Broad Consultation Research Articles

Cash transfers, climate shocks vulnerability and households\u2019 resilience in Togo

This paper uses data from the survey of basic wellbeing indicators (2015) to investigate climate-related risk perceived impact on the household’s living standard in Togo. We investigate the data using a subjective approach with a Probit model and a Propensity Score Matching Method. For the majority of households in the sample, the results suggest, on the one hand, a significant impact of climate-related risk on their living standards. On the other hand, the estimation results show that income from activities increases the resilience and reduction of Togo households' climate-related effects. Finally, remittances increase the households' ability to be less climate vulnerable and play a significant role in the household’s resilience building. In terms of public policies, the results imply that a broader consultation and strategy are needed to reduce the consequences of climate related-risks on households in Togo.

Artificial intelligence, human rights, democracy, and the rule of law: a primer

In September 2019, the Council of Europe's Committee of Ministers adopted the terms of reference for the Ad Hoc Committee on Artificial Intelligence (CAHAI). The CAHAI is charged with examining the feasibility and potential elements of a legal framework for the design, development, and deployment of AI systems that accord with Council of Europe standards across the interrelated areas of human rights, democracy, and the rule of law. As a first and necessary step in carrying out this responsibility, the CAHAI's Feasibility Study, adopted by its plenary in December 2020, has explored options for an international legal response that fills existing gaps in legislation and tailors the use of binding and non-binding legal instruments to the specific risks and opportunities presented by AI systems. The Study examines how the fundamental rights and freedoms that are already codified in international human rights law can be used as the basis for such a legal framework. It proposes nine principles and priorities that are fitted to the novel challenges posed by the design, development, and deployment of AI systems. When codified into law, these principles and priorities create a set of interlocking rights and obligations that will work towards ensuring that the design and use of AI technologies conform to the values of human rights, democracy, and the rule of law. The purpose of this primer, co-produced by The Alan Turing Institute and the Council of Europe, is to introduce the main concepts and principles presented in the CAHAI's Feasibility Study for a general, non-technical audience. It also aims to provide some background information on the areas of AI innovation, human rights law, technology policy, and compliance mechanisms covered therein. In keeping with the Council of Europe's commitment to broad multi-stakeholder consultations, outreach, and engagement, this primer has been designed to help facilitate the meaningful and informed participation of an inclusive group of stakeholders as the CAHAI seeks feedback and guidance regarding the essential issues raised by the Feasibility Study.

Making it Work for Everyone: Developing Flexible Digital Clinical Communication Modules for Health Disciplines in an Australian Context

Purpose: This paper discusses an innovative multi-disciplinary approach to the development and evaluation of flexible, digital clinical communication learning resources to support students in twelve health disciplines to develop clinical communication skills in preparation for their clinical placements. Methods: A modified Delphi survey was sent to all stakeholders in the Division of Health Sciences to identify the most important communication skills from the list of 61 communication skills identified by Bachmann et al in 2013. Lecturers, clinical educators, clinicians, and students were invited to rate the importance of each skill. Results: A set of digital resources was created for teaching clinical communication to students across all years and disciplines and for use by clinical educators in the Division to prepare students for clinical placement. In addition, an effective methodology for course development, involving broad consultation and multi-disciplinary development teams comprised of clinicians and other educational experts, was developed. The resources were implemented in two disciplines, podiatry and midwifery, and evaluated pre- and post-placement using a qualitative and quantitative method developed with the course coordinators. Conclusions: There are identifiable clinical communication skills which are applicable across numerous health disciplines and as for other learnable skills, teaching can be enhanced by breaking them down into specific, demonstrable elements which students can observe and practice. Using the pedagogy and methods outlined in the paper, students demonstrated increased awareness of the importance of communication in the clinical context, and the capacity to evaluate their performance of those skills.

