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Mai T, Mushtaq S, Tong YD, Nguyen-Huy T, Richards R, Marcussen T. Harnessing a systems approach for sustainable adaptation in vulnerable mega-deltas: A case study of the dyke heightening program in the Vietnamese Mekong Delta's floodplains. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 954:176501. [PMID: 39326749 DOI: 10.1016/j.scitotenv.2024.176501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2024] [Revised: 09/15/2024] [Accepted: 09/23/2024] [Indexed: 09/28/2024]
Affiliation(s)
- Thanh Mai
- Centre for Applied Climate Sciences, University of Southern Queensland, Toowoomba, QLD 4350, Australia.
| | - Shahbaz Mushtaq
- Centre for Applied Climate Sciences, University of Southern Queensland, Toowoomba, QLD 4350, Australia
| | - Yen Dan Tong
- La Trobe Business School, La Trobe University, Melbourne, VIC 3086, Australia; School of Economics, Can Tho University, Viet Nam
| | - Thong Nguyen-Huy
- Centre for Applied Climate Sciences, University of Southern Queensland, Toowoomba, QLD 4350, Australia; Ho Chi Minh City Space Technology Application Center, Vietnam National Space Center, Vietnam Academy of Science and Technology, Ho Chi Minh City, Viet Nam
| | - Russell Richards
- Faculty of Business, Economics and Laws, the University of Queensland, Brisbane, QLD 4067, Australia
| | - Torben Marcussen
- Centre for Applied Climate Sciences, University of Southern Queensland, Toowoomba, QLD 4350, Australia
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Kwamie A, Causevic S, Tomson G, Sie A, Sauerborn R, Rasanathan K, Ottersen OP. Prepared for the polycrisis? The need for complexity science and systems thinking to address global and national evidence gaps. BMJ Glob Health 2024; 9:e014887. [PMID: 39266018 PMCID: PMC11429278 DOI: 10.1136/bmjgh-2023-014887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 08/28/2024] [Indexed: 09/14/2024] Open
Abstract
The Sustainable Development Goals are far off track. The convergence of global threats such as climate change, conflict and the lasting effects of the COVID-19 pandemic-among others-call for better data and research evidence that can account for the complex interactions between these threats. In the time of polycrisis, global and national-level data and research evidence must address complexity. Viewed through the lens of 'systemic risk', there is a need for data and research evidence that is sufficiently representative of the multiple interdependencies of global threats. Instead, current global published literature seems to be dominated by correlational, descriptive studies that are unable to account for complex interactions. The literature is geographically limited and rarely from countries facing severe polycrisis threats. As a result, country guidance fails to treat these threats interdependently. Applied systems thinking can offer more diverse research methods that are able to generate complex evidence. This is achievable through more participatory processes that will assist stakeholders in defining system boundaries and behaviours. Additionally, applied systems thinking can draw on known methods for hypothesising, modelling, visualising and testing complex system properties over time. Application is much needed for generating evidence at the global level and within national-level policy processes and structures.
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Affiliation(s)
- Aku Kwamie
- Alliance for Health Policy and Systems Research, World Health Organization, Geneva, GE, Switzerland
| | - Sara Causevic
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
| | - Goran Tomson
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Stockholm, Sweden
| | - Ali Sie
- Centre de Recherche en Sante de Nouna, Nouna, Boucle du Mouhoun, Burkina Faso
| | - Rainer Sauerborn
- Institute for Global Health, Heidelberg University, Heidelberg, Germany
| | - Kumanan Rasanathan
- Alliance for Health Policy and Systems Research, World Health Organization, Geneva, GE, Switzerland
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Sharma S, Davies C, Mana HRT, Baker M, Kvalsvig A, Walton M. Supporting whānau during COVID-19 pandemic in Aotearoa New Zealand: a systems thinking case study. BMC Health Serv Res 2024; 24:717. [PMID: 38858664 PMCID: PMC11165734 DOI: 10.1186/s12913-024-11164-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 05/31/2024] [Indexed: 06/12/2024] Open
Abstract
BACKGROUND The Aotearoa New Zealand COVID-19 pandemic response has been hailed as a success story, however, there are concerns about how equitable it has been. This study explored the experience of a collective of Māori health and social service providers in the greater Wellington region of Aotearoa New Zeland delivering COVID-19 responses. METHODS The study was a collaboration between a large urban Māori health and social service provider, Tākiri Mai Te Ata whānau ora collective, and public health researchers in Aotearoa New Zealand. Two online workshops were held with staff of the Māori service provider, collectively developing a qualitative causal loop diagram and generating systemic insights. The causal loop diagram showed interactions of various factors affecting COVID-19 response for supporting whānau (Māori family/households) at a community level. The iceberg model of systems thinking offered insights for action in understanding causal loop diagrams, emphasizing impactful changes at less visible levels. RESULTS Six interacting subsystems were identified within the causal loop diagram that highlighted the systemic barriers and opportunities for effective COVID-19 response to Māori whānau. The medical model of health service produces difficulties for delivering kaupapa Māori services. Along with pre-existing vulnerability and health system gaps, these difficulties increased the risk of negative impacts on Māori whānau as COVID-19 cases increased. The study highlighted a critical need to create equal power in health perspectives, reducing dominance of the individual-focused medical model for better support of whānau during future pandemics. CONCLUSIONS The study provided insights on systemic traps, their interactions and delays contributing to a relatively less effective COVID-19 response for Māori whānau and offered insights for improvement. In the light of recent changes in the Aotearoa New Zealand health system, the findings emphasize the urgent need for structural reform to address power imbalances and establish kaupapa Māori approach and equity as a norm in service planning and delivery.
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Affiliation(s)
- Sudesh Sharma
- Institute of Environmental Science and Research, 27 Creyke Road, Ilam, Christchurch, 8041, New Zealand.
| | - Cheryl Davies
- Kōkiri Marae Hauora and Te Rōpū Rangahau Hauora A Eru Pōmare, University of Otago, 7-9 Barnes Street, Seaview, Lower Hutt , Wellington, 5010, New Zealand
| | - Helena Rattray-Te Mana
- Institute of Environmental Science and Research, 34 Kenepuru Drive, Porirua, Wellington, 5022, New Zealand
| | - Michael Baker
- University of Otago, 23A Mein Street, Newtown, Wellington, 6021, New Zealand
| | - Amanda Kvalsvig
- University of Otago, 23A Mein Street, Newtown, Wellington, 6021, New Zealand
| | - Mat Walton
- Institute of Environmental Science and Research, 34 Kenepuru Drive, Porirua, Wellington, 5022, New Zealand
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Luna Pinzon A, Waterlander W, de Pooter N, Altenburg T, Dijkstra C, Emke H, van den Eynde E, Overman ML, Busch V, Renders CM, Halberstadt J, Nusselder W, den Hertog K, Chinapaw M, Verhoeff A, Stronks K. Development of an action programme tackling obesity-related behaviours in adolescents: a participatory system dynamics approach. Health Res Policy Syst 2024; 22:30. [PMID: 38429775 PMCID: PMC10908105 DOI: 10.1186/s12961-024-01116-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 02/02/2024] [Indexed: 03/03/2024] Open
Abstract
System dynamics approaches are increasingly addressing the complexity of public health problems such as childhood overweight and obesity. These approaches often use system mapping methods, such as the construction of causal loop diagrams, to gain an understanding of the system of interest. However, there is limited practical guidance on how such a system understanding can inform the development of an action programme that can facilitate systems changes. The Lifestyle Innovations Based on Youth Knowledge and Experience (LIKE) programme combines system dynamics and participatory action research to improve obesity-related behaviours, including diet, physical activity, sleep and sedentary behaviour, in 10-14-year-old adolescents in Amsterdam, the Netherlands. This paper illustrates how we used a previously obtained understanding of the system of obesity-related behaviours in adolescents to develop an action programme to facilitate systems changes. A team of evaluation researchers guided interdisciplinary action-groups throughout the process of identifying mechanisms, applying the Intervention Level Framework to identify leverage points and arriving at action ideas with aligning theories of change. The LIKE action programme consisted of 8 mechanisms, 9 leverage points and 14 action ideas which targeted the system's structure and function within multiple subsystems. This illustrates the feasibility of developing actions targeting higher system levels within the confines of a research project timeframe when sufficient and dedicated effort in this process is invested. Furthermore, the system dynamics action programme presented in this study contributes towards the development and implementation of public health programmes that aim to facilitate systems changes in practice.
