Policy Research Articles

PT DANONE'S HANDLING OF FINANCIAL ISSUES AND CRISIS DUE TO THE ISSUANCE OF THE MUI FATWA BOYCOTT

This article discusses the issue management and crisis communication implemented by the food and beverage company, Danone, in responding to the spread of hoax news related to the MUI fatwa accusing its products of supporting Israel. This fake news poses a serious threat to the reputation and trust of consumers so it also affects the company's finances and requires an effective financial management strategy. This article analyzes in depth the steps taken by Danone in responding to these problems, including problem identification, crisis planning, forming a crisis management team, and implementing appropriate management strategies to maintain financial liquidity. This research also highlights the impact of boycott news on the liquidity of the PT Danone company. The results of this research provide insight into how large companies such as Danone are able to handle complex issue challenges in the era of social media and the rapid dissemination of information in maintaining company financial liquidity. It is hoped that these findings will contribute to business practitioners, policy makers and researchers interested in the financial sector, especially in the highly sensitive food and beverage industry. This research also emphasizes the importance of targeted issues and financial management strategies as a key factor in maintaining company liquidity in the midst of an unexpected crisis situation.

THE ROLE OF DYNAMIC CAPABILITIES IN LINKING EXPORT COMMITMENT TO EXPORT PERFORMANCE: AN EMPIRICAL STUDY OF EXPORTING FIRMS

This study examines the relationship between export commitment, dynamic capabilities, and export performance in the context of international business. The conceptual model presented depicts dynamic capabilities as a mediating variable between export commitment and export performance.The study employs a quantitative approach, using survey data collected from 195 respondents representing exporting firms with SEM PLS analysis. The analysis's findings show that export commitment significantly improves both export performance and dynamic capabilities. Export performance is positively impacted by dynamic capabilities as well, albeit this relationship is not very strong.These results imply that companies who are more committed to exporting typically have stronger dynamic capabilities and export performance. Nevertheless, the initial hypothesis regarding the mediating role of dynamic capacities in the link between export commitment and export performance is not supported. This research advances our knowledge of how companies can enhance their export performance through the development of export commitment and the fortification of dynamic skills. This study has significance for managers and policy makers who want to increase exporting enterprises' international competitiveness.

Utilizing virtual communities of practice in the national campaign of wheat in Egypt: action research

Abstract Background Virtual Community of Practices (VCoP) simply is a method to use social media in extension, yet its roots depend on a combination of four concepts: community of practice, social media, social learning theory, and pluralistic extension. The technical action research design was followed to put the VCoP into action and explore its profile. This study aimed to introduce a community of practice using social network applications to policy makers in the agricultural sector. Methodology Action research was conducted to validate the use of a VCoP in the National Campaign of Wheat in Egypt. A baseline survey, a content analysis of VCoP conversations, and an assessment study were used to collect the data. The frequency, range, percentage, mean, and average score were used for statistical analysis. Results The VCoP reached 22.22% and 10.40% of the wheat farmers in the two target villages, respectively. A high degree of knowledge exchange was detected among members, while messages crossed the VCoP borders as friends were invited to join the group. The VCoP helped its members establish new relationships with other stakeholders, and they expressed their need to expand membership to include other stakeholders. The media used in the VCoP was satisfactory; however, the need for more video messages and internet links was expressed. Extension agents believe that the VCoP complements other extension methods. Farmers see greater potential for cooperation than conflict, while bias is minimal among research, extension, traders, and company agents. Conclusions Farmers and other service providers in a village can be aggregated in a VCoP. This approach has proven to be valid as an extension community method for generating and sharing information with high “reach”. Coordination and training are essential for running and managing groups. Yearly programs, rather than seasonal programs, are more suitable for sustainability.

