Athlete Psychological Resilience and Integration with Digital Mental Health Implementation Amid Covid-19

The current pandemic’s effect on mental health is uncertain with reports of it being largely negative related to loneliness and unemployment. There are different responses to pandemic stress with regards to cultural differences and social environment. Athletes are special in their experience of psychological resilience – there is a trend of positive adjustment to adversity and stress. However, further systematic review is required to confirm these findings along with an athlete-specific psychological resilience instrument. Key themes in relationships include a dichotomous mental health state marked by maladjustment and subsequent resilience, biopsychosocial factors as well as an array of cultural, social and environmental support and demands marked by stressors within and outside of sport. Digital mental health implementation is a logical next step for advancing the construct of athlete psychological resilience towards complementing an effective prevention and early intervention. However, mental health practitioners are grappling with digital mental health in a hybrid model of care. There is a need for converging on methodologies due to the rapid development of digital technologies which have outpaced evaluation of rigorous digital mental health interventions. The functions and implications of human and machine interactions require explainable and responsible implementation for more certain and positive outcomes to arise

Editorial: Athlete Psychological Resilience and Digital Mental Health Implementation

An athlete’s ability to adapt to stress and adversity is vital for their psychological resilience. While resilience has been traditionally considered from a physiological perspective in sports, in recent years, the importance of the mind–body connection has led to a growing interest in the field of athlete psychological resilience. In this Research Topic, we have received papers evaluating different approaches to psychological resilience in elite athletes, endurance athletes (ranging from competitive amateurs to professional athletes), and tactical athletes also known as high-performance military personnel. Three of the four articles of this collection primarily examined athlete psychological resilience and one article also focused on digital mental health implementation. Each article is presented separately because of the investigation of different types of athletes in addition to the exploration of cognitive and/or psychological resilience

Community perceptions of bushfire risk

The public often view and evaluate risk differently from researchers and experts. Understanding how the public construct their perceptions of risk can greatly improve risk communication, and direct risk reduction strategies most appropriately. This chapter explores the social construction of risk in two peri-urban bushfire-prone communities in Queensland. These case studies were undertaken in 2005 using a multiplemethods approach, which included group interviews with community and fire brigade members, and a community survey. While there are common factors that can similarly influence perceptions of bushfire risks within and between communities, there are often local-based issues unique to a community that have important implications for bushfire management. Through understanding and clarifying fire issues in communities, fire managers can address problems affecting bushfire risk mitigation in their local cOl1ullUnily. Engaging the community through a number of means could help considerably. The community should be viewed as a resource - communities have the capacity to act, despite vulnerabilities

Future use of natural gas under tightening climate targets

Natural gas has developed as a prominent energy source across the world over the last century. However, its use in the future will be constrained by evolving climate goals, and an optimal role for natural gas in a future 1.5°C world is debated. We conduct a systematic review of the literature, and analysis of the Intergovernmental Panel on Climate Change SR1.5 scenarios to understand the role of natural gas in a 1.5°C world. We also examine key factors that influence the use of gas such as Carbon Capture and Storage and Negative Emissions Technologies. We find that global gas use decreases more considerably under a 1.5°C target than 2°C with half of the 1.5°C scenarios reducing gas use by at least ∼35% by 2050 and ∼70% by 2100 against 2019 consumption. We find there is no correlation between the level of Negative Emissions Technologies and the permitted gas use in Intergovernmental Panel on Climate Change scenarios, while there is a strong correlation between gas use and the deployment of Carbon Capture and Storage. Regionally, there are considerable ranges in gas use, with the Organisation for Economic Cooperation and Development & European Union seeing the greatest decrease in use and Asia increasing use until 2050. Notwithstanding this uncertainty, global natural gas use is likely to decrease in the coming decades in response to climate goals

A compendium of ecological knowledge for restoration of freshwater fishes in Australia’s Murray–Darling Basin

