The primary objective of transdisciplinary research (TDR) is to contribute to the solution of complex \'real-world\' problems by integrating heterogeneous knowledge and achieving societal effects. However, establishing a continuous impact orientation during TDR processes remains a challenge, as the necessary tools are not yet sufficiently available. We developed and tested a half-day workshop format for strengthening the impact-oriented project management and research activities of seven TDR projects. Our findings indicate that the reflective impact workshops supported participants in pursuing societal effects systematically. Applying the methodological approach also fosters TDR process qualities such as knowledge integration. Conducted at different project stages, the results can serve as a basis for monitoring and adapting the project design. The reflective approach•includes scientific and non-scientific TDR project team members,•draws on Theory of Change as a conceptual framework and motivates participants to reflect on plausible impact pathways and make implicit assumptions about interlinkages between different forms of societal effects explicit, and•provides results which enable project partners to adjust their project design for greater societal effectiveness.

BACKGROUND: The high number of unnecessary alarms in intensive care settings leads to alarm fatigue among staff and threatens patient safety. To develop and implement effective and sustainable solutions for alarm management in intensive care units (ICUs), an understanding of staff interactions with the patient monitoring system and alarm management practices is essential.
OBJECTIVE: This study investigated the interaction of nurses and physicians with the patient monitoring system, their perceptions of alarm management, and smart alarm management solutions.
METHODS: This explorative qualitative study with an ethnographic, multimethods approach was conducted in an ICU of a German university hospital. Using triangulation in data collection, 102 hours of field observations, 12 semistructured interviews with ICU staff members, and the results of a participatory task were analyzed. The data analysis followed an inductive, grounded theory approach.
RESULTS: Nurses and physicians reported interacting with the continuous vital sign monitoring system for most of their work time and tasks. There were no established standards for alarm management; instead, nurses and physicians stated that alarms were addressed through ad hoc reactions, a practice they viewed as problematic. Staff members\' perceptions of intelligent alarm management varied, but they highlighted the importance of understandable and traceable suggestions to increase trust and cognitive ease.
CONCLUSIONS: Staff members\' interactions with the omnipresent patient monitoring system and its alarms are essential parts of ICU workflows and clinical decision-making. Alarm management standards and workflows have been shown to be deficient. Our observations, as well as staff feedback, suggest that changes are warranted. Solutions for alarm management should be designed and implemented with users, workflows, and real-world data at the core.

The healthcare pathway is at the heart of public health organization concerns, but communication between the various players can be an obstacle. This work, produced by a French transdisciplinary team, offers a methodological approach based on formalized consensus to elaborate a glossary of healthcare pathways. A two-steps procedure was elaborated, including a double rounded Delphi method to formalize expert consensus, and two groups of experts: a workgroup and a review group.
The workgroup provided a list of words or expressions that, in their opinion, described, evaluated or compared the healthcare pathways for patients, caregivers or regulators. The review group checked this list and added or deleted words or expressions. Then, definitions were added by the workgroup based into account three dimensions: official, academic and from the field. The review group validated the definitions and provided complementary proposals if needed.
After pooling the list of words proposed by each of the six members of the working group, 417 words/expressions were ranked. After the two rounds of evaluation, 294 words/expressions were rated \"appropriate\" and were analyzed by the review group. This group, after two rounds of evaluation, agreed on 263 words/expressions that were transmitted to the working group who defined them. These definitions were rated by the review group. The first round of evaluation established 195 definitions as being appropriated whereas 68 definitions were amended by the review group.
This glossary supports transdisciplinary communication, reduces the extent of variations in practice and optimizes decision-making. International debate on all aspects might be strengthened by an improved understanding of the concept of health pathway.

