Evidence-based policymaking (EBPM) improves the quality of decision-making and ensures that necessary policies reach the populations who need them. Although EBPM-promoting factors have been conceptually explored, interventions that comprehensively address these factors remain under-investigated. Through qualitative research, we previously identified 25 factors that promote EBPM. Thus, this study aimed to (1) evaluate the perceived effectiveness of factors that promote EBPM and (2) assess the perceived effectiveness of interventions designed to address these factors. A cross-sectional survey was conducted in Japan among three stakeholder groups: policymakers, researchers and knowledge brokers (KBs). Participants assessed the perceived effectiveness of the 25 factors and 75 corresponding intervention strategies. The mean scores were calculated for each factor, and the proportion of respondents who considered each intervention effective within its respective factor was determined. Of the 154 invited participants, 55 completed the survey, including policymakers (n = 15), researchers (n = 25) and KBs (n = 15). The highest-rated factor was "organizing and disseminating leverageable evidence and data" (mean = 4.53), which included the intervention "development of data infrastructure easily utilizable by researchers while ensuring personal information protection", selected as effective by 78.2% of the respondents. The second highest-rated factor was "enhancing the knowledge and skills of policymakers and researchers in policymaking processes, EBPM, and research" (mean = 4.37). Within this factor, two interventions shared the highest selection rate (72.3%): "establishment of an in-ministry training system enabling policymakers to acquire essential skills regardless of department" and "development and provision of EBPM-related educational content for professional organizations (academic societies) and policymakers". This study identified the perceived effectiveness of 25 EBPM-promoting factors and 75 related interventions in the Japanese policymaking context on the basis of input from policymakers, researchers and KBs. These findings provide a foundation for the implementation of strategies by outlining practical interventions. The descriptive trends in perceived effectiveness across stakeholders suggest that implementation should reflect each group's priorities, roles and constraints. This study contributes to EBPM literature by systematically linking factors with interventions and demonstrating how stakeholder perspectives differ, thereby strengthening the basis for promoting EBPM in practice.
Dietitians are increasingly called upon to address complex food systems challenges, including the transition to circular economies that support both human and planetary health. This reflexive perspective draws on a structured reflective process undertaken by the research team to explore how dietitians can apply their core competencies, such as critical thinking, evidence-based practice, and communication, to lead and facilitate food systems transformation. Drawing on a case study from the Bega Valley region of Australia, known for its unique focus on circularity, researchers from the University of Wollongong conducted interviews with small-scale agrifood producers to identify barriers and enablers to circular supply chains. Findings from this prior qualitative study subsequently informed a structured reflection process undertaken by the inter-disciplinary research team which included dietitians. Using Borton's Reflective Model ('What? So What? Now What?' framework), researchers reflected on the role of dietitians in advancing food systems transformation. Reflexive thematic analysis was applied to the written reflections to identify key themes across each stage of the framework. Of the 10 original research team members, seven completed the reflection process, comprising three dietitians, two engineers with an interest in circular economy, one supply chain expert, and one food systems doctoral researcher. The collective reflections showed: What? We engaged in research exploring perspectives of small-scale producers towards circularity to understand the barriers and enablers towards implementing more circular supply chains. So What? The reflection highlighted dietitians' capacity to engage diverse stakeholders and navigate complexity, with potential to broaden their scope in transitioning the food system. Now What? Researchers proposed actionable pathways to increase dietitians' competencies in systems transformation. Professional advocacy is required to position dietitians for future food system and policy roles. Reflections from this study suggest that dietitians are well-positioned to act as connectors and brokers within food systems when equipped with systems thinking tools and opportunities for cross-sector engagement.
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The study examines sibling brokerage as a form of cultural, linguistic and institutional labour performed by siblings of individuals with intellectual and developmental disabilities from historically marginalised communities. Ten adult sibling brokers were recruited and completed open-ended questionnaires. Data were analysed thematically, guided by conceptual frameworks of epistemic injustice. Findings reveal that sibling brokers serve as system navigators, translating institutional logics, advocating for services and rearticulating family knowledge. Their labour often began in childhood, was shaped by hegemonic expectations to fit into the system and was frequently unacknowledged or co-opted by professionals. Sibling brokerage is not ancillary but structurally embedded labour that compensates for systemic gaps in accessibility and inclusion. Future research should examine how such roles are institutionally produced and sustained and envision justice-oriented systems that recognise the expertise of sibling brokers. This study explores the experiences of siblings who help their families navigate disability services for a brother or sister with intellectual or developmental disabilities' service access, namely, sibling brokers. Many of these sibling brokers, especially from culturally and linguistically diverse communities, take on important roles like translating, interpreting, filling out forms and advocating for services—often starting at a young age. Their work goes far beyond helping out at home; they are doing important tasks usually handled by trained professionals, yet their efforts are often overlooked or taken for granted. This research calls for greater recognition of sibling expertise and urges systems to support these siblings with appropriate acknowledgement.
