Collective action within an environment of unknown unknowns: Experiences with the port of Mars Game.

There is limited research about how groups solve collective action problems in uncertain environments, especially if groups are confronted with unknown unknowns. We aim to develop a more comprehensive view of the characteristics that allow both groups and individuals to navigate such issues more effectively. In this article, we present the results of a new online experiment where individuals make decisions of whether to contribute to the group or pursue self-interest in an environment with high uncertainty, including unknown unknowns. The behavioral game, Port of Mars is framed as a first-generation habitat on Mars where participants have to make decisions on how much to invest in the shared infrastructure to maintain system health and how much to invest in personal goals. Participants can chat during the game, and take surveys before and after the game in order to measure personality attributes and observations from the game. Initial results suggest that a higher average social value orientation and more communication are the key factors that explain why some groups are more successful than others in surviving Port of Mars. Neither other attributes of players nor the group's communication content explain the observed differences between groups.

Patient and public involvement in international research: Perspectives of a team of researchers from six countries on collaborating with people with lived experiences of dementia and end-of-life.

BACKGROUND: Patient and public involvement (PPI) is a critical priority in research, policy, academia and advocacy organizations. PPI in dementia research is gaining momentum. However, these efforts are missing in international projects aimed at those living with advanced dementia in long-term care (LTC) homes. Additional complexities can arise in enacting PPI within the context of integration of a palliative approach to care and experiences around end-of-life in (EOL) dementia. The mySupport study involved implementing the Family Carer Decision Support (FCDS) intervention for care partners of those living with advanced dementia in LTC in six countries. RESEARCH DESIGN AND OBJECTIVE: An interpretive description study was conducted to explore the perspectives of international researchers from six countries on engaging people with lived experiences of dementia and EOL care in research processes. The findings from this study informed the development of a PPI strategy and a subsequent toolkit for the FCDS intervention. FINDINGS: Thirty-eight interviews were completed with project researchers: 12 from the United Kingdom, 8 from Canada, 7 from Ireland, 4 each from Italy and The Netherlands and 3 from the Czech Republic. Four broad themes describe international researchers' perspectives on advancing methods of engagement for people with lived experiences of dementia and EOL in international PPI activities: (1) Groundwork to engage in research; (2) planning for research activities is key; (3) focus on meaningful engagement and (4) having foresight for practical issues shaping PPI. DISCUSSION AND IMPLICATIONS: International projects that involve PPI can present many sources of challenges. The findings in this study highlight important considerations for foundational work for incorporating PPI in international projects. Learning from world leaders and those with lived experiences in various regions can be insightful and help share tools and resources. PATIENT OR PUBLIC CONTRIBUTION: PPI was envisioned as a critical part of conducting the mySupport study. The findings from this study informed the development of a PPI strategy and an international Strategic Guiding Council that included family carers of those living with advanced dementia in LTC homes in six countries. This manuscript focused on the perspectives of researchers on their engagement with people with lived experiences of dementia and EOL. The perspectives of persons with lived experiences on engaging in the mySupport research study will be reported in a forthcoming manuscript.

Implementing peer support work in mental health care in Germany: The methodological framework of the collaborative, participatory, mixed-methods study (ImpPeer-Psy5).

BACKGROUND: Starting in the 1990s in the United States, individuals with lived experience of mental health crises and recovery have been employed as peer support workers (PSWs) internationally. However, the implementation of PSW in clinical contexts remains challenging. METHODS: This manuscript presents and discusses the methodological framework of the ImpPeer-Psy5 study on the PSW implementation in the German mental healthcare sector. This study used a mixed-methods and collaborative research approach, as well as participatory research strategies. After describing the study design, populations, teamwork and assessments, the epistemic challenges of its methodological framework will be critically discussed and how it has iteratively shaped the object of study. DISCUSSION AND PRACTICAL IMPLICATIONS: The healthcare, policy and funding context of PSW implementation as well as the study's methodological framework have differently influenced the ways in which the implementation of PSW has been conceived in this study. The choice of a collaborative or participatory methodological framework is advised to better align research questions and procedures to the specific needs and challenges of PSWs and other stakeholders concerned with PSW implementation. PATIENT AND PUBLIC CONTRIBUTION: The research team of the ImpPeer-Psy5 study was collaboratively staffed by a portion of researchers who also identify as users or survivors of psychiatric services. A nonprofit organization for the training of PSWs served as a practice partner throughout the research process. Different participatory formats involve a significant number of diverse stakeholders relevant to PSW implementation.