Концептуальні засади зовнішньої політики КНР за правління Сі Цзіньпіна

The article defines the conceptual foundations of China's foreign policy under Xi Jinping. China's foreign policy under Xi Jinping has been based on a number of concepts put forward by the Chinese government, which clearly show that China aspires to be a leading player in the international arena. The purpose of the study is to analyze the conceptual foundations of China's foreign policy under Xi Jinping. The article examines China's foreign policy initiatives implemented since 2012: Chinese dream, community of common destin», Belt and Road Initiative, new model of international relations, new model of US-China relations, common, comprehensive, cooperative and sustainable security, the principle of broad consultation, joint contribution and common benefits in global governance. The conceptual approaches of the PRC to the Asia-Pacific region, Arab countries, Latin America, and Africa are also considered. It is noted that China's foreign policy initiatives are strategic, multidimensial and innovative. Their strategy is to help achieve the grand goal – revival of the Chinese nation. China's foreign policy initiatives are multidimensial in that they cover political, security, economic, financial, legal, cultural and environmental aspects. The innovativeness of China's foreign policy lies in the fact that Xi Jinping's concepts focus on China's contribution to the overall development of mankind and it includes new Chinese theories of a multipolar world – new model of international relations and a new model of great powers.. It is also noted that Xi Jinping's foreign policy ideas are mostly politically vague and not specific enough, and that China has not yet been able to offer attractive universal concepts.

Towards standardization of economic evaluation research in the youth psychosocial care sector: A broad consultation in the Netherlands.

Stakeholders are increasingly interested in the societal impact of psychosocial interventions in the youth sector, in terms of costs and quality of life, as well as in outcomes research. The aim of this broad consultation was to reach consensus regarding the steps to be undertaken to set a research agenda for the Netherlands Organisation for Health Research and Development (ZonMw) programme. The broad consultation consisted of an eight-step procedure, including the conceptualization of a consultation document consisting of a scoping review of (mainly) international opinion/methodological literature and an inventory of existing Dutch guidelines and manuals for economic evaluation, a written consultation procedure among a broad range of stakeholders, and a consultation meeting with these stakeholders. In total 21 documents were included in the scoping review. A total of 24 stakeholders participated in the written consultation procedure and 14 stakeholders during the consultation meeting. The methodological issues and challenges, which were ranked in the top 5 by the stakeholders, are (i) outcome measurement, (ii) outcome identification, (iii) cost valuation, (iv) outcome valuation, and (v) time horizon/analytical approach. The existing guidelines and manuals provided guidance for some, but not all, issues and challenges. This broad consultation has contributed to a research agenda for the ZonMw programme, which will in the long run lead to the standardization of economic evaluations in this sector in the Netherlands and methodological improvement of economic evaluations in the Dutch youth sector.

Developing a policy framework to support role extension in diagnostic radiography in Ghana

IntroductionA global shortage of radiologists is affecting the timely provision of imaging reports and thus healthcare delivery. This situation has been the main driving factor behind successful role extension by radiographers into areas that traditionally were within the scope of radiologists, including image interpretation and reporting. The shortage of radiologists is even worse in developing countries like Ghana. There is a need for policy to guide the introduction and implementation of role extension in Ghana. MethodsA qualitative, single case study with multiple sites across the country was used. A sample of 16 participants, including 8 radiographers, 3 radiologists, 3 medical officers, a senior official each from the Ministry of Health and the Allied Health Professions Council, were interviewed about role extension. ResultsThe findings indicate the need for a guiding policy of role extension to be spear headed by the Ministry of Health to gain the needed credibility. The findings suggest the policy should be made to meet the local needs of the country. It also established the policy should regulate education and training and the scope of practice. ConclusionThe study established the need for policy to guide the introduction and practice of role extension in diagnostic radiography in Ghana. The study also established the need for a broad consultation of all key stakeholders based on an internationally accepted consensus building model.

