Key Determinant Research Articles

Cyclic coupling and working characteristics analysis of a novel combined cycle engine concept for aviation applications

The imperative for small aviation engines lies in the pursuit of heightened power-to-weight ratios and thermal efficiencies. Relying solely on piston engines and gas turbines is insufficient to concurrently meet these evolving performance demands. This paper introduces the concept of a combined cycle aviation engine (CCAE), amalgamating the cycle modes of piston engines and gas turbines. The CCAE achieves flexible control over turbine operating states and engine performance through the adjustment of the energy distribution between these two cycles. The air diversion strategy (α) and the burner's fuel supply strategy (λb) are identified as the key determinants of system performance. To comprehensively investigate the impact of α and λb on CCAE's performance, this paper constructs a theoretical model, a simulation model, and a test bench. The simulation model's accuracy is validated through test data, and the air-fuel ratio range for burner stable combustion is explored. The simulation results indicate a reduction of 50 % in the fluctuation of turbine speed within a single cycle. Under high-altitude conditions, CCAE's intake mass flow rate, power, and efficiency are notably enhanced when compared to conventional turbocharged piston engines. These findings contribute valuable insights that can inform the application of CCAE within the aviation domain.

Health-Related Behaviors and Academic Achievement Among College Students.

College students' academic achievement has crucial implications for their future success. Students' health may be a key determinant of academic performance, but more research is needed to understand this relationship. Secondary analysis of the American College Health Association-National College Health Assessment III pre-COVID-19 Spring 2020 dataset. N = 39146 undergraduates at 75 higher education institutions (14% mean response rate, comparable with other large-scale national college health surveys). Self-reported grade point average (GPA) and 33 health behaviors in the categories of dietary behavior, physical activity, sedentary behavior, substance use, sexual risk behavior, violence-related behavior, mental health, and sleep behavior. Weighted cross-tabulations examining the association between GPA and health behaviors; multinomial logistic regressions assessing if behaviors predicted GPA, controlling for year, sex/gender, and race/ethnicity. Individual GPA categories were also compared to a D/F referent group. There were gradient trends across GPA categories for A through D/F (18 behaviors) or A through C (12 behaviors) (P < .001). Each health behavior predicted GPA differences (P < .001), except heroin use (P = .052). The A GPA group was significantly different from the D/F GPA group for 27 behaviors (P < .001). In general, protective behaviors corresponded with higher GPAs and most risk behaviors were associated with lower GPAs. There is a link between numerous health behaviors and academic performance. Stakeholders invested in college students' health and academics should engage in mutually beneficial strategies to safeguard students' current and future well-being and success.

A Critique and Examination of the Polysocial Risk Score Approach: Predicting Cognition in the Health and Retirement Study.

Polysocial risk scores were recently proposed as a strategy to improve clinical relevance of knowledge about social determinants of health. The objective of this paper was to assess if the polysocial risk score model improves prediction of cognition and all-cause mortality in middle-aged and older adults beyond simpler models including a smaller set of key social determinants of health. We used a sample of 13,773 individuals aged 50+ at baseline from the 2006 to 2018 waves of the Health and Retirement Study, a US population-based longitudinal cohort. Four linear mixed models were compared: two simple models including a priori selected covariates and two polysocial risk score models which used LASSO regularization to select covariates among 9 or 21 candidate social predictors. All models included age. Predictive accuracy was assessed via R-squared and root mean-squared prediction error (RMSPE) using training/test split and cross-validation. For predicting cognition, the simple model including age, race, gender, and education had an R-squared of 0.31 and an RMSPE of 0.880. Compared with this, the most complex polysocial risk score selected 12 predictors (R-squared=0.35 and RMSPE=0.858; 2.2% improvement). For all-cause mortality, the simple model including age, race, gender, and education had an AUROC of 0.747, while the most complex polysocial risk score did not demonstrate improved performance (AUROC = 0.745). Models built on a smaller set of key social determinants performed comparably to models built on a more complex set of social "risk factors".

Gas Chromatography-Mass Spectrometry Metabolites and Transcriptome Profiling Reveal Molecular Mechanisms and Differences in Terpene Biosynthesis in Two Torrya grandis Cultivars during Postharvest Ripening.

