply chain management (SCM) capability?” and “how does SCM capability matter in explaining the environmental performance variation of firms operating in large emerging economies?” Using survey data collected from 272 firms in China, the study discovers that specific forms of digital innovation play a positive role in driving the development of SCM capability. The results of the empirical analyses provide further supportive evidence indicating that SCM capability functions as an important role by either partially or fully mediating the relations between the effect of digital innovation and firm environmental performance.The tenth paper by Yang and Yang examined the association between dynamic capabilities (DCs) and corporate performance in ESG management. This empirical study tested this as an alternative method using topic modeling with Word2Vec. The findings imply that DCs can enhance corporate performance under uncertainty and pursue a balanced way of sensing-seizing-recofiguring capabilities through ESG management.The eleventh paper by Son and Kim attempted to examine the relationship between ESG management and financial performance and the role of socially responsible investment by the National Pension Fund (NPF), Korea's largest institutional investor. Their primary discoveries are that Korean firms with good financial performance actively participate in ESG. NPF has a propensity to invest in firms with high financial and ESG performance.The twelfth paper by Lee and Yang investigated the impact of CSR performance feedback on future CSR performance to answer the following research questions: First, how does positive CSR performance feedback affect future CSR performance? Second, how does negative CSR performance influence future CSR performance? By performing generalized least squares (GLS) regression analysis based on Korean company data from 2012 to 2019, their empirical findings document that positive social and historical performance feedback positively affected CSR performance.The thirteenth paper by Liang et al. explored the role of DCs for ESG strategies as well as sustainable management performance. A research model was established by using DC theory, thereby integrating sustainable management and ESG literature. According to the results of their statistical analyses, both absorptive capability and adaptive capability have considerable effects on sustainable management performance through implementation of the ESG strategy as a mediating factor.The fourteenth paper by Wu and Kuang began with its anticipation that key subordinate executives would play a role linking superiors and subordinates within the top management team (TMT). Based on their recognition of the heterogeneity of TMT preference, data from Chinese listed firms from 2010 to 2019 were used. Their empirical results exhibited a positive relationship between key sub-level executives' governance and accounting conservatism. They also indicated that CEO overconfidence could positively modulate this relationship.The fifteenth paper by Li and Qamruzzaman examined the nexus of tourism-driven sustainable human capital development (HCD) in emerging economies from 1984 to 2019. In this process, they observed a statistically substantial and long-lasting favorable correlation between tourism and HCD.The sixteenth paper by Park and Oh identified the different types of information used by investors to make investment decisions based on the UTAUT (Unified Theory of Acceptance and Use of Technology) model. This paper figures out how ESG information affects the decisions of individual investors regarding investments and the factors that affect such behaviors.The seventeenth paper by Park et al. used text scraped from Twitter. It polished the data to identify trends in ESG themes and their sentimental value over time. This paper informs us how the general public feels about ESG through sentiment analysis.The eighteenth paper by Lee et al. addressed that ESG at the host country level significantly impacts the implementation of clean development mechanisms (CDM). Moreover, the results of zero-expansion Poisson regression extended the ESG pillar based on institutional theory and emphasized the importance of sustainable development.The nineteenth paper by As a final remark, the guest editors would like to thank all the reviewers and all those who submitted papers to this Research Topic. The editor-in-chief of Frontiers in Psychology, Axel Cleeremans, also deserves special gratitude. We are incredibly appreciative of the participants' kindness and efforts, both of which have made this special edition possible.All authors listed have made a substantial, direct, and intellectual contribution to the work and approved it for publication.This work was supported by the Soonchunhyang University Research Fund.The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.