Planning for inclusion? An assessment of Ontario's emergency preparedness guide for people with disabilities

People with disabilities are impacted disproportionately by ‘natural’ disasters. In part this heightened vulnerability reflects cultural, economic and political processes that (re)produce the broader social exclusion of people with disabilities. More immediately, it reflects the exclusion of people with disabilities from disaster management and emergency preparedness efforts. This paper presents findings from an in-depth case study of Ontario's Emergency Preparedness Guide for People with Disabilities as one attempt at inclusive emergency planning, drawing on key informant interviews with government officials and disability organizations. Analysis shows that while the guide's development involved broad consultation, it fails to reflect the diversity of Ontario's disabled communities. At the same time, the guide's emphasis on fostering individual resilience in the face of emergencies is contested by disability organizations' emphasis on interdependence, preparedness and action at the community level and in the context of broader social and material conditions. Interviews with people with intellectual disabilities reinforce the value of a focus on interdependence, preparedness and action at a community, rather than an individual, level.

A new approach for the mandatory application of the thermal regulation of construction (RTCM) in the future moroccan buildings

This study made it possible to retrace the major stages in the implementation of thermal regulations for buildings while placing them in their global and regional framework. This regulation, which was born following the crucial energy consumption experienced by the building sector and which has prompted countries to take regulatory steps to combat this scourge. Morocco is also committed to this approach by setting up the Moroccan Construction Thermal Regulation (RTCM), in order to guarantee energy efficient buildings. Following the comparison with the Thermal Building Regulations of Tunisia (RTBT), a country enjoying a comparable climatic and economic framework, our study also allowed us to underline the similarity of approaches in the two countries but also the delay experienced by Morocco in this implementation which fortunately is in the process of filling it by accelerating the procedures. Our work is in line with this perspective, by making it possible to highlight the steps taken in the establishment of this RTCM and those that remain to be developed, refined or adapted to the country context. In this sense, a broad consultation of stakeholders (decision-makers, prescribers and professionals) through a survey, allowed us to elucidate the reasons for the delay in the implementation of this RTCM, and the skepticism of both sides to its consideration favoring by far its voluntary aspect of its application. This consultation has especially enabled us to enrich this regulation for a better adaptability to the Moroccan context, ensuring at the same time a fairly flexible transition from a voluntary application to a compulsory application. In addition, we have reviewed the high performance insulation materials to be offered for both building envelopes and their structures. And for better performance, we have also proposed the integration of certain Moroccan standards in digital simulation tools for thermally insulating buildings and which will be developed in the next work.

Towards standardization guidelines for in silico approaches in personalized medicine.

Despite the ever-progressing technological advances in producing data in health and clinical research, the generation of new knowledge for medical benefits through advanced analytics still lags behind its full potential. Reasons for this obstacle are the inherent heterogeneity of data sources and the lack of broadly accepted standards. Further hurdles are associated with legal and ethical issues surrounding the use of personal/patient data across disciplines and borders. Consequently, there is a need for broadly applicable standards compliant with legal and ethical regulations that allow interpretation of heterogeneous health data through in silico methodologies to advance personalized medicine. To tackle these standardization challenges, the Horizon2020 Coordinating and Support Action EU-STANDS4PM initiated an EU-wide mapping process to evaluate strategies for data integration and data-driven in silico modelling approaches to develop standards, recommendations and guidelines for personalized medicine. A first step towards this goal is a broad stakeholder consultation process initiated by an EU-STANDS4PM workshop at the annual COMBINE meeting (COMBINE 2019 workshop report in same issue). This forum analysed the status quo of data and model standards and reflected on possibilities as well as challenges for cross-domain data integration to facilitate in silico modelling approaches for personalized medicine.

