Search

BACKGROUND: Inadequate and inequitable access to quality behavioral health services and high costs within the mental health systems are long-standing problems. System-level (e.g., fee-for-service payment model, lack of a universal payor) and individual factors (e.g., lack of knowledge of existing resources) contribute to difficulties in accessing resources and services. Patients are underserved in County behavioral health systems in the United States. Orange Countys (California) Behavioral Health System Transformation project sought to improve access by addressing two parts of their system: developing a template for value-based contracts that promote payor-agnostic care (Part 1); developing a digital platform to support resource navigation (Part 2). Our aim was to evaluate facilitators of and barriers to each of these system changes. METHODS: We collected interview data from County or health care agency leaders, contracted partners, and community stakeholders. Themes were informed by the Consolidated Framework for Implementation Research. RESULTS: Five themes were identified related to behavioral health system transformation, including 1) aligning goals and values, 2) addressing fit, 3) fostering engagement and partnership, 4) being aware of implementation contexts, and 5) promoting communication. A lack of fit into incentive structures and changing state guidelines and priorities were barriers to contract development. Involving diverse communities to inform design and content facilitated the process of developing digital tools. CONCLUSIONS: The study highlights the multifaceted factors that help facilitate or hinder behavioral health system transformation, such as the need for addressing systematic and process behaviors, leveraging the knowledge of leadership and community stakeholders, fostering collaboration, and adapting to implementation contexts.

While existing literature describing the use of co-design has focused on its application within individual-level or group-level health interventions, the use of co-design to plan and support the implementation of mental health and substance use health stepped care (MHSUH) models and other MHSUH system transformation initiatives is more limited. In this commentary, the authors describe the Populating the Model Series, a co-design-based, system-level planning intervention specifically developed for sites implementing the Stepped Care 2.0 (SC2.0) model of care. The use of co-design, which is a core component of the SC2.0 model, distributes risk through engagement across the community, broadens the system of care to include and acknowledge informal and formal options, creates person-centricity, and incorporates access points and care modalities that are tailored to the intervention site's context. Seven steps are identified within the Populating the Model Series including assessing intervention site readiness, understanding site context, planning and adjusting engagement of key groups for co-design, learning through workshop sessions and co-design, validation with key groups, understanding findings, and application of findings. This guidance provides an actionable process framework for the application of co-design in the planning and implementation of SC2.0 and other stepped care models. [ABSTRACT FROM AUTHOR]

The article shares strategies associated with reengineering the core functionalities of an electronic health record (EHR) system of a Kentucky geriatric-focused primary care (PC) clinic. It notes that the strategy necessitated a shift from traditional roles of geriatrician-led PC to team-based PC. It states that the success of the strategy relied on comprehensive education for team members on age-friendly health care.

Abstract Background Inadequate and inequitable access to quality behavioral health services and high costs within the mental health systems are long-standing problems. System-level (e.g., fee-for-service payment model, lack of a universal payor) and individual factors (e.g., lack of knowledge of existing resources) contribute to difficulties in accessing resources and services. Patients are underserved in County behavioral health systems in the United States. Orange County’s (California) Behavioral Health System Transformation project sought to improve access by addressing two parts of their system: developing a template for value-based contracts that promote payor-agnostic care (Part 1); developing a digital platform to support resource navigation (Part 2). Our aim was to evaluate facilitators of and barriers to each of these system changes. Methods We collected interview data from County or health care agency leaders, contracted partners, and community stakeholders. Themes were informed by the Consolidated Framework for Implementation Research. Results Five themes were identified related to behavioral health system transformation, including 1) aligning goals and values, 2) addressing fit, 3) fostering engagement and partnership, 4) being aware of implementation contexts, and 5) promoting communication. A lack of fit into incentive structures and changing state guidelines and priorities were barriers to contract development. Involving diverse communities to inform design and content facilitated the process of developing digital tools. Conclusions The study highlights the multifaceted factors that help facilitate or hinder behavioral health system transformation, such as the need for addressing systematic and process behaviors, leveraging the knowledge of leadership and community stakeholders, fostering collaboration, and adapting to implementation contexts.

