ABSTRACT
PurposeMotivated by the growing and urgent demands for a unified set of internationally accepted, and high-quality environmental, social and governance (hereafter ESG) disclosure standards, this exploratory study aims to propose a roadmap for setting out the proper technical groundwork for global ESG disclosure standards. Design/methodology/approachAn exploratory study is conducted to gain initial understanding and insights into establishing a worldwide set of standards for reporting on sustainability, as this topic has not been extensively studied. This study examines the viewpoints of various stakeholders, including sustainability practitioners, academics and organizations focused on ESG issues, to generate knowledge that is more solid than knowledge produced when one group of stakeholders work alone. FindingsThe results revealed that there is an ongoing and incompatible debate regarding several conceptual and practical challenges for setting a unified set of ESG disclosure standards. Practical implicationsThe study results provide multidimensional insights for regulatory parties and standard-setters to develop a high-quality package of global ESG reporting standards. This, in turn, enables different groups of stakeholders to understand the firm's impact on the environment, society and economy. Originality/valueResearch into this timely and relevant global issue is considered an appealing area of study and deserves significant attention. Thereby, working on this topic merits remarkable attention. Furthermore, this exploratory article provides valuable and informative suggestions for creating a unified and high-quality set of internationally accepted sustainability reporting standards.
ABSTRACT
OnTrackNY is a nationally recognized Coordinated Specialty Care model disseminated across New York state for young people experiencing early non-affective psychosis. OnTrackNY is a network of 22 teams located in licensed outpatient clinics, serving over 2500 individuals. OnTrackNY offers medication management, case management, individual and group cognitive behaviourally oriented therapy, family support and psychoeducation, supported employment and education, and peer support services. Teams receive training for implementation through an intermediary organization called OnTrack Central. OnTrackNY was selected as a regional hub of the National Institute of Mental Health Early Psychosis Intervention Network (EPINET), a national learning healthcare system (LHS) for young adults with early psychosis. This symposium will present the different ways in which EPINET OnTrackNY implemented systematic communitybased participatory processes to ensure robust stakeholder involvement to improve the quality of OnTrackNY care. Florence will present results of an assessment of stakeholder feedback experiences used to develop strategies for assertive outreach and engagement of program participants, families and providers. Bello will present on mechanisms for integrating of co-creation principles to design, develop and execute quality improvement projects in EPINET OnTrackNY. Stefancic will present on quality improvement projects that used rapid cycle qualitative methods, tools, and strategies to build team capacity and flexibility to respond to an LHS. Montague will present adaptations to OnTrackNY services during the COVID-19 pandemic using an implementation science framework. Finally, Patel will lead a discussion on the implications of involving individuals with lived experiences in all phases of the process to maximize learning in an LHS.
ABSTRACT
The COVID-19 pandemic is accelerating the growth of e-commerce. As a result, urban freight transport volume is increasing, leading to traffic congestion and negative environmental impacts, while service quality is deteriorating. These challenges can be addressed through radical innovation of urban last mile logistics with environmental-friendly transportation modes (e. g., cargo bikes), consolidation points (e. g., micro hubs) and new digital service models (e. g., time window alignments). However, sustainability improvements lead to higher costs and will not be realized - beyond pilot studies - until they become economically viable. Therefore, willingness-to-pay (WTP) for sustainable last mile innovations (LMI) is one of the most important success factors. In our work, we aim to investigate the WTP for the additional costs of sustainable LMI. While various stakeholders such as online retailers, logistics service providers or city administrations could benefit from sustainable LMI, in our study we focus on the group that is likely to benefit the most: urban inhabitants. Therefore, we investigated consumers' WTP for sustainable LMI by conducting a questionnaire survey in Germany in September and October 2020 (n = 1,071) and analyzing the data using multivariate statistics. The results show four consumer segments, their characteristics, and their WTP for LMI. Based on the results, implications for stakeholders (especially online retailers) are derived to address the behavior of each consumer segment towards more sustainability in urban last mile logistics. Further research would be interesting to evaluate allocation scenarios for the additional costs among all last mile stakeholders empirically. © 2023 The Authors. Published by ELSEVIER B.V.