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Affiliation(s)
- Angie Luna Pinzon
- Department of Public and Occupational Health, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands.
- Health Behaviors and Chronic Diseases, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.
| | - Wilma Waterlander
- Department of Public and Occupational Health, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
- Health Behaviors and Chronic Diseases, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Naomi de Pooter
- Department of Public and Occupational Health, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
- Health Behaviors and Chronic Diseases, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Teatske Altenburg
- Health Behaviors and Chronic Diseases, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
- Department of Public and Occupational Health, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands
| | - Coosje Dijkstra
- Health Behaviors and Chronic Diseases, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, 1081HV, Amsterdam, The Netherlands
| | - Helga Emke
- Health Behaviors and Chronic Diseases, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
- Department of Public and Occupational Health, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, 1081HV, Amsterdam, The Netherlands
| | - Emma van den Eynde
- Division of Endocrinology, Department of Pediatrics, Erasmus MC-Sophia Children's Hospital, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Meredith L Overman
- Department of Health Promotion, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, 6229ER, Maastricht, The Netherlands
| | - Vincent Busch
- Sarphati Amsterdam, Public Health Service (GGD), City of Amsterdam, Nieuwe Achtergracht 100, 1018WT, Amsterdam, The Netherlands
| | - Carry M Renders
- Health Behaviors and Chronic Diseases, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, 1081HV, Amsterdam, The Netherlands
| | - Jutka Halberstadt
- Health Behaviors and Chronic Diseases, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, 1081HV, Amsterdam, The Netherlands
| | - Wilma Nusselder
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, 3015CN, Rotterdam, The Netherlands
| | - Karen den Hertog
- Amsterdam Healthy Weight Approach, Public Health Service (GGD), City of Amsterdam, Nieuwe Achtergracht 100, 1018WT, Amsterdam, The Netherlands
| | - Mai Chinapaw
- Health Behaviors and Chronic Diseases, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
- Department of Public and Occupational Health, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands
| | - Arnoud Verhoeff
- Sarphati Amsterdam, Public Health Service (GGD), City of Amsterdam, Nieuwe Achtergracht 100, 1018WT, Amsterdam, The Netherlands
- Department of Sociology, University of Amsterdam, 1018WV, Amsterdam, The Netherlands
| | - Karien Stronks
- Department of Public and Occupational Health, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
- Health Behaviors and Chronic Diseases, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
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Terry K, Yang F, Yao Q, Liu C. The role of social media in public health crises caused by infectious disease: a scoping review. BMJ Glob Health 2023; 8:e013515. [PMID: 38154810 PMCID: PMC10759087 DOI: 10.1136/bmjgh-2023-013515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 12/06/2023] [Indexed: 12/30/2023] Open
Abstract
IMPORTANCE The onset of the COVID-19 global pandemic highlighted the increasing role played by social media in the generation, dissemination and consumption of outbreak-related information. OBJECTIVE The objective of the current review is to identify and summarise the role of social media in public health crises caused by infectious disease, using a five-step scoping review protocol. EVIDENCE REVIEW Keyword lists for two categories were generated: social media and public health crisis. By combining these keywords, an advanced search of various relevant databases was performed to identify all articles of interest from 2000 to 2021, with an initial retrieval date of 13 December 2021. A total of six medical and health science, psychology, social science and communication databases were searched: PubMed, Web of Science, Scopus, Embase, PsycINFO and CNKI. A three-stage screening process against inclusion and exclusion criteria was conducted. FINDINGS A total of 338 studies were identified for data extraction, with the earliest study published in 2010. Thematic analysis of the role of social media revealed three broad themes: surveillance monitoring, risk communication and disease control. Within these themes, 12 subthemes were also identified. Within surveillance monitoring, the subthemes were disease detection and prediction, public attitude and attention, public sentiment and mental health. Within risk communication, the subthemes were health advice, information-seeking behaviour, infodemics/misinformation circulation, seeking help online, online distance education and telehealth. Finally, within disease control, the subthemes were government response, public behaviour change and health education information quality. It was clear that the pace of research in this area has gradually increased over time as social media has evolved, with an explosion in attention following the outbreak of COVID-19. CONCLUSIONS AND RELEVANCE Social media has become a hugely powerful force in public health and cannot be ignored or viewed as a minor consideration when developing public health policy. Limitations of the study are discussed, along with implications for government, health authorities and individual users. The pressing need for government and health authorities to formalise evidence-based strategies for communicating via social media is highlighted, as well as issues for individual users in assessing the quality and reliability of information consumed on social media platforms.
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Affiliation(s)
- Kirsty Terry
- School of Psychology and Public Health, La Trobe University - Bundoora Campus, Bundoora, Victoria, Australia
| | - Fei Yang
- School of Political Science and Public Administration, Wuhan University, Wuhan, Hubei, China
| | - Qiang Yao
- School of Political Science and Public Administration, Wuhan University, Wuhan, Hubei, China
| | - Chaojie Liu
- School of Psychology and Public Health, La Trobe University - Bundoora Campus, Bundoora, Victoria, Australia
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Sigahi TFAC, Sznelwar LI, Rampasso IS, Moraes GHSMD, Girotto Júnior G, Pinto Júnior A, Anholon R. Proposal of guidelines to assist managers to face pressing challenges confronting Latin American universities: a complexity theory perspective. ERGONOMICS 2023; 66:1203-1218. [PMID: 36121401 DOI: 10.1080/00140139.2022.2126895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 09/14/2022] [Indexed: 06/15/2023]
Abstract
The Covid-19 pandemic exacerbated pre-existing problems in Latin America and posed unprecedented challenges for Latin American universities (LAU). These challenges can be characterised as complex problems that cannot be understood through reductionist approaches. This paper aims (i) to provide a complex system perspective of the challenges confronting LAUs and (ii) to propose guidelines for managers of LAUs to address them in practice. A multidisciplinary group was formed and conducted an iterative process of research, brainstorming and debate of potential solutions to the following problems considered particularly important by their universities: mental health issues in the university environment, student learning gaps, brain drain, and anti-science movements. Complexity theory and E/HF concepts are integrated to demonstrate that understanding what LAUs are experiencing in a fragmented manner is impossible, and that the interactions between the challenges should be at the centre of the managers' actions plans. Practitioner summary: Managers of LAUs can benefit from the guidelines proposed to understand the pressing challenges confronting universities and develop systemic approaches to address them.
