This article provides a thorough analysis of the evolution and current state of global neurosurgery, emphasizing the transformative power of partnerships between various stakeholders to address the stark inequities in neurosurgical care, especially in LMICs. It discusses the transition from reliance on short-term medical missions to the development of sustainable, locally led neurosurgical programs through education, training, and infrastructure development. The article highlights the importance of long-term educational exchanges, innovative digital learning platforms, and strategic collaborations with foundations, philanthropic organizations, and academic institutions to build local capacities, enhance global neurosurgical competency, and promote self-sufficiency in neurosurgical care across different regions.

BACKGROUND: Collaboration between parents and school nurses is important for effective healthcare in schools. This study focuses on the competency of school nurses, which encompasses their knowledge and self-efficacy in diabetes care, and investigates how these factors, along with workload, influence healthcare partnerships in schools. However, it is unknown whether school nurses\' knowledge and self-efficacy about diabetes care, as well as their workload, affect school healthcare partnerships concerning children with type 1 diabetes.
OBJECTIVE: This study aimed to investigate the impact of school nurses\' self-efficacy, knowledge, attitude, and role overload on healthcare partnerships with parents of children with type 1 diabetes in schools.
METHODS: A cross-sectional, descriptive design.
METHODS: Between December 2023 and January 2024 in South Korea, 142 elementary- and middle-school nurses participated in this study.
METHODS: School healthcare partnership, self-efficacy in diabetes education, knowledge of and attitude toward school healthcare for type 1 diabetes, and the role-overload scale were utilized in the analysis. Data were analyzed using multiple regression.
RESULTS: Knowledge of school healthcare (β = 0.34, p < .001) and attitude toward it (β = 0.29 p = .001) for type 1 diabetes, as well as the grade level of the current employing school (β = -0.15, p = .039) were predictors of school healthcare partnerships. These three variables explained 30.3 % of the total variance in school healthcare partnerships (F = 21.44, p < .001).
CONCLUSIONS: Knowledge of school healthcare and attitudes toward it for type 1 diabetes were identified as factors in school nurses\' school healthcare partnerships. Therefore, interventions to strengthen school nurses\' competencies should be developed to improve school healthcare partnerships.

OBJECTIVE: First, to understand Papua New Guinea (PNG) oncology nursing issues perceived through the nurses\' lens of unmet supportive care needs of people affected by cancer and to identify nurses\' self-perceived educational priorities in cancer care. Second, to evaluate the tailored bidirectional learning and knowledge transfer among the participants of the Australia Capital Territory Health and PNG Oncology Nursing Development Program hosted in Australia in June 2023.
METHODS: A qualitative descriptive study was conducted. Two focus groups were audio-recorded, transcribed, and analyzed using inductive thematic analysis. Based on PNG oncology nurses\' experiences and self-assessed educational needs, the findings were analyzed and presented separately for Time 1 before the PNG Oncology Nursing Development program and Time 2 following the completion of the program.
RESULTS: The findings from the Time 1 focus group identified four themes: (1) educational priorities, (2) system-wide challenges, (3) patient unmet care needs, and (4) cultural beliefs. After the completion of the educational program, there were four emergent themes: (1) new educational experiences, (2) learnings into practice, (3) culturally sensitive nursing, and (4) leadership (PNG nursing trailblazers). This study, for the first time, provided the PNG RNs with a \"voice,\" to empower them to take more leading roles in important decision-making regarding care structures and management.
CONCLUSIONS: Policymakers, government officials, and international cancer organizations must continue to work together to support cancer control in PNG in light of the current and projected limited resources and barriers to timely cancer diagnosis and treatment in PNG.
CONCLUSIONS: Through observing and learning from a modern cancer department, PNG oncology nurses have gained insight into what is needed for a safe cancer service for both patients and nurses. Oncology nursing education in PNG needs to be further developed, enhanced, and supported for sustainability of cancer nurses in the long term.

