Survey Of Stakeholders Research Articles

DESIGNING FOR PROGRAM SUSTAINABILITY: AN EVALUATION OF BC’S PROVINCIAL BETTER AT HOME PROGRAM

Abstract Better at Home programs help older adults in communities across British Columbia with non-medical tasks such as light housekeeping, yard work, transportation to appointments, grocery and meal delivery, and friendly visiting, helping them to remain at home and stay connected to their communities. Better at Home is funded by the Province of British Columbia and managed by the United Way. An evaluation of 81 Better at Home programs took place over 2022/23 focusing on the delivery, design, and sustainability of programs. A multipronged evaluation approach was utilized, including site visits; document and administrative data review; interviews with program staff, older adults, and caregivers (n=87); and a survey of program stakeholders (n=399). Over 2021/22, a total of 244,875 services were provided through Better at Home. The most common services provided were light housekeeping, friendly visiting, prepared meal delivery, and grocery services. The evaluation identified design and delivery best practices (e.g., building trust and relationships), program opportunities (e.g., leveraging communities of practice), and lessons learned (e.g., increasing awareness of burnout, capacity, and duplication). Some challenges to program efficiency were also identified (e.g., increased demand for services and complexity of client needs, staff and volunteer turnover). Six program improvements were recommended to ensure the long-term sustainability of Better at Home programs: 1) Securing multi-year funding that accounts for inflation, 2) Ensuring sufficient human resources for service delivery, 3) Offering strategic training opportunities, 4) Continuing to invest in existing programs, 5) Growing partnerships and community networks, and 6) Providing comprehensive supports to program staff.

Human-robot Collaboration in Warehousing: a Cloud-powered Revolution

This case study aims to understand the challenges faced by bigger warehouses in verticals such as logistics and warehousing, in the supply chain. It deconstructs the Warehouse Automation Management (WMS) technology and how it has evolved since its inception. It delves deeper into the problem statement that is majorly focused on the impact of COVID-19 on warehouse operations. Challenges such as labor shortage, capacity restrictions, health and safety protocols, and large inventory management became more prominent and affected the business operations. Additionally, this case study analyzes the solution i.e. Warehouse Management System in a holistic approach. It is a user-centric and human-driven solution, rather than being solely robot-oriented. Furthermore, It talks about the collaboration of the latest technologies such as Artificial Intelligence, IoT (Internet of Things), Automated Guided Vehicles (AGVs), Blockchain, etc. The culmination of all these technologies and keeping the user-centric approach in mind was an innovation of a new technology called Cobots i.e. Collaborative Robots. These robots are automated by nature and are close to humans for their operations, not for the physical aspect of a task but for the strategic aspect of it. In addition, extensive Primary Research was conducted for this case study through various research methods such as in-depth interviews and surveys of the core stakeholders of the industry.

Awareness and experiences on core outcome set development and use amongst stakeholders from low- and middle- income countries: An online survey.

Harmonization of outcomes to be measured in clinical trials can reduce research waste and enhance research translation. One of the ways to standardize measurement is through development and use of core outcome sets (COS). There is limited involvement of low- and middle-income country (LMIC) stakeholders in COS development and use. This study explores the level of awareness and experiences of LMIC stakeholders in the development and use of COS. We conducted an online survey of LMIC stakeholders. Three existing COS (pre-eclampsia, COVID-19, palliative care) were presented as case scenarios, and respondents asked to state (with reason(s)) if they would or would not use the COS if they were working in that area. Quantitative data were analyzed descriptively while qualitative data were analyzed thematically. Of 81 respondents, 26 had COS experience, 9 of whom had been involved in COS development. Personal research interests and prevalence of disease are key drivers for initiation/participation in a given COS project. Most respondents would use the COS for pre-eclampsia (18/26) and COVID-19 (19/26) since the development process included key stakeholders. More than half of the respondents were not sure or would not use the palliative care COS as they felt stakeholder engagement was limited and it was developed for a different resource setting. Respondents reported that use of COS can be limited by (i) feasibility of measuring the outcomes in the COS, (ii) knowledge on the usefulness and availability of COS and (iii) lack of wide stakeholder engagement in the COS development process including having patients and carers in the development process. To ensure the development and use of COS in LMICs, collaborations are essential in awareness raising on COS utility, training, and COS development. The COS also needs to be made accessible in locally understandable languages and feasible to measure in LMICs.