Organ transplantation is regarded as a lifesaving procedure, and a worldwide organ shortage has catalysed the market of illegal organ trade, especially for kidneys, due to high demand and need in low and middle-income countries like Pakistan. This process is often facilitated by sophisticated, organised crime networks acting within or parallel with licit healthcare systems, exploiting the vulnerable communities. Therefore, this study aims to explore the lived experiences of individuals who illegally donate their kidneys in Pakistan, with special focus on the whole process to map the findings on the crime script framework. The present study employs a qualitative, exploratory design using a semi-structured interview guide. Detailed in-depth interviews were conducted with five kidney donors using the snowball sampling technique. A thematic analysis approach was employed to interpret data, aided by crime script analysis to analyse the systemic organisation of the illegal kidney trade. Findings were divided into three major themes: Before Donation, During Donation, and After Donation. Participants explained that they were deceived by brokers, blindfolded, taken to hidden sites, and subjected to coercive surgery. Most suffered from health decline, psychological trauma, and economic instability after donation, with no long-term benefits. The crime script framework identified the sequential pattern of exploitation by brokers and collusive medical staff. Pakistan's illegal kidney trade is operated through an intricate yet predictable cycle based on poverty and poor regulation. Targeted policy change, institutional responsibility, and donor-focused protective measures are desperately needed to end exploitation.
Emphasis on 'evidence-based' practice in education has intensified in Australia over the past three decades. This article charts this rise by presenting a corpus-assisted discourse analysis of a purpose-built corpus of over 1,600 articles published in Australian national and capital city daily newspapers between 1988 and 2024. Using the conceptual lens of 'media logic' (Altheide, 2013), we explore four phases of 'evidence-based' practice linked to the 'what works' agenda. Our analysis finds an increasing focus over time on specific aspects of pedagogical instruction, particularly in the areas of phonics and reading, with emphasis placed on the superiority of explicit and direct instruction. Within the corpus, evidence-based approaches are often equated with value-neutral, rigorous and effective methods, and the idea of 'evidence' as universally uncontested, proven and removed from teacher professional judgement. The final years of the corpus demonstrate a marked increase in attention to 'evidence-based' and 'what works' approaches, in parallel with reference to knowledge brokers and other private interests. Within this push for 'what works', we identified a growing emphasis on outsourcing traditional teacher-led activities, such as lesson planning and curriculum work, as frequently advocated by private interests, intermediary organisations and knowledge brokers, positioning the notion of 'evidence-based' as a silver bullet for a number of problems, including teacher shortages.
Aged care systems are under increasing pressures, demanding optimised interdisciplinary teams. Pharmacist roles are expanding into these teams, and successful integration requires an understanding of team member perspectives. This systematic review and meta-synthesis aimed to identify, analyse and present the published literature pertaining to healthcare professional perspectives of the roles of pharmacists working in residential aged care settings. A systematic search of literature published between 2000 and 2025, in English language only, was undertaken across Embase, Medline, CINAHL and Web of Science. Primary studies addressing the research aim were eligible for inclusion. The Mixed Methods Appraisal Tool was used to assess methodological quality of each paper; no papers were excluded based on quality. Two researchers independently reviewed and reached consensus agreement for all studies to include. Both researchers undertook a thematic synthesis of qualitative data to identify analytic themes. After removing duplicates, 1874 unique papers were identified through database searching and an additional two papers identified through citation searching. After screening, we included 39 papers for data extraction and analysis. Three overarching themes were identified. Theme 1: 'Supporting the role' describes how pharmacist roles in aged care are supported through building trust with the team, education and experience, access to information, specific attributes, organisational buy-in, favourable models of care, and role clarity. Theme 2: 'Medicines expertise activities' describes how pharmacists perform three key roles valued by healthcare staff: knowledge and communication brokers, filling existing gaps in care, and optimising quality use of medicines. Theme 3: 'Helping the team' illustrates health professionals' perception of three distinct outcomes of pharmacist input (ie enhanced confidence, improved workforce capacity and capability, and improved person-centred care). This meta-synthesis of the evidence regarding the perceptions of healthcare professionals on the role of pharmacists in aged care provides contextual information for individuals, organisations and policy-makers for future implementation. Pharmacists are perceived to improve stakeholder confidence, staff capacity and capability, and overall person-centred care. Embedded roles that foster interdisciplinary collaboration are preferred to irregular visiting roles. These embedded roles are enabled through a range of mechanisms that policymakers, organisations and individuals may leverage for successful implementation in future iterations.