BACKGROUND: Studies have shown insufficient utilization of care for patients with erectile dysfunction (ED) after radical prostatectomy (RP).
OBJECTIVE: The aim of this study was to evaluate variables associated with barriers to seeking and receiving ED treatment.
METHODS: In this multicenter prospective cross-sectional study, the functional outcomes of 936 patients were assessed 10 to 15 years after RP. A total of 525 patients with ED or incontinence were asked about their treatment experiences or lack thereof. The data were analyzed using the chi-square test, t test, and multivariate logistic analyses.
RESULTS: Patients answered validated questionnaires regarding information sources, communication with their partner and urologist, and barriers to ED treatment.
RESULTS: Of the 525 patients, 80 were not available to survey. A total of 304 patients answered the survey (response: 68.0%). A total of 246 patients had ED and were included in this study. The mean age at surgery was 64.4 ± 6.1 years, and the mean age at the time of this survey was 77.1 ± 6.2 years. The mean follow-up duration was 12.7 ± 1.5 years. Forty-six percent (n = 114 of 246) of the patients had never received ED treatment. The most important conversation partners regarding the ED were the partner (69% [n = 169 of 246]) and the urologist (48% [n = 118 of 246]). Patients who never received ED treatment were less likely to have conversations with their urologist (34% vs 60%; P < .001), had less support (51% vs 68%; P = .01), and had less interest in sex from their partner (20% vs 40%; P = .001). Communication with other groups (general practitioners, other physicians, family, friends, and the Internet) had no influence on ED treatment utilization. The most relevant barrier to receiving ED treatment was the belief that treatment would not help (65%). No interest in sex from their partner (odds ratio, 3.9) and no conversation with their urologist about ED (odds ratio, 2.9) were found to be independent predictors of not receiving ED treatment.
CONCLUSIONS: Urologists should have enhanced awareness of how to approach patients directly about their ED and actively offer them treatment options.
UNASSIGNED: These results should be further validated in a multicenter, prospective study. Response bias may have affected the results. Furthermore, the current cohort was relatively old.
CONCLUSIONS: This study revealed that no interest in sex from one\'s partner and insufficient communication with a urologist were relevant barriers to insufficient utilization of ED treatment after RP.

OBJECTIVE: The purpose of this study was to identify the factors influencing pediatric nurses\' job stress, including their level of fatigue and partnerships with the parents of patients. This investigation aimed to findings of this study may lead to the development of strategies to reduce pediatric nurse\'s job stress.
METHODS: Participants were recruited from pediatric, pediatric intensive care, and neonatal intensive care units across seven general hospitals. Eligibility requires a minimum of 6 months of experience in pediatric nursing. The sample size was determined using the G*power program, considering various variables, including age, marital status, presence of children, and work-related characteristics, leading to a final sample size of 135, adjusted for a 10% dropout rate. Data collection was conducted through self-report questionnaires, and analysis involved frequency, percentage, mean, standard deviation, t-tests, ANOVA, and stepwise multiple regression, using SPSS Statistics 27.0.
RESULTS: This study confirmed a significant correlation between pediatric nurses\' fatigue and job stress, with higher levels of fatigue associated with increased job stress. Stepwise regression analysis showed that fatigue and age were significant predictors of job stress among pediatric nurses, explaining 23% of the variance. However, detailed analysis showed that younger nurses had lower job stress scores compared to older nurses. This result suggests that more experienced nurses may experience higher job stress due to increased responsibilities and emotional burdens.
CONCLUSIONS: This study identified the need for effective strategies to manage fatigue and reduce job stress among pediatric nurses during the COVID-19 pandemic. Younger nurses, particularly those under 25 and between 26 and 30 years old, experience lower job stress compared to older nurses. Comprehensive support systems should be developed, including workload management, emotional support, and programs to enhance partnerships between nurses and parents. These strategies can improve job satisfaction and the quality of care provided to young patients. Additionally, they ensure a more resilient and effective healthcare workforce during pandemics and similar crises.