Pharmaceutical treatment and psychotherapy constitute the most common treatment methods for depression and anxiety. Physical training has been shown to have comparable effect to cognitive behavioral therapy in treatment of mild to moderate depression and anxiety. Physically active individuals also show lower risks to develop depression and relapse in depression.The objectives are to evaluate how physical activity can affect depressive and anxiety symptoms, by examining biomarkers in the blood and from the gut and also by measuring cognitive functions. Hopefully, this can lead to new treatment strategies for patients with depression and anxiety.102 patients are randomized to two groups and undergo 12 weeks intervention as add-on to standard outpatient psychiatric treatment. The first group will participate in physical training three times per week and the other group will receive relaxation therapy on a weekly basis. Daily activity intensity will be measured before and at the last week of intervention with an accelerometer. Blood and faeces sample collection, symptom grading by clinician together with self-rating scales and cognitive screening will be performed at baseline, week 12 and one year of follow-up. The cognitive screenings are performed digitally in cooperation with Mindmore.The RCT is currently recruiting patients at the Department of Psychiatry of Örebro University Hospital.The project aims to be holistic in its approach, combining the defining clinical psychiatric symptoms in patients who have both depression and anxiety with the finding and evaluation of new biomarkers from blood and gut to improve cognitive functions.No significant relationships.


Ageing world populations and increases in life expectancy have facilitated an interest in developing ageing models that promote inclusivity and positive perceptions of ageing. This scoping review examines how and to what extent research that utilizes successful, active, productive, and healthy ageing framework(s) include death or dying. The study followed Joanna Briggs Institute’s methodological standard for scoping reviews and PRISMA guidelines and conformed to Arskey and O’Malley’s five-stage framework. A thematic analysis was used to identify how research utilizes the concepts of death and dying in the context of positive ageing models. The analysis identified five core themes: (a) the critique that death and dying dimensions in positive ageing models are absent; (b) older adults’ outlooks on death and dying while ageing well; (c) religious and spiritual dimensions of ageing well; (d) negative consequences of positive ageing models without death and dying dimensions; and (e) the future of death and dying in positive ageing models. The results bolster support for a paradigm shift that redefines what it means to age successfully without denying death. Incorporating the topics of death and dying into ageing conversations encourages individuals to ponder their end-of-life preferences and proactively participate in their advanced care plans. Death and dying conversations help care providers support people to live and die in a manner that is meaningful to them and inspire those receiving care to live fully and deeply and to think about the legacy that they want to leave.


Under the skin is an intricately woven tale of Professor Alex Anstey's career as a junior doctor then general practitioner and ultimately academic dermatologist working in the NHS. Personal memoirs are punctuated by amusing clinical vignettes, key moments in recent British political history and chapters devoted to heroes in health care. These influential and inspirational men and women range from military nurses to the founding father of evidence‐based medicine to pioneering Oxford Regius Professors and giants of medical education. These heroes have been well researched, and the quirky details the author has uncovered will delight readers.The book provides valuable insights into the history, the machinations and struggles of the NHS both in the early days and during the pandemic. Anstey details his inspiration and journey to improve clinical efficiency in his corner of Wales. In 2000, his efforts ultimately led the Gwent Healthcare NHS trust in winning the UK Dermatology Team of the Year. The foundation of repairing a strained hospital system he details is based on consultation with all team members and connecting with the local GPs through personal interactions, education, triage and telehealth. This is a thoughtful book on how health services run and how clinicians must be in tune with both their support team and their managers, with lessons applicable beyond dermatology.Other chapters are devoted to academia, research, scientific journal stewardship and politics. Contemporary themes of teledermatology (even more relevant post‐COVID‐19) and patient partnership or empowerment are discussed. The charming Welsh personalities and stories only augment the tale. I enjoyed this beautifully written book very much and would recommend it to not only dermatologists but all healthcare workers with an interest in hospitals and health management. If you have worked in the NHS or aspire to building a better team, equally this is essential reading.No conflict of interest to declare.


Autism is a neurodevelopmental disorder that is considered more common in males; however, ascertainment estimates of ASD in the UK population suggest a significant proportion of female cases of ASD go unrecognised and undiagnosed. This review examines whether the apparent underdiagnosis of girls may be attributed to gender sampling bias in the validation of diagnostic instruments routinely used to diagnose autism.To compare the gender ratio in validation samples of commonly used diagnostic tools for autism to estimates of the gender distribution of children with autism in the UK populationA review of diagnostic tool manuals and a targeted literature search identified the gender of sample participants used to validate tools used by Scottish ASD services. Analysis of validation samples compared the mean percentage of female participants with ASD to estimates of the proportion of girls with ASD in the UK population.Data on 7 tools was extracted. The mean percentage of female sample participants with ASD was significantly lower than the ascertainment estimate of females with ASD in the UK population =-3.67) and significantly lower than the mean percentage of females in comparison groups =-3.06).There is low representation of females in validity samples of tools, which may reduce their sensitivity to the female phenotype and contribute to diagnostic disparities. Future research is warranted on why instruments are poorer detectors of ASD in girls and how female features of ASD could be better represented in their structure.


