Key Action Areas Research Articles

Transitioning Management Policy For Armed Forces To Sustainable Civilian Life

The issue of transitioning from military service to civilian life is complicated and affects people in a number of ways, including personal, family, financial, social, administrative, and health. Military personnel go through this transition for several reasons, such as the need for personal security, health issues, retirement, or termination. Some retirees have no trouble adjusting to civilian life, but others encounter major obstacles like homelessness, unemployment, mental health issues, and other psychological hurdles. Military retirees frequently struggle with issues of identity, purpose, and belonging as they transition from a regimented setting to a more fluid civilian one. Addressing these issues and fostering a climate that supports retirees in achieving a sustainable and satisfying civilian life requires the cooperation of policymakers, service providers, and communities. For veterans to be able to make valuable contributions to society after serving, a smooth transition is essential.The transition management process for Armed Forces Retirees is examined in this study with an emphasis on the function of public governance, which encompasses the institutions, practices, and processes that influence society. A successful transition depends on effective governance, which includes pertinent agencies, rules, and decision-making procedures. The study used a mixed-methods approach to collect data from retirees of the Armed Forces of the Philippines using questionnaires and interviews. Key areas for action are highlighted by the results, which show a negative association between economic sustainability and social acceptance and a significant positive correlation between social sustainability and community integration. Keywords: Post-Service Employment, Transition Issues, Military Retirement Planning, Social Reintegration, Veteran Empowerment, Transition Management, Transition to Civilian Life Integration, Sustainable Transition, Policy Development, Retirement Transition Programs, Military to Civilian Transition, Armed Forces Retirees

Climate-Driven Alterations in the Mercury Cycle: Implications for Wildlife Managers Through a One Health Lens

Mercury (Hg) is a naturally occurring element, but atmospheric Hg has increased due to human activities since the industrial revolution. When deposited in aquatic environments, atmospheric Hg can be converted to methyl mercury (MeHg), which bioaccumulates in ecosystems and can cause neurologic and endocrine disruption in high quantities. While higher atmospheric Hg levels do not always translate to higher contamination in wildlife, museum specimens over the past 2 centuries have documented an increase in species that feed at higher trophic levels. Increased exposure to pollutants presents an additional threat to fish and wildlife populations already facing habitat loss or degradation due to global change. Additionally, Hg cycling and bioaccumulation are primarily driven by geophysical, ecological, and biogeochemical processes in the environment, all of which may be modulated by climate change. In this review, we begin by describing where, when, and how the Hg cycle may be altered by climate change and how this may impact wildlife exposure to MeHg. Next, we summarize the already observed physiological effects of increased MeHg exposure to wildlife and identify future climate change vulnerabilities. We illustrate the implications for wildlife managers through a case study and conclude by suggesting key areas for management action to mitigate harmful effects and conserve wildlife and habitats amid global change.

Climate resilience and health: the planet's vital signs are flashing red

Six of the nine Earth systems are dangerously stressed: climate change, biodiversity loss, land use, pollution, freshwater availability, and the global biogeochemical cycles of nitrogen and phosphorus. Analogous to human multi-organ failure, cascading planetary tipping points threaten to cause irreversible damage to our societies. This ecological crisis is already manifesting in avariety of health risks, from heat-related deaths and respiratory diseases to mental health. For future generations, continuing business as usual in the present means much less prosperity, security, freedom, and-most importantly-health. The ecological crisis is the greatest threat to human health in the 21stcentury. Climate resilience is defined as the necessary integration of climate adaptation and mitigation, and is acentral component of preventive health care. Key action areas include: 1)considering the current and future health impacts of the ecological crisis in prevention, diagnosis, and treatment; 2)educating policymakers about climate resilience and health, and deriving concrete actions for municipalities, states, and federal governments; 3)implementing climate-sensitive health advice in outpatient and inpatient settings and educating the public; 4)initiating and participating in municipal, regional, and national sectoral and cross-sectoral action alliances; 5)monitoring greenhouse gas emissions and developing implementation plans for emission-free health facilities; and finally, 6)prioritizing climate resilience and health in research and education. Special attention is given to measures that have multiple positive effects on both human health and Earth systems, known as co-benefits. By not limiting themselves to medical measures alone, but overcoming displacement and intervening in political and societal processes, health experts can play akey role in combating this crisis.

