Innovative Health Research Articles

Optimising wound monitoring: Can digital tools improve healing outcomes and clinic efficiency.

Chronic wounds present significant challenges for patients and nursing care teams worldwide. Digital health tools offer potential for more standardised and efficient nursing care pathways but require further rigorous evaluation. This retrospective matched cohort study aimed to compare the impacts of a digital tracking application for wound documentation versus traditional manual nursing assessments. Data from 5236 patients with various wound types were analysed. Propensity score matching balanced groups, and bivariate tests, correlation analyses, linear regression, and Hayes' Process Macro Model 15 were utilised for a mediation-moderation model. Digital wound tracking was associated with significantly shorter healing durations (15 vs. 35 days) and fewer clinic nursing visits (3 vs. 5.8 visits) compared to standard nursing monitoring. Digital tracking demonstrated improved wound size reduction over time. Laboratory values tested did not consistently predict healing outcomes. Digital tracking exhibited moderate negative correlations with the total number of nursing visits. Regression analysis identified wound complexity, hospitalizations, and initial wound size as clinical predictors for more nursing visits in patients with diabetes mellitus (p < .01). Digital tracking significantly reduced the number of associated nursing visits for patients with peripheral vascular disease. These findings suggest that digital wound management may streamline nursing care and provide advantages, particularly for comorbid populations facing treatment burdens. This study adhered to STROBE guidelines in reporting this observational research. By streamlining documentation and potentially shortening healing times, digital wound tracking could help optimise nursing resources, enhance wound care standards, and improve patient experiences. This supports further exploration of digital health innovations to advance evidence-based nursing practice. This study involved retrospective analysis of existing patient records and did not directly include patients or the public in the design, conduct, or reporting of the research.

From Strategy to Synergy: Paving Ontario's Proactive Path in Precision Medicine with Collaboration and Visionary Leadership.

Ontario is shifting to a Precision Medicine (PM) model, which emphasizes tailored patient care, an initiative reflected in the formation of Ontario Health Teams. However, this shift faces significant data governance, policy formulation, and technology integration hurdles. To overcome these barriers, we advocate for a comprehensive PM framework to orchestrate collaboration among healthcare providers, policymakers, and technologists. This framework enhances data management, propels digital health innovations, and uphold ethical standards in AI applications. Effective deployment of this framework is crucial for actualizing PM's promise in Ontario, potentially revolutionizing healthcare delivery.

Canada's Digital Health Workforce: The Role of Innovation, Research and Policy.

The rapid growth of digital health and use of technology has led to an increased demand for qualified professionals in the areas of health informatics (HI) and health information management (HIM). This is reflected by the growth in the number of educational programs and graduates in these areas. However, to develop a culture of digital health innovation in Canada, the role of research needs to be critically examined. In this paper we discuss some of these issues around the relation between research and innovation, and the development of an innovation culture in health informatics, health information management and digital health in Canada. Recommendations for facilitating this development in terms of funding, granting and policy are also explored.

