Lee, Lisa; Sheikh, Aziz
Appropriately identifying and representing stakeholders' interests and viewpoints in evaluations of health information technology (health IT) is a critical part of ensuring continued progress and innovation in eHealth. This contribution therefore seeks to clarify the principles of stakeholder analysis in an eHealth context. We describe this with reference to a mixed methods national evaluation of ePrescribing systems in English hospitals. We use this evaluation to exemplify the engagement and analytical tools required to ensure a detailed understanding of the issues, challenges and lessons learnt across stakeholder groups. We conclude that this type of approach may support the robustness of evaluations of health IT as well as their longer term impact on innovation in the field.
Tompa, Emile; de Boer, Henriette; Macdonald, Sara; Alamgir, Hasanat; Koehoorn, Mieke; Guzman, Jaime
This study identified and prioritized resources and outcomes that should be considered in more comprehensive and scientifically rigorous health and safety economic evaluations according to healthcare sector stakeholders. A literature review and stakeholder interviews identified candidate resources and outcomes and then a Delphi panel ranked them. According to the panel, the top five resources were (a) health and safety staff time; (b) training workers; (c) program planning, promotion, and evaluation costs; (d) equipment purchases and upgrades; and (e) administration costs. The top five outcomes were (a) number of injuries, illnesses, and general sickness absences; (b) safety climate; (c) days lost due to injuries, illnesses, and general sickness absences; (d) job satisfaction and engagement; and (e) quality of care and patient safety. These findings emphasize stakeholders' stated priorities and are useful as a benchmark for assessing the quality of health and safety economic evaluations and the comprehensiveness of these findings. © 2016 The Author(s).
Bouzon, Marina; Govindan, Kannan; Rodriguez, Carlos Manuel Taboada
In the past few decades, an interest in reverse logistics has attracted the attention of industries and also has become a subject of interest for researchers. However, while reverse logistics is becoming a mandatory element of the supply chain in developed countries particularly due to legislation...... issues, the subject is still in a state of infancy in emerging economies such as Brazil. In these connections, impediments to reverse logistics implementation must be considered and analyzed, as well as the many different perspectives from the key stakeholders for their development. The objective...... of this research is to evaluate the interrelationship among reverse logistics barriers from the perspectives of the most important stakeholders in the Brazilian context. For this purpose, a Multi-Criteria Decision Making tool named grey-based Decision Making Trial and Evaluation Laboratory (grey-DEMATEL) was used...
Full Text Available In the last decade the provision of school breakfast has increased significantly in the UK. However, there is an absence of knowledge regarding senior stakeholder views on the processes and potential outcomes on different groups, within the communities served by school breakfast programs. The purpose of this study was to examine the views and experiences of senior level stakeholders and thereby provide an original qualitative contribution to the research. A sample of senior level stakeholders were recruited, including senior officers, directors and elected members, from within a Local Authority (LA involved in the leadership, implementation and delivery of a council-wide universal free school breakfast (USFB program, and from the senior staff body of mainstream primary and special schools, participating in the program. A grounded theory analysis of the data collected identified issues encountered in the implementation and delivery, and views on the funding and future of a USFB program, in addition to perceived outcomes of children, parents, families, schools and the wider community. The results refer to both positive and negative issues and implications associated with the program, according to the perspectives of senior level stakeholders. Perceived positive outcomes included benefits to children, families, schools and the community. For instance, alleviating hunger, improving health outcomes, and conferring financial benefits, with the potential to cumulate in overall improvements in educational, social and behavioral outcomes. Reported negative implications included the absence of an effective communication strategy in implementing the USFB program; in addition to concerns about the impacts of ‘double-breakfasting’ on obesity levels among children, particularly in less deprived communities. Findings were validated using theoretical sampling and saturation, triangulation methods, member checks, and inter-rater reliability measures. In
Full Text Available In the competition for economically attractive stakeholders, regions have to implement strategies to gain and adhere those interest groups. Empirical studies concerning the migration motivations show that it is not only labor market but also soft locational factors of the social environment, nature and landscape that are of high importance: A majority of the population is willing to move or rather stay at a special place because of such soft locational factors. This study examines the impact of regional marketing projects on the development of regions from the perspectives of inhabitants and tourists as well as general attributes to measure a region’s attractiveness from the perspective of high potentials. We argue that those projects that fit to the region and its unique selling propositions contribute to positioning and building location brand value. We show that projects have a socio-economic effect on the attitude towards regions and contribute to building location brand value. An analysis of group differences shows that the project influence on the region and region attractiveness are perceived in significantly different manner depending on the knowledge level of the stakeholder group. Consequently, one should increase the awareness of marketing activities and regions and focus on soft locational factors while establishing and positioning a region brand.
Hansen, Morten Balle; Vedung, Evert
This article introduces a new approach to program theory evaluation called theory-based stakeholder evaluation or the TSE model for short. Most theory-based approaches are program theory driven and some are stakeholder oriented as well. Practically, all of the latter fuse the program perceptions of the various stakeholder groups into one unitary…
Bedaf, Sandra; Marti, Patrizia; Amirabdollahian, Farshid; de Witte, Luc
The potential of service robots for seniors is given increasing attention as the ageing population in Western countries will continue to grow as well as the demand for home care. In order to capture the experience of living with a robot at home, a multi-perspective evaluation was conducted. Older adults (n = 10) were invited to execute an actual interaction scenario with the Care-O-bot ® robot in a home-like environment and were questioned about their experiences. Additionally, interviews were conducted with the elderly participants, informal carers (n = 7) and professional caregivers (n = 11). Seniors showed to be more keen to accept the robot than their caregivers and relatives. However, the robot in its current form was found to be too limited and participants wished the robot could perform more complex tasks. In order to be acceptable a future robot should execute these complex tasks based on the personal preferences of the user which would require the robot to be flexible and extremely smart, comparable to the care that is delivered by a human carer. Developing the functional features to perform activities is not the only challenge in robot development that deserves the attention of robot developers. The development of social behaviour and skills should be addressed as well. This is possible adopting a person-centred design approach, which relies on validation activities with actual users in realistic environments, similar to those described in this paper. Implications for rehabilitation Attitude of older adults towards service robots Potential of service robots for older adults.
Ravazzani, Silvia; Mormino, Sara
This paper explores collaborative learning activities involving HR and external stakeholders that organizations decide to plan and implement in order to obtain benefits in terms of knowledge sharing, stakeholder understanding and value creation. The increasing uncertainty and multiplicity of comp...... and corporate learning in a stakeholder-oriented perspective can play a strategic role in supporting business strategy, providing organizations the resources to meet internal and external needs (Wilson, 2005) and to interconnect with their value network.......This paper explores collaborative learning activities involving HR and external stakeholders that organizations decide to plan and implement in order to obtain benefits in terms of knowledge sharing, stakeholder understanding and value creation. The increasing uncertainty and multiplicity...... of competitive pressures and stakeholder demands (Harrison, St. John, 1996) require organizations, and in particular HR, to take on a more strategic role aimed to build new capability and support the overarching business strategy (Ulrich, Beatty 2001). This study draws on Strategic Human Resource Management...
Traditional societal and cultural background of Japanese in general indicates the intrinsic difficulty in involving the public as stakeholders in the process of any type of decision making in policy matters. It is characterized by the long-taught virtue of harmonization and obedience to others. In addition, characteristic system of Japanese traditional industrial society, such as lifetime employment, seniority-based wage system, and enterprise-based labour union, encourages the loyalty to the employer/company, but not to the public. The public or ordinary citizens would seldom come out as stakeholders and express their true feelings or real opinions, even though younger generation is notably getting out from such a trend. On the other hand, it is a common practice in Japanese society for any business or administrative transactions to try to obtain 'consensus' among relevant parties concerned (stakeholders) by negotiations behind the curtain prior to the formal discussion. In this sense, 'stakeholders involvement' is accepted and practised as a matter of course, but mostly for actions between parties of equivalently influential status levels or between 'directly relevant' parties such as those between the different government agencies, between regulators and industries. The concept of 'Involving the public in decision making as stakeholders' is not yet fully understood nor accepted in Japan both by regulators and by the public so far as the issue of radiation protection is concerned. These situations are explained with some examples. (author)
Kinash, Shelley; Crane, Linda; Judd, Madelaine-Marie; Knight, Cecily
A literature review identified 12 strategies that have been empirically linked to improvements in graduate employability. A survey methodology was used to investigate self-reported use and/or perspectives on these strategies among four stakeholder groups. The following questions were asked: to students--What strategies are you using to improve…
Stakeholder literature has acknowledged the need to complement the extant theory on stakeholder management by more dynamic perspectives. This article makes use of the recent terminology of stakewatcher and stakeseeker to illustrate the dynamic aspect of stakeholder theory transposed in the graphical representation of Freeman’s stakeholder model. Presenting a few selected case studies, it applies the scheme on the concept of value responsibility chain; it exemplifies the role of stakeseekers i...
Despite comprehensive school reform (CSR) model developers' best intentions to make school stakeholders adhere strictly to the implementation of model components, school stakeholders implementing CSR models inevitably make adaptations to the CSR model. Adaptations are made to CSR models because school stakeholders internalize CSR model practices…
Setiawan, Andri D.; Cuppen, Eefje
Carbon capture and storage (CCS) is being considered as an option to reduce CO 2 emissions worldwide. Yet recent cases show that CCS faces divergent public acceptance issues. This paper investigates stakeholder perspectives on CCS in Indonesia. Q methodology was adopted to analyse the diversity of stakeholder perspectives. Four perspectives were identified: (1) “CO 2 emissions reduction through clean energy sources rather than CCS”; (2) “CCS as one of the options in the transition to a sustainable energy system”; (3) “CCS as the only optimal solution to reduce CO 2 emissions”; (4) “CCS is only a tactic to keep burning coal forever”. Based on these results, we argue that stakeholder acceptance of CCS should be understood as a complex notion. This means that understanding whether or under what conditions stakeholders would be willing to support CCS, requires consideration of stakeholders' viewpoints about broader questions of CO 2 emission reduction and energy supply in Indonesia, rather than studying attitudes towards CCS in isolation. We discuss how the approach taken in this study can be used and followed up in policymaking on CCS in Indonesia. - Highlights: • We investigate stakeholder perspectives on CCS in Indonesia with Q methodology. • The study revealed four shared perspectives on CCS in Indonesia. • Of the four perspectives, two are contrasting perspectives: one pro and one con CCS. • The other two are nuanced perspectives and differ in their argumentation on CCS. • From these results we derive academic and policy implications
Stakeholder Perspectives on the Link between Business Studies and Quality Education: Botswana's Experience. ... Journal of Social Development in Africa ... International instruments such as the Millennium Development Goals' (MDG's) and ...
Full Text Available Organizations inform stakeholders about their current and future activities, processes, created value, strategic intentions, and other information that may influence the established relationships. Organizations choose to communicate with stakeholders by different means and in varied ways. The annual report represents a way of communicating between companies and their stakeholders, and it is offering comprehensive information about how companies operates and creates value. The business model is an emerging concept in management literature and practice. The concept describes the logic by which a organization creates, maintains and delivers value for its stakeholders. Through annual reports organisations can communicate to stakeholders information about their business models.We investigated how information about business models is explicitly communicated through annual reports, and how this information is reffering to stakeholders. Our paper aims to reveal which stakeholders are more often mentioned when organizations are communicating about business models through annual reports. This approach shows the attention degree given by organizations to stakeholders. We perceived this from a strategic point of view, as a strategic signal. Thus, we considered if the stakeholder is mentioned more frequent in the communicated message it has a greater role in communication strategy about business model. We conducted an exploratory research and have realized a content analysis.The analysed data consist in over a thousand annual reports from 96 organizations. We analysed the informations transmitted by organizations through annual reports. The annual reports were for a time period of 12 years. Most of the selected companies are multi-business, and are operating in different industries. The results show the stakeholder’s hierarchy based on how often they were mentioned in the communicated messages about business models through annual reports. Based on our
Full Text Available In an increasingly global and highly competitive business world of today, the business sector pays meticulous attention to stakeholders - groups or individuals, which affect or are affected by business decisions. The paper examines the methodology of identifying key stakeholders, demonstrates the process of their various mapping models, as well as the manner in which stakeholders, in cooperation with a corporation, create the opportunity to be engaged at an early stage of a project, activity or business decision, thus establishing a precedent according to which both sides benefit. By doing so, the business sector can ensure that its actions will receive 'a social licence to operate', whereas various groups of stakeholders will be offered a possibility to be included in business dealings for the sake of protecting their interests. The authors of the paper have analysed a two-way process of stakeholder management in establishing corporate reputation which is reflected in business performance and results. It was concluded that stakeholder engagement should foster innovation and lead to broader social prosperity, achieving the main goal of sustainability: business excellence according to the principles of the triple final result, by realizing synergy between the social community, environment and profit.
Chhatre, Sumedha; Gallo, Joseph J; Wittink, Marsha; Schwartz, J Sanford; Jayadevappa, Ravishankar
To elicit patient stakeholders' experience and perspectives about patient-centred care. Qualitative. A large urban healthcare system. Four patient stakeholders who are prostate cancer survivors. Experience and perspectives of patient stakeholders regarding patient-centred care and treatment decisions. Our patient stakeholders represented a diverse socio-demographic group. The patient stakeholders identified engagement and dialogue with physicians as crucial elements of patient-centred care model. The degree of patient-centred care was observed to be dependent on the situations. High severity conditions warranted a higher level of patient involvement, compared to mild conditions. They agreed that patient-centred care should not mean that patients can demand inappropriate treatments. An important attribute of patient-centred outcomes research model is the involvement of stakeholders. However, we have limited knowledge about the experience of patient stakeholders in patient-centred outcomes research. Our study indicates that patient stakeholders offer a unique perspective as researchers and policy-makers aim to precisely define patient-centred research and care.
Peltokorpi, Antti; Alho, Antti; Kujala, Jaakko; Aitamurto, Johanna; Parvinen, Petri
This paper aims to create a model for evaluating organizational change initiatives from a stakeholder resistance viewpoint. The paper presents a model to evaluate change projects and their expected benefits. Factors affecting the challenge to implement change were defined based on stakeholder theory literature. The authors test the model's practical validity for screening change initiatives to improve operating room productivity. Change initiatives can be evaluated using six factors: the effect of the planned intervention on stakeholders' actions and position; stakeholders' capability to influence the project's implementation; motivation to participate; capability to change; change complexity; and management capability. The presented model's generalizability should be explored by filtering presented factors through a larger number of historical cases operating in different healthcare contexts. The link between stakeholders, the change challenge and the outcomes of change projects needs to be empirically tested. The proposed model can be used to prioritize change projects, manage stakeholder resistance and establish a better organizational and professional competence for managing healthcare organization change projects. New insights into existing stakeholder-related understanding of change project successes are provided.
Prime concern on stakeholders is a crucial aspect in each business success. Among the wide spectrum of organizational strategies, Strategic Entrepreneurship pays a greater emphasis. This essay details practical as well as empirical grounds with regard to the notion of Strategic Entrepreneurship. Focally, strategic Entrepreneurship is an integration of Entrepreneurship (Opportunity Seeking Behavior) and Strategic Management (Advantage Seeking Behavior). Thus I conclude, an amalgamation of Str...
Moreno, Megan A; Egan, Katie G; Bare, Kaitlyn; Young, Henry N; Cox, Elizabeth D
Internet use is nearly ubiquitous among US youth; risks to internet use include cyberbullying, privacy violations and unwanted solicitation. Internet safety education may prevent these negative consequences; however, it is unclear at what age this education should begin and what group is responsible for teaching this topic. Surveys were distributed to key stakeholders in youth safety education including public school teachers, clinicians, parents and adolescents. Surveys assessed age at which internet safety education should begin, as well as experiences teaching and learning internet safety. Surveys of adults assessed willingness to teach internet safety. Finally, participants were asked to identify a group whose primary responsibility it should be to teach internet safety. A total of 356 participants completed the survey (93.4% response rate), including 77 teachers, 111 clinicians, 72 parents and 96 adolescents. Stakeholders felt the optimal mean age to begin teaching internet safety was 7.2 years (SD = 2.5), range 2-15. Internet safety was regularly taught by some teachers (20.8%), few clinicians (2.6%) and many parents (40.3%). The majority of teachers, clinicians and parents were willing to teach internet safety, but all groups surveyed identified parents as having primary responsibility for teaching this topic. Findings suggest agreement among key stakeholders for teaching internet safety at a young age, and for identifying parents as primary teachers of this topic. Clinicians have a unique opportunity to support parents by providing resources, guidance and support.
Shaw, David M; Elger, Bernice S
For a wider project on aging in prison, the authors interviewed 35 older prisoners and 24 stakeholders (prison staff, prison healthcare professionals, and policy makers) about healthcare for prisoners. In all, 6 prisoners and 3 stakeholders spontaneously expressed their attitudes concerning assisted suicide. Some prisoners seek assisted suicide for medical reasons and others because they regard spending the rest of their lives in prison as undignified. However, stakeholders identified several ethical and practical challenges in providing assisted suicide to prisoners. This article presents these perspectives on assisted suicide in prison and provides an ethical analysis of the issues raised.
Full Text Available Business Process Management (BPM has been increasingly focused as an holistic approach to manage organizations for better organizational effectiveness. BPM involves the use of innovative performance measurement systems to follow up, coordinate, control and improve processes and overall business efficacy and efficiency. In this paper we propose a global holistic perspective of integrated information, combining the view of all stakeholders and both qualitative and quantitative information, as a basic prerequisite for quality of information for better decision making. The paper includes findings from an empirical case study of measuring Parkinson's Disease Neurosurgery process, including stakeholder's view with an integrative perspective.
The need for the appreciation of values and knowledge diversity has contributed to the increasing relevance of stakeholder participation in the monitoring and evaluation (M&E) of development projects. Using mixed methods research design and indicators, this paper assesses the outcomes of the participatory monitoring ...
Orr, Shannon K.
One of the challenges facing program evaluation education is how to bridge the need to train students in theoretical and methodological foundations, and also prepare them for the unpredictability and complex environment outside the classroom. This issue is particularly challenging in terms of understanding stakeholder values and interests. The…
Beskow, Laura M; Friedman, Joëlle Y; Hardy, N Chantelle; Lin, Li; Weinfurt, Kevin P
Complex and sometimes controversial information must be conveyed during the consent process for participation in biorepositories, and studies suggest that consent documents in general are growing in length and complexity. As a first step toward creating a simplified biorepository consent form, we gathered data from multiple stakeholders about what information was most important for prospective participants to know when making a decision about taking part in a biorepository. We recruited 52 research participants, 12 researchers, and 20 institutional review board representatives from Durham and Kannapolis, NC. These subjects were asked to read a model biorepository consent form and highlight sentences they deemed most important. On average, institutional review board representatives identified 72.3% of the sentences as important; researchers selected 53.0%, and participants 40.4% (P = 0.0004). Participants most often selected sentences about the kinds of individual research results that might be offered, privacy risks, and large-scale data sharing. Researchers highlighted sentences about the biorepository's purpose, privacy protections, costs, and participant access to individual results. Institutional review board representatives highlighted sentences about collection of basic personal information, medical record access, and duration of storage. The differing mandates of these three groups can translate into widely divergent opinions about what information is important and appropriate to include a consent form. These differences could frustrate efforts to move simplified forms--for biobanking as well as for other kinds of research--into actual use, despite continued calls for such forms.
Bravi, F; Gibertoni, D; Marcon, A; Sicotte, C; Minvielle, E; Rucci, P; Angelastro, A; Carradori, T; Fantini, M P
Hospital networks are an emerging organizational form designed to face the new challenges of public health systems. Although the benefits introduced by network models in terms of rationalization of resources are known, evidence about stakeholders' perspectives on hospital network performance from the literature is scanty. Using the Competing Values Framework of organizational effectiveness and its subsequent adaptation by Minvielle et al., we conducted in 2009 a survey in five hospitals of an Italian network for oncological care to examine and compare the views on hospital network performance of internal stakeholders (physicians, nurses and the administrative staff). 329 questionnaires exploring stakeholders' perspectives were completed, with a response rate of 65.8%. Using exploratory factor analysis of the 66 items of the questionnaire, we identified 4 factors, i.e. Centrality of relationships, Quality of care, Attractiveness/Reputation and Staff empowerment and Protection of workers' rights. 42 items were retained in the analysis. Factor scores proved to be high (mean score>8 on a 10-item scale), except for Attractiveness/Reputation (mean score 6.79), indicating that stakeholders attach a higher importance to relational and health care aspects. Comparison of factor scores among stakeholders did not reveal significant differences, suggesting a broadly shared view on hospital network performance. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.
Malvey, Donna; Fottler, Myron D; Slovensky, Donna J
In the highly competitive health care environment, the survival of an organization may depend on how well powerful stakeholders are managed. Yet, the existing strategic stakeholder management process does not include evaluation of stakeholder management performance. To address this critical gap, this paper proposes a systematic method for evaluation using a stakeholder report card. An example of a physician report card based on this methodology is presented.
Sexton, Natalie R.; Burkardt, Nina; Swann, Margaret Earlene; Stewart, Susan C.
The National Wildlife Refuge System, managed by the U.S. Fish and Wildlife Service (FWS), is the largest system of public lands in the world dedicated to wildlife conservation. There are over 545 national wildlife refuges nationwide, encompassing 95 million acres. As part of the National Wildlife Refuge System Improvement Act of 1997, each refuge is developing 15-year comprehensive conservation plans (CCPs). Each CCP describes a vision and desired future condition for the refuge and outlines goals, objectives, and management strategies for each refuge's habitat and visitor service programs. The CCP process for Canaan Valley National Wildlife Refuge (Refuge) in Davis, West Virginia was initiated in 2006. This planning process provides a unique opportunity for public input and involvement. Public involvement is an important part of the CCP process. Participation by parties with a stake in the resource (stakeholders) has the potential to increase understanding and support and reduce conflicts. Additionally, meaningful public participation in a decision process may increase trust and provide satisfaction in terms of both process and outcome for management and the public. Public meetings are a common way to obtain input from community members, visitors, and potential visitors. An 'Issues Workbook' is another tool the FWS uses to obtain public input and participation early in the planning process. Sometimes, however, these traditional methods do not capture the full range of perspectives that exist. A stakeholder evaluation is a way to more fully understand community preferences and opinions related to key topics in refuge planning. It can also help refuge staff understand how changes in management affect individuals in terms of their preference for services and experiences. Secondarily, a process such as this can address 'social goals' such as fostering trust in regulating agencies and reducing conflict among stakeholders. As part of the CCP planning effort at Canaan
Full Text Available Including stakeholder perspectives in environmental decision making is in many countries a legal requirement and is widely seen as beneficial as it can help increase decision legitimacy, likelihood of implementation, and quality of the outcome. Whereas the theoretical literature on stakeholder engagement is large, less attention has been devoted to comparing and discussing different methodological approaches. Here, we compare three approaches—multi-criteria analysis, plural rationality theory, and scenario construction—that include stakeholders’ perspectives in environmental decision making. We find differences between the approaches concerning the assumptions about stakeholder rationality and whether experts and/or stakeholders are in charge of framing the problem. Further differences concern the type of data input from stakeholders and how it is used by the experts, as well as the role of stakeholders and whether they are involved early—already for identifying options—or later in the process, for evaluating or ranking alternatives analyzed by the experts. The choice of approach thus predetermines the type and depth of stakeholder engagement. No approach is “better” than another, but they are suited for different problems and research aims: the choice of the approach, however, has a large impact on the results.
Crocker-Buque, Tim; Mounier-Jack, Sandra
To evaluate stakeholders' understanding and opinions of the International Finance Facility for Immunisation (IFFIm); to identify factors affecting funding levels; and to explore the future use of IFFIm. Between July and September 2015, we interviewed 33 individuals from 25 organizations identified as stakeholders in IFFIm. In total 22.5 hours of semi-structured interviews were recorded, transcribed and analysed using a framework method. Stakeholders' understanding of IFFIm's financing mechanism and its outcomes varied and many stakeholders wanted more information. Participants highlighted that the change in the macro-economic environment following the 2008 financial crisis affected national policy in donor countries and subsequently the number of new commitments IFFIm received. Since Gavi is now seen as a successful and mature organization, participants stated that donors prefer to donate directly to Gavi. The pharmaceutical industry valued IFFIm for providing funding stability and flexibility. Other stakeholders valued IFFIm's ability to access funds early and enable Gavi to increase vaccine coverage. Overall, stakeholders thought IFFIm was successful, but they had divergent views about IFFIm's on-going role. Participants listed two issues where bond financing mechanisms may be suitable: emergency preparedness and outcome-based time-limited interventions. The benefit of pledging funds through IFFIm needs to be re-evaluated. There are potential uses for bond financing to raise funds for other global health issues, but these must be carefully considered against criteria to establish effectiveness, with quantifiable pre-defined outcome indicators to evaluate performance.
Adamack, Monica; Rush, Kathy L
The purpose of this qualitative study was to understand multiple stakeholder perspectives of new graduate (NG) transition programs. It was part of a larger mixed-methods study (2011) designed to provide a comprehensive assessment of new graduate nurse transition best practices, across six British Columbia health authorities. Data collection involved individual interviews with academic nurse educators (n=4) and separate focus groups with new graduate (n=48) and front-line nurse leaders (n=69). Disparity emerged as the overriding theme and described differences between stakeholder group perspectives, between expectations and reality, and within and across programs. Four disparities emerged: entry-level education and practice, perspectives on employment and career planning, transition program elements and support. Despite general satisfaction with undergraduate preparation, theory-practice gaps were identified. New Graduates experienced misalignments between their employment expectations and their realities. The employed student nurse program in which many new graduates had participated did not always yield employment, but when it did, differences in transitional expectations arose between new graduates and leaders. There was considerable variation across and within provincial new graduate programs with respect to orientation, supernumerary time and preceptorship characteristics, including lack of training. Disparities arose in the nature, amount of and access to support and the monitoring of new graduate progress. Findings reinforced organizational complexities and the importance of communication across education and practice sectors. This paper uncovers the tensions between the perspectives of new graduates and nurse leaders about transitional programs and opens the opportunity to collaborate in aligning the perspectives.
Briggs, Andrew M; Jordan, Joanne E; Speerin, Robyn; Jennings, Matthew; Bragge, Peter; Chua, Jason; Slater, Helen
health system had been considered prior to implementation was strongly supported, while 'success' was perceived as an already familiar evaluation concept. Perceived challenges associated with standardised evaluation included identifying, defining and measuring key 'readiness' and 'success' indicators; impacts of systems and context changes; cost; meaningful stakeholder consultation and developing a widely applicable framework. A standardised evaluation framework that includes a strong focus on 'readiness' is important to ensure successful and sustainable implementation of musculoskeletal MoCs.
DunnGalvin, A.; Chan, C. -H.; Crevel, R.
to summarize the perspectives of all the key stakeholders (including clinicians, patients, food industry and regulators), with the aim of defining common health protection and risk minimization goals. The lack of agreed reference doses has resulted in inconsistent application of PAL by the food industry...... and in levels of contamination that prompt withdrawal action by enforcement officers. So there is a poor relationship between the presence or absence of PAL and actual reaction risk. This has led to a loss of trust in PAL, reducing the ability of consumers with food allergies to make informed choices....... The result has been reduced avoidance, reduced quality of life and increased risk-taking by consumers who often ignore PAL. All contributing stakeholders agree that PAL must reflect actual risk. PAL should be transparent and consistent with rules underpinning decision-making process being communicated...
McCabe, G.H.; Serie, P.J.
Involving citizens, interest groups, and regulators in environmental restoration and waste management programs is a challenge for government agencies and the organizations that support them. To be effective, such involvement activities must identify all individuals and groups who have a stake in the cleanup. Their participation must be early, substantive, and meaningful. Stockholders must be able to see how their input was considered and used, and feel that a good- faith effort was made to reconcile conflicting objectives. The Integrated Demonstration for Cleanup of Volatile Organic Compounds at Arid Sites (VOC-Arid ID) is a Department of Energy Office of Technology Development project located at Hanford. Along with technical evaluation of innovative cleanup technologies, the program is conducting an institutional assessment of regulatory and public acceptance of new technologies. Through a series of interviews and workshops, and use of a computerized information management tool, stakeholders are having a voice in the evaluation. Public and regulatory reaction has been positive
Gupta, Adyya; Dhillon, Preet K; Govil, Jyotsna; Bumb, Dipika; Dey, Subhojit; Krishnan, Suneeta
Cancer is a leading cause of death worldwide. A large proportion of cancer deaths are preventable through early detection but there are a range of social, emotional, cultural and financial dimensions that hinder the effectiveness of cancer prevention and treatment efforts. Cancer stigma is one such barrier and is increasingly recognized as an important factor influencing health awareness and promotion, and hence, disease prevention and control. The impact and extent of stigma on the cancer early detection and care continuum is poorly understood in India. To evaluate cancer awareness and stigma from multiple stakeholder perspectives in North India, including men and women from the general population, health care professionals and educators, and cancer survivors. A qualitative study was conducted with in-depth interviews (IDIs) and focus group discussions (FGDs) among 39 individuals over a period of 3 months in 2014. Three groups of participants were chosen purposively - 1) men and women who attended cancer screening camps held by the Indian Cancer Society, Delhi; 2) health care providers and 3) cancer survivors. Most participants were unaware of what cancers are in general, their causes and ways of prevention. Attitudes of families towards cancer patients were observed to be positive and caring. Nevertheless, stigma and its impact emerged as a cross cutting theme across all groups. Cost of treatment, lack of awarenes and beliefs in alternate medicines were identified as some of the major barriers to seeking care. This study suggests a need for spreading awareness, knowledge about cancers and assessing associated impact among the people. Also Future research is recommended to help eradicate stigma from the society and reduce cancer-related stigma in the Indian context.
Reddy, S.; Painuly, Jyoti P.
State, India, as a case study, the paper develops a systematic classification of barriers to the adoption of RETs (economic, technological, market and institutional) and ranking them based on the perceptions of various stakeholders. The results provide evidence of how the consumers receive RET...... information and make decisions using their limited analytical capabilities. The analysis is used to enhance the knowledge by introducing ideas based on behavioural theory. Not only do these ideas help understanding the consumer perspective, they also help develop policy interventions. The aim is to define...
Adams, Adrienne E.; Nnawulezi, Nkiru A.; Vandenberg, Lela
From a utilization-focused evaluation perspective, the success of an evaluation is rooted in the extent to which the evaluation was used by stakeholders. This paper details the "Expectations to Change" (E2C) process, an interactive, workshop-based method designed to engage primary users with their evaluation findings as a means of…
Evans, Jenna M; Baker, G Ross
Health service organizations and professionals are under increasing pressure to work together to deliver integrated patient care. A common understanding of integration strategies may facilitate the delivery of integrated care across inter-organizational and inter-professional boundaries. This paper aims to build a framework for exploring and potentially aligning multiple stakeholder perspectives of systems integration. The authors draw from the literature on shared mental models, strategic management and change, framing, stakeholder management, and systems theory to develop a new construct, Mental Models of Integrated Care (MMIC), which consists of three types of mental models, i.e. integration-task, system-role, and integration-belief. The MMIC construct encompasses many of the known barriers and enablers to integrating care while also providing a comprehensive, theory-based framework of psychological factors that may influence inter-organizational and inter-professional relations. While the existing literature on integration focuses on optimizing structures and processes, the MMIC construct emphasizes the convergence and divergence of stakeholders' knowledge and beliefs, and how these underlying cognitions influence interactions (or lack thereof) across the continuum of care. MMIC may help to: explain what differentiates effective from ineffective integration initiatives; determine system readiness to integrate; diagnose integration problems; and develop interventions for enhancing integrative processes and ultimately the delivery of integrated care. Global interest and ongoing challenges in integrating care underline the need for research on the mental models that characterize the behaviors of actors within health systems; the proposed framework offers a starting point for applying a cognitive perspective to health systems integration.
Poth, Cheryl-Anne; Shulha, Lyn
This chapter describes evaluator behaviors revealed by the case analysis of a participatory and developmental evaluation. The analysis revealed that the evaluator paid specific attention to individual stakeholder cues. These cues were related to three elements of the evaluation: negotiating the design, monitoring individual stakeholder needs, and…
Stolk-Vos, Aline C; van de Klundert, Joris J; Maijers, Niels; Zijlmans, Bart L M; Busschbach, Jan J V
To develop a method to define a multi-stakeholder perspective on health-service quality that enables the expression of differences in systematically identified stakeholders' perspectives, and to pilot the approach for cataract care. Mixed-method study between 2014 and 2015. Cataract care in the Netherlands. Stakeholder representatives. We first identified and classified stakeholders using stakeholder theory. Participants established a multi-stakeholder perspective on quality of cataract care using concept mapping, this yielded a cluster map based on multivariate statistical analyses. Consensus-based quality dimensions were subsequently defined in a plenary stakeholder session. Stakeholders and multi-stakeholder perspective on health-service quality. Our analysis identified seven definitive stakeholders, as follows: the Dutch Ophthalmology Society, ophthalmologists, general practitioners, optometrists, health insurers, hospitals and private clinics. Patients, as dependent stakeholders, were considered to lack power by other stakeholders; hence, they were not classified as definitive stakeholders. Overall, 18 stakeholders representing ophthalmologists, general practitioners, optometrists, health insurers, hospitals, private clinics, patients, patient federations and the Dutch Healthcare Institute sorted 125 systematically collected indicators into the seven following clusters: patient centeredness and accessibility, interpersonal conduct and expectations, experienced outcome, clinical outcome, process and structure, medical technical acting and safety. Importance scores from stakeholders directly involved in the cataract service delivery process correlated strongly, as did scores from stakeholders not directly involved in this process. Using a case study on cataract care, the proposed methods enable different views among stakeholders concerning quality dimensions to be systematically revealed, and the stakeholders jointly agreed on these dimensions. The methods
Lopes, Edilene; Street, Jackie; Carter, Drew; Merlin, Tracy
Governments use a variety of processes to incorporate public perspectives into policymaking, but few studies have evaluated these processes from participants' point of view. The objective of this study was twofold: to understand the perspectives of selected stakeholders with regard to involvement processes used by Australian Advisory Committees to engage the public and patients; and to identify barriers and facilitators to participation. Twelve semi-structured interviews were conducted with representatives of different stakeholder groups involved in health technology funding decisions in Australia. Data were collected and analysed using a theoretical framework created by Rowe and Frewer, but adapted to more fully acknowledge issues of power and influence. Stakeholder groups disagreed as to what constitutes effective and inclusive patient involvement. Barriers reported by interviewees included poor communication, a lack of transparency, unworkable deadlines, and inadequate representativeness. Also described were problems associated with defining the task for patients and their advocates and with the timing of patient input in the decision-making process. Interviewees suggested that patient participation could be improved by increasing the number of patient organizations engaged in processes and including those organizations at different stages of decision making, especially earlier. The different evaluations made by stakeholder groups appear to be underpinned by contrasting conceptions of public involvement and its value, in line with Graham Martin's work which distinguishes between 'technocratic' and 'democratic' public involvement. Understanding stakeholders' perspectives and the contrasting conceptions of public involvement could foster future agreement on which processes should be used to involve the public in decision making. © 2015 John Wiley & Sons Ltd.
...), National Cyber Security Division (NCSD), United States Computer Emergency Readiness Team (US-CERT) will... of Homeland Security, National Protection and Programs Directorate, Office of Cybersecurity and... DEPARTMENT OF HOMELAND SECURITY [Docket No. DHS-2011-0116] GFIRST Conference Stakeholder...
Jaasma, P.G.; Wolters, E.J.M.; Frens, J.W.; Hummels, C.C.M.
Societal issues in cities concern many different stakeholders, all involved from different perspectives. In the context of deliberative democracy, this asks for a broad participation of stakeholders to influence and contribute to decision-making processes. We designed [X]Changing Perspectives, to
Nazar, Hamde; Nazar, Zachariah
Self-care advice and management of minor ailments have long been provided in community pharmacies across England. However, formal pharmacy minor ailment service provision is geographically variable and has yet to gain recognition and political support as a valued sustainable service for nationwide adoption and commissioning. To investigate the sustainability potential of pharmacy minor ailment services from the perspective of community pharmacy stakeholders within the North East of England. A mixed methods approach was adopted to survey and interview stakeholders from the North East of England who commission; provide; and/or represent groups influencing the design, delivery and investment in community pharmacy clinical and public health services. The 40-item Programme Sustainability Assessment Tool, a validated instrument to assess a public health programme's capacity for sustainability across eight domains, was administered to fifty-three stakeholders, identified from a pharmacy minor ailments showcase event. The same stakeholders were invited for a semi-structured interview to explore issues further. Interviews were audio-recorded, transcribed verbatim, and underwent framework analysis. Forty-two (79.2% response rate) stakeholders representing commissioning, provider and influencing (e.g. Local Professional Network) organisations completed the assessment tool. Pharmacy minor ailment services were rated as unsustainable across the majority of the domains. Elements within the domain 'Partnerships' demonstrated potential for sustainability. Stakeholder interviews provided detailed explanation for the low scoring sustainability domains, highlighting the multifaceted challenges threatening these services. The Programme Sustainability Assessment Tool allowed stakeholders to evaluate the potential of pharmacy minor ailment services in England. Follow-up interviews highlighted that initial design and implementation of services was poorly conceived and lacked evidence
Mazor, Kathleen M.; Gaglio, Bridget; Nekhlyudov, Larissa; Alexander, Gwen L.; Stark, Azadeh; Hornbrook, Mark C.; Walsh, Kathleen; Boggs, Jennifer; Lemay, Celeste A.; Firneno, Cassandra; Biggins, Colleen; Blosky, Mary Ann; Arora, Neeraj K.
Purpose: Patient-centered communication is critical to quality cancer care. Effective communication can help patients and family members cope with cancer, make informed decisions, and effectively manage their care; suboptimal communication can contribute to care breakdowns and undermine clinician-patient relationships. The study purpose was to explore stakeholders' views on the feasibility and acceptability of collecting self-reported patient and family perceptions of communication experiences while receiving cancer care. The results were intended to inform the design, development, and implementation of a structured and generalizable patient-level reporting system. Methods: This was a formative, qualitative study that used semistructured interviews with cancer patients, family members, clinicians, and leaders of health care organizations. The constant comparative method was used to identify major themes in the interview transcripts. Results: A total of 106 stakeholders were interviewed. Thematic saturation was achieved. All stakeholders recognized the importance of communication and endorsed efforts to improve communication during cancer care. Patients, clinicians, and leaders expressed concerns about the potential consequences of reports of suboptimal communication experiences, such as damage to the clinician-patient relationship, and the need for effective improvement strategies. Patients and family members would report good communication experiences in order to encourage such practices. Practical and logistic issues were identified. Conclusion: Patient reports of their communication experiences during cancer care could increase understanding of the communication process, stimulate improvements, inform interventions, and provide a basis for evaluating changes in communication practices. This qualitative study provides a foundation for the design and pilot testing of such a patient reporting system. PMID:23943884
Mampaey, Jelle; Huisman, Jeroen
Earlier studies on stakeholder management in European universities focused on proactive strategies, that is, substantive organizational practices to establish and maintain mutually beneficial exchanges between universities and their stakeholders. We argue that the literature on stakeholder management has to be extended by theorizing defensive…
Gooyert, V. de; Rouwette, E.A.J.A.; Kranenburg, H.L. van; Freeman, R.E.
The role of stakeholders in organizational decision-making is gaining more and more attention. Managers find that in order to create value sustainably and ethically, it is necessary to balance the interests of various stakeholders. This trend is reflected in the management literature, where much
Johnson, Stephen B; Farach, Frank J; Pelphrey, Kevin; Rozenblit, Leon
This study assesses data management needs in clinical research from the perspectives of researchers, software analysts and developers. This is a mixed-methods study that employs sublanguage analysis in an innovative manner to link the assessments. We performed content analysis using sublanguage theory on transcribed interviews conducted with researchers at four universities. A business analyst independently extracted potential software features from the transcriptions, which were translated into the sublanguage. This common sublanguage was then used to create survey questions for researchers, analysts and developers about the desirability and difficulty of features. Results were synthesized using the common sublanguage to compare stakeholder perceptions with the original content analysis. Individual researchers exhibited significant diversity of perspectives that did not correlate by role or site. Researchers had mixed feelings about their technologies, and sought improvements in integration, interoperability and interaction as well as engaging with study participants. Researchers and analysts agreed that data integration has higher desirability and mobile technology has lower desirability but disagreed on the desirability of data validation rules. Developers agreed that data integration and validation are the most difficult to implement. Researchers perceive tasks related to study execution, analysis and quality control as highly strategic, in contrast with tactical tasks related to data manipulation. Researchers have only partial technologic support for analysis and quality control, and poor support for study execution. Software for data integration and validation appears critical to support clinical research, but may be expensive to implement. Features to support study workflow, collaboration and engagement have been underappreciated, but may prove to be easy successes. Software developers should consider the strategic goals of researchers with regard to the
Md. Mashiur Rahman
Full Text Available In every life cycle of the project there are numerous people or organizations involved either directly or indirectly. While these type of people and organizations involved are called stakeholders and these may include the project team, client or customer, community, environment, suppliers, government. Stakeholders contribute and share their experiences, knowledge, and insights to support the project throughout its life cycle and therefore it is crucial to capture their input. However, before initiation of the project, stakeholders need to be identified. Following the fact that there are strategies and processes for stakeholder identification, it is not clear what skills are needed to employ those strategies for stakeholder identification. These skills are exceedingly important to have because in today's corporate world, the project team must be flexible in every aspect of their job and be able to complement their skills for the success of stakeholder identification. Using literature review, this paper seeks to describe the skills of project leader needed to identify the project team and the external stakeholders. Inductive approach was followed in this study and data was collected qualitatively using secondary sources. There are two essential skills i.e. relationship building skills and communication skills for internal stakeholders and four major skills i.e. communication skills, people skills, intellectual skills and conceptual skills for external stakeholders are identified for the identification of project stakeholders through literature review considering the sustainability issues in the project management.
Giannakopoulos, C.; Roussos, A.; Karali, A.; Hatzaki, M.; Xanthopoulos, G.; Chatzinikos, E.; Fyllas, N.; Georgiades, N.; Karetsos, G.; Maheras, G.; Nikolaou, I.; Proutsos, N.; Sbarounis, T.; Tsaggari, K.; Tzamtzis, I.; Goodess, C.
In this work, we present a synthesis of the presentations and discussions which arose during a workshop on 'Impacts of climate change on forest fires' held in September 2011 at the National Observatory of Athens, Greece in the framework of EU project CLIMRUN. At first, a general presentation about climate change and extremes in the Greek territory provided the necessary background to the audience and highlighted the need for data and information exchange between scientists and stakeholders through climate services within CLIMRUN. Discussions and presentations that followed linked climate with forest science through the use of a meteorological index for fire risk and future projections of fire danger using regional climate models. The current situation on Greek forests was also presented, as well as future steps that should be taken to ameliorate the situation under a climate change world. A time series analysis of changes in forest fires using available historical data on forest ecosystems in Greece was given in this session. This led to the topic of forest fire risk assessment and fire prevention, stating all actions towards sustainable management of forests and effective mechanisms to control fires under climate change. Options for a smooth adaptation of forests to climate change were discussed together with the lessons learned on practical level on prevention, repression and rehabilitation of forest fires. In between there were useful interventions on sustainable hunting and biodiversity protection and on climate change impacts on forest ecosystems dynamics. The importance of developing an educational program for primary/secondary school students on forest fire management was also highlighted. The perspective of forest stakeholders on climate change and how this change can affect their current or future activities was addressed through a questionnaire they were asked to complete. Results showed that the majority of the participants consider climate variability
de Jonge, Laury P J W M; Timmerman, Angelique A; Govaerts, Marjan J B; Muris, Jean W M; Muijtjens, Arno M M; Kramer, Anneke W M; van der Vleuten, Cees P M
Workplace-Based Assessment (WBA) plays a pivotal role in present-day competency-based medical curricula. Validity in WBA mainly depends on how stakeholders (e.g. clinical supervisors and learners) use the assessments-rather than on the intrinsic qualities of instruments and methods. Current research on assessment in clinical contexts seems to imply that variable behaviours during performance assessment of both assessors and learners may well reflect their respective beliefs and perspectives towards WBA. We therefore performed a Q methodological study to explore perspectives underlying stakeholders' behaviours in WBA in a postgraduate medical training program. Five different perspectives on performance assessment were extracted: Agency, Mutuality, Objectivity, Adaptivity and Accountability. These perspectives reflect both differences and similarities in stakeholder perceptions and preferences regarding the utility of WBA. In comparing and contrasting the various perspectives, we identified two key areas of disagreement, specifically 'the locus of regulation of learning' (i.e., self-regulated versus externally regulated learning) and 'the extent to which assessment should be standardised' (i.e., tailored versus standardised assessment). Differing perspectives may variously affect stakeholders' acceptance, use-and, consequently, the effectiveness-of assessment programmes. Continuous interaction between all stakeholders is essential to monitor, adapt and improve assessment practices and to stimulate the development of a shared mental model. Better understanding of underlying stakeholder perspectives could be an important step in bridging the gap between psychometric and socio-constructivist approaches in WBA.
Hees, Hiske L; Nieuwenhuijsen, Karen; Koeter, Maarten W J; Bültmann, Ute; Schene, Aart H
To examine the perspectives of key stakeholders involved in the return-to-work (RTW) process regarding the definition of successful RTW outcome after sickness absence related to common mental disorders (CMD's). A mixed-method design was used: First, we used qualitative methods (focus groups, interviews) to identify a broad range of criteria important for the definition of successful RTW (N = 57). Criteria were grouped into content-related clusters. Second, we used a quantitative approach (online questionnaire) to identify, among a larger stakeholder sample (N = 178), the clusters and criteria most important for successful RTW. A total of 11 clusters, consisting of 52 unique criteria, were identified. In defining successful RTW, supervisors and occupational physicians regarded "Sustainability" and "At-work functioning" most important, while employees regarded "Sustainability," "Job satisfaction," "Work-home balance," and "Mental Functioning" most important. Despite agreement on the importance of certain criteria, considerable differences among stakeholders were observed. Key stakeholders vary in the aspects and criteria they regard as important when defining successful RTW after CMD-related sickness absence. Current definitions of RTW outcomes used in scientific research may not accurately reflect these key stakeholder perspectives. Future studies should be more aware of the perspective from which they aim to evaluate the effectiveness of a RTW intervention, and define their RTW outcomes accordingly.
Hiske L Hees
Full Text Available OBJECTIVES: To examine the perspectives of key stakeholders involved in the return-to-work (RTW process regarding the definition of successful RTW outcome after sickness absence related to common mental disorders (CMD's. METHODS: A mixed-method design was used: First, we used qualitative methods (focus groups, interviews to identify a broad range of criteria important for the definition of successful RTW (N = 57. Criteria were grouped into content-related clusters. Second, we used a quantitative approach (online questionnaire to identify, among a larger stakeholder sample (N = 178, the clusters and criteria most important for successful RTW. RESULTS: A total of 11 clusters, consisting of 52 unique criteria, were identified. In defining successful RTW, supervisors and occupational physicians regarded "Sustainability" and "At-work functioning" most important, while employees regarded "Sustainability," "Job satisfaction," "Work-home balance," and "Mental Functioning" most important. Despite agreement on the importance of certain criteria, considerable differences among stakeholders were observed. CONCLUSIONS: Key stakeholders vary in the aspects and criteria they regard as important when defining successful RTW after CMD-related sickness absence. Current definitions of RTW outcomes used in scientific research may not accurately reflect these key stakeholder perspectives. Future studies should be more aware of the perspective from which they aim to evaluate the effectiveness of a RTW intervention, and define their RTW outcomes accordingly.
Full Text Available Whether water systems can be operated successfully and sustainably is influenced by the attitudes and willingness of stakeholders involved in the management of such systems. This study quantitatively evaluates the interests of different stakeholders in wastewater reuse systems in Beijing. Such interests comprise economic, environmental, and social effects induced by the wastewater reuse systems. The study considers four main stakeholders in Beijing, namely the Municipal Administration Committee (MAC, Municipal Environmental Protection Bureau (MEPB, plant managers, and users. Cost benefit analysis is conducted to determine the aforementioned interests separately from the perspectives of the various stakeholders. The results reveal that not all stakeholders’ interests in the wastewater reuse systems in Beijing are satisfied. From the perspectives of both the MAC and MEPB, the evaluation results indicate that both decentralized and centralized wastewater reuse systems are economically feasible. However, from the viewpoints of plant managers and users, the results reveal that only the centralized wastewater reuse systems are economically feasible, whereas the decentralized systems are not. The failure to satisfy the interests of plant managers and users may be a major reason for the interrupted operation of the decentralized systems in Beijing. The study demonstrates that successful and sustainable development of a new water project necessitates satisfying the interests of all stakeholders.
Design of a study evaluating the effects, health economics, and stakeholder perspectives of a multi-component occupational rehabilitation program with an added workplace intervention - a study protocol.
Rise, Marit B; Skagseth, Martin; Klevanger, Nina E; Aasdahl, Lene; Borchgrevink, Petter; Jensen, Chris; Tenggren, Hanne; Halsteinli, Vidar; Jacobsen, Trym N; Løland, Svein B; Johnsen, Roar; Fimland, Marius S
Recent research has suggested that interventions at the workplace might be the most potent ingredient in return to work interventions, but few studies have investigated the different effects of workplace interventions as part of occupational rehabilitation programs. The comprehensive design described in this article includes effect (on return to work and health outcomes), and health economic evaluations of a workplace intervention added to a multicomponent rehabilitation program. Qualitative and mixed method studies will investigate sick-listed persons', rehabilitation therapists' and employers' perspectives on the usability and outcomes of the rehabilitation program and the workplace intervention. The program and intervention are provided to patients with musculoskeletal, psychological or general and unspecified diagnoses. The program is multi-component and includes Acceptance and Commitment Therapy, physical exercise, patient education and creating a plan for increased work participation. Persons who are employed, aged from 18 to 60 years, with a current sick leave status of 50% or more and a diagnosis within the musculoskeletal, psychological or general and unspecified chapters of International Classification of Primary Care-2 (ICPC-2) will be recruited to a researcher-blinded parallel-group randomized controlled trial. All participants take part in an in-patient occupational rehabilitation program, while the intervention group also takes part in an intervention at the workplace. The effect and economic evaluation will investigate the effect of the added workplace intervention. The primary outcome measures will be time until full sustainable return to work and total number of sickness absence days in the 12 months after inclusion. Health economic evaluations will investigate the cost-effectiveness and cost-utility. Qualitative studies will investigate rehabilitation therapists' experiences with working towards return to work within an ACT-approach and
Onyiah, Pamela; Adamu, Al-Mukhtar Y; Afolabi, Rotimi F; Ajumobi, Olufemi; Ughasoro, Maduka D; Odeyinka, Oluwaseun; Nguku, Patrick; Ajayi, IkeOluwapo O
We conducted a study to determine stakeholders' perspective of the bottlenecks, concerns and needs to malaria operational research (MOR) agenda setting in Nigeria. Eighty-five (37.9%) stakeholders identified lack of positive behavioural change as the major bottleneck to MOR across the malaria thematic areas comprising of malaria prevention 58.8% (50), case management 34.8% (39), advocacy communication and social mobilisation 4.7% (4) while procurement and supply chain management (PSM) and programme management experts had the least response of 1.2% (1) each. Other bottlenecks were inadequate capacity to implement (13.8%, n = 31), inadequate funds (11.6%, n = 26), poor supply management (9.4%, n = 21), administrative bureaucracy (5.8%, n = 13), inadequacy of experts (1.3%, n = 3) and poor policy implementation (4.9%, n = 11). Of the 31 stakeholders who opined lack of capacity to execute malaria operational research; 17 (54.8%), 10 (32.3%), 3 (9.7%) and 1 (3.2%) were experts in case management, malaria prevention, surveillance, monitoring and evaluation and PSM respectively. Improvement in community enlightenment and awareness strategies; and active involvement of health care workers public and private sectors were identified solutions to lack of positive behavioural change.
Raadgever, G. T.; Mostert, E.; van de Giesen, N. C.
