Mindfulness journal ranked first for the most published articles and citations. “The benefits of being present: Mindfulness and its role in psychological well-being,” written by Brown and Ryan, was the most cited article. Mindfulness, meditation, depression, intervention, stress reduction, stress, and anxiety are the top co-occurrence keywords. The timeline of cluster analysis discloses that before 2010, hypertension, cancer, mindfulness, generalized anxiety disorder, and other topics received great attention. In the decade since 2010, scholars have shown interest in meta-analysis, attention, and self-assessment, and keen attention to mindfulness-based interventions. These findings provide an important foundation to direct future research.This study comprehensively summarizes research in the field of meditation, especially mindfulness meditation from 1900 to 2021, by analyzing the knowledge map through CiteSpace and VOSviewer software. Using “mindfulness *” or “meditation *” as the topic, articles included in the Science Citation Index Expanded and Social Sciences Citation Index were searched in the web of science core database, resulting in the selection of 19,752 articles. Over half a century ago, Deikman published the field’s first article in the Journal of Nervous and Mental Disease in 1963, and publications have soared in subsequent decades. The USA is in the core position in terms of global collaboration, total publication numbers, and total citations. The  Meditation is comprised of a family of self-regulation practices that train attention and awareness to bring mental processes under greater voluntary control to thereby foster general mental well-being and development, and/or specific capacities such as calmness, clarity, and concentration . Among tIn recent decades, the research on mindfulness and meditation has developed rapidly, and a variety of topics have emerged ,6. For eTherefore, an analysis of the development, current status, and the relationships between key points and important events of the mindfulness and meditation literature is essential to inform the direction of future research.Bibliometrics is the cross-disciplinary science of quantitative analysis of all knowledge carriers by mathematical and statistical methods . It is nThe aim of this study was to reveal the inner structure pattern and citation landscape of mindfulness and meditation publications from a general perspective. CiteSpace and VOSviewer were used to analyze annual publication outputs, publication distributions by country and institution, author productivity, and collaboration patterns to provide an informed perspective on the evolution and development of mindfulness and meditation as a scientific discipline. Moreover, analyses of document co-citation networks, research clusters, and reference citation bursts were performed to offer insights into research topics and trend evaluations over time from different perspectives, thereby facilitating future research.Science Citation Index Expanded (SCI-E) and Social Sciences Citation Index (SSCI) articles from 1900 to 2021 (4 March 2021) were searched, with “mindfulness *” or “meditation *” as the theme, in the Web of Science Core Collection. Considering that mindfulness is an important part of meditation classification and the focus of the current research, and there is a mixture of mindfulness and meditation concepts in some studies ,28,29, “CiteSpace 5.3.R4  and VOSviewer 1.6.16  were used for knowledge mapping analysis. CiteSpace is a Java application for analyzing and visualizing co-citation networks . It suppVOSviewer is a software tool developed for constructing and viewing bibliometric maps. It constructs a map based on a co-occurrence matrix .In the visualizations, one node represents a project (such as an author or a country), the size of the node reflects its importance , and the color of the node signifies the group according to the default clustering method. Network connections denote collaborations between projects. The line width represents the intensity of collaboration. In this study, we used VOSviewer to make country collaboration, inter-institution collaboration, co-authorship, and co-citation networks.Before analyzing the results, all the inconsistencies in the bibliographic data were standardized and corrected. These inconsistencies appeared due to errors in the process of capturing the WOS data, abbreviations, and mistakes made by the authors in the references. For example, to prevent classification errors, we uniformly revised the expressions cognitive behavior therapy, cognitive behaviour therapy, cognitive behavioural therapy, cognitive-behavior therapy, and cognitive behavioral therapy to cognitive-behavioral therapy. The inconsistencies were checked by the first author. See Journal of Nervous and Mental Disease in 1963 [Meditation emphasizes mental development, such as bhavana  in Buddhism and lien-hsin (refining the mind) in Taoism. In Western definitions, meditation is a self-regulation strategy with a particular focus on training attention . The fir in 1963 . Eight sIn addition to Deikman’s research, Kabat-Zinn played an important role in the promotion of meditation. Among the top 10 most frequently cited articles, Kabat-Zinn contributed 3 articles . See During the century from 1900 to 1999, only 625 meditation articles were published . Journal of Personality and Social Psychology (JPSP) by Brown and Ryan (2003) [n (2003) , was citn (2003)  and “Minn (2003) , rankingPsychological Inquiry (1370 citations). Baer published highly cited articles in Assessment (2849 citations) and in Clinical Psychology-Science and Practice , while Kabat-Zinn wrote impactful papers in CPSP (2553 citations) and General Hospital Psychiatry (1666 citations).Among the top fifteen most cited publications, three authors contributed two articles each. For example, Brown published two highly cited articles in JPSP (4585 citations) as well as in Journal of Consulting and Clinical Psychology , which publishes articles regarding prevention and treatment in all areas of clinical and clinical–health psychology, and especially on topics that appeal to a broad readership. The journal addresses a wide range of topics that include epidemiology, the use of psychological services, as well as healthcare economics of behavioral therapy.The most cited source journal is JPSP, which publishes original papers in all areas of personality and social psychology, including attitude and social cognition, interpersonal relations and group processes, as well as personality processes and individual differences. Three highly cited articles were from CPSP , the official publication of the American Psychological Association Division 12, the Society of Clinical Psychology. The journal publishes papers regarding developments in the science and practice of clinical psychology and related mental health fields. Two articles were from the The total number of publications, total citations, and CP (citations/publication) can be used to analyze the impact of papers published in leading countries. The countries producing the most publications on mindfulness and meditation were the USA, England, Australia, Canada, Germany, the People’s Republic of China, The Netherlands, Spain, Italy, and India . The USANine of the ten most prolific institutions in the mindfulness and meditation field were located in the USA. The top three institutions were Harvard University, the University of Toronto, and the University of Washington. The top three institutions for total citations were Harvard University , the University of Massachusetts , and the University of Toronto , while articles from the University of Massachusetts (86.56), the University of Toronto (56.81), and the University of Wisconsin (51.24) generated the highest CP .Mindfulness Journal began recently, in 2010, as a journal dedicated to the mindfulness field, it has published the largest number of articles (1288), followed by Frontiers in Psychology (442) and Annals of Behavioral Medicine (269). Mindfulness ranked first in total citations , followed by Behavior Research and Therapy (9601 citations) and Personal and Individual Differences (6084 citations). Behavior Research and Therapy ranked first in CP (76.81), followed by the Journal of Clinical Psychology (54.39) and Consciousness and Cognition (38.33). Three articles were cited more than 1000 times, and these were Hayes et al. (2006) [Behavior Research and Therapy (2327 citations), Shapiro et al. (2006) [Journal of Clinical Psychology (1273 citations), and Davidson et al. (2003) [Psychological Medicine (1237 citations).. (2006)  from Behchology 4 and Anna. (2003)  from PsyThe results of our analysis of collaborations among countries (regions), institutions, and authors are presented in Link strength, literature quantity, and citations are the indicators of collaborative degree. The number of literature access was set to 30, and 264 of the 10,495 institutions meeting the standards were displayed. Keywords represent the highly concentrated content of literature research. The co-occurrence frequency of keywords can reflect dynamic trends of mindfulness and meditation research. Keywords with high frequencies reflect the focus of the research field. They identify advanced research methods, hot issues to be solved urgently, or academic topics of interest in particular timeframes.If two items (such as articles) are cited together in the references of a cited item, they are co-cited. The number of co-citations can be used to measure the similarity and correlation between articles. Journal co-citations, article co-citations, and keyword co-citations can be analyzed according to different project contents.Through the analysis of co-cited documents, we can obtain a knowledge base of a particular field. The research frontier is composed of a collection of cited literature that comprises these knowledge bases.The VOSviewer identified 96,779 journals. A co-citation relationship is defined by the simultaneous citations of two papers in a third paper . ReferenNext, the literature was divided into clusters. The log-likelihood test algorithm was used to extract nominal terms from the keywords of the cited literature and to name the clusters . To bettPublications receiving a surging citation frequency reflect emerging trends in scientific research fields. Citation bursts suggest increased scholarly attention to the corresponding publications. CiteSpace provides burst detection that can detect large changes in the number of citations in a particular timeframe, and is used to identify the declining or increasing use of a topic word or keyword. Our study provided a comprehensive perspective of the evolution and development of mindfulness and meditation literature. By using bibliometric methods and customized text mining techniques, we analyzed distribution , collaboration , and document co-citations .Journal of Nervous and Mental Disease. Consequently, mindfulness and meditation research have a long history. However, the numbers of mindfulness and meditation-related publications fluctuated at low levels during the 20th century. Since 2004, the number of publications has increased by more than 30% every few years. The citation rate has increased by more than 30% in over half of the years since 2002. At the same time, the prevailing