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Introduction: International policy is encouraging a re-design of health and social care services, including the use of social prescribing. Torbay and South Devon NHS Foundation Trust, an Integrated Care Organisation in the UK, commissioned a voluntary sector ‘Wellbeing Coordination’ service as a key element of the wider care model. This case study seeks to understand how primary, acute, social, community and voluntary services are working together in a locality hub and the impact of wellbeing coordinators on service users’ well-being, use and cost of health and social care services Methods: A before-and-after study, supplemented with qualitative case studies, practitioner interviews/surveys, observations of multidisciplinary team (MDT) meetings and service user/caregiver interactions. Applying an action-based participatory approach, findings were co-produced with stakeholders and members of the public by embedded researchers-in-residence. Quantitative service user data were collected on health and social well-being outcomes and frailty on referral and 12 weeks. Comprehensive activity and cost data were collected at 12 months pre- and post-referral. Results: Health outcomes and service activity data were collected on 49 participants receiving the wellbeing coordination programme. All person-reported outcomes showed statistically significant increases in mean change scores (Warwick-Edinburgh Mental Well-being Scale, Well-being Star™, Patient Activation Measure, Rockwood Clinical Frailty Scale, Living well goals met). Qualitative case studies and observations highlighted key mechanisms of the intervention and the hub working. The impact on health and social care use and cost was more nuanced, with mean activity and cost increasing overall. Referrals from the Enhanced Intermediate Care MDTs (20/49) showed higher levels of use and cost. At locality hub level, the practitioner survey, observations and interview findings show an increase in vertical and horizontal organisational integration and high levels of staff-reported person-centeredness while embodying a strengths-based approach. Discussion: The study shows a positive impact on outcomes and mixed patterns regarding activity and cost. The findings indicate potential for more ‘down-stream’ and preventative work. The close links with the wider voluntary sector add to the hub offer in holding more complexity, providing access and continuity of care, and delivering holistic and personalised care in the right place and at the right time. Conclusion: Key elements of how the hub works indicate the importance of leadership, co-ordination, communication, colocation, and contracting that allows the nourishing of trusting relationships and crossing of organisational and professional boundaries. Lessons learned: Challenges included pooling resources, record sharing, information governance and engaging all stakeholders in a shared vision for a strengths-based, person-centred culture. Ownership and bottom up dynamics and formal and informal relationships between practitioners at all levels, including the community they work with, were key features for overcoming these. Limitations: Case studies and participatory research approaches may be considered lesser to experimental study designs. However, context is crucial to integrated care and extrapolating generalizable findings. Co-production and triangulating varying data sources helps studying and implementing complex system wide transformation. Suggestions for future research: The Researcher-in-Residence model could be rolled out across systems to facilitate learning, and to increase robustness of insights.

Purpose: Co-creation of a citizen-science research initiative with a collaborative team of community members and university-based scientists to address regional disparities in maternal and fetal health outcomes for Black birthing people. Description: Citizen scientist-led projects, where community members actively contribute to each discovery step, from setting a research agenda to collecting data and disseminating results, can extend community participatory research initiatives and help reconceptualize traditional research processes. The Pregnancy Collaborative is a citizen-science research initiative and one of nine scientific committees of The Pittsburgh Study—a longitudinal, community-partnered study designed to bring together collaborators to improve child thriving. Assessment: Ten community members and five university-based scientists participated during all phases of developing a citizen-scientist collaboration over an initial two-and-a-half-year period. Phases include forming the Pregnancy Collaborative and group research ethics training; co-creating a research agenda grounded in shared principles; and community-partnered data collection, analysis, and dissemination. These phases produced three key co-designed products: (1) a mission and vision statement of the Pregnancy Collaborative, (2) a Collaborative-endorsed research agenda, and (3) a citizen-scientist-executed research survey. Conclusion: Lessons learned from the formation of the Pregnancy Collaborative highlight the importance of equitable power distribution through bidirectional knowledge sharing and by centering intellectual effort, lived experience, and tools and resources of those affected by health inequities. Using a citizen science approach to co-designing and executing research helps us move maternal health inequity work from "research on" to "research with." Significance: Persistent disparities characterize maternal and child health outcomes in the United States. These disparities, mediated by poverty, racism, and place-based social and structural determinants of health, are the biggest threats to Black maternal health. Recently, community-engaged efforts to improve Black maternal health disparities have moved towards cross-sector approaches that center the lived experiences of Black birthing people. Despite these comprehensive approaches, community members rarely participate throughout the research lifecycle. Citizen science-led projects like those described in this paper are one way to acknowledge and commit to bidirectional community-partnered research and action. [ABSTRACT FROM AUTHOR]

The 2018–2021 wildfire seasons were a glimpse of the future: deadly damaging fires in Mediterranean regions and high fire activity outside the typical fire season, also in temperate and boreal areas. This challenge cannot be solved with the traditional mono‐disciplinary approach of fire suppression. There is a critical need to change fire management from fire resistance to landscape resilience: Living with fire. Climate change thereby creates an urgency for understanding the integrated drivers of fire impacts and risks, and for designing creative and effective risk reduction, management and communication strategies. We argue that achieving this integrated fire management requires inter‐ and transdisciplinary research based on four axes of diversity: combining cross‐geography, cross‐risk, and cross‐sector approaches while embracing social diversity. This requires a new way of training our future experts, a broader way of defining scientific excellence, and stimulation of opportunities for people from various disciplines and sectors to meet and learn. Plain Language Summary: Because fire in the landscape is often seen as bad, management of fires in the landscape tends to be focused on putting all fires out. But fire belongs in nature and fire services around the world increasingly face the limits of firefighting. Some fires are now becoming so extreme that they cannot be controlled anymore. The way out of this challenge is to accept fire in the landscape, and work with it instead of against it. Here we argue that to live with fire, diversity is essential in four ways: to better connect knowledge and people in different countries, working on different risks, and working in science and practice, and to do this with more diverse people. We conclude by giving suggestions how to achieve this, including a new way of training our future experts. Key Points: Integrated fire management is needed to solve current fire challengesThis requires a cross‐geography, cross‐risk and cross‐sector approach embracing social diversityWe must train the next generation of inter‐ and transdisciplinary integrated fire management teams based on these four axes of diversity [ABSTRACT FROM AUTHOR]

