Frontiers in Public Health最新文献

{"title":"Trends and predictions of maternal sepsis and other maternal infections among women of childbearing age: a systematic analysis for the global burden of disease study 2019.","authors":"Hang Qian, Weifeng Shang, Sheng Zhang, Xiaojun Pan, Sisi Huang, Hui Li, Zhenliang Wen, Jiao Liu, Dechang Chen","doi":"10.3389/fpubh.2024.1428271","DOIUrl":"10.3389/fpubh.2024.1428271","url":null,"abstract":"<p><strong>Background: </strong>Maternal sepsis and other maternal infections (MSMIs) are major public health concerns worldwide. However, comprehensive data on their global burden and evolving trends remain sparse. This study aims to explore the epidemiological trends of MSMIs in women of childbearing age (WCBA) from 1990 to 2019, investigate the relationship between disease burden and age, period, and birth cohorts, and then provide a prediction of MSMIs incidence and deaths.</p><p><strong>Methods: </strong>The estimates and 95% uncertainty intervals (UIs) for the incidence and death number of MSMIs in seven age groups (15-19, 20-24, 25-29, 30-34, 35-39, 40-44, 45-49 years) were obtained from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. The age-standardized incidence and mortality rates of MSMIs in WCBA were estimated utilizing the age standardization by direct method. Joinpoint regression analysis was employed to investigate the changing trends of age-standardized incidence and mortality rates from 1990 to 2019. Age-period-cohort analysis was utilized to estimate the independent effects of age, period, and birth cohorts. Furthermore, a Nordpred age-period-cohort analysis was implemented to predict the global epidemiological trends through 2044.</p><p><strong>Results: </strong>In 2019, the estimated global age-standardized incidence and mortality rates of MSMIs in WCBA were 1072.90 (95% UI: 725.93 to 1483.46) and 0.86 (95% UI: 0.69 to 1.05), respectively. The highest disease burden existed in the African Region. From 1990 to 2019, the estimated global age-standardized incidence and mortality rates of MSMIs (AAPC: -1.32, 95% CI: -1.34 to -1.30; AAPC: -3.39, 95% CI: -4.28 to -2.48) in WCBA both demonstrated significant declining trends. The changing trends varied significantly across 6 regions and 204 countries. The effects of age, period, and cohort on incidence and mortality rates differed. From 2020 to 2044, the global age-standardized incidence rate of MSMIs in WCBA was predicted to decrease whereas the case number increases slowly.</p><p><strong>Conclusion: </strong>The global trends in MSMIs incidence and mortality generally showed a decline with considerable heterogeneity, indicating both the effectiveness and unevenness of global management of MSMIs. Moreover, the predicted increased case number highlights prominent challenges in the control of MSMIs.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11538001/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142590125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reduce, reinforce, and replenish: safeguarding the early-life microbiota to reduce intergenerational health disparities.","authors":"Darlene L Y Dai, Charisse Petersen, Stuart E Turvey","doi":"10.3389/fpubh.2024.1455503","DOIUrl":"10.3389/fpubh.2024.1455503","url":null,"abstract":"<p><p>Socioeconomic (SE) disparity and health inequity are closely intertwined and associated with cross-generational increases in the rates of multiple chronic non-communicable diseases (NCDs) in North America and beyond. Coinciding with this social trend is an observed loss of biodiversity within the community of colonizing microbes that live in and on our bodies. Researchers have rightfully pointed to the microbiota as a key modifiable factor with the potential to ease existing health inequities. Although a number of studies have connected the adult microbiome to socioeconomic determinants and health outcomes, few studies have investigated the role of the infant microbiome in perpetuating these outcomes across generations. It is an essential and important question as the infant microbiota is highly sensitive to external forces, and observed shifts during this critical window often portend long-term outcomes of health and disease. While this is often studied in the context of direct modulators, such as delivery mode, family size, antibiotic exposure, and breastfeeding, many of these factors are tied to underlying socioeconomic and/or cross-generational factors. Exploring cross-generational socioeconomic and health inequities through the lens of the infant microbiome may provide valuable avenues to break these intergenerational cycles. In this review, we will focus on the impact of social inequality in infant microbiome development and discuss the benefits of prioritizing and restoring early-life microbiota maturation for reducing intergenerational health disparities.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11537995/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142590209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Educational attainment, brain cortical structure, and sarcopenia: a Mendelian randomization study.","authors":"Yunqing Zhang, Ruideng Wang, Zhengyang Chen, Fang Zhou, Shilong Su","doi":"10.3389/fpubh.2024.1415343","DOIUrl":"10.3389/fpubh.2024.1415343","url":null,"abstract":"<p><strong>Background: </strong>Previous observational studies have suggested associations between high-level educational attainment (EA) and a lower risk of sarcopenia. However, the causality inferred from those studies was subjected to residual confounding and reverse causation. The protective effect of EA on sarcopenia may be mediated via changes in brain cortical structure. The aim of this study was to use a two-step Mendelian randomization (MR) analysis to illustrate the causal relationship between EA, brain cortical structure, and sarcopenia.