BACKGROUNDStrengthening research leadership in low- and middle-income countries (LMICs) is essential for addressing diseases of poverty. Since 1999, World Health Organization (WHO) Special Programme for Research and Training in Tropical Diseases (TDR) has supported this through the Clinical Research and Development Fellowship (CRDF), but evidence on its long-term impact remains limited. We therefore assessed the leadership trajectories of CRDF fellows trained between 1999 and 2021.METHODSAn online cross-sectional survey of CRDF alumni (1999–2021) used a structured questionnaire capturing career progression, productivity, leadership roles, collaborations, institutional contributions, and challenges.RESULTSOf 116 fellows contacted, 88 responded (75.8%). More than half had secured competitive funding (55.7%), with a median grant value of USD 512,320 (interquartile range: 111,629–1,200,000; range: USD 700–70,000,000), including multiple national and international awards. Career advancement was notable: 43.2% served as principal investigators and nearly 80% supervised research staff. Many led developments of infrastructure and operating procedures (63.6%). Re-entry grants strengthened institutional capacity for respondents. Collaborations were sustained nationally (77.3%) and through South–South partnerships (71.6%). Almost all fellows (98.9%) continued applying TDR-acquired leadership skills. One third contributed to policy documents. Persistent barriers included difficulty accessing funding, limited institutional support, scarce national funding, and heavy workloads.CONCLUSIONCRDF alumni reported substantial engagement in research leadership, scientific productivity, and institutional capacity strengthening in LMICs.

Purpose Young-onset Parkinson’s disease (YOPD) reshapes everyday life at home, yet research on how younger adults negotiate domestic space and home modification remains limited. This article examines how people living with YOPD make sense of, adopt, delay and resist home modifications and how these decisions are shaped by identity, aesthetics, relationships and expectations about the future. Methods The study draws on qualitative data from an Australian project involving narrative, semi-structured interviews and a photovoice activity. Nine participants (aged 38–67) were selected due to their substantive engagement with home-related themes. Transcripts were analysed using experience-centred narrative analysis with an inductive, constant-comparative approach. Results Three interrelated findings were identified. First, home modifications often transformed the meaning of home, with assistive technologies contributing to feelings of medicalisation as domestic spaces came to resemble “nursing homes.” This created tensions between safety, aesthetics and identity. Second, participants evaluated homes through prognosis, planning for uncertain futures by prioritising accessibility within the dwelling and beyond it, revealing how homes were re-imagined as infrastructures for sustaining autonomy. Third, participants described feeling “aged out of time,” as assistive devices signalled premature ageing, prompting selective uptake and delayed implementation even when supports were available. Conclusion Home modification in YOPD is not a purely functional response to impairment but a sociomaterial negotiation that mediates identity, relationships, temporality and the meanings of home. Policies and services should better recognise the distinctive life-course positioning of younger adults with Parkinson’s by supporting earlier, collaborative and aesthetically sensitive planning to home adaption.

Tobacco use remains one of the greatest public health challenges worldwide. Social short-video platforms have become the primary channel through which the public obtains smoking-cessation information. Grounded in the Health Belief Model and the Theory of Planned Behavior, this study evaluates the information quality of smoking-cessation short videos on Chinese short-video platforms. We analyzed 262 video samples from four major platforms-TikTok, Kwai, Bilibili, and BuzzVideo. Two researchers who received standardized training independently evaluated each video using the Medical Quality Video Evaluation Tool (MQ-VET), the Global Quality Scale (GQS), and the mDISCERN score. Finally, we performed multiple linear regression to identify factors influencing video quality and user interaction. Of the 262 videos included, only 17.6% were produced by medical experts. Overall information quality was low: median MQ-VET was 44 (41-47), median GQS was 2 (2-3), and median mDISCERN was 2 (1-2). In multivariable regression, videos produced by Medical experts (β = 0.586, p < 0.001) and by Public welfare organizations (β = 0.130, p = 0.001) had significantly higher quality than those produced by Individual users. For user engagement, measured by number of likes, information quality (MQ-VET) (β = 0.215, p = 0.009), TikTok as the platform (β = 0.358, p < 0.001), and Bilibili as the platform (β = 0.485, p < 0.001) were significant positive predictors. Quality scores correlated positively with user interaction (ρ = 0.14-0.35, p < 0.005), whereas video duration correlated negatively with interaction (ρ = -0.14 to -0.29, p < 0.01). Content about smoking cessation on mainstream Chinese short-video platforms is predominantly user-generated, and it is often fragmented, scientifically weak, and lacking elements of behavior-change psychology. Despite these shortcomings, high-quality videos still attract substantial user engagement. To harness the broad reach of these platforms, we propose constructing a four-party cooperation framework among government, platforms, experts, and users grounded in the "Healthy China 2030" initiative, establishing a quality-certification system, and incentivizing medical experts to produce rigorous, high-quality content.

