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Lesbian, gay, bisexual and trans+a (LGBT+) people report poorer health than the general population and worse experiences of healthcare particularly cancer, palliative/end-of-life, dementia and mental health provision. This is attributable to: a) social inequalities, including 'minority stress'; b) associated health-risk behaviours (e.g. smoking, excessive drug/alcohol use, obesity); c) loneliness and isolation, affecting physical/mental health and mortality; d) anticipated/experienced discrimination and e) inadequate understandings of needs among healthcare providers. Older LGBT+ people are particularly affected, due to the effects of both cumulative disadvantage and ageing. There is a need for greater and more robust research data to support growing international and national government initiatives aimed at addressing these health inequalities. We identify seven key research strategies: 1) Production of large datasets; 2) Comparative data collection; 3) Addressing diversity and intersectionality among LGBT+ older people; 4) Investigation of healthcare services' capacity to deliver LGBT+ affirmative healthcare and associated education and training needs; 5) Identification of effective health promotion and/or treatment interventions for older LGBT+ people, and sub-groups within this umbrella category; 6) Development an (older) LGBT+ health equity model; 7) Utilisation of social justice concepts to ensure meaningful, change-orientated data production which will inform and support government policy, health promotion and healthcare interventions.

The neuropathological confirmation of amyloid-β (Aβ) plaques and tau neurofibrillary tangles (NFT) remains the gold standard for a definitive diagnosis of Alzheimer's disease (AD). Nowadays, the in vivo diagnosis of AD is greatly aided by both cerebrospinal fluid (CSF) and positron emission tomography (PET) biomarkers. Although highly accurate, their broad implementation is restricted by high cost, limited accessibility and invasiveness. We recently developed a high-performance, ultrasensitive immunoassay for the quantification of tau phosphorylated at threonine-181 (p-tau181) in plasma, which identifies AD pathophysiology with high accuracy. However, it remains unclear whether plasma p-tau181, measured years before the death, can predict the eventual neuropathological confirmation of AD, and successfully discriminates AD from non-AD dementia pathologies. We studied a unique cohort of 115 individuals with longitudinal blood collections with clinical evaluation at 8, 4 and 2 years prior to neuropathological assessment at death. The results demonstrate that plasma p-tau181 associates better with AD neuropathology and Braak staging than a clinical diagnosis 8 years before post-mortem. Moreover, while all patients had a diagnosis of AD dementia during life, plasma p-tau181 proved to discriminate AD from non-AD pathologies with high accuracy (AUC = 97.4%, 95% CI = 94.1-100%) even 8 years before death. Additionally, the longitudinal trajectory of plasma p-tau181 was assessed in all patients. We found that the main increases in plasma p-tau181 occurred between 8 and 4 years prior to death in patients with AD neuropathology and later plateauing. In contrast, non-AD pathologies and controls exhibited minor, albeit significant, increases in p-tau181 up until death. Overall, our study demonstrates that plasma p-tau181 is highly predictive and specific of AD neuropathology years before post-mortem examination. These data add further support for the use of plasma p-tau181 to aid clinical management in primary care and recruitment for clinical trials. ; Open access funding provided by University of Gothenburg. This study represents independent research partly funded by the National Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London. Tissue samples were supplied by The London Neurodegenerative Diseases Brain Bank, which receives funding from the UK Medical Research Council and as part of the Brains for Dementia Research programme, jointly funded by Alzheimer's Research UK and the Alzheimer's Society. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health. The datasets used and/or analysed during the current study available from the corresponding author on reasonable request. TKK holds a postdoctoral fellowship from the BrightFocus Foundation (#A2020812F), and was further supported by the Swedish Alzheimer Foundation (Alzheimerfonden; #AF-930627), the Swedish Brain Foundation (Hjärnfonden; #FO2020-0240), the Swedish Dementia Foundation (Demensförbundet), the Agneta Prytz-Folkes and Gösta Folkes Foundation, Gamla Tjänarinnor, the Aina (Ann) Wallströms and Mary-Ann Sjöbloms Foundation, the Gun and Bertil Stohnes Foundation, and the Anna Lisa and Brother Björnsson's Foundation. MSC received funding from the European Union's Horizon 2020 Research and Innovation Program under the Marie Sklodowska-Curie action grant agreement no. 752310, and currently receives funding from Instituto de Salud Carlos III (PI19/00155) and from the Spanish Ministry of Science, Innovation and Universities (Juan de la Cierva Programme grant IJC2018-037478-I). AH is funded by Research Centre for Mental Health and Biomedical Research Unit for Dementia. KB holds the Torsten Söderberg Professorship in Medicine and is supported by grants from the Swedish Research Council, the Swedish Alzheimer Foundation, and the Swedish Brain Foundation. AH is funded by Research Centre for Mental Health and Biomedical Research Unit for Dementia. KB holds the Torsten Söderberg Professorship in Medicine and is supported by grants from the Swedish Research Council, the Swedish Alzheimer Foundation, and the Swedish Brain Foundation. KB holds the Torsten Söderberg Professorship in Medicine at the Royal Swedish Academy of Sciences, and is supported by the Swedish Research Council (#2017-00915), the Swedish Alzheimer Foundation (#AF-742881), Hjärnfonden, Sweden (#FO2017-0243), and a grant (#ALFGBG-715986) from the Swedish state under the agreement between the Swedish government and the County Councils, the ALF-agreement. NJA is supported by the Wallenberg Centre for Molecular and Translational Medicine, the Swedish Alzheimer Foundation (Alzheimerfonden), the Swedish Dementia Foundation (Demensförbundet), and Hjärnfonden, Sweden.