RCP is defined as the ’ratio of the activity of a radionuclide in a stated chemical species in a material over the total activity of all species containing that radionuclide in this material’  and/or Instant Thin-layer Chromatography (ITLC) under the same experimental conditions for cross validation . The rules of Good Radiopharmacy Practice (GRP) dictate that RCP of an injectable radiopharmaceutical The paucity of purified actinium materials combined with the lack of stable isotopes and measurable spectroscopic properties for this element has prevented the isolation and structural investigation of authentic samples of its coordination compounds and made it arduous to determine their chromatographic properties (Deblonde et al.


The last decade has witnessed huge technological advances in genomics, particularly in DNA sequencing. Here, we review the actual and potential application of genomics in supporting in situ conservation of crop wild relatives (CWRs). In addition to helping in prioritization of protection of CWR taxa and in situ conservation sites, genome analysis is allowing the identification of novel alleles that need to be prioritized for conservation. Genomics is enabling the identification of potential sources of important adaptive traits that can guide the establishment or enrichment of in situ genetic reserves. Genomic tools also have the potential for developing a robust framework for monitoring and reporting genome‐based indicators of genetic diversity changes associated with factors such as land use or climate change. These tools have been demonstrated to have an important role in managing the conservation of populations, supporting sustainable access and utilization of CWR diversity, enhancing accelerated domestication of new crops and forensic genomics thus preventing misappropriation of genetic resources. Despite this great potential, many policy makers and conservation managers have failed to recognize and appreciate the need to accelerate the application of genomics to support the conservation and management of biodiversity in CWRs to underpin global food security. Funding and inadequate genomic expertise among conservation practitioners also remain major hindrances to the widespread application of genomics in conservation. It is estimated that there are about 50,000–60,000 CWR species globally, out of which 700 need to be prioritized for conservation  and its CWRS, thus resolving the gene pool classification in this genus which has remained inconsistent and contradictory  was developed with the aim of providing a globally coordinated and harmonized system of biodiversity monitoring  Walp landraces and wild relatives has provided insights on the crops domestication suggesting a divergent domestication process   which is a perennial CWR of wheat  (Zsögön et al., Domestication marks a major deliberate effort of promoting the use of wild plants by manipulating their genetic and phenotypic traits in order to suit the needs of human kind. Genomics presents tools, resources and knowledge to accelerate domestication of new species thus potentially enhancing food and nutritional security (Brozynska et al., 9.2Provisions that allow utilization of in situ CWR genetic diversity should be tempered with appropriate laws and regulations that prohibit illegal harvesting and over‐exploitation that could threaten the survival of the CWRs. Such regulatory frameworks should have sufficient and enforceable safeguards that helps prevent bio‐piracy. Molecular analysis is aiding law enforcement and regulatory authorities in detecting cases of illegal harvesting and trade of wild populations (Aubriot et al., It has been argued by Wambugu et al.  that adv9.3Solanum demissum Lindl and stem rust from wild wheat Aegilops tauschii Coss into the respective cultivated gene pool (Prescott‐Allen & Prescott‐Allen, Climate change currently poses the single largest threat to world agriculture and global food security. Although CWR populations are facing immense threats in the wild due to climate change, those populations that will successfully withstand these threats will be a useful source of genes for breeding for increased climate resilience. Genomics is providing tools to dissect the genetic basis of important traits and understand the functional trait diversity that is available in CWRS. Information on candidate genes and trait associated genetic markers is important in accelerating the use of CWRs in breeding programmes. The use of CWRs in crop improvement is particularly important in crops where genetic gain has been low as a result of inadequate variation in the domesticated gene pool for key target traits. Genomic data has enabled identification of regions that have lost important genetic diversity during the domestication process (Wang et al., 10One of the major challenges facing in situ conservation is that the majority of CWRs are poorly studied and may not have a lot of genomic information and resources which may be required to guide conservation management. For species with limited genomic information, there have been considerable advances in genomic technologies allowing genome wide marker discovery, even for poorly studied taxa. Genotyping by sequencing is a powerful marker technology which is suitable for species with no reference genome sequence (Elshire et al., The cost, computational requirements and necessary bioinformatic expertise for deploying genomics is high and may be beyond the reach of most conservation practitioners thus hindering its real world application (Flanagan et al., In future, genome editing might offer an opportunity to support PGR conservation by introducing novel alleles that confer adaptive capacity against climate change as well as removing deleterious ones that reduce fitness (Breed et al., The authors declare no conflict of interest.Peterson W. Wambugu wrote the first draft. Both authors contributed to the editing of the manuscript.


