Focal Areas Research Articles

Updating the Association for Nursing Professional Development's Spirit of Inquiry Focus Areas.

Updating the Association for Nursing Professional Development's Spirit of Inquiry Focus Areas.

Post-Operative Recovery and Preparation for Ambulation after Foot and Ankle Surgery

This is a review article that focuses on patient self-recovery, pain modulation without pain medication, edema control and preparation for ambulation after a foot or ankle surgery both elective and traumatic surgical procedures. The available evidence and literature review were limited due to the few studies that are devoted to this area of focus. This review article takes a comprehensive and prescriptive perspective into strategies of the aftermath of the physiological and psychological effects on the body, specifically the lower extremity after foot or ankle surgery. Some of these strategies include initial edema control, nutrition, scar massage and reduction of non-mobile skin from the surgical incision within the surgery. A review of the theory of prehabilitation and examples of therapeutic exercises are explained within the article which target important proximal gait muscles needed for ambulation which can be conditioned with the foot and ankle in a CAM boot or a cast.

Effects of Dietary Supplementation with Bacillus subtilis natto on Growth, Digestive Enzyme Activity, Immune Response, and Intestinal Microorganisms of Red Sea Bream, Pagrus major

This study investigated the influence of dietary supplementation with Bacillus subtilis natto (BSN) on various physiological parameters in red sea bream (Pagrus major). Key areas of focus included growth performance, enzymatic activity related to digestion, blood biochemical markers, immune function, and intestinal microorganisms. Fish were fed diets containing the following five levels of BSN: 0 (BN0), 1 × 107 (BN1), 1 × 108 (BN2), 1 × 109 (BN3), and 1 × 1010 (BN4) CFU kg−1 for 56 days. Fish in the BN3 and BN4 groups exhibited significantly enhanced growth performance compared to the BN0 group (p < 0.05). Additionally, the activities of amylase and protease were markedly higher in the BN3 and BN4 groups (p < 0.05), while lipase activity was significantly elevated in fish fed the BN3 diet (p < 0.05). Plasma total protein levels also showed a significant increase in the BN3 group (p < 0.05). Hematocrit values were significantly improved in the BN2, BN3, and BN4 groups (p < 0.05). The intestinal microbiota of the BN4 group revealed a significant increase in the populations of B. subtilis and Lactobacillus, along with a notable decrease in Escherichia coli, compared to all other groups (p < 0.05). The observed improvements in specific growth rate and the upregulation of growth-related gene expression further highlight the potential of BSN to enhance the growth performance of red sea bream. In conclusion, dietary supplementation with BSN at 1 × 109 and 1 × 1010 CFU kg−1 shows promise in improving the growth, health, and immune response of red sea bream.

Expanding access to addictions care: Implementation of a 24-hour healthcare provider support line in British Columbia, Canada

BackgroundMorbidity and mortality related to substance use have risen to catastrophic levels in North America, and treatment services are often difficult to access. In response, the province of British Columbia (BC), Canada, launched a province-wide addiction medicine support phone line that offers clinicians immediate access to phone consultation with an addictions medicine expert. The service operates 24/7 is accessible to any clinician in the province seeking assistance with an addiction-related question. We describe an evaluation of the reach and perceived impact of the service over its first two years.MethodsThe 24/7 Addiction Medicine Clinician Support Line was evaluated prospectively from June 2020 to April 2022. All provider-to-provider encounters were included. Data was collected from two primary sources: health provider demographic information collected at the time of consultation, and optional clinician surveys conducted after the consultation was complete. Descriptive data are presented as numerical values and percentages.ResultsOver the 22-month evaluation period, 1,279 consultations were requested by 631 distinct care providers across British Columbia. The service averaged 15 calls per week across the province, and 51.5% of calls were made outside of business hours. Physicians made the majority of calls to the service (n = 865, 67.6%), followed by nurse practitioners (n = 162, 12.7%). Among those who completed a follow-up survey (n = 258 calls, 20.2% total calls), 81.8% (n = 211) were “very” or “extremely” satisfied with the consultation. Of these respondents, 65.5% (n = 169) reported that the consultation led to the provision of better care for their patient, with 58.1% (n = 150) initiating a new prescription and 22.1% (n = 57) reporting expedited treatment for their patient. The consultation area of focus was most commonly opioid use (n = 417; 59.6%), followed by polysubstance use (n = 98; 14.0%).ConclusionsThe impact of the 24/7 Addiction Clinician Support Line was widespread, and the service increased accessibility to evidence-based addictions treatment across a range of care settings. Clinicians expressed a high degree of satisfaction with the service. To our knowledge, this province-wide program is the first of its kind in North America, offering a scalable and adaptable model to support access to evidence-based addictions care in under-resourced settings.

