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Repeated information is often perceived as more truthful than new information. This finding is known as the illusory truth effect, and it is typically thought to occur because repetition increases processing fluency. Because fluency and truth are frequently correlated in the real world, people learn to use processing fluency as a marker for truthfulness. Although the illusory truth effect is a robust phenomenon, almost all studies examining it have used three or fewer repetitions. To address this limitation, we conducted two experiments using a larger number of repetitions. In Experiment 1, we showed participants trivia statements up to 9 times and in Experiment 2 statements were shown up to 27 times. Later, participants rated the truthfulness of the previously seen statements and of new statements. In both experiments, we found that perceived truthfulness increased as the number of repetitions increased. However, these truth rating increases were logarithmic in shape. The largest increase in perceived truth came from encountering a statement for the second time, and beyond this were incrementally smaller increases in perceived truth for each additional repetition. These findings add to our theoretical understanding of the illusory truth effect and have applications for advertising, politics, and the propagation of “fake news.”

“Stereotype threat” is often thought of as a singular construct, with moderators and mechanisms that are stable across groups and domains. However, this is not always true. To illustrate this, the current review focuses on the stereotype threat that older adults face about their cognitive abilities. Drawing upon the multithreat framework, I first provide evidence that this is a self-concept threat and not a group-reputation threat. Because this differs from the forms of stereotype threat experienced by other groups (e.g., the threat that minority students face about their intellectual abilities), the moderators of stereotype threat observed in other groups (i.e., group identification) do not always generalize to age-based stereotype threat about cognitive decline. Looking beyond the forms of stereotype threat elicited, this review also provides evidence that the mechanisms underlying stereotype-threat effects may vary across the adult life span. Because of age-related improvements in emotion-regulation abilities, stereotype threat does not seem to reduce older adults’ executive-control resources. Overall, this review highlights the need to approach the concept of stereotype threat with more granularity, allowing researchers to design more effective stereotype-threat interventions. It will also shed light on why certain stereotype threat effects “fail to replicate” across domains or groups.

Strengthening health systems, addressing population ageing and advancing disaster preparedness have been central priorities in global public health research over recent decades. This editorial provides a retrospective overview of the WHO Centre for Health Development in Kobe, Japan, examining its role as an outposted WHO research centre and its contributions to evidence generation and policy support over a 30-year period. The overview describes the centre’s evolving research agenda, from early work on urban health and social determinants to leadership in ageing, long-term care systems and disaster risk management. It outlines contributions to universal health coverage through research on service delivery, financing and measurement of unmet care needs, as well as the development of policy tools, global research networks and methodological guidance. Collaboration with international and local partners, knowledge dissemination and capacity-building activities are also highlighted. The editorial notes the planned closure of the centre following the withdrawal of local financial support and documents its role in informing policy debates and supporting global health research.

In the past decade, the Government of China initiated health-care reforms to achieve universal access to health care by 2020. We assessed trends in health-care access and financial protection between 2003, and 2011, nationwide. We used data from the 2003, 2008, and 2011 National Health Services Survey (NHSS), which used multistage stratified cluster sampling to select 94 of 2859 counties from China's 31 provinces and municipalities. The 2011 survey was done with a subset of the NHSS sampling frame to monitor key indicators after the national health-care reforms were announced in 2009. Three sets of indicators were chosen to measure trends in access to coverage, health-care activities, and financial protection. Data were disaggregated by urban or rural residence and by three geographical regions: east, central, and west, and by household income. We examined change in equity across and within regions. The number of households interviewed was 57 023 in 2003, 56 456 in 2008, and 18 822 in 2011. Response rates were 98·3%, 95·0%, and 95·5%, respectively. The number of individuals interviewed was 193 689 in 2003, 177 501 in 2008, and 59 835 in 2011. Between 2003 and 2011, insurance coverage increased from 29·7% (57 526 of 193 689) to 95·7% (57 262 of 59 835, p<0·0001). The average share of inpatient costs reimbursed from insurance increased from 14·4 (13·7–15·1) in 2003 to 46·9 (44·7–49·1) in 2011 (p<0·0001). Hospital delivery rates averaged 95·8% (1219 of 1272) in 2011. Hospital admissions increased 2·5 times to 8·8% (5288 of 59 835, p<0·0001) in 2011 from 3·6% (6981 of 193 689) in 2003. 12·9% of households (2425 of 18 800) had catastrophic health expenses in 2011. Caesarean section rates increased from 19·2% (736 of 3835) to 36·3% (443 of 1221, p<0·0001) between 2003 and 2011. Remarkable increases in insurance coverage and inpatient reimbursement were accompanied by increased use and coverage of health care. Important advances have been made in achieving equal access to services and insurance coverage across and within regions. However, these increases have not been accompanied by reductions in catastrophic health expenses. With the achievement of basic health-services coverage, future challenges include stronger risk protection, and greater efficiency and quality of care. None.

Negative stereotypes about aging can impair older adults' memory via stereotype threat; however, the mechanisms underlying this phenomenon are unclear. In two experiments, we tested competing predictions derived from two theoretical accounts of stereotype threat: executive-control interference and regulatory fit. Older adults completed a working memory test either under stereotype threat about age-related memory declines or not under such threat. Monetary incentives were manipulated such that recall led to gains or forgetting led to losses. The executive-control-interference account predicts that stereotype threat decreases the availability of executive-control resources and hence should impair working memory performance. The regulatory-fit account predicts that threat induces a prevention focus, which should impair performance when gains are emphasized but improve performance when losses are emphasized. Results were consistent only with the regulatory-fit account. Although stereotype threat significantly impaired older adults' working memory performance when remembering led to gains, it significantly improved performance when forgetting led to losses.

