We reflect on a decade of Responsible Research and Innovation (RRI) as a discourse emerging from the European Commission (EC) 10 years ago. We discuss the foundations for RRI, its emergence during the Seventh Framework programme and its subsequent evolution during Horizon 2020. We discuss how an original vision for RRI became framed around five so-called ‘keys’: gender, open access, science communication, ethics and public engagement. We consider the prospects for RRI within the context of the EC’s Open Science agenda and Horizon Europe programme, before closing with some reflections on the contribution RRI has made to debates concerning the relationship between science, innovation and society over the last decade.

Little is known about effective strategies for disseminating and implementing complex clinical innovations across large healthcare systems. This paper describes processes undertaken and tools developed by the U.S. Department of Veterans Affairs (VA) Mental Health Quality Enhancement Research Initiative (MH-QUERI) to guide its efforts to partner with clinical leaders to prepare for national dissemination and implementation of collaborative care for depression.

Thyroid disease is a very common condition that influences the entire human body, including cognitive function and mental health. As a result, thyroid disease has been associated with multiple neuropsychiatric conditions. However, the relationship between thyroid dysfunction and suicide is still controversial. We conducted a systematic review and meta-analysis to describe the association of thyroid function with suicidal behavior in adults. We searched four data bases (MEDLINE, EMBASE, PsycINFO, and Scopus) from their inception to 20 July 2018. Studies that reported mean values and standard deviation (SD) of thyroid hormone levels [Thyroid-stimulating hormone (TSH), free thyroxine (FT4), free triiodothyronine (FT3), total thyroxine (TT4), and total triiodothyronine (TT3)] in patients with suicidal behavior compared with controls were included in this meta-analysis. The abstracts and papers retrieved with our search strategies were reviewed independently and in duplicate by four reviewers for assessment of inclusion criteria and data extraction, as well as for evaluation of risk of bias. Random-effects models were used in this meta-analysis to establish the mean difference on thyroid function tests between groups. Overall, 2278 articles were identified, and 13 studies met the inclusion criteria. These studies involved 2807 participants, including 826 participants identified with suicidal behavior. We found that patients with suicide behavior had lower levels of FT3 (−0.20 pg/mL; p = 0.02) and TT4 (−0.23 µg/dL; p = 0.045) compared to controls. We found no differences in either TSH, FT4, or TT3 levels among groups. With our search strategy, we did not identify studies with a comparison of overt/subclinical thyroid disease prevalence between patients with and without suicide behavior. The studies included in this meta-analysis had a low-to-moderate risk of bias. In the available literature, the evidence regarding the association of thyroid disorders and suicidal behavior is limited. We found that patients with suicidal behavior have significantly lower mean FT3 and TT4 levels when compared to patients without suicidal behavior. The clinical implications and pathophysiologic mechanisms of these differences remain unknown and further research is needed.

Our study considers the governance, ethics and operational challenges associated with the acquisition, manipulation and commodification of ‘big data’ in the financial services sector. To the best of our knowledge, there are no published studies describing empirical research undertaken within companies in this sector to understand how they are responding to such challenges: our field-based research is a significant initial contribution in this respect. We describe the results of a micro-ethnographic study undertaken in a small-to-medium-sized company developing disruptive, technology-related platforms and services in the banking and retail sectors based on big data and associated analytics: these are used to derive commercially valuable insights from personal customer data in exchange for cash back and targeted rewards. The company was found to employ a multi-level innovation governance approach, underpinned by an ethical strategy based on a principle of mutual benefit (among stakeholders). Opt-in and informed consent for using data for specific purposes was supported by principles of data minimisation and anonymisation, with unrestricted use of secondary, anonymised and aggregated data to develop insights. Governance, which included contextual data protection legislation, payment-card industry data usage standards and internal corporate controls, presented as bespoke organisational practices relating to data security and privacy. These in total set the governance and ethics frame for big data innovation at the company within which it has had to be both adaptive and responsive under conditions of normative and regulatory uncertainty.

To compare the effectiveness of a conceptually-based, multicomponent "enhanced" strategy with a "basic" strategy for implementing antipsychotic management recommendations of VA schizophrenia guidelines. Two VA medical centers in each of 3 Veterans Integrated Service Networks were randomized to either a basic educational implementation strategy or the enhanced strategy, in which a trained nurse promoted provider guideline adherence and patient compliance. Patients with acute exacerbation of schizophrenia were enrolled and assessed at baseline and 6 months and their medical records were abstracted; 291 participants were included in analyses. Logistic regression models were developed for rates of: (1) switching patients from first-generation antipsychotics (FGA) to second-generation antipsychotics (SGA), and (2) guideline-concordant antipsychotic dose. Of participants prescribed FGAs at baseline, those at enhanced sites were significantly more likely than participants at basic sites to have an SGA added to the FGA during the study (29% vs. 8%; adjusted OR = 7.7; 95% CI: 2.0-30.1), but were not significantly more likely to be switched to monotherapy with an SGA (29% vs. 23%). Guideline-concordant antipsychotic dosing was not significantly affected by the intervention. The enhanced guideline implementation strategy increased addition of SGAs to FGA therapy, but did not significantly increase guideline-recommended switching from FGA to SGA monotherapy. Antipsychotic dosing was not significantly altered. The study illustrates the challenges of changing clinical behavior. Strategies to improve medication management for schizophrenia are needed, and must incorporate recommendations likely to emerge from recent research suggesting comparable effectiveness of SGAs and FGAs.