This article identifies different stakeholder perspectives on future flood management in the downstream parts of the Rhine basin in Germany and The Netherlands. The perspectives were identified using Q methodology, which proved to be a good, but time-intensive, method for eliciting and analyzing stakeholder perspectives in a structured and unbiased way. Three shared perspectives were found: A) "Anticipation and institutions", B) "Space for flooding" and C) "Knowledge and engineering". These three perspectives share a central concern for the provision of safety against flooding, but disagree on the expected autonomous developments and the preferred measures. In perspective A, the expected climate change and economic growth call for fast action. To deal with the increasing flood risk, mostly institutional measures are proposed, such as the development of a stronger basin commission. In perspective B, an increasing spatial pressure on the river area is expected, and the proposed measures are focused on mitigating damage, e.g., through controlled flooding and compartmentalization. In perspective C, the role of expert knowledge and technological improvements is emphasized. Preferred strategies include strengthening the dikes and differentiation of safety standards. An overview of stakeholder perspectives can be useful in natural resources management for 1) setting the research agenda, 2) identifying differences in values and interests that need to be discussed, 3) creating awareness among a broad range of stakeholders, and 4) developing scenarios.
Rosso, M.; Bottero, M.; Pomarico, S.; La Ferlita, S.; Comino, E.
The use of hydroelectric potential and the protection of the river ecosystem are two contrasting aspects that arise in the management of the same resource, generating conflicts between different stakeholders. The purpose of the paper is to develop a multi-level decision-making tool, able to support energy planning, with specific reference to the construction of hydropower plants in mountain areas. Starting from a real-world problem concerning the basin of the Sesia Valley (Italy), an evaluation framework based on the combined use of Multicriteria Evaluation and Stakeholders Analysis is proposed in the study. The results of the work show that the methodology is able to grant participated decisions through a multi-stakeholders traceable and transparent assessment process, to highlight the important elements of the decision problem and to support the definition of future design guidelines. - Highlights: • The paper concerns a multi-level decision-making tool able to support energy planning. • The evaluation framework is based on the use of AHP and Stakeholders Analysis. • Hydropower projects in the Sesia Valley (Italy) are evaluated and ranked in the study. • Environmental, economic, technical and sociopolitical criteria have been considered. • 42 stakeholder groups have been included in the evaluation
Longitudinal comparative evaluation of the equivalence of an integrated peer-support and clinical staffing model for residential mental health rehabilitation: a mixed methods protocol incorporating multiple stakeholder perspectives.
Parker, Stephen; Dark, Frances; Newman, Ellie; Korman, Nicole; Meurk, Carla; Siskind, Dan; Harris, Meredith
A novel staffing model integrating peer support workers and clinical staff within a unified team is being trialled at community based residential rehabilitation units in Australia. A mixed-methods protocol for the longitudinal evaluation of the outcomes, expectations and experiences of care by consumers and staff under this staffing model in two units will be compared to one unit operating a traditional clinical staffing. The study is unique with regards to the context, the longitudinal approach and consideration of multiple stakeholder perspectives. The longitudinal mixed methods design integrates a quantitative evaluation of the outcomes of care for consumers at three residential rehabilitation units with an applied qualitative research methodology. The quantitative component utilizes a prospective cohort design to explore whether equivalent outcomes are achieved through engagement at residential rehabilitation units operating integrated and clinical staffing models. Comparative data will be available from the time of admission, discharge and 12-month period post-discharge from the units. Additionally, retrospective data for the 12-month period prior to admission will be utilized to consider changes in functioning pre and post engagement with residential rehabilitation care. The primary outcome will be change in psychosocial functioning, assessed using the total score on the Health of the Nation Outcome Scales (HoNOS). Planned secondary outcomes will include changes in symptomatology, disability, recovery orientation, carer quality of life, emergency department presentations, psychiatric inpatient bed days, and psychological distress and wellbeing. Planned analyses will include: cohort description; hierarchical linear regression modelling of the predictors of change in HoNOS following CCU care; and descriptive comparisons of the costs associated with the two staffing models. The qualitative component utilizes a pragmatic approach to grounded theory, with
O'Sullivan, Rita G.
Collaborative Evaluation systematically invites and engages stakeholders in program evaluation planning and implementation. Unlike "distanced" evaluation approaches, which reject stakeholder participation as evaluation team members, Collaborative Evaluation assumes that active, on-going engagement between evaluators and program staff,…
Mayhew, Matthew J.; Caldwell, Rebecca J.; Goldman, Emily Grey
The purpose of this study was to derive an empirically based understanding of campus violence. Grounded in a communication paradigm offered by sociolinguistic scholars, we adopted a phenomenological approach for conducting and analyzing 23 interviews from campus community stakeholders, including students, staff, faculty, administrators, and…
O'Dwyer, B.; Unerman, J.; Hession, E.
By means of a questionnaire survey, this paper ascertains and analyses the views of a number of Irish stakeholders regarding the adequacy and potential of corporate sustainability reporting to meet their information needs and help them hold corporations to account. The study focuses on ascertaining
Blair, J D; Buesseler, J A
Applying Porter's model of competitive forces to health care, stakeholder concepts are integrated to analyze the future of medical groups. Using both quantitative survey and qualitative observational data, competitors, physician suppliers, integrated systems new entrants, patient and managed care buyers, and hospitals substitutes are examined.
Forlini, Cynthia; Racine, Eric
The existence of diverging discourses in the media and academia on the use of prescription medications to improve cognition in healthy individuals, i.e. "cognitive enhancement" (CE) creates the need to better understand perspectives from stakeholders. This qualitative focus-group study examined perspectives from students, parents and healthcare providers on CE. Stakeholders expressed ambivalence regarding CE (i.e. reactions to, definitions of, risks, and benefits). They were reluctant to adopt analogies to performance-enhancing steroids and caffeine though these analogies were useful in discussing concepts common to the use of different performance-enhancing substances. Media coverage of CE was criticized for lack of scientific rigor, ethical clarity, and inadvertent promotion of CE. Ambivalence of stakeholders suggests fundamental discomfort with economic and social driving forces of CE. Forms of public dialogue that voice the unease and ambivalence of stakeholders should be pursued to avoid opting hastily for permissive or restrictive health policies for CE.
Curtis, Ashlee; Miller, Peter; Droste, Nicolas; McFarlane, Emma; Martino, Florentine; Palmer, Darren
Liquor accords were introduced as an intervention to reduce alcohol-related harm in and around licensed venues. There have been very few evaluations of the accords, made all the more difficult given the multitude of measures that are often implemented under their banner. This study provides perspectives on the effectiveness of the liquor accords from key stakeholders who were involved in the strategy. In-depth interviews were conducted with 97 key stakeholders as part of a larger study, of which 46 spoke about the effectiveness of liquor accords. Responses were analysed using thematic analysis. Stakeholders reported the greatest benefit of liquor accords to be their ability to improve communication. Many stakeholders recognised the need for mandatory attendance and discussed whether the accords are a waste of time of resources. Stakeholders did not generally view liquor accords as effective means of reducing alcohol-related harm. There was a lack of positive feedback about liquor accords provided by stakeholders, indicating a clear need to better understand the role of liquor accords, and what they aim to achieve. Responsive regulation theory suggests that the dual roles of communication and intervention are confused, leading to some of the inherent problems with accords. The role and aims of liquor accords need to be clearly defined. The findings suggest that separating the communication and regulatory functions from accords will lead to a clearer role for accords, and interventions and regulation might be better placed in the hands of regulators and enforcement. [Curtis A, Miller P, Droste N, McFarlane E, Martino F, Palmer D. 'The ones that turn up are the ones that are responsible': Key stakeholders perspectives on liquor accords. Drug Alcohol Rev 2016;35:273-279]. © 2016 Australasian Professional Society on Alcohol and other Drugs.
Johannessen, Marius Rohde; Sæbø, Øystein; Flak, Leif Skiftenes
Purpose Despite the potential of social media, it has proven difficult to get people actively involved in the decision-making processes. There is a need for more research on how stakeholders manage and use social media to communicate. Thus, we examine major stakeholders’ communication preferences in eParticipation initiatives and discuss how this affects the public sphere. Design/methodology/approach The study was conducted as a qualitative case study. Data sources include interviews, social ...
Tom G Ryan
Full Text Available In this mixed methods study the authors describe the institution-level perceptions of stakeholders transitioning to a new learning management system (LMS. We address issues related to change, the institution’s administration of the transition process, problems encountered, and realized learning via online survey data collection, analysis, and interpretation. We further detail results of a faculty survey, which sought to illuminate the LMS transition experience. The summation includes suggestions for institutions as they prepare for, and move through, foreseeable LMS change and transition.
Gilmartin, Mattia J; Freeman, R Edward
This article examines the recent controversy in health care delivery about whether it should be conceptualized as a business. The current debate implicitly appeals to a common understanding of business and business practices that is no longer very useful. This common notion, which the authors call "cowboy capitalism," conceptualizes business as a competitive jungle resting on self-interest and an urge for competition in order to survive. The authors suggest that stakeholder capitalism offers a more useful framework for the dialogue about health care reform.
Kuo, Alice A; Crapnell, Tara; Lau, Lynette; Anderson, Kristy A; Shattuck, Paul
Individuals with autism spectrum disorder (ASD) are reported to experience significant challenges during the transition to adulthood. Although recent evidence indicates that individuals with ASD experience poor outcomes in adulthood, little is understood about the contributing factors. In this qualitative study, we investigated the barriers to and needs in research and practice in the transition to adulthood among individuals with ASD. Thirteen researchers, including service providers, family members, and an individual with ASD participated in 30- to 60-minute, semistructured, open-ended telephone interviews. Interviews were transcribed, and data were analyzed by using an inductive approach to identify themes related to barriers to and needs in the transition to adulthood for youth with ASD. Stakeholders identified the need for transition planning and preparation to begin earlier and for systems to better accommodate the interests and varying abilities of individuals with ASD. Stakeholders also felt that parent and service provider expectations and perceptions influence early opportunities and experiences offered throughout the transition process. This study reveals the multilevel barriers to and needs in the transition to adulthood and the need for interagency and multidisciplinary collaboration and research to address the varying levels of needs, abilities, and multisector challenges. Copyright © 2018 by the American Academy of Pediatrics.
Acosta, Joie D; Whitley, Margaret D; May, Linnea Warren; Dubowitz, Tamara; Williams, Malcolm V; Chandra, Anita
Since 2013, the Robert Wood Johnson Foundation (RWJF) has embarked on a pioneering effort to advance a Culture of Health. The Culture of Health action framework is founded on a vision in which "everyone in our diverse society leads healthier lives now and for generations to come." To put the Culture of Health vision into action, RWJF asked RAND Health to support the development of an action framework and measurement strategy. This article summarizes the stakeholder engagement efforts that RAND used to inform this work. It draws on a series of interviews and focus groups that RAND researchers conducted with stakeholders both within and outside the United States. It should be of interest to RWJF, as well as to those individuals and organizations interested in advancing the Culture of Health action framework. Given that RWJF is focused on using the Culture of Health action framework and measures to catalyze national dialogue about content and investments to improve population health and well-being, the study should be beneficial to a range of national, state, and local leaders across a variety of sectors that contribute to health as described by the Culture of Health action framework.
Popa, Adela Elena
In the summer of 2010, Romania undertook a process of hospital decentralisation as part of the reform in the healthcare sector. The national newsprint media covered the process thoroughly. This paper is a study of how key stakeholders' views, attitudes, beliefs and attitudes towards decentralisation are represented in print media. 106 articles, published between June and September 2010, retrieved from the online databases of six leading national dailies were analysed. A mixed methodology was used in the data analysis stage. The qualitative data exploration identified five voices belonging to stakeholders involved directly or indirectly in the process: the representatives of central government, the local authorities (district and local councils, municipal mayors), health professionals (managers and physicians in hospitals), the media (journalists, analysts) and finally voices from civil society, professional associations and advocacy groups. These were the main actors negotiating the subjective meanings of the decentralisation process. An imbalance between these key actors were observed in the frequency, content and tone of the messages delivered in media during the four months. Central government and the local authorities were the most active voices, but the respective discourses differed significantly. An analysis of the accounts identified three main themes: the financial problem (hospitals liabilities and future spending), human resource in hospitals (the impact of decentralisation upon it) and the political character of the decentralisation. Copyright © 2013 John Wiley & Sons, Ltd.
Garrido, Pablo; Elbakidze, Marine; Angelstam, Per
respondents showed more appreciation for regulating and supporting services, which included biodiversity conservation and climate regulation. Private and public sector respondents appreciated provisioning services more, whereas the civil sector mentioned supporting and regulating services more. For instance......, water regulation was only mentioned by civil and public sector respondents, while genetic resource preservation was only expressed by the private sector. All sectors noted cultural services as key ES. We discuss most mentioned ES by respondents, the co-production nature of ES in wood-pastures, as well...... to describe stakeholders' appreciation of ES from dehesa landscapes in northern Extremadura, Spain. A total of 45 ES were mentioned, and compared among different sectors and levels of governance. At the local level, people appreciated especially provisioning and cultural services. In contrast, regional level...
Buchelt Beata Irma
Full Text Available Over the past decade, theoretical and empirical research on the various aspects of human resources (HR within the healthcare (HC sector has grown extensively due to its′ strategic importance in the sector. There is a visible tendency among researchers to pursue an effective human resource management (HRM strategies, methods, and tools. Countries implement policies which should increase the amount and competences of employees within healthcare. Providers of HC services (i.e. hospitals tend to enforce modern HRM solutions adapted from business organisations to attract, retain and develop HR. However, these seem not be as effective as they could (Hyde et al., 2013. Because of this, authors approached a researched reality from the point of view of a contextual paradigm, assuming that HRM solutions to be effective should match the reality of HC providers (Pocztowski, 2008. The aim of the research was to detect determinants which might influence the management of medical personnel in hospitals and identify the possible strength of these determinants so a more adjusted organisational and human resource management strategy could be elaborated. The list of possible determinants of hospital operations as the result of meta-analysis was elaborated. The list created the basis for interviews conducted among stakeholders and experts. Respondents were asked to appraise the factors with the usage of numerical scale considering their influence on medical personnel management in hospitals (physicians, nurses and others. In total, there were 28 interviews completed. The general conclusion which can be drawn from the analysis of these data is that hospitals should reorient their HRM practices in such the way that not only the quantitative but also the qualitative aspect of performance would be properly handled. This paper draws from HRM theory (contextual approach, stakeholder theory, and healthcare management theory, adding new insight to each in the context of
Germani, Tamara; Zwaigenbaum, Lonnie; Magill-Evans, Joyce; Hodgetts, Sandy; Ball, Geoff
To determine (a) the essential components of social participation for preschool children with Autism Spectrum Disorder (ASD) using stakeholders' perspectives and (b) the facilitators and barriers experienced in promoting social participation. A mixed-methods, web-based survey utilizing the International Classification of Functioning, Disability and Health - Child and Youth version (ICF-CY) taxonomy was circulated across Canada through purposeful snowball sampling. Frequency analysis of the combined responses of 74 stakeholders revealed the most essential components of social participation were: (a) behavior management, (b) social interactions, and (c) various types of play. Further, content analysis revealed that stakeholders used intrinsic motivation strategies and contingency management to facilitate social participation. Stakeholders reported that the purpose of social participation was to engage the child in fun, enjoyable social activities that developed relationships between the child and peers and created a sense of belonging in the community.
Sharp, Adam L; Cobb, Enesha M; Dresden, Scott M; Richardson, Derek K; Sabbatini, Amber K; Sauser, Kori; Kocher, Keith E
In the face of escalating spending, measuring and maximizing the value of health services has become an important focus of health reform. Recent initiatives aim to incentivize high-value care through provider and hospital payment reform, but the role of the emergency department (ED) remains poorly defined. To achieve an improved understanding of the value of emergency care, we have developed a framework that incorporates the perspectives of stakeholders in the delivery of health services. A pragmatic review of the literature informed the design of this framework to standardize the definition of value in emergency care and discuss outcomes and costs from different stakeholder perspectives. The viewpoint of patient, provider, payer, health system, and society is each used to assess value for emergency medical conditions. We found that the value attributed to emergency care differs substantially by stakeholder perspective. Potential targets to improve ED value may be aimed at improving outcomes or controlling costs, depending on the acuity of the clinical condition. The value of emergency care varies by perspective, and a better understanding is achieved when specific outcomes and costs can be identified, quantified, and measured. Using this framework can help stakeholders find common ground to prioritize which costs and outcomes to target for research, quality improvement efforts, and future health policy impacting emergency care. Copyright © 2014 Elsevier Inc. All rights reserved.
O'Sullivan, N.; O'Dwyer, B.
Purpose - The purpose of this paper is to present an in-depth, context rich, and stakeholder-focused perspective on the legitimation dynamics surrounding the initiation and evolution of one of the key financial sector environmental and social responsibility initiatives in recent years, the Equator
Barbour, Emily; Allan, Andrew; Whitehead, Paul; Salehin, Mashfiqus; Lazzar, Attila; Lim, Michelle; Munsur Rahman, Md.
Successful management of water resources requires an integrated approach considering the complex relationships between different biophysical processes, governance frameworks and socio-economic factors. The Ecosystem Services for Poverty Alleviation (ESPA) Deltas project has developed a range of socio-economic scenarios using a participatory approach, and applied these across different biophysical models as well as an integrated environmental, socio-economic model of the Ganges-Brahmaputra-Meghna (GBM) Delta. This work demonstrates a novel approach through the consideration of multiple ecosystem services and related socio-economic factors in the development of scenarios; the application of these to multiple models at multiple scales; and the participatory approach to improve project outcomes and engage national level stakeholders and policy makers. Scenarios can assist in planning for an uncertain future through exploring plausible alternatives. To adequately assess the potential impacts of future changes and management strategies on water resources, the wider biophysical, socio-economic and governance context needs to be considered. A series of stakeholder workshops have been held in Bangladesh to identify issues of main concern relating to the GBM Delta; to iteratively develop scenario narratives for business as usual, less sustainable, and more sustainable development pathways; and to translate these qualitative scenarios into a quantitative form suitable for analysis. The combined impact of these scenarios and climate change on water quantity and quality within the GBM Basin are demonstrated. Results suggest that climate change is likely to impact on both peak and low flows to a greater extent than most socio-economic changes. However, the diversion of water from the Ganges and Brahmaputra has the potential to significantly impact on water availability in Bangladesh depending on the timing and quantity of diversions. Both climate change and socio
The Volatile Organic Compounds in Arid Soils Integrated Demonstration (VOC-Arid ID) supported the demonstration of a number of innovative technologies, not all of which were evaluated in the integrated demonstration's stakeholder involvement program. These technologies have been organized into two categories and the first category ranked in order of priority according to interest in the evaluation of the technology. The purpose of this report is to present issues stakeholders would likely raise concerning each of the technologies in light of commentary, insights, data requirements, concerns, and recommendations offered during the VOC-Arid ID's three-year stakeholder involvement, technology evaluation program. A secondary purpose is to provide a closeout status for each of the technologies associated with the VOC-Arid ID. This report concludes with a summary of concerns and requirements that stakeholders have for all innovative technologies
Hansen, Morten Balle; Heilesen, J. B.
In the broader context of evaluation design, this paper examines and compares pros and cons of a theory-based approach to evaluation (TBE) with the Theory-Based Stakeholder evaluation (TSE) model, introduced by Morten Balle Hansen and Evert Vedung (Hansen and Vedung 2010). While most approaches...... to TBE construct one unitary theory of the program (Coryn et al. 2011), the TSE-model emphasizes the importance of keeping theories of diverse stakeholders apart. This paper applies the TSE-model to an evaluation study conducted by the Danish Evaluation Institute (EVA) of the Danish system of quality......-model, as an alternative to traditional program theory evaluation....
Full Text Available The decline of the public man of the industrial era and the rise of the digital communities engage publics in new forms of expression by forming and framing networks that replace political communities. Our identity has changed as far as the public man is falling apart in this liquid era, leaving its structured power to dissipated voices of the interactive media. Networking became a political way of being. Publics’ classification differs according to their multiple usages, to their responses and overt behaviors to social stimuli, as well as on the context and situations of interaction. We intend in this essay to define digital publics or audiences as popular and to draw a theoretical perspective on their characteristics and behavior.
Kolk, A.; Pinkse, J.
The strategic management of corporate sustainability tends to be approached from one theoretical perspective in academic research and publications in mainstream journals simultaneously. In corporate practice, however, a sustainability issue has different dimensions that cannot be captured if only one such lens is taken. The purpose of this article is to develop a more integrated perspective, embedded in a stakeholder view. This paper uses climate change as an example to illustrate how institutional, resource-based, supply chain and stakeholder views are all important to characterize and understand corporate strategic responses to one issue. This is subsequently linked to the climate strategies and related capabilities of companies, reckoning with societal and competitive contexts. Findings - What a corporate climate strategy looks like depends on the type of stakeholders that a company manages more proactively, which is in turn determined by the extent to which these stakeholders control critical resources. While empirical literature usually adopts a particular theoretical perspective, this article has attempted to develop a more integrative approach on corporate responses to climate change
Hayes-Labruto, Leslie; Schillebeeckx, Simon J.D.; Workman, Mark; Shah, Nilay
This article critically compares China's rare earth policy with perspectives upheld in the rest of the world (ROW). We introduce rare earth elements and their importance for energy and present how China and the ROW are framing the policy debate. We find strongly dissonant views with regards to motives for foreign direct investment, China's two-tiered pricing structure and its questionable innovation potential. Using the metaphor of “China Inc.”, we compare the Chinese government to a socially responsible corporation that aims to balance the needs of its internal stakeholders with the demands from a resource-dependent world. We find that China's internal stakeholders have more power and legitimacy in the REE debate than the ROW and reconceptualise various possible mitigation strategies that could change current international policy and market dynamics. As such, we aim to reframe the perspectives that seem to govern the West and argue in favor of policy formation that explicitly acknowledges China's triple bottom line ambitions and encourages the ROW to engage with China in a more nuanced manner. - Highlights: • Very different perspectives persist regarding China's rare earth policies. • Scarcity, substitutability and uncertainty drive the divergent perspectives. • We compare China to a socially responsible corporation, “China Inc.”. • China's internal stakeholders have higher salience than ROW. • We propose and reframe policy mitigation strategies
Wolff, Jamie; Parker, Claire; Borisoff, Jaimie; Mortenson, W Ben; Mattie, Johanne
Exoskeleton technology has potential benefits for wheelchair users' health and mobility. However, there are practical barriers to their everyday use as a mobility device. To further understand potential exoskeleton use, and facilitate the development of new technologies, a study was undertaken to explore perspectives of wheelchair users and healthcare professionals on reasons for use of exoskeleton technology, and the importance of a variety of device characteristics. An online survey with quantitative and qualitative components was conducted with wheelchair users and healthcare professionals working directly with individuals with mobility impairments. Respondents rated whether they would use or recommend an exoskeleton for four potential reasons. Seventeen design features were rated and compared in terms of their importance. An exploratory factor analysis was conducted to categorize the 17 design features into meaningful groupings. Content analysis was used to identify themes for the open ended questions regarding reasons for use of an exoskeleton. 481 survey responses were analyzed, 354 from wheelchair users and 127 from healthcare professionals. The most highly rated reason for potential use or recommendation of an exoskeleton was health benefits. Of the design features, 4 had a median rating of very important: minimization of falls risk, comfort, putting on/taking off the device, and purchase cost. Factor analysis identified two main categories of design features: Functional Activities and Technology Characteristics. Qualitative findings indicated that health and physical benefits, use for activity and access reasons, and psychosocial benefits were important considerations in whether to use or recommend an exoskeleton. This study emphasizes the importance of developing future exoskeletons that are comfortable, affordable, minimize fall risk, and enable functional activities. Findings from this study can be utilized to inform the priorities for future
... ENVIRONMENTAL PROTECTION AGENCY [FRL-9190-2] Stakeholder Meeting Regarding Re-Evaluation of... conferences during which the Agency will have a technical dialogue with stakeholders regarding re-evaluation of currently approved Total Coliform Rule (TCR) analytical methods. At these meetings, stakeholders...
Najafizada, Said Ahmad Maisam; Labonté, Ronald; Bourgeault, Ivy Lynn
The objectives of this study were two-fold: 1) to examine how different stakeholders define sustainability, and 2) to identify barriers to and facilitators of the sustainability of the Afghan CHW program. We interviewed 63 individual key informants, and conducted 11 focus groups [35 people] with policymakers, health managers, community health workers, and community members across Afghanistan. The participants were purposefully selected to provide a wide range of perspectives. Different stakeholders define sustainability differently. Policymakers emphasize financial resources; health managers, organizational operations; and community-level stakeholders, routine frontline activities. The facilitators they identify include integration into the health system, community support, and capable human resources. Barriers they noted include lack of financial resources, poor program design and implementation, and poor quality of services. Measures to ensure sustainability could be national revenue allocation, health-specific taxation, and community financing. Sustainability is complicated and has multiple facets. The plurality of understanding of sustainability among stakeholders should be addressed explicitly in the program design. To ensure sustainability, there is a need for a coordinated effort amongst all stakeholders. Copyright Â© 2016 Elsevier Ltd. All rights reserved.
Frerichs, Leah; Kim, Mimi; Dave, Gaurav; Cheney, Ann; Hassmiller Lich, Kristen; Jones, Jennifer; Young, Tiffany L; Cene, Crystal W; Varma, Deepthi S; Schaal, Jennifer; Black, Adina; Striley, Catherine W; Vassar, Stefanie; Sullivan, Greer; Cottler, Linda B; Brown, Arleen; Burke, Jessica G; Corbie-Smith, Giselle
Community-academic research partnerships aim to build stakeholder trust in order to improve the reach and translation of health research, but there is limited empirical research regarding effective ways to build trust. This multisite study was launched to identify similarities and differences among stakeholders' perspectives of antecedents to trust in research partnerships. In 2013-2014, we conducted a mixed-methods concept mapping study with participants from three major stakeholder groups who identified and rated the importance of different antecedents of trust on a 5-point Likert-type scale. Study participants were community members ( n = 66), health care providers ( n = 38), and academic researchers ( n = 44). All stakeholder groups rated "authentic communication" and "reciprocal relationships" the highest in importance. Community members rated "communication/methodology to resolve problems" ( M = 4.23, SD = 0.58) significantly higher than academic researchers ( M = 3.87, SD = 0.67) and health care providers ( M = 3.89, SD = 0.62; p importance of issues related to "sustainability." The importance of communication and relationships across stakeholders indicates the importance of colearning processes that involve the exchange of knowledge and skills. The differences uncovered suggest specific areas where attention and skill building may be needed to improve trust within partnerships. More research on how partnerships can improve communication specific to problem solving and sustainability is merited.
This study was conducted to theoretically develop and empirically test a structural equation model of tourism destination competitiveness from the tourism stakeholders'perspective. The proposed hypotheses that attempted to identify the structural relationships among the five constructs in the model were examined through a series of analyses in LISREL: 1) perceived tourism development impacts, 2) environmental attitudes, 3) place attachment, 4) development preferences about destination attract...
... Effectiveness Evaluation 2010; Supplemental Notice of Multi- Stakeholder Technical Conference on the Integrated..., Teleconferences, Regional Workshops and Multi-Stakeholder Technical Conference on the Integrated Licensing Process... opportunity for industry, state and Federal agencies, tribes, and other stakeholders to express their views...
Goodman, Melody S.; Sanders Thompson, Vetta L.
In this commentary, we discuss the science of stakeholder engagement in research. We propose a classification system with definitions to determine where projects lie on the stakeholder engagement continuum. We discuss the key elements of implementation and evaluation of stakeholder engagement in research posing key questions to consider when doing this work. We commend and critique the work of Hamilton et al. in their multilevel stakeholder engagement in a VA implementation trial of evidence-...
Navi, Maryam; Hansen, Alana; Nitschke, Monika; Hanson-Easey, Scott; Pisaniello, Dino
Climate-related health indicators are potentially useful for tracking and predicting the adverse public health effects of climate change, identifying vulnerable populations, and monitoring interventions. However, there is a need to understand stakeholders' perspectives on the identification, development, and utility of such indicators. A qualitative approach was used, comprising semi-structured interviews with key informants and service providers from government and non-government stakeholder organizations in South Australia. Stakeholders saw a need for indicators that could enable the monitoring of health impacts and time trends, vulnerability to climate change, and those which could also be used as communication tools. Four key criteria for utility were identified, namely robust and credible indicators, specificity, data availability, and being able to be spatially represented. The variability of risk factors in different regions, lack of resources, and data and methodological issues were identified as the main barriers to indicator development. This study demonstrates a high level of stakeholder awareness of the health impacts of climate change, and the need for indicators that can inform policy makers regarding interventions.
Mackie, Thomas I; Sheldrick, Radley C; de Ferranti, Sarah D; Saunders, Tully; Rojas, Erick G; Leslie, Laurel K
US federal funding agencies increasingly incentivize stakeholder-engaged research which represents a paradigm shift toward incorporating a range of stakeholders in research design, conduct, and dissemination. We use qualitative methods to capture experience-based recommendations on how to operationalize 4 Patient-Centered Outcomes Research (PCOR) principles in stakeholder-engaged research, specifically: (1) reciprocal relationships; (2) colearning; (3) partnership; and (4) trust, transparency, and honesty. We conducted semistructured interviews with members of a stakeholder panel who participated in a 2-year comparative effectiveness study of cholesterol screening and treatment among young adults. Participants included 8 young adults and parent panelists and 11 professional panelists (clinicians, researchers, policy developers, and disseminators). The interview guide included questions about the 4 PCOR principles and queried preferred strategies to attain them. Interview transcripts were analyzed using an a priori and emergent coding structure. Participants provided strategies to promote the 4 PCOR principles. Although some stakeholder-identified strategies were complementary, others conflicted due to (1) competing ideologies identified among the principles, and (2) distinct stakeholder preferences. Illustrative of competing ideologies, participants simultaneously preferred receiving relevant articles before calls (to facilitate colearning) but also minimal outside reading (to achieve partnership). Illustrative of distinct stakeholder preferences, young adult and parent panelists generally preferred calls to occur on weekends/evenings, whereas professional panelists preferred mid-week work hours. Our exploratory study provides stakeholder-identified strategies to achieve the 4 PCOR principles, and demonstrates the need to identify, acknowledge, and address potentially conflicting strategies due to the potential for competing ideologies or variation in stakeholder
Dunet, Diane O; Reyes, Michele
Different people who have a stake or interest in a training course (stakeholders) may have markedly different definitions of what constitutes "training success" and how they will use evaluation results. Stakeholders at multiple levels within and outside of the organization guided the development of an evaluation plan for a Web-based training course on hemochromatosis. Stakeholder interests and values were reflected in the type, level, and rigor of evaluation methods selected. Our mixed-method evaluation design emphasized small sample sizes and repeated measures. Limited resources for evaluation were leveraged by focusing on the data needs of key stakeholders, understanding how they wanted to use evaluation results, and collecting data needed for stakeholder decision making. Regular feedback to key stakeholders provided opportunities for updating the course evaluation plan to meet emerging needs for new or different information. Early and repeated involvement of stakeholders in the evaluation process also helped build support for the final product. Involving patient advocacy groups, managers, and representative course participants improved the course and enhanced product dissemination. For training courses, evaluation planning is an opportunity to tailor methods and data collection to meet the information needs of particular stakeholders. Rigorous evaluation research of every training course may be infeasible or unwarranted; however, course evaluations can be improved by good planning. A stakeholder-focused approach can build a picture of the results and impact of training while fostering the practical use of evaluation data.
Georgiou, Andrew; Magrabi, Farah; Hypponen, Hannele; Wong, Zoie Shui-Yee; Nykänen, Pirkko; Scott, Philip J; Ammenwerth, Elske; Rigby, Michael
The paper draws attention to: i) key considerations involving the confidentiality, privacy, and security of shared data; and ii) the requirements needed to build collaborative arrangements encompassing all stakeholders with the goal of ensuring safe, secure, and quality use of shared data. A narrative review of existing research and policy approaches along with expert perspectives drawn from the International Medical Informatics Association (IMIA) Working Group on Technology Assessment and Quality Development in Health Care and the European Federation for Medical Informatics (EFMI) Working Group for Assessment of Health Information Systems. The technological ability to merge, link, re-use, and exchange data has outpaced the establishment of policies, procedures, and processes to monitor the ethics and legality of shared use of data. Questions remain about how to guarantee the security of shared data, and how to establish and maintain public trust across large-scale shared data enterprises. This paper identifies the importance of data governance frameworks (incorporating engagement with all stakeholders) to underpin the management of the ethics and legality of shared data use. The paper also provides some key considerations for the establishment of national approaches and measures to monitor compliance with best practice. Data sharing endeavours can help to underpin new collaborative models of health care which provide shared information, engagement, and accountability amongst all stakeholders. We believe that commitment to rigorous evaluation and stakeholder engagement will be critical to delivering health data benefits and the establishment of collaborative models of health care into the future. Georg Thieme Verlag KG Stuttgart.
Monterrosa, Eva C; Campirano, Fabricio; Tolentino Mayo, Lizbeth; Frongillo, Edward A; Hernández Cordero, Sonia; Kaufer-Horwitz, Martha; Rivera, Juan A
In Mexico, the school environment has been promoting sale of unhealthy foods. There is little empirical evidence on multi-stakeholder perspectives around national school food policy to regulate this. We studied stakeholders' perspectives on the proposed regulation for school sale of unhealthy foods. Comments about the regulation were available from an open consultation process held in June 2010 before the approval and implementation of the regulation. To examine perspectives, we coded 597 comments for beliefs, expectations and demands in NVivo. We created matrices by actors: academics, parents, citizens, health professionals and food industry. For academics, citizens and health professionals, the primary issue regarding the regulation was obesity, while for parents it was health of children. Academics, citizens, health professionals and parents believed that government was responsible for health of citizens, expected that this regulation would improve eating habits and health (i.e. less obesity and chronic diseases), and demanded that unhealthy foods be removed from schools. Parents demanded immediate action for school food policy that would protect their children. Citizens and health professionals demanded nutrition education and healthy food environment. Food industry opposed the regulation because it would not solve obesity or improve diet and physical activity behaviours. Instead, industry would lose income and jobs. Food industry demanded policy aimed at families that included nutrition education and physical activity. There was substantial consensus in narratives and perspectives for most actor types, with the primary narrative being the food environment followed by shared responsibility. Food industry rejected both these narratives, espousing instead the narrative of personal responsibility. Consensus among most actor groups supports the potential success of implementation of the regulation in Mexican schools. With regard to addressing childhood obesity
Williams, J.R.; Kane, D.; Smith, T.B. Jr.
The U.S. Department of Energy (DOE), Office of Civilian Radioactive Waste Management (OCRWM), began evaluating a multipurpose canister (MPC) concept in October of 1992. This followed recommendations by the Nuclear Waste Technical Review Board (NWTRB) and the U.S. Nuclear Regulatory Commission (NRC) that DOE develop a nuclear waste management system that achieves system integration, standardization, and reduced fuel-handling operations. Industry organizations such as Edison Electric Institute (EEI) and Electric Power Research Institute (EPRI) had conducted earlier studies that concluded advantages to the nuclear waste management system may be offered by such a concept. The MPC concept involves a metal canister which would contain multiple spent nuclear fuel assemblies. The canister would be sealed at the nuclear power plant and would not be reopened. The MPC would then be placed inside separate casks or overpacks for storage, transportation, and disposal. An important factor in DOE's evaluation of the MPC concept was the involvement of external parties. This paper describes that involvement process for the OCRWM's MPC implementation program. External parties who have an interest or stake in the program are referred to as stakeholders
Goodman, Melody S; Sanders Thompson, Vetta L
In this commentary, we discuss the science of stakeholder engagement in research. We propose a classification system with definitions to determine where projects lie on the stakeholder engagement continuum. We discuss the key elements of implementation and evaluation of stakeholder engagement in research posing key questions to consider when doing this work. We commend and critique the work of Hamilton et al. in their multilevel stakeholder engagement in a VA implementation trial of evidence-based quality improvement in women's health primary care. We also discuss the need for more work in this area to enhance the science of stakeholder engagement in research.
Rojas-Anaya, Hector; Skogen, Karoline; Miles, Kenneth Alan
To identify factors that influence the use of PET in phase III oncology trials in the UK by evaluating stakeholder perspectives. A wide range of UK PET research stakeholders with a potential interest in the use of PET in phase III trials were identified and invited to participate. These UK PET research stakeholders were consulted using a semistructured questionnaire on their personal experience with and involvement in PET research, the role of PET in phase III oncology clinical trials and on the promotion of UK PET research and unmet clinical needs in oncology. Responses were analysed quantitatively and by qualitative content analysis of free-text responses. A total of 118 responses were received from a wide range of stakeholders representing several professional groups and working environments. Of these respondents, 49 (42%) were using PET in their research. There was the general perception that using PET in clinical research is beneficial in oncology. The two major barriers identified were poor availability of PET and perceived difficulties in funding of excess treatment costs (75% of respondents). Other factors included limited coverage of PET in training, uncertainty about developing imaging protocols or the status of tracers other than 18F-fluorodeoxyglucose, and low awareness of the role of PET in patient selection for therapeutic trials. Patient concerns about radiation were not perceived as a research barrier. Interventions that improve the availability and funding pathways for PET research scans and that increase researcher awareness could help promote the use of PET for phase III oncology trials in the UK.
This report gives an overview of completed research activities on the value ascribed by users, local communities and stakeholders to functions, goods and services (including non‐use values) derived from the aquatic resources in the study areas. The perceived impact of factors such as environmental...... degradation, changing demand for goods and services and modified highland aquatic resources management practices on these values has also been assessed. To help structure this analysis stakeholder Delphi studies have been undertaken in each country involving representatives from all stakeholder groups...
Heckel, Maria; Herbst, Franziska A; Adelhardt, Thomas; Tiedtke, Johanna M; Sturm, Alexander; Stiel, Stephanie; Ostgathe, Christoph
Information lacks about institutional stakeholders' perspectives on management approaches of multidrug-resistant bacterial organism in end-of-life situations. The term "institutional stakeholder" includes persons in leading positions with responsibility in hospitals' multidrug-resistant bacterial organism management. They have great influence on how strategies on multidrug-resistant bacterial organism management approaches in institutions of the public health system are designed. This study targeted institutional stakeholders' individual perspectives on multidrug-resistant bacterial organism colonization or infection and isolation measures at the end of life. Between March and December 2014, institutional stakeholders of two study centers, a German palliative care unit and a geriatric ward, were queried in semistructured interviews. Interviews were audiotaped, transcribed verbatim, and analyzed qualitatively with the aid of the software MAXQDA for qualitative data analysis using principles of Grounded Theory. In addition, two external stakeholders were interviewed to enrich data. Key issues addressed by institutional stakeholders (N=18) were the relevance of multidrug-resistant bacterial organism in palliative and geriatric care, contradictions between hygiene principles and patients' and family caregivers' needs and divergence from standards, frame conditions, and reflections on standardization of multidrug-resistant bacterial organism end-of-life care procedures. Results show that institutional stakeholders face a dilemma between their responsibility in protecting third persons and ensuring patients' quality of life. Until further empirical evidence establishes a clear multidrug-resistant bacterial organism management approach in end-of-life care, stakeholders suggest a case-based approach. The institutional stakeholders' perspectives and their suggestion of a case-based approach advance the development process of a patient-, family-, staff-, and institutional
Full Text Available Objective: To obtain a multi-stakeholder perspective of community pharmacy practice change. Design: Qualitative study. Setting: Community pharmacy in rural Mississippi. Participants: Fourteen key stakeholders of the patient care practice including pharmacists (n=4, support staff (n=2, collaborating providers (n=4, patients (n=3, and a payer (n=1. Intervention: Semi-structured interviews and participant-observation techniques were used. Main outcome measures: Description of the community pharmacy's practice and business model and identification of practice change facilitators. Results: Change facilitators for this practice included: a positive reputation in the community, forming solid relationships with providers, and convenience of patient services. Communication in and outside of the practice, adequate reimbursement, and resource allocation were identified as challenges. Conclusions: This case study is a multi-stakeholder examination of community pharmacy practice change and readers are provided with a real-world example of a community pharmacy's successful establishment of a patient care practice. Type: Case Study
Vilme, Helene; López, Ivette A; Walters, Lurleen; Suther, Sandra; Brown, C Perry; Dutton, Matthew; Barber, Janet
To explore the perspectives of various stakeholders on whether an HBCU has the resources to establish a farm-to-university program that can improve fruits and vegetables intake among African American students. Additionally, this study assessed students' satisfaction with fruits and vegetables served in University dining halls, and their desire for changes in policies to increase local fruits and vegetables access on campus. This study employed a mixed method data collection strategy. Semi-structured interviews were used to explore the stakeholders' perspectives and self-administered questionnaires were used to assess students' satisfaction with fruits and vegetables and desire for policy changes. Barriers reported by both food service administrators and farmers were cost and variation in supply and demand. Students expressed lack of satisfaction with fresh produce served in campus dining halls and a desire for change in policies to increase local fruits and vegetables access on campus. While there is student desire for improved access to fresh produce on campus, there are perceived barriers to overcome. University partnerships are needed to address the desired nutritional improvements.
Full Text Available This study aims to provide a more complete and exhaustive perspective on the whole range of potential strategies to fight stigma by considering the perspectives of different stakeholders. Delegates to a Canadian conference were invited to participate in a survey that focused on stigma, from which the responses to the following question were analyzed: tell us briefly what you do to reduce prejudice and stigma toward people with a diagnosis of mental disorder? From 253 participants, 15 categories of strategies to fight stigma were identified from the verbatim (e.g., sharing/encouraging disclosure. These categories fell under six main themes: education, contact, protestation, person centered, working on recovery and social inclusion, and reflexive consciousness. The occurrence of these themes was different among stakeholders (clinical, organizational, and experiential knowledge. For example, people with mental disorders (experiential knowledge often mentioned contact and person centered strategies, while mental health professionals (clinical knowledge preferred education and working on recovery and social inclusion strategies. The results from this study highlight the need to pay more attention to the concept of disclosure of mental disorders in the process for de-stigmatization. Future studies are needed to assess the impact of the emerging strategies to fight stigma in the community.
Smyth, Siobhán; Casey, Dympna; Cooney, Adeline; Higgins, Agnes; McGuinness, David; Bainbridge, Emma; Keys, Mary; Georgieva, Irina; Brosnan, Liz; Beecher, Claire; Hallahan, Brian; McDonald, Colm; Murphy, Kathy
There is international interest in, and continued concern about, the potential long-term impact of involuntary admission to psychiatric institutions, and the effect this coercive action has on a person's well-being and human rights. Involuntary detention in hospital remains a controversial process that involves stakeholders with competing concerns and who often describe negative experiences of the process, which can have long-lasting effects on the therapeutic relationship with service users. The aim of the present study was to explore the perspectives of key stakeholders involved in the involuntary admission and detention of people under the Mental Health Act 2001 in Ireland. Focus groups were used to collect data. Stakeholders interviewed were service users, relatives, general practitioners, psychiatrists, mental health nurses, solicitors, tribunal members, and police. Data were analysed using a general inductive approach. Three key categories emerged: (i) getting help; (ii) detention under the Act; and (iii) experiences of the tribunal process. This research highlights gaps in information and uncertainty about the involuntary admission process for stakeholders, but particularly for service users who are most affected by inadequate processes and supports. Mental health law has traditionally focussed on narrower areas of detention and treatment, but human rights law requires a greater refocussing on supporting service users to ensure a truly voluntary approach to care. The recent human rights treaty, the UN Convention on the Rights of Persons with Disabilities, is to guarantee a broad range of fundamental rights, such as liberty and integrity, which can be affected by coercive processes of involuntary admission and treatment. © 2016 Australian College of Mental Health Nurses Inc.
Sharma, Anjali; Chiliade, Philippe; Michael Reyes, E; Thomas, Kate K; Collens, Stephen R; Rafael Morales, José
In 2008, the US government mandated that HIV/AIDS care and treatment programs funded by the US President's Emergency Plan for AIDS Relief (PEPFAR) should shift from US-based international partners (IPs) to registered locally owned organizations (local partners, or LPs). The US Health Resources and Services Administration (HRSA) developed the Clinical Assessment for Systems Strengthening (ClASS) framework for technical assistance in resource-constrained settings. The ClASS framework involves all stakeholders in the identification of LPs' strengths and needs for technical assistance. This article examines the role of ClASS in building capacity of LPs that can endure and adapt to changing financial and policy environments. All stakeholders (n=68) in Kenya, Zambia, and Nigeria who had participated in the ClASS from LPs and IPs, the US Centers for Disease Control and Prevention (CDC), and, in Nigeria, HIV/AIDS treatment facilities (TFs) were interviewed individually or in groups (n=42) using an open-ended interview guide. Thematic analysis revealed stakeholder perspectives on ClASS-initiated changes and their sustainability. Local organizations were motivated to make changes in internal operations with the ClASS approach, PEPFAR's competitive funding climate, organizational goals, and desired patient health outcomes. Local organizations drew on internal resources and, if needed, technical assistance from IPs. Reportedly, ClASS-initiated changes and remedial action plans made LPs more competitive for PEPFAR funding. LPs also attributed their successful funding applications to their preexisting systems and reputation. Bureaucracy, complex and competing tasks, and staff attrition impeded progress toward the desired changes. Although CDC continues to provide technical assistance through IPs, declining PEPFAR funds threaten the consolidation of gains, smooth program transition, and continuity of treatment services. The well-timed adaptation and implementation of Cl
Full Text Available Purpose – The purpose of this paper is to put forward the argument that New Zealand�s tourism industry generally fails to acknowledge the importance of the access market. Despite anecdotal evidence of the market's value and strong legislation, New Zealand�s access market arguably remains underserviced and misunderstood. The current research sought to explore social and business rationales to support a future for accessible tourism in New Zealand, from the perspectives of its key stakeholders. It sought to uncover contemporary issues in the tourism industry, to examine the capacity and context for which issues can be addressed and overcome, to achieve a future for accessible tourism in New Zealand. Design/methodology/approach – Under the interpretive paradigm, original, exploratory research was conducted. Semi-structured interviews were carried out with ten key New Zealand tourism industry stakeholders who agreed to participate in the research. Qualitative data were thematically analysed. The following five key themes inductively emerged from the data: "Accessibility as a human right: Developing a culture of accessibility"; "Accessible tourism: Good for business?"; "Bottom-up, market-led approach"; "Leadership from the top: Moving from apathy to action"; and "Meeting somewhere in the middle". The five themes correspond to themes evidenced in the wider literature and present propositions for the future development of accessible tourism in New Zealand. Findings – Findings revealed stakeholder opinions of an industry exemplifying minimal awareness and consideration for accessibility. Accessibility was perceived to be an issue of social change, requiring the achievement of a cultural shift where accessibility is envisioned as a cultural norm necessary for the future. Whilst top-down leadership and support were deemed pertinent, ownership and accountability were seen to be crucial at the lower, operational levels of the industry. A "meeting
Schwind, Jessica S; Goldstein, Tracey; Thomas, Kate; Mazet, Jonna A K; Smith, Woutrina A
The capacity to conduct zoonotic pathogen surveillance in wildlife is critical for the recognition and identification of emerging health threats. The PREDICT project, a component of United States Agency for International Development's Emerging Pandemic Threats program, has introduced capacity building efforts to increase zoonotic pathogen surveillance in wildlife in global 'hot spot' regions where zoonotic disease emergence is likely to occur. Understanding priorities, challenges, and opportunities from the perspectives of the stakeholders is a key component of any successful capacity building program. A survey was administered to wildlife officials and to PREDICT-implementing in-country project scientists in 16 participating countries in order to identify similarities and differences in perspectives between the groups regarding capacity needs for zoonotic pathogen surveillance in wildlife. Both stakeholder groups identified some human-animal interfaces (i.e. areas of high contact between wildlife and humans with the potential risk for disease transmission), such as hunting and markets, as important for ongoing targeting of wildlife surveillance. Similarly, findings regarding challenges across stakeholder groups showed some agreement in that a lack of sustainable funding across regions was the greatest challenge for conducting wildlife surveillance for zoonotic pathogens (wildlife officials: 96% and project scientists: 81%). However, the opportunity for improving zoonotic pathogen surveillance capacity identified most frequently by wildlife officials as important was increasing communication or coordination among agencies, sectors, or regions (100% of wildlife officials), whereas the most frequent opportunities identified as important by project scientists were increasing human capacity, increasing laboratory capacity, and the growing interest or awareness regarding wildlife disease or surveillance programs (all identified by 69% of project scientists). A One
Maiwald, Karin; de Rijk, Angelique; Guzman, Jaime; Schonstein, Eva; Yassi, Annalee
Introduction Workplace disability prevention is important, but stakeholders can differ in their appreciation of such interventions. We present a responsive evaluation of a workplace disability prevention intervention in a Canadian healthcare organization. Three groups of stakeholders were included: designers of the intervention, deliverers, and workers. The aim was to examine the appreciation of this intervention by analyzing the discrepancies with respect to what these various stakeholders s...
Backhouse, Amy; Richards, David A; McCabe, Rose; Watkins, Ross; Dickens, Chris
Interventions aiming to coordinate services for the community-based dementia population vary in components, organisation and implementation. In this review we aimed to investigate the views of stakeholders on the key components of community-based interventions coordinating care in dementia. We searched four databases from inception to June 2015; Medline, The Cochrane Library, EMBASE and PsycINFO, this was aided by a search of four grey literature databases, and backward and forward citation tracking of included papers. Title and abstract screening was followed by a full text screen by two independent reviewers, and quality was assessed using the CASP appraisal tool. We then conducted thematic synthesis on extracted data. A total of seven papers from five independent studies were included in the review, and encompassed the views of over 100 participants from three countries. Through thematic synthesis we identified 32 initial codes that were grouped into 5 second-order themes: (1) case manager had four associated codes and described preferences for the case manager personal and professional attributes, including a sound knowledge in dementia and availability of local services; (2) communication had five associated codes and emphasized the importance stakeholders placed on multichannel communication with service users, as well as between multidisciplinary teams and across organisations; (3) intervention had 11 associated codes which focused primarily on the practicalities of implementation such as the contact type and frequency between case managers and service users, and the importance of case manager training and service evaluation; (4) resources had five associated codes which outlined stakeholder views on the required resources for coordinating interventions and potential overlap with existing resources, as well as arising issues when available resources do not meet those required for successful implementation; and (5) support had seven associated codes that
Ersek, Mary; Hickman, Susan E; Thomas, Anne C; Bernard, Brittany; Unroe, Kathleen T
The need to reduce burdensome and costly hospitalizations of frail nursing home residents is well documented. The Optimizing Patient Transfers, Impacting Medical Quality, and Improving Symptoms: Transforming Institutional Care (OPTIMISTIC) project achieved this reduction through a multicomponent collaborative care model. We conducted an implementation-focused project evaluation to describe stakeholders' perspectives on (a) the most and least effective components of the intervention; (b) barriers to implementation; and (c) program features that promoted its adoption. Nineteen nursing homes participated in OPTIMISTIC. We conducted semistructured, qualitative interviews with 63 stakeholders: 23 nursing home staff and leaders, 4 primary care providers, 10 family members, and 26 OPTIMISTIC clinical staff. We used directed content analysis to analyze the data. We found universal endorsement of the value of in-depth advance care planning (ACP) discussions in reducing hospitalizations and improving care. Similarly, all stakeholder groups emphasized that nursing home access to specially trained, project registered nurses (RNs) and nurse practitioners (NPs) with time to focus on ACP, comprehensive resident assessment, and staff education was particularly valuable in identifying residents' goals for care. Challenges to implementation included inadequately trained facility staff and resistance to changing practice. In addition, the program sometimes failed to communicate its goals and activities clearly, leaving facilities uncertain about the OPTIMISTIC clinical staff's roles in the facilities. These findings are important for dissemination efforts related to the OPTIMISTIC care model and may be applicable to other innovations in nursing homes. Published by Oxford University Press on behalf of The Gerontological Society of America 2017. This work is written by (a) US Government employee(s) and is in the public domain in the US.
Ward, Claire Leonie; Shaw, David; Anane-Sarpong, Evelyn; Sankoh, Osman; Tanner, Marcel; Elger, Bernice
The study uses a qualitative empirical method to define Health Research for Development. This project explores the perspectives of stakeholders in an international health research partnership operating in Ghana and Tanzania. We conducted 52 key informant interviews with major stakeholders in an international multicenter partnership between GlaxoSmithKline (GSK, Vaccine Developer) and the global health nonprofit organisation PATH and its Malaria Vaccine Initiative program (PATH/MVI, Funder-Development Partner), (RTS, S) (NCT00866619). The respondents included teams from four clinical research centres (two centres in Ghana and two in Tanzania) and various collaborating partners. This paper analyses responses to the question: What is Health Research for Development? Based on the stakeholders' experience the respondents offered many ways of defining Health Research for Development. The responses fell into four broad themes: i) Equitable Partnerships; ii) System Sustainability; iii) Addressing Local Health Targets, and iv) Regional Commitment to Benefit Sharing. Through defining Health Research for Development six key learning points were generated from the four result themes: 1) Ensure there is local research leadership working with the collaborative partnership, and local healthcare system, to align the project agenda and activities with local research and health priorities; 2) Know the country-specific context - map the social, health, legislative and political setting; 3) Define an explicit development component and plan of action in a research project; 4) Address the barriers and opportunities to sustain system capacity. 5) Support decentralised health system decision-making to facilitate the translation pathway; 6) Govern, monitor and evaluate the development components of health research partnerships. Overall, equity and unity between partners are required to deliver health research for development. © 2017 John Wiley & Sons Ltd.