Jamu as Indonesian Cultural Heritage and Modern Health Innovation

Jamu, as a traditional Indonesian medicine, stood firmly as a symbol of timeless cultural heritage wisdom amidst the hustle and bustle of modern civilization, with all its technological and medical advances. It has served as a reflection of philosophical underpinnings and a proven source of health in Indonesian society over thousands of years (Agustina &amp; Fitrianti, 2020). In this editorial, we delve into how jamu, as Indonesia's cultural heritage, not only survived, but also thrived and adapted to modernization and globalization. We recognize that preserving herbal medicine requires concerted efforts, such as those undertaken by Satria et al. (2023), who utilized a casual game design to enhance the understanding and knowledge of herbal medicine. It is imperative to continue such endeavors to ensure the sustainability of herbal products in the future.&#x0D; The history of jamu was chronicled in ancient manuscripts and orally transmitted through generations by indigenous people of the archipelago. Each leaf, root, seed, and spice, when boiled or ground, contributed to a complex yet refined recipe, yielding a beverage imbued not only with health benefits, but also with the stories and prayers of ancestors. With every sip of jamu, it seemed as if we were directly assimilating the wisdom of our forebears who possessed a profound understanding of nature and the human body. However, the jamu did not remain confined to the past. In the modern era, it has undergone a transformation, permeating health clinics, spas, and even contemporary cafés. Scientific research has unveiled active components within jamu with therapeutic potential, corroborating beliefs held for centuries. For instance, studies on Curcuma xanthorrhiza have revealed the presence of xanthorrhizol compounds with anticancer properties (Nurcholis et al., 2018), while the utilization of curcuminoid compounds from turmeric in various functional food products exemplifies this trend (Munekata et al., 2021). This demonstrates that jamu, with its deep-rooted traditions, serves as a gateway for the future of integrative medicine.&#x0D; Currently, advances in jamu production are burgeoning. Ainurofiq et al. (2023) pioneered the granule formulation of SIRMA herbal medicine to heighten its antioxidant activity. Moreover, innovative marketing strategies are being implemented, such as leveraging websites and social media platforms (Purwantisari et al., 2022). Additionally, captivating packaging and creative marketing endeavors have effectively introduced jamu to both the younger generations and the international market. Collaborations with nutritionists and chefs have transformed jamu into not only a health elixir, but also a source of enjoyment. However, along with its escalating popularity, challenges have surfaced. Standardization and certification have emerged as critical issues that uphold the quality and authenticity of herbal medicines. Several researchers have undertaken pivotal studies in this regard, including authentication of herbal medicine via UV-Vis spectrophotometry (Husain et al., 2023) and identification of chemical drug adulteration in herbal medicine using FTIR-ATR ((Fatmarahmi et al., 2022). In collaboration with stakeholders in the herbal industry, it is imperative for the government to establish regulations conducive to innovation while safeguarding the timeless tradition embodied in herbal medicine. Furthermore, public education regarding the benefits and proper use of herbal medicines is paramount. Such awareness will foster the sustainability and preservation of herbal medicines as an integral component of a wholesome lifestyle.&#x0D; In conclusion, the jamu exemplifies the harmonious fusion of tradition and innovation. Within its cups, we discover a seamless connection between the past and the future, bestowing upon us not only health benefits but also the treasured identity and cultural heritage of Indonesia. Let us raise our glasses to jamu, the elixir that flows through the veins of Indonesian culture, sustaining us both now and in generations to come.

Partnership-building considerations for implementation science in learning health systems: a case study of the Implementation Science Collaborative in Alberta, Canada.

Implementation of health innovations is inherently collaborative, requiring trans-sectoral partnerships between implementation researchers, innovation teams, and implementation practitioners. Implementation science has been shown to improve implementation successes; however, challenges that hinder partnerships to advance implementation science continue to persist. Using a whole-system approach to assess and respond to implementation science partnership barriers may shed light on effective responses. We conducted a case study of Alberta's learning health system, using semi-structured group and individual interviews to create a nuanced understanding of the considerations required for implementation research collaborations. We interviewed 53 participants representing 21 offices in the health system, academia, professional associations, and government who regularly plan, evaluate, and/or study health system implementation initiatives in Alberta. Using the Partnership Model for Research Capacity Building, we identified current facilitators and challenges for partnerships for conducting and using implementation science, at different levels of Alberta's health-research ecosystem. Alberta's healthcare system is well set up to readily embed intervention effectiveness and efficacy research. Infrastructure was also in place to strengthen implementation practice. However, weaknesses around exchanging knowledge and skills, providing feedback and mentoring, and accommodating diversity affected the ability of both individuals and teams to build implementation science capacity. Without this capacity, teams could not participate in embedded implementation research collaborations. We report the response of the Alberta Strategy for Patient-Oriented Research SUPPORT Unit to these barriers to provide practical guidance on various program options to strengthen individual- and organization-level implementation science capacity. This study applied a whole-system approach to assess factors across Alberta's health-research ecosystem, which affect partnerships to advance implementation science. Our findings illustrated that partnership considerations go beyond interpersonal factors and include system-wide considerations. With the results, health organization leaders have (1) a method for assessing organizational capability to readily embed implementation research and (2) a catalog of potential responses to create conditions to readily engage with implementation science in their day-to-day implementation processes.