Delivery of cognition‐oriented treatments for older people with MCI in Australian Memory Clinics: A pilot implementation study

AbstractBackgroundThere is good evidence that cognition‐oriented treatments (COTs) including cognitive training and rehabilitation benefit older adults, including those with mild cognitive impairment or dementia. Despite this, there remains a research‐to‐practice gap where these interventions are not readily available in clinical practice. This paper will describe the protocol for a pilot/feasibility implementation study of rolling out COTs for people with MCI in the Australian Memory Clinic Network.MethodThe Australian Dementia Network (ADNeT) Working Group on Cognitive Interventions is tasked with bridging the evidence‐practice gap in Australian Memory Clinics. We have conducted a scoping review of COT implementation efforts around the world, a multi stakeholder survey to understand needs in gaps, have developed an online clinician‐training toolkit for choosing and delivering interventions, and are conducting an implementation study in 2023 using the RE‐AIM Implementation Framework (Glasgow et al. 2019; www.re‐aim.org), assessing Reach, Efficacy, Adoption, Implementation, and Maintenance of COTs in six participating clinics throughout Australia.ResultOur scoping review identified 29 eligible studies but only four have used formal implementation frameworks. Cognitive stimulation was the most frequent approach in these studies, and only a small proportion investigated cost‐effectiveness and maintenance parameters. The stakeholder survey confirmed that clinicians believe it is very important to offer interventions as part of routine clinical practice, and that more training was required. Progress of our implementation study to date will be described including the clinician training tool.ConclusionThis is the first study in Australia to address the evidence‐practice gap in COT research, and will inform the development of a larger implementation study to continue building the evidence base for the costs and benefits associated with incorporating these evidence‐based approaches in clinical practice.

Abstract A027: Creating partnerships to deliver community-based interventions for cancer prevention in a historically African American community

Abstract Be Well Communities™ is MD Anderson’s signature place-based approach for cancer prevention and control, working with communities to promote wellness and address modifiable risk factors for cancer. In this project, the planning phase of the Be Well Communities’ model was implemented in Acres Homes, a neighborhood in northwest Houston with more than 57,000 residents. While the changing demographics show increasing numbers of residents of Hispanic descent (43% of the population), Acres Homes still experiences effects of a legacy of Blacks experiencing poverty; more than half of the population of Acres Homes resides in census tracts that are considered areas of persistent poverty. Further, it is a medically underserved area with relatively high rates of unhealthy behaviors, as compared to Healthy People 2030 goals. To work toward addressing the disparities in health outcomes experienced by community residents, a community advisory group (Steering Committee) including residents, non-profit organizations, health care partners, city and county agencies, plus other stakeholders, was convened and aligned through a structured process to develop shared goals, foster multisector collaboration (as measured by a stakeholder survey administered twice), and enhance community capacity to improve health outcomes through development of a Community Action Plan. Clear, achievable goals were developed, multisector collaboration was enhanced, and more than 400 hours of capacity building support led to a Community Action Plan focused on healthy eating and active living, including 15 evidence-based interventions led by 18 organizations. The majority (93%) of the Steering Committee reports that this plan reflects community priorities and will reach the residents most in need. In the first 2 years of implementation nearly 40% of the residents of the community have been reached by programs including more than 5,000 residents participating in physical activity opportunities, classes and over 1000 individuals receiving outreach from a Community Health Worker within the safety-net hospital system to receive access to healthy food access and nutrition education programming. By listening and developing trust, the Be Well Communities team successfully worked with Acres Homes residents and organizations to enhance community capacity to address health inequities in one of Houston’s most historic communities. Citation Format: Ruth Rechis, Haley Gardiner, Katy Oestman, Stephanie Nutt, Michael T. Walsh Jr.. Creating partnerships to deliver community-based interventions for cancer prevention in a historically African American community [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr A027.

