Foresight Project

<h3>Background</h3> A large proportion of the working population is at risk of illnesses, accidents and mortality caused by exposure to unfavourable working conditions, such as chemicals, physical strain, noise and stress. To assess the health impact of occupational exposures in the population, we estimated Population Attributable Fractions (PAFs). PAF is defined as the fraction of all cases of a particular disease in a population that is attributable to a specific exposure. The PAF provides insight in the estimated fraction of all workers that would not have occurred if there had been no exposure. <h3>Methods</h3> In the context of the Public Health Foresight Study 2024, we estimated the attributable mortality, years of life lost, years of life lived with disability and disability-adjusted life years (DALYs) for a selection of occupational risk-outcome pairs. PAFs were calculated using relative risks (RRs) of a given outcome and the proportion of workers exposed to the working conditions. RRs were derived from the literature, data on occupational exposure from Dutch studies. If these were not available, PAFs from the literature were used. The estimated PAFs were combined with the disease-specific burden and mortality results and summed. <h3>Results</h3> In 2022, unfavourable working conditions caused 4.1% of the total disease burden and 2.4% of the total mortality in The Netherlands. Exposure to substances leads to the highest occupational burden, followed by psychosocial stressors. The highest occupational burden is due mental disorders, followed by respiratory diseases, cancer and musculoskeletal disorders. Whereas most work-related deaths are caused by cancer, followed by heart diseases and respiratory diseases. <h3>Discussion</h3> Attributable burden of disease assessments provide comprehensive, comparable estimates of health impacts and their associated occupational risks. These estimates give policy makers insight in the influence of occupational risks on the health of employees.

Climate change significantly threatens agriculture and food systems in developing countries, especially in Senegal, where agriculture is vital for livelihoods and economic advancement. A study investigated the factors influencing the adoption of Climate-Smart Agriculture (CSA) innovations among smallholder farmers in Koumpentum, Senegal. Through comprehensive research and multistage random sampling, 270 smallholder farmers were interviewed using structured questionnaires. The results indicated that 56.3% of the farmers have adopted CSA practices. Household size, perceived climate change, and access to climate advisory information positively influenced 70.4% of farmers to adopt crop rotation. Additionally, the farmer's experience (in years) and perception of climate change influenced the adoption of conservation tillage. The study highlights how smallholder-specific characteristics and external influences interact to determine CSA adoption. Moreover, it underscores the need for targeted interventions to promote CSA practices, emphasizing the importance of farmer education, access to climate advisory services, and capacity building. Based on our findings, the policy recommendations include aligning CSA innovations with smallholder preferences and local conditions to enhance adoption rates and strengthen climate resilience in agricultural systems. Policymakers should integrate CSA into Senegalese agricultural policy and develop innovative financing mechanisms to encourage the adoption of adaptation technologies tailored to local contexts to address current and future climate risks.

BackgroundThis is a time of unprecedented change in healthcare. More physicians are being tasked with stepping into a variety of leadership roles without having received the training needed to be an effective leader. Previous data have demonstrated the effectiveness of both leadership coaching and 360-feedback tools to foster physician well-being and leadership growth. In this proof of concept study, we explore the combined effect of these two tools. The objective of this study was to examine the effect of a brief physician 360 leadership coaching intervention on perception of professional dynamics and acquired leadership skills.MethodsParticipants completed a tailored 360-feedback tool to gather input on their leadership skills, then engaged in five bi-weekly leadership coaching sessions. We conducted a post-intervention semi-structured qualitative interview. Qualitative data were coded using an inductive thematic analysis approach.ResultsTwenty-three primary care physicians at an academic medical center engaged in the 360 leadership coaching study. Participants reported that the intervention yielded valuable benefits in five coaching sessions. Two overarching themes emerged: a Shift in leadership awareness and Navigating their environment. Leadership awareness included increased clarity of purpose and role, and recognition that routine feedback is critical to leadership development. Navigating their environment included gaining relationship-building communication, organizational awareness and navigation strategies.ConclusionsCombining a tailored 360-feedback tool with a five-session leadership coaching intervention provided physicians with valued support infrastructure for becoming more effective leaders. Physicians described a nuanced understanding of the leadership challenges physicians face, and identified the leadership tools needed to navigate the evolving healthcare delivery landscape. Curricula for physician leadership learning could consider this combination of a customized 360 plus targeted leadership coaching for training physician leaders.

What if I told you, that humans are not very special? That the very qualities that make us human are not pre‐given features but are rather properties generated by our participation in the world at large. In this view, humans are not mere expressions of blueprints. Rather, we are shaped and fashioned in the course of our lives by many different environments. This presentation challenges the notion of agency itself through an exploration of a recent project we conducted on service robots and human interaction. I raise questions on the nature of our humanness and the idea of ‘humanity’ as a special, protected class. If we set aside humans as special and unique, we tend to then dehumanise and downscale everything that is non‐human, setting the stage for our current malaise where our environment is objectified as a resource to be used up as quickly as possible. I conclude that a shared and sustainable world is one where the qualities of life are accorded to all things, human and non‐human alike.