Frontiers in Public Health最新文献

{"title":"Identifying skills required of new epidemiologists: a content analysis of Canadian job postings and master's programs.","authors":"Karli E Chalmers, Kelsey L Spence","doi":"10.3389/fpubh.2024.1418494","DOIUrl":"10.3389/fpubh.2024.1418494","url":null,"abstract":"<p><strong>Introduction: </strong>The rise of emerging public health threats has increased the need for qualified epidemiologists in Canada. Our study aimed to identify the knowledge, skills, and abilities (KSAs) required of epidemiologists entering the workforce and determine whether these align with those taught in graduate epidemiology programs.</p><p><strong>Methods: </strong>An inductive content analysis of Canadian job postings from May to December 2023 containing the keyword \"epidemiology\" and requiring master's degrees in epidemiology or related fields was conducted to identify the KSAs required in the workforce. Inductive content analysis of Master of Science (MSc) program descriptions and core course descriptions was completed to discern skills gained through Canadian graduate epidemiology and public health programs.</p><p><strong>Results: </strong>Based on the 295 job postings analyzed, five KSA categories were identified: communication skills (<i>n</i> = 268, 90.8%), analytical skills (<i>n</i> = 267, 90.5%), soft skills (<i>n</i> = 254, 86.1%), research methodology (<i>n</i> = 217, 73.6%), and knowledge of epidemiological concepts (<i>n</i> = 170, 57.6%). Analysis of 18 MSc programs found that that all of them described analytical skills, research methodology, and epidemiological concepts within their curriculum. Communication skills were described in 94.4% (<i>n</i> = 17) of programs, while soft skills were mentioned in 50.0% (<i>n</i> = 9). However, only 66.7% (<i>n</i> = 12) of programs outlined learning objectives or specified the skills acquired from their programs in their descriptions.</p><p><strong>Conclusion: </strong>There was alignment between the needs of the Canadian epidemiology job market and MSc programs, particularly in analytical skills and research methodology. However, development of soft skills should be emphasized within graduate epidemiology programs to better prepare graduates for the job market. Future research should aim to develop competency statements for epidemiologists in training to ensure consistency across graduate programs and promote career readiness.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11446749/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142371474","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 effect of air pollutants on COPD-hospitalized patients in Lanzhou, China (2015-2019).","authors":"Limei Jin, Shuya Fang, Yaxing Nan, Jihong Hu, Hua Jin","doi":"10.3389/fpubh.2024.1399662","DOIUrl":"10.3389/fpubh.2024.1399662","url":null,"abstract":"<p><strong>Background: </strong>Lanzhou is the largest heavy industrial city in northwest China and it is a typical geographical valley-like city. However, there are few studies on the relationship between air pollutants and COPD, and their respective sample sizes are small, resulting in inconsistent results. The aim of this study is to analyze the effects of air pollutants on COPD hospitalizations in Lanzhou, China.</p><p><strong>Methods: </strong>An ecological time series study with distributed lag non-linear model (DLNM) was used for analysis. Daily COPD hospitalization data in Lanzhou from 1 January 2015 to 31 December 2019 were collected from 25 hospitals, as well as air pollutant data and meteorological data.</p><p><strong>Results: </strong>A total of 18,275 COPD hospitalizations were enrolled. For 10 μg/m³ increase in PM_2.5, PM₁₀, SO₂, NO₂, and 1 mg/m³ increase in CO at lag 07 day, the RR95%CI of COPD hospitalizations were 1.048 (1.030, 1.067), 1.008 (1.004, 1.013), 1.091 (1.048, 1.135), 1.043 (1.018, 1.068), and 1.160 (1.084, 1.242), respectively. The exposure-response curves between air pollutants (except O3-8h) and COPD hospitalizations were approximately linear with no thresholds. Female, and the harmful effect of PM on aged <65 years, the effect of gaseous pollutant on those aged ≥65 years, were stronger, particularly in the cold season. Exposure to air pollutants (except O_3-8h) might increase the risk of COPD hospitalizations. O_3-8h has a weak and unstable effect on COPD.</p><p><strong>Conclusion: </strong>Exposure to air pollutants (except O_3-8h) increases the risk of COPD hospitalizations. O_3-8h has a weak and unstable effect on COPD hospital admissions. The harmful effect of gaseous pollutants (except O_3-8h) on COPD-hospitalized patients was stronger than that of PM.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11446802/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142371550","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":"Improving physical and mental health in women with breast cancer undergoing anthracycline-based chemotherapy through wearable device-based aerobic exercise: a randomized controlled trial.","authors":"Hongmei Li, Die Sang, Lijing Gong, Boliang Wang, Yong Wang, Xiao Jia, Jingjing Yu, Zhenxing Kong, Haiyun Liu, Yimin Zhang","doi":"10.3389/fpubh.2024.1451101","DOIUrl":"10.3389/fpubh.2024.1451101","url":null,"abstract":"<p><strong>Purpose: </strong>Aimed to assess the impact of wearable device-based aerobic exercise on the physical and mental well-being of women with breast cancer (BC) undergoing chemotherapy.