Tunable enhancement of the cylindrical Luneburg lens focusing ability with the aid of a conformal graphene strip

We consider the plane wave focusing characteristics of the layered cylindrical Luneburg lens equipped with a conformal strip of graphene, in the H-polarization case. The angular width and location of the strip is arbitrary, and its surface impedance is characterized with the aid of the quantum-physics Kubo formalism. We use a mathematically accurate full-wave analytical regularization technique, which is based on the explicit inversion of the problem static part and yields a Fredholm second-kind matrix equation. This guarantees the convergence of the resulting meshless numerical algorithm. We compute the focusing ability of a microsize lens as a function of the frequency in the wide range up to 60 THz. This analysis shows that a graphene strip, placed into the focal area of the Luneburg lens, enhances its focusing ability at the resonance frequency of the strip plasmon mode proportionally to the quality factor. This frequency is defined by the strip width and is tunable with the aid of graphene’s chemical potential.

Knockdown of Keratin 6 Within Arsenite-Transformed Human Urothelial Cells Decreases Basal/Squamous Expression, Inhibits Growth, and Increases Cisplatin Sensitivity

Urothelial carcinoma (UC) is prevalent, especially in elderly males. The high rate of recurrence, treatment regime, and follow-up monitoring make UC a global health and economic burden. Arsenic is a ubiquitous toxicant that can be found in drinking water, and it is known that exposure to arsenic is associated with UC development. Around 25% of diagnosed UC cases are muscle-invasive (MIUC) which have poor prognosis and develop chemoresistance, especially if tumors are associated with squamous differentiation (SD). The immortalized UROtsa cell line is derived from normal human urothelium and our lab has malignantly transformed these cells using arsenite (As3+). These cells represent a basal subtype model of MIUC and the tumors derived from the As3+-transformed cells histologically and molecularly resemble clinical cases of the basal subtype of MIUC that have focal areas SD and expression of the basal keratins (KRT1, 5, 6, 14, and 16). Our previous data demonstrate that KRT6 protein expression correlates to areas of SD within the tumors. For this study, we performed a lentiviral knockdown of KRT6 in As3+-transformed UROtsa cells to evaluate the effects on morphology, gene/protein expression, growth, colony formation, and cisplatin sensitivity. The knockdown of KRT6 resulted in decreased expression of the basal keratins, decreased growth, decreased colony formation, and increased sensitivity to cisplatin, the standard treatment for MIUC. The results of this study suggest that KRT6 plays a role in UC cell growth and is an exploitable target to increase cisplatin sensitivity for MIUC tumors that may have developed resistance to cisplatin treatment.

Parent-Led Applied Behavior Analysis to Impact Clinical Outcomes for Individuals on the Autism Spectrum: Retrospective Chart Review.

