Government Guidelines Research Articles

Intravitreal anti-vascular endothelial growth factor therapy for retinal diseases in Norway from 2011 to 2021: A combined registry and survey study.

To investigate the use of intravitreal anti-vascular endothelial growth factor (anti-VEGF) therapy in Norway from 2011 to 2021 and explore how the eye departments organized their injection services. We combined data from the Norwegian Patient Registry (NPR) with survey responses from Norway's 22 eye departments. The NPR data encompassed all registered intravitreal injection episodes from 2011 to 2021. The survey contained questions about local treatment practices and emphasized neovascular age-related macular degeneration (nAMD), retinal vein occlusion and diabetic macular edema. A total of 47247 unique patients received 841 646 intravitreal injections in the study period. The number of patients per year increased from 6522 in 2011 to 20 635 in 2021. The number of injections per year increased from 30 926 in 2011 to 125 258 in 2021. The most frequent diagnosis was nAMD. In 2021, the age-adjusted treatment activity in Norway's 11 counties ranged from 47.8 to 75.5 injections per 1000 inhabitants aged ≥50 years. The use of aflibercept gradually exceeded bevacizumab, but the aflibercept proportion per county ranged from 38 to 82% in 2021. The survey revealed varying treatment practices, local guidelines were often absent, and only half of the departments defined a lower visual limit for initiating or maintaining treatment. The use of intravitreal anti-VEGF therapy increased considerably from 2011 to 2021, but there was considerable regional variation in treatment activity, drug utilization and organization of injection services. These findings emphasize the need for strengthened governance and national guidelines to ensure equal treatment nationally.

Analysis of Local Wisdom-based Physics Modul Ajar on Merdeka Mengajar Platform

The learning process in the Kurikulum Merdeka ensures that the learning practices are student-centered. The focus of this curriculum is the revival of learning. One important point in this new curriculum is Modul Ajar. Modul Ajar has significant role in the success of learning process, especially in the subject of Physics. The government provides guidelines for the development, along with several samples, because in this curriculum, teachers are given the authority to develop the Modul Ajar based on characters and needs of the students. This matter creates new problem which is the teacher difficulty on developing Modul Ajar in accordance to government guidelines, student characters, and also different school environtments. Modul ajar in Merdeka Mengajar platform are still limited. Therefore, the researcher proposes to analyze the Physics Modul Ajar in Merdeka Platform in the context of Local Wisdom as a Needs Analysis for the development of future Modul Ajar. This local wisdom aligns with Profil Pelajar Pancasila, which is one of the key components of Kurikulum Merdeka. The method used in this research is Document Analysis method and surveys. Document Analysis includes the analysis of the availability of Modul Ajar in Merdeka Mengajar Platform, which contains General Information, Core Component, and Attachments. A survey was conducted among 57 Physics teachers. The survey point out that 82,5% of the respondents consider the Merdeka Mengajar Platform as a reference for developing of Modul Ajar.

P102: Supporting Informal Carers to Undertake Regular Physical Activity from Home: a Co-design and Prototype Development Study of a novel app, “CareFit”

Background:Informal carers (unpaid family members and friends), are critical to millions worldwide for the ongoing delivery of health and well-being needs. However, the physical and mental wellbeing of caregivers is often poor including low levels of physical activity, frequently owed to contributing factors such as lack of time, lack of support and motivation. Thus, accessible evidence-based tools to facilitate physical activity for carers are urgently needed.Objective:The aim of this study was to co-design and develop a novel mobile app to educate and support carers in the undertaking of regular physical activity. This is achieved via integration of the transtheoretical model of behaviour change and UK physical activity guidelines across 8 weeks of use.Methods:We co-designed a mobile app, “CareFit,” by directly involving caregivers, health care professionals, and social care professionals in the requirements, capturing, and evaluation phases across a number of Agile Scrum development sprints. Requirements for CareFit were grounded in a combination of behavioural change science and UK government physical activity guidelines.Results:Participants identified different barriers and enablers to physical activity, such as a lack of time, recognition of existing activities, and concerns regarding safely undertaking physical activity. Requirements analysis highlighted the importance of simplicity in design and a need to anchor development around the everyday needs of caregivers (eg, easy-to-use video instructions, reducing text). Our final prototype app integrated guidance for undertaking physical activity at home through educational, physical activity, and communication components.Conclusions:Integrating government guidelines with models of behavioural change into a mobile app to support the physical activity of carers is novel and holds future promise. Integrating core physical activity guidelines into a co-designed smartphone app with functionality such as a weekly planner and educational material for users is feasible acceptable and usable. Here we will document the latest developments on the project including an ongoing national study currently taking place in Scotland to test the prototype with 50 carers.

