The study provided some quantitative support for suggestions arising from qualitative research about how perceptions of continuity/discontinuity in the relationship may impact on the caregiving spouse's emotional well-being. Helping couples to maintain a sense of continuity and couplehood may assist their emotional adjustment to dementia.

Background The field of digital health has grown rapidly in part due to digital health tools’ potential to reduce health inequities. However, such potential has not always been realized. The design approaches used in digital health are one of the known aspects that have an impact on health equity. Objective The aim of our scoping review will be to understand how design approaches in digital health have an impact on health equity. Methods A scoping review of studies that describe how design practices for digital health have an impact on health equity will be carried out. The scoping review will follow the methodologies laid out by Arksey and O’Malley, the Joanna Briggs Institute, and the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) checklist. The PubMed, Embase, Web of Science, and ACM Digital Library databases will be searched for peer-reviewed papers. The ProQuest Dissertations and Theses and Global Index Medicus databases will be searched for gray literature. The results will be screened against our inclusion and exclusion criteria. Subsequently, the data extracted from the included studies will be analyzed. Results As of March 2022, a preliminary search of the peer-reviewed databases has yielded over 4900 studies, and more are anticipated when gray literature databases are searched. We expect that after duplicates are removed and screening is completed, a much smaller number of studies will meet all of our inclusion criteria. Conclusions Although there has been much discussion about the importance of design for lowering barriers to digital health participation, the evidence base demonstrating its impacts on health equity is less obvious. We hope that our findings will contribute to a better understanding of the impact that design in digital health has on health equity and that these findings will translate into action that leads to stronger, more equitable health care systems.

A 44-year-old man presented to the emergency department with severe pain after an accident at the gym. He reported he had been doing squats while balancing a 200-kg bar across his trapezius. His knee gave way and he fell to the floor, with the weight landing on his lower back. The patient managed to crawl out from under the weight but did not attempt to walk. On arrival at the emergency department he had full power in both lower limbs and normal sensation to light touch in all dermatomes of the lower limbs. The area over vertebral bodies T11 through L2 was exquisitely tender. Initial frontal and lateral plain films (Panels A and B, respectively) and an axial computed tomographic study of the area from T12 through L1 (Panel C) showed fracture-dislocation. The patient was taken to the operating room that night for open reduction and internal fixation of the fracture-dislocation of vertebral bodies T12 through L1. Postoperatively, he had preservation of normal neurologic function, with the exception of mild paresthesia on both sides of his trunk in a T12 dermatomal distribution.

Purpose -This study sought to develop a predictive model of criminal risk in civil psychiatric populations, by determining the relative impacts of 1) psychopathy, 2) drug use, 3) impulsivity and 4) intelligence on levels of criminality.Design/methodology/approach -The sample consisted of 871 civil psychiatric patients, selected from the MacArthur Violence Risk Assessment Study, who had been diagnosed with a mental illness or personality disorder, and hospitalised less than 21 days. Each participant was administered the Hare Psychopathy Checklist Screening Version (PCL:SV), Barratt Impulsiveness Scale (BIS-11), and the Wechsler Adult Intelligence Scale (WAIS-R). In addition, information on background demographics, drug use and criminality was obtained via a self-report questionnaire.Findings -Pearson correlations identified significant positive relationships between past arrests, psychopathy, impulsivity, and drug use. Intelligence was negatively related to past arrests. Multiple regression identified a significant main effect for Factor 2 psychopathy on past arrests when controlling for all covariates, but not for Factor 1 psychopathy, intelligence or impulsivity. Drug use and gender had small univariate effects.Research limitations/implications -It is suggested that future research investigates the influence of specific mental disorders on different types of offending.Originality/value -By investigating predictors of criminal behaviour in civil psychiatric patients, the present study makes valuable contributions to the research literature, enhancing our theoretical understanding of the relationships between psychopathy and criminality/recidivism. It also has notable implications in applied practice, for example; in the development and refinement of risk assessment methods.

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