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To address societal challenges, research and innovation approaches, involving a wide range of actors, are increasingly promoted by policy communities. This paper explores the practice of Quadruple Helix collaborations for responsible innovation and how these implement the theoretical ambition of including actors from different societal sectors in innovation, including actors from the fields of arts, media and civil society, which is conceptualized as the Fourth Helix in this concept. Referring to cross-sector collaboration literature and based on an empirical investigation, we explore which actors, representing the Fourth Helix, actually engage in innovation collaborations, how this engagement plays out in practice, and the institutional and systemic dynamics involved in output and value creation. We rely on data from three Social Labs in Austria, Germany, and the Netherlands, which constitute qualitative, change-oriented research processes, where we researched and engaged with actors from cases constituting- or aiming for a Quadruple Helix collaboration. This was accompanied by a desktop study including qualitative interviews of 51 further cases. We find that the actual engagement of actors from civil society is fragile and that forces beyond Quadruple Helix cases impact these quite firmly in some cases.

BackgroundDigital public health (DiPH) interventions may help us tackle substantial public health challenges and reach historically underserved populations, in addition to presenting valuable opportunities to improve and complement existing services. However, DiPH interventions are often triggered through technological advancements and opportunities rather than public health needs. To develop and evaluate interventions designed to serve public health needs, a comprehensive framework is needed that systematically covers all aspects with relevance for public health. This includes considering the complexity of the technology, the context in which the technology is supposed to operate, its implementation, and its effects on public health, including ethical, legal, and social aspects. ObjectiveWe aimed to develop such a DiPH framework with a comprehensive list of core principles to be considered throughout the development and evaluation process of any DiPH intervention. MethodsThe resulting digital public health framework (DigiPHrame) was based on a scoping review of existing digital health and public health frameworks. After extracting all assessment criteria from these frameworks, we clustered the criteria. During a series of multidisciplinary meetings with experts from the Leibniz ScienceCampus Digital Public Health, we restructured each domain to represent the complexity of DiPH. In this paper, we used a COVID-19 contact–tracing app as a use case to illustrate how DigiPHrame may be applied to assess DiPH interventions. ResultsThe current version of DigiPHrame consists of 182 questions nested under 12 domains. Domain 1 describes the current status of health needs and existing interventions; domains 2 and 3, the DiPH technology under assessment and aspects related to human-computer interaction, respectively; domains 4 and 5, structural and process aspects, respectively; and domains 6-12, contextual conditions and the outcomes of the DiPH intervention from broad perspectives. In the CWA use case, a number of questions relevant during its development but also important for assessors once the CWA was available were highlighted. ConclusionsDigiPHrame is a comprehensive framework for the development and assessment of digital technologies designed for public health purposes. It is a living framework and will, therefore, be updated regularly and as new public health needs and technological advancements emerge.

BackgroundSocial health in the context of dementia has recently gained interest. The development of a social health conceptual framework at the individual and social environmental levels, has revealed a critical need for a further exploration of social health markers that can be used in the development of dementia intervention and to construct social health measures.ObjectiveTo identify social health markers in the context of dementia.MethodThis international qualitative study included six countries: Australia, Germany, Indonesia, Italy, Poland, and the Netherlands. Using purposive sampling, three to five cases per country were recruited to the study, with each case consisting of a person living with dementia, a primary informal caregiver, an active network member, and a health care professional involved in the care of the person with dementia. In-depth interviews, using an agreed topic guide, and content analysis were conducted to identify known and new social health markers. The codes were then categorized against our conceptual framework of social health.ResultsSixty-seven participants were interviewed. We identified various social health markers, ranging from those that are commonly used in epidemiological studies such as loneliness to novel markers of social health at the individual and the social environmental level. Examples of novel individual-level markers were efforts to comply with social norms and making own choices in, for example, keeping contact or refusing support. At a social environmental level, examples of novel markers were proximity (physical distance) and the function of the social network of helping the person maintaining dignity.ConclusionsThe current study identified both well-known and novel social health markers in the context of dementia, mapped to the social health framework we developed. Future research should focus on translating these markers into validated measures and on developing social health focused interventions for persons with dementia.

