Changes In System Research Articles

How resilient was international trade to Covid-19? Insights from clusters of European countries

The Covid-19 crisis spread worldwideat lightningspeed mainly due to the interconnectedness of today's economies as evidenced by major disruptions in international trade. This articleaims to assessthe possible shifts that coronavirus disease has triggered inthe trade activity of European countriesin two particularly affected sectors, that is foodand machinery and transport equipment. In this process, exploratory data analysis is conductedtoaccurately explain the patterns lying behind the observed variations in trade values. Furthermore, clusteranalysis is performedonthe sample of European countries by applying hierarchical and K-means clustering algorithms using Python's libraries. Byexamining clusters of countries with similar trade profiles, this article contributes to discussions on global value chains, and to which extent there is data-based evidence to indicate systemic changes and reconfiguration ofglobal production processes.

Adaptation strategies of paddy farmers to build resilience to climate change in kahama district, Tanzania

The study investigates the adaptation strategies used by the paddy farmers in Kahama District to increase their adaptability to climate change. The study focuses on four main objectives, including changed farming practices, changes in cropping practices, strategies used to adapt to climate change, and desired interventions to improve agricultural production and resilience to climate change. A mixed-methods strategy is used in the study to collect both quantitative and qualitative data. According to the data, paddy farmers in Kahama District have used a number of climate change adaptation strategies. These adaptations include modifications to irrigation techniques, timing adjustments for planting, seed variety changes, and fertilizer treatment adjustments. The study also reveals a change in crop systems, with farmers choosing drought-tolerant cultivars, intercropping, and crop diversification; increased water management practices, increased soil conservation practices, and informed decision-making through the use of climate information services are some of the strategies used by paddy farmers to adapt to climate change. The study also identifies the interventions that farmers want to see implemented, such as enhanced irrigation systems, workshops on climate-resilient farming techniques, access to resilient seed varieties, and dependable weather forecasting and climate information services. These findings show the paddy farmers in the Kahama District's proactive response to the problems posed by climate change and help to better understand the adaptation measures they have used. The study highlights the importance of assisting farmers in advancing their current strategies and knowledge while also attending to their unique requirements. Implementing desired actions, such as expanding climate information services, supplying training and access to robust seed varieties, and enhancing irrigation infrastructure, can significantly increase agricultural productivity and the region's resistance to climate change. For politicians, extension services, and development organizations looking to promote climate change adaptation and sustainable agriculture, these research findings have real-world applications. Paddy farmers' ability to adapt, agricultural output, and livelihood security in the face of climate change problems can all be improved by matching interventions and policies with their recognized needs and goals. Such activities can support attempts to achieve food security and sustainable development in the Kahama District and other areas, as well as the agricultural sector's overall resilience.

Differences in Racial and Ethnic Disparities Between First and Repeat Kidney Transplantation.

Recent data suggest patients with graft failure had better access to repeat kidney transplantation (re-KT) than transplant-naive dialysis accessing first KT. This was postulated to be because of better familiarity with the transplant process and healthcare system; whether this advantage is equitably distributed is not known. We compared the magnitude of racial/ethnic disparities in access to re-KT versus first KT. Using United States Renal Data System, we identified 104 454 White, Black, and Hispanic patients with a history of graft failure from 1995 to 2018, and 2 357 753 transplant-naive dialysis patients. We used adjusted Cox regression to estimate disparities in access to first and re-KT and whether the magnitude of these disparities differed between first and re-KT using a Wald test. Black patients had inferior access to both waitlisting and receiving first KT and re-KT. However, the racial/ethnic disparities in waitlisting for (adjusted hazard ratio [aHR] = 0.77; 95% confidence interval [CI], 0.74-0.80) and receiving re-KT (aHR = 0.61; 95% CI, 0.58-0.64) was greater than the racial/ethnic disparities in first KT (waitlisting: aHR = 0.91; 95% CI, 0.90-0.93; Pinteraction = 0.001; KT: aHR = 0.68; 95% CI, 0.64-0.72; Pinteraction < 0.001). For Hispanic patients, ethnic disparities in waitlisting for re-KT (aHR = 0.83; 95% CI, 0.79-0.88) were greater than for first KT (aHR = 1.14; 95% CI, 1.11-1.16; Pinteraction < 0.001). However, the disparity in receiving re-KT (aHR = 0.76; 95% CI, 0.72-0.80) was similar to that for first KT (aHR = 0.73; 95% CI, 0.68-0.79; Pinteraction = 0.55). Inferences were similar when restricting the cohorts to the Kidney Allocation System era. Unlike White patients, Black and Hispanic patients with graft failure do not experience improved access to re-KT. This suggests that structural and systemic barriers likely persist for racialized patients accessing re-KT, and systemic changes are needed to achieve transplant equity.