Stidham, Melanie; Simon-Brown, Viviane [Department of Forest Ecosystems and Society, College of Forestry, Oregon State University, 321 Richardson Hall, Corvallis, OR 97331 (United States)
Within the state of Oregon, USA, there is considerable interest in the possibility of converting forest biomass to energy. A number of studies have assessed the technical feasibility of forest biomass energy, but few have focused on social aspects, an important consideration in projects involving public forests. This study explores the social context of converting forest biomass to energy, using qualitative research methods. Semi-structured interviews were conducted with forty individuals representing nine different stakeholder groups. Information gained through interviews was used to understand stakeholder views on forest biomass energy, including their perspectives on potential barriers and opportunities in Oregon. Findings indicate the most challenging barrier will be access to long-term, consistent supply. A related challenge is the long history of contention between parties over forest products coming from public lands. However, findings also show that there are many areas of common ground between these groups that have historically been at odds, such as agreement on the necessity of restoration treatments in certain forest types, the by-product of which could be used for biomass generation. Potential conflicts still exist, for instance over projects in mixed conifer forests. Development of policies and projects through inclusive, collaborative approaches could alleviate controversies, potentially allowing more activities to move forward. Information provided by this research creates a foundation for discussions as forest biomass energy becomes an increasingly prominent issue in Oregon, the western USA, and other regions of the world. (author)
Sridharan, Sanjeev; Campbell, Bernadette; Zinzow, Heidi
The authors present a stakeholder-driven method, the earliest anticipated timeline of impact, which is designed to assess stakeholder expectations for the earliest time frame in which social programs are likely to affect outcomes. The utility of the anticipated timeline of impact is illustrated using an example from an evaluation of a…
... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Docket No. AD10-7-000] ILP Effectiveness Evaluation 2010; Additional Notice of Multi- Stakeholder Technical Conference on the Integrated..., Teleconferences, Regional Workshops And Multi-Stakeholder Technical Conference On The Integrated Licensing Process...
GEUNCHAN LIM; HEESEOK LEE; TAEHUN KIM
The management of competing stakeholders has emerged as an important topic for formulating business strategies. This is especially the case in the complicated business environment like the healthcare IT (Information Technology) industries. This paper proposes a methodology to formulate business strategies based on stakeholders' demands. Our methodology begins with the understanding of stakeholders' demands. This understanding is particularly useful for businesses with conflicting stakeholders...
In this study, categories, dimensions, and criteria for evaluating regional climate services are derived by a participatory approach with potential service users at the German Baltic Sea coast. The development is carried out within nine face-to-face interviews conducted with decision makers, working in climate sensitive sectors at the German Baltic Sea coast. Three main groups of categories were localized which seem to matter most to the considered stakeholders and which seem to be crucial evaluation categories for regional climate services: (1) credibility, (2) relevance, and (3) appropriateness. For each of these evaluation categories several dimensions emerged, indicating certain perspectives of stakeholder demands. When summarizing these evaluation categories and their dimensions, 13 evaluation criteria for regional climate services can be derived (see Table 1). The results show that stakeholders do mainly address components other than those found in the literature (e.g. inputs, process, outputs, outcomes, and impacts). This might indicate that an evaluation, following solely literature-based (non-participative) components, is not sufficient to localize deficiencies or efficiencies within a regional climate service, since it might lead to results which are not relevant for potential users.
Marsily, Ghislain de
The author contributed to the discussion by providing a presentation from the perspective of an academic. In reviewing the role of science, the author focused on the important roles of science and R and D following a siting process. Science and R and D is essential for understanding the physical systems, displaying and demonstrating processes involved, measuring key parameters, and assessing areas of residual uncertainty. He outlined a number of factors that are key to making a strong case to stakeholders, to demonstrate that the system is well understood: - explaining the past history of the site; - explaining unexpected features or occurrences (such as seismic anomalies); - ensuring the capacity to observe and note unexpected features; - having the capacity to introduce new measurements that can inform the system; - deriving scientific validation of theory (noting the example of WIPP); - maintaining the capacity to be at the frontier of science; and - having the ability to answer unexpected questions from any party. It was suggested that credibility and stakeholder confidence is linked, in part, to credibility of the research in the eyes of the scientific community. The scientific community must be engaged to address questions of interest to the public. The role of peer review is essential in establishing the credibility of researchers, and within academic circles, publications in the scientific literature is highly valued. It is important for both implementers and regulators to retain their own capabilities and competence to be credible in the eyes of stakeholders. The experience of Andra was noted, in underscoring the importance of having high-level scientists internal to the implementing organization to ensure momentum and institutional knowledge. Thesis students also offer ways of promoting science in areas of interest concerning radioactive waste management. Demonstration plays an essential and distinct role from R and D. It offers tangible insight to
Full Text Available Background: In 2008, the US government mandated that HIV/AIDS care and treatment programs funded by the US President's Emergency Plan for AIDS Relief (PEPFAR should shift from US-based international partners (IPs to registered locally owned organizations (local partners, or LPs. The US Health Resources and Services Administration (HRSA developed the Clinical Assessment for Systems Strengthening (ClASS framework for technical assistance in resource-constrained settings. The ClASS framework involves all stakeholders in the identification of LPs’ strengths and needs for technical assistance. Objective: This article examines the role of ClASS in building capacity of LPs that can endure and adapt to changing financial and policy environments. Design: All stakeholders (n=68 in Kenya, Zambia, and Nigeria who had participated in the ClASS from LPs and IPs, the US Centers for Disease Control and Prevention (CDC, and, in Nigeria, HIV/AIDS treatment facilities (TFs were interviewed individually or in groups (n=42 using an open-ended interview guide. Thematic analysis revealed stakeholder perspectives on ClASS-initiated changes and their sustainability. Results: Local organizations were motivated to make changes in internal operations with the ClASS approach, PEPFAR's competitive funding climate, organizational goals, and desired patient health outcomes. Local organizations drew on internal resources and, if needed, technical assistance from IPs. Reportedly, ClASS-initiated changes and remedial action plans made LPs more competitive for PEPFAR funding. LPs also attributed their successful funding applications to their preexisting systems and reputation. Bureaucracy, complex and competing tasks, and staff attrition impeded progress toward the desired changes. Although CDC continues to provide technical assistance through IPs, declining PEPFAR funds threaten the consolidation of gains, smooth program transition, and continuity of treatment services
Hees, Hiske L.; Nieuwenhuijsen, Karen; Koeter, Maarten W. J.; Bultmann, Ute; Schene, Aart H.
Objectives: To examine the perspectives of key stakeholders involved in the return-to-work (RTW) process regarding the definition of successful RTW outcome after sickness absence related to common mental disorders (CMD's). Methods: A mixed-method design was used: First, we used qualitative methods
He, Meilin; Devine, Laura; Zhuang, Jun
The government, private sectors, and others users of the Internet are increasingly faced with the risk of cyber incidents. Damage to computer systems and theft of sensitive data caused by cyber attacks have the potential to result in lasting harm to entities under attack, or to society as a whole. The effects of cyber attacks are not always obvious, and detecting them is not a simple proposition. As the U.S. federal government believes that information sharing on cybersecurity issues among organizations is essential to safety, security, and resilience, the importance of trusted information exchange has been emphasized to support public and private decision making by encouraging the creation of the Information Sharing and Analysis Center (ISAC). Through a decision-theoretic approach, this article provides new perspectives on ISAC, and the advent of the new Information Sharing and Analysis Organizations (ISAOs), which are intended to provide similar benefits to organizations that cannot fit easily into the ISAC structure. To help understand the processes of information sharing against cyber threats, this article illustrates 15 representative information sharing structures between ISAC, government, and other participating entities, and provide discussions on the strategic interactions between different stakeholders. This article also identifies the costs of information sharing and information security borne by different parties in this public-private partnership both before and after cyber attacks, as well as the two main benefits. This article provides perspectives on the mechanism of information sharing and some detailed cost-benefit analysis. © 2017 Society for Risk Analysis.
Full Text Available Abstract Background Interventions aiming to coordinate services for the community-based dementia population vary in components, organisation and implementation. In this review we aimed to investigate the views of stakeholders on the key components of community-based interventions coordinating care in dementia. Methods We searched four databases from inception to June 2015; Medline, The Cochrane Library, EMBASE and PsycINFO, this was aided by a search of four grey literature databases, and backward and forward citation tracking of included papers. Title and abstract screening was followed by a full text screen by two independent reviewers, and quality was assessed using the CASP appraisal tool. We then conducted thematic synthesis on extracted data. Results A total of seven papers from five independent studies were included in the review, and encompassed the views of over 100 participants from three countries. Through thematic synthesis we identified 32 initial codes that were grouped into 5 second-order themes: (1 case manager had four associated codes and described preferences for the case manager personal and professional attributes, including a sound knowledge in dementia and availability of local services; (2 communication had five associated codes and emphasized the importance stakeholders placed on multichannel communication with service users, as well as between multidisciplinary teams and across organisations; (3 intervention had 11 associated codes which focused primarily on the practicalities of implementation such as the contact type and frequency between case managers and service users, and the importance of case manager training and service evaluation; (4 resources had five associated codes which outlined stakeholder views on the required resources for coordinating interventions and potential overlap with existing resources, as well as arising issues when available resources do not meet those required for successful implementation
Schandelmaier, Stefan; Leibold, Andrea; Fischer, Katrin; Mager, Ralph; Hoffmann-Richter, Ulrike; Bachmann, Monica Susanne; Kedzia, Sarah; Busse, Jason Walter; Guyatt, Gordon Henry; Jeger, Joerg; Marelli, Renato; De Boer, Wout Ernst Lodewijk; Kunz, Regina
In Switzerland, evaluation of work capacity in individuals with mental disorders has come under criticism. We surveyed stakeholders about their concerns and expectations of the current claim process. We conducted a nationwide online survey among five stakeholder groups. We asked 37 questions addressing the claim process and the evaluation of work capacity, the maximum acceptable disagreement in judgments on work capacity, and its documentation. Response rate among 704 stakeholders (95 plaintiff lawyers, 285 treating psychiatrists, 129 expert psychiatrists evaluating work capacity, 64 social judges, 131 insurers) varied between 71% and 29%. Of the lawyers, 92% were dissatisfied with the current claim process, as were psychiatrists (73%) and experts (64%), whereas the majority of judges (72%) and insurers (81%) were satisfied. Stakeholders agreed in their concerns, such as the lack of a transparent relationship between the experts' findings and their conclusions regarding work capacity, medical evaluations inappropriately addressing legal issues, and the experts' delay in finalising the report. Findings mirror the characteristics that stakeholders consider important for an optimal work capacity evaluation. For a scenario where two experts evaluate the same claimant, stakeholders considered an inter-rater difference of 10%‒20% in work capacity at maximum acceptable. Plaintiff lawyers, treating psychiatrists and experts perceive major problems in work capacity evaluation of psychiatric claims whereas judges and insurers see the process more positively. Efforts to improve the process should include clarifying the basis on which judgments are made, restricting judgments to areas of expertise, and ensuring prompt submission of evaluations.
Jacobson, Miriam R; Azzam, Tarek
This article presents a study of the effects of stakeholder involvement on perceptions of an evaluation's credibility. Crowdsourced members of the public and a group of educational administrators read a description of a hypothetical program and two evaluations of the program: one conducted by a researcher and one conducted by program staff (i.e. program stakeholders). Study participants were randomly assigned versions of the scenario with different levels of stakeholder credibility and types of findings. Results showed that both samples perceived the researcher's evaluation findings to be more credible than the program staff's, but that this difference was significantly reduced when the program staff were described to be highly credible. The article concludes with implications for theory and research on evaluation dissemination and stakeholder involvement. Copyright © 2018 Elsevier Ltd. All rights reserved.
Collins, Sarah A; Rozenblum, Ronen; Leung, Wai Yin; Morrison, Constance Rc; Stade, Diana L; McNally, Kelly; Bourie, Patricia Q; Massaro, Anthony; Bokser, Seth; Dwyer, Cindy; Greysen, Ryan S; Agarwal, Priyanka; Thornton, Kevin; Dalal, Anuj K
To describe current practices and stakeholder perspectives of patient portals in the acute care setting. We aimed to: (1) identify key features, (2) recognize challenges, (3) understand current practices for design, configuration, and use, and (4) propose new directions for investigation and innovation. Mixed methods including surveys, interviews, focus groups, and site visits with stakeholders at leading academic medical centers. Thematic analyses to inform development of an explanatory model and recommendations. Site surveys were administered to 5 institutions. Thirty interviews/focus groups were conducted at 4 site visits that included a total of 84 participants. Ten themes regarding content and functionality, engagement and culture, and access and security were identified, from which an explanatory model of current practices was developed. Key features included clinical data, messaging, glossary, patient education, patient personalization and family engagement tools, and tiered displays. Four actionable recommendations were identified by group consensus. Design, development, and implementation of acute care patient portals should consider: (1) providing a single integrated experience across care settings, (2) humanizing the patient-clinician relationship via personalization tools, (3) providing equitable access, and (4) creating a clear organizational mission and strategy to achieve outcomes of interest. Portals should provide a single integrated experience across the inpatient and ambulatory settings. Core functionality includes tools that facilitate communication, personalize the patient, and deliver education to advance safe, coordinated, and dignified patient-centered care. Our findings can be used to inform a "road map" for future work related to acute care patient portals. © The Author 2016. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: firstname.lastname@example.org
Bhatnagar, Tim; Ben Mortensen, W; Mattie, Johanne; Wolff, Jamie; Parker, Claire; Borisoff, Jaimie
Exoskeleton technology has potential benefits for wheelchair users' health and mobility. However, there are practical barriers to their everyday use as a mobility device. In particular, challenges related to travelling longer distances and transitioning between using a wheelchair and exoskeleton walking may present significant deterrents to regular exoskeleton use. In an effort to remove these barriers, a combined exoskeleton-wheelchair concept ('COMBO') has been proposed, which aims to achieve the benefits of both these mobility technologies. Given the inherent importance of including user-stakeholder opinions when designing an assistive technology solution, a study was undertaken to explore the perspectives of wheelchair users and healthcare professionals on the proposed conceptual design of the COMBO. An online survey with quantitative and qualitative components was conducted with wheelchair users and healthcare professionals working directly with individuals with mobility impairments. Respondents rated whether they would use or recommend a COMBO for four potential reasons. Nine design features were rated and compared in terms of their importance. Content analysis was used to analyze data from an open-ended question regarding additional perceptions about using or recommending a COMBO. A total of 481 survey responses were analyzed, 354 from wheelchair users and 127 from healthcare professionals. Potential health benefits was the most highly rated reason for potential use or recommendation of a COMBO. Of the 9 design features, 2 had a median rating of very important: inclusion of a fall-protection mechanism, and the ability for the operator to use their hands while standing. Qualitative findings indicated that health and physical benefits, use for daily life activities, and psychosocial benefits were important considerations in whether to use or recommend the COMBO. This study captures the opinions and perspectives of two stakeholder groups for an exoskeleton
Full Text Available How can buildings be combined with agricultural production and what are the major potential benefits and challenges for the introduction of zero-acreage farming (ZFarming in Berlin from the relevant stakeholders’ perspectives? These questions were explored through a series of interviews and stakeholder workshops held between 2011 and 2013. The aim was to identify the most suitable building-integrated farming model for the Berlin metropolitan area and to develop guidelines for the model’s successful and sustainable implementation through a stakeholder-driven approach. This paper provides an aggregated synthesis of the outcomes derived from the qualitative interviews and stakeholder workshops. As the results reveal, the stakeholders perceive potential benefits and challenges related to the issue of ZFarming in all dimensions (economic, social, environmental and political. They largely agreed on the importance of focusing on local resources, using energy-efficient production—including social and educational aspects—and developing new market structures when introducing ZFarming to the city of Berlin. The stakeholders identified urban rooftop greenhouses (RTG as the most promising farming model for Berlin. In a joint collaboration of all stakeholders, a manual for RTG was developed within the participatory innovation process that addresses the identified problems and challenges associated with future implementation and governance of RTG in Berlin and beyond.
Luera, Gail Rose
As the field of environmental education has matured since its inception in 1970, so have the number and variety of environmental programs. Along with the increased number of programs has come a need for in-depth program evaluations. This is especially critical because of reductions in educational funding and competition for a place in an already crowded curriculum. Evaluation is essential to convince the educational community that environmental education can improve the curriculum, ensure cost effectiveness, and become more relevant to students. Drawing on program evaluation research, action research, and interpretive (qualitative) research to strengthen the research design and methodology, this dissertation explores how different stakeholders of two environmental education programs determine program effectiveness. Effectiveness was investigated primarily through the use of in-depth interviews of participants, program sponsors, and professionals. Program success at the professional field level was determined by criteria set by the North American Association for Environmental Education. Characteristics considered in the selection of programs for this study included: method of dissemination, sponsor, subject focus, the method of action which they encourage, and their vision for the future. Using the qualitative case study approach, the Orange County Outdoor Science School in California and Project WILD in Michigan were evaluated. The results show that all levels of stakeholders perceived the two programs to be effective. Areas of effectiveness varied with each program and by stakeholder level. Issues facing each program also differed. At the Orange County Outdoor Science School, program cost was named as the major issue. The most often cited issues for Project WILD was public awareness of the program and stabilizing long term financial support for the Michigan program. Interview data were analyzed at the question level in addition to the thematic level. Themes which
Daigneault, Pierre-Marc; Jacob, Steve; Tremblay, Joël
Stakeholder participation is an important trend in the field of program evaluation. Although a few measurement instruments have been proposed, they either have not been empirically validated or do not cover the full content of the concept. This study consists of a first empirical validation of a measurement instrument that fully covers the content of participation, namely the Participatory Evaluation Measurement Instrument (PEMI). It specifically examines (1) the intercoder reliability of scores derived by two research assistants on published evaluation cases; (2) the convergence between the scores of coders and those of key respondents (i.e., authors); and (3) the convergence between the authors' scores on the PEMI and the Evaluation Involvement Scale (EIS). A purposive sample of 40 cases drawn from the evaluation literature was used to assess reliability. One author per case in this sample was then invited to participate in a survey; 25 fully usable questionnaires were received. Stakeholder participation was measured on nominal and ordinal scales. Cohen's κ, the intraclass correlation coefficient, and Spearman's ρ were used to assess reliability and convergence. Reliability results ranged from fair to excellent. Convergence between coders' and authors' scores ranged from poor to good. Scores derived from the PEMI and the EIS were moderately associated. Evidence from this study is strong in the case of intercoder reliability and ranges from weak to strong in the case of convergent validation. Globally, this suggests that the PEMI can produce scores that are both reliable and valid.
Gu, Yulong; Warren, James Roy; Day, Karen Jean
This study aimed to characterize the challenges in using genetic information in health care and to identify opportunities for improvement. Taking a grounded theory approach, semistructured interviews were conducted with 48 participants to collect multiple stakeholder perspectives on genetic services in New Zealand. Three themes emerged from the data: (1) four service delivery models were identified in operation, including both those expected models involving genetic counselors and variations that do not route through the formal genetic service program; (2) multiple barriers to sharing and using genetic information were perceived, including technological, organizational, institutional, legal, ethical, and social issues; and (3) impediments to wider use of genetic testing technology, including variable understanding of genetic test utilities among clinicians and the limited capacity of clinical genetic services. Targeting these problems, information technologies and knowledge management tools have the potential to support key tasks in genetic services delivery, improve knowledge processes, and enhance knowledge networks. Because of the effect of issues in genetic information and knowledge management, the potential of human genetic variation knowledge to enhance health care delivery has been put on a "leash."
Sturges, Keith M.
Drawing on a qualitative study of an educational reform and its external evaluation, I describe how a well-intentioned but poorly conceptualized evaluation helped perpetuate asymmetries in the generation and use of evaluation findings. This article explores this project's failure to clarify evaluator roles, identify intended users and expected…
The purpose of this study is to develop a stakeholder map to describe the most important stakeholders and the process of stakeholder relationships in higher education. According to the perspective of the balanced scorecard, the classification of stakeholders integrates stakeholders into strategic management. Stakeholder maps are essential in…
Ward, Claire Leonie; Shaw, David; Anane-Sarpong, Evelyn; Sankoh, Osman; Tanner, Marcel; Elger, Bernice
This study explores ethical issues raised in providing medical care to participants and communities of low-resource settings involved in a Phase II/III pediatric malaria vaccine trial (PMVT). We conducted 52 key informant interviews with major stakeholders of an international multi-center PMVT (GSK/PATH-MVI RTS,S) (NCT00866619) in Ghana and Tanzania. Based on their stakeholder experiences, the responses fell into three main themes: (a) undue inducement, (b) community disparities, and (c) broad therapeutic misconceptions. The study identified the critical ethical aspects, from the perspectives of stakeholders, of delivering health care during a PMVT. The study showed that integrating research into health care services needs to be addressed in a manner that upholds the favorable risk-benefit ratio of research and attends to the health needs of local populations. The implementation of research should aim to improve local standards of care through building a collaborative agenda with local institutions and systems of health.
Walsh, Kenneth; Bothe, Janine; Edgar, Denise; Beaven, Geraldine; Burgess, Bernadette; Dickson, Vhari; Dunn, Stephen; Horning, Lynda; Jensen, Janice; Kandl, Bronia; Nonu, Miriam; Owen, Fran; Moss, Cheryle
The impetus for this research came from a group of 11 Clinical Nurse Consultants (CNCs) within a health service in NSW, Australia, who wanted to investigate the CNC role from multiple stakeholder perspectives. With support from academic researchers, the CNCs designed and implemented the study. The aim of this research project was to investigate the role of the CNC from the multiple perspectives of CNCs and other stakeholders who work with CNCs in the Health District. This was a co-operative inquiry that utilised qualitative descriptive research approach. Co-operative inquiry methods enabled 11 CNCs to work as co-researchers and to conduct the investigation. The co-researchers implemented a qualitative descriptive design for the research and used interviews (7) and focus groups (16) with CNC stakeholders (n = 103) to gather sufficient data to investigate the role of the CNC in the organisation. Thematic analysis was undertaken to obtain the results. The CNC role is invaluable to all stakeholders and it was seen as the "glue" which holds teams together. Stakeholder expectations of the CNC role were multiple and generally agreed. Five themes derived from the data are reported as "clinical leadership as core", "making a direct difference to patient care", "service development as an outcome", "role breadth or narrowness and boundaries", and "career development". There was clear appreciation of the work that CNCs do in their roles, and the part that the CNC role plays in achieving quality health outcomes. The role of the CNC is complex and the CNCs themselves often negotiate these complexities to ensure beneficial outcomes for the patient and organisation. For the wider audience this study has given further insights into the role of these nurses and the perspectives of those with whom they work.
Mashamba-Thompson, Tivani P; Jama, Ngcwalisa A; Sartorius, Benn; Drain, Paul K; Thompson, Rowan M
Key stakeholders' involvement is crucial to the sustainability of quality point-of-care (POC) diagnostics services in low-and-middle income countries. The aim of this study was to explore key stakeholder perceptions on the implementation of POC diagnostics in rural primary healthcare (PHC) clinics in South Africa. We conducted a qualitative study encompassing in-depth interviews with multiple key stakeholders of POC diagnostic services for rural and resource-limited PHC clinics. Interviews were digitally recorded and transcribed verbatim prior to thematic content analysis. Thematic content analysis was conducted using themes guided by the World Health Organisation (WHO) quality-ASSURED (Affordable, Sensitive, Specific, User friendly, Rapid and to enable treatment at first visit and Robust, Equipment free and Delivered to those who need it) criteria for POC diagnostic services in resource-limited settings. 11 key stakeholders participated in the study. All stakeholders perceived the main advantage of POC diagnostics as enabling access to healthcare for rural patients. Stakeholders perceived the current POC diagnostic services to have an ability to meet patients' needs, but recommended further improvement of the following areas: research on cost-effectiveness; improved quality management systems; development of affordable POC diagnostic and clinic-based monitoring and evaluation. Key stakeholders of POC diagnostics in rural PHC clinics in South Africa highlighted the need to assess affordability and ensure quality assurance of current services before adopting new POC diagnostics and scaling up current POC diagnostics.
Kusters, Koen; Buck, Louise; de Graaf, Maartje; Minang, Peter; van Oosten, Cora; Zagt, Roderick
Integrated landscape initiatives typically aim to strengthen landscape governance by developing and facilitating multi-stakeholder platforms. These are institutional coordination mechanisms that enable discussions, negotiations, and joint planning between stakeholders from various sectors in a given landscape. Multi-stakeholder platforms tend to involve complex processes with diverse actors, whose objectives and focus may be subjected to periodic re-evaluation, revision or reform. In this article we propose a participatory method to aid planning, monitoring, and evaluation of such platforms, and we report on experiences from piloting the method in Ghana and Indonesia. The method is comprised of three components. The first can be used to look ahead, identifying priorities for future multi-stakeholder collaboration in the landscape. It is based on the identification of four aspirations that are common across multi-stakeholder platforms in integrated landscape initiatives. The second can be used to look inward. It focuses on the processes within an existing multi-stakeholder platform in order to identify areas for possible improvement. The third can be used to look back, identifying the main outcomes of an existing platform and comparing them to the original objectives. The three components can be implemented together or separately. They can be used to inform planning and adaptive management of the platform, as well as to demonstrate performance and inform the design of new interventions.
Full Text Available In China, large hydraulic engineering projects have made a great contribution to social economic development; at the same time, they also lead to social risks that affect social stability. The pluralism of stakeholders in large hydraulic engineering projects and the complex interrelationship among stakeholders are the important factors affecting social stability risk. Previous studies of social stability risk have mainly focused on risk identification and risk assessment, without considering the relationships among stakeholders and their linkages of risks. For large hydraulic engineering projects, this paper investigated the relevant risk factors and their interrelationships through a literature review and interviews that represented stakeholder perspectives. The key social stability risk factors were identified based on social network analysis. A multi-channel project financial system, a perfect interest compensation mechanism, an efficient prevention mechanism of group events, and a complete project schedule control system were proposed to mitigate the social stability risks. This study combined stakeholder management with risk management by using social network analysis, providing reference for the social stability risk management of large engineering projects in China.
R. K. Tyagi
Problem statement: The Corporate Social Responsibility concerns got global attention in large scale industries but the SMEs which are no less prone to create critical problems for the human, social and natural environments inimical to the society as a whole and survival at large, have not attracted the required attention. The case focuses on the dynamics of the corporate and stakeholder perspective on CSR in Sports Goods Industry Meerut. Approach: This study examined the corporate and stakeho...
O'Donnell, Alison J; Bogner, Hillary R; Cronholm, Peter F; Kellom, Katherine; Miller-Day, Michelle; McClintock, Heather F de Vries; Kaye, Elise M; Gabbay, Robert
Hypertension is a major modifiable risk factor for cardiovascular and kidney disease, yet the proportion of adults whose hypertension is controlled is low. The patient-centered medical home (PCMH) is a model for care delivery that emphasizes patient-centered and team-based care and focuses on quality and safety. Our goal was to investigate changes in hypertension care under PCMH implementation in a large multipayer PCMH demonstration project that may have led to improvements in hypertension control. The PCMH transformation initiative conducted 118 semistructured interviews at 17 primary care practices in southeastern Pennsylvania between January 2011 and January 2012. Clinicians (n = 47), medical assistants (n = 26), office administrators (n = 12), care managers (n = 11), front office staff (n = 7), patient educators (n = 4), nurses (n = 4), social workers (n = 4), and other administrators (n = 3) participated in interviews. Study personnel used thematic analysis to identify themes related to hypertension care. Clinicians described difficulties in expanding services under PCMH to meet the needs of the growing number of patients with hypertension as well as how perceptions of hypertension control differed from actual performance. Staff and office administrators discussed achieving patient-centered hypertension care through patient education and self-management support with personalized care plans. They indicated that patient report cards were helpful tools. Participants across all groups discussed a team- and systems-based approach to hypertension care. Practices undergoing PCMH transformation may consider stakeholder perspectives about patient-centered, team-based, and systems-based approaches as they work to optimize hypertension care.
Full Text Available Background: Community health workers (CHWs form a vital link between the community and the health department in several countries. In India, since 2005 this role is largely being played by Accredited Social Health Activists (ASHAs, who are village-level female workers. Though ASHAs primarily work for the health department, in a model being tested in Rajasthan they support two government departments. Focusing on the ASHA in this new role as a link worker between two departments, this paper examines factors associated with her work performance from a multi-stakeholder perspective. Design: The study was done in 16 villages from two administrative blocks of Udaipur district in Rajasthan. The findings are based on 63 in-depth interviews with ASHAs, their co-workers and representatives from the two departments. The interviews were conducted using interview guides. An inductive approach with open coding was used for manual data analysis. Results: This study shows that an ASHA's motivation and performance are affected by a variety of factors that emerge from the complex context in which she works. These include various personal (e.g. education, professional (e.g. training, job security, and organisational (e.g. infrastructure factors along with others that emerge from external work environment. The participants suggested various ways to address these challenges. Conclusion: In order to improve the performance of ASHAs, apart from taking corrective actions at the professional and organisational front on a priority basis, it is equally essential to promote cordial work relationships amongst ASHAs and other community-level workers from the two departments. This will also have a positive impact on community health.
Sharma, Reetu; Webster, Premila; Bhattacharyya, Sanghita
Community health workers (CHWs) form a vital link between the community and the health department in several countries. In India, since 2005 this role is largely being played by Accredited Social Health Activists (ASHAs), who are village-level female workers. Though ASHAs primarily work for the health department, in a model being tested in Rajasthan they support two government departments. Focusing on the ASHA in this new role as a link worker between two departments, this paper examines factors associated with her work performance from a multi-stakeholder perspective. The study was done in 16 villages from two administrative blocks of Udaipur district in Rajasthan. The findings are based on 63 in-depth interviews with ASHAs, their co-workers and representatives from the two departments. The interviews were conducted using interview guides. An inductive approach with open coding was used for manual data analysis. This study shows that an ASHA's motivation and performance are affected by a variety of factors that emerge from the complex context in which she works. These include various personal (e.g. education), professional (e.g. training, job security), and organisational (e.g. infrastructure) factors along with others that emerge from external work environment. The participants suggested various ways to address these challenges. In order to improve the performance of ASHAs, apart from taking corrective actions at the professional and organisational front on a priority basis, it is equally essential to promote cordial work relationships amongst ASHAs and other community-level workers from the two departments. This will also have a positive impact on community health.
Baur, V.E.; van Elteren, A.H.G.; Nierse, C.J.; Abma, T.A.
Asymmetric relations among stakeholders create challenges in participatory evaluation processes. Power and conflict may hinder equal and genuine communication about the value of the practices evaluated. Guidelines to deal with these sociopolitical challenges are scarce and usually focus on the need
Walls, J.; Rowe, G.; Frewer, L.J.
There are considerable uncertainties regarding how stakeholder engagement should be enacted. The lack of clear guidelines on good practice is arguably a consequence of an absence of evaluations on the effectiveness of past engagement exercises. Here we describe the evaluation of one engagement event
Gulikers, Judith T. M.; Baartman, Liesbeth K. J.; Biemans, Harm J. A.
Schools are held more responsible for evaluating, quality assuring and improving their student assessments. Teachers' lack of understanding of new, competence-based assessments as well as the lack of key stakeholders' involvement, hamper effective and efficient self-evaluations by teachers of innovative, competence-based assessments (CBAs). While…
Although key stakeholders in blended tertiary environments (BTEs) fulfil an extraordinary role in higher education, significant gaps in knowledge about their identities may be impeding the provision of stakeholder support, limiting their ability to promote effective learning and teaching. As online growth intensifies, it is critical that tertiary…
Anand, N.R.; Van Duin, J.H.R.; Tavasszy, L.A.; Wigan, M.
City logistics is characterized as a distributed decision making system due to its heterogeneous stakeholders and their conflicting objectives. To understand the complexity of interactions among these stakeholders, the first step is taken by developing an ontology for city logistics domain. Ontology
Hunka, Agnieszka; Meli, Mattia; Thit, Amalie
-structured interviews were conducted with stakeholders from regulatory authorities, industry and academia all over Europe. The key informant approach was employed in recruiting our participants. They were first identified as key stakeholders in the field and then sampled by means of a purposive sampling, where each...
Deverka, Patricia A; Lavallee, Danielle C; Desai, Priyanka J; Armstrong, Joanne; Gorman, Mark; Hole-Curry, Leah; O'Leary, James; Ruffner, B W; Watkins, John; Veenstra, David L; Baker, Laurence H; Unger, Joseph M; Ramsey, Scott D
The Center for Comparative Effectiveness Research in Cancer Genomics completed a 2-year stakeholder-guided process for the prioritization of genomic tests for comparative effectiveness research studies. We sought to evaluate the effectiveness of engagement procedures in achieving project goals and to identify opportunities for future improvements. The evaluation included an online questionnaire, one-on-one telephone interviews and facilitated discussion. Responses to the online questionnaire were tabulated for descriptive purposes, while transcripts from key informant interviews were analyzed using a directed content analysis approach. A total of 11 out of 13 stakeholders completed both the online questionnaire and interview process, while nine participated in the facilitated discussion. Eighty-nine percent of questionnaire items received overall ratings of agree or strongly agree; 11% of responses were rated as neutral with the exception of a single rating of disagreement with an item regarding the clarity of how stakeholder input was incorporated into project decisions. Recommendations for future improvement included developing standard recruitment practices, role descriptions and processes for improved communication with clinical and comparative effectiveness research investigators. Evaluation of the stakeholder engagement process provided constructive feedback for future improvements and should be routinely conducted to ensure maximal effectiveness of stakeholder involvement.
Svendsen, A. [CoreRelation Consulting Inc., Delta, BC (Canada)]|[Simon Fraser Univ., Burnaby, BC (Canada); Laberge, M. [Simon Fraser Univ., Burnaby, BC (Canada)
Management philosophies concerning stakeholder engagement were reviewed. This presentation provided guidelines for managers working from a sustainability value creation framework who wish to develop more effective ways to engage with stakeholders and high stakes issues that cross political, social and organizational boundaries. It was suggested that conflicts over resources, the demand for participation and the increasing power of Non-Governmental Organizations have all contributed to the increased need for stakeholder engagement. A review of different types of stakeholders was provided. Earlier strategies of managing stakeholders were examined, in which externalities such as environmental cost were not accounted for. By contrast, the emerging management philosophy presented here stressed a recognition that long term survival relied on the good health of external and internal environments. Core business strategies were discussed with reference to core values. It was suggested that a longer term focus, inclusiveness, and integration were beneficial to businesses as a whole. A case study of Clayoquot Sound was presented. The concept of social capital was examined. Individual and collective learning were evaluated. A model for engaging stakeholder networks was presented as well as a step by step procedural guide, which included the creation of a solid foundation; organizational alignment; strategy; the importance of asking questions; trust building; evaluation; and renewal. Challenges to stakeholder engagement included finding resources; ensuring consistency; patience; a tendency in business to measure success in short term payoffs; and maintaining a stakeholder perspective. It was concluded that the benefits of a sustainability value creation framework for businesses far outweighed any initial disadvantages. refs., tabs., figs.
Tivani P. Mashamba-Thompson
Full Text Available Introduction: Key stakeholders’ involvement is crucial to the sustainability of quality point-of-care (POC diagnostics services in low-and-middle income countries. The aim of this study was to explore key stakeholder perceptions on the implementation of POC diagnostics in rural primary healthcare (PHC clinics in South Africa. Method: We conducted a qualitative study encompassing in-depth interviews with multiple key stakeholders of POC diagnostic services for rural and resource-limited PHC clinics. Interviews were digitally recorded and transcribed verbatim prior to thematic content analysis. Thematic content analysis was conducted using themes guided by the World Health Organisation (WHO quality-ASSURED (Affordable, Sensitive, Specific, User friendly, Rapid and to enable treatment at first visit and Robust, Equipment free and Delivered to those who need it criteria for POC diagnostic services in resource-limited settings. Results: 11 key stakeholders participated in the study. All stakeholders perceived the main advantage of POC diagnostics as enabling access to healthcare for rural patients. Stakeholders perceived the current POC diagnostic services to have an ability to meet patients’ needs, but recommended further improvement of the following areas: research on cost-effectiveness; improved quality management systems; development of affordable POC diagnostic and clinic-based monitoring and evaluation. Conclusions: Key stakeholders of POC diagnostics in rural PHC clinics in South Africa highlighted the need to assess affordability and ensure quality assurance of current services before adopting new POC diagnostics and scaling up current POC diagnostics.
Peterson, T.S.; McCabe, G.; Niesen, K.; Serie, P.
Technology is urgently needed to clean up contamination by volatile organic compounds at United States Department of Energy (DOE) sites. In many cases, however, existing technology is too slow, inefficient, or expensive. The record of technology development is, in some cases, similarly disappointing. Remediation technologies developed at great expense and evaluated piecemeal over long periods have not been deployed because, in the end, the public judged them ineffective or unacceptable. The need for successful methods of remediation is too great and resources too limited to continue with ineffective technology evaluation. In order to make good decisions about which technologies to deploy, remedial project managers need to know stakeholders' requirements for the performance of proposed technologies. Expanding stakeholder involvement regionally identifies the concerns of a broad range of stakeholders at and DOE sites throughout the West -- issues that must be taken into account if technologies are to be accepted for wide deployment
Markhorst, Joekie; Martirosyan, Liana; Calsbeek, Hiske; Braspenning, Jozé
Transparency in diabetes care requires quality indicators that are of interest to stakeholders in order to optimise their usage. Indicator development is often focused on consensus, and little is known about stakeholders' preferences for information on quality. To explore the preferences of consumers, providers, purchasers and policy makers for different quality domains and indicators in relation to the intended use of quality indicators. Between June and December 2009, 14 semi-structured interviews were held with stakeholders who have a decisive vote in the selection of the national indicator set for diabetes care in the Netherlands. The following subjects were explored: (1) the aims of using information on quality; (2) the interpretation of and preferences for the quality domains of safety, timeliness, effectiveness and patient-centredness in relation to the user aims; and (3) the preferences for structure, process or outcome indicators. Content analysis was used to analyse qualitative data. Stakeholders had similar and different aims according to their roles. The interpretations of quality domains varied greatly between the stakeholders. Besides differences in interpretation, their preferences were similar. Most stakeholders prioritised patient-centredness above the other domains of quality, ranked in order of priority as safety, effectiveness and timeliness, whereas purchasers also prioritised efficiency. All stakeholders preferred to use process indicators or a mix of process and outcome indicators. The preferences of the stakeholders for quality indicators seem to be neither well-refined nor congruent. The implementation of an indicator set can probably be improved if the stakeholders' definitions and preferences for quality domains become more explicit during the selection process for indicators.
Laar, Amos; Kotoh, Agnes; Parker, Megan; Milani, Peiman; Tawiah, Charlotte; Soor, Shobhita; Anankware, Jacob P; Kalra, Nikhila; Manu, Grace; Tandoh, Akua; Zobrist, Stephanie; Engmann, Cyril; Pelto, Gretel
Meeting the nutritive needs of infants and young children is a challenge in Ghana. Alternative animal source foods, including insects, could enhance infant and young child dietary quality while also improving livelihoods. To investigate the perspectives of Ghanaian stakeholders on the acceptability of the palm weevil larvae ( akokono) as a food source and the feasibility of micro-farming this local edible insect as a complementary food for infants and young children. We conducted an ethnographic study in the Brong-Ahafo Region of Ghana. First, 48 caregivers were asked questions about feeding and care practices, including attitudes toward production and consumption of akokono. Then, a selection of previously interviewed respondents joined 1 of 8 focus group discussions to provide further insight on key themes that emerged from earlier interviews. Concurrently, interviews with 25 other key local stakeholders were conducted. Respondents generally had favorable perceptions of akokono as a nutritious food. A small minority would not consume akokono for religious reasons. Key factors positively influencing the acceptability of akokono as a complementary food were familiarity with the consumption of akokono by the primary caregiver and health worker endorsement of akokono. Stakeholders consider the larvae farmable and were open to its domestication. Anticipated barriers to scaling up akokono micro-farming include a need for greater familiarity with and acceptance of the insect as food for infants and young children and creation of a sustainable market. Engagement with stakeholders, including health workers, will facilitate use of akokono as a complementary food.
Kooskora, Mari, 1969-
Äriühingute valitsemise kontseptsioon ja teoreetiline taust; Eesti omanike ja tippjuhtide ootused suhetes erinevate huvigruppidega ning äriühingute valitsemine huvigruppide teooriast lähtudes. Skeem: The stakeholder model. Tabelid: Contractual and community stakeholders; Overview of how perceptions of the main stakeholder groups among Estonian business leaders between 1995-2004 have changed
Taghva, Arsia; Farsi, Zahra; Javanmard, Yavar; Atashi, Afsaneh; Hajebi, Ahmad; Noorbala, Ahmad Ali
Stigma affects all aspects of mental disorders, and is the most important risk factor for promoting mental health. The aim of this study was to explore strategies effective in reducing the stigma toward people with mental disorders in Iran. This qualitative study was conducted from 2013 to 2016. All participants were recruited by purposive sampling method. The majority of them were stakeholders of mental health in Iran. Data were collected through eight individual interviews, two focus groups, and six written narratives. The data were collected, coded and analyzed simultaneously. Content analysis was employed to analyze the qualitative interview data. The major themes that emerged were: "Emphasis on education and changing attitudes", "Changing the culture", "Promoting supportive services", "Role of various organizations and institutions", "Integrated reform of structures and policies to improve the performance of custodians", and "Evidence-based actions". This study did not investigate the extent of stigma or its origins, rather it examines strategies appropriate for implementation in Iran. Additional studies are needed to evaluate the effectiveness of strategies for reducing the stigma attached to patients with mental disorders.
Byron, Gerard; Ziedonis, Douglas M; McGrath, Caroline; Frazier, Jean A; deTorrijos, Fernando; Fulwiler, Carl
Occupational stress and burnout adversely impacts mental health care staff well-being and patient outcomes. Mindfulness training reduces staff stress and may improve patient care. However, few studies explore mental health setting implementation. This qualitative study used focus groups to evaluate stakeholders' perceptions of organizational factors affecting implementation of an adapted version of Mindfulness-Based Stress Reduction (MBSR) for staff on adolescent mental health units. Common facilitators included leadership securing buy-in with staff, allocating staff time to participate, and quiet space for training and practice. Other facilitators were past staff knowledge of mindfulness, local champions, and acculturating staff with mindfulness through a non-mandatory training attendance policy. Common barriers were limited staff time to attend training sessions and insufficient training coverage for some staff. Staff also reported improved focus when interacting with adolescents and improved social cohesion on the units. We conclude that a mindfulness-based program for reducing occupational stress can be successfully implemented on adolescent mental health units. Implementation appeared to change the social context of the units, including staff and patient interactions. More broadly, our findings highlight the importance of environmental factors in shaping attitudes, diffusion of innovation, and acculturation of wellness program implementations.
Nabyonga Orem, Juliet; Marchal, Bruno; Mafigiri, DavidKaawa; Ssengooba, Freddie; Macq, Jean; Da Silveira, Valeria Campos; Criel, Bart
Stakeholder roles in the application of evidence are influenced by context, the nature of the evidence, the policy development process, and stakeholder interactions. Past research has highlighted the role of stakeholders in knowledge translation (KT) without paying adequate attention to the peculiarities of low-income countries. Here we identify the roles, relations, and interactions among the key stakeholders involved in KT in Uganda and the challenges that they face. This study employed qualitative approaches to examine the roles of and links among various stakeholders in KT. In-depth interviews were conducted with 21 key informants and focused on the key actors in KT, their perceived roles, and challenges. Major stakeholders included civil society organizations with perceived roles of advocacy, community mobilization, and implementation. These stakeholders may ignore unconvincing evidence. The community's role was perceived as advocacy and participation in setting research priorities. The key role of the media was perceived as knowledge dissemination, but respondents noted that the media may misrepresent evidence if it is received in a poorly packaged form. The perceived roles of policy makers were evidence uptake, establishing platforms for KT and stewardship; negative roles included ignoring or even misrepresenting evidence that is not in their favor. The roles of parliamentarians were perceived as advocacy and community mobilization, but they were noted to pursue objectives that may not be supported by the evidence. The researchers' main role was defined as evidence generation, but focusing disproportionately on academic interests was cited as a concern. The donors' main role was defined as funding research and KT, but respondents were concerned about the local relevance of donor-supported research. Respondents reported that links among stakeholders were weak due to the absence of institutionalized, inclusive platforms. Challenges facing the stakeholders in
Hua-Hung (Robin) Weng; Ja-Shen Chen; Pei-Ching Chen
“Going green” has become an important environmental issue in contemporary business practice worldwide. This study examined the influence of a number of factors on green innovation and the consequences in terms of performance. The stakeholder theory was adopted to observe the effects of each stakeholder on the green innovation practices of companies and to determine how green innovation practices influence environmental and business performance. A research model with eight hypotheses was propo...
Fischer, Sara Elisa; Strandberg-Larsen, Martin
Global health policy is created largely through a collaborative process between development agencies and aid-recipient governments, yet it remains unclear whether governments retain ownership over the creation of policy in their own countries. An assessment of the power structure in this relationship and its influence over agenda-setting is thus the first step towards understanding where progress is still needed in policy-making for development. This study employed qualitative policy analysis methodology to examine how health-related policy agendas are adopted in low-income countries, using Tanzania as a case study. Semi-structured, in-depth, key informant interviews with 11 policy-makers were conducted on perspectives of the agenda-setting process and its actors. Kingdon's stream theory was chosen as the lens through which to interpret the data analysis. This study demonstrates that while stakeholders each have ways of influencing the process, the power to do so can be assessed based on three major factors: financial incentives, technical expertise, and influential position. Since donors often have two or all of these elements simultaneously a natural power imbalance ensues, whereby donor interests tend to prevail over recipient government limitations in prioritization of agendas. One way to mediate these imbalances seems to be the initiation of meaningful policy dialogue. In Tanzania, the agenda-setting process operates within a complex network of factors that interact until a "policy window" opens and a decision is made. Power in this process often lies not with the Tanzanian government but with the donors, and the contrast between latent presence and deliberate use of this power seems to be based on the donor ideology behind giving aid (defined here by funding modality). Donors who used pooled funding (PF) modalities were less likely to exploit their inherent power, whereas those who preferred to maintain maximum control over the aid they provided (ie, non
Middleton, G; Keegan, R; Henderson, H
Food for Fitness is an on-going multi-component health promotion programme, delivered in primary and secondary schools by community nutrition assistants. The programme uses nutritional interventions aimed at promoting healthier eating practices for children. This service evaluation investigated the receipt and delivery of the programme, as perceived by local stakeholders who had experienced and administered the service. Semi-structured interviews and focus groups were carried out with three key stakeholder groups: health professionals (n = 9), school teachers (n = 10) and senior health officials (n = 3). Qualitative data were transcribed verbatim and received thematic analysis with deductive and inductive processes. Stakeholders reported that the programme contributed to the development of food education and healthy-eating practices of children in the local area. Stakeholders considered that the main concern was the limited capacity and size of the service. They described problems with long-term sustainability in supporting schools with maintaining nutritional interventions, highlighting issues regarding contact, planning and organisation of several interventions. The findings of the service evaluation inform service management, organisation and ground-level delivery. The use of stakeholder opinion provided contextualised information on the factors that impact on the implementation of the programme. The richness of the qualitative results can guide future planning and provision for similar health promotion nutrition programmes delivered in the school environment. © 2012 The Authors. Journal of Human Nutrition and Dietetics © 2012 The British Dietetic Association Ltd.
Camden, Chantal; Shikako-Thomas, Keiko; Nguyen, Tram; Graham, Emma; Thomas, Aliki; Sprung, Jennifer; Morris, Christopher; Russell, Dianne J
To describe how stakeholder engagement has been undertaken and evaluated in rehabilitation research. A scoping review of the scientific literature using five search strategies. Quantitative and qualitative analyses using extracted data. Interpretation of results was iteratively discussed within the team, which included a parent stakeholder. Searches identified 101 candidate papers; 28 were read in full to assess eligibility and 19 were included in the review. People with disabilities and their families were more frequently involved compared to other stakeholders. Stakeholders were often involved in planning and evaluating service delivery. A key issue was identifying stakeholders; strategies used to support their involvement included creating committees, organizing meetings, clarifying roles and offering training. Communication, power sharing and resources influenced how stakeholders could be engaged in the research. Perceived outcomes of stakeholder engagement included the creation of partnerships, facilitating the research process and the application of the results, and empowering stakeholders. Stakeholder engagement outcomes were rarely formally evaluated. There is a great interest in rehabilitation to engage stakeholders in the research process. However, further evidence is needed to identify effective strategies for meaningful stakeholder engagement that leads to more useful research that positively impacts practice. Implications for Rehabilitation Using several strategies to engage various stakeholders throughout the research process is thought to increase the quality of the research and the rehabilitation process by developing proposals and programs responding better to their needs. Engagement strategies need to be better reported and evaluated in the literature. Engagement facilitate uptake of research findings by increasing stakeholders' awareness of the evidence, the resources available and their own ability to act upon a situation. Factors influencing
Nguyen, Thi Dieu Phuong; Lund, Søren; Banta, Gary Thomas
The present report on stakeholder evaluation of highland aquatic resources provides an overview of completed research activities undertaken within the HighARCS project on the value ascribed by users, local communities and stakeholders to functions, goods and services (including non-use values......) derived from the aquatic resources in the Northern and Central of Vietnam. The perceived impact of factors such as environmental degradation, changing demand for goods and services and modified highland aquatic resources management practices on these values has also been assessed....
Cornachione, Edgard B., Jr.; Trombetta, Maria R.; Casa Nova, Silvia P. C.
To what extent does the intense and direct involvement of internal stakeholders, such as program managers and staff members, play a significant role toward evaluation use? Stakeholder involvement is a key element in evaluation and evaluation use is considered within a broader sense that includes organizational knowledge, individual skills, and…
Jones, Jen; Nix, Nancy A; Snyder, Elizabeth Hodges
Health impact assessment (HIA) is a process used to inform planning and decision making in a range of sectors by identifying potential positive and negative health effects of proposed projects, programs, or policies. Stakeholder engagement is an integral component of HIA and requires careful consideration of participant diversity and appropriate methodologies. Ensuring that the engagement process is able to capture and address Indigenous worldviews and definitions of health is important where Indigenous populations are impacted, particularly in northern regions experiencing increases in natural resource development activities on Indigenous lands. Investigate local participant perspectives of an HIA of a proposed Alaska coal mine, with a focus on the ability of the HIA process to capture, reflect, and address health concerns communicated by Alaska Native participants. A qualitative approach guided by semi-structured interviews with purposeful sampling to select key informants who participated in the coal mine HIA stakeholder engagement process. QUALITATIVE DATA IDENTIFIED THREE KEY THEMES AS IMPORTANT FROM THE PERSPECTIVE OF ALASKA NATIVE PARTICIPANTS IN THE ALASKA COAL MINE HIA STAKEHOLDER ENGAGEMENT PROCESS: (i) the inability of the engagement process to recognize an Indigenous way of sharing or gathering information; (ii) the lack of recognizing traditional knowledge and its use for identifying health impacts and status; and (iii) the inability of the engagement process to register the relationship Indigenous people have with the environment in which they live. Issues of trust in the HIA process and of the HIA findings were expressed within each theme. Recommendations derived from the research identify the need to acknowledge and incorporate the history of colonialism and assimilation policies in an HIA when assessing health impacts of resource development on or near Indigenous lands. These historical contexts must be included in baseline conditions to understand
Full Text Available In recent years, we have witnessed how companies and institutions have devoted significant effort to developing Corporate Social Responsibility (CSR policies, basing their decision on the improvement in company results and the subsequent benefits for shareholders and other stakeholders. CSR means that managers must go beyond the mere satisfaction of the shareholders and take steps to establish balanced relations with all their stakeholders. The principles behind the CSR approach empower stakeholder governance. To test whether CSR policy constitutes a factor in value creation for shareholders and certain stakeholders such as employees, creditors and the State, we conducted an explanatory study, using a Correlated Random Effects approach, which compares the socially responsible companies included in the Spanish sustainability index, FTSE4Good Ibex, with the companies listed on the other indices of the IBEX family. On the one hand, the data show that sustainability reporting is well established in large companies in Spain but that it needs to be introduced more extensively in small and medium-sized enterprises. On the other hand, the findings point out that CSR has a positive and significant influence on the distribution of value in favor of the State, a negative influence for employees and no influence on other stakeholders.