This study uses data from the 2017-2018 National Health and Aging Trends Study and the 2017 National Study of Caregiving to examine whether caregiving network configuration factors  and caregiver supports  are associated with consequences of unmet needs among older adults. Findings from this study will provide greater understanding of how caregiving contexts shape the quality of care and health of older adults who rely on help from family caregivers.


Youth radicalization is an ongoing and growing challenge worldwide , 2. AdolRadicalization Among Adolescents authors from various countries address this issue and illustrate how youth are disproportionately represented in radicalized networks across different continents. Now more than ever it is essential scholars and policymakers attempt to better understand the underlying mechanisms and factors driving youth radicalization and formulate effective policies and interventions. In addition to addressing this priority, this Research Topic also considers the role that psychopathological factors play in individual processes of youth radicalization and examines how young people who hold extremist views and experience psychological vulnerabilities, can be best supported by professionals.In the Frontiers for Psychiatry Research Topic: Miconi et al.); to social networks and psychological manipulation , mental health and trauma , and psychopathology . Several papers show that that the relationship between psychopathology and violent extremism is not straightforward or one-dimensional and that it interacts with other factors. One of several articles by French scholars illustrate that psychological trauma can create vulnerabilities to radicalization amongst youth. In such cases treatments targeting psychological trauma may be one way to prevent violent radicalization.A number of articles in this Research Topic, explore various underlying mechanisms of youth radicalization ranging from the influence of personal uncertainly and negative outlooks about life . This can increase the risk of biased and incorrect interpretations of what places youth at risk of radicalization. Prevailing public and political assumptions about the causes and manifestations of violent extremism can reinforce particular viewpoints and lead to inappropriate counseling and treatment options for radicalized youth across different ideological spectrums. How best to intervene with radicalized youth is a developing field of knowledge and experience is in its infancy. As Australian experience highlights, pluralistic, non-punitive multidisciplinary approaches can be used to address various developmental and psychosocial vulnerabilities, in addition to violent extremist risk factors amongst young offenders (Barracosa and March). These approaches should be supplemented by youth-specific practitioner expertise, and a range of violent extremism case management and risk assessment measures. In another paper by French scholars, the authors conclude that professionals must consider individual risk factors and vulnerabilities, but also need to tap into existing strengths, resilience and coping strategies that youth at risk of radicalization can possess and implement forms of psychotherapeutic support for this group .Among practitioners there can be a lack of specialist knowledge with regards to psychopathology and extremism among young people. A demonstrated by a Dutch paper such knowledge and expertise is not always available  and all raise important questions about youth radicalize and what can be done about it. This includes whether young people involved in violent extremism differ in their risks and vulnerabilities compared to adults who have radicalized or other “ordinary” delinquents? Does this therefore require different forms of tailored treatment? Findings from papers in this Research Topic are derived from cohort studies and individual case studies and all draw attention to overlapping and divergent factors and processes. While the evaluation of youth specific deradicalization programs is lacking [, BarracoAll authors listed have made a substantial, direct, and intellectual contribution to the work and approved it for publication.The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.