Sequential levetiracetam and phenytoin in electroencephalographic neonatal seizures unresponsive to phenobarbital: a multicenter prospective observational study in India

Although levetiracetam and phenytoin are widely used antiseizure medications (ASM) in neonates, their efficacy on seizure freedom is unclear. We evaluated electroencephalographic (EEG) seizure freedom following sequential levetiracetam and phenytoin in neonatal seizures unresponsive to phenobarbital. We recruited neonates born ≥35 weeks and aged <72h who had continued electrographic seizures despite phenobarbital, from three Indian hospitals, between 20 June 2020 and 31 July 2022. The neonates were treated with intravenous levetiracetam (20mg/kg x 2 doses, second line) followed by phenytoin (20mg/kg x 2 doses, third line) if seizures persisted. The primary outcome was complete seizure freedom, defined as an absence of seizures on EEG for at least 60min within 40min from the start of infusion. Of the 206 neonates with continued seizures despite phenobarbital, 152 received levetiracetam with EEG. Of these one EEG was missing, 47 (31.1%) were in status epilepticus, and primary outcome data were available in 145. Seizure freedom occurred in 20 (13.8%; 95% CI 8.6%-20.5%) after levetiracetam; 16 (80.0%) responded to the first dose and 4 (20.0%) to the second dose. Of the 125 neonates with persisting seizures after levetiracetam, 114 received phenytoin under EEG monitoring. Of these, the primary outcome data were available in 104. Seizure freedom occurred in 59 (56.7%; 95% CI 46.7%-66.4%) neonates; 54 (91.5%) responded to the first dose and 5 (8.5%) to the second dose. With the conventional doses, levetiracetam was associated with immediate EEG seizure cessation in only 14% of phenobarbital unresponsive neonatal seizures. Additional treatment with phenytoin along with levetiracetam attained seizure freedom in further 57%. Safety and efficacy of higher doses of levetiracetam should be evaluated in well-designed randomised controlled trials. National Institute for Health and Care Research (NIHR) Research and Innovation for Global Health Transformation (NIHR200144).

How can technology be used to support communication in palliative care beyond the covid-19 pandemic: a mixed-methods national survey of palliative care healthcare professionals

BackgroundDevelopments in digital health have the potential to create new opportunities for healthcare professionals support delivery of palliative care. Globally, many palliative care professionals used digital health innovations to support communication with staff, patients and caregivers, during COVID-19 pandemic. However, there is limited data about the views of palliative care professionals of using digital health to support communication during the pandemic. We aimed to describe how palliative care professionals used technology to support communication (multidisciplinary team working, education and with patients and family caregivers) during the COVID-19 pandemic.Method(s)UK based palliative care healthcare professionals completed an electronic questionnaire to describe their use of digital health, during the COVID-19 pandemic, to support (1) communication within the multidisciplinary team (MDT), (2) education and (3) to support communication with patients and carers.ResultsTwo hundred and thirty-four palliative care professionals participated. Most (n = 227, 97%) described an increase in their use of digital health, to support communication, since the start of the COVID-19 pandemic. We identified benefits and challenges for digital health communication, which we summarised into themes, including ‘a new way of working’, ‘developing a new approach to learning’ and ‘impacting care’.Conclusion(s)Since the pandemic, palliative care professionals have increased their use of digital health to support communication in clinical practice. We have identified facilitators and barriers for future practice. Further work should identify the levels of support needed for organisations to ensure that digital health interventions are meaningfully used to help palliative care professionals effectively communicate with patients, caregivers and staff.

Digital Knowledge Translation Tools for Disseminating Sexual and Reproductive Health Information to Adolescents: Protocol for an Evidence Gap Map Review.