Defining patient perception of overall well-being and disease activity in the OMERACT Juvenile Idiopathic Arthritis (JIA) core domain set: A report from the JIA working group

ObjectiveThe OMERACT Juvenile Idiopathic Arthritis (JIA) Working Group (WG) aimed to reach agreement on a consensus-based definition and description of the core domain related to patient perception of overall well-being and disease activity. MethodsA committee of patient research partners, clinicians, methodologists, and researchers drafted working definitions and descriptions. The WG conducted two iterative electronic stakeholder surveys to obtain consensus on domain description, definition, and the distinction between patient perception of overall well-being and disease activity. These definitions were then presented at the OMERACT 2023 Special Interest Group (SIG) session for agreement. ResultsForty-five participants, from 7 countries and 4 continents, were comprised of six patients, 18 caregivers, and 21 healthcare providers. The consensus threshold (70%) was exceeded on all survey questions from both stakeholder groups (patients/caregivers, all others). Agreement was obtained on the new definition, description, and domain title, along with agreement on separate assessments of two target domains, patient perception of overall well-being as it relates to disease and patient perception of disease activity. ConclusionThrough an iterative consensus process and achieving agreement from the OMERACT SIG session attendees, the JIA WG has created a detailed definition and description for the two target domains in the patient perception of overall well-being related to disease core domain of the JIA mandatory core domain set. The next phase of this work will be instrument selection using the OMERACT filter 2.2.

Banked term umbilical cord blood to meet the packed red blood cell transfusion needs of extremely-low-gestational-age neonates: a feasibility analysis.

To assess the feasibility of drawing, processing, safety-testing, and banking term umbilical cord blood to meet the packed red blood cell transfusion (RBC Tx) needs of extremely-low-gestational-age neonates (ELGANs). (1) Retrospectively analyze all ELGANs RBC Tx over the past three years, (2) Estimate local cord blood availability, (3) Assess interest in this project, and implementation barriers, through stakeholder surveys. In three years we cared for 266 ELGANs; 165 (62%) received ≥1 RBC Tx. Annual RBC Tx averaged 197 (95% CI, 152-243). If 10% of our 10,353 annual term births had cord blood drawn and processed, and half of those tested were acceptable for Tx, collections would exceed the 95th % upper estimate for need by >four-fold. Interest exceeded 97%. Identified barriers included FDA approval, training to collect cord blood, and cost. RBC Tx needs of ELGANS could be met by local cord blood collection.

Gridlock in compromise, or is multi-objective optimisation possible in renewable energy planning? A stakeholder analysis using scenario-MCDA

ABSTRACT The energy and climate crises are driving renewable energy, but it is currently facing obstacles in leading countries. Balancing environmental, social and economic interests has become complex at the regional level due to spatial trade-offs in a contested space. To investigate stakeholder willingness to compromise on a joint ranking on wind and solar energy sites, multi-criteria decision analysis (MCDA) planning support was explored. Using a two-part stakeholder survey, four groups were identified: ‘advocates’ who were satisfied with the site ranking (66%), ‘realists’ who were willing to compromise despite previous disagreement (13%), ‘dissenters’ not accepting (35%), and ‘dogmatists’ not engaging. Planning decisions and stakeholder engagement are underpinned by distinct attitudes towards the role of (democratic) planning and sustainable development. The use of trade-off analysis can ensure transparency and trace back stakeholder interests in making planning decisions. However, decision quality factors also need to be considered to ensure a thorough planning reflection.

Cybersecurity Framework for Ensuring Confidentiality, Integrity, and Availability of University Management Systems in Bangladesh.