Essack, Zaynab; Koen, Jennifer; Barsdorf, Nicola; Slack, Catherine; Quayle, Michael; Milford, Cedilia; Lindegger, Graham; Ranchod, Chitra; Mukuka, Richard
There is little published literature on the ethical concerns of stakeholders in HIV vaccine trials. This study explored the ethical challenges identified by various stakeholders, through an open-ended, in-depth approach. While the few previous studies have been largely quantitative, respondents in this study had the opportunity to spontaneously identify the issues that they perceived to be of priority concern in the South African context. Stakeholders spontaneously identified the following as ethical priorities: informed consent, social harms, collaborative relationships between research stakeholders, the participation of children and adolescents, access to treatment for participants who become infected with HIV, physical harms, fair participant and community selection, confidentiality, benefits, and payment. While there is some speculation that research in developing countries poses special ethical challenges, overall no issues were identified that have not been anticipated in international guidance, literature and popular frameworks. However, the South African context affords a distinctive gloss to these expected issues; for example, respondents were concerned that the predominant selection of black participants may perpetuate racist practices of apartheid. Stakeholders should be aware of contextual factors impacting on the implementation of ethical principles. We make a series of recommendations for South African trials, including amendments to the ethical-legal framework and research policies, and, for further research.
Full Text Available The study aims at exploring the needs of a broad group of stakeholders of Malaysian public universities with respect to information items that should be disclosed in the university annual report, and their views on the disclosure importance of the items. This is a preliminary study towards the effort to develop an accountability reporting framework for Malaysian public universities. A questionnaire survey on the universities‟ stakeholders representing each stakeholder group which include policy makers, students, parents, employers, the public, university management and employees, suppliers and oversight entities was carried out in order to identify and confirm the stakeholders‟ disclosure needs. It is expected that the needs of the stakeholders in terms of information to be reported are comprehensive which include financial and non-financial information; and there are differences in the views on the disclosure importance of information among the stakeholder groups. The findings of this study provide a clear understanding of the information that should be disclosed in the annual reports of Malaysian public universities for accountability purpose. The findings may potentially assist the public universities to improve the way they discharge their public accountability through annual reporting.
Lee, Lisa; Cresswell, Kathrin; Slee, Ann; Slight, Sarah P; Coleman, Jamie; Sheikh, Aziz
To evaluate how an online toolkit may support ePrescribing deployments in National Health Service hospitals, by assessing the type of knowledge-based resources currently sought by key stakeholders. Questionnaire-based survey of attendees at a national ePrescribing symposium. 2013 National ePrescribing Symposium in London, UK. Eighty-four delegates were eligible for inclusion in the survey, of whom 70 completed and returned the questionnaire. Estimate of the usefulness and type of content to be included in an ePrescribing toolkit. Interest in a toolkit designed to support the implementation and use of ePrescribing systems was high (n = 64; 91.4%). As could be expected given the current dearth of such a resource, few respondents (n = 2; 2.9%) had access or used an ePrescribing toolkit at the time of the survey. Anticipated users for the toolkit included implementation (n = 62; 88.6%) and information technology (n = 61; 87.1%) teams, pharmacists (n = 61; 87.1%), doctors (n = 58; 82.9%) and nurses (n = 56; 80.0%). Summary guidance for every stage of the implementation (n = 48; 68.6%), planning and monitoring tools (n = 47; 67.1%) and case studies of hospitals' experiences (n = 45; 64.3%) were considered the most useful types of content. There is a clear need for reliable and up-to-date knowledge to support ePrescribing system deployments and longer term use. The findings highlight how a toolkit may become a useful instrument for the management of knowledge in the field, not least by allowing the exchange of ideas and shared learning.
Corcoran, Mark; Byrne, Michael
Primary care psychology services (PCPS) represent an important resource in meeting the various health needs of our communities. This study evaluated the PCPS in a two-county area within the Republic of Ireland. The objectives were to (i) examine the viewpoints of the service for both psychologists and stakeholders (healthcare professionals only) and (ii) examine the enactment of the stepped care model of service provision. Separate surveys were sent to primary care psychologists (n = 8), general practitioners (GPs; n = 69) and other stakeholders in the two counties. GPs and stakeholders were required to rate the current PCPS. The GP survey specifically examined referrals to the PCPS and service configuration, while the stakeholder survey also requested suggestions for future service provision. Psychologists were required to provide information regarding their workload, time spent on certain tasks and productivity ideas. Referral numbers, waiting lists and waiting times were also obtained. All 8 psychologists, 23 GPs (33% response rate) and 37 stakeholders (unknown response rate) responded. GPs and stakeholders reported access to the PCPS as a primary concern, with waiting times of up to 80 weeks in some areas. Service provision to children and adults was uneven between counties. A stepped care model of service provision was not observed. Access can be improved by further implementation of a stepped care service, developing a high-throughput service for adults (based on a stepped care model), and employing a single waiting list for each county to ensure equal access. © 2016 John Wiley & Sons Ltd.
Jain, Varsha; Roy, Subhadip; Damle, Neha; Jagani, Khyati
Nutraceuticals, a combination of nutrition and pharmaceutical, have grown rapidly as a product globally. Nutraceuticals can be advertised directly to consumers as well as prescribed, and thus involve multiple stakeholders in the marketing communication process. The present study investigates the marketing communication aspects of nutraceuticals using 216 semistructured in-depth interviews including all stakeholders in the process such as company/brand, physicians, pharmacists, and consumers. The findings bring out the role of each participant in the communication process and a comprehensive picture of the same. The insights would facilitate the nutraceutical brands to understand and implement marketing effective communication strategies.
Full Text Available In China, dockless bike-sharing programs (DBSPs play a significant role in promoting the goals of sustainable urban travel and carbon emissions reduction. However, the sustainability of DBSPs is increasingly being challenged as various issues associated with different stakeholders emerge. While numerous studies have focused on the barriers to traditional bike-sharing programs, the sustainability performance of new-generation DBSPs is largely overlooked. It is accordingly imperative to understand the primary challenges that impede the sustainability of DBSPs and to consider what stimulative measures can be taken. In this study, we investigate the factors that are critical to DBSPs’ sustainability from a network perspective. Stakeholder-associated factors and their interrelations were identified via literature analysis and interviews, and the social network analysis (SNA method was employed to recognize the critical factors and links in DBSPs. As a result, 10 critical factors and 10 major interactions were identified and further classified into six challenges. Sharing transport schemes, legislative perfection, public private partnership (PPP, and product lifecycle management (PLM were proposed to govern these challenges. This paper contributes to the existing body of knowledge of bike-sharing programs via a network approach that integrates the key influencing factors with those factors’ associated stakeholders. Furthermore, these findings provide the government and operators with implications for mitigating the tough challenges and facilitating the sustainability of DBSPs.
Boonstra, Albert; van Offenbeek, Marjolein; Vos, Janita F.J.
This article analyzes the tensions evolving from project management dilemmas and how they relate to stakeholders in large technology projects. The study addresses an organization-wide electronic health record implementation in a large hospital. It adopts a duality lens in exploring whether and how
Kaminskiene, Lina; Rutkiene, Aušra
The article discusses the practice of internships in Lithuanian higher education in the context of changes and challenges to educational reforms, particularly in the enhancement of relations with the labour market and related stakeholders. Higher education institutions are grappling with the changing conception, and duration, of the internship.…
Frantál, Bohumil; Kunc, Josef; Klusáček, Petr; Martinát, Stanislav
44E, 44E (2015), s. 91-107 ISSN 2247-8310 R&D Projects: GA TA ČR(CZ) TD020259 Institutional support: RVO:68145535 Keywords : brownfields * success factors * stakeholders perception Subject RIV: DE - Earth Magnetism, Geodesy, Geography http://rtsa.ro/tras/index.php/tras/article/view/427/417
Joosen, M.C.W.; Arends, I.; Lugtenberg, M.; van Gestel, J.A.W.M.; Schaapveld, B.C.T.M.; Terluin, B.; van Weeghel, J.; van der Klink, J.J.L.; Brouwers, E.P.M.
Background: Common mental disorders (CMDs) are among the leading causes of disability worldwide and are a pressing issue for society. CMDs are the most prevalent causes of sickness absence and different stakeholders are involved in facilitating return to work. In this qualitative study, the
Sharma, Umesh; Loreman, Tim; Simi, Janine
This paper reports perceived barriers and facilitators of disability-inclusive education, and outcomes of an effective system of inclusive education in the Solomon Islands. Data were gathered from a variety of stakeholder group participants (n = 10) and individual key informants (n = 2), ranging from parents of children with disabilities to…
Wilkins, Stephen; Huisman, Jeroen
The purpose of this article is to identify and discuss the possible uses of higher education journal rankings, and the associated advantages and disadvantages of using them. The research involved 40 individuals--lecturers, university managers, journal editors and publishers--who represented a range of stakeholders involved with research into…
Maiwald, Karin; de Rijk, Angelique; Guzman, Jaime; Schonstein, Eva; Yassi, Annalee
INTRODUCTION Workplace disability prevention is important, but stakeholders can differ in their appreciation of such interventions. We present a responsive evaluation of a workplace disability prevention intervention in a Canadian healthcare organization. Three groups of stakeholders were included: designers of the intervention, deliverers, and workers. The aim was to examine the appreciation of this intervention by analyzing the discrepancies with respect to what these various stakeholders see as the causes of work disability, what the intervention should aim at to address this problem, and to what extent the intervention works in practice. METHODS A qualitative research method was used, including data-triangulation: (a) documentary materials; (b) semi-structured interviews with the deliverers and workers (n = 14); (c) participatory observations of group meetings (n = 6); (d) member-checking meetings (n = 3); (e) focus-group meetings (n = 2). A grounded theory approach, including some ethnographic methodology, was used for the data-analysis. RESULTS Stakeholders' perceptions of causes for work disability differ, as do preferred strategies for prevention. Designers proposed work-directed measures to change the workplace and work organizations, and individual-directed measures to change workers' behaviour. Deliverers targeted individual-directed measures, however, workers were mostly seeking work-directed measures. To assess how the intervention was working, designers sought a wide range of outcome measures. Deliverers focused on measurable outcomes targeted at reducing work time-loss. Workers perceived that this intervention offered short-term benefits yet fell short in ensuring sustainable return-to-work. CONCLUSION This study provides understanding of where discrepancies between stakeholders' perceptions about interventions come from. Our findings have implications for workplace disability prevention intervention development, implementation and evaluation
Carr, Gemma; Bloeschl, Guenter; Loucks, Daniel Pete
Evaluation of participation programmes, projects and activities is essential to identify whether stakeholder involvement has been successful in achieving its aims. Aims may include an improvement in water resource management such as enhanced ecological functioning, an improvement in human wellbeing and economic conditions, or overcoming a conflict between interest groups. Evaluating against "interest-based" resource management criteria requires that a desirable outcome can be identified, agreed upon and be measured at the time of evaluation. In many water management situations where collaborative approaches are applied, multiple interests and objectives are present, or stakeholders have not yet identified their own positions and priorities. Even if a resource management objective has been identified and strategy agreed upon, resource management changes tend to emerge over longer timescales and evaluation frequently takes place before they can be recognised. Evaluating against resource management criteria may lead evaluators to conclude that a programme has failed because it has not achieved a resource management objective at the time of evaluation. This presents a critical challenge to researchers assessing the effectiveness of stakeholder participation programmes. One strategy to overcome this is to conduct "goal-free" evaluation to identify what the programme is actually achieving. An evaluation framework that includes intermediary outcomes that are both tangible achievements such as innovation, creation of new organisations, and shared information and knowledge, as well as intangible achievements such as trust and network development can be applied to more broadly assess a programme's success. Analysis of case-studies in the published literature for which a resource management outcome has been achieved shows that intermediary outcomes frequently precede resource management outcomes. They seem to emerge over shorter timescales than resource management outcomes
The topical session discussed the following questions: - How to decide which of the various dialogue tools fits a waste management process, decision phase, and desired outcomes? - How to evaluate whether the dialogue process has been successful or not? - What can be expected, what should practitioners watch out for when applying some of the more commonly-used tools? This report summarises the responses given to the above questions by session contributors, and compares them with some general findings in public participation research. It was argued by most that although public participation will not guarantee an automatic success of the waste management programme, without it decision makers likely will be heading for tremendous difficulties. The public will not be contented by information only, but demands to be involved in the decision making process. Very strong motivation is needed to participate in a complex deliberation process that includes learning about or analysing a wide range of technical and non-technical issues, as well as gradually working out solutions or plans that are acceptable to all parties. Accomplishing such participation is an even more significant effort when it is a 'spare time', unpaid occupation. Under these conditions, the persons who attend all consultation meetings tend to be the ones who feel strongly against the project and who may not be open to the type of dialogue that decision makers would like to engage with them. As in other risk management and political situations, it is the very definition of 'what is at risk', and 'what should be done about it' that is brought to the fore. All these facts were recognised as significant challenges to the participation process. According to session participants, however, there are no alternatives or shortcuts to public involvement as a tool to make the decision making process in RWM transparent and acceptable. Most agreed that efforts should be allocated to using
Staunton, Ciara; Tindana, Paulina; Hendricks, Melany; Moodley, Keymanthri
Genomic biobanking research is undergoing exponential growth in Africa raising a host of legal, ethical and social issues. Given the scientific complexity associated with genomics, there is a growing recognition globally of the importance of science translation and community engagement (CE) for this type of research, as it creates the potential to build relationships, increase trust, improve consent processes and empower local communities. Despite this level of recognition, there is a lack of empirical evidence of the practise and processes for effective CE in genomic biobanking in Africa. To begin to address this vacuum, 17 in-depth face to face interviews were conducted with South African experts in genomic biobanking research and CE to provide insight into the process, benefits and challenges of CE in South Africa. Emerging themes were analysed using a contextualised thematic approach. Several themes emerged concerning the conduct of CE in genomic biobanking research in Africa. Although the literature tends to focus on the local community in CE, respondents in this study described three different layers of stakeholder engagement: community level, peer level and high level. Community level engagement includes potential participants, community advisory boards (CAB) and field workers; peer level engagement includes researchers, biobankers and scientists, while high level engagement includes government officials, funders and policy makers. Although education of each stakeholder layer is important, education of the community layer can be most challenging, due to the complexity of the research and educational levels of stakeholders in this layer. CE is time-consuming and often requires an interdisciplinary research team approach. However careful planning of the engagement strategy, including an understanding of the differing layers of stakeholder engagement, and the specific educational needs at each layer, can help in the development of a relationship based on trust
Battelle has conducted a three-year effort, funded by the U. S Department of Energy's (DOE) Office of Technology Development, to involve stakeholders in evaluating innovative technologies to clean up volatile organic compound (VOC) contamination at arid sites. Stakeholders have been encouraged to participate in the demonstration of these innovative technologies in order to improve decisions made by DOE and its contractors about technology development, demonstration, and deployment. The basic approach is to identify people and organizations with a stake in the remediation process, and hence in the demonstration of innovative technologies. Stakeholders have included public interest group and environmental group representatives, regulators, technology users, Native Americans, Hispanic community members, and local elected officials. These people are invited to be involved and they are presented with substantive information about the technologies. Their input in terms of identifying issues and concerns, defining the kinds of information needed from the demonstrations, and assessing the acceptability of the technologies for deployment, will help ensure that only broadly promising technologies are carried forward. This approach is designed to increase the likelihood of successful deployment of the new technologies needed to accomplish environmental restoration throughout the DOE complex and at private facilities. The hypothesis in conducting this regional stakeholder involvement program is that there will be different data requirements for different sites due to geographical, institutional, programmatic, and cultural differences at the sites. Identifying the broadest set of data requirements, collecting this information during the technology demonstration, and providing the results of the demonstration to stakeholders will enhance the acceptance of the technology at these sites and, thereby, enhance the technology's deployability
...) to evaluate the personal property pilot programs as part of Management Reform Memorandum # 6. This thesis evaluates the policy alternatives for reengineering the DOD personal property program using a stakeholder approach...
Full Text Available In the early 90s, the Cameroon Ministry of Health implemented a National Health Information System (NHIS based on a bottom- up approach of manually collecting and reporting health data. Little is known about the implementation and functioning of the NHIS. The purpose of this study was to assess the implementation of the NHIS by documenting experiences of individual stakeholders, and to suggest recommendations for improvement. We reviewed relevant documents and conducted face-to-face interviews (N=4 with individuals directly involved with data gathering, reporting and storage. Content analysis was used to analyze textual data. We found a stalled and inefficient NHIS characterized by general lack of personnel, a labor-intensive process, delay in reporting data, much reliance on field staff, and lack of incentives. A move to an electronic health information system without involving all stakeholders and adequately addressing the issues plaguing the current system is premature.
O'Leary, A; Usher, C; Lynch, M; Hall, M; Hemeryk, L; Spillane, S; Gallagher, P; Barry, M
The Health (Pricing and Supply of Medical Goods) Act 2013 passed into law in July 2013 and legislated for generic substitution in Ireland. The aim of the study was to ascertain the knowledge and perceptions of stakeholders i.e. patients, pharmacists and prescribers, of generic medicines and to generic substitution with the passing of legislation. Three stakeholder specific questionnaires were developed to assess knowledge of and perceptions to generic medicines and generic substitution. Purposive samples of patients, prescribers and pharmacists were analysed. Descriptive quantitative and qualitative analyses were undertaken. A total of 762 healthcare professionals and 353 patients were recruited. The study highlighted that over 84% of patients were familiar with generic medicines and are supportive of the concept of generic substitution. Approximately 74% of prescribers and 84% of pharmacists were supportive of generic substitution in most cases. The main areas of concern highlighted by the healthcare professionals that might impact on the successful implementation of the policy, were the issue of bioequivalence with generic medicines, the computer software systems used at present in general practitioner (GP) surgeries and the availability of branded generics. The findings from this study identify a high baseline rate of acceptance to generic medicines and generic substitution among patients, prescribers and pharmacists in the Irish setting. The concerns of the main stakeholders provide a valuable insight into the potential difficulties that may arise in its implementation, and the need for on-going reassurance and proactive dissemination of the impact of the generic substitution policy. The existing positive attitude to generic medicines and generic substitution among key stakeholders in Ireland to generic substitution, combined with appropriate support and collaboration should result in the desired increase in rates of prescribing, dispensing and use of generic
Beidas, Rinad S; Stewart, Rebecca E; Adams, Danielle R; Fernandez, Tara; Lustbader, Susanna; Powell, Byron J; Aarons, Gregory A; Hoagwood, Kimberly E; Evans, Arthur C; Hurford, Matthew O; Rubin, Ronnie; Hadley, Trevor; Mandell, David S; Barg, Frances K
Our goal was to identify barriers and facilitators to the implementation of evidence-based practices from the perspectives of multiple stakeholders in a large publicly funded mental health system. We completed 56 interviews with three stakeholder groups: treatment developers (n = 7), agency administrators (n = 33), and system leadership (n = 16). The three stakeholder groups converged on the importance of inner (e.g., agency competing resources and demands, therapist educational background) and outer context (e.g., funding) factors as barriers to implementation. Potential threats to implementation and sustainability included the fiscal landscape of community mental health clinics and an evolving workforce. Intervention characteristics were rarely endorsed as barriers. Inner context, outer context, and intervention characteristics were all seen as important facilitators. All stakeholders endorsed the importance of coordinated collaboration across stakeholder groups within the system to successfully implement evidence-based practices.
Matthews, Lynda R; Pockett, Rosalie B; Nisbet, Gillian; Thistlethwaite, Jill E; Dunston, Roger; Lee, Alison; White, Jill F
A substantial literature engaging with the directions and experiences of stakeholders involved in interprofessional health education exists at the international level, yet almost nothing has been published that documents and analyses the Australian experience. Accordingly, this study aimed to scope the experiences of key stakeholders in health and higher education in relation to the development of interprofessional practice capabilities in health graduates in Australia. Twenty-seven semi-structured interviews and two focus groups of key stakeholders involved in the development and delivery of interprofessional health education in Australian higher education were undertaken. Interview data were coded to identify categories that were organised into key themes, according to principles of thematic analysis. Three themes were identified: the need for common ground between health and higher education, constraints and enablers in current practice, and the need for research to establish an evidence base. Five directions for national development were also identified. The study identified a range of interconnected changes that will be required to successfully mainstream interprofessional education within Australia, in particular, the importance of addressing issues of culture change and the need for a nationally coordinated and research informed approach. These findings reiterate those found in the international literature.
Helland, Aasgeir; Kastenholz, Hans; Thidell, Aake; Arnfalk, Peter; Deppert, Knut
The novel properties of nanoparticulate materials (NPM) and the rapid development of NPM based products have raised many unanswered questions and concerns by different stakeholders over its consequences for the environment and human health. These concerns have led to an increasing discussion in both the US and Europe about possible regulatory policies for NPM. In this article a comparative study of stakeholders' perceptions on regulatory policy issues with NPM in Europe is presented. It was found that industry wants to regulate this area if the scientific evidence demonstrates that NPM are harmful, but also that the regulatory bodies do not find it necessary at this point of time to regulate until scientific evidence demonstrates that NPM are harmful. This research therefore shows that there will most likely not be any regulatory interventions until there is an established and convincing scientific knowledge base demonstrating that NPM can be hazardous. It is furthermore discussed in this article the different roles and responsibilities of the stakeholders in financing the research required to establish the necessary level of fundamental scientific evidence. It was also found that the activity of the regulatory bodies on this issue differ between the European countries
Full Text Available Effective climate adaptation requires engagement (awareness, motivation, and capacity to act at relevant scales, from individuals to global institutions. In many parts of the world, research attention has focused on the engagement of the general public. We suggest that studies also need to focus on key stakeholders in the government and non-governmental sectors who participate in adaptation planning processes, so that a better understanding may be achieved of the distinct knowledge cultures that influence their engagement with climate change. Indonesia is a key actor in climate adaptation because of the potentially dire consequences for its population’s livelihoods and well-being. In this paper we consider whether ‘climate knowledge cultures’ exist amongst stakeholders at multiple organisational levels in Nusa Tenggara Barat (NTB Province, Eastern Indonesia. Surveys were conducted with 124 stakeholders from differing levels at the beginning of four multi-stakeholder climate adaptation workshops. Questions elicited perceptions of their region’s challenges, observation and awareness of climate change, feelings they associated with climate change, beliefs regarding causes, risks and preparedness for climate change, and timeframes they associated with the future. Across all levels, climate change ranked highest as the first challenge participants identified, followed by food security, but well-being ranked highest when the top three challenges were combined. Most participants believed climate change was happening, but those working at higher organisational levels were more likely to attribute climate change to human factors whereas those at lower levels were more likely to think it was a natural phenomenon. Women were in greater agreement and more optimistic than men about current government policies to cope with climate change. Perceptions differed between sub-districts, reflecting NTB’s climatic diversity. We note that although climate
Salami, Bukola; Hegadoren, Kathleen; Kirova, Anna; Meherali, Salima; Nsaliwa, Christina; Chiu, Yvonne
This study examines stakeholders' perspectives on the health and well-being of temporary foreign workers (TFWs) and their families in Alberta, Canada. We used a critically informed qualitative methodology. We interviewed 13 stakeholders, including service providers and policy makers. Stakeholders involved in providing services to TFWs perceived that the workers experience (1) barriers in accessing mental health services, (2) mental health challenges, (3) family health challenges, (4) occupational health challenges, and (5) income and social status as a social determinant of health. Immigration and class status intersect to influence the health of this vulnerable population in Canada.
Heriard Dubreuil, G.; Gadbois, S.
The management of high level radioactive waste is nowadays recognised as a complex decision-making process entailing technical, environmental, ethical, social, political and economic dimensions where no solution can be reached solely on the basis of technical considerations. While this issue is acknowledged as a problem for the community as a whole, waste management remains a global problem looking for a local solution. Starting from this view, COWAM network (Community Waste Management), developed under the Fifth Framework Programme of the European Commission, addressed the following objectives: 1) To empower local actors through a networking process; 2) To gather and discuss the available experiences of decision-making processes at the local level within their national context in Europe; 3) To set up an arena for balanced exchanges between local actors, NGOs, regulators and implementers; 4) To promote new approaches to decision-making in national contexts in Europe. COWAM network comprises 230 delegates from 10 European countries, involving in priority local communities and NGOs. The emphasis put on the local participation enabled members of COWAM network to overcome distrust and to build common lessons and views beyond usual stakeholder positions. Through the analysis of case studies different issues were identified, among them two relate more specifically to: 1) Expertise what is the purpose of expertise on environmental impact in the decision-making process? How is this expertise linked with other scientific and non scientific issues? What is the role of stakeholders in expertise? 2) Environmental quality in the long term and sustainable development how is the impact of radioactive waste management facilities on the environment in the long term taken into account? how is this associated with the sustainable development of the hosting community? How are local stakeholders involved in these issues and what is the expected benefit from their participation? (author)
van den Bold, Mara; Kohli, Neha; Gillespie, Stuart; Zuberi, Samar; Rajeesh, Sangeetha; Chakraborty, Barnali
Almost half of all children in South Asia are stunted. Although agriculture has the potential to be a strong driver of undernutrition reduction and serves as the main source of livelihood for over half of South Asia's population, its potential to reduce undernutrition is currently not being realized. The Leveraging Agriculture for Nutrition in South Asia (LANSA) research consortium seeks to understand how agriculture and agrifood systems can be better designed to improve nutrition in South Asia. In 2013 and 2014, LANSA carried out interviews with stakeholders influential in, and/or knowledgeable of, agriculture-nutrition policy in India, Pakistan, and Bangladesh, to gain a better understanding of the institutional and political factors surrounding the nutrition sensitivity of agriculture in the region. Semistructured interviews were carried out in India, Bangladesh, and Pakistan with a total of 56 stakeholders representing international organizations, research, government, civil society, donors, and the private sector. The findings point to mixed perspectives on countries' policy sensitivity toward nutrition. There was consensus among stakeholders on the importance of political commitment to nutrition, improving nutrition literacy, strengthening capacities, and improving the use of financial resources. Although there are different ways in which South Asian agriculture can improve its impact on nutrition, sensitizing key influencers to the importance of nutrition for the health of a country's population appears as a critical issue. This should in turn serve as the premise for political commitment, intersectoral coordination to implement nutrition-relevant policies, adequately resourced nutrition-specific and nutrition-sensitive programs, and sufficient capacities at all levels. © The Author(s) 2015.
Kitching, Fiona; Winbolt, Margaret; MacPhail, Aleece; Ibrahim, Joseph E
Participatory web-based platforms, including social media, have been recognised as valuable learning tools in healthcare education for over a decade. Use of these platforms is now widespread in tertiary education. It is less widely accepted as a tool for continuing professional education and development at the industry level. This study explores perspectives of senior stakeholders in the nursing home sector to explore perceived benefits, barriers and risks for use in professional education. Qualitative data were collected through semi-structured interviews of 'high level' clinical and executive staff from a cross section of nursing home stakeholder organisations. Established printed educational material (PEM) was used as a case study for adaptation to web-based social applications. Questions were designed to gather information about the interviewee's views on the potential to apply PEM to programs such as blogs, Twitter and YouTube to deliver education and aid communication in the sector. Twelve participants from eleven stakeholder organisations took part in the study. Most participants were cautious about the use of social media programs in continuing professional education. Participants described the benefits (contemporary information, delivered rapidly, varying formats) and barriers (credibility of information, potential misinterpretation, sector demographics, time constraints) to uptake of these programs. The majority of participants preferred formal e-learning programs to web-based social media applications. Reservations expressed about the use of social media, such as accuracy, legal and privacy risks to the organisation reflected those previously expressed by the broader medical community. Copyright © 2015 Elsevier Ltd. All rights reserved.
Hinton, Ladson; Sciolla, Andrés F; Unützer, Jürgen; Elizarraras, Edward; Kravitz, Richard L; Apesoa-Varano, Ester Carolina
Family members often play important roles in the lives of depressed older men and frequently attend primary care visits with their loved ones, yet surprisingly little is known about how to most effectively engage and include family members in depression treatment. However, including family in depression treatment may be difficult due to several factors, such as depression stigma and family conflicts. The objective of this study was to describe challenges in engaging family members in older men's depression treatment and potential strategies to overcome those challenges. A cross-sectional, qualitative descriptive interview study was conducted in a safety-net, Federally Qualified Health Center in California's Central Valley. A total of 37 stakeholders were recruited, including 15 depressed older (i.e. age ≥ 60) men, 12 family members, and 10 clinic staff. Depressed men were identified through mail outreach, waiting room screening, and referral. Depressed men identified family members who were later approached to participate. We also recruited a purposeful sample of clinic staff. Interviews explored stakeholder perspectives on family involvement in men's depression treatment as part of a primary care intervention. Interviews were conducted using a semi-structured interview guide, tape-recorded, transcribed verbatim, and translated if the interview was conducted in Spanish. Four themes were identified representing core challenges: engaging men at the right time; preserving men's sense of autonomy; managing privacy concerns; and navigating family tensions. Stakeholders also provided practical suggestions and advice about how each of these challenges might be addressed. While engaging family is a promising approach to strengthen depression care for older men in primary care settings, several potential challenges exist. Family- centered depression intervention development and clinical practice need to anticipate these challenges and to develop approaches and
Setia, Monika; Islam, Amina M; Thompson, James P; Matchar, David B
An expanding elderly population poses challenges for the provision of care and treatment for age-related physical and mental disorders. Cognitive impairment (CI)/dementia is one such mental disorder that is on the rise in Singapore and has concomitant implications for social and health systems. The objective of this study is to understand the perspectives of prominent stakeholders about current and future issues and challenges associated with CI/dementia among the elderly in Singapore. Using indepth interviews, this qualitative study obtained the views of multiple stakeholders on issues and challenges associated with CI/dementia in Singapore. The 30 individuals interviewed as part of the study included clinicians, policy-makers, researchers, community workers, administrators, and caregivers. Using a framework approach, interview texts were indexed into domains and issues by utilizing NVivo 9.0 software. The stakeholders expressed concerns related to multiple domains of the CI/dementia care system: attitude and awareness, economics, education, family caregiving, inputs to care system, living arrangements, prevention, screening and diagnosis, and treatment and management of care. Within each domain, multiple issues and challenges were identified by respondents. The study identifies a complex set of inter-related issues and challenges that are associated with the care and treatment of people with CI/dementia. The results suggest that CI and dementia profoundly affect patients, families, and communities and that the issues related to the two disorders are truly system-wide. These findings lay the foundation for utilization of a systems approach to studying CI/dementia and provide an analytic framework for future research on complex health care issues.
Haddow, Gill; O'Donnell, Catherine A; Heaney, David
To explore stakeholder perspectives of the implementation of a new, national integrated nurse-led telephone advice and consultation service [National Health Service 24 (NHS 24)], comparing the views of stakeholders from different health care organizations. Semi-structured interviews with 26 stakeholders including partner organizations located in primary and secondary unscheduled care settings [general practitioner (GP) out-of-hours cooperative; accident and emergency department; national ambulance service, members of NHS 24 and national policy makers. Attendance at key meetings, documentary review and email implementation diaries provided a contextual history of events with which interview data could be compared. The contextual history of events highlighted a fast-paced implementation process, with little time for reflection. Key areas of partner concern were increasing workload, the clinical safety of nurse triage and the lack of communication across the organizations. Concerns were most apparent within the GP out-of-hours cooperative, leading to calls for the dissolution of the partnership. Accident and emergency and ambulance service responses were more conciliatory, suggesting that such problems were to be expected within the developmental phase of a new organization. Further exploration of these responses highlighted the sense of ownership within the GP cooperative, with GPs having both financial and philosophical ownership of the cooperative. This was not apparent within the other two partner organizations, in particular the ambulance service, which operated on a regional model very similar to that of NHS 24. As the delivery of unscheduled primary health care crosses professional boundaries and locations, different organizations and professional groups must develop new ways of partnership working, developing trust and confidence in each other. The results of this study highlight, for the first time, the key importance of understanding the professional
Hua-Hung (Robin Weng
Full Text Available “Going green” has become an important environmental issue in contemporary business practice worldwide. This study examined the influence of a number of factors on green innovation and the consequences in terms of performance. The stakeholder theory was adopted to observe the effects of each stakeholder on the green innovation practices of companies and to determine how green innovation practices influence environmental and business performance. A research model with eight hypotheses was proposed to determine the associations between the variables of interest. An empirical survey was conducted of 202 Taiwanese service and manufacturing companies. The survey found that pressure from competitors and the government, along with employee conduct, all had significant and positive effects on green innovation practices. Additionally, a moderating effect of innovation orientation existed only in the relationship between green product innovation practices and employee conduct. This study not only provides a systematic way to analyze the effects of green innovation practices but also suggests the best means for companies to adopt green innovation practices.
Full Text Available The paper presents the results of an interna-tional comparative survey of stakeholders from four European countries (the Czech Republic, Germany, Poland and Romania. The aim was to identify and classify the ‘success factors’ of brownfelds regeneration and to detect signifcant convergences and divergences concerning the drivers and barriers of regeneration processes in different geographical and institutional contexts. The existence of ecological burden or site con-tamination, overall regeneration costs and clari-fed ownership relations are considered the most important factors of regeneration internationally. Especially in Romania but also in Poland, the fac-tors at national level (legislation, incentives, and foreign direct investments are perceived to be more infuential than in the Czech Republic and Germany, where a stronger emphasis is put on the location factors (whether a brownfeld is lo-cated in rural, urban or inner city area and trans-port links. Physical attributes such as the site’s area and terrain are also considered among the most signifcant factors in Romania. While rep-resentatives of public administration emphasized more the importance of legislation, state incen-tives and general localization, the investors and developers highlighted local factors (landscape protection limits, place marketing, and previous use of brownfelds. The emphasis on political and geographical factors increases with the level of experience of stakeholders, while the empha-sis on site specifc factors decreases with the length of experience.
Lillebø, Ana I.; Stålnacke, Per; Gooch, Geoffrey D.; Krysanova, Valentina; Bielecka, Małgorzata
The main objective of the work carried out in the scope of a three years collaborative research project was to develop science-based strategies and a decision support framework for the integrated management of coastal lagoons and their catchments and, in this context, to enhance connectivity between research and policymaking. In this paper our main objective is to share the lessons learned from the innovative methodology used throughout the project. To achieve the proposed objectives, the multidisciplinary scientific knowledge in the project team was combined and integrated with the knowledge and views of local stakeholders of four selected European coastal lagoons, using a three step participatory approach. With this innovative approach, which included the usage of eco-hydrological and water quality-modelling tools, the team developed and analyzed integrated scenarios of possible economic development and environmental impacts in four European lagoons and their catchments. These scenarios were presented and discussed with stakeholders, giving rise to management recommendations for each case study lagoon. Results show that some management options might be transferrable to other European lagoons having similar climatic, geophysical and socio-economic settings. In management terms, the project output provides a set of policy guidelines derived from the different analyses conducted and proposes initiatives concerning management implementation in a local-regional-national-European setting.
Bielicki, J. M.; Pollak, M.; Wilson, E.; Elliot, T. R.; Guo, B.; Nogues, J. P.; Peters, C. A.
CO2 capture and storage involves injecting captured CO2 into geologic formations, such as deep saline aquifers. This injected CO2 is to be "stored" within the rock matrix for hundreds to thousands of years, but injected CO2, or the brine it displaces, may leak from the target reservoir. Such leakage could interfere with other subsurface activities-water production, energy production, energy storage, and waste disposal-or migrate to the surface. Each of these interferences will incur multiple costs to a variety of stakeholders. Even if injected or displaced fluids do not interfere with other subsurface activities or make their way to the surface, costs will be incurred to find and fix the leak. Consequently, the suitability of a site for CO2 storage must therefore include an assessment of the risk of leakage and interference with various other activities within a three-dimensional proximity of where CO2 is being injected. We present a spatial analysis of leakage and interference risk associated with injecting CO2 into a portion of the Mount Simon sandstone in the Michigan Basin. Risk is the probability of an outcome multiplied by the impact of that outcome (Ro=po*Io). An outcome is the result of the leakage (e.g., interference with oil production), and the impact is the cost associated with the outcome. Each outcome has costs that will vary by stakeholder. Our analysis presents CO2 storage risk for multiple outcomes in a spatially explicit manner that varies by stakeholder. We use the ELSA semi-analytical model for estimating CO2 and brine leakage from aquifers to determine plume and pressure front radii, and CO2 and brine leakage probabilities for the Mount Simon sandstone and multiple units above it. Results of ELSA simulations are incorporated into RISCS: the Risk Interference Subsurface CO2 Storage model. RISCS uses three-dimensional data on subsurface geology and the locations of wells and boreholes to spatially estimate risks associated with CO2 leakage from
Esmail, Laura; Moore, Emily; Rein, Alison
Despite the growing demand for research that engages stakeholders, there is limited evidence in the literature to demonstrate its value - or return on investment. This gap indicates a general lack of evaluation of engagement activities. To adequately inform engagement activities, we need to further investigate the dividends of engaged research, and how to evaluate these effects. This paper synthesizes the literature on hypothesized impacts of engagement, shares what has been evaluated and identifies steps needed to reduce the gap between engagement's promises and the underlying evidence supporting its practice. This assessment provides explicit guidance for better alignment of engagement's promised benefits with evaluation efforts and identifies specific areas for development of evaluative measures and better reporting processes.
Background The regulation of the markets for Complementary and Alternative Medicine (CAM) products presents a global challenge. There is a dearth of studies that have examined or evaluated the regulatory policies of CAM products in the Eastern Mediterranean Region (EMR). We investigate the regulatory frameworks and the barriers for the proper regulation and integration of CAM products in Lebanon, as an example of an EMR country with a weak public infrastructure. Methods We utilized a qualitative study design involving a series of semi-structured interviews with stakeholders of the CAM market in Lebanon. Snowball sampling was used to identify interviewees; interviews continued until the "saturation" point was reached. A total of 16 interviews were carried out with decision makers, representatives of professional associations, academic researchers, CAM product importers, policy makers and a media representative. Interviews were transcribed and thematic analysis of scripts was carried out. Results There was a consensus among all stakeholders that the regulation of the market for CAM products in Lebanon needs to be strengthened. Thematic analysis identified a number of impediments jeopardizing the safety of public consumption and hindering the integration of CAM therapies into mainstream medicine; including: weak infrastructure, poor regulation, ineffective policies and politics, weak CAM awareness and sub-optimal coordination and cooperation among stakeholders. With respect to policy instruments, voluntary instruments (self regulation) were deemed ineffective by stakeholders due to poor awareness of both users and providers on safe use of CAM products. Stakeholders' rather recommended the adoption of a combination of mixed (enhancing public awareness and integration of CAM into medical and nursing curricula) and compulsory (stricter governmental regulation) policy instruments for the regulation of the market for CAM products. Conclusions The current status quo with
Putnam, Michelle; Pickard, Joseph G.; Rodriguez, Carroll; Shear, Erin
Persons with dementia are often excluded from consumer-directed home- and community-based service programs because they cannot direct their own care. Surrogates are permitted in some states, thereby allowing program participation. This study explored family caregiver perspectives on policies that support family needs related to providing care to…
Full Text Available Macro-regional cooperation in the EU are networks that use the horizontal and vertical dimension of the multilevel governance system to influence both strategic decision-making as well as implementation activities. Drawing on an analysis of expert interviews in the Danube Region the paper scrutinizes stakeholders’ shared views towards expectations, challenges and added values, and thereby seeks to explain why a trend towards macro-regions arises and for what reasons stakeholders are getting involved. The analysis of the drivers for stakeholders’ commitment in the EU Danube Region Strategy shows that new governance arrangements need to be adjustable to different contexts, allow for negotiation and new network creation whilst simultaneously offering the political ability to act. The evidence presented suggests that multilevel governance in the EU is becoming increasingly complex, embracing more and different types of cooperation, with soft characteristics as crucial elements.
Hlongwana, Khumbulani Welcome; Tsoka-Gwegweni, Joyce
The past decade has seen substantial global reduction in malaria morbidity and mortality due to increased international funding and decisive steps by the international malaria community to fight malaria. South Africa has been declared ready to institute malaria elimination. However, research on the factors that would affect this policy implementation is inadequate. To investigate the stakeholders' understanding of the malaria elimination policy in South Africa, including their perceived barriers and facilitators to effective policy implementation. The study followed a constructivist epistemological approach which manifests in phenomenological study design. Twelve purposively selected key informants from malaria researchers, provincial and national malaria programmes were interviewed using semi-structured interviews. Interview questions elicited interviewees' knowledge of the policy and its achievability, including any perceived barriers and facilitating factors to effective implementation. The hybrid approach was used to perform thematic data analysis. The dominant view was that malaria remains a problem in South Africa, exacerbated by staff attitudes and poor capacity, lack of resources, lack of new effective intervention tools, lack of intra- and inter-departmental collaboration, poor cross-border collaboration and weak stakeholder collaboration. Informants were concerned about the target year (2018) for elimination, and about the process followed in developing the policy, including the perceived malaria epidemiology shortfalls, regulatory issues and political context of the policy. Achievability of malaria elimination remains a subject of intense debate for a variety of reasons. These include the sporadic nature of malaria resurgence, raising questions about the contributions of malaria control interventions and climate to the transmission trends in South Africa. The shortage of resources, inadequate staff capacity, lack of any new effective intervention tools
Full Text Available Higher education provision typically requires learners to physically attend sessions on campus. The economic climate has changed significantly over the past few years in the UK and globally. Inevitably changes to student funding and the increased competitive nature of the job market have impacted on university teaching. The use of work based learning (WBL is an alternative flexible form of learning that attempts to tackle these issues. It enables students to learn whilst they work, addressing the funding issues, and enhancing their employability through the acquisition of higher professional qualifications. Often such WBL programmes are designed, delivered and supported from the view of the student and academic staff with little consideration of other stakeholders such as employers, workplace mentors and professional bodies and the input they can bring to enrich the learning and teaching provision. This paper presents the findings from a survey conducted among stakeholders from all four pillars of WBL, namely the learner, the academic environment, the workplace and the external context. Online questionnaires and interviews were carried out with students, tutors, program leaders, employers and professional bodies from four postgraduate programmes at the university. The results show that while there is a reluctance to embrace technology among some academic staff, students are generally positive about using the technology. The survey also demonstrates that there is a lack of creativity and imagination in the use of technology, where often platforms such as virtual learning environments are used simply as repositories for presentation slides, handouts, etc. The results of the study conclude or rather remind all involving parties to pay more emphasis on quality of online programme delivery by embracing technology and use it in novel and imaginative ways to provide a learning and teaching provision fit for the twenty-first century.
Turner, Phillip J.; Campbell, Lisa M.; Van Dover, Cindy L.
The apparent prevalence of rare species (rarity) in the deep sea is a concern for environmental management and conservation of biodiversity. Rare species are often considered at risk of extinction and, in terrestrial and shallow water environments, have been shown to play key roles within an ecosystem. In the deep-sea environment, current research focuses primarily on abundant species and deep-sea stakeholders are questioning the importance of rare species in ecosystem functioning. This study asks whether deep-sea stakeholders (primarily scientists) view rare-species research as a priority in guiding environmental management. Delphi methodology (i.e., an iterative survey approach) was used to understand views about whether or not 'deep-sea scientists should allocate more resources to research on rare species in the deep sea, even if this means less resources might be available for abundant-species research.' Results suggest little consensus regarding the prioritization of resources for rare-species research. From Survey 1 to Survey 3, the average participant response shifted toward a view that rare-species research is not a priority if it comes at a cost to research on abundant species. Participants pointed to the need for a balanced approach and highlighted knowledge gaps about even the most fundamental questions, including whether rare species are truly 'rare' or simply under-sampled. Participants emphasized the lack of basic biological knowledge for rare and abundant species, particularly abundant meio- and microscopic species, as well as uncertainty in the roles rare and abundant species play in ecosystem processes. Approaches that jointly consider the role of rare and abundant species in ecosystem functioning (e.g., biological trait analysis) may help to clarify the extent to which rare species need to be incorporated into deep-sea environment management in order to maintain ecosystem functioning.
Sang, Katherine J C; Gyi, Diane E; Haslam, Cheryl O
Musculoskeletal disorders are one of the leading causes of work related ill health and sickness absence. Those who drive as part of their job may be at particular risk, with evidence suggesting that prolonged exposure to driving is associated with increased absence from work due to low back pain. Business drivers often work away from a traditional office environment. Such mobile working may pose greater risks to occupational health due to increased ergonomic risks, for example working from the car, longer working hours and a lack of concern amongst drivers about health and safety. It has been suggested that occupational health practices have not adapted to meet the needs of peripatetic workers. The current study explored how occupational health services are delivered to business drivers. Semi-structured interviews were carried out with a sample of 31 stakeholders in 4 organisations. Respondents included, health and safety professionals, occupational health nurses, fleet managers and high mileage business drivers. The interviews were transcribed and analysed using 'Template Analysis'. The data revealed that, within these organisations, the provision of occupational health services was often fragmented and drivers and other key stakeholders were often unaware of the existing systems within their organisations. The peripatetic nature of business drivers meant that they were difficult for occupational health teams to reach. The paper concludes by presenting recommendations for occupational health professionals and researchers engaged with improving the health of peripatetic workers, namely that occupational health policies should be integrated in company strategy and widely disseminated to drivers and those with responsibility for managing their occupational health provision. Copyright © 2010 Elsevier Ltd and The Ergonomics Society. All rights reserved.
Arnott, J. C.; Kirchhoff, C.
Co-production, a theory of and approach to knowledge production that accommodates joint effort between scientists and non-scientists in one or more stages of research process, is increasingly identified as a strategy to improve the usability of global change research. However, little research has been done to obtain perspectives of non-scientist participants that contribute to coproduced research projects on the process of co-production itself. The result is that it is often unclear if coproduced research achieves its intended objectives for stakeholders that contribute to it. An added irony is that designs and approaches to co-production often do not in themselves reflect input from non-scientist participants. To meet this gap, this paper reports on an analysis of semi-structured interviews of practitioners that participated in a NOAA-funded study addressing the impacts of climate change on harmful algal blooms in the Western Lake Erie Basin. The interviews solicited responses from these participants about their motivation for participating in the project, the impact to their work as a result of participation, and their suggestions for how to improve the experience in the future. Results indicate that non-scientist participants in research projects possess a very broad range of reasons for participation and a diverse set of attitudes about their experiences and perceived benefits. These findings should add evidence of and perspective to a growing area of recognition that information end-users (e.g., stakeholders, practitioners, decision-makers) are not a homogenous set of actors, and therefore strategies for engaging with them on knowledge production need to adjust accordingly. We reflect on these findings to conclude that future co-production efforts would be better served by considering the work of co-production as more than just bringing together two different but internally similar communities (e.g., "scientists" and "stakeholders") and instead treating its
Ethical issues and problems in business are receiving increasing attention, both in terms of criticism of examples of "bad" behaviour of business actors and in terms of the development of ethical codes of conduct in certain companies, ethical visions for businesses etc. In general, ethical problems seem to be increasingly prevalent in business, but ethics tend to be disregarded by traditional organisational and managerial theory. This calls for the development of an ethical perspective on bu...
Fusheini, Adam; Marnoch, Gordon; Gray, Ann Marie
Ghana's National Health Insurance Scheme (NHIS), established by an Act of Parliament (Act 650), in 2003 and since replaced by Act 852 of 2012 remains, in African terms, unprecedented in terms of growth and coverage. As a result, the scheme has received praise for its associated legal reforms, clinical audit mechanisms and for serving as a hub for knowledge sharing and learning within the context of South-South cooperation. The scheme continues to shape national health insurance thinking in Africa. While the success, especially in coverage and financial access has been highlighted by many authors, insufficient attention has been paid to critical and context-specific factors. This paper seeks to fill that gap. Based on an empirical qualitative case study of stakeholders' views on challenges and success factors in four mutual schemes (district offices) located in two regions of Ghana, the study uses the concept of policy translation to assess whether the Ghana scheme could provide useful lessons to other African and developing countries in their quest to implement social/NHISs. In the study, interviewees referred to both 'hard and soft' elements as driving the "success" of the Ghana scheme. The main 'hard elements' include bureaucratic and legal enforcement capacities; IT; financing; governance, administration and management; regulating membership of the scheme; and service provision and coverage capabilities. The 'soft' elements identified relate to: the background/context of the health insurance scheme; innovative ways of funding the NHIS, the hybrid nature of the Ghana scheme; political will, commitment by government, stakeholders and public cooperation; social structure of Ghana (solidarity); and ownership and participation. Other developing countries can expect to translate rather than re-assemble a national health insurance programme in an incomplete and highly modified form over a period of years, amounting to a process best conceived as germination as opposed
Ma, J.; Deng, Liming
The issue of Corporate Social Responsibility (CSR) has been attracting the attention from many disciplines such as economics, management, laws, sociality and philosophy since last century. The purpose of this study is to explore the impact of CSR on performance and develop a CSR evaluation system. Building on the definition of CSR and Stakeholder theory, this article built a path-relationship model of CSR and business operation performance. The paper also constructed CSR evaluation system based on KLD index, GRJ report, CSR accounting account, SA8000, ISO14000 etc. The research provides a basis for future studies about the relationship between CSR and business performance and shed some light on the evaluation of CSR practices.
Full Text Available Building a sustainable performance system at the level of the local public administrations must have as starting point the local public administration’s (LPA mission and must go down to the level of the individual. This system must follow the external performance that it delivers to the citizens, the outcomes generated, but also the internal performance which suggests how to achieve the external performance. We propose in this regard the simultaneous use of the Balanced Scorecard tool for managing the internal performance and the Public Service Value Model for measuring the external performance measurement which derives from the organization's mission. In the second part of the work we analyzed comparatively the external performance created by the county capitals of Romania in the year 2013 using the Public Service Value Model (PSVM. Based on this analysis, the county capitals of Romania can be divided in the following categories: high performance organizations (value driven, budget conscious organizations, low performance organizations (sleeping giants and quality conscious organizations. This classification is useful both for the external and internal stakeholders because it shows the efficiency of public money spending and the areas in which the LPA is performing well, and also the ones that need to be improved.
Kim, Katherine K; Browe, Dennis K; Logan, Holly C; Holm, Roberta; Hack, Lori; Ohno-Machado, Lucila
There is currently limited information on best practices for the development of governance requirements for distributed research networks (DRNs), an emerging model that promotes clinical data reuse and improves timeliness of comparative effectiveness research. Much of the existing information is based on a single type of stakeholder such as researchers or administrators. This paper reports on a triangulated approach to developing DRN data governance requirements based on a combination of policy analysis with experts, interviews with institutional leaders, and patient focus groups. This approach is illustrated with an example from the Scalable National Network for Effectiveness Research, which resulted in 91 requirements. These requirements were analyzed against the Fair Information Practice Principles (FIPPs) and Health Insurance Portability and Accountability Act (HIPAA) protected versus non-protected health information. The requirements addressed all FIPPs, showing how a DRN's technical infrastructure is able to fulfill HIPAA regulations, protect privacy, and provide a trustworthy platform for research. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Dahal, Rojan; Upadhyay, Atul; Ewald, Benjamin
One Health is a concept which fosters collaborative relationships between human health, animal health and environmental health partners. Diseases are emerging and re-emerging in South Asia due to poor sanitation, close proximity of people to livestock, deforestation, porous borders, climate change, changes in human behaviour and unhygienic food preparation and consumption practices. This review was completed in two stages. First, we conducted a review of peer-reviewed literature and grey literature available in Google search engine related to One Health in four countries (Bangladesh, Bhutan, India and Nepal). Second, we used a structured questionnaire completed by the key stakeholders working on One Health for the collection of information related to the challenges in implementing One Health. Most of the One Health activities in South Asia are determined by donor preferences. Bangladesh and India did considerable work in advancing One Health with limited support from the government agencies. Weak surveillance mechanisms, uncertain cost-effectiveness of One Health compared with the existing approach, human resources and laboratory capacity are some of the factors hindering implementation of the One Health concept. Implementation of One Health is growing in the South Asia region with limited or no government acceptance. To institutionalise it, there is a need for leadership, government support and funding. © British Veterinary Association (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Su, Ming Ming; Wall, Geoffrey; Ma, Zhong
Ecotourism development is closely associated with the sustainability of protected natural areas. When facilitated by appropriate management, ecotourism can contribute to conservation and development, as well as the well-being of local communities. As such, ecotourism has been proposed and practiced in different forms in many places, including China. This study assesses ecotourism development at Xingkai Lake National Nature Reserve in Heilongjiang Province, China. Key informant interviews were conducted with representatives from the provincial Forestry Department, the Nature Reserve, and the local community. Observation was undertaken on three site visits and secondary data were collected. The potential for providing quality natural experiences is high and tourism development is occurring rapidly. However, current relationships between people, resources, and tourism have yet to provide mutual benefits necessary for successful ecotourism. The multi-stakeholder management style and the ambiguity of landownership within the nature reserve constitute structural difficulties for ecotourism management and operation. Although participation in ecotourism could provide a livelihood opportunity and interests in involvement in tourism have been identified among the local fishing community, current involvement is limited mainly due to the lack of mechanisms for participation. Therefore, it is recommended that management programs and government policies should be established to provide a platform for community participation in ecotourism. Then, a positive synergistic relationship between tourism, environment, and community could be developed. Planning and policy requirements are discussed for ecotourism development in protected areas in China.