English

The main objective of the article was to examine the forces that shape the behaviour of the actors in the local economic development implementation process in Accra Metropolitan, Keta Municipal and Shai-Osudoku District assemblies. Using qualitative data from multiple sources combined with multiple case studies, the study found that the three Metropolitan, Municipal and District assemblies implemented somewhat different LED strategies with multiple actors’ involvement. Lack of due diligence, weak and lack of institutional independence, absence of political leadership commitment, and political expediency negatively impacted LED implementation in the Accra Metropolitan and Keta Municipal Assemblies while Shai-Osudoku District Assembly had smooth local economic development implementation. Dynamics such as the land tenure system, micro and macro politics, administrative and institutional procedures, and political leadership shaped the behaviour of the actors in the three assemblies. Based on these, the study recommends that politicians should desist from interfering in LED issues; governments should consider the interests of local government units’ development needs in introducing local economic development interventions and broad consultations should be done before initiating local economic development initiatives. Key words: Actors, local economic development, LED interventions, metropolitan, municipal and district assemblies.

ЗАРУБІЖНИЙ ДОСВІД ГРОМАДСЬКИХ КОНСУЛЬТАЦІЙ ЯК ФОРМИ КОМУНІКАЦІЇ ГРОМАДСЬКОСТІ, ЩО ВПЛИВАЄ НА ПРИЙНЯТТЯ РІШЕНЬ У СФЕРІ ОХОРОНИ ЗДОРОВ’Я

Порушено питання щодо залучення громадськості до обговорень важливих рішень у сфері охорони здоров’я. В Україні є низка нормативно-правових актів, які визначають необхідність та правовий механізм обов’язкового залучення громадськості до прийняття рішень у публічному управлінні сферою охорони здоров’я та її адмініструванні, однак фактично такі консультації не відіграють ніякої ролі. Розглянуто зарубіжний досвід громадських консультацій у сфері охорони здоров’я. Здійснено аналіз співпраці громадськості та органів публічного управління й адміністрування в різних державах та комунікативних інструментів, що використовуються для цього. Наголошено на необхідності розвитку громадських консультацій як важливого складника демократичного процесу.

Analysis of farm households’ perceived climate change impacts, vulnerability and resilience in Ghana

Analysis of climate impacts, vulnerability and resilience is crucial to understand how humans relate with global environmental changes. Against the backdrop of lack of comprehensive information on assessment on these indicators within Ghana's context, this study used cross-sectional data from 300 farmers from two districts of Ghana to analyze climate change through a subjective approach. The data was analysed using ordered probit regression. The result established that, majority of the farm households perceived significantly high impacts of climate change on their livelihoods; low to very low climate vulnerability; and high to very high resilience to climate change. The factors that explained the level of climate impact were age, credit access, number of unemployed households, household per capita expenditure, and number of times of flood a farmer experienced in recent times. The estimated climate vulnerability level of the farmers was significantly influenced by education, credit, membership of farmer based organization (FBO), unemployed household members, non-farm income, environmental warning and droughts. Also, climate resilience of the farmers was significantly influenced by the location, credit access, FBO membership, consumption expenditure, drought and source of domestic water. The result established that a broader consultation and strategy is required to address the consequences of climate change and to improve the resilience of farm households in Ghana.

Asking Authors to Nominate Reviewers

In the process of submitting manuscripts to journals it is still quite common for authors to be asked to nominate reviewers. We are unsure exactly how widespread this practice is and we pose the question: Should the practice of authors nominating reviewers continue?

The Chief Fallacy: A Commentary on Hostility to Hospitality

Abstract This commentary takes issue with three central themes contained in Michael and Tracy Balboni’s Hostility to Hospitality: the argument against a ‘spirituality of immanence’ prevalent in biomedicine, the proposal for ‘structural pluralism’ as a model of institutional reform that addresses the alleged deficiencies of immanence, and the role of ‘chief love’ in the conceptualisation of a spirituality suitable to this form of pluralism. Drawing on a brief discussion of spiritualities which do not fit into the hermeneutic of ‘chief love’, we suggest that the Balbonis’ argument contains largely unexamined assumptions coloured by the authors’ own theological commitments. We contend that the success of ‘structural pluralism’ hinges on the extent to which the authors can credibly disentangle particular religious interests from their proposal for institutional reform, and that this requires broad consultation of spiritual experiences beyond ‘chief love’ and the critique of immanence. The World Health Organisation’s cross-cultural methodology employed in the development of a quality of life measure that incorporates “religiousness, spirituality and personal beliefs” (‘WHOQOL-SRPB’) is briefly discussed as an example of such consultation.