Objective: To describe the solutions community health nurses (CHNs) identify to address health inequities during the COVID‐19 pandemic and to explore what leadership competencies enable CHNs to enact these solutions. Design: Online survey, distributed to all members of the Community Health Nurses of Canada and associated provincial and territorial networks. Participants: Inclusion criteria included all nurses who were working during the COVID‐19 pandemic in Canada. A total of 245 responses were included in the analysis. Measurement: The survey included 25 open ended and fixed response questions. Descriptive statistics were used to describe the quantitative data. Framework Analysis was used to analyze the qualitative data. Results: Solutions focused on advancing health equity and expanding community relationships and partnerships were identified as priorities. To enact these solutions system transformation, engaging others, and developing coalitions were identified as the main leadership competencies required by CHNs. Conclusion: Participants in this study clearly articulated structural and process solutions to address health inequities among priority populations during the pandemic. CHNs described with practice knowledge and confidence that solutions enacted in system transformation with community partners are necessary to advance health equity. [ABSTRACT FROM AUTHOR]

This study aims to prove that the transformation of TPS 3R in Kalimojosari Village is effective in developing the village economy through literature research with a qualitative approach. TPS 3R is one of the waste treatment system solutions that can solve waste problems. 3R-based TPS is a pattern of waste management approach on a communal or regional scale, involving the active role of the government and the community. TPS 3R has potential in its contribution to the village economic development process. TPS 3R has benefits that can be felt directly by the surrounding community from various sectors. So that the transformation of TPS 3R can be applied in various regions, especially Kalimojosari Village. [ABSTRACT FROM AUTHOR]

Over-extraction of groundwater is a prominent challenge in India, with profound implication for food security, livelihoods, and economic development. As groundwater is an ‘invisible’ and mobile common pool resource, sustainable governance of groundwater is complex, multifaceted, requiring coordination among various stakeholders at different scales. It remains an open question as to what can be done to strengthen the governance of groundwater, particularly on the scale necessary to address widespread depletion of resources. The growing competition over groundwater resources calls for systemic changes towards sustainable water management. These require understanding the behaviours of actors in the system network, as well as the institutions that shape the direction in which the system moves. In this paper, we offer a behavioural perspective to system transformation and apply it to the example of an Indian NGO working on sustainable natural resource governance. The organisation, Foundation for Ecological Security (FES), has been co-designing and using various institutional tools for groundwater governance with the collaboration of other NGOs and government partners, academic and research organisations towards strengthening governance of water. At the local level, these include groundwater monitoring and crop water budgeting, combined with experiential learning tools such as games for demand management, and supply side interventions to support water harvesting and recharge. These tools are combined with efforts to strengthen multi-actor platforms, building coalitions and capacity of government, civil society and private sector actors to support groundwater governance at scale. By combining local and systemic approaches, the aim is to influence water governance on a larger scale and contribute to the sustainable management of water resources in India. Our reflections illustrate how conceptual thinking can inform multi-methods approaches which consider that sustainably improving groundwater management at large scale requires inter-linked behavioural changes of diverse actors. Our approach constitutes critical reflection and conceptualization, based on situated knowledge which contributes to designing better adapted and more powerful intervention strategies through informed argument.

Perry and colleagues’ study of a programme to reconfigure cancer surgery provision in Greater Manchester highlights the importance of accounting for history in making successful change. In this short commentary, I expand on some of Perry and colleagues’ key findings. I note the way in which those leading change in Greater Manchester combined formal expertise in change management with sensitivity to local context, enhancing their approach to change through attention to details around relationships, events and assumptions that might otherwise have derailed the process. I identify lessons for others in how best to account for history in leading change, highlighting in particular the need to attempt to access and understand forms of history that may be suppressed, difficult-to-articulate, or otherwise marginalised.

As a discipline, marketing will need to shift as businesses and other institutions respond to the numerous crises now facing the world—either proactively towards transformative sustainable marketing, as it has been termed, or reactively in an effort to sustain business as usual. This paper argues that proactive transformation towards fostering flourishing for all will keep the discipline healthy and viable. That transformation, however, requires significant rethinking of marketing’s core paradigm, purposes, and the performance metrics by which it is measured, which in turn influence key aspects marketing practice (including processes, procedures, and policies) and related power structures. All of these shifts will be emergent and hence unpredictable (though core questions can be considered as preparation), because of the nature of the complexly wicked context in which systemic change occurs.