Terpene aroma compounds are key quality attributes of postharvest Torreya grandis nuts, contributing to their commercial value. However, terpene biosynthesis and regulatory networks in different T. grandis cvs. are still poorly understood. Here, chief cvs. 'Xi Fei' and 'Xiangya Fei' were investigated for their differences in terpene biosynthesis and gene expression levels during postharvest ripening using headspace solid-phase microextraction (HS-SPME) coupled with gas chromatography-mass spectrometry (GC-MS) and transcriptomic datasets. A total of 28 and 22 aroma compounds were identified in 'Xi Fei' and 'Xiangya Fei', respectively. Interestingly, differences in aroma composition between the two cvs. were mostly attributed to D-limonene and α-pinene levels as key determinants in Torreya nuts' flavor. Further, transcriptome profiling, correlation analysis, and RT-qPCR annotated two novel genes, TgTPS1 in 'Xi Fei' and TgTPS2 in 'Xiangya Fei', involved in terpene biosynthesis. In addition, six transcription factors (TFs) with comparable expression patterns to TgTPS1 and four TFs to TgTPS2 were identified via correlation analysis of a volatile and transcriptome dataset to be involved in terpene biosynthesis. Our study provides novel insight into terpene biosynthesis and its regulation at the molecular level in T. grandis nut and presents a valuable reference for metabolic engineering and aroma improvement in this less explored nut.

Digital transformation model for universities: A preliminary proposal

This article presents the results of a research project aimed at designing a theoretical model for digital transformation at the Autonomous University of Chile. The research methodology adopts a case study approach with a mixed method combining quantitative and qualitative techniques. This approach provides a nuanced and comprehensive understanding of the dimensions and factors shaping the digital transformation model, incorporating insights from 97 students and eight experts. The model comprises three phases, nine dimensions, and 54 indicators, emphasizing the integral connection between digital maturity and value creation for students. Key success determinants in the university's digital transformation processes are outlined, including the strategic approach, organizational culture, utilization of technological infrastructure, and technology management capabilities. Practical implications underscore the significance of acknowledging the impact of power relations during the digital transformation journey, influencing internal processes, IT governance coordination, roles of personnel in technical and managerial positions, teachers’ performance, and students' trust and loyalty to the institution. The article concludes by identifying factors that influence the institution's capacity to implement technological changes aligned with its strategic, technical, and logistical requirements. Future studies could redefine the roles of administrative, teaching, and student staff, fostering increased digital maturity, continuous innovation in services and processes, and the creation of new digital learning spaces centered around student needs.

Importance of cardiac-synchronized vagus nerve stimulation parameters on the provoked chronotropic response for different levels of cardiac innervation.

The influence of vagus nerve stimulation (VNS) parameters on provoked cardiac effects in different levels of cardiac innervation is not well understood yet. This study examines the effects of VNS on heart rate (HR) modulation across a spectrum of cardiac innervation states, providing data for the potential optimization of VNS in cardiac therapies. Utilizing previously published data from VNS experiments on six sheep with intact innervation, and data of additional experiments in five rabbits post bilateral rostral vagotomy, and four isolated rabbit hearts with additionally removed sympathetic influences, the study explored the impact of diverse VNS parameters on HR. Significant differences in physiological threshold charges were identified across groups: 0.09 ± 0.06μC for intact, 0.20 ± 0.04μC for vagotomized, and 9.00 ± 0.75μC for isolated hearts. Charge was a key determinant of HR reduction across all innervation states, with diminishing correlations from intact (r = 0.7) to isolated hearts (r = 0.44). An inverse relationship was observed for the number of pulses, with its influence growing in conditions of reduced innervation (intact r = 0.11, isolated r = 0.37). Frequency and stimulation delay showed minimal correlations (r < 0.17) in all conditions. Our study highlights for the first time that VNS parameters, including stimulation intensity, pulse width, and pulse number, crucially modulate heart rate across different cardiac innervation states. Intensity and pulse width significantly influence heart rate in innervated states, while pulse number is key in denervated states. Frequency and delay have less impact impact across all innervation states. These findings suggest the importance of customizing VNS therapy based on innervation status, offering insights for optimizing cardiac neuromodulation.

