scholarly journals Orchestrating the Participation of Women Organisations in the UNFCCC Led Climate Finance Decision Making

Climate ◽  
2021 ◽  
Vol 9 (9) ◽  
pp. 135
Author(s):  
Svetlana Frenova
Keyword(s):  
Decision Making ◽  
Mixed Methods ◽  
Climate Finance ◽  
Policy Framing ◽  
Early Evidence ◽  
Policy Goals ◽  
Participation Of Women ◽  
And Gender ◽  
Document Review

The study applies orchestration as a conceptual framework to provide early evidence on the engagement of women organisations in UNFCCC-led climate finance governance and reflect on the quality of their mobilisation. Women organisations are one of the non-state stakeholders, whose role is acknowledged in the UNFCCC Decision 3/CP.25 for improving gender-responsiveness of climate finance. Within the UNFCCC, orchestration is used as a governance approach to enhance the mobilisation of non-state actors for facilitating the implementation of policy goals. The study utilises mixed methods including document review and interviews with key informants. The findings of the study indicate that the quality of orchestration has been low, i.e., the engagement of women organisations in the UNFCCC-led climate finance decision making has, so far, been limited. This is due to the lack of policy convergence on the purposes of orchestration, as well as the newness, and complexity of the issues at the intersection of climate finance and gender. While the concept of orchestration is intended to enhance decision making practices, the study suggests that in the case of the engagement of women organisations in the UNFCCC-led climate finance governance, orchestration is used only for symbolic purposes. To make the engagement of women organisations more meaningful, there is a need to diversify the existing orchestration practices and improve consistency in policy framing.

scholarly journals P077 What matters to Ulcerative Colitis patients when they make treatment decisions? A systematic review

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S180-S180
Author(s):  
A M Folan ◽  
G Jones ◽  
D Baker ◽  
S Brown ◽  
M Lee ◽  
...  
Keyword(s):  
Systematic Review ◽  
Ulcerative Colitis ◽  
Decision Making ◽  
Mixed Methods ◽  
Elective Surgery ◽  
Treatment Decisions ◽  
Physical Symptoms ◽  
Adherence To Medication ◽  
What Matters

Abstract Background The decision for ulcerative colitis (UC) patients to opt for elective surgery or continue medical treatment is dependent on patient preferences taking into account a range of factors. In addition to choosing between medical and surgical treatment, patients undergoing elective surgery are presented with a further decision regarding which operation to choose. The aim of this systematic review is to identify and understand what matters to UC patients when they are making these decisions. Methods Five electronic databases (PubMed, Scopus, CINAHL, Medline, and Embase) were searched for relevant literature up to 15 October 2020. Qualitative, quantitative and mixed-methods studies were included in this review. Studies reporting on what was important to UC patients (over 16 years of age) when they make treatment decisions were included. The Mixed Methods Appraisal Tool was used to assess the quality of the papers. Thematic analysis was used to analyse the data. Results The searches identified 6,917 papers and a final 19 (eight quantitative, seven qualitative, four mixed methods) papers were included. All studies were published since 2007 and included a total of 3,328 participants from nine countries. Five overarching themes (and their associated 20 sub-themes) were generated to describe the factors reported as important to UC patients in making treatment decisions. These were: 1. Information provision (information content, knowledge about their illness, quality of information); 2. Impact of the treatment upon daily life (controlling physical symptoms, quality of life); 3. Levels of risk (trade-off, high risk, concern and worry); 4. Burden of treatment (the need to see benefits of medication, route and size of medication, side effects, dosing frequency, costs, effort of being the patient, adherence to medication, surgery concerns, timing of surgery); and 5. Patient-clinician relationship (shared decision-making, communication, mismatch between what clinicians and patients consider to be important). Conclusion Communication between patients and their IBD teams should take into account the range of factors that influence their treatment decision making. Decision support interventions that incorporate such factors may better support the patient-clinician relationship and improve knowledge of treatment options and how these impact on what matters to them. Future studies are needed to determine which factors identified in this review are dominant.