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Affiliation(s)
- Tiago F A C Sigahi
- School of Mechanical Engineering, State University of Campinas, Campinas, Brazil
| | - Laerte Idal Sznelwar
- Department of Production Engineering, University of São Paulo, São Paulo, Brazil
| | - Izabela Simon Rampasso
- Departamento de Ingeniería Industrial, Universidad Católica del Norte, Antofagasta, Chile
| | | | | | | | - Rosley Anholon
- School of Mechanical Engineering, State University of Campinas, Campinas, Brazil
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Meng X, Guo M, Gao Z, Kang L. Interaction between travel restriction policies and the spread of COVID-19. TRANSPORT POLICY 2023; 136:209-227. [PMID: 37065273 PMCID: PMC10086066 DOI: 10.1016/j.tranpol.2023.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 03/30/2023] [Accepted: 04/06/2023] [Indexed: 06/19/2023]
Abstract
To investigate the interaction between travel restriction policies and the spread of COVID-19, we collected data on human mobility trends, population density, Gross Domestic Product (GDP) per capita, daily new confirmed cases (or deaths), and the total confirmed cases (or deaths), as well as governmental travel restriction policies from 33 countries. The data collection period was from April 2020 to February 2022, resulting in 24,090 data points. We then developed a structural causal model to describe the causal relationship between these variables. Using the Dowhy method to solve the developed model, we found several significant results that passed the refutation test. Specifically, travel restriction policies played an important role in slowing the spread of COVID-19 until May 2021. International travel controls and school closures had an impact on reducing the spread of the pandemic beyond the impact of travel restrictions. Additionally, May 2021 marked a turning point in the spread of COVID-19 as it became more infectious, but the mortality rate gradually decreased. The impact of travel restriction policies on human mobility and the pandemic diminished over time. Overall, the cancellation of public events and restrictions on public gatherings were more effective than other travel restriction policies. Our findings provide insights into the effects of travel restriction policies and travel behavioral changes on the spread of COVID-19, while controlling for informational and other confounding variables. This experience can be applied in the future to respond to emergent infectious diseases.
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Affiliation(s)
- Xin Meng
- School of Traffic and Transportation, Beijing Jiaotong University, Beijing, 100044, China
| | - Mingxue Guo
- School of Traffic and Transportation, Beijing Jiaotong University, Beijing, 100044, China
| | - Ziyou Gao
- School of Traffic and Transportation, Beijing Jiaotong University, Beijing, 100044, China
| | - Liujiang Kang
- School of Traffic and Transportation, Beijing Jiaotong University, Beijing, 100044, China
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Asif M, Inam A, Adamowski J, Shoaib M, Tariq H, Ahmad S, Alizadeh MR, Nazeer A. Development of methods for the simplification of complex group built causal loop diagrams: A case study of the Rechna doab. Ecol Modell 2023. [DOI: 10.1016/j.ecolmodel.2022.110192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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9
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Addressing Complexity in the Pandemic Context: How Systems Thinking Can Facilitate Understanding of Design Aspects for Preventive Technologies. INFORMATICS 2023. [DOI: 10.3390/informatics10010007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
The COVID-19 pandemic constitutes a wicked problem that is defined by rapidly evolving and dynamic conditions, where the physical world changes (e.g., pathogens mutate) and, in parallel, our understanding and knowledge rapidly progress. Various preventive measures have been developed or proposed to manage the situation, including digital preventive technologies to support contact tracing or physical distancing. The complexity of the pandemic and the rapidly evolving nature of the situation pose challenges for the design of effective preventive technologies. The aim of this conceptual paper is to apply a systems thinking model, DSRP (distinctions, systems, relations, perspectives) to explain the underlying assumptions, patterns, and connections of the pandemic domain, as well as to identify potential leverage points for design of preventive technologies. Two different design approaches, contact tracing and nudging for distance, are compared, focusing on how their design and preventive logic are related to system complexity. The analysis explains why a contact tracing technology involves more complexity, which can challenge both implementation and user understanding. A system utilizing nudges can operate using a more distinct system boundary, which can benefit understanding and implementation. However, frequent nudges might pose challenges for user experience. This further implies that these technologies have different contextual requirements and are useful at different levels in society. The main contribution of this work is to show how systems thinking can organize our understanding and guide the design of preventive technologies in the context of epidemics and pandemics.
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Molenaar J, Van Praag L. Migrants as 'vulnerable groups' in the COVID-19 pandemic: A critical discourse analysis of a taken-for-granted label in academic literature. SSM. QUALITATIVE RESEARCH IN HEALTH 2022; 2:100076. [PMID: 35529889 PMCID: PMC9052635 DOI: 10.1016/j.ssmqr.2022.100076] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 03/23/2022] [Accepted: 03/25/2022] [Indexed: 01/12/2023]
Abstract
The COVID-19 pandemic affects different people unequally, and migrants are frequently among the groups considered particularly vulnerable. However, conceptualizations of 'vulnerability' are often ambiguous and poorly defined. Using critical discourse analysis methods, this article analyses the academic use of the term 'vulnerable' applied to migrants in the context of the COVID-19 pandemic across public health and social science disciplines. Our findings indicate that the concept of vulnerability is frequently applied to migrants in the COVID-19 context as a descriptor with seemingly taken-for-granted applicability. Migrants are considered vulnerable for a wide variety of reasons, most commonly relating to exposure to and risk of contracting COVID-19; poverty or low socio-economic status; precarity; access to healthcare; discrimination; and language barriers. Drivers of migrants' vulnerability were frequently construed as immutable societal characteristics. Additionally, our analysis revealed widespread generalization in the use of the notion of vulnerability, with limited consideration of the heterogeneity among and between diverse groups of migrants. Conceptualizations of migrants' vulnerability in the COVID-19 pandemic were sometimes used to advance seemingly contradictory policy implications or conclusions, and migrants' own views and lived experiences were often marginalized or excluded within these discourses. Our analysis highlights that although some definable groups of people are certainly more likely to suffer harm in crisis situations like the COVID-19 pandemic, the use of 'vulnerable' as a fixed descriptor has potentially negative implications. As an alternative, we suggest thinking about vulnerability as the dynamic outcome of a process of 'vulnerabilisation' shaped by social order and power relations.