ObjectivesThis study aimed to develop and apply a structured approach for prioritising topics for systematic reviews in public health, framed according to the readily applicable PICO format, which encourages the involvement of stakeholders’ preferences in a transparent matter.MethodsWe developed a multi-stage process, consisting of a scoping and two Delphi stages with web-based surveys and invited public health stakeholders in Switzerland to participate: First, respondents specified topics for different public health domains, which were reformulated in a PICO format by content analysis. Second, respondents rated the topics using five stakeholder-refined assessment criteria. Overall rankings were calculated to assess differences between stakeholder groups and rating criteria.ResultsIn total, 215 respondents suggested 728 topics altogether. The response rate in the two Delphi stages was 91.6% and 77.6%, respectively. Most top-rated review topics focused on the effectiveness of interventions providing education to different target groups, followed by interventions to increase access to specific healthcare services.ConclusionOur approach encourages involvement of stakeholders in identifying priorities for systematic reviews and highlights disparities between stakeholders and between individual criteria.

Abstract Introduction There is an increasing emphasis on exploring ways to improve students' transition from the classroom into the clinical environment. Diagnostic radiography (DR) students undergo rigorous theoretical and practical training before they are exposed to the clinical environment. It has been found that when DR students commence clinical learning in the workplace for the very first time, they experience difficulties in this transition. At the site of investigation, a newly integrated and dedicated clinical preparedness (CP) programme was offered; however, little is known about the DR students' perceptions of this programme. Methods A qualitative approach coupled with a self‐developed, cross‐sectional research tool was employed. First‐year DR students were purposefully sampled against the inclusion and exclusion criteria. The principle of voluntary participation was upheld throughout the data collection process. The data were analysed using Braun and Clarke's six steps of thematic analysis. Results Forty‐two responses were collected. Following a thematic analysis, two overarching themes were developed, namely: (1) reflections on the CP programme and (2) suggestions for future CP programmes. Conclusion This study demonstrated the need for effective CP programmes as an approach to ease the transition of first‐year DR students from the classroom into the clinical environment. Several suggestions, for example, an extended CP programme and a clinical information pack were made for the offering of similar programmes in the future.

Introduction Compulsory admissions are associated with feelings of fear, humiliation and powerlessness. The number of compulsory admissions in Germany and other high-income countries has increased in recent years. Peer support has been shown to increase the self-efficacy of individuals with mental health conditions in acute crises and to reduce the use of coercive measures in clinical settings. The objective of this study is to reduce the number of compulsory admissions by involving peer support workers (PSWs) in acute mental health crises in outreach and outpatient settings.Methods and analysis This one-year intervention is an exploratory, cluster randomised study. Trained PSWs will join the public crisis intervention services (CIS) in two of five regions (the intervention regions) in the city of Bremen (Germany). PSWs will participate in crisis interventions and aspects of the mental health services. They will be involved in developing and conducting an antistigma training for police officers. The remaining three regions will serve as control regions. All individuals aged 18 and older who experience an acute mental health crisis during the operating hours of the regional CIS in the city of Bremen (around 2000 in previous years) will be included in the study. Semistructured interviews will be conducted with PSWs, 30 patients from control and intervention regions, as well as two focus group discussions with CIS staff. A descriptive comparison between all participants in the intervention and control regions will assess the proportion of compulsory admissions in crisis interventions during the baseline and intervention years, including an analysis of temporal changes.Ethics and dissemination This study was approved by the Ethics Committee of the University of Bremen (file 2022-09) on 20 June 2022. The results will be presented via scientific conferences, scientific journals and communicated to policy-makers and practitioners.Trial registration number DRKS00029377.