Autism spectrum disorder (ASD) can have traits that impact multiple domains of functioning and quality of life, which can persevere throughout life. To mitigate the impact of ASD on the long-term trajectory of an individual's life, it is imperative to seek early and adequate treatment via scientifically validated approaches, of which applied behavior analysis (ABA) is the gold standard. ABA treatment must be delivered via a behavior technician with oversight from a board-certified behavior analyst. However, shortages in certified ABA therapists create treatment access barriers for individuals on the autism spectrum. Increased ASD prevalence demands innovations for treatment delivery. Parent-led treatment models for neurodevelopmental conditions are effective yet underutilized and may be used to fill this care gap. This study reports findings from a retrospective chart review of clinical outcomes for children that received parent-led ABA treatment and intends to examine the sustained impact that modifications to ABA delivery have had on a subset of patients of Montera, Inc. dba Forta ("Forta"), as measured by progress toward skill acquisition within multiple focus areas (FAs). Parents received ≥40 hours of training in ABA prior to initiating treatment, and patients were prescribed focused (<25 hours/week) or comprehensive (>25-40 hours/week) treatment plans. Retrospective data were evaluated over ≥90 days for 30 patients. The clinical outcomes of patients were additionally assessed by age (2-5 years, 6-12 years, 13-22 years) and utilization of prescribed treatment. Treatment encompassed skill acquisition goals; to facilitate data collection consistency, successful attempts were logged within a software application built in-house. Improved goal achievement success between weeks 1-20 was observed for older age, all utilization, and both treatment plan type cohorts. Success rates increased over time for most FAs, with the exception of executive functioning in the youngest cohort and comprehensive plan cohort. Goal achievement experienced peaks and declines from week to week, as expected for ABA treatment; however, overall trends indicated increased skill acquisition success rates. Of 40 unique combinations of analysis cohorts and FAs, 20 showed statistically significant positive linear relationships (P<.05). Statistically significant positive linear relationships were observed in the high utilization cohort (communication with P=.04, social skills with P=.02); in the fair and full utilization cohorts (overall success with P=.03 for the fair utilization cohort and P=.001 for the full utilization cohort, and success in emotional regulation with P<.001 for the fair utilization cohort and P<.001 for the full utilization cohort); and in the comprehensive treatment cohort (communication with P=.001, emotional regulation with P=.045). Parent-led ABA can lead to goal achievement and improved clinical outcomes and may be a viable solution to overcome treatment access barriers that delay initiation or continuation of care.

Heterogenic nature of guerrilla gardening

ABSTRACT For some time now, researchers from various academic disciplines have been engaged in the study of green guerrilla gardening, a grassroots activity involving the planting of vegetation in public spaces. In essence, they view it as a social movement with the objective of reclaiming control of public space and modifying its functionality. However, Author identifies a greater diversity within this movement, which he categorises into four basic types of activity: gardening, activism, art and farming. Each of these categories can be further subdivided into distinct areas of focus, including the beautification of urban spaces, the promotion of social change, the provision of food sources, the advancement of education, and the fostering of community building. The diverse nature of guerrilla gardening allows it to fulfil a multitude of roles and objectives. It can therefore be concluded that the phenomenon is heterogeneous, and that the term used to describe it should be understood more broadly in order to encompass this range of activities. Empirical research is increasingly indicating a discrepancy between the practice of gardeners and the expectations of theorists. For example, the use of military terminology, while humorous, can be seen as an overly optimistic expectation of the actions of these often humble gardeners, while emphasising an activist (political) stance. Furthermore, the author notes that research on guerrilla gardening lacks in-depth aesthetic reflection.

Renal Toxic Effects of MgO NPs in Male Rats

Engineered nanomaterials are so tiny that they cannot be seen without special equipment; they are found in many industrial products today, consumer products, medicines, and food products. The small size and other properties of nanomaterials can make them very hazardous to human health. Magnesium oxide nanoparticles (MgO NPs), or metal oxides, have several advantages compared to other metal oxide nanoparticles because of their properties. Therefore, multiple uses of MgO NPs put human health at risk from prolonged exposure. The study aimed to determine how treatment with oral doses of MgO nanoparticles affects the kidneys of male rats through the oral route at 250 and 1000 mg/kg for 14 days, 28 days, and 56 days, respectively. Sixty mature male rats (2.5–3 months) were divided randomly into twelve groups of six rats each and gavaged with MgO NPs. The results observed a significant increase (p&lt;0.01) in urea, creatinine, and uric acid; the histopathological examinations demonstrated necrotic debris inside the lumen of renal tubules; debris of lining epithelial cells inside the lumen of renal tubules; and the marked renal tubules were non-functional focal areas of necrosis and apoptosis. MgO NPs demonstrate potential issues with the kidneys and human health.