Ripples and Rocks: Strategic Plans of the American Library Association 2000–2025

ABSTRACT It has been 25 years since Kathleen de la Peña McCook’s Equity in the American Library Association: Rocks in the Whirlpool (McCook 2002) provided historical context for the American Library Association’s (ALA) guiding principles, goals, and key action areas. “Equity of Access,” one of the five key action areas identified by the ALA Council in 1998, is central to the ALA’s mission, which emphasizes enhancing learning and ensuring access to information for all. How have the goals and priorities of ALA changed or remained the same after 25 years?

Two decades of women's sexual and reproductive health and rights in Nigeria: Successes, challenges, and opportunities.

With over 200 million people, 50% of Nigeria's population comprises women of reproductive age (15-49 years), making Sexual Reproductive Health and Rights (SRHR) invaluable in achieving SDGs 3 and 5 on health and well-being and gender equality, respectively. Although Nigeria's reproductive health indices have improved over the past two decades, some critical gaps must be closed. We examined SRHR trends in Nigeria using the Nigerian DHS data sets spanning 2003-2018. Key indicators examined included contraceptive prevalence, skilled assistance during delivery, child marriage, and female genital mutilation prevalence. Reducing maternal mortality rates, closing the quality and availability data gaps, equitably increasing the needed healthcare workforce, and systematically integrating a gender lens into programming remain key priority areas for action. Implementation research through gender transformative approaches is highly relevant in identifying, testing, and scaling effective and culturally appropriate interventions.

Evaluation of the Education Plan and Activities of Swiss Sport Integrity. A report of a science-practice co-operation.

Introduction The WADA requires the National Antidoping Organisations (NADOs) to annually evaluate its education plan and activities to accomplish the International Standard for Education of the WADA Code (2021), preferably done in cooperation with an independent external partner from the field of science and research. Therefore, Swiss Sport Integrity (SSI) and Institute of Sport Science (ISPW) entered into a cooperation agreement in 2020 for annual evaluating SSI’s education plan and activities from 2021 to 2024. This contribution aims to reporting the process of such a science-practice cooperation and identifying factors that are critical for effective cooperative evaluation. Methods The evaluation concept was developed on sound theoretical considerations following evaluation critieria guidelines (e.g., Sander, 2006). The evaluation focus of SSI’s education plan and activities covers three aspects: basic principles, long-term aims, and key areas for action according to WADA Code. For data gathering, a questionnaire to Swiss elite athletes (Swiss Olympic Card holder) and a questionnaire to their respective coaches as instruments were applied. The questionnaires were conducted during the year as part of the SSI education courses, which are mandatory for all Swiss elite athletes. Additionally, internal data from SSI and Swiss Olympic were gathered. The analysed data were merged and summarised in the annual management report for WADA. The process of cooperation was then reflected among the actors involved in the evaluation with identifying phases approached and assessing critical factors, both restricting and promoting, for effective cooperation. Results As large part of the results – the athletes’ responses – are confidential and limited to internal use of SSI and reporting to WADA, the presentation is limited to displaying the athletes’ and coaches’ questionnaires and pointing to the methodological challenges and limitations faced. The presentation’s focus is on reporting the cooperation process and determing factors. Results reveal that accepting and including external perspectives, understanding of the framework conditions, mutual trust and engagement, dedicated task specification and distrubition, knowledge and data sharing are perceived beneficial for co-operating. Discussion/Conclusion The discussion highlights the identified key points for effective processing in a science-practice co-cooperation and point to how to ensure this (good practice). Then transferability to other science-practice co-operations is briefly discussed. Concluding, the continuation and expansion of the existing cooperation with the entry into force of the new WADA Code 2027 will be briefly outlined.

Vital Directions For Health And Health Care: Priorities For 2025.

