To save content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about saving content to .
To save content items to your Kindle, first ensure no-reply@cambridge.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
To address the treatment gap for common mental disorders in low- and middle-income countries facing humanitarian challenges, it is crucial to build the capacity of primary healthcare workers (PHCWs) and integrate mental healthcare into primary care settings.
Aims
To investigate the effectiveness of a Mental Health Gap Action Programme Humanitarian Intervention Guide (mhGAP-HIG) adapted for use in Pakistan to build the capacity of PHCWs in Khyber Pakhtunkhwa.
Method
Six mhGAP-HIG training workshops were conducted, each lasting for 5 days, across six districts of Khyber Pakhtunkhwa. A total of 105 PHCWs (74 primary care physicians and 31 clinical psychologists) were trained through these workshops. We used multiple triangulations for data collection and analyses. Paired-sample t-tests were applied to compare scores on knowledge questionnaires pre- and post-training and after 8 months. We also conducted thematic analysis to examine participants’ feedback regarding the training, and performed content analysis on the participants’ reflections on the adapted guide.
Results
Our findings demonstrated significant improvements in PHCWs’ knowledge related to the mental health conditions in the mhGAP-HIG. Their scores improved by 12.08%, increasing from 73.86% pre-training to 85.94% post-training. Noticeable improvements in knowledge were recorded for the modules ‘Harmful use of alcohol and drugs’ (22.56%), ‘General principles of care’ and ‘Other significant mental health complaints’ (15.15%), ‘Acute stress’ (13.80%) and ‘Suicide’ and ‘Epilepsy’ (13.13%). The thematic analysis of the feedback of the PHCWs and trainers recommended the use of the guide to strengthen pre-service training and broaden the scope of the initiative to train PHCWs across the province.
Conclusions
This study underscores the feasibility of implementing an adapted mhGAP-HIG for training primary care physicians and clinical psychologists within the existing healthcare resources of Khyber Pakhtunkhwa. The preliminary findings endorse the scalability across other districts in the province.
On 25 February 2024, the final text of the Investment Facilitation for Development (IFD) Agreement was released, marking a pivotal moment in the reform of International Investment Law (IIL). This article examines the trajectory of IIL through the lens of three distinct phases – investment protection, liberalization, and, now, investment facilitation – arguing that this latest phase represents a ‘third configuration’ of the field. While past reforms have struggled with legitimacy crises and governance limitations, investment facilitation introduces a ‘risk-capacity’ approach that prioritizes trust-building, regulatory coherence, and sustainable investment governance. By analyzing the well-designed mechanisms of the IFD Agreement, this article demonstrates how investment facilitation transforms IIL from a power-driven framework into a capacity-enhancing system, reducing its marginalization and fostering inclusivity among World Trade Organization (WTO) members. Finally, this study outlines potential next steps for the IFD Agreement, emphasizing its role as a blueprint for future multilateral investment governance.
This paper describes the development and initial implementation of the Compendium of D&I Catalogs, a tool created by a Clinical and Translational Science Awards (CTSA) consortium working group to streamline navigation of the proliferating online resources, catalogs and interactive tools designed to guide application of dissemination and implementation (D&I) science. The Compendium is a curated, dynamically-updated list of 35 D&I resource catalogs organized into eight categories: comprehensive resources; frameworks, theories, and models; methods and measures; funding; practitioner resources; training; CTSA infrastructure; health equity. Eight CTSA hubs volunteered to serve as “early adopters” for the tool and completed an evaluation of its initial implementation. Among these “early adopters,” half had implemented the Compendium within their websites, describing the web implementation process as “easy.” Remaining “early adopter” respondents cited institutional web development capacity concerns and competing priorities as reasons for delayed implementation. All respondents valued the Compendium’s dynamic updates. Among implementing sites, roughly two-thirds directly embedded the Compendium into their institutional websites, with the others providing a link to the Compendium. For CTSAs striving to meet the rising demand for D&I expertise and resources, the Compendium of D&I Catalogs represents a simple, low-cost tool to enhance accessibility of D&I capacity-building resources.