trend in mindfulness and meditation literature has been towards increased collaboration among countries, institutions, and authors.First, the number of publications and citations may reflect the overall development of the mindfulness and meditation field. No papers on mindfulness and meditation were published until over half a century ago, when Deikman  publisheSecond, from the perspective of distribution, the USA has been the center of global collaboration, and its strength of cooperation has been much higher than that of other countries. The USA also has led other countries in total numbers of publications and citations. However, Canada ranked first in the CP. From the perspective of research institutions, Harvard University ranked first in total numbers of publications and citations, while the University of Massachusetts ranked first in the CP. Nine of the top ten institutions in the global field of mindfulness and meditation are located in the United States. Harvard Medical School has been at the center of inter-institution collaboration. Taken together, our data indicate that the USA is in the core position in the field of mindfulness and meditation.Mindfulness ranked first for the most published articles and citations. However, Behavior Research and Therapy ranked first in the CP. From the perspective of journal co-citation analysis, JPSP has the most co-citations and the largest link strength, followed by Mindfulness. Brown and Ryan are the most cited authors, due to multiple citations of their article: “The benefits of being present: Mindfulness and its role in psychological well-being” [Third, in terms of the influence of journals and authors, l-being” .Fourth, keyword analysis disclosed that in general, physical and mental health disorders such as depression, anxiety, stress, emotion regulation, and quality of life have been the primary research foci in the field of mindfulness and meditation, which reflects its wide therapeutic applications. At the same time, a large number of randomized controlled trials and meta-analyses have been completed. Researchers have also paid attention to validity of measurement tools and the mechanism of mindfulness and meditation.Mindfulness, and JCCP are the leading journals in the field of mindfulness and meditation. The common concerns of scholars include reviews and meta-analyses of the clinical utility of mindfulness and meditation, and these include the classic articles by the developers of MBSR, MBCT, and ACT, and mindfulness-related questionnaires. The timeline of cluster analysis discloses that before 2010, hypertension, cancer, mindfulness, generalized anxiety disorder, and other topics received great attention. In the decade since 2010, scholars have shown interest in meta-analysis, attention, and self-assessment, and keen attention to mindfulness-based interventions. The development of MAAS and FFMQ questionnaires and the studies of the clinical efficacy of mindfulness and meditation showed the strongest bursts. A review of the effect of MBCT on preventing recurrent depression showed the earliest citation burst.Fifth, JPSP, Recently, another article using the bibliometric method to analyze mindfulness hotspots was published . In contCitation bursts reflect the emerging trends in scientific research fields and suggest the future directions. Tang et al., (2015)  showed tIt is essential to pay attention to misinformation and poor methodology in previous mindfulness studies, with a particular focus on assessment, mindfulness training, possible alternative effects, and intersection with brain imaging in the future . ScholarFurthermore, effectiveness studies that carefully consider how to reach out to communities of need with evidence-based, cost-effective, and sustainable mindfulness interventions are needed in the coming years . The timAlthough meditation can be roughly divided into focused attention meditation and open monitoring meditation, it is difficult to separate specific meditation techniques , so the subcategories of meditation were not compared in this study.The names of the clusters were obtained by extracting terms from the keywords of the references through the log likelihood test algorithm. Since over 19,752 articles were identified, it was impossible for the authors to refine and analyze the content of each article. Since the articles were not randomly checked as to whether they are related to the topic, this may be problematic because some terms, such as meditation, have multiple meanings in English, some of which are irrelevant. Another major limitation is that the search was limited to databases  that mainly include English publications, excluding most journals published in other languages. This will bias the results. For example, if Chinese or Korean databases were included, the results may be very different from those of a large number of papers in East Asia.As an interdisciplinary science of quantitative analysis, bibliometrics can predict the status and development trend of mindfulness and meditation. Despite these advantages, it cannot recommend which method is better through indicators such as effect size, as in meta-analysis. Furthermore, bibliometric analysis is mainly based on the abstract, title, keywords, and references, without checking the full text of the paper, which also affects the final results.In conclusion, this study provided a comprehensive review and intuitive analysis of publications related to mindfulness and meditation from 1900 to 2021. Using two effective bibliometric tools, VOSviewer and CiteSpace, this paper analyzed status and development trends of this field from many perspectives, and may inform future research in the field of mindfulness and meditation.


Handbook of Positive Youth Development: Advancing Research, Policy, and Practice in Global Contexts edited by Profs. Radosveta Dimitrova and Nora Wiium combine theory, empirical research, and practical considerations for relevant policy and practice. The volume includes 37 distinctive chapters covering a multitude of theoretical and methodological approaches with youth and young adults from diverse cultures, ethnics, and sociodemographic backgrounds. With unique samples and global approaches to research, policy, and practice, this volume presents the most inclusive collection of Positive Youth Development (PYD) among youth and emerging adults to date.The The introductory chapter provides an overview of the main models of PYD, namely, the developmental assets , one of the leading scholars in PYD research and intervention, especially in Asia. In his brief overview, Shek summarizes several unique features and relevant conceptual and methodological contributions. Next, all 37 chapters are organized along with two major categories with empirical contributions, including a substantial number of youth and emerging adults  in major geographical continents, many of which are neglected in the research literature on adolescence. Part I, Positive Youth Development in Global Contexts; Part II, Positive Youth Development Applications and Interventions were structured to represent first, the most neglected cultural contexts and populations around the globe. The final chapter by John Geldhof, Svea Olsen, and Asia Thogmartin , leading PYD scholars in the U.S. and globally, represents an overview of the contributions to the PYD field, with a relevant outlook for research, policy, and practice. This volume represents a valuable scholarly resource for students, researchers, lecturers, and practitioners, interested to promote and advance PYD scholarship globally and specifically in underrepresented contexts.This volume begins with a handbook may be useful for social scientists, psychological, mental and public health professionals, researchers, practitioners, and youth leaders interested in promoting PYD from a variety of disciplines .The editors recommend this exciting volume to students, researchers, specialists, and stakeholders, such as policymakers who are committed to improving the lives of young people globally. This The author confirms being the sole contributor of this work and has approved it for publication.The author declares that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.


With the unprecedented expansion of COVID-19 in the world since December 2019, Iran’s health system, like other countries, faced various challenges in managing the disease, which led to numerous experiences and lessons learned. This study was conducted to identify these challenges regarding unique political, economic, and cultural issues, which could help other countries with similar situations.The present study was performed using a qualitative multi-method approach with a content analysis method. The data were collected through in-depth and semi-structured interviews and focused group discussions with 60 key persons who were selected purposefully, including policymakers, health care workers, and affected people by the disease, and the review of all available national reports between February 21, 2020, and March 22, 2021. The data collection and analysis were done simultaneously.Identified critical challenges for the management of COVID-19 in the health system were limited evidence and scientific controversies, poor social prevention and social inequalities, burnout and sustained workload among healthcare workers, improper management of resources and equipment, the lack of a guideline for contact tracing, and patient flow management, and mental health problems in the community.According to our results, measures should be taken to conduct a continuous comprehensive risk assessment and develop a national response plan with an emphasis on precise contact tracing, active screening, patient flow, paying attention to the psychological and social dimensions of the disease, and also transparency of social inequalities in the face of risk factors of the COVID-19. Also, the social protection programs should become a vital tool for policymakers and supporting the vulnerable groups using the capacity of the community and international cooperation to develop a vaccine, which is difficult to procure due to the sanctions. The pandemic of coronavirus disease 2019 (COVID-19) has led to a high rate of morbidity and mortality and imposed a burden of billions of dollars [The rapid spread of the disease with several waves and peaks for around a year and a half has imposed a lot of pressure on the health system and the other parts of the community worldwide. Many health care professionals are on the front lines of battling the COVID-19 public health crisis, and many hospitals are overwhelmed with suspected or infected cases of COVID-19. This global pandemic can be characterized by the complexity of its origin, the speed of its spread, and the unpredictability of its scale and impact . QuarantThere is still significant ambiguity as the pandemic continues to evolve. COVID-19 vaccines have started to be rolled out in countries worldwide, but this does not mean the crisis is close to being solved or people can return to normal life . We are On February 19, 2020, Iran confirmed two patients that were infected with the COVID-19 in Qom city, and more cases were reported in Tehran in a few days later . The sprThe present study was carried out with a multi-method approach using qualitative content analysis to