Full Text Available Abstract Background Increasing access to healthy foods and beverages in disadvantaged communities is a public health priority due to alarmingly high rates of obesity. The Virtual Supermarket Program (VSP is a Baltimore City Health Department program that uses online grocery ordering to deliver food to low-income neighborhoods. This study evaluates stakeholder preferences and barriers of program implementation. Methods This study assessed the feasibility, sustainability and efficacy of the VSP by surveying 93 customers and interviewing 14 programmatic stakeholders who had recently used the VSP or been involved with program design and implementation. Results We identified the following themes: The VSP addressed transportation barriers and food availability. The VSP impacted customers and the city by including improving food purchasing behavior, creating a food justice “brand for the city”, and fostering a sense of community. Customers appreciated using Supplemental Nutrition Assistance Program (SNAP benefits to pay for groceries, but policy changes are needed allow online processing of SNAP benefits. Conclusions This evaluation summarizes lessons learned and serves as a guide to other public health leaders interested in developing similar programs. Provisions in the U.S. Department of Agriculture (USDA Farm Bill 2014 allow for select grocers to pilot online transactions with SNAP benefits. If these pilots are efficacious, the VSP model could be easily disseminated.
Lagisetty, Pooja; Flamm, Laura; Rak, Summer; Landgraf, Jessica; Heisler, Michele; Forman, Jane
Increasing access to healthy foods and beverages in disadvantaged communities is a public health priority due to alarmingly high rates of obesity. The Virtual Supermarket Program (VSP) is a Baltimore City Health Department program that uses online grocery ordering to deliver food to low-income neighborhoods. This study evaluates stakeholder preferences and barriers of program implementation. This study assessed the feasibility, sustainability and efficacy of the VSP by surveying 93 customers and interviewing 14 programmatic stakeholders who had recently used the VSP or been involved with program design and implementation. We identified the following themes: The VSP addressed transportation barriers and food availability. The VSP impacted customers and the city by including improving food purchasing behavior, creating a food justice "brand for the city", and fostering a sense of community. Customers appreciated using Supplemental Nutrition Assistance Program (SNAP) benefits to pay for groceries, but policy changes are needed allow online processing of SNAP benefits. This evaluation summarizes lessons learned and serves as a guide to other public health leaders interested in developing similar programs. Provisions in the U.S. Department of Agriculture (USDA) Farm Bill 2014 allow for select grocers to pilot online transactions with SNAP benefits. If these pilots are efficacious, the VSP model could be easily disseminated.
Wubben, E.F.M.; Isakhanyan, G.
An agropark is a cluster in which several primary producers and processors cooperate to enhance sustainable agrofood production. Because agroparks represent complex system innovations, this article studies their realisation trajectories from the stakeholder management perspective. By using the case
Chen, Huey T.; Turner, Nannette C.
Health promotion and social betterment program interventions are based on either formal theory from academia or stakeholder theory from stakeholders' observations and experiences in working with clients. Over time, formal theory-based interventions have acquired high prestige, while stakeholder theory-based interventions have been held in low…
The BESAFE project organized its first stakeholder meeting at INBO in Brussels on 23 and 24 May 2013. Committed stakeholder involvement is central to BESAFE’s success, and the intention of this first workshop was to get initial feedback as well as to involve stakeholders in a brainstorm about the
Qian, Yi; Yan, Fei; Wang, Wei; Clancy, Shayna; Akkhavong, Kongsap; Vonglokham, Manithong; Outhensackda, Somphou; Østbye, Truls
The Lao People's Democratic Republic is facing a critical shortage and maldistribution of health workers. Strengthening of the health workforce has been adopted as one of the five priorities of the National Health Sector Strategy (2013-2025). This study aims to identify, explore, and better understand the key challenges for strengthening the Laotian health workforce. This study applied exploratory and descriptive qualitative methods and adapted a working life-span framework. Twenty-three key stakeholders with particular insights into the current situation of the health workforce were purposively recruited for in-depth interviews. Important policy documents were also collected from key informants during the interviews. Thematic analysis was employed for the textual data using MAXQDA 10. The overarching problem is that there is a perceived severe shortage of skilled health workers (doctors, nurses, and midwives) and lab technicians, especially in primary health facilities and rural areas. Key informants also identified five problems: insufficient production of health workers both in quantity and quality, a limited national budget to recruit enough health staff and provide sufficient and equitable salaries and incentives, limited management capacity, poor recruitment for work in rural areas, and lack of well-designed continuing education programs for professional development. These problems are interrelated, both in how the issues arise and in the effect they have on one another. To improve the distribution of health workers in rural areas, strategies for increasing production and strengthening retention should be well integrated for better effectiveness. It is also essential to take the Laotian-specific context into consideration during intervention development and implementation. Furthermore, the government should acknowledge the inadequate health management capacity and invest to improve human resource management capacity at all levels. Finally, assessment of
Some background information is provided concerning new air emission standards for coal-fired generation in Alberta which were announced in June 2001 by the Environment Minister. An assessment of the situation has revealed that the existing management system is effective. The author questions whether it would be suitable to meet the challenges now emerging, such as multi-pollutant approaches, airshed approaches, cumulative effects, market-based approaches, and greenhouse gases. A Statement of Opportunity was tabled by the Alberta government with the Clean Air Strategic Alliance (CASA) board in November 2001, with the goals of outlining future emission management expectations, maintaining the competitive electricity market in Alberta, and a reduction of environmental impacts, among others. A CASA electricity project team was formed, whose stated objective was the development of an air emissions management approach to include standards and performance expectations for the electricity sector of Alberta. Stakeholders and the public were consulted for the purpose of establishing a common information base to be used in the identification of emissions to be addressed, the identification and assessment of management options and the recommendation of management approaches. The development of the terms of reference was accomplished through the establishment of a working group in January 2002. which were then approved in March 2002 by the CASA board. The budget and work plan were approved in June 2002, and an interim review is planned for November 2002 with the final report and recommendations expected in June 2003. The members of the team were listed, and some of the challenges are reviewed
Laurie T, Martin; Linnea Warren, May; Sarah, Weilant; Joie D, Acosta; Anita, Chandra
In 2013, the Robert Wood Johnson Foundation embarked on a pioneering effort to advance a Culture of Health. This report focuses on two questions that are central to understanding how individuals and sectors think about health and are motivated to promote it: How can the commonly understood concepts of cultural identity (e.g., ethnic or religious; lesbian, gay, bisexual, transgender plus; military) and organizational culture be harnessed to develop a Culture of Health? How can incentives be used to promote individual health and engage investors and leaders within organizations or governments to promote health and well-being broadly? This study draws on 43 one-hour semistructured interviews that RAND researchers conducted with stakeholders whose work focused on cultural alignment, incentives, or both to learn how organizations are addressing and leveraging culture and incentives to promote health and well-being, as well as to identify facilitators, barriers, potential best practices, and lessons learned. Key findings include the following: Equity is often addressed in silos, which impedes progress toward a unified goal of health equity for all; members of specific cultural groups need to be given a voice in health-related activities; systems are built around prevailing cultural norms, making it challenging for those working with specific cultures to make cultural adaptations; and not all incentives are monetary. Recommendations include institutionalizing practices that ensure ongoing input from marginalized populations, identifying ways to help smaller organizations overcome structural inequalities, and institutionalizing health promotion efforts in sectors other than public health or health care to sustain collaborative efforts.
Belza, Basia; Miyawaki, Christina E; Allen, Peg; King, Diane K; Marquez, David X; Jones, Dina L; Janicek, Sarah; Rosenberg, Dori; Brown, David R
Mall walking has been a popular physical activity for decades. However, little is known about why mall managers support these programs or why adults choose to walk. Our study aim was to describe mall walking programs from the perspectives of walkers, managers, and leaders. Twenty-eight walkers, 16 walking program managers, and six walking program leaders from five states participated in a telephone or in-person semi-structured interview (N = 50). Interview guides were developed using a social-ecological model. Interviews were recorded, transcribed verbatim, and analyzed thematically. All informants indicated satisfaction with their program and environmental features. Differences in expectations were noted in that walkers wanted a safe, clean, and social place whereas managers and leaders felt a need to provide programmatic features. Given the favorable walking environments in malls, there is an opportunity for public health professionals, health care organizations, and providers of aging services to partner with malls to promote walking.
Mays, Claire; Pescatore, Claudio; )
The Forum on Stakeholder Confidence (FSC) was created to facilitate the sharing of international experience in addressing the societal dimension of radioactive waste management. It explores means of ensuring an effective dialogue with the public, and considers ways to strengthen confidence in decision-making processes. This addressed a variety of topics ranging from stakeholder identity, evolutions in participatory democracy, and trust in the institutional framework, to the role of open dialogue in all aspects of radioactive waste management. The session was opened with an overview of theoretical, legal and substantive justifications for public participation in environmental governance, explaining that the typical physical characteristics of environmental issues (complexity, uncertainty, large temporal and spatial scales, and irreversibility) pose challenges to traditional decision making frameworks. The Danish example was then described, with the prominent role of the Danish Board of Technology, mandated to perform independent technology assessment and to support public debate by communicating assessment results to Parliament, other political decision makers and the Danish population. The RISCOM-II work on criteria for evaluating dialogue processes was then presented (clear aims and objectives will aid in planning a process, and can be used to evaluate it; the participants in a dialogue may have different views about its goals and so the planning and evaluation should involve these persons in order to come to a shared understanding). Then, a framework for evaluation at the level of government is outlined - a study on information, consultation and public participation in policy-making found that evaluation is often overlooked. As a conclusion, the topical presentations were analysed by placing them against a background of research on public participation. Choosing stakeholder involvement tools is part of a larger planning process in which not just methods, but
Carrying out a project as planned is not a guarantee for success. Projects may fail because project management does not take the requirements, wishes and concerns of stakeholders sufficiently into account. Projects can only be successful though contributions from stakeholders. And in the end, it is the stakeholders that evaluate whether they find that the project is a success. To manage stakeholders effectively, you need to know your stakeholders, their behaviours and attitudes towards the project. In Project Stakeholder Management, the authors give guidance on how to adopt an analytical and s
Full Text Available In efforts to increase human well-being while maintaining the natural systems and processes upon which we depend, navigating the trade-offs that can arise between different ecosystem services is a profound challenge. We evaluated a recently developed simple analytic framework for assessing ecosystem service trade-offs, which characterizes such trade-offs in terms of their underlying biophysical constraints as well as divergences in stakeholders' values for the services in question. Through a workshop and subsequent discussions, we identified four different types of challenging situations under which the framework allows important insights to clarify the nature of stakeholder conflicts, obstacles to promoting more sustainable outcomes, and potential enabling factors to promote efficiency and sustainability of ecosystem service yields. We illustrated the framework's analytical steps by applying them to case studies representing three of the challenging situations. We explored the fourth challenging situation conceptually, using published literature for examples. We examined the potential utility and feasibility of using the framework as a participatory tool in resource management and conflict resolution. We concluded that the framework can be instrumental for promoting pluralism and insightful analysis of trade-offs. The insights offered here may be viewed as hypotheses to be tested and refined as additional unforeseen challenges and benefits are revealed as the framework is put into practice.
Hayden, Mary H; Barrett, Erika; Bernard, Guyah; Toko, Eunice N; Agawo, Maurice; Okello, Amanda M; Gunn, Jayleen K L; Ernst, Kacey C
Increasing the active participation of professional women in vector control (VC) activities may help promote greater gender equity in the workplace and reduce the burden of vector-borne diseases. This stakeholder survey examined the current roles and perspective of professionals employed in the VC sector in Kenya, Indonesia, India, and other countries. The largest barriers that women face in pursuing leadership roles in the VC sector include lack of awareness of career opportunities, limitations based on cultural norms, and the belief that VC is men's work. These barriers could be addressed through improving education and recruitment campaigns, as well as supporting higher education and mentoring programs. Females were almost six times more likely to be encouraged to pursue leadership positions in their organization compared with male respondents (odds ratio = 5.9, P > 0.03, 95% confidence interval: 1.19, 29.42). These findings suggest that once women are recruited into the VC workforce, they face minimal discrimination and have increased leadership opportunities.
Sabbe, Alexia; Oulami, Halima; Zekraoui, Wahiba; Hikmat, Halima; Temmerman, Marleen; Leye, Els
In Morocco, the social and legal framework surrounding sexual and reproductive health has transformed greatly in the past decade, especially with the introduction of the new Family Law or Moudawana. Yet, despite raising the minimum age of marriage for girls and stipulating equal rights in the family, child and forced marriage is widespread. The objective of this research study was to explore perspectives of a broad range of professionals on factors that contribute to the occurrence of child and forced marriage in Morocco. A qualitative approach was used to generate both primary and secondary data for the analysis. Primary data consist of individual semi-structured interviews that were conducted with 22 professionals from various sectors: health, legal, education, NGO's and government. Sources of secondary data include academic papers, government and NGO reports, various legal documents and media reports. Data were analyzed using thematic qualitative analysis. Four major themes arose from the data, indicating that the following elements contribute to child and forced marriage: (1) the legal and social divergence in conceptualizing forced and child marriage; (2) the impact of legislation; (3) the role of education; and (4) the economic factor. Emphasis was especially placed on the new Family Code or Moudawana as having the greatest influence on advancement of women's rights in the sphere of marriage. However, participants pointed out that embedded patriarchal attitudes and behaviours limit its effectiveness. The study provided a comprehensive understanding of the factors that compound the problem of child and forced marriage in Morocco. From the viewpoint of professionals, who are closely involved in tackling the issue, policy measures and the law have the greatest potential to bring child and forced marriage to a halt. However, the implementation of new legal tools is facing barriers and resistance. Additionally, the legal and policy framework should go hand in hand
Wahlster, Philip; Goetghebeur, Mireille; Schaller, Sandra; Kriza, Christine; Kolominsky-Rabas, Peter
Health technology assessment and healthcare decision-making are based on multiple criteria and evidence, and heterogeneous opinions of participating stakeholders. Multi-criteria decision analysis (MCDA) offers a potential framework to systematize this process and take different perspectives into account. The objectives of this study were to explore perspectives and preferences across German stakeholders when appraising healthcare interventions, using multi-criteria assessment of a heart pulmonary sensor as a case study. An online survey of 100 German healthcare stakeholders was conducted using a comprehensive MCDA framework (EVIDEM V2.2). Participants were asked to provide i) relative weights for each criterion of the framework; ii) performance scores for a health pulmonary sensor, based on available data synthesized for each criterion; and iii) qualitative feedback on the consideration of contextual criteria. Normalized weights and scores were combined using a linear model to calculate a value estimate across different stakeholders. Differences across types of stakeholders were explored. The survey was completed by 54 participants. The most important criteria were efficacy, patient reported outcomes, disease severity, safety, and quality of evidence (relative weight >0.075 each). Compared to all participants, policymakers gave more weight to budget impact and quality of evidence. The quantitative appraisal of a pulmonary heart sensor revealed differences in scoring performance of this intervention at the criteria level between stakeholder groups. The highest value estimate of the sensor reached 0.68 (on a scale of 0 to 1, 1 representing maximum value) for industry representatives and the lowest value of 0.40 was reported for policymakers, compared to 0.48 for all participants. Participants indicated that most qualitative criteria should be considered and their impact on the quantitative appraisal was captured transparently. The study identified important
Background Globalisation has prompted countries to evaluate their position on trade in health services. However, this is often done from a multi-lateral, rather than a regional or bi-lateral perspective. In a previous review, we concluded that most of the issues raised could be better addressed from a bi-lateral relationship. We report here the results of a qualitative exercise to assess stakeholders' perceptions on the prospects for such a bi-lateral system, and its ability to address concerns associated with medical tourism. Methods 30 semi-structured interviews were carried out with stakeholders, 20 in India and 10 in the UK, to assess their views on the potential offered by a bi-lateral relationship on medical tourism between both countries. Issues discussed include data availability, origin of medical tourists, quality and continuity of care, regulation and litigation, barriers to medical tourism, policy changes needed, and prospects for such a bi-lateral relationship. Results The majority of stakeholders were concerned about the quality of health services patients would receive abroad, regulation and litigation procedures, lack of continuity of care, and the effect of such trade on the healthcare available to the local population in India. However, when considering trade from a bi-lateral point of view, there was disagreement on how these issues would apply. There was further disagreement on the importance of the Diaspora and the validity of the UK's 'rule' that patients should not fly more than three hours to obtain care. Although the opinion on the prospects for an India-UK bi-lateral relationship was varied, there was no consensus on what policy changes would be needed for such a relationship to take place. Conclusions Whilst the literature review previously carried out suggested that a bi-lateral relationship would be best-placed to address the concerns regarding medical tourism, there was scepticism from the analysis provided in this paper based on the
Smith Richard D
Full Text Available Abstract Background Globalisation has prompted countries to evaluate their position on trade in health services. However, this is often done from a multi-lateral, rather than a regional or bi-lateral perspective. In a previous review, we concluded that most of the issues raised could be better addressed from a bi-lateral relationship. We report here the results of a qualitative exercise to assess stakeholders' perceptions on the prospects for such a bi-lateral system, and its ability to address concerns associated with medical tourism. Methods 30 semi-structured interviews were carried out with stakeholders, 20 in India and 10 in the UK, to assess their views on the potential offered by a bi-lateral relationship on medical tourism between both countries. Issues discussed include data availability, origin of medical tourists, quality and continuity of care, regulation and litigation, barriers to medical tourism, policy changes needed, and prospects for such a bi-lateral relationship. Results The majority of stakeholders were concerned about the quality of health services patients would receive abroad, regulation and litigation procedures, lack of continuity of care, and the effect of such trade on the healthcare available to the local population in India. However, when considering trade from a bi-lateral point of view, there was disagreement on how these issues would apply. There was further disagreement on the importance of the Diaspora and the validity of the UK's 'rule' that patients should not fly more than three hours to obtain care. Although the opinion on the prospects for an India-UK bi-lateral relationship was varied, there was no consensus on what policy changes would be needed for such a relationship to take place. Conclusions Whilst the literature review previously carried out suggested that a bi-lateral relationship would be best-placed to address the concerns regarding medical tourism, there was scepticism from the analysis provided
Martínez Álvarez, Melisa; Chanda, Rupa; Smith, Richard D
Globalisation has prompted countries to evaluate their position on trade in health services. However, this is often done from a multi-lateral, rather than a regional or bi-lateral perspective. In a previous review, we concluded that most of the issues raised could be better addressed from a bi-lateral relationship. We report here the results of a qualitative exercise to assess stakeholders' perceptions on the prospects for such a bi-lateral system, and its ability to address concerns associated with medical tourism. 30 semi-structured interviews were carried out with stakeholders, 20 in India and 10 in the UK, to assess their views on the potential offered by a bi-lateral relationship on medical tourism between both countries. Issues discussed include data availability, origin of medical tourists, quality and continuity of care, regulation and litigation, barriers to medical tourism, policy changes needed, and prospects for such a bi-lateral relationship. The majority of stakeholders were concerned about the quality of health services patients would receive abroad, regulation and litigation procedures, lack of continuity of care, and the effect of such trade on the healthcare available to the local population in India. However, when considering trade from a bi-lateral point of view, there was disagreement on how these issues would apply. There was further disagreement on the importance of the Diaspora and the validity of the UK's 'rule' that patients should not fly more than three hours to obtain care. Although the opinion on the prospects for an India-UK bi-lateral relationship was varied, there was no consensus on what policy changes would be needed for such a relationship to take place. Whilst the literature review previously carried out suggested that a bi-lateral relationship would be best-placed to address the concerns regarding medical tourism, there was scepticism from the analysis provided in this paper based on the over-riding feeling that the political
Byron, Gerard; Ziedonis, Douglas M.; McGrath, Caroline; Frazier, Jean A.; deTorrijos, Fernando; Fulwiler, Carl
Occupational stress and burnout adversely impacts mental health care staff well-being and patient outcomes. Mindfulness training reduces staff stress and may improve patient care. However, few studies explore mental health setting implementation. This qualitative study used focus groups to evaluate stakeholders’ perceptions of organizational factors affecting implementation of an adapted version of Mindfulness-Based Stress Reduction (MBSR) for staff on adolescent mental health units. Common f...
Elms, Heather; Berman, Shawn; Wicks, Andrew C
This paper utilizes a qualitative case study of the health care industry and a recent legal case to demonstrate that stakeholder theory's focus on ethics, without recognition of the effects of incentives, severely limits the theory's ability to provide managerial direction and explain managerial behavior. While ethics provide a basis for stakeholder prioritization, incentives influence whether managerial action is consistent with that prioritization. Our health care examples highlight this and other limitations of stakeholder theory and demonstrate the explanatory and directive power added by the inclusion of the interactive effects of ethics and incentives in stakeholder ordering.
Reinwald, Anja Kaldahl; Kræmmergaard, Pernille
a stakeholder perspective. The paper reports how they succeeded in involving the most important stakeholders in the process of reaching transformational government. Finally the paper offers six lessons learned, based on the case study, about how to manage the involved stakeholders to reach transformational...
Koen, Jennifer; Essack, Zaynab; Slack, Catherine; Lindegger, Graham; Newman, Peter A
Civil society organizations (CSOs) have significantly impacted on the politics of health research and the field of bioethics. In the global HIV epidemic, CSOs have served a pivotal stakeholder role. The dire need for development of new prevention technologies has raised critical challenges for the ethical engagement of community stakeholders in HIV research. This study explored the perspectives of CSO representatives involved in HIV prevention trials (HPTs) on the impact of premature trial closures on stakeholder engagement. Fourteen respondents from South African and international CSOs representing activist and advocacy groups, community mobilisation initiatives, and human and legal rights groups were purposively sampled based on involvement in HPTs. Interviews were conducted from February-May 2010. Descriptive analysis was undertaken across interviews and key themes were developed inductively. CSO representatives largely described positive outcomes of recent microbicide and HIV vaccine trial terminations, particularly in South Africa, which they attributed to improvements in stakeholder engagement. Ongoing challenges to community engagement included the need for principled justifications for selective stakeholder engagement at strategic time-points, as well as the need for legitimate alternatives to CABs as mechanisms for engagement. Key issues for CSOs in relation to research were also raised. © 2012 John Wiley & Sons Ltd.
Apitz, Sabine E; Fitzpatrick, Anne G; McNally, Amanda; Harrison, David; Coughlin, Conor; Edwards, Deborah A
Regulatory decisions on remediation should consider affected communities' needs and values, and how these might be impacted by remedial options; this process requires that diverse stakeholders are able to engage in a transparent consideration of value trade-offs and of the distribution of risks and benefits associated with remedial actions and outcomes. The Stakeholder Values Assessment (SVA) tool was developed to evaluate remedial impacts on environmental quality, economic viability, and social equity in the context of stakeholder values and priorities. Stakeholder values were linked to the pillars of sustainability and also to a range of metrics to evaluate how sediment remediation affects these values. Sediment remedial alternatives proposed by the US Environmental Protection Agency (USEPA) for the Portland Harbor Superfund Site were scored for each metric, based upon data provided in published feasibility study (FS) documents. Metric scores were aggregated to generate scores for each value; these were then aggregated to generate scores for each pillar of sustainability. In parallel, the inferred priorities (in terms of regional remediation, restoration, planning, and development) of diverse stakeholder groups (SGs) were used to evaluate the sensitivity and robustness of the values-based sustainability assessment to diverse SG priorities. This approach, which addresses social indicators of impact and then integrates them with indicators of environmental and economic impacts, goes well beyond the Comprehensive Environmental Response, Compensation and Liability Act's (CERCLA) 9 criteria for evaluating remedial alternatives because it evaluates how remedial alternatives might be ranked in terms of the diverse values and priorities of stakeholders. This approach identified trade-offs and points of potential contention, providing a systematic, semiquantitative, transparent valuation tool that can be used in community engagement. Integr Environ Assess Manag 2018
Wallace, Sarah J; Worrall, Linda; Rose, Tanya; Le Dorze, Guylaine
This study synthesised the findings of three separate consensus processes exploring the perspectives of key stakeholder groups about important aphasia treatment outcomes. This process was conducted to generate recommendations for outcome domains to be included in a core outcome set for aphasia treatment trials. International Classification of Functioning, Disability, and Health codes were examined to identify where the groups of: (1) people with aphasia, (2) family members, (3) aphasia researchers, and (4) aphasia clinicians/managers, demonstrated congruence in their perspectives regarding important treatment outcomes. Codes were contextualized using qualitative data. Congruence across three or more stakeholder groups was evident for ICF chapters: Mental functions; Communication; and Services, systems, and policies. Quality of life was explicitly identified by clinicians/managers and researchers, while people with aphasia and their families identified outcomes known to be determinants of quality of life. Core aphasia outcomes include: language, emotional wellbeing, communication, patient-reported satisfaction with treatment and impact of treatment, and quality of life. International Classification of Functioning, Disability, and Health coding can be used to compare stakeholder perspectives and identify domains for core outcome sets. Pairing coding with qualitative data may ensure important nuances of meaning are retained. Implications for rehabilitation The outcomes measured in treatment research should be relevant to stakeholders and support health care decision making. Core outcome sets (agreed, minimum set of outcomes, and outcome measures) are increasingly being used to ensure the relevancy and consistency of the outcomes measured in treatment studies. Important aphasia treatment outcomes span all components of the International Classification of Functioning, Disability, and Health. Stakeholders demonstrated congruence in the identification of important
Herbst, Franziska A; Heckel, Maria; Tiedtke, Johanna M; Adelhardt, Thomas; Sturm, Alexander; Stiel, Stephanie; Ostgathe, Christoph
There is a lack of research into how hospital staff and institutional stakeholders (i. e. institutional representatives from public health authorities, hospital hygiene, and the departments of microbiology, palliative care, and geriatrics) engage with patients who are carriers of multidrug-resistant organisms and receiving end-of-life care. Knowledge of their experiences, workload, and needs should be considered in dealing with hospitalized carriers of multidrug-resistant organisms as well as staff education. This study explored and compared staff members' and stakeholders' perspectives on multidrug-resistant organisms and on provision of end-of-life care to carrier patients. In this study four focus groups consisting of hospital staff members and institutional stakeholders were formed within a mixed-methods parent study in a palliative care unit at a university clinic and a geriatric ward of a Catholic and academic teaching hospital. Participants discussed results from staff and stakeholder interviews from a former study phase. Data were analyzed according to Grounded Theory and perspectives of staff members and institutional stakeholders were compared and contrasted. Key issues debated by staff members (N = 19) and institutional stakeholders (N = 10) were 1) the additional workload, 2) reasons for uncertainty about handling carrier patients, 3) the format of continuing education, and 4) the preferred management approach for dealing with multidrug-resistant organism carrier patients. Although similar barriers (e. g. colleagues' ambiguous opinions) were identified, both groups drew different conclusions concerning the management of these barriers. While institutional stakeholders recommended making decisions on hygiene measures under consideration of the specific patient situation, staff members preferred the use of standardized hygiene measures which should be applied uniformly to all patients. Staff members and institutional stakeholders
Swan, Peter; Atkinson, Sarah
Arts and health organisations must increasingly provide measurable evidence of impact to stakeholders, which can pose both logistical and ideological challenges. This paper examines the relationship between the ethos of an arts and health organisation with external demands for evaluation. Research involved an ethnographic engagement where the first author worked closely with the organisation for a year. In addition to informal discussions, twenty semi-structured interviews were conducted with core staff and participants. Transcribed interviews were coded and emerging themes were identified. Staff considered evaluation to be necessary and useful, yet also to be time consuming and a potential threat to their ethos. Nevertheless, they were able to negotiate the terms of evaluation to enable them to meet their own needs as well as those of funders and other stakeholders. While not completely resisting outside demands for evaluation, the organisation was seen to intentionally rework demands for evidence into processes they felt they could work with, thus enabling their ethos to be maintained.
Nery-Hurwit, Mara; Kincl, Laurel; Driver, Simon; Heller, Brittany
Individuals with disabilities face increasing health and employment disparities, including increased risk of morbidity and mortality and decreased earnings, occupational roles, and greater risk of injury at work. Thus, there is a need to improve workplace safety and health promotion efforts for people with disability. The purpose of this study was to obtain stakeholder feedback about an online program, Be Active, Work Safe, which was developed to increase the physical activity and workplace safety practices of individuals with disability. Eight stakeholders (content experts and individuals with disability) evaluated the 8-week online program and provided feedback on accessibility, usability, and content using quantitative and qualitative approaches. Stakeholders suggested changes to the organization, layout and accessibility, and content. This included making a stronger connection between the physical activity and workplace safety components of the program, broadening content to apply to individuals in different vocational fields, and reducing the number of participant assessments. Engaging stakeholders in the development of health promotion programs is critical to ensure the unique issues of the population are addressed and facilitate engagement in the program. Feedback provided by stakeholders improved the program and provided insight on barriers for adoption of the program. Copyright © 2017 Elsevier Ltd. All rights reserved.
Roy, Virginie; Rivard, Marie-Claude; Trudeau, François
Around the world, various interventions have been developed to encourage the adoption of healthy lifestyles, particularly nutrition and physical activity. Physical, political, economic and socio-cultural environments have a major influence on individual attitudes in relation to healthy lifestyle. However, stakeholders with the greatest impact on improving these environments are not always well informed about the theory and their roles on the creation of environments favourable to healthy lifestyles. Various stakeholders from the province of Quebec were therefore invited to attend training sessions in order to prepare them to act on these four environments. 1) To describe the perceptions of the stakeholders who attended these sessions concerning the content and teaching methods and 2) to identify stakeholders’ changes of perceptions and practices following the training session. Twelve (12) focus groups and 52 individual interviews were conducted across Quebec with stakeholders who attended a training session. Our results indicate increased awareness of stakeholders on the importance of their role but also the need to more precisely target those aspects requiring increased awareness. A content better suited to the level of expertise is therefore proposed to maximize the benefits of these training sessions. Training sessions must be addressed to influential stakeholders with a limited knowledge on the subject, which is often the case for municipal decision-makers known to play a major role in promoting environments favourable to healthy eating and physical activity.
Dorsten, Aimee-Marie; Sifford, K Susan; Bharucha, Ashok; Mecca, Laurel Person; Wactlar, Howard
ASSISTIVE TECHNOLOGIES ARE RELATIVELY novel tools for research and daily care in long-term care (LTC) facilities that are faced with the burgeoning of the older adult population and dwindling staffing resources. The degree to which stakeholders in LTC facilities are receptive to the use of these technologies is poorly understood. Eighteen semi-structured focus groups and one interview were conducted with relevant groups of stakeholders at seven LTC facilities in southwestern Pennsylvania. Common themes identified across all focus groups centered on concerns for privacy, autonomy, cost, and safety associated with implementation of novel technologies. The relative importance of each theme varied by stakeholder group as well as the perceived severity of cognitive and/or physical disability. Our findings suggest that ethical issues are critical to acceptance of novel technologies by their end users, and that stakeholder groups are interdependent and require shared communication about the acceptance of these emerging technologies.
Caniato, Marco; Vaccari, Mentore; Visvanathan, Chettiyappan; Zurbrügg, Christian
Highlights: • Assessment of infectious waste management in Bangkok, in particular incineration. • Integration of social network and stakeholder analysis assessment methods. • Assessment of stakeholder characteristics, role, interaction and communication. • Interviewees self-evaluate their own characteristics and the system. • Non-technical aspects are important for system acceptability, and sustainability. - Abstract: Assessing the strengths and weaknesses of a solid waste management scheme requires an accurate analysis and integration of several determining features. In addition to the technical aspects, any such system shows a complex interaction of actors with varying stakes, decision-making power and influence, as well as a favourable or disabling environment. When capitalizing on the knowledge and experience from a specific case, it is also crucial that experts do not “forget” or underestimate the importance of such social determinants and that they are familiar with the methods and tools to assess them. Social network analysis (SNA) and stakeholder analysis (SA) methods can be successfully applied to better understand actors’ role and actions, analyse driving forces and existing coordination among stakeholders, as well as identify bottlenecks in communication which affect daily operations or strategic planning for the future way forward. SNA and SA, appropriately adjusted for a certain system, can provide a useful integration to methods by assessing other aspects to ensure a comprehensive picture of the situation. This paper describes how to integrate SNA and SA in order to survey a solid waste management system. This paper presents the results of an analysis of On-Nuch infectious waste incinerator in Bangkok, Thailand. Stakeholders were interviewed and asked to prioritize characteristics and relationships which they consider particularly important for system development and success of the scheme. In such a way, a large quantity of information
Caniato, Marco, E-mail: email@example.com [University of Brescia, Research Centre on Appropriate Technologies for Environmental Management in Developing Countries (CeTAmb), Via Branze, 43, 25123 Brescia (Italy); Vaccari, Mentore, E-mail: firstname.lastname@example.org [University of Brescia, Research Centre on Appropriate Technologies for Environmental Management in Developing Countries (CeTAmb), Via Branze, 43, 25123 Brescia (Italy); Visvanathan, Chettiyappan, E-mail: email@example.com [Asian Institute of Technology (AIT), School of Environment, Resources and Development (SERD), P.O. Box 4, Klong Luang, Pathumthani 12120 (Thailand); Zurbrügg, Christian, E-mail: firstname.lastname@example.org [University of Brescia, Research Centre on Appropriate Technologies for Environmental Management in Developing Countries (CeTAmb), Via Branze, 43, 25123 Brescia (Italy); Eawag: Swiss Federal Institute of Aquatic Science and Technology, Department of Water and Sanitation in Developing Countries (Sandec), Ueberlandstrasse 133, 8600 Duebendorf (Switzerland)
Highlights: • Assessment of infectious waste management in Bangkok, in particular incineration. • Integration of social network and stakeholder analysis assessment methods. • Assessment of stakeholder characteristics, role, interaction and communication. • Interviewees self-evaluate their own characteristics and the system. • Non-technical aspects are important for system acceptability, and sustainability. - Abstract: Assessing the strengths and weaknesses of a solid waste management scheme requires an accurate analysis and integration of several determining features. In addition to the technical aspects, any such system shows a complex interaction of actors with varying stakes, decision-making power and influence, as well as a favourable or disabling environment. When capitalizing on the knowledge and experience from a specific case, it is also crucial that experts do not “forget” or underestimate the importance of such social determinants and that they are familiar with the methods and tools to assess them. Social network analysis (SNA) and stakeholder analysis (SA) methods can be successfully applied to better understand actors’ role and actions, analyse driving forces and existing coordination among stakeholders, as well as identify bottlenecks in communication which affect daily operations or strategic planning for the future way forward. SNA and SA, appropriately adjusted for a certain system, can provide a useful integration to methods by assessing other aspects to ensure a comprehensive picture of the situation. This paper describes how to integrate SNA and SA in order to survey a solid waste management system. This paper presents the results of an analysis of On-Nuch infectious waste incinerator in Bangkok, Thailand. Stakeholders were interviewed and asked to prioritize characteristics and relationships which they consider particularly important for system development and success of the scheme. In such a way, a large quantity of information
Lu, Yingjie; Wu, Yang; Liu, Jingfang; Li, Jia; Zhang, Pengzhu
Health care social media used for health information exchange and emotional communication involves different types of users, including patients, caregivers, and health professionals. However, it is difficult to identify different stakeholders because user identification data are lacking due to privacy protection and proprietary interests. Therefore, identifying the concerns of different stakeholders and how they use health care social media when confronted with huge amounts of health-related messages posted by users is a critical problem. We aimed to develop a new content analysis method using text mining techniques applied in health care social media to (1) identify different health care stakeholders, (2) determine hot topics of concern, and (3) measure sentiment expression by different stakeholders. We collected 138,161 messages posted by 39,606 members in lung cancer, diabetes, and breast cancer forums in the online community MedHelp.org over 10 years (January 2007 to October 2016) as experimental data. We used text mining techniques to process text data to identify different stakeholders and determine health-related hot topics, and then analyzed sentiment expression. We identified 3 significantly different stakeholder groups using expectation maximization clustering (3 performance metrics: Rand=0.802, Jaccard=0.393, Fowlkes-Mallows=0.537; Phealth-related topics: symptom, examination, drug, procedure, and complication (Rand=0.783, Jaccard=0.369, Fowlkes-Mallows=0.495; Psocial media services to facilitate diverse stakeholder engagement for health information sharing and social interaction more effectively. ©Yingjie Lu, Yang Wu, Jingfang Liu, Jia Li, Pengzhu Zhang. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 07.04.2017.
Kornum, Niels; Mühlbacher, Hans
This article introduces the special issue on multi-stakeholder virtual dialogue. Research as well as managerial practice in marketing has traditionally focused on single stakeholders and a one-way communication perspective. This special issue takes a novel approach by directing attention...... success. While marketing literature increasingly recognizes that divers stakeholders have an impact on a company''s success, little is known about how virtual multi-stakeholder dialogue changes marketing research and management. This special issue provides insights on what roles stakeholders may play...... to the simultaneous interaction with and of a variety of stakeholders and the fact that customers and other stakeholders of a company can take the initiative to that interaction. Stakeholders can launch a discussion, spread news, participate in value creation, can heavily influence each other and a company''s market...
Liu, Peng; Zhou, Yuan; Zhou, Dillon K.; Xue, Lan
Small-and-medium-sized enterprises (SMEs) are significant to China's emission reduction programme. This research aims to improve our understanding of the challenge of diffusing green-manufacturing technologies among SMEs in China. Specifically, this study examines the Chinese Government's effort to facilitate reduction of energy consumption among SMEs through Energy Performance Contracts (EPCs) to incentivize domestic manufacturers to adopt energy efficient measures (EEMs) in order to reduce demand for energy and corresponding drop in emissions. The data is gathered from relevant EPC stakeholders in the National Motor Upgrading Demonstration Project and its implementation in Dongguan city, which is based on 30 in-depth interviews and 6 focus group discussions. Using stakeholder analysis, this study finds that guaranteed energy savings model is the favorite model in implementation, given the gained benefits outweigh committed resources, and the control capability overrides possible risks among the two core stakeholders. The outcomes of this study may allow the government to have a clear understanding of stakeholder perception of the different EPC models used in China so the design and deployment of these mechanisms can be improved. - Highlights: • Examine the barriers faced by green technologies when they are promoted to SMEs on a large scale. • Explain why green technology diffusion is thwarted when stakeholders cannot reach compromises. • Find that the guaranteed energy savings model is the best mechanism for upgrading SMEs. • Note that new EPC models and new policies are needed to increase stakeholders’ adoption rate.
Stout, Nicole L; Andrews, Kimberly; Binkley, Jill M; Schmitz, Kathryn H; Smith, Robert A
The prospective surveillance model proposes a paradigm shift in the delivery of care for patients with breast cancer. The model is based on clinical research and clinical practice experience that was reviewed and discussed at a multidisciplinary meeting. The model identifies critical physical sequelae of treatment as well as timeframes for identification of and surveillance for these issues. Although the model of ongoing assessment for physical impairment and early rehabilitative intervention creates a framework for care, broad support and active dissemination among a variety of stakeholders will be required to transform patient care. Translating research findings to transform practice often occurs on a protracted timeline. The authors sought participation from a variety of stakeholder representatives throughout the process of creating this model in an effort to ensure that it reflects the realities of the patient experience and care delivery, to incorporate their input regarding the construct and viability of the model, and to potentiate effective and efficient strategies for implementation. This article summarizes comments from stakeholder representatives concerning the prospective surveillance model for rehabilitation for women treated for breast cancer. Concerns addressed include the scope of impairments included in the model, the potential creation of barriers to exercise and participation in community exercise programs, and cost and feasibility issues. Stakeholder disseminations strategies are also presented. Overall, there is recognition by the stakeholder group that this model calls attention to important unmet needs and defines a crucial opportunity to improve care for breast cancer survivors. Copyright © 2012 American Cancer Society.
Fraser, Trish; Kira, Anette
To investigate views of New Zealand key stakeholders (stakeholders) and smokers on very low nicotine content (VLNC) cigarettes, and a policy mandating that only VLNC cigarettes are available for sale. Using a semi-structured interview schedule, we interviewed 17 stakeholders and held focus groups with 21 smokers. Questions were asked about VLNC cigarettes and a VLNC cigarette-only policy. Smokers were given approximately 15 VLNC cigarettes to take home and smoke. One week after the focus groups, 17 smokers were interviewed. Data were analysed using a general inductive approach. Stakeholders and smokers were largely unconvinced of the value of a mandated reduction in nicotine in cigarettes. After smoking VLNC cigarettes, smokers had less interest in them but would support them being sold alongside high nicotine content (HNC) cigarettes at a much cheaper price. The government is not likely to mandate nicotine reduction in cigarettes if there is a perceived lack of support from stakeholders or smokers. However, they could make VLNC cigarettes available as an option for smokers utilising a differential tax favouring VLNC cigarettes. If this were combined with better access to nicotine containing e-cigarettes, smokers may shift away from HNC cigarettes.
Sparrevik, M.; Ellen, G.J.; Duijn, M.
The management of environmental pollution has changed considerably since the growth of environmental awareness in the late 1960s. The general increased environmental concern and involvement of stakeholders in today's environmental issues may enhance the need to consider risk in a much broader social
Supporting the "Infrastructure Needs of 21st Century School Library Programs," also known as the Pennsylvania School Library Project, was a one-year project conducted in Pennsylvania to better identify and understand what stakeholders--teachers, administrators, parents, school and community leaders, and education associations--expect…
Full Text Available Based on the modern contract theory, expectancy theory, and stakeholder theory, this paper analyzes how stakeholders relationship influences the efficiency of commercial banks and finds that the efficiency is a function of stakeholders relationship. A DEA model with Seiford's linear transformation function is developed to evaluate the efficiency in consideration of the undesirable output. The panel Tobit model is established to conduct empirical research with data of 14 Chinese commercial banks from 2004 to 2012. The study finds that except for business customer relation, stakeholder relationship is the key variable that influences comprehensive efficiency of commercial banks.
Wolsink, M.; Breukers, S.
This paper analyses patterns in beliefs about the implementation of wind power as part of a geographical comparison of onshore wind power developments in the Netherlands, North-Rhine Westphalia and England. Q methodology is applied, in order to systematically compare the patterns in stakeholder
van Duin, Ron; Slabbekoorn, Marijn; Tavasszy, L.A.; Quak, H
Cities’ sustainability strategies seem to aim at the reduction of the negative impacts of urban freight transport.In the past decades, many public and private initiatives have struggled to gain broad stakeholder support and thus remain viable. Researchers and practitioners have only recently
Ron van Duin; Marijn Slabbekoorn; Lori Tavasszy; Hans Quak
Cities’ sustainability strategies seem to aim at the reduction of the negative impacts of urban freight transport. In the past decades, many public and private initiatives have struggled to gain broad stakeholder support and thus remain viable. Researchers and practitioners have only recently
Conallin, John; McLoughlin, Craig A.; Campbell, Josh; Knight, Roger; Bright, Troy; Fisher, Ian
The complex nature of freshwater systems provides challenges for incorporating evidence-based techniques into management. This paper investigates the potential of participatory evidence-based techniques to involve local stakeholders and make decisions based on different "knowledge" sources within adaptive management programs. It focuses on the application of thresholds of potential concern (TPC) within strategic adaptive management (SAM) for facilitating inclusive decision-making. The study is based on the case of the Edward-Wakool (E-W) "Fish and Flows" SAM project in the Murray-Darling River Basin, Australia. We demonstrate the application of TPCs for improving collaborative decision-making within the E-W, associated with environmental watering requirements, and other natural resource management programs such as fish stocking. The development of TPCs in the E-W fish and flows SAM project helped improve stakeholder involvement and understanding of the system, and also the effectiveness of the implemented management interventions. TPCs ultimately helped inform environmental flow management activities. The TPC process complemented monitoring that was already occurring in the system and provided a mechanism for linking formal and informal knowledge to form explicit and measurable endpoints from objectives. The TPC process faced challenges due to the perceived reduction in scientific rigor within initial TPC development and use. However, TPCs must remain tangible to managers and other stakeholders, in order to aid in the implementation of adaptive management. Once accepted by stakeholders, over time TPCs should be reviewed and refined in order to increase their scientific rigor, as new information is generated.
Flak, Leif Skiftenes; Rose, Jeremy
to e-Government. Originally a management theory, stakeholder theory advocates addressing the concerns of all stakeholders in a firm, as opposed to concentration on the interests of senior managers and stockholders. Apart from the original profit focus, there is no serious conceptual mismatch between...... of governance. Finally, the paper makes recommendations for future work in adapting ST to the e-government context....
Asayut, Narong; Sookaneknun, Phayom; Chaiyasong, Surasak; Saramunee, Kritsanee
Identify costs, outcomes and stakeholders' perspectives associated with incorporation of community pharmacy services into the Thai National Health Insurance System and their values to all stakeholders. Using a combination of search terms, a comprehensive literature search was performed using the Thai Journal Citation Index Centre, Health System Research Institute database, PubMed and references from recent reviews. Identified studies were published between January 2000 and December 2014. The review included publications in English and Thai on primary research undertaken in community pharmacies associated with the National Health Insurance System. Two independent authors performed study selection, data extraction and quality assessment. The literature search yielded 251 titles, with 18 satisfying the inclusion criteria. Clinical outcomes of community pharmacy services included control and reduction in blood pressure and blood sugar, improved adherence to medications, an increase in acceptance of interventions, and an increase in healthy behaviours. Thirty-three percentage of those at risk of diabetes and hypertension achieved normal blood sugar and blood pressure levels after being followed for 2-6 months by a community pharmacist. The cost of collaborative screening by community pharmacies and primary care units was US$ 4.5. Diabetes management costs were US$ 5.1-30.7. Community pharmacists reported high satisfaction rates. Stakeholders' perspectives revealed support for the community pharmacists' roles and the inclusion of community pharmacies as partners with the National Health Insurance System. Community pharmacy services improved outcomes for diabetic and hypertensive patients. This review supports the feasibility of incorporating community pharmacies into the Thai National Health System. © 2017 Royal Pharmaceutical Society.
Steinke, Claudia; Webster, Lynn; Fontaine, Marie
Using the environment as a strategic tool is one of the most cost-effective and enduring approaches for improving public health; however, it is one that requires multiple perspectives. The purpose of this article is to highlight an innovative methodology that has been developed for conducting comprehensive performance evaluations in public sector health facilities in Canada. The building performance evaluation methodology described in this paper is a government initiative. The project team developed a comprehensive building evaluation process for all new capital health projects that would respond to the aforementioned need for stakeholders to be more accountable and to better integrate the larger organizational strategy of facilities. The Balanced Scorecard, which is a multiparadigmatic, performance-based business framework, serves as the underlying theoretical framework for this initiative. It was applied in the development of the conceptual model entitled the Building Performance Evaluation Scorecard, which provides the following benefits: (1) It illustrates a process to link facilities more effectively to the overall mission and goals of an organization; (2) It is both a measurement and a management system that has the ability to link regional facilities to measures of success and larger business goals; (3) It provides a standardized methodology that ensures consistency in assessing building performance; and (4) It is more comprehensive than traditional building evaluations. The methodology presented in this paper is both a measurement and management system that integrates the principles of evidence-based design with the practices of pre- and post-occupancy evaluation. It promotes accountability and continues throughout the life cycle of a project. The advantage of applying this framework is that it engages health organizations in clarifying a vision and strategy for their facilities and helps translate those strategies into action and measurable performance
Cooper, Vanessa A.; Lichtenstein, Sharman; Smith, Ross
This chapter explores the provision of after-sales information technology (IT) support services using Web-based self-service systems (WSSs) in a business-to-business (B2B) context. A recent study conducted at six large multi-national IT support organisations revealed a number of critical success factors (CSFs) and stakeholder-based issues. To better identify and understand these important enablers and barriers, we explain how WSSs should be considered within a complex network of service providers, business partners and customer firms. The CSFs and stakeholder-based issues are discussed. The chapter highlights that for more successful service provision using WSSs, IT service providers should collaborate more effectively with enterprise customers and business partners and should better integrate their WSSs.
This study describes and interprets differences in stakeholder interaction as rhetorically constructed in environmental reports and in interviews with environmental managers. It also interprets the role of the natural environment among stakeholders, and discusses how that role is justified or not justified. The study focuses in a business perspective on stakeholder interaction in environmental management. Characteristically, stakeholder studies of environmental management have concentrated on...
Gaston Meskens; Erik Laes; Gilbert Eggermont
Full text of publication follows: Our modern society is increasingly faced with challenges and problems that cannot be solved by a purely technical, political or social approach. Radioactive waste disposal site selection and management can be characterised as one of these challenges that require a trans-disciplinary approach, integrating social, philosophical and ethical aspects in a 'technical' practice. Along the spirit of this trans-disciplinary approach, and in order to ensure the necessary public support for a policy decision regarding this practice, stakeholder involvement is more and more seen as a necessary policy element in the decision making process. The aim is to achieve the broad involvement of individuals from civil society, with significant representation from local communities, elected representatives and NGO's, as well as scientists from outside radioactive waste management organisations, together with established players in the field, such as the implementers of radioactive waste management, public authorities, experts and waste producers. Several initiatives regarding stakeholder involvement in radioactive waste management have been taken already in Europe, as well in the research era as in 'the real world'. The presentation will give a state of the art by examining some representative examples on both national and European level. The focus will be on the main social, philosophical and ethical aspects of the problem at stake, seen through a trans-disciplinary research lens. The presentation will conclude with some ideas that could inspire as well theoretical researchers as stakeholders-in-the-field. (authors)
Meskens, Gaston; Laes, Erik; Eggermont, Gilbert
Our modern society is increasingly faced with challenges and problems that cannot be solved by a purely technical, political or social approach. Radioactive waste disposal site selection and management can be characterised as one of these challenges that require a transdisciplinary approach, integrating social, philosophical and ethical aspects in a 'technical' practice. Along the spirit of this transdisciplinary approach, and in order to ensure the necessary public support for a policy decision regarding this practice, stakeholder involvement is more and more seen as a necessary policy element in the decision making process. The aim is to achieve the broad involvement of individuals from civil society, with significant representation from local communities, elected representatives and NGO's, as well as scientists from outside radioactive waste management organisations, together with established players in the field, such as the implementers of radioactive waste management, public authorities, experts and waste producers. Several initiatives regarding stakeholder involvement in radioactive waste management have been taken already in Europe, as well in the research era as in 'the real world'. The presentation will give a state of the art by examining some representative examples on both national and European level. The focus will be on the main social, philosophical and ethical aspects of the problem at stake, seen through a transdisciplinary research lens. The presentation will conclude with some ideas that could inspire as well theoretical researchers as stakeholders-in-the-field (Full text of contribution)
This report resents evaluations, recommendations, and requirements concerning Tunable Hybrid Plasma (THP) derived from a three-year program of stake holder involvement. THP destroys volatile organic compounds by directing a moderate energy electron beam into a flow of air containing organic contaminants. This report is for technology developers and for those responsible for making decisions about the use of technology to remediate contamination by volatile organic compounds. Stakeholders` perspectives help those responsible for technology deployment make good decisions concerning the acceptability and applicability of THP to the remediation problems the face. In addition, this report presents data requirements for the technology`s field demonstration defined by stakeholders associated with the Hanford site in Washington State, as well as detailed comments on THP from stakeholders from four other sites throughout the western United States.
