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Chronic noncommunicable diseases (NCDs) such as asthma, diabetes, cancer, and persistent musculoskeletal pain impose an escalating and unsustainable burden on young people, their families, and society. Exploring how mobile health (mHealth) technologies can support management for young people with NCDs is imperative. The aim of this study was to identify, appraise, and synthesize available qualitative evidence on users' experiences of mHealth technologies for NCD management in young people. We explored the perspectives of both end users (young people) and implementers (health policy makers, clinicians, and researchers). A systematic review and meta-synthesis of qualitative studies. Eligibility criteria included full reports published in peer-reviewed journals from January 2007 to December 2016, searched across databases including EMBASE, MEDLINE (PubMed), Scopus, and PsycINFO. All qualitative studies that evaluated the use of mHealth technologies to support young people (in the age range of 15-24 years) in managing their chronic NCDs were considered. Two independent reviewers identified eligible reports and conducted critical appraisal (based on the Joanna Briggs Institute Qualitative Assessment and Review Instrument: JBI-QARI). Three reviewers independently, then collaboratively, synthesized and interpreted data through an inductive and iterative process to derive emergent themes across the included data. External validity checking was undertaken by an expert clinical researcher and for relevant content, a health policy expert. Themes were subsequently subjected to a meta-synthesis, with findings compared and contrasted between user groups and policy and practice recommendations derived. Twelve studies met our inclusion criteria. Among studies of end users (N=7), mHealth technologies supported the management of young people with diabetes, cancer, and asthma. Implementer studies (N=5) covered the management of cognitive and communicative disabilities, asthma, chronic self-harm, and attention deficit hyperactivity disorder. Quality ratings were higher for implementer compared with end user studies. Both complementary and unique user themes emerged. Themes derived for end users of mHealth included (1) Experiences of functionality that supported self-management, (2) Acceptance (technical usability and feasibility), (3) Importance of codesign, and (4) Perceptions of benefit (self-efficacy and empowerment). For implementers, derived themes included (1) Characteristics that supported self-management (functional, technical, and behavior change); (2) Implementation challenges (systems level, service delivery level, and clinical level); (3) Adoption considerations for specific populations (training end users; specific design requirements); and (4) Codesign and tailoring to facilitate uptake and person-centered care. Synthesizing available data revealed both complementary and unique user perspectives on enablers and barriers to designing, developing, and implementing mHealth technologies to support young people's management of their chronic NCDs. PROSPERO CRD42017056317; http://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD 42017056317 (Archived by WebCite at http://www.webcitation.org/6vZ5UkKLp).

Background Musculoskeletal pain is multidimensional and associated with significant societal impact. Persistent or chronic pain is a public health priority. A step towards high-value care is a contemporary understanding of pain. While pain-related knowledge has been examined in specific conditions (e.g. neck pain) knowledge of the public’s broader understanding regarding musculoskeletal pain per se , warrants investigation. This study examined the public’s knowledge and beliefs regarding musculoskeletal pain and pain management. Methods This observational cohort study was conducted in Guernsey (January 2019-February 2020). Participants ( n  = 1656; 76.0% female) completed an online questionnaire capturing: demographics, pain experience, work absenteeism, understanding of pain and pain management, multidimensional influences, physical activity, pain catastrophising and healthcare decision-making. Statements were deemed true/false/equivocal and mapped to biopsychosocial/biomedical/neutral perspectives based upon contemporary literature. Descriptive statistics were analysed for each statement. Participants’ responses were examined for alignment to a contemporary viewpoint and themes within responses derived using a semi-quantitative approach modelled on direct content analysis. Comparisons between participants with/without pain were examined (χ 2 -squared/Wilcoxon Rank Sum test). Results Within the cohort 83.6% reported currently experiencing pain. The overarching theme was perspectives that reflected both biomedical and contemporary, multidimensional understandings of pain. Sub-themes included uncertainty about pain persistence and evidence-based means to reduce recurrence, and reliance upon healthcare professionals for guiding decision-making. Compared to those with pain, those without had a greater belief that psychological interventions may help and lower pain catastrophising. Conclusions Participants’ understanding of pain demonstrated both biomedical and multidimensional pain understanding consistent with elements of a contemporary understanding of pain.

Species–environment relationships are often studied at large spatial scales, but effective conservation requires an understanding of local-scale environmental drivers and pressures. Widespread degradation and fragmentation of forests have increased the proportion of tropical mammal habitat that is affected by edge effects. Edge effects include greater exposure to anthropogenic disturbance and abiotic changes that synergistically influence how well populations can cope with climate change. We investigated relationships between distance to the forest edge, forest structure, microclimate and terrestrial mammal detections in a selectively logged forest at the boundary of Gunung Leuser National Park in Sumatra, Indonesia. We collected mammal detection data from motion-activated camera traps, microclimate data from automated climate data loggers and forest structure data from vegetation plots. Daily mean and maximum temperatures significantly decreased with distance from the forest edge, whereas tree height and minimum temperature increased. Mammal diversity was lower at the forest edge compared to the interior. Mammals were detected less frequently at the forest edge, although this relationship varied between mammal orders. Mammal detections were best explained by temperature, tree height and tree diameter at breast height. These results demonstrate that abiotic changes in forests brought on by edge effects have negative impacts on mammals, but these effects vary between mammal taxa because of differing sensitivities to human disturbance. Our findings highlight the importance of considering local-scale environmental drivers in determining species–environment relationships to identify key habitat features such as microclimate refuges that should be prioritized in ecosystem management.

