The European regulatory framework lacks standardisation as regards the minimum requirements for shelter facilities, making defining welfare standards for dogs challenging. Dog (Canis familiaris) welfare assessments should consist of a comprehensive set of measurements that allow the calculation of an overall ‘welfare score.’ The Shelter Quality protocol was developed for the purpose of assessing shelter dog welfare. The study aims to establish a standardised system for evaluating shelter dog welfare by obtaining agreement from experts on the weighting of different measures contributing to an overall welfare score. The Delphi technique is a widely used method for establishing consensus among experts. Two Delphi procedures were implemented and we compared their effectiveness in achieving expert consensus by evaluating rounds’ numbers required to reach consensus and the response and attrition rates. Expert consensus was achieved in Delphi 1 when the standard deviation in the expert weightings was ≤ 5. This was achieved easily for the welfare score weightings of the four principles: ‘Good feeding’, ‘Good housing’, ‘Good Health’, and ‘Appropriate behaviour.’ Animal-based measures were found to reach consensus more quickly than resource-based measures. In Delphi 2, we used the coefficient of variation to determine consensus. No statistical differences were found between the two Delphi methods for attrition rate, response rate or number of participants. Continuing rounds until a consensus is reached is recommended as this method balances time and participant fatigue. A standardised scoring system is provided, using a single overall score of welfare that can be used to compare welfare standards between shelters.

The COVID-19 outbreak has raised numerous challenges for mental health service system in China. The pandemic has many affects on clinical, research and teaching, due to the strict quarantine in china. Fight the COVID-19 became the most important thing in work. We outlined major mental health needs during COVID-19 outbreak from the exiting studies and challenges for mental health professionals, and how to manage these challenges in China. To reduce the risk of negative psychological outcomes associated with the COVID-19 pandemic, the Central Health Authority of China and different national academic societies have integrated mental health crisis interventions into the general deployment of disease prevention and treatment. The NHCC developed a mental health triage strategy to provide four levels of psychological crisis interventions. More than 20 specific guidelines and expert consensus for mental health services for the COVID-19 outbreak were disseminated by the end of February 2020 to provide timely guidance for frontline health care professionals. External mental health expert teams in other provinces were also established to provide emergency mental health services in Hubei province, China. In addition, widespread adoption of online public education, psychological counseling, and hotline services have been set up for those in need. Although the COVID-19 pandemic has been under control in China, we should take a proactive lead to share its protocol of emergency mental health services with other countries affected by the COVID-19 pandemic. Also international cooperation is urgely needed to control the COVID-19 pandemic worldwide. Large-scale epidemiological surveys should be conducted to examine the prevalence of mental health problems associated with the COVID-19 pandemic to inform the development of appropriate mental health services in future.

The development of DSM-III through DSM-5 has relied heavily on expert consensus. In this essay, we provide an historical and critical perspective on this process. Over the last 40 years, medicine has struggled to find appropriate methods for summarizing research results and making clinical recommendations. When such recommendations are issued by authorized organizations, they can have widespread influence (i.e. DSM-III and its successors). In the 1970s, expert consensus conferences, led by the NIH, reviewed research about controversial medical issues and successfully disseminated results. However, these consensus conferences struggled with aggregating the complex available evidence. In the 1990s, the rise of evidence-based medicine cast doubt on the reliability of expert consensus. Since then, medicine has increasingly relied on systematic reviews, as developed by the evidence-based medicine movement, and advocated for their early incorporation in expert consensus efforts. With the partial exception of DSM-IV, such systematic evidence-based reviews have not been consistently integrated into the development of the DSMs, leaving their development out of step with the larger medical field. Like the recommendations made for the NIH consensus conferences, we argue that the DSM process should be modified to require systematic evidence-based reviews before Work Groups make their assessments. Our suggestions – which would require leadership and additional resources to set standards for appropriate evidence hierarchies, carry out systematic reviews, and upgrade the group process – should improve the objectivity of the DSM, increase the validity of its results, and improve the reception of any changes in nosology.