As human activity accelerates the global crisis facing wildlife populations, private land conservation provides an example of wildlife management challenges in social-ecological systems. This study reports on the research phase of \'WildTracker\' - a co-created citizen science project, involving 160 landholders across three Tasmanian regions. This was a transdisciplinary collaboration between an environmental organisation, university researchers, and local landholders. Focusing on mammal and bird species, the project integrated diverse data types and technologies: social surveys, quantitative ecology, motion sensor cameras, acoustic recorders, and advanced machine-learning analytics. An iterative analytical methodology encompassed Pearson and point-biserial correlation for interrelationships, Non-Metric Multidimensional Scaling (NMDS) for clustering, and Random Forest machine learning for variable importance and prediction. Taken together, these analyses revealed complex relationships between wildlife populations and a suite of ecological, socio-economic, and land management variables. Both site-scale habitat characteristics and landscape-scale vegetation patterns were useful predictors of mammal and bird activity, but these relationships were different for mammals and birds. Four focal mammal species showed variation in their response to ecological and land management drivers. Unexpectedly, threatened species, such as the eastern quoll (Dasyurus viverrinus), favoured locations where habitat was substantially modified by human activities. The research provides actionable insights for landowners, and highlights the importance of \'messy,\' ecologically heterogeneous, mixed agricultural landscapes for wildlife conservation. The identification of thresholds in habitat fragmentation reinforced the importance of collaboration across private landscapes. Participatory research models such as WildTracker can complement efforts to address the wicked problem of wildlife conservation in the Anthropocene.

Participatory and collaborative approaches in sustainability science and public health research contribute to co-producing evidence that can support interventions by involving diverse societal actors that range from individual citizens to entire communities. However, existing philosophical accounts of evidence are not adequate to deal with the kind of evidence generated and used in such approaches. In this paper, we present an account of evidence as clues for action through participatory and collaborative research inspired by philosopher Susan Haack\'s theory of evidence. Differently from most accounts of evidence for use in policies and interventions, our account combines action-oriented (the how) and actors-oriented (the who) considerations. We build on Haack\'s theory and on the analysis of examples of participatory and collaborative research in sustainability science and public health research to flesh out six procedural criteria for the generation and mobilization of evidence in and from participatory research. Action-oriented criteria invite to look at evidence from a (a) foundherentist, (b) gradational and (c) quasi-holistic perspective. Actors-oriented criteria point out that evidence generation and utilization are (d) social, (e) personal, and (f) embedded. We suggest that these criteria may reinforce participatory and collaborative approaches to evidence co-production when addressing complex problems in sustainability science and public health allowing for the generation of a kind of practical objectivity.

This Letter to the Editor provides an update on the research from the Glushkov Institute of Cybernetics of the National Academy of Sciences of Ukraine. The Institute\'s research team in collaboration with Ternopil National Medical University began a new project called \"Development of the cloud-based platform for patient-centered telerehabilitation of oncology patients with mathematical-related modeling.\" The project is dedicated to the development of a hybrid cloud-based platform, and the creation on its basis of information technology for the telemedicine rehabilitation of cancer patients, and adapted for patients with combat stress disorder. The distinctive features of the proposed technology are a combination of artificial intelligence methods with accurate mathematical methods for optimization: developing mathematical models of problems of discrete, and non-smooth optimization, subgradient space transformation algorithms (to minimize non-smooth functions with tens of thousands of variables), and a method of global equilibrium search, etc.

BACKGROUND: This paper discusses a paradox in mental health. It manifests as a relationship between adverse \"bad\" effects (suffering, clinical costs, loss of productivity) in individuals and populations and advantageous \"good\" aspects of mental disorders. These beneficial aspects (scientific, artistic and political accomplishments) emanate at the societal level through the frequently unprecedented creativity of people suffering from mental disorders and their relatives. Such gains can contribute to societal innovation and problem-solving. Especially in times of accelerated social-ecological change, approaches are needed that facilitate best-possible mental health care but also recognize creative ideas conducive to beneficial clinical and social-ecological innovations as soon as possible.
CONCLUSIONS: This paper emphasizes the need to account for creativity as a crucial component in evolving mental health systems and societies. It highlights the need for wide-ranging approaches and discusses how research targeting multiple facets (e.g., brain level, cognitive neuroscience, psychiatry, neurology, socio-cultural, economic and other factors) might further our understanding of the creativity-mental disorder link and its importance for innovating mental health systems and societies.
CONCLUSIONS: Our discussion clarifies that considerable research will be needed to obtain a better understanding of how creativity associated with mental disorders may help to create more sustainable societies on a fast-changing planet through innovative ideas. Given the current-state-of-the-art of research and healthcare management, our discussion is currently speculative. However, it provides a basis for how pros and cons might be studied in the future through transdisciplinary research and collaborations across sectors of society.