ABSTRACT
Background: Improving basic infection control (IC) practices, diagnostics and anti-microbial stewardship (AMS) are key tools to handle antimicrobial resistance (AMR). Material(s) and Method(s): This is a retrospective study done over 6 years (2016-2021) in an oncology centre in North India with many on-going interventions to improve IC practices, diagnostics and AMS. This study looked into AMR patterns from clinical isolates, rates of hospital acquired infections (HAI) and clinical outcomes. Result(s): Over all, 98,915 samples were sent for culture from 158,191 admitted patients. Most commonly isolated organism was E. coli (n = 6951;30.1%) followed by Klebsiella pneumoniae (n = 5801;25.1%) and Pseudomonas aeroginosa (n = 3041;13.1%). VRE (Vancomycin resistant Enterococcus) rates fell down from 43.5% in Jan-June 2016 to 12.2% in July-Dec 2021, same was seen in CR (carbapenem resistant) Pseudomonas (23.0%-20.6%, CR Acinetobacter (66.6%-17.02%) and CR E. coli (21.6%-19.4%) over the same study period. Rate of isolation of Candida spp. from non-sterile sites also showed reduction (1.68 per 100 patients to 0.65 per 100 patients). Incidence of health care associated infections also fell from 2.3 to 1.19 per 1000 line days for CLABSI, 2.28 to 1.88 per 1000 catheter days for CAUTI. There was no change in overall mortality rates across the study period. Conclusion(s): This study emphasizes the point that improving compliance to standard IC recommendations and improving diagnostics can help in reducing the burden of antimicrobial resistance.Copyright © 2023 Indian Association of Medical Microbiologists
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
The COVID-19 pandemic is accelerating the growth of e-commerce. As a result, urban freight transport volume is increasing, leading to traffic congestion and negative environmental impacts, while service quality is deteriorating. These challenges can be addressed through radical innovation of urban last mile logistics with environmental-friendly transportation modes (e. g., cargo bikes), consolidation points (e. g., micro hubs) and new digital service models (e. g., time window alignments). However, sustainability improvements lead to higher costs and will not be realized - beyond pilot studies - until they become economically viable. Therefore, willingness-to-pay (WTP) for sustainable last mile innovations (LMI) is one of the most important success factors. In our work, we aim to investigate the WTP for the additional costs of sustainable LMI. While various stakeholders such as online retailers, logistics service providers or city administrations could benefit from sustainable LMI, in our study we focus on the group that is likely to benefit the most: urban inhabitants. Therefore, we investigated consumers' WTP for sustainable LMI by conducting a questionnaire survey in Germany in September and October 2020 (n = 1,071) and analyzing the data using multivariate statistics. The results show four consumer segments, their characteristics, and their WTP for LMI. Based on the results, implications for stakeholders (especially online retailers) are derived to address the behavior of each consumer segment towards more sustainability in urban last mile logistics. Further research would be interesting to evaluate allocation scenarios for the additional costs among all last mile stakeholders empirically. © 2023 The Authors. Published by ELSEVIER B.V.
ABSTRACT
With the increasing internet accessibility in India and the challenges posed by the Covid-19 pandemic, the practice of virtual court hearing has been accelerated in India. The virtual Court acts as an effective means to conduct Court proceedings, debarring geographical barriers and uplifting Courtroom functioning's productivity. Along with the practical applicability of virtual court hearings in India comes the glitches or challenges posed by the virtual hearing of matters. Nonetheless, the necessity of physical hearing of matters cannot be ignored. In pursuance of this, arguments in favor of reverting towards physical hearings after the pandemic situation ends are being posed before the Indian Judiciary, which negates the applicability of virtual courtrooms. Thereby, this article aims to analyze the applicability, necessity and efficacy of virtual court hearings and the challenges posed by Virtual Court hearings in India.Copyright © 2020 Ubiquity Press. All rights reserved.