Superlative mechanical energy absorbing efficiency discovered through self-driving lab-human partnership

Energy absorbing efficiency is a key determinant of a structure’s ability to provide mechanical protection and is defined by the amount of energy that can be absorbed prior to stresses increasing to a level that damages the system to be protected. Here, we explore the energy absorbing efficiency of additively manufactured polymer structures by using a self-driving lab (SDL) to perform >25,000 physical experiments on generalized cylindrical shells. We use a human-SDL collaborative approach where experiments are selected from over trillions of candidates in an 11-dimensional parameter space using Bayesian optimization and then automatically performed while the human team monitors progress to periodically modify aspects of the system. The result of this human-SDL campaign is the discovery of a structure with a 75.2% energy absorbing efficiency and a library of experimental data that reveals transferable principles for designing tough structures.

STARTUPS -Requirement Factor in Finance

This abstract examines critical factors influencing startup success in securing financial resources. It explores the multifaceted dynamics encompassing funding sources, investor preferences, and regulatory frameworks. Key determinants such as business model viability, market potential, and founder credibility are scrutinized for their impact on attracting investment. Additionally, the study delves into emerging trends like crowdfunding and venture capital trends shaping the financing landscape. By synthesizing empirical evidence and industry insights, this abstract sheds light on the imperative considerations for startups navigating the complex terrain of finance, offering valuable guidance for entrepreneurial endeavors. Key Words: optics, photonics, light, lasers, templates, journals

Factors that Affect the Performance of Health Workers in Providing Comprehensive Emergency Obstetric and Newborn Care

Background Comprehensive Emergency Obstetric and Newborn Care (CEmONC) at a tertiary hospital aims to provide sub-specialistic care for life-threatening maternal and neonatal emergency cases. The performance of healthcare workers (HCWs) is a key determinant of the quality of this hospital service, as it could eventually affect the clinical outcome of patients. Objectives This study was performed to analyze the factors affecting the performance of HCWs in providing CEmONC services at a tertiary hospital. Methods This cross-sectional research used an online questionnaire through Google Form (Google LLC, USA) from June to July 2022 distributed to 198 HCWs who contributed to CEmONC services at a tertiary hospital. A total of 119 HCWs who had worked for more than one year were included. The collected data were then analyzed with bivariate and multivariate analysis. Results In this study, 68 HCWs (57.1%) had a good performance in implementing the CEmONC services. The significant factors influencing the performance of HCWs were Quality (adjusted odds ratio [AOR] = 31.914; p = 0.003), Quantity (AOR = 15.573; p = 0.003), Work effectiveness (AOR = 20.256; p=0.003), Timeliness (AOR = 27.543; p=0.001), and Teamwork (AOR = 6.773; p=0.031). Meanwhile, age, gender, professional background, length of work experience, and commitment were not associated with the performance of HCWs (p &gt; 0.05). Conclusion The better performance of HCWs was significantly correlated with good quality, adequate quantity, effective work, being on time, and good teamwork. Therefore, this result suggests that hospital managers should conduct periodic monitoring and evaluation regarding the performance of their employees to improve the quality of CEmONC services at the hospital.

External representations in strategic decision‐making: Understanding strategy's reliance on visuals

AbstractResearch SummaryExternal representations, particularly visuals, are important in strategic decision‐making. However, their pervasiveness and impact are not well understood in the strategy literature. Based on cognitive science research, we identify four cognitive functions crucial to strategic decision‐making that benefit from using external representations. We also propose a conceptual model and propositions that explain how the quality of strategic decision‐making depends on the interactions among task environment, external representations, and managers. We show that external representations influence in predictable ways the boundedly rational process of searching for new strategies. Key determinants include the manager's representational capability and the usability and malleability of the external representation. We discuss implications for users, designers, and teachers of external representations in strategy, as well as suggest avenues for future research.Managerial SummaryThis research points to the pivotal role of external representations, especially visuals, in strategic decision‐making. Drawing from cognitive science, this study identifies four critical cognitive functions that benefit from these external representations—working memory, long‐term memory, pattern recognition, and knowledge transfer. Further, the study highlights that external representations significantly influence the process of strategic decision‐making in predictable ways. Finally, we show that not all external representations are alike in their ease of use and a managers' ability to operate on an external representation, referred to as representational capability, greatly affects the decision‐making quality. The implications extend to users, designers, and educators of external representations, urging attention to the design and use of external representations for improved decision outcomes.