OBJECTIVE: Rates of some psychological disorders are higher among enlisted U.S. military personnel than socio-demographically matched civilians. Indirect evidence suggests some internalizing and externalizing psychological problems among enlistees onset prior to enlistment. However, the consistency and strength of the associations between pre-enlistment psychological problems and enlistment over time is unknown. We address this uncertainty by examining whether internalizing and externalizing problems in high school predicted subsequent military enlistment using a large cohort-sequential panel study. METHOD: The Monitoring the Future study administered baseline surveys from 1989–2014 and biennial follow-up surveys two and four years later to national samples of high-school seniors (n = 20,823). Validated self-report scales assessed internalizing (depression, low self-esteem) and externalizing (risk-taking, school misbehavior, conduct disorder, interpersonal violence, alcohol, and drug use) problems in each survey. Follow-up surveys assessed military enlistment. Logistic regression models were used to estimate associations of problems scales with subsequent enlistment. RESULTS: School misbehavior in 12(th) grade, and risk-taking in 12(th) grade and two years after graduation were associated with significantly elevated odds of enlistment at follow-up. Although modest, these associations were linear and invariant across respondent sex and baseline survey year. CONCLUSIONS: School misbehavior and risk-taking predicted subsequent enlistment and there was no evidence of historical changes in these associations over the course of 25 years; these pre-enlistment psychological problems do not fully explain the high rates of psychological disorders among enlisted military personnel. Further research is needed to determine whether these predictors are associated with negative outcomes during or after military service.

International audience ; Corporate social responsibility has gone mainstream, and many companies have taken meaningful steps towards a more sustainable future. Yet global environmental indicators continue to worsen, and individual corporate efforts may be hitting the point of diminishing returns. Voluntary action by the private sector is not a panacea-regulatory action by the public sector remains necessary. Such public sector progress will be more likely if it is supported by influential segments of the business community. Recent court rulings in the U.S. make it easy for companies to hide their political activities from the public, yet the indicators of CSR used by ratings agencies and socially responsible investment funds mostly ignore corporate political action. We argue that it is time for CSR metrics to be expanded to critically assess and evaluate firms based on the sustainability impacts of their public policy positions. To enable such assessments, firms need to become as transparent about their political activity as many have become about their CSR efforts, and CSR rating services and ethical investment funds need to demand such information from firms and include an assessment of corporate political activity in their ratings. † We thank the Albert and Elaine Borchard Foundation for their generous financial support.