This report resents evaluations, recommendations, and requirements concerning Tunable Hybrid Plasma (THP) derived from a three-year program of stake holder involvement. THP destroys volatile organic compounds by directing a moderate energy electron beam into a flow of air containing organic contaminants. This report is for technology developers and for those responsible for making decisions about the use of technology to remediate contamination by volatile organic compounds. Stakeholders' perspectives help those responsible for technology deployment make good decisions concerning the acceptability and applicability of THP to the remediation problems the face. In addition, this report presents data requirements for the technology's field demonstration defined by stakeholders associated with the Hanford site in Washington State, as well as detailed comments on THP from stakeholders from four other sites throughout the western United States
Bautista, Susana; Zucca, Claudio; Urghege, Anna M.; Ramón Vallejo, V.
knowledge exchange at multiple levels. The change between the initial and final perspectives on the assessment criteria and the quality of the management actions assessed was considered to be a metric of the learning gained through the IAPro process. A decrease in the variability of weights and rates given by the stakeholders to each criteria and management action reflects the consensus building process that takes place during the discussion sessions.
Maxian Rusche, Tim
In order to step up its efforts in reducing climate change, the European Commission (hereafter: the Commission) has launched in June 2000 its European climate change program (hereafter: ECCP). This wide-ranging stakeholder consultation aimed at identifying and developing all elements necessary for a European climate change strategy. The ECCP formally came to a close in April 2003. This paper analyses the inner workings of ECCP, and how ECCP has delivered with regard to its objectives. Special attention is paid to ECCP's Working Group 1, 'Flexible Mechanisms', which developed the foundations for the European emission trading scheme (hereafter: EU ETS). The paper draws on documents published on the Commission's ECCP web-site, on academic literature, on press releases from stakeholders and on interviews with four participants in the ECCP process. Using this method, the paper offers important insights as to how the consensus-building for establishing the world's biggest carbon-trading scheme has started long time before the formal legislative process. (author)
Grafakos, S.; Zevgolis, D.; Oikonomou, V.
Evaluation of energy and climate policy interactions is a complex issue which has not been addressed systematically. Multi Criteria Decision Analysis (MCDA) evaluation processes have been applied widely to different policy and decision cases as they have the ability to cope with high complexity, by structuring and analyzing the policy problem in a transparent and systematic way. Criteria weights elicitation techniques are developed within the framework of MCDA to integrate stakeholders' preferential information in the decision making and evaluation process. There are variant methods to determine criteria weights which can be used in various ways for different policy evaluation purposes. During decision making, policy makers and relevant stakeholders implicitly or explicitly express their relative importance between the evaluation criteria by assigning weighting factors to them. More particular, climate change policy problems lack a simple, transparent and structured way to incorporate stakeholders' views and values. In order to incorporate stakeholders' weighting preferences into an ex ante evaluation of climate change and energy policy instruments interaction, an integrative constructive weighting methodology has been developed. This paper presents the main characteristics of evaluation of energy and climate policy interactions, the reasoning behind the development of the weighting tool, its main theoretical and functional characteristics and the results of its application to obtain and incorporate stakeholders' preferences on energy and climate change policy evaluation criteria. The weighting method that has been elaborated and applied to derive stakeholders' preferences for criteria weights is a combination of pair wise comparisons and ratio importance weighting methods. Initially introduces the stakeholders to the evaluation process through a warming up holistic approach for ranking the criteria and then requires them to express their ratio relative importance
Svirydzenka, Nadzeya; Ronzoni, Pablo; Dogra, Nisha
Defining quality in health presents many challenges. The Institute of Medicine (IOM) defined quality clinical care as care that is equitable, timely, safe, efficient, effective and patient centred. However, it is not clear how different stakeholders within a child and adolescent mental health service (CAMHS) understand and/or apply this framework. This project aims to identify key stakeholders" understanding of the meaning of quality in the context of CAMHS. The study sample comprised of three groups: (i) patients and carers, (ii) CAMHS clinical staff, and (iii) commissioners (Total N = 24). Semi-structured interviews were used to collect data and thematic analysis was applied to explore participant's views on the meaning and measurement of quality and how these might reflect the IOM indicators and their relevance in CAMHS. An initial barrier to implementing quality care in CAMHS was the difficulty and limited agreement in defining the meaning of quality care, its measurement and implementation for all participants. Clinical staff defined quality as personal values, a set of practical rules, or clinical discharge rates; while patients suggested being more involved in the decision-making process. Commissioners, while supportive of adequate safeguarding and patient satisfaction procedures, did not explicitly link their view on quality to commissioning guidelines. Identifying practical barriers to implementing quality care was easier for all interviewees and common themes included: lack of meaningful measures, recourses, accountability, and training. All interviewees considered the IOM six markers as comprehensive and relevant to CAMHS. No respondent individually or within one stakeholder group identified more than a few of the indicators or barriers of a quality CAMHS service. However, the composite responses of the respondents enable us to develop a more complete picture of how to improve quality care in practice and guide future research in the area.
Hodge, Judith; Herforth, Anna; Gillespie, Stuart; Beyero, Mesfin; Wagah, Margaret; Semakula, Richard
There is growing recognition that "nutrition-sensitive" development is necessary to ensure nutrition security and reduce malnutrition. While agriculture has the potential to be a strong driver of malnutrition reduction and serves as the main source of livelihood for approximately two-thirds of East Africa's population, its potential to reduce malnutrition is currently not being realized. Leveraging Agriculture for Nutrition in East Africa is a research study based in Ethiopia, Kenya, and Uganda that seeks to understand the enabling environment necessary for optimizing the contribution of the food and agriculture sector to nutrition outcomes. Its objectives were to explore stakeholder perceptions of nutrition-agriculture linkages, of political and institutional challenges and opportunities, of evidence that is available and influential for policy making, and of key issues with regard to capacity. Open-ended and semistructured interviews were conducted with 53 stakeholders from government, civil society, donors, United Nations organizations, private sector, and research/academic institutions in Ethiopia, Kenya, and Uganda in 2014. Although policy opportunities and contexts are different between the 3 countries, stakeholders identified similar barriers to greater action, including a narrow focus on solely market-oriented and staple crop production, a lack of clarity and incentives within the agriculture sector about improving nutrition and how to translate policy into action, and lack of capacity in human and financial resources. Many actions to improve the nutrition sensitivity of agriculture were mentioned, including crop diversification, value chain activities and improved market access, nutrition education, and reduction in time and labor costs to women. Many opportunities exist to strengthen the impact of agriculture on nutrition in East Africa, but stronger formulation and implementation of policies will require adequate human resources, funds, timely data on
Tindana, Paulina; Molyneux, Catherine S; Bull, Susan; Parker, Michael
For many decades, access to human biological samples, such as cells, tissues, organs, blood, and sub-cellular materials such as DNA, for use in biomedical research, has been central in understanding the nature and transmission of diseases across the globe. However, the limitations of current ethical and regulatory frameworks in sub-Saharan Africa to govern the collection, export, storage and reuse of these samples have resulted in inconsistencies in practice and a number of ethical concerns for sample donors, researchers and research ethics committees. This paper examines stakeholders' perspectives of and responses to the ethical issues arising from these research practices. We employed a qualitative strategy of inquiry for this research including in-depth interviews and focus group discussions with key research stakeholders in Kenya (Nairobi and Kilifi), and Ghana (Accra and Navrongo). The stakeholders interviewed emphasised the compelling scientific importance of sample export, storage and reuse, and acknowledged the existence of some structures governing these research practices, but they also highlighted the pressing need for a number of practical ethical concerns to be addressed in order to ensure high standards of practice and to maintain public confidence in international research collaborations. These concerns relate to obtaining culturally appropriate consent for sample export and reuse, understanding cultural sensitivities around the use of blood samples, facilitating a degree of local control of samples and sustainable scientific capacity building. Drawing on these findings and existing literature, we argue that the ethical issues arising in practice need to be understood in the context of the interactions between host research institutions and local communities and between collaborating institutions. We propose a set of 'key points-to-consider' for research institutions, ethics committees and funding agencies to address these issues.
Ray, Kristin N; Miller, Elizabeth
Stakeholder engagement is an emerging field with little evidence to inform best practices. Guidelines are needed to improve the quality of research on stakeholder engagement through more intentional planning, evaluation and reporting. We developed a preliminary framework for planning, evaluating and reporting stakeholder engagement, informed by published conceptual models and recommendations and then refined through our own stakeholder engagement experience. Our proposed exploratory framework highlights contexts and processes to be addressed in planning stakeholder engagement, and potential immediate, intermediate and long-term outcomes that warrant evaluation. We use this framework to illustrate both the minimum information needed for reporting stakeholder-engaged research and the comprehensive detail needed for reporting research on stakeholder engagement.
Schneider, Jennifer L; Davis, James; Kauffman, Tia L; Reiss, Jacob A; McGinley, Cheryl; Arnold, Kathleen; Zepp, Jamilyn; Gilmore, Marian; Muessig, Kristin R; Syngal, Sapna; Acheson, Louise; Wiesner, Georgia L; Peterson, Susan K; Goddard, Katrina A B
Evidence-based guidelines recommend that all newly diagnosed colon cancer be screened for Lynch syndrome (LS), but best practices for implementing universal tumor screening have not been extensively studied. We interviewed a range of stakeholders in an integrated health-care system to identify initial factors that might promote or hinder the successful implementation of a universal LS screening program. We conducted interviews with health-plan leaders, managers, and staff. Interviews were audio-recorded and transcribed. Thematic analysis began with a grounded approach and was also guided by the Practical Robust Implementation and Sustainability Model (PRISM). We completed 14 interviews with leaders/managers and staff representing involved clinical and health-plan departments. Although stakeholders supported the concept of universal screening, they identified several internal (organizational) and external (environment) factors that promote or hinder implementation. Facilitating factors included perceived benefits of screening for patients and organization, collaboration between departments, and availability of organizational resources. Barriers were also identified, including: lack of awareness of guidelines, lack of guideline clarity, staffing and program "ownership" concerns, and cost uncertainties. Analysis also revealed nine important infrastructure-type considerations for successful implementation. We found that clinical, laboratory, and administrative departments supported universal tumor screening for LS. Requirements for successful implementation may include interdepartmental collaboration and communication, patient and provider/staff education, and significant infrastructure and resource support related to laboratory processing and systems for electronic ordering and tracking.
Chen, Huey T
The Campbellian validity model and the traditional top-down approach to validity have had a profound influence on research and evaluation. That model includes the concepts of internal and external validity and within that model, the preeminence of internal validity as demonstrated in the top-down approach. Evaluators and researchers have, however, increasingly recognized that in an evaluation, the over-emphasis on internal validity reduces that evaluation's usefulness and contributes to the gulf between academic and practical communities regarding interventions. This article examines the limitations of the Campbellian validity model and the top-down approach and provides a comprehensive, alternative model, known as the integrative validity model for program evaluation. The integrative validity model includes the concept of viable validity, which is predicated on a bottom-up approach to validity. This approach better reflects stakeholders' evaluation views and concerns, makes external validity workable, and becomes therefore a preferable alternative for evaluation of health promotion/social betterment programs. The integrative validity model and the bottom-up approach enable evaluators to meet scientific and practical requirements, facilitate in advancing external validity, and gain a new perspective on methods. The new perspective also furnishes a balanced view of credible evidence, and offers an alternative perspective for funding. Copyright (c) 2009 Elsevier Ltd. All rights reserved.
El-Jardali, Fadi; Adam, Taghreed; Ataya, Nour; Jamal, Diana; Jaafar, Maha
Systems Thinking (ST) has recently been promoted as an important approach to health systems strengthening. However, ST is not common practice, particularly in Low- and Middle-Income Countries (LMICs). This paper seeks to explore the barriers that may hinder its application in the Eastern Mediterranean Region (EMR) and possible strategies to mitigate them. A survey consisting of open-ended questions was conducted with a purposive sample of health policy-makers such as senior officials from the Ministry of Health (MoH), researchers, and other stakeholders such as civil society groups and professional associations from ten countries in the region. A total of 62 respondents participated in the study. Thematic analysis was conducted. There was strong recognition of the relevance and usefulness of ST to health systems policy-making and research, although misconceptions about what ST means were also identified. Experience with applying ST was very limited. Approaches to designing health policies in the EMR were perceived as reactive and fragmented (66%). Commonly perceived constraints to application of ST were: a perceived notion of its costliness combined with lack of the necessary funding to operationalize it (53%), competing political interests and lack of government accountability (50%), lack of awareness about relevance and value (47%), limited capacity to apply it (45%), and difficulty in coordinating and managing stakeholders (39%). While several strategies have been proposed to mitigate most of these constraints, they emphasized the importance of political endorsement and adoption of ST at the leadership level, together with building the necessary capacity to apply it and apply the learning in research and practice.
Shea, Emma O'; Timmons, Suzanne; Shea, Eamon O'; Fox, Siobhan; Irving, Kate
Respite services provide a break in the caregiving relationship for people with dementia and their carers, however they are often under-used and service acceptability can be low. This study aims to understand key stakeholders' experiences of respite services for people with dementia, with a view to informing respite service development. A systematic search was conducted of the Pubmed/MedLine, Embase, Cinahl, PsychInfo, Scopus, Web of Science, and Cochrane databases (1980-2016, English) with fixed search terms relating to 'respite' and 'dementia', following PRISMA guidelines. Noblit and Hare's approach to meta-ethnography was employed. Key concepts were identified across the papers and reciprocal and refutational translation techniques were applied to primary studies; findings were synthesized into third order interpretations and finally, a 'line-of-argument' was developed. In total 23 papers were reviewed, which described 20 independent samples across 12 countries. The views of 889 participants were synthesized (13 people with dementia, 690 carers, 44 'service providers', 52 frontline staff, 70 managers, 12 volunteers, six academic/policy-makers, and two independent consultants). Five key concepts were identified and outlined i.e. 1) the transition to service use 2) expanding organizational capacity 3) dementia care quality 4) building a collaborative care partnership and 5) dyad restoration. There was broad agreement around the key areas for service development across the range of stakeholders (flexible and responsive person-centred care, meaningful activity for people with dementia, enhanced client-service communication and informational support). However, there was clear divergence in stakeholder perspectives around the barriers to implementation of such developments. Organizational tension was evident between frontline staff and management in respite services, hindering the cultural change necessary to facilitate service development in line with dyad's needs
Harclerode, Melissa A; Lal, Pankaj; Vedwan, Neeraj; Wolde, Bernabas; Miller, Michael E
Stakeholder engagement is a vital sustainable remediation practice for obtaining useful feedback and identifying societal needs. Evaluating and integrating risk perception of stakeholders into remediation and outreach efforts allows for greater insight, increases the likelihood of success and ultimately, benefits the community by protecting its members from environmental hazards. In this study, we identified risk perception factors that influenced residents' level of concern for mitigating their exposure to elevated concentrations of lead in household paint and historic fill material. Risk perception factors were assessed by an in-person survey conducted in public green spaces. The analysis of survey participants' responses indicated that their perception of risk to exposed lead was mostly influenced by the presence of hazardous materials in close proximity to their residence, the ability to address pollution, and awareness, interest, and individual accountability in mitigating environmental risks. Responses also revealed that residents considered risk of lead and soil pollution as less menacing than the presence of more immediate and perceptible risks posed by factors such as air and water pollution. In addition, the community seemed to exhibit "optimism bias" and did not identify itself at high risk to susceptible and immediate hazards, including lead exposure. This lack of concern over lead exposure created a significant obstacle to community participation in state-led education and outreach programs. By integrating risk perception analysis and increasing stakeholder engagement, we can bring more attention to this issue, educate the public about the threat of lead pollution, and efficiently use financial resources to implement a more sustainable solution. Copyright © 2016. Published by Elsevier Ltd.
Laycock, Alison; Bailie, Jodie; Matthews, Veronica; Cunningham, Frances; Harvey, Gillian; Percival, Nikki; Bailie, Ross
Bringing together continuous quality improvement (CQI) data from multiple health services offers opportunities to identify common improvement priorities and to develop interventions at various system levels to achieve large-scale improvement in care. An important principle of CQI is practitioner participation in interpreting data and planning evidence-based change. This study will contribute knowledge about engaging diverse stakeholders in collaborative and theoretically informed processes to identify and address priority evidence-practice gaps in care delivery. This paper describes a developmental evaluation to support and refine a novel interactive dissemination project using aggregated CQI data from Aboriginal and Torres Strait Islander primary healthcare centres in Australia. The project aims to effect multilevel system improvement in Aboriginal and Torres Strait Islander primary healthcare. Data will be gathered using document analysis, online surveys, interviews with participants and iterative analytical processes with the research team. These methods will enable real-time feedback to guide refinements to the design, reports, tools and processes as the interactive dissemination project is implemented. Qualitative data from interviews and surveys will be analysed and interpreted to provide in-depth understanding of factors that influence engagement and stakeholder perspectives about use of the aggregated data and generated improvement strategies. Sources of data will be triangulated to build up a comprehensive, contextualised perspective and integrated understanding of the project's development, implementation and findings. The Human Research Ethics Committee (HREC) of the Northern Territory Department of Health and Menzies School of Health Research (Project 2015-2329), the Central Australian HREC (Project 15-288) and the Charles Darwin University HREC (Project H15030) approved the study. Dissemination will include articles in peer-reviewed journals, policy
This report presents evaluations, recommendations, and requirements concerning passive soil vapor extraction (PSVE) derived from a three-year program of stakeholder involvement. PSVE takes advantage of the naturally occurring tendency of soil vapor to leave the subsurface during periods of low barometric pressure. PSVE seeks to expedite the release of volatile contaminants through the use of boreholes and technological enhancements. This report is for technology developers and those responsible for making decisions about the use of technology to remediate contamination by volatile organic compounds. Stakeholders' perspectives help those responsible for technology deployment to make good decisions concerning the acceptability and applicability of PSVE to the remediation problems they face. The report provides: stakeholders' final evaluation of the acceptability of PSVE in light of the technology's field test; stakeholders' principal comments concerning PSVE; requirements that stakeholders have of any remediation technology. Technology decision makers should take these conclusions into account in evaluating the effectiveness and acceptability of any remedial method proposed for their site. In addition, the report presents data requirements for the technology's field demonstration defined by stakeholders associated with the Hanford site in Washington State, as well as detailed comments on PSVE from stakeholders from Sandia National Laboratory, Rocky Flats, Idaho National Engineering Laboratory, and Los Alamos National Laboratory
Birken, Sarah A; Urquhart, Robin; Munoz-Plaza, Corrine; Zizzi, Alexandra R; Haines, Emily; Stover, Angela; Mayer, Deborah K; Hahn, Erin E
The purpose of this study was to compare outcomes assessed in extant randomized controlled trials (RCTs) to outcomes that stakeholders expect from survivorship care plans (SCPs). To facilitate the transition from active treatment to follow-up care for the 15.5 million US cancer survivors, many organizations require SCP use. However, results of several RCTs of SCPs' effectiveness have been null, possibly because they have evaluated outcomes on which SCPs should be expected to have limited influence. Stakeholders (e.g., survivors, oncologists) may expect outcomes that differ from RCTs' outcomes. We identified RCTs' outcomes using a PubMed literature review. We identified outcomes that stakeholders expect from SCPs using semistructured interviews with stakeholders in three healthcare systems in the USA and Canada. Finally, we mapped RCTs' outcomes onto stakeholder-identified outcomes. RCT outcomes did not fully address outcomes that stakeholders expected from SCPs, and RCTs assessed outcomes that stakeholders did not expect from SCPs. RCTs often assessed outcomes only from survivors' perspectives. RCTs of SCPs' effectiveness have not assessed outcomes that stakeholders expect. To better understand SCPs' effectiveness, future RCTs should assess outcomes of SCP use that are relevant from the perspective of multiple stakeholders. SCPs' effectiveness may be optimized when used with an eye toward outcomes that stakeholders expect from SCPs. For survivors, this means using SCPs as a map to guide them with respect to what kind of follow-up care they should seek, when they should seek it, and from whom they should seek it.
Patel, Haridarshan N; Ursan, Iulia D; Zueger, Patrick M; Cavallari, Larisa H; Pickard, A Simon
Pharmacogenomics has an important role in the evolution of personalized medicine, and its widespread uptake may ultimately depend on the interests and perspectives of key players in health care. Our aim was to summarize studies on stakeholder perspectives and attitudes toward pharmacogenomic testing. Thus, we conducted a review of original research studies that reported stakeholder views on pharmacogenomic testing using a structured approach in PubMed, International Pharmaceutical Abstracts, Cumulative Index to Nursing and Allied Health Literature, and EMBASE. A standardized data abstraction form was developed that included stakeholder group of interest-patients, general public, providers, and payers. Stakeholder views regarding barriers to pharmacogenetic implementation were organized into the following themes: ancillary information-related, clinical, economic, educational, ethical or legal, medical mistrust, and practicality. Of 34 studies that met our inclusion criteria, 37 perspectives were reported (15 on providers, 9 on the general public, 9 on patients, and 4 on payers). The most common topics that arose in studies of providers related to clinical usefulness of genetic data (n=11) and educational needs (n=11). Among the general public, the most common concerns were medical mistrust (n=5), insufficient education (n=5), and practicality (n=5). The most prevalent issues from the patient perspective were ethical or legal (n=6) and economic (n=5) issues. Among payers, leading issues were practicality (n=4) and clinical usefulness (n=3). There was overlap in the topics and concerns across stakeholder perspectives, including lack of knowledge about pharmacogenomic testing. Views on issues related to privacy, cost, and test result dissemination varied by stakeholder perspective. Limited research had been conducted in underrepresented groups. Efforts to address the issues raised by stakeholders may facilitate the implementation of pharmacogenomic testing into
Hannon, Peggy A; Hammerback, Kristen; Garson, Gayle; Harris, Jeffrey R; Sopher, Carrie J
Study goals were to (1) describe stakeholder perceptions of workplace health promotion (WHP) appropriateness, (2) describe barriers and facilitators to implementing WHP, (3) learn the extent to which WHP programs are offered to workers' spouses and partners and assess attitudes toward including partners in WHP programs, and (4) describe willingness to collaborate with nonprofit agencies to offer WHP. Five 1.5-hour focus groups. The focus groups were conducted with representatives of midsized (100-999 workers) workplaces in the Seattle metropolitan area, Washington state. Thirty-four human resources professionals in charge of WHP programs and policies from five low-wage industries: accommodation/food services, manufacturing, health care/social assistance, education, and retail trade. A semistructured discussion guide. Qualitative analysis of focus group transcripts using grounded theory to identify themes. Most participants viewed WHP as appropriate, but many expressed reservations about intruding in workers' personal lives. Barriers to implementing WHP included cost, time, logistical challenges, and unsupportive culture. Participants saw value in extending WHP programs to workers' partners, but were unsure how to do so. Most were willing to work with nonprofit agencies to offer WHP. Midsized, low-wage employers face significant barriers to implementing WHP; to reach these employers and their workers, nonprofit agencies and WHP vendors need to offer WHP programs that are inexpensive, turnkey, and easy to adapt.
Lukasiewicz, Anna; Dare, Melanie (Lain)
This paper explores environmental water management as a social process of navigating conflicting interests through a distributive justice lens. Environmental water management can achieve substantial ecological outcomes and address ongoing river degradation caused by past management and climate change; however it also causes specific and substantial burdens and benefits to different groups of stakeholders. Given that in most developed countries the majority of land is under private tenure, environmental watering must have active cooperation of private landholders to achieve its ecological outcomes and thus it must effectively deal with an array of vested interests. Australia's reforms aimed at reallocating water from production to the environment have resulted in significant considerable volumes of environmental water. In the state of New South Wales, this water is managed by the state and national governments with the help of five Environmental Water Advisory Groups made up of a wide representation of interests. In this paper, we explore the perceptions of environmental, government, irrigator and grazing representatives, which demonstrate conflicting principles over how environmental water should be distributed. We detail how government water managers reconcile competing distributive principles of equity (ensuring that no one is disproportionally affected or benefits unduly), need (achieving environmental outcomes) and efficiency (prioritizing operational feasibility) in order to maintain the social acceptability of environmental water.
Alameddine, Mohamad; Yassoub, Rami; Mourad, Yara; Khodr, Hiba
This study explores the recruitment and retention conditions influencing primary health care (PHC) human resources for health (HRH) in Qatar and suggests strategies for their improvement. A qualitative design employing semistructured key informant interviews with PHC stakeholders in Qatar was utilized. Key interviewees were originally recognized, and snowball sampling was used to identify additional interviewees until reaching saturation point. Interview scripts were transcribed and then analyzed thematically using the Nvivo software package. Thematic analysis precipitated a number of themes. Under recruitment, the centrality of enhancing collaboration with academic institutions, enhancing extrinsic benefits, and strengthening human resources recruitment and management practices. Dedicated support needs to be provided to expatriate HRH especially in regard to housing services, children schooling, and streamlining administrative processes for relocation. Findings revealed that job security, continuous professional development, objective performance appraisal systems, enhanced job transparency, and remuneration are key retention concerns. The study provides a number of recommendations for the proper recruitment and retention of HRH. Health planners and decision makers must take these recommendations into consideration to ensure the presence of a competent and sustainable HRH in the PHC sector in the future.
Uneke, Chigozie Jesse; Ezeoha, Abel Ebeh; Ndukwe, Chinwendu Daniel; Oyibo, Patrick Gold; Onwe, Friday; Aulakh, Bhupinder Kaur
Nigeria is one of the low and middle income countries (LMICs) facing severe resource constraint, making it impossible for adequate resources to be allocated to the health sector. Priority setting becomes imperative because it guides investments in health care, health research and respects resource constraints. The objective of this study was to enhance the knowledge and understanding of policymakers on research priority setting and to conduct a research priority setting exercise. A one-day evidence-to-policy research priority setting meeting was held. The meeting participants included senior and middle level policymakers and key decision makers/stakeholders in the health sector in Ebonyi State southeastern Nigeria. The priorities setting meeting involved a training session on priority setting process and conduction of priority setting exercise using the essential national health research (ENHR) approach. The focus was on the health systems building blocks (health workforce; health finance; leadership/governance; medical products/technology; service delivery; and health information/evidence). Of the total of 92 policymakers invited 90(97.8%) attended the meeting. It was the consensus of the policymakers that research should focus on the challenges of optimal access to health products and technology; effective health service delivery and disease control under a national emergency situation; the shortfalls in the supply of professional personnel; and the issues of governance in the health sector management. Research priority setting exercise involving policymakers is an example of demand driven strategy in the health policymaking process capable of reversing inequities and strengthening the health systems in LMICs.
Gulikers, J.T.M.; Baartman, L.K.J.; Biemans, H.
Schools are held more responsible for evaluating, quality assuring and improving their student assessments. Teachers’ lack of understanding of new, competence-based assessments as well as the lack of key stakeholders’ involvement, hamper effective and efficient self-evaluations by teachers of
Gulikers, J.T.M.; Baartman, L.; Biemans, H.J.A.
Schools are held more responsible for evaluating, quality assuring and improving their student assessments. Teachers’ lack of understanding of new, competence-based assessments as well as the lack of key stakeholders’ involvement, hamper effective and efficient self-evaluations by teachers of
Campbell, Bernadette; Mark, Melvin M.
Evaluation theories can be tested in various ways. One approach, the experimental analogue study, is described and illustrated in this article. The approach is presented as a method worthy to use in the pursuit of what Alkin and others have called descriptive evaluation theory. Drawing on analogue studies conducted by the first author, we…
Ehrenkranz, Peter D; Calleja, Jesus Mg; El-Sadr, Wafaa; Fakoya, Ade O; Ford, Nathan; Grimsrud, Anna; Harris, Kate L; Jed, Suzanne L; Low-Beer, Daniel; Patel, Sadhna V; Rabkin, Miriam; Reidy, William John; Reinisch, Annette; Siberry, George K; Tally, Leigh A; Zulu, Isaac; Zaidi, Irum
The World Health Organization's (WHO) recommendation of "Treat All" has accelerated the call for differentiated antiretroviral therapy (ART) delivery, a method of care that efficiently uses limited resources to increase access to HIV treatment. WHO has further recommended that stable individuals on ART receive refills every 3 to 6 months and attend clinical visits every 3 to 6 months. However, there is not yet consensus on how to ensure that the quality of services is maintained as countries strive to meet these standards. This commentary responds to this gap by defining a pragmatic approach to the monitoring and evaluation (M&E) of the scale up of differentiated ART delivery for global and national stakeholders. Programme managers need to demonstrate that the scale up of differentiated ART delivery is achieving the desired effectiveness and efficiency outcomes to justify continued support by national and global stakeholders. To achieve this goal, the two existing global WHO HIV treatment indicators of ART retention and viral suppression should be augmented with two broad aggregate measures. The addition of indicators measuring the frequency of (1) clinical and (2) refill visits by PLHIV per year will allow evaluation of the pace of scale up while monitoring its overall effect on the quality and efficiency of services. The combination of these four routinely collected aggregate indicators will also facilitate the comparison of outcomes among facilities, regions or countries implementing different models of ART delivery. Enhanced monitoring or additional assessments will be required to answer other critical questions on the process of implementation, acceptability, effectiveness and efficiency. These proposed outcomes are useful markers for the effectiveness and efficiency of the health system's attempts to deliver quality treatment to those who need it-and still reserve as much of the available resource pool as possible for other key elements of the HIV response
Full Text Available Joanne Morris,1 Karen Grimmer,2 Lisa Gilmore,1 Chandima Perera,3 Gordon Waddington,4 Greg Kyle,4 Bryan Ashman,5 Karen Murphy61The Physiotherapy Department, The Canberra Hospital, ACT Health, Canberra, ACT, Australia; 2International Centre for Allied Health Evidence, University of South Australia, Adelaide, SA, Australia; 3Department of Rheumatology, The Canberra Hospital, Canberra, ACT, Australia; 4The Faculty of Health, University of Canberra, Canberra, ACT, Australia; 5Department of Surgical Services, The Canberra Hospital, Canberra, ACT, Australia; 6Office of Allied Health Advisor, ACT Health, Canberra, ACT, AustraliaAbstract: Sustainable implementation of new workforce redesign initiatives requires strategies that minimize barriers and optimize supports. Such strategies could be provided by a set of guiding principles. A broad understanding of the concerns of all the key stakeholder groups is required before effective strategies and initiatives are developed. Many new workforce redesign initiatives are not underpinned by prior planning, and this threatens their uptake and sustainability. This study reports on a cross-sectional qualitative study that sought the perspectives of representatives of key stakeholders in a new workforce redesign initiative (extended-scope-of-practice physiotherapy in one Australian tertiary hospital. The key stakeholder groups were those that had been involved in some way in the development, management, training, funding, and/or delivery of the initiative. Data were collected using semistructured questions, answered individually by interview or in writing. Responses were themed collaboratively, using descriptive analysis. Key identified themes comprised: the importance of service marketing; proactively addressing barriers; using readily understood nomenclature; demonstrating service quality and safety, monitoring adverse events, measuring health and cost outcomes; legislative issues; registration; promoting viable
Gobel, B.; Zwart, D. De; Hesselink, G.J.; Pijnenborg, L.; Barach, P.; Kalkman, C.J.; Johnson, J.K.
BACKGROUND: Much of the research on improving patient handovers has focused on enhancing communication within the hospital system, but there have been relatively few efforts aimed at addressing the challenges at the interface between the hospital and the primary care setting. METHODS: A qualitative
Fusheini, Adam; Marnoch, Gordon; Gray, Ann Marie
Background: Ghana’s National Health Insurance Scheme (NHIS), established by an Act of Parliament (Act 650), in 2003 and since replaced by Act 852 of 2012 remains, in African terms, unprecedented in terms of growth and coverage. As a result, the scheme has received praise for its associated legal reforms, clinical audit mechanisms and for serving as a hub for knowledge sharing and learning within the context of South-South cooperation. The scheme continues to shape national health insurance thinking in Africa. While the success, especially in coverage and financial access has been highlighted by many authors, insufficient attention has been paid to critical and context-specific factors. This paper seeks to fill that gap. Methods: Based on an empirical qualitative case study of stakeholders’ views on challenges and success factors in four mutual schemes (district offices) located in two regions of Ghana, the study uses the concept of policy translation to assess whether the Ghana scheme could provide useful lessons to other African and developing countries in their quest to implement social/NHISs. Results: In the study, interviewees referred to both ‘hard and soft’ elements as driving the "success" of the Ghana scheme. The main ‘hard elements’ include bureaucratic and legal enforcement capacities; IT; financing; governance, administration and management; regulating membership of the scheme; and service provision and coverage capabilities. The ‘soft’ elements identified relate to: the background/context of the health insurance scheme; innovative ways of funding the NHIS, the hybrid nature of the Ghana scheme; political will, commitment by government, stakeholders and public cooperation; social structure of Ghana (solidarity); and ownership and participation. Conclusion: Other developing countries can expect to translate rather than re-assemble a national health insurance programme in an incomplete and highly modified form over a period of years
Vemulakonda, Vijaya M; Jones, Jacqueline
Randomized controlled trials (RCTs) are considered the gold standard for assessing treatment efficacy. However, pediatric surgical RCTs have been limited in their ability to recruit patients. The purpose of this study was to identify barriers and motivators to pediatric participation in surgical RCTs. We conducted a series of two focus groups with parents and one focus group with urology providers for children aged analysis of focus group findings. Theme analysis was used for all qualitative transcribed text data obtained from focus groups and open-ended survey questions using team-based inductive approaches. Descriptive statistics were obtained for the remainder of the provider survey. Using qualitative text from stakeholders (n = 38) we identified four key themes across the data: responsibility to my child; responsibility to my patient; responsibility to the field; and irreversibility of surgery. Participants felt there was an obligation to be informed of relevant scientific research within a clinic research culture. However, there remains a disconnect for parents between randomized research studies that may ultimately benefit their child, depending on their age and concern their child is being treated as a 'guinea pig'. Some parents were willing to participate in RCTs but all were more open to participate in an observational study where the treatment decisions were felt to be under their control even when there was no "right answer" or multiple equivalent options for treatment. There was mixed opinion across the parents and providers whether research trial education and enrollment should be provided by the pediatrician or urologist. Active physician decisions were seen as critical within the context of a long term clinical relationship and provision of information of risks and benefits without pressure were considered essential for ethical research by both parents and providers. While some parents are open to participation in surgical RCTs, providers and
Full Text Available Background Ghana’s National Health Insurance Scheme (NHIS, established by an Act of Parliament (Act 650, in 2003 and since replaced by Act 852 of 2012 remains, in African terms, unprecedented in terms of growth and coverage. As a result, the scheme has received praise for its associated legal reforms, clinical audit mechanisms and for serving as a hub for knowledge sharing and learning within the context of South-South cooperation. The scheme continues to shape national health insurance thinking in Africa. While the success, especially in coverage and financial access has been highlighted by many authors, insufficient attention has been paid to critical and context-specific factors. This paper seeks to fill that gap. Methods Based on an empirical qualitative case study of stakeholders’ views on challenges and success factors in four mutual schemes (district offices located in two regions of Ghana, the study uses the concept of policy translation to assess whether the Ghana scheme could provide useful lessons to other African and developing countries in their quest to implement social/NHISs. Results In the study, interviewees referred to both ‘hard and soft’ elements as driving the “success” of the Ghana scheme. The main ‘hard elements’ include bureaucratic and legal enforcement capacities; IT; financing; governance, administration and management; regulating membership of the scheme; and service provision and coverage capabilities. The ‘soft’ elements identified relate to: the background/context of the health insurance scheme; innovative ways of funding the NHIS, the hybrid nature of the Ghana scheme; political will, commitment by government, stakeholders and public cooperation; social structure of Ghana (solidarity; and ownership and participation. Conclusion Other developing countries can expect to translate rather than re-assemble a national health insurance programme in an incomplete and highly modified form over a period
Burns, Michael; Baylor, Carolyn; Dudgeon, Brian J; Starks, Helene; Yorkston, Kathryn
The purpose of this study was to explore the experiences of patients with aphasia, their family members, and physicians related to communication during medical interactions. Face-to-face, semistructured interviews were conducted with 18 participants—6 patients with aphasia, 6 family members involved in patient care, and 6 practicing physicians. A qualitative description approach was used to collect and summarize narratives from participants' perspectives and experiences. Participants were asked about experiences with communication during medical interactions in which the family member accompanied the patient. Interviews were audio- and/or video-recorded, transcribed, and then coded to identify main themes. Patients and family members generally described their communication experiences as positive, yet all participants discussed challenges and frustrations. Three themes emerged: (a) patients and family members work as a team, (b) patients and family members want physicians to "just try" to communicate with the patient, and (c) physicians want to interact with patients but may not know how. Participants discussed the need for successful accommodation, or changing how one communicates, to help facilitate the patients' increased understanding and ability to express themselves. Over- and underaccommodation with communication were commonly reported as problems. Speech-language pathologists have a role to play in helping to improve communication during medical interactions. Implications for current speech-language pathologist practice and future directions of research are discussed.
Decision makers often need assistance in understanding the dynamic interactions and linkages among economic, environmental and social systems in coastal watersheds. They also need scientific input to better evaluate the potential costs and benefits of intervention options. The US...
McCusker, Jane; Yaffe, Mark; Sussman, Tamara; Kates, Nick; Mulvale, Gillian; Jayabarathan, Ajantha; Law, Susan; Haggerty, Jeannie
To develop a framework for research and evaluation of collaborative mental health care for depression, which includes attributes or domains of care that are important to consumers. A literature review on collaborative mental health care for depression was completed and used to guide discussion at an interactive workshop with pan-Canadian participants comprising people treated for depression with collaborative mental health care, as well as their family members; primary care and mental health practitioners; decision makers; and researchers. Thematic analysis of qualitative data from the workshop identified key attributes of collaborative care that are important to consumers and family members, as well as factors that may contribute to improved consumer experiences. The workshop identified an overarching theme of partnership between consumers and practitioners involved in collaborative care. Eight attributes of collaborative care were considered to be essential or very important to consumers and family members: respectfulness; involvement of consumers in treatment decisions; accessibility; provision of information; coordination; whole-person care; responsiveness to changing needs; and comprehensiveness. Three inter-related groups of factors may affect the consumer experience of collaborative care, namely, organizational aspects of care; consumer characteristics and personal resources; and community resources. A preliminary evaluation framework was developed and is presented here to guide further evaluation and research on consumer-centred collaborative mental health care for depression.
Mak, Angela Ka Ying
Cancer and return to work has been extensively studied in the Western context and yet it has not received much academic attention in Asia. This paper aims to review the current Singapore government rehabilitation initiatives in collaboration with the policy community, identify the socio-environmental barriers to implementing the existing programs for cancer survivors, highlights the demand-side of research development and illustrates the viewpoints of small and medium enterprise employers in Singapore from a recent study. Implications and future directions in developing evidence-based rehabilitation policies and initiatives for cancer survivors in Singapore and the Southeast Asian region are also discussed. A review of occupational rehabilitation literature relevant to Singapore looking at legislation, policies, initiatives and services was performed. Current state-of-art research in occupational rehabilitation from an employer perspective was also synthesized. Challenges and barriers of adopting the current rehabilitation initiatives and programs for cancer survivors exist largely due to the lack of centralized effort, clear definitions and understanding between people with disabilities, chronic illness and cancer as well as an evidence-based policy community. In addition, too much emphasis on new hiring than retaining in current services and there are no specific guidelines to help employers deal with issues when retaining employees with health history, such as workplace accommodation, appraisal, discrimination and grievance handling. Palpable blind spots in the current occupational rehabilitation system and policy were highlighted in this paper. Coupled with systemic improvements, continuous government resource support and developing an evidence-based policy community between the government, employers, healthcare professionals, industry and community partners and non-profit organizations, a positive change of the rehabilitation initiatives and services is
Hull, Naomi S; Schubert, Lisa C; Smith, Julie P
Breastfeeding is widely accepted as an important public health issue for babies and their mothers. Yet, despite this, Australia continues to struggle with reaching global targets for breastfeeding indicators. In 2007, the Best Start Parliamentary Inquiry Report was released and set the stage for the Australian National Breastfeeding Strategy [2010-2015), which was announced in November 2009, with the vision to increase Australia's breastfeeding rates of infants at 6 months of age and beyond. The aim of this research project was to explore the perspectives of key stakeholders in the field of infant feeding in Australia on the implementation of the strategy, barriers and enablers to its successful implementation and actions that were still needed. Using qualitative research methods of in-depth, semi-structured interviews and thematic analysis, this study identifies main themes of these perceptions about the strategy implementation and some recommendations for future strategies and further research. The main themes identified were initial opinions of the strategy as a blueprint for action, the strategy as a driver for action, lessons learned and recommendations for the future. For success in improving implementation of national breastfeeding strategies, it is recommended that Australia establish an independent breastfeeding/infant feeding committee, increase the political prioritisation of issues surrounding infant feeding and strengthen the regulation of the marketing of breastmilk substitutes.
This report presents evaluations, recommendations, and requirements concerning ResonantSonic Drilling (Sonic Drilling), derived from a three-year program of stakeholder involvement. Sonic Drilling is an innovative method to reach contamination in soil and groundwater. The resonant sonic drill rig uses counter-rotating weights to generate energy, which causes the drill pipe to vibrate elastically along its entire length. In the resonant condition, forces of up to 200,000 pounds are transmitted to the drill bit face to create a cutting action. The resonant energy causes subsurface materials to move back into the adjacent formation, permitting the drill pipe to advance. This report is for technology developers and those responsible for making decisions about the use of technology to remediate contamination by volatile organic compounds. Stakeholders' perspectives help those responsible for technology deployment to make good decisions concerning the acceptability and applicability of sonic drilling to the remediation problems they face
Edge, Karen; Marphatia, Akanksha A.
This paper details our collaborative work on the Improving Learning Outcomes in Primary Schools (ILOPS) project in Burundi, Malawi, Uganda and Senegal. ILOPS set out to establish an innovative template for multi-stakeholder, multinational participatory evaluation (PE) and examine the fundamental roles, relationships and evidence that underpin the…
A detailed report examining the role of public outreach and stakeholder engagement in stormwater funding decisions based on the experiences of eleven small and medium-sized communities in New England.
Kneafsey, Rosie; Brown, Sarah; Sein, Kim; Chamley, Carol; Parsons, Joanne
To report findings from a qualitative study of key stakeholders' perspectives on 'compassion' in the health care context. To present the 'Framework for Compassionate Interpersonal Relations'. Although many research articles, health policies and health care strategies identify compassion as an underpinning value and key component of health care quality, identifying a unified definition of compassion is challenging. For Higher Education Institutions implementing 'values-based' recruitment processes, a clearer understanding of this core concept is vital. Exploratory, qualitative design. Academic staff, health care students, clinicians and service users (n = 45), participated in nine focus groups where they were asked to define compassion in the context of health care. Data were transcribed verbatim and analysed using thematic analysis. Four overarching themes were drawn from the data. The first theme centred on the participants' definitions of compassion, while the second identified compassionate behaviours. The third theme related to the barriers and threats to compassionate practice and the fourth, focused on ways to support compassion in practice. Participants believed that the health care staff should be 'consistently compassionate', and were emphatic that compassion should not be substituted with a 'care without engagement' approach. The findings concur with other research, which identifies the link between compassion and empathy and the importance of establishing meaningful connections with others. While participants in this study recognised the pressures of health care work and accepted that the expectation of 'consistent compassion' was not necessarily realistic, it was still seen as an important goal. Participants held clear expectations regarding practitioners' communication skills and used these as a proxy for compassionate practice. The 'Framework for Compassionate Inter-personal Relations' may be used to promote reflection on the implementation of
Haywood, Kirstie; Lyddiatt, Anne; Brace-McDonnell, Samantha J; Staniszewska, Sophie; Salek, Sam
Active patient engagement is increasingly viewed as essential to ensuring that patient-driven perspectives are considered throughout the research process. However, guidance for patient engagement (PE) in HRQoL research does not exist, the evidence-base for practice is limited, and we know relatively little about underpinning values that can impact on PE practice. This is the first study to explore the values that should underpin PE in contemporary HRQoL research to help inform future good practice guidance. A modified 'World Café' was hosted as a collaborative activity between patient partners, clinicians and researchers: self-nominated conference delegates participated in group discussions to explore values associated with the conduct and consequences of PE. Values were captured via post-it notes and by nominated note-takers. Data were thematically analysed: emergent themes were coded and agreement checked. Association between emergent themes, values and the Public Involvement Impact Assessment Framework were explored. Eighty participants, including 12 patient partners, participated in the 90-min event. Three core values were defined: (1) building relationships; (2) improving research quality and impact; and (3) developing best practice. Participants valued the importance of building genuine, collaborative and deliberative relationships-underpinned by honesty, respect, co-learning and equity-and the impact of effective PE on research quality and relevance. An explicit statement of values seeks to align all stakeholders on the purpose, practice and credibility of PE activities. An innovative, flexible and transparent research environment was valued as essential to developing a trustworthy evidence-base with which to underpin future guidance for good PE practice.
Alyamani, Talal M.
Environmental issues and reliance on fossil fuel sources, including coal, oil, and natural gas, are the two most common energy issues that are currently faced by the United States (U.S.). Incorporation of renewable energy sources, a non-economical option in electricity generation compared to conventional sources that burn fossil fuels, single handedly promises a viable solution for both of these issues. Several energy policies have concordantly been suggested to reduce the financial burden of adopting renewable energy technologies and make such technologies competitive with conventional sources throughout the U.S. This study presents a modeling and analysis approach for comprehensive evaluation of renewable energy policies with respect to their benefits to various related stakeholders--customers, utilities, governmental and environmental agencies--where the debilitating impacts, advantages, and disadvantages of such policies can be assessed and quantified at the state level. In this work, a novel simulation framework is presented to help policymakers promptly assess and evaluate policies from different perspectives of its stakeholders. The proposed framework is composed of four modules: 1) a database that collates the economic, operational, and environmental data; 2) elucidation of policy, which devises the policy for the simulation model; 3) a preliminary analysis, which makes predictions for consumption, supply, and prices; and 4) a simulation model. After the validity of the proposed framework is demonstrated, a series of planned Florida and Texas renewable energy policies are implemented into the presented framework as case studies. Two solar and one energy efficiency programs are selected as part of the Florida case study. A utility rebate and federal tax credit programs are selected as part of the Texas case study. The results obtained from the simulation and conclusions drawn on the assessment of current energy policies are presented with respect to the
Kumar, M.; Tiwari, M. K.; Wong, K. Y.
The paper aims to illustrate the use of fuzzy data envelopment analysis (DEA) in analyzing reverse supply chain (RSC) performance from the manufacturer's perspective. By using an alternative alpha-cut approach, the fuzzy DEA model was converted into a crisp linear programming problem, thereby...... usually ensures an environmentally friendly supply chain network, companies which have implemented RSC techniques since a longer duration do not necessarily have a more efficient supply chain in general....
Rockstroh, M; Franke, S; Hofer, M; Will, A; Kasparick, M; Andersen, B; Neumuth, T
Clinical working environments have become very complex imposing many different tasks in diagnosis, medical treatment, and care procedures. During the German flagship project OR.NET, more than 50 partners developed technologies for an open integration of medical devices and IT systems in the operating room. The aim of the present work was to evaluate a large set of the proposed concepts from the perspectives of various stakeholders. The demonstration OR is focused on interventions from the head and neck surgery and was developed in close cooperation with surgeons and numerous colleagues of the project partners. The demonstration OR was qualitatively evaluated including technical as well as clinical aspects. In the evaluation, a questionnaire was used to obtain feedback from hospital operators. The clinical implications were covered by structured interviews with surgeons, anesthesiologists and OR staff. In the present work, we qualitatively evaluate a subset of the proposed concepts from the perspectives of various stakeholders. The feedback of the clinicians indicates that there is a need for a flexible data and control integration. The hospital operators stress the need for tools to simplify risk management in openly integrated operating rooms. The implementation of openly integrated operating rooms will positively affect the surgeons, the anesthesiologists, the surgical nursing staff, as well as the technical personnel and the hospital operators. The evaluation demonstrated the need for OR integration technologies and identified the missing tools to support risk management and approval as the main barriers for future installments.
van der Putten, Ingeborg M; Evers, Silvia M A A; Deogaonkar, Rohan; Jit, Mark; Hutubessy, Raymond C W
Current health economic evaluation guidelines mainly concentrate on immediate health gains and cost savings for the individual involved in the intervention. However, it has been argued that these guidelines are too narrow to capture the full impact of vaccination in low and middle income countries. The inclusion of broader economic impact of vaccines (BEIV) has therefore been proposed. Some examples of these are productivity-related gains, macro-economic impact, and different externalities. Despite their potency, the extent to which such benefits can and should be incorporated into economic evaluations of vaccination is still unclear. This mixed methods study aims to assess the relevance of BEIV to different stakeholders involved in the vaccine introduction decision making process. In this mixed method study an internet based survey was sent to attendees of the New and Underutilized Vaccines Initiative meeting in Montreux, Switzerland in 2011. Additionally, semi-structured interviews of 15 minutes each were conducted during the meeting. Study participants included decision makers, experts and funders of vaccines and immunization programs in low and middle income countries. Descriptive analysis of the survey, along with identification of common themes and factors extracted from the interviews and open survey questions was undertaken. Evidence on macro-economic impact, burden of disease and ecological effects were perceived as being most valuable towards aiding decision making for vaccine introduction by the 26 survey respondents. The 14 interviewees highlighted the importance of burden of disease and different types of indirect effects. Furthermore, some new interpretations of BEIVs were discussed, such as the potential negative impact of wastage during immunization programs and the idea of using vaccines as a platform for delivering other types of health interventions. Interviewees also highlighted the importance of using a broader perspective in connection to
Verbeke, Wim; Van Loo, Ellen J; Vanhonacker, Filiep; Delcour, Ilse; Spanoghe, Pieter; van Klaveren, Jacob D
This study evaluates the attitudes and perspectives of different stakeholder groups (agricultural producers, pesticide manufacturers, trading companies, retailers, regulators, food safety authorities, scientists and NGOs) towards the concepts of cumulative and aggregate exposure assessment of pesticides by means of qualitative in-depth interviews (n = 15) and a quantitative stakeholder survey (n = 65). The stakeholders involved generally agreed that the use of chemical pesticides is needed, primarily for meeting the need of feeding the growing world population, while clearly acknowledging the problematic nature of human exposure to pesticide residues. Current monitoring was generally perceived to be adequate, but the timeliness and consistency of monitoring practices across countries were questioned. The concept of cumulative exposure assessment was better understood by stakeholders than the concept of aggregate exposure assessment. Identified pitfalls were data availability, data limitations, sources and ways of dealing with uncertainties, as well as information and training needs. Regulators and food safety authorities were perceived as the stakeholder groups for whom cumulative and aggregate pesticide exposure assessment methods and tools would be most useful and acceptable. Insights obtained from this exploratory study have been integrated in the development of targeted and stakeholder-tailored dissemination and training programmes that were implemented within the EU-FP7 project ACROPOLIS. Copyright © 2014 Elsevier Ltd. All rights reserved.
