Key Action Areas Research Articles

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.

Intra- and interpersonal influences on child adjustment and resilience in welfare care: A qualitative study with former caregivers in Switzerland

Despite the growing research on child maltreatment within welfare care, few studies have included the caregivers who were involved in care provision and can provide insights on an intra- and interpersonal level. Therefore, this study aimed to examine intra- and interpersonal factors that promoted or hindered the adaptive adjustment and resilience of children in welfare care, from the previously neglected perspective of former caregivers. Qualitative semi-structured interviews were conducted with N = 12 Swiss former caregivers. Participants were 10 females and 2 males, aged between 58–91 years (mean age = 74.5 years). Interviews were audio-recorded, transcribed, and analyzed using framework analysis. Two themes emerged from the data on both the intrapersonal level (i.e., Core Characteristics, Coping), and interpersonal level (i.e., Caregiving Attitudes and Actions, Relationships and Attachment). Resilience hindering factors included emotion regulation difficulties, issues within the child-caregiver relationship (e.g., differential treatment, abuse and punitive measures, lack of affection and attachment), and placement disruptions. Resilience promoting factors included coping via creativity and imagination, and social and emotional support beyond the caregiver (e.g., siblings, animals). Results highlight key areas for action at the intra- and interpersonal levels, including psychotherapeutic interventions for children in care (e.g., addressing insecure attachment), and psychoeducation and mentoring programs to enhance caregiver reflective practices and improve care provision. Future research and practice should incorporate the caregiver perspective to develop the training and support for care staff and ensure the safeguarding of (current and future) children in welfare care.

Priority setting: Development of the South Australian Aboriginal Chronic Disease Consortium RoadMap for Action.

Aboriginal and Torres Strait Islander (Aboriginal) people in South Australia are overburdened by cardiovascular disease, diabetes and cancer. The South Australian Aboriginal Chronic Disease Consortium (Consortium) was established in June 2017 as a collaborative partnership to lead the implementation of three state-wide chronic disease plans using a strategic approach to identifying key priority areas for action. In 2017-2018, the Consortium Coordinating Centre facilitated a priority setting process, which involved extensive consultation, including a prioritisation survey and stakeholder workshops. The Consortium's Aboriginal Community Reference Group was instrumental in leading the identification of priorities for action. The Consortium RoadMap for Action identified seven across-plan priorities and six condition-specific priorities. It acknowledged that: strengthening social and emotional well-being is central to improving health outcomes; prevention and early detection, acute management and ongoing management are all components of the continuum of care; and improving access to services, strengthening the workforce, and monitoring and evaluation are required across the continuum of care. Widespread implementation failure in the past across the health system and health services implementation and research translation highlights the value of the Consortium approach and its commitment to implementing the state-wide chronic disease plans in a collaborative manner. The Consortium relies on and fosters cross-sectoral alignment, with all key players including all public, private and Aboriginal Community Controlled health services, to progress its priorities and aspirations to improve health outcomes for Aboriginal people using evidence-based strategies. SO WHAT?: Rigorous and transparent priority setting processes that bring together research, clinical practice, health services operations, policy and community perspectives can foster intersectoral collaboration and partnership and support the implementation of shared priorities.

Overview of the ten global conferences on health promotion and implications for future work

Since 1986, the WHO has held ten global health promotion conferences covering various health promotion issues and sustainable development worldwide. These sessions have formed a series of consensus and actions that guide promoting health globally. This study analyzed the declarations, reports, and news materials from the ten conferences that studied health promotion action areas, focal topics, actor networks, partnership relationships, and other significant outcomes. It also explored how these conferences contributed to the construction and advancement of global health promotion consensus and actions. The first Global Conference on Health Promotion identified the concept of health promotion and five key action areas, laying the foundation for subsequent conferences and health promotion actions. Over the years, the ten conferences continuously expanded the essence of health promotion, developed partnership relationships, formulated public health promotion policies, and called for health promotion actions. This process culminated in the formation of global consensus and collective actions. The latter conferences have gained significant attention and influence. The conferences offer valuable insights for future global health promotion endeavors and provide global perspectives and pathways for the development of Healthy China.