The article studies the problem of comprehensive assessment of the phenomenon of digital transformation. The paper describes the place and role of digitalization in close mutually reinforcing relationship with other aspects of socio-technical-economic transformation of the 21st century. A phenomenological approach has been proposed to assess direct and indirect manifestations of digital transformation in a wide range of socio-technological areas that ultimately affct economy. Using the example of transportation industry, the intersection of some identifid socio-economic and economic-technological aspects at the level of macroand microeconomics, as well as human existence, has been examined. It has been proposed to consider digitalization as a fild of applied knowledge and competencies, which is just acquiring the phase of formation, from the position of sustainable development for unifiation of diffrent-format manifestations of digital transformation in many areas of life. Digitalization effcts have been brought to the methodological framework of the sustainable development approach as an interrelation of economic, social and technological aspects adapted to real economy. The conclusion has been made about digital transformation as part of overall accelerated socio-technical progress, which implies a deeper and more systematic attitude to the phenomenon of digitalization. It has been proposed to continue research in this approach from expert positions and use the fidings to develop applied methodology for the use of digital technologies in terms of sustainable development.

Copyright of Journal of Engineering for Thermal Energy & Power / Reneng Dongli Gongcheng is the property of Journal of Engineering for Thermal Energy & Power and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The aim of the article is to present the security determinants as well as changes regarding the strategic priorities of state security of Georgia after the war with Russia in 2008. Since the beginning of the system transformation into a legal democratic state, Georgia has been developing essential reforms that involved the establishment of democratic institutions, state modernisation, the development of a free trade economy, as well as directed towards Euro-Atlantic and western institutions for co-operation and security. In the international dimension, these efforts have met the encouragement and support of the western and democratic states and institutions, especially NATO and the EU. On the other hand, Georgia had to face the huge opposition from the Russian Federation that aimed to maintainits previous area of influence and oppose the pro-western development in the region of South Caucasus. The war in 2008 (Russian aggression) slowed down these transformation processes and was the reason for the change of perceiving the security environment of Georgia and the role and attitude of Russian Federation towards the post-Soviet space. It resulted in necessary efforts to rebuild the country after the ravages of war on the one hand, and in the considerable change regarding the restoration of institutions and possibilities connected with the main security goals on the Georgian pro-democratic and pro-western way. [ABSTRACT FROM AUTHOR]

This article summarizes a body of practice and theory that the author has, with colleagues, built up over the past 30 years through working, in many different contexts, with teams of diverse stakeholder leaders collaborating to transform the social systems of which they are part. It tells the story of the development, through first-, second-, and third-person observations recorded in a sequence of five books plus a guidebook, of an approach to social transformation that focuses on unblocking three innate human drives that are in permanent tension: love, power, and justice.

The article focuses on ETH Zurich's Air Travel Project and its aim to substantially reduce emissions from academic air travel, aligning with the broader movement to prioritize sustainability in academia. Topics include challenges in mitigating aviation emissions, the ETH Air Travel Project's strategies for emission reduction, and perceptions and attitudes towards air travel among ETH Zurich members, emphasizing the need for a transformative approach to reshape academic travel behavior.

As a discipline, marketing will need to shift as businesses and other institutions respond to the numerous crises now facing the world—either proactively towards transformative sustainable marketing, as it has been termed, or reactively in an effort to sustain business as usual. This paper argues that proactive transformation towards fostering flourishing for all will keep the discipline healthy and viable. That transformation, however, requires significant rethinking of marketing’s core paradigm, purposes, and the performance metrics by which it is measured, which in turn influence key aspects marketing practice (including processes, procedures, and policies) and related power structures. All of these shifts will be emergent and hence unpredictable (though core questions can be considered as preparation), because of the nature of the complexly wicked context in which systemic change occurs. [ABSTRACT FROM AUTHOR]