Advancing global change biology through experimental manipulations: Where have we been and where might we go?

This commentary summarizes the publication history of Global Change Biology for works on experimental manipulations over the past 25 years and highlights a number of key publications. The retrospective summary is then followed by some thoughts on the future of experimental work as it relates to mechanistic understanding and methodological needs. Experiments for elevated CO2 atmospheres and anticipated warming scenarios which take us beyond historical analogs are suggested as future priorities. Disturbance is also highlighted as a key agent of global change. Because experiments are demanding of both personnel effort and limited fiscal resources, the allocation of experimental investments across Earth's biomes should be done in ecosystems of key importance. Uncertainty analysis and broad community consultation should be used to identify research questions and target biomes that will yield substantial gains in predictive confidence and societal relevance. A full range of methodological approaches covering small to large spatial scales will continue to be justified as a source of mechanistic understanding. Nevertheless, experiments operating at larger spatial scales encompassing organismal, edaphic, and environmental diversity of target ecosystems are favored, as they allow for the assessment of long‐term biogeochemical feedbacks enabling a full range of questions to be addressed. Such studies must also include adequate investment in measurements of key interacting variables (e.g., water and nutrient availability and budgets) to enable mechanistic understanding of responses and to interpret context dependency. Integration of ecosystem‐scale manipulations with focused process‐based manipulations, networks, and large‐scale observations will aid more complete understanding of ecosystem responses, context dependence, and the extrapolation of results. From the outset, these studies must be informed by and integrated with ecosystem models that provide quantitative predictions from their embedded mechanistic hypotheses. A true two‐way interaction between experiments and models will simultaneously increase the rate and robustness of Global Change research.

Facilitators and barriers to the training and maintenance of young persons’ advisory groups (YPAGs)

IntroductionIncreasing demands from public and private healthcare coupled with national initiatives in patient-oriented research has led to an increase in avenues to allow patients to be directly involved in research. In particular, the push towards participation of children and youth has resulted in the formation of pediatric patient advisory groups with broad partnerships and consultation requests across the globe. However, there is a lack of evidence to examine the challenges in formation and training of young persons’ advisory groups (YPAGs) and management processes required thereafter.Purpose and objectivesThis study’s purpose is to document YPAG formation and training protocols around the world, highlight common strengths, and evaluate pitfalls and challenges. The results from this study will subsequently inform the development of standardized training protocols for children and youth to be piloted globally.MethodsIn this study, 17 select YPAG team leaders from 7 countries were surveyed to determine current training techniques used within existing groups. 17 youth representatives and 16 team leaders were then interviewed to gather further qualitative data on facilitators and barriers that aid or prevent successful initiation and maintenance of these groups. Qualitative interview data was coded and analyzed using NVivo by two independent reviewers (SYC, VWLT). Any inconsistencies in thematic analysis was confirmed by a third reviewer (JB).ResultsThe most common training topics include consent and assent (64.71%), clinical trials (64.71%), and patient safety (70.59%). There are significant discrepancies to the amount of training received by each team. Most YPAGs out of the 17 groups receive no formal training (58.82%) while training sessions in the remaining 7 groups vary in both duration and frequency. Collectively, meetings ranged from 15 minutes to 6 hours long, with the majority of team meetings being 2–3 hours long (58.82%). The most common training facilitators are a positive relationship with a local hospital (82.35%) and access to a dedicated team coordinator (64.71%). 70.59% of team leaders identified a lack of access to appropriate educational materials available as a drawback to the impact of their YPAG, making this the greatest common barrier.ConclusionBringing children and youth to the forefront of paediatric trials and clinical research facilitates appropriate patient representation in subsequent research decision-making. There is an urgency to create and implement standardized protocols for the training of children and youth, especially in preparation for national and international research consultations. This low barrier framework may be of special interest to lower-middle-income countries who wish to encourage community participation in healthcare.