Benefits of applying standardized frameworks to implement psychosocial tools such as the ‘My Logbook’

Abstract Purpose Evidence-based interventions (EBIs) are essential to improve the well-being and neurocognitive outcomes of pediatric cancer patients; however, considerable barriers hamper the implementation of these tools. The present study assessed health care professionals’ (HCP) perceived barriers and facilitators to the implementation of a specific EBI for pediatric oncology in a standardized manner to define effective solutions and practical recommendations. Methods An adapted version of the Consolidated Framework for Implementation Research (CFIR) questionnaire was applied to inquire n = 31 HCPs in pediatric oncology about the five domains of implementation. Results While most ‘intervention characteristics’ were considered beneficial for implementation, various aspects of the ‘inner’ and ‘outer setting’ were considered problematic. The most prevalent barriers included a shortage in resources, poor integration of EBIs into policies and lacking incentives such as user benefits. Concrete proposed and realized steps to facilitate effective implementation include a patient-focused design and continuous evaluation and adaption of the tool, a detailed EBI user manual and application workshops, as well as regular interdisciplinary meetings to improve communication. Regarding the internal and external settings, involving policy makers, establishing psychosocial care in the insurance system and increasing awareness by sharing evidence are essential steps for improved implementation. Conclusion Based on standardized implementation evaluation, various targeted actions could be defined and implemented to facilitate successful implementation of EBIs in pediatric oncology. The results emphasize that psychosocial care must become an integral part of treatment standards and public health policies to ensure that effective psychosocial interventions for improved wellbeing and neurocognitive skills successfully reach pediatric cancer patients. Trial registration number ClinicalTrials.gov Identifier: NCT04474678 (July 17th 2020).

Deep Learning for Urban Tree Canopy Coverage Analysis: A Comparison and Case Study

Urban tree canopy (UTC) coverage, or area, is an important metric for monitoring changes in UTC over large areas within a municipality. Several methods have been used to obtain these data, but remote sensing image classification is one of the fastest and most reliable over large areas. However, most studies have tested only one or two classification methods to accomplish this while using costly satellite imagery or LiDAR data. This study seeks to compare three urban tree canopy cover classifiers by testing a deep learning U-Net convolutional neural network (CNN), support vector machine learning classifier (SVM) and a random forests machine learning classifier (RF) on cost-free 2012 aerial imagery over a small southern USA city and midsize, growing southern USA city. The results of the experiment are then used to decide the best classifier and apply it to more recent aerial imagery to determine canopy changes over a 10-year period. The changes are subsequently compared visually and statistically with recent urban heat maps derived from thermal Landsat 9 satellite data to compare the means of temperatures within areas of UTC loss and no change. The U-Net CNN classifier proved to provide the best overall accuracy for both cities (89.8% and 91.4%), while also requiring the most training and classification time. When compared spatially with city heat maps, city periphery regions were most impacted by substantial changes in UTC area as cities grow and the outer regions get warmer. Furthermore, areas of UTC loss had higher temperatures than those areas with no canopy change. The broader impacts of this study reach the urban forestry managers at the local, state/province, and national levels as they seek to provide data-driven decisions for policy makers.

Perspectives, Experiences, and Practices of Healthcare Professionals and Patients Towards Herb–Drug Interaction: A Systematic Review of Qualitative Studies

ABSTRACTThe aim of the study was to understand healthcare professionals, pharmacists, and patients perspectives and experiences on clinical practice of herb–drug interactions (HDIs). A systematic review of qualitative studies was conduct. 10 electronic databases were searched from inception through September 2023. Qualitative studies, mixed‐method studies, and unstructured or semi‐structured cross‐sectional surveys focused on healthcare professionals, pharmacists and patients' perspectives, attitudes, clinical practice behaviors, and information needs regarding HDI were included. Thematic synthesis employed Nvivo 12 software. Of 6655 studies identified, 1267 full‐text articles were retrieved. Of these, 18 studies conducted in 11 countries/regions were eligible for inclusion, involving 1273 patients, 302 healthcare professionals, and 230 pharmacists. Five over‐arching explanatory themes were identified: perspectives, attitudes, practices, experiences, expectations, and information needs. Complementary and alternative (CAM) physicians, pharmacists, and general practitioners were considered by patients to possess the ability or responsibility to assess potential HDIs. Pharmacists yet encountered difficulties due to conflicting information sources and inadequate training. Healthcare professionals, including pharmacists, usually only assessed HDIs when they were deemed to cause serious adverse effects. Regarding expectations and information needs, patients were particularly concerned about the risk of adverse HDIs, the severity of HDIs, and the appropriate intervals between drug doses. They would like to receive relevant HDI alerts. Results suggest that government, policy makers, healthcare professionals, and the education system should give attention to HDIs and improve health professional—patient communication. Further research should also be conducted on the understanding and practices of CAM practitioners in China.Trial Registration: CRD42022324777 (https://www.crd.york.ac.uk/PROSPERO/#recordDetails)