The article presents the main research focus on Generation X in Poland, on the problem of this generation’s (un)adjustment and (non)capitalization of the potential and circumstances related to the collapse of socialism and the onset of the country’s system transformation process. In countries such as Poland this problem becomes of particular significance because the life of Generation X became integrally interwoven with the radical political, social and economic changes. The primary objective of this paper is to present selected conditions of a start of the working lives of the Polish Generation X and the significance thereof for a successful entry into the adult life by this generation. An attempted analysis covered homogeneity vs. diversity of behaviors typical of this generation. The paper comprised studying the subject literature, the desk research method, descriptive statistics method and the collective case study method. Reference was made to the reports and data bases collected by Eurostat and by Poland and the USA, including by the bureaus for statistics in both countries.

Evaluation that supports social, ecological, and governance systems change and transformation raises ethical questions about what and whose worldviews do and should ground evaluative processes. This article illustrates one approach to ethical analysis within a case study of the first phase of an initiative to co-create a monitoring, evaluation, and learning system. The case drew on the principles of Blue Marble Evaluation in partnership with local staff and Indigenous leaders of the Amazon Sacred Headwaters Initiative. The approach uses critical and relational systems thinking to examine the sources of motivation, power, knowledge, and legitimacy that influence and should influence an evaluation system. Results reframe typical early phase evaluation process work from a contractual agreement to a co-created ethical space that engenders the legitimacy of the evaluation process. Contributions include a conceptual framework and process for ethical analysis that could be adapted by others. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Community Mental Health is the property of Canadian Periodical for Community Studies Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

To ensure the safety and stability of the bridge during construction, construction monitoring of the bridge and its temporary support system is required. The bridge closure stage involves system conversion, and the effect of unbalanced load on the bridge during cantilever construction needs to be considered. The construction monitoring of the temporary support system of the thin-walled pier bridge based on the reconstruction of Gaozeng bridge was studied. The MIDAS model of the thin-walled pier bridge was established to simulate the cantilever construction process of the continuous beam. The safety of the thin-walled pier construction process was analyzed by combining theory and simulation. The results show that even under the most dangerous working conditions, the stresses on the thin-walled piers are within the safe range. The construction monitoring of the temporary support system ensures the safety of the whole process of bridge construction. [ABSTRACT FROM AUTHOR]

Abstract Background The Covid-19 pandemic has created an unprecedented challenge for health and social care systems globally. There is an urgent need for research on experiences of COVID-19 at different levels of health systems, including lessons from professional, organisational and local system responses, that can be used to inform managerial and policy responses. Methods This paper presents the findings from a thematic analysis of front-line staff experiences working across the Norfolk and Waveney integrated care system (ICS) in the East of England during April and October 2020 to address the question “What are the experiences and perceptions of partner organisations and practitioners at multiple levels of the health system in responding to COVID-19 during the first wave of the pandemic?” This question was posed to learn from how practitioners, interdependent partner organisations and the system experienced the pandemic and responded. 176 interview transcripts derived from one to one and focus group interviews, meeting notes and feedback from a “We Care Together” Instagram campaign were submitted for qualitative thematic analysis to an external research team at a regional University commissioned to undertake an independent evaluation. Three phases of qualitative analysis were systematically undertaken to derive the findings. Findings Thirty-one themes were distilled highlighting lessons learned from things that went well compared with those that did not; challenges compared with the celebrations and outcomes; learning and insights gained; impact on role; and system headlines. The analysis supported the ICS to inform and capitalise on system wide learning for integration, improvement and innovations in patient and care home resident safety, and staff wellbeing to deal with successive waves of the pandemic as well as prioritising workforce development priorities as part of its People Plan. Conclusions The findings contribute to a growing body of knowledge about what impact the pandemic has had on health and social care systems and front-line practitioners globally. It is important to understand the impact at all three levels of the system (micro, meso and macro) as it is the meso and macro system levels that ultimately impact front line staff experiences and the ability to deliver person centered safe and effective care in any context. The paper presents implications for future workforce and health services policy, practice innovation and research.