The Federal Ministry of Education and Research (BMBF) issued a call for a new nationwide research network on mental disorders, the German Center of Mental Health (DZPG). The Munich/Augsburg consortium was selected to participate as one of six partner sites with its concept "Precision in Mental Health (PriMe): Understanding, predicting, and preventing chronicity." PriMe bundles interdisciplinary research from the Ludwig-Maximilians-University (LMU), Technical University of Munich (TUM), University of Augsburg (UniA), Helmholtz Center Munich (HMGU), and Max Planck Institute of Psychiatry (MPIP) and has a focus on schizophrenia (SZ), bipolar disorder (BPD), and major depressive disorder (MDD). PriMe takes a longitudinal perspective on these three disorders from the at-risk stage to the first-episode, relapsing, and chronic stages. These disorders pose a major health burden because in up to 50% of patients they cause untreatable residual symptoms, which lead to early social and vocational disability, comorbidities, and excess mortality. PriMe aims at reducing mortality on different levels, e.g., reducing death by psychiatric and somatic comorbidities, and will approach this goal by addressing interdisciplinary and cross-sector approaches across the lifespan. PriMe aims to add a precision medicine framework to the DZPG that will propel deeper understanding, more accurate prediction, and personalized prevention to prevent disease chronicity and mortality across mental illnesses. This framework is structured along the translational chain and will be used by PriMe to innovate the preventive and therapeutic management of SZ, BPD, and MDD from rural to urban areas and from patients in early disease stages to patients with long-term disease courses. Research will build on platforms that include one on model systems, one on the identification and validation of predictive markers, one on the development of novel multimodal treatments, one on the regulation and strengthening of the uptake and dissemination of personalized treatments, and finally one on testing of the clinical effectiveness, utility, and scalability of such personalized treatments. In accordance with the translational chain, PriMe's expertise includes the ability to integrate understanding of bio-behavioral processes based on innovative models, to translate this knowledge into clinical practice and to promote user participation in mental health research and care. [ABSTRACT FROM AUTHOR]

Problem: In Canadian society, public policies guide the development and administration of social services and systems, including the public education system, the justice system, family services, social housing and income support. However, because social services are often planned and implemented in a 'siloed' manner, coordination and collaboration across departments, sectors and organisations is sorely lacking. Data and resource constraints may prevent services being evaluated to ensure they meet the needs of the people for whom they are intended. When the needs of individuals are not addressed, the result is poor outcomes and wasted resources across multiple areas. Our Response: In 2018, we formed the SPECTRUM Partnership in response to a recognised need for collaborative cross-sector approaches to strengthening the policies that shape social services and systems in our country. The tripartite SPECTRUM partnership comprises representatives from community organisations, government and academia, and is an entity designed to conduct social policy research and evaluation, incorporating interdisciplinary perspectives and expertise from its members. Guided by community-driven research questions and building on existing data resources, SPECTRUM seeks to address specific knowledge gaps in social programs, services and systems. New research findings are then translated into viable public policy options, in alignment with government priorities, and presented to policy-makers for consideration. Implications: In this practice-based article, we describe the key steps we took to create the SPECTRUM partnership, build our collective capacity for research and evaluation, and transform our research findings into actionable evidence to support sound public policy. We outline four of SPECTRUM's achievements to date in the hope that the lessons we learned during the development of the partnership may serve as a guide for others aiming to optimise public policy development in a collaborative evidence-based way. [ABSTRACT FROM AUTHOR]

Background: Adults with intellectual and developmental disabilities (IDD) have high rates of homelessness. This observational study evaluates Bridges to Housing, a cross‐sector intervention offering immediate access to housing and supports to this population in Toronto, Canada. Methods: Twenty‐six participants, enrolled between April 2016 and December 2017, were assessed at baseline, six and 12 months post‐enrolment. Descriptive statistics and generalized linear modelling evaluated quality of life (QOL) and service needs outcomes. Twenty‐one service users and providers participated in semi‐structured interviews between August 2017 and June 2018 to elicit their experiences of the intervention, which were analysed thematically. Results: Twelve months post‐enrolment, 24 participants were successfully housed and reported increased QOL scores (F(2,43) = 13.73, p = <.001) and decreased perceived unmet service needs (Wald χ2(2) = 12.93, p =.002). Individual‐, intervention‐ and system‐level characteristics facilitated housing stability in this population. Conclusions: Cross‐sector approaches can improve outcomes for homeless adults with IDD and may have an important role in supporting this marginalized population. [ABSTRACT FROM AUTHOR]

Municipal recreation infrastructure is critical for enhancing people’s opportunities to be physically active during leisure time and reducing usage inequities. Yet, the literature on municipal equity-sensitive strategies is limited. To address this gap, we combined a socio-ecological framework with equity, diversity, and inclusion (EDI) and health equity lenses to examine intersecting social and structural determinants of municipal recreation (indoor and outdoor) infrastructure usage. We used data from 22 focus groups involving youth, adult regular users, and adult non-regular users. The intersecting factors influencing people’s utilization experiences were organized at intrapersonal, socio-cultural environment, organization, and built and natural environment levels. Policy and practice implications for municipal governments vis-à-vis EDI and health equity considerations are discussed. Recommendations include public transportation improvement, design of strategic communication plans, and linking activities with opportunities for socialization, among others. [ABSTRACT FROM AUTHOR]