Predicting Mutual Fund Stress Levels Utilizing SEBI’s Stress Test Parameters in MidCap and SmallCap Funds Using Deep Learning Models

Abstract: The Association of Mutual Funds of India (AMFI), under the direction of the Securities and Exchange Board of India (SEBI), provided open access to various risk parameters with respect to MidCap and SmallCap funds for the first time from February 2024. Our study utilizes AMFI datasets from February 2024 to September 2024 which consisted of 14 variables. Among these, the primary variable identified in grading mutual funds is the stress test parameter, expressed as number of days required to liquidate between 50% and 25% of the portfolio, respectively, on a pro-rata basis under stress conditions as a response variable. The objective of our paper is to build and test various neural network models which can help in predicting stress levels with the highest accuracy and specificity in MidCap and SmallCap mutual funds based on AMFI’s 14 parameters as predictors. The results suggest that the simpler neural network model architectures show higher accuracy. We used Artificial Neural Networks (ANN) over other machine learning methods due to its ability to analyze the impact of dynamic interrelationships among 14 variables on the dependent variable, independent of the statistical distribution of parameters considered. Predicting stress levels with the highest accuracy in MidCap and SmallCap mutual funds will benefit investors by reducing information asymmetry while allocating investments based on their risk tolerance. It will help policy makers in designing controls to protect smaller investors and provide warnings for funds with unusually high risk.

Generative AI and Investigative Journalism—An Application of Baumol's Cost Disease Across Mass Communication Sectors

Generative artificial intelligence (AI) has transformed various industries, automating tasks and enhancing productivity. Yet, its impact varies across sectors. In mass communication, AI has notably benefited entertainment, public relations, and advertising. However, it poses a lesser advantage for investigative journalism, where labor-intensive research and other highly specialized activities depend on highly educated journalists. This situation parallels Baumol's concept of a cost disease, which applies to labor-intensive “stagnant” service sectors such as healthcare, education, and the performing arts. These sectors rely heavily on human labor and struggle to achieve significant productivity gains from technological advances. This means they may require decreasing wages or increasing subsidies to compete with more productive industries. In mass communication, this phenomenon could be especially pertinent to (investigative) journalism, which directly competes for attention with other communication forms. This could exacerbate pressures on wages and working conditions, hindering the attraction of talent to the field and necessitating higher public spending on this vital journalism form. This commentary presents a cross-industry analysis of the impact of generative AI on communication sectors and derives directions for further research that would enhance our understanding of journalism's economic viability in a digital communication landscape and inform policy makers to address the affiliated societal challenges. It closes with a discussion of Guzman and Lewis’s call for more cross-industry research on AI in communication industries.

Effectiveness and Heterogeneous Effects of Purchase Grants for Electric Vehicles

AbstractWe evaluate German purchase subsidies for battery electric vehicles (BEVs) and plug-in hybrid electric vehicles (PHEVs) using data on new vehicle registrations in Germany during 2015-2022. We account for confounding time trends and interacting EU-level $$\text {CO}_{2}$$ standards using neighboring countries as a control group. We find that 40% of BEV and 25% of PHEV registrations were subsidy-induced. The program had strong distributional effects, with greater uptake in wealthier and greener counties. We estimate implied abatement costs of 870 euro per ton of $$\text {CO}_{2}$$ for BEVs and 2,470 euro for PHEVs, suggesting that policy makers should re-balance support schemes away from PHEVs.

