Indigenous Sundanese Leadership: Eco-Systemic Lessons on Zero Emissions: A conversation with Indigenous leaders in Ciptagelar, West Java.

'Ecology of mind' (Bateson, 1972) is a key concept applied to this project engaged in by a social anthropologist, a policy researcher, and a Sundanese Chief. Together we explore how the agendas for COP 26 could be attained and to what extent the Nobel economist Elinor Ostrom's (2018) eight principles are relevant for managing the commons and key learnings that can be shared more broadly.The paper details the Sundanese forest community's organisational systems to support living in ways that re-generate and sustain the forest and the way that the community has connected with Universitas Padjadjaran and an NGO called the Common Room Networks (common room.id), in order to support and extend their learning with nature program within and beyond Indonesia. Decolonising and learning from Indigenous leadership can be fostered through forming communities of practice between universities and indigenous leaders. The paper discusses how the Ciptagelar community demonstrates low carbon living and how they have organised agriculture in terms of a seasonal calendar. It makes the case that sharing their agricultural methods and community lifestyle to lower emissions could help to inspire others to follow their re-generative approach to governance and their organisational strategies. The paper demonstrates the relevance of Ostrom's principles which are considered in relation to the case study. On the basis of a series of conversations held via zoom and email we make a case for learning from the leadership rooted in the Sundanese culture and demonstrated in West Java First Nations. It can be read as a twin paper with the paper on the Venda forest, titled 'Eco-centric living: a way forward towards zero carbon'.

Use of Implementation Science for a Sustained Reduction of Central-Line-Associated Bloodstream Infections in a High-Volume, Regional Burn Unit.

OBJECTIVE We describe the use of implementation science at the unit level and organizational level to guide an intervention to reduce central-line-associated bloodstream infections (CLABSIs) in a high-volume, regional, burn intensive care unit (BICU). DESIGN A single center observational quasi-experimental study. SETTING A regional BICU in Maryland serving 300-400 burn patients annually. INTERVENTIONS In 2011, an organizational-level and unit-level intervention was implemented to reduce the rates of CLABSI in a high-risk patient population in the BICU. At the organization level, leaders declared a goal of zero infections, created an infrastructure to support improvement efforts by creating a coordinating team, and engaged bedside staff. Performance data were transparently shared. At the unit level, the Comprehensive Unit-based Safety Program (CUSP)/ Translating Research Into Practice (TRIP) model was used. A series of interventions were implemented: development of new blood culture procurement criteria, implementation of chlorhexidine bathing and chlorhexidine dressings, use of alcohol impregnated caps, routine performance of root-cause analysis with executive engagement, and routine central venous catheter changes. RESULTS The use of an implementation science framework to guide multiple interventions resulted in the reduction of CLABSI rates from 15.5 per 1,000 central-line days to zero with a sustained rate of zero CLABSIs over 3 years (rate difference, 15.5; 95% confidence interval, 8.54-22.48). CONCLUSIONS CLABSIs in high-risk units may be preventable with the a use a structured organizational and unit-level paradigm. Infect Control Hosp Epidemiol 2017;38:1306-1311.

Evolutionary drift in systems of care development.

While we agree that it is necessary to articulate a "clearly specified population" for the definition of systems of care, we believe that limiting systems of care to "children and youth with serious emotional disturbance and their families" is not in the best interest of most communities. Using this narrow population definition excludes the other 80-90% of the youth who have mental health challenges but have not risen to the highest level of need. If all children and their families receive the right amount of support from the system of care at the right time, they will avoid the need for more intensive and expensive services and supports later. This public health approach helps to build more stable communities and redirects scarce resources to interventions that are less costly than those needed for youth who already have developed serious emotional disturbances. The key to successfully supplying the "right amount at the right time" is to ensure that the system of care is truly needs driven, rather than agency or service system driven. A system of care for children, youth and their families should reflect community preferences and embrace a public health approach where all levels of need are served.

Developing and maintaining collaboration in systems of care for children and youths with emotional and behavioral disabilities and their families.

Many communities have implemented systems of care in an effort to better coordinate and integrate mental health and other social services for children and youths, while simultaneously managing existing funding sources more effectively. Systems of care represent a fundamentally different way of delivering mental health services and accordingly require new approaches for both developing and sustaining collaboration. This article examines obstacles to collaboration and addresses key factors required to build and sustain collaboration.