This study examines the sustainable coping strategies adopted by organic farmers to enhance resilience against climate change in Nagapattinam district, Tamil Nadu. Using a mixed-methods approach, primary data were collected from 425 organic farmers through structured surveys, along with qualitative insights from focus group discussions and key informant interviews. The findings reveal that 71.8% of farmers adopted at least three climate-resilient practices, with 44.2% classified as high adopters, indicating substantial engagement with sustainable agriculture. Key practices include composting (83.8%), crop diversification (72.7%), and integrated pest management (73.4%). Logistic regression results demonstrate that education (β = 0.187, p &lt; 0.01), farm size (β = 0.642, p &lt; 0.01), access to extension services (β = 0.833, p &lt; 0.01), credit access (β = 0.517, p &lt; 0.05), FPO membership (β = 0.751, p &lt; 0.05), and climate risk perception (β = 0.286, p &lt; 0.05) significantly increase the likelihood of adoption, with an overall prediction accuracy of 81.2%. The Probit model shows that education reduces hurdle probability by 2.9%, credit access by 7.8%, and FPO membership by 6.4%, while distance to market increases constraints by 1.8% per km. Major constraints include high labor requirement (mean = 4.62), limited credit (4.41), and lack of organic inputs (4.33). The study concludes that organic farming serves as an effective climate-resilient strategy, but its scalability depends on strengthening institutional support, financial access, and market linkages. Policy interventions should prioritize integrated support systems to enhance adaptive capacity and ensure sustainable agricultural development in coastal regions.

Over-the-counter (OTC) medicines are frequently used during pregnancy. As these medicines are often used without medical supervision, accessible and reliable safety information is essential. However, finding reliable and understandable information on the safety of these medicines during pregnancy is often experienced as difficult. Hence, there is a need for a new easily accessible electronic health (eHealth) tool that empowers women to actively seek information to support safer self-medication practices during pregnancy and breastfeeding. This study aimed to describe the development and dissemination process of a Dutch mobile app providing reliable safety information on OTC medicines during pregnancy and breastfeeding using a development and formative evaluation approach. The app was developed over a 2-year project comprising 5 phases, including preparation, development, preimplementation, implementation, and evaluation. Mixed-method strategies, including questionnaires, focus groups, and user feedback rounds, were applied to involve the target population in the development process. Medicine safety information in the app was based on the latest scientific evidence. First-year app-usage outcomes included app downloads, usage patterns, and information-seeking behavior. Input from 253 potential users formed the foundation for the development of the MediMama app (Netherlands Pharmacovigilance Centre Lareb), with users expressing a need for clear, reliable, and easily accessible information on medication safety during pregnancy and breastfeeding. The app was launched on Mother's Day 2024 and provides safety information on over 250 OTC medicines, including supplements and herbal remedies, across 27 medicine categories. Promotion occurred through multiple online and offline channels. During its first year, the MediMama app was downloaded 22,415 times, with an average of 370 unique daily users, indicating substantial user engagement. Information on paracetamol (acetaminophen) and nasal sprays was most frequently accessed, reflecting the need for information on commonly used OTC medicines among the target population. One year after its launch, the MediMama app is considered a promising tool in maternity care, meeting the target population's need for accessible OTC medicine safety information. The app aims to support informed decision-making, contributing to safer medication use during pregnancy and breastfeeding. Further research is required to evaluate the effectiveness of the implementation strategy, as well as the app's impact on maternal medication use behaviors and health outcomes.