Purpose: Before COVID-19, Kenya was among the countries in sub-Saharan Africa already dealing with high Gender-Based Violence (GBV) issues. Kenya had experienced prior convoluted emergencies and endemics, which had an inordinate impingement on women and girls that heightened their vulnerability to GBV. The Kenyan Ministry of Public Service and Gender reported that in 2020, there was an increase of 36% in GBV cases (Roy et al., 2021). COVID-19 had a devastating effect in rural communities, whereby women were most impacted. This study aims to understand the lessons learned from public leaders in implementing policies that could address GBV through better leadership approaches. Design/methodology/approach: This is an exploratory-qualitative study in which six participants comprised of policymakers or government representatives that were interviewed in semi-structured interviews. Findings: The qualitative narratives provided evidence that suggests a complex relationship between the COVID-19 lockdowns and movement restrictions policies and played a direct factor in the rise in GBV in vulnerable populations. The individual country policies and sectoral policies varied in how vulnerable women's needs were addressed, which led to diverse socioeconomic and health consequences. Originality/value: This research delineates the impacts of the failure of Kenyan leaders to implement gender focused COVID-19 policies and guidelines that considered the physical, mental, violence and the economic impact such emergencies have on women and girls in rural communities. [ABSTRACT FROM AUTHOR]

Background: The Base of the Pyramid (BoP) project is a public–private partnership initiated by Novo Nordisk that aims to facilitate access to diabetes care for people at the base of the economic pyramid in low- and middle-income countries (LMICs). In Kenya, the BoP, through a partnership model, aims to strengthen five pillars of diabetes care: increased awareness of diabetes; early diagnosis of diabetes; access to quality care by trained professionals; stable and affordable insulin supply; and improved self-management through patient education. Objectives: This study evaluates the extent to which BoP Kenya is scalable and sustainable, whether stakeholders share in its value, and whether BoP Kenya has improved access to diabetes care. Method: The Rapid Assessment Protocol for Insulin Access (RAPIA), an approach developed to provide a broad situational analysis of diabetes care, was used to examine health infrastructure and diabetes care pathways in Kenya. At the national level, the RAPIA was applied in a SWOT analysis of the BoP through in-depth interviews with key stakeholders. At individual and county health system levels, RAPIA was adapted to explore the impact of the BoP on access to diabetes care through a comparison of an intervention and control county. Results: The BoP was implemented in 28 of 47 counties in Kenya. Meru, a county where BoP was implemented, had 35 of 62 facilities (56%) participating in the BoP. Of the five pillars of the BoP, most notable progress was made in achieving the fourth (stable and affordable insulin supply). A price ceiling of 500KSh (US$5) per vial of insulin was established in the intervention county, with greater fluctuation and stock-outs in the non-intervention county. Despite reduced insulin costs, many patients with diabetes could not afford the additive expenses of monitoring, medicines, and travel. Less progress was made over the other pillars, which also faced challenges to sustainability and scalability. Conclusion: In the context of the rising prevalence of non-communicable diseases in LMICs, cross-sector approaches to improving access to care are increasingly needed. Public–private partnerships such as the BoP are necessary but not sufficient to ensure access to health care for people with diabetes at the base of the economic pyramid in Kenya. [ABSTRACT FROM AUTHOR]

Dam development improves water, food, and energy security but often with negative impacts on human health. The transmission of dam-related diseases persists in many dammed catchments despite treatment campaigns. On the Senegal River Basin, the transmission of Schistosoma spp. parasites has been elevated since the construction of dams in the late 1980's. We use narrative analysis and qualitative content analysis of archival documents from this setting to examine health as a component of the food-energy-water (FEW) nexus and understand priorities and trade-offs between sectors across the policy-to-practice continuum. We find that health is recognized as an important component of river basin development, but that priorities articulated at the policy level are not translated into management practices. Incorporating health as a management objective is possible without imposing substantial trade-offs to FEW resources. Coordinated research and surveillance across transboundary jurisdictions will be necessary to inform decision-making on how to operate dams in ways that mitigate their negative health impacts. • Disease transmission in dammed areas persists despite mitigation efforts. • We expand the food-energy-water nexus in the Senegal River to include health. • Our historical analysis examines cross-sector approaches to disease mitigation in dammed areas. • Health is a policy priority that is not translated into dam management practice. • Coordinated knowledge creation is key to translate health priorities into practice. [ABSTRACT FROM AUTHOR]

This study aimed to determine the mental health competence of faculty in a higher education institution in the Philippines and explore their dominant characteristics demonstrated by their functions, practices, and behavior. Utilizing a descriptive survey research design, this integrates methods to comprehensively assess the 123 purposively chosen faculty members' mental health awareness competence. Drawing on a standardized questionnaire (Siason, A., 2021), the research delves into faculty competence (Kourgiantakis et al., 2023) with three subcategories: functions and responsibilities within the academic environment, practices in addressing students' mental health issues, and student perceptions of faculty attitudes toward mental health concerns. Findings indicate a high level of mental health competence among the faculty members who maintain a classroom atmosphere that promotes respect for individual and cultural differences. Faculty demonstrated proficiency in fulfilling their roles and responsibilities, fostering a collaborative learning atmosphere, and recognizing individual uniqueness and preferences. This contributes to the evolving role of teachers in making students confronting mental health difficulties feel accepted and respected as unique people. Notably, there was a difference in the behaviors or impressions of students as exhibited by teachers in a public HEI when grouped according to marital status. [ABSTRACT FROM AUTHOR]

This paper examines the literature on the Sustainability in the Arctic region, using a bibliometric analysis of 213 English-language articles published between 1980 and 2022 exploiting Bibliometrix, an R package. To find relevant literature using the Web of Science (WOS) database, we searched for documents using mesh terms based on the query of two terms, "Arctic & Sustainability". We used the Boolean operator "AND" to combine the two terms and the Boolean operator "OR" to include synonyms of the terms. The articles retrieved were authored by 724 researchers, published in 98 journals, representing 132 countries, and growing at 5.08% annually. The findings reveal that a substantial portion of the Arctic sustainability literature placed significant emphasis on the examination of climate change, adaptation, and vulnerabilities affecting local communities. Furthermore, the more recent publications in this field concentrate predominantly on exploring perceptions and governance. [ABSTRACT FROM AUTHOR]