Initiating, innovating and accelerating edible cities. A case study based on two transition experiments in the city of Dresden (Germany)

Civic transition experiments targeting sustainable food production increasingly engage with edible cities aiming at providing free food on public urban spaces. To deepen the understanding regarding how transition experiments can build urban transformative capacities, this paper presents a transdisciplinary case study on two civic edible city initiatives and their measures to cooperatively initiate, innovate, and accelerate edible cities in Dresden (Germany). We identified the two key action areas “civic participation” and “cooperative area activation” covering ten key transition activities to illustrate the variety and content of a transformation towards an edible city. Based on expert interviews and document analyses, we evaluated their process progression by linking research from urban ecology with transformation science. By visualizing its quantitative results, common and distinct patterns of the edible city initiatives could be made visible. Overall, we found that the level of activity is highest in the key action area of “citizen participation”. In this context, both transition experiments had different but specific foci in terms of their key transition activities (i.e. education, activation of stakeholders), whereby activities related to civic empowerment and social cohesion were lacking in both cases. To re-shape narratives pertaining to land access, food production, and participation under the principles of justice, we suggest that transition experiments related to “civic participation” and “cooperative area activation” must be approached together. Our systematic assessment can then enable civic transition teams to strategically identify common goals that need to be prioritized for initiating, innovating, and accelerating urban edible commons.

Cloud computing for sustainable development: An analysis of environmental, economic and social benefits

This research paper examines the role of cloud computing in promoting sustainable development. Cloud Computing (CC) has emerged as a transformative technology that has the potential to reduce the environmental impact of businesses and organizations, while also enabling economic growth and social development. The paper explores the environmental benefits of cloud computing, including energy efficiency, reduced carbon emissions, and the potential for renewable energy integration. It also examines the economic and social benefits of cloud computing, including cost savings, increased productivity, and improved access to technology. The paper concludes by highlighting the potential challenges and opportunities associated with the adoption of cloud computing for sustainable development and identifies key areas for future research and policy action. Overall, the paper argues that cloud computing has the potential to play a critical role in promoting sustainable development, and that further research and policy action are needed to realize its full potential.

The importance and added value of patient involvement in person-centred medication reviews.

Background: The iSIMPATHY (implementing Stimulating Innovation in the Management of Polypharmacy and Adherence Through the Years) team is conducting person-centred medication reviews using a 7-step review tool focusing on ‘what matters to you’1.
 iSIMPATHY is an EU-funded partnership between Scotland, Ireland and Northern Ireland. One of the main drivers for change is the WHO 3rd global patient safety challenge, Medication Without Harm which aims to reduce severe avoidable medication-related harm by 50% globally in the next 5 years, with one of the key action areas being polypharmacy2. To date over 1400 person-centred medication reviews have been conducted with patients in Northern Ireland. These reviews aim to reduce inappropriate polypharmacy, promote adherence and health literacy and provide patient education.
 Personal and Public Involvement (PPI) feedback was sought prior to the project starting and patient engagement has continued throughout.
 Method: Structured, person-centred medication reviews were conducted in acute medical wards in a secondary care setting in Northern Ireland. Priority was given to those on 10 or more medicines or a high risk medicine, over 50 and resident in a care home or approaching end of life. Data were collected for a cohort of 66 patients who consented to an iSIMPATHY review. Data were analysed to determine the interventions made due to patient involvement in the review as compared with interventions which could be made by completing a kardex (medicine list) review only.
 Results: An average of 9.3 interventions were made per patient, significance was graded using the Eadon system, with 4.4% graded 3 (significant but does not lead to an improvement in patient care), 88.9% graded 4 (significant and results in an improvement in standard of care) and 6.7% graded 5 (very significant and prevents major organ failure or an adverse reaction of similar importance). Interventions included checking and requesting laboratory tests, omitted medicines started, adjustments made for allergy, frailty, renal or liver impairment and identification of adverse drug reactions. Importantly, 88% (n=58) of patients had an intervention made because the medication review was discussed with them. This resulted in 38% additional interventions and included 22% of grade 5 interventions.
 The themes of additional interventions were: adherence and inhaler education (19%), identification of unmet/unknown health need and symptom control (15%), community support services (15%), lifestyle (12%), reduction and stopping unnecessary/inappropriate medicines (10%), identification of important additional information (10%), sick day rules (8%), self-care (7%) and referral to other services (5%).
 Conclusion: Patient involvement in their medication review leads to the identification of new and unmet needs, allows for the provision of counselling on medicines, adherence and lifestyle and prompts discussion and action on the deprescribing of inappropriate and unnecessary medicines. These additional interventions are clinically significant for the patient.
 Next steps: Medication reviews and data collection continues with the aim of scale and spread. For results and learning opportunities search https://www.isimpathy.eu/.
 
 https://www.isimpathy.eu/
 Medication Safety in Polypharmacy Technical Report, World Health Organisation 2019.
 
 https://www.who.int/initiatives/medication-without-harm
 
 Eadon, H. Assessing the quality of ward pharmacists’ interventions. Int. J. Pharm. Pract 1992, 1, 145–147
 