Changes in the central nervous system in football players: an MRI study.

Football (soccer) is the world's most popular team sport. To comprehensively examine the brain in football (soccer) players, with the use of magnetic resonance imaging (MRI) techniques. The study involved 65 football players and 62 controls. The MR examinations were performed using MR 1.5-T system (Optima MR 360; GE Medical Systems). The examinations were carried out in the 3D Bravo, CUBE, FSEpropeller, and diffusion-weighted imaging (DWI) sequences. The 1HMRS signal was obtained from the volume of interest in the frontal and occipital lobes on both sides. The present study, based on structural MRI, shows some changes in the brains of the group of football players. The findings show asymmetry of the ventricular system in four football players, arachnoid cysts in the parieto-occipital region, and pineal cysts. NAA/Cr concentration in the right frontal lobe was lower in the football players than in the controls, and the Glx/Cr concentration in the right occipital lobe was higher. The apparent diffusion coefficient value is lower in football players in the occipital lobes. Playing football can cause measurable changes in the brain, known to occur in patients diagnosed with traumatic brain injury. The present findings fill the gap in the literature by contributing evidence showing that playing football may lead to changes in the brain, without clinical symptoms of concussion.

Non-drug therapies for patients with vibration disease associated with exposure to local vibration

Non-drug methods include acupuncture, the most effective way to regulate the body's energy system. Pulsed magnetic stimulation (PMS) is based on the application of the principles of electromagnetic induction, causes hyperpolarization or depolarization of nerve cells. The methods are practically not used in the clinic of occupational diseases, and their effectiveness in the treatment of vibration disease (VD) has not been established. The study aims to evaluate changes in the central nervous system and peripheral nerves, as well as in the psychological status of patients with vibration disease after sessions of acupuncture and pulsed magnetic stimulation. Using the acupuncture method, 24 male patients were treated with a diagnosis of VD associated with exposure to local vibration (average age 49.9±3.8 years, average length of service — 19.4±4.3 years), PMS — 24 people with a diagnosis of VD associated with exposure to local vibration (average age 48.8±3.4 years, average length of service — 18.1±3.4 years). The treatment methods performed made it possible to improve the quality of therapy, which was confirmed by a positive change in the indicators of visual and somatosensory evoked potentials, data from electroneuromyographic studies, vibration sensitivity and algesimetry, the state of the mnestic and attentional spheres of activity improved. The use of the acupuncture method allowed to improve the indicators of bioelectric activity of the brain: the amplitude of the peak N1 of visual evoked potentials increased (from 3.2 to 6.7 MV, p&lt;0.05), the latency of the peak P200 decreased from 178.0 to 142.5 ms, p&lt;0.05. The threshold of pain sensitivity on the zygomatic bone, on the phalanx of the 2nd finger of the hand and on the protruding part of the inner ankle decreased by 63, 125 and 250 Hz, p&lt;0.05. Vibration sensitivity improved (on the ulnar process, phalanx of 2 fingers of the hand, p&lt;0.01, on the tubercle of the tibia, p&lt;0.05). Magnetic stimulation contributed to the improvement of cerebral changes in the treated patients — the latency of auditory evoked potentials decreased (p&lt;0.03 for peak P1 and p&lt;0.05 for peak P2), the amplitude of visual evoked potentials increased (p&lt;0.05), the bioelectric activity of the occipital lobes of the brain increased. The duration of the afferent excitation wave at the level of the cervical region (latency N11 and N13, p&lt;0.05) and thalamic structures (latency P25, p&lt;0.05) increased. Non-drug therapy allowed to restore the time of excitation by the motor component of axons in patients on the upper extremities during acupuncture, on the upper and lower extremities during treatment with magnetic stimulation (p&lt;0.05), improved indicators characterizing the mnestic-attentional and psychoemotional spheres of the treated. Ethics. Conclusion of the MEС of the Federal State Budgetary Scientific Institution "East Siberian Institute of Medical and Environmental Research" No. 32 dated 09/10/2019.