International audience ; Corporate social responsibility has gone mainstream, and many companies have taken meaningful steps towards a more sustainable future. Yet global environmental indicators continue to worsen, and individual corporate efforts may be hitting the point of diminishing returns. Voluntary action by the private sector is not a panacea-regulatory action by the public sector remains necessary. Such public sector progress will be more likely if it is supported by influential segments of the business community. Recent court rulings in the U.S. make it easy for companies to hide their political activities from the public, yet the indicators of CSR used by ratings agencies and socially responsible investment funds mostly ignore corporate political action. We argue that it is time for CSR metrics to be expanded to critically assess and evaluate firms based on the sustainability impacts of their public policy positions. To enable such assessments, firms need to become as transparent about their political activity as many have become about their CSR efforts, and CSR rating services and ethical investment funds need to demand such information from firms and include an assessment of corporate political activity in their ratings. † We thank the Albert and Elaine Borchard Foundation for their generous financial support.

International audience ; Corporate social responsibility has gone mainstream, and many companies have taken meaningful steps towards a more sustainable future. Yet global environmental indicators continue to worsen, and individual corporate efforts may be hitting the point of diminishing returns. Voluntary action by the private sector is not a panacea-regulatory action by the public sector remains necessary. Such public sector progress will be more likely if it is supported by influential segments of the business community. Recent court rulings in the U.S. make it easy for companies to hide their political activities from the public, yet the indicators of CSR used by ratings agencies and socially responsible investment funds mostly ignore corporate political action. We argue that it is time for CSR metrics to be expanded to critically assess and evaluate firms based on the sustainability impacts of their public policy positions. To enable such assessments, firms need to become as transparent about their political activity as many have become about their CSR efforts, and CSR rating services and ethical investment funds need to demand such information from firms and include an assessment of corporate political activity in their ratings. † We thank the Albert and Elaine Borchard Foundation for their generous financial support.

International audience ; Corporate social responsibility has gone mainstream, and many companies have taken meaningful steps towards a more sustainable future. Yet global environmental indicators continue to worsen, and individual corporate efforts may be hitting the point of diminishing returns. Voluntary action by the private sector is not a panacea-regulatory action by the public sector remains necessary. Such public sector progress will be more likely if it is supported by influential segments of the business community. Recent court rulings in the U.S. make it easy for companies to hide their political activities from the public, yet the indicators of CSR used by ratings agencies and socially responsible investment funds mostly ignore corporate political action. We argue that it is time for CSR metrics to be expanded to critically assess and evaluate firms based on the sustainability impacts of their public policy positions. To enable such assessments, firms need to become as transparent about their political activity as many have become about their CSR efforts, and CSR rating services and ethical investment funds need to demand such information from firms and include an assessment of corporate political activity in their ratings. † We thank the Albert and Elaine Borchard Foundation for their generous financial support.

International audience ; Corporate social responsibility has gone mainstream, and many companies have taken meaningful steps towards a more sustainable future. Yet global environmental indicators continue to worsen, and individual corporate efforts may be hitting the point of diminishing returns. Voluntary action by the private sector is not a panacea-regulatory action by the public sector remains necessary. Such public sector progress will be more likely if it is supported by influential segments of the business community. Recent court rulings in the U.S. make it easy for companies to hide their political activities from the public, yet the indicators of CSR used by ratings agencies and socially responsible investment funds mostly ignore corporate political action. We argue that it is time for CSR metrics to be expanded to critically assess and evaluate firms based on the sustainability impacts of their public policy positions. To enable such assessments, firms need to become as transparent about their political activity as many have become about their CSR efforts, and CSR rating services and ethical investment funds need to demand such information from firms and include an assessment of corporate political activity in their ratings. † We thank the Albert and Elaine Borchard Foundation for their generous financial support.

International audience ; Corporate social responsibility has gone mainstream, and many companies have taken meaningful steps towards a more sustainable future. Yet global environmental indicators continue to worsen, and individual corporate efforts may be hitting the point of diminishing returns. Voluntary action by the private sector is not a panacea-regulatory action by the public sector remains necessary. Such public sector progress will be more likely if it is supported by influential segments of the business community. Recent court rulings in the U.S. make it easy for companies to hide their political activities from the public, yet the indicators of CSR used by ratings agencies and socially responsible investment funds mostly ignore corporate political action. We argue that it is time for CSR metrics to be expanded to critically assess and evaluate firms based on the sustainability impacts of their public policy positions. To enable such assessments, firms need to become as transparent about their political activity as many have become about their CSR efforts, and CSR rating services and ethical investment funds need to demand such information from firms and include an assessment of corporate political activity in their ratings. † We thank the Albert and Elaine Borchard Foundation for their generous financial support.