Management and organization studies (MOS) scholars have recently brought attention to the lack of engagement with social equity and justice in tackling grand challenges. We argue that environmental justice (EJ) can deepen MOS' engagement with social equity in addressing grand challenges, particularly climate change. Through a bibliometric analysis and qualitative review, we explore scholarly communities within EJ literature and draw connections to MOS research. We develop three bridges between EJ and MOS scholarship: (a) investigating organizational roles and processes in distributing environmental benefits and burdens within socioecological systems, (b) situating the firm within structural and historical contexts that create and perpetuate environmental injustices, and (c) prioritizing the goals, perspectives, and agency of activists and neglected voices within environmental conflicts and solutions. Ultimately, this review aims to build meaningful pathways to embed EJ in MOS research on grand challenges. [ABSTRACT FROM AUTHOR]

School energy management is one of the efforts to support the Sustainable Development Goals (SDGs), which focus on using clean and affordable energy and tackling climate change. This study aims to analyze and describe the planning, implementation, evaluation, and school energy management actions to improve the quality of facilities and infrastructure at Cendekia Muda Middle School and Muhammadiyah 8 Middle School Bandung. This study uses a qualitative method with a case study approach. Data was collected through observation, interviews, and documentation--data reduction techniques, data presentation, and concluding analyzed data. The study results show that planning for school energy management in both schools involves various parties, referring to government policies and considering technical, economic, social, and environmental aspects. The implementation of school energy management in both schools includes saving electricity, using renewable energy, managing waste, and counseling students and the community. Evaluation of school energy management in both schools was carried out using quantitative and qualitative indicators and involving internal and external parties. School energy management measures in both schools took the form of improving facilities, adding alternative energy sources, developing environmental programs, and collaborating with other parties. The results of this study are that school energy management in both schools has been carried out well and has positively impacted the quality of facilities and infrastructure, saving operational costs, increasing environmental awareness, and contributing to SDG achievement. This research implies that school energy management needs to be improved by continuously innovating, monitoring, evaluating, and socializing. [ABSTRACT FROM AUTHOR]

Severewildfires are an intermittent problemin England. The paper presents the first analysis of wildfire policy, showing its halting evolution over two decades. First efforts to coordinate wildfire management came from local fire operation groups, where stakeholders such as fire services, land owners and amenity groups shared knowledge and equipment to tackle the problem. A variety of structures and informal management solutions emerged in response to local needs. Knowledge of wildfire accumulated within regional and national wildfire forums and academic networks. Only later did the need for central emergency planning and the response to climate change produce a national policy response. Fire statistics have allowed wildfires to be spatially evidenced on a national scale only since 2009. National awareness of wildfire was spurred by the 2011 fire season, and the high-impact Swinley Forest fire, which threatened critical infrastructure and communities within 50 miles of London. Severe wildfire was included in the National Risk Register for the first time in 2013. Cross-sector approaches to wildfire proved difficult as government responsibility is fragmented along the hazard chain. Stakeholders such as the Forestry Commission pioneered good practice in adaptive land management to build fire resilience into UK forests. The grass-roots evolution of participatory solutions has also been a key enabling process. A coordinated policy is now needed to identify best practice and to promote understanding of the role of fire in the ecosystem. [ABSTRACT FROM AUTHOR]

A collaborative approach to care of parents with a mental illness is essential to address the needs of the whole family. However, a number of constraints within adult mental health and child-focused services prevent a unified approach to the care of families where a parent has a mental illness (FaPMI). This paper reports on a cross-sector workforce development initiative aimed to build skill and knowledge in practitioners to work with FaPMI. The initiative included training in the 'Keeping Families and Children in Mind' e-resource to mental health, child and family services. The resource was combined with face to face training and small group meetings over six weeks, to help develop emerging champions/practice leaders to promote FaPMI-focused practice. A significant decline in the perceived ability to engage in FaPMI-focused practice emerged immediately post-training. The lack of perceived organisational supports was the major barrier to the implementation of FaPMIfocused practice across sectors. However following continued support of practitioners, a significant increase in FaPMI-focused practice across sectors, and a return to pre-survey levels of perceived organizational support, was observed at six-month post-training. The importance of providing additional implementation supports and time to consolidate practice change following training is highlighted. Recommended implementation and training strategies that will improve FaPMI-focused cross-sector approaches to better meet the need of FaPMI are described. [ABSTRACT FROM AUTHOR]

Background: The prevalence of Wuchereria bancrofti, which causes lymphatic filariasis (LF) in The Gambia was among the highest in Africa in the 1950s. However, surveys conducted in 1975 and 1976 revealed a dramatic decline in LF endemicity in the absence of mass drug administration (MDA). The decline in prevalence was partly attributed to a significant reduction in mosquito density through the widespread use of insecticidal nets. Based on findings elsewhere that vector control alone can interrupt LF, we asked the question in 2013 whether the rapid scale up in the use of insecticidal nets in The Gambia had interrupted LF transmission. Methodology/Principal Finding: We present here the results of three independently designed filariasis surveys conducted over a period of 17 years (1997–2013), and involving over 6000 subjects in 21 districts across all administrative divisions in The Gambia. An immunochromatographic (ICT) test was used to detect W. bancrofti antigen during all three surveys. In 2001, tests performed on stored samples collected between 1997 and 2000, in three divisions, failed to show positive individuals from two divisions that were previously highly endemic for LF, suggesting a decline towards extinction in some areas. Results of the second survey conducted in 2003 showed that LF was no longer endemic in 16 of 21 districts surveyed. The 2013 survey used a WHO recommended LF transmission verification tool involving 3180 6–7 year-olds attending 60 schools across the country. We demonstrated that transmission of W. bancrofti has been interrupted in all 21 districts. Conclusions: We conclude that LF transmission may have been interrupted in The Gambia through the extensive use of insecticidal nets for malaria control for decades. The growing evidence for the impact of malaria vector control activities on parasite transmission has been endorsed by WHO through a position statement in 2011 on integrated vector management to control malaria and LF. Author Summary: The prevalence of lymphatic filariasis (LF), in The Gambia was among the highest in Africa in the 1950s when about 50% of the adult population was positive for microfilaraemia. However, surveys conducted in 1975 and 1976 revealed a dramatic decline in LF endemicity in the absence of systematic treatment with anti-filaria medicines. This decline in LF prevalence in all villages was partly attributed to a significant drop in human-mosquito contact through a sustained reduction in rainfall in the 1960s and 1970s and the widespread use of insecticidal nets to protect against malaria. We asked the question in 2013 whether the rapid scale up in the use of insecticidal nets for malaria control in Gambia had resulted in the interruption of LF transmission. In this paper we present the results of three independently designed filariasis surveys conducted over a period of 17 years (1997–2013), and involving over 6000 subjects in 21 districts across all administrative divisions in the country. In 2001, tests performed to detect circulating filarial antigens (CFA) in serum samples collected between 1997 and 2000, in three divisions, failed to show positive individuals from two that were previously highly endemic for the LF. Results of the second survey conducted in 2003 indicated that five of the 21 districts were slightly endemic for LF with CFA rates of 1% or 2% but MDA was never implemented in The Gambia. The results of our final survey conducted in 2013 were unequivocal in confirming the absence of transmission of LF in all 21 districts surveyed using WHO recommended statistically robust and validated tool known as transmission assessment survey (TAS). The Gambia achieving a non-endemic status for LF represents a significant step in the efforts to shrink the filariasis endemicity map and demonstrates the value of cross sector approaches in disease control. [ABSTRACT FROM AUTHOR]