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Affiliation(s)
- Jil Molenaar
- Centre for Migration and Intercultural Studies (CeMIS), University of Antwerp, Stadscampus, S.LN55.202, Lange Nieuwstraat 55, B-2000, Antwerp, Belgium
| | - Lore Van Praag
- Centre for Migration and Intercultural Studies (CeMIS), University of Antwerp, Stadscampus, S.LN55.202, Lange Nieuwstraat 55, B-2000, Antwerp, Belgium
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Study of the Effect of Urban Densification and Micrometeorology on the Sustainability of a Coronavirus-Type Pandemic. ATMOSPHERE 2022. [DOI: 10.3390/atmos13071073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
This research examines the persistence of a pandemic in urban environments subjected to intensive densification processes, applying chaotic analysis tools to hourly time series constructed by relating accumulated patients with meteorological and pollutant variables (measured at ground level). To investigate this objective, seven communes of the metropolitan region of Santiago de Chile that present intensive urbanization processes that affect urban micrometeorology, favoring the concentration of pollutants, were considered. Quotients were constructed between the number of hourly patients with SARS-CoV-2 that accumulated in each commune over a period of two years and the hourly variables of urban micrometeorology (temperature, magnitude of wind speed, relative humidity) and pollutant concentration (tropospheric ozone, particulate material of 2.5 and 10 μm) constituting a new family of time series. Chaos theory was applied to these new time series, obtaining the chaotic parameters Lyapunov coefficient, correlation entropy, Lempel–Ziv complexity, Hurst coefficient and the fractal dimension in each measurement commune. The results showed that the accumulated patients (2020–2022), of the order of 400,000, belonged to the five communes (with a built area of approximately 300,000 m2 in recent years) that had the highest urban densification, which affected urban meteorology, favored the concentration of pollutants and made the SARS-Cov-2 pandemic more persistent. The “ideal” density of built housing should balance a pandemic and nullify its expansion.
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Vianna Franco MP, Molnár O, Dorninger C, Laciny A, Treven M, Weger J, Albuquerque EDME, Cazzolla Gatti R, Villanueva Hernandez LA, Jakab M, Marizzi C, Menéndez LP, Poliseli L, Rodríguez HB, Caniglia G. Diversity regained: Precautionary approaches to COVID-19 as a phenomenon of the total environment. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 825:154029. [PMID: 35202694 PMCID: PMC8861146 DOI: 10.1016/j.scitotenv.2022.154029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 02/15/2022] [Accepted: 02/16/2022] [Indexed: 05/02/2023]
Abstract
As COVID-19 emerged as a phenomenon of the total environment, and despite the intertwined and complex relationships that make humanity an organic part of the Bio- and Geospheres, the majority of our responses to it have been corrective in character, with few or no consideration for unintended consequences which bring about further vulnerability to unanticipated global events. Tackling COVID-19 entails a systemic and precautionary approach to human-nature relations, which we frame as regaining diversity in the Geo-, Bio-, and Anthropospheres. Its implementation requires nothing short of an overhaul in the way we interact with and build knowledge from natural and social environments. Hence, we discuss the urgency of shifting from current to precautionary approaches to COVID-19 and look, through the lens of diversity, at the anticipated benefits in four systems crucially affecting and affected by the pandemic: health, land, knowledge and innovation. Our reflections offer a glimpse of the sort of changes needed, from pursuing planetary health and creating more harmonious forms of land use to providing a multi-level platform for other ways of knowing/understanding and turning innovation into a source of global public goods. These exemplary initiatives introduce and solidify systemic thinking in policymaking and move priorities from reaction-based strategies to precautionary frameworks.
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Affiliation(s)
- Marco P Vianna Franco
- Konrad Lorenz Institute for Evolution and Cognition Research, Martinstrasse 12, Klosterneuburg 3400, Austria
| | - Orsolya Molnár
- Konrad Lorenz Institute for Evolution and Cognition Research, Martinstrasse 12, Klosterneuburg 3400, Austria.
| | - Christian Dorninger
- Konrad Lorenz Institute for Evolution and Cognition Research, Martinstrasse 12, Klosterneuburg 3400, Austria; Institute of Social Ecology, University of Natural Resources and Life Sciences, Schottenfeldgasse 29, Vienna 1070, Austria
| | - Alice Laciny
- Konrad Lorenz Institute for Evolution and Cognition Research, Martinstrasse 12, Klosterneuburg 3400, Austria
| | - Marco Treven
- Konrad Lorenz Institute for Evolution and Cognition Research, Martinstrasse 12, Klosterneuburg 3400, Austria
| | - Jacob Weger
- Konrad Lorenz Institute for Evolution and Cognition Research, Martinstrasse 12, Klosterneuburg 3400, Austria
| | - Eduardo da Motta E Albuquerque
- Cedeplar, Universidade Federal de Minas Gerais, Av. Pres. Antônio Carlos, 6627 - Pampulha, Belo Horizonte, MG 31270-901, Brazil
| | - Roberto Cazzolla Gatti
- Department of Biological, Geological and Environmental Sciences, University of Bologna, Via Zamboni, 33, 40126 Bologna, BO, Italy
| | | | - Manuel Jakab
- Department for Academic Communication, Sigmund Freud University, Freudpl. 1, Vienna 1020, Austria
| | - Christine Marizzi
- BioBus, 1361 Amsterdam Avenue, Ste 340, New York, NY, 10027, United States
| | - Lumila Paula Menéndez
- Department of Anthropology of the Americas, University of Bonn, Regina-Pacis-Weg 3, 53113 Bonn, Germany; Department of Evolutionary Biology, University of Vienna, Universitätsring 1, 1010 Vienna, Austria
| | - Luana Poliseli
- Konrad Lorenz Institute for Evolution and Cognition Research, Martinstrasse 12, Klosterneuburg 3400, Austria
| | | | - Guido Caniglia
- Konrad Lorenz Institute for Evolution and Cognition Research, Martinstrasse 12, Klosterneuburg 3400, Austria
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Introduction to the Special Issue “Life in the Time of a Pandemic: Social, Economic, Health and Environmental Impacts of COVID-19—Systems Approach Study”. SYSTEMS 2022. [DOI: 10.3390/systems10020036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The preambles in many of the articles in this Special Issue have highlighted how COVID-19 has affected, and is continuing to affect, the way that individuals, groups, organisations and countries operate [...]
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Haeffner M, Hames F, Barbour MM, Reeves JM, Platell G, Grover S. Expanding collaborative autoethnography into the world of natural science for transdisciplinary teams. ONE EARTH (CAMBRIDGE, MASS.) 2022; 5:157-167. [PMID: 36569281 PMCID: PMC9767446 DOI: 10.1016/j.oneear.2022.01.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Wicked problems such as climate change and the COVID-19 pandemic require authentically transdisciplinary approaches to achieving effective collaboration. There exist several research approaches for identifying the components and interactions of complex problems; however, collaborative autoethnography provides an empirical way to collect and analyze self-reflection that leads to transformative change. Here, we present a case study of collaborative autoethnography, applied as a tool to transform research practice among a group of natural and social scientists, by constructively revealing and resolving deep, often unseen, disciplinary divides. We ask, "How can natural and social scientists genuinely accept, respect, and share one another's approaches to work on the wicked problems that need to be solved?" This study demonstrates how disciplinary divisions can be successfully bridged by open-minded and committed collaborators who are prepared to recognize the academic bias they bring to their research and use this as a platform of strength.