Importance of undergraduate institution prestige in physics faculty hiring networks

Reforming the professionalization experiences of future faculty members, including their undergraduate experience, provides a possible means to create scalable change in higher education. However, this requires an understanding of where faculty undergraduate training occurs. We analyze data from 7748 tenure-line faculty members across 611 U.S. physics departments, including their undergraduate alma mater and their employer university. The resulting undergraduate professionalization network reveals a prestige hierarchy similar in strength to those previously found in hiring networks at the Ph.D. level, indicating that the road to faculty jobs begins during undergraduate admissions. Furthermore, 42% of physics faculty members earned their undergraduate degrees from institutions outside of the United States. These results reinforce the importance of institutional prestige in academia and offer a potential strategy for driving systemic change. Published by the American Physical Society 2024

Mapping mental models in sustainability transitions

Sustainability transitions inherently involve system change, which needs to be initiated and accepted by a wide variety of actors. How actors perceive the system or transition of interest can shape key decisions in a transition process. Still, little transition research has combined this system perspective with the actor's perspective. At this intersection lies the concept of mental models, which are actors' system perceptions, consisting of beliefs about the causal interrelations between system components. Mapping mental models of actors in sustainability transitions may (1) increase our understanding of the system that needs to transform, (2) reveal obstacles or opportunities for change, and (3) demonstrate similarities and differences in system perceptions between actors. We present three types of transition mental models and illustrate these with examples. We conclude with avenues for future mental model research and discuss how insights from mental models can inform strategies to develop or steer transitions.

Longitudinal effects of sexual minority stigma on depressive symptoms among young men who have sex with men: Distinguish between and within person effects.

Young men who have sex with men (YMSM) may experience high levels of sexual minority stigma (SMS) and depressive symptoms (DS) over the world and in China. However, there is a lack of studies investigating the longitudinal effects of SMS on DS of YMSM, especially focusing on YMSM and separating the between-person and within-person effects. This study aimed to fill the said gaps. Study data were derived from a prospective cohort of 349 YMSM from central China (Wuhan, Changsha, Nanchang), the baseline survey was started in 2017 with one follow-up visit every year. SMS and DS were measured three times using valid and reliable instruments. The cross-lagged panel model (CLPM) and the random intercept CLPM (RI-CLPM) were used to examine the between-person and within-person concurrent and lagged effects, respectively. Findings of CLPM revealed bidirectional associations between SMS and DS over time. RI-CLPM suggested that at the between-person level, SMS was significantly associated with DS, echoing the results of CLPM. However, this reciprocal relationship has not been found at the within-person level. The associations between SMS and DS among YMSM at the population level is more significant than that at the individual level. We suggest that interventions should be against the adverse effects of cultural marginalization and systemic change the social concepts to reduce the amount of SMS in society.