The article focuses on the urgent need to address the health risks faced by outdoor workers due to climate change, highlighting the impact of extreme weather events on their well-being and productivity. Topics include the necessity for interdisciplinary collaboration involving health care professionals, public health experts, and other stakeholders to develop tailored interventions and strategies for protecting outdoor workers.

Although ethnicity is a contributing factor to the ongoing crisis in South Sudan, particularly after the re-escalation of violence in December of 2013, the characterization of the conflict as an ethnic crisis is insufficient. This analysis will reframe the violence in terms of both its proximate and root causes, including a comprehensive examination of systemic problems of underdevelopment. The reframing of root causes is necessary to appropriately create the local, regional, national, and international responses that will dually address the immediate sources of violence and contribute towards the social, legal, and institutional infrastructure required to transition the new nation from conflict to durable peace and stability. This argument will be substantiated by a historic analysis of South Sudan done in three distinct segments: Sudan's 1956 independence until the signing of the 2005 Comprehensive Peace Agreement (CPA), including an analysis of the two civil wars between the North and South; the interim period, between the 2005 CPA and South Sudan's independence in 2011; and the post-independence period. The final sections offer pragmatic, cross-sectoral recommendations for peacebuilding and capacity building in order to ameliorate the current humanitarian crisis and to establish the human and national security that will guard against conflict recurrence. The recommendations will both consider current cross-sector approaches which privilege traditional actors, such as nongovernmental organizations (NGOs) and governments and present new recommendations that include nontraditional actors, such as Internally-displaced persons (IDPs), refugees, and diasporic communities. [ABSTRACT FROM AUTHOR]

There is a global movement for people with a disability towards person-centred practices with opportunities for self-determination and choice. Person-centred approaches may involve individual funding ( IF) for the purchase of required support. A shift to a person-centred model and IF should allow people with a disability and their carers greater choice in therapy access. However, individuals who live in rural and remote areas have less choice and access to therapy services than their metropolitan counterparts. Drawing on data from a larger study into therapy service delivery in a rural and remote area of New South Wales, Australia, this study describes some benefits and barriers to using IF to access therapy services in rural areas. Ten carers and 60 service providers participated in audio-recorded focus groups and individual interviews during which IF was discussed. Transcribed data were analysed using thematic analysis and constant comparison. Greater access to and choice of therapy providers were identified as benefits of IF. Four barriers were identified: (i) lack of information and advice; (ii) limited local service options and capacity; (iii) higher costs and fewer services and (iv) complexity of self-managing packages. A range of strategies is required to address the barriers to using IF in rural and remote areas. Carers indicated a need for: accessible information; a local contact person for support and guidance; adequate financial compensation to offset additional travel expenses and coordinated eligibility and accountability systems. Service providers required: coordinated cross-sector approaches; local workforce planning to address therapist shortages; certainty around service viability and growth; clear policies and procedures around implementation of IF. This study highlights the need for further discussion and research about how to overcome the barriers to the optimal use of an IF model for those living in rural and remote areas. [ABSTRACT FROM AUTHOR]

The article presents a case study which investigates the approaches to curriculum development for enterprise education and considers the sustainability issues for delivery in these sectors under an Entrepreneurship Action Plan in Wales, Great Britain. It mentions that this analysis of the curriculum development initiatives were based on a several stages of categorization modelincluding inspiration, information and implementation and activities involving cross-sector approaches.

Background: Federally qualified health centers (FQHCs) are integral to the U.S. healthcare safety net and uniquely situated in disadvantaged neighborhoods. The 2009 American Recovery and Reinvestment Act (ARRA) invested $2 billion in FQHC stimulus during the Great Recession; but it remains unknown whether this investment was associated with extended benefits for disadvantaged neighborhoods. Methods: We used a propensity-score matched longitudinal design (2008–2012) to examine whether the 2009 ARRA FQHC investment was associated with local jobs and establishments recovery in FQHC neighborhoods. Job change data were obtained from the Longitudinal Employer-Household Dynamics (LEHD) survey and calculated as an annual rate per 1,000 population. Establishment change data were obtained from the National Neighborhood Data Archive (NaNDA) and calculated as an annual rate per 10,000 population. Establishment data included 4 establishment types: healthcare services, eating/drinking places, retail establishments, and grocery stores. Fixed effects were used to compare annual rates of jobs and establishments recovery between ARRA-funded FQHC census tracts and a matched control group. Results: Of 50,381 tracts, 2,223 contained ≥ 1 FQHC that received ARRA funding. A higher proportion of FQHC tracts had an extreme poverty designation (11.6% vs. 5.4%), high unemployment rate (45.4% vs. 30.3%), and > 50% minority racial/ethnic composition (48.1% vs. 36.3%). On average, jobs grew at an annual rate of 3.84 jobs per 1,000 population (95% CI: 3.62,4.06). In propensity-score weighted models, jobs in ARRA-funded tracts grew at a higher annual rate of 4.34 per 1,000 (95% CI: 2.56,6.12) relative to those with similar social vulnerability. We observed persistent decline in non-healthcare establishments (-1.35 per 10,000; 95% CI: -1.68,-1.02); but did not observe decline in healthcare establishments. Conclusions: Direct funding to HCs may be an effective strategy to support healthcare establishments and some jobs recovery in disadvantaged neighborhoods during recession, reinforcing the important multidimensional roles HCs play in these communities. However, HCs may benefit from additional investments that target upstream determinants of health to mitigate uneven recovery and neighborhood decline. [ABSTRACT FROM AUTHOR]