Assessment of psychometric properties of the Dari version of the Pittsburgh Sleep Quality Index (PSQI) among Afghans

Abstract Background Sleep helps in improving the functions of all systems of human body. Disturbance in sleep can cause immediate adverse effects on normal human physiologic functions. Main objective of this study was to explore the psychometric properties of the Dari version of the of Pittsburgh Sleep Quality Index (PSQI) among general adult population of Afghanistan. Methods This methodological study has been conducted during July to November 2023. Reliability and validity of PSQI were evaluated using Cronbach’s Alpha and confirmatory factor analysis, respectively. Pearson correlation analysis was conducted to assess the convergent validity of the components of PSQI, comparing results with those obtained from the DASS-21 subdomains. Results In this cross-sectional study, 965 Afghan adults were studied during five months of duration between July and November, 2023. Mean age of the study participants was 35.2 years. The prevalence of sleep disturbance was 44.6% (430/965). Among them, 59.3% (572/965) reported experiencing subjective sleep quality disturbances less than once a week, 36.2% (349/965) had sleep latency issues less than once a week, 17.6% (170/965) had sleep duration disruption once or twice a week, while 36.3% (350/965) had daytime dysfunction less than once a week. The Cronbach’s alpha coefficient for the seven-component scale was 0.677, indicating acceptable internal consistency. Substantial and statistically significant positive correlations were present among the component of PSQI subjective sleep quality and sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleeping medication, daytime dysfunction, DASS-Depression, DASS-Anxiety, and DASS-Stress. The overall PSQI exhibited favorable fit indices, supporting the proposed single-factor structure among adult Afghan population. Conclusion Prevalence of sleep disturbance was very high among adult population of Afghanistan. This study provided useful information that will help policy makers (such as ministry of public health as well as international donor agencies like WHO, USAID, and UNICEF) to design a better strategy to reduce the prevalence of sleep disturbance that affects health of the Afghan community at large.

Dropout from Maternity Continuum of Care and Associated Factors Among Mothers Who Gave Birth After War in Adigrat Town, Tigray, Northern Ethiopia 2024

<i>Background: </i>Maternity continuum of care is the continuity of maternal health care services given to mothers during antenatal period, child birth and post natal period. It is one of the strategic programs meant to lower the death rates of mothers, newborns, and children. In spite of this, a large number of moms discontinue their participation in maternal continuum care. Dropout from the maternity continuum of care is prevalent public health issue in underdeveloped nations, such as Ethiopia. <i>Methods: </i>Community based quantitative cross-sectional study was carried out among 357 mothers who gave birth in the 12 months in Adigrat town. Systematic sampling method was used to obtain study participants. Data was collected using pretested, semi- structured and face to face interviewer administered questioner. Bivariable and multivariable logistic regression model was fitted. Variables having p-value less than 0.2 in bivariable analysis was entered to multivariable logistic regression model. In multivariable logistic regression adjusted odds ratio with 95% confidence interval was used to determine strength and direction of the association between dependent and independent variables. <i>Results:</i> The overall magnitude of drop out from the maternity continuum of care was 237 (66.4%) [95%CI (61.3-70.9)], 60.6% drop out from ANC visit, 5.6% drop out from skill birth attendant and 58.9% drop out from PNC. Mothers never heard on maternal health care service (AOR=4.179 (1.107, 15.783), service out of health facility (AOR =5.136 (1.988, 13.267) noabortionhistory (AOR=1.424 (1.113, 12.133), unplannedpregnancy (AOR=5.478 (1.902, 15.777), less than 4 ANC visit (AOR= 5.583 (2.598, 11. 997) and mothers attitude (AOR=15.049 (2.489, 32.997) were statically significant factors associated with drop out from maternity continuum of care. <i>Conclusion and discussion: </i>This study showed that magnitude of drop out from maternity continuum of care was high as compared to WHO recommendations. As a result concerned stakeholders and policy makers should initiate more than four ANC visit, create awareness on harmful traditional practice, bad pregnancy history, support mothers to use family planning to prevent unplanned pregnancy, and work on attitude change of the community.