Identifying professional and pedagogical deficiencies of a medical university teacher

In this article, the authors presented certain results of a study devoted to identifying deficiencies in the psychological and pedagogical activities of medical university teachers. A definition is given to the concept of professional deficits as a lack (limitation) in professional competence that prevents the effective implementation of professional actions. The purpose of this work was to describe the areas of professional deficits of teachers of higher medical schools. In the article, the authors tried to answer the questions: How ready are the teaching staff of a medical university for changes in the higher education system? What professional deficiencies most often arise among teachers and how to deal with them? A number of studies conducted at the Department of Pedagogy and Psychology of Further Education indicate that university teachers have a number of professional deficiencies. The reasons for these deficits are varied, since the work experience of teachers, areas of professional deficits, etc. vary. The work was based on regulatory documents, such as “Strategic priorities in the implementation of the state program of the Russian Federation “Development of Education” until 2030.” Professional deficits were examined in five main areas of professional pedagogical activity: scientific-theoretical, methodological, psychological-pedagogical, communicative and general pedagogical. Research on deficits in these areas has been conducted and analyzed. Professional deficits were identified through a sociological survey of teachers in offline and online formats using a specially created questionnaire. The questionnaire was developed using tools from various areas of psychological and pedagogical knowledge. The set of these deficits is unique for each teacher. No teacher is immune from professional difficulties: both young and experienced teachers face them. Professional pedagogical deficits depend not only on the personal characteristics and developed competencies of the teacher, but also on the developing educational environment in which he is located. Purposeful work in this direction will help to overcome professional deficits. This activity is carried out by the Department of Pedagogy and Psychology of Further Education during advanced training and professional retraining of university teachers.

A qualitative exploration of professionals' perspectives on the implementation of reablement intervention programs in community care.

Reablement is considered a complex intervention due to its multicomponent, person-centered, holistic approach promoting older adults' active participation in daily activities. It is important to consider the unique context in which complex interventions are implemented, as contextual factors may interact and influence implementation outcomes. As part of the European TRANS-SENIOR project, this qualitative study aimed to gain insight into professionals' experiences with reablement implementation in Dutch community care. Using the Consolidated Framework for Implementation Research, four focus groups were conducted comprising 32 professionals. Two groups were formed: one at operational level, including therapists, nursing staff, social workers, and domestic support; and one at organizational/strategic level, including project leaders, managers, directors, municipality representatives and health insurers. Participating care organizations had at least 6 months of experience with deploying and implementing reablement. Findings reflected three themes: (1) strength of interdisciplinary collaboration; highlighting significance of sharing goals and beliefs, (2) integrating the reablement philosophy into the organization; underscoring managements role in fostering support across all organizational layers, and (3) achieving a culture change in the healthcare system; emphasizing current funding models impeding value-based care tailored to the individual's goals and needs. The results offer valuable insights for implementation of complex interventions, like reablement.

Educators’ perspectives on harmful sexual behaviour

ABSTRACT Child sexual abuse is an epidemic, yet many are unaware that a significant proportion of sexual abuse is perpetrated by children and adolescents. Research indicates that professionals can hold unhelpful views of those engaging in Harmful Sexual Behaviour (HSB) and lack confidence when handling cases. Given educators' proximity to young people, their experiences could shed light on the current picture within schools. The study aimed to contribute to the growing evidence-base, by exploring educators’ perspectives on HSB. Semi-structured interviews were conducted with 10 educators working in English schools. Thematic analysis elicited three key themes: Awareness of HSB in education; Responses to fictitious and real-life cases; and perceptions of HSB. Educators demonstrated some knowledge of HSB and understood the processes for responding to cases. Real and fictional cases of HSB elicited strong, negative emotion in the sample. Recommendations included specialist training and support for educators and systemic change to minimise harm. PRACTICE IMPACT STATEMENT The findings of the study provide valuable insight regarding the first-hand experiences of teaching staff in relation to Harmful Sexual Behaviour (HSB); and the emotional impact of working with young people affected by sexual harm. It also takes into account systemic issues which perpetuate HSB. Recommendations seek to improve educators' confidence and competency, promote best practice, and tackle the prevalence of sexual harm in schools through “whole school” approaches.