Graduate-level instruction relies on more than syllabi, rubrics, and institutional policies; it is sustained by a tacit architecture of expectations that shapes how instructors teach and how adult learners engage with feedback, revision, and academic growth. This conceptual essay names and theorizes the pedagogical contract, i.e., an implicit, reciprocal set of obligations that underlies instructional relationships in adult and continuing higher education. Although adjacent constructs, such as psychological contracts, learning contracts, and the didactical contract address related dynamics, none account for the relational and procedural expectations that govern iterative learning in graduate-level settings. Drawing on a representative vignette and a synthesis of adult learning theory, feedback literacy research, and scholarship on emotional and cognitive labor, the article illustrates how breaches of the pedagogical contract unfold and why they matter. A typology of six breach patterns clarifies the mechanisms through which reciprocity erodes, shifting the burden of learning disproportionately onto instructors and disrupting the conditions necessary for meaningful academic development. The analysis highlights the pedagogical, relational, emotional, and institutional consequences of these breaches and offers practical strategies for articulating expectations, reinforcing role clarity, and structuring revision cycles to support substantive engagement.

ABSTRACT This paper examines how middle managers in higher education institutions in South Africa and Northern Ireland navigate the complex and often contradictory demands of institutional transformation in post-conflict settings. Drawing on a hermeneutic phenomenological approach, the study foregrounds the agency of mid-level leaders as they engage with top-down policies, intersecting identities, and deeply embedded institutional cultures. The concept of destructive interference is introduced as a lens to understand the challenges of promoting transformation in post-conflict higher education contexts. Participants’ narratives reveal that transformation is not a linear process, but a contested, discursive and affective one, shaped by ideological clashes, competing logics, and constraints. Three interrelated tensions are identified as destructive interference that impact middle-manager agency: university discursive structures that reproduce historically sedimented hierarchies; the perverse logic of leadership, in which performative change is rewarded over substantive engagement and stratified legacies of inequality that differentially position actors and (de)legitimise specific identities and experiences, depending on historically situated configurations of power. The study positions transformation as a historically situated and ideologically charged process. By centring the lived experiences of middle-managers, the paper offers a critical account of how institutions reproduce or transform inequality, centring managers' agency for transformation as one that navigates destructive interference while holding open possibilities for substantive transformation.

BackgroundTelepathology has emerged as a transformative digital health solution to address the global shortage of pathologists and the unequal distribution of diagnostic services, particularly in underserved and rural areas. In Henan Province, China, high diagnostic demand, rapid population growth, and limited pathology expertise exacerbate regional health care inequities, leading to delayed diagnoses and restricted access to specialist care.ObjectiveThis study aimed to design, implement, and evaluate a province-wide telepathology system integrating web and mobile platforms to enhance diagnostic quality, efficiency, and equitable access across health care tiers.MethodsWe conducted a retrospective, multicenter observational study using deidentified data from 120 health care institutions between 2016 and 2024. The system used a 3-tier architecture with virtual private network–secured transmission and a Browser-Server framework, supporting standardized whole-slide image acquisition, remote review, and reporting via web interfaces and a WeChat (Tencent) mini-program. System performance was assessed by consultation volume, turnaround time, concurrency, and diagnostic concordance in a subset of 1027 cases with paired tertiary-hospital expert diagnoses. Economic impact was estimated using previously published per-case savings, reflecting patient travel and ancillary cost reductions. Additional assessments included workflow integration, mobile platform use, and system stability under peak load.ResultsOver 8 years, the network processed 72,916 consultations encompassing 355,104 whole-slide images, supporting 220-300 concurrent users with stable performance. Median turnaround time was 10.06 (IQR 1.63-29.10) hours, with 96.41% (70,298/72,916) of cases completed within 72 hours. County-level hospitals contributed 77.63% (56,603/72,916) of consultations, demonstrating substantial engagement from lower-tier institutions. In the diagnostic subset, originating-site preliminary classifications achieved 0.90 sensitivity and 0.75 specificity relative to expert reference diagnoses, with 17.2% discordance corrected through remote expert review. Estimated annual direct cost savings ranged from US $0.14 to $0.63 million. Mobile-enabled access facilitated remote review and reporting without compromising data security, supporting integration into routine clinical workflows across diverse hospital settings.ConclusionsThe Henan Province telepathology system demonstrates that a centrally coordinated, scalable digital health platform can improve diagnostic efficiency, quality, and equity in resource-constrained settings. High county-level hospital use highlights its potential to reduce geographic and structural diagnostic inequities. Future work should explore formal cost-effectiveness evaluation, artificial intelligence–assisted diagnostic support, and cross-regional interoperability to enable broader adoption and sustainable integration into health care systems.

