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Association of unmet healthcare needs with depressive symptoms and COVID-19 pandemic-related factors among adults, 2009-2022: a nationwide study in Korea
No full textBackground: To investigate the long-term trends in prevalence and pandemic-related factors of unmet healthcare needs among a nationwide large-scale cohort with or without depressive symptoms from the Korea Community Health Survey.Methods: We analyzed 2,850,315 Korean adults aged 19 years or older, including individuals with or without depressive symptoms. Our study investigated the trends and risk factors for unmet healthcare needs among individuals, stratified by the presence of depressive symptoms during the pre-pandemic (2009–2019) and pandemic era (2020–2022). Weighted odds ratios and weighted regression slope coefficients (β) with 95% confidence intervals (CIs) were employed to analyze the prevalence of unmet healthcare needs.Results: Of a total of 2,850,315 individuals (mean ± standard deviation age, 53.04 ± 17.43 years; male, 44.81%). Unmet healthcare needs decreased in both groups during the observation period. Individuals with depressive symptoms had a 2–3 times higher prevalence of unmet healthcare needs. The downward trend for those with depressive symptoms, from 34.55% (95% CI, 33.77–35.34) in 2009–2010 to 21.50% (20.91–22.09) in 2017–2019, reversed during the pandemic, increasing from 13.82% (12.95–14.69) in 2020 to 14.37% (13.62–15.12) in 2022.Conclusion: The study highlights increased unmet healthcare needs among individuals with depressive symptoms during the pandemic, emphasizing the necessity for tailored policies and effective healthcare distribution to reduce barriers for vulnerable populations during global crises.</p
Impact of Retinotomy on Retinal Displacement after Macula-Involving Retinal Detachment Repair: Post Hoc Analysis of the PostRD Trial
No full textPurpose:
To explore the effect of subretinal fluid drainage on the amplitude of retinal displacement and distortion following macula-involving retinal detachment repair.
Methods:
Post hoc analysis of the PostRD trial - patients who underwent a drainage retinotomy at the surgeon’s discretion were compared to break drainage. Primary outcome - amplitude of retinal displacement on autofluorescence imaging at 6 months postoperatively. Secondary outcome measures - operative success; visual acuity; objective Distortion Scores & OCT imaging outcomes.
Results:
262 patients recruited, 69 underwent drainage retinotomy. Re-detachment occurred in 11/69 (16%) of the retinotomy group versus 12/193 (6%) of the non-retinotomy group. Regression analysis revealed the extent of RD to be the only risk factor for failure. Failures were excluded. At 6 months, the retinotomy group had a lower amplitude of retinal displacement (P 0.02). Multivariable regression analysis showed that face down positioning and drainage retinotomy were both independent predictors for reducing amplitude of retinal displacement (P <0.01 and P 0.038) respectively, whilst extent of RD was a significant predictor for an increase in displacement (P 0.003).Visual acuity was higher in the retinotomy group (77 letters vs 74 non-retinotomy P 0.04) but similar when phakic patients were excluded (P 0.35). Objective D-Chart Distortion scores were lower (p=0.002). Retinal folds were more common in the retinotomy group (14.5% vs 8.7% non-retinotomy [P 0.004]).
Conclusion:
Retinotomy may be associated with a lower amplitude of displacement and lower distortion despite a higher incidence of retinal folds. No association was found between retinotomy and retinal re-detachment.</p
Digitalisation and Beyond: Economic Perspectives on Granular Energy Data
No full textEnergy transition relies on integrating renewable energy sources and end-use electrification. These pose operational, economic, and regulatory challenges on energy sector’s stakeholders. Through smart-metering, digitalisation enables suppliers to implement innovative dynamic tariffs and bundling services, while consumers are incentivised to adopt these bundled services and increase their demand flexibilities. Investments in grid digitalisation and real-time monitoring are crucial to achieve efficient, fast, and fair integration of renewables. In this paper we discuss the challenges posed by the implementation of digital solutions in the power sector and discuss the mapping from technological solutions to economic incentives, needed to examine their economic implications and trade-offs. This is needed to overcome unintended consequences and incentives posing obstacles towards the green transition, and ‘future-proof’ the energy systems. We build this mapping by exploring some key economic issues emerging from the diffusion of smart meter granular data, focusing on the impact of data interoperability, standardisation, and centralised vs decentralised solutions on efficiency, inequality, and market competition. Finally, we derive regulatory recommendations for a successful energy systems’ digitalisation.</p
Impact of animal socioecology on gut microbial communities: insights from wild meerkats in the Kalahari