Do disclosure of ESG information policies inhibit the value of heavily polluting Enterprises?—Evidence from China

Green governance and high-quality green development are crucial to the growth of enterprises; therefore, this paper examines how environmental, social, and corporate governance (ESG) disclosure policies affect the value of heavily polluting companies. The study's data is from the new version of the Governance Guidelines for Public Companies promulgated by the China Securities Regulatory Commission in 2018. Thus, the data of China's public companies from 2011 to 2021 is used for the study's analysis. The methods applied for our estimation analysis are the differences-in-differences (DID) and the mediation effect model. The findings depict that ESG information disclosure policies can significantly inhibit the corporate value of heavily polluting enterprises (HPE). Enterprise technological innovation plays a mediating effect in this mechanism; that is, after introducing the policy, it effectively alleviates the information asymmetry and promotes enterprise technological innovation, but it also damages the enterprise value. Further analysis shows that the inhibition effect of ESG information disclosure policy on the value of HPE is heterogeneous, and for non-state-owned enterprises, ESG information disclosure policies have a stronger inhibitory effect. Also, there is little difference between the central and western regions and the eastern region in terms of the inhibitory effect of ESG disclosure policies on the value of HPE. The conclusion of this paper is conducive to improving the information disclosure policy of listed companies and promoting the green development of enterprises.

Reducing Barriers to COVID-19 Vaccination Uptake: Community Ideas from Urban and Rural Kenya

Following the rapid development of COVID-19 vaccines, addressing vaccine hesitancy and optimizing uptake have emerged as critical challenges, emphasizing the importance of reducing barriers toward COVID-19 vaccination. This study investigates ideas on ways to reduce barriers to COVID-19 vaccination uptake. It explores methods that can overcome COVID-19 vaccination barriers through qualitative research: interviews and group discussions involving healthcare providers, administration personnel, teachers, and individuals with chronic conditions across urban (Mombasa) and rural (Kilifi) Kenya. Audio-recorded discussions were transcribed and thematically analyzed across locations. Five themes emerged in our results regarding the reduction in barriers to COVID-19 vaccination in the context of Kenya, including awareness campaigns, engaging diverse stakeholders, using various communication techniques, capacity building to increase vaccination centers and trained staff, and lastly, revising relevant government health policies and guidelines. These results indicate the importance of adopting multiple approaches, as no single strategy can boost vaccine acceptance. Moreover, this study provides recommendations for conceiving actionable interventions to potentially boost vaccine demand and maintain routine immunization in Kenya.

A comprehensive evaluation of sustainable mineral resources governance in Pakistan: An analysis of challenges and reforms

Researchers and institutions continue to formulate governance mechanisms and guidelines for using mineral resources for socio-economic purposes. The movement of sustainable mineral resource development has received high attention recently. This research planned to conduct a systematic review of the existing literature and institutional guidelines to explore and create a code of international best mining guidelines (IBMC) focusing on sustainable mineral resources growth. The study also planned to explore and compare the mining and minerals governance mechanisms of Pakistan against IBMC. Moreover, this research also explores how the mineral resources governance mechanisms and best mining guidelines actually reflect at the local operational level in Pakistan. The research methods include conducting a systematic literature review of the existing literature and institutional guidelines to create IBMC exploring the mining and mineral sector governance mechanisms of Pakistan, including institutional, legal, policy, regulatory, and fiscal frameworks for comparing against IBMC; conducting interviews with key informants to explore how the current local mining practices reflect against the best mining guidelines. This research found that a stable political and economic environment and sound infrastructure facilities are the basic conditions for attracting investment in the mining and mineral industry. Using a systematic review, this research has created IBMC, which can be used as a standard for improving governance mechanisms, including the institutional, legal, policy, and fiscal frameworks focusing on sustainable mineral resource growth by developed nations. The findings explored various challenges as well that hinder sustainable mineral resource growth in Pakistan. Some of the challenges include lack of unilateral institutional and legal controls, technocratic policy formulation, dissuasive fiscal system, and taxations, lack of proper cadaster system, poor accountability and transparency, corruption and rent-seeking, illegal mining, environmental issues, health and safety issues of mine workers, inadequate training and development of mining workers, exclusion of local communities from decision-making processes. To address these challenges, this research advocates for reforming mineral governance mechanisms according to IBMC. The findings of the study may steer the mining industry toward responsible and sustainable growth in Pakistan and other mineral-rich developing nations.