</p><p><strong>Methods: </strong>Forty adult women with BC who underwent anthracycline-based chemotherapy were randomly allocated to the exercise group (<i>n</i> = 21) or the control group (<i>n</i> = 19). Both groups received standard health education and oncology care. In addition, the exercise group wore wearable devices to engage in moderate to high-intensity (50-90% HRmax) aerobic exercise during chemotherapy, while the control group did not carry out exercise intervention. Health-related physical fitness level, physical activity energy expenditure (PAEE), anxiety and depression scores, sleep quality, cancer-related fatigue, and overall quality of life (QoL), were assessed both before (prior to the first chemotherapy session) and after (prior to the fifth chemotherapy session) the exercise intervention. Exercise-related adverse events, exercise compliance, number and severity of gastrointestinal reactions and myelosuppression occurred were recorded during the exercise intervention.</p><p><strong>Results: </strong>After the intervention, compared to the control group, the exercise group (1) had significantly higher relative VO₂peak (<i>p</i> = 0.003) and handgrip strength (<i>p</i> < 0.001); (2) had significantly higher PAEE (<i>p</i> < 0.001); (3) had a significantly lower scores in anxiety (<i>p</i> = 0.007), depression (<i>p</i> = 0.028), sleep quality in domains of subjective sleep quality (<i>p</i> = 0.010), sleep disturbances (<i>p</i> = 0.004), daytime dysfunction (<i>p</i> = 0.007), cancer-related fatigue in domains of physical (<i>p</i> < 0.001) and affective (<i>p</i> < 0.001); and (4) had a significantly lower scores in QoL in domains of physical well-being (<i>p</i> < 0.001) and emotional well-being (<i>p</i> = 0.019), while a significantly higher scores in functional well-being (<i>p</i> < 0.001). Patients in the exercise group experienced less severe gastrointestinal reactions (<i>p</i> = 0.028) and myelosuppressive symptoms (<i>p</i> < 0.001) than that in the control group. Patients in the exercise group had no serious exercise-related adverse events, with a mean exercise adherence of 81.8%.</p><p><strong>Conclusion: </strong>Wearable device-based aerobic exercise during chemotherapy can be an effective adjunctive therapy to improve physical and mental health in BC patients.</p><p><strong>Clinical trial registration: </strong>https://www.chictr.org.cn/showproj.html?proj=200247, Identifier: ChiCTR2300073667.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11446794/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142371475","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 impact of smartphone dependence on college students' sleep quality: the chain-mediated role of negative emotions and health-promoting behaviors.","authors":"Yunfei Tao, Zhaozhi Liu, Li Huang, Haowei Liu, Haodong Tian, Jinlong Wu, Lan Li, Li Peng","doi":"10.3389/fpubh.2024.1454217","DOIUrl":"10.3389/fpubh.2024.1454217","url":null,"abstract":"<p><strong>Objective: </strong>Sleep disturbances among college students have become a significant issue affecting their daily lives. This study aims to explore the relationship between smartphone dependence and sleep quality and examine the mediating roles of negative emotions and health-promoting behaviors.</p><p><strong>Methods: </strong>A total of 23,652 college students were included in the study, and 21,314 valid questionnaires were collected. The survey assessed demographic factors, smartphone dependence, sleep quality, negative emotions, and health-promoting behaviors. A chain mediation analysis was conducted to examine the relationships among these factors.</p><p><strong>Results: </strong>Smartphone dependence was significantly positively correlated with sleep quality (<i>r</i> = 0.272, <i>p</i> < 0.001) and negative emotions (<i>r</i> = 0.414, <i>p</i> < 0.001), and significantly negatively correlated with health-promoting behaviors (<i>r</i> = -0.178, <i>p</i> < 0.001). Sleep quality was positively correlated with negative emotions (<i>r</i> = 0.472, <i>p</i> < 0.001) and negatively correlated with health-promoting behaviors (<i>r</i> = -0.218, <i>p</i> < 0.001).Smartphone dependence was a significant positive predictor of sleep quality. Moreover, negative emotions and health-promoting behaviors influenced the relationship between smartphone dependence and sleep quality. The total effect, direct effect, and indirect effect values were 0.304, 0.122, and 0.170, respectively.</p><p><strong>Conclusion: </strong>Different demographic factors (such as gender and place of residence) can lead to variations in different variables. Smartphone dependence and negative emotions have a positive impact on sleep quality among college students, while health-promoting behaviors have a negative impact. Smartphone dependence directly and positively affects sleep quality and can also influence it indirectly through the mediating effects of negative emotions and health-promoting behaviors, both individually and in a chain-like manner.