International audience Corporate social responsibility has gone mainstream, and many companies have taken meaningful steps towards a more sustainable future. Yet global environmental indicators continue to worsen, and individual corporate efforts may be hitting the point of diminishing returns. Voluntary action by the private sector is not a panacea-regulatory action by the public sector remains necessary. Such public sector progress will be more likely if it is supported by influential segments of the business community. Recent court rulings in the U.S. make it easy for companies to hide their political activities from the public, yet the indicators of CSR used by ratings agencies and socially responsible investment funds mostly ignore corporate political action. We argue that it is time for CSR metrics to be expanded to critically assess and evaluate firms based on the sustainability impacts of their public policy positions. To enable such assessments, firms need to become as transparent about their political activity as many have become about their CSR efforts, and CSR rating services and ethical investment funds need to demand such information from firms and include an assessment of corporate political activity in their ratings. † We thank the Albert and Elaine Borchard Foundation for their generous financial support.

International audience ; Corporate social responsibility has gone mainstream, and many companies have taken meaningful steps towards a more sustainable future. Yet global environmental indicators continue to worsen, and individual corporate efforts may be hitting the point of diminishing returns. Voluntary action by the private sector is not a panacea-regulatory action by the public sector remains necessary. Such public sector progress will be more likely if it is supported by influential segments of the business community. Recent court rulings in the U.S. make it easy for companies to hide their political activities from the public, yet the indicators of CSR used by ratings agencies and socially responsible investment funds mostly ignore corporate political action. We argue that it is time for CSR metrics to be expanded to critically assess and evaluate firms based on the sustainability impacts of their public policy positions. To enable such assessments, firms need to become as transparent about their political activity as many have become about their CSR efforts, and CSR rating services and ethical investment funds need to demand such information from firms and include an assessment of corporate political activity in their ratings. † We thank the Albert and Elaine Borchard Foundation for their generous financial support.

Corporate sustainability has gone mainstream, and many companies have taken meaningful steps to improve their own environmental performance. But while corporate political actions such as lobbying can have a greater impact on environmental quality, they are ignored in most current sustainability metrics. It is time for these metrics to be expanded to critically assess firms based on the sustainability impacts of their public policy positions. To enable such assessments, firms must become as transparent about their corporate political responsibility (CPR) as their corporate social responsibility (CSR). For their part, rating systems must demand such information from firms and include evaluations of corporate political activity in their assessments of corporate environmental responsibility.

Corporate sustainability has gone mainstream, and many companies have taken meaningful steps to improve their own environmental performance. But while corporate political actions such as lobbying can have a greater impact on environmental quality, they are ignored in most current sustainability metrics. It is time for these metrics to be expanded to critically assess firms based on the sustainability impacts of their public policy positions. To enable such assessments, firms must become as transparent about their corporate political responsibility (CPR) as their corporate social responsibility (CSR). For their part, rating systems must demand such information from firms and include evaluations of corporate political activity in their assessments of corporate environmental responsibility.

Persistent suicide ideation (SI) is known to be a risk factor for subsequent suicidal behaviors. Reducing SI persistence among people with a history of SI consequently might be a useful target for preventive intervention; however, basic information is lacking about patterns and predictors of SI persistence. We report preliminary retrospective data on annual SI persistence in a representative sample of 3,501 U.S. Army soldiers with lifetime SI from the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS). Reports about age-of-onset and number of years with SI were used to estimate two definitions of persistence: persistence beyond year-of-onset and proportional annual persistence (i.e., percentage of years with SI since year-of-onset). Results revealed that for 47.8% of respondents with lifetime SI, their SI did not persist beyond the year-of-onset. For the 52.2% whose SI did persist beyond the year-of-onset, the median (inter-quartile range) proportional annual persistence was 33% (17–67%). Significant predictors of increased persistence were different for respondents with pre-enlistment SI onset (prior histories of attention-deficit/hyperactivity disorder [ADHD], bipolar disorder, and panic disorder) and post-enlistment SI onset (male, combat support military occupation specialty, prior histories of ADHD, panic disorder, and posttraumatic stress disorder). These predictors of persistence are different from the predictors of SI onset, suggesting that secondary preventive interventions to reduce SI persistence may need to focus on different factors than primary preventive interventions to reduce SI onset.