Poverty Alleviation Policy Strategy Through Sustainability Development Goals (SDGs) and Indonesia's Economic Resources

The purpose of this research is to examine and provide guidelines for local governments, communities, academics, and the private sector in planning and implementing poverty alleviation activities that are more effective, efficient, and on target. In addition, the specific objectives of this study are: 1) increasing the rate of regional economic growth through optimizing potential sources of regional income, 2) increasing per capita income, and 3) reducing poverty, unemployment, and socioeconomic inequality of the community. The research was conducted in Palembang City, South Sumatra, Indonesia, in the last 10 years, namely 2017-2022. The research approach uses qualitative descriptive analysis. Data sources include secondary data and Regional Statistics. The results of this study are based on the Sustainability Development Goals (SDGs) indicators, there are four priority scales in poverty alleviation, namely, Health and Infrastructure (Priority I), Education (Priority II), Food Stability (Priority III), and Population and Employment (Priority IV). Therefore, as a solution to poverty alleviation strategies, a budget approach through optimizing the regional economy and regional sources of income as well as community empowerment factors is important. In addition, involvement between elements (government, organizations, communities, universities, and institutions) is expected to continue as an effort to realize poverty alleviation can be overcome optimally.

A Longitudinal Evaluation of Coronavirus Disease 2019 and Its Effects on Spinal Decompressions With or Without Fusion.

Retrospective cohort. The objectives were to (1) compare the safety of spine surgery before and after the emergence of coronavirus disease 2019 (COVID-19) and (2) determine whether patients with a history of COVID-19 were at increased risk of adverse events. The COVID-19 pandemic had a tremendous impact on several health care services. In spine surgery, elective cases were canceled and patients received delayed care due to the uncertainty of disease transmission and surgical outcomes. As new coronavirus variants arise, health care systems require guidance on how to provide optimal patient care to all those in need of our services. A retrospective review of patients undergoing spine surgery between January 1, 2019 and June 30, 2021 was performed. Patients were split into pre-COVID or post-COVID cohorts based on local government guidelines. Inpatient complications, 90-day readmission, and 90-day mortality were compared between groups. Secondary analysis included multiple logistic regression to determine independent predictors of each outcome. A total of 2976 patients were included for analysis with 1701 patients designated as pre-COVID and 1275 as post-COVID. The pre-COVID cohort had fewer patients undergoing revision surgery (16.8% vs 21.9%, P < 0.001) and a lower home discharge rate (84.5% vs 88.2%, P = 0.008). Inpatient complication (9.9% vs 9.2%, P = 0.562), inpatient mortality (0.1% vs 0.2%, P = 0.193), 90-day readmission (3.4% vs 3.2%, P = 0.828), and 90-day mortality rates (0.8% vs 0.8%, P = 0.902) were similar between groups. Patients with positive COVID-19 tests before surgery had similar complication rates (7.7% vs 6.1%, P = 1.000) as those without a positive test documented. After the emergence of COVID-19, patients undergoing spine surgery had a greater number of medical comorbidities, but similar rates of inpatient complications, readmission, and mortality. Prior COVID-19 infection was not associated with an increased risk of postsurgical complications or mortality. Level III.