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Affiliation(s)
- Melissa Haeffner
- Environmental Science and Management, Portland State University, 1719 SW 10th Avenue, Portland, OR 97201-3203, USA,Corresponding author
| | - Fern Hames
- Arthur Rylah Institute for Environmental Research, Department of Environment, Land, Water and Planning, Heidelberg, VIC, Australia
| | - Margaret M. Barbour
- School of Life and Environmental Sciences, University of Sydney, Sydney, NSW, Australia,Te Aka Mātuatua - School of Science, University of Waikato, Hamilton, New Zealand
| | - Jessica M. Reeves
- Future Regions Research Centre, Federation University, Churchill, VIC, Australia
| | - Ghislaine Platell
- University of Western Australia, Perth, Australia and Energetics, Perth, WA, Australia
| | - Samantha Grover
- Applied Chemistry and Environmental Science, RMIT University, 124 La Trobe Street, Melbourne, VIC, Australia
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Baugh Littlejohns L, Hill C, Neudorf C. Diverse Approaches to Creating and Using Causal Loop Diagrams in Public Health Research: Recommendations From a Scoping Review. Public Health Rev 2022; 42:1604352. [PMID: 35140995 PMCID: PMC8712315 DOI: 10.3389/phrs.2021.1604352] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 11/25/2021] [Indexed: 11/13/2022] Open
Abstract
Objectives: Complex systems thinking methods are increasingly called for and used as analytical lenses in public health research. The use of qualitative system mapping and in particular, causal loop diagrams (CLDs) is described as one promising method or tool. To our knowledge there are no published literature reviews that synthesize public health research regarding how CLDs are created and used. Methods: We conducted a scoping review to address this gap in the public health literature. Inclusion criteria included: 1) focused on public health research, 2) peer reviewed journal article, 3) described and/or created a CLD, and 4) published in English from January 2018 to March 2021. Twenty-three articles were selected from the search strategy. Results: CLDs were described as a new tool and were based upon primary and secondary data, researcher driven and group processes, and numerous data analysis methods and frameworks. Intended uses of CLDs ranged from illustrating complexity to informing policy and practice. Conclusion: From our learnings we propose nine recommendations for building knowledge and skill in creating and using CLDs for future public health research.
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Affiliation(s)
| | - Carly Hill
- Community Health and Epidemiology, University of Saskatchewan, Saskatoon, SK, Canada
| | - Cory Neudorf
- Community Health and Epidemiology, University of Saskatchewan, Saskatoon, SK, Canada
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Cunha LRA, Antunes BBP, Rodrigues VP, Ceryno PS, Leiras A. Measuring the impact of donations at the Bottom of the Pyramid (BoP) amid the COVID-19 pandemic. ANNALS OF OPERATIONS RESEARCH 2022; 335:1-31. [PMID: 35039706 PMCID: PMC8754524 DOI: 10.1007/s10479-021-04378-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 10/21/2021] [Indexed: 06/14/2023]
Abstract
The governments' isolation measures to contain the transmission of COVID-19 imposed a dilemma for the people at the bottom of the pyramid. Since these people have very unreliable sources of income, a dilemma arises: they must either work under risky conditions or refrain from work and suffer from income cuts. Emergency donations of food and cleaning supplies in a pandemic context might be overlooked by government and civil society actors. This paper aims to model the effects of donations on mitigating the negative effects of COVID-19 on vulnerable communities. Applying the system dynamics method, we simulated the behaviour of the pandemic in Rio de Janeiro (Brazil) communities and the impacts that donations of food and cleaning supplies have in these settings. We administered surveys to the beneficiaries and local organisations responsible for the final distribution of donations to gather information from the field operations. The results show that increasing access to cleaning supplies in communities through donations can significantly reduce coronavirus transmission, particularly in high-density and low-resource areas, such as slums in urban settings. In addition, we also show that food donations can increase the vulnerable population's ability to afford necessities, alleviating the stress caused by the pandemic on this portion of the population. Therefore, this work helps decision-makers (such as government and non-governmental organisations) understand the impacts of donations on controlling outbreaks, especially under COVID-19 conditions, in a low-resource environment and, thus, aid these hard-to-reach populations in a pandemic setting.
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Affiliation(s)
- Luiza Ribeiro Alves Cunha
- Department of Industrial Engineering, Pontifical Catholic University of Rio de Janeiro, Marquês de São Vicente St., 225 – Gávea, Rio de Janeiro, RJ 22541-041 Brazil
| | - Bianca B. P. Antunes
- Department of Industrial Engineering, Pontifical Catholic University of Rio de Janeiro, Marquês de São Vicente St., 225 – Gávea, Rio de Janeiro, RJ 22541-041 Brazil
| | | | - Paula Santos Ceryno
- Department of Production Engineering, Federal University of the State of Rio de Janeiro, Pasteur Av., 296 – Urca, Rio de Janeiro, RJ 22290-240 Brazil
| | - Adriana Leiras
- Department of Industrial Engineering, Pontifical Catholic University of Rio de Janeiro, Marquês de São Vicente St., 225 – Gávea, Rio de Janeiro, RJ 22541-041 Brazil
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Implications of COVID-19 Mitigation Policies for National Well-Being: A Systems Perspective. SUSTAINABILITY 2021. [DOI: 10.3390/su14010433] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The ongoing COVID-19 crisis and measures aimed at curbing the pandemic have a widespread impact on various aspects of well-being, such as housing, social connections, and others. Moreover, COVID-19 does not affect all population groups equally. This study analyzes the impact of major COVID-19 non-pharmaceutical interventions (NPIs) on a set of national well-being indicators from the most recent version of the OECD Well-Being Framework. Using causal loop diagrams (systems maps), we consider direct and indirect effects of these policies on various components of the national well-being system. Our results show that business closures directly and/or indirectly impact more national well-being components than any other policy. The most affected national well-being components by all policies are life satisfaction, perceived health, and prevalence of depressive symptoms. In addition, we specify how the impact of the anti-pandemic measures differs for various population strata, using the degree of income and employment loss as key stratifying variables. Our insights can be helpful to identify and promote measures that can alleviate the adverse effects of the COVID-19 crisis on the national well-being.
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Omukuti J, Barlow M, Giraudo ME, Lines T, Grugel J. Systems thinking in COVID-19 recovery is urgently needed to deliver sustainable development for women and girls. Lancet Planet Health 2021; 5:e921-e928. [PMID: 34895499 PMCID: PMC8654361 DOI: 10.1016/s2542-5196(21)00232-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 08/14/2021] [Accepted: 08/19/2021] [Indexed: 06/14/2023]
Abstract
In low-income and middle-income countries, such as those in sub-Saharan Africa and Latin America, the COVID-19 pandemic has had substantial implications for women's wellbeing. Policy responses to the COVID-19 pandemic have highlighted the gendered aspect of pandemics; however, addressing the gendered implications of the COVID-19 pandemic comprehensively and effectively requires a planetary health perspective that embraces systems thinking to inequalities. This Viewpoint is based on collective reflections from research done by the authors on COVID-19 responses by international and regional organisations, and national governments, in Latin America and sub-Saharan Africa between June, 2020, and June, 2021. A range of international and regional actors have made important policy recommendations to address the gendered implications of the COVID-19 pandemic on women's health and wellbeing since the start of the pandemic. However, national-level policy responses to the COVID-19 pandemic have been partial and inconsistent with regards to gender in both sub-Saharan Africa and Latin America, largely failing to recognise the multiple drivers of gendered health inequalities. This Viewpoint proposes that addressing the effects of the COVID-19 pandemic on women in low-income and middle-income countries should adopt a systems thinking approach and be informed by the question of who is affected as opposed to who is infected. In adopting the systems thinking approach, responses will be more able to recognise and address the direct gendered effects of the pandemic and those that emerge indirectly through a combination of long-standing structural inequalities and gendered responses to the pandemic.