Every nation has its own language with distinctive features and historical background that differentiate between one another. Indonesian language and Afrikaans language is regarded to possess several historical resemblances. Indonesia was once colonized by the Dutch for 350 years, and therefore, some of the words or language structure in Indonesian language are influenced by Dutch language. In the meantime, South African people in the northern part of the country are very familiar with Dutch language. The study found out several similar words between Indonesian and Afrikaans language. The unique variations discovered in this study comprised: 1) similar spelling and pronunciation, 2) different spelling but similar pronunciation, 3) similar spelling but different pronunciation, and 4) almost similar spelling and pronunciation, but with similar meaning. Therefore, both languages are comparable in terms of identifying similarities and differences between both languages' sound and spelling. The study intended to provide a reference for the Indonesian Language for Foreign Learners ("Bahasa Indonesia bagi Penutur Asing," or henceforth, BIPA) teachers that conduct language teaching to the BIPA learners from South Africa. Vice versa, the BIPA learners will be able to comprehend Indonesian words following the dissemination of language kinship between Indonesian and Afrikaans language. Following that, the BIPA learning process will be more effective.

Abstract Background Research priority setting (RPS) studies are necessary to close the significant gap between the scientific evidence produced and the evidence stakeholders need. Their findings can make resource allocation in research more efficient. However, no general framework for conducting an RPS study among public health stakeholders exists. RPS studies in public health are rare and no such study has been previously conducted and published in Germany. Therefore, we aimed to investigate which research topics in public health are prioritised by relevant stakeholders in Germany. Methods Our RPS study consisted of a scoping stage and a Delphi stage each split into two rounds. Firstly, we invited members of the German Public Health Association to gather expert insights during two initial workshops. Next, we defined the relevant stakeholder groups and recruited respondents. Thereafter, we collected research topics and assessment criteria with the respondents in the first Delphi round and aggregated the responses through content analysis. Finally, we asked the respondents to rate the research topics with the assessment criteria in the second Delphi round. Results In total, 94 out of the 140 invited public health organisations nominated 230 respondents for the Delphi study of whom almost 90% participated in both Delphi rounds. We compiled a comprehensive list of 76 research topics that were rated and ranked by several assessment criteria. We split the research topics into two types, substantive research topics and methodological-theoretical research topics respectively, to ensure the comparability among the research topics. In both types of research topics—substantive research topics and methodological-theoretical research topics—the respective top five ranked research topics hardly differed between public health researchers and public health practitioners. However, clear differences exist in the priority ranking of many (non-top priority) research topics between the stakeholder groups. Conclusions This research demonstrates that it is possible, with limited resources, to prioritise research topics for public health at the national level involving a wide range of pertinent stakeholders. The results can be used by research funding institutions to initiate calls for research projects with an increased relevance for health and/or scientific progress.

Abstract Anthropogenic pressures on nature have been causing population declines for centuries. Intensified persecution of apex predators, like the golden eagle, resulted in population bottlenecks during the 19th and 20th centuries. To study population genetics and demographic history of the golden eagle throughout its distribution, we collected museum samples from previously underrepresented regions, such as Russia and Central Asia. We used 12 microsatellite loci and a fragment of the mitochondrial DNA control region to re‐evaluate phylogeography of Eurasian golden eagles and study the impacts of the population bottleneck. Our results revealed a north–south genetic gradient, expressed by the difference between Mediterranean and Holarctic lineages, as well as genetically distinct Northern Europe and Central Asia and Caucasus regions. Furthermore, Northern Europe exhibited the lowest, whereas Central Asia and Caucasus had the highest genetic diversity. Although golden eagles maintained relatively high genetic diversity, we detected genetic signatures of the recent bottleneck, including reduced genetic diversity and a decline in the effective female population size around the year 1975. Our study improves the knowledge of the genetic composition of Eurasian golden eagles and highlights the importance of understanding their historical population dynamics in the face of ongoing and future conservation efforts.