In this paper, we investigate the asymptotic tracking control for a class of strict-feedback nonlinear systems with unknown nonlinear functions and output constraint. The nonlinear transformation function-based system transformation approach is employed to convert the initial constrained system into an unconstrained one. To achieve the objective of asymptotic tracking, the tracking error is scaled by an exponential proportional function. Furthermore, to address the challenge of repetitive derivation of virtual control laws that occurs in the traditional design process of high-order backstepping methods, a first-order filter is applied. The designed control scheme guarantees that the system output will asymptotically track a predefined reference tracking trajectory while ensuring that the output constraint is not violated. Moreover, it is shown that the filter error will converge asymptotically to the origin. The effectiveness of the developed control strategy is verified through simulation results. • This study introduces a nonlinear system transformation function to convert the initial constrained control problem. • An exponential-type proportional function is constructed. • The asymptotic convergence performance can be guaranteed. [ABSTRACT FROM AUTHOR]

The dynamic nature of today’s manufacturing industry, which is caused by the intense global competition and constant technological advancements, requires systems that are highly adaptive and responsive to demand fluctuations. Reconfigurable manufacturing systems (RMS) enable such responsiveness through their main characteristics. This paper addresses the problem of RMS configuration design, where the demand of a single product varies throughout its production life cycle, and the system configuration must change accordingly to satisfy the required demand with minimum cost. A two-phased method is developed to handle the primary system configuration design and the necessary system reconfigurations according to demand rate changes. This method takes advantage of Reconfigurable Machine Tools in RMS. In fact, by adding/removing modules to/from a specific modular reconfigurable machine, its production capability could be increased, with lower cost. A novel mixed integer linear programming formulation is presented in the second phase of the method to optimise the process of selecting the best possible transformation for the existing machine configurations. Two different cases are designed and solved by implementing the established method. The results of these cases in terms of capital cost, capacity expansion cost, unused capacity and number of transformations, are compared with two hypothetical scenarios. Analyses of the obtained results indicate the efficiency of the proposed approach and offer a promising outlook for further research. [ABSTRACT FROM AUTHOR]

Background: Youth mental health challenges are an emerging and persistent global public health issue despite efforts for improvement. As part of a broader social innovation study to transform youth mental health systems, this scoping review assesses interventions that aim for systems‐level changes to improve the mental well‐being of transitional age youth (TAY) (15–25 years) in high‐income countries. Methods: The scoping review method of Arksey and O'Malley (International Journal of Social Research Methodology, 8, 2005, 19) was used. Seven health and social service databases were utilized with study inclusion criteria applied. Titles and abstracts were screened by two independent reviewers, and four members of the research team were involved in the review and thematic analysis of selected studies. Results: A total of 5652 peer‐reviewed articles were screened at the title and abstract level, of which 65 were assessed in full for eligibility, and 29 were included for final analysis. The peer‐reviewed articles and gray literature were based in seven different high‐income countries and published between 2008 and 2019. Four major themes to support youth mental health were identified in the literature: (a) improving transitions from youth to adult mental healthcare services; (b) moving care from institutions to the community; (c) general empowerment of youth in society; and (d) youth voice within the system. Inconsistent or limited systems‐level approaches to TAY mental health care were noted. Conclusions: There remains a need for innovative, evidence‐based approaches to improve TAY mental health care. [ABSTRACT FROM AUTHOR]

This article provides a snapshot of the legislative framework for, and ministries and agencies involved in or with influence over, the education of the health and disability workforce, including examples of disconnection between the wider health and education sectors. Particular challenges occur between health professional regulators, education providers and clinical (placement) providers because their respective areas of expertise tend to be siloed, thus reducing the capacity for a coordinated and holistic perspective. Four potential 'bridges' for linking these 'islands' of expertise are suggested. The current period of institutional reforms in the health and education sectors presents an opportunity to refine the structures and systems for workforce education and planning, thereby facilitating a more flexible, responsive and resilient workforce which is better equipped to engage with, and improve outcomes for, the wider community. [ABSTRACT FROM AUTHOR]