Equity for Women and Marginalized Groups in Patriarchal Societies during Forest Landscape Restoration: The Controlling Influence of Tradition and Culture

2019 ◽  
Vol 46 (03) ◽  
pp. 241-246
Author(s):  
Jack Baynes ◽  
John Herbohn ◽  
Nestor Gregorio ◽  
William Unsworth ◽  
Émilie Houde Tremblay
Keyword(s):  
Decision Making ◽  
Gender Equity ◽  
Institutional Development ◽  
The Philippines ◽  
Small Scale ◽  
Marginalized Groups ◽  
Forest Landscape Restoration ◽  
Participation Of Women ◽  
And Gender ◽  
Structured Approach

SummaryWe explore the difficulty of achieving equity for women in two forest and livelihood restoration (FLR) pilot projects, one each in Papua New Guinea (PNG) and the Philippines. We use institutional bricolage as a framework to explain the context and background of stakeholders’ decision-making and the consequent impact on equity and benefit distribution. In the Philippines, material and institutional support was initially successful in assisting participants to establish small-scale tree plantations. A structured approach to institutional development has successfully evolved to meet the needs of women, even though corruption has re-emerged as a destabilizing influence. In PNG, despite success in establishing trees and crops, the participation of women was subjugated to traditional customs and norms that precluded them from engaging in land management decisions. The capacity-building and gender-equity principles of FLR consequently became compromised. We conclude that in some patriarchal societies achieving equity for women will be difficult and progress will be contingent on a detailed understanding of the effects of traditional customs and norms on participation and decision-making.

scholarly journals Optimization of Upper Extremity Rehabilitation by Combining Telerehabilitation With an Exergame in People With Chronic Stroke: Protocol for a Mixed Methods Study

10.2196/14629 ◽  
2020 ◽  
Vol 9 (5) ◽  
pp. e14629
Author(s):  
Dorra Rakia Allegue ◽  
Dahlia Kairy ◽  
Johanne Higgins ◽  
Philippe Archambault ◽  
Francois Michaud ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Decision Making ◽  
Mixed Methods ◽  
Upper Extremity ◽  
Shared Decision Making ◽  
Stroke Rehabilitation ◽  
Mixed Methods Study ◽  
Decision Making Process ◽  
Shared Decision

Background Exergames have the potential to provide an accessible, remote approach for poststroke upper extremity (UE) rehabilitation. However, the use of exergames without any follow-up by a health professional could lead to compensatory movements during the exercises, inadequate choice of difficulty level, exercises not being completed, and lack of motivation to pursue exercise programs, thereby decreasing their benefits. Combining telerehabilitation with exergames could allow continuous adjustment of the exercises and monitoring of the participant’s completion and adherence. At present, there is limited evidence regarding the feasibility or efficacy of combining telerehabilitation and exergames for stroke rehabilitation. Objective This study aims to (1) determine the preliminary efficacy of using telerehabilitation combined with exergames on UE motor recovery, function, quality of life, and motivation in participants with chronic stroke, compared with conventional therapy (the graded repetitive arm supplementary program; GRASP); (2) examine the feasibility of using the technology with participants diagnosed with stroke at home; and (3) identify the obstacles and facilitators for its use by participants diagnosed with stroke and stroke therapists and understand the shared decision-making process. Methods A mixed methods study protocol is proposed, including a randomized, blinded feasibility trial with an embedded multiple case study. The intervention consists of the provision of a remote rehabilitation program, during which participants will use the Jintronix exergame for UE training and the Reacts Application to conduct videoconferenced sessions with the therapists (physical or occupational therapists). We plan to recruit 52 participants diagnosed with stroke, randomly assigned to a control group (n=26; 2-month on-paper home exercise program: the GRASP with no supervision) and an experimental group (n=26; 2-month home program using the technology). The primary outcome is the Fugl-Meyer UE Assessment, a performance-based measure of UE impairment. The secondary outcomes are self-reported questionnaires and include the Motor Activity Log-28 (quality and frequency of use of the UE), Stroke Impact Scale-16 (the quality of life), and Treatment Self-Regulation Questionnaire (motivation). Feasibility data include process, resources, management, and scientific outcomes. Qualitative data will be collected by interviews with both participants and therapists. Results At present, data collection was ongoing with one participant who had completed the exergame- telerehabilitation based intervention. We expect to collect preliminary efficacy data of this technology on the functional and motor recovery of the UE, following a stroke; collect feasibility data with users at home (adherence, safety, and technical difficulties); and identify the obstacles and facilitators for the technology use and understand the shared decision-making process. Conclusions This paper describes the protocol underlying the study of a telerehabilitation-exergame technology to contribute to understanding its feasibility and preliminary efficacy for UE stroke rehabilitation. Trial Registration ClinicalTrials.gov NCT03759106; http://clinicaltrials.gov/show/NCT03759106. International Registered Report Identifier (IRRID) DERR1-10.2196/14629