ABSTRACT
One constraint of Thai soybean production is the volume of seeds used for cultivation in the dry season or after the rice season. PhuPha Man district, KhonKaenprovince, in Northeast Thailand, faces the same problem and can be solved by producing seeds during the rainy season for use in the dry season. The collaborative brainstorming to participatory action development employed in this community-based soybean production project involves four steps: (1) needs assessment, (2) planning, (3) implementation, and (4) evaluation. From 2019-2020, a total of 40 farmers jointly participated in this project: 20 from the Non-Korm Sub-district and 20 from the Sawab Sub-district. They agreed to implement three missions: (1) Farmer group management. A Community-based Soybean Seed Production Center (CSSPC) was established in each area. Each CSSPC was responsible for determining the structure and role of management, including the implementation of disciplines. (2) Seed production management. During its implementation, a shortage of rainfall and drought occurred from September to October 2019, causing soybean production to decline. Moreover, product harvesting and project evaluation took place at the site during the COVID-19 pandemic from January to May 2020, influencing the ability of farmers and facilitators to work together on group activities which required delicate management of the monitoring, control, production, exchange, and learning to solve problems. (3) Seed purchasing and distribution management. Rainfall shortage and drought influenced the ability of the farmers to produce the required soybean seeds. Consequently, the CSSPC did not purchase the seeds and manage their distribution.Copyright © 2023, Anka Publishers. All rights reserved.
ABSTRACT
Background and aim: During the early stages of the COVID-19 pandemic, nationwide lockdowns caused disruption in the diets, physical activities, and lifestyles of patients with type 2 diabetes. Previous reports on the possible association between race/ethnicity, COVID-19, and mortality have shown that Hispanic/Latino patients with type 2 diabetes who are socioeconomically disadvantaged are disproportionately affected by this novel virus. The aim of this study was to explore stressors associated with changes in diabetes self-management behaviors. Our goal was to highlight the health disparities in these vulnerable racial/ethnic minority communities and underscore the need for effective interventions. Methods and participants: Participants were enrolled in part of a larger randomized controlled trial to compare diabetes telehealth management (DTM) with comprehensive outpatient management (COM) in terms of critical patient-centered outcomes among Hispanic/Latino patients with type 2 diabetes. We conducted a thematic analysis using patient notes collected from two research nurses between March 2020 and March 2021. Two authors read through the transcripts independently to identify overarching themes. Once the themes had been identified, both authors convened to compare themes and ensure that similar themes were identified within the transcripts. Any discrepancies were discussed by the larger study team until a consensus was reached. Results: Six themes emerged, each of which can be categorized as either a source or an outcome of stress. Sources of stress associated with the COVID-19 pandemic were (1) fear of contracting COVID-19, (2) disruptions from lockdowns, and (3) financial stressors (e.g., loss of income). Outcomes of COVID-19 stressors were (1) reduced diabetes management (e.g., reduced diabetes monitoring and physical activity), (2) suboptimal mental health outcomes (e.g., anxiety and depression), and (3) outcomes of financial stressors. Conclusion: The findings indicated that underserved Hispanic/Latino patients with type 2 diabetes encountered a number of stressors that led to the deterioration of diabetes self-management behaviors during the pandemic.
ABSTRACT
The outbreak of the famous Corona Virus in the world at the end of the year 2019 has triggered the world to bring major changes to the everyday walks of life. This virus entered Pakistan in February 2020 and resulted in the lockdown to be enforced throughout the country. Just as many other fields of life, the education sector also had to tolerate a massive hit of this closing down. The traditional approach of education based on the face-to-face interactions between the students and instructors went dependent on online platforms. This was a major and sudden switch, which was found extremely difficult throughout the world as well as in Pakistan. The concept of online education was not anything new. It prevailed earlier also, but that was the one conducted after proper planning, which was not at all in the case Covid-19. This research paper first discusses the perspectives of parents and teachers on the effectiveness of online education by qualitative approach. Secondly, the results of the conducted surveys are evaluated in the quantitative part of the paper. Further, the results of both the research types are compared to discuss and reason the overall scenario of online education in Pakistan. © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.