In an increasingly interconnected and technologically advanced world, the efficient operation of University Management Systems (UMS) is essential for the proper functioning of educational institutions. However, with the rapid digitization of processes, the risk of cyber threats targeting these systems has also grown significantly. This research presents a comprehensive Cybersecurity Framework tailored to the context of Bangladesh, aimed at ensuring the confidentiality, integrity, and availability of University Management Systems. The proposed framework is designed to address the unique challenges and requirements faced by universities in Bangladesh, considering factors such as the evolving threat landscape, resource constraints, and regulatory environment. Drawing upon established cybersecurity principles and best practices, the framework encompasses a multi-layered approach that encompasses preventive, detective, and responsive measures. Key components of the framework include the identification and assessment of potential vulnerabilities within UMS, the implementation of robust access controls and encryption mechanisms, continuous monitoring and threat detection, incident response planning, and user awareness training. The framework's adaptability allows universities to tailor its components to their specific organizational structures and risk profiles, thus promoting a proactive and dynamic approach to cybersecurity. The research further evaluates the effectiveness of the proposed framework through a combination of quantitative and qualitative methods, including system assessments, penetration testing, and stakeholder surveys. Results demonstrate the framework's ability to enhance the security posture of UMS in Bangladesh, contributing to the preservation of sensitive data, the prevention of unauthorized access, and the sustained availability of critical services.

Troubled waters: Riparian ecosystem services and community opposition to the largest dam removal project in Europe, Vezins Dam, France

The largest Dam removal project in Europe occurred in 2019 with removal of the Vezins Dam on the Sélune River in Normandy, France. The French State ordered removal of the 36-m high Vezins Dam and the 16-m high la Roche-qui-Boit Dam along the Sélune River to restore ecological and longitudinal connectivity to improve riparian water quality, and especially to restore migratory species of Atlantic salmon (Salmo salar) and eel (Anguilla anguilla). We examine community opposition to removal of the Vezins Dam through the lens of riparian ecosystem services and stakeholder values. Primary data sources includes fieldwork, interviews, and an online survey of local stakeholders. Text analysis and interview coding occurred with ATLAS.ti 22, and highlight themes related to federal-local communication and riparian ecosystem services. The French State ineffectively communicated with local communities regarding dam removal benefits and riparian stakeholder values. While the state focused on biophysical ecosystem services, experiential ecosystem services, such as place attachment, were more important to riparian stakeholders. Often portrayed as a positive benefit, here dam removal lacked community support. Failure of government authorities to effectively incorporate stakeholder values along a continuum of ecosystem services substantially compromises future large-scale federal environmental management projects dependent upon local community support. By examining how local actors experienced dam removal, study results increase understanding of environmental governance and the local consequences of national policy decisions, of use in future dam removal projects – including for large dams – in France and internationally.

After action review of the COVID-19 surveillance system in Quang Ninh Province, Vietnam, in 2020.

Surveillance is the backbone of any response to an infectious disease outbreak, and comprehensive evaluation of surveillance systems is crucial. However, structured evaluations of surveillance systems during the COVID-19 pandemic are scarce. We conducted an after action review (AAR) of the performance of the COVID-19 surveillance system in Quang Ninh Province, Vietnam, during 2020 using the COVID-19-specific AAR methodology developed by the World Health Organization in combination with guidance from the US Centers for Disease Control and Prevention (CDC). We conducted a stakeholder survey, document reviews, and key informant interviews with staff from Quang Ninh CDC's COVID-19 surveillance system. The COVID-19 surveillance system was based on the pre-existing surveillance system in the province. The system's strengths were early preparation for emergency response, strong governance and central coordination, and multidisciplinary collaboration. Stakeholders agreed that the system proved useful and adaptive to the fast-evolving COVID-19 situation but was weakened by overly complex systems, redundant administrative processes, unclear communication channels, and lack of resources. Overall, the surveillance systems in Quang Ninh province proved effective in containing COVID-19 and adaptive in a fast-changing epidemiological context. Several recommendations were made based on identified areas of concern that are of relevance for COVID-19 surveillance systems in Vietnam and similar settings.