Processing and Properties of Polyhydroxyalkanoate/ZnO Nanocomposites: A Review of Their Potential as Sustainable Packaging Materials

The escalating environmental concerns associated with conventional plastic packaging have accelerated the development of sustainable alternatives, making food packaging a focus area for innovation. Bioplastics, particularly polyhydroxyalkanoates (PHAs), have emerged as potential candidates due to their biobased origin, biodegradability, and biocompatibility. PHAs stand out for their good mechanical and medium gas permeability properties, making them promising materials for food packaging applications. In parallel, zinc oxide (ZnO) nanoparticles (NPs) have gained attention for their antimicrobial properties and ability to enhance the mechanical and barrier properties of (bio)polymers. This review aims to provide a comprehensive introduction to the research on PHA/ZnO nanocomposites. It starts with the importance and current challenges of food packaging, followed by a discussion on the opportunities of bioplastics and PHAs. Next, the synthesis, properties, and application areas of ZnO NPs are discussed to introduce their potential use in (bio)plastic food packaging. Early research on PHA/ZnO nanocomposites has focused on solvent-assisted production methods, whereas novel technologies can offer additional possibilities with regard to industrial upscaling, safer or cheaper processing, or more specific incorporation of ZnO NPs in the matrix or on the surface of PHA films or fibers. Here, the use of solvent casting, melt processing, electrospinning, centrifugal fiber spinning, miniemulsion encapsulation, and ultrasonic spray coating to produce PHA/ZnO nanocomposites is explained. Finally, an overview is given of the reported effects of ZnO NP incorporation on thermal, mechanical, gas barrier, UV barrier, and antimicrobial properties in ZnO nanocomposites based on poly(3-hydroxybutyrate), poly(3-hydroxybutyrate-co-3-hydroxyvalerate), and poly(3-hydroxybutyrate-co-3-hydroxyhexanoate). We conclude that the functionality of PHA materials can be improved by optimizing the ZnO incorporation process and the complex interplay between intrinsic ZnO NP properties, dispersion quality, matrix–filler interactions, and crystallinity. Further research regarding the antimicrobial efficiency and potential migration of ZnO NPs in food (simulants) and the End-of-Life will determine the market potential of PHA/ZnO nanocomposites as active packaging material.

Synthesis Methods for Electrochemically Applicable High Entropy Oxides.

As field-dispatchable power sources offer an alternative means of energy conversion, electrocatalyst development has become an area of intense focus. Emphasis has been placed on the transition from expensive electrocatalysts such as platinum and palladium toward earth abundant materials. Such a shift would result in lowered costs, enhanced durability, and an increased potential for implementation on a broader scale. High entropy oxides (HEOs) are an emerging class of materials that can offer both earth abundance and tunability of composition and morphology, making them excellent candidates for electrocatalysis. Several approaches have been taken to synthesize these materials and achieve balance between single-phase, highly crystalline products and high-surface area, nanostructured products. This work offers a survey of these methods, as well as our perspective on the most promising pathways forward. Emphasis is placed on clarifying the benefits, challenges, and overall suitability of each means of synthesis with electrocatalytic applications in mind.