Orientation: The introduction of various incentive schemes in the South African workplace creates incentive-induced employee productivity spillovers but could differ between industries and geographic areas. Research purpose: The aim of the study was to determine the industry and geographic nature of incentive-induced employee productivity spillovers to inform managerial decision-making on intrinsic and extrinsic motivators. Motivation for the study: The introduction of incentive schemes is an important motivator of employee productivity in the workplace. For this study, it was deemed important to indicate whether incentive-induced employee productivity spillovers differ between industries and geographic areas by taking into consideration firm-size, firm-profitability, different incentive schemes, trade union presence, employee age and skill levels. Research approach/design and method: Fixed-effect panel data estimations were computed to predict incentive-induced employee productivity spillover effects based on secondary firm-based data sets. Main findings: Incentive scheme-induced employee productivity spillover effects were generally similar for all the different industry and geographic areas. The spillovers increased with greater firm-sizes, higher profitability levels, introduction of greater levels of monetary-based incentive schemes (especially for unionised employee segments), and allocation of incentive schemes to the middle- age employee grouping (35 years–55 years) as well as higher skilled employees. Practical/managerial implications: The effective introduction of incentive schemes in the workplace is an important mechanism for creating positive employee productivity spillover effects and it is generally common for all firms irrespective of the industry or geographic area. Contribution/value-add: Improved understanding of incentive-induced employee productivity spillovers in the South African workplace will enable the effective alignment of incentive schemes with firm profitability.

IntroductionThe use of recirculating aquaculture systems (RAS) to produce Atlantic salmon smolts has resulted in exceptionally high fish growth rates. However, there are potential negative trade-offs between fast growth and key physiological processes, such as inadequate smoltification and early sexual maturation, which can both be linked to body energy reserves.MethodsThis study determined the effect of i) dietary fat levels on Atlantic salmon whole-body fat and fatty acids composition, growth performance and smoltification and ii) a previous dietary regime on seawater growth performance and male early sexual maturation. In freshwater RAS, salmon parr (~19g) were fed 3 fat levels (20, 24, and 28%) over a 14-week period at 12°C. Subsequently, in seawater flow-through systems, smolt (~96g) were fed a control diet (26%) for 12 weeks at 2 temperatures (12 and 16°C).ResultsDietary fat levels resulted in differences in k-factor, fish whole-body fat and fatty acids composition; the low fat diet resulted in fish with a 23% lower whole-body fat when compared to the other two dietary groups at the end of the freshwater phase. These differences in whole-body fat faded at the end of the seawater phase. During the freshwater phase, all three feeds resulted in a comparable growth performance and smoltification indicator values, including k-factor, gill Na+, K+-ATPase, blood serum chloride and smolt index score. In contrast, water temperature resulted in fish body weight differences, where groups reared at 16°C were larger than those reared at 12°C. Nevertheless, both temperature regimes supported a similar thermal growth coefficient. Smolts grown at 16°C showed a higher level of the sex steroids androstenedione compared to those at 12°C. However, 11-ketotestosterone and testosterone levels did not differ despite a trend for higher levels at 16°C. Furthermore, testis histology at the final sampling indicated that some individuals showed initial signs of maturation (stage 3).DiscussionIn conclusion, varying dietary fat levels (20 - 28%) during the freshwater phase did not influence smoltification or male early sexual maturation during the subsequent grow-out phase. However, a temperature increase from 12 to 16°C resulted in larger fish and appeared to stimulate early male maturation in some fish individuals.

Soil crusting (surface sealing) is widespread and serious in ecotouristic game parks and reserves in southern Africa, and especially South Africa. In this study, mineral soil crusts were found to be the problem in the Dinokeng Game Reserve (DGR), South Africa. Large areas of bare soil crusted areas were found in this reserve. The cause of this crusting was found to be historical agricultural practices such as cultivation with maize on non-arable soils and overgrazing by cattle. Negative impacts of soil crusting include reduction of water infiltration, leading to increased runoff and erosion and induced drought; inhibiting soil aeration; inhibiting germination and seedling emergence; and inhibiting root functioning and development. In this study in the DGR, a bare crusted area, where cultivation was abandoned 50 years before and there has been no recovery to rangeland since then, was selected for a field trial to determine the effectiveness of the application of various soil ameliorants on soil crust alleviation and improvement of water infiltration rate. The following ameliorants were evaluated: polyacrylamide (PAM) at levels of 5 and 20 kg/ha, gypsum at 2.5 t/ha, and molasses meal at 5 t/ha, as well as combinations of PAM and molasses meal, PAM and gypsum and gypsum and molasses meal. Brush packing, without any ameliorant applied, was also included as treatment, as well as a control with no treatments. PAM treatments increased final infiltration rate (FIR) by between 100–206%. The high efficacy of the lowest PAM treatment is at a cost of only USD 15 per hectare economically important. On the studied soil gypsum application reduced FIR by 81%, while molasses meal had minimal effect. These ameliorants can therefore not be recommended on such soil.