Announcing The Lancet Global Health Commission on Global Eye Health

Announcing The Lancet Global Health Commission on Global Eye Health

Whale sanctuaries – An analysis of their contribution to marine ecosystem-based management

Goal 14, ‘Life Below Water’, of the United Nations Sustainable Development Goals sets a target for nations to increase the number of marine protected areas managed using ecosystem-based management, which requires interventions focused on fish stock conservation and enhancement, environmental sustainability and ecosystem services of benefit to human beings. Although not adhering to the International Union for Conservation of Nature's criteria for marine protected areas, whale sanctuaries are an increasingly common approach to conservation around the world. This paper is the first in the academic literature to use a case study approach to review the extent to which whale sanctuaries contribute to ecosystem-based management. A fifteen-criteria framework for marine ecosystem-based management is applied with reference to six whale sanctuary case studies, including the International Whaling Commission's two designations in the Indian Ocean and Southern Ocean. The review underscores the generally very limited contribution of whale sanctuaries to ecosystem-based management, unless they are explicit in stating conservation goals and embedding these within iterative management plans. The Hawaiian Islands Humpback Whale National Marine Sanctuary is cited as an example of an approach that comes closest to fulfilling the objectives of ecosystem-based management, albeit its designation lacks consideration of ecosystem dynamics and the interrelationships between multiple economic actors operating within its boundaries. In order to meet the requirements of Goal 14, the case studies in this paper reveal advancements necessary for whale sanctuaries to transition towards ecosystem-based management: establishment of objectives broader than the conservation of whale stocks, assessment of the contribution of the sanctuary to human well-being and trade-offs in ecosystem services, accounting for ecological and socio-economic dynamics, and ensuring broad stakeholder consultation and participatory adaptive management.

Mapping Ecosystem Services to Human Well‐being: a toolkit to support integrated landscape management for the SDGs

The Sustainable Development Goals (SDGs) emphasize the global and multi-dimensional nature of sustainability and thus require improving our capacity to articulate and trace the impact of ecosystem change to measures of human well-being. Yet, the integrated nature of these goals is challenging to assess without similarly integrated assessment tools. We present a new modeling toolkit, "Mapping Ecosystem Services to Human well-being" (MESH), that integrates commonly used, stand-alone ecosystem services (ES) models from the InVEST suite of models to quantify and illustrate the trade-offs and synergies across five ecosystem services and up to 10 associated SDGs. Development of the software and its functionality were informed by a broad stakeholder consultation with ministries, non-governmental organizations and civil society groups in West Africa to identify common barriers to uptake and application of modeling tools in developing countries. In light of this process, key features included in MESH are (1) integration of multiple ecosystem service (ES) models into a common modeling framework supported by a curated base data set, (2) built-in scenario generation capacity to support policy analysis, (3) visualization of outcomes and trade-offs, and (4) mapping of ecosystem service change to SDG targets and goals. We illustrate the use of MESH in a case study in the Volta basin of West Africa comparing the effectiveness of three alternative conservation prioritization approaches: (1) land cover-based, (2) topographic-based, and (3) an ecosystem service-based approach to minimize the impact of agricultural expansion. We evaluate these approaches by linking changes in service supply to potential impacts on achievement of specific SDG goals and targets.

Beyond tokenism: meaningful youth engagement in planetary health

Beyond tokenism: meaningful youth engagement in planetary health