A global value chain (GVC)-an international network linking producers and consumers through multiple intermediaries-has rapidly emerged in recent years to connect geographically dispersed cultivators and consumers of legal medical cannabis. This is commonly presented as an important new economic development opportunity for low- and middle-income countries with favourable agro-ecological conditions. This paper analyses the growth of the legal medical cannabis GVC in South Africa, a major emerging supplier, focusing on how chain governance and power relations shape processes of inclusion, exclusion, and value capture. The paper draws on 34 semi-structured interviews conducted between 2021 and 2024 with a range of stakeholders in the medical cannabis GVC, including cultivators, brokers, consultants, and civil society. Interviews were analysed using Nvivo with a hybrid coding strategy. Interviews reveal that cultivators face intersecting challenges: regulatory complexity, increasingly intense competition, bargaining power imbalances, and a demanding series of quality conventions in which the sensory and aesthetic qualities of an artisanal product must be combined with pharmaceutical rigour. Barriers to entry are high, and costly upgrading processes are necessary to avoid falling into a commoditisation trap as easily-replaceable suppliers of a generic good, subject to 'race to the bottom' competition and price volatility. These challenges undermine aspirations for medical cannabis exports to serve as an inclusive economic development opportunity for small-scale cultivators in the Global South. GVC participation requires major capital expenditures and advanced capabilities. Overcoming these challenges would require significant policy support.
Rehabilitation physicians worldwide have been called to take action to explore and implement the International Society of Physical and Rehabilitation Medicine's Clinical Functioning Information Tool - ClinFIT. ClinFIT is an International Classification of Functioning, Disability and Health-based and clinician-administered tool that can be used to systematically assess and report functioning of different patient populations across the care continuum and support the monitoring of rehabilitation outcomes. One essential action step is getting familiar with ClinFIT. It is possible to create a ClinFIT version for your setting and purpose, either by tailoring an existing ClinFIT version or by developing a new version for a specific health condition or context. This paper describes how to create a ClinFIT that works for you. Specifically, it provides you with information about current ClinFIT versions and what to consider when creating the desired ClinFIT version and presents a step-by-step guide for either tailoring an existing ClinFIT version or for developing a new ClinFIT version. This paper also introduces reporting considerations to enhance clinical utility as well as emerging opportunities offered by artificial intelligence and other digital technologies. Lastly, the authors invite all PRM physicians worldwide to join the ClinFIT community as knowledge-brokers and as champions, actively disseminating information about ClinFIT and participating in ClinFIT research.
The principle of dignity of risk (DoR) has become a cornerstone of contemporary aged care reform. DoR is ethically framed as an extension of autonomy and person-centred care. While widely considered in policy and professional discourse, DoR is often treated as a self-evident ethical good, with limited critical attention to how it is operationalised within regulated care systems. This paper offers a critical ethical analysis of DoR as enacted in contemporary aged care, arguing that it functions not merely as a moral principle but as a moral technology that redistributes responsibility, liability and ethical burden across residents, nurses, families, organisations and regulatory structures. Drawing on nursing ethics, relational autonomy and regulatory theory, the paper examines how documentation practices, audit cultures and family involvement reconstitute nurses as ethical risk brokers who must legitimise resident choice while remaining accountable for adverse outcomes. Rather than rejecting DoR, the paper reframes it as a form of collective ethical responsibility which requires organisational, regulatory and moral support for nurses beyond individualised accountability. This analysis highlights the need to move from symbolic invocations of autonomy toward ethically sustainable practices that recognise the relational and institutional labour underpinning DoR in everyday nursing practice.