Artist in residence in government (AIRG) programs that embed artists within civic work are becoming increasingly popular across the United States. As governments are challenged to shift systems to be more equitable, repair infrastructure and prepare for future crises, cross-sectoral collaboration models offer new ways of working. Cross-sectoral collaboration that embeds artists in non-arts sectors spurs civic innovation and shifts contexts to inspire new ideas and opportunities. This article builds a guiding framework of the characteristics and considerations that shape AIRG programs in order to present possible pathways that can be followed in program development and implementation. Foundationally, each AIRG is unique and responsive to the specific underlying social, political, economic, environmental and cultural preconditions of place. The guiding framework details preconditions, program design and partners, and program structure, followed by an analysis of the challenges and opportunities. Research was conducted on AIRG programs operating in 2020 and 2021. [ABSTRACT FROM AUTHOR]

Background: One of the most significant developmental accomplishments is the emergence of language in early childhood. Whilst this process is effortless for most children, others can face significant hurdles. Identifying, in the early years, which children will go on to have developmental language disorder is, however, fraught with several well‐documented challenges. In the preceding paper we described and linked new research evidence about factors that influence language development in the early years, noting that exposure to some may be time sensitive and that these influences cluster together and can accumulate over time. We demonstrated that risk profiles were associated with and characterised low language trajectories, and we considered how this information could be integrated into a concept that moves beyond screening at single time points in the early years. We argue that this evidence might be used to build an improved early years framework for language thereby creating a more equitable surveillance system that does not leave children living in less advantageous circumstances behind. Underpinning this thinking was a bioecological framework that incorporates the social, environmental and family factors in the child's ecosystem known to influence language development in the early years. Aims: To develop a proposal for the design and implementation of an early language public health framework based on current best evidence Methods: We synthesised the findings from the companion paper (Reilly & McKean 2023) regarding early language trajectories, inequalities and clustering of risks with key public health concepts, relevant intervention evidence and implementation theories to develop a new framework for language surveillance and preventative interventions in the early years. Main Contribution: An evidence informed early language public health framework is presented. Describing in turn (1) essential components; (2) relevant interventions; (3) essential qualities for implementation ((i) probabilistic, (ii) proportionate, (iii) developmental and sustained and (iv) codesigned); (4) system‐level structures and (5) processes required to adopt and embed an early language public health framework in an existing Local Government Area's child health surveillance and early prevention‐intervention systems. Conclusions: Children's language development influences their life chances across the life course and language difficulties are unfairly distributed across society. Current evidence points to the need for whole systems approaches to early child language and enables a blueprint for such a framework to be described. WHAT THIS PAPER ADDS: What is already known on the subject: Early child language development sets the stage for a child's life chances and language difficulties can have profound long‐term consequences. Such difficulties are unfairly distributed across society and the reach of preventative services is not universal or equitable. What this study adds: Several effective primary and secondary preventative interventions exist but their successful implementation is not straightforward. An early language public health framework of surveillance and intervention is described to provide equitable and effective early interventions to children from 0–4 years. We detail the essential components, interventions and qualities of that framework and describe system‐level structures and processes required to adopt and embed an early language public health framework in a given locality. What are the clinical implications of this work?: A whole systems approach to early child language is required and should be co‐designed through local collaboration with family, community and children's services stakeholders. A public health speech and language therapist role could catalyse the implementation of such approaches and support continuous improvement. [ABSTRACT FROM AUTHOR]

Background: There has been a lack of progress in reducing obesity in the United Kingdom (UK) despite Government strategies released over the last 30 years. These strategies, including the most recent publication from July 2020, have focused on childhood obesity and high fat, sugar and/or salt (HFSS) marketing restrictions, particularly broadcast advertising. In this study, we aimed to examine a range of expert views on the potential impact and the relative importance of such policies. Methods: Semi-structured interviews were conducted with 42 experts in policy (n = 19), industry (n = 10), and advocacy (n = 13) with an interest in obesity. The UK Government’s 2020 obesity strategy was used as a prompt to guide discussion on policy options. Qualitative thematic analysis was employed to answer the three research questions and themes were inductively coded within each research question. Data were also cross compared using matrix coding and a form of framework analysis to examine the views expressed by the different types of stakeholders. Results: Reactions to the July 2020 proposal were mixed among policy and advocacy stakeholders, while commercial stakeholders expressed disappointment. A main theme emerging in all groups was frustration with the policy process and wishing to see more clarity regarding restrictions and their implementation. There was an overall lack of trust that the government would carry out their proposed plan and agreement that a more comprehensive, multi-sector approach aimed at the underlying drivers of obesity would be most effective, with some stakeholders indicating that some of the proposed policies could make a difference if implemented robustly. On the theme of promoting healthier options, some stakeholders suggested lowering the prices of ‘healthy’ products and making them more accessible to combat regressivity. There was a potentially surprising level of agreement between policy/advocacy stakeholders and commercial stakeholders, although commercial stakeholders were more likely to advocate for collaboration between government and industry as well as voluntary industry measures. Conclusion: While HFSS marketing restrictions have a role to play and send a strong signal – provided they are implemented comprehensively – investment in these policies needs to be part of wider efforts to tackle the underlying drivers of obesity. [ABSTRACT FROM AUTHOR]