Discursivities around migration have always shaped and defined the Kerala imaginary. Notwithstanding, there have not been any substantial engagements with Kerala’s rather deep history of internal migration. The Malabar migration that witnessed the large-scale movement of people from Travancore to British Malabar between the 1920s and 1970s is largely seen as a peasant migration incurred by the severe socio-economic conditions, including poverty and the Second World War. A notable specificity of the migration was the high composition of Syrian Christians among the peasants. To critically problematize this community specificity, this article closely analyses Vinoy Thomas’s novel Karikkotatakary (2014). This article argues that Malabar migration could be viewed as an instantiation of the Syrian Christian community’s assertion and contends further that Vinoy Thomas deploys Dalit Christianity as a critical pointer to respond to these latent historicities of Malabar migration, serving as a critique of Syrian Christian religiosity and community consciousness.

ABSTRACT This study examines the understudied intermediary role of planning consultants in shaping public participation in smart city planning in Indonesia. In this descriptive qualitative study, we analyzed interviews with stakeholders in Mojokerto Regency, Indonesia using established participation frameworks. Evidence from this case indicates that consultants bridge technical and communicative gaps and may align with the tokenism spectrum due to centralized government authority and absent feedback mechanisms, thereby undermining public trust and substantive engagement. Institutional constraints limit consultants’ capacity to champion inclusive planning and constrain participation to procedural compliance, raising questions about achieving genuinely community-driven transformation.

ABSTRACT The Recovery and Resilience Facility of the European Union (EU) provided member states with funds to counteract the economic consequences of the pandemic and required the submission of national action plans. The EU developed guidance on how member states should apply for and use these funds, directing applicants to include a gendered analysis. While there is significant variation in the levels of gender awareness within the national plans, the Irish plan is notable in that it lacks any substantial engagement with gender considerations. Using document analysis and policy maker interviews, this article examines the causes and outcomes of this disengagement, exploring this puzzle of a lack of gender sensitive economic policy-making in Ireland. We examine why, despite direction from the EU, those charged with Ireland’s economic policy framework omitted any significant consideration of gender. Drilling down into a specific example of how gender considerations were marginalised in economic governance, we argue for understanding more about how the interpretive or cognitive lens that policy makers apply reinforces long-standing norms about what matters. We contribute to feminist political economic analysis of the EU and national policy-making, highlighting where the blockages to gender equality lie.