While Industry 4.0 established connectivity and automation as foundations of smart factories, the emerging vision of Industry 5.0 emphasizes human-centric, resilient, and sustainable systems. Within this evolution, integrating Digital Twins (DTs) with Programmable Logic Controllers (PLCs) in cloud environments remains constrained by the lack of communication protocols that satisfy strict real-time requirements. To address this gap, this paper introduces and validates a WebSocket-S7 protocol bridge for low-latency, full-duplex communication between Siemens S7 PLCs and cloud-hosted DT models. The main contribution of this work is the design and experimental validation of a lightweight, event-driven WebSocket-S7 architecture. This architecture decouples real-time PLC execution from cloud-based digital twin interaction, enabling deterministic performance over wide-area networks without relying on brokers or polling mechanisms. A comprehensive evaluation compares the proposed bridge with MQTT, OPC UA, and Modbus for real-time PLC-DT interactions managed through Node-RED. Using AWS as the cloud backend, the study assesses performance, scalability, and stability under single-user and multi-user emulated loads. Protocols were profiled using JMeter (load and latency), Wireshark (packet traces), and the Unity Profiler (CPU/memory on Android), with timing judged against IEC 61588 ([Formula: see text]). In remote cloud deployment, WebSocket-S7 achieved an average round-trip time (RTT) of 87 ms, remaining within the IEC 61588 threshold. It outperformed alternative protocols by clear margins-34.6% lower RTT than MQTT (133 ms), 46.3% lower than OPC UA (162 ms), and 55.2% lower than Modbus (194 ms), yielding absolute gains of 46, 75, and 107 ms, respectively. Under multi-user emulation, WebSocket-S7 maintained sub-100 ms average response times for up to 40 concurrent users with near-zero error rates, while MQTT offered a balanced option for moderate-throughput scenarios. These trends reflect WebSocket's lightweight framing and persistent, broker-less transport. Together, these characteristics minimize connection overhead and jitter in WAN conditions. The findings position WebSocket-S7 as a lightweight and scalable solution for remote DT-PLC integration, particularly when standardized protocols incur higher overhead. By consistently meeting IEC-compliant timing requirements, the proposed bridge provides a practical and robust foundation for deploying real-time digital twins in both educational and industrial automation settings.
Background: Family-centered care (FCC) is a foundational principle in pediatric healthcare, yet its implementation in culturally specific contexts remains poorly understood. In Saudi Arabia, Islamic values, collective family structures, and gendered caregiving norms shape how mothers engage with pediatric intensive care in ways that existing Western-derived FCC models do not fully capture. The aim of this study was to explore Saudi mothers' experiences of family-centered care during their children's pediatric intensive care unit (PICU) admissions, focusing on perceived barriers, cultural negotiations, and evolving advocacy strategies. Methods: A qualitative descriptive study was conducted with 17 Saudi mothers whose children had been admitted to PICUs across major hospitals in Saudi Arabia within the preceding 12 months. Semi-structured interviews lasting 40-70 min were conducted in Arabic using a pilot-tested, 15-item guide. Data were analyzed through Braun and Clarke's six-phase reflexive thematic analysis. Trustworthiness was strengthened through member checking, reflexive journaling, negative case analysis, and investigator triangulation. Reporting adheres to the Consolidated Criteria for Reporting Qualitative Research (COREQ). Result: Five interconnected themes emerged: (1) confronting crisis and uncertainty, (2) renegotiating maternal identity, (3) brokering culture within biomedicine, (4) forging trust with care teams, and (5) evolving into advocates. These themes trace a developmental arc from initial disorientation through progressive empowerment, shaped at every stage by culturally grounded resources and constraints. Mothers functioned as cultural brokers performing invisible labor that healthcare systems neither recognized nor supported. Conclusions: Saudi mothers in PICUs engage in sophisticated cultural mediation between family systems and biomedical institutions under conditions of acute stress. Findings underscore the need for structurally embedded cultural responsiveness in PICU policy, including continuous cultural assessment, care-team continuity, and family advocacy support.
Background. The Medicare Part D program provides stand-alone prescription drug insurance to US residents aged ≥65 y and those with disabilities. Annually, they can choose to stay with their plan or to switch to one of the many alternative plans. Behavioral decision-making research has proposed various strategies for tackling such complex choices. Here, we interviewed Medicare Part D beneficiaries to understand their real-world experiences with making their plan choices and examined quotes from those who stayed with their first plan and those who had switched. Method. In July 2023, we conducted phone interviews with 20 Medicare Part D beneficiaries aged 57 to 86 y who were recruited through the US-wide Understanding America Study. Results. Eleven interviewees had stayed with their first plan, and 9 had switched. Stayers and switchers applied similar strategies, with mixed success. Using decision-support tools such as the Medicare plan-finder Web site, booklet, and mailers could be time-consuming and confusing. Recommendations were taken from insurance brokers, agents, and pharmacists, often without questioning their advice. Interviewees varied widely in the amount of information they considered, with some using heuristics to reduce their choice set and others considering only 1 recommended option. Few beneficiaries made annual plan comparisons, and while some deferred choices until necessary, others did not act even after being confronted with plan changes or negative experiences - due to knowledge and time constraints. Discussion. Medicare beneficiaries use various strategies known from the behavioral decision-making research literature for tackling complex choices between Medicare Part D stand-alone plans. Each strategy posed its own challenges. We discuss our findings in light of the behavioral decision-making literature and recommend policies for helping beneficiaries with their plan choices. We interviewed Medicare Part D beneficiaries about how they tackled drug insurance plan choices with many options and complicated features.Interviewees reported using decision-support tools, seeking help, applying heuristics, and relying on choice deferral, but with mixed success.Qualitatively, similar experiences were described by interviewees who stayed with their initial plan and those who had switched.We recommend policies for addressing the difficulties beneficiaries had in applying these strategies.