COVID-19 Constructs of College Students and New Normal Learning Delivery Modalities in Higher Education

The coronavirus disease 2019, or COVID-19, forced the shift from normal to the new normal in the Philippines, the ASEAN region, and the rest of the world. This descriptive-qualitative inquiry sought to uncover the COVID-19 constructs of college students and to determine new normal learning delivery modalities in the context of a state-owned higher education institution. Anchored on the constructivist lens and the grounded theory, Ricoeur’s hermeneutic analysis served as a method of exploring the narratives. The perceived effects of the community quarantines were modes of schooling changed, mental health was tested, internet connectivity problems, economic impacts, and boredom. To better respond to the pandemic, the participants believed that the higher education institution may listen to all stakeholders, learn from other universities, and formulate research-based actions. Modular and online modes wherein blended learning synchronously and asynchronously served as the operational learning delivery modalities of the higher education institution. The learning delivery modalities of the higher education institution complied with the policies and guidelines of the national government, local government units, and the Inter-Agency Task Force for the Management of Emerging Infectious Diseases. The new normal learning delivery modalities in a higher education institution based on the constructs of the COVID-19 pandemic of college students were formulated. The results of this study may serve as bases for developing participatory and proactive educational policies and guidelines in transitioning from normal to the new normal.

Multi-period, multi-timescale stochastic optimization model for simultaneous capacity investment and energy management decisions for hybrid Micro-Grids with green hydrogen production under uncertainty

Given the steep rises in renewable energy's proportion in the global energy mix expected over several decades, a systematic way to plan the long-term deployment is needed. The main challenges are how to handle the significant uncertainties in technologies and market dynamics over a large time horizon. The problem is further complicated by the fast-timescale volatility of renewable energy sources, potentially causing grid instability and unfulfilled demands. As a remedy, energy storage and power-to-hydrogen systems are considered in conjunction with energy management system but doing so raises the complexity of the planning problem further. In this work, the long-term capacity planning for a hybrid microgrid (HM) system is formulated as a multi-period stochastic decision problem that considers uncertainties occurring at multiple timescales. Long-term capacity decisions are inherently linked with energy dispatch and storage decisions occurring at fast-timescale and it is best to solve for them simultaneously. However, the computational demand for solving it becomes quickly intractable with problem size. To this end, we propose to develop a Markov decision process (MDP) formulation of the problem and use simulation-based reinforcement learning for multi-period capacity investments of the planning horizon. The MDP includes the policies used for dispatch and storage operation, which are represented by linear programming as a part of the simulation model. The effectiveness of our proposed method is demonstrated with a case study, where decisions over multiple decades are considered along with various uncertainties of multi-timescales. Economic and environmental assessments are performed, providing valuable guidelines for government's energy policy.

Infection prevention measures and its determinants in childcare facilities during the COVID-19 pandemic: A nationwide survey (2022–2023)

BackgroundThe coronavirus disease-2019 (COVID-19) pandemic presented an unprecedented challenge to societies, necessitating adaptations in infection prevention measures. While there is ample data on infection prevention practices in workplace and healthcare settings, comprehensive data specific to childcare facilities has been lacking. MethodsWe conducted a nationwide web-based survey capturing responses from various childcare facilities (N = 549). This aimed to understand the adaptation in infection prevention measures between fiscal years 2022 and 2023, the status of events and activities, and the factors influencing decision-making related to infection prevention. ResultsFrom 2022 to 2023, most childcare facilities reduced infection prevention practices like mandatory mask-wearing (46.9 %–7.5 %) and eating without conversing (56.5 %–7.4 %), whereas they continued high levels of hand sanitization and checking child's health condition before attendance. The frequency of events and activities (e.g., athletic meets, field trips) increased, with many being held without restrictions. Surprisingly, 62.8 % of facilities used items not recommended for infection prevention. The influence of local government guidelines (risk ratio, 0.69; 95%CI, 0.53–0.90) and the input from junior teachers (risk ratio, 0.85; 95%CI, 0.72–0.99) were associated with reduced risk of using inappropriate items. Furthermore, childcare facilities emphasized the need to collaborate with public health and medical professionals for more accurate and efficient decision-making during pandemics. ConclusionsThe survey provides insights into the evolving practices of Japanese childcare facilities during the COVID-19 pandemic. It underscores the importance of refining information sources, enhancing decision-making processes, and fostering collaboration with the medical community for future pandemics and natural disasters.

Financial Technology and Financial Inclusion of Small and Medium Enterprises in Kenya: Do Government Regulations Really Matter?