Over the last hundred years, many large carnivore species have suffered range contractions, population losses, and habitat alterations that may be influencing their dietary preferences. To identify shifting isotopic niches and reconstruct past and present diets from species of high conservation concern, stable isotope analysis (SIA) of δ13C and δ15N values of tissue from museum collections and ongoing non-invasive monitoring programs offers an effective approach. Here, we assessed the long-term alterations in the trophic structure of a generalist large carnivore over a time of population loss and recovery. Wolverine stable carbon (δ13C) and nitrogen (δ15N) isotopes were measured in hair samples collected from 44 individuals in Finland for the period 1905–2020, and potential dietary were quantified using isotopic niche metrics shifts in two study areas. We provide evidence of a long-term diet shift in Finnish wolverines, with a temporal depletion of hair’s δ13C (β = −0.016‰, R² = 0.46, p < 0.001). Correspondingly, there was a shift in the isotopic niches of the Historical population (before the year 2000) and Recent population (after 2000), with the niche overlap between the Historical and Recent periods being only 33% throughout Finland, and even lower in the two study areas (22% to 24%). The breadth of the isotopic niche, however, did not significantly differ between the two periods, suggesting that despite a change in diet composition, wolverines did not specialize more. The trophic level of wolverines in Finland was stable throughout the study period, with no significant change in δ15N with time (β = 0.0055‰, R² = 0.043, p = 0.17). In summary: A) the strong trophic resilience of this top predator was shown by the stability of its niche breadth and trophic level feeding regime during periods of population decline and recovery as well as during a period of major anthropogenic alterations in their environment; B) the use of SIA methods on historical and recent hairs provided a unique tool to unravel long-term changes in wolverine feeding strategies.

Background: South Africa (SA), in 2021, experienced a wave of civil unrest following political events that led to mass looting and the destruction of property. Civil unrests, among other disruptions, have been seen to cause ripple effects on healthcare education, particularly for radiography students who undergo work integrated learning within hospitals and universities, even during these times of unrest. Aim: This study aimed to explore and describe the undergraduate diagnostic radiography students’ experience of the civil unrest that occurred in SA in 2021. Setting: The study was conducted across five universities in South Africa, offering the diagnostic radiography programme. Methods: A qualitative, interpretive phenomenological design was employed as it enabled the researchers to facilitate focus group interviews to gain insight into the lived experiences of the students during this time. Results: Four themes emerged from the study data, namely: (1) Negative effects on students’ emotional and psychological well-being, (2) Academic and clinical support mechanisms during disruptions, (3) The influence of disruptions on clinical training, (4) Recommendations to support students for future disruptions. Conclusion: The participants from this study described the negative effects that the civil unrest had on their emotional and mental well-being. There is a need for increased support mechanisms during times of disruptions from universities across South Africa. Contribution: The findings highlight the ripple effects that disruptions, such as civil unrests, have on radiography students. This can assist universities to relook at their institutional support structures, in order to enhance the current support given to students across universities in times of disruptions.

Background: Nigeria is among the top five countries that have the highest gap between people reported as diagnosed and estimated to have developed tuberculosis (TB). To bridge this gap, there is a need for innovative approaches to identify geographical areas at high risk of TB transmission and targeted active case finding (ACF) interventions. Leveraging community-level data together with granular sociodemographic contextual information can unmask local hotspots that could be otherwise missed. This work evaluated whether this approach helps to reach communities with higher numbers of undiagnosed TB. Methodology: A retrospective analysis of the data generated from an ACF intervention program in four southwestern states in Nigeria was conducted. Wards (the smallest administrative level in Nigeria) were further subdivided into smaller population clusters. ACF sites and their respective TB screening outputs were mapped to these population clusters. This data were then combined with open-source high-resolution contextual data to train a Bayesian inference model. The model predicted TB positivity rates on the community level (population cluster level), and these were visualised on a customised geoportal for use by the local teams to identify communities at high risk of TB transmission and plan ACF interventions. The TB positivity yield (proportion) observed at model-predicted hotspots was compared with the yield obtained at other sites identified based on aggregated notification data. Results: The yield in population clusters that were predicted to have high TB positivity rates by the model was at least 1.75 times higher (p-value < 0.001) than the yield in other locations in all four states. Conclusions: The community-level Bayesian predictive model has the potential to guide ACF implementers to high-TB-positivity areas for finding undiagnosed TB in the communities, thus improving the efficiency of interventions.