Health researchers are encouraged by governments, funders, and journals to conduct research in partnership with people with lived experience. However, conducting research with authentic engagement and partnership with those who are experts by experience, but may not have research methods training, requires resources and specialized skills. The McMaster Collaborative for Health and Aging developed a fellowship program for trainees that builds their capacity to conduct research in partnership with older adults with relevant lived experience. We share this case example, with its successes and challenges, to encourage creative reformation of traditional research training.The Collaborative used an iterative design process, involving researchers, trainees and older adult and caregiver partners, who, together, developed a fellowship program for trainees that provides support and mentorship to plan and conduct health research in partnership with people with lived experience.Since 2022, the Partnership in Research Fellowship has been offered biannually. The application process was purposefully designed to be both constructive and supportive. Opportunities for one-on-one consultations; key resources, including a guide for developing a plan to involve people with relevant lived experience; and feedback from older adult and researcher reviewers are provided to all applicants. Successful trainees engage with older adult and caregiver partners from the Collaborative to advance and enhance a range of skills from facilitating partner meetings to forming advisory committees. Trainees are awarded $1500 CAD to foster reciprocal partnerships. Ten graduate students from various disciplines have participated. Trainees reported positive impacts on their knowledge, comfort, and approach to partnered research. However, the time required for undertaking partnered research activities and involving diverse partners remain obstacles to meaningful engagement.Partnering with people with lived experience in the design of educational programs embeds the principles of partnership and can increase the value and reward for all involved. We share the Partnership in Research Fellowship as a case example to inspire new and transformative approaches in research training and mentorship that will move the field forward from engagement theory to meaningful enactment.
Health researchers are encouraged by governments, funders, and journals to conduct research in partnership with individuals with relevant health conditions or experience. However, conducting research with individuals who are experts by experience, but may not have research training, requires resources and specialized skills. The McMaster Collaborative for Health and Aging developed a fellowship program to support and mentor trainees to conduct their research in partnership with people with lived experience and turn engagement theory into action.The Collaborative involved researchers, trainees, and older adults in the development of the fellowship program. Since 2022, the Partnership in Research Fellowship has been offered twice a year. The application process was designed to be both supportive and informative. Opportunities for one-on-one consultations; key resources, including guiding questions to consider when planning to involve people with relevant lived experience; and feedback from older adults and researchers, are provided to all applicants. Each trainee receives $1500 CAD to support building strong, two-way partnerships. Since the fellowship’s launch, 10 graduate students from different fields have participated. Trainees reported improvements in their knowledge and comfort to partner with people with lived experience in research. However, challenges, such as the extra time needed for conducting partnered research as well as locating and involving those from diverse backgrounds, were identified.Involving people with lived experience in the design of research training incorporates partnership principles and may enhance the benefits and satisfaction for everyone involved. We share the Partnership in Research Fellowship, as an example, to inspire new approaches in research training and mentorship.

BACKGROUND: Global health partnerships are increasingly being used to improve coordination, strengthen health systems, and incentivize government commitment for public health programs. From 2012 to 2022, the Bill & Melinda Gates Foundation (BMGF) and Aliko Dangote Foundation (ADF) forged Memorandum of Understanding (MoU) partnership agreements with six northern state governments to strengthen routine immunization (RI) systems and sustainably increase immunization coverage. This mixed methods evaluation describes the RI MoUs contribution to improving program performance, strengthening capacity and government financial commitment as well as towards increasing immunization coverage.
METHODS: Drawing from stakeholder interviews and a desk review, we describe the MoU inputs and processes and adherence to design. We assess the extent to which the program achieved its objectives as well as the benefits and challenges by drawing from a health facility assessment, client exit interview and qualitative interviews with service providers, community leaders and program participants. Finally, we assess the overall impact of the MoU by evaluating trends in immunization coverage rates.
RESULTS: We found the RI MoUs across the six states to be mostly successful in strengthening health systems, improving accountability and coordination, and increasing the utilization of services and financing for RI. Across all six states, pentavalent 3 vaccine coverage increased from 2011 to 2021 and in some states, the gains were substantial. For example, in Yobe, vaccination coverage increased from 10% in 2011 to nearly 60% in 2021. However, in Sokoto, the change was minimal increasing from only 4% in 2011 to nearly 8% in 2021. However, evaluation findings indicate that issues pertaining to human resources for health, insecurity that inhibits supportive supervision and vaccine logistics as well as harmful socio-cultural norms remain a persistent challenge in the states. There is also a need for a rigorous monitoring and evaluation plan with well-defined measures collected prior to and throughout implementation.
CONCLUSIONS: Introducing a multi-partner approach grounded in a MoU agreement provides a promising approach to addressing health system challenges that confront RI programs.