Copyright of Tunnel Construction / Suidao Jianshe (Zhong-Yingwen Ban) is the property of Tunnel Construction Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Implementing mental health recovery into services is a policy priority in Canada and globally. To that end, a 5 year study was undertaken with seven organisations providing mental health and housing services to people living with a mental health challenge to implement guidelines for the transformation of services and systems towards a recovery-orientation. Multi-stakeholder implementation teams were established and a facilitated process guided teams to choosing and planning for the implementation of one recovery innovation. The recovery innovations chosen were hiring peer support workers, Wellness Recovery Action Planning (WRAP), a family support group, and staff recovery training. Methods: This study reports on data collected at the post-implementation stage. 90 service users, service providers, family members, managers, other actors and knowledge users participated in 41 group, individual or dyad semi-structured interviews. The interview guides included open-ended questions eliciting participants' impressions regarding the impact of implementing the innovation on service users, service providers and organisations. We applied a collaborative qualitative content analysis approach in NVivo12 to coding and interpreting the data generated from these questions. Results: Eighteen impacts of implementing recovery innovations from the perspectives of diverse stakeholder groups were identified. Three impacts of working as an implementation team member and as part of a research project were also identified. Impacts were developed into a conceptual framework organised around four overall categories of impact: Ways of being, Ways of interacting, Ways of thinking, and Ways of operating and doing business. Conclusions: The IMpacts of Recovery Innovations (IMRI) framework version 1 can assist researchers, evaluators and decision-makers identify, explore and understand impact in the context of recovery innovations. The framework helps fill a gap in conceptualising service and organisation-level impacts. Future research is needed to validate the framework and map it to existing methods for studying impact. [ABSTRACT FROM AUTHOR]

This paper investigates the distributed cooperative learning (DCL) from adaptive neural network (NN) control for a group of strict-feedback systems, where the structure of all strict-feedback systems is identical. In order to achieve DCL easily, the system transformation method is employed for the strict-feedback systems. For an agent, only one radial basis function NN is used to approximate the lumped uncertainty in control design. Then the output tracking performance of all strict-feedback systems is guaranteed. What's more, we prove that weights of all NNs in a multi-agent system converge to a small neighborhood around their common optimal value if the topology of the multi-agent system is connected and undirected. Thus, the approximation domain of all NNs is enlarged. Further, the previous learned NNs are used to improve the control performance. Finally, we provide two examples to demonstrate the effectiveness of the proposed scheme. [ABSTRACT FROM AUTHOR]

Analyzing the impact of a sustainability agenda in research and innovation on system transition is a critical research topic. This literature stream aims to examine how research and innovation can deal with wicked-problems at a dynamic system level to create more sustainable future systems. However, this study addresses two main issues in the current sustainability transition literature. First, the literature to date offers little insight into concrete implications for the management of innovation processes at the organizational level. Second, sustainability is often addressed as per se desirable. While the concept of Sustainable Innovation (SI) can valuably contribute in addressing the first issue by providing essential features to analyze business management procedures and their broader implications on socio-technical systems, it falls short in addressing the second issue. Essential aspects of sustainability, such as the responsibility for potential future trade-offs through innovation, are not strategically integrated into the current framework. This study argues that without strategic integration of responsibility, there is a risk of contributing to a partially-sustainable—”irresponsible”—socio-technical system change as a result of business innovation activities. Therefore, an extended innovation process model for sustainability to embed responsibility at the core of innovation activities is required. For this purpose, the framework of Responsible Research and Innovation (RRI) is utilized. This paper reports on findings from a systematic literature review of a representative sample of empirical studies from the SI and RRI literature. Thereby, the goal was to extend the understanding of management opportunities within innovation processes for sustainability through the implementation of RRI principles, in order to create sustainable socio-technical systems.

