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BACKGROUND: Effective integration of evidence and youth perspectives into policy is crucial for supporting the future health and well-being of young people. The aim of this project was to translate evidence from the Access 3 project to support development of a new state policy on youth health and well-being within New South Wales (NSW), Australia. Ensuring the active contribution of young people within policy development was a key objective of the knowledge translation (KT) process. METHODS: The KT activity consisted of a 1-day facilitated forum with 64 purposively sampled stakeholders. Participants included eight young people, 14 policy-makers, 15 academics, 22 clinicians or managers from NSW health services, four general practitioners and one mental health service worker. Research to be translated came from the synthesized findings of the NSW Access 3 project. The design of the forum included stakeholder presentations and group workshops, guided by the 2003 Lavis et al. KT framework that was improved by the Grimshaw et al. KT framework in 2012. Members of the Access 3 research team took on the role of knowledge brokers throughout the KT process. Participant satisfaction with the workshop was evaluated using a brief self-report survey. Policy uptake was determined through examination of the subsequent NSW Youth Health Framework 2017-2024. RESULTS: A total of 25 policy recommendations were established through the workshop, and these were grouped into six themes that broadly aligned with the synthesized findings from the Access 3 project. The six policy themes were (1) technology solutions, (2) integrated care and investment to build capacity, (3) adolescent health checks, (4) workforce, (5) youth participation and (6) youth health indicators. Forum members were asked to vote on the importance of individual recommendations. These policy recommendations were subsequently presented to the NSW Ministry of Health, with some evidence of policy uptake identified. The major

Non-communicable diseases (NCDs), a leading cause of global morbidity and mortality, are key challenges to achieving the 2030 Sustainable Development Goals. Looking at trends over the years, the surge in NCDs is anticipated to continue, with the greatest impact on the poor and marginalized groups, mainly from low and middle-income countries (LMICs) [1]. During the COVID-19 pandemic, people with one or more underlying NCDs were particularly vulnerable given the increased risk of severe disease and death [2]. Despite being vulnerable, people living with NCDs (PLWNCDs) faced challenges meeting their health care needs, attributed to the preventive measures against COVID-19 such as physical distancing and nationwide lockdowns and restrictions, which further exacerbated their physical and mental health outcomes [1]. COVID-19 disrupted the regular health services as the demand for acute care surged and strained the already weak public health system of many countries, especially in those hardest-hit by COVID-19, such as India, Nepal, Bangladesh, Brazil, Iran, and some other LMICs, stretching them beyond their capacity. In fact, the pandemic in some LMICs contributed to a near collapse of health service delivery [1]. Given their increase vulnerability to COVID-19, although PLWNCDs required greater support and care to manage their conditions than ever before, overwhelmed health care systems failed to meet their needs.

BACKGROUND: Musculoskeletal (MSK) conditions, MSK pain and MSK injury/trauma are the largest contributors to the global burden of disability, yet global guidance to arrest the rising disability burden is lacking. We aimed to explore contemporary context, challenges and opportunities at a global level and relevant to health systems strengthening for MSK health, as identified by international key informants (KIs) to inform a global MSK health strategic response. METHODS: An in-depth qualitative study was undertaken with international KIs, purposively sampled across high-income and low and middle-income countries (LMICs). KIs identified as representatives of peak global and international organisations (clinical/professional, advocacy, national government and the World Health Organization), thought leaders, and people with lived experience in advocacy roles. Verbatim transcripts of individual semi-structured interviews were analysed inductively using a grounded theory method. Data were organised into categories describing 1) contemporary context; 2) goals; 3) guiding principles; 4) accelerators for action; and 5) strategic priority areas (pillars), to build a data-driven logic model. Here, we report on categories 1-4 of the logic model. RESULTS: Thirty-one KIs from 20 countries (40% LMICs) affiliated with 25 organisations participated. Six themes described contemporary context (category 1): 1) MSK health is afforded relatively lower priority status compared with other health conditions and is poorly legitimised; 2) improving MSK health is more than just healthcare; 3) global guidance for country-level system strengthening is needed; 4) impact of COVID-19 on MSK health; 5) multiple inequities associated with MSK health; and 6) complexity in health service delivery for MSK health. Five guiding principles (category 3) focussed on adaptability; inclusiveness through co-design; prevention and reducing disability; a lifecourse approach; and equity and value-based care. Goals