Sustainability Service Chain Capabilities in the Oil and Gas Industry: A Fuzzy Hybrid Approach SWARA-MABAC

This study aims to redefine the capabilities of the service supply chain in the Iranian oil and gas industry, where the concept of service chains has remained underdeveloped due to a traditional focus on conventional service chains. It seeks to compare the capabilities of the oil and gas service supply chain to those in other sectors and explore whether applied research is necessary to improve service chain performance. The study was conducted in three stages, involving ten petroleum and natural gas experts. The first stage focused on identifying key capabilities, yielding seven significant capabilities and 28 critical sub-capabilities. In the second stage, the SWARA fuzzy hybrid approach was employed to weigh and prioritize these capabilities, while the fuzzy MABAC methodology was used for strategic decision-making. Finally, the model’s sensitivity was assessed using fuzzy methods to validate the findings. The results highlight the highest priority capability for service providers: the ability to utilize information for updating information processing capacity in making decisions within the service supply chain. The selected location, G1, emerged as a key area of focus. This approach presents a novel method for optimizing service supply chain locations within the oil and gas sector. This paper introduces a unique approach to selecting optimal service supply chain locations in the oil and gas industry, addressing critical gaps in previous research. Employing advanced fuzzy hybrid methodologies provides valuable insights into improving service chain capabilities, offering a competitive advantage for companies operating in this sector.

Developing mental wellbeing promotion practices in Finnish primary schools: The CONSENSUS project

Abstract Issue/problem Schools constitute a key arena for promoting mental wellbeing among children and adolescents, and the Finnish welfare state has many beneficial structures in place for promoting mental wellbeing in schools. However, as mental health problems are prevalent, the need to advance this work is vital, ideally applying a holistic approach focusing on school-family interaction. Description of the problem The Finnish CONSENSUS project (2021-2025) focuses on the development of new practices and collaboration models in mental wellbeing promotion, targeting pupils in 13 primary schools in the Ostrobothnia region. The project answers question such as: What focal areas are prioritized by stakeholders in the development of mental wellbeing promotion in schools? How do participatory principles contribute to the development process and related outcomes? Results In 2024, a synthesis of previous project results (interviews, focus groups and longitudinal survey data collected among pupils, school personnel, school health care services and parents) was generated. The synthesis encompasses 20 possible priority areas to focus on in the development of mental well-being promotion actions, which are ranked by stakeholder representatives utilizing Delphi methods. Some pinpointed priority areas are implemented and evaluated in collaboration with self-selected schools during the academic year 2024-2025. Lessons Results highlight priorities in the development of mental wellbeing promotion in Finnish primary schools and describe focal areas being piloted, also illustrating opportunities and challenges when implementing participatory principles in action research projects. Key messages • Project results highlight prioritized areas in the development of mental wellbeing promotion in Finnish schools, as well as new initiatives currently being piloted. • The project approach emphasising participatory principles provides lessons for other initiatives focusing on mental wellbeing promotion development in schools.

Developing regional Diabetes Registries in Italy: pilot projects implementation within JACARDI

Abstract Issue/Problem In Italy a National Diabetes registry is planned but not yet set up at the Ministry; JACARDI is contributing to speed up the process so that critical gaps in health data availability can be filled. While some regional registries exist, the lack of cohesion and standardization hinders the tracking of prevalence, incidence, and sequelae, crucial for evidence-based policymaking amidst rising diabetes rates. Description of the Problem The JACARDI project, supported by EU funding and running for four years, engages 76 partners from 21 countries and includes 142 national-level projects. Among its focus areas is enhancing data availability, aiming to establish harmonized regional Diabetes registries in Italy to tackle this issue. These efforts aim to create a scalable model enabling data linkage, diabetes type differentiation, and socio-demographic integration. Collaboration with health authorities and societies, drawing insights from existing registries, informs the development process. Results A total of 11 regional Diabetes registries are currently in the design phase of implementation. They adhere to a clearly defined methodology, with established essential parameters and data linkage. Consensus on these parameters and linkage was reached through stakeholder discussions, drawing on past registry experiences. The primary goal of the registries is to monitor diabetes prevalence, stratify incidence by demographics, and track sequelae to inform targeted interventions and resource allocation. While scalability beyond Italy may encounter administrative challenges, standardized protocols facilitate transferability. Data Protection stands out as a significant implementation obstacle. Lessons Standardized data collection, stakeholder collaboration, and sustainability are vital in registry development. Leveraging data availability for surveillance demonstrates adaptability and scalability, offering valuable insights for enhancing diabetes management. Key messages • Standardized data collection and stakeholder collaboration are pivotal in establishing effective diabetes registries, fostering equity and improving health outcomes. • Leveraging data availability for surveillance offers a scalable and sustainable approach to diabetes management, facilitating informed policymaking and interventions.