scholarly journals Optimization of Upper Extremity Rehabilitation by Combining Telerehabilitation With an Exergame in People With Chronic Stroke: Protocol for a Mixed Methods Study (Preprint)

2019 ◽  
Author(s):  
Dorra Rakia Allegue ◽  
Dahlia Kairy ◽  
Johanne Higgins ◽  
Philippe Archambault ◽  
Francois Michaud ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Decision Making ◽  
Mixed Methods ◽  
Upper Extremity ◽  
Shared Decision Making ◽  
Stroke Rehabilitation ◽  
Mixed Methods Study ◽  
Decision Making Process ◽  
Shared Decision

BACKGROUND Exergames have the potential to provide an accessible, remote approach for poststroke upper extremity (UE) rehabilitation. However, the use of exergames without any follow-up by a health professional could lead to compensatory movements during the exercises, inadequate choice of difficulty level, exercises not being completed, and lack of motivation to pursue exercise programs, thereby decreasing their benefits. Combining telerehabilitation with exergames could allow continuous adjustment of the exercises and monitoring of the participant’s completion and adherence. At present, there is limited evidence regarding the feasibility or efficacy of combining telerehabilitation and exergames for stroke rehabilitation. OBJECTIVE This study aims to (1) determine the preliminary efficacy of using telerehabilitation combined with exergames on UE motor recovery, function, quality of life, and motivation in participants with chronic stroke, compared with conventional therapy (the graded repetitive arm supplementary program; GRASP); (2) examine the feasibility of using the technology with participants diagnosed with stroke at home; and (3) identify the obstacles and facilitators for its use by participants diagnosed with stroke and stroke therapists and understand the shared decision-making process. METHODS A mixed methods study protocol is proposed, including a randomized, blinded feasibility trial with an embedded multiple case study. The intervention consists of the provision of a remote rehabilitation program, during which participants will use the Jintronix exergame for UE training and the Reacts Application to conduct videoconferenced sessions with the therapists (physical or occupational therapists). We plan to recruit 52 participants diagnosed with stroke, randomly assigned to a control group (n=26; 2-month on-paper home exercise program: the GRASP with no supervision) and an experimental group (n=26; 2-month home program using the technology). The primary outcome is the Fugl-Meyer UE Assessment, a performance-based measure of UE impairment. The secondary outcomes are self-reported questionnaires and include the Motor Activity Log-28 (quality and frequency of use of the UE), Stroke Impact Scale-16 (the quality of life), and Treatment Self-Regulation Questionnaire (motivation). Feasibility data include process, resources, management, and scientific outcomes. Qualitative data will be collected by interviews with both participants and therapists. RESULTS At present, data collection was ongoing with one participant who had completed the exergame- telerehabilitation based intervention. We expect to collect preliminary efficacy data of this technology on the functional and motor recovery of the UE, following a stroke; collect feasibility data with users at home (adherence, safety, and technical difficulties); and identify the obstacles and facilitators for the technology use and understand the shared decision-making process. CONCLUSIONS This paper describes the protocol underlying the study of a telerehabilitation-exergame technology to contribute to understanding its feasibility and preliminary efficacy for UE stroke rehabilitation. CLINICALTRIAL ClinicalTrials.gov NCT03759106; http://clinicaltrials.gov/show/NCT03759106. INTERNATIONAL REGISTERED REPORT DERR1-10.2196/14629