INTRODUCTION: Despite the profound burden of disease, a strategic global response to optimise musculoskeletal (MSK) health and guide national-level health systems strengthening priorities remains absent. Auspiced by the Global Alliance for Musculoskeletal Health (G-MUSC), we aimed to empirically derive requisite priorities and components of a strategic response to guide global and national-level action on MSK health. METHODS: Design: mixed-methods, three-phase design.Phase 1: qualitative study with international key informants (KIs), including patient representatives and people with lived experience. KIs characterised the contemporary landscape for MSK health and priorities for a global strategic response.Phase 2: scoping review of national health policies to identify contemporary MSK policy trends and foci.Phase 3: informed by phases 1-2, was a global eDelphi where multisectoral panellists rated and iterated a framework of priorities and detailed components/actions. RESULTS: Phase 1: 31 KIs representing 25 organisations were sampled from 20 countries (40% low and middle income (LMIC)). Inductively derived themes were used to construct a logic model to underpin latter phases, consisting of five guiding principles, eight strategic priority areas and seven accelerators for action.Phase 2: of the 165 documents identified, 41 (24.8%) from 22 countries (88% high-income countries) and 2 regions met the inclusion criteria. Eight overarching policy themes, supported by 47 subthemes, were derived, aligning closely with the logic model.Phase 3: 674 panellists from 72 countries (46% LMICs) participated in round 1 and 439 (65%) in round 2 of the eDelphi. Fifty-nine components were retained with 10 (17%) identified as essential for health systems. 97.6% and 94.8% agreed or strongly agreed the framework was valuable and credible, respectively, for health systems strengthening. CONCLUSION: An empirically derived framework, co-designed and strongly supported by multisectoral stakeh

The Codex Alimentarius has approved ongoing work for international guidance on front-of-pack (FoP) nutrition labelling, which is a core intervention for prevention of diet-related noncommunicable disease. This guidance will have implications for national policy decision-making regarding this important public health issue. However, FoP nutrition labelling is also a trade and commerce policy issue. In this study, we analyze the global governance of FoP nutrition labelling and current policy processes, to inform public health policy and advocacy. We present findings from a qualitative governance and institutional analysis, based on key informant interviews with 28 global actors. The study found that Codex guidance was perceived as likely to have a high impact on FoP nutrition labelling globally. However, a small and highly interconnected “regime complex” of international institutions surrounds FoP nutrition labelling at the global level, and influence on Codex discussions is being exerted differentially by actors at the national and global level, particularly by government and industry actors. There are thus risks associated with conflicts of interests in the development of global guidance on FoP nutrition labelling. There are also opportunities for more strategic and coordinated public health engagement.

Late Glacial to Holocene ice retreat was investigated along a 120 km long fjord system, reaching from Gran Campo Nevado (GCN) to Seno Skyring in the southernmost Andes (53°S). The aim was to improve the knowledge on regional and global control on glacier recession with special emphasis on latitudinal shifting of the westerlies. The timing of ice retreat was derived from peat and sediment cores, using mineralogical and chemical characteristics, and pollen as proxies. Stratigraphy was based on 14C-AMS ages and tephrochronology. The ice retreat of the Seno Skyring Glacier lobe is marked by an ice rafted debris layer which was formed around 18,300 to 17,500 cal. yr B.P. Subsequently, fast glacier retreat occurred until around 15,000 to 14,000 cal. yr B.P. during which around 84% of Skyring Glacier were lost. This fast recession was probably also triggered by an increase of the Equilibrium Line Altitude (ELA) from 200 to 300 m. Subsequently, the ice surface was lowered below the ELA in an area that previously made up more than 50% of the accumulation area. Much slower retreat and glacier fluctuations of limited extent in the fjord channel system northeast of GCN occurred between around 14,000 to 11,000 cal. yr B.P. during both the Antarctic Cold Reversal and the Younger Dryas. This slow down of retreat indicates a decline in the general warming trend and/or increased precipitation, due to a southward migration of the westerlies. After around 11,000 cal. yr B.P. pollen distribution shows evolved Magellanic Rainforest and similar climate as at present, which lasted throughout most of the Holocene. Only Late Neoglacial moraine systems were formed in the period 1220–1460 AD, and subsequently in the 1620s AD, and between 1870 and 1910 AD. The results indicate that the Gran Campo Nevado ice cap has reacted more sensitive and partly distinct to climate change, compared to the Patagonian Ice Field.