In 2023, Colorado implemented the only state-funded marketplace-like US private health insurance program for undocumented immigrants. Community health workers and brokers served as enrollment assisters (EAs) and played a pivotal role in helping clients enroll in insurance plans and navigate the health care system. Understanding the perspectives of EAs is important to inform scalability and implementation as other states consider launching similar state-funded health insurance programs for undocumented immigrants, particularly amid declining federal support for underserved populations. To explore the experiences of EAs who supported undocumented immigrants in enrolling in and using private health insurance. This qualitative study included semistructured interviews conducted between December 2024 and March 2025 in both English and Spanish at EA sites across Colorado. Interviews were audio-recorded, translated, transcribed, and analyzed using thematic analysis. EAs who enrolled undocumented immigrants in private health insurance during at least 2 of the enrollment years from 2023 to 2025 were interviewed. Themes and subthemes. A total of 24 individuals (16 [67%] female; 8 [33%] male) participated. Four themes were identified: (1) improved health and reduced reliance on emergency services (limited insurance options; improved health and quality of life; reduced need for emergency services), (2) limited spots, high demand, and need for health literacy education (emotional distress from limited spots amid high need; low-level health insurance literacy and need for education), (3) strong rapport with EAs helps to alleviate fears of deportation (perceived risk to future citizenship from insurance enrollment; community relationships, trust, and rapport), and (4) culturally responsive strategies for resources, processes, and policy (building connection through culturally informed preenrollment resources; enhancing postenrollment support for lasting impact; redesigning the allocation process; strategies for policy improvements to strengthen the framework). In this qualitative study, EAs perceived that the program fills a long-standing gap in health insurance coverage, improving clients' health and quality of life while reducing emergency use. They also identified challenges related to the limited number of spots and client unfamiliarity with insurance. These findings may inform efforts by other states seeking to develop similar programs for undocumented immigrants.
This cross-sectional study estimates the proportion of beneficiaries enrolled in Medicare Advantage by brokers and the associated broker fees in the US.
Scientists are increasingly expected to not only produce objective science but also to use their science and expertise to support the public good. Prior studies indicate that scientists see both responsibilities as important; however, it is not clear how scientists manage these responsibilities when they are perceived to be in tension. In this study, scientists at land-grant institutions (n = 87) were presented with binary choices to identify where tensions may exist and how scientists make decisions between competing responsibilities. We examined nine categories of potential tensions: direct conflicts between objectivity and public impact, engagement in public outreach, communication priorities and approach, political engagement and perceived bias, the media, funding and disclosure, supporting/protecting specific causes, diversity, and ethical decision making. Results indicate that scientists belong to three cultures of ethical thought: arbiters, advocates, and brokers. These cultures roughly align with the scientist roles described by Pielke and suggest different prioritizations of commitment to public service relative to commitment to objective science, though both commitments were valued. There was variation across cultures of thought on whether scientists should openly support policies based on their research. Broad areas of agreement across cultures of thought were also identified. Scientists of all cultures of thought indicated a willingness to see themselves in a public role, communicating openly with non-experts on issues where scientific research intersects with the public good. There was also an expressed need for scientists to receive better training and tools to manage conflicting responsibilities.