What Are the Needs of Senior Tourists? Evidence from Remote Regions of Europe

Economies ◽  
2021 ◽  
Vol 9 (4) ◽  
pp. 148
Author(s):  
Joanna Zielińska-Szczepkowska
Keyword(s):  
Decision Making ◽  
Mixed Methods ◽  
European Countries ◽  
Financial Resources ◽  
Survey Method ◽  
Quality Of Services ◽  
Key Factors ◽  
Mixed Methods Approach ◽  
Historical Sites

Tourism is one of the fastest-growing industries in Europe, with growth mostly centered in major cities and urban locations. Nevertheless, remote destinations can also offer tranquility and accessibility, as well as both unexploited and unknown development potential for active senior travelers. The purpose of this paper is to analyze, on the basis of information gathered from 1705 questionnaires, senior touristic behavior, including motivations and decision-making issues for senior travelers in 11 remote regions of nine European countries (Finland, Latvia, Poland, Slovakia, Hungary, Bulgaria, Spain, Ireland, and Greece). A mixed-methods approach was used to fulfill the research objectives. Both interviews and the survey method were applied to generate data from senior tourists. The present study will focus on the key factors explaining senior tourists’ motivations and barriers to travel. The results of surveys conducted within the TOURAGE project indicate the significant potential of remote regions in the development of senior tourism. For senior respondents, a very important reason for going on holiday is the possibility of enjoying rest and silence. Safety, nature, historical sites, quality of services, and easy transportation connections are the top five attraction factors for seniors when choosing a destination. At the same time, according to the interviews, among the important problems negatively influencing the size of the senior tourism market in remote regions are: difficulties in reaching seniors with tourist offers, a lack of promotion of local tourist products aimed at seniors, and finally a lack of financial resources for the implementation of local projects supporting the development of senior tourism.

scholarly journals Informing Consent: A Grounded Theory Study of Parents of Transgender and Gender-Diverse Youth Seeking Gender-Confirming Endocrinological Interventions

2021 ◽  
Vol 11 (4) ◽  
pp. 440-458
Author(s):  
Charles F. Shepard ◽  
Darius A. Green ◽  
Karli M. Fleitas ◽  
Debbie C. Sturm
Keyword(s):  
Decision Making ◽  
Grounded Theory ◽  
Informed Consent ◽  
Hormone Replacement ◽  
National Sample ◽  
Contributing Factors ◽  
Grounded Theory Study ◽  
Gender Diverse ◽  
And Gender ◽  
Document Review

This qualitative grounded theory study is the first of its kind aimed at understanding the decision-making process of parents and guardians of transgender and gender-diverse (TGD) youth providing informed consent for their children to undergo gender-confirming endocrinological interventions (GCEI), such as hormone replacement therapy and puberty blockers. Using primarily intensive interviews supported by observational field notes and document review, this study examined the decision-making processes of a national sample of participants who identified as a parent or legal guardian of at least one TGD youth and who have given informed consent for the youth in their care to undergo GCEI. A variety of inhibiting and contributing factors were illuminated as well as a “dissonance-to-consonance” model that participants used to combine contributing factors to overcome inhibitors and grant informed consent. Implications for professional counseling practitioners are discussed, including guidance for direct services, gatekeeping, case management, and advocacy functions.

scholarly journals A Mixed Methods Study Describing the Quality of Healthcare Received by Transgender and Gender Nonconforming Patients at a Large Integrated Health System

Healthcare ◽  
2021 ◽  
Vol 9 (5) ◽  
pp. 530
Author(s):  
Suma Vupputuri ◽  
Stacie L. Daugherty ◽  
Kalvin Yu ◽  
Alphonse J. Derus ◽  
Laura E. Vasquez ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Mixed Methods ◽  
Qualitative Analysis ◽  
Focus Groups ◽  
Health System ◽  
Mixed Methods Study ◽  
Gender Nonconforming ◽  
Integrated Health ◽  
And Gender