The Power of Partnership Beyond Social Prescribing.

This commentary focuses on the social determinants of health and how they may be more fully integrated into engagement-capable environments. In this commentary, the authors provide excerpts from their in-depth discussion that explored how the foundational principles of the Gattuso Centre for Social Medicine emphasize the importance of prioritizing care for populations that are marginalized and engaging communities to improve health outcomes. The article delves into some of the historic and current issues facing communities and individuals that are marginalized and describes how a large academic centre has leveraged its structures and resources to build partnerships with communities and community organizations to address these challenges.

Benefits and functionality of an interorganisational workplace health management network - insights from the companies' perspective.

Introduction: Workplace health management (WHM) is a worthwhile investment for companies. Nevertheless, the implementation of health-promoting interventions remains limited, especially in small and medium-sized enterprises. Interorganisational networks could be a promising way to raise awareness of the advantages of implementing WHM. Therefore, the aim of this study is to analyse the perceived functionality and benefits of a regional WHM network from companies' perspective and to present initial results on this specific topic. Methods: An explorative qualitative case study was conducted analysing ERZgesund, a WHM network in a rural region in Germany. Twenty-two companies that participated in the network were interviewed about their experiences and perceived advantages and disadvantages participating in the WHM network ERZgesund. Results: The findings show that the network has raised awareness about WHM among the companies, provides opportunities for exchange of knowledge and experiences, and generates or strengthens collaboration. The positive effects were enhanced by the network's structure, such as regionality and a direct contact person. Nevertheless, some companies stated that they would welcome a higher level of participation and transparency. Conclusion: Overall, it becomes clear that a WHM network can be a valuable tool to emphasize the relevance of WHM to companies. Therefore, further studies should validate and intensify the research on WHM networks to ensure a long-term benefit from the network.

Computational evolution of social norms in well-mixed and group-structured populations.

Models of indirect reciprocity study how social norms promote cooperation. In these models, cooperative individuals build up a positive reputation, which in turn helps them in their future interactions. The exact reputational benefits of cooperation depend on the norm in place, which may change over time. Previous research focused on the stability of social norms. Much less is known about how social norms initially evolve when competing with many others. A comprehensive evolutionary analysis, however, has been difficult. Even among the comparably simple space of so-called third-order norms, there are thousands of possibilities, each one inducing its own reputation dynamics. To address this challenge, we use large-scale computer simulations. We study the reputation dynamics of each third-order norm and all evolutionary transitions between them. In contrast to established work with only a handful of norms, we find that cooperation is hard to maintain in well-mixed populations. However, within group-structured populations, cooperation can emerge. The most successful norm in our simulations is particularly simple. It regards cooperation as universally positive, and defection as usually negative-unless defection takes the form of justified punishment. This research sheds light on the complex interplay of social norms, their induced reputation dynamics, and population structure.

Establishing the importance of co-creation and self-efficacy in creative collaboration with artificial intelligence.

The emergence of generative AI technologies has led to an increasing number of people collaborating with AI to produce creative works. Across two experimental studies, in which we carefully designed and programmed state-of-the-art human-AI interfaces, we examine how the design of generative AI systems influences human creativity (poetry writing). First, we find that people were most creative when writing a poem on their own, compared to first receiving a poem generated by an AI system and using sophisticated tools to edit it (Study 1). Following this, we demonstrate that this creativity deficit dissipates when people co-create with-not edit-AI and establish creative self-efficacy as an important mechanism in this process (Study 2). Thus, our findings indicate that people must occupy the role of a co-creator, not an editor, to reap the benefits of generative AI in the production of creative works.

What competencies are needed to develop collaboration between general practitioners and pharmacists through initial interprofessional training? An analysis of training needs through a qualitative occupational didactic approach.