explore a deeper understanding of the experiences gained from managing COVID-19 in Iran. The study was started with a focus group discussion (FGD.) with 60 key persons in five groups of people with different experiences and backgrounds from various departments to explore the health system’s challenges to manage COVID-19 in Iran. These FGDs were conducted at two intervals of 3 months, started in August 2020.Following FGDs and to develop the explored concepts, in-depth individual interviews were conducted. It is noteworthy that according to the rules of social distance at the time of the COVID-19 outbreak, the interviews were conducted by telephone or via Skype. A total of 60 people participated in FGDs, of whom 30 cases were recruited for in-depth interviews. The study participants were selected purposefully and sampling was continued until saturation  between February 21, 2020, and March 22, 2021.Simultaneously with data collection, qualitative content analysis was performed through the Graneheim and Lundman approach. In addition to the content of the selected documents and reports, the text of the FGDs and interviews was also transcribed and then, read several times, and the key points and concepts related to the objectives of the research were identified. Data were analyzed concurrently with data collection using content analysis. Interview transcripts were read to grasp participants’ perceptions and then, the meaning units were identified and coded with conceptual labels. Preliminary coding was performed and then, the codes were permanently compared in terms of similarity and difference. After this stage, each set of similar codes developed sub-categories and categories, and finally, challenges were explored –14.This study has several strengths. The information was collected and analyzed since the first time the country formed the Coronavirus Headquarters . Also, to improve the study power, the multi-method approach, including individual interviews, FGDs, and document analysis, was used.To evaluate the trustworthiness of the findings, Guba and Lincoln’s criteria, including credibility, transferability, dependability, and confirmability were applied . The resTo explore the challenges to manage COVID-19 in Iran, 60 people from different disciplines were studied  Measures to change the health behaviors of the community and improve self-care; 2) Social distance plans; and 3) Active screening, finding patients, and isolating COVID-19 cases, which were not wholly fulfilled.These interventions caused Iran to have acceptable success in the relative control of the first wave of the COVID-19 for several weeks. Our results showed that despite the efforts made, due to the limited evidence and scientific controversies, severe sanctions, the insufficient preparedness of society and the health system, lack of a plan for risk communication and community engagement, and after an early reopening, challenges arose in the management of the disease and the number of deaths and hospitalized people has increased for several times. The challenges explored by the study were classified into six main categories: the limited evidence and scientific controversies, inadequate attention to political, social, cultural, and economic issues and community involvement, burnout and sustained workload of health care workers, improper management of the resources and equipment, lack of updated and agreed guidelines for contact tracing and patient flow, and long-lasting community mental health problems and shortcomings in the support of vulnerable groups by the society.The nature of the COVID-19 and the way(s) it had spread globally are still unknown, which has led to the rapid spread of the disease in different countries. The transmission potential in asymptomatic, symptomatic, mild, and severe cases remains unknown. In some cases of COVID-19, we face inconsistencies between laboratory diagnosis and clinical and radiographic findings. In line with this part of the results, some studies have focused on the unknown nature of the virus and its complex etiologies , 17.In the early onset of a pandemic, there were discrepancies in the recommendations from health authorities, such as the World Health Organization (WHO) and Centers for Disease Control and Prevention (CDC) . The undThe political, social, cultural, and economic status of society was recognized as an influential factor. Social and religious norms, especially in traditional societies, affect the level of exposure of people. The existence of religious and traditional ceremonies that are accompanied by crowds has been an influential factor, and these aggregations have made social distancing measures more difficult , 25. TheIn some cases, some people due to poor economic conditions have not been able to provide disinfectants and masks, making it impossible to break the chain of infection. During the pandemic, different countries, based on their cultural needs and financial ability, have used different strategies and programs to control the disease. In India, the announcement of a nationwide home quarantine for 3 weeks from March 26, 2020, and the help of police forces to prevent people from leaving their homes, closing cultural and religious centers, stopping the tourism industry, and holding some popular Indian sports, such as cricket without spectators were some actions to control the disease . The impThe intensive work of health care providers during COVID-19 physically and emotionally has made them exhausted . AdequatIn this regard, Brazil has listed the benefits of official employees and employers from the short-term work programs supported by the government and unemployment insurance and payment for the first 15 days of sick leave to the employees who have tested positive for COVID-19. India has also allocated medical insurance for health care providers . In GermImproper management of resources and equipment was found to be one of the most effective barriers to control COVID-19 in this study. Several studies have also shown the importance of supply chain impact and resource scarcity –37.Equipment, such as PPE, ventilators, oxygen, and diagnostic kits should be available to control the disease . ProvidiContact tracing is an essential control measure to break the chains of COVID-19 transmission . BecauseFinally, to manage the next wave of the disease, it is recommended to make a clear decision on when to reopen educational centers, monitoring the implementation of social distancing protocols, establishing more strict and serious rules for traffic restrictions, quarantine of contacted and vulnerable people, real-time exchange of information with establishing a trustable communication with the people to educate and accompany them for quarantine and social distancing. Providing appropriate and timely social support for vulnerable groups can decrease the number of patients and deaths. Supporting the country to procure vaccines at least for vulnerable groups by the international community can help the health system to manage the next coming waves or peaks.Some limitations should be considered when interpreting the results of this study. The main limitation of this study like other qualitative studies is the lack of generalizability of the results, which is related to the nature and philosophical assumptions of the qualitative paradigm, which our study is not an exception. Because of the pandemic, it was not possible to do face-to-face interviews, which could help to explore more in-depth experiences of the study participants and probe unclear points of view. Moreover, some health care workers and policymakers were reluctant to participate in the study and share their experiences, and finally, some related reports were not available for analysis. To overcome these limitations, we tried to use the triangulation approach for data gathering, including FGD, in-depth individual interviews and document analysis, and selecting participants with maximum diversity of experiences.The results of this study indicated that considering the scientific controversies and using trustworthy evidence, paying attention to the political, social, cultural, and economic situation, burnout and sustained workload of health care workers, effective management of the resources and equipment, developing updated and agreed guidelines for contact tracing and patient flow, and planning for mental health in the community, and national social protection program are crucial factors to manage COVID-19. Assessing these challenges in the health system in response to COVID-19 can improve the knowledge of service providers and can be served as a primary framework for planning by the health system to enhance readiness to manage this long-lasting and devastating event and similar situations. This study indicated the need for public participation in the whole process of disease management, paying attention to social inequality in the face of the disease, and the need to address various aspects of the disease to deal with the disease. Continuous risk assessment, predicting possible scenarios for similar conditions, and developing a comprehensive national response plan are also recommended. Longitudinal studies are needed to fully understand the symptoms, the time of the pathogenesis, and the long-term effects of the disease on health and psychological, social, and other dimensions. Moreover, transparency of social inequalities faces risk factors so that sometimes economic resources are not eligible enough to provide adequate support to different groups in the society, especially vulnerable people. In Iran, extensive sanctions and insufficient resources have reduced the access of vulnerable groups to the vaccine, needed resources, and services. We believe that the complete transfer of disease management to the health sector has sometimes led to a lack of attention to other influential aspects of the disease, such as economic, social, and cultural dimensions. Countries that reopened early without a reduction in transmission rate are suffering from new spikes of contamination. However, countries that quarantined quickly and rigorously could control the virus more effectively. Finally, a strong risk communication strategy should remind citizens that the pandemic is not over, and also international collaboration is critical for manage this devastating pandemic.


The Clark Tibbitts Award lecture will feature an address by Debra Dobbs, PhD, FGSA in memory of the 2021 award recipient, Kathryn Hyer, PhD, FGSA. AGHE's Clark Tibbitts Award was established in 1980 and named for an architect of the field of gerontological education. The award is given each year to an individual or organization that has made an outstanding contribution to the advancement of gerontology and geriatrics education. The Hiram J. Friedsam Award lecture will feature an address by the 2021 award recipient, Pamela Elfenbein, MSW, PhD, FAGHE, HS-BCP. Hiram J. Friedsam was the professor, co-founder, and director of the Center for Studies in Aging and dean of the School of Community Service at the University of Northern Texas. Dr. Friedsam was an outstanding teacher, researcher, colleague, and mentor to students, faculty, and administrators, as well as a past president of AGHE. The purpose of this award is to recognize those who emulate Dr. Friedsam's excellence in mentorship.