This article describes the Implementation Science (IS) Scholars Program at the University of Arkansas for Medical Sciences (UAMS). The program’s goal is to translate knowledge, approaches, and methods from IS to front-line clinicians in an academic medical center, thereby supporting its goals as a learning health system and promoting a dynamic workforce of IS-informed change leaders. Initiated in 2020, the program is relatively unique in that it attempts to translate concepts and knowledge from IS to clinicians to improve their skills as implementers and change agents. The program is supported by the Translational Research Institute, the UAMS’ awardee of the Clinical and Translational Science Award Program. The two-year program provides 20% salary coverage, bespoke didactics, and close mentoring on a Scholar-initiated project to improve care in their clinical context. The program has trained four cohorts of Scholars over the program’s initial five years. We describe the program, our evaluation of it thus far, and future plans. The program has contributed to numerous healthcare improvements and served as a gateway to future implementation and other research activities among some Scholars.
In the coming decades, Antarctica will face a range of challenges linked to transnational issues such as climate change, plastics pollution and geopolitical tension. Such challenges make it increasingly important for the Antarctic sector to ensure that there is broad public support for the ongoing political and environmental stewardship of the southern polar region. Initiatives such as the 2032–2033 International Polar Year offer a unique opportunity to enhance public knowledge of and investment in Antarctic research, but little is currently known about how well-suited the Antarctic sector is to the work of public engagement. In this paper, we present the results of an exploratory survey (n = 76) conducted in 2022–2023 to examine the Antarctic sector’s capacity to engage with the public. We find that, while public engagement work is certainly happening in the Antarctic sector, it is often ad hoc and under-resourced, and the skillset associated with engagement work is commonly undervalued. In order to capitalize on the opportunities presented by the next International Polar Year, we recommend that the organizations within the Antarctic sector collaborate on a joint public engagement strategy.
As Ethiopia advances towards efficient resource utilization and UHC through strategic health purchasing, the institutionalization of HTA will play a critical role. This study aims to identify key stakeholders, analyze the political economy surrounding HTA and priority setting in Ethiopia, and assess existing skills and capacities for a robust and sustainable HTA system.
Methods
We employed a mixed-method approach, combining 16 key informant interviews, 24 document reviews, and a cross-sectional survey (n=65) to assess national HTA capacity. We employed the Walt and Gilson policy analysis triangle framework, alongside Campos and Reich’s framework, to evaluate the context, process, content, and actors influencing HTA institutionalization, and to explore the complex interplay of institutions, positions, power, and interests among various stakeholders.
Results
While there is a general commitment to implementing HTA across various government agencies and stakeholder groups, the institutionalization process faces several challenges, involving multiple agencies with overlapping mandates, raises bureaucratic challenges and potential conflicts, risking horizontal fragmentation as agencies compete for authority, budget, and influence. The involvement of other key stakeholders, such as professional associations, patients, and the public, is notably lacking. Challenges such as limited HTA expertise, high professional turnover, and gaps in specific HTA knowledge areas persist, with capacity-building efforts often failing to address organizational needs effectively.
Conclusions
The complexity of HTA institutionalization in Ethiopia underscores the necessity of managing intricate inter-agency dynamics, establishing a robust legal framework for an inclusive and transparent HTA process, building local capacity, and securing sustainable, domestically aligned funding.
Petersen didn’t set out to be a researcher, much less a developmental scientist, but found that she loved it! Her journey was unusual but productive, adding to knowledge of adolescence, and especially correlates of puberty. She also contributed to gender issues in research as well as attention to rigorous statistical and psychometric methods. Her tendency to be attracted to interesting opportunities led her to additional roles, particularly leadership. This had the unfortunate effect of truncating her research career, though not her writing. Her experiences in research and especially with leadership roles were influenced by issues of sexism and other kids of exclusion, leading to her current emphases on global engagement and capacity building. The net result has been a satisfying life.