In 2016, ahead of the US presidential election, the National Academy of Medicine launched the strategic initiative Vital Directions for Health and Health Care-a series of papers on critical areas of US health care written by the nation's experts and intended to provide nonpartisan guidance to the incoming administration. The National Academy of Medicine continued the initiative in 2021. The current series, titled Vital Directions for Health and Health Care: Priorities for 2025, contains six articles on priority areas in US health and medicine that demand urgent attention. Here we provide an overview of the articles, which spotlight key areas for action and transformative change: revitalizing the biomedical research enterprise, modernizing public health, charting new directions for women's health, safely integrating artificial intelligence throughout the health care system, addressing the impact of climate change on health and equity, and transforming the US health care system to one that performs at par with the systems of other industrialized nations. Common themes include coordinating a strategic vision, correcting adverse economic incentives, investing in the health care workforce, reducing fragmentation, and emphasizing equity. Each article offers actionable priorities for the new administration to improve health outcomes for all Americans.

Protocol for the enhanced management of multimorbid patients with COPD and severe asthma: role of indoor air quality

IntroductionReducing unplanned hospital admissions in chronic patients at risk is a key area for action due to the high healthcare and societal burden of the phenomenon. The inconclusive results of...

Health Professionals’ Recommendations for a Malaysian Dementia Plan

ABSTRACT About 8.5% of Malaysians have dementia. However, current national policies and practice guidelines for older adults do not specifically address issues and key action areas for the implementation of a Malaysian dementia plan. Therefore, this study aims to identify key priorities for the development of a Malaysian dementia plan based on healthcare professionals’ recommendations, ensuring quality and accessible nationwide care for individuals with dementia. Semi-structured interviews were conducted with 21 healthcare professionals, including general practitioners, geriatricians, neurologists, pharmacists, nutritionists, occupational therapists, nurses, and psychologists. Thematic analysis revealed four key priorities for a Malaysian dementia plan: (1) Public Awareness and Destigmatization of Dementia, (2) Early Detection of Dementia, (3) Establishing Efficient Care Pathways, (4) Support For Carers and Family Members. The findings highlight the complexity of dementia care, emphasizing medical, rehabilitative, psychosocial, and societal needs. The emphasis on healthcare professionals’ perspectives in this study underscores the importance of including individuals with dementia, their families, and carers as participants in future research.

Digital health interventions for adolescents living with HIV in low- and middle-income countries: A narrative review and logic model

The development of digital health interventions for adolescents living with HIV (ALHIV) in low- and middle-income countries (LMICs) remains poorly understood due to limited research. This narrative review applies a logic model to synthesize evidence on the development and adaptation of digital health interventions for ALHIV in LMICs. The review identifies studies involving interventions such as mobile apps or online support groups from databases including MEDLINE, PubMed, SCOPUS and gray literature. Grounded in the WHO framework for Youth-centered Digital Health Interventions, the model addresses health system challenges and links intervention components to process and health outcomes. Individual, family and environmental contextual factors are incorporated to enhance the model's relevance. This model serves as a guide for stakeholders, including designers, developers, implementers, researchers, and funders, in designing and evaluating digital interventions for ALHIV in resource-constrained settings, while highlighting key areas for future research and policy action. Registration N/A. Tweetable abstract A logic model for guiding the design of digital health interventions for adolescents living with HIV in low- & middle-income countries.

Energy and Ecological Concept of a Zero-Emission Building Using Renewable Energy Sources—Case Study in Poland