International Journal of Women's Dermatology (IJWD), everyone agreed that making our reach as inclusive and international as possible was critically important. The WDS has members from five continents and, to that end, both the IJWD’s editorial board and advisory board also have international representation across the globe, including Argentina, Australia, Brazil, Denmark, France, Iran, India, Israel, Germany, Greece, the Philippines, and the United States. What does international actually mean? According to the Oxford English dictionary, international means “across several countries”; hence, the inclusion of articles from North America among articles from South America, Europe, the Middle East, Asia, and Oceania does not mean that articles contributed from the United States are not international. Otherwise, the term international would be misrepresented in a U.S.-centric view of the world.When the board of the Women's Dermatologic Society (WDS) voted in 2013 to approve the proposal by board members Drs. Dedee Murrell and Jane Grant-Kels to explore the feasibility of developing the Within the IJWD, our focus is not just on the skin and hair disease of women and their families, but also on issues faced by women in the field of dermatology in their careers. Dermatology is one of the most competitive fields of medicine to gain entry into and requires top grades in medical school, research and publications, and connections to go beyond just training and into a successful academic, public hospital, or private practice career, along with hopefully a good personal life. The IJWD's January 2020 issue focused on the gender gap in academic dermatology and the supporting the personal and professional lives of female dermatologists. The IJWD March 2021 issue focused on skin of color and diversity and inclusion initiatives. Both issues highlighted many of these aspects for patients and dermatologists alike .Another way that the IJWD and WDS foster the careers of women in dermatology is to enable them to submit and publish interesting case letters, research letters, clinical pearls, editorials, review articles, and original research to our journal. In this issue, our signature piece, the Women's Health Highlight, comes from India regarding an issue very important to women: hirsutism . We alsoInternational Journal of Dermatology, whose editor is also an Egyptian woman, Dr. Rokea el Azhary, from the Mayo Clinic. Cindy was born in Princeton, New Jersey, and was a Fulbright scholar in French-speaking Guinea, Africa. There, she met her future husband, who also became a Fulbright scholar in the United States. Cindy ran the ISD almost single handedly for many years. She died tragically in a car accident in Maryland  Froehlich . For morMaryland .The ISD's mentorship program, currently co-chaired by IJWD editorial board members Prof. Rashmi Sarkar from India and Dr. Martin Kassir from Dallas, has supported both female and male dermatologists from poor countries to learn from experts in other countries for periods of up to 3 months . Cindy w


Conclusions: The approval lag of vaccines was observed in the Asia-Pacific region, indicating a gap between the Asia-pacific region and the US and EU in regard to access to new vaccines. Future studies need to analyze the background factors related to the gap in availability and vaccine approval lag in the Asia-Pacific region and assess the impact of vaccine approval lag in the region.Background: The introduction of new vaccines has been delayed in some countries in the Asia-Pacific region, which has led to delays in accessing vaccines for target patients. However, the approval lag of vaccines in the Asia-Pacific region has not been assessed. The objective of this study is to assess the availability and approval lag of vaccines in Asia-Pacific countries and compare them among Asia-Pacific countries, the United States (US), and Europe (EU). Methods: The information on vaccines prequalified by the World Health Organization (WHO) between 2010 and 2019 was obtained primarily from the WHO website. The date of approval of the WHO prequalified vaccine in Australia, India, South Korea, Thailand, Singapore, Malaysia, the US, and EU was retrieved from the official website of national regulatory agencies. The vaccines were divided into two groups based on their first approval pathway, that is, vaccines that were first approved by SRA  and those that were first approved by non-SRA. The absolute approval lag represented the availability of the vaccine. Relative approval lag represented the lag time between the approval date of the country of interest and the first global approval date and was measured as the median approval lag. A Mann–Whitney U test was used to examine statistical differences between relative approval lag between the SRA first and the non-SRA first groups. Results: A total of 92 vaccines were prequalified by the WHO between 2010 and 2019, but only 61 vaccines were included in the analysis. Over 50% of vaccines were first licensed by non-SRAs. Of all the WHO-prequalified vaccines, the median approval lag in the ASEAN countries in this study was longer than those in the US and EU, with a median of 30 months in Australia, 15 months in South Korea, 52 months in Thailand, and 23 months in Singapore, compared to 0 months in the US and EU. The differences in approval lags between SRA first vaccines and non-SRA first vaccines were statistically significant in South Korea and Thailand ( Nearly two-thirds of the world’s population live in the Asia-Pacific region. The region has a high diversity in cultural, political, economic, and other areas that influence vaccine development, implementation, and registration ,2. In thHowever, the transformation was not equal across countries, and high-income and low-middle income countries still have different vaccine development, implementation, and registration processes. The differences in vaccine development in the region include all steps of vaccine innovation, production, and consumption. The region includes China, India, Indonesia, and Vietnam, which are eligible countries or graduate countries from the Global Alliance for Vaccines and Immunization (GAVI), a global public–private health corporation to help poor countries obtain access to vaccines with full financial support . HoweverThere is a delay in the introduction of new vaccines in some countries in the region . The delAsian-Pacific countries do not have a central regulatory approval process like the European Medicines Agency (EMA) in Europe or the Pan American Health Organization (PAHO), which coordinates regional vaccination programs and centrally purchases eligible vaccines . The divThere are several efforts to streamline regulatory requirements between countries and regions. There are also efforts to encourage mutual recognition practices between national regulatory authorities in an effort to preserve resources and time and avoid redundancy in Asia . For exaVaccines are a highly cost-effective intervention to prevent infectious diseases with rare serious adverse reactions . EffectiDespite the fact that understanding drug lag for vaccines is crucial for public health, there is no comparative study on the approval lag of vaccines in the Asia-Pacific region. We fill the gap in the literature and evaluate the availability and approval lag of vaccines in Asia-Pacific countries and compare among Asia-Pacific countries, the US, and EU.We collected information on vaccines that were prequalified by WHO between 1 January 2010, and 31 December 2019. The WHO prequalification is a systematic process to assess and ensure that healthcare products comply with international standards of quality, safety, and efficacy . WHO preInformation about commercial names, vaccine types, and dates of prequalification was retrieved from the WHO website. Information about the date of approval of the WHO prequalified vaccine in selected Asia-Pacific countries, the US FDA, and EMA was retrieved from the official websites of the drug approval agencies for each country .There were prequalified 92 prequalified vaccines between 1 January 2010 and 31 December 2019. We excluded different doses of the same vaccine products and used the fastest prequalified date among different doses of the same vaccine. We excluded vaccines that do not have proprietary brand names because of the difficulty encountered in collecting approval data and approved dates. Ultimately, 61 vaccines were evaluated in the present study .http://www.who.int/medicines/regulation/sras/en/ (accessed on 22 January 2021)) and those that were first approved by non-SRA (non-SRA first). The stringent regulatory authorities (SRA) are the national regulatory agencies, which are the members or observers, or associates of the International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH) [The 61 vaccines we extracted were divided into two groups based on their first approval pathway, that is, vaccines that were first approved by the stringent regulatory authority (SRA first) (the stringent regulatory authority (SRA) Australia, Austria, Belgium, Bulgaria, Canada, Cyprus, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Iceland, Ireland, Italy, Japan, Latvia, Liechtenstein, Lithuania, Luxembourg, Malta, Netherlands, Norway, Poland, Portugal, Romania, Slovakia, Slovenia, Spain, Sweden, Switzerland, United Kingdom, and United States of America . Organizse (ICH) .The vaccine approval date refers to the date of regulatory approval by the national regulatory authorities, including the US Food and Drug Administration (US FDA), the European Medicines Agency (EMA), the Therapeutic Goods Administration in Australia, the Central Drugs Standard Control Organization (CDSCO) in India, the Ministry of Food and Drug Safety (MFDS) in South Korea, the Thai Food and Drug Administration in Thailand, the Health Sciences Authority (HSA) in Singapore, and the National Pharmaceutical Regulatory Agency (NPRA) in Malaysia.We assessed and described the approval lag in terms of “absolute approval lag” and “relative approval lag”. Absolute approval lag is the percentage of newly approved vaccines in the countries of interest out of the total number of all studied vaccines. Relative approval lag is the delay in approval in a study country after the drug’s first approval .p-value of ≤0.05 was considered to indicate statistical significance. Statistical analysis was performed using SPSS version 25 .Continuous variables were shown as the median and range, and categorical variables were shown as the number and percentage. The median was used to compute drug lag, as it is less sensitive to extreme values than the average. The Mann–Whitney U test was used to examine the statistical difference between the relative approval lag between the SRA first and non-SRA first groups. A Characteristics of WHO-prequalified vaccines are summarized in The absolute approval lags of the studied vaccines are shown in Vaccines first approved and manufactured in the US or the EU are available in all selected countries. Those approved and manufactured in India are available in all selected Asian countries and EU, and those approved and manufactured in South Korea are licensed only in their own country and ASEAN, including Thailand, Singapore, and Malaysia .Diphtheria–tetanus–pertussis, hepatitis A, influenza A meningococcal, pneumococcal, and rotavirus vaccines were licensed in all selected countries. Among all vaccine types, influenza vaccines accounted for the largest proportion of the studied WHO-prequalified vaccines . South Korea approved 60% of the studied WHO-prequalified influenza vaccines . The Ebola vaccine was only approved in the US and EU, while Japanese encephalitis vaccines were only approved in Asian countries .Relative approval lags of the studied WHO prequalified vaccines are summarized in The relative approval lag of WHO prequalified vaccines by vaccine type is shown in The difference in relative approval lag between the SRA first and non-SRA first groups was examined only in India, South Korea, and Thailand because non-SRA first vaccines were not available in the US and because of the lack of approval date data for non-SRA first vaccines in other countries. Our findings showed that the difference between the relative approval lag between SRA first and non-SRA first groups in South Korea and Thailand is statistically significant .This study aims to evaluate the availability of vaccines and the delay in access to vaccines in Asia-Pacific countries. Our results found that the non-SRA first vaccines were over a half of the WHO-prequalified vaccines, with 34.4% and 16.4% being first approved by India and South Korea, respectively. Usually, the vaccine manufacturing country is the first country to approve the vaccines. India and South Korea are members of the Developing Countries Vaccine Manufacturers Network (DCVMN), which has the capacity to manufacture and supply high-quality vaccines at affordable prices. The DCVMN plays an important role in supplying vaccines in developing countries , which aFor the relative approval lag of all vaccines and SRA-first vaccines, the Asia-Pacific countries have a longer relative approval lag than the US and the EU. Our finding of the longer approval lag in Asia compared to the US and EU was consistent with previous studies that assessed the approval lag in cancer drugs in India , inflammSoutheast Asian countries, such as Thailand, Malaysia, and Singapore, use the ASEAN (the Association of Southeast Asian Nations) Common Technical Dossier (CTD) format ,25,26, wThe approval lag in the SRA first group in Thailand is shorter than those in the non-SRA first group. This may be because the SRA is more strict in requirements and review for approval than non-SRA, and, in Thailand, pharmaceutical products that have already been approved by the SRA can use an accelerated process to speed up the registration of vaccines . This waPneumococcal vaccines have the shortest median approval lag. Pneumococcal infection is one of the major vaccine-preventable diseases  and a maDue to the difficulty of collecting vaccine approval data and approval dates, some data may be missing, especially for Malaysia and India. These countries have no online searchable databases for vaccines; the approval data from India was obtained from a summary of product characteristics, and the approval data from Malaysia was obtained from a Registered Product List. The challenge in data collection resulted in the small sample size in the analysis. Therefore, the relative drug lag in some countries might not represent the actual relative drug lag in those countries. The analysis of possible reasons behind the delays in approval of vaccines in the Asia-Pacific region is not conducted in this study, due to the limitation of data available. The same question needs to be addressed for vaccine approval for coronavirus disease (COVID-19) in future studies.The SRA has more facilities and experts to review vaccines for marketing authorization compared to the non-SRA. The marketing authorization in SRA is usually faster than in non-SRA, and thus, people in the SRA can get access to vaccines faster than in the non-SRA. At the same time, the case of Australia and India need further attention. India has quick access to the vaccines it manufactures while Australia has a slow marketing authorization process compared to India, Singapore, or Korea . This obRegardless, our study has merit by showing the approval lag of vaccines in the Asia-Pacific region, indicating a gap between the Asia-Pacific region and the US and EU in regard to access to new vaccines. Vaccination is a cost-effective intervention and one of the most successful methods to prevent infectious diseases and improve health status. Access to vaccines can also save time and money and reduce the social and economic burden of the disease. Therefore, continued efforts to reduce the approval lag for vaccines are essential for public health in the region. Future studies need to analyze the background factors related to the gap in availability and vaccine approval lag in the Asia-Pacific region and assess the impact of vaccine approval lag in the region.The gap in vaccine availability may be attributed to the incidence and disease burden, financial resources, and inclusion in national immunization programs. The vaccine approval lag in the Asia-Pacific region may be attributed to the differences in vaccine development and registration process in between countries and regions, low disease attention and awareness, low disease incidence and burden in the region, and the non-national immunization programs vaccines.