No full textThe social organisation of animals likely shapes the composition, diversity and stability of microbiomes, giving rise to the concept of the ‘social microbiome’—microbial communities shared within and across social units, or ‘islands’, ranging from individuals to entire ecosystems. Understanding the connections and their underlying drivers is crucial for revealing how socioecology influences microbiomes and associated health outcomes. However, empirical assessments are still limited, and the relative influence of social organisation compared to intrinsic (biological) and extrinsic (environmental) factors in shaping microbiomes is particularly unclear. Here, we used a long‐term, individual‐based study of Kalahari meerkats ( Suricata suricatta ) to test predictions from the social microbiome concept. We assessed the relative influence of social factors, biological traits and environmental variables on gut microbial communities, while also accounting for the effects of microbial phylogenetic relatedness and within‐host associations or co‐occurrence independent of phylogeny. Meerkat microbiomes exhibited highly ‘nested’ and weakly ‘modular’ structures: individuals with lower diversity hosted amplicon sequence variants (ASVs) that were subsets of the overall community, though some bacterial taxa clustered distinctly among hosts. Microbiomes were more similar within social groups than between them. Group membership strongly influenced the co‐occurrence of many beneficial ASVs, as well as a few potentially harmful ones. This effect was stronger than that of kinship, though closer relatives shared more similar microbiomes within some groups. While a range of social, biological and environmental factors influenced bacterial abundance, group membership, individual age and sampling time since sunrise had the most significant impact. ASV‐ASV co‐occurrence within hosts, independent of phylogeny, also played a major role. In contrast, individual‐level social traits (e.g. dominance, immigration), other environmental (e.g. sampling temperature, rainfall, hours since foraging), demographic (sex) and health‐related factors (body condition, disease status) had weaker effects on bacterial abundance. We show that gut microbiomes are shaped by a combination of factors, highlighting the importance of separating the effects of social organisation from individual social traits, biological factors, environmental influences and microbe–microbe interactions. By identifying drivers of both beneficial and detrimental bacterial co‐occurrence, we provide a foundation for assessing how the social microbiome affects animal health and fitness.</p
The barriers and facilitators to primary care optometrists supporting patients with low vision in England
No full textIntroduction: Research suggests that patients with low vision identify optometrists as their core eye care provider within the community; hence, optometrists are well placed to provide support, advice and potentially certify patients. A qualitative study was conducted to ascertain the barriers and facilitators to primary care optometrists supporting patients with low vision. Methods: An online questionnaire used open‐ended questions to investigate optometrists' knowledge of the Certification of Vision Impairment and registration processes, and the barriers they faced when providing support to patients with low vision. Unmet training needs on low vision and whether optometrists would be happy to certify patients were also explored; data were analysed using deductive thematic analysis. Results: A total of 148 questionnaires were completed by optometrists in England between October 2023 and January 2024. Varying levels of knowledge were found regarding the certification and registration process. Three barrier‐related themes were identified. These were system barriers, practitioner barriers and patient barriers. Four themes were identified related to facilitators to supporting patients with low vision. These were training methods, training needs, low vision pathway, including optometrists' ability to certify patients and communication between services. Conclusions: With appropriate remuneration, optometrists reported positively with regard to upskilling and extending their scope of practice to ensure the best care for patients. Optometrists were found to be happy to certify patients if appropriate training and remuneration were received. This would involve the development of a funded Low Vision Pathway in England. Optometrists would benefit from further Continuing Professional Development training with elements from local Eye Clinic Liaison Officers, low vision practitioners and the Hospital Eye Service to improve knowledge around the certification and registration process and local support services available.</p
A Systematic Review of Staff Perspectives on Safety on Psychiatric Wards
No full textPatients on psychiatric wards encounter harm while receiving care, which leads to millions of fatalities every year. Understanding staff's perspectives on patients' safety on psychiatric wards is crucial for managing safety issues and concerns. This study aims to provide a reliable summary of the current evidence on staff's perspectives regarding safety on psychiatric wards. Studies were identified through systematic searches of six electronic databases. The characteristics of eligible studies were limited to peer‐reviewed qualitative research published in the English language within the last 10 years, which explored staff's perspective on patient safety in psychiatric wards. Seventeen studies met all the eligibility criteria. Data synthesis was performed using a thematic analysis approach, and four major themes were identified: perception of safety, safety interventions, therapeutic environment, staff and patients' safety. Patient safety on psychiatric wards is multifaceted, necessitating a balance between protection and autonomy, effective environmental design, compassionate care, and staff well‐being. Safety interventions must consider both patients' needs and the emotional and physical demands on staff to create a therapeutic and secure environment.</p
Coping, civilian transition, and gambling harm severity in UK armed forces veterans