Many freshwater fishes are imperilled globally, and there is a need for easily accessible, contemporary ecological knowledge to guide management. This compendium contains knowledge collated from over 600 publications and 27 expert workshops to support the restoration of 9 priority native freshwater fish species, representative of the range of life-history strategies and values in south-eastern Australia’s Murray–Darling Basin. To help prioritise future research investment and restoration actions, ecological knowledge and threats were assessed for each species and life stage. There is considerable new knowledge (80% of publications used were from the past 20 years), but this varied among species and life stages, with most known about adults, then egg, juvenile and larval stages (in that order). The biggest knowledge gaps concerned early life stage requirements, survival, recruitment, growth rates, condition and movements. Key threats include reduced longitudinal and lateral connectivity, altered flows, loss of refugia, reductions in both flowing (lotic) and slackwater riverine habitats, degradation of wetland habitats, alien species interactions and loss of aquatic vegetation. Examples and case studies illustrating the application of this knowledge to underpin effective restoration management are provided. This extensive ecological evidence base for multiple species is presented in a tabular format to assist a range of readers

Values of natural and human-made wetlands: A meta-analysis

The values of goods and services provided by wetland ecosystems are examined through a meta-analysis of an expanded database of wetland value estimates and with a focus on human-made wetlands. This study extends and improves upon previous meta-analyses of the wetland valuation literature in terms of the number of observations, geographical coverage, wetland class and integrity, and the measurement of the effects of scarcity and anthropogenic pressure. We find that water quality improvement, nonconsumptive recreation, and provision of natural habitat and biodiversity are highly valued services. Substitution effects are observed through the negative correlation between values and abundance of other wetlands. Wetland values are found to increase with anthropogenic pressure. An extended metaregression model with cross effects shows that the valuation of specific services varies with the type of wetland producing them. Human-made wetlands are highly valued for biodiversity enhancement, water quality improvement, and flood control

Convalescent plasma in patients admitted to hospital with COVID-19 (RECOVERY): a randomised controlled, open-label, platform trial

SummaryBackground Azithromycin has been proposed as a treatment for COVID-19 on the basis of its immunomodulatoryactions. We aimed to evaluate the safety and efficacy of azithromycin in patients admitted to hospital with COVID-19.Methods In this randomised, controlled, open-label, adaptive platform trial (Randomised Evaluation of COVID-19Therapy [RECOVERY]), several possible treatments were compared with usual care in patients admitted to hospitalwith COVID-19 in the UK. The trial is underway at 176 hospitals in the UK. Eligible and consenting patients wererandomly allocated to either usual standard of care alone or usual standard of care plus azithromycin 500 mg once perday by mouth or intravenously for 10 days or until discharge (or allocation to one of the other RECOVERY treatmentgroups). Patients were assigned via web-based simple (unstratified) randomisation with allocation concealment andwere twice as likely to be randomly assigned to usual care than to any of the active treatment groups. Participants andlocal study staff were not masked to the allocated treatment, but all others involved in the trial were masked to theoutcome data during the trial. The primary outcome was 28-day all-cause mortality, assessed in the intention-to-treatpopulation. The trial is registered with ISRCTN, 50189673, and ClinicalTrials.gov, NCT04381936.Findings Between April 7 and Nov 27, 2020, of 16 442 patients enrolled in the RECOVERY trial, 9433 (57%) wereeligible and 7763 were included in the assessment of azithromycin. The mean age of these study participants was65·3 years (SD 15·7) and approximately a third were women (2944 [38%] of 7763). 2582 patients were randomlyallocated to receive azithromycin and 5181 patients were randomly allocated to usual care alone. Overall,561 (22%) patients allocated to azithromycin and 1162 (22%) patients allocated to usual care died within 28 days(rate ratio 0·97, 95% CI 0·87–1·07; p=0·50). No significant difference was seen in duration of hospital stay (median10 days [IQR 5 to >28] vs 11 days [5 to >28]) or the proportion of patients discharged from hospital alive within 28 days(rate ratio 1·04, 95% CI 0·98–1·10; p=0·19). Among those not on invasive mechanical ventilation at baseline, nosignificant difference was seen in the proportion meeting the composite endpoint of invasive mechanical ventilationor death (risk ratio 0·95, 95% CI 0·87–1·03; p=0·24).Interpretation In patients admitted to hospital with COVID-19, azithromycin did not improve survival or otherprespecified clinical outcomes. Azithromycin use in patients admitted to hospital with COVID-19 should be restrictedto patients in whom there is a clear antimicrobial indication

