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Importance: The COVID-19 pandemic is the greatest global test of health leadership of our generation. There is an urgent need to provide guidance for leaders at all levels during the unprecedented preresolution recovery stage.
Objective: To create an evidence- and expertise-informed framework of leadership imperatives to serve as a resource to guide health and public health leaders during the postemergency stage of the pandemic.
Evidence Review: A literature search in PubMed, MEDLINE, and Embase revealed 10 910 articles published between 2000 and 2021 that included the terms leadership and variations of emergency, crisis, disaster, pandemic, COVID-19, or public health. Using the Standards for Quality Improvement Reporting Excellence reporting guideline for consensus statement development, this assessment adopted a 6-round modified Delphi approach involving 32 expert coauthors from 17 countries who participated in creating and validating a framework outlining essential leadership imperatives.
Findings: The 10 imperatives in the framework are: (1) acknowledge staff and celebrate successes; (2) provide support for staff well-being; (3) develop a clear understanding of the current local and global context, along with informed projections; (4) prepare for future emergencies (personnel, resources, protocols, contingency plans, coalitions, and training); (5) reassess priorities explicitly and regularly and provide purpose, meaning, and direction; (6) maximize team, organizational, and system performance and discuss enhancements; (7) manage the backlog of paused services and consider improvements while avoiding burnout and moral distress; (8) sustain learning, innovations, and collaborations, and imagine future possibilities; (9) provide regular communication and engender trust; and (10) in consultation with public health and fellow leaders, provide safety information and recommendations to government, other organizations, staff, and the community to improve equitable and integrated care and emergency preparedness systemwide.
Conclusions And Relevance: Leaders who most effectively implement these imperatives are ideally positioned to address urgent needs and inequalities in health systems and to cocreate with their organizations a future that best serves stakeholders and communities.
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http://dx.doi.org/10.1001/jamanetworkopen.2021.20295 | DOI Listing |
Public Health
September 2025
Department of Public Health, Erasmus MC University Medical Center, Rotterdam, the Netherlands.
Objectives: Participation rates in fecal immunochemical test (FIT)-based colorectal cancer (CRC) screening differ across socio-demographic subgroups. The largest health gains could be achieved in subgroups with low participation rates and high risk of CRC. We investigated the CRC risk within different socio-demographic subgroups with low participation in the Dutch CRC screening program.
View Article and Find Full Text PDFTurk J Pediatr
September 2025
Division of Developmental Pediatrics, Department of Pediatrics, Faculty of Medicine, Hacettepe University, Ankara, Türkiye.
Background: Autism spectrum disorder (ASD) is more frequently diagnosed in boys than in girls, possibly due to gender-based differences in symptom presentation or referral patterns. This study investigates gender-related variations in symptom severity and clinical presentation among preschool children referred for suspected ASD.
Methods: This study included 125 children (boys: n=103; girls: n=22) aged 2-5 years suspected of having ASD.
Turk J Pediatr
September 2025
Division of Pediatric Infectious Diseases, Faculty of Medicine, İstanbul University, İstanbul, Türkiye.
Aim: This study aimed to describe barriers and facilitators of the adherence of children with human immunodeficiency virus (HIV) to antiretroviral therapy (ART) from the perspectives of their caregivers.
Methods: In-depth interviews were held with the caregivers of 15 children. The collected data were analyzed using thematic analysis procedures.
Turk J Pediatr
September 2025
West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China.
Background: The α-actinin-4 (ACTN4) gene encodes an actin-binding protein, which plays a crucial role in maintaining the structure and function of podocytes. Previous studies have confirmed that ACTN4 mutations can lead to focal segmental glomerulosclerosis-1 (FSGS1), a rare disease primarily manifesting in adolescence or adulthood, characterized by mild to moderate proteinuria, with some cases progressing slowly to end-stage renal disease.
Case Presentation: We report a 12.
Turk J Pediatr
September 2025
Department of Pediatric Neurology, Faculty of Medicine, İstanbul University-Cerrahpaşa, İstanbul, Türkiye.
Background: Children with cerebral palsy (CP) may experience epilepsy and challenges with movement, posture, cognition, and musculoskeletal development, which can impact their quality of life (QOL). In this study, we investigated the relationship between demographic and clinical variables as well as QOL in children with spastic CP.
Methods: Children aged 6 to 12 years with CP who were followed-up at our tertiary center were included in this cross-sectional study, regardless of the cause.