To gain an understanding of the attribution of patients to newly introduced Ontario Health Teams (OHT). OHTs are responsible for organizing and delivering health local care based on established connections between patients, their primary care providers, and hospitals. Furthermore, we aim to identify areas with poor geographic access to care.We used GIS analyses and maps to depict the attribution of patients to OHTs based on their uptake of primary care and hospital referral patterns. Residents of a specific local area can be attributed to different OHTs based on their prevailing health seeking choices. This leads to a creation of non-unique OHT ‘capture zones’, which may pose challenges in primary health care planning and delivery.The range of spatial analyses and maps used in this study helps to overcome some of these limitations and provides healthcare administrators with important geographic layer of information not available through other data summary methods.We used GIS analyses and maps to depict the attribution of patients to OHTs based on their uptake of primary care and hospital referral patterns. Residents of a specific local area can be attributed to different OHTs based on their prevailing health seeking choices. This leads to a creation of non-unique OHT ‘capture zones’, which may pose challenges in primary health care planning and delivery.The range of spatial analyses and maps used in this study helps to overcome some of these limitations and provides healthcare administrators with important geographic layer of information not available through other data summary methods.These attribution maps and data tables are an essential resource for planners and decisions makers in identifying priorities within the regional provision of primary care. This knowledge is essential to a better understanding of health care needs of local populations, and to implementing improvements in health care access.


Joy in Motion is a nationwide physical activity and well-being programme aimed at early childhood education and care (ECEC) launched in 2015 in Finland. The aim is to enable every child to be physically active and enjoy physical activity every day. Latest updates of the Finnish recommendations for physical activity in early childhood was published in 2016. The key message in the recommendations is Joy, play and doing together. Daily physical activity is just as important for children's well-being as healthy nutrition and sufficient sleep and rest. Presentations discuss the current state of the programme with more than 2200 registered early education units and provides concrete examples of the promotion work in practice.


The authors regret that the author contributions were incorrect in the original article. Two co-first authors were originally indicated, however Fangfang Zhao should be the only first author as indicated here.The Royal Society of Chemistry apologises for these errors and any consequent inconvenience to authors and readers.


This paper outlines a mixed methods research study conducted at three independent boarding schools  that all focus on sport and physical activity. In total independent boarding schools attracts more than 30.000 students per year, which makes it a very popular choice for young people. Interestingly, this particular type of schools have not been researched much.This study aims to provide an insight into the special qualities of Danish independent boarding schools and explore how a focus on sport and physical activity in relation to personal development of young people plays a role at three of these schools.The analyses are based on an online survey distributed to 1020 students at the participating schools in March 2019. In total, 865 students answered the survey. The purpose of the survey was to collect quantitative data on background issues, the students' motives for choosing independent boarding school life and to gain an insight into what the students' perceived as the special qualities of living on such a school - typically for one year. The quantitative findings are enriched by empirical findings and conclusions from qualitative data generated via six MSc theses.The survey results show that students to a great extent choose an independent boarding school based on the sports program (73%), facilities (69%) and sport performance levels (51%). The students point out getting new friends (92%), being a part of a community (92%), learning to collaborate (91%) and solving conflicts (88%) as some of the special qualities of life at independent boarding schools. The qualitative analyses reveals that sense of community, social interaction with fellow students and the relationship between teachers and students are perceived as the main qualities of this type of school life. Furthermore, the analyses points out that sport and physical activity can both hinder and promote qualities as the ones mentioned.The study contributes to new and important insights into a popular and unique type of school in Denmark, but more research is undoubtedly needed.


The corrected images for Figure The authors regret that the original version of our paper, unfortunately, contained incorrect pictures in Figure The correction made in this erratum does not affect the original data and conclusions. The authors apologize for any inconvenience that the errors may have caused.