Empowerment and participation are promoted as critical factors in meaningful development processes; however, action-oriented researchers face challenges in fostering genuine empowerment and meaningful participation within traditional funding cycles and research timelines. This case study illustrates a participatory methodology employed by researchers in partnership with one Honduran non-governmental organization (NGO) to conduct \'practical\' participatory evaluation with rural Honduran youth. Through collaborative autoethnography, two components of this methodology are identified and described. The first component - \'foundational elements\'- includes the NGO\'s culture of transformative participation and the organization\'s attention to synergies in the insider/outsider identities of research partners. The second component includes the ability of the research team to leverage this foundation for the participatory evaluation with rural youth. Importantly, this ability was grounded in and shaped by long-term, trust-based relationships between research partners. These relationships were the catalyst for success in this participatory initiative, connecting the \'foundational elements\' identified to the collaborative outcomes experienced. Overall, this case study contributes to current and ongoing scholarly discussions on how to facilitate meaningful participation and capability expansion in research and evaluation contexts.

Systems thinking has been recognized as valuable to public health policy, research and practice. Commentators and reviews have highlighted that there is still much to be done to embrace its potential. Here, we highlight that much of the discourse about systems thinking in, and for, public health supports the pursuit of a narrow path and is limited with respect to the lineages of Systems that are embraced. We invite readers to see the potential of systems thinking in pursuing a broader path which is motivated by a concern for alleviating health inequalities. This does not replace the narrow path but encompasses it. It prompts different considerations with respect to the nature of the transformation, partnership working and legitimacy. It also invites a different way of engaging with systems thinking and different ways of conceptualizing and managing change. The broad path both requires, and helps enhance, new ways of doing, relating, organizing, knowing and framing which are vital for the future of public health as a global concern.

BACKGROUND: In 2014 the National Health Service (NHS) in England released the Five Year Forward plan1, envisioning a shift in power from health professionals to patients and the public. In response the Society and College of Radiographers (SCoR) produced the \"Patient, Public and Practitioner Partnership within Imaging and Radiotherapy: Guiding Principles\" (P4) document which was implemented within four domains of radiography practice; service delivery, service development, education and research2. This project explored how these guidelines were implemented; and whether improvement to the quality and scope were needed, leading to making recommendations for updating the document.
METHODS: A mixed methods design was adopted with two phases. Phase 1 - a survey exploring use of the P4 document\'s guiding principles. There was no maximum number of participants to ensure inclusivity. Phase 2 - one focus group and four one-to-one interviews from the four domains3.
RESULTS: 626 participants completed the phase 1 survey. 18.85% (n=118) of participants were aware of the document and used it as a reference tool for practice, teaching, and research. 81.15% (n=508) of participants stated they were unaware of the document. Themes from phase 2; importance of service user involvement in service delivery and evaluation, resources to ensure service user involvement, suggestions to update the P4 document and use of the P4 document in radiographer education. Participants acknowledged guidance in the document was best practice. They reported more awareness of patients\' needs and the effect this has on radiographers in supporting their needs.
CONCLUSIONS: Participants recommended the document be given greater visibility. The voices of patients and the public must be heard within radiography practice.
CONCLUSIONS: Feedback from this study can be used for the future development of the P4 document.