ABSTRACT
Over the course of a clinical trial, changes in the practice environment have the potential to reduce internal and external validity and impact change in patient outcomes. Such ''history effects''1 can take the form of changes in standard of care, clinical guidelines and recommendations, new drug/device availability in the marketplace, testing and screening procedures, and, as recently experienced, a global pandemic. Clinical trials conducted over many years are particularly susceptible to history effects. Such effects can impact foundational ability to continue a trial, including clinician equipoise and ability to implement trial interventions, necessitating awareness and action planning. For example, Curtis et al.2 acknowledged challenges with clinical guideline history effects and issued recommendations for addressing them such as consideration of participant wellbeing, stakeholder engagement, safety monitoring, review of guideline and policy changes, and development of rules for protocol changes. This session will explore how four multisite clinical trials conducted with VA Cooperative Studies Program sponsorship and coordination have weathered history effects during prolonged periods of enrollment. Topics to be covered include the implementation of pragmatic designs, monitoring of clinical guidelines, assessing control group treatment conditions, modifying protocols, adjusting quality assurance procedures, refining recruitment pathways, and training site investigators. The speakers, Study Chairs, will describe best practices and provide recommendations for navigating history effects in prolonged multisite clinical trials that can ensure outcomes remain relevant and compelling to inform public health at trial commencement. The CSP 2008/PTXRx study is a pragmatic, randomized, double-blind, placebo-controlled, multicenter clinical trial of Veteran patients with diabetic kidney disease (DKD) examining whether pentoxifylline (PTX), when added to usual care, can delay time to end-stage renal disease or death. Enrollment for the study began in 2019, and it is anticipated that 9 years of follow-up will be required to observe the required number of primary events. Given the long duration of the study, changes in clinical guidelines were anticipated and have occurred, including the approval of new DKD therapies and introduction of a new formula for estimated glomerular filtration rate (eGFR) calculation. In anticipation of these changes, the study design allows for whatever standard of care is extant at any time during the course of the study. PTXR's pragmatic trial design and protocol leverage the VA's research infrastructure and remote platforms allowing the study to be responsive to external changes and to safely continue during a global pandemic. The CSP 596/OPTION study is a randomized, double- blind, multicenter trial of Veteran patients with a first or second recurrent Clostridium difficile infection (CDI) comparing (1) fidaxomicin and (2) vancomycin, followed by a taper and pulse to (3) a standard vancomycin regimen. Since enrollment began in 2016, significant changes in CDI epidemiology and clinical management have impacted the study. The COVID-19 pandemic also resulted in an administrative hold on all trial activity followed by staggered reopening of sites due to variable COVID-19 activity and clinical priorities. Many clinical laboratories switched to algorithms that included free toxin assays in addition to polymerase chain reaction (PCR) tests out of concern for overdiagnosis based on PCR testing alone, reducing the number of potentially enrollable cases. There has been increased empirical vancomycin treatment for recurrent CDI without confirmation by stool testing, a requirement for enrollment, and a recruitment strategy for identifying potential cases. Finally, conflicting clinical guidelines for recurrent CDI has created potential equipoise when considering enrollment. Ongoing educational efforts have been made to clarify the protocol and emphasize the validity of the research question as well as protoco changes to allow safe enrollment and follow-up of participants in the face of the ongoing COVID-19 pandemic. The CSP 2005/VALOR is a phase III randomized, open label, multicenter clinical trial of Veteran patients with operable stage I non-small cell lung cancer that compares stereotactic radiotherapy and anatomic pulmonary resection with a primary outcome measure of overall survival. The study was activated in 2017 and recruitment to the trial has been affected by ongoing changes in public and clinician perceptions about stereotactic radiotherapy and surgery that have interfered with equipoise and willingness of participants to enroll. The study team perpetually addresses this challenge through group conversations with local site investigators, study coordinators, and other research personnel to preserve group equipoise across the study. Since the study's activation, new safety information about stereotactic radiotherapy has emerged necessitating protocol modifications while aiming to preserve internal and external validity. The includes modifying standard operating procedures for the study's centralized quality assurance program that has had to adapt its process to remain contemporary. STARPORT, funded by VA CSRD with CSP collaboration, is a randomized, open label, multicenter clinical trial of Veteran patients with oligorecurrent prostate cancer comparing the effects of standard systemic therapy (SST) alone or with PET-directed local therapy using surgery or radiation. Although enrollment was initiated in 2021, changes are already evident in clinical practice guidelines regarding the use of imaging in workup in this patient population. Shortly before the start of accrual, 18F-DCFPyL PSMA PET/CT received FDA-approval. Consequently, it is being rapidly adopted at the STARPORT VA medical centers and the use of conventional imaging using CT or bone scan prior to PET/CT imaging-part of the original eligibility criteria-quickly is falling out of favor. Furthermore, shortly after the start of enrollment, NCCN guidelines adopted the stance that conventional imaging was no longer required in the setting of PSMA PET/CT imaging, solidifying the transition away from conventional imaging. Thus, the protocol is being amended to remove the requirement for conventional imaging as part of workup for oligorecurrence. In addition, to be generalizable, the study is designed to integrate future PSMA radiotracers that are incorporated into practice as well as changes in SST regimens over the time of the study.