Be Well™ Acres Homes: a community-driven, evidence-based approach to reduce health inequities through sustained cross-sector partnership

PurposeBe Well Communities™ is MD Anderson’s signature place-based approach for cancer prevention and control, working with communities to promote wellness and address modifiable risk factors for cancer. The purpose of this paper is to describe implementation of the planning phase of the Be Well Communities model in Acres Homes which began in 2019.MethodsA community advisory group (Steering Committee) including residents, non-profit organizations, health care partners, city and county agencies, plus other stakeholders, was convened and aligned through a structured process to develop shared goals, foster multisector collaboration, as measured by a stakeholder survey administered twice, and enhance community capacity to improve health outcomes through development of a Community Action Plan.ResultsClear, achievable goals were developed, multisector collaboration was enhanced, and more than 400 h of capacity building support led to a Community Action Plan initially focused on healthy eating and active living, including 15 evidence-based interventions led by 18 organizations. The majority (93%) of the Steering Committee reports that this plan reflects community priorities and will reach the residents most in need.ConclusionBy listening and developing trust, the Be Well Communities team successfully worked with Acres Homes residents and organizations to enhance community capacity to address health inequities in one of Houston’s most diverse and historic communities.

Livelihood support for caregivers of children with developmental disabilities: findings from a scoping review and stakeholder survey

Purpose Poverty amongst families with a child with disability adversely impacts child and family quality of life. We aimed to identify existing approaches to livelihood support for caregivers of children with developmental disabilities in low- and middle-income countries. Methods This mixed-method study incorporated a scoping literature review and online stakeholder survey. We utilised the World Health Organization community-based rehabilitation (CBR) matrix as a guiding framework for knowledge synthesis and descriptively analysed the included articles and survey responses. Results We included 11 peer-reviewed publications, 6 grey literature articles, and 49 survey responses from stakeholders working in 22 countries. Identified programmes reported direct and indirect strategies for livelihood support targeting multiple elements of the CBR matrix; particularly skills development, access to social protection measures, and self-employment; frequently in collaboration with specialist partners, and as one component of a wider intervention. Self-help groups were also common. No publications examined effectiveness of livelihood support approaches in mitigating poverty, with most describing observational studies at small scale. Conclusion Whilst stakeholders describe a variety of direct and indirect approaches to livelihood support for caregivers of children with disabilities, there is a lack of published literature on content, process, and impact to inform future programme development and delivery.

Developing an integrated participatory methodology framework for campus sustainability assessment tools (CSAT): A case study of a sino-foreign university in China

The issue of sustainable development is a topic that needs to be studied, analysed, and addressed by higher education institutions. Campus sustainability assessment tools (CSATs) are commonly adopted internationally to evaluate and improve measures utilised for the development outcomes of universities. Whilst some Chinese universities have taken positive steps towards attaining sustainability in their operations, teaching and/or research, and China has come up with its own evaluation criteria for green universities, majority of their approach still have shortcomings, such as lack of multiple stakeholder involvement and a one size fits all approach to campus sustainability strategy. Thus, the aim of this paper is to investigate two core methodological issues (top-down and non-transparent approaches and the limited consideration of context-specific issues) that impact the efficacy of CSATs in order to optimize the selection process for indicators and enhance the development CSAT for Chinese campuses and other campuses globally. Based on the widely used assessment tools (both campus and neighbourhood) in foreign countries, 147 corresponding assessment indicators in 16 domains were collated through qualitative review of existing assessment tools and the questionnaire-based analysis through the analytic hierarchy process (AHP). The case study campus selected was the University of Nottingham Ningbo China. The indicators to be investigated were selected based on frequency and distributed in the form of a questionnaire to the staff and students after a comprehensive stakeholder survey analysis. The staff and students were used to illustrate the high interest and high influence dynamic versus the high interest and low influence dynamic. This research was conducted to gain insight towards developing an integrated, inclusive, and context relevant CSAT. Furthermore, a new framework was developed for Chinese Campus sustainable assessment planning, using the University of Nottingham Ningbo as Case study. This framework provides step by step phases for CSAT development that includes the database phase, minimization phase, stakeholder phase and integration and implementation phase. Within these phases, factors that determined the success and failure were discussed such as issues of acceptability versus pragmatism, willingness of stakeholders to participate, weighing of indicators, stakeholder analysis and redistribution of power for the less influential. This led to the sample selection of indicators, which serve as validation of impact of this integrated methodological process. The final recommendation given is that all regions should create and provide avenues for tailored processes for the selection, weighting and criteria development of sustainability indicators and assessment tools. This needs to promote inclusivity, transparency and contextual relevance in decision making, which should be the main considerations for any truly sustainable framework. In addition, as a final measure to ensure methods such as CSATs are implemented in wider China and globally, this study identified the need for coordination, support, and participation of competent and sustainability driven leaders, government parastatals (National and provincial level), pilot demonstration, as well as data transparency throughout related campus departments.