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11446859/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142371551","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":"Breaking chains of tobacco: empowering African American churches in West Virginia for a healthier future.","authors":"Donald Reed, Truman Dangerfield, Rhonda Robinson, Kenneth Ray, Kathy Danberry, Kim Tieman","doi":"10.3389/fpubh.2024.1472654","DOIUrl":"10.3389/fpubh.2024.1472654","url":null,"abstract":"<p><p>Across West Virginia, tobacco use continues to be a significant public health challenge. Specifically, tobacco use is linked to high poverty across the state and disproportionately affects African Americans. A faith-based tobacco prevention network was formed to address these concerns and increase education and cessation. The West Virginia African American Tobacco Prevention Network (WVAATPN) was formed in 2021 and since then has expanded its reach across the state, involving 22 congregations. The Network's model includes annual training for lay leaders on various tobacco-related topics, tailored educational curriculum for congregations, and collaboration with national experts to enhance program efficacy. The Network has run educational and cessation workshops and promoted events such as No Menthol Sunday. Workshops have yielded positive outcomes among participants, including increased awareness of tobacco marketing tactics, higher cessation rates, and improved understanding of the health impacts of tobacco. The WVAATPN continues to expand its reach and effectiveness by advocating for policy change, enhancing community engagement, and fostering partnerships to combat tobacco-related disparities in West Virginia's African American communities.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11448452/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142371470","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":"Editorial: A gendered approach for accelerating prevention and control of NCDs.","authors":"Aswathy Sreedevi, P S Rakesh, Sairu Philip","doi":"10.3389/fpubh.2024.1484592","DOIUrl":"10.3389/fpubh.2024.1484592","url":null,"abstract":"","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11448705/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142371473","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":"Dimensions of quality of life of older adults in relation to selected sociodemographic variables-a prospective cohort study.","authors":"Mariola Głowacka, Zofia Sienkiewicz, Grażyna Dykowska, Beata Haor","doi":"10.3389/fpubh.2024.1419008","DOIUrl":"10.3389/fpubh.2024.1419008","url":null,"abstract":"<p><strong>Background: </strong>Based on its definition of an individual's quality of life, the World Health Organization identified the following six basic domains of this concept: physical domain, psychological domain, level of independence, social relationships, environment and spirituality. The aim of the study was to examine these quality of life dimensions in pre-older and older adults in relation to selected sociodemographic variables.</p><p><strong>Methods: </strong>The study included 2,040 adults aged 55 or older. It was conducted using a diagnostic survey by means of a questionnaire with sociodemographic questions and the EQ-5D-3L descriptive system.</p><p><strong>Results: </strong>The vast majority of male and female respondents reported no problems in most EQ-5D-3L dimensions. However, the mean EQ-5D-3L index score indicated a slight difference in scores between men and women. A statistically significant difference between male and female respondents in individual dimension scores was found only for the usual activities dimension. The proportion of respondents reporting no problems decreased with age in most dimensions, except for anxiety/depression. Age was statistically significantly correlated with all individual dimension scores and the index score. The vast majority of respondents across all education levels reported no problems in most dimensions. Education was statistically significantly correlated with all individual dimension scores and the index score.</p><p><strong>Conclusion: </strong>The vast majority of respondents across both sexes and all education levels reported no problems in most EQ-5D-3L dimensions. The proportion of respondents reporting no problems decreased with age in most EQ-5D-3L dimensions. Systematic research on dimensions of health-related quality of life will help design measures for healthy and successful ageing.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11447615/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142371472","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":"Collaboration for new therapies: maximizing health and innovation.","authors":"Jorge Mestre-Ferrandiz, Pierre Meulien, Dennis A Ostwald, Virginia Acha","doi":"10.3389/fpubh.2024.1383107","DOIUrl":"10.3389/fpubh.2024.1383107","url":null,"abstract":"<p><strong>Introduction: </strong>Innovative medicines and vaccines can provide direct health benefits to patients and populations by preventing, treating and curing diseases, and also drive wider socioeconomic and productivity gains. However, researching and developing them is complex and risky. Funding for life sciences R&D has different sources: public, charitable/NGO, and private sector. We believe there is consensus that all are required, although there is less understanding about their respective roles, synergies, and funding priorities. The purpose of this paper is to provide an overview of the current life sciences innovation ecosystem in Europe, highlighting challenges for funding and innovation of new therapies and our proposed options to address these.</p><p><strong>Methods: </strong>The basis of this paper stems from the reflections made by the co-authors during a webinar with title \"Collaboration for new therapies: maximising funding and innovation,\" in March 2023, with further targeted literature reviews.</p><p><strong>Results: </strong>We identify eight challenges in the European life sciences ecosystem, some closely related, and nine options that we think might be helpful to address them. Each option on its own can have different levels of 'impact', but collectively will provide synergies among them, and thus maximize their impact.