We present a community-led equity framework as a foundation for promoting equity on the Central Coast of California. We discuss the key elements of a participatory, community-led evaluation and planning approach for the Central Coast Regional Equity Initiative, which aims to advocate for social, health, environmental, and economic equity through region-wide cross-sector collaboration, community and research-informed action, and an indigenized and decolonized approach. Through a systematic mixed-methods evaluation and planning approach, including Community Consultations and Strategic Action Planning, we found that our community's lived experience contributes to a deeper understanding of inequities, and that engagement in cross-sector collaboration empowers our community to bridge data with action organizing. The findings demonstrate that engagement in community-led evaluation and planning contributes to a greater readiness for cross-sector collaborative action and a sense of community ownership of solutions to equity issues, and sets the stage for deeper-rooted, long-term success built on genuine reciprocity and trust. We present our community-led equity framework inviting others to adopt systematic community knowledge-base-building that values community wisdom, identifies power imbalance, promotes trust-building through healthy discomfort, and encourages reflective action. [ABSTRACT FROM AUTHOR]

Promoting inclusive and sustainable economic and social development whilst simultaneously adapting to climate change impacts and mitigating greenhouse gas emissions – Climate Compatible Development (CCD) – requires coherent policy approaches that span multiple sectors. This paper develops and applies a qualitative content analysis to assess national sector policies of ten southern African countries to determine their approaches for water, agriculture, forestry and energy and their compatibility with the aims of the three dimensions of CCD (development, climate adaptation and climate mitigation). Results indicate that sector policies currently only partially support shifts towards CCD, with approaches that both complement and detract from CCD being prioritized by national governments. Agriculture offers the greatest number of potentially viable approaches capable of achieving the development, adaptation and mitigation aims inherent in CCD, while energy the least. National governments should focus on developing coherent, cross-sector approaches that deliver such potential triple wins in order to promote new forms of inclusive and sustainable economic and social development, whilst facilitating adaptation to climate change impacts and supporting mitigation activities. Doing so will also go a long way towards ensuring the progress needed for achieving the Sustainable Development Goals (SDGs) and Nationally Determined Contributions (NDCs) to the Paris Climate Agreement. [ABSTRACT FROM AUTHOR]

Degrowth has become a recognised paradigm for identifying and critiquing systemic unsustainability rooted in the capitalist, growth-compelled economy. Increasingly, degrowth is discussed in relation to specific economic sectors such as the agri-food system. This paper builds on the foundational work of Gerber (2020) and Nelson and Edwards (2021). While both publications take a rather specific analytical or disciplinary focus—the former specifically connects critical agrarian studies and degrowth, the latter explores the contributions of the recent volume 'Food for degrowth'—this paper takes stock of the emerging body of literature on degrowth and agri-food systems more broadly. It proposes research avenues that deepen, expand and diversify degrowth research on agri-food systems in four areas: (i) degrowth conceptualisations; (ii) theorisation of transformations towards sustainability; (iii) the political economy of degrowth agri-food systems; and (iv) rurality and degrowth. Together, these avenues devote due attention to a variety of agents (ranging from translocal networks to non-humans), spaces (e.g. the rural), theories (e.g. sustainability transitions and transformations towards sustainability) and policies (of the agricultural sector and beyond) that thus far have received limited attention within the degrowth literature. The critical social science perspective on degrowth agri-food systems, which is advanced in this paper, illuminates that the present unsustainability and injustice of hegemonic agri-food systems are not merely a problem of that sector alone, but rather are ingrained in the social imaginaries of how economies and societies should work as well as in the political–economic structures that uphold and reproduce these imaginaries. [ABSTRACT FROM AUTHOR]

Background and Objectives The construction of an Age-Friendly City (AFC) requires active contribution from relevant interest groups including older adults, nonprofit organizations, and policy-makers. However, given that relevant interest groups may have limited resources, knowledge, and skills, as well as unique contextual factors, they often require help from intermediary organizations—actors that aim to build interest groups' capabilities. Our objectives were to examine the functions of universities, as an example of intermediary organizations, in facilitating the construction of an AFC, and identify critical factors that enable intermediary organizations to perform their functions. Research Design and Methods We conducted three focus groups and one individual interview with multiple interest groups including older adults and social workers from nonprofit organizations and local government involved in a 6-year citywide AFC project in Hong Kong. Participants were asked to share their views on the role of universities in relation to their own experiences and roles in the project. Data generated from the interviews were analyzed using thematic analysis. Results Four themes pertinent to the functions of universities in facilitating development were identified: facilitating cross-sector collaborations, knowledge diffusion, interest-group building, and mediating divergent interests. We also found that neutrality and reputability are key characteristics for intermediary organizations to wield sufficient legitimacy to perform their functions efficiently. Discussion and Implications Findings underscore the important yet overlooked role of intermediary organizations in bridging and mediating different interest groups to facilitate AFC development. We advance gerontological scholarship by providing insights into the theoretical mechanisms and practice implications for intermediary organizations in fostering an AFC. [ABSTRACT FROM AUTHOR]

The need for new and evidence-based solutions for mobilizing stakeholders and resources in sport for development and peace (SDP) is increasingly emphasized in a number of recent policy documents including the Kazan Action Plan and a set of publications by the Commonwealth Secretariat. This paper provides a response to these calls for the development of mechanisms and toolkits to support multistakeholder collaboration. We draw on our combined experiences in SDP research, practice, and funding to identify how multistakeholder initiatives in SDP can be better leveraged. Specifically, we discuss how Brown’s (2015) five elements of bridge-building for social transformation, namely, compelling and locally relevant goals; cross-boundary leadership systems; generative theories of change; systems enabling and protecting innovation; and investment in institutionalizing change, apply in the SDP domain. The practical framework we have outlined provides a common ground and starting point to build upon for generating improved synergies among a multitude of stakeholders. [ABSTRACT FROM AUTHOR]

This paper analyses policies and practices designed to support digital transformation in the tourism workforce in six OECD countries, namely Germany, Greece, Iceland, New Zealand, Switzerland, and the United Kingdom. Data for the project were gathered via a questionnaire survey, interviews with key informants and examination of various policy documents in 2021. Contrasting practice in relation to digital skills development is revealed. Significant deficiencies are evident in relation to the availability of high‐quality data, evaluation, understanding, leadership, and infrastructure among the six countries. Ways in which effective policy development might emerge are suggested. [ABSTRACT FROM AUTHOR]