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Affiliation(s)
- Jessica Omukuti
- Interdisciplinary Global Development Centre, University of York, York, UK; Department of Environment and Geography, University of York, York, UK
| | - Matt Barlow
- Interdisciplinary Global Development Centre, University of York, York, UK; Department of Politics, University of York, York, UK
| | | | - Tallulah Lines
- Interdisciplinary Global Development Centre, University of York, York, UK; Department of Politics, University of York, York, UK
| | - Jean Grugel
- Interdisciplinary Global Development Centre, University of York, York, UK; Department of Politics, University of York, York, UK.
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Developing Complexity-Informed COVID-19 Responses to Optimize Community Well-Being: A Systems Thinking Approach. SYSTEMS 2021. [DOI: 10.3390/systems9030068] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Despite a range of federal and state interventions to slow the spread of COVID-19, the US has seen millions of infections and hundreds of thousands of deaths. Top-down mandates have been ineffective because the community spread of the pandemic has been influenced by complex local dynamics that have evolved over time. Systems thinking approaches, specifically causal loop diagrams, and leverage points, are important techniques for representing complexity at the local level and identifying responsive systems change opportunities. This commentary presents a causal loop diagram highlighting the progressive effects of prolonged state-level COVID-19 mandates at the community level. We also identify potential system leverage points that address these effects and present an imagined future state causal loop diagram in which these solutions are implemented. Our future system demonstrates the importance of collaborations to enable community-driven, bottom-up approaches to public health crises, such as the COVID-19 pandemic, that are adaptive and responsive to local needs.
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Causal Loop Diagramming of Socioeconomic Impacts of COVID-19: State-of-the-Art, Gaps and Good Practices. SYSTEMS 2021. [DOI: 10.3390/systems9030065] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The complexity, multidimensionality, and persistence of the COVID-19 pandemic have prompted both researchers and policymakers to turn to transdisciplinary methods in dealing with the wickedness of the crisis. While there are increasing calls to use systems thinking to address the intricacy of COVID-19, examples of practical applications of systems thinking are still scarce. We revealed and reviewed eight studies which developed causal loop diagrams (CLDs) to assess the impact of the COVID-19 pandemic on a broader socioeconomic system. We find that major drivers across all studies are the magnitude of the infection spread and government interventions to curb the pandemic, while the most impacted variables are public perception of the pandemic and the risk of infection. The reviewed COVID-19 CLDs consistently exhibit certain complexity patterns, for example, they contain a higher number of two- and three-element feedback loops than comparable random networks. However, they fall short in representing linear complexity such as multiple causes and effects, as well as cascading impacts. We also discuss good practices for creating and presenting CLDs using the reviewed diagrams as illustration. We suggest that increasing transparency and rigor of the CLD development processes can help to overcome the lack of systems thinking applications to address the challenges of the COVID-19 crisis.
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Boons F, Doherty B, Köhler J, Papachristos G, Wells P. Disrupting transitions: Qualitatively modelling the impact of Covid-19 on UK food and mobility provision. ENVIRONMENTAL INNOVATION AND SOCIETAL TRANSITIONS 2021; 40:1-19. [PMID: 34751238 PMCID: PMC8565922 DOI: 10.1016/j.eist.2021.04.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 04/13/2021] [Accepted: 04/16/2021] [Indexed: 06/13/2023]
Abstract
The 2020 Covid-19 pandemic provides an empirical testing ground for assessing the impact of critical events on societal transitions. Such events are typically seen as exogenous to the transition process, an assumption which is investigated in this paper. Using a qualitative system dynamics modelling approach we conceptualize transition pathways as sets of interacting sequences of events. This enables the analysis of event sequences that constitute the evolving pandemic as impacting on those pathways. We apply this approach to the provision of (auto)mobility and food in the UK. This shows the way in which the pandemic has had a differential effect on ongoing transitions in both systems, sometimes slowing them down, and sometimes accelerating them. In addition, it reveals how it has established new transition pathways. The empirical work further shows how qualitative modelling with system dynamics facilitates an explicit and systematic comparative analysis of transition case studies.
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Affiliation(s)
- Frank Boons
- University of Manchester, Room 9.011, AMBS, Booth Street West, Manchester, M15 6PB, United Kingdom
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22
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A Systems Analysis Critique of Sport-Science Research. Int J Sports Physiol Perform 2021; 16:1385-1392. [PMID: 34453014 DOI: 10.1123/ijspp.2020-0934] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 04/12/2021] [Accepted: 05/19/2021] [Indexed: 11/18/2022]
Abstract
PURPOSE The broad aim of sport-science research is to enhance the performance of coaches and athletes. Despite decades of such research, it is well documented that sport-science research lacks empirical evidence, and critics have questioned its scientific methods. Moreover, many have pointed to a research-practice gap, whereby the work undertaken by researchers is not readily applied by practitioners. The aim of this study was to use a systems thinking analysis method, causal loop diagrams, to understand the systemic issues that interact to influence the quality of sport-science research. METHODS A group model-building process was utilized to develop the causal loop diagram based on data obtained from relevant peer-reviewed literature and subject-matter experts. RESULTS The findings demonstrate the panoply of systemic influences associated with sport-science research, including the existence of silos, a focus on quantitative research, archaic practices, and an academic system that is incongruous with what it actually purports to achieve. CONCLUSIONS The emergent outcome of the interacting components is the creation of an underperforming sport-science research system, as indicated by a lack of ecological validity, translation to practice, and, ultimately, a research-practice gap.
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Understanding the maternal and child health system response to payment for performance in Tanzania using a causal loop diagram approach. Soc Sci Med 2021; 285:114277. [PMID: 34343830 PMCID: PMC8434440 DOI: 10.1016/j.socscimed.2021.114277] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 07/13/2021] [Accepted: 07/27/2021] [Indexed: 11/24/2022]
Abstract
Payment for performance (P4P) has been employed in low and middle-income (LMIC) countries to improve quality and coverage of maternal and child health (MCH) services. However, there is a lack of consensus on how P4P affects health systems. There is a need to evaluate P4P effects on health systems using methods suitable for evaluating complex systems. We developed a causal loop diagram (CLD) to further understand the pathways to impact of P4P on delivery and uptake of MCH services in Tanzania. The CLD was developed and validated using qualitative data from a process evaluation of a P4P scheme in Tanzania, with additional stakeholder dialogue sought to strengthen confidence in the diagram. The CLD maps the interacting mechanisms involved in provider achievement of targets, reporting of health information, and population care seeking, and identifies those mechanisms affected by P4P. For example, the availability of drugs and medical commodities impacts not only provider achievement of P4P targets but also demand of services and is impacted by P4P through the availability of additional facility resources and the incentivisation of district managers to reduce drug stock outs. The CLD also identifies mechanisms key to facility achievement of targets but are not within the scope of the programme; the activities of health facility governing committees and community health workers, for example, are key to demand stimulation and effective resource use at the facility level but both groups were omitted from the incentive system. P4P design considerations generated from this work include appropriately incentivising the availability of drugs and staffing in facilities and those responsible for demand creation in communities. Further research using CLDs to study heath systems in LMIC is urgently needed to further our understanding of how systems respond to interventions and how to strengthen systems to deliver better coverage and quality of care. Holistic analysis key to avoiding suboptimal P4P performance. Availability of drugs is influenced by P4P and affects success of P4P. Need to incentivise groups outside facility that support service coverage.