Background:Artificial intelligence (AI) and large language models (LLMs) are increasingly integrated into healthcare, yet their adoption in pediatric urology remains insufficiently explored. Pediatric urology, with its complex and rare conditions, may particularly benefit from AI-based innovations.Objectives:This study aimed to assess pediatric urologists’ awareness, usage patterns, and perceptions regarding AI and LLMs, while also identifying potential applications, barriers, and educational needs.Design:A cross-sectional, descriptive survey was conducted among pediatric urologists.Methods:Between May and July 2025, a 21-item questionnaire was distributed via professional networks and mailing lists. Items addressed demographics, knowledge of AI, frequency and purpose of AI and LLM use, perceived clinical and surgical applications, ethical concerns, and interest in AI training. Descriptive statistics were used for analysis.Results:Of 368 invited pediatric urologists, 103 (28%) responded. Most reported moderate (35.0%) or low (29.1%) knowledge of AI, yet more than half (51.5%) used AI tools daily. LLMs had been used by 96.1% of participants, mainly for scientific writing (78.8%), language editing (54.5%), and text summarization (46.5%). Surgical simulation (46.6%), imaging-based strategy planning (40.8%), and preoperative planning (36.9%) were identified as promising clinical applications. Barriers included lack of trust (52.4%), ethical concerns (43.7%), and insufficient knowledge (35.0%). A strong interest in structured AI training was expressed by 81% of participants. Although responses were obtained from multiple countries, the majority of participants were based in Turkey, and the findings should be interpreted accordingly.Conclusion:Pediatric urologists demonstrate substantial engagement with AI in academic work, while clinical integration is still limited. The findings highlight a strong demand for AI education and emphasize the need for regulatory clarity, ethical frameworks, and validated tools to enable safe and effective use of AI in pediatric urology.

This study investigates patterns of saving behaviour and financial vulnerability among women gig workers in the Malabar region of Kerala, a state characterised by high female literacy alongside substantial engagement in informal employment. Based on primary data collected from 300 women engaged in diverse gig occupations, the analysis employs descriptive statistics, logistic regression, and complementary log–log models to identify key socio-economic determinants of savings participation and financial vulnerability. The complementary log–log model is used to robustly estimate non-linear effects, thereby enhancing the reliability of the empirical inferences. The results indicate that income stability, financial goals, access to formal financial products, financial literacy, control over finances, and household responsibilities, particularly during financial emergencies, significantly shape the earnings and saving behaviour of women gig workers. In contrast, income volatility, job insecurity, and limited access to credit significantly exacerbate financial vulnerability. The empirical evidence suggests that inclusive finance, tailored financial literacy efforts, and effective social protection play a pivotal role in reducing income instability and enhancing livelihood security among women gig workers.

This article introduces the MoPEI (Mechanisms of Precarious Economic Incorporation) framework, a conceptual-analytical tool for explaining how refugees are steered into precarious labor through the relational and layered intersections of multiple mechanisms. Considering the labor market realities of Central and Eastern Europe, MoPEI identifies six such mechanisms – structural constraints, temporal and legal ambiguity, migration infrastructures, semi-compliance, normative pressures, and bounded agency – and models their interplays using network analysis. We apply this framework to a case study of forcibly displaced Ukrainians in Czechia, where our evidence points to their substantial engagement in informal, semi-formal, and precarious economic activities alongside rapid labor market entry. Drawing on two waves of survey data (2022, 2023) and focus group discussions, our findings demonstrate how the MoPEI mechanisms interact to facilitate and institutionalize precarious incorporation, shaped by entrenched brokerage practices, weak protection, limited agency, and structural disadvantages. In doing so, MoPEI addresses the limits of fragmented and thematically specific explanations by offering a relational account of how precarious incorporation is co-produced.

ObjectiveTo evaluate the educational quality, reliability, and transparency of YouTube™ videos on lipoedema, and to examine associations with uploader type and engagement metrics.MethodsOn 15 May 2025 we searched YouTube™ for "lipoedema," screened the first 200 relevance-ranked items, and included videos ≥60 s with intelligible audio. Advertisements, duplicates and soundless videos were excluded. Two independent physicians in Physical Medicine and Rehabilitation (PM&R) rated eligible videos using DISCERN, the Global Quality Score (GQS), and the Journal of the American Medical Association (JAMA) benchmark criteria; disagreements were discussed and original ratings retained for agreement analyses. We recorded upload date, duration, views, likes, comments, channel subscribers, uploader category, and content domain.ResultsWe analyzed 92 YouTube™ lipoedema videos uploaded between 25 February 2015 and 8 January 2025. Uploader mix: vascular surgeons 39.1% (largest) and PM&R physicians 4.3% (smallest); the most common topic was definition + symptoms + management (26.1%). Mean DISCERN totals were 33.47 ± 9.88 and 33.42 ± 8.68 (both poor); mean GQS 2.18 ± 0.82 and 2.43 ± 0.81; only 6.6% were high quality and none scored 5/5. Views correlated strongly with likes and comments (both p < .001), moderately with duration (p < .01), and weakly with subscribers (p < .05). Inter-rater agreement was strong (r = 0.859/0.663/1.000; all p < .001).ConclusionThe overall quality and transparency of YouTube™ lipoedema videos are suboptimal despite substantial engagement. Increasing expert-authored, evidence-based content-particularly from PM&R- and co-produced patient-clinician videos may better align reliability with reach.