The reprocessing of personal protective equipment that is only intended for single use has been brought into focus by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, especially regarding respiratory masks.1–4
Despite the central role that patient and community engagement plays in translational science and health equity research, there remain significant institutional barriers for researchers and their community partners to engage in this work meaningfully and sustainably. The goal of this paper is to describe the process and outcomes of Engage for Equity PLUS at Stanford School of Medicine, which was aimed at understanding and addressing institutional barriers and facilitators for community-engaged research (CEnR).
Methods:
A Stanford champion team of four faculty and two community partners worked with the University of New Mexico team to conduct two workshops (n = 26), focus groups (n = 2), interviews with leaders (n = 4), and an Institutional Multi-Stakeholder Survey (n = 35). These data were employed for action planning to identify strategies to build institutional support for CEnR.
Results:
Findings revealed several key institutional barriers to CEnR, such as the need to modify organizational policies and practices to expedite and simplify CEnR administration, silos in collaboration, and the need for capacity building. Facilitators included several offices devoted to and engaging in innovative CEnR efforts. Based on these findings, action planning resulted in three priorities: 1) Addressing IRB barriers, 2) Addressing barriers in post-award policies and procedures, and 3) Increasing training in CEnR within Stanford and for community partners.
Conclusions:
Addressing institutional barriers is critical for Academic Medical Centers and their partners to meaningfully and sustainably engage in CEnR. The Engage for Equity PLUS process offers a roadmap for Academic Medical Centers with translational science and health equity goals.
Research is needed to improve the performance of primary health care. In Africa, few family physicians conduct research, and therefore an online research training and mentorship programme was developed to build research capacity amongst novice and early career researchers.
Aim:
To evaluate the implementation of the AfriWon Research Collaborative (ARC) training and e-mentorship programme in sub-Saharan Africa.
Methods:
A 10-module online curriculum was supported by peer and faculty e-mentorship, to mentor participants in writing a research protocol. A convergent mixed methods study combined quantitative and qualitative data to evaluate nine implementation outcomes.
Findings:
Fifty-three participants (20 mentees, 19 peer mentors, and 14 faculty mentors), mostly male (70%), participated in the ARC online programme. The programme was seen as an acceptable and appropriate initiative. Mentees were mostly postgraduate students from African countries. Faculty mentors were mostly experienced researchers from outside of Africa. There were issues with team selection, orientation, communication, and role clarification. Only 35% of the mentees completed the programme. Alignment of mentoring in teams and engagement with the online learning materials was an issue. Costs were relatively modest and dependent on donor funds.
Conclusion:
Despite many challenges, the majority of participants supported the sustainability of the programme. The evaluation highlights the strengths and weaknesses of the ARC programme and e-mentoring. The ARC working group needed to ensure better organization and leadership of the teams. Going forward the programme should focus more on developing peer mentors and local supervisory capacity as well as the mentees.
The public health nutrition workforce is well placed to contribute to bold climate action; however, tertiary educators are seeking practical examples of how to adequately prepare our future workforce. This study examines the responses of university students engaged in a co-designed planetary health education workshop as part of their public health nutrition training.
Design:
A mixed-methods approach was used to collect and interpret student responses to four interactive tasks facilitated during an in-person workshop. Data were analysed using statistical tests, frequency counting and content analysis.
Setting:
The intervention was co-designed by students (n 5) and an educator over a 4-week period as part of a larger multi-disciplinary study at an Australian university.
Participants:
The workshop engaged nutrition and dietetics students (n 44) enrolled in public health nutrition coursework.
Results:
Students reported an increase in self-perceived knowledge about planetary health as a concept and how they can promote it within their future professional roles. Students’ descriptions of what planetary health means to them were focused on humans’ role in protecting and preserving the ecosystem, the responsible and sustainable use of natural resources and a need to sustain a healthy life for future generations. Students prioritised the values of ‘collaboration’ and ‘respect’ as being critical to guide personal and professional practice to promote planetary health.
Conclusions:
This study demonstrated that incorporating planetary health curricula designed by, and for, university students could be a feasible and effective way to prepare the future public health nutrition workforce to address planetary health challenges.
Disaster preparedness plays a vital role in mitigating risks and strengthening resilience of local communities in rural areas. This study examines the linkage between psychological factors and 4 kinds of disaster preparedness intentions and explores the challenges in translating intentions into actions.