Background: The Covid-19 pandemic has created an unprecedented challenge for health and social care systems globally. There is an urgent need for research on experiences of COVID-19 at different levels of health systems, including lessons from professional, organisational and local system responses, that can be used to inform managerial and policy responses. Methods: This paper presents the findings from a thematic analysis of front-line staff experiences working across the Norfolk and Waveney integrated care system (ICS) in the East of England during April and October 2020 to address the question "What are the experiences and perceptions of partner organisations and practitioners at multiple levels of the health system in responding to COVID-19 during the first wave of the pandemic?" This question was posed to learn from how practitioners, interdependent partner organisations and the system experienced the pandemic and responded. 176 interview transcripts derived from one to one and focus group interviews, meeting notes and feedback from a "We Care Together" Instagram campaign were submitted for qualitative thematic analysis to an external research team at a regional University commissioned to undertake an independent evaluation. Three phases of qualitative analysis were systematically undertaken to derive the findings. Findings: Thirty-one themes were distilled highlighting lessons learned from things that went well compared with those that did not; challenges compared with the celebrations and outcomes; learning and insights gained; impact on role; and system headlines. The analysis supported the ICS to inform and capitalise on system wide learning for integration, improvement and innovations in patient and care home resident safety, and staff wellbeing to deal with successive waves of the pandemic as well as prioritising workforce development priorities as part of its People Plan. Conclusions: The findings contribute to a growing body of knowledge about what impact the pandemic has had on health and social care systems and front-line practitioners globally. It is important to understand the impact at all three levels of the system (micro, meso and macro) as it is the meso and macro system levels that ultimately impact front line staff experiences and the ability to deliver person centered safe and effective care in any context. The paper presents implications for future workforce and health services policy, practice innovation and research. [ABSTRACT FROM AUTHOR]

A newly established 'systemic approach to technology packaging' for improved scaling has emerged in the literature. This approach suggests that core transformative innovations can be scaled more effectively through scaling readiness, which helps identify complementary innovations that support and facilitate the scalability of the core innovation. Since these packaging approaches start with single core innovations, we propose that they can benefit from the broader literature on sustainable agricultural systems transformation and readiness. The objective of this paper is to advocate for a more comprehensive packaging of innovations for sustainable agricultural system transformations by better understanding gaps in the agricultural system – and its capacity for change. This approach provides a stronger rationale for the selection of relevant innovations to be packaged together. We introduce the concept of agricultural 'system readiness' as a possible framework for guiding such bundles. The paper begins with a comprehensive literature review that identifies the current gaps in tools and methods to guide system transformation. It also focuses on the specific literature on innovation packaging for scaling, and builds on the gaps of existing approaches as a rationale for introducing the concept of system readiness (mostly used in infrastructure engineering), and adapting it to agricultural science. We also use illustrative hypothetical examples from mixed crop-livestock systems in the drylands to show how two approaches – 'packaging for scaling' and 'packaging for transformation' – can lead to different innovation packages. The concept of system readiness is introduced, defined and advocated. We show that it can help identify performance gaps in agricultural systems and guide better planning for system strengthening and integration. We conclude with possible complementarities between the two approaches of scaling and system readiness. The agricultural system readiness approach, as outlined in this paper, would be particularly beneficial for agricultural research-for-development, as well as other agricultural investment programs that seek to identify strategies for fostering sustainable transition in farming systems. Such programs would typically entail complexity-aware theories of change that focus on stimulating sustainable transformation pathways related to key target areas, such as agroecology, sustainable intensification, and system integration (e.g., crop-livestock integration and integrated pest management). The system readiness approach can support such programs through the identification, prioritization, targeting, and empowerment of the most significant (and transformative) system components by identifying respective innovations to be packaged. [Display omitted] • A "System Readiness" (SysR) framework was introduced to pilot and guide the transformation of farming systems • There is a need for a paradigm shift from innovation-driven scaling to scaling activities that strengthen systems for inclusive innovation. • Entry points for system transformation can now be identified and prioritized based on SysR. • "Packaging for System Transformation" using SysR and "Scaling Readiness for Packaging Innovation" approaches can be complementary. [ABSTRACT FROM AUTHOR]

As part of the Global Smart Drinking Goals campaign launched in 2018 in 6 "City Pilots" around the world, the Businesses That Care (BTC; Empresas Que se Cuidan in Spanish) prevention system was developed and implemented in Zacatecas, Mexico. BTC is a private business sector adaptation of the Communities That Care prevention system. BTC is designed to address underage alcohol use through a combination of a company-led prevention system, an adapted family-based prevention program with parents employed at participating companies, and environmental prevention strategies for company employees. BTC was designed to be congruent with other health and safety efforts in the region (e.g., media campaign, road safety, and school prevention efforts). This study presents the feasibility and adoption of the BTC system in Zacatecas. Process implementation measures indicated successful participant recruitment, retention, and adherence to intervention protocols. The first 4 stages of BTC implementation were completed within 14 months, with Stage 5 being interrupted by the COVID-19 pandemic. BTC Prevention Committee members, made up of employees from BTC participating companies, received 9 out of 10 BTC trainings/workshops during this time. Results provide evidence of the acceptability and feasibility for private companies to implement a prevention system approach for reducing youth alcohol use. [ABSTRACT FROM AUTHOR]