The space station is a large-scale and comprehensive research facility capable of long-term human habitation in near-Earth space, with systematic support by space transport and widely covered tracking, telemetry, command and communication. It allows extensive and long-term research under the special conditions of space and responds to urgent scientific needs in space in a timely manner. 000 experiments have been conducted, including large-scale scientific research and important technology verification, opening new research directions for space life science and human science, as well as microgravity science that uses microgravity conditions to study the movement of matter and basic physical laws. These experiments also expanded research into space astronomy, solar system science, Earth science, the space environment and new technology, thus playing an irreplaceable role in the human understanding of nature, and promoting scientific and technological advances.Since the first manned space flight in 1961, two emerging trends have influenced international human space activities. The first trend is manned space exploration represented by the remarkable Apollo program that landed astronauts on the moon. To date, some human space projects have ambitious plans to explore the moon and beyond. The second trend is space science research performed by astronauts in space. Dozens of space laboratories and space stations have been launched, such as the Salute series laboratory, Skylab, the shuttle-borne series laboratory, Mir Space Station and International Space Station currently still in operation. About 20In the past, the development of space science in China was limited by the small scale of space activities and the lack of opportunities for space experiments. Now, construction on the China Space Station (CSS) has begun, with the core module launched in 2021. It will become the most important near-Earth space laboratory for China and the world in the next 10 years. As a result of China's 30-year effort in manned projects, the CSS offers the opportunity for large-scale scientific research that will benefit Chinese scientists and their international peers.Space life science and human research will investigate the nature of life phenomena and their reactions to microgravity conditions, biomedical issues relating to long-term space exploration, and biotechnology for maintaining human health. Microgravity physics will focus on fundamental physical laws, as well as basic research for application in fluid mechanics, thermophysics and combustion and materials science, with a goal of supporting ground industries. Space astronomy and Earth science will aim to deepen our understanding of dark matter, dark energy, compact objects, galaxy formation and evolution, and the global changes of the Earth. New space technology will develop and verify a new generation of space technology for science and space application.Research in four areas has been planned for the CSS. In order to support research in various fields, the CSS is developing major supporting research facilities such as the 2-meter-diameter China Sky Survey Telescope and the High Energy Cosmic-Radiation Detector. Fourteen experimental racks and three extravehicular exposure devices have been deployed, including the Life and Ecology Research Rack, Biotechnology Research Rack, Fluid Physics Research Rack, Cold Atom Physics Research Rack, High Precision Time-Frequency System, High-Temperature Materials Research Rack, Container-Free Materials Processing Rack and Combustion Sciences Research Rack. Further scientific planning and upgrading of experimental devices will continue in the future.The CSS is fully open to international researchers, and guides for the open solicitation of research proposals will be regularly issued. International scientists may submit proposals through the China Manned Space Engineering Office, the United Nations Committee on the Peaceful Uses of Outer Space, or national space agencies under bilateral cooperation agreements.Chinese scientists look forward to extensive cooperation with scientists around the globe, and hope that research activities in the CSS will make a unique contribution to our collective understanding of nature. Through effective dissemination of scientific findings, CSS research programs will promote an understanding and passion for science to the general public, especially to young people.


Similarly, guidelines for cancer treatment and reference to the WHO List of Essential Medicines are specified in the cancer-related plans of 53% (82 of 155) and 30% (45 of 150) of countries, respectively.3 Beyond service delivery, other health system building blocks such as health workforce, financing, and governance issues remain poorly addressed. Consequently, cancer care is often fragmented and difficult to navigate.Despite many low- and middle-income countries (LMICs) advancing in the development of national cancer control plans, governments are often constrained in their capacity to deliver on the full spectrum of cancer services with most plans unfunded. A study of publicly available cancer-related plans from 158 countries found that a mere 45% (70 of 155) of countries have specified radiotherapy services in their plans.4 This built on UICC's advocacy efforts to advance global resolutions for palliative care and an expanded essential medicines list, adopted by the WHO Member States in 2014 and 2016, respectively, as well as the overarching Cancer Resolution adopted in 2017.In response, the Union for International Cancer Control (UICC), with its network of more than 1,100 member organizations, established a new program of action to mobilize and engage civil society in driving access to cancer treatment.9 These measures were evidence of readiness to support core cancer services, evidence of an active civil society and engagement with other sectors, and evidence of progress in the implementation of national commitments to cancer and NCD control measures.First launched in 2017, the city-based initiative City Cancer Challenge leveraged the reputation of UICC as a trusted civil society partner with the power to convene diverse stakeholders. Through its extensive global membership in LMICs, relationships with patient groups, national cancer institutes, cancer registries, professional associations, and industry partners, UICC was able to rapidly engage a first set of so-called key learning cities. Specifically, Asuncion, Paraguay; Cali, Colombia; Kumasi, Ghana; and Yangon, Myanmar, were selected against three measures of readiness assessed using data collected by WHO, other UN Agencies, and UICC members reporting on cancer and NCD control.The convening of the major decision makers in the cancer care ecosystem in these cities provided the initial impetus for creating a locally led, multistakeholder, and multilevel governance approach to assess local needs and design data-driven solutions to cancer care. With City Cancer Challenge Foundation (C/Can) established as a standalone foundation in 2019, and now operational in nine cities . The recognition of the role of cities in achieving the Sustainable Development Goals through goal 11 has provided an alternative framework whereby global, national, and local health goals are aligned and cities are vehicles of implementation. In this way, cities' proximity to local users and providers is best used to drive locally led solutions that are context-specific. City-led initiatives for hypertension, tobacco control, and diabetes,19 Georgia is a key example wherein the current health care system is a blend of privately owned hospitals and state-owned small-scale health care providers.20 Taking a multisectoral approach to address fragmentation in care and improve the quality, standardization and financial coverage of cancer care were identified by local stakeholders as major priorities in Tbilisi through the city-wide needs assessment, which involved 174 professionals from 27 institutions including the Ministry of Refugees and Accommodation of Georgia, Tbilisi City Hall, the National Center for Disease Control and Public Health of Georgia, and the Georgian Patients Union. An agreed objective was to increase accessibility to internationally recognized treatment standards for oncologic patients and, specifically, to reduce out-of-pocket spending on cancer services. The response was that in 2020, the Government of Georgia announced the expansion of cancer medicines covered by the Universal Healthcare Program together with an increase in financial coverage per patient, per annum.21 The approach in Georgia underscores how coordinated engagement and collaboration across sectors can help to address collective priorities and, more broadly, in this case, to support the Government of Georgia's commitment to provide universal health coverage.22 Moreover, it supports the adoption of a multilevel governance approach  to promote dialogue and inform priority setting. This approach can also be a catalyst for filling city-level gaps and securing investment in public health services, by communicating data-driven priorities to regional and national governments. This was the case in Colombia, whereby the city-wide needs assessment involving 186 health professionals in Cali highlighted gaps in access to cancer services in the public system and health system fragmentation.23 In alignment with the national strategy24 and international best practices,25 this prompted a feasibility study for the implementation of a Comprehensive Cancer Care Center within the reference tertiary public hospital, which services the entire Valle del Cauca region. As a result, Colombia's Ministry of Health and the regional government of Valle del Cauca have jointly supported the creation of the center through investment in infrastructure and equipment for medical imaging, radiotherapy, and pathology to strengthen existing services and meet future demand.27As the complexity of health systems grows, and with the increasing presence of private oncology providers, intersectoral partnerships and facilitated stakeholder communications can promote the elimination of cancer-related inequities.29 Even with this support, however, ongoing threats to implementation must be managed. For example, the strains placed on the national health system and local health professionals by the global coronavirus pandemic require new strategies to support local leaders to sustain activities.Maintaining high-level commitment, even during changes in political leadership, is central to sustainable system improvements as well as financing and delivery of outcomes. In Paraguay, a change in President in 2018 risked deprioritizing cancer in the national health agenda and withdrawal of support for C/Can's activities in Asuncion. Through strong leadership from the bipartisan City Executive Committee (convened by C/Can) and targeted communications, the first national cancer law was adopted under the new government's leadership.Finally, community partnerships are critical in developing solutions that respond to the needs of the most vulnerable. Local governments and providers have everyday contact with health care professionals and patients with cancer and their families and are closest to their concerns and priorities. Across C/Can's first seven cities, more than 900 