Methods
This study utilized survey data from 325 households in Chongqing, China, that are threatened by geological disasters. We conducted empirical analysis using a regression model and carried out several robustness tests. The independent variables, psychological factors, are divided into risk appraisal, coping appraisal, and stakeholder appraisal. The dependent variable, disaster preparedness intentions, includes evacuation, disaster insurance, emergency supplies storage, and behaving eco-friendly.
Results
Multiple psychological factors have significant influence on disaster preparedness intentions, with varying impacts on different preparedness aspects. Social barriers—lack of capital, access, and triggers—hinder translating preparedness intentions into actions.
Conclusions
Our study integrates protection motivation theory and protective action decision model to understand psychological factors influencing disaster preparedness in rural China. We identify key factors significantly impact preparedness intentions and uncover barriers hindering the translation of intentions into actions. The findings underscore the importance of integrated approaches that bridge the gap between psychological awareness and the availability of resources, ultimately fostering a more resilient society in the face of disasters.
Big cats are of conservation concern throughout their range, and genetic tools are often employed to study them for various purposes. However, there are several difficulties in using genetic tools for big cat conservation that could be resolved by modern methods of DNA sequencing. Recent reports of the sighting of a putative Javan tiger Panthera tigris sondaica in West Java, Indonesia, highlight some of the difficulties of studying the genetics of big cats. We reanalysed the data of the original reports and found that the conclusions were drawn based on incorrect copies of the genes. Specifically, the nuclear copy of the mitochondrial gene was analysed with the mitochondrial sequence, leading to discordance in the results. However, re-sequencing of the remaining DNA confirms that the sighting could have been that of a tiger, but the subspecies cannot be confirmed. This work highlights the urgency of developing high-throughput sequencing infrastructure in the tropics and the need for reliable databases for the study of big cats.
Threat perception in international relations has received much academic attention and continues to do so. Other contributions to this special section on how leaders feel security dangers or perceive threats with radical uncertainty are closely intertwined with this article’s focus on threats that are vague and not immediately perceptible. Humans possess a capacity for thinking about and imagining the future known as prospection. Faced with threatening futures, can governments prepare their civil servants to systematically manage uncertainties and anticipate dangers? Drawing on empirical data from interviews with foresight practitioners in the United Kingdom and Singapore, this article examines how governments are nudging civil servants to deploy futures techniques as part of threat perception.
Countries frequently use health technology assessment (HTA) to set priorities for introducing new interventions or evaluating existing interventions; however, applying the tool effectively is heavily dependent on a country’s resources and capacity. Infrastructure and data, technical expertise, broad stakeholder involvement, and financial support are required to improve HTA processes. In the Asia-Pacific, HTAsiaLink was established to facilitate this practice, but strengthening and legitimizing this organization are needed to maximize its potential to support HTA institutionalization in the region. To realize this objective, HTAsiaLink can serve as a center of excellence while providing experiential learning and sharing information. As a learning hub, HTAsiaLink can share resources—particularly data—that can contribute to joint HTAs as done in the European Union and strengthen capacity in countries needing to develop their HTA expertise.
The Centers for Disease Control and Prevention (CDC)-funded Cancer Prevention and Control Research Network (CPCRN) has been a leader in cancer-related dissemination & implementation (D&I) science. Given increased demand for D&I research, the CPCRN Scholars Program launched in 2021 to expand the number of practitioners, researchers, and trainees proficient in cancer D&I science methods.
Methods:
The evaluation was informed by a logic model and data collected through electronic surveys. Through an application process (baseline survey), we assessed scholars’ competencies in D&I science domains/subdomains, collected demographic data, and asked scholars to share proposed project ideas. We distributed an exit survey one month after program completion to assess scholars’ experience and engagement with the program and changes in D&I competencies. A follow-up survey was administered to alumni nine months post-program to measure their continued network engagement, accomplishments, and skills.