Health systems are the central part of infrastructure in societies and their smooth operation is important for the continuation of a wide range of critical operations in any country. The COVID-19 pandemic has actualised questions on health system resilience defined as the system's ability to prepare for, manage  and learn from external shocks.. However, economic recessions as well as long- and short-term stresses related to aging, climate change and migration, and most recently a war have underlined that also in Europe the governments need to prepare their health systems to face different types of threats in order to guarantee effective protection to population health in their countries. The importance of the task to strengthen health system resilience has been comprehended at national and international level. International actors including WHO, OECD and World Bank have designed policy advice on strengthening health systems against external shocks, the European Union has launched programmes for preparing for future health emergencies, and individual countries are designing policy and system reforms allowing for health crises. In the workshop we address policies to strengthen health system resilience drawing on the experiences in three countries: Ireland which entered the COVID-19 pandemic with a legacy of the recent economic crisis hitting hard health care financing, Finland which has been implementing a major health care reform concomitantly with the pandemic, and Denmark which offers a case study on organisational learning from the pandemic within the hospital sector and chronic patient care. Based on these three case studies the workshop also contemplates whether learning from shocks is always helpful in terms of system transformation or whether they can also create path dependencies that weaken the systems’ ability to prepare for unknown threats. The workshop will broaden the view by discussing the trends of health system reforms in European countries and considering international advice on system and policy reforms to strengthen health system resilience.• Shocks create opportunities for reform and better performance and challenges through overloaded systems and fast decision-making.• Assuming all shocks are like the last weakens preparedness and adaptability.


There are development and advancement on concepts and methods for applications in neurorobotics that are continually achieved and published. This Research Topic provides a mini collection of up-to-date technologies and methods which address challenges and tackle limitations in neurorobotics. Those technologies and methods collected in this Research Topic involve various applications in neurorobotics ranging from human machine interface, rehabilitation, and treatment.Assessment methodology for human-exoskeleton interactions: Kinetic analysis based on muscle activation . A new assessment protocol on human-exoskeleton interaction that requires a fewer number of instruments and leads to an easier process was proposed.Kinetic parameters and effects associated with the interaction between human and exoskeleton based on electromyogram (EMG) and muscular activities were evaluated in Influence of proprioceptive training based on ankle-foot robot on improving lower limbs function in patients after a stroke . The experimental results suggest that the motor function and walking ability in patients after a stroke can be effectively improved from the proprioceptive training based on an ankle-foot robot.The influence of proprioceptive training on lower limb function in patients after a stroke was examined and presented in ClueDepth Grasp: Leveraging positional clues of depth for completing depth of transparent objects , a deep learning technique was developed for improving a perception on transparent objects for machines and robots. The better accuracy and successful employment of a humanoid robot grasping were achieved. The ClearGrasp dataset that is a set of images of transparent objects is made publicly available at https://sites.google.com/view/~cleargrasp/data?authuser=0.In Blind detection of circular image rotation angle based on Ensemble Transfer Regression and fused HOG  is another work that develops a deep neural networks model for improving a perception of machines and robots. The improved performance on accuracy of rotation angle estimation can be achieved using the ensemble transfer learning regression networks model.The comparison of electroencephalography power and event related potential in success and failure during multitask game . A significant difference in EEG power associated with a theta band (4–7 Hz) was evidenced. This finding thus implies that the theta power of EEG acquired from the frontal area of the brain can be applied for predicting the success or failure of the Go trial.A video game has been adopted as a part of treatment for children with attention-deficit hyperactivity disorder (ADHD). The brain activity of subjects during playing and interacting with a multitask game in virtual reality (VR) was focused in The author confirms being the sole contributor of this work and has approved it for publication.


Most of the lectures and workshops were offered via the Microsoft Teams platform. Student presentations were delivered virtually as well. Due to social distancing requirements, practical junior peer teaching opportunities were not available. We were surprised to observe high levels of enrolment during the virtual offering of the elective, with no decline in participant numbers.,,,Previous studies have evaluated the perceptions and experiences of student participants of similar teaching electives offered at institutions across North America.Future studies will be needed to examine the impact of the elective offered in the virtual format during the COVID 19 pandemic – and a shift in focus from observing and evaluating bedside and physical examination skills to evaluating virtual didactic presentations. Presently, 50% of medical schools in the United States (and only our institution in Canada) offer a dedicated fourth-year medical school elective in clinical teaching.The authors declare that they have no conflict of interest.