</p><p><strong>Methods: </strong>Instrumental variables at the genome-wide significance level were obtained from publicly available datasets, and inverse variance weighted as the primary method was used for MR analysis. We perform several sensitivity analyses, including Cochran Q test, MR-Egger intercept test, leave-one-out analyses, and MR Pleiotropy Residual Sum and Outlier to evaluate the reliability of the results.</p><p><strong>Results: </strong>EA was causally associated with increased appendicular lean mass (<i>β</i> = 0.25, 95% confidence interval (CI): 0.19 to 0.31, <i>p</i> = 2.25 × 10^-15), hand grip strength (left: <i>β</i> = 0.042, 95% CI: 0.013 to 0.071, <i>p</i> = 4.77 × 10^-3 and right: <i>β</i> = 0.050, 95% CI: 0.022 to 0.079, <i>p</i> = 5.17 × 10^-4), and usual walking pace (β = 0.20, 95% CI: 0.18 to 0.22, <i>p</i> = 6.16 × 10^-83). In addition, EA was associated with increased brain cortical surface area (<i>β</i> = 4082.36, 95% CI: 2513.35 to 5681.38, <i>p</i> = 3.40 × 10^-7) and cortical thickness (TH) (<i>β</i> = 0.014, 95% CI: 0.0045 to 0.023, <i>p</i> = 3.45 × 10^-3). Regarding the causal effect of EA on usual walking pace, the mediatory effect of TH was 0.0069 and the proportion of mediation by TH was 3.43%.</p><p><strong>Conclusion: </strong>The study will have revealed the protective causal effect of EA on sarcopenia, which provides a reference for the prevention of sarcopenia at the public health level. We also will have found EA could affect the brain cortical structure, and the brain cortical structure could mediate the protective effect of EA against sarcopenia risk.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11538070/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142589810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The SINFONIA project repository for AI-based algorithms and health data.","authors":"Jorge Fernández-Fabeiro, Álvaro Carballido, Ángel M Fernández-Fernández, Manoel R Moldes, David Villar, Jose C Mouriño","doi":"10.3389/fpubh.2024.1448988","DOIUrl":"10.3389/fpubh.2024.1448988","url":null,"abstract":"<p><p>The SINFONIA project's main objective is to develop novel methodologies and tools that will provide a comprehensive risk appraisal for detrimental effects of radiation exposure on patients, workers, caretakers, and comforters, the public, and the environment during the management of patients suspected or diagnosed with lymphoma, brain tumors, and breast cancers. The project plan defines a series of key objectives to be achieved on the way to the main objective. One of these objectives is to develop and operate a repository to collect, pool, and share data from imaging and non-imaging examinations and radiation therapy sessions, histological results, and demographic information related to individual patients with lymphoma, brain tumors, and breast cancers. This paper presents the final version of that repository, a cloud-based platform for imaging and non-imaging data. It results from the implementation and integration of several software tools and programming frameworks under an evolutive architecture according to the project partners' needs and the constraints of the General Data Protection Regulation. It provides, among other services, data uploading and downloading, data sharing, file decompression, data searching, DICOM previsualization, and an infrastructure for submitting and running Artificial Intelligence models.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11539176/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142590221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigating the implementation of a novel approach to alcohol screening and brief intervention in Mexico: a mixed-methods study using pseudo-patients.","authors":"Deborah A Fisher, Joel W Grube, Liz Lilliott-González, Marissa Elias, Robert Sturm, Christopher L Ringwalt, Ted R Miller, Elena Cardenas Vargas, Tom Achoki, Angela Rizzo","doi":"10.3389/fpubh.2024.1416190","DOIUrl":"10.3389/fpubh.2024.1416190","url":null,"abstract":"<p><strong>Introduction: </strong>Low- and middle-income countries bear disproportionate burdens from excessive alcohol consumption, yet have fewer resources to identify and intervene with risky drinkers. Low-cost screening and brief intervention (SBI) models offer a tool for addressing this health problem and reducing disparities.</p><p><strong>Methods: </strong>In this mixed-methods study, trained pseudo-patients visited health clinics in Zacatecas, Mexico, where a novel SBI model was used with trained nonmedical health educators (HEs) conducting SBI in waiting areas. Pseudo-patients, who provided responses to the AUDIT-C screening items designed to trigger a brief intervention (BI), waited for HEs to engage them in an SBI encounter. Data on HEs' behaviors, SBI components provided, and contextual characteristics were coded from audio recordings of the encounters using an SBI checklist and from pseudo-patient interviews.