Digital or eHealth knowledge translation (KT) interventions have been identified as useful public health tools, particularly to advance sexual and reproductive health (SRH) among adolescents. Existing literature reviews on digital health interventions for adolescents' SRH demonstrate limitations, including shortcomings in reporting and comprehensiveness that limit the utility and trustworthiness of findings. However, there is a lack of evidence synthesis on the effectiveness of available digital or mobile health KT tools to promote SRH interventions for adolescents. We aim to identify, map, and describe existing empirical evidence on the digital KT tools developed to improve adolescent SRH outcomes globally. This study will be conducted using an evidence gap map (EGM) approach to address the objectives, including reviewing relevant literature and a landscape analysis of the outcomes of interest. The following electronic databases will be searched for retrieval of literature: MEDLINE (1946-present), Embase (1974-present), and Global Health (1910-present) via OVID; CINAHL (1936-present) via EBSCOhost; Scopus (1976-present); and Cochrane Library (1993-present) via Wiley. We will include only those studies that focused on adolescents aged 10-19 years and addressed SRH outcomes. We will include experimental studies (randomized or cluster randomized and nonrandomized controlled trials, including quasi-randomized, controlled before-after, and interruptive time series) and observational studies, that is, including prospective cohort and case-control studies. The experimental and observational studies will only be included in the presence of control or comparison arms. Studies with a historical control arm will be excluded. The systematic review software, Covidence (Ventas Health Innovation), will be used to screen and select the studies. Further, 2 independent reviewers will complete the first and second levels of screening of studies and any conflicts arising will be resolved by consensus between the 2 reviewers or by involving the third reviewer. We will conduct the quality assessment of all included studies using the Risk of Bias tool for randomized controlled trials and nonrandomized controlled trials, and AMSTAR2 for systematic reviews. Papers screening, data extraction, and synthesis will be completed by March 2024. We will use EPPI-Mapper (The International Public Policy Observatory) software to generate an online evidence map and to produce the tables and figures for the descriptive report. This EGM review will identify areas with high-quality, evidence-based digital KT tools (for immediate scale and spread) and areas where few or no KT tools exist (for targeted KT tool development and research or policy prioritization). This protocol focused on mapping eHealth KT tools that have been used in the literature to address SRH among adolescents. This will be the first EGM exercise to map digital KT tools to promote adolescents' SRH and will incorporate a range of published sources. DERR1-10.2196/55081.

Curricula and resources related to social entrepreneurship and public health innovation within schools of public health in the United States.

This paper examines the current state of social innovation and entrepreneurship programming, courses, and centers within schools of public health through a survey data analysis. This report presents a cross-sectional survey conducted among faculty members of public health schools in the United States. The survey aims to determine the availability and current state of student-centered programs and courses centered around social innovation and entrepreneurship within schools of public health. Insights were drawn from 19 professionals across 15 schools of public health. Uncertainties surround the sustainability of current programs, with insufficient funding, human resources, and the need to teach more pressing topics identified as the most significant obstacles. Key areas identified as opportunities for growth were faculty engagement, expertise, and funding to expand more structured programming.

Interactive Narrative-Based Digital Health Interventions for Vaccine Communication: Protocol for a Scoping Review.

Interactive narrative-based digital health interventions hold promise for effectively addressing the complex determinants of vaccine hesitancy and promoting effective communication across a wide range of settings and vaccine types. Synthesizing evidence related to the implementation and evaluation of these interventions could offer valuable perspectives for shaping future strategies in vaccine communication. Prior systematic and scoping reviews have examined narrative-based vaccine communication interventions but not the inclusion of interactivity in such interventions. The overall objective of the scoping review is to summarize the evidence on the use of interactive narrative-based digital health interventions for vaccine communication. Specific research questions focus on describing the use of interactive narrative-based digital health interventions (RQ1), describing evaluations of the impact of interactive narrative-based digital health interventions on promoting vaccine uptake (RQ2), and factors associated with their implementation (RQ3). A detailed search string will be used to search the following databases for records that are relevant to the review questions: PubMed, Embase, Scopus, Web of Science, CINAHL, and PsycINFO. Two reviewers will independently screen the titles and abstracts of identified records against the predefined eligibility criteria. Subsequently, eligible records will undergo comprehensive full-text screening by 2 independent reviewers to assess their relevance to review questions. A data charting tool will be developed and used to extract relevant information from the included articles. The extracted information will be analyzed following the review questions and presented as a narrative summary. Tabular or graphical representations will be used to display review findings, as relevant. Public health informationists were consulted to develop the detailed search strategy. The final search string comprised terms related to narrative communication, digital health, and vaccines. The search string was customized to each proposed publication database and implemented on April 18, 2023. A total of 4474 unique records were identified using the search strategy and imported into the Covidence (Veritas Health Innovation Ltd) review management software for title and abstract screening. Title and abstract screening of identified records are ongoing as of December 29, 2023. To our knowledge, this will be the first scoping review to investigate the features of interactive narrative-based digital health interventions and their role in vaccine communication. The goal of this study is to provide a comprehensive overview of the current research landscape and identify prevailing gaps in knowledge. The findings will provide insights for future research and development of novel applications of interactive narrative-based digital health vaccine communication interventions. DERR1-10.2196/51137.