</p><p><strong>Discussion: </strong>It is critical to ascertain how the strengths of each actor can be leveraged to bring new medicines/treatments to market, quicker and more efficiently. We need a trusted environment, with strategic collaborations between the public and private sectors, and policy initiatives and incentives should be targeted to strengthen the infrastructure with the aim of fostering such optimal alliances.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11446746/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142371471","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":"Vaccine hesitancy among parents of children in their first two years of life.","authors":"Ruth Magyar, Peter K Voitl, Julian J M Voitl, Susanne C Diesner-Treiber","doi":"10.3389/fpubh.2024.1438737","DOIUrl":"10.3389/fpubh.2024.1438737","url":null,"abstract":"<p><strong>Background: </strong>Vaccine hesitancy is considered a primary cause of outbreaks of vaccine-preventable infectious diseases. The Austrian vaccination plan includes 24 vaccinations in the first 2 years of life, 12 for free and 12 subject to a fee. Since preterm babies are more susceptible to severe infections, immunization is a vital protection strategy. This study examines the routine immunization schedule recommended for children in Austria, the number of timely vaccinations, and the number of delayed and rejected vaccinations. Possible reasons for vaccination delays and rejection and potential influencing factors (preterm birth, COVID-19 pandemic, information sources) are also analyzed.</p><p><strong>Methods: </strong>We included children aged 2 to 5 years who presented to Vienna's largest pediatric center with an Austrian mother-child pass and spent the first 2 years of their lives in Austria. Data was collected using questionnaires about the vaccination status, parents' reasons for any rejections or delays in the recommended vaccination regimen, the impact of the COVID-19 pandemic on individuals' vaccination behavior, and child-specific influencing factors such as preterm birth and socioeconomic factors.</p><p><strong>Results: </strong>90% of the 150 study subjects follow the recommendations on routine vaccinations, while 40-62% accept vaccinations subject to a fee. Preterm infants received less fee-based (53%) as well as gratuitous (88%) vaccinations. While free vaccinations tend to be delayed, more fee based vaccinations are rejected. With free vaccinations, delays and refusals occur due to illness or missed appointments. In the case of fee- required vaccinations, however, fears of side effects are also one of the main reasons. Due to the COVID-19 pandemic, about a quarter of parents have become more skeptical about vaccines. However, the vaccination rate of premature babies is usually just below that of full-term babies. Physicians remain the most trustworthy source of information about vaccinations.</p><p><strong>Conclusion: </strong>Free vaccinations are more accepted by parents than fee based vaccinations. Preterm babies, which are a high risk group for vaccination preventable diseases, show a lower or delayed vaccination rate, which must be prevented through intensive doctor education. In addition, vaccination hesitancy changed during the COVID-19 pandemic, which needs to be addressed during the medical consultation.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11448122/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142371552","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":"Neocolonialism and science diplomacy: personal reflections from the Middle East on mental health policy and practice.","authors":"Nadia Taysir Dabbagh","doi":"10.3389/fpubh.2024.1409341","DOIUrl":"10.3389/fpubh.2024.1409341","url":null,"abstract":"<p><p>Neocolonialism has led to an imbalance in the production of knowledge and a clunky imposition of frameworks and models of practice that do not meet the needs of local communities. In contrast they can serve the central function of colonialism by draining valuable resources. Inequity of science diplomacy has diluted local voices and given precedence to colonialist knowledge and models of practice. It is argued that clinical, training and research excellence applies to those activities that meet and fulfil the clinical, training and research needs of the community in which they are embedded. Through personal reflection on contrasting Middle Eastern settings (Palestine and the UAE), the call is for the source of knowledge production and the driver for innovation to be daily clinical experiences listening to families in the community. This will result in policy and practices that are meaningful and impactful as illustrated by way of three examples: (1) a narrative approach to exploring suicide (2) an \"all-hands-on-deck\" clinical pathway for Autism assessments which transformed the lives of children and families with little additional resource, but with a fundamental shift in approach from \"top down\" to \"bottom up\" one as part of an organization-wide \"Patient First\" approach and (3) a rights-based, collective approach to developing mental health strategy. These examples are linked in terms of taking a shared \"listening approach\" but are applied to different levels moving from personal individual narratives to community clinical service to national strategy.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11448117/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142371549","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}