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24
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Social Determinants of Health Influencing the New Zealand COVID-19 Response and Recovery: A Scoping Review and Causal Loop Diagram. SYSTEMS 2021. [DOI: 10.3390/systems9030052] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The Coronavirus pandemic of 2019–20 (COVID-19) affected multiple social determinants of health (SDH) across the globe, including in New Zealand, exacerbating health inequities. Understanding these system dynamics can support decision making for the pandemic response and recovery measures. This study combined a scoping review with a causal loop diagram to further understanding of the connections between SDH, pandemic measures, and both short- and long-term outcomes in New Zealand. The causal loop diagram showed the reinforcing nature of structural SDH, such as colonization and socio-economic influences, on health inequities. While balancing actions taken by government eliminated COVID-19, the diagram showed that existing structural SDH inequities could increase health inequities in the longer term, unless the opportunity is taken for socio-economic policies to be reset. Such policy resets would be difficult to implement, as they are at odds with the current socio-economic system. The causal loop diagram highlighted that SDH significantly influenced the dynamics of the COVID-19 impact and response, pointing to a need for purposeful systemic action to disrupt the reinforcing loops which increase health inequities over time. This will require strong systems leadership, and coordination between policy makers and implementation at local level.
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Rajpal A, Sayyed Kassem L, Aron DC. Management of diabetes in elderly patients during the COVID-19 pandemic: current and future perspectives. Expert Rev Endocrinol Metab 2021; 16:181-189. [PMID: 34096441 DOI: 10.1080/17446651.2021.1927708] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 05/06/2021] [Indexed: 02/09/2023]
Abstract
Introduction: The COVID-19 pandemic has affected the entire population with the most deleterious effects in elders. Elders, especially those with diabetes, are at the highest risk of COVID-19 related adverse outcomes and mortality. This is usually linked to the comorbidities that accumulate with age, diabetes-related chronic inflammation, and the pandemic's psychosocial effects.Areas covered: We present some approaches to manage these complicated elderly patients with diabetes during the COVID-19 pandemic. In the inpatient setting, we suggest similar (pre-pandemic) glycemic targets and emphasize the importance of using IV insulin and possible use of continuous glucose monitoring to reduce exposure and PPE utilization. Outside the hospital, we recommend optimal glycemic control within the limits imposed by considerations of safety. We also describe the advantages and challenges of using various technological platforms in clinical care.Expert opinion: The COVID-19 pandemic has lifted the veil off serious deficiencies in the infrastructures for care at both the individual level and the population level and also highlighted some of the strengths, all of which affect individuals with diabetes and COVID-19. We anticipate that things will not return to 'normal' after the COVID-19 pandemic has run its course, but rather they will be superseded by 'New Normal.'
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Affiliation(s)
- Aman Rajpal
- Endocrine Section, Department of Medicine, Louis Stokes VA Medical Center, Cleveland, OH
- Division of Clinical and Molecular Endocrinology, Department of Medicine, Case Western Reserve University, Cleveland, OH
| | - Laure Sayyed Kassem
- Endocrine Section, Department of Medicine, Louis Stokes VA Medical Center, Cleveland, OH
- Division of Clinical and Molecular Endocrinology, Department of Medicine, Case Western Reserve University, Cleveland, OH
| | - David C Aron
- Endocrine Section, Department of Medicine, Louis Stokes VA Medical Center, Cleveland, OH
- Division of Clinical and Molecular Endocrinology, Department of Medicine, Case Western Reserve University, Cleveland, OH
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Wang B, Mansouri M. Dealing with COVID‐19 Pandemic in Complex Societal System for Resilience Study: A Systems Approach. INCOSE INTERNATIONAL SYMPOSIUM 2021. [PMCID: PMC8667639 DOI: 10.1002/j.2334-5837.2021.00860.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The continuing spread of COVID‐19 has triggered a global health crisis with raising a series of problems in healthcare, economics, policymaking and environment, which significantly affected the resilience of the whole societal system. We emphasize the societal system, as an adaptive and complex system, has a fundamental impact on the spread of the virus linked to individual behavior change and disaster governance system. This paper combined system thinking and resilience thinking to visualize the complexity and comprehend the governance system under global pandemic threats towards recovering the resilient society. We underline the societal system can be affected by the pandemic, and in turn, impinge on the individual behaviors and governance with a proposed multi‐stage and multi‐scalar framework dealt with the process from crisis to recovery. Meanwhile, a qualitative system dynamics model is proposed inspired by the general Susceptible‐Infected‐Recovery (SIR) model with multiple interactions and interdependency of intervention policies, human psychological factors and mobility‐related factors to explore the influence on the societal system with time effect. Through this perspective, we should enhance the sense of crisis and integrate resilience thinking into the current hazards and recovery process combined with the interconnectedness among societal system in the future.
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Affiliation(s)
- Bijun Wang
- Stevens Institute of Technology Hoboken NJ USA
| | - Mo Mansouri
- Stevens Institute of Technology Hoboken NJ USA
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27
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Salmon PM, Stevens N, McLean S, Hulme A, Read GJM. Human Factors and Ergonomics and the management of existential threats: A work domain analysis of a COVID-19 return from lockdown restrictions system. HUMAN FACTORS AND ERGONOMICS IN MANUFACTURING 2021; 31:412-424. [PMID: 34230798 PMCID: PMC8250482 DOI: 10.1002/hfm.20897] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Revised: 03/03/2021] [Accepted: 03/22/2021] [Indexed: 06/13/2023]
Abstract
Following strict "lockdown" restrictions designed to control the spread of the COVID-19 virus, many jurisdictions are now engaged in a process of easing restrictions in an attempt to stimulate economic and social activity while continuing to suppress virus transmission. This is challenging and complex, and in several regions, new outbreaks have emerged. We argue that systems Human Factors and Ergonomics methods can assist in understanding and optimizing the return from lockdown. To demonstrate, we used work domain analysis to develop an abstraction hierarchy model of a generic "return from lockdown restrictions" system. The model was assessed to identify (a) issues preventing a successful return from lockdown; and (b) leverage points that could be exploited to optimize future processes. The findings show that the aim of continuing to suppress virus transmission conflicts with the aims of returning to pre-virus economic and social activity levels. As a result, many functions act against each other, ensuring that the system cannot optimally achieve all three of its primary aims. Potential leverage points include modifying the goals and rules of the system and enhancing communications and feedback. Specifically, it is argued that moderating economic aims and modifying how social and community activities are undertaken will result in longer term suppression of the virus.