Future Finland – A nationwide Finnish multidisciplinary birth cohort initiative

Abstract Increasing evidence suggests that early-life conditions may have substantial consequences on individual health and wellbeing throughout the lifecycle. Development of complex social and health issues may be best understood through longitudinal studies that combine the perspectives of social and health sciences. Future Finland aims to collect a nationwide lifelong data resource that through collaborative multidisciplinary research will strengthen future population welfare. Future Finland will be based on index children born in Finland (43.000/year) during a specific time period. National registers and other administrative data sources will provide data for the age cohort (children), their parents and siblings, with special effort on data from more rarely used sources (e.g., electronic health records, school records). Subsets of cohort members will be recruited in early pregnancy (consent) to undergo deeper data collection through questionnaires, biological and environmental samples and measurements, and digital monitoring data (e.g., physical activity, citizens digital footprint). The Future Finland preparatory phase started in 2023 at the Finnish Institute for Health and Welfare (THL). The Future Finland design and focus areas are currently being planned based on identified information gaps and with consultations of experts from other birth cohort studies. Data collection is planned to start in 2025 by piloting and foreseen to expand to full-scale in 2027-2028. The Future Finland data resource will be made available for the entire research community as openly as possible, at the same time maintaining the highest possible data security standards to protect privacy now and in the future. Future Finland enables novel interdisciplinary research and intervention setups, which will strengthen the knowledge base for societal decision-making and promote the future population welfare. Future Finland is funded by the Finnish Cultural Foundation. Key messages • Future Finland initiative will collect a nationwide lifelong data resource enabling novel cross-disciplinary research designs to produce groundbreaking and impactful scientific results. • A larger-scale use of data enables novel interdisciplinary research and intervention setups strengthening the knowledge base for societal decision-making and promoting the future population welfare.

The global research landscape and future trends in healthcare Total Quality Management

Total Quality Management (TQM) is instrumental in augmenting the quality and efficacy of healthcare service delivery, but a comprehensive evaluation of present and evolving TQM research trends within healthcare research articles is notably absent. This study provides an insightful view into the prevailing international scenarios and upcoming research frontiers in healthcare TQM research field, utilizing bibliometric mapping through VOSviewer. Drawing data from 360 publications in the Web of Science core citation database, it delineates a steady growth in the field over the last 30 years. Research outputs span 51 countries and regions, with notable contributions from the United States, United Kingdom, Netherlands, and Italy. The top five research institutions and numerous authors predominantly hail from the United States. Key keywords in near years encompass healthcare safety, healthcare quality assurance, quality indicators, and the application of Six Sigma management principles. This exploration serves as a pivotal reference for understanding the global research landscape and future trends in healthcare TQM, particularly in guaranteeing quality and safety. Future scientific endeavors will build upon these focus areas, exploring and connecting research gaps in more specialized fields.

Low-cost fabrication of digital light processing 3D printed conical microneedles for biomedical applications

The 3D printing of microneedles has become an emerging area of research focus due to its ability to rapidly create microneedle arrays with parametrically variable geometry and composition. Through direct fabrication or via replica molding, 3D printed microneedles can facilitate iterative array assessment and act as a screening tool to quickly establish optimal parameters for tissue insertion and capacity for biomarker monitoring or drug release. However, the widespread adoption of 3D printing by microneedle array researcher group faces multiple barriers: (1) Investment in 3D printing systems that are traditionally associated with high-resolution pose a significant financial cost, (2) Current high-resolution printing methods are often slow and not conducive to rapid manufacturing, (3) Material selection can be limited in some ‘proprietary’ 3D printing systems (e.g. CLIP, SLA, or 2PP), (4) Given the multidisciplinary nature of the microneedle-field, researchers may not have the expertise to optimize printing parameters for a given material or printer. This work explores how ultra-low-cost digital light processing (DLP) printers can rapidly produce functional microneedle arrays for a variety of purposes, whether direct print, master mold production, or creation of coated microneedles, at a fraction of the cost of currently used systems. Further, this work highlights that high quality microneedle arrays can be created using DLP printing methods with reliability exceeding 98 %, tip radii on the order of 30 µm, and with appropriate parameter input optimization, high quality microneedle arrays can be fabricated that express desirable characteristics for multiple forms of solid microneedle array production.

