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Due to the demographic shift complex care management of older multimorbid patients with changing functional capacities has become core clinical business for many stakeholders in western health care systems. It is the aim of the mini‐review to summarise evidence to be translated into clinical practice for pharmacists and medical doctors and interested readers. The review is based upon a comprehensive literature review in PubMed and EMBASE from 2000 to 2018 and grey literature. Interprofessional exchange and discussion among stakeholders from geriatric medicine and the International Association for Pharmaceutical Technology during a meeting in Graz, Austria 2018, led to the narrowing of the review addressing complex care needs of geriatric patients. In this mini‐review, attention is drawn to a comprehensive therapeutic goal setting according to evidence‐based guidelines: clinical, disease‐related care aspects, functional capacities, evaluated by comprehensive geriatric assessment, and patient's wishes and perspectives as main drivers for personalised complex care of geriatric patients. [ABSTRACT FROM AUTHOR]

Key summary points: Aim: The aim of the paper is to give insight into MOOCs in general and to specifically describe a MOOC developed in the course of the SCOPE project "Screening for Chronic Kidney Disease (CKD) among older People across Europe". Findings: The major target of the MOOC was the improvement of knowledge for a broad audience. The SCOPE MOOCs are freely accessible, structured in three modules, offer additional learning material and guarantee knowledge dissemination about aging and chronic kidney diseases. Message: The MOOCs represent a contemporary example of how modern technology is supporting a transition to modern training in geriatrics. Purpose: To cover the increasing need for professional knowledge, skills and competences in the care of older people, new learning techniques have been developed. Using the Internet to provide educational material has come into focus of many academic institutions as the learning content can easily be transferred to a larger audience. Since the first launch of a "massive open online course" (MOOC) in 2008, this educational format has raised increasing interest among education experts. The current publication provides insight into the new format of MOOCs in general and specifically describes a MOOC developed by a Pan-European Consortium "Screening for Chronic Kidney Disease (CKD) among Older People across Europe" (SCOPE), a project funded by the European Commission under the umbrella of the Horizon 2020 program. Methods: Technical background, learning theories and content of the MOOC of the SCOPE project are presented in this overview. Results: The MOOC of the SCOPE project is provided on the MOOC ICT platform iMoox. The courses are built up of video clips, textual descriptions, graphics, animations and audio designed with a clear structure and learning goals. The concise video clips with a maximum length of 15–20 min are equipped with additional learning material such as documents, links and asynchronous communication opportunities. Conclusion: MOOCs are recognized as a contemporary approach to transfer required knowledge and skills not only in general but also in geriatric medicine, as the health and social care environment is ever-changing and becoming more complex. [ABSTRACT FROM AUTHOR]

Upon continuous stress exposure, plants display attenuated metabolic stress responses due to regulatory feedback loops. Here, we have tested the hypothesis that pulsed stress exposure with intervening recovery periods should affect these feedback loops, thereby causing increased accumulation of stress‐induced metabolites. The response of Arabidopsis plantlets to continuous UV‐B exposure (Cuv) was compared with that of pulsed UV‐B exposure (Puv). The differential responses to Puv versus Cuv were monitored at the level of gene expression and metabolite accumulation, using wild type (WT) and different mutant lines. In comparison with Cuv, Puv increased sinapyl and flavonol (S + F) content, whereas adaptive growth attenuation was reduced. Furthermore, in a myb4 mutant (AtMYB4, repressor‐type R2R3‐MYB transcription factor), the S + F content was increased only for Cuv, but not beyond the level for Puv observed in WT. These observations and the ability of AtMYB4 to repress AtMYB12/AtMYB111‐mediated activation of target gene promoters (pCHS and pFLS) indicate that the increase of S + F content after Puv observed in WT plants results from reduced feedback inhibition by AtMYB4. The results support the notion that stress‐induced metabolic changes not necessarily cause a growth penalty. Furthermore, the observed Puv‐induced increase in flavonol accumulation may stimulate reevaluation of commercial plant production practices. Attenuation of plant secondary metabolite accumulation in response to continuous stress exposure is thought to depend on regulatory feedback loops. This study explores to what extent intervening stress‐free recovery periods can dampen these negative feedback loops. Treatment of Arabidopsis seedlings to UV‐B light revealed that pulsed stress exposure results in increased flavonol accumulation as compared with continuous exposure. Analysis of various mutant lines indicates that this phenomenon is due to a modified action of the transcriptional repressor AtMYB4. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic puts health and care systems under pressure globally. This current paper highlights challenges arising in the care for older and vulnerable populations in this context and reflects upon possible perspectives for different systems making use of nested integrated care approaches adapted during the work of the EU-funded project VIGOUR ("Evidence based Guidance to Scale-up Integrated Care in Europe", funded by the European Union's Health Programme 2014-2020 under Grant Agreement Number 826640)., Competing Interests: The authors have no competing interests to declare., (Copyright: © 2020 The Author(s).)