Nature-Based Solutions in the EU: Innovating with nature to address social, economic and environmental challenges.

Contemporary societies are facing a broad range of challenges, from pressures on human health and well-being to natural capital depletion, and the security of food, water and energy. These challenges are deeply intertwined with global processes, such as climate change and with local events such as natural disasters. The EU's research & innovation (R&I) policy is now seeking to address these challenges from a new perspective, with Nature-Based Solutions, and turn them into innovation opportunities that optimise the synergies between nature, society and the economy. Nature-Based Solutions can be an opportunity for innovation, and are here promoted by both policymakers and practitioners as a cost-effective way of creating a greener, more sustainable, and more competitive economy. Since 2013, the European Commission has devoted particular attention to Nature-Based Solutions through consultations and dialogues that sought to make the concept of these solutions more concrete and to define the concept's place within the spectrum of ecosystem-based approaches. In 2014, the Commission launched an expert group, which conducted further analysis, and made recommendations to help increase the use of Nature-Based Solutions and bring nature back into cities. In 2015, a survey was conducted on citizens' views and perceptions of 'Nature in Cities' to provide further insight for future work. Based on these elements and on results from running EU projects, the Commission has developed an R&I agenda for Nature-Based Solutions and has published targeted calls for proposals for large-scale demonstration projects in this field in 2016 and 2017. Additional R&I actions at EU level that promote systemic Nature-Based Solutions and their benefits to cities and territories are planned with the aim to improve the implementation capacity and evidence base for deploying Nature-Based Solutions and developing corresponding future markets. They are also expected to foster an interdisciplinary R&I and stakeholder community and the exchange of good practices in this field, as well as help shaping and implementing international R&I agendas on Nature-Based Solutions.

Current trends in surgical treatment of the acromioclavicular joint injuries in 2023: a review of the literature.

Background: This article examines the wide range of surgical reconstruction options available for acromioclavicular (AC) joint injuries. However, the lack of consensus regarding the most suitable surgical techniques is attributed to the high and variable failure rates observed with current approaches. Methods: This article presents a comprehensive overview of the current surgical principles and techniques used by renowned experts in the field of AC shoulder injury management. Results: It emphasizes the significance of addressing horizontal and rotational instability in AC injuries and highlights the impact of impaired scapular biomechanics. Conclusion: By exploring these emerging concepts and strategies, the article aims to lay the foundation for future studies aimed at improving treatment outcomes and patient management.

[Complement inhibitors: A global point of view]. / Les inhibiteurs du complément : une vue d'ensemble.

Innate immunity, and more specifically the complement system, has arised renewed interest in the medical field in recent years. Many innovative complement-inhibiting drugs have appeared, acting at various levels of the complement cascade. These drugs have made it possible to transform poor prognosis of certain diseases. Many of them are currently being tested in clinical trials for various indications. Many questions appear about their optimal use and their future indications. This article recalls the fundamental role of the complement system in the human organism. It then discusses the diseases in which the complement is involved on the pathophysiological level. The third part details the different classes of complement inhibitors and briefly recalls the indications for which these treatments seem the most promising. Finally, we end with a discussion that highlights the different aspects and questions induced by these new treatments.

Exploring the nature of adaptive capacity for resilience in healthcare across different healthcare contexts; a metasynthesis of narratives.

Adaptive capacity has been described as instrumental for the development of resilience in healthcare. Yet, our theoretical understanding of adaptive capacity remains relatively underdeveloped. This research therefore aims at developing a new understanding of the nature of adaptive capacity by exploring the following research questions: 1. What constitutes adaptive capacity across different healthcare contexts? and 2. What type of enabling factors support adaptive capacity across different healthcare contexts? The study used a novel combination of qualitative methods featuring a metasynthesis of narratives based on empirical research to contribute understanding of adaptive capacity across different healthcare contexts. The findings show that adaptive capacity was found to include four forms: reframing, aligning, coping, and innovating. A framework illustrating the relatedness between the identified forms, in terms of resources, change and enablers, is provided. Based on these findings, a new definition of adaptive capacity for resilience in healthcare is proposed.

[Assessment of the Internal Medicine Multidisciplinary Team meetings at the Grenoble University Hospital]. / Évaluation des réunions de concertation pluridisciplinaire de médecine interne au CHU Grenoble Alpes.