Despite high coverage of China's Family Doctor Contract Services (FDCS), substantive utilization among hypertensive populations remains suboptimal. By decomposing service packages into granular clinical components, this study addresses the limitations of prior research focused on generic primary care attributes. We aim to quantify patient preferences and identify heterogeneity to align service delivery with specialized management needs, thereby facilitating the transition from nominal enrollment to substantive engagement. A Discrete Choice Experiment (DCE) was conducted to community hypertension patients in Nanjing, China. Five key attributes were identified through literature review, qualitative interviews, and expert consultation. A Mixed Logit Model (MLM) and Latent Class Model (LCM) were employed to estimate attribute importance, willingness to pay (WTP), and preference heterogeneity. Analysis of 638 responses, with 596 participants passing the internal consistency check. The Mixed Logit Model demonstrated that all five attributes exerted a statistically significant influence on patient choices. In terms of relative importance, medication type was the primary driver, followed by the scope of services, payment method, appointment scheduling, and the annual contract fee. WTP estimates indicated positive valuations for original-brand medications, integrated clinical service bundles, and multi-source payment structures. Furthermore, the Latent Class Model identified two distinct subgroups reflecting preference heterogeneity within the sample. Therapeutic certainty significantly outweighs economic considerations for community hypertension patients, with the pronounced preference for original-brand medications serving as a critical proxy for clinical safety. Policy should encompass state-led support for original-drug development while simultaneously enhancing institutional trust in generic alternatives through transparent quality evidence. Transitioning toward stratified, patient-centered management is essential to address preference heterogeneity and improve the substantive effectiveness of the family doctor system in China.

• All readers read for identification with the characters in the books they are reading • Marginalised readers seek out representation in their reading • Marginalised readers also read across dominant spaces of normativity • Readers from dominant identity groups read less widely in terms of representation • A small subset of readers respond negatively to connections between identity and reading This article examines the mutually constitutive relationship between identity, social participation, and reading, through a survey of 3089 readers in the United States, United Kingdom and Australia conducted in 2022. This is driven by an intersectional call to take seriously individualised experiences of identity including diverse and overlapping identities, consider multiple marginalisations, and interrogate normative modes of thinking. This connects to a commitment shared with other scholars of reading practice to undertake research that is simultaneously descriptive and critical. This forms the basis for our survey design, comprehending substantial engagement with readers’ reporting of their own reading practices. We work through multifaceted understandings of identity in our survey, and use this as the basis for examining specific patterns of identity formation through reading practice, and considering how individual experiences connect to larger systemic power dynamics. We find that all readers read for identification with the characters in the books that they read. However, readers who belong to multiply marginalised groups must go against the grain of dominant structures of representation to seek out opportunities for identification in their reading, and still also tend to read across dominant spaces of normativity, whereas readers who belong to dominant identity groups do not similarly read against the grain. Income and education complicate this by potentially dictating access to diverse books. Select readers were confronted by the survey’s interest in identity and reading; while a survey is inherently normative, interesting trends of counter-cultural pushback emerged in free-text spaces as readers navigated the limitations of the tool.