Purpose: The current pandemic and ongoing climate risks highlight the limited capacity of various systems, including health and social ones, to respond to population-scale and long-term threats. Practices to reduce the impacts on the health and well-being of populations must evolve from a reactive mode to preventive, proactive and concerted actions beginning at individual and community levels. Experiences and lessons learned from the pandemic will help to better prevent and reduce the psychosocial impacts of floods, or other hydroclimatic risks, in a climate change context. Design/methodology/approach: The present paper first describes the complexity and the challenges associated with climate change and systemic risks. It also presents some systemic frameworks of mental health determinants, and provides an overview of the different types of psychosocial impacts of disasters. Through various Quebec case studies and using lessons learned from past and recent flood-related events, recommendations are made on how to better integrate individual and community factors in disaster response. Findings: Results highlight the fact that people who have been affected by the events are significantly more likely to have mental health problems than those not exposed to flooding. They further demonstrate the adverse and long-term effects of floods on psychological health, notably stemming from indirect stressors at the community and institutional levels. Different strategies are proposed from individual-centered to systemic approaches, in putting forward the advantages from intersectoral and multirisk researches and interventions. Originality/value: The establishment of an intersectoral flood network, namely the InterSectoral Flood Network of Québec (RIISQ), is presented as an interesting avenue to foster interdisciplinary collaboration and a systemic view of flood risks. Intersectoral work is proving to be a major issue in the management of systemic risks, and should concern communities, health and mental health professionals, and the various levels of governance. As climate change is called upon to lead to more and more systemic risks, close collaboration between all the areas concerned with the management of the factors of vulnerability and exposure of populations will be necessary to respond effectively to damages and impacts (direct and indirect) linked to new meteorological and compound hazards. This means as well to better integrate the communication managers into the risk management team. [ABSTRACT FROM AUTHOR]

Background: Children and youth are an important population group requiring specific policies to address their needs. In Australia, most children and youth are doing well, however, certain equity groups are not. To address child and youth health equity in policy, applying a social determinants of health approach is considered best practice. For over 10 years governments in Australia have been called upon to address the social determinants of health, however, there has been limited action. Health and education departments are typically most involved in policy development for children and youth. To date, there have been limited systematic analyses of Australian child and youth health policies, and selected education wellbeing policies, with a social determinants of health and health equity focus and this study aims to contribute to addressing this gap. Methods: Policy analysis was conducted across 26 Australian child and youth health policies, and selected education wellbeing policies. We used an existing prior coding framework to understand the extent the social determinants of health and health equity were addressed. All policies were strategic level and only included if dated 2009 onwards. Results: Across 26 selected policies only 10% of strategies addressed the social determinants of health, demonstrating a lack of policy action. However, there is relatively even focus on all developmental stages, and an increased focus on youth. Equity is acknowledged across most policies with some groups receiving more attention including Aboriginal and Torres Strait Islander children. The social determinants of health addressed, to some degree, include early childhood development, education, parental workplace conditions, healthy settings, and housing, those least mentioned include public transport and regulation. Conclusion: This study demonstrates a lack of policy action on the social determinants of health within Australian child and youth health policy, and selected education wellbeing policies. Rather, the application of a siloed, and predominantly acute care approach. However, there is recognition of equity across all policies; an emphasis on housing as a determinant of health; and a link between health and education departments through education wellbeing policies, specifically addressing the issue of mental health. [ABSTRACT FROM AUTHOR]

Social and educational disruptions during the COVID-19 pandemic have exacerbated concerns about adolescents' mental health and suicidal behavior. Data from the 2021 Adolescent Behaviors and Experiences Survey (ABES) indicate that 37.1% of U.S. high school students reported poor mental health during the COVID-19 pandemic, with 19.9% considering and 9.0% attempting suicide in the preceding year (1). Adverse childhood experiences (ACEs)* are associated with poor mental health and suicidal behaviors (2,3), and high prevalence of some ACEs have been documented during the pandemic (4). ACEs are preventable, potentially traumatic events that occur in childhood (ages 0-17 years) such as neglect, experiencing or witnessing violence, or having a family member attempt or die by suicide. Also included are aspects of a child's environment that can undermine their sense of safety, stability, and bonding. Associations between ACEs occurring during the pandemic and mental health or suicidal behaviors among U.S. high school students were examined using ABES data. Experience of one to two ACEs was associated with poorer mental health and increased suicidal behaviors, and these deleterious outcomes increased with additional ACE exposure. After adjusting for demographic characteristics, adolescents who reported four or more ACEs during the pandemic had a prevalence of poor current mental health four times as high as, and a prevalence of past-year suicide attempts 25 times as high as, those without ACEs during the pandemic. Experience of specific ACE types (e.g., emotional abuse) was associated with higher prevalences of poor mental health and suicidal behaviors. Prevention and intervention strategies (5), including early identification and trauma-informed mental health service and support provision, for ACEs and their acute and long-term impacts could help address the U.S. child and adolescent mental health and suicide crisis.†. [ABSTRACT FROM AUTHOR]

Black communities have been disproportionately impacted by the syndemic of COVID‐19 and structural racism. Place‐based initiatives (PBIs) are well‐positioned to respond to this syndemic. This study sought to highlight disparities in access to social determinants of health (SDH) between two racially segregated communities, assess residents' needs and measure resource accessibility in one predominantly Black community, and describe the PBI's response. We measured racial disparities in access to SDH before COVID‐19 using an SDH Index. We assessed participants' needs using a needs assessment and documented resource availability. A Geographic Information System (GIS) was used to measure resource accessibility. Results show inequities in access to SDH between the two communities before COVID‐19. Following the onset of COVID‐19, unemployment and food insecurity were higher in the predominantly Black community relative to the US population. Available resources did not always align with participants' needs and were less accessible for residents without private transportation. The PBI's response to the syndemic spanned SDH sectors. Inequitable access to SDH may be produced by structural racism and exacerbated by COVID‐19. PBIs are well‐equipped to employ a contextually informed, data‐driven, cross‐sector response to the syndemic. [ABSTRACT FROM AUTHOR]