BACKGROUND: Collaborative practice in primary health care increases care quality and security. In France, primary health care professionals increasingly work together. The link between general practitioners (GPs) and community pharmacists (CPs) is an important element. Nevertheless, effective collaboration between GPs and CPs is difficult to develop and formalize. Interprofessional education has been identified as a necessary step to prepare "collaborative practice-ready professionals". We aimed to identify the interprofessional training needs of last-year GP and CP students to develop interprofessional collaborations. METHOD: We conducted an analysis of training needs using a method inspired by occupational didactics. We collected data through individual semidirective interviews with CPs and GPs in 2022. At each stage we aimed to identify the elements of the occupational didactics to deduce the training needs in the form of a frame of reference: apparent competencies, emblematic situations and acting characteristics. We conducted an initial deductive thematic analysis to identify the apparent competencies of the two professions, the emblematic situations in which these competencies are used, and the acting characteristics used in these situations. We made an inductive categorization to define the collaborative competence and the families of situations and to model the actions of this GP-CP collaboration. RESULTS: We defined the competency "to collaborate effectively in an interprofessional setting in order to respond to care issues in one's territory" expressed in various professional situations. We described it by three capacities based on two interacting dynamics: one-off exchanges and structured collaborations. Various communication tools facilitate the implementation of these interactions. We modeled the actions of the GP-CP collaboration in the form of a conceptual map. CONCLUSION: The collaboration between the CP and the GP implements a competency that could be integrated into their professional referential. This competency, entitled "collaborating effectively in interprofessional settings to respond to care issues in one's territory", is expressed in a variety of professional situations. It is based on two parallel and interacting dynamics: one-off exchanges and a dynamic of lasting collaboration. This study thus lays the groundwork for the development of this collaborative skill among general practice and pharmacy residents.

Examining aid fragmentation and collaboration opportunities in Cambodia's health sector.

BACKGROUND: Cambodia's health sector faces significant challenges exacerbated by aid fragmentation, where development aid is dispersed among numerous small, uncoordinated projects. This study examines the distribution of health sector aid among Cambodia's principal donors to identify priorities, overlaps, and potential collaboration opportunities, addressing the urgent need for aid efficiency and alignment with national health priorities. METHODS: Utilizing OECD datasets and the Herfindahl-Hirschman Index (HHI) for the years 2010-2021, this study quantifies aid fragmentation within Cambodia's health sector. It analyzes aid allocations from the top five donors-United States, Australia, South Korea, Japan, and Germany-across various health projects and initiatives, evaluating the extent of fragmentation and identifying areas for potential donor collaboration. RESULTS: This study's findings highlight a pervasive issue of aid fragmentation within Cambodia's health sector, evident through the sector's low HHI score. This indicates a widespread distribution of aid across numerous small-scale initiatives, rather than targeted, unified efforts. A notable example includes Japan and Korea, which exhibit lower HHI scores, indicating a more pronounced fragmentation in their aid allocation. These countries' contributions are spread across various sectors without a dominant focus, contrasting with the United States' significant dedication to infectious disease control. However, beyond this specific area, the US's aid distribution across other priority health areas shows signs of fragmentation. This scattered approach to aid allocation, even amidst instances of focused support, illustrates the overarching challenge of aligning donor contributions with the holistic needs of Cambodia's health infrastructure. CONCLUSIONS: This investigation highlights the critical need for enhanced collaboration and strategic harmonization among international donors to mitigate aid fragmentation in Cambodia's health sector. It underscores the importance of adopting integrated and priority-aligned aid strategies to improve the efficiency and impact of health aid. By fostering synergistic partnerships and harmonizing donor efforts, there is a potential to create a more cohesive support framework that resonates with Cambodia's comprehensive health requirements and contributes to sustainable health outcomes. Such harmonization not only aligns with Sustainable Development Goal 3 by optimizing health services and outcomes but also strengthens global partnerships under Sustainable Development Goal 17, fostering a unified approach to international development.

Digital endpoints in clinical trials: emerging themes from a multi-stakeholder Knowledge Exchange event.

BACKGROUND: Digital technologies, such as wearable devices and smartphone applications (apps), can enable the decentralisation of clinical trials by measuring endpoints in people's chosen locations rather than in traditional clinical settings. Digital endpoints can allow high-frequency and sensitive measurements of health outcomes compared to visit-based endpoints which provide an episodic snapshot of a person's health. However, there are underexplored challenges in this emerging space that require interdisciplinary and cross-sector collaboration. A multi-stakeholder Knowledge Exchange event was organised to facilitate conversations across silos within this research ecosystem. METHODS: A survey was sent to an initial list of stakeholders to identify potential discussion topics. Additional stakeholders were identified through iterative discussions on perspectives that needed representation. Co-design meetings with attendees were held to discuss the scope, format and ethos of the event. The event itself featured a cross-disciplinary selection of talks, a panel discussion, small-group discussions facilitated via a rolling seating plan and audience participation via Slido. A transcript was generated from the day, which, together with the output from Slido, provided a record of the day's discussions. Finally, meetings were held following the event to identify the key challenges for digital endpoints which emerged and reflections and recommendations for dissemination. RESULTS: Several challenges for digital endpoints were identified in the following areas: patient adherence and acceptability; algorithms and software for devices; design, analysis and conduct of clinical trials with digital endpoints; the environmental impact of digital endpoints; and the need for ongoing ethical support. Learnings taken for next generation events include the need to include additional stakeholder perspectives, such as those of funders and regulators, and the need for additional resources and facilitation to allow patient and public contributors to engage meaningfully during the event. CONCLUSIONS: The event emphasised the importance of consortium building and highlighted the critical role that collaborative, multi-disciplinary, and cross-sector efforts play in driving innovation in research design and strategic partnership building moving forward. This necessitates enhanced recognition by funders to support multi-stakeholder projects with patient involvement, standardised terminology, and the utilisation of open-source software.