The effects of board compensation on the voluntary establishment of an internal audit function

PurposeThis study examines the effects of board members’ compensation on the voluntary establishment of an internal audit function in publicly listed firms. While previous studies have identified some individual determinants related to the voluntary establishment of an internal audit function, the existing evidence on how board members’ compensation affects voluntary use of internal audit is, at best, ambiguous, scarce and incoherent.Design/methodology/approachBoard compensation is a central incentive instrument in the classic principal–agent relationship between the owners and board members. The theme is empirically examined by using data compiled from Finnish publicly listed companies for the period 2015 to 2018. Since the dependent variable of the study is a binary variable, the logistic regression method was chosen as the statistical method of the study.FindingsOur results unequivocally show that generous compensation of the board members increases the likelihood of establishing an internal audit function. Thus, we conclude that good corporate governance can be improved through generous compensation of board members.Originality/valueIdentifying the determinants of internal audit is vital to better understand the mechanisms that facilitate firms' improvement of internal control and risk management in terms of voluntarily adopting an internal audit function, and the implementation of good governance in general. Although numerous determinants of internal audit have been identified in previous studies, this study showed that one of the key determinants has so far been overlooked; namely, the remuneration of board members.

Enhancing Circular Economy with Digital Technologies: A PLS-SEM Approach

This study investigates the transformative potential of the digital economy in fostering the principles of a circular economy. Utilizing the SmartPLS methodology, we explore key determinants that drive the transition towards a sustainable economic framework and assess their impacts on both environmental sustainability and economic resilience. Our analysis highlights that the integration of digital technologies, such as IoT, blockchain, and AI, within circular economy practices can significantly enhance resource efficiency, reduce waste, and promote sustainable economic growth. These technologies enable better tracking and management of resources, facilitating closed-loop systems that are essential for a circular economy. However, our findings also identify substantial challenges, including concerns over data security, digital divide, and unequal access to advanced technologies, which may hinder the equitable distribution of benefits. The study underscores the importance of an integrated policy approach that combines technological innovation with supportive regulatory frameworks to address these challenges and maximize the benefits of digital integration. Policymakers are encouraged to develop strategies that not only foster technological advancements but also ensure inclusive access and address security issues. This research provides comprehensive insights for stakeholders, including governments, businesses, and academia, in designing effective strategies and policies aimed at promoting a sustainable circular economy in the digital era. By aligning digital advancements with circular economy principles, we can pave the way towards achieving sustainable development goals and creating a resilient economic future.

Prevalence and determinants of moderate-to-severe anaemia in the third trimester of pregnancy: a multicenter cross-sectional study in Lagos, Nigeria

The high burden of anaemia during pregnancy underscores the urgent need to gain a comprehensive understanding of the factors contributing to its widespread occurrence. Our study assessed the prevalence and the trends of moderate-to-severe anaemia (MSA) in late pregnancy (28 to 36 weeks) and then investigated the key determinants driving this prevalence among women in Lagos, Nigeria. We conducted a secondary data analysis involving 1216 women enrolled in the Predict-PPH study between January and March 2023. We employed a multivariate binary logistic regression model with a backward stepwise selection approach to identify significant predictors of MSA. The study revealed a 14.5% prevalence of MSA during pregnancy. Independent predictors of MSA included having given birth to two or more children (adjusted odds ratio = 1.46, 95% confidence interval: 1.03–2.07), having a maternal body mass index (BMI) of 28 kg/m2 or higher (adjusted odds ratio = 1.84, 95% confidence interval: 1.29–2.61), having less than tertiary education (adjusted odds ratio = 1.51, 95% confidence interval: 1.08–2.11), and being unemployed (adjusted odds ratio = 1.97, 95% confidence interval: 1.19–3.26). It is crucial for pregnant women, particularly those with higher parities and elevated BMI, to be monitored regularly for anaemia and its consequences during their antenatal care. Additionally, addressing the link between low education, unemployment, and anaemia necessitates comprehensive strategies that empower women in terms of education and economic status to enhance the overall well-being of individuals and communities, ultimately reducing the prevalence of anaemia and associated health issues in pregnancy.

Research on multilateral collaboration strategies in agricultural seed quality assurance.