How – and How Much? An Analysis of Major Conflict Lines Regarding the Transformation of German Animal Farming

Based on the concept of a 'future workshop', this paper contributes to the understanding of major conflict lines and future pathways for animal farming in Germany. Participants in the future workshop were tasked with outlining their ideal vision of the future of animal farming, focusing on both its mode and quantity. We found three different types of visions differing in their motivation, farming methods, and the scale of envisioned animal farming: ‘Higher Standards’ (V1), ‘System Change and Reduction’ (V2), ‘Alternatives to Animal Farming’ (V3). V1 seeks to secure the quantities of supply and demand of animal products in Germany with minor adjustments towards improved animal welfare and investments in resource-efficiency and climate friendliness. V2 advocates for comprehensive social and environmental systemic changes throughout the agri-food sector, with substantially fewer animals involved. V3 aims to replace animal farming, with plant-based and other alternatives, whenever and wherever possible. Our findings suggest that there is little ground for a societal consensus on a single future mode and scale of animal farming. Stakeholder dialogues and policy initiatives should therefore allow for different pathways while focusing on compromises in the near future. Short-term solutions may be acceptable to supporters of all three visions, however, achieving this requires reframing the debate from ‘securing the future of animal farming’ to ‘guiding the future of animal farming’, acknowledging the potential – albeit partly – replacement of animal farming by suitable alternatives.

Spin–orbit-coupled Bose gas with Rydberg interactions confined in a two-dimensional optical lattice

We consider the ground state of Rydberg-dressed Bose gas with spin–orbit coupling and confined in a two-dimensional optical lattice. The effects of system’s parameters, especially the nonlocal Rydberg interaction and spin–orbit coupling, on the ground-state structure of such a system are explored in full parameter space. It is found that in the absence of spin–orbit coupling, the ground-state structure of the system changes from the initial optical lattice structure to a two-dimensional periodic one with the cell size decreasing with the strength of Rydberg interaction. In the presence of spin–orbit coupling, both the phase and the internal structure of unit cell show strong dependence on the strength of spin–orbit coupling. Finally, the strong interacting gas is also considered.

Cardiovascular Effects of Neurofeedback Course in Various Sports Adaptation Strategies: an Open Controlled Study

INTRODUCTION. Neurofeedback is effectively applied in clinical practice. Cardiovascular effects (CVEs) from different sports adaptation strategies in course-based β-rhythm neurofeedback are under-studied. AIM. To evaluate the CVEs of the neurofeedback course under different sports adaptation strategies. MATERIALS AND METHODS. The study included 1020 men (18–21 years) during the preparatory training period. Following groups were formed: 1 — cyclic sports (n = 387); 2 — speed-strength sports (n = 255); 3 — single combat (n = 31); 4 — team sports (n = 173); 5 — complex coordination sports (n = 174). The CVEs were assessed with the BOSLAB complex (Russia), with eyes open and muscles relaxed. EEG electrodes were applied bipolarly (Cz-Fz). Session types: graphic (10 minutes), game (16 minutes), where the β-rhythm level was increased and maintained. Indices of systemic pressure, cardiac activity; peripheral vessels, functional changes of the cardiovascular system (CVS) were also examined. RESULTS AND DISCUSSION. Along with improved attention, the 10th session revealed positive CVEs in the 1st, 3rd, 4th and 5th groups with CVS economization. 1st group: CVEs are a desirable response option. 2nd group: ambiguous heterochronic CVEs, with improved systemic pressure and reduced cardiac activity, indices of peripheral vessels, cardiovascular regulation index. These effects, mainly in strength sports, are caused by the long-term sports adaptation strategy, associated with hypoxia and incomplete recovery of the spent resources, causing incomplete adaptation. It is associated with mastering the β-rhythm control skill, different in the nature from the activities with the formed adaptation strategy in the long-term training process. 3rd group (10th session): changes in the brain structure (BS) function formed CVEs involving mechanisms maintaining systemic pressure, regarded as optimal. 4th and 5th groups: optimized BS and CVEs activities. CONCLUSION. The positive CVEs demonstrated expediency of the β-rhythm neurofeedback course. Ambiguous CVEs in groups of speed-strength sports are studied for neurofeedback technology modification.