Abstract Background Dementia is a multi-factorial condition rather than a natural and inevitable consequence of ageing. Some factors related to dementia have been studied much more extensively than others. To gain an overview of known or suspected influential factors is a prerequisite to design studies that aim to identify causal relationships and interactions between factors. This article aims to develop a visual model that a) identifies factors related to cognitive decline that signal the onset of dementia, b) structures them by different domains and c) reflects on and visualizes the possible causal links and interactions between these factors based on expert input using a causal loop diagram. Method We used a mixed-method, step-wise approach: 1. A systematic literature review on factors related to cognitive decline; 2. A group model building (GMB) workshop with experts from different disciplines; 3. Structured discussions within the group of researchers. The results were continuously synthesized and graphically transformed into a causal loop diagram. Results The causal loop diagram comprises 73 factors that were structured into six domains: physical (medical) factors (23), social health factors (21), psychological factors (14), environmental factors (5), demographic factors (5) and lifestyle factors (3). 57 factors were identified in the systematic literature review, additionally 16 factors, mostly of the social health cluster, were identified during the GMB session and the feedback rounds. Conclusion The causal loop diagram offers a comprehensive visualisation of factors related to cognitive decline and their interactions. It supports the generation of hypotheses on causal relationships and interactions of factors within and between domains.

Robust feature selection is vital for creating reliable and interpretable machine-learning (ML) models. When designing statistical prediction models in cases where domain knowledge is limited and underlying interactions are unknown, choosing the optimal set of features is often difficult. To mitigate this issue, we introduce a multidata (M) causal feature selection approach that simultaneously processes an ensemble of time series datasets and produces a single set of causal drivers. This approach uses the causal discovery algorithms PC $ {}_1 $ or PCMCI that are implemented in the Tigramite Python package. These algorithms utilize conditional independence tests to infer parts of the causal graph. Our causal feature selection approach filters out causally spurious links before passing the remaining causal features as inputs to ML models (multiple linear regression and random forest) that predict the targets. We apply our framework to the statistical intensity prediction of Western Pacific tropical cyclones (TCs), for which it is often difficult to accurately choose drivers and their dimensionality reduction (time lags, vertical levels, and area-averaging). Using more stringent significance thresholds in the conditional independence tests helps eliminate spurious causal relationships, thus helping the ML model generalize better to unseen TC cases. M-PC $ {}_1 $ with a reduced number of features outperforms M-PCMCI, noncausal ML, and other feature selection methods (lagged correlation and random), even slightly outperforming feature selection based on explainable artificial intelligence. The optimal causal drivers obtained from our causal feature selection help improve our understanding of underlying relationships and suggest new potential drivers of TC intensification.

Background: In rugby, the shoulder contributes to attack/defence during collisions, tackling, falling, scrummaging, and mauling. We investigated the frequency, tissue, and pathology type of shoulder injuries per player position among professional South African rugby players, and compared injury severity in the context of momentum, intensity, and collision variables. Methods: A prospective study collecting shoulder injury data of 80 male Super Rugby players (>18 years) over 4 seasons (2018–2021). Players wore a Catapult Evo GPS unit during training and match-play, recording performance variables and collision forces during injury. We collected tissue and pathology types of injury from players’ medical files, clinical examinations, and special investigations. Results: Shoulder injuries contributed to 17% of all injuries, ranging from 2 to 34% per year. Forwards (63%) sustained most shoulder injuries, specifically locks (30%). Acromioclavicular (AC) joint (47%) was mostly involved, and ligament/joint capsule (65%) was the most common tissue type injured. Injuries with the highest average momentum resulted in players suffering minimal to mild severity injuries (1–7 days time-loss). Backs (631.15 kg·m/s) required less momentum than forwards (816.00 kg·m/s) to suffer injuries resulting in >28 days time-loss (p = 0.008). Backs encountered higher match intensity (67.76 m/min, p = 0.031) and highest average collisions (0.28/min) without suffering more severe (>28 days time-loss) injuries. Match intensity of >60 m/min resulted in more than 55% of shoulder injuries. Conclusion: One in six injuries in this cohort was shoulder-related. Forwards, specifically locks, sustained most shoulder injuries. The AC joint was the tissue type that mainly contributed. Backline players were involved in higher velocity contact, game intensity, and collision frequency but suffered fewer injuries. However, they required less momentum to sustain more severe injuries.