Background Resilience refers to an individual’s ability to maintain effective functioning, by resisting, withstanding or recovering from stressors or adversity, including pain associated with physical injury (J Clin Psychol Med Settings 28:518–28, 2021). The aim of this scoping review is to determine the role of resilience in the experience of movement-evoked pain (MEP) and return to functional activity following a musculoskeletal injury. Methods This review conformed to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews and the scoping review protocol of the Joanna Briggs Institute (JBI). Five databases and one grey literature database were searched using predetermined key words and index terms to capture published and unpublished records on the topic. Two authors independently screened the title and abstract of each record, with the full-text of eligible records being reviewed. Papers were eligible for inclusion if they examined the population, concept and context of interest, were written in English and the full text was available. Data were extracted from each eligible record to guide discussion of the available literature on this topic. Results Of 4771 records, 2695 articles underwent screening based on their title and abstract. After title and abstract screening 132 articles were eligible for full text review, with 24 articles included in the final analysis. This review identified that psychological resilience has primarily been investigated in the context of a range of age-related pathologies. The choice of functional and movement-evoked pain assessments in the included studies were often guided by the pathology of interest, with some being general or injury specific. Conclusion This scoping review identified inconsistent conclusions regarding the role of resilience in the experience of MEP and the ability to return to function for older adults with a musculoskeletal injury. This scoping review highlights the need for longitudinal research to be conducted that allows a broader age range, including younger adults, to determine if multidimensional resilience may promote recovery form musculoskeletal injury.

Seven Action Targets of the Post-2020 Global Biodiversity Framework aim to address the direct threats to biodiversity: land- and sea-use change (Targets 1–3), overexploitation (Target 5), invasive species (Target 6), pollution (Target 7) and climate change (Target 8). Achieving these Action Targets will benefit many species, but a substantial number of threatened species will continue to decline without additional recovery actions (Bolam et al., 2020) and so Target 4 specifically aims to ‘ensure active management actions to enable the recovery and conservation of species’ (CBD, 2021). For the prioritization of actions, the Species Threat Abatement and Recovery metric (Mair et al., 2021) uses IUCN Red List data to calculate the relative contribution of threats to extinction risk at any spatial scale and can be used to measure how national actions may contribute to Action Targets and the reduction of species extinction risk.

Mobile health (mHealth) apps are increasingly being used by community members to track symptoms and manage endometriosis. In addition, clinicians use mHealth apps for continued medical education and clinical decision-making and recommend good-quality apps to patients. However, poor-quality apps can spread misinformation or provide recommendations that are not evidence-based. Therefore, a critical evaluation is needed to assess and recommend good-quality endometriosis mHealth apps. This study aimed to evaluate the quality and provide recommendations for good quality endometriosis mHealth apps for the community and clinicians. PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 guidelines informed the search of mHealth apps on the Google Play Store and Apple App Store. The search terms included \"endometriosis,\" \"adenomyosis,\" and \"pelvic pain.\" mHealth apps were eligible if they were (1) related to the search terms, (2) were in the English language, and (3) were available free of cost. Only the free content of the eligible mHealth apps was assessed. ENLIGHT, a validated evaluation tool for mobile and web-based interventions, was used to assess the quality across 7 domains such as usability, visual design, user engagement, content, therapeutic persuasiveness, therapeutic alliance, and general subjective evaluation. mHealth apps with a total score of ≥3.5 were classified as \"good\" according to the ENLIGHT scoring system and are recommended as good-quality mHealth apps for endometriosis care. In total, 42 mHealth apps were screened, and 19 were included in the quality assessment. A total of 6 good-quality mHealth apps were identified (QENDO, Bearable, Luna for Health, Matilda Health, Branch Health: Pain Management, and CHARLI Health). These apps provided symptom-tracking functions and self-management support. A total of 17 apps were designed for community use, while 2 apps provided a digital endometriosis classification tool to clinicians. Most mHealth apps scored well (≥3.5) in the domains of usability (16/19, 84.2%), visual design (14/19, 73.7%), user engagement (11/19, 57.9%), and content (15/19, 78.9%). Few eHealth websites scored well on therapeutic persuasiveness (6/19, 31.6%), therapeutic alliance (9/19, 47.4%), and general subjective evaluation (6/19, 31.6%). Although time and geographical location can influence the search results, we identified 6 \"good-quality\" endometriosis mHealth apps that can be recommended to the endometriosis community. mHealth apps designed for community use should evaluate their effectiveness on user's endometriosis knowledge, self-recommended management strategies, pain self-efficacy, user satisfaction, and user quality of life. Digital technology should be leveraged to develop mHealth apps for clinicians that contribute to continued medical education and assist clinical decision-making in endometriosis management. Factors that enhance usability, visual design, therapeutic persuasiveness, and therapeutic alliance should be incorporated to ensure successful and long-term uptake of mHealth apps. PROSPERO CRD42020185475; https://tinyurl.com/384dkkmj.

