ABSTRACT
Climate change is an extremely complex challenge characterized by its systemic nature and deep uncertainties. Thus, finding solutions requires a continuing and constructive dialogue between the research community and a wide range of stakeholders from governments, non-governmental organizations, civil society, international organizations, industry, businesses and financial institutions. The ENGAGE project (https://www.engage-climate.org/) is advancing knowledge co-production through an iterative process of stakeholder engagement with two main streams: (i) stakeholder co-design and assessment of global decarbonization pathways and (ii) stakeholder dialogues on national policies and pathways. Both the global and national stakeholder processes are designed to inform multiple project activities, including: conceptualization of feasibility and assessing the feasibility of decarbonization policies and strategies;decarbonization pathway development using integrated assessment models and considering both feasibility and equity;and assessment of the relative importance of climate change impacts vis-à-vis potential co-benefits. With the start of the COVID-19 pandemic 6 months after the beginning of the project, all of the stakeholder engagement activities had to be organized as online events. Between March 2020 and April 2022, 5 online workshops were organized, two at the global level and 3 at the regional/national level. This paper documents how the challenges of effectively engaging stakeholders in a co-design and dialogue process in an online setting have been met through a process of evaluation and learning that led to the introduction of new approaches and tools to support an inclusive exploration and development of low-carbon transition pathways. We show that a combination of interactive visualizations, open channel surveys and moderated breakout groups are particularly useful tools for online stakeholder engagement. The learning that has taken place through the use of these tools is demonstrated with reference to both the research team (e.g., learning about stakeholders' views on the feasibility of decarbonization pathways) and the stakeholders (e.g., learning about experiences in other countries in dealing with the challenges of decarbonization). The results of using these tools have been used within the project in the design of new decarbonization pathways using integrated assessment models, in the development of a framework for feasibility assessment and in increased attention to socio-economic drivers of change. We conclude that despite several advantages of online engagement, such as the expanded geographical coverage and reduced CO2 emissions, the need to keep online meetings short means that important elements of face-to-face meetings cannot be included. Online activities cannot completely replace physical meetings when dealing with complex issues such as climate change. Copyright © 2023 Jäger, Brutschin, Pianta, Omann, Kammerlander, Sudharmma Vishwanathan, Vrontisi, MacDonald and van Ruijven.
ABSTRACT
Introduction: With the recent worldwide outbreak of COVID-19, it became clear that certain comorbidities areassociated with an increased risk of complications and death. Several publications have reported an increased rateof ICU admission and mortality in cancer patients. This has led to guidelines advising more conservativeapproaches to cancer therapy, including chemotherapy. In the absence of prospective, disease-specific outcomedata, there is a risk of overestimating the risk of COVID-19 and thus increasing cancer-specific mortality or ofunderestimating. MammaPrint has been validated for selecting clinically high-risk breast cancer patients in whomchemotherapy can be avoided safely. Methods: We evaluated the current published literature related to the potential risk of breast cancer andchemotherapy in association with COVID-19. We estimated the potential risk of severe events in COVID-19 breastcancer patients receiving adjuvant chemotherapy to assess whether MammaPrint could help us further in makingchemotherapy decisions specific to an infectious epidemic risk. Results: The risk of COVID-19 morbidity and mortality in patients receiving chemotherapy could be greater than 1.5to 2 times higher than usual. However, other associated conditions frequently found in the breast cancer populationseem to still play a significant role in a worse outcome. We found no data to quantify the effect of chemotherapy ordata allowing us to adapt the MammaPrint Score to risk in an infectious epidemic. Conclusion: Adjuvant chemotherapy carries a potential risk for morbidity and mortality. Data from the currentliterature do not show the magnitude of the added risk for breast cancer patients on adjuvant chemotherapy inassociation with SARS Cov-2 infection. By using MammaPrint in hormone receptor-positive patients with up to threenodes in whom chemotherapy is considered, the treatment-related risk can be limited, allowing safe de-escalation oftherapy without increased cancer-specific mortality. We plan to pursue the statistical question of how the level of riskat any of the sites on the spectrum relates to distant metastasis-free survival so that mortality risks can be betterestimated during an infection.