Public Health.

Background: The projected doubling of dementia prevalence by 2050 highlights the critical importance of altering the dementia trajectory and associated burden. Modifiable risk factors account for 40% of dementia risk (Livingston et al, 2020), including physical inactivity in late life. Protective effects of physical activity (PA) may be greater during earlier stages of neuropathological change, either directly by influencing the brain, or, indirectly by protecting against hypertension, obesity, and diabetes.

Developing Topics.

Background: Brain connectivity patterns, measured with Magnetic Resonance Imaging (MRI), have been recently studied as a potential biomarker for Alzheimer's disease dementia (AD). A 'disconnected brain' has been associated with greater cognitive impairment in pathological aging (Bennett & Madden, 2014), but it is unclear how this occurs in groups at risk of AD.

Method: Participants (n = 227; aged 55+ years) from the Dementia Prevention Research Clinic, New Zealand, were classified as control (C; n = 35), subjective cognitive decline (SCD; n = 60), single-domain amnestic mild cognitive impairment (aMCI; n = 54), multiple-domain MCI (mMCI; n = 52), and AD (n = 26).

Integrated Approaches for the Delivery of Maternal and Child Health Services with Childhood Immunization Programs in Low- and Middle-Income Countries: Systematic Review Update 2011-2020.

: The integration of maternal and child health services (MCH) with routine immunization is an important global health strategy, particularly in low- and middle-income countries (LMICs). However, evidence is lacking regarding the best practices for service integration and the effect of integration on immunization and linked health service outcomes. : We searched publication databases and gray literature for articles published between 2011 and 2020 that include approaches to integrating MCH services with immunizations during the first two years of life in LMICs.

Changing the trajectories of mental health difficulties in Norfolk and Suffolk: a research-priority-setting project with patients, the public, clinicians, policymakers and other stakeholders-study protocol.

Introduction: Mental health problems are the most significant cause of disability and have high annual economic costs; hence, they are a priority for the government, service providers and policymakers. Consisting of largely coastal and rural communities, the populations of Norfolk and Suffolk, UK, have elevated burdens of mental health problems, areas with high levels of deprivation and an increasing migrant population. However, these communities are underserved by research and areas with the greatest mental health needs are not represented or engaged in research.

Safety, tolerability, and efficacy of an in-class combination therapy switch from bosentan plus sildenafil to ambrisentan plus tadalafil in children with pulmonary arterial hypertension.

The aim of this single-centre retrospective observational study was to evaluate the safety, tolerability, and efficacy of an in-class combination therapy switch from bosentan plus sildenafil to ambrisentan plus tadalafil in children with pulmonary arterial hypertension. Children aged over 5 years who were established on sildenafil plus bosentan were offered to undergo a therapy switch from May 2014 to May 2021 and, if remaining in the service, followed up to May 2024. Children with Eisenmenger syndrome, open intra or extra-cardiac shunt, or with pulmonary hypertension-associated lung disease were excluded.