Modelling the role of marine protected area in biodiversity conservation

This study explored the anthropogenic stressors of a coral habitat and predicted the role of a proposed MPA around coral habitat on biodiversity conservation. The study was conducted in the Saint Martin's Island which is located in the south east coastal area of Bangladesh. Data on anthropogenic stressors were collected through intensive stakeholder survey and the role of MPA in biodiversity conservation was explored by utilizing Allometric Trophic Network model. This study identified about 16 anthropogenic stressors for the coral reef ecosystem. Increasing fishing pressure significantly reduced the species biomass while reduced fishing pressure increased the biomass of species. Biomass of the species in the system with no fishing area increased significantly (3–6%) while compared with the species biomass of an area without fishing restriction. Our simulations found that imposing fishing restriction in an exploited system significantly improve the species standing stock. Our model outputs suggest that declaration of MPA is beneficial for conservation of biodiversity. However, for sustainable implementation of conservation initiatives a proper management framework is necessary integrating diverse stakeholders.

An Adaptive Consumer Centric Management Model For Central Bank Digital Currency With Special Reference To Coimbatore District

A revolutionary turning point in the financial services industry has been reached with the introduction of Central Bank Digital Currency (CBDC). This research proposes an adaptable Consumer-Centric Management Model (CCMM) designed for the distinct financial environment of Coimbatore District, with the potential to transform digital transactions and consumer interaction. The model uses insights from customer experiences and preferences, with a focus on consumer protection, privacy, and security. To collect both quantitative and qualitative data for the study, a mixed-method approach is employed, which involves conducting stakeholder interviews and surveys. The Coimbatore District's financial institutions, central banks, and regulatory bodies can incorporate CBDC in a way that puts the interests of their customers first by following the guidelines provided by the CCMM. It covers stakeholder cooperation, risk management, consumer awareness, and regulatory compliance.

Systematizing Information Use to Address Determinants of Health Worker Health in South Africa: A Cross-sectional Mixed Method Study

BackgroundRecognizing that access to safe and healthy working conditions is a human right, the World Health Organization (WHO) calls for specific occupational safety and health (OSH) programs for health workers (HWs). The WHO health systems’ building blocks, and the International Labour Organization (ILO), highlight the importance of information as part of effective systems. This study examined how OSH stakeholders access, use, and value an occupational health information system (OHIS). MethodsA cross-sectional survey of OSH stakeholders was conducted as part of a larger quasi experimental study in four teaching hospitals. The study hospitals and participants were purposefully selected and data collected using a modified questionnaire with both closed and open-ended questions. Quantitative analysis was conducted and themes identified for qualitative analysis. Ethics approval was provided by the University of Pretoria and University of British Columbia. ResultsThere were 71 participants comprised of hospital managers, health and safety representatives, trade unions representatives and OSH professionals. At least 42% reported poor accessibility and poor timeliness of OHIS for decision-making. Only 50% had access to computers and 27% reported poor computer skills. When existing, OHIS was poorly organized and needed upgrades, with 85% reporting the need for significant reforms. Only 45% reported use of OHIS for decision-making in their OSH role. ConclusionGiven the gap in access and utilization of information needed to protect worker’s rights to a safe and healthy workplace, more attention is warranted to OHIS development and use as well as education and training in South Africa and beyond.