Analysis of Inter-institucional Cooperation Practices for Science, Technology, and Innovation in Health

This study aimed to analyze practices of inter-institutional cooperation for science, technology, and innovation in health in different countries and institutions available in scientific journals. Eight articles were chosen for discussion in this study. This work also introduced a method for constructing a platform model that might guide performance improvement actions in inter-institutional cooperation activities in science, technology, and innovation in health. We observed that this subject is evolving and that there is an opportunity to perform additional studies to develop this scientific area. This work enhanced the discussion on this progressing scientific and practical area.

Adjunctive interventions: change methods directed at recipients that support uptake and use of health innovations

BackgroundImplementation science groups change methods into two categories: (1) clinical, behavioral, or biomedical intervention targeting recipient’s health outcomes and (2) implementation strategies targeting the delivery system. Differentiating interventions from strategies based on their intended functions is critical to accurately attributing their effects to health or implementation outcomes. However, in coordinating 200+ HIV implementation research projects and conducting systematic reviews, we identified change methods that had characteristics of both interventions and strategies that were inconsistently categorized. To alleviate confusion and improve change method specification, we propose that implementation science should adopt an extant but rarely used term—adjunctive interventions—to classify change methods that are distinct from the common intervention/strategy taxonomy.Main textAdjunctive interventions as change methods that target recipients (e.g., patients, participants) of a health intervention but are designed to increase recipients’ motivation, self-efficacy, or capacity for initiating, adhering to, complying with, or engaging with the health intervention over time. In two of our published reviews on implementation of HIV interventions, 25 out of 45 coded change methods fell into this gray area between strategy and intervention. We also noted instances in which the same change method was labelled as the intervention (“the thing”), as an adjunctive intervention, or an implementation strategy in different studies—further muddying the waters. Adjunctive interventions are distinguished from other change methods by their intended targets, desired outcomes, and theory of action and causal processes. Whereas health interventions target recipients and have a direct, causal effect on the health outcome, adjunctive interventions enhance recipients’ attitudes and behaviors to engage with the intervention and have an indirect causal link to the health outcome via increasing the probability of recipients’ utilization and adherence to the intervention. Adjunctive interventions are incapable of directly producing the health outcome and will themselves require implementation strategies to effectively impact sustained uptake, utilization, and adherence. Case examples, logic modeling, and considerations (e.g., relationship to consumer engagement strategies) for adjunctive intervention research are provided.ConclusionConceptualizing adjunctive interventions as a separate type of change method will advance implementation research by improving tests of effectiveness, and the specification of mechanisms and outcomes.

Growing Concern About Unsheltered Homelessness Among Veterans: Clinical Characteristics and Engagement in Health Care Services.

Veteran homelessness has declined in the past decade, but the proportion of unsheltered homeless veterans has increased. We identified characteristics of unsheltered homelessness in a large contemporary veteran cohort and examined outpatient and inpatient encounters before and after intake to US Department of Veterans Affairs (VA) homeless programs. National data from the Homeless Operations Management Evaluation System (HOMES) database and the Corporate Data Warehouse were analyzed on 191 204 veterans experiencing housing instability from January 2018 through December 2021. We used hierarchical multivariate logistic regressions to model associations between sheltered status and veteran correlates. Repeated-measures analysis of variance assessed changes in care utilization after intake in homeless programs. Age <50 years (odds ratio [OR] = 1.3; 95% CI, 1.2-1.4), Hispanic ethnicity (OR = 1.2; 95% CI, 1.1-1.3), some college education (OR = 1.1; 95% CI, 1.0-1.1), and a bachelor's degree (OR = 1.2; 95% CI, 1.1-1.2) were associated with veteran unsheltered homelessness. Unsheltered veterans were more likely to have a VA service-connected disability (OR = 1.4; 95% CI, 1.4-1.5), military sexual trauma (OR = 1.1; 95% CI, 1.0-1.1), and/or combat exposure (OR = 1.1; 95% CI, 1.0-1.1). Unsheltered and sheltered homeless veterans had an increase in outpatient encounters and a decrease in inpatient care after intake to the VA homeless program. Contemporary unsheltered homeless veterans are younger and Hispanic with some college education. Innovative public health approaches that better engage and reduce barriers to entry need to be tested for a diverse unsheltered homeless population.