Zero-emission buildings, which do not emit CO2 or other greenhouse gases throughout their entire life cycle, play a crucial role in sustainable development and the fight against climate change. Achieving carbon neutrality in construction requires considering emissions associated with material production, construction, operation, as well as demolition and disposal. These buildings utilize energy-efficient technologies, renewable energy sources, and low-carbon materials, minimizing their environmental impact. The building sector accounts for a significant percentage of global greenhouse gas emissions, making it a key area for climate action. In Poland, where aging and energy-inefficient buildings prevail, the need for a transition towards zero-emission buildings is particularly urgent. This paper assesses the feasibility and hurdles of retrofitting existing buildings to achieve zero emissions by utilizing renewable energy systems like solar photovoltaic and heat pump technologies. The publication discusses the technical, economic, and legal aspects of this transformation, with particular emphasis on the Polish context and available support programs. The purpose of this publication is to disseminate practical knowledge and foster innovation among architects, investors, and decision-makers engaged in the development of a sustainable built environment. A key example is Net Zero Energy Buildings (NZEBs), which generate as much energy as they consume over a year through technologies such as photovoltaic panels, solar collectors, and heat pumps. NZEBs combine effective insulation, energy-efficient systems, and smart energy management to minimize consumption, and may even produce excess energy that feeds back into the grid. Despite challenges in construction and maintenance, the increasing adoption of zero-emission and NZEBs worldwide reflects their long-term ecological, economic, and health benefits. The focus of this publication is to analyze the potential for transforming standard buildings, as defined by current regulations, into zero-emission buildings powered entirely by renewable energy sources. This case study analyzes the energy potential of a residential building located in Krakow, Poland. The building’s energy efficiency potential was assessed through computer simulations using Audytor OZC software (version 7.0 Pro, Sankom), taking into account local climate conditions and building standards. The study analyzed the impact of various strategies, such as upgrading thermal insulation, using energy-efficient windows, and installing photovoltaic panels, on energy consumption and CO2 emissions.

Public perceptions of climate change and health in Wales: a national cross-sectional survey

Public perceptions of climate change and health in Wales: a national cross-sectional survey

Optimizing Colorectal Screening in Portugal with Process Mining

Abstract Background Efficient healthcare screening programs management influences patient outcomes. Process mining has emerged as a powerful tool to enhance these programs by refining complex workflows and pinpointing operational deviations. Objectives This study utilizes process mining techniques to analyze the colorectal cancer screening program in Northern Portugal, focusing on detecting deviations and performance bottlenecks in process models. Methods This screening program started in March 2018, but process mining was only used on data posterior to 2020. Over 1 million case observations from administrative data were included in the process model analysis, involving more than six key process activities and numerous resources. We used new software and statistical tools for process mining to rapidly compute observations and filter for different operational needs and monitor interventions. Results The discovery analysis identified deviations, such as unexpected performance issues and irregular activity sequences. Although over 100 traces were identified, fewer than five traces accounted for more than 90% of all case paths, indicating the most common traces that have a true impact in participation rates, referral rates, and treatment rates. Notable differences in resource performance during specific periods, such as COVID-19 or seasonal events, were also observed. These findings provided insights for adjusting resource allocation and improving coordination, with impact in minimizing seasonal phenomena or peak production periods. Lessons Process mining offers actionable insights for effective health program coordination, enabling the monitoring and timely response to process deviations. With key areas for action identified in a more timely and precise manner, we can enhance efficiency, and expand population coverage and treatment referral. Future initiatives will focus on further process optimization and national coverage expansion using these management tools. Key messages • Process mining revolutionizes healthcare by enabling the strategic management of complex oncological screening program workflows. • Comprehensive data analysis across the patient pathway enhances program efficiency and expands treatment access.

Pathways for Strengthening Lived Experience Leadership for Transformative Systems Change: Reflections on Research and Collective Change Strategies.

The Activating Lived Experience Leadership (ALEL) project was a South Australian participatory action research project that aimed to improve the ways lived experience is recognised, valued and integrated across mental health and social sector systems. ALEL was completed during 2019-2021, where it engaged 182 participants in generating community action and research knowledge. Our paper discusses the project's processes of building a collective partnership among lived experience leaders and other leaders from within the sector, so that the actions and strategies identified through research could be implemented by systems-level impact. We describe the collaborative process and key learnings that resulted in eight key action areas for transformative systems change in South Australia. The project invited a diverse range of self-identified lived experience and other leaders to be involved in a PAR process featuring formal qualitative research (focus groups, surveys and interviews) as well as community development activities (leaders' summit meetings, consultations, training and community of practice meetings). These processes were used to help us describe the purpose, achievements and potential of lived experience leadership. Project priorities and systems-level analysis was also undertaken with lived experience sector leaders and project advisors across two leaders' summit meetings, integrating research outcomes with sector planning to define high-level actions and a vision for transformational change. Participatory action research as informed by systems change and collective impact strategies assisted the project to generate detailed findings about the experiences and complexities of lived experience leadership, and collective responses of how systems could better support, be accountable to and leverage lived experience perspectives, experience and peer-work approaches. Systems change to define, value and embed lived experience leadership benefits from collective efforts in both formal research and sector development activities. These can be used to generate foundational understandings and guidance for working together in genuine ways for transforming mental health and social sector systems, experience and outcomes. Members of lived experience communities codesigned the project, and contributed to project governance and the development of all findings and project reports.

