Online political participation has been presented as a possible solution to declining levels of trust in traditional politics. However, the most marginalised communities are often the least connected and participate least in digital citizenship programmes. Much existing literature rests on a binary understanding of citizens as being either connected or unconnected. Progress is therefore often understood simply as a process of "connecting the unconnected." This paper presents primary empirical research from the Philippines, which suggests that such binary understandings disguise more than they reveal. We argue that it is descriptively more accurate and more analytically useful to recognise that multiple classes of technology access exist, which limit digital citizenship in multiple ways. Qualitative methods were used to learn from non-users and the least connected about the barriers to online civic participation that they experience.The 5'A's of Technology Access was employed as a framework to analyse those barriers and reveal the social and economic factors that they reflect, reproduce, and amplify.Findings suggest that nonbinary and nontechnical understandings of the barriers to digital inclusion are essential to any effective attempt to remove the remaining obstacles to genuinely inclusive digital citizenship.
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BACKGROUND: Sedation in intensive care is fundamental for optimizing clinical outcomes. For many years the world has been facing high rates of opioid use, and to combat the increasing opioid addiction plans at both national and international level have been implemented. 1 The COVID-19 pandemic posed a major challenge for health systems and also increased the use of sedatives and opioid analgesia for prolonged periods of time, and at high doses, in a significant proportion of patients. In our institutions, the shortage of many drugs for intravenous (IV) analgosedation forces us to alternatives to replace out-of-stock drugs or to seek sedation goals, which are difficult to obtain with traditional drugs at high doses. 2 METHODS: This was an analytical retrospective cohort study evaluating the follow-up of subjects with inclusion criteria from ICU admission to discharge (alive or dead). Five end points were measured: need for high-dose opioids (6 200 lg/h), comparison of inhaled versus IV sedation of opioid analgesic doses, midazolam dose, need for muscle relaxant, and risk of delirium. RESULTS: A total of 283 subjects were included in the study, of whom 230 were administered IV sedation and 53 inhaled sedation. In the inhaled sedation group, the relative risks (RRs) were 0.5 (95% CI 0.4-0.8, P 5 .045) for need of high-dose fentanyl, 0.3 (95% CI 0.20-0.45, P < .001) for need of muscle relaxant, and 0.8 (95% CI 0.61-1.15, P 5 .25) for risk of delirium. The median difference of fentanyl dose between the inhaled sedation and IV sedation groups was 61 lg/h or 1,200 lg/d (2.2 ampules/d, P < .001), and that of midazolam dose was 5.7 mg/h. CONCLUSIONS: Inhaled sedation was associated with lower doses of opioids, benzodiazepines, and muscle relaxants compared to IV sedation. This therapy should be considered as an alternative in critically ill patients requiring prolonged ventilatory support and where IV sedation is not possible, always under adequate supervision of ICU staff.
Aid agencies, governments, and donors are expanding investment in digitisation of their beneficiary identification and registration systems, and remote and algorithmic control of humanitarian and social protection programmes. They are doing so in ways that may facilitate the move from humanitarian assistance to government provision, and facilitate the delivery of shock-responsive social protection. This paper looks at evidence on the role of digital technologies in the nexus between humanitarian and social assistance, assessing their benefits and risks. We conclude with an exploration of emergent research themes, recommendations for future research in this area, and links with the broader Better Assistance in Crises (BASIC) Research programme themes.
This paper begins by locating the Global Open Data for Agriculture and Nutrition project (GODAN) in the context of wider debates in the open data movement by first reviewing the literature on open data and open data for agriculture and nutrition (ODAN). The review identifies a number of important gaps and limitations in the existing literature. There has been no independent evaluation of who most benefits or who is being left behind regarding ODAN. There has been no independent evaluation of gender or diversity in ODAN or of the development outcomes or impacts of ODAN. The existing research on ODAN is over-reliant on key open data organisations and open data insiders who produce most of the research. This creates bias in the data and analysis. The authors recommend that these gaps are addressed in future research. The paper contributes a novel conceptual ‘SCOTA’ framework for analysing the barriers to and drivers of open data adoption, which could be readily applied in other domains. Using this framework to review the existing literature highlights the fact that ODAN research and practice has been predominantly supply-side focused on the production of open data. The authors argue that if open data is to ‘leave no one behind’, greater attention now needs to be paid to understanding the demand-side of the equation and the role of intermediaries. The paper argues that there is a compelling need to improve the participation of women, people living with disabilities, and other marginalised groups in all aspects of open data for agriculture and nutrition. The authors see a need for further research and action to enhance the capabilities of marginalised people to make effective use of open data. The paper concludes with the recommendation that an independent strategic review of open data in agriculture and nutrition is overdue. Such a review should encompass the structural factors shaping the process of ODAN; include a focus on the intermediary and demand-side processes; and identify who benefits and who is being left behind.
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