The widely used socioecological rainbow model from Dahlgren and Whitehead specifies determinants of health inequity on multiple hierarchical levels and suggests that these determinants may interact both within and between levels. At the time of its inception, digital determinants only played a minor role in tackling inequities in public health and were therefore not specifically considered. This has dramatically changed: From today's perspective, health inequities increasingly depend on digital determinants. In this article, we suggest adapting the Dahlgren-Whitehead model to reflect these developments. We propose a model that allows formulating testable hypotheses, interpreting research findings, and developing policy implications against the background of the global spread of digital technologies. This may facilitate the development of a new line of research and logic models for public health interventions in the digital age. Using the COVID-19 pandemic as a case study, we illustrate how the digitization of all aspects of life affects the different levels of determinants of health inequities in the Dahlgren–Whitehead model. In doing so, we deliberately argue for not introducing a separate digital sphere in its own right, but for understanding digitization as a phenomenon that permeates all levels of determinants of health inequities. As a result, we present a digital rainbow model that integrates Dahlgren and Whitehead's 1991 model with digital environments to identify current health promotion and research issues without changing the rainbow model's initial structure.

Background: Social health in the context of dementia has recently gained interest. The development of a social health conceptual framework at the individual and social environmental levels, has revealed a critical need for a further exploration of social health markers that can be used in the development of dementia intervention and to construct social health measures. Objective: To identify social health markers in the context of dementia. Method: This international qualitative study included six countries: Australia, Germany, Indonesia, Italy, Poland, and the Netherlands. Using purposive sampling, three to five cases per countrywere recruitedtothe study, witheachcase consisting of a person living with dementia, a primary informal caregiver, an active network member, and a health care professional involved in the care of the person with dementia. In-depth interviews, using an agreed topic guide, and content analysis were conducted to identify known and new social health markers. The codes were then categorized against our conceptual framework of social health. Results: Sixty-seven participants were interviewed. We identified various social health markers, ranging from those that are commonly used in epidemiological studies such as loneliness to novel markers of social health at the individual and the social environmental level. Examples of novel individual-level markers were efforts to comply with social norms and making own choices in, for example, keeping contact or refusing support. At a social environmental level, examples of novel markers were proximity (physical distance) and the function of the social network of helping the person maintaining dignity. Conclusions: The current study identified both well-known and novel social health markers in the context of dementia, mapped to the social health framework we developed. Future research should focus on translating these markers into validated measures and on developing social health focused interventions for persons with dementia. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to develop and apply a structured approach for prioritising topics for systematic reviews in public health, framed according to the readily applicable PICO format, which encourages the involvement of stakeholders' preferences in a transparent matter. Methods: We developed a multi-stage process, consisting of a scoping and two Delphi stages with web-based surveys and invited public health stakeholders in Switzerland to participate: First, respondents specified topics for different public health domains, which were reformulated in a PICO format by content analysis. Second, respondents rated the topics using five stakeholder-refined assessment criteria. Overall rankings were calculated to assess differences between stakeholder groups and rating criteria. Results: In total, 215 respondents suggested 728 topics altogether. The response rate in the two Delphi stages was 91.6% and 77.6%, respectively. Most top-rated review topics focused on the effectiveness of interventions providing education to different target groups, followed by interventions to increase access to specific healthcare services. Conclusion: Our approach encourages involvement of stakeholders in identifying priorities for systematic reviews and highlights disparities between stakeholders and between individual criteria. [ABSTRACT FROM AUTHOR]