Combined effects of urbanization and climate variability on water and carbon balances in a rice paddy-dominated basin in southern China

Abstract Urbanization is known to elevate storm runoff, but how it influences carbon cycle and ecosystem productivity through altering the evapotranspiration (ET) process is less clear. We examined the combined effects of urbanization including change in impervious surface area (ISA) and climate variability on the water and carbon balances of the Qinhuai River Basin (QRB) over 2001–2018. QRB represents a typical rice paddy-dominated region that experienced rapid urbanization in southern China. We improved a monthly scale water supply stress index ecosystem service model by integrating local eddy flux measurements and high-resolution remote sensing data. We found a significant downward trend in both ET (−4.6 mm yr−1, p < 0.05) and gross primary productivity (GPP) (−10.4 gC m−2 yr−1, p < 0.05) but a significant upward trend in water yield (Q) (+28.6 mm yr−1, p < 0.05). These ecosystem function changes coincided with a 96% increase in urban areas, 1.9-fold increase in ISA, and a 37% reduction in rice paddy fields. The mean annual watershed GPP decreased from 1048 gC m−2 to 998 gC m−2 while the annual Q increased from 284 mm to 669 mm from 2001 to 2018. Scenario modeling experiments suggested that the negative impacts of loss of rice paddy fields and increase in ISA on ET and GPP overwhelmed the positive impacts of climate warming. The reduction in GPP and increase in Q were largely attributed to the increases in ISA, not necessarily due to changes in land use types (e.g. urban area). The expansion of urban area, increase in ISA and reduction in leaf area index, and increase in precipitation explained the increase in Q. Our research offers insight about the interactions of carbon and water cycles through the critical ET processes under a changing climate and land surface characteristics at a watershed level. Our modeling tool and analysis provides land managers and policy makers information for designing effective ‘Urban Nature-based Solutions’ to mitigate the negative environmental effects of urbanization on carbon and water resources.

Concurrent Mentions of Vaping and Alcohol on Twitter: Latent Dirichlet Analysis

Background Co-use of alcohol and e-cigarettes (often called vaping) has been linked with long-term health outcomes, including increased risk for substance use disorder. Co-use may have been exacerbated by the COVID-19 pandemic. Social networking sites may offer insights into current perspectives on polysubstance use. Objective The aims of this study were to investigate concurrent mentions of vaping and alcohol on Twitter (subsequently rebranded X) during a time of changing vaping regulations in the United States and the emergence of the COVID-19 pandemic. Methods Tweets including both vape- and alcohol-related terms posted between October 2019 and September 2020 were analyzed using latent Dirichlet allocation modeling. Distinct topics were identified and described. Results Three topics were identified across 6437 tweets: (1) flavors and flavor ban (n=3334, 51.8% of tweets), (2) co-use discourse (n=1119, 17.4%), and (3) availability and access regulation (n=1984, 30.8%). Co-use discussions often portrayed co-use as positive and prosocial. Tweets focused on regulation often used alcohol regulations for comparison. Some focused on the perceived overregulation of vaping (compared to alcohol), while others supported limiting youth access but not at the expense of adult access (eg, stronger age verification over product bans). Across topics, vaping was typically portrayed as less harmful than alcohol use. The benefits of flavors for adult smoking cessation were also discussed. The distribution of topics across time varied across both pre– and post–regulatory change and pre– and post–COVID-19 pandemic declaration periods, suggesting shifts in topic focus salience across time. Conclusions Co-use discussions on social media during this time of regulatory change and social upheaval typically portrayed both vaping and alcohol use in a positive light. It also included debates surrounding the differences in regulation of the 2 substances—particularly as it related to limiting youth access. Emergent themes from the analysis suggest that alcohol was perceived as more harmful but less regulated and more accessible to underage youth than vaping products. Frequent discussions and comparisons of the 2 substances as it relates to their regulation emphasize the still-evolving vaping policy landscape. Social media content analyses during times of change may help regulators and policy makers to better understand and respond to common concerns and potential misconceptions surrounding drug-related policies and accessibility.