Health and quality of life development plan: from theory to practice

Abstract In 2019, a decentralization process in Portugal transferred health governance competencies and autonomy from central to municipal level. Despite empowering local authorities to shape health policies and strategic partnerships, municipalities turned to academia for public health planning expertise. This work depicts how the National School of Public Health devised a Health and Quality of Life Development Plan for one such municipality. A two-stage approach was used. Firstly, a comprehensive overview of population health status and determinants was produced. It involved analysing local and national legal frameworks and worldwide strategic literature; assessing sociodemographic, economic, environmental and health indicators; questioning residents and key stakeholders; and city council and local health authorities working sessions. Secondly, detailed strategies were laid out to address specific health needs and determinants. It involved analysing similar municipal plans; selecting priority health actions; and designing evidence-based interventions with target, timeline, estimated resources and outcomes measures. The authors built and applied a public health planning methodology, resulting in a profound health diagnosis. Public and stakeholder scrutiny ensured prioritization of key action areas and effective working pathways in strategic planning were introduced. Furthermore, evidence-based actions adapted to local capacity, budget and resources were presented. Outputs range from health literacy sessions in schools to contingency plans for public health emergencies. Health governance responsibilities’ redefinition evidenced a knowledge gap and drove the need to consult academia to develop evidence-based health policies. By creating this methodology, the authors defined strategic pillars and tailored operational recommendations for municipalities, which rely on ongoing indicator monitoring and, ultimately aim to improve population health through concerted efforts. Key messages • The decentralization of health competencies granted local autonomy in shaping health policies. To support decision and policy-making, a comprehensive tool for health diagnosis assessment was designed. • The need for a concerted local action with definition of territorialized development strategies, highlights the value of a deep connection between decision-makers and academia as a consulting entity.

Economic Burden Associated With Untreated Mental Illness in Indiana

There is a paucity of systematically captured data on the costs incurred by society-individuals, families, and communities-from untreated mental illnesses in the US. However, these data are necessary for decision-making on actions and allocation of societal resources and should be considered by policymakers, clinicians, and employers. To estimate the economic burden associated with untreated mental illness at the societal level. This cross-sectional study used multiple data sources to tabulate the annual cost of untreated mental illness among residents (≥5 years old) in Indiana in 2019: the US National Survey on Drug Use and Health, the National Survey of Children's Health, Indiana government sources, and Indiana Medicaid enrollment and claims data. Data analyses were conducted from January to May 2022. Direct nonhealth care costs (eg, criminal justice system, homeless shelters), indirect costs (unemployment, workplace productivity losses due to absenteeism and presenteeism, all-cause mortality, suicide, caregiver direct health care, caregiver productivity losses, and missed primary education), and direct health care costs (disease-related health care expenditures). The study population consisted of 6 179 105 individuals (median [SD] age, 38.0 [0.2] years; 3 132 806 [50.7%] were women) of whom an estimated 429 407 (95% CI, 349 526-528 171) had untreated mental illness in 2019. The economic burden of untreated mental illness in Indiana was estimated to be $4.2 billion annually (range of uncertainty [RoU], $2.1 billion-$7.0 billion). The cost of untreated mental illness included $3.3 billion (RoU, $1.7 billion-$5.4 billion) in indirect costs, $708.5 million (RoU, $335 million-$1.2 billion) in direct health care costs, and $185.4 million (RoU, $29.9 million-$471.5 million) in nonhealth care costs. This cross-sectional study found that untreated mental illness may have significant financial consequences for society. These findings put into perspective the case for action and should be considered by policymakers, clinicians, and employers when allocating societal resources and funding. States can replicate this comprehensive framework as they prioritize key areas for action regarding mental health services and treatments.

Closing the Gap

Equity, diversity, and inclusion (EDI) plans and initiatives are at the forefront of many libraries’ strategic planning (Mallon, 2019). Efforts, big or small, such as mandatory all-staff EDI training sessions (Downers Grove Public Library, 2021), EDI focused patron programming, or simply promoting the local library as a place of opportunity for all (ALA, 2019), demonstrate the American Library Association (ALA)’s Core Values in practice (ALA, 2006). In fact, Diversity is one of eight key action areas that are used as guiding principles for investment of energies and resources (ALA, 2007). These key action areas represent priorities and clear focuses within the ALA’s own strategic plan (ALA, 2017), which serves to outline the organization's long-term goals and high-level outcomes (Hirsh, 2022). The ALA has historically promoted themselves as supporters, allies, and anti-racists, playing an important role in many libraries’ strategic plans and philosophies. But, despite libraries being regarded as the ‘most inclusive’ institutions in the United States (Jaeger, 2018), there appears to be internal and external gaps in truly achieving these EDI goals. It is necessary to further explore where these gaps are and propose solutions to ensure clearer action is being taken to support and highlight these strategies.