</p><p><strong>Results: </strong>Quantitative analyses examined the consistency in pseudo-patients' targeted AUDIT-C scores and those documented by HEs as well as the frequency of delivery of SBI components. Across 71 interactions, kappas between HEs' scores and the targeted AUDIT-C scores ranged from 0.33 to 0.45 across AUDIT-C items; it was 0.16 for the total AUDIT-C. In 41% of interactions, the HEs recorded total AUDIT-C scores that accurately reflected the targeted scores, 45% were below, and 14% exceeded them. Analyses of checklist items and transcripts showed that HEs demonstrated desired interpersonal skills (attentive, empathetic, professional) and provided general information regarding risks and recommendations about reducing consumption. In contrast, personalized BI components (exploring pseudo-patients' personal challenges and concerns about reducing drinking; making a plan) occurred much less frequently. Pseudo-patient interviews revealed contextual factors (noise, lack of privacy) that may have negatively affected SBI interactions.</p><p><strong>Discussion: </strong>Using trained nonmedical persons to administer SBI holds promise to increase its reach. However, ongoing training and monitoring, prioritizing comprehensive BIs, eliminating contextual barriers, and electronic delivery of screening may help ensure high quality delivery.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11538022/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142590013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The potential of including the microbiome as biomarker in population-based health studies: methods and benefits.","authors":"Florence E Buytaers, Nicolas Berger, Johan Van der Heyden, Nancy H C Roosens, Sigrid C J De Keersmaecker","doi":"10.3389/fpubh.2024.1467121","DOIUrl":"10.3389/fpubh.2024.1467121","url":null,"abstract":"<p><p>The key role of our microbiome in influencing our health status, and its relationship with our environment and lifestyle or health behaviors, have been shown in the last decades. Therefore, the human microbiome has the potential to act as a biomarker or indicator of health or exposure to health risks in the general population, if information on the microbiome can be collected in population-based health surveys or cohorts. It could then be associated with epidemiological participant data such as demographic, clinical or exposure profiles. However, to our knowledge, microbiome sampling has not yet been included as biological evidence of health or exposure to health risks in large population-based studies representative of the general population. In this mini-review, we first highlight some practical considerations for microbiome sampling and analysis that need to be considered in the context of a population study. We then present some examples of topics where the microbiome could be included as biological evidence in population-based health studies for the benefit of public health, and how this could be developed in the future. In doing so, we aim to highlight the benefits of having microbiome data available at the level of the general population, combined with epidemiological data from health surveys, and hence how microbiological data could be used in the future to assess human health. We also stress the challenges that remain to be overcome to allow the use of this microbiome data in order to improve proactive public health policies.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11538166/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142590219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dengue fever: a decade of burden in Iran.","authors":"Zahra Heydarifard, Fatemeh Heydarifard, Fatemeh Sadat Mousavi, Milad Zandi","doi":"10.3389/fpubh.2024.1484594","DOIUrl":"10.3389/fpubh.2024.1484594","url":null,"abstract":"<p><p>Since the first reported traveler case of Dengue in Tehran in 2008, the virus has gradually spread across Iran, driven by factors including international travel, climate change, and Aedes mosquito vectors. The disease has manifested in various forms, ranging from mild fever to severe dengue, with notable cases identified in Sistan and Baluchistan Province. Despite the increasing prevalence, Iran faces significant challenges in surveillance, diagnosis, and vector control. This perspective comprehensively analyzes dengue virus epidemiology in Iran, emphasizing the need for enhanced public health strategies, including genomic surveillance, targeted interventions, and health education. The findings highlight the critical importance of addressing these challenges to mitigate the potential for large-scale dengue epidemics and protect public health.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11537875/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142592505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case study: lessons learned from a community-based early frailty intervention programme in Singapore.","authors":"Kamala Priya Jayaprakash, Rachel Ngo, Elianna Lee, Pey Ling Chng, Hengky Lee, Salan Chua, Deborah Lee, Carina Wong, Viknessh S","doi":"10.3389/fpubh.2024.1445347","DOIUrl":"10.3389/fpubh.2024.1445347","url":null,"abstract":"<p><p>Frailty is a dynamic and evolving state of health which involves the gradual loss of physiological in-built reserves. In Singapore, there is growing interest in delivering frailty intervention programmes at scale in the community to meet the demands of an ageing population. New methods of programme delivery such as community-led models that do not rely on healthcare professional manpower are critical to address this unmet need. In this paper, we describe our experience and some lessons learned from the implementation of a community-based early frailty intervention programme for older adults, delivered for the first time by trained laypersons. From August to September 2022, \"Steady Lah,\" a community-based early frailty intervention programme with physical activity and nutrition-based elements, was conducted at an Active Ageing Centre in Singapore. A total of 23 participants with mean age of 73.8 years were enrolled in the 12-session programme comprising of progressive strength and balance-based exercises and workshop-based learning focusing on nutrition. In the implementation of this run of \"Steady Lah,\" modifications were made from a healthcare professional-led model to a trained layperson-led model with additional steps taken to ensure participant safety and assess overall effectiveness when delivered by trained laypersons. Good collaboration between stakeholders in healthcare institutions and the community is necessary to co-develop a model that prioritises the needs of the frail older adults.