Results:
Three cohorts completed the program, consisting of 20, 17, and 25 scholars in Years 1-3, respectively. There was a significant increase in the total D&I competency scores for all three cohorts for 4 overarching domains and 43 subdomains (MPre = 1.38 MPost = 1.89). Differences were greatest for the domain of Practice-Based Considerations (0.50 mean difference) and Theory & Analysis (0.47 mean difference). Alumni surveys revealed that scholars appreciated access to D&I-focused webinars, toolkits, and training resources. 80% remain engaged with CPCRN workgroups and investigators.
Conclusions:
Program evaluation with scholars and alumni helped with ongoing quality assurance, introspection, and iterative program adaptation to meet scholars’ needs. This approach is recommended for large-scale capacity-building training programs.
This paper explores the development of the Dissemination and Implementation Science Collaborative (DISC) at the Medical University of South Carolina, established through the Clinical and Translational Science Award program. DISC aims to accelerate clinical and translational science by providing training, mentorship, and collaboration opportunities in dissemination and implementation (D&I) science. Through DISC, investigators, trainees, and community partners are equipped with the knowledge and skills to conduct D&I research and translate findings into practice, particularly in South Carolina’s public health and healthcare landscape. We describe efforts to achieve the major overarching aims of DISC, which include conducting scientific workforce training, providing mentorship and consultation, and advancing methods and processes for D&I research. By sharing DISC experiences, successes, and challenges, this paper aims to support the growth of D&I research and capacity-building programs, fostering collaboration and shared resources in the field.
Carbon neutrality cannot be achieved without different economic sectors, individuals and households, and the government making serious efforts. Green finance in different forms including environmental, social and governance investment and carbon emissions trading are used to measure the reduction in carbon emissions and place a monetary value on them. However, because of inconsistencies or even manipulation in the monitoring/measurement, reporting and verification (MRV) of air quality and carbon emissions data, the effectiveness of green finance has been largely compromised. Environmental MRV is a technology-based engineering task, which is also heavily impacted by institutional design and professionalism. This commentary will draw upon principal–agent theory and the practical arrangements of environmental MRV to discuss why professionalism is badly needed and how to bridge the missing link for achieving carbon neutrality and sustainability transitions.
Engaging diverse partners in each phase of the research process is the gold standard of community-engaged research and adds value to the impact of implementation science. However, partner engagement in dissemination, particularly meaningful involvement in developing peer-reviewed manuscripts, is lacking. The Implementation Science Centers in Cancer Control are using the Translational Science Benefits Model to demonstrate the impact of our work beyond traditional metrics, including building capacity and promoting community engagement. This paper presents a case example of one center that has developed a policy for including community partners as coauthors. Standard practices are used to foster clear communications and bidirectional collaboration. Of published papers focused on center infrastructure and implementation research pilots, 92% have community partner coauthors. This includes 21 individuals in roles ranging from physician assistant to medical director to quality manager. Through this intentional experience of co-creation, community partners have strengthened implementation science expertise. Community coauthors have also ensured that data interpretation and dissemination reflect real-world practice environments and offer sustainable strategies for rapid translation to practice improvements. Funders, academic journals, and researchers all have important roles to play in supporting community coauthors as critical thought partners who can help to narrow the gap between research and practice.
The effect of filtering face piece grade 2 (FFP2) masks for infection prevention is essential in health care systems; however, it depends on supply chains. Efficient methods to reprocess FFP2 masks may be needed in disasters. Therefore, different UV-C irradiation schemes for bacterial decontamination of used FFP2 masks were investigated.
Seventy-eight masks were irradiated with UV light for durations between 3 and 120 seconds and subsequently analyzed for the presence of viable bacteria on the inside. Ten masks served as the control group. Irradiation on the inside of the masks reduced bacteria in proportion to the dose, with an almost complete decontamination after 30 seconds. Outside irradiation reduced the quantity of colonies without time-dependent effects. Both sides of irradiation for a cumulated 30 seconds or more showed almost complete decontamination.
Overall, this study suggests that standardized UV irradiation schemes with treatment to both sides might be an efficient and effective method for FFP2 mask decontamination in times of insufficient supplies.