Chaney, Beth; Chaney, Don; Paige, Samantha; Payne-Purvis, Caroline; Tennant, Bethany; Walsh-Childers, Kim; Sriram, PS; Alber, Julia
Background Patients with chronic obstructive pulmonary disease (COPD) often report inadequate access to comprehensive patient education resources. Objective The purpose of this study was to incorporate community-engagement principles within a mixed-method research design to evaluate the usability and acceptability of a self-tailored social media resource center for medically underserved patients with COPD. Methods A multiphase sequential design (qual → QUANT → quant + QUAL) was incorporated into the current study, whereby a small-scale qualitative (qual) study informed the design of a social media website prototype that was tested with patients during a computer-based usability study (QUANT). To identify usability violations and determine whether or not patients found the website prototype acceptable for use, each patient was asked to complete an 18-item website usability and acceptability questionnaire, as well as a retrospective, in-depth, semistructured interview (quant + QUAL). Results The majority of medically underserved patients with COPD (n=8, mean 56 years, SD 7) found the social media website prototype to be easy to navigate and relevant to their self-management information needs. Mean responses on the 18-item website usability and acceptability questionnaire were very high on a scale of 1 (strongly disagree) to 5 (strongly agree) (mean 4.72, SD 0.33). However, the majority of patients identified several usability violations related to the prototype’s information design, interactive capabilities, and navigational structure. Specifically, 6 out of 8 (75%) patients struggled to create a log-in account to access the prototype, and 7 out of 8 patients (88%) experienced difficulty posting and replying to comments on an interactive discussion forum. Conclusions Patient perceptions of most social media website prototype features (eg, clickable picture-based screenshots of videos, comment tools) were largely positive. Mixed-method stakeholder feedback was
Caniato, Marco; Vaccari, Mentore; Visvanathan, Chettiyappan; Zurbrügg, Christian
Assessing the strengths and weaknesses of a solid waste management scheme requires an accurate analysis and integration of several determining features. In addition to the technical aspects, any such system shows a complex interaction of actors with varying stakes, decision-making power and influence, as well as a favourable or disabling environment. When capitalizing on the knowledge and experience from a specific case, it is also crucial that experts do not "forget" or underestimate the importance of such social determinants and that they are familiar with the methods and tools to assess them. Social network analysis (SNA) and stakeholder analysis (SA) methods can be successfully applied to better understand actors' role and actions, analyse driving forces and existing coordination among stakeholders, as well as identify bottlenecks in communication which affect daily operations or strategic planning for the future way forward. SNA and SA, appropriately adjusted for a certain system, can provide a useful integration to methods by assessing other aspects to ensure a comprehensive picture of the situation. This paper describes how to integrate SNA and SA in order to survey a solid waste management system. This paper presents the results of an analysis of On-Nuch infectious waste incinerator in Bangkok, Thailand. Stakeholders were interviewed and asked to prioritize characteristics and relationships which they consider particularly important for system development and success of the scheme. In such a way, a large quantity of information about organization, communication between stakeholders and their perception about operation, environmental and health impact, and potential alternatives for the system was collected in a systematic way. The survey results suggest that stakeholders are generally satisfied with the system operation, though communication should be improved. Moreover, stakeholders should be strategically more involved in system development planning
2nd FSC Workshop - Executive Summary and International Perspective, Stakeholder Involvement and Confidence in the Process of Decision-making for the Disposal of Spent Nuclear Fuel in Finland, 15-16 November 2001, Turku, Finland
The 2. FSC workshop examined 'Stakeholder Involvement and Confidence in the Process of Decision-making for the Disposal of Spent Nuclear Fuel in Finland'. By gathering Finnish Stakeholders, those who expressed favour and opposition, as well as observer-participants from the other NEA/FSC countries, a joint reflection on a complex reality was achieved from which general conclusions can also be drawn concerning stakeholder involvement in the long-term management of radioactive waste. This Executive Summary gives an overview of the presentations and discussions that took place at the workshop. It presents, for the most part, a factual account of the individual presentations and of the discussions that took place. It relies importantly on the notes that were taken at the meeting. Most materials are elaborated upon in a fuller way in the texts that the various speakers and session moderators contributed for these proceedings. The structure of the Executive Summary follows the structure of the workshop itself. Complementary to this Executive Summary and also provided with this document, is a NEA Secretariat's perspective aiming to place the results of all discussions, feedback and site visit into an international perspective
Nielsen, Morten Velsing; Bryndum, Nina; Bedsted, Bjørn
This article addresses the theory and practice of creating responsiveness among actors through deliberative dialogue processes with stakeholders from diverse institutional settings. The EU’s decision to mainstream stakeholder deliberation in research and innovation, as part of its focus......, the article illustrates the challenges of applying theory to five European stakeholder workshops co-organised by the authors. The illustration highlights the difficult interaction between theory and practice. The article concludes that while theoretical perspectives can provide general guidance, practical...... experience is essential when dealing with the trade-offs that are an intrinsic part of organising stakeholder workshops....
The Canadian nuclear regulatory agency endorses the Systematic Approach to Training (SAT) as the most reliable method of providing effective, efficient training to Nuclear Power Plant (NPP) personnel. However the benefits of SAT cannot be realized unless all five phases of SAT are implemented. This is particularly true with respect to evaluation. Although each phase of SAT builds on the preceding one, the evaluation phase continuously feeds back into each of the others and also provides the means to verify the entire training programme building process. It is useful, therefore, to examine the issues relating to the what, why, who, when and how of training programme evaluation. ''What'' identifies the various aspects of the training programme to be evaluated, including the need for training, the training standard, the task list, trainer competence, test results, training results, program acceptance and numerous indicators that identify a need for evaluation. ''Why'' addresses legal and regulatory aspects, resource management, worker and public safety, worker and trainer competence and morale, and the cost/benefit of the training program. ''Who'' examines the need to involve trainers, trainees, plant subject matter experts (SMEs), and both plant and training centre supervisory and management staff. ''When'' addresses time-related concerns such as the importance of ensuring at the outset that the training program is actually needed, the necessity of responding promptly to local, national and world events, changes in legal and regulatory responsibilities, and the overriding importance of timely, routine training program evaluations. ''How'' describes the process of conducting a training program evaluation, and addresses the relationships of these five aspects of evaluation to each other. (author). 10 refs
The purpose of this study is to provide a new perspective for evaluating physicality in learning with a preliminary experimental study based on embodied cognition. While there are studies showing no superiority of physical manipulation over virtual manipulation, there are also studies that seem to advocate adding more physicality in simulations…
Full Text Available The idea of this paper is to determine the mental models of actors in the firm with respect to the stakeholder approach of corporate governance. The use of the cognitive map to view these diagrams to show the ways of thinking and conceptualization of the stakeholder approach. The paper takes a corporate governance perspective, discusses stakeholder model. It takes also a cognitive mapping technique.
...] Information Sharing With Agency Stakeholders: Public Meeting AGENCY: Animal and Plant Health Inspection... stakeholders regarding cross-Agency strategic priorities. We are also announcing that APHIS is hosting a public... opportunity for stakeholders to ask questions and share their perspective. DATES: The meeting will be held on...
Francisco Inacio P M Bastos
Full Text Available Academic evaluation has been an essential component of modern science since its inception, as science has moved away from personalized patronage toward its contemporary role as an essential enterprise of contemporary, democratic societies. In recent years, Brazil has experienced sustained growth in its scientific output, which is nowadays fully compatible with its status as a high middle-income country striving to become a fully developed, more equitable country in the years to come. Growth usually takes place amidst challenges and dilemmas and, in Brazil as elsewhere, academic evaluation is not exempt from such difficulties. In a large, profoundly heterogeneous country with a national evaluation system and nationwide on-line platforms disseminating information on the most disparate fields of knowledge, the main challenges refer to how to pay attention to detail without losing sight of comprehensiveness and how to handle social and regional diversity while preserving academic excellence as the fundamental benchmark.
Biglino, Giovanni; Moharem-Elgamal, Sarah; Lee, Matthew; Tulloh, Robert; Caputo, Massimo
The case of an 11-year-old male patient with truncus arteriosus is presented. The patient has a right aortic arch, a repaired truncus arteriosus, pulmonary artery stenosis, as well as conduit stenosis, with a complex surgical plan being discussed. In order to gather additional insight into the patient's anatomy prior to the surgery and to facilitate communication with the patient's parents, a three-dimensional (3D) model of his heart and main vessels was created from computed tomography data. Feedback was collected from different stakeholders. The patient and his parents were both struck by the size of the heart, with the parents further elaborating on how the 3D model was more intuitive a tool than medical images as well as " an helpful talking point to the other members of the family " and potentially also at school. The surgeon and cardiologist commented on gaining better understanding of the 3D relationship between a markedly narrowed right pulmonary artery and the aorta, with the surgeon ultimately coming to a decision of dividing the ascending aorta quite high to access the right pulmonary artery for patch reconstruction and thus planning to arrest the circulation beforehand. The imaging expert remarked on the potential to " improve communication in multidisciplinary meetings ," while a medical trainee, who also had a chance to evaluate the model, remarked that " having the model in front of me and being able to see the exact abnormality makes this particular case much more memorable. [ … ] 3D printed models could have immense potential in pathology and anatomy teaching for the training of healthcare professionals ."
Full Text Available The case of an 11-year-old male patient with truncus arteriosus is presented. The patient has a right aortic arch, a repaired truncus arteriosus, pulmonary artery stenosis, as well as conduit stenosis, with a complex surgical plan being discussed. In order to gather additional insight into the patient’s anatomy prior to the surgery and to facilitate communication with the patient’s parents, a three-dimensional (3D model of his heart and main vessels was created from computed tomography data. Feedback was collected from different stakeholders. The patient and his parents were both struck by the size of the heart, with the parents further elaborating on how the 3D model was more intuitive a tool than medical images as well as “an helpful talking point to the other members of the family” and potentially also at school. The surgeon and cardiologist commented on gaining better understanding of the 3D relationship between a markedly narrowed right pulmonary artery and the aorta, with the surgeon ultimately coming to a decision of dividing the ascending aorta quite high to access the right pulmonary artery for patch reconstruction and thus planning to arrest the circulation beforehand. The imaging expert remarked on the potential to “improve communication in multidisciplinary meetings,” while a medical trainee, who also had a chance to evaluate the model, remarked that “having the model in front of me and being able to see the exact abnormality makes this particular case much more memorable. […] 3D printed models could have immense potential in pathology and anatomy teaching for the training of healthcare professionals.”
Haar, D. van der; Hosking, D.M.
Appreciative Inquiry (AI) has become increasingly popular as a social constructionist approach to organizational change and development. Many claims are made about its status and value but there are few published evaluation studies. We discuss these matters by setting out our own version of
Leisti, Tuomas; Halonen, Raisa; Kokkonen, Anna; Weckman, Hanna; Mettänen, Marja; Lensu, Lasse; Ritala, Risto; Oittinen, Pirkko; Nyman, Göte
The psychological complexity of multivariate image quality evaluation makes it difficult to develop general image quality metrics. Quality evaluation includes several mental processes and ignoring these processes and the use of a few test images can lead to biased results. By using a qualitative/quantitative (Interpretation Based Quality, IBQ) methodology, we examined the process of pair-wise comparison in a setting, where the quality of the images printed by laser printer on different paper grades was evaluated. Test image consisted of a picture of a table covered with several objects. Three other images were also used, photographs of a woman, cityscape and countryside. In addition to the pair-wise comparisons, observers (N=10) were interviewed about the subjective quality attributes they used in making their quality decisions. An examination of the individual pair-wise comparisons revealed serious inconsistencies in observers' evaluations on the test image content, but not on other contexts. The qualitative analysis showed that this inconsistency was due to the observers' focus of attention. The lack of easily recognizable context in the test image may have contributed to this inconsistency. To obtain reliable knowledge of the effect of image context or attention on subjective image quality, a qualitative methodology is needed.
Hofstede, G.J.; Schepers, H.E.; Trienekens, J.H.
This paper was written for KLICT to evaluate the focus area Transparency in Netchains. It revisits the definitions and research agenda in the review paper with which the focal area started (Hofstede 2002). The definition of transparency has turned out to serve its purpose. The research has
Coutu, Marie-France; Légaré, France; Durand, Marie-José; Stacey, Dawn; Labrecque, Marie-Elise; Corbière, Marc; Bainbridge, Lesley
Purpose To establish the acceptability and feasibility of implementing a shared decision-making (SDM) model in work rehabilitation. Methods We used a sequential mixed-methods design with diverse stakeholder groups (representatives of private and public employers, insurers, and unions, as well as workers having participated in a work rehabilitation program). First, a survey using a self-administered questionnaire enabled stakeholders to rate their level of agreement with the model's acceptability and feasibility and propose modifications, if necessary. Second, eight focus groups representing key stakeholders (n = 34) and four one-on-one interviews with workers were conducted, based on the questionnaire results. For each stakeholder group, we computed the percentage of agreement with the model's acceptability and feasibility and performed thematic analyses of the transcripts. Results Less than 50% of each stakeholder group initially agreed with the overall acceptability and feasibility of the model. Stakeholders proposed 37 modifications to the objectives, 17 to the activities, and 39 to improve the model's feasibility. Based on in-depth analysis of the transcripts, indicators were added to one objective, an interview guide was added as proposed by insurers to ensure compliance of the SDM process with insurance contract requirements, and one objective was reformulated. Conclusion Despite initially low agreement with the model's acceptability on the survey, subsequent discussions led to three minor changes and contributed to the model's ultimate acceptability and feasibility. Later steps will involve assessing the extent of implementation of the model in real rehabilitation settings to see if other modifications are necessary before assessing its impact.
Kuis, Esther E; Goossensen, Anne
Care ethical theories provide an excellent opening for evaluation of healthcare practices since searching for (moments of) good care from a moral perspective is central to care ethics. However, a fruitful way to translate care ethical insights into measurable criteria and how to measure these criteria has as yet been unexplored: this study describes one of the first attempts. To investigate whether the emotional touchpoint method is suitable for evaluating care from a care ethical perspective. An adapted version of the emotional touchpoint interview method was used. Touchpoints represent the key moments to the experience of receiving care, where the patient recalls being touched emotionally or cognitively. Participants and research context: Interviews were conducted at three different care settings: a hospital, mental healthcare institution and care facility for older people. A total of 31 participants (29 patients and 2 relatives) took part in the study. Ethical considerations: The research was found not to be subject to the (Dutch) Medical Research Involving Human Subjects Act. A three-step care ethical evaluation model was developed and described using two touchpoints as examples. A focus group meeting showed that the method was considered of great value for partaking institutions in comparison with existing methods. Reflection and discussion: Considering existing methods to evaluate quality of care, the touchpoint method belongs to the category of instruments which evaluate the patient experience. The touchpoint method distinguishes itself because no pre-defined categories are used but the values of patients are followed, which is an essential issue from a care ethical perspective. The method portrays the insider perspective of patients and thereby contributes to humanizing care. The touchpoint method is a valuable instrument for evaluating care; it generates evaluation data about the core care ethical principle of responsiveness.
Khazai, B.; Anhorn, J.; Burton, C.
Approaches that make resilience tangible and operational for decision makers have to deal effectively with the degree of impact and change required through different strategic actions in addressing agreed-upon resilience goals. A Resilience Performance Scorecard (RPS) has been designed to enable local stakeholders in identifying existing strengths and weaknesses through providing information on key performance targets along six dimensions of urban resilience both at the city and sub-city district level of geography. The purpose in the development of the Scorecard approach is to build a tool that can provide information on the overall resilience performance and capture the key functional and organizational areas for urban resilience with local government officials. The Resilience Performance Scorecard (RPS) was developed jointly by the Center for Disaster Management and Risk Reduction Technology (CEDIM) at Karlsruhe Institute of Technology, the South Asia Institute (SAI) at Heidelberg University, the and Global Earthquake Model (GEM) Foundation. It was initially implemented with the Lalitpur Sub-Metropolitan Municipality in Nepal one year before the 25 April 7.8 magnitude Gorkha earthquake event as a self-evaluation tool through a fully participatory process with local stakeholders. In a follow-up participatory assessment and implementation of the RPS one month after the earthquake, the results of the participatory resilience investigation demonstrate areas where action towards resilience should be prioritized and reflect the change in perception of resilience among the stakeholders in the face of a large damaging event.
Community Opinion and Satisfaction with the Leadership at an Urban Community Educational Learning Center during an Organizational Transformation Process: A Frontline Perspective from Community Stakeholders
Lewis, Joseph Lee
This study examined selected community stakeholders' perception of the current leadership at their local community educational learning center during an organizational transformation and cultural change process. The transition from a community college to an educational learning center, mandated in 2006 by the Accredition Commission and agreed on…
Dina Alexandra Marques Miragaia
Full Text Available The objective of this study is to analyse the efficiency of non-profit sports clubs and identify the perceptions of their directors with regards to the stakeholders that exert the greatest influence over club efficiency levels. In order to analyse the efficiency of these clubs, we made recourse to the Data Envelopment Analysis (DEA method. We also applied the Mann-Whitney test, to identify whether there are significant differences between efficient and non-efficient clubs with regards to the influence held by their stakeholders. We thus report that the majority of clubs operate efficiently. Both the efficient and the non-efficient clubs classify the club managers, members, sponsors, fans and athletes as the most important stakeholders to their efficiency levels. The results convey how there are no significant differences among the management team perceptions on the role of stakeholders in attaining club efficiency. The study also details the respective procedures that inefficient clubs should adopt in order to approximate the efficiency frontier.
This book extends test structure applications described in Microelectronic Test Structures for CMOS Technology (Springer 2011) to digital CMOS product chips. Intended for engineering students and professionals, this book provides a single comprehensive source for evaluating CMOS technology and product test data from a basic knowledge of the physical behavior of the constituent components. Elementary circuits that exhibit key properties of complex CMOS chips are simulated and analyzed, and an integrated view of design, test and characterization is developed. Appropriately designed circuit monitors embedded in the CMOS chip serve to correlate CMOS technology models and circuit design tools to the hardware and also aid in test debug. Impact of silicon process variability, reliability, and power and performance sensitivities to a range of product application conditions are described. Circuit simulations exemplify the methodologies presented, and problems are included at the end of the chapters.
Research and development directed towards the assessment of the long-term performance of radioactive waste disposal systems has been recognised as a priority area with a strong need for international co-operation and co-ordination. The ultimate aims is to promote the quality and credibility of safety assessment techniques for radioactive waste disposal. Sorption in the geosphere is one of the key processes for retarding the transport of radionuclide from the underground disposal facility to the biosphere. In many cases, sorption in the near field and in the biosphere is also important. A workshop, organised to favor discussion around a small number of invited papers, was held in October 1991: - to evaluate critically the way sorption processes are incorporated in performance assessment models; - to identify open issues of high priority, and; - to propose future activities to resolve these issues. These proceedings reproduce the invited papers and the conclusions and recommendations adopted by the workshop. Eight papers are in the INIS SCOPE. The main subjects studied are: sorption database comparison, sorption database development and three case studies, experimental techniques, adsorption models
Allen, L. E.; Silva, M. K.
The Waste Isolation Pilot Plant (WIPP), a repository for defense transuranic (TRU) waste, was built and is operated by the U.S. Department of Energy (DOE). The WIPP Land Withdrawal Act (LWA) required initial certification of compliance of the WIPP by the U.S. Environmental Protection Agency (EPA). In addition, a recertification decision is required by the LWA every five years, dated from the initial receipt of TRU waste. The first TRU waste shipment arrived at the WIPP on March 26, 1999, and therefore the first recertification application is due from DOE to EPA by March 25, 2004. The Environmental Evaluation Group (EEG) provides technical oversight of the WIPP project on behalf of the State of New Mexico. The EEG considers the first recertification as a precedent setting event. Therefore, the EEG began the identification of recertification issues immediately following the initial certification decision. These issues have evolved since that time, based on discussions with the DOE and EEG's understanding of DOE's ongoing research. Performance assessment is required by the EPA certification and its results are needed to determine whether the facility remains in compliance at the time of the recertification application. The DOE must submit periodic change reports to the EPA which summarize activities and conditions that differ from the compliance application. Also, the EPA may request additional information from the DOE that may pertain to continued compliance. These changes and new information must be considered for recertification performance assessment
One important aspect of Integrated Environmental Assessment is combining a scientific expertise and stakeholder concerns. Here, we propose a method to integrate stakeholder preferences, in particular preferences of stakeholders with differing environmental perspectives with a se...
Anderson de Cuevas, Rachel; Nylén, Lotta; Burström, Bo; Whitehead, Margaret
Public involvement in research is considered good practice by European funders; however, evidence of its research impact is sparse, particularly in relation to large-scale epidemiological research. To explore what difference public and stakeholder involvement made to the interpretation of findings from an evaluation of a natural policy experiment to influence the wider social determinants of health: 'Flexicurity'. Stockholm County, Sweden. Members of the public from different occupational groups represented by blue-collar and white-collar trade union representatives. Also, members of three stakeholder groups: the Swedish national employment agency; an employers' association and politicians sitting on a national labour market committee. Total: 17 participants. Qualitative study of process and outcomes of public and stakeholder participation in four focused workshops on the interpretation of initial findings from the flexicurity evaluation. New insights from participants benefiting the interpretation of our research findings or conceptualisation of future research. Participants sensed more drastic and nuanced change in the Swedish welfare system over recent decades than was evident from our literature reviews and policy analysis. They also elaborated hidden developments in the Swedish labour market that were increasingly leading to 'insiders' and 'outsiders', with differing experiences and consequences for financial and job security. Their explanation of the differential effects of the various collective agreements for different occupational groups was new and raised further potential research questions. Their first-hand experience provided new insights into how changes to the social protection system were contributing to the increasing trends in poverty among unemployed people with limiting long-standing illness. The politicians provided further reasoning behind some of the policy changes and their intended and unintended consequences. These insights fed into
Rustagi, Alison S; Manjate, Rosa Marlene; Gloyd, Stephen; John-Stewart, Grace; Micek, Mark; Gimbel, Sarah; Sherr, Kenneth
Task shifting is a common strategy to deliver antiretroviral therapy (ART) in resource-limited settings and is safe and effective if implemented appropriately. Consensus among stakeholders is necessary to formulate clear national policies that maintain high-quality care. We sought to understand key stakeholders' opinions regarding task shifting of HIV care in Mozambique and to characterize which specific tasks stakeholders considered appropriate for specific cadres of health workers. National and provincial Ministry of Health leaders, representatives from donor and non-governmental organizations (NGOs), and clinicians providing HIV care were intentionally selected to represent diverse viewpoints. Using open- and closed-ended questions, interviewees were asked about their general support of task shifting, its potential advantages and disadvantages, and whether each of seven cadres of non-physician health workers should perform each of eight tasks related to ART provision. Responses were tallied overall and stratified by current job category. Interviews were conducted between November 2007 and June 2008. Of 62 stakeholders interviewed, 44% held leadership positions in the Ministry of Health, 44% were clinicians providing HIV care, and 13% were donors or employed by NGOs; 89% held a medical degree. Stakeholders were highly supportive of physician assistants performing simple ART-related tasks and unanimous in opposing community health workers providing any ART-related services. The most commonly cited motives to implement task shifting were to increase ART access, decrease physician workload, and decrease patient wait time, whereas chief concerns included reduced quality of care and poor training and supervision. Support for task shifting was higher among clinicians than policy and programme leaders for three specific task/cadre combinations: general mid-level nurses to initiate ART in adults (supported by 75% of clinicians vs. 41% of non-clinicians) and in pregnant
Awoonor-Williams, John Koku; Tindana, Paulina; Dalinjong, Philip Ayizem; Nartey, Harry; Akazili, James
In 2005, the World Health Assembly (WHA) of the World Health Organization (WHO) urged member states to aim at achieving affordable universal coverage and access to key promotive, preventive, curative, rehabilitative and palliative health interventions for all their citizens on the basis of equity and solidarity. Since then, some African countries, including Ghana, have taken steps to introduce national health insurance reforms as one of the key strategies towards achieving universal health coverage (UHC). The aim of this study was to get a better understanding of how Ghana's health insurance institutions interact with stakeholders and other health sector programmes in promoting primary health care (PHC). Specifically, the study identified the key areas of misalignment between the operations of the NHIS and that of PHC. Using qualitative and survey methods, this study involved interviews with various stakeholders in six selected districts in the Upper East region of Ghana. The key stakeholders included the National Health Insurance Authority (NHIA), district coordinators of the National Health Insurance Schemes (NHIS), the Ghana Health Service (GHS) and District Health Management Teams (DHMTs) who supervise the district hospitals, health centers/clinics and the Community-based Health and Planning Services (CHPS) compounds as well as other public and private PHC providers. A stakeholders' workshop was organized to validate the preliminary results which provided a platform for stakeholders to deliberate on the key areas of misalignment especially, and to elicit additional information, ideas and responses, comments and recommendations from respondents for the achievement of the goals of UHC and PHC. The key areas of misalignments identified during this pilot study included: delays in reimbursements of claims for services provided by health care providers, which serves as a disincentive for service providers to support the NHIS; inadequate coordination among
Brewer, Jeffrey L; Taber-Doughty, Teresa; Kubik, Sara
We investigated the perceptions of people about the safety, security and privacy of a telecare monitoring system for adults with developmental disabilities living in residential settings. The telecare system was used by remote caregivers overnight, when staff were not present in the homes. We surveyed 127 people from different stakeholder groups in the state of Indiana. The people surveyed included those with knowledge or experience of telecare, and those without. The stakeholders were clients, their advocates, service provider administrators and independent case coordinators. The responses in each category for every group were positive except one: only 4 of the 11 telecare case coordinators agreed that the telecare system provided a secure environment. Overall, the telecare system was perceived to be as safe, secure and private as the conventional alternative of having staff in the home.
Peterson, T.; McCabe, G.; Niesen, K.; Serie, P.
A three-phased stakeholder participation program was conducted to support the Volatile Organic Compounds Arid Site Integrated Demonstration (VOC-Arid ID). The US DOE's Office of Technology Development (OTD) sponsored and directed the VOC-Arid ID. Its purpose was to develop and demonstrate new technologies for remediating VOC contamination in soil and ground water. The integrated demonstration, hosted by the Hanford site in Washington State, is being transitioned into the Department of Energy's (DOE) Plume Focus Area. The Plume Focus Area has the same basic objectives as the ID, but is broader in scope and is a team effort with technology developers and technology users. The objective is to demonstrate a promising technology once, and if results warrant deploy it broadly across the DOE complex and in private sector applications
Linke, Sebastian; Dreyer, Marion; Sellke, Piet
The protection of the Baltic Sea ecosystem is exacerbated by the social, environmental and economic complexities of governing European fisheries. Increased stakeholder participation and knowledge integration are suggested to improve the EU's Common Fisheries Policy (CFP), suffering from legitimacy, credibility and compliance problems. As a result, the CFP was revised in 2002 to involve fisheries representatives, NGOs and other stakeholders through so called Regional Advisory Councils (RACs) in the policy process. We address the RAC's task to incorporate stakeholder knowledge into the EU's fisheries governance system in empirical and theoretical perspectives. Drawing on a four-stage governance concept we subsequently suggest that a basic problem is a mismatch between participation purpose (knowledge inclusion) and the governance stage at which RACs are formally positioned (evaluation of management proposals). We conclude that, if the aim is to broaden the knowledge base of fisheries management, stakeholders need to be included earlier in the governance process.
Khodyakov, Dmitry; Savitsky, Terrance D; Dalal, Siddhartha
Public and stakeholder engagement can improve the quality of both research and policy decision making. However, such engagement poses significant methodological challenges in terms of collecting and analysing input from large, diverse groups. To explain how online approaches can facilitate iterative stakeholder engagement, to describe how input from large and diverse stakeholder groups can be analysed and to propose a collaborative learning framework (CLF) to interpret stakeholder engagement results. We use 'A National Conversation on Reducing the Burden of Suicide in the United States' as a case study of online stakeholder engagement and employ a Bayesian data modelling approach to develop a CLF. Our data modelling results identified six distinct stakeholder clusters that varied in the degree of individual articulation and group agreement and exhibited one of the three learning styles: learning towards consensus, learning by contrast and groupthink. Learning by contrast was the most common, or dominant, learning style in this study. Study results were used to develop a CLF, which helps explore multitude of stakeholder perspectives; identifies clusters of participants with similar shifts in beliefs; offers an empirically derived indicator of engagement quality; and helps determine the dominant learning style. The ability to detect learning by contrast helps illustrate differences in stakeholder perspectives, which may help policymakers, including Patient-Centered Outcomes Research Institute, make better decisions by soliciting and incorporating input from patients, caregivers, health-care providers and researchers. Study results have important implications for soliciting and incorporating input from stakeholders with different interests and perspectives. © 2015 The Authors. Health Expectations Published by John Wiley & Sons Ltd.
Devitt, C; Boyle, L; Teixeira, D L; O'Connell, N E; Hawe, M; Hanlon, A
A SWOT (Strengths, Weaknesses, Opportunities and Threats) analysis is a strategic management tool applied to policy planning and decision-making. This short report presents the results of a SWOT analysis, carried out with n = 16 stakeholders i) involved in the pig industry in the Republic of Ireland and Northern Ireland, and ii) in general animal welfare and food safety policy areas. As part of a larger study called PIGWELFIND, the analysis sought to explore the potential development of pig meat inspection as an animal welfare and diagnostic tool. The final SWOT framework comprised two strengths, three opportunities, six weaknesses, and five threats. Issues around relationships and communication between producers and their veterinary practitioner, processors and producers were common to both the strengths and weakness clusters. Practical challenges within the processing plant were also named. Overall, the SWOT framework complements results reported in Devitt et al. (Ir Vet J 69:2, 2016) regarding problematic issues within the current system of information feedback on meat inspection especially within the Republic of Ireland, and the wider challenges of communication and problems of distrust. The results of the SWOT analysis support the conclusions from Devitt et al. (Ir Vet J 69:2, 2016), that trust between all stakeholders across the supply chain will be essential for the development of an effective environment in which to realise the full diagnostic potential of MI data. Further stakeholder engagement could seek to apply the findings of the SWOT analysis to a policy Delphi methodology, as used elsewhere.
von Wallpach, Sylvia; Voyer, Benjamin; Kastanakis, Minas
This article introduces the special section on reciprocal co-creation of stakeholder and brand identities. Branding research and practice traditionally focus on the managerial creation and implementation of brand identity. Based on recent paradigmatic shifts from managerial to co-creative branding...... and from consumer to multi-stakeholder approaches in marketing, this special section develops a dynamic, process-oriented perspective on brand identity. Brand identity continuously emerges as a dynamic outcome of social processes of stakeholder interaction. Reciprocally, brand identity plays a potentially...... important role in ongoing interactive identity development processes of stakeholders. The special section contributes to deepening the understanding of this reciprocal co-creation of stakeholder and brand identities, through a series of conceptual and empirical articles. The Introduction reviews four...
Deines, J. M.; Kendall, A. D.; Butler, J. J., Jr.; Hyndman, D. W.
Irrigation greatly enhances agricultural yields and stabilizes farmer incomes, but overexploitation of water resources has depleted groundwater aquifers around the globe. In much of the High Plains Aquifer (HPA) in the United States, water-level declines threaten the continued viability of agricultural operations reliant on irrigation. Policy and management institutions to address this sustainability challenge differ widely across the HPA and the world. In Kansas, grassroots-driven legislation in 2012 allowed local stakeholder groups to establish Local Enhanced Management Areas (LEMAs) and work with state officials to generate enforceable and monitored water use reduction programs. The pioneering LEMA was formed in 2013, following a popular vote by farmers within a 256 km2 region in northwestern Kansas. The group sought to reduce groundwater pumping by 20% through 2017 in order to stabilize water levels while minimally reducing crop productivity. Initial statistical estimates indicate the LEMA has been successful; planning is underway to extend it for five years (2018-2022) and to implement additional LEMAs in the wider groundwater management district. Here, we assess the efficacy of this first LEMA with coupled crop-hydrology models to quantify water budget impacts and any associated trade-offs in crop productivity. We drive these models with a novel data fusion of water use data and our recent remotely sensed Annual Irrigation Maps (AIM) dataset, allowing detailed tracking of irrigation water in space and time. Results from these process-based models provide detailed insights into changes in the physical system resulting from the LEMA program that can inform future stakeholder-driven management in Kansas and in stressed aquifers around the world.
McCabe, G.H.; Stein, S.L.; Serie, P.J.
The US Department of Energy (DOE) faces a major challenge in cleaning up its contaminated sites throughout the United States. One major area of concern is the plumes in soil and ground water which are contaminated with a myriad of different pollutants. DOE recently organized its plume-related problems into the Plume Focus Area. The mission of the Plume Focus Area is to enhance the deployment of innovative technologies for containing and cleaning up contaminant plumes in ground water and soil at all DOE sites. Environmental cleanup priorities for soil and ground water plumes are being defined and technology users have the challenge of matching current and innovative technologies to those priorities. By involving a range of stakeholders in the selection, demonstration, and evaluation of new technologies, the deployment of these technologies can be enhanced. If new plume cleanup technologies are to be deployable, they must improve on today's baseline technologies. The Sites' Coordination Team (SCT) of the Plume Focus Area develops and supports the implementation of methods for stakeholder involvement throughout the multiple steps that define focus area activities. Site-specific teams are being formed to carry out the strategy at each site, and the teams will work through Site Technology Coordination Groups (STCGs) at each location. The SCT is responsible for identifying the site-specific stakeholder involvement teams, training the team members, preparing needed national-level guidance and strategies, helping the teams tailor a strategy for their particular site that meets the overall needs of the focus area, and facilitating inter-site coordination. The results will be used to develop national technology acceptance reports on the innovative technologies being funded and evaluated under the Plume Focus Area
Lammerts, Lieke; Schaafsma, Frederieke G; van Mechelen, Willem; Anema, Johannes R
A process evaluation of a participatory supportive return to work program, aimed at workers without a (permanent) employment contract who are sick-listed due to a common mental disorder, revealed that this program was executed less successfully than similar programs evaluated in earlier studies. The program consisted of a participatory approach, integrated care and direct placement in competitive employment. Aim of this study was to get a better understanding of the execution of the program by evaluating stakeholders' perceptions. In the absence of an employer, the program was applied by the Dutch Social Security Agency, in collaboration with vocational rehabilitation agencies. Together with the sick-listed workers, these were the main stakeholders. Our research questions involved stakeholders' perceptions of the function(s) of the program, and their perceptions of barriers and facilitators for a successful execution of the program within the Dutch social security sector. Semi-structured interviews were held with five sick-listed workers, eight professionals of the Social Security Agency, and two case managers of vocational rehabilitation agencies. Interview topics were related to experiences with different components of the program. Selection of respondents was based on purposive sampling and continued until data saturation was reached. Content analysis was applied to identify patterns in the data. Two researchers developed a coding system, based on predefined topics and themes emerging from the data. Although perceived functions of some components of the program were as intended, all stakeholders stressed that the program often had not resulted in return to work. Perceived barriers for a successful execution were related to a poor collaboration between the Dutch Social Security Agency, vocational rehabilitation agencies and healthcare providers, the type of experienced (health) problems, time constraints, and limited job opportunities. For future implementation
Stakeholder Analysis WorksheetA worksheet that can be used to document potential stakeholder groups, the information or expertise they hold, the role that they can play, their interests or concerns about the HIA
Pipkin, Erin; Porter, Sean; Clark, Rickie
For every public project, there is a diverse group of stakeholders who need and want information. During this session we outline important stakeholders, how and when to involve them in the planning process, and how targeted messaging might be the key to your project’s success. We also discuss how to identify and manage stakeholders who oppose your project.
Meredith Jane Kuipers
Full Text Available Background: In Ethiopia, improvement and innovation of the emergency care system is hindered by lack of specialist doctors trained in emergency medicine, underdeveloped emergency care infrastructure, and consumable resource limitations. Our aim was to examine the critical factors affecting retention of graduates from the Addis Ababa University (AAU post-graduate emergency medicine (EM training program within the Ethiopian health care system. Methods: Qualitative interviews were conducted with current AAU EM residents and stakeholders in Ethiopian EM. Mixed-methods inductive thematic analysis was performed. Results: Resident and stakeholder participants identified critical factors in three domains: the individual condition, the occupational environment, and the national context. Within each domain, priority themes emerged from the responses, including the importance of career satisfaction over the career continuum (individual condition, the opportunity to be involved in the developing EM program and challenges associated with resource, economic, and employment constraints (occupational environment, and perceptions regarding the state of awareness of EM and the capacity for change at the societal level (national context. Conclusions: This work underscores the need to resolve multiple systemic and cultural issues within the Ethiopian health care landscape in order to address EM graduate retention. It also highlights the potential success of a retention strategy focused on the career ambitions of keen EM doctors.
Crespi-Lofton, Judy; Skelton, Jann B
The American Pharmacists Association (APhA) convened the Biologics and Biosimilars Stakeholder Conference on November 30, 2016, in Washington DC. The objectives of the Conference were to determine the key issues and challenges within the marketplace for biologics, follow-on biologics (FOBs), and biosimilars, identify potential roles and responsibilities of pharmacists regarding biologic and biosimilar medications, and identify actions or activities that pharmacists may take to optimize the safe and cost-effective use of biologics and biosimilars. National thought leaders and stakeholder representatives, including individuals from the Food and Drug Administration, Centers for Medicare and Medicaid Services, a private third-party payer, manufacturers, and several national organizations of health care professionals, participated in the conference. Information shared by this group was supplemented with relevant legal and regulatory information and published literature. Biologics play a valuable role in the treatment of numerous health conditions, but their associated costs, which tend to be greater than those of small-molecule drugs, place a burden on the health care system. Biosimilars (both noninterchangeable and interchangeable) are highly similar copies of the originator biologic and offer the potential to reduce costs and improve patient access to biological products by increasing treatment options and creating a more competitive market. Despite the potential benefits of biosimilars, certain factors may limit their uptake. The conference participants explored issues that different stakeholders think influence the use of biologics, including biosimilars, in the United States. Barriers included technology, prescriber-pharmacist communication, legislation and regulations, limited patient and health care practitioner knowledge of biological products, patient and health care practitioner perceptions of biosimilars, and evolving science or lack of long-term data. After
Albano, Christine M.; Cox, Dale A.; Dettinger, Michael; Shaller, Kevin; Welborn, Toby L.; McCarthy, Maureen
Atmospheric rivers (ARs) are strongly linked to extreme winter precipitation events in the Western U.S., accounting for 80 percent of extreme floods in the Sierra Nevada and surrounding lowlands. In 2010, the U.S. Geological Survey developed the ARkStorm extreme storm scenario for California to quantify risks from extreme winter storms and to allow stakeholders to better explore and mitigate potential impacts. To explore impacts on natural resources and communities in montane and adjacent environments, we downscaled the scenario to the greater Lake Tahoe, Reno and Carson City region of northern Nevada and California. This ArkStorm@Tahoe scenario was presented at six stakeholder meetings, each with a different geographic and subject matter focus. Discussions were facilitated by the ARkStorm@Tahoe team to identify social and ecological vulnerabilities to extreme winter storms, science and information needs, and proactive measures that might minimize impacts from this type of event. Information collected in these meetings was used to develop a tabletop emergency response exercise and set of recommendations for increasing resilience to extreme winter storm events in both Tahoe and the downstream communities of Northern Nevada.Over 300 individuals participated in ARkStorm@Tahoe stakeholder meetings and the emergency response exercise, including representatives from emergency response, natural resource and ecosystem management, health and human services, public utilities, and businesses. Interruption of transportation, communications, and lack of power and backup fuel supplies were identified as the most likely and primary points of failure across multiple sectors and geographies, as these interruptions have cascading effects on natural and human systems by impeding emergency response efforts. Other key issues that arose in discussions included contamination risks to water supplies and aquatic ecosystems, especially in the Tahoe Basin and Pyramid Lake, interagency
Perrault, G.A.; Barrett, L.B.
A demand-side management (DSM) process evaluation is a qualitative, expert assessment of how a utility marketing program is being conducted. It reviews the efficiency and effectiveness in which a utility plans, manages, executes, and monitors the delivery of DSM programs to its marketplace. Process evaluations,which includes load impact, customer satisfaction and cost-effectiveness analysis, are becoming an increasingly significant component. The process evaluation focus is on the program planning and delivery process as opposed to the energy impacts resulting from the specific measures or products of the program. Because of this process-oriented focus, such evaluations can identify important opportunities for improving the cost-effectiveness of a program without significantly changing product lines. The evaluation may identify administrative or delivery process improvements. In addition, the evaluation may identify ways of improving the degree to which the customer is satisfied with the program or the utility. Since process evaluations are usually conducted as part of a utility's mandated DSM measurement and evaluation plan, they tend to focus mainly on the stated needs of the regulator as opposed to company management. This can be a problem. Although the regulatory perspective is important, in an increasingly competitive business environment, utilities must not overlook management's business and operational needs for specific information regarding DSM program planning, control, execution, and evaluation. This paper discusses some of the conflicts that exist between the regulator's and management's needs for DSM program evaluation results and presents some approaches for assuring that both needs are met. It is organized to first discuss the scope of a process evaluation, then the evaluation issues, the management concerns, and finally reporting of results
Full Text Available Companies’ strategies and values must be in accordance to stakeholders’ expectations and needs because their role and influences on companies’ activity are decisive for companies future development. Corporate Social Responsibility is a meaningful way through which companies can pursue sustainable development by having a coherent economical, social and environmental perspective on how the business should be managed. CSR must become an integral part of corporate management system, because it has a major role in distressing the relation between company and major stakeholders, both internally and externally. CSR is a global phenomenon, which draws the attention of a growing number of partisans, from public private and social sector. To demonstrate the applicability of the theoretical approaches deduced from the existing literature, the authors recourse to an empirical qualitative research, conducted through a questionnaire implemented to top managers, HR managers and heads of CSR departments within large companies that operate in Romania. The research is based on the analysis of a number of 87 questionnaires and aims to highlight major stakeholders and finding how companies’ responsible activities can influence stakeholders. This study is designed to highlight how prioritization of stakeholders influences CSR initiatives within large companies that operate in Romania, and to present a perspective of company’s approach towards shared value influence major stakeholders. The conclusions drawn have a greater relevance both theoretically and especially practically because provides insights on how large companies perceive CSR and how stakeholders influence responsible initiatives in emergent country like Romania where stereotypes are difficult to manage.
The author set the context for his presentation by profiling the geographic location and history of Oskarshamn including the feasibility study and the council's 2002 unanimous vote to accept site investigation with 13 conditions and clarifications. The municipality's policy places an emphasis on ensuring safety first, providing information on the table from all parties at all times, and ensuring active engagement and influence. Working groups were established by the municipality to follow the safety issues and ensure that the 13 conditions are fulfilled, require investigations enhance citizens' competence; collect and forward questions and issues; and draw experience from local participation in other national programmes. Reaching informed consent in siting depends upon many factors, a key factor of which is RD and D. The author identified two components that he believes to be key to achieving informed stakeholder consent: first a need to build local competence on local terms, allowing the municipality to have the capacity to independently judge the project. The second challenge is to achieve consent - a conclusion by a majority that the repository can be accepted and is compatible with the broader visions for the municipality. R and D, together with parameters from site investigations form the basic safety case for repository siting. It was noted that evaluations of safety also are based on assumptions and value judgements. The author underscored that the public has a much better understanding of R and D than most experts are aware of, and that implementers should have faith in the public and trust the public's ability to absorb the facts and follow the issues. Citizens understand the quality aspects of R and D, including the role for peer reviews. The public is also aware that facts change over time and that scientists may hold different opinions. The presentation emphasized the importance of capacity-building at the local level. Stable local
Schaefer, Manuel S.; Lloyd, Bob; Stephenson, Janet R.
New Zealand (NZ) aims to expand the deployment of wind energy as one means to achieve 90% of electricity generation from renewables by 2025 and in addition to reduce green house gas (GHG) emissions. Due to electricity market regulations that inhibit market entry for independent developers, New Zealand's wind energy development has been limited to primarily large wind farms developed by a handful of electricity utilities. In contrast to many other countries, NZ lacks policy support for entry of smaller investors into the wind generation sector. In order to gage the acceptability of a feed in tariff (FIT) for wind energy in New Zealand, a survey questionnaire (366 respondents) with land owning farmers and semi structured interviews with wind energy stakeholders was conducted. Although international literature suggests that a FIT would be the most suitable policy support scheme to accelerate wind energy deployment, this conclusion was not reached by many influential stakeholders in NZ. However, a majority of the surveyed farmers supported the introduction of a FIT for wind energy. The study also revealed that farmers' acceptance of wind energy in their local area increases with their awareness about climate change issues. - Highlights: ► Of countries in the world with a good wind regime, NZ has a low level of policy support for wind energy. ► A survey of landowning farmers in NZ (366 respondents) indicated support for a feed in tariff for wind energy. ► The major electricity generators, however, did not indicate support for a feed in tariff. ► A low level of recognition of climate change being anthropogenic was found among landowning farmers.
Full Text Available The purpose of this paper is to evaluate the degree of comprehension and enforcement of social responsibility (SR practices in micro, small and medium companies in Barranquilla (Colombia, based on the Stakeholders theory. Using an exploratory factor analysis on 779 companies it was found that the variables with a stronger explanatory influence for socially responsible performance are employees, environment, and community. By contrast, corporate management, value chain, and government/public sector condition the development of SR actions. Particularly, there is a weak perception and lack of will among owners and company managers to undertake comprehensive programs of social responsibility, as well as the formalization of those actions with an impact on the SR.
Boonstra, Albert; Eseryel, U. Yeliz; van Offenbeek, Marjolein A.G.
Governing IT while incorporating stakeholders with diverse institutional backgrounds remains a challenge. Stakeholder groups are typically socialized differently, and may have different perspectives on IT governance dilemmas. Yet, extant literature offers only limited insight on socialized views on
: the Business & Human Rights regime from a UN Global Compact perspective; and mandatory CSR reporting. Supplying integrated teaching notes and generalising on the examples, we explain how legal method may help students of business ethics, organisation and management – future managers – in their analysis...... to the business ethics literature by explaining how legal method complements stakeholder theory for organisational practice....
Jenniskens, Françoise; Tiendrebeogo, Georges; Coolen, Anne; Blok, Lucie; Kouanda, Seni; Sataru, Fuseini; Ralisimalala, Andriamampianina; Mwapasa, Victor; Kiyombo, Mbela; Plummer, David
Health systems have experienced unprecedented stress in recent years, and as yet no consensus has emerged as to how to deal with the multiple burden of disease in the context of HIV and AIDS and other competing health priorities. Priority setting is essential, yet this is a complex, multifaceted process. Drawing on a study conducted in five African countries, this paper explores different stakeholders' perceptions of health priorities, how priorities are defined in practice, the process of resource allocation for HIV and Health and how different stakeholders perceive this. A sub-analysis was conducted of selected data from a wider qualitative study that explored the interactions between health systems and HIV and AIDS responses in five sub-Saharan countries (Burkina Faso, the Democratic Republic of Congo, Ghana, Madagascar and Malawi). Key background documents were analysed and semi-structured interviews (n = 258) and focus group discussions (n = 45) were held with representatives of communities, health personnel, decision makers, civil society representatives and development partners at both national and district level. Health priorities were expressed either in terms of specific health problems and diseases or gaps in service delivery requiring a strengthening of the overall health system. In all five countries study respondents (with the exception of community members in Ghana) identified malaria and HIV as the two top health priorities. Community representatives were more likely to report concerns about accessibility of services and quality of care. National level respondents often referred to wider systemic challenges in relation to achieving the Millennium Development Goals (MDGs). Indeed, actual priority setting was heavily influenced by international agendas (e.g. MDGs) and by the ways in which development partners were supporting national strategic planning processes. At the same time, multi-stakeholder processes were increasingly used to identify
Lafreniere, Katherine C; Deshpande, Sameer; Bjornlund, Henning; Hunter, M Gordon
Many attempts to implement resource management initiatives in Canadian and international communities have been resisted by stakeholders despite inclusion of their representatives in the decision-making process. Managers' failure to understand stakeholders' perspectives when proposing initiatives is a potential cause of this resistance. Our study uses marketing thought to enhance stakeholder theory by bringing in an audience-centric perspective. We attempt to understand how stakeholders perceive their interests in an organization and consequently decide how to influence that organization. By doing so, we investigate whether a disconnect exists between the perceptions of managers and those of stakeholders. Natural resource managers can utilize this knowledge to garner stakeholder support for the organization and its activities. We support this claim with findings from a water transfer plebiscite held in the Canadian province of Alberta. Sixteen personal interviews employing narrative inquiry were conducted to document voters' (i.e., irrigators') interpretations. Copyright © 2013 Elsevier Ltd. All rights reserved.
Pierce, Richard D; Hegle, Jennifer; Sabin, Keith; Agustian, Edo; Johnston, Lisa G; Mills, Stephen; Todd, Catherine S
People who inject drugs (PWID) are at increased HIV transmission risk because of unsafe injecting practices and a host of other individual, network, and structural factors. Thus, PWID have a great need for services within the Cascade of HIV prevention, diagnosis, care, and treatment (HIV Cascade). Yet the systems that monitor their progress through the Cascade are often lacking. Subsequently, fewer reliable data are available to guide programs targeting this key population (KP). Programmatic data, which are helpful in tracking PWID through the Cascade, also are limited because not all countries have harm reduction programming from which to estimate Cascade indicators. Also, due to stigma and the illegal nature of drug use, PWID may not disclose their drug use behavior or HIV status when accessing services. Consequently, PWID appear to have low HIV testing rates and, for those living with HIV, lower access to health services and lower viral suppression rates than do other KP groups. This commentary, based on outcomes from an international stakeholder meeting, identifies data gaps and proposes solutions to strengthen strategic information (SI), the systematic collection, analysis, and dissemination of information, to optimize HIV prevention, care, and treatment programming for PWID.
Foglia, L.; Rossetto, R.; Borsi, I.; Josef, S.; Boukalova, Z.; Triana, F.; Ghetta, M.; Sabbatini, T.; Bonari, E.; Cannata, M.; De Filippis, G.
The EU H2020 FREEWAT project (FREE and open source software tools for WATer resource management) aims at simplifying the application of EU-water related Directives, by developing an open source and public domain, GIS-integrated platform for planning and management of ground- and surface-water resources. The FREEWAT platform is conceived as a canvas, where several distributed and physically-based simulation codes are virtually integrated. The choice of such codes was supported by the result of a survey performed by means of questionnaires distributed to 14 case study FREEWAT project partners and several stakeholders. This was performed in the first phase of the project within the WP 6 (Enhanced science and participatory approach evidence-based decision making), Task 6.1 (Definition of a "needs/tools" evaluation grid). About 30% among all the invited entities and institutions from several EU and non-EU Countries expressed their interest in contributing to the survey. Most of them were research institutions, government and geoenvironmental companies and river basin authorities.The result of the questionnaire provided a spectrum of needs and priorities of partners/stakeholders, which were addressed during the development phase of the FREEWAT platform. The main needs identified were related to ground- and surface-water quality, sustainable water management, interaction between groundwater/surface-water bodies, and design and management of Managed Aquifer Recharge schemes. Needs and priorities were then connected to the specific EU Directives and Regulations to be addressed.One of the main goals of the questionnaires was to collect information and suggestions regarding the use of existing commercial/open-source software tools to address needs and priorities, and regarding the needs to address specific water-related processes/problems.
Full Text Available Background: To develop and implement more effective programs of health care delivery to prevent and control diabetes, Iran has developed and implemented the urban phase of the specialized care program for diabetic′s patients. Deeply understanding the views and experiences of various stakeholders in this program can assist policy makers to identify the program′s strengths and weaknesses and enable them to develop action plans. Hence, the present study aimed to evaluate the planning and establishing of this program from the perspective of providers. Methods: A qualitative study was applied using documents review and face-to-face semi-structured interviews with the program leads and relevant executive managers of the local medical universities. Thematic analysis was used to analyze the data. Results: Three main themes and nine subthemes were explored, including program planning (the content and the strengths, weaknesses, and corrective measures, implementation (executive mechanisms at the university level, establishment of referral system, collaboration between deputies of health and treatment, information dissemination mechanisms, satisfaction measurement and strengths, weaknesses and corrective measures, and result (implementation results. Conclusions: The urban phase of the specialized care program for diabetic′s patients has been a good base to improve continuity of care, which emphasizes on controlling and prevention of occurrence or progression of chronic complications of diabetes. This model can also be used for better management of other chronic disease. However, there are still issues that should be considered and improved such as allocation of guaranteed resources, more trained health professionals, and more evidence based guidelines and protocols, better collaboration among medical universities′ deputies, clearer payment system for program evaluation and better information management system.
Full Text Available Abstract Background Health systems have experienced unprecedented stress in recent years, and as yet no consensus has emerged as to how to deal with the multiple burden of disease in the context of HIV and AIDS and other competing health priorities. Priority setting is essential, yet this is a complex, multifaceted process. Drawing on a study conducted in five African countries, this paper explores different stakeholders′ perceptions of health priorities, how priorities are defined in practice, the process of resource allocation for HIV and Health and how different stakeholders perceive this. Methods A sub-analysis was conducted of selected data from a wider qualitative study that explored the interactions between health systems and HIV and AIDS responses in five sub-Saharan countries (Burkina Faso, the Democratic Republic of Congo, Ghana, Madagascar and Malawi. Key background documents were analysed and semi-structured interviews (n = 258 and focus group discussions (n = 45 were held with representatives of communities, health personnel, decision makers, civil society representatives and development partners at both national and district level. Results Health priorities were expressed either in terms of specific health problems and diseases or gaps in service delivery requiring a strengthening of the overall health system. In all five countries study respondents (with the exception of community members in Ghana identified malaria and HIV as the two top health priorities. Community representatives were more likely to report concerns about accessibility of services and quality of care. National level respondents often referred to wider systemic challenges in relation to achieving the Millennium Development Goals (MDGs. Indeed, actual priority setting was heavily influenced by international agendas (e.g. MDGs and by the ways in which development partners were supporting national strategic planning processes. At the same time, multi-stakeholder
Echohawk, John Chris; Dorries, Alison M.; Eberhart, Craig F.; Werdel, Nancy
The RACER (Risk Analysis, Communication, Evaluation, and Reduction) project was created in 2003, as an effort to enhance the Los Alamos National Laboratory's ability to effectively communicate the data and processes used to evaluate environmental risks to the public and the environment. The RACER project staff consists of members of Risk Assessment Corporation, Los Alamos National Laboratory (LANL), and the New Mexico Environment Department (NMED). RACER staff worked closely with members of the community, tribal governments, and others within NMED and LANL to create innovative tools and a process that could provide information to regulators, LANL and the community about the sources of public health risk and ecological impact from LAN L operations. The RACER Data Analysis Tool (DA T) provides the public with webbased access to environmental measurement data collected in and around the LANL site. Its purpose is to provide a 'transparent' view to the public of all data collected by LANL and NMED regarding the LANL site. The DAT is available to the public at 'www.racernm.com'.