Seeds, as the initial products in agricultural systems, play a pivotal role in ensuring quality, fundamental to national food security and sustainable agricultural development. This study introduces a concept integrating public governance and evolutionary game theory to construct a quadripartite evolutionary game model involving seed companies, certification agencies, farmers, and governmental departments. It considers the strategic choices of these stakeholders under varying economic motivations and market mechanisms, as well as the influence of external regulation and incentives on game strategies. The existence conditions for evolutionarily stable strategy combinations are determined using the Lyapunov first method, and MATLAB is employed for numerical simulation analysis to validate the game analysis under initial conditions. The simulation results reveal two potential equilibrium points corresponding to different strategic choices among stakeholders. The study finds that producing high-quality seeds and the refusal of certification agencies to engage in rent-seeking are crucial for ensuring seed quality. Additionally, the cost-benefit ratio of seed companies, the speculative cost of certification agencies, and the rights-protection cost of farmers are key determinants in the evolution of seed quality assurance strategies. This research also holds practical significance in enhancing seed quality assurance mechanisms and fostering sustainable development in agriculture.

Influence of temperature fluctuations on anaerobic digestion: Optimum performance is achieved at 45 °C

This study implemented five successive temperature stages (35 °C–45 °C–55 °C–45 °C–35 °C) in a continuous stirred tank reactor, designated as D35-1, D45-1, D55, D45-2, and D35-2, respectively. The objective was to probe the mechanism of temperature transformations on methanogenesis performance, microbial community, and metabolic pathways. The suitability of 45 °C for anaerobic digestion (AD) under varying temperatures was emphatically expounded. Intriguingly, optimal methanogenesis performance was attained at 45 °C, with methane production reaching 238.51 mL/g VS/d in D45-1 and 245.91 mL/g VS/d in D45-2, signifying increases of 17.66% and 21.32% contrasted with D35-2, respectively. Additionally, considerable resistance to temperature shocks at 45 °C was also manifested, as evidenced by a recovery time of 2 days in D45-2. At 45 °C, an effective balance between hydrolysis and methanogenesis was observed, maintaining a dynamic equilibrium between acetoclastic and hydrogenotrophic methanogenesis. The primary drivers in D45-1 were Caldicoprobacter, Bathyarchaeia, and Methanosarcina, while Anaerolinea and Methanosarcina were the key determinants in D45-2. By contrast, methanogenesis was suppressed at other stages. Therefore, 45 °C emerges as a viable alternative to conventional temperatures when confronted with temperature fluctuations to optimize energy efficiency. The results provide novel insights into AD temperature management and pave the way for engineering applications.

‘Atawhai’: a primary care provider-led response to family violence in Aotearoa New Zealand

BackgroundAs a key determinant of ill-health, family violence is inadequately responded to within Aotearoa New Zealand health policy and practice. Without adequate system support, health professionals can often be unsure of what to do, or how to help. Developed in response to this system gap, ‘Atawhai’ aims to make it easier for primary care professionals to respond to family violence.MethodsUnderpinned by indigenous Māori customs, Atawhai combines complexity theory and participatory research methodologies to be responsive to the complexity involved in family violence. We worked with 14 primary care professionals across ten whakawhitiwhiti kōrero wānanga (meetings for deliberate dialogue) to identify and develop primary care system pathways and tools for responding to family violence. This paper focuses on the development of Atawhai through wānanga and observation methods. Methods used to capture change will be reported separately.FindingsAtawhai is a relational response to family violence, focused on developing a network of trusted relationships between health and social care professionals to support safe responses to those accessing care. This study identified four key health system pathways to responsiveness and developed associated tools to support health care responsiveness to family violence. We found the quality of relationships, both among professionals and with those accessing care, coupled with critical reflection on the systems and structures that shape policy and practice are essential in generating change within primary care settings.ConclusionsAtawhai is a unique health care response to family violence evidenced on empirical knowledge of primary care professionals. Our theoretical lens calls attention to parts of the system often obscured by current health care responses to family violence. Atawhai presents an opportunity to develop a grassroots-informed, long-term response to family violence that evolves in response to needs.