Primary Energy and Carbon Impacts of Structural Frames with Equivalent Design Criteria: Influence of Different Materials and Levels of Prefabrication

This study aims to analyze the life-cycle primary energy and climate impacts of structural frames, paying particular attention to the design and prefabrication of different structural materials. The study considers an existing single-story office building with a composite concrete–steel structure and compares it with two functionally equivalent structures, i.e., a conventional reinforced concrete structure and a conventional steel structure. The existing building is located in San Felice sul Panaro, Italy. This study integrates dynamic structural analysis and life-cycle assessment (LCA). The study finds that the use of different materials can reduce the life-cycle primary energy use and CO2-eq emissions by up to 12%. Furthermore, the benefits derived from the recovery and recycling of materials can reduce the primary energy use and CO2-eq emissions by up to 47% and 36%, respectively. The prefabrication of structural elements can also reduce the primary energy use and CO2-eq emissions in the construction stage. A sensitivity analysis considers changes in the electricity supply system and shows that the primary energy and CO2-eq emissions due to prefabrication decrease when assuming marginal electricity based on renewable energies. This analysis supports the development of sustainable structural design to meet the standards concerning the whole-life-cycle carbon emissions of buildings.

ТРАНСФОРМАЦІЯ МЕНЕДЖМЕНТУ БУДІВЕЛЬНИХ ПРОЄКТІВ В УМОВАХ ГЛОБАЛЬНОЇ ЦИФРОВІЗАЦІЯ

Introduction. The article discusses the need for systemic qualitative changes in the management structure and requirements for the construction project management process in the context of digital transformation, characterized by a combination of advanced technologies and the integration of physical and digital systems. The importance of considering the problems and aspects of digital transformation in the context of new generations (a qualitatively new cluster of human capital), digital talent, changing the mindset of project managers, as well as key changes in construction project management systems in the digital environment is highlighted. Problem statement. The construction industry is a fundamental sector of the economy of any country. A construction project is a structural element of the “construction” system, which allows to form the economic effect of the industry's development as a whole. Modern construction project management includes a set of interconnected but heterogeneous subsystems that together should increase the level of economic profitability. The defining subsystems are: 1. Strategic risk management: Given the volatility of raw material markets and the high value of some materials, the introduction of circular approaches in construction management can help reduce the vulnerability of projects to risks associated with fluctuations in material prices. 2. Efficient use of resources: A central goal of construction management is to optimize the use of resources to achieve project goals. The use of circular economy principles will allow to use resources more efficiently and reduce the cost of purchasing new materials.

Guidelines for Assessing Maternal Cardiovascular Physiology During Pregnancy and Postpartum.

Maternal mortality rates are at an all-time high across the world and are set to increase in subsequent years. Cardiovascular disease is the leading cause of death during pregnancy and postpartum, especially in the US. Therefore, understanding the physiological changes in the cardiovascular system during normal pregnancy is necessary to understand disease-related pathology. Significant systemic and cardiovascular physiological changes occur during pregnancy that are essential for supporting the maternal-fetal dyad. The physiological impact of pregnancy on the cardiovascular system has been examined in both experimental animal models and in humans. However, there is a continued need in this field of study to provide increased rigor and reproducibility. Therefore, these guidelines aim to provide information regarding best practices and recommendations to accurately and rigorously measure cardiovascular physiology during normal and cardiovascular-disease-complicated pregnancies in human and animal models.