A three-country survey of stakeholders on Continuous Professional Development in Public Health

Abstract Background Health and social care systems in Eastern Partnership Countries are in the process of “digital transformation”, and health professionals started widespread use of digital registers and databases. This challenge highlights the importance of upskilling workforces. However, in some of these countries there are not well functioning Continuous Professional Development (CPD) systems available and less attention is paid to widening access to life-long learning (LLL) education at High Educational Institutions (HEIs). Study aimed to explore the view of stakeholders on the needs and perspectives of CPD in the Public Health on the example of Georgia, Armenia and Moldova. Methods Quantitative research method was used. A special questionnaire was designed for the study. Survey was administered in November-December 2022 in Georgia, Armenia and Moldova. Results In total, 122 stakeholders from various areas (Ministry of Health, PH institutions, hospitals, HEIs) participated in the survey with 58,7% being at a high management level and with 82.5% having more than 15 years of total working experience. The majority of respondents (94,6%) worked in the state sector. Study reveals several common needs and perspectives in all three countries. Majority of stakeholders (97,8%) suggested that there is a lack of qualified staff with the necessary competencies and skills. In addition, large share of stakeholders (95,7%) mentioned that there is a lack of training opportunities and relevant CPD Programs in e-health and digitalization, medical and social registries, electronic surveillance systems, as well lack of financial support (93,4%), absence of appropriate regulation (90,2%). Conclusions Stakeholders in Georgia, Armenia and Moldova considered that existing gaps can be filled through strengthening the national system of CPD and developing of high quality CPD Programs oriented on specific knowledge and skills in the Public Health. Key messages • It is important in Eastern Partnership Countries to develop CPD programs with a focus on digital skills according to the best European practice and experience. • High Educational Institutions can play a significant role in delivering LLL for the health workforce in Public Health.

Systematic review of the effectiveness of menstrual health interventions in low- and middle-income countries in the East Asia and Pacific region

In the context of rapidly expanding policy and practice, this systematic review collates and appraises evidence for the effectiveness of menstrual health interventions in the East Asia and Pacific region. Structured searches were undertaken in 7 databases and Google Scholar. Grey literature was identified through searching and survey of stakeholders. Quantitative evaluations were eligible. We audited the interventions and outcomes assessed in current evidence, undertook risk of bias assessment, and narrative synthesis of findings. The review protocol was registered prior to searching (PROSPERO: 343613). Eighteen studies were eligible; categorised according to the requirements for menstrual health they addressed. Information and education intervention studies (n=11) found school-based programs improved menstrual knowledge test scores but did not evaluate impacts on broader outcomes. Evaluations of interventions providing materials, facilities, and services for menstruation (n=4) focused on product acceptability. Studies exhibited a serious risk of bias without adequate controls, limitations in intervention allocation, adherence, and participant retention. Six studies of interventions to improve care for menstrual discomforts found decreased self-reported pain but had serious bias without placebo controls. Two interventions targeted the supportive social environment for menstruation. There is insufficient evidence for the effectiveness of menstrual health interventions in the East Asia and Pacific region. Future research must improve reporting, provide clear intervention theory of change, and improve measurement of core concepts. Evaluations of interventions that align with policy and practice are needed, facilitated by partnerships between researchers, government, and practitioners. UNICEF. Reckitt Global Hygiene Institute. NHMRC.

Understanding Delayed Graft Function to Improve Organ Utilization and Patient Outcomes: Report of a Scientific Workshop Sponsored by the National Kidney Foundation

Delayed graft function (DGF) is a common complication after kidney transplant. Despite extensive literature on the topic, the extant definition of DGF has not been conducive to advancing the scientific understanding of the influences and mechanisms contributing to its onset, duration, resolution, or long-term prognostic implications. In 2022, the National Kidney Foundation sponsored a multidisciplinary scientific workshop to comprehensively review the current state of knowledge about the diagnosis, therapy, and management of DGF and conducted a survey of relevant stakeholders on topics of clinical and regulatory interest. In this Special Report, we propose and defend a novel taxonomy for the clinical and research definitions of DGF, address key regulatory and clinical practice issues surrounding DGF, review the current state of therapies to reduce and/or attenuate DGF, offer considerations for clinical practice related to the outpatient management of DGF, and outline a prospective research and policy agenda.