Dimethyl fumarate in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial

Dimethyl fumarate (DMF) inhibits inflammasome-mediated inflammation and has been proposed as a treatment for patients hospitalised with COVID-19. This randomised, controlled, open-label platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), is assessing multiple treatments in patients hospitalised for COVID-19 (NCT04381936, ISRCTN50189673). In this assessment of DMF performed at 27 UK hospitals, adults were randomly allocated (1:1) to either usual standard of care alone or usual standard of care plus DMF. The primary outcome was clinical status on day 5 measured on a seven-point ordinal scale. Secondary outcomes were time to sustained improvement in clinical status, time to discharge, day 5 peripheral blood oxygenation, day 5 C-reactive protein, and improvement in day 10 clinical status. Between 2 March 2021 and 18 November 2021, 713 patients were enroled in the DMF evaluation, of whom 356 were randomly allocated to receive usual care plus DMF, and 357 to usual care alone. 95% of patients received corticosteroids as part of routine care. There was no evidence of a beneficial effect of DMF on clinical status at day 5 (common odds ratio of unfavourable outcome 1.12; 95% CI 0.86-1.47; p = 0.40). There was no significant effect of DMF on any secondary outcome

Dimethyl fumarate in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial

Dimethyl fumarate (DMF) inhibits inflammasome-mediated inflammation and has been proposed as a treatment for patients hospitalised with COVID-19. This randomised, controlled, open-label platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), is assessing multiple treatments in patients hospitalised for COVID-19 (NCT04381936, ISRCTN50189673). In this assessment of DMF performed at 27 UK hospitals, adults were randomly allocated (1:1) to either usual standard of care alone or usual standard of care plus DMF. The primary outcome was clinical status on day 5 measured on a seven-point ordinal scale. Secondary outcomes were time to sustained improvement in clinical status, time to discharge, day 5 peripheral blood oxygenation, day 5 C-reactive protein, and improvement in day 10 clinical status. Between 2 March 2021 and 18 November 2021, 713 patients were enroled in the DMF evaluation, of whom 356 were randomly allocated to receive usual care plus DMF, and 357 to usual care alone. 95% of patients received corticosteroids as part of routine care. There was no evidence of a beneficial effect of DMF on clinical status at day 5 (common odds ratio of unfavourable outcome 1.12; 95% CI 0.86-1.47; p = 0.40). There was no significant effect of DMF on any secondary outcome

Human-Computer Interaction in Digital Mental Health

Human-computer interaction (HCI) has contributed to the design and development of some efficient, user-friendly, cost-effective, and adaptable digital mental health solutions. But HCI has not been well-combined into technological developments resulting in quality and safety concerns. Digital platforms and artificial intelligence (AI) have a good potential to improve prediction, identification, coordination, and treatment by mental health care and suicide prevention services. AI is driving web-based and smartphone apps; mostly it is used for self-help and guided cognitive behavioral therapy (CBT) for anxiety and depression. Interactive AI may help real-time screening and treatment in outdated, strained or lacking mental healthcare systems. The barriers for using AI in mental healthcare include accessibility, efficacy, reliability, usability, safety, security, ethics, suitable education and training, and socio-cultural adaptability. Apps, real-time machine learning algorithms, immersive technologies, and digital phenotyping are notable prospects. Generally, there is a need for faster and better human factors in combination with machine interaction and automation, higher levels of effectiveness evaluation and the application of blended, hybrid or stepped care in an adjunct approach. HCI modeling may assist in the design and development of usable applications, and to effectively recognize, acknowledge, and address the inequities of mental health care and suicide prevention and assist in the digital therapeutic alliance