Supporting sustainability requires understanding human-nature relations, which we approached as social constructions that can be studied through nature-related discourses. We examined human-nature relations in Finland by combining approaches from environmental social sciences and arts-based research into a mixed-methods design. A public online survey (n = 726) and post-performance audience interviews (n = 71) portrayed nature positively. Respondents\' ideas of nature ranged from natural scientific to philosophical; from dualistic to holistic; and from ecocentric to anthropocentric. A factor analysis revealed discourses focusing on wellbeing, conservation, ecoanxiety, pro-environmentalism, outdoor activity, and enjoying nature. Interviews added spiritual and over-generational aspects and revealed the importance of embodied experiences in nature relations. We identified dimensions that structure the relations, including human-nature positionality, engagement and contact with nature, and conception and thought. The emotional and experiential aspects, and nature-related practices, deserve further research. We demonstrate how a diversity of human-nature relations co-exists and co-evolves.

Digital assistive technologies have the potential to address the pressing need for adequate therapy options for patients with long COVID (also known as post-COVID-19 condition) by enabling the implementation of individual and independent rehabilitation programs. However, the involvement of the target patient group is necessary to develop digital devices that are closely aligned to the needs of this particular patient group.
Participatory design approaches, such as cocreation, may be a solution for achieving usability and user acceptance. However, there are currently no set methods for implementing cocreative development processes incorporating patients. This study addresses the following research questions: what are the tasks and challenges associated with the involvement of patient groups? What lessons can be learned regarding the adequate involvement of patients with long COVID?
First, a literature review based on a 3-stage snowball process was conducted to identify the tasks and challenges emerging in the context of the cocreation of digital assistive devices and services with patient groups. Second, a qualitative analysis was conducted in an attempt to extract relevant findings and criteria from the identified studies. Third, using the method of theory adaptation, this paper presents recommendations for the further development of the existing concepts of cocreation in relation to patients with long COVID.
The challenges of an active involvement of patients in cocreative development in health care include hierarchical barriers and differences in the levels of specific knowledge between professionals and patients. In the case of long COVID, patients themselves are still inexperienced in dealing with their symptoms and are hardly organized into established groups. This amplifies general hurdles and leads to questions of group identity, power structure, and knowledge creation, which are not sufficiently addressed by the current methods of cocreation.
The adaptation of transdisciplinary methods to cocreative development approaches focusing on collaborative and inclusive communication can address the recurring challenges of actively integrating patients with long COVID into development processes.

Coping with surprise and uncertainty resulting from the emergence of undesired and unexpected novelty or the sudden reorganization of systems at multiple spatiotemporal scales requires both a scientific process that can incorporate diverse expertise and viewpoints, and a scientific framework that can account for the structure and dynamics of interacting social-ecological systems (SES) and the inherent uncertainty of what might emerge in the future. We argue that combining a convergence scientific process with a panarchy framework provides a pathway for improving our understanding of, and response to, emergence. Emergent phenomena are often unexpected (e.g., pandemics, regime shifts) and can be highly disruptive, so can pose a significant challenge to the development of sustainable and resilient SES. Convergence science is a new approach promoted by the U.S. National Science Foundation for tackling complex problems confronting humanity through the integration of multiple perspectives, expertise, methods, tools, and analytical approaches. Panarchy theory is a framework useful for studying emergence, because it characterizes complex systems of people and nature as dynamically organized and structured within and across scales of space and time. It accounts for the fundamental tenets of complex systems and explicitly grapples with emergence, including the emergence of novelty, and the emergent property of social-ecological resilience. We provide an overview of panarchy, convergence science, and emergence. We discuss the significant data and methodological challenges of using panarchy in a convergence approach to address emergent phenomena, as well as state-of-the-art methods for overcoming them. We present two examples that would benefit from such an approach: climate change and its impacts on social-ecological systems, and the relationships between infectious disease and social-ecological systems.