Socio-economic factors affecting spatial inequalities in pregnancy-related ambulance attendances in Greater London

Exploring inequalities in ambulance and pre-hospital demand is important to improve service equity and reduce wider health inequalities. Maternity incidents amongst ambulance demand are a key area of focus because of the specialized care that is needed for patients, as well as the impact of wider determinants of health on pregnancy outcomes. Since there are spatial inequalities amongst pregnant patients who call for an ambulance, the aim of this study is to assess the underlying factors associated with pregnancy related ambulance complaints, to determine why maternity patients utilize the ambulance service. Local indicators of spatial autocorrelation were used to identify clusters of ambulance maternity demand within Greater London (UK). A negative binomial regression model was used to explore associations between socioeconomic, environmental, accessibility and demographic variables. Our results reveal that neighborhoods with low adult skills (i.e. qualifications/English language abilities) have a higher rate of demand. Moreover, our results imply that the demand for ambulance services may not be directly tied to health outcomes; rather, it might be more closely associated with patients' reasons for calling an ambulance, irrespective of the actual necessity. The benefits of identifying factors that drive demand in ambulance services are not just linked to improving equity, but also to reducing demand, ultimately relieving pressure on services if alternative options are identified or underlying causes addressed. Doing so can improve health inequalities by firstly, improving ambulance care equity by directly supporting a better allocation of resources within ambulance systems to target patterns in demand.

Skills for the energy transition: a Northern Ireland perspective

A major area of focus for anyone involved in the energy transition to net zero is attracting, growing and retaining new talent with the appropriate skills that will enable delivery of a net zero target for Northern Ireland by 2050. This article explores the ways in which NIE Networks, the network operator in Northern Ireland, is working in collaboration with the sector, Government and Education providers to address the skills shortage.

Ensuring sustainable impact of the national report on climate change and health in Germany 2023

Abstract Issue/problem The Robert Koch Institute recently coordinated a status report on climate change and health for Germany, detailing the current and future impact of climate change on health through 14 chapters. Description of the problem A central aim was to ensure the report’s long-term impact and public health value. Essential areas of focus have therefore been stakeholder-specific communication and establishing a network of experts for continued scientific exchange. Results The publication of the report as peer-reviewed articles has served to reach the scientific community. Another target group are public health practitioners and decision makers at subnational levels, who can contribute towards climate change mitigation and adaptation measures relevant to health, as recommended in the report. This latter group was reached through various methods and formats of science communication, including conferences aimed at the public health sector, through target-group oriented podcasts, social media engagement and digital town hall discussions. Following publication, the experts involved in writing, reviewing and using the report were invited to establish a network in order to support long-term scientific exchange and collaborations and in turn ensure the report’s sustainable impact and value. Lessons Through follow-up evaluations, the reception of the report and the further communication needs of this target group were analysed. A major lesson was to include the insights of public health practitioners more systematically and at an earlier stage in any future reports. As for the establishment of a network, a survey amongst the authors and other experts showed what this group considers the goals of this network: creating synergies and connections with existing initiatives and providing a platform for further exchange, especially amongst researchers addressing similar questions, such as the efficacy of mitigation and adaptation measures, from different angles. Key messages • Local public health practitioners are important stakeholders for climate change and health for ensuring public health impact. • The expertise in the network will support continued scientific exchange on climate change and health and thus ensure the national report’s sustainability.