Introduction: The use of recirculating aquaculture systems (RAS) to produce Atlantic salmon smolts has resulted in exceptionally high fish growth rates. However, there are potential negative trade-offs between fast growth and key physiological processes, such as inadequate smoltification and early sexual maturation, which can both be linked to body energy reserves. Methods: This study determined the effect of i) dietary fat levels on Atlantic salmon whole-body fat and fatty acids composition, growth performance and smoltification and ii) a previous dietary regime on seawater growth performance and male early sexual maturation. In freshwater RAS, salmon parr (~19g) were fed 3 fat levels (20, 24, and 28%) over a 14-week period at 12℃. Subsequently, in seawater flow-through systems, smolt (~96g) were fed a control diet (26%) for 12 weeks at 2 temperatures (12 and 16℃). Results: Dietary fat levels resulted in differences in k-factor, fish whole-body fat and fatty acids composition; the low fat diet resulted in fish with a 23% lower whole-body fat when compared to the other two dietary groups at the end of the freshwater phase. These differences in whole-body fat faded at the end of the seawater phase. During the freshwater phase, all three feeds resulted in a comparable growth performance and smoltification indicator values, including k-factor, gill Na+, K+-ATPase, blood serum chloride and smolt index score. In contrast, water temperature resulted in fish body weight differences, where groups reared at 16℃ were larger than those reared at 12℃. Nevertheless, both temperature regimes supported a similar thermal growth coefficient. Smolts grown at 16℃ showed a higher level of the sex steroids androstenedione compared to those at 12℃. However, 11-ketotestosterone and testosterone levels did not differ despite a trend for higher levels at 16℃. Furthermore, testis histology at the final sampling indicated that some individuals showed initial signs of maturation (stage 3). Discussion: In conclusion, varying dietary fat levels (20 - 28%) during the freshwater phase did not influence smoltification or male early sexual maturation during the subsequent grow-out phase. However, a temperature increase from 12 to 16℃ resulted in larger fish and appeared to stimulate early male maturation in some fish individuals. [ABSTRACT FROM AUTHOR]

Peracetic acid (PAA) is an oxidative disinfectant with a broad spectrum of antimicrobial activity and low environmental impact. In this study, we investigated the physiological impacts of PAA application in Atlantic salmon (Salmo salar) parr reared in freshwater recirculating aquaculture systems over a 4-week period. PAA at a target concentration of 1 mg/L was administered either in pulse (every 3 days) or continuous. The group that did not receive PAA served as a control. Fish tissue samples were collected for histology, gene expression, and biochemical analyses at day 0 and after 2 and 4 weeks of exposure. The expression of genes encoding for antioxidant defence in the olfactory organs, skin, and gills changed during the trial, but the temporal effects were more pronounced than inter-treatment impacts. The glutathione group of antioxidant genes was more responsive to PAA. In most cases, an upregulation was observed. Significantly lower levels of reactive oxygen species were identified in the plasma and skin mucus of the two PAA-exposed groups at week 4; nonetheless, significantly increased levels of total antioxidant capacity were only observed in the skin mucus of fish from the continuous treatment group. Additional markers of oxidative stress (i.e., 8-oxo-2′-deoxyguanosine and o,o'-dityrosine) were analysed in the skin, gills, liver, and dorsal fins. These markers were unaffected by the two PAA treatments. Sporadic reversible structural alterations were observed in the three mucosal organs; the changes were time-dependent, and the effects of PAA treatment were minimal. The number of mucous cells varied over time but not within treatments except in the skin of the pulse group at week 4 where a reduction was observed. The ratio of acidic and neutral mucous cells in the skin and gills were affected by PAA treatments especially in the pulse group. Overall, this study revealed that Atlantic salmon parr mobilised mucosal and systemic antioxidant defences against the oxidative disinfectant PAA, but it was evident that the mode of application did not impose a strong influence. The minimal effects of PAA application on the indicators of health and welfare underscore the potential use of PAA as a routine disinfectant in recirculating aquaculture systems.