A gestalt shift? Reflections from researchers turned elected representatives on the real-world use of evidence in policy making

This practice piece will present a comparative reflection of how the use of evidence in policy looks when viewed from the outside, as a researcher, with how evidence use is experienced when working as a policy maker. The three authors are unusual in sharing an experience of studying evidence use in policy before becoming elected politicians who are involved in policy making and who have therefore gained a very different, more direct experience of how evidence is used in policy-making settings. Synhaeve has studied evidence use in secure youth care and is an elected councillor and was elected national member of parliament for the Democrats 66 Party in the Netherlands, McMahon has studied evidence use in public health and is an elected councillor for the Labour Party in England, while Heap has studied evidence use in social security policy and is an elected councillor for the Green Party in Scotland. The practice piece will consider to what extent their perspectives on evidence use in policy have shifted as they have moved from researcher to political representative and policy maker, and will consider to what extent these experiences have been shaped by their substantive policy interests and the political systems in which each is operating. It will conclude by summarising the collective insights that have emerged for the three authors as they have shifted to viewing evidence use from the perspective of an insider, who is using evidence in making policy, rather than an outsider, producing evidence with a view to influencing policy.

Exploring the Role of Tools and Technologies in Enhancing Human Knowledge Acquisition: The Flora of Cambodia as a Pilot Project.

The globalization of the world profoundly impacts the academic and scientific domains. Technological advances have enabled an immeasurable progress in many scientific fields, for example structural or functional genomics, bioinformatics or even the development of artificial intelligence, which is becoming a catalyst for disciplines such as taxonomy. However, we are witnessing an unprecedented paradox. We have entered a period described as the 6th mass extinction (e.g., Ceballos et al. 2015, Ceballos et al. 2020, Cowie et al. 2022), where biodiversity has been in decline for many years because of anthropogenic activity (Myers et al. 2000, Sachs et al. 2009, Butchart et al. 2010) and yet, techniques have never been so advanced (e.g., online databases, metabarcording and eDNA identification methods). They produce a deluge of results and data that must be managed to facilitate their access and re-use and benefit to all users, i.e., scientists and stake-holders or policy makers on a global scale. Currently, the flora of Cambodia is part of the Flora of Cambodia, Laos and Viêt-nam*1 and is jointly edited by the Royal Botanic Garden of Edinburgh and the Muséum national d’Histoire naturelle in Paris since 2013. Given Cambodia's historical ties to French Indochina, France's long-term presence has significantly contributed to the documentation of Cambodia's biodiversity. The largest collection of Cambodian specimens is housed at the Paris Herbarium. The Flora of Cambodia project (Ung 2023) started in 2023 as a pilot project for testing the effectiveness of different open tools developped for taxonomists, e.g., the echinopscis platform*2 developped at the Royal Botanical Garden Kew; Bionomia*3; data made available online through platforms such as the Global Biodiversity Information Facility, Atlas of Living Australia, and World Flora Online. Other sources will also be used, like publications (Joyce et al. 2020) and "les herbonautes"*4, a citizen science platform. The short-term result is to produce a checklist of the vascular plants of Cambodia in multiple languages including Khmer. This project aligns with the FAIR (Findable, Accessible, Interoperable, Reusable) (Wilkinson et al. 2016) and CARE (Collective benefit, Authority to control, Responsability, Ethics) (Carroll et al. 2020) principles.