The Study of "Healthy Alley" and Home Care Program Policies to Develop Sustainable Health Innovation in Makassar, Indonesia

This study describes the implementation of public service innovations (“Healthy Alley” and home care) in Makassar to disclose facts about the factors supporting innovations so that they can be sustainable in the future. Data were collected through a structured interview process with 14 informants and through observation by researchers. Secondary data were collected from national journal articles and annual report documents from the Department of Health, Makassar Regional Development, and Research Agency. Validity and reliability were addressed by triangulating data sources. Out of five innovation attributes, the “Healthy Alley” and home care innovations only met four standards. The research findings revealed that the home care innovation program has been well implemented compared to the "Healthy Alley" innovation program. This condition was due to the two different innovation programs in the handling system. The sustainability of public service innovation can be realized by taking into account several supporting indicators: 1. Commitment of Implementor; 2. User Participation; 3. Supported; 4. Network. Also, it is known that a public service innovation program with a good handling system will succeed in improving the quality of public service policies that affect innovation, but the budget will make things easier.

Insights From The Global Innovation and New Technology (GIANT) Health Event 2023

Insights From The Global Innovation and New Technology (GIANT) Health Event 2023

Advancing sustainable implementation of an evidence-based mental health intervention in Sierra Leone’s schools: protocol for a hybrid type 3 implementation-effectiveness trial

BackgroundMental health disorders among youth contribute substantially to the global burden of disease, which is exacerbated in low- and middle-income countries (LMICs) due to large mental health treatment gaps. In Sierra Leone, a West African country with a long history of complex adversity, the mental health treatment gap is estimated at 98%. Implementing innovative mental health interventions that can be sustained at scale is a priority. The Youth Readiness Intervention (YRI) is an evidence-based mental health intervention for youth that can be delivered feasibly by lay health workers/nonspecialists. Using mobile-based technologies to assist implementation could improve the reach and sustainability of the YRI in Sierra Leone. This study aims to train teachers to deliver the YRI in Sierra Leone’s secondary schools and test the feasibility, acceptability, cost, and fidelity to the YRI of a mobile-based supervision model compared with standard, in-person supervision.MethodsWe will conduct a hybrid type 3 implementation-effectiveness cluster randomized trial to assess the feasibility, acceptability, costs and fidelity to the YRI implemented by teachers receiving mobile-based supervision vs. standard supervision. Enrolled schools (N = 50) will be randomized to YRI + mobile supervision (N = 20), YRI + standard supervision (N = 20) or waitlist control (N = 10). We will recruit and enroll four teachers per intervention-condition school (N = 160) and 1200 youth. We will collect data on implementation outcomes among teachers, principals and youth via a mixed methods approach at baseline and post-intervention. We will also collect quantitative data on youth mental health and functioning as secondary outcomes at baseline and post-intervention, as well as cost-effectiveness data at 12-month follow-up.DiscussionStudy findings have the potential to expand the reach of mental health services among youth in low-resource settings via a teacher workforce. The use of mobile tools, if successful, could support further scale out and sustainment of the YRI to other regions of Sierra Leone and West Africa more broadly, which could help address the mental health treatment gap.Trial registrationClinical Trial Network: NCT05737667.

Gut Microbiome Integration in Drug Discovery and Development of Small Molecules.

Human microbiomes, particularly in the gut, could have a major impact on the efficacy and toxicity of drugs. However, gut microbial metabolism is often neglected in the drug discovery and development process. Medicen, a Paris-based human health innovation cluster, has gathered more than 30 international leading experts from pharma, academia, biotech, clinical research organizations, and regulatory science to develop proposals to facilitate the integration of microbiome science into drug discovery and development. Seven subteams were formed to cover the complementary expertise areas of 1) pharma experience and case studies, 2) in silico microbiome-drug interaction, 3) in vitro microbial stability screening, 4) gut fermentation models, 5) animal models, 6) microbiome integration in clinical and regulatory aspects, and 7) microbiome ecosystems and models. Each expert team produced a state-of-the-art report of their respective field highlighting existing microbiome-related tools at every stage of drug discovery and development. The most critical limitations are the growing, but still limited, drug-microbiome interaction data to produce predictive models and the lack of agreed-upon standards despite recent progress. In this paper we will report on and share proposals covering 1) how microbiome tools can support moving a compound from drug discovery to clinical proof-of-concept studies and alert early on potential undesired properties stemming from microbiome-induced drug metabolism and 2) how microbiome data can be generated and integrated in pharmacokinetic models that are predictive of the human situation. Examples of drugs metabolized by the microbiome will be discussed in detail to support recommendations from the working group. SIGNIFICANCE STATEMENT: Gut microbial metabolism is often neglected in the drug discovery and development process despite growing evidence of drugs' efficacy and safety impacted by their interaction with the microbiome. This paper will detail existing microbiome-related tools covering every stage of drug discovery and development, current progress, and limitations, as well as recommendations to integrate them into the drug discovery and development process.