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Affiliation(s)
- Paul M. Salmon
- Centre for Human Factors and Sociotechnical SystemsUniversity of the Sunshine CoastSunshine CoastQueenslandAustralia
| | - Nicholas Stevens
- Centre for Human Factors and Sociotechnical SystemsUniversity of the Sunshine CoastSunshine CoastQueenslandAustralia
| | - Scott McLean
- Centre for Human Factors and Sociotechnical SystemsUniversity of the Sunshine CoastSunshine CoastQueenslandAustralia
| | - Adam Hulme
- Centre for Human Factors and Sociotechnical SystemsUniversity of the Sunshine CoastSunshine CoastQueenslandAustralia
| | - Gemma J. M. Read
- Centre for Human Factors and Sociotechnical SystemsUniversity of the Sunshine CoastSunshine CoastQueenslandAustralia
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Zięba K. How can systems thinking help us in the COVID‐19 crisis? KNOWLEDGE AND PROCESS MANAGEMENT 2021. [PMCID: PMC8441870 DOI: 10.1002/kpm.1680] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Affiliation(s)
- Krzysztof Zięba
- Faculty of Management and Economics Gdansk University of Technology Gdansk Poland
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Cawthorn DM, Kennaugh A, Ferreira SM. The future of sustainability in the context of COVID-19. AMBIO 2021; 50:812-821. [PMID: 33289053 PMCID: PMC7720924 DOI: 10.1007/s13280-020-01430-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 10/20/2020] [Accepted: 10/24/2020] [Indexed: 05/09/2023]
Abstract
The COVID-19 pandemic is a global crisis emanating both from a virus (SARS-CoV-2) and from the drastic actions to contain it. Here, we reflect on the immediate responses of most world powers amid the pandemic chaos: totalitarian surveillance and nationalist isolation. Drawing on published literature, we consider measures such as wildlife-use bans, lockdowns and travel restrictions, along with their reverberations for people, economies and the planet. Our synthesis highlights significant shortfalls of applying command-and-control tactics in emergencies. For one, heavy-handed bans risk enormous unintended consequences and tend to fail if they lack legitimacy or clash with people's values. Furthermore, reactive and myopic strategies typically view the pandemic as a stand-alone crisis, rather than unravelling the complex interplay of nature-society interactions through which zoonotic diseases originate. A return to adaptive management approaches that recognise root causes and foster socio-ecological resilience will be essential to improve human and planetary health and mitigate future pandemics.
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Affiliation(s)
- Donna-Mareè Cawthorn
- School of Biology and Environmental Sciences, University of Mpumalanga, Nelspruit, 1200 South Africa
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Abstract
Previous research regarding PhD students’ well-being (PhD-WB) has lacked a comprehensive and systemic analysis. This research engages with a systems approach to examine the multiple variables, including feedback mechanisms, which influence PhD-WB over time. The model was developed using a structural analysis method (Cross-impact analysis MICMAC) that informed a causal loop diagram (CLD). The aim was to understand what promotes (drivers) and inhibits (barriers) PhD students’ well-being. The results show that PhD students’ well-being reflects an interplay between university, financial support, students’ mental and physical health, and family/friends. However, the analysis shows that the role of the drivers is dynamic, and they can become barriers in certain circumstances. This insight validates the application of systems thinking to illustrate the complexity of PhD students’ well-being.
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Richards R, Meynecke JO, Sahin O. Addressing dynamic uncertainty in the whale-watching industry under climate change and system shocks. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 756:143889. [PMID: 33302062 DOI: 10.1016/j.scitotenv.2020.143889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 11/17/2020] [Accepted: 11/17/2020] [Indexed: 06/12/2023]
Abstract
Whale-watching is a global tourism industry whose annual revenue exceeds two billion dollars. Australia is a key player in this industry, especially on the east and west coast where humpback whales migrate each year between their breeding and feeding grounds. However, the global whale-watching industry faces uncertainty from changing whale migration patterns, with whales progressively 'arriving' at the traditional whale-watching areas earlier than in previous years/decades. If the whale-watching industry cannot evolve with these changing dynamics then the arrival of the whales might be missed resulting in a potential loss of revenue. This social-ecological issue has suddenly been exacerbated by the disruption to tourism caused by the global pandemic COVID-19. In this study, we use a systems modelling framework, which combines qualitative and quantitative processes, to evaluate the social-ecological system behaviour of the whale-watching industry. We apply this systems approach to the Gold Coast, one of Australia's premier tourist destinations and home to a vibrant whale-watching industry. The outcome of this systems assessment is that the efficacy of the whale-watching industry is affected through determinants of both supply (ability to respond to changes in whale behaviour) and demand (attractiveness of whale-watching). Furthermore, the recovery time of all tourism after COVID-19 will take years if not decades.
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Affiliation(s)
- Russell Richards
- School of Business, The University of Queensland, Brisbane, QLD 4072, Australia; Griffith Centre for Coastal Management, Griffith University, Gold Coast Campus, QLD 4222, Australia.
| | - Jan-Olaf Meynecke
- Griffith Centre for Coastal Management, Griffith University, Gold Coast Campus, QLD 4222, Australia; Griffith Climate Change Response Program, Griffith University, Gold Coast Campus, QLD 4222, Australia; Humpbacks & High-rises Inc., Gold Coast, QLD 4222, Australia
| | - Oz Sahin
- Griffith Climate Change Response Program, Griffith University, Gold Coast Campus, QLD 4222, Australia; School of Engineering and Built Environment, Griffith University, Gold Coast Campus, QLD 4222, Australia; Cities Research Institute, Griffith University, Gold Coast Campus, QLD 4222, Australia
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A Critical Inquiry into the Value of Systems Thinking in the Time of COVID-19 Crisis. SYSTEMS 2021. [DOI: 10.3390/systems9010013] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The COVID-19 pandemic offers an historic precedent to review and challenge the values of social, economic, environmental, and cultural belief systems. The concept of the “New Normal” and the experience of the global pandemic provide points of transition in thinking about our relationship to our planet and to each other. These include the fragility of contemporary economics, dependency on industrialized urban infrastructures, and reliance on top-down governance, vulnerability to climate disasters, dislocation from the natural world, societal inequalities, and the loss of cultural memory. The paper considers the potential role of systems thinking in attempting to manage societies’ responses to the pandemic. To provide the methodological context in which some systems thinking can be applied to alleviate the pandemic, we conduct a focused literature review of systemic frameworks, and using examples from Brazil and England, the paper questions the validity of existing disaster management systems and proposes an integrated critical systems approach. Reflecting on these experiences, questions of systems criticality are further developed and considered in relation to critical recovery from disasters and as integral critical systems (ICS) to interrogate the intention of systems. Finally, the paper reflects upon the value of systems and the values embedded in systems that may or may not promote equitable well-being in recovery from disasters such as COVID-19.
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Klement RJ. The SARS-CoV-2 Crisis: Has Medicine Finally Entered a Reductionist Era? Complement Med Res 2020; 27:207-208. [PMID: 32750700 DOI: 10.1159/000510453] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 07/24/2020] [Indexed: 11/19/2022]
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