Full Text Available Between 2009-2013 the Bill and Melinda Gates Foundation transitioned its HIV/AIDS prevention initiative in India from being a stand-alone program outside of government, to being fully government funded and implemented. We present an independent prospective evaluation of the transition.The evaluation drew upon (1 a structured survey of transition readiness in a sample of 80 targeted HIV prevention programs prior to transition; (2 a structured survey assessing institutionalization of program features in a sample of 70 targeted intervention (TI programs, one year post-transition; and (3 case studies of 15 TI programs.Transition was conducted in 3 rounds. While the 2009 transition round was problematic, subsequent rounds were implemented more smoothly. In the 2011 and 2012 transition rounds, Avahan programs were well prepared for transition with the large majority of TI program staff trained for transition, high alignment with government clinical, financial and managerial norms, and strong government commitment to the program. One year post transition there were significant program changes, but these were largely perceived positively. Notable negative changes were: limited flexibility in program management, delays in funding, commodity stock outs, and community member perceptions of a narrowing in program focus. Service coverage outcomes were sustained at least six months post-transition.The study suggests that significant investments in transition preparation contributed to a smooth transition and sustained service coverage. Notwithstanding, there were substantive program changes post-transition. Five key lessons for transition design and implementation are identified.
de Brún, T; O'Reilly-de Brún, M; Van Weel-Baumgarten, E; Burns, N; Dowrick, C; Lionis, C; O'Donnell, C; Mair, F S; Papadakaki, M; Saridaki, A; Spiegel, W; Van Weel, C; Van den Muijsenbergh, M; MacFarlane, A
It is important for health care workers to know the needs and expectations of their patients. Therefore, service users have to be involved in research. To achieve a meaningful dialogue between service users, healthcare workers and researchers, participatory methods are needed. This paper describes how the application of a specific participatory methodology, Participatory Learning and Action (PLA) can lead to such a meaningful dialogue. In PLA all stakeholders are regarded as equal partners and collaborators in research.During 2011-2015, a European project called RESTORE used PLA in Austria, Greece, Ireland, The Netherlands and the UK to investigate how communication between primary health care workers and their migrant patients could be improved.Seventy eight migrants, interpreters, doctors, nurses and other key stakeholders (see Table 2) participated in 62 PLA sessions. These dialogues (involving discussions, activities, PLA techniques and evaluations) were generally 2-3 h long and were recorded and analysed by the researchers.Participants reported many positive experiences about their dialogues with other stakeholders. There was a positive, trusting atmosphere in which all stakeholders could express their views despite differences in social power. This made for better understanding within and across stakeholder groups. For instance a doctor changed her view on the use of interpreters after a migrant explained why this was important. Negative experiences were rare: some doctors and healthcare workers thought the PLA sessions took a lot of time; and despite the good dialogue, there was disappointment that very few migrants used the new interpreting service. Background In order to be effective, primary healthcare must understand the health needs, values and expectations of the population it serves. Recent research has shown that the involvement of service users and other stakeholders and gathering information on their perspectives can contribute positively to many
An Evaluation of the Generalized Intelligent Framework for Tutoring (GIFT) from an Author’s Perspective by Robert A Sottilare, Keith W...Intelligent Framework for Tutoring (GIFT) from an Author’s Perspective Robert A Sottilare and Keith W Brawner Human Research and Engineering...SUBTITLE An Evaluation of the Generalized Intelligent Framework for Tutoring (GIFT) from an Author’s Perspective 5a. CONTRACT NUMBER 5b. GRANT
Full Text Available Health and environmental agencies are routinely called upon to provide risk-related information to the public-at-large and to more narrowly defined audiences, such as children, pregnant women, or labourers. While a large body of guidance is available, it is often general and transferability to new contexts is not well understood. In particular, the relevance of this guidance for South-East Asia is not clear. This paper reports the results of a study, using Q method, that aimed to develop a better understanding of officers’ and staff’s perspectives on health and environmental risk communication within a single regulatory agency in Thailand, the Pollution Control Department. The results demon- strate that there are multiple perspectives, and they are unrelated to roles or experience. This study contributes to a deeper understanding of the ways that officers and staff within a national agency with important responsibilities for health and environmental risk communication in Thailand think about these responsibilities and how to achieve them. ----- Gesundheits- und Umweltbehörden erfüllen üblicherweise die Rolle der allgemeinen Öffentlichkeit, aber auch speziellen Zielgruppen wie Kindern, Schwangeren oder ArbeiterInnen, risikobasierte Infor- mationen zur Verfügung zu stellen. Trotz vorhandener Beratung ist diese oft sehr allgemein gehalten und eine Übertragbarkeit auf neue Kontexte ist schwierig. Besonders die Relevanz der Beratung in Bezug auf Südostasien ist oft unklar. Dieser Artikel berichtet über die Ergebnisse einer auf der Q-Methode basierenden Studie, die versucht, ein besseres Verständnis über die Perspektiven von Führungskräften und MitarbeiterInnen in Bezug auf Gesundheits- und Umweltrisikokommunikation innerhalb der thailändischen Behörde für Umweltschutz zu gewinnen. Die Ergebnisse zeigen, dass es, unabhängig von den Rollen und Erfahrungen der Befragten, sehr unterschiedliche Perspektiven über Verantwortlichkeiten
Abdoul, Hendy; Perrey, Christophe; Tubach, Florence; Amiel, Philippe; Durand-Zaleski, Isabelle; Alberti, Corinne
Peer review is the most widely used method for evaluating grant applications in clinical research. Criticisms of peer review include lack of equity, suspicion of biases, and conflicts of interest (CoI). CoIs raise questions of fairness, transparency, and trust in grant allocation. Few observational studies have assessed these issues. We report the results of a qualitative study on reviewers' and applicants' perceptions and experiences of CoIs in reviews of French academic grant applications. We designed a qualitative study using semi-structured interviews and direct observation. We asked members of assessment panels, external reviewers, and applicants to participate in semi-structured interviews. Two independent researchers conducted in-depth reviews and line-by-line coding of all transcribed interviews, which were also subjected to Tropes® software text analysis, to detect and qualify themes associated with CoIs. Most participants (73/98) spontaneously reported that non-financial CoIs predominated over financial CoIs. Non-financial CoIs mainly involved rivalry among disciplines, cronyism, and geographic and academic biases. However, none of the participants challenged the validity of peer review. Reviewers who felt they might be affected by CoIs said they reacted in a variety of ways: routine refusal to review, routine attempt to conduct an impartial review, or decision on a case-by-case basis. Multiple means of managing non-financial CoIs were suggested, including increased transparency throughout the review process, with public disclosure of non-financial CoIs, and careful selection of independent reviewers, including foreign experts and methodologists. Our study underscores the importance of considering non-financial CoIs when reviewing research grant applications, in addition to financial CoIs. Specific measures are needed to prevent a negative impact of non-financial CoIs on the fairness of resource allocation. Whether and how public disclosure of non
Full Text Available BACKGROUND: Peer review is the most widely used method for evaluating grant applications in clinical research. Criticisms of peer review include lack of equity, suspicion of biases, and conflicts of interest (CoI. CoIs raise questions of fairness, transparency, and trust in grant allocation. Few observational studies have assessed these issues. We report the results of a qualitative study on reviewers' and applicants' perceptions and experiences of CoIs in reviews of French academic grant applications. METHODOLOGY AND PRINCIPAL FINDINGS: We designed a qualitative study using semi-structured interviews and direct observation. We asked members of assessment panels, external reviewers, and applicants to participate in semi-structured interviews. Two independent researchers conducted in-depth reviews and line-by-line coding of all transcribed interviews, which were also subjected to Tropes® software text analysis, to detect and qualify themes associated with CoIs. Most participants (73/98 spontaneously reported that non-financial CoIs predominated over financial CoIs. Non-financial CoIs mainly involved rivalry among disciplines, cronyism, and geographic and academic biases. However, none of the participants challenged the validity of peer review. Reviewers who felt they might be affected by CoIs said they reacted in a variety of ways: routine refusal to review, routine attempt to conduct an impartial review, or decision on a case-by-case basis. Multiple means of managing non-financial CoIs were suggested, including increased transparency throughout the review process, with public disclosure of non-financial CoIs, and careful selection of independent reviewers, including foreign experts and methodologists. CONCLUSIONS: Our study underscores the importance of considering non-financial CoIs when reviewing research grant applications, in addition to financial CoIs. Specific measures are needed to prevent a negative impact of non-financial CoIs on the
National Oceanic and Atmospheric Administration, Department of Commerce — The National Marine Fisheries Service (NMFS) conducted a survey of fisheries stakeholders on the Gulf and East Coasts of the United States seeking their views on...
Full Text Available Road transport accounts for 72.06% of total transport CO2, which is considered a cause of climate change. At present, the use of alternative fuels has become a pressing issue and a significant number of automakers and scholars have devoted themselves to the study and subsequent development of alternative fuel vehicles (AFVs. The evaluation of AFVs should consider not only air pollution reduction and fuel efficiency but also AFV sustainability. In general, the field of sustainable development is subdivided into three areas: economic, environmental, and social. On the basis of the sustainable development perspective, this study presents an evaluation framework for AFVs by using the DEMATEL-based analytical network process. The results reveal that the five most important criteria are price, added value, user acceptance, reduction of hazardous substances, and dematerialization. Price is the most important criterion because it can improve the popularity of AFVs and affect other criteria, including user acceptance. Additional, the energy usage criterion is expected to significantly affect the sustainable development of AFVs. These results should be seriously considered by automakers and governments in developing AFVs.
Pedersen, S.M.; Boesen, M.V.; Baker, D.
In this study, the task of evaluating research projects’ relevance and scientific quality is addressed, and a pilot study is executed for five Danish food and agricultural research programmes. Literature reviewed emphasises the importance of context, of consistency and transparency and of the cost...... of evaluation. Moreover, the purpose of research evaluation is thoroughly examined. The method developed and implemented addresses each of these concerns, particularly by employing simple measures and by complementing quantitative analysis with qualitative exercises featuring structured stakeholder interviews...
Friedman, Andrew L; Miles, Samantha
... of the concept on practice and policy. However, as the concept has become more popular, the path has become tangled with the many different ways the concept has been used. For example, different practices have come to be called stakeholder activities, particularly by those seeking to use the label to legitimize their actions. Also, a range of different definitions as to what a stakeholder is has emerged. Concentrating on these issues encourages a view of a second future path of the stake...
Sveinsdottir, Thordis; Wessels, Bridgette; Smallwood, Rod; Linde, Peter; Kalla, Vasso; Tsoukala, Victoria; Sondervan, Jeroen
This report is the deliverable for Work Package 1 (WP1), Stakeholder Values and Ecosystems, of the EU FP7 funded project RECODE (Grant Agreement No: 321463), which focuses on developing Policy Recommendations for Open Access to Research Data in Europe. WP1 focuses on understanding stakeholder values and ecosystems in Open Access, dissemination and preservation in the area of scientific and scholarly data (thus not government data). The objectives of this WP are as follows: • Identify and map ...
The popularity of the stakeholder model has been achieved thanks to its powerful visual scheme and its very simplicity. Stakeholder management has become an important tool to transfer ethics to management practice and strategy. Nevertheless, legitimate criticism continues to insist on clarification and emphasises on the perfectible nature of the model. Here, rather than building on the discussion from a philosophical or theoretical point of view, a different and innovative approach has been c...
Conceptually, education quality of higher education can be determined by evaluation of their stakeholders's satisfaction level. The purpose of this study is to describe how students as external stakeholder and lecturers as internal stakeholder, perceived their satisfaction of learning experience in the university. This study was conducted in…
Full Text Available Global environmental assessments (GEAs are among the most large-scale, formalized processes for synthesizing knowledge at the science–policy–society interface. The successful engagement of diverse stakeholders in GEAs is often described as a crucial mechanism for increasing their legitimacy, salience and credibility. However, the diversity of perspectives on the more precise objectives for stakeholder engagement remains largely unclear. The aims of this study are to categorize and characterize the diversity of perspectives on objectives for stakeholder engagement in GEAs; to explore differences in perspectives within and between different stakeholder groups and categories; and to test whether the more practical prioritization and selection of objectives in GEAs can be linked to deliberative policy learning as a higher-level rationale for stakeholder engagement. For these purposes, we conduct a grounded theory analysis and a keyword analysis of interview material and official GEA documents relating to two GEAs: UN Environment’s Fifth Global Environment Outlook and the Working Group III contribution to the Intergovernmental Panel on Climate Change Fifth Assessment Report. Based on the analysis, we identify six categories of objectives and present as hypotheses promising ways forward for prioritizing and characterizing objectives for stakeholder engagement in GEAs, as well as potential reasons for the differences between perspectives on objectives. This study draws attention to the need for future GEA processes to have more explicit discussions on the objectives for stakeholder engagement, as well as the importance of moving towards increasingly deliberative and inclusive assessment processes more broadly.
Bawole, Justice Nyigmah
This article investigates the involvement of local stakeholders in the environmental impact assessment (EIA) processes of Ghana's first off-shore oil fields (the Jubilee fields). Adopting key informants interviews and documentary reviews, the article argues that the public hearings and the other stakeholder engagement processes were cosmetic and rhetoric with the view to meeting legal requirements rather than a purposeful interest in eliciting inputs from local stakeholders. It further argues that the operators appear to lack the social legitimacy and social license that will make them acceptable in the project communities. A rigorous community engagement along with a commitment to actively involving local stakeholders in the corporate social responsibility (CSR) programmes of the partners may enhance the image of the partners and improve their social legitimacy. Local government agencies should be capacitated to actively engage project organisers; and government must mitigate the impact of the oil projects through well-structured social support programmes.
Bawole, Justice Nyigmah
This article investigates the involvement of local stakeholders in the environmental impact assessment (EIA) processes of Ghana's first off-shore oil fields (the Jubilee fields). Adopting key informants interviews and documentary reviews, the article argues that the public hearings and the other stakeholder engagement processes were cosmetic and rhetoric with the view to meeting legal requirements rather than a purposeful interest in eliciting inputs from local stakeholders. It further argues that the operators appear to lack the social legitimacy and social license that will make them acceptable in the project communities. A rigorous community engagement along with a commitment to actively involving local stakeholders in the corporate social responsibility (CSR) programmes of the partners may enhance the image of the partners and improve their social legitimacy. Local government agencies should be capacitated to actively engage project organisers; and government must mitigate the impact of the oil projects through well-structured social support programmes.
Sarah K Summers
Full Text Available Carbon credits are an increasingly prevalent market-based mechanism used to subsidize household water treatment technologies (HWT. This involves generating credits through the reduction of carbon emissions from boiling water by providing a technology that reduces greenhouse gas emissions linked to climate change. Proponents claim this process delivers health and environmental benefits by providing clean drinking water and reducing greenhouse gases. Selling carbon credits associated with HWT projects requires rigorous monitoring to ensure households are using the HWT and achieving the desired benefits of the device. Critics have suggested that the technologies provide neither the benefits of clean water nor reduced emissions. This study explores the perspectives of carbon credit and water, sanitation and hygiene (WASH experts on HWT carbon credit projects.Thirteen semi-structured, in-depth interviews were conducted with key informants from the WASH and carbon credit development sectors. The interviews explored perceptions of the two groups with respect to the procedures applied in the Gold Standard methodology for trading Voluntary Emission Reduction (VER credits.Agreement among the WASH and carbon credit experts existed for the concept of suppressed demand and parameters in the baseline water boiling test. Key differences, however, existed. WASH experts' responses highlighted a focus on objectively verifiable data for monitoring carbon projects while carbon credit experts called for contextualizing observed data with the need for flexibility and balancing financial viability with quality assurance.Carbon credit projects have the potential to become an important financing mechanism for clean energy in low- and middle-income countries. Based on this research we recommend that more effort be placed on building consensus on the underlying assumptions for obtaining carbon credits from HWT projects, as well as the approved methods for monitoring
Summers, Sarah K; Rainey, Rochelle; Kaur, Maneet; Graham, Jay P
Carbon credits are an increasingly prevalent market-based mechanism used to subsidize household water treatment technologies (HWT). This involves generating credits through the reduction of carbon emissions from boiling water by providing a technology that reduces greenhouse gas emissions linked to climate change. Proponents claim this process delivers health and environmental benefits by providing clean drinking water and reducing greenhouse gases. Selling carbon credits associated with HWT projects requires rigorous monitoring to ensure households are using the HWT and achieving the desired benefits of the device. Critics have suggested that the technologies provide neither the benefits of clean water nor reduced emissions. This study explores the perspectives of carbon credit and water, sanitation and hygiene (WASH) experts on HWT carbon credit projects. Thirteen semi-structured, in-depth interviews were conducted with key informants from the WASH and carbon credit development sectors. The interviews explored perceptions of the two groups with respect to the procedures applied in the Gold Standard methodology for trading Voluntary Emission Reduction (VER) credits. Agreement among the WASH and carbon credit experts existed for the concept of suppressed demand and parameters in the baseline water boiling test. Key differences, however, existed. WASH experts' responses highlighted a focus on objectively verifiable data for monitoring carbon projects while carbon credit experts called for contextualizing observed data with the need for flexibility and balancing financial viability with quality assurance. Carbon credit projects have the potential to become an important financing mechanism for clean energy in low- and middle-income countries. Based on this research we recommend that more effort be placed on building consensus on the underlying assumptions for obtaining carbon credits from HWT projects, as well as the approved methods for monitoring correct and
Summers, Sarah K.; Rainey, Rochelle; Kaur, Maneet; Graham, Jay P.
Background Carbon credits are an increasingly prevalent market-based mechanism used to subsidize household water treatment technologies (HWT). This involves generating credits through the reduction of carbon emissions from boiling water by providing a technology that reduces greenhouse gas emissions linked to climate change. Proponents claim this process delivers health and environmental benefits by providing clean drinking water and reducing greenhouse gases. Selling carbon credits associated with HWT projects requires rigorous monitoring to ensure households are using the HWT and achieving the desired benefits of the device. Critics have suggested that the technologies provide neither the benefits of clean water nor reduced emissions. This study explores the perspectives of carbon credit and water, sanitation and hygiene (WASH) experts on HWT carbon credit projects. Methods Thirteen semi-structured, in-depth interviews were conducted with key informants from the WASH and carbon credit development sectors. The interviews explored perceptions of the two groups with respect to the procedures applied in the Gold Standard methodology for trading Voluntary Emission Reduction (VER) credits. Results Agreement among the WASH and carbon credit experts existed for the concept of suppressed demand and parameters in the baseline water boiling test. Key differences, however, existed. WASH experts’ responses highlighted a focus on objectively verifiable data for monitoring carbon projects while carbon credit experts called for contextualizing observed data with the need for flexibility and balancing financial viability with quality assurance. Conclusions Carbon credit projects have the potential to become an important financing mechanism for clean energy in low- and middle-income countries. Based on this research we recommend that more effort be placed on building consensus on the underlying assumptions for obtaining carbon credits from HWT projects, as well as the approved
Full Text Available Background: Having a common vision among network stakeholders is an important ingredient to developing a performance evaluation process. Consensus methods may be a viable means to reconcile the perceptions of different stakeholders about the dimensions to include in a performance evaluation framework.Objectives: To determine whether individual organizations within traumatic brain injury (TBI networks differ in perceptions about the importance of performance dimensions for the evaluation of TBI networks and to explore the extent to which group consensus sessions could reconcile these perceptions.Methods: We used TRIAGE, a consensus technique that combines an individual and a group data collection phase to explore the perceptions of network stakeholders and to reach a consensus within structured group discussions.Results: One hundred and thirty-nine professionals from 43 organizations within eight TBI networks participated in the individual data collection; 62 professionals from these same organisations contributed to the group data collection. The extent of consensus based on questionnaire results (e.g. individual data collection was low, however, 100% agreement was obtained for each network during the consensus group sessions. The median importance scores and mean ranks attributed to the dimensions by individuals compared to groups did not differ greatly. Group discussions were found useful in understanding the reasons motivating the scoring, for resolving differences among participants, and for harmonizing their values.Conclusion: Group discussions, as part of a consensus technique, appear to be a useful process to reconcile diverging perceptions of network performance among stakeholders.
Chol, Chol; Hunter, Cynthia; Debru, Berhane; Haile, Berhana; Negin, Joel; Cumming, Robert G
Wars affect maternal health services by destroying health systems. Eritrea experienced two wars with neighbouring Ethiopia. Despite this, the maternal mortality ratio (MMR) in Eritrea fell by 69% from 1590 per 100,000 live births in 1990 to 501 in 2015. This study aimed to examine facilitators of and barriers to the utilisation of and access to maternal health services in Eritrea. Using in-depth interviews and field observations for data collection, this qualitative study was conducted in five healthcare facilities in Asmara, the capital of Eritrea, in February and March 2016. The participants were: women (n = 40), husbands (n = 5), healthcare providers (n = 10), and decision makers (n = 5). There were two perceived facilitators of utilisation of and access to maternal health services: health education (related to the WHO health service delivery building blocks) and improvement in gender equality driven by the role played by Eritrean women as combatants during the War of Independence (1961-1991). The only perceived barrier was poor quality of care due to lack of ultrasound machines, short clinic opening hours, and shortage of healthcare workers (related to the WHO health workforce building block). This study assessed women and their husbands/partners' perceptions and the possible effects of contemporary Eritrean culture and the history of war on the utilisation of and access to maternal health services in the country. As well, we examined healthcare providers' and decision makers' perspectives. The two key facilitators of women's utilisation of and access to maternal health services were health education and women's empowerment driven by their role as combatants during the War of Independence. One main barrier was poor quality of care due to lack of ultrasound machines, short clinic opening hours, and a shortage of healthcare workers. As only a limited number of qualitative studies have been published about maternal health services in war
Miller, B.; Sinclair, J. [Elon University, Elon, NC (United States). School Community
Focus group research was used to examine how community stakeholders, a group with local industry experience, responded to coal industry advocacy messages. The stakeholders expressed beliefs about both the advertiser and the coal industry, and while their knowledge led to critical consideration of the industry campaign, they also expressed a desire to identify with positive messages about their community. Applying a postpositivist research perspective, a new model is introduced to integrate these beliefs in terms of advertiser trust and industry accountability under the existing theoretical framework of persuasion knowledge. Agent and topic knowledge are combined in this model based on responses to the industry advocacy campaign. In doing so, this study integrates a priori theory within a new context, extending the current theoretical framework to include an understanding of how community stakeholders - a common target for marketplace advocacy - interpret industry messages.
Mr Gadano, Undersecretary for Nuclear Energy, Argentina spoke from the perspective of a country looking forward to becoming a member of the NEA. He reviewed the place of nuclear energy in his country's energy mix and called attention to its role in positively addressing the global challenges of climate change and energy security. Mr Gadano also described the federal system which governs Argentina. Drawing on his expertise as a lawmaker and nuclear regulator but also as an academic sociologist, he stressed that reaching agreement on siting initiatives for example requires a sustainable relation with stakeholders, including regional governments. This is important because in the end, 'the best project is the one you can finish'
Tennant, Michele R; Cataldo, Tara Tobin; Sherwill-Navarro, Pamela; Jesano, Rae
This paper describes a survey-based evaluation of the five-year old Liaison Librarian Program at the University of Florida. Liaison librarians, faculty, students, staff, residents, and post-doctoral associates were queried via Web-based surveys. Questions addressed client and liaison perspectives on a variety of issues, including program and service awareness and usage, client-library relations and communication, client support for the program, and liaison workload. Approximately 43% of the 323 client respondents were aware of liaison services; 72% (n = 163) of these clients had had contact with their liaison. Ninety-five percent (n = 101) of faculty and students who reported contact with their liaison supported the continuation of the program. Liaison services were used by a greater percentage of faculty than students, although they had similar patterns of usage and reported the same "traditional" services to be most important. Liaisons indicated that communications with clients had increased, the reputation of the library was enhanced, and their workloads had increased as a result of the Liaison Librarian Program. Survey results suggest that the Liaison Librarian Program has a core set of clients who use and highly value the services provided by liaisons. Recommendations addressing workload, training, marketing, and administrative support are provided.
Longo, Daniel R
The proliferation of health care consumer reports (also known as "consumer guides," "report cards," and "performance reports") designed to assist consumers in making more informed health care decisions makes it vital to understand the perspective of employers who provide the vast majority of health insurance to the working population regarding the use of these reports. There is little empirical evidence on how consumer reports are used by employers to make health care purchasing decisions. This study fills that gap by surveying 154 businesses in Boone County, Missouri, regarding their evaluation of a consumer guide. The majority of employers surveyed indicate that the report will not have a direct effect on their health care purchasing decisions. However, they indicate that the reports are "positive and worthwhile" and their responses reflect a favorable view of the health care organization that developed and disseminated the report. Additionally, findings indicate that employers generally prefer consumer reports as a means to compare local health care institutions, rather than reviewing national averages to locate the same information. Report developers should take precautions to determine the intent of such reports, as they may not achieve the objective of changing employers' health care purchasing behavior.
Since 2007, the New England Aquarium has led a national effort to increase the capacity of informal science venues to effectively communicate about climate change. We are now leading the NSF-funded National Network for Ocean and Climate Change Interpretation (NNOCCI), partnering with the Association of Zoos and Aquariums, FrameWorks Institute, Woods Hole Oceanographic Institution, Monterey Bay Aquarium, and National Aquarium, with evaluation conducted by the New Knowledge Organization, Pennsylvania State University, and Ohio State University. NNOCCI enables teams of informal science interpreters across the country to serve as "communication strategists" - beyond merely conveying information they can influence public perceptions, given their high level of commitment, knowledge, public trust, social networks, and visitor contact. We provide in-depth training as well as an alumni network for ongoing learning, implementation support, leadership development, and coalition building. Our goals are to achieve a systemic national impact, embed our work within multiple ongoing regional and national climate change education networks, and leave an enduring legacy. What is the most useful theoretical model for conceptualizing the work of the NNOCCI community? This presentation will examine the pros and cons of three perspectives -- community of practice, collective impact, and social movements. The community of practice approach emphasizes use of common tools, support for practice, social learning, and organic development of leadership. A collective impact model focuses on defining common outcomes, aligning activities toward a common goal, structured collaboration. A social movement emphasizes building group identity and creating a sense of group efficacy. This presentation will address how these models compare in terms of their utility in program planning and evaluation, their fit with the unique characteristics of the NNOCCI community, and their relevance to our program goals.
Laude, Daniel; Weibel, Antoinette; Sachs, Sybille; Schafheitle, Simon Daniel
Stakeholder theory has addressed the role of trust in organization-stakeholder relationships in depth. Although it is similarly relevant, distrust as a distinct construct from (low) trust has received relatively little consideration by stakeholder theorists. Thus, this article focuses on stakeholder distrust and reflects on the findings of distrust research in organizational studies and the implications for stakeholder theory. For this purpose, we conduct a systematic literature review of org...
With reference to the discussion about shareholder versus stakeholder maximization it is argued that the normal type of maximization is in fact stakeholder-owner maxi-mization. This means maximization of the sum of the value of the shares and stake-holder benefits belonging to the dominating stakeholder-owner. Maximization of shareholder value is a special case of owner-maximization, and only under quite re-strictive assumptions shareholder maximization is larger or equal to stakeholder-owner...
Lauesen, Linne Marie
, the global warming, the disasters of global consumerism in terms of the collapse of the Rana Plaza factory in the fashion industry, are examples of how the stakeholder concept cannot continue to be defined as narrow as corporations usually does. The butterfly effect of globalism has shown to be – yes, global....... Even the smallest company, the single consumer and the tiniest decision made by anyone may in the future – perhaps even tomorrow – affect stakeholders, we didn’t know existed. The future generation is also to be considered as stakeholders, which decisions made today may affect. Companies, consumers......, everyday people including children already know this even from the first day at school if not before. What we need is not knowledge about these phenomena – it is how to think globally when we decide locally: in companies, in daily households, in education of our future generations. This chapter discusses...
Юлія Юріївна ГУСЄВА
Full Text Available An approach based on an integration of requirements breakdown structure and work breakdown structure of the project is proposed. It can complement existing methods of project stakeholders classification with the indicator of resource input, which can be defined in monetary terms. A method of requirements monitoring is proposed, which allows you to track the requirements of project stakeholders over time according to the actual amount of resources spent by analogy with the earned value method. Proposed indexes are the basis not only for monitoring but for the forecast of the project. The need of creating of a mechanism for getting baseline data taking into account the existence of different types of requirements of project stakeholders is grounded.
Corina M. Rădulescu
Full Text Available The process of regeneration of abandoned areas or deteriorated structures in the cities of Romania has become a strategy of urban-integrated development. Conversions and/or regeneration of facilities in the form of assets, with different destinations, are part of the new trend of urban regeneration and a strategy used to attract investment capital. The disappearance of mining industry sites in Maramures County, Romania, has allowed the expansion and planning of new spaces for public use and/or semipublic, and most cities have opened new development perspectives. The study is based on empirical research conducted on the brownfields of Baia-Mare City. This research investigates how stakeholders of an urban regeneration project can be more actively involved in the decision-making processes with regard to the strategic elements of the renewal project of Cuprom, as a former mining industry area. This research contributes to the development of the investigation of new types of knowledge of stakeholder analysis and improves the available practices for stakeholder salience. Social networks created and consolidated by stakeholders of an urban regeneration project are the object of analysis, evaluation, and monitoring of the equilibrium between project management and grant of resources and capital. This paper studies the salience of stakeholders of the SEPA-CUPROM project from Baia-Mare using the social networking approach. Visualization by graphical methods of social networking analysis is a useful instrument in the decision-making process of brownfield projects as part of sustainable strategies in Romania.
Finding solutions for complex societal problems requires cross-boundary collaboration between multiple stakeholders who represent various practices, disciplines and perspectives. The authentic, multi-stakeholder Regional Learning Environment (RLE) is expected to develop higher education students’
Vari, A.; Pescatore, C.
The FSC workshop in Spain provided an important opportunity to carry out an in-depth examination of decision-making processes undertaken in an NEA member country, and to reflect on the evolution that has taken place over time. It offered a well-rounded perspective on the inclusion of stakeholders in decision making, and the atmosphere of the meetings was conducive to an honest and open exchange of ideas. The workshop started with the introduction of two case studies: the earlier attempt in Spain to locate a potential site for a high-level waste (HLW) disposal facility, and the dismantling of the Vandellos-I nuclear power plant. This was followed by two days of presentations and round-table discussions based on the recent COWAM Spain initiative (stemming from the EU-wide project on Community Waste Management), which aims at developing recommendations for institutional arrangements and decision-making processes concerning the siting of waste management facilities in Spain. This article provides a brief summary of the case studies and the COWAM Spain initiative, followed by some of the lessons learnt from an international perspective. (authors)
Galinsky, Adam D; Ku, Gillian
Perspective-taking, by means of creating an overlap between self and other cognitive representations, has been found to effectively decrease stereotyping and ingroup favoritism. In the present investigation, the authors examined the potential moderating role of self-esteem on the effects of perspective-taking on prejudice. In two experiments, it was found that perspective-takers, but not control participants, with temporarily or chronically high self-esteem evaluated an outgroup more positively than perspective-takers with low self-esteem. This finding suggests an irony of perspective-taking: it builds off egocentric biases to improve outgroup evaluations. The discussion focuses on how debiasing intergroup thought is often best accomplished by working through the very processes that produced the bias in the first place.
Uegaki, K.; Bruijne, M.C. de; Lambeek, L.; Anema, J.R.; Beek, A.J. van der; Mechelen, W. van; Tulder, M.W. van
Objective: Using a standardized quality criteria list, we appraised the methodological quality of economic evaluations of occupational safety and health (OSH) interventions conducted from a corporate perspective. Methods: The primary literature search was conducted in Medline and Embase.
With reference to the discussion about shareholder versus stakeholder maximization it is argued that the normal type of maximization is in fact stakeholder-owner maxi-mization. This means maximization of the sum of the value of the shares and stake-holder benefits belonging to the dominating...... including the shareholders of a company. Although it may be the ultimate goal for Corporate Social Responsibility to achieve this kind of maximization, broad stakeholder maximization is quite difficult to give a precise definition. There is no one-dimensional measure to add different stakeholder benefits...... not traded on the mar-ket, and therefore there is no possibility for practical application. Broad stakeholder maximization instead in practical applications becomes satisfying certain stakeholder demands, so that the practical application will be stakeholder-owner maximization un-der constraints defined...
Madsen, Charlotte Bernhard; Crevel, René; Chan, Chun-Han
, uncertainty is caused by the unpredictability of reactions and the concern about whether avoidance strategies will be effective enough. Variability of symptoms and the lack of markers do not allow stratification of patients according to their reactivity, and force health professionals to give the same advice...
Coordination of Decision Making in Spain. The 'COWAM Spain' Initiative and the Current Project Under Consideration for a National Interim Storage Facility for Spent Fuel and High Level Waste. The Sixth Workshop of the Forum on Stakeholder Confidence. Executive Summary and International Perspective
speakers introduced the COWAM Spain initiative and expounded its three main themes: (i) democracy and participatory systems for the local level; (ii) the interplay between the national and local level; and (iii) long-term governance. Presentations provided a background to subsequent round table discussions that included both local stakeholders and international delegates. Day 3 afternoon was devoted to the feedback by two thematic rapporteurs. They evaluated the meeting from two distinct perspectives: that of the policy making approach, and of participatory decision making. The present Summary gives an overview of the presentations and discussions that took place at the workshop and the community visit. The structure of the Executive Summary follows the structure of the workshop itself. Complementary to this Executive Summary, and also provided with this document, is the NEA Secretariat's reflection highlighting from an international perspective some of the lessons to be learnt
Cheng, Vivian M. Y.
Infusing creativity elements into regular classroom was an important movement in recent Asian educational reforms. A large-scale research study was conducted in Hong Kong to explore the possibilities, outcomes and difficulties of this kind of curriculum change from students' perspectives. Based mainly on Western creativity literature, this study…
Beaudoin, Christina; Parker, Tonya; Tiemersma, Karol; Lewis, Colleen
This article presents the results of a survey of student and faculty perspectives within a university-level instructional physical activity (PA) program. The results revealed that students enrolled in the courses primarily for enjoyment and to stay fit. A majority of students ranked the quality of instruction as excellent, were interested in new…
Bridoux, F.; Stoelhorst, J.W.
Instrumental stakeholder theory proposes a positive relationship between fairness toward stakeholders and firm performance. Yet, some firms are successful with an arms-length approach to stakeholder management, based on bargaining power rather than fairness. We address this puzzle by relaxing the
Biekart, Kees; Fowler, Alan
textabstractThe nature and dynamics of ownership are often neglected features of multi-stakeholder initiatives (MSIs). Seventeen cases in four countries illustrate characteristics of narrow government or broad societal ownership and forces for change over time. Refinements to the application of Gaventa’s Power Cube are used to analyse such shifts from the perspective of invited and closed spaces for participation. Observations about ways in which stakeholder groups can create a more enabling ...
Mei, Yi You; Marquard, Jenna; Jacelon, Cynthia; DeFeo, Audrey L
Patient falls are the leading cause of unintentional injury and death among older adults. In 2000, falls resulted in over 10,300 elderly deaths, costing the United States approximately $179 million in incidence and medical costs. Furthermore, non-fatal injuries caused by falls cost the United States $19 billion annually. Health information technology (IT) applications, specifically electronic falls reporting systems, can aid quality improvement efforts to prevent patient falls. Yet, long-term residential care facilities (LTRCFs) often do not have the financial resources to implement health IT, and workers in these settings are often not ready to adopt such systems. Additionally, most health IT evaluations are conducted in large acute-care settings, so LTRCF administrators currently lack evidence to support the value of health IT. In this paper, we detail the development of a novel, easy-to-use system to facilitate electronic patient falls reporting within a LTRCF using off-the-shelf technology that can be inexpensively implemented in a wide variety of settings. We report the results of four complimentary system evaluation measures that take into consideration varied organizational stakeholders' perspectives: (1) System-level benefits and costs, (2) system usability, via scenario-based use cases, (3) a holistic assessment of users' physical, cognitive, and marcoergonomic (work system) challenges in using the system, and (4) user technology acceptance. We report the viability of collecting and analyzing data specific to each evaluation measure and detail the relative merits of each measure in judging whether the system is acceptable to each stakeholder. The electronic falls reporting system was successfully implemented, with 100% reporting at 3-months post-implementation. The system-level benefits and costs approach showed that the electronic system required no initial investment costs aside from personnel costs and significant benefits accrued from user time savings
Peek, Sebastiaan Theodorus Michaël; Wouters, Eveline J M; Luijkx, Katrien G; Vrijhoef, Hubertus J M
to who should pay for the technology. Additionally, each stakeholder group mentioned specific steps that need to be taken to achieve successful implementation. Collectively, stakeholders felt that they need to take the leap (ie, change attitudes, change policies, and collaborate with other organizations); bridge the gap (ie, match technology with individuals and stimulate interdisciplinary education); facilitate technology for the masses (ie, work on products and research that support large-scale rollouts and train target groups on how to use technology); and take time to reflect (ie, evaluate use and outcomes). Stakeholders largely agree on the direction in which they should be heading; however, they have different perspectives with regard to the technologies that can be employed and the work that is needed to implement them. Central to these issues seems to be the tailoring of technology or technologies to the specific needs of each community-dwelling older adult and the work that is needed by stakeholders to support this type of service delivery on a large scale.
Hansen, Steffen Foss
In order to facilitate stakeholder discussions on how to regulate nanotechnology, the opensource program multicriteria mapping (MCM) was used to structure 26 interviews with stakeholders in the USA. MCM offers a systematic part quantitative, part qualitative approach to clarify why some regulatory options (bans, moratoriums, voluntary measures, etc.) were deemed to be acceptable/unacceptable by various stakeholders and which criteria stakeholders used to evaluate the different regulatory options. Adopting an incremental approach and implementing a new regulatory framework was evaluated as the best options whereas a complete ban and no additional regulation of nanotechnology were found to be the least favorable. Criteria applied differed substantially among stakeholders and included social, ethical, regulatory, environmental, and health issues. Opinions on future regulation seem far less polarized than expected and it seems that stakeholders would welcome a combination of voluntary measures, an incremental approach and forming of a new regulatory framework.
Hansen, Steffen Foss
In order to facilitate stakeholder discussions on how to regulate nanotechnology, the opensource program multicriteria mapping (MCM) was used to structure 26 interviews with stakeholders in the USA. MCM offers a systematic part quantitative, part qualitative approach to clarify why some regulatory options (bans, moratoriums, voluntary measures, etc.) were deemed to be acceptable/unacceptable by various stakeholders and which criteria stakeholders used to evaluate the different regulatory options. Adopting an incremental approach and implementing a new regulatory framework was evaluated as the best options whereas a complete ban and no additional regulation of nanotechnology were found to be the least favorable. Criteria applied differed substantially among stakeholders and included social, ethical, regulatory, environmental, and health issues. Opinions on future regulation seem far less polarized than expected and it seems that stakeholders would welcome a combination of voluntary measures, an incremental approach and forming of a new regulatory framework.
Lund, Anker Brink
Historically, government regulation has significantly impacted the room for manoeuvre enjoyed by media managers, especially in public service media but increasingly also in privately owned firms. Currently stakeholders of many different kinds attempt to influence media industries, using a number...... of the world arguably features the most complex and continuous development in these aspects. Our particular interest investigates media governance, which is not understood as an external given but considered as a premise of strategic management. It is argued that to secure an appropriate remit for an industry...... or firm to that guarantees a longer-term licence to operate, media managers must engage different audiences and authorities in relation to restrictive as well as prescriptive regulation. Achieving that requires approaching media governance from a stakeholder perspective, which inherently involves a broad...
If you want to be stopped in your tracks today through political action, litigation or both, then ignore the concerns of stakeholders who believe that they have been or will be adversely impacted by what you want to do. The frustrated attempts by the United States to permanently dispose of its high level radioactive waste confirm this reality. Unless and until fundamental changes are made in the decision making process, the gridlock of litigation and political maneuvering precipitated by efforts to perfect a permanent repository will remain and likely intensify
Watt, Amber M; Hiller, Janet E; Braunack-Mayer, Annette J; Moss, John R; Buchan, Heather; Wale, Janet; Riitano, Dagmara E; Hodgetts, Katherine; Street, Jackie M; Elshaug, Adam G
Governments and other payers are yet to determine optimal processes by which to review the safety, effectiveness, and cost-effectiveness of technologies and procedures that are in active use within health systems, and rescind funding (partially or fully) from those that display poor profiles against these parameters. To further progress a disinvestment agenda, a model is required to support payers in implementing disinvestment in a transparent manner that may withstand challenge from vested interests and concerned citizens. Combining approaches from health technology assessment and deliberative democratic theory, this project seeks to determine if and how wide stakeholder engagement can contribute to improved decision-making processes, wherein the views of both vested and non-vested stakeholders are seen to contribute to informing policy implementation within a disinvestment context. Systematic reviews pertaining to illustrative case studies were developed and formed the evidence base for discussion. Review findings were presented at a series of deliberative, evidence-informed stakeholder engagements, including partisan (clinicians and consumers) and non-partisan (representative community members) stakeholders. Participants were actively facilitated towards identifying shared and dissenting perspectives regarding public funding policy for each of the case studies and developing their own funding models in response to the evidence presented. Policy advisors will subsequently be invited to evaluate disinvestment options based on the scientific and colloquial evidence presented to them, and to explore the value of this information to their decision-making processes with reference to disinvestment. Analysis of the varied outputs of the deliberative engagements will contribute to the methodological development around how to best integrate scientific and colloquial evidence for consideration by policy advisors. It may contribute to the legitimization of broad and
O'Rourke, Tammy; Higuchi, Kathryn S; Hogg, William
A recent change in Canada's primary care system led to the introduction of Nurse Practitioner-Led clinics. The literature suggests that stakeholders can influence system change initiatives. However, very little is known about healthcare stakeholder motivations, particularly stakeholders who are seen as resistors to change. To examine stakeholder participation in the system change process that led to the introduction of the first Nurse Practitioner-Led clinic in Ontario. This single case study included two site visits, semistructured individual tape-recorded interviews, and the examination of relevant public documents. Qualitative content analysis was used to analyze the data. Sixteen individuals from different healthcare sectors and professions participated in the interviews and 20 documents were reviewed. Six key themes emerged from the data. Linking Evidence to Action The findings from the study present a new perspective on stakeholder participation that includes both those who supported the proposed change and those who advocated for a different change. The findings identify stakeholder activities used to shape, share, and protect their visions for system change. The conceptual model presented in this study adds to the understanding of challenges and complexities involved in healthcare system change. Understanding why and how stakeholders participate in change can help healthcare leaders in planning activities to enhance stakeholder involvement in healthcare system change. © 2016 Sigma Theta Tau International.
Planas-Lladó, Anna; Feliu, Lidia; Castro, Francesc; Fraguell, Rosa Maria; Arbat, Gerard; Pujol, Joan; Suñol, Joan Josep; Daunis-i-Estadella, Pepus
This article analyses the use of peer evaluation as a tool for evaluating teamwork and students' perceptions of this type of evaluation. A study was conducted of six subjects included on five degree courses at the University of Girona. In all of these subjects, students carried out a team activity, evaluated the performance of the team and the…
This paper focuses on the influences and changes of recent Taiwan teacher preparation program evaluation (TTPPE) as one of the national evaluation projects conducted by the Higher Education Evaluation and Accreditation Council of Taiwan. The main concerns are what kind of ideology is transformed through the policy by means of evaluation, and what…
By employing interpretive policy analysis this thesis aims to assess, measure, and explain policy capacity for government and non-government organizations involved in reclaiming Alberta's oil sands. Using this type of analysis to assess policy capacity is a novel approach for understanding reclamation policy; and therefore, this research will provide a unique contribution to the literature surrounding reclamation policy. The oil sands region in northeast Alberta, Canada is an area of interest for a few reasons; primarily because of the vast reserves of bitumen and the environmental cost associated with developing this resource. An increase in global oil demand has established incentive for industry to seek out and develop new reserves. Alberta's oil sands are one of the largest remaining reserves in the world, and there is significant interest in increasing production in this region. Furthermore, tensions in several oil exporting nations in the Middle East remain unresolved, and this has garnered additional support for a supply side solution to North American oil demands. This solution relies upon the development of reserves in both the United States and Canada. These compounding factors have contributed to the increased development in the oil sands of northeastern Alberta. Essentially, a rapid expansion of oil sands operations is ongoing, and is the source of significant disturbance across the region. This disturbance, and the promises of reclamation, is a source of contentious debates amongst stakeholders and continues to be highly visible in the media. If oil sands operations are to retain their social license to operate, it is critical that reclamation efforts be effective. One concern non-governmental organizations (NGOs) expressed criticizes the current monitoring and enforcement of regulatory programs in the oil sands. Alberta's NGOs have suggested the data made available to them originates from industrial sources, and is generally unchecked by government
Scientists, politicians, the public, school children, our neighbours, you. All of these groups of people have a stake in CERN, and all are important to us. The list of stakeholders in an organisation as large and complex as CERN is a long and ever lengthening one. Each group has its own specific interests and needs in terms of what kind of information it requires from CERN and how we should engage. It’s important, therefore, for us to ensure that we’re communicating optimally with everyone we care about and who cares about us. This is something that CERN has always taken seriously. The CERN Courier, for example, was first published in 1959 and we had a pro-active public information office right from the start. Today, our stakeholder relations are spread between several groups and teams, reflecting the nature of CERN today. But while we’re already doing a good job, I think we can do better by exploiting the synergies between these teams, and that’s wh...
Haverkort, J J Mark; Leenen, Luke P H
Presently used evaluation techniques rely on 3 traditional dimensions: reports from observers, registration system data, and observational cameras. Some of these techniques are observer-dependent and are not reproducible for a second review. This proof-of-concept study aimed to test the feasibility of extending evaluation to a fourth dimension, the patient's perspective. Footage was obtained during a large, full-scale hospital trauma drill. Two mock victims were equipped with point-of-view cameras filming from the patient's head. Based on the Major Incident Hospital's first experience during the drill, a protocol was developed for a prospective, standardized method to evaluate a hospital's major incident response from the patient's perspective. The protocol was then tested in a second drill for its feasibility. New insights were gained after review of the footage. The traditional observer missed some of the evaluation points, which were seen on the point-of-view cameras. The information gained from the patient's perspective proved to be implementable into the designed protocol. Use of point-of-view camera recordings from a mock patient's perspective is a valuable addition to traditional evaluation of trauma drills and trauma care. Protocols should be designed to optimize and objectify judgement of such footage. (Disaster Med Public Health Preparedness. 2017;11:594-599).
Stone, V.; Pozzi-Mucelli, S.; Tran, L.
of the current and future risk assessment of NMs. RESULTS: The framework for future research has been developed from the opinions of over 80 stakeholders, that describes the research priorities for effective development of an intelligent testing strategy (ITS) to allow risk evaluation of NMs. In this context......BACKGROUND: To assess the risk of all nanomaterials (NMs) on a case-by-case basis is challenging in terms of financial, ethical and time resources. Instead a more intelligent approach to knowledge gain and risk assessment is required. METHODS: A framework of future research priorities was developed......-priority research areas are described via a series of stepping stones, or hexagon diagrams structured into a time perspective. Importantly, this framework is flexible, allowing individual stakeholders to identify where their own activities and expertise are positioned within the prioritisation pathway...
Tarun, Prashant; Krueger, Dale
In the United States System of Education the growth of student evaluations from 1973 to 1993 has increased from 29% to 86% which in turn has increased the importance of student evaluations on faculty retention, tenure, and promotion. However, the impact student evaluations have had on student academic development generates complex educational…
Kaupanger, R.M.; Kostelnik, K.M.; Milam, L.M.
The Buried Waste Integrated Demonstration (BWID) is a program funded by the US Department of Energy (DOE) Office of Technology Development. BWID supports the applied research, development, demonstration, and evaluation of a suite of advanced technologies that together form a comprehensive remediation system for the effective and efficient remediation of buried waste. Stakeholder participation in the DOE Environmental Management decision-making process is critical to remediation efforts. Appropriate mechanisms for communication with the public, private sector, regulators, elected officials, and others are being aggressively pursued by BWID to permit informed participation. This document summarizes public outreach efforts during FY-93 and presents a strategy for expanded stakeholder involvement during FY-94
Methods of nuclear data evaluation have been highly developed during the past decade, especially after introducing the concept of covariance. This makes it utmost important how to evaluate covariance matrices for nuclear data. It can be said that covariance evaluation is just the nuclear data evaluation, because the covariance matrix has quantitatively decisive function in current evaluation methods. The covariance primarily represents experimental uncertainties. However, correlation of individual uncertainties between different data must be taken into account and it can not be conducted without detailed physical considerations on experimental conditions. This procedure depends on the evaluator and the estimated covariance does also. The mathematical properties of the covariance have been intensively discussed. Their physical properties should be studied to apply it to the nuclear data evaluation, and then, in this report, are reviewed to give the base for further development of the covariance application. (orig.)
Full Text Available With regard to changes in the environment of tertiary education and tertiary educational systems, universities are now unlikely to succeed as ‘separated closed’ institutions that are unresponsive to their environment and stakeholders. Stakeholder analysis is considered as an important part of university management and marketing and universities have to take care of key stakeholder groups and build long term relationships with them. This paper focuses on the stakeholder analysis and adopts the stake-holder theory and analysis for the needs of the Czech market of tertiary education. This paper analyses results of the author’s online questionnaire that provided the input for data analysis deploying basic descriptive analysis and first steps of stakeholder analysis – identification, categorization and prioritization. Results of author’s research show that there are only slight differences between public and private universities and their perspective concerning generic stakeholder groups of universities. However the research revealed two controversial stakeholder groups – donors and competitors. In comparison with other stakeholder groups perception of these two stakeholder groups by public and private universities is very different. Stakeholder groups of public and private universities were categorized into four basic groups - primary internal stakeholder groups, primary external stakeholder groups, secondary internal stakeholder groups, and secondary external stakeholder groups. Primary internal and external stakeholder groups which are crucial for survival of universities are the most important stakeholder groups for universities. The author identified ten most important stakeholder groups for public and private universities separately, based on assigned priorities that will be used for further research.
Babiuch, W.M.; Farhar, B.C.
Stakeholder analysis allows analysts to identify how parties might be affected by government projects. This process involves identifying the likely impacts of a proposed action and stakeholder groups affected by that action. Additionally, the process involves assessing how these groups might be affected and suggesting measures to mitigate any adverse effects. Evidence suggests that the efficiency and effectiveness of government actions can be increased and adverse social impacts mitigated when officials understand how a proposed action might affect stakeholders. This report discusses how to conduct useful stakeholder analyses for government officials making decisions on energy-efficiency and renewable-energy technologies and their commercialization. It discusses methodological issues that may affect the validity and reliability of findings, including sampling, generalizability, validity, ``uncooperative`` stakeholder groups, using social indicators, and the effect of government regulations. The Appendix contains resource directories and a list of specialists in stakeholder analysis and involvement.
The aim of this study is to examine stakeholder involvement in an Enterprise Resource Planning (ERP) System project that involves implementation and improvement of the implemented system. The study targets stakeholders, their classification, and their degree of importance during different phases of an ERP project life cycle, i.e. planning, implementation, stabilisation and improvement. The study shows that stakeholder involvement and their salience vary along the ERP project life cycle a...
Fleurence, Rachael L; Forsythe, Laura P; Lauer, Michael; Rotter, Jason; Ioannidis, John P A; Beal, Anne; Frank, Lori; Selby, Joseph V
The inaugural round of merit review for the Patient