ABSTRACT
Aim: PR is an integral part of chronic respiratory disease (CRD) management. Evidence on the effectiveness, applicable components, and deliverable models have generated from high-income countries a different clinical context from low- and middle-income countries. Informed by global PR guidelines, a systematic review and stakeholder engagement, we adapted a PR programme to home-based (because of COVID) in a low-resource setting. This feasibility study tested the PR programme in Bangladesh. Method(s): Intervention was, assessment at the PR centre, twice-weekly tele-supervised sessions for 8 weeks at home. Primary outcomes were Endurance Shuttle Walk Test (ESWT) and COPD Assessment Test (CAT). Nonparametric tests were used to compare pre-and post- outcomes using SPSS version 26. Result(s): 51 participants (33 male;mean age 55yrs (SD 12)) were recruited with a range of CRDs. 40 completed the final assessment (COVID deterred eight follow-ups). Both ESWT and CAT improved by more than the minimum clinically important difference (MCID). Conclusion(s): Home-based PR is feasible in the Bangladesh context and associated with significant improvements in functional exercise capacity and health-related quality of life.
ABSTRACT
The Covid-19 pandemic has exacerbated the environmental crisis in which our ecosystem is posed. In this context, the call to reorganize the production and consumption models to implement sustainable economic models is emerging. Accordingly, the Circular Economy paradigm, based on the reduction, reuse and recycling practices, has spurred as one of the best ways to manage this emergency state. The scientific literature has highlighted that, to shift from a traditional linear economic model to a circular economic one, the involvement of the whole supply chain is required, especially in the agri-food sector. In this perspective, the stakeholders' engagement plays a pivotal role in reaching the global goal. The present research aims to explore the stakeholders' perception of messages conveyed through social media on circular economy in agri-food, using a coding framework based on the reclassification of the "Glossary of Circular Economy” according to a 4-R paradigm (reduce, reuse, recycle and reduce). In particular, the study analyses the stakeholders' reactions to Twitter posts focused on agri-food and circular economy from the beginning of the pandemic until now. © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.
ABSTRACT
Background: The Covid-19 pandemic has hit Western India hard, with Pune district reporting extremely high numbers of cases. During this time, the KEM Hospital Research Centre (KEMHRC), Pune undertook a study determining COVID-19 seropositivity within villages in the Pune district. Aim(s): To engage various stakeholders in establishing sentinel sero-surveillance to monitor the trend of SARS-CoV-2 infection transmission in the general population in rural Western India. Method(s): An extensive stakeholder engagement drive was undertaken to drive successful recruitment and implementation of our study. Between February 2021 and May 2021, we conducted 150 meetings with a range of community stakeholders including: village heads;nurses;community health workers and local government representatives, in open-aired community spaces. We advised community members on the purpose and significance of the study, clarified any concerns, and gathered and incorporated their inputs regarding study implementation. Result(s): The team built trust with local communities through these meetings with continued engagement during field work and data collection helping build rapport and create ownership of the study. KEMHRC successfully enrolled 14,500 individuals residing in 150 villages in Pune district. Conclusion(s): The feedback sharing process is important in ensuring that engagement with the community is not limited to a one-time activity but continuous. Training & supplying opportunities can also generate stakeholder engagement champions. Effective communication, active engagement are key elements for effective engagement in research.