Background: The Covid-19 pandemic has created an unprecedented challenge for health and social care systems globally. There is an urgent need for research on experiences of COVID-19 at different levels of health systems, including lessons from professional, organisational and local system responses, that can be used to inform managerial and policy responses.Methods: This paper presents the findings from a thematic analysis of front-line staff experiences working across the Norfolk and Waveney integrated care system (ICS) in the East of England during April and October 2020 to address the question "What are the experiences and perceptions of partner organisations and practitioners at multiple levels of the health system in responding to COVID-19 during the first wave of the pandemic?" This question was posed to learn from how practitioners, interdependent partner organisations and the system experienced the pandemic and responded. 176 interview transcripts derived from one to one and focus group interviews, meeting notes and feedback from a "We Care Together" Instagram campaign were submitted for qualitative thematic analysis to an external research team at a regional University commissioned to undertake an independent evaluation. Three phases of qualitative analysis were systematically undertaken to derive the findings.Findings: Thirty-one themes were distilled highlighting lessons learned from things that went well compared with those that did not; challenges compared with the celebrations and outcomes; learning and insights gained; impact on role; and system headlines. The analysis supported the ICS to inform and capitalise on system wide learning for integration, improvement and innovations in patient and care home resident safety, and staff wellbeing to deal with successive waves of the pandemic as well as prioritising workforce development priorities as part of its People Plan.Conclusions: The findings contribute to a growing body of knowledge about what impact the pandemic has had on health and social care systems and front-line practitioners globally. It is important to understand the impact at all three levels of the system (micro, meso and macro) as it is the meso and macro system levels that ultimately impact front line staff experiences and the ability to deliver person centered safe and effective care in any context. The paper presents implications for future workforce and health services policy, practice innovation and research. [ABSTRACT FROM AUTHOR]

The article presents the main research focus on Generation X in Poland, on the problem of this generation's (un)adjustment and (non)capitalization of the potential and circumstances related to the collapse of socialism and the onset of the country's system transformation process. In countries such as Poland this problem becomes of particular significance because the life of Generation X became integrally interwoven with the radical political, social and economic changes. The primary objective of this paper is to present selected conditions of a start of the working lives of the Polish Generation X and the significance thereof for a successful entry into the adult life by this generation. An attempted analysis covered homogeneity vs. diversity of behaviors typical of this generation. The paper comprised studying the subject literature, the desk research method, descriptive statistics method and the collective case study method. Reference was made to the reports and data bases collected by Eurostat and by Poland and the USA, including by the bureaus for statistics in both countries. [ABSTRACT FROM AUTHOR]

The Anthropology of Mental Health Interest Group affirms that the state of mental health in Academic Anthropology needs serious attention and transformation. We respond to structural inequities in academia that exacerbate mental distress among graduate students and other anthropologists who experience oppression, by putting forward a policy statement with recommendations to create more equitable learning and working environments. [ABSTRACT FROM AUTHOR]

Transformation (T-) systems are innovative collections of initiatives and efforts geared to bringing about a flourishing socio-ecological system in a given context. They comprise of the totality of initiatives, people and organizations who are collectively seeking to transform a particular issue or geography in a common direction, when they attempt to align their efforts for greater effectiveness, as a result of that growing identity and self-awareness. This article explores the concept of transformation (T-) systems, and how they can become impactful organizing frames for change agents. Another innovative type of entity, the Transformation Catalyst (TC), works to connect, cohere, and amplify the work of actors and initiatives, who generally work independently, into coherent T-systems. We use evolving work in the sustainable seafood arena to illustrate these ideas.