A systematic literature review on public health and healthcare resources for pandemic preparedness planning

Abstract Background Generating insights into resource demands during outbreaks is an important aspect of pandemic preparedness. The EU PANDEM-2 project used resource modelling to explore the demand profile for key resources during pandemic scenarios. This review aimed to identify public health and healthcare resources needed to respond to pandemic threats and the ranges of parameter values on the use of these resources for pandemic influenza (including the novel influenza A(H1N1)pdm09 pandemic) and the COVID-19 pandemic, to support modelling activities. Methods We conducted a systematic literature review and searched Embase and Medline databases (1995 – June 2023) for articles that included a model, scenario, or simulation of pandemic resources and/or describe resource parameters, for example personal protective equipment (PPE) usage, length of stay (LoS) in intensive care unit (ICU), or vaccine efficacy. Papers with data on resource parameters from all countries were included. Results We identified 2754 articles of which 147 were included in the final review. Forty-six different resource parameters with values related to non-ICU beds (n = 43 articles), ICU beds (n = 57), mechanical ventilation (n = 39), healthcare workers (n = 12), pharmaceuticals (n = 21), PPE (n = 8), vaccines (n = 26), and testing and tracing (n = 19). Differences between resource types related to pandemic influenza and COVID-19 were observed, for example on mechanical ventilation (mostly for COVID-19) and testing & tracing (all for COVID-19). Conclusion This review provides an overview of public health and healthcare resources with associated parameters in the context of pandemic influenza and the COVID-19 pandemic. Providing insight into the ranges of plausible parameter values on the use of public health and healthcare resources improves the accuracy of results of modelling different scenarios, and thus decision-making by policy makers and hospital planners. This review also highlights a scarcity of published data on important public health resources.

Older Adults’ Perspectives and Experiences With Digital Health in Singapore: Qualitative Study

Background Technology use among older adults is increasingly common. Even though there is potential in leveraging technology to help them manage their health, only a small fraction of them use it for health-related purposes. Objective This study seeks to understand the perspectives of and experiences with digital health (DH) among older adults in Singapore. Methods A total of 16 participants (age range 60-80 years; n=11, 69% female) were interviewed for approximately an hour (range 27-64 minutes) about their health, DH use, and DH experiences. The interviews were recorded, transcribed verbatim, and thematically analyzed. Results Five main themes emerged from the interview: support in developing DH literacy, credibility, cost and benefit considerations, intrinsic drive to be healthy, and telehealth. Older adults need support in familiarizing themselves with DH. When considering DH options, older adults often relied on credible sources and preferred DH to be free. Monetary incentives were brought up as motivators. The intrinsic drive to live longer and healthily was expressed to be a huge encouragement to use DH to help obtain health-related knowledge and achieve healthy living goals. The idea of telehealth was also appealing among older adults but was seen to be more suited for individuals who have issues accessing a physical clinic. Conclusions Our findings offer insights into the various aspects that matter to older adults in the adoption of DH, which in turn can help reshape their health-seeking behavior and lifestyle. As such, policy makers and DH implementors are encouraged to take these into consideration and align their strategies accordingly.

Nats’eji (healing): Examining patient and provider experiences with hospital-based Indigenous wellness services in Northwest Territories, Canada

Abstract Objective This study aimed to examine how Indigenous patients and biomedical healthcare providers understand and experience the Indigenous wellness services at a hospital in the Northwest Territories. Methods The qualitative study (May 2018–June 2022) was overseen by a regional Indigenous Community Advisory Committee. Guided by Two-Eyed Seeing and post-colonial theory, the study employed a community-engaged research design, and included two strategies for data generation: (1) interviews with Indigenous Elders, patient advocates, biomedical healthcare providers, policy makers, and hospital administrators (n = 41), and (2) iterative sharing circles with Indigenous Elders (n = 4). Data from the interviews and first sharing circle were transcribed, thematically analyzed, and presented to the sharing circle Elders for validation. Results The study revealed three overarching and related themes: (1) Elders and patient advocates emphasized that while the Indigenous wellness services at the hospital play a pivotal role connecting patients with cultural supports, the hospital was still not effectively bringing Indigenous healing practices into hospital care; (2) participants identified that structural factors (i.e., policy and governance decisions) shaped patients’ experiences with the wellness services; and (3) participants underscored that deeply rooted forces (i.e., racism, colonialism, and biomedical dominance) inhibit the integration of Indigenous healing practices. Conclusion The findings extend understandings of hospital-based Indigenous wellness services by surfacing relationships between deeply rooted forces, organizational structures, and Indigenous patients’ experiences. Altogether, they suggest that to advance care for Indigenous patients and improve the integration of Indigenous healing practices, a system-wide transformation is necessary, which includes Indigenous governance at the hospital and a recognition of the value of Indigenous healing practices.

