Physical Activity as a Clinical Tool against Depression: Opportunities and Challenges.

Depression is a major public health issue in numerous countries, with around 300 million people worldwide suffering from it. Typically, depressed patients are treated with antidepressants or psychological therapy or a combination of both. However, there are some limitations associated with these therapies and as a result, over the past decades a number of alternative or complementary therapies have been developed. Exercise is one such option that is supported by published extensive basic and clinical research data. The aim of this review was to examine the beneficial effects of exercise in depression. Physical activity and exercise have been shown to be effective in treating mild-to-moderate depression and in reducing mortality and symptoms of major depression. However, physical activity and exercise are still underused in clinical practice. This review attempts to propose a framework to help clinicians in their decision-making process, how to incorporate physical activity in their toolkit of potential therapeutic responses for depressed patients. We first summarize the interactions between depression and physical activities, with a particular focus on the potential antidepressant physiological effects of physical activity. We then identify some of the barriers blocking physical activity from being used to fight depression. Finally, we present several perspectives and ideas that can help in optimizing mitigation strategies to challenge these barriers, including actions on physical activity representations, ways to increase the accessibility of physical activity, and the potential of technology to help both clinicians and patients.

Online Presence of the Funeral Industry: The Example of the Quebec Federation of Funeral Cooperatives.

The digitalization of modern societies has offered new tools for funeral industries to reach the communities they serve, ranging from using technologies in funeral planning, in commemoration of the dead, or to support the bereaved. The COVID-19 pandemic only pushed this need for online presence of the funeral industries further. We explore the digitalization of funeral industries through the example of Quebec (Canada), where many funeral institutions are regrouped under a federation of funeral cooperatives. We analyze how this influences the delivery of funeral services and allows the development of common services answering various needs of the population (e.g., a funding program for youth funerals, an ecological memorialization program, online grief support). Finally, we discuss how the federation's online presence contributes to its mission, and more largely whether it changes the perception of the industry.

Grieving in the digital era: Mapping online support for grief and bereavement.

OBJECTIVE: To describe the landscape of digital resources available for grief and bereavement, and to explore cultural variations through the analysis of patterns in three languages with a multinational repartition (English, French and Spanish). METHODS: For each language, websites were collected through a systematized approach and classified according to their category (governmental, health, educational, social media, conventional media, spiritual), their country of origin, and the type of support they offered (practical support, services, peer support, informational support, resources). RESULTS: A total of 2587 websites (English: 1003; French 678; Spanish: 906) were analyzed. Cultural variations were observed both for the websites' categories and the types of support. Half of the websites presented at least one type of support, informational support being the most prevalent, followed by practical support. English websites presented significantly more support than Spanish websites, with French websites in between. PRACTICE IMPLICATIONS: By using an extensive survey, our results allow for a general mapping of online websites that is comparable across languages, but also unveil digital dynamics unknown to date. These results further the multicultural understanding of digital support for grief and bereavement, propose an innovative and operational typology for online support and raise awareness of the current support landscape.

COVID-19 and digital inequalities: Reciprocal impacts and mitigation strategies.

With more than three billion people in isolation, the status of digital spaces is switching from an amenity to a necessity, as they become not only the main way to access information and services, but also one of the only remaining vectors for economic, educational, and leisure activities as well as for social interactions to take place. However, not all are equals in terms of access to networks or connected devices, or when it comes to the skills required to navigate computerized spaces optimally. Digital inequalities were already existing, yet the COVID-19 crisis is exacerbating them dramatically. On the one hand, the crisis will worsen digital inequalities within the population. On the other hand, digital inequalities represent a major risk factor of vulnerability for exposure to the virus itself, and for the non-sanitary consequences of the crisis. Therefore, this paper aims at exploring the reciprocal impacts of the COVID-19 crisis and digital inequalities, and to propose operative solutions to help fight the nefarious consequences of the crisis. We first describe how digital inequalities are a determinant of health. We then investigate how COVID-19 can potentiate digital inequalities, and how digital inequalities potentiate vulnerability to COVID-19. Finally, in order to contribute to the mitigation of this crisis, we propose a set of multi-layered strategies focusing on actionability that can be implemented at multiple structural levels, ranging from governmental to corporate and community levels.

Older Adults' Knowledge of Anxiety Disorders.

OBJECTIVES: The underuse of mental health services for anxiety disorders is particularly pronounced among older adults and could, in part, be explained by a lack of knowledge on this subject in this population. The purpose of this study was to document senior's knowledge of anxiety. METHOD: Young adults (n = 64) and older adults (n = 78) completed a sociodemographic questionnaire (including clinical variables), the Beck Anxiety Inventory and a questionnaire measuring their knowledge of the various dimensions of anxiety disorders, including symptoms, risk factors, and treatments. RESULTS: Results show that older adults have less knowledge about anxiety disorders than young adults and that this difference is observable for all dimensions assessed. Low level of education is associated with less knowledge of anxiety disorders. Students and those who were employed scored better that those who were retired and those with incomes below $10,000 scored better than those with higher incomes. DISCUSSION: Results show the importance and the diversity of knowledge needs with regards to anxiety disorders among older adults. A strategy to enhance knowledge about anxiety disorders among older adults should be adapted to this specific population (with regards to its delivery approach) and includes diverse domains of knowledge.

Understanding online health information: Evaluation, tools, and strategies.

OBJECTIVE: Considering the status of the Internet as a prominent source of health information, assessing online health material has become a central issue in patient education. We describe the strategies available to evaluate the characteristics of online health information, including readability, emotional content, understandability, usability. METHODS: Popular tools used in assessment of readability, emotional content and comprehensibility of online health information were reviewed. Tools designed to evaluate both printed and online material were considered. RESULTS: Readability tools are widely used in online health material evaluation and are highly covariant. Assessment of emotional content of online health-related communications via sentiment analysis tools is becoming more popular. Understandability and usability tools have been developed specifically for health-related material, but each tool has important limitations and has been tested on a limited number of health issues. CONCLUSION: Despite the availability of numerous assessment tools, their overall reliability differs between readability (high) and understandability (low). Approaches combining multiple assessment tools and involving both quantitative and qualitative observations would optimize assessment strategies. PRACTICE IMPLICATIONS: Effective assessment of online health information should rely on mixed strategies combining quantitative and qualitative evaluations. Assessment tools should be selected according to their functional properties and compatibility with target material.