Compared with younger adults, older adults have a relative preference to attend to and remember positive over negative information. This is known as the “positivity effect,” and researchers have typically evoked socioemotional selectivity theory to explain it. According to socioemotional selectivity theory, as people get older they begin to perceive their time left in life as more limited. These reduced time horizons prompt older adults to prioritize achieving emotional gratification and thus exhibit increased positivity in attention and recall. Although this is the most commonly cited explanation of the positivity effect, there is currently a lack of clear experimental evidence demonstrating a link between time horizons and positivity. The goal of the current research was to address this issue. In two separate experiments, we asked participants to complete a writing activity, which directed them to think of time as being either limited or expansive (Experiments 1 and 2 ) or did not orient them to think about time in a particular manner (Experiment 2 ). Participants were then shown a series of emotional pictures, which they subsequently tried to recall. Results from both studies showed that regardless of chronological age, thinking about a limited future enhanced the relative positivity of participants’ recall. Furthermore, the results of Experiment 2 showed that this effect was not driven by changes in mood. Thus, the fact that older adults’ recall is typically more positive than younger adults’ recall may index naturally shifting time horizons and goals with age.

Leading edge surface erosion is an emerging issue in wind turbine blade reliability, causing a reduction in power performance, aerodynamic loads imbalance, increased noise emission, and, ultimately, additional maintenance costs, and, if left untreated, it leads to the compromise of the functionality of the blade. In this work, we first propose an empirical spatio-temporal stochastic model for simulating leading edge erosion, to be used in conjunction with aeroelastic simulations, and subsequently present a deep learning model to be trained on simulated data, which aims to monitor leading edge erosion by detecting and classifying the degradation severity. This could help wind farm operators to reduce maintenance costs by planning cleaning and repair activities more efficiently. The main ingredients of the model include a damage process that progresses at random times, across multiple discrete states characterized by a non-homogeneous compound Poisson process, which is used to describe the random and time-dependent degradation of the blade surface, thus implicitly affecting its aerodynamic properties. The model allows for one, or more, zones along the span of the blades to be independently affected by erosion. The proposed model accounts for uncertainties in the local airfoil aerodynamics via parameterization of the lift and drag coefficients’ curves. The proposed model was used to generate a stochastic ensemble of degrading airfoil aerodynamic polars, for use in forward aero-servo-elastic simulations, where we computed the effect of leading edge erosion degradation on the dynamic response of a wind turbine under varying turbulent input inflow conditions. The dynamic response was chosen as a defining output as this relates to the output variable that is most commonly monitored under a structural health monitoring (SHM) regime. In this context, we further proposed an approach for spatio-temporal dependent diagnostics of leading erosion, namely, a deep learning attention-based Transformer, which we modified for classification tasks on slow degradation processes with long sequence multivariate time-series as inputs. We performed multiple sets of numerical experiments, aiming to evaluate the Transformer for diagnostics and assess its limitations. The results revealed Transformers as a potent method for diagnosis of such degradation processes. The attention-based mechanism allows the network to focus on different features at different time intervals for better prediction accuracy, especially for long time-series sequences representing a slow degradation process.

Background Against the background of the recruitment crisis in general practice, we aimed to determine what United Kingdom (UK) medical students value in their future careers, how they perceive careers in general practice (GP) and what influences them. Methods Cross-sectional survey of 280 final and penultimate year medical students at the University of Oxford, with questions relating to career choices, factors of importance when choosing a career and attitudes towards general practice as a career. Quantitative methods included cluster analysis, chi squared tests of independence and logistic regression analysis. Qualitative data were analysed thematically using the Framework method. Results Response rate was 89% (280/315). 40% of participants said that general practice was an attractive or very attractive career option. Respondents valued job satisfaction, work-life balance and close relationships with patients. However, fewer than 20% of respondents agreed that community-based working was important to them and many (often citing particular GPs they had observed) felt that general practice as currently structured may not be satisfying or fulfilling because of high workload, financial pressures and externally imposed directives. 63% perceived GPs to have lower status than hospital specialties and 49% thought the overall culture of their medical school had negatively influenced their views towards general practice. Some respondents considered that general practice would not be intellectually challenging or compatible with a research career; some appeared to have had limited exposure to academic primary care. Conclusions With the caveat that this was a sample from a single medical school, medical students may be put off careers in general practice by three main things: low perceived value of community-based working and low status of general practice (linked to a prevailing medical school culture); observing the pressures under which GPs currently work; and lack of exposure to academic role models and primary care-based research opportunities. To improve recruitment of the next generation of GPs, medical schools must provide high quality placements in general practice, expose students to academic role models and highlight to policymakers the links between the current pressures in UK general practice and the recruitment crisis.

Hospitals compose a large share of total health spending in most countries, and thus have been the target of reforms to improve efficiency and reduce costs. In China, the government implemented national health care reform to improve access to essential services and reduce high out-of-pocket medical spending. A key component is the comprehensive reform of public hospitals on a pilot basis, although it remains one of the least understood aspects of health care reform in China. This article outlines the main goals of the reform of public hospitals in China, progress to date and the direction of reform between now and 2015. Then, we review experiences from industrialized countries and discuss the applicability to the Chinese reform process. Based on the policy directions focusing on efficiency and quality, and reflecting on how hospital systems in other countries have responded, the article concludes that the hospital of the future in China operates at county level. Barriers to realizing this are discussed.