Crape myrtle LiGAoxs displaying activities of gibberellin oxidases respond to branching architecture

In the realm of ornamental horticulture, crape myrtle (Lagerstroemia indica) stands out for its aesthetic appeal, attributed largely to its vibrant flowers and distinctive branching architecture. This study embarked on a comprehensive exploration of the gibberellin oxidase (GAox) gene family in crape myrtle, illuminating its pivotal role in regulating GA levels, a key determinant of plant developmental processes. We identified and characterized 36 LiGAox genes, subdivided into GA2ox, GA3ox, GA20ox, and GAox-like subgroups, through genomic analyses. These genes' evolutionary trajectories were delineated, revealing significant gene expansions attributed to segmental duplication events. Functional analyses highlighted the divergent expression patterns of LiGAox genes across different crape myrtle varieties, associating them with variations in flower color and branching architecture. Enzymatic activity assays on selected LiGA2ox enzymes exhibited pronounced GA2 oxidase activity, suggesting a potential regulatory role in GA biosynthesis. Our findings offered a novel insight into the molecular underpinnings of GA-mediated growth and development in L. indica, providing a foundational framework for future genetic enhancements aimed at optimizing ornamental traits.

Immune Cell Migration to Cancer.

Immune cell migration is required for the development of an effective and robust immune response. This elegant process is regulated by both cellular and environmental factors, with variables such as immune cell state, anatomical location, and disease state that govern differences in migration patterns. In all cases, a major factor is the expression of cell surface receptors and their cognate ligands. Rapid adaptation to environmental conditions partly depends on intrinsic cellular immune factors that affect a cell's ability to adjust to new environment. In this review, we discuss both myeloid and lymphoid cells and outline key determinants that govern immune cell migration, including molecules required for immune cell adhesion, modes of migration, chemotaxis, and specific chemokine signaling. Furthermore, we summarize tumor-specific elements that contribute to immune cell trafficking to cancer, while also exploring microenvironment factors that can alter these cellular dynamics within the tumor in both a pro and antitumor fashion. Specifically, we highlight the importance of the secretome in these later aspects. This review considers a myriad of factors that impact immune cell trajectory in cancer. We aim to highlight the immunotherapeutic targets that can be harnessed to achieve controlled immune trafficking to and within tumors.

Farmers’ Willingness to Stop Tobacco Cultivation and Perception of Alternate Food Crops to Replace It: Case of Major Tobacco Growing Areas in Bangladesh

Background: The study was conducted to ascertain the farmers’ willingness to stop tobacco cultivation, identify the determinants of farmers’ desire to stop tobacco cultivation and discover alternate food crops farmers are interested in cultivating in Bangladesh. Methods: A total of 377 tobacco growers in most tobacco-growing areas in Bangladesh were surveyed using a sample randomization technique using binary logistic regression and the factors influencing farmers’ choice to produce tobacco were examined. Face-to-face structured surveys from January 2022 to March 2023 were conducted in Mirpur Upazila (Sub-district) from Kushtia and Gangachara Upazila from Rangpur districts of Bangladesh. Result: Only 46.4% of the farmers are willing to stop tobacco cultivation. The key determinants for their willingness to stop growing tobacco are education level, tobacco cultivation experience, incentives and organizational participation of the tobacco farmers. In the farmer’s view, maize, mustard, potatoes and lentils are the most suitable food crops to replace tobacco. To shift tobacco farmers to growing food crops, the Government should increase the farmers’ educational level and offer inputs, loans and other incentives to promote alternate crops like maize, mustard, potato and lentil.

Change, Adversity, and Adaptation: Young People's Experience of the COVID-19 Pandemic Expressed through Artwork and Semi-Structured Interviews.

This study explores how young people's mental health was affected by the COVID-19 pandemic using artwork and semi-structured interviews. The mental health impacts of the pandemic are important to understand so that policy and practice professionals can support those affected, prepare and respond to future crises, and support young people who are isolated and restricted in other contexts. Co-designed participatory art workshops and interviews were conducted with 16-18-year-olds (n = 21, 62% female) from the London-based Longitudinal cohort Study of Cognition, Adolescents and Mobile Phones (SCAMP). Artworks and interview transcripts were qualitatively co-and analysed with young people. From interviews, six themes were identified: adaptation, restriction, change, challenges, overcoming adversity, and lockdown life. From the artwork, four themes were identified: trapped, negative mental wellbeing, positive emotions, and technology. Everyday factors such as home environment, social support, hobbies, habits, and online education were key determinants of how challenged and restricted participants felt, and their capacity to overcome this. This demonstrates the importance of wider (social and environmental) determinants and supports a systems-level public health approach to young people's mental health. For example, young people's mental health services should collaborate with other sectors to address such determinants in a holistic way. Clearer guidance and support with occupation, relationships, environment, routine and activities could mitigate the negative mental health impacts of major environmental changes on young people.