Building Cross-sectoral Collaborations to Address Perinatal Health Inequities: Insights From the Dutch Healthy Pregnancy 4 All-3 Program.

BACKGROUND: Addressing perinatal health inequities is the joint responsibility of professionals working for local governments, the medical, social, and public health sector. Cross-sectoral collaboration between these professionals is challenging. For such collaborations to succeed, a transition, ie, a fundamental shift in the dominant structure, culture, and practices at the systems level, is necessary. We investigated facilitators and barriers for cross-sectoral collaborations, when addressing perinatal health inequities in the Netherlands. Additionally, we studied how cross-sectoral collaborations can be facilitated by action research. METHODS: We used interview and questionnaire data of the Healthy Pregnancy 4 All-3 (HP4All-3) program, which resulted from action research in six Dutch municipalities. All interviews were coded using open codes related to facilitators and barriers for cross-sectoral collaboration and categorized into three subgroups: structural, cultural, or practical. The answers to the questionnaire were analyzed and summarized quantitatively. RESULTS: We conducted 53 interviews with a total of 81 professionals. The most important ingredients for cross-sectoral collaborations mentioned by the interviewees were: (1) structural: having a solid network with a clear overview of professionals working in the different sectors, (2) cultural: having a joint vision/goal, and (3) practical: short lines of communication and timely sharing of information. A total of 85 professionals filled in (parts of) the questionnaire. Two-thirds to over 80 percent replied that the HP4All-3 program had an added value in building cross-sectoral collaborations. CONCLUSION: Our research shows that cross-sectoral collaborations in the context of perinatal health are hampered by structural, cultural, and practical barriers. Analyzing facilitators and barriers at these three levels helps to identify bottlenecks in cross-sectoral collaboration. Action researchers can be of great advantage in facilitating collaboration, as they can offer an open setting for reflection and instigate a sense of urgency for building collaborations.

The Perils of Partnership: Interactions Between Public Health England, Drinkaware, and the Portman Group Surrounding the Drink Free Days Campaign.

BACKGROUND: There is growing evidence that the alcohol industry seeks to obstruct public health policies that might affect future alcohol sales. In parallel, the alcohol industry funds organisations that engage in "responsible drinking" campaigns. Evidence is growing that the content and delivery of such campaigns serves industry, rather than public health interests, yet these organizations continue to be the subject of partnerships with government health departments. This study aimed to examine the nature and potential impacts of such partnerships by analysing the practices of the alcohol industry-funded charity Drinkaware during the establishment of the Drink Free Days campaign. METHODS: A case study based on an inductive analysis of documents revealed by freedom of information (FoI) request regarding communications between Drinkaware, Public Health England (PHE), and the Portman Group, in the years running up to, and during, the Drink Free Days campaign, a partnership between alcohol industry-funded charity Drinkware, and PHE. RESULTS: This study reveals a range of less visible, system-level effects of such partnerships for government departments and civil society. The tensions observed, as exhibited by discrepancies between internal and external communications, the emphasis on managing and mitigating the perception of negative consequences, and the links to wider alcohol industry initiatives and bodies, suggest the need for wider considerations of organizational conflicts of interest, and of possible indirect, harmful consequences to policy-making. These include the marginalization of other civil society voices, the displacing of more effective policy options, and strategic alignment with other industry lobbying activities. CONCLUSION: The findings have implications for how public health practitioners and health organisations might better weigh the potential trade-offs of partnership in the context of health promotion campaigns.

Drivers and collaborative governance of public health emergency response in the context of digital city.