The study sought to evaluate the significance of government regulations on the relationship between financial technology and financial inclusion of Small and Medium Enterprises in Kenya. This study emanates from the Doctoral dissertation of the first author where the co-authors served as supervisors. Technology, Organization and Environment Theory and Financial Intermediation Theory were utilized. The study adopted explanatory research design. The top 100 Small Medium Enterprises in Kenya constitute the target population and the sample size was 200 based on purposive sampling technique and simple random sampling where two respondents were picked from each Small Medium Enterprises of interest. A response rate of 81.5 percent was achieved. The study used multiple regression analysis and it was established that government regulations had significant moderation effect on the relationship between financial technology and financial inclusion of small and medium enterprises in Kenya. The study recommends that the existing transaction limits should be reviewed in line with economic conditions of the country. Government should ensure that favorable lending rates are put in place so as to further enhance the level of financial inclusion of small and medium enterprises in Kenya. Government guidelines on screening of customers should be favorable to business owners and stringent requirements should be discouraged. Keywords: Government Regulations, Financial Technology, Financial Inclusion, Small and Medium Enterprises

"Be honest and gain trust": a population health study to understand the factors associated with building trust in local government related to COVID-19 and vaccination in three historically disinvested neighborhoods in New York City.

Distrust in government among people of color is a response to generations of systemic racism that have produced preventable health inequities. Higher levels of trust in government are associated with better adherence to government guidelines and policies during emergencies, but factors associated with trust and potential actions to increase trust in local government are not well understood. The COVID-19 Community Recovery study sampled participants from the New York City (NYC) Department of Health and Mental Hygiene's NYC Health Panel, a probability-based survey panel who complete health surveys periodically. Participants who lived in one of three historically disinvested communities in NYC where the NYC Department of Health and Mental Hygiene has dedicated resources to reduce health inequities were included. The cross-sectional survey was fielded from September 30 to November 4, 2021 and could be self-administered online or conducted via CATI (Computer Assisted Telephone Interviewing) in English, Spanish, and Simplified Chinese (Mandarin and Cantonese by phone). Demographic data were summarized by descriptive statistics. Crude and adjusted logistic regression analyses were used to assess factors predictive of trust in local government as a source of information about COVID-19 vaccines. Open-ended responses about strengthening residents' trust in local government were coded using an iteratively generated codebook. In total, 46% of respondents indicated NYC local government was a trusted source of information about COVID-19 vaccines, relatively high compared to other sources. In bivariate analyses, race/ethnicity, age group, educational attainment, length of time living in NYC, and household income were significantly associated with identifying NYC government as a trusted source of information about COVID-19 vaccines. In multivariable logistic regression, no variables remained significant predictors of selecting local government as a trusted source of information. Key recommendations for local government agencies to build residents' trust include communicating clearly and honestly, addressing socioeconomic challenges, and enhancing public COVID-19 protection measures. Study findings demonstrate that nearly half of residents in three historically divested NYC communities consider local government to be a trusted source of information about COVID-19 vaccines. Strategies to increase trust in local government can help reduce community transmission of COVID-19 and protect public health.

Reducing the impact of COVID-19 on physical activity and mental health

Abstract Background During the COVID-19 pandemic the United Kingdom government released regular guidance on limiting the spread of COVID-19. People, including those with long term conditions, were told to use physical distancing, self-isolation and/or shielding during COVID-19 to protect themselves and others. A consequence of these interventions was to exacerbate poor lifestyle behaviours, namely less physical activity. Objectives To propose recommendations to support and sustain their physical activity of people with long term conditions during and after COVID-19 or other pandemics. Methods A mixed methods project was conducted. An online quantitative survey with 368 people in the United Kingdom was conducted, followed by 26 online semi-structured interviews. Results The study demonstrated that online resources are not accessible for all populations. During COVID-19 pandemic, provision of PA information was most commonly available online. Also, COVID-19 lockdowns meant the sudden loss of opportunities to be active along with the social interaction and motivation usually in place to support activity. Finally, physical activity guidelines should be more specific. Local and national government guidelines were identified as unclear for those living with long term conditions and should be more specific regarding what people who were shielding could and could not do. Conclusions Based on the findings, more suitable and accessible physical activity guidelines for people with long term conditions is recommended. Also, prioritizing vulnerable groups is recommended to support physical activity to avoid the worsening of emotional wellbeing, and quality of life. Finally, government and public health authorities should consider charities and long term conditions voluntary organizations to design bespoke physical activity recommendations and guidelines for those shielding at home and living with long term conditions. Key messages • Government and public health authorities design bespoke PA recommendations for those living with LTCs. • Simple strategies such as ‘move more and sit less’ or ‘breaking up sitting time’ could be promoted as safe and accessible options for those living with LTCs.