Quality improvement project - Reducing the inadvertent prescribing of unopposed estrogen in primary care Dr Liz Horrocks Banstead PCN.

The aim of the project was to reduce the risk of patients using the estrogen only part of their hormone replacement therapy (HRT) inadvertently in Banstead PCN. Although understanding about the risk of unopposed estrogen is well understood by prescribers, there are numerous flash points where this exposure can occur which was highlighted by several cases encountered during a study period of 3months. Cases encountered revealed numerous reasons for this exposure which were split into three areas: Prescribing factors, dispensing checks and patient understanding. Quality improvement suggestions were tailored to the factors involved. IT system changes to EMIS, our main computer software provider, were proposed to enable safer prescribing. Following discussion with key stakeholders, increased education for pharmacists was proposed alongside an alert sticker system at the dispensing end point. Patient understanding and education for all parties was delivered through various routes. The IT system alterations required are complex and still awaited. Funding was obtained and stickers distributed. The results from a re-audit from this intervention are awaited. Interim education measures at an individual level were meantime explored and the impact of them assessed. Patient education and the role of social media were explored. I produced a short video which was circulated to doctors with the plan to distribute via other clinician social media accounts. A key discovery through this study is that many of the flash points identified can be difficult to detect and many are not measurable. The increasing number of HRT prescriptions, time pressures in primary care and the known risk from using unopposed estrogen of endometrial cancer means these changes are of potential great value.

Climate change, public health, and animal welfare: towards a One Health approach to reducing animal agriculture’s climate footprint

Animal agriculture contributes significantly to global greenhouse gas (GHG) emissions—an estimated 12%-20% of total anthropogenic emissions. This has led both governmental and private actors to propose various ways to mitigate those climate impacts. This paper applies a One Health lens to the issue, arguing that the choice of solutions should not only consider the potential to reduce GHG emissions—which is not always a given—but also the implications for public health and animal welfare. With this perspective, we examine the potential public health and animal welfare impacts of three types of strategies that are often proposed: (1) “sustainable intensification” methods, aimed at maintaining or increasing production while limiting emissions and avoiding further land conversion; (2) “species shift” approaches, which focus on changing diets to consume meat from animals produced with lower GHG emissions instead of that of animals associated with higher emissions; and (3) “systemic dietary change” approaches that promote shifts towards whole plant-based foods or novel alternatives to conventional animal products. We discuss how some approaches—particularly those associated with sustainable intensification and species shift—could introduce new and significant risks to public health and animal welfare. Promoting systemic dietary change helps to overcome some of these challenges, but requires careful attention to equity to ensure that vulnerable populations still have access to the nutrients they need. We end with recommendations for a more holistic approach to reducing emissions from farmed animals that can help avoid trade-offs and increase synergies with other societal goals.

Leveraging systems science and design thinking to advance implementation science: moving toward a solution-oriented paradigm

Many public health challenges are characterized by complexity that reflects the dynamic systems in which they occur. Such systems involve multiple interdependent factors, actors, and sectors that influence health, and are a primary driver of challenges of insufficient implementation, sustainment, and scale of evidence-based public health interventions. Implementation science frameworks have been developed to help embed evidence-based interventions in diverse settings and identify key factors that facilitate or hinder implementation. These frameworks are largely static in that they do not explain the nature and dynamics of interrelationships among the identified determinants, nor how those determinants might change over time. Furthermore, most implementation science frameworks are top-down, deterministic, and linear, leaving critical gaps in understanding of both how to intervene on determinants of successful implementation and how to scale evidence-based solutions. Design thinking and systems science offer methods for transforming this problem-oriented paradigm into one that is solution-oriented. This article describes these two approaches and how they can be integrated into implementation science strategies to promote implementation, sustainment, and scaling of public health innovation, ultimately resulting in transformative systems changes that improve population health.