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11537922/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142589707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The price of pressure: nationwide survey on lifestyle disturbances, occupational burnout and compromised perceived-competency among radiology residents in China.","authors":"Zeqi Liu, Qinqi Yao, Peicheng Wang, Lijun Shen, Hange Li, Jingfeng Zhang, Maoqing Jiang, Zhenghan Yang, Zhenchang Wang, Jianjun Zheng, Jiming Zhu, You Wu","doi":"10.3389/fpubh.2024.1472397","DOIUrl":"10.3389/fpubh.2024.1472397","url":null,"abstract":"<p><strong>Objectives: </strong>The competency of radiology directly affects the quality and equity of medical services. Due to their different occupational characteristics compared to other specialists, this study aims to evaluate the impacts of lifestyles on competency and burnout in radiology residents in China.</p><p><strong>Materials and methods: </strong>A nationwide, cross-sectional survey was conducted from December 1, 2020 to April 30, 2021. A total of 12,208 radiology residents during their standardized residency training in China were invited. Multivariate linear regression and logistic regression were conducted to identify perceived competency and burnout associated with lifestyles.</p><p><strong>Results: </strong>Of the 3,666 participants, 58.02% were female, 82.24% were aged <30 years, 40.53% were from the Eastern region, and 92.06% obtained a bachelor's degree. The radiology residents with high-level lifestyles had higher competency (<i>β =</i> 0.16, 95% CI = [0.01, 0.32]), particularly in the realms of sleep, physical activity, and alcohol consumption. The correlation was stronger in residents with longer work hours and more night shifts. Residents with insomnia (OR = 7.69, 95% CI = [4.23, 14.67]) and less exercise (OR = 6.24, 95% CI = [1.33, 29.37]) had higher burnout risk, while residents who smoked had a lower risk (OR = 0.60, 95% CI = [0.40, 0.89]). And lifestyle factors had a slightly different impact on emotional exhaustion and depersonalization.</p><p><strong>Conclusion: </strong>Radiology residents' lifestyles can be emphasized, as it may reflect their pressure and wellbeing and influence their concentration, competency, burnout and performance. Policymakers and hospital administrators should incorporate practical and modifiable strategies into work routines to improve the lifestyle quality of residents.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11538024/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142590220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An effective approach to tackling complex health policy challenges. Using a clinical microsystems approach and rethinking codesign.","authors":"M Duggan, J A Dunbar, M A Morgan, K P Mc Namara, M P de Courten, R V Calder","doi":"10.3389/fpubh.2024.1405034","DOIUrl":"10.3389/fpubh.2024.1405034","url":null,"abstract":"<p><p>That people with serious mental illness have poor physical health and face a significant life expectancy gap compared with the general population is well known. Despite considerable policy focus in some countries, the gap in life expectancy remains. Tackling complex and persistent health problems such as this requires a systems-based approach, recognising the complexity of interacting components and their effects on the problem and on each other and applying collaborative analysis, design and implementation by those with knowledge of and expertise in the problem and the context. This paper describes the methods used to develop the Australian Being Equally Well National Policy Roadmap for better physical health care and longer lives for people with severe mental illness. Whilst recognising that high rates of physical health comorbidities are caused by many factors including lifestyle, access to high-quality healthcare and medication side effects, the work was focused on what could be done within Australian primary care to improve the physical health of this cohort. A Clinical Microsystem Approach was applied to synthesise clinical evidence with professional and lived experience, and an innovative policy development process was established, creating trust across all system levels. Participants with different kinds of knowledge and experience worked in discrete groups according to their professional or expert role whilst also being supported to participate in an intensive cross-collaboration. The potential value of this methodology for tackling other complex problems in health policy is discussed.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11537869/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142589454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}