Background Endometriosis is a chronic inflammatory condition that is associated with painful periods and a variety of co-morbid symptoms for 10% of women and people presumed female at birth globally and upto 14% in Australia. Poor community and medical endometriosis awareness commonly leads to the normalisation of symptoms and dismissal of diagnostic or treatment needs. Community members often search for endometriosis information online. We explored the digital needs of those affected by endometriosis to support the co-creation of EndoZone, an evidence-based platform. Methods Thirty-six people participated in eight semi-structured focus group discussions conducted across Australia between March–May 2020. One was conducted face-to-face and the remaining focus groups were conducted online via Zoom conferencing due to the COVID-19 lockdown. Those living with endometriosis (young group aged 16–18 years [ n  = 9] and the adult group aged  ≥  19 years [ n  = 19]) and their supporters (parents and partners aged  ≥  18 years ( n  = 8)) were invited to participate in the focus groups. The discussions were audio-recorded and transcribed verbatim. Transcripts were thoroughly checked for accuracy. Meaningful codes were extracted and categorised using NVIVO 12 software through a thematic analysis approach. Categories were clustered into meaningful themes. Results The mean duration of focus groups was 1 h 55 min. The average age of those experiencing endometriosis and pelvic pain symptoms was 26.8 years, while the average age of supporters was 39.7 years. Participants primarily lived in major cities (53.6% - those experiencing endometriosis symptoms; 75% - supporters). Three main themes were identified: the need for (1) a central hub of endometriosis information (2), holistic strategies for symptom management and overall wellbeing, and (3) unique features to support the digital user experience. Conclusion This study demonstrated the value for an evidence-based digital platform for endometriosis in the Australian community. It was identified that different groups such as adolescents, young adults and supporters such as parents and partners, have unique and varied information needs. A digital platform that caters to these needs should incorporate unique tailoring approaches appropriate for each group, providing just-in-time information to manage acute pain episodes and creating a digital endometriosis community network. Trial registration N/A.

Understanding the neutral, biological, and environmental processes driving species distributions is valuable in informing conservation efforts because it will help us predict how species will respond to changes in environmental conditions. Environmental processes affect species differently according to their biological traits, which determine how they interact with their environment. Therefore, functional, trait-based modeling approaches are considered important for predicting distributions and species responses to change but even for data-rich primate communities our understanding of the relationships between traits and environmental conditions is limited. Here we use a large-scale, high-resolution data set of African diurnal primate distributions, biological traits, and environmental conditions to investigate the role of biological traits and environmental trait filtering in primate distributions. We collected data from published sources for 354 sites and 14 genera with 57 species across sub-Saharan Africa. We then combined a three-table ordination method, RLQ, with the fourth-corner approach to test relationships between environmental variables and biological traits and used a mapping approach to visually assess patterning in primate genus and species’ distributions. We found no significant relationships between any groups of environmental variables and biological traits, despite a clear role of environmental filtering in driving genus and species’ distributions. The most important environmental driver of species distributions was temperature seasonality, followed by rainfall. We conclude that the relative flexibility of many primate genera means that not any one particular set of traits drives their species–environment associations, despite the clear role of such associations in their distribution patterns.

IntroductionDespite the profound burden of disease, a strategic global response to optimise musculoskeletal (MSK) health and guide national-level health systems strengthening priorities remains absent. Auspiced by the Global Alliance for Musculoskeletal Health (G-MUSC), we aimed to empirically derive requisite priorities and components of a strategic response to guide global and national-level action on MSK health.MethodsDesign: mixed-methods, three-phase design.Phase 1: qualitative study with international key informants (KIs), including patient representatives and people with lived experience. KIs characterised the contemporary landscape for MSK health and priorities for a global strategic response.Phase 2: scoping review of national health policies to identify contemporary MSK policy trends and foci.Phase 3: informed by phases 1–2, was a global eDelphi where multisectoral panellists rated and iterated a framework of priorities and detailed components/actions.ResultsPhase 1: 31 KIs representing 25 organisations were sampled from 20 countries (40% low and middle income (LMIC)). Inductively derived themes were used to construct a logic model to underpin latter phases, consisting of five guiding principles, eight strategic priority areas and seven accelerators for action.Phase 2: of the 165 documents identified, 41 (24.8%) from 22 countries (88% high-income countries) and 2 regions met the inclusion criteria. Eight overarching policy themes, supported by 47 subthemes, were derived, aligning closely with the logic model.Phase 3: 674 panellists from 72 countries (46% LMICs) participated in round 1 and 439 (65%) in round 2 of the eDelphi. Fifty-nine components were retained with 10 (17%) identified as essential for health systems. 97.6% and 94.8% agreed or strongly agreed the framework was valuable and credible, respectively, for health systems strengthening.ConclusionAn empirically derived framework, co-designed and strongly supported by multisectoral stakeholders, can now be used as a blueprint for global and country-level responses to improve MSK health and prioritise system strengthening initiatives.