Introduction: With the frequent occurrence of public health events, the government inevitably makes many mistakes in emergency management. In modern emergency management, it is particularly important to promote the diversification of emergency management subjects and improve the government's emergency management ability. Methods: In order to make up for the deficiency of government's participation in public health emergency management, this paper analyzes the driving factors and driving effects of enterprises' participation in public health emergency response under the background of digital city. A fully explained structural model is used to analyze the relationship between the different drivers. In addition, the spatial and temporal distribution characteristics of public health events were analyzed through spatial auto-correlation. On this basis, the government cooperative governance strategy is discussed. Results and discussion: The results show that in the context of digital cities, there are 14 driving factors for enterprises to participate in public health emergency response. The most important factors are the company's own development needs, relative technical advantages and so on. The driving efficiency is mainly concentrated in three aspects: psychology, resources and structure. Public health events have periodicity in time distribution and regional differences in spatial distribution. The significance of this study is to help the government improve the emergency management ability from different angles.

Memory and target payoff enhance cooperation in evolutionary social dilemmas.

We proposed a neighbor selection mechanism based on memory and target payoff, where the target payoff is the maximum value of the group's average expected payoff. According to this mechanism, individuals prioritize selecting neighbors whose average payoffs in the last M rounds are close to the target payoff for strategy learning, aiming to maximize the group's expected payoff. Simulation results on the grid-based Prisoner's Dilemma and Snowdrift games demonstrate that this mechanism can significantly improve the group's payoff and cooperation level. Furthermore, the longer the memory length, the higher the group's payoff and cooperation level. Overall, the combination of memory and target payoff can lead to the emergence and persistence of cooperation in social dilemmas as individuals are motivated to cooperate based on both their past experiences and future goals. This interplay highlights the significance of taking into account numerous variables in comprehending and promoting cooperation within evolutionary frameworks.

The effect of multi-tasks mechanism on cooperation in evolutionary game.

Human games are inherently diverse, involving more than mere identity interactions. The diversity of game tasks offers a more authentic explanation in the exploration of social dilemmas. Human behavior is also influenced by conformity, and prosociality is a crucial factor in addressing social dilemmas. This study proposes a generalized prisoner's dilemma model of task diversity that incorporates a conformity-driven interaction. Simulation findings indicate that the diversity of multi-tasks and the path dependence contribute to the flourishing of cooperation in games. Conformity-driven interactions also promote cooperation. However, this promotion effect does not increase linearly, and only appropriate task sizes and suitable proportions of conformity-driven interactions yield optimal results. From a broader group perspective, the interplay of network adaptation, task size, and conformity-driven interaction can form a structure of attractors or repellents.

How Should MLP Clinicians and Attorneys Help Veterans Secure Disability Benefits When Health Records Documentation Is Insufficient?

This case commentary considers unique features of medical-legal partnerships (MLPs) in the Veterans Health Administration that may potentially mediate and minimize ethical tensions that may arise in MLP collaborations involving diagnosing and documenting disability.

How Should We Measure Effectiveness of Medical-Legal Partnerships?

Medical-legal partnerships (MLPs) try to mitigate health inequity by uniting legal and health professionals to respond to legal determinants of patients' health. While there is a long tradition of "patients-to-policy" work in MLPs, the current empirical evidence base has evaluated MLP effectiveness by assessing benefits to individual patients, clinicians, and hospital and legal systems. This article calls for future research to measure how community power, which includes shifting power to impacted communities to develop and lead equity-focused agendas, is built as both a process and an outcome of MLPs.

Why MLP Legal Care Should Be Financed as Health Care.

Medical-legal partnership (MLP) integrates the unique expertise of lawyers into collaborative clinical environments. MLP teams meet the needs of individual patients while also detecting structural problems at the root of health inequities and advancing solutions at the institutional, community, and system levels. Yet MLPs today operate in limited settings and survive on scant budgets. Expanding their impact requires secure funding. Financing MLPs as health care can do the following: (1) help address inequity at the point of care; (2) enable expert diagnosis and treatment of nonmedical drivers of health; (3) enhance team-based practice in health care organizations; (4) offer another way for clinicians to participate in advocacy; and (5) bolster a broader movement to increase access to justice.

How Should a Medical-Legal Partnership Address Unique Needs of People With Criminal Legal System Involvement?

Medical-legal partnerships (MLPs) are well suited to address health-harming legal needs associated with the collateral consequences of mass incarceration in the United States, such as those that limit access to food, housing, employment, and family reunification postrelease. MLP innovations seek to expand the current model to address patients' criminal, as well as postrelease, civil legal needs by including community health workers and some patients as legal partners and creating coalitions to promote local and state policy change. Overall, this article explains how these MLP innovations can support rights of people returning to communities after incarceration and can be leveraged to mitigate criminal legal system involvement.