patients and 1,200 health care professionals have been engaged in the city needs assessment process. Additionally, local professional associations, patient associations, and civil society representatives are engaged from the outset as part of the local decision-making structure.30 responds to the urgent need to reduce inequities in access to breast cancer diagnosis, multimodality treatment, and palliative care services. The development of these guidelines provides a roadmap to improve the coordination of cancer care and supports cities to lead on gender-responsive policies that meet the specific needs and barriers to care faced by women in their communities. Importantly, these local efforts can be scaled through initiatives such as the WHO Global Breast Cancer Initiative and Global Strategy to Accelerate the Elimination of Cervical Cancer.32All C/Can cities have demonstrated readiness and commitment to adopt these enablers through a memorandum of understanding between government authorities, civil society, and C/Can. This agreement also commits cities to lead on collaborative, evidence-informed planning and execution of city-level projects that will drive common goals to improve cancer outcomes. In the case of Yangon, by the end of 2020, resource-appropriate breast and cervical cancer guidelines and multidisciplinary team methodologies in pathology, pain management, and radiotherapy have been developed through the C/Can process with city and national stakeholders and international experts. These collaborative efforts also formed the basis for a new resource, which will be scaled to all cities. The guide for developing resource-appropriate breast cancer management guidelines, developed in partnership with the Breast Health Global Initiative,29 Specific attention is given to the actions taken to activate, strengthen, and multiply effective health services, workforce, and infrastructure. Three papers in this series address pathology, radiotherapy, and multidisciplinary care and collectively show how C/Can applies a multistakeholder and multilevel governance approach to respond to cities' needs. Case studies will also be used to showcase knowledge exchange between individuals, institutions, and cities on planning and uptake of best practices and highlight common challenges to successful implementation.Informed by these insights garnered in the first cities, this special series presents the C/Can approach as it currently stands following 4 years of iterative and adaptive change. The first paper in the series provides a detailed assessment of this framework, specifying the activities at each stage, as well as the outputs, processes, and practices across the lifecycle of the intervention.In the final paper, C/Can's fit-for-purpose Monitoring, Evaluation, and Learning Framework to measure progress and impact over time will be described. Integral to an ongoing process of continuous learning and iteration, the framework is designed to provide data-driven insights into what is working well, as well as what adjustments may be needed to drive improvements in the approach.As C/Can continues to validate this city-led approach, further refinement will be required. Technical cooperation to strengthen each of the six pillars of the health system is at the core of C/Can's model. As C/Can grows its reach, the unique needs of each new city require recalibrating the delicate balance between increasing efficiency by replicating existing city solutions and further customization of technical cooperation offerings for local context. Second is a further understanding of the complex adaptive nature of health systems. In the current context with all cities managing the additional strain of the global pandemic, C/Can will need to go beyond the six pillars and focus on their interconnectedness and the political, social, and economic influences affecting health system resilience in each city. Third is the need to build data capacity at the individual, institutional, and policy levels. Quality data are a prerequisite to be responsive to the local context and leverage the expertise, resources, and commitments of C/Can's network stakeholders and partners. Experience of running data collection processes in seven of the nine cities has highlighted the challenges of collecting quality systems-level data. These include low levels of data literacy, lack of organizational processes for the ethical use and sharing of data, and policy barriers to effective and responsible use of systems data. As an emerging area of work, in 2021, C/Can is piloting new data quality processes and policies as well as a customized data platform. A collaboration with the University of Malaya, Greater Petaling, will explore how to support data-and-analytics activities at scale in C/Can cities in ways that build local data capacity and inform policy change.C/Can will continue to integrate on-the-ground learnings to scale, adapt, and validate its approach, and contribute to a robust evidence base for the effective implementation of locally adapted cancer care solutions in LMICs.


The Association of Southeastern Biologists was founded in 1937 with the goal of increasing the contact and collaboration between scientists in the southeastern United States (US). With the exception of two years during World War II and one year during the COVID-19 pandemic, the Association has met annually to promote research and education in the biological sciences by providing a student-friendly networking environment. In recent years, the Association has placed an increased focus on diversity, equity, and inclusion among elected and appointed leaders, among participants in the annual meeting, and in the development of funding and other opportunities for students. This work prompted us to review the history of our Association, including periods of racial segregation and inequity, and focus on our current efforts to promote access and inclusion by students and scientists from myriad underrepresented groups. In so doing, the past provides us with the opportunity to cast a vision for the future of the Association. In this paper, we seek to share the journey of the Association of Southeastern Biologists in this regard so that we may be transparent, exposing the missteps and amplifying the successes of our organization. We envision this work as a first step toward creating a more open and inclusive scientific community for the future. Professional societies play a critical role in disseminating scientific discoveries and forging collaboration among scientists. These organizations typically fall into two categories: 1) national or international organizations with large meetings that move across a broad geographical area or 2) smaller statewide and regional meetings and organizations. To our knowledge, since its founding in 1937, the Association of Southeastern Biologists (ASB) has been the only scientific association that spans the entire Southeastern US and is one of the largest regional, multi-disciplinary biological associations in the country. The ASB operates with the goal of increasing contact and collaboration between scientists in the region, representing biologists from many sub-disciplines, including student, faculty, and non-academic professionals. While the ASB prides itself on being a working association with an active and engaged membership, the past several years have served as a period of reflection on our growth and values, specifically as they relate to diversity, equity, and inclusion. Upon reflection, we feel that the ASB, as a broad-reaching organization, is uniquely positioned to drive change not only within our own association but across academic institutions represented within the ASB, and our practice may serve as a model to other scientific societies.As we in the ASB leadership reflect on our history , we encoTo better foster communication between biologists in the Southeastern US, the ASB was officially established as a scientific association at an invitational meeting at the University of Georgia in 1937 . The inaHistories of the ASB  acknowleIn the 1950s, adherence to Jim Crow Laws would, unfortunately, limit participation of Black scientists in ASB functions. In 1954, Dr. James H.M. Henderson, a plant physiologist from Tuskegee University, was denied registration to the annual meeting held in Baton Rouge, Louisiana . Dr. HenRacial integration of the ASB would not occur until the late 1950s. In 1958, Dr. Lafayette Frederick, a Black plant biologist then at Southern University in Baton Rouge, Louisiana, was recommended to attend the annual meeting of the ASB in Gainesville, Florida . He tookvia the 1990 American Institute of Biological Sciences (AIBS) Conclave of Presidents. The event, held in Washington D.C., was attended by ASB President Frank Day. In his “A View from Here” column, A key turning point in the ASB’s efforts in diversity, equity, and inclusion came ASB members were involved in organizing and presenting at the 41st Annual Meeting of AIBS in Richmond, Virginia. Included in this meeting were a symposium, roundtable, and reception focused on minorities in biology . In thatad hoc committee on Women, Minority, and Handicapped Affairs that was tasked with organizing “activities and programs which encourage and enhance the involvement of underrepresented groups in biology”  complete a comprehensive strategic plan for the Association that clearly integrates diversity, equity, and inclusion throughout; 2) pursue an external assessment of the Association’s diversity, equity, and inclusion activities; 3) increase engagement of members with disabilities to improve accessibility to both content and activities; 4) collaborate with HBCUs and other Minority Serving Institutions (MSIs) currently active in the ASB to strengthen and build additional partnerships; 5) engage first-generation and underrepresented students and their mentors in the application process for diversity, equity, and inclusion support awards; and 6) pursue external funding for mentorship activities.The ASB was established in the segregated South, and it is clear that past actions of the Association caused harm to established and incipient scientists. Lasting social change must come from within, and it is guided by the actions of individuals. As we move forward, we recognize that there are still many more steps that the ASB must take in order to be truly supportive of all of its members. These efforts include working to be actively anti-racist, to provide support and mentoring opportunities for historically excluded students and faculty, to value and champion diversity within our scientific society, and to fight for equality and inclusivity in our communities. To truly achieve these steps, we acknowledge that we need to continue to be reflective, build on the expertise of scientists and individuals working to address diversity, equity, and inclusion issues within our association and more broadly, and to honor the legacy of our past heroes and champions within the ASB, including Dr. Mary Stuart MacDougall, Dr. Lafayette Frederick, and others who helped break down barriers that prevented the ASB from being a truly inclusive organization. In closing, we invite all members of the ASB and ASB’s friends, partners, and affiliates throughout the Southeastern US to join us in these efforts.