Reframing physically active learning as movement-centred pedagogy: a European priority action framework

BackgroundPhysically active learning (PAL) has emerged as a promising way of eliciting health and education-based outcomes for pupils. Concurrently, research suggests large variability in how PAL is perceived, operationalized, and prioritized in practice across Europe. Therefore, this study aimed to co-develop a framework for action to support the adoption and implementation of PAL.MethodsAdopting a design thinking approach, 40 international stakeholders representing 13 countries engaged in an idea generation workshop during a two-day PAL international conference. Participants included professionals from research (n = 20), practice (n = 4) and policy (n = 1) or a combination (n = 15). Their experience with PAL ranged from none to 19 years (with an average of 3.9 years). Participants were allocated into one of six heterogeneous and multidisciplinary groups and led through interactive tasks to identify: the landscape for PAL across Europe, barriers to the adoption and implementation of PAL, and key objectives for research, policy and practice to improve the adoption and implementation of PAL. All discussions were audio recorded and prioritized objectives were transcribed verbatim and analysed using inductive qualitative content analysis.ResultsFive interlinked and mutually reinforcing themes were identified: (1) Integration of the health and education paradigms (2) Coherent national policy and decision making (3) Building confident and competent teachers (4) Adopting a whole school approach for PAL (5) Strengthening the evidence base for PAL.ConclusionsThe priority action framework identifies five key areas for action to facilitate PAL adoption and implementation across Europe. Central to the success of border uptake of PAL is the integration of the health and education paradigms. To achieve this aim, reframing PAL as movement-centered pedagogy would provide a more holistic and inclusive perspective.

The Cancer Moonshot Immuno-Oncology Translational Network at 5: accelerating cancer immunotherapies.

The Immuno-Oncology Translational Network (IOTN) was established in 2018 as part of the Cancer Moonshot. In 2022, President Joe Biden set new goals to reduce the cancer death rate by half within 25 years and improve the lives of people with cancer and cancer survivors. The IOTN is focused on accelerating translation of cancer immunology research, from bench to bedside, and improving immunotherapy outcomes across a wide array of cancers in the adult population. The unique structure and team science approach of the IOTN is designed to accelerate discovery and evaluation of novel immune-based therapeutic and prevention strategies. In this article, we describe IOTN progress to date, including new initiatives and the development of a robust set of resources to advance cancer immunology research. We summarize new insights by IOTN researchers, some of which are ripe for translation for several types of cancers. Looking to the future, we identify barriers to the translation of immuno-oncology concepts into clinical trials and key areas for action and improvements that are suitable for high-yield investments. Based on these experiences, we recommend novel National Institutes of Health funding mechanisms and development of new resources to address these barriers.

Critical success factors for construction industry transition to circular economy: developing countries’ perspectives

PurposeCircular economy (CE) is increasingly used as a system solution framework for tackling climate change. Existing CE solutions have been found effective in other sectors but ineffective in the construction sector (CS) due to the inability to account for unique CS dynamics that are essential for its success. With CS being one of the worst polluters, this research aimed to investigate critical success factors (CSFs) and a practical CE implementation framework for the sector.Design/methodology/approachMixed methods research involving descriptive surveys of construction professionals in Kazakhstan, Malaysia and Turkey was used to explore priority dimensions of McKinsey’s ReSOLVE (“regenerate, share, optimize, loop, virtualize and exchange”) circulatory framework, and the associated CSFs that underpin successful implementation of CE in the sector. Empirical data were analyzed using the fuzzy analytical hierarchy process (F-AHP) and the Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) algorithm.FindingsResults showed that “Optimize” and “Loop” were the most critical of the six dimensions of CE implementation framework for successful circularity transition of the CS in each case study country. Twenty-seven CSFs identified in the study were clustered into seven key action areas for successful rollout of the ReSOLVE framework, namely, legislative and documentation, financial, design, external/stakeholder, technological, internal and construction/production/waste management.Practical implicationsThe study makes a unique contribution to existing knowledge by exploring ReSOLVE-based CSFs for successful CE implementation in the CS through the lenses of experienced construction practitioners and experts in developing countries. The findings are expected to provide a deeper insight into the most significant CSFs to be focused on with the limited resources available to decision-makers in the CS. The findings would also inform regulatory policy reformations aimed at facilitating greater rate of implementation of CE in the construction value chain.Originality/valueThe study – the first of its kind – established and validated a wholistic and construction-specific CE implementation framework to guide built environment professionals and policymakers in formulating a roadmap for successful CS’s transition to circularity and hopefully paving the way for improved economic, social and environmental performance of the sector.