Transgender and gender nonconforming (TGNC) patients have been seeking medical care in higher numbers and have faced unique social, personal, and health issues that affect the quality of care they receive. The purpose of this study was to conduct a mixed-methods study to describe TGNC care at Kaiser Permanente Mid-Atlantic States, a large integrated health system. We used a transgender registry to describe a TGNC patient population and compared healthcare utilization between TGNC patients and non-TGNC patients. Four focus groups were also conducted among 28 patients. Atlas.ti software was used to code and analyze themes for the qualitative analysis. Among the 282 adults TGNC patients, the mean age was 32.6 years. Of the study sample, 59% were White, and 27% were Black. TGNC patients demonstrated an increased use of email/telephone visits and the online patient portal and more cancellations and no-shows compared to non-TGNC controls. Of the 28 TGNC patients who participated in the focus groups, 39% identified as female, 21% as a transman, and 18% as non-binary/genderqueer. Participants were predominantly White (68%), highly educated (74%), and reported use of hormones (89%). Themes that emerged from our qualitative analysis included: limited availability of TGNC information; positive and negative sentiments regarding patient–provider interactions; issues with case management; limited access to care; lack of coordination of care; negative staff experiences. We identified specific areas in a health system to improve the quality of care of TGNC patients, including specific TGNC training for providers and staff, a source of TGNC information/resources, and hiring and training TGNC-specific case managers.

scholarly journals Quality of life, recovery and decision-making: a mixed methods study of mental health recovery in social care

2018 ◽  
Vol 54 (6) ◽  
pp. 715-723 ◽  
Author(s):  
Michael Coffey ◽  
Ben Hannigan ◽  
Alan Meudell ◽  
Mari Jones ◽  
Julian Hunt ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Decision Making ◽  
Mixed Methods ◽  
Social Care ◽  
Mixed Methods Study ◽  
Mental Health Recovery

scholarly journals What factors affect clinical decision-making about access to stroke rehabilitation? A systematic review

2018 ◽  
Vol 33 (2) ◽  
pp. 304-316 ◽  
Author(s):  
Verity Longley ◽  
Sarah Peters ◽  
Caroline Swarbrick ◽  
Audrey Bowen
Keyword(s):  
Decision Making ◽  
Mixed Methods ◽  
Stroke Rehabilitation ◽  
English Language ◽  
Clinical Decision Making ◽  
Organizational Factors ◽  
Clinical Decision ◽  
Included Study ◽  
Patient Level

Objectives: To determine the factors affecting clinical decision-making about which patients should receive stroke rehabilitation. Methods: Data sources (MEDLINE, CINAHL, AMED and PsycINFO) were searched systematically from database inception to August 2018. Full-text English-language studies of data from stroke clinicians were included. Studies of patients were excluded. The included studies were any design focussed on clinical decision-making for referral or admission into stroke rehabilitation. Summary factors were compiled from each included study. The quality of the included studies was assessed using the Mixed Methods Appraisal Tool. Results: After removing duplicates, 1915 papers were identified, of which 13 met the inclusion criteria. Eight included studies were qualitative and one used mixed methods. A total of 292 clinicians were included in the studies. Quality of the included studies was mixed. Patient-level and organizational factors as well as characteristics of individual clinicians contributed to decisions about rehabilitation. The most often described factors were patients’ pre- and poststroke function ( n = 6 studies), presence of dementia ( n = 6), patients’ social/family support ( n = 6), organizational service pressures ( n = 7) and the decision-making clinician’s own knowledge ( n = 5) and emotions ( n = 5). Conclusion: The results highlight a lack of clinical guidance to aid decision-making and reveal that a subjective approach to rehabilitation decision-making influenced by patient-level and organizational factors alongside clinicians’ characteristics occurs across services and countries.

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