Background: Coronavirus Diesease-2019 (COVID-19) outbreak has led to the suspension of the activities of dental schools. Therefore, reorganizing clinical settings and supporting services as quickly as possible has received much attention to reopen dental schools. The present study aimed to evaluate the applicability of the Intervention Mapping (IM) approach for designing, implementing, and evaluating an intervention program to prevent and control COVID-19 in dental schools.Methods: Following the IM protocol, six steps were completed in the planning and development of an intervention, targeting, and management of Dental School during the COVID-19 pandemic.Results: The information obtained from the needs assessment revealed that the COVID-19 outbreak prevention was associated with the use of personal protective equipment by all target groups, infection control measures taken in the environment, preparation of the environment and equipment, changes in the treatment plan according to the COVID-19 pandemic, changing the admission process of patients, and reduction of attendance of target groups in the school are linked with. In this study, determinant factors affecting the COVID-19 prevention at the individual level were identified based on the Protection Motivation Theory (PMT). In this program, various methods, such as presentation of information, modeling role, and persuasion measures, were utilized and the practical programs included educational films and group discussions implemented.Conclusions: Our findings indicated that intervention in dental environments on the basis of the IM process can develop a comprehensive and structured program in the dental school and hence can reduce the risk of the COVID-19 infection. In recent months, the high prevalence of the new coronavirus disease-2019 (COVID-19) is considered an international public health concern (Due to the high transmissibility of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), close contact between the patients and dentists, nature of dental procedures , 4, and The activities of dental schools have been resumed by imposing some restrictions from June 21, 2020 in Iran due to the educational needs of students and the medical needs of patients. Given the vast number of patients and their close contact with students, teachers, and staff in the dental schools, some managerial, educational, and environmental interventions are necessary to be implemented for the protection of all stockholders. To reopen the schools, it is required to provide immediate educational, clinical, and support services .The Centers for Disease Control and Prevention (CDC), American Dental Association (ADA), and WHO have provided some effective practical guidelines for controlling the prevalence of COVID-19 in dental settings . HoweverIt is a protocol that helps to design multilevel health promotion interventions and selects appropriate implementation strategies . IM consStep 1: Conducting needs assessmentStep 2: Specifying change objectivesStep 3: Selecting theory-based methods and practical strategiesStep 4: Developing program componentsStep 5: Specifying implementationStep 6: Generating evaluation plan .Steps 1–4 focus on the presentation of multilevel interventions for improving health behaviors and environmental conditions.In the first step of IM, planners evaluate assets and needs.At this stage, all representatives, such as executives and those who are responsible for protecting the intervention, were involved in the program to determine required measures for implementing the program and identifying determinants (obstacles and facilitators). To involve patients in the program, a committee called the COVID-19 Prevention Committee at the School of Dentistry (CPDS) was formed on May 21, 2020. The members of this committee consist of the representatives of the students, the chairman of the infection control committee of the school, representative of the university teachers, staff representative, manager of the nursing office, patient representative, an IT official of the school, representative of the department of financial and administrative affairs of the school, the head of public affairs, the dean of the school, and some SHS2020 standard company's representatives. The recognized stakeholders were in both individual and environmental levels. The team manager (Head of the School) determined the responsibilities of each team member and the decision-making structure. During this session, the members of the three teams, namely, education, infection control, and logistics, were separately assigned for performing relevant activities.To assign all actors, barriers, and potential facilitators of implementing the intervention, it was necessary to conduct a needs assessment. For this reason, the brainstorming method was used in CPDS, and the results of the previous regular evaluation that have already been conducted in the school were applied. Moreover, the environmental conditions were observed and evaluated.At this point, social, epidemiological, and behavioral-environmental analyses were performed. The needs assessment of the present study was focused on the school as the target group, such as teachers, students, staff , and patients. This entailed a review of literature on determinants and factors associated with the prevalence of COVID-19 in dental settings and the role of behaviorally and environmentally predetermined risk factors in the rise of the prevalence of COVID-19 and its determinants. The committee used the experimental data, theoretical references, and collected new data  to prepare a list of behavioral and environmental risk factors affecting the spread of COVID-19 and its determinants. In this phase, recognition of the school capabilities was achieved.At this stage, CPDS identified the expected changes in the behavioral and environmental factors, which were already determined in the needs assessment stage. The prioritization of behavioral and environmental consequences was performed according to their importance and variability by literature review and the consensus between the members of the CPDS committee. Afterward, functional objectives were determined for each behavioral and environmental consequence and their determinants, and a matrix of change objectives was plotted for each program level. We used brainstorming, a review of literature, and constructs of health promotion theories to identify the determinants.In this step of CPDS, the brainstorming method and literature review were used to identify the appropriate methods and strategies affecting the determinants in step 2. During this process, a summary of the theoretical methods proposed by Bartholomew et al. was applied . SpecialIn this step, the intervention content was proposed by the CPDS team, and the protocols of implementation, activities, and training materials were produced. The cultural adaptation of these programs was conducted through consultation with the program stakeholders. Then, the scope, sequence, communication channels, themes, and a list of required materials were provided and documented. Meanwhile, a review of the existing training materials was performed to determine whether the training materials have already been consistent with the objectives of this program or not. Afterward, the required training materials were produced and pre-tested.At this step, the potential adopters and implementers of the program were identified. A review of the transplantation system (CPDS) was also performed. Then, the functional objectives of adoption, implementation , and program survival were identified. In the next stage, the determinants of adoption, implementation, and survival of the program were determined using the brainstorming method and literature review. Based on the importance and variability, the prioritization of the change objectives was conducted. Then, appropriate methods and strategies affecting the determinants of adoption, implementation, and survival of the program were selected, and the intervention was designed and developed to use the program.In the final stage of IM, a plan was provided by the planners to evaluate the effectiveness and quality of the intervention . In the A checklist was designed for the evaluation of behavioral and environmental factors, performance objectives, determinants, and change objectives. A checklist was also designed for the process evaluation. Evaluation indicators and criteria were determined, and the evaluation plan was documented. To evaluate the program, the context, input, process, and product (CIPP) evaluation checklist was utilized . The evaThe protocol of this study was approved by the Ethics Committee of the Hamadan University of Medical Sciences . The questionnaire was anonymous, and informed consent was obtained from the participants in the survey. Participation in the study was voluntary.As of May 21, 2020, a total of 129,341 cases with COVID-19 have been laboratory confirmed and 7,249 deaths diagnosed ; and theOne of the key points in the control of infectious disease epidemics is designing interventions to emphasize the simultaneous increase of perceived fear and threat and perceived efficacy  for disease prevention and self-efficacy. Therefore, Protection Motivation Theory (PMT) was used to better understand the performance of preventive behaviors at an individual level .A high commitment of management to implement the intervention, high level of staff education, access to new device/equipment, sufficient budget, sufficient workforce to implement the intervention, and presence of qualified professors in the field of infection control were among the strengths of the faculty.Based on the information obtained from the needs assessment stage, two objectives of the program  were considered to prevent the spread of the COVID-19. For the target group, such as students and professors, the program was defined at the individual level as the use of appropriate personal protective equipment and suitable treatment measures to prevent the spread of COVID-19 .In the target group of administrative staff and patients, the implementation of the preventive behaviors to prevent the transmission and spread of COVID-19 was considered as the program objective at the individual level.Due to the important role of the medical staff and service personnel in infection control, the use of appropriate personal protective equipment and precise infection control measures among them was considered at the individual level in addition to the other staff.In addition, the objectives of the program for environmental factors were to prepare the environment and equipment, change the system of queuing and admission of patients, and reduce the capacity of target groups in the faculty. According to the program objectives, performance objectives were defined at the individual level for students, professors, administrative staff, medical staff, and patients, and the performance objectives were defined at the environmental level for providers .After identifying the functional objectives, the important and changeable determinants of these objectives were selected for each level based on the results of the IM phase. For the individual level, PMT was selected as a framework for describing factors in relation to preventive behaviors of COVID-19 . AnotherFinally, for providers  at the environmental level, the knowledge of the latest COVID-19 prevention guidelines in dental settings, barriers, attitudes, and outcome expectations were chosen as determinants. Next, the matrix of change objectives, which is derived from the intersection of performance objectives with determinants, was formed for each level of intervention .These performance objectives have been developed based on the protocols of the WHO, CDC, and the Ministry of Health and Medical Education of Iran –11.To reduce the presence of target groups in the school, contact-less treatment