Knowledge brokering, the process of connecting research with policy and practice, carries significant responsibility for accurate and honest representation of evidence. Despite this, there is currently no agreed-upon definition of research misuse in knowledge-brokering contexts, nor a framework for identifying it. Ofsted's 2021 mathematics 'research review' attracted substantial critique from the mathematics education community, with multiple claims of research misuse, making it a well-documented case through which to explore these issues. This article argues that Ofsted (2021) constitutes research misuse in knowledge brokering, enabled by research-washing, defined as presenting evidence-based work as credible or trustworthy without using credible or trustworthy processes to create it. A novel typology of research misuse in knowledge brokering is proposed, drawing on the author's extensive experience as a knowledge broker and comprising misquotation or mis-citation, necrocitation, transmission, cherry-picking, conflict of interest, misrepresentation, misinference and hubris. This typology is tested against Ofsted (2021) using publicly available community critiques as evidence. Substantial and sustained evidence of multiple elements of the typology is found, supporting a conclusion of research misuse. Identifying research misuse in knowledge-brokering products such as evidence syntheses and research reviews is crucial for holding knowledge brokers accountable. The typology proposed here could be validated against further cases and developed into a practical tool for evaluating knowledge-brokering quality and practice.
Given the public health burden associated with health behaviors such as substance use, significant efforts are directed toward developing effective interventions to facilitate health behavior change. As digital technologies continue to advance at accelerating pace and integrate into people's daily lives, researchers have a unique and significant opportunity to leverage these tools to advance theory and practice. Emerging tools, novel intervention targets, and technologies have great potential to improve health behavior change research to unburden individuals and communities impacted by substance use and related behaviors, though much work remains to be done to fully realize this potential. This article examines the current state of the health behavior change research highlighting recent innovations facilitated by digital transformations. Looking ahead, potential challenges and opportunities are discussed, along with a call for health behavior change researchers to become intentional interdisciplinary collaborators and innovation brokers toward the development of effective theory-informed digital tools and to maximize the field's impact on public health outcomes. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
Despite the established need for evidence-based practice (EBP), its implementation in nursing remains inconsistent due to organizational, presentation, and individual barriers. Mentorship is frequently cited as a solution, yet its specific mechanisms for bridging evidence to practice are underexplored. This study aimed to examine how mentorship functions as a strategy to support EBP implementation. First, we discuss how mentorship addresses nurse-related barriers by providing just-in-time coaching and role modeling, enabling mentors to build mentees' critical appraisal skills and clinical confidence. Second, we examine how mentorship mitigates presentation-related barriers by enabling mentors to act as knowledge brokers, translating complex evidence into accessible, context-specific guidance for the bedside. Third, we outline how mentorship addresses organizational or setting-related barriers by embedding EBP into formalized structures, including defined mentor roles, protected time, and evaluation metrics. To operationalize these mechanisms, we propose an implementation mapping framework that identifies key actors, targeted actions, and measurable outcomes while addressing structural challenges such as limited protected time. We conclude that formalized mentorship is essential for transforming theoretical evidence into sustainable bedside practice and fostering a culture of excellence that directly improves patient outcomes.
The deep integration of the Internet of Things (IoT) and blockchain technology enables emerging applications in multi-party collaboration and trusted data sharing. However, the scalability constraints of blockchain networks remain a major bottleneck when handling high-frequency interactions in IoT-blockchain systems. Sharding addresses this challenge by partitioning the blockchain network into parallel sub-networks. Nevertheless, it introduces significant coordination overhead for cross-shard transactions. Among mitigation strategies, Broker-based mechanisms (e.g., BrokerChain) have attracted increasing attention for their efficiency in handling cross-shard communication by reducing verification overhead and communication latency. Despite these advantages, existing research typically treats the Broker group as a fixed configuration, neglecting the impact of Broker selection on system performance. To bridge this gap, this paper proposes the Accumulative Activity-Temporal Liveness Broker Selection Strategy (AT-BSS) to optimize cross-shard transaction processing in sharded IoT-blockchains. Specifically, we formally characterize the Accumulative Activity and Temporal Liveness of accounts in the account-transaction network and use these two metrics to identify accounts that maximize transaction-aggregation efficiency. We implement AT-BSS on the BlockEmulator platform and evaluate it against two baselines, namely, ABChain and BrokerChain. Under different settings of the number of Brokers (BrokerNum), number of shards (ShardNum), transaction arrival rate (InjectSpeed), and maximum block size (MaxBlockSize), AT-BSS consistently outperforms both baselines in terms of Transactions Per Second (TPS), Transaction Confirmation Latency (TCL), and Cross-shard Transaction Ratio (CTX). Compared with ABChain, AT-BSS achieves up to 15.5% higher TPS and reduces TCL and CTX by up to 80.2% and 28.7%, respectively. AT-BSS yields more pronounced results over BrokerChain, with TPS improvements of up to 229% and reductions of up to 97.7% in TCL and 80.5% in CTX.