No full textVeterans are prone to experiencing both mental health challenges and harm from gambling, yet little is known about the psychosocial factors that may increase risk. This study examined predictors of gambling harm severity in a sample of UK Armed Forces veterans with a focus on coping styles and reintegration into civilian employment. A cross-sectional survey was conducted among 414 former personnel using validated measures of gambling behavior, coping, and mental health symptoms including alcohol use. Of the 226 (54.6%) who had gambled in the past year, 3.1% had scores suggestive of problem gambling. Results showed that 46% of participants exhibited symptoms suggestive of posttraumatic stress disorder (PTSD), while 8.4% reported severe anxiety, 10.2% severe depression, and 11.1% high-risk alcohol use. Gambling harm severity was positively predicted by difficulties adapting to civilian employment and maladaptive coping strategies such as self-blame and substance use, while use of informational support was found to be protective. Given higher rates of primary care engagement among veterans, routine screening for gambling-related harm in such settings may improve early detection and intervention. The findings underscore the need for integrated mental health services that consider both psychological and social determinants of gambling harm severity in veterans during the military-to-civilian transition.</p
A systematic review into the application of ground-based interferometric radar systems for bridge monitoring
No full textGround-based interferometric radar (GBIR) is a powerful remote sensing technique used for infrastructure monitoring, particularly in the field of bridge structural health monitoring (SHM). Despite its high resolution and rapid data acquisition and the availability of various commercial systems, GBIR has not yet been fully recognised or routinely adopted in standard bridge monitoring practices. This study presents a comprehensive review of GBIR technologies and methods historically applied in bridge SHM. A total of 104 peer-reviewed papers were selected through a systematic review process, encompassing 128 monitored bridges assessed using a wide range of GBIR systems. The applications of GBIR across different bridge materials and operational conditions are discussed in detail. The review shows that 76% of GBIR applications focus on roadway and railway bridges. In terms of materials, steel and concrete bridges dominate the dataset, accounting for 95% of the total, while masonry bridges represent only 5%. The GBIR system types examined in this study are categorised into six main groups based on their technical specifications, with their key characteristics and capabilities analysed. The review also investigates bridge feature extraction techniques, revealing a predominant focus on identifying natural frequencies, while fewer studies explore the extraction of damping ratios and structural mode shapes. Furthermore, the integration of GBIR with other sensing technologies—particularly accelerometers—is explored, highlighting opportunities for complementary sensor fusion. Overall, this study provides a comprehensive overview of the current state of practice and identifies key areas for future research and technological development.</p
V-CARE (Virtual Care After REsuscitation): protocol for a randomized feasibility study of a virtual psychoeducational intervention after cardiac arrest—a STEPCARE sub-study
No full textBackground: Out-of-hospital cardiac arrest (OHCA) survivors and their relatives may face challenges following hospital discharge, relating to mood, cognition, and returning to normal day-to-day activities. Identified research gaps include a lack of knowledge around what type of intervention is needed to best navigate recovery. In this study, we investigate the feasibility and patient acceptability of a new virtual psychoeducational group intervention for OHCA survivors and their relatives and compare it to a control group receiving a digital information booklet. Methods: V-CARE is a comparative, single-blind randomized pilot trial including participants at selected sites of the STEPCARE trial, in the United Kingdom and Sweden. Inclusion criteria are a modified Rankin Scale (mRS) ≤ 3 at 30-day follow-up; no diagnosis of dementia; and not experiencing an acute psychiatric episode. One caregiver per patient is invited to participate optionally. The intervention group in V-CARE receives four semi-structured, one-hour-long, psychoeducational sessions delivered remotely via video call by a trained clinician once a week, 2–3 months after hospital discharge. The sessions cover understanding cardiac arrest; coping with fatigue and memory problems; managing low mood and anxiety; and returning to daily life. The control group receives an information booklet focused on fatigue, memory/cognitive problems, mental health, and practical coping strategies. Results: Primary: feasibility (number of patients consented) and acceptability (retention rate); secondary: satisfaction with care (Client Satisfaction Questionnaire 8 item), self-management skills (Self-Management Assessment Scale) and, where available, health-related outcomes assessed in the STEPCARE Extended Follow-up sub-study including cognition, fatigue, mood, quality of life, and return to work. Conclusions: If preliminary insights from the V-CARE trial suggest the intervention to be feasible and acceptable, the results will be used to design a larger trial aimed at informing future interventions to support OHCA recovery.</p
Introduction: Transitional Justice in the Age of Surveillance Capitalism
No full textThis chapter introduces the intersection between transitional justice and the evolving paradigm of surveillance capitalism, a model characterized by the extraction and monetization of personal data by corporations. As Shoshana Zuboff argues, this new form of capitalism enables tech giants to collect vast amounts of human data, shaping consumer behavior and influencing political processes. The chapter explores how this concentration of power poses ethical challenges and threats to democracy and human rights, particularly within the context of transitional justice. It questions whether traditional justice mechanisms can adequately address the widespread influence of corporations, whose digital surveillance technologies may facilitate new forms of oppression. Additionally, it delves into the legal implications of regulating corporate wrongdoing in the digital age, arguing for the necessity of adapting transitional justice frameworks to ensure accountability and non-repetition in a world increasingly dominated by data exploitation and corporate power.</p
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