Early identification of cerebral palsy (CP) enables timely intervention during critical periods of neuroplasticity, yet diagnosis remains delayed in many health systems. In British Columbia (BC), fragmented referral pathways and restrictive neonatal follow-up criteria have limited access to standardized early motor assessment, particularly for infants outside major urban centers. To address these gaps, a province-wide virtual screening pathway was developed to improve equitable access to early CP detection. The Early Motor Screening Program (EMSP) was implemented in 2022 as a virtual, risk-stratified screening pathway for infants at elevated neurological risk. The program integrates caregiver-recorded General Movements Assessment (GMA) videos, telehealth-based clinical review, and coordinated referral to an interdisciplinary Cerebral Palsy Early Detection Clinic (CPEDC). Eligibility criteria were defined using epidemiological risk stratification, prioritizing infants with medical conditions associated with substantially increased CP risk. This community-based implementation case study used a descriptive observational design drawing on routinely collected program and clinical data. Outcomes included program uptake, screening completion, GMA findings, referral patterns, caregiver experience, and system-level indicators. Analyses were descriptive and interpreted as implementation and pathway outcomes rather than diagnostic performance. Between June 2022 and September 2025, 883 infants were referred to the EMSP, with 622 (70%) completing GMA assessments. Abnormal GMA findings were identified in 114 infants (18%), who were referred to CPEDC for further evaluation. Among these infants, 25 (22%) received a CP diagnosis, while others required monitoring or were discharged. Referral volumes increased steadily across the study period, with participation from all health authorities and substantial engagement from rural and remote regions. Caregiver feedback indicated high acceptability and feasibility of the virtual screening model. Provincial data demonstrated a temporal, system-level reduction in the average age of CP diagnosis among high-risk infants engaged in early detection pathways, from approximately 25 months to 7 months. This case study demonstrates the feasibility of implementing a province-wide virtual early motor screening pathway within a publicly funded health system. Coordinated, risk-based, and telehealth-enabled models may expand access to early CP identification and support more timely clinical pathways, with potential applicability to other jurisdictions seeking equitable early neurodevelopmental screening.

The relationship of Friedrich Hölderlin with ancient Greece assumes multifaceted forms across his creative oeuvre, and the figure of Achilles stands as a pivotal embodiment thereof. While the elegy Achill constitutes Hölderlin' s most substantial engagement with the hero, it is crucial to note that Achilles appears persistently—from the early poetry and the novel Hyperion (including its drafts) to the later poetic works. The Achilles figure thus provides a critical vantage point for examining Hölderlin' s engagement with antiquity. It affords insights into his construction of personal destiny and tragic experience, his quest for the ancient Greek ideal of personhood, and, ultimately, the representation of the failure inherent in such idealistic pursuits. Through this lens, one gains a nuanced and holistic reconsideration of Hölderlin' s complex stance toward ancient Greece.

The Local Development Council (LDC) plays a critical role in local governance through its integrative and participatory planning and budget policymaking functions mandated by the 1991 Local Government Code. The LDC’s participatory governance goal, stemming from the Code’s requirement for civil society organization (CSO) membership, has been gradually problematized over the years to extend beyond the operational functionality of formalized activities and mechanisms toward participation that empowers citizen influence in policymaking in local government units (LGUs). Drawing from a national baseline survey of LDCs, this study examines CSO participation through the lens of compliance with mandated mechanisms and practices that structure LDC functions and activities, as perceived by LDC members (CSOs and LGU functionaries). Findings indicate that formalized mechanisms are necessary but insufficient for advancing participatory governance principles in LDCs. LGUs demonstrate relatively high compliance in involving CSOs in LDC committees and budget processes, yet perception gaps reveal that LGUs systematically overestimate CSO engagement, particularly in provinces and municipalities. Results also suggest that LGUs tend to equate the sufficiency of participation with compliance to minimum operational requirements set by national policies, while both LGUs and CSOs underscore persistent gaps in CSOs’ technical capacity to meet the varying demands of policymaking across LGU types and budget phases. Furthermore, analysis of participation frequency reveals that more recurrent activities do not necessarily translate into more substantive engagement. Instead, biannual to quarterly activities approximate an optimal frequency for meaningful participation, especially in high-functioning LDCs with stronger agenda-setting and deliberation practices. The study provides recommendations for nuancing national policies with LGU characteristics and local policymaking phases and for creating relational and deliberative spaces that enable LDC stakeholders to steer the quality of their participation with the support and oversight of the national government and CSO networks.