INTRODUCTION: Multidisciplinary team (MDT) meetings purpose is to optimize the disease management regarding state of science. While cancer MDT has proven its effectiveness, this is not yet the case with internal medicine MDT. METHODS: We performed a descriptive monocentric retrospective study. Data were collected from 247 MDT meeting reports which took place at the Grenoble University Hospital over a 5 years period. We investigated the data related to patient, MDT features, and decision-making process and reporting. Discussions were classified as diagnostic and/or therapeutic. RESULTS: Three specialties, among which at least internal medicine, attended to meetings. While 12% of cases were considered as "complex", a specialist opinion was required in 18% of diagnostic discussions. With regards to therapeutic discussions, 35% were supported by guidelines, 50% of therapeutic implementation involved innovating and expensive drugs, with off-label prescription in 75% of them. The decision-making process was described in 6% of the reports. Treatment recommendations were actually implemented in 72% of the patients. CONCLUSION: MDT meetings in Internal medicine meets a real need of physicians, in the ultimate interest of the patient. A prospective analysis would be interesting for a better definition of the evaluation criteria of these MDT meetings, meeting the physicians' needs, in patient management best interest. Prospective analyses are needed to better define MDT meetings assessment criteria.

Why Multi-Family Groups for Transgender Adolescents and Their Parents?

The author presents a therapeutic approach for contemporary families carried out in an innovative mental health care setting. This approach involves receiving both transgender adolescents and their parents. Initially, the adolescents are brought together in a discussion group. Then, the parents of these adolescents are gathered without their children in order to reflect on family relations and social adaptation and to receive support when needed. Both groups are gathered together a couple of times a year in a multi-family meeting. Using a dynamic based on the principle of free association and the interplay of identifications among participants, the author points out how these groups and multi-family gatherings promote mental health and prevent mental disorders and the disruption of family relations.

Innovative financing for late-stage global health research and development: the Global Health Investment Fund.

Innovative financing strategies for global health are urgently needed to reinvigorate investment and new tools for impact. Bottleneck areas along the research and development (R&D) pipeline require particular attention, such as the transitions from preclinical discovery to clinical study, and product development to implementation and delivery. Successful organizations mobilizing and disbursing resources through innovating financing mechanisms include UNITAID, the Global Fund, and Gavi, the Vaccine Alliance. Although precise numbers are poorly documented, estimated investment in low-income settings falls seriously short of local need. This commentary discusses the newly established Global Health Investment Fund as a case study to support late-stage global health R&D.

Many diseases, one model of care?

Patients with multiple chronic conditions (multimorbidity) have complex and extensive health and social care needs that are not well served by current silo-based models of care. A lack of integration between care providers often leads to fragmented, incomplete, and ineffective care, leaving many patients overwhelmed and unable to navigate their way towards better health outcomes. In planning for the future, healthcare policies and models of care are required that cater for the complex needs of patients with multimorbidity and that deliver coordinated care that is patient-centred and focused on disease prevention, multidisciplinary teamwork and shared decision-making, and on empowering patients to self-manage. Salient lessons can be learnt from the work undertaken at a European and national level to develop care models in cancer and diabetes - two complex and often co-occurring conditions requiring coordinated long-term care. Innovative work is also underway in many European countries aimed at improving the integration of care for people with multimorbidity, resulting in more efficient and cost-effective health outcomes. This article reviews some of the most innovative programmes that have been initiated across and within Europe with the aim of improving the way care is delivered to people with complex and multiple long-term conditions. This work provides a foundation upon which to build better, more effective models of care for people with multimorbidity.

Neuroart: picturing the neuroscience of intentional actions in art and science.

Intentional actions cover a broad spectrum of human behaviors involving consciousness, creativity, innovative thinking, problem-solving, critical thinking, and other related cognitive processes self-evident in the arts and sciences. The author discusses the brain activity associated with action intentions, connecting this activity with the creative process. Focusing on one seminal artwork created and exhibited over a period of three decades, Thought Assemblies (1979-82, 2014), he describes how this symbolic art interprets the neuropsychological processes of intuition and analytical reasoning. It explores numerous basic questions concerning observed interactions between artistic and scientific inquiries, conceptions, perceptions, and representations connecting mind and nature. Pointing to some key neural mechanisms responsible for forming and implementing intentions, he considers why and how we create, discover, invent, and innovate. He suggests ways of metaphorical thinking and symbolic modeling that can help integrate the neuroscience of intentional actions with the neuroscience of creativity, art and neuroaesthetics.

Innovating capability training-based construction of information literacy education course system for military postgraduates / 中华医学图书情报杂志

After the problems in military postgraduate information literacy education were analyzed, the construction of a systematic and coherent information literacy education course system for military postgraduates in close combination with their subjects was proposed by setting up multidimensional education target, designing three-stage foundation-subject-innovation course, combining traditional literature retrieval course and embedded professional course, combining case teaching, heuristic discussion and innovative talent information literacy training approach, by infiltrating the physical and virtual space both in and outside university, and by participating in the study and research activities of postgraduates.