Effectiveness of the economic growth factors: productivity and innovation

The article reveals the modern problem of the rates of economic growth of the Ukrainian economy, as well as other countries, associated with their significant decrease. It is shown that its problem occurrence can also be explained by the lack of attention to the activation of innovative processes in the country during the formation of real economic policy. The assumption is substantiated that this happened due to insufficient prioritization of the separate production factor – innovation, in neoclassical methods of macroeconomic analysis. Therefore, they did not provide the right guidelines for governments in the formation of economic strategies and programs. Such countries demonstrate a stable value of the “GDP gap” against successful countries. Ukraine has been in this trend for many years, not only in relation to the countries – economic leaders, but also to its closest neighbors.A macroeconomic analysis is presented that demonstrates the presence of a “productivity paradox” in many European countries after the 2008 crisis: GDP, measured in current US dollars, exists with minor fluctuations rather than a steady upward trend. It was confirmed that the “GDP gap” did not fundamentally change between groups of countries with different types of economies. It is shown that the emergence of the “productivity paradox” phenomenon is because, against the background of the large-scale development of modern innovation processes, the main indicators of measuring the productivity of labor and other resources have significantly decreased compared to the previous times. Performance statistics of economic growth factors, built on the dominant neoclassical models, show less and less explanatory power for revealing the role of labor productivity in economic growth. This was confirmed by the regression analysis carried out, which proved insufficient attention of Ukrainian economic policy to endogenous factors of innovative development.The analysis of endogenous models of economic growth and Schumpeterian conceptual approaches showed that the key factor of economic growth in modern conditions should be the factor of scientific and technological innovations, because the existing globalization processes and the formation of the Industry 4.0 industries are contributed not only to integration of national economies and the global technological changes, but also condition by the strengthening of the divergence between developed and developing countries. It is shown that these processes occur due to the lack of sufficient own innovation potential of developing countries.&#x0D; JEL classіfіcatіon: O11, O20, O32, O38, O40

Organising for collaboration with schools: experiences from six Swedish universities

ABSTRACT Collaboration between universities and schools has been emphasised by both governments and within educational development research in the Nordic countries. However, educational research has tended to focus on the practitioners’ perspectives and experiences, i.e., researchers and teachers. Our intention is to contribute to the field with research from another perspective; that of organising for collaboration. This is done by focusing on the experiences of university representatives responsible for the organisation of collaboration within a Swedish nation-wide initiative, the ULF project. Our theoretical framework draws on the literature of partial organisation. The results indicate that the different approaches and solutions used by universities could not only potentially strengthen schools’ opportunities to participate in educational collaboration with universities but also lead to different opportunities, reinforcing previously existing differences between school organisers. The results are discussed in relation to governmental intentions and guidelines.

The Application of the Likelihood Ratio Test and the Cochran-Mantel-Haenszel Test to Discrimination Cases

In practice, the ultimate outcome of many important discrimination cases, for example, the Wal-Mart, Nike and Goldman-Sachs equal pay cases, is determined at the stage when the plaintiffs request that the case be certified as a class action. The primary statistical issue at this time is whether the employment practice in question leads to a common pattern of outcomes disadvantaging most plaintiffs. However, there are no formal procedures or government guidelines for checking whether an employment practice results in a common pattern of disparity. This article proposes using the slightly modified likelihood ratio test and the one-sided Cochran-Mantel-Haenszel (CMH) test to examine data relevant to deciding whether this commonality requirement is satisfied. Data considered at the class certification stage from several actual cases are analyzed by the proposed procedures. The results often show that the employment practice at issue created a common pattern of disparity, however, based on the evidence presented to the courts, the class action requests were denied.