Assessing the Quality of an Online Democratic Deliberation on COVID-19 Pandemic Triage Protocols for Access to Critical Care in an Extreme Pandemic Context: Mixed Methods Study

Background Online democratic deliberation (ODD) may foster public engagement in new health strategies by providing opportunities for knowledge exchange between experts, policy makers, and the public. It can favor decision-making by generating new points of view and solutions to existing problems. Deliberation experts recommend gathering feedback from participants to optimize future implementation. However, this online modality has not been frequently evaluated. Objective This study aims to (1) assess the quality of an ODD held in Quebec and Ontario, Canada, on the topic of COVID-19 triage protocols for access to critical care in an extreme pandemic context and (2) determine its transformative aspect according to the perceptions of participants. Methods We conducted a simultaneous ODD in Quebec and Ontario on May 28 and June 4, 2022, with a diversified target audience not working in the health care system. We used a thematic analysis for the transcripts of the deliberation and the written comments of the participants related to the quality of the process. Participants responded to a postdeliberation questionnaire to assess the quality of the ODD and identify changes in their perspectives on COVID-19 pandemic triage protocols after the deliberation exercise. Descriptive statistics were used. An index was calculated to determine equality of participation. Results The ODD involved 47 diverse participants from the public (n=20, 43% from Quebec and n=27, 57% from Ontario). Five themes emerged: (1) process appreciation, (2) learning experience, (3) reflecting on the common good, (4) technological aspects, and (5) transformative aspects. A total of 46 participants responded to the questionnaire. Participants considered the quality of the ODD satisfactory in terms of process, information shared, reasoning, and videoconferencing. A total of 4 (80%) of 5 participants reported at least 1 change of perspective on some of the criteria and values discussed. Most participants reported that the online modality was accessible and user-friendly. We found low polarization when calculating equal participation. Improvements identified were measures to replace participants when unable to connect and optimization of time during discussions. Conclusions Overall, the participants perceived the quality of ODD as satisfactory. Some participants self-reported a change of opinion after deliberation. The online modality may be an acceptable alternative for democratic deliberation but with some organizational adaptations.

Buildings in Hot Climate Zones—Quantification of Energy and CO2 Reduction Potential for Different Architecture and Building Services Measures

Reducing energy and associated greenhouse gas emissions in buildings is one of the key aspects of climate change on a global level. To put the building sector on a low carbon development path, policies and adequate financing play a crucial role in each region. In the global South, policies and regulations related to the decarbonization of the building stock are increasingly being implemented. For policy and decision makers, adequate data on the status quo of the building stock, as well as the quantification of energy reduction measures, are essential to make informed decisions on the building regulatory and funding framework. The objective of this study is to provide data-driven insights into the potential for energy and CO2 reduction in buildings across various hot climate zones in the Global South. A simulation-based approach was employed to model five different building types, ranging from residential homes to office buildings, under a variety of architectural and building services scenarios. The simulations were conducted using the dynamic building energy simulation tool EnergyPlus, which assessed the impact of various energy-saving measures under both current and projected future climate conditions. This study concludes that optimizing passive design features, such as improved windows, solar shading, and reflective surfaces, in conjunction with active systems like decentralized cooling units and renewable energy integration, can result in a notable reduction in energy demand and emissions. Our findings provide a robust basis for policymakers to develop targeted energy efficiency strategies for buildings in hot climate zones, which will play a crucial role in achieving climate goals in the Global South.