and remote learning were considered. This intervention was performed by using a telephone or online appointment system, teledentistry, implementation of virtual teaching, phone or online screening of patients, and installation of the Picture Archiving and Communication Systems software (PACS). The patient screening was conducted through a telephone call or appointment system so that before making an appointment, the patient was asked to complete the COVD-19 screening. After completing the screening form, if he/she was not identified as a high-risk case, was referred to oral diseases resident to do teledentistry. At this level, patients would express their symptoms and problems, and then if necessary, would send a photograph of their mouth to the oral diseases resident. The resident determines whether the person needs essential or urgent treatment or not based on the patient history and the provided photograph. An appointment was considered for the patients who need special treatments.Virtual teaching was considered for theoretical courses. Adobe connect platform was considered for theoretical courses and webinar.The installation of PACS software, which reduces paper records, increases the speed and accuracy of diagnoses and subsequently reduces the patient waiting time and their contact with staff, students, and faculty in the department. The PACS software could increase the speed and accuracy of diagnoses and subsequently reduce the patient waiting time and their contact with staff, students and faculty in the department.At this stage, all the change objectives were organized by the relevant determinants, and the methods of each category of the objectives were identified through the brainstorming method. Afterward, a theoretical and experimental review was performed to identify the appropriate methods and strategies for changing determinants.The strategy planning team determined the strategies in two ways, such as  brainstoIn this step, a final intervention framework was produced for implementation. Based on the needs assessment data and the additional focus group discussion with the target group, to collect the data regarding intervention material preferences, the planning team provided a list of intervention materials and activities. In practical, in this intervention, the COVID-19 instructions recommended by Iran's Ministry of Health and the instructions in relation to infection control were considered , ward managers, infection control team of the school, and the representatives of SHS2020 standard.Then, the executive team was informed about the methods and strategies for implementation of the intervention in different target groups and the tasks of the designated teams in detail.The instructions of the Ministry of Health were also provided for the executors.Context, Input, Process, and Product evaluation checklist was used to evaluate the program . This chContext, Input, Process, and Product components were selectively used in different sequences and generally at the same time depending on the need for specific evaluations . In thisEvaluation in this study encompassed the following steps:1. Contractual agreements: A clear understanding of the evaluation that needs to be conducted was established.2. Assessing the conditions and programming context: The needs, strengths and weaknesses, threats, opportunities, and problems in the faculty environment were assessed and evaluated. This step was consistent with the needs assessment phase and performed concurrently with this phase.3. Evaluation of the program inputs: Existing strategies and programs, capacity and feasibility of the designed program, evaluation of budget and equipment, tools, and materials required to conduct the program were assessed and evaluated. This step was also performed with the needs assessment phase.4. Evaluation of the program processes: Monitoring, documentation, and evaluation of the program activities were performed, and representatives of SHS2020 standard were involved in monitoring, observation, preserving photographic records, and providing periodic progress reports on the program implementation. At this stage, the checklists were prepared and completed by the standard representatives through observation. By photography and preparing a report regarding the documentation and intervention processes and the periodic progress reports to the faculty officials, they were informed of the program process. This time, it was determined whether all the modules of the program have been implemented? Does the program run according to the predetermined sequences and strategies? Did all the target groups receive the program? To what extent are the targets groups have involved in the program? Is the predetermined performance objective accomplished?The satisfaction of the target groups related to the intervention was also questioned.5. Evaluation of the program consequences: The information about the acceptance, modification, or rejection of the program was evaluated by asking from the target groups. The outcomes of this program included: increasing knowledge, perceived threat, perceived efficiency, reducing barriers to understanding, and increasing preventive behaviors against COVID-19 infection, which is obtained through completing the PMT questionnaire by staff, faculty, and students before and after the intervention.6. Evaluation of the effectiveness of program: The results of the quality and importance of the program must be evaluated. In this regard, the effectiveness of the interventions will be evaluated by the number of involved cases in dental school related to therapeutic and educational processes 3 months after the intervention. After performing above six evaluation steps by the representatives of BRSM Company and providing a report on the observance of applicable professional standards to the faculty officials, the identified defects were fixed. Moreover, the head office of the BRSM Company was invited to refer to the faculty for the final evaluation of the program. After conducting the final evaluations by the faculty, the evaluators of this company, on 28 June, 2020, considered the faculty to be eligible for the SHS2020 standard certification .7. Sustainability evaluation: This stage that will be carried out by BRSM Company 6 months after the initial evaluation, it will be determined to what extent the program has been successfully institutionalized and will continue over time.8. The final synthesis report: Consistent reports of evaluation findings were collected and communicated to the faculty stakeholders. Reports on the program background, implementation, and results of the program were presented to a wide range of audiences, and they were informed of the interventions carried out and the results of the evaluation by BRSM.The present study describes the process design, content, and evaluation of COVID-19 preventive intervention in dental schools. This study for the first time provides practical and simple guidelines for reopening dental schools and providing dental services during the COVID-19 epidemic. Due to the lack of a global protocol for dental services during this pandemic, dental services have been partially or completely disrupted in many countries. In this regard, the lack of standard protocols can increase the prevalence of COVID-19 in dental health centers.While some national health institutions, such as the NHS, have provided guidance and advice for managing clinical dental emergencies during epidemics . This inIn this study, IM was used as a conceptual framework for the intervention design. Although the design of the intervention was a time-consuming process, it can lead to the implementation of the intervention with a systematic and evidence-based approach.The Centers for Disease Control and Prevention, ADA, and WHO provided some recommendations for the control of the prevalence of COVID-19 for dentists and dental staff, such as patient screening, infection control , behavioral measures , and treatment measures  .The first essential step for the safe management of patients during the pandemic is investigating risk level of patient through screening patients to cut the transmission chain and evaluating the chief complaint of the patients . These cThe most important measures to control the infection included selecting one person to supply the disinfectants for surfaces, equipment, and tools. At the beginning of each day, this person prepared the appropriate disinfectants for the surfaces, equipment, and tools according to the standard protocol and provided them for the medical staff in different wards. Isolation of well-ventilated dental chair unit  was conducted as another important measure of infection control .Fear arousal strategy as behaviors that protect people against life-threatening conditions (such as COVID-19) is often used as an effective way to promote health, prevent disease, and adopt healthy behaviors in society . HoweverStaff training was also conducted in small groups in large spaces with proper ventilation.In the present study, the intervention was designed based on the latest scientific findings in the field of COVID-19 as another important measure. Therefore, a scientific research team was formed to access the latest scientific findings through searching and then inform the planning team every 72 h. The planning team examines the received information scientifically, evaluates their compliance with the facilities and policies of the organization, makes the necessary changes in the program, and informs the project implementers. However, finding a balance between previous and new findings and constantly updating the information regarding the transmission and prevention ways of COVID-19 are still challenges, especially in dentistry.This study had some limitations at the time of implementation of the intervention. These limitations were related to insufficient scientific information about the nature of the virus like its transmission modes, and incubation time, and due to constant updating information, the effectiveness of the preventive methods remains a challenge.This study describes the performance of the Iranian School of Dentistry in developing disease prevention strategies during the COVID-19 pandemic based on the IM process. Our findings indicated that the intervention in dental settings based on the IM process leads to a comprehensive and structured program in dental schools. Therefore, the teamwork can consider the necessary changes in the running programs as the global and national guidelines for the epidemic change. Therefore, it can be concluded that intervention in dental environments based on the IM process can develop a comprehensive and structured program in the dental school.The original contributions presented in the study are included in the article/supplementary material, further inquiries can be directed to the corresponding authors.The studies involving human participants were reviewed and approved by the Hamadan University of Medical Sciences Ethics Committee . This study and the method of obtaining consent were approved by the Ethics Committee. The questionnaire was anonymous and informed consent was considered as agreeing to participate in the survey. Participation in the study was voluntary. The patients/participants provided their written informed consent to participate in this study.AM, SS, SB, NR, AH, MM, HK, and OA contributed to the study concept and design. SS, NR, BB, OA, and AP contributed to the acquisition of data. SS, MM, and AP contributed to the initial drafting of the manuscript. SS, AM, AH, and SB contributed to study supervision. All authors contributed to the interpretation of data and critical revision of the report.We acknowledge funding from the Hamadan University of Medical Sciences (9905283448).The content is solely the responsibility of the authors.The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.