‘Being there’ is what matters: Methodological and ethical challenges when undertaking research on the outdoor environment with older people during and beyond the COVID-19 pandemic

This paper reflects on adapting research methods and processes during the COVID-19 pandemic, drawing on our experiences of conducting research on the outdoor environment with older people (aged 50+) living in Scotland. First, we discuss the challenges to the organisation of research experienced in the context of changing government and university guidelines and managing delays to planned research timelines. The shift toward remote methods stimulated by the pandemic transformed traditional notions of the research field. We consider some of the implications of this for outdoor environment research, grounded as it is on exploring the interaction between people and the places they are embedded within. Further, despite a growth of literature highlighting the benefits of remote research, we found uses for digital and online approaches limited when working with older people. Second, we reflect on whether research with older people in the context of a pandemic can be conducted ethically. Drawing on our research we describe how developing an ‘ethics of care’ included negotiating with formal ethics processes but also the relational, situated ethics of qualitative health research that, because of the pandemic, had begun to shift in new ways. We describe the often intangible impacts of COVID-19 such as social isolation and bereavement that we uncovered as researchers entering into the lives of older people. In closing, we outline some of the key lessons learnt from conducting research on outdoor environments with older people to enable future qualitative health research during and beyond the pandemic.

Getting it Right First Time in Trauma Clinic: How a Pandemic Improved Service Provision for Orthopaedic Patients

Introduction: The 2019 coronavirus outbreak (COVID-19) fast became a global pandemic. In the United Kingdom, guidlines were introduced to help control the spread of this virus. Hospitals made significant changes to accommodate for the change in demand. Orthopaedic trauma services needed to remain, however, the management of orthopaedic trauma needed modifying to comply with government and hospital guidelines. Method: Queens’s hospital, Burton, is a level III trauma unit. The orthopaedic department manages upper and lower limb trauma as well as head and chest and spine trauma. Injured patients can be referred to the orthopaedic team from the community or from the Major and Minor Emergency Department. To accommodate new guidelines, the orthopaedic department introduced a ‘virtual clinic’ and a ‘trauma clinic’. The virtual clinic took place in the morning and discussed referrals from the day before. The ‘trauma clinic’ followed on from the virtual clinic and lasted the remainder of the day. Results: The intervention introduced to Queens’s hospital was beneficial for patients, staff and for the hospital. It improved waiting times, reduced the time patients spent in hospital, reduced the number of hospital attendees and enhanced knowledge of common orthopaedic injuries for staffing involved in reviewing and managing these injuries. Conclusion: For our department, these changes improved service provision, staff education and patient safety. These benefits could be seen in other trusts if a similar method of managing trauma patients was introduced.

Priority Corridor Zone for Human-Tiger Conflict Mitigation: A Landscape Connectivity Approach in West Sumatra Region, Indonesia

Excessive fragmentation of natural landscapes has led to the depletion of tiger habitats in the wild, resulting in year-round human-tiger conflict (HTC) that inflicts physical, material, and psychological losses on both humans and tigers. This research aims to provide strategies for addressing HTC through priority corridor planning as a mitigation measure, using a landscape connectivity approach widely employed to tackle ecological issues. Additionally, we and Stakeholders endeavor to determine priority corridors by initially collecting temporal conflict data, indirect evidence of tiger presence, tiger disturbance data, as well as geospatial data from government agencies involved in conservation and planning. First, we identify ecological connectivity index areas, followed by spatial modeling of HTC potential and corridor analysis using graph theory models. Our last step involves conducting a focus group discussion with stakeholders to determine priority corridors. Our analysis reveals that 65% of connectivity index areas are still connected, followed by 20% with moderate connectivity and 15% with low connectivity. Another finding is that the highest potential for conflict occurs in areas on the edge of the outer conservation zone dominated by agricultural land and plantations, and after the FGD, 12 priority tiger corridors are identified, with these locations having the highest conflict history compared to other areas that need to be connected. Finally, our Pearson correlation test results show that out of 8 potential HTC variables with landscape connectivity, 7 variables have strong connections, and 1 variable shows a weak relationship. We hope that the findings of this research will be valuable for both national and international governments and conservation NGOs as one of the mitigation solutions for HTC, contributing to sustainable development through conservation. Furthermore, our findings can serve as guidelines for local government and international conservation NGOs will formulate future policies regarding HTC mitigation and corridor implementation to ensure the sustainability of this endemic species in the wild.