From Potential to Action: Strategies for Supporting Female Founders in the Pre-Start-Up Phase

In today’s global economy, the role of start-ups is recognized as crucial for a country's competitiveness. Creating a supportive entrepreneurial ecosystem is therefore essential to enable founders to realize their potential optimally. Notably, there is a significant gender disparity in start-ups, suggesting a vast untapped entrepreneurial potential among women. This research aims to enhance the utilization of female start-up potential by providing actionable recommendations, based on an empirical analysis of the pre-start-up process of (potential) female founders. Through a qualitative research methodology, this study investigates the factors influencing women's journey towards entrepreneurship, considering diverse biographies and life situations. Interviews with ten women showed the complexity of the pre-start-up phase and the necessity for a broad support system. The study identifies several key areas for action to foster female entrepreneurship. Firstly, increasing awareness and visibility of self-employment as a viable career path for women is crucial, requiring more female role models and media representation to challenge traditional gender roles and stereotypes. This could cultivate a natural inclination towards entrepreneurship and sectors with high start-up activity. Moreover, lessening the disproportionate burden of family responsibilities on women is essential, suggesting enhancements in childcare facilities and encouraging shared domestic duties. The research further suggests the implementation of support programs to reduce barriers and provide a realistic view of entrepreneurship, alongside the potential benefits of mentorship in both pre- and post-start-up phases. Women's risk-averse, cautious approach in the pre-start-up process often leads to hesitance in developing innovative projects. Encouraging a focus on market needs and early engagement with potential customers, alongside proactive network building, seeking co-founders, or outsourcing, can address knowledge gaps and reduce uncertainties, making self-employment a more attractive option. This study emphasizes the importance of a collaborative effort among various stakeholders in the entrepreneurial ecosystem to unlock the entrepreneurial potential among women.

Advancing the future of equitable access to health care: recommendations from international health care leaders.

Disparities in access to health care are persistent and contribute to poor health outcomes for many populations around the world. Barriers to access are often similar across countries, despite differences in how health systems are structured. Health care leaders can work to address these barriers through bold, evidence-based actions. The Future of Health (FOH), an international community of senior health leaders, collaborated with the Duke-Margolis Institute for Health Policy to identify priority organizational and policy actions needed to improve equitable access to health care through a consensus-building exercise, a targeted literature review, and an expert discussion group. This paper describes four key action areas for health care leaders that FOH members identified as critical to enabling the future of equitable access to health care: ensuring prioritization of and accountability for equitable access to care; establishing comprehensive, organization-wide strategies to address barriers to access; clearly defining and incentivizing improvement on key measures related to reducing disparities in access; and establishing cross-sector partnerships to improve equitable access.

Health system performance assessment and reforms, Oman.

To prioritize key areas of action and investment for the next strategic cycle of national development plans (2026-2031) in Oman, we needed a holistic view of the country's health system and its main deficiencies and inefficiencies. Informed by the World Health Organization framework, our team of seven national health ministry staff and two international experts conducted a rapid health system performance assessment. We used already available data to identify system bottlenecks and their potential root causes, verifying our findings with key informant interviews. Oman's 4.9 million population is relatively young (average age 28years) but ageing, with a mounting burden of chronic diseases. While health-care services are free for Omani nationals, more than 1.5 million expatriates rely on out-of-pocket payments for health-care services. Strengthening primary health care, improving the quality of care, providing financial protection, and ensuring that public and private health-care providers operate within the same legal and procedural framework are recognized as key national priorities. Our assessment highlighted the need to extend health service coverage to the whole population, strengthen private health-care sector governance, improve health education, increase financial investment, and expand the country's capacity for data collection and analysis. The assessment framework allowed us to identify areas where information is lacking and use already available data to analyse multiple health outcomes. As well as identifying issues that need to be addressed during the next policy development cycle, our findings have contributed towards the preparation of a more extensive assessment.