Case Study – Developing a National Research and Evidence Base for The Health and Wellbeing Chapter of The Welsh Government’s 2023 Innovation Strategy for Wales

This paper presents research informing the Welsh Government’s (WG) Health and Wellbeing chapter of the new Innovation Strategy for Wales (ISW). WG recognises the need for a cross portfolio Innovation Strategy to bring greater coherence and alignment to our existing Welsh health and social care innovation ecosystem, particularly in a post EU environment. This approach aims to support greater collaboration between healthcare, industry, academia and the third sector to deliver greater impact and value by developing, sharing and adopting innovative practice, leadership and skills development and supporting new technology development. As part of the development process, key stakeholders were identified as part of an innovation ‘push’ and innovation ‘pull’ nexus approach. Organisations were categorised into domains of health and social care providers, innovation infrastructure, technology platforms, innovation centres, and partnerships across Wales’s health and life sciences ecosystem. A qualitative, action research led approach was used to derive the key themes supporting development of the ISW health chapter. Multi-sector consultations were conducted with experts from various fields, including health, social, care, research, and technology. Our analysis of qualitative data collected through an extensive consultation process led to the emergence of areas of prioritisation for the ISW. Three areas of prioritisation were identified in the analysis: a) Creating coherency across the innovation ecosystem, where every partner understands their role; b) Focusing innovation activity on NHS Wales organisational needs/priorities, generating ‘Innovation Pull’; c) Creating an ‘adoption ready’ pipeline of innovation externally into health and social care at scale, creating an ‘Innovation Push’ offer. The ISW aims to create the optimal conditions for an innovation ecosystem underpinned by clear infrastructure and a robust policy framework, which has the full support from health and social care leadership, to create a culture of innovation at all levels of the health and social care system. The ISW was launched on 27th February 2023, with full political support from the Welsh Government Cabinet; a majority Labour party government supported by the Plaid Cymru party, as part of the Welsh Government’s 2021 election cooperation agreement.

Development of the "LAser Surgical skills Evaluation for Residents" (LASER) Scale Through a Modified Delphi Method.

The CO2 laser is frequently used during microlaryngeal surgery (MLS) for a variety of pathology including laryngeal malignancy and stenosis. Learning how to use the laser safely is part of the curriculum for every otolaryngology resident. However, assessment of laryngoscopy technical skills can be challenging for supervisors, making it difficult to adequately provide feedback to trainees. "LAser Surgical skills Evaluation for Residents" (LASER) Scale aims to facilitate the evaluation of residents' performance and promote constructive feedback. The initial evaluation grid was based on a literature review of CO2 laser laryngoscopy (with an emphasis on indications, technique, safety, and efficacy) using Covidence systematic review software (Veritas Health Innovation). The final version was produced after 4 rounds of Delphi surveys. This study was an international collaboration including 15 otolaryngologists with either laryngology or head and neck surgery subspecialties. Panelists were based in Canada (8), the United States (3), France (1), Spain (1), Belgium (1), and Lebanon (1). The process involved 4 rounds of Delphi surveys. Assessment categories included: anesthesia considerations, pre- and perioperative laser safety measures, and surgical technique. Consensus was reached on final survey completion. Through a modified Delphi method, a novel scale was developed through an international collaborative effort that evaluates resident skillset in CO2 laser MLS. Future studies are warranted to validate this assessment tool.

Hope and Grit: How Human-Centered Product Design Enhanced Student Mental Health

Two organizations that focus on tech-based health innovation have partnered to improve the mental health of young adults. In this “tech for good” project, Hopelab and Grit Digital Health worked together to create an app using human-centered product design. With the core needs of users at the forefront, the team developed an app both with and for college students to combat loneliness, a prevalent issue that can lead to other problems such as depression, anxiety, and even dropping out of college. The team also applied systems thinking to address the root causes of this “wicked problem,” resulting in their Nod app, which has improved outcomes for college students. This article is based on the author’s award-winning case study.