The ‘Wellbeing Wardrobe’ as a tool to promote just transitions in the fashion and textile industry

ABSTRACT In this paper we discuss the pressing need for a just transition in one of our most environmentally and socially problematic contemporary industries: the fashion and textiles industry. We detail the current injustices in the industry, from both environmental and socio-economic standpoints, and then move on to providing some suggestions as to how these entrenched problems with the industry could be addressed. Specifically, we identify five key action areas that could take us towards a just transition for the fashion and textiles industry: establishing limits, developing new indicators, promoting fairness, implementing just modes of governance, and creating new exchange systems. We propose policy interventions in each of these five action areas and discuss how they could practically be put into practice. In doing so, we develop a novel theoretical concept for a more just version of the global fashion industry: the ‘Wellbeing Wardrobe’, which draws on wellbeing economics and de-growth thinking applied to the contemporary fashion industry.

Rural social movement strategies confronting global food crises: ‘overcoming the crisis of capitalism or exiting altogether from capitalism in crisis?’

ABSTRACT This essay examines the impacts of global food crises on rural social movements (RSMs) and recalls the context of the capitalism in crisis within which their resistance efforts are situated. It reviews key areas of RSM action: building alternative practice, deconstructing dominant narratives, boosting organizational strength, deepening political education, mobilizing to win battles that impact peoples' livelihoods, expanding convergence among movements, and reclaiming governance from corporate capture. It suggests that the transformative potential of this multitude of activities might be further sharpened by setting them within a long-term strategy of contrasting and progressively supplanting the capitalist mode of organizing the economy and society.

Dementia care landscape in Nepal: Understanding the context, barriers, and opportunities for the development of a national dementia care plan.

This study was conducted to comprehensively understand the context, barriers, and opportunities for improving dementia care, treatment, and support. The objective is to guide the development of a national dementia care plan. This document review was conducted by analyzing literature available in the public domain, including scientific publications, project documents/reports, media reports, and hospital records. Additionally, annual reports published by the Department of Health Services, national census and demographic and health survey reports, Old Age Homes, and other relevant government reports were examined. Firsthand information was gathered from relevant stakeholders based on the World Health Organization's situational analysis framework for dementia plans. This framework encompasses four domains: Policy context (national ministries, legislation, policies, strategies, plans related to dementia, mental health, aging, and disability), service delivery assessment (health and social care workforces, services, support and treatment programmes, and promotion of awareness and understanding), and epidemiological indicators (prevalence and incidence rates of dementia, risk factors). Ethical clearance was obtained from the Institutional Review Committee (IRC) of B.P. Koirala Institute of Health Sciences (IRC no.2658/023). Existing policies in Nepal inadequately address the needs of people with dementia and their caregivers. Concerning health services, the Government of Nepal provides financial subsidies to individuals diagnosed with dementia; however, numerous hurdles impede access to care. These obstacles include geographical and structural barriers, an inefficient public healthcare system, weak governance, financial constraints, low awareness levels, stigma, and inadequate workforce. Furthermore, the absence of robust nationally representative epidemiological studies on dementia in Nepal hampers the development of evidence-based plans and policies. Similarly, there are no interventions targeted at caregivers of people with dementia, and no initiatives for dementia prevention are in place. This review underscores the urgent need to formulate a comprehensive national dementia care plan to address the growing challenges. Key priority action areas include the integration of dementia care into primary healthcare services, training workforce to provide the care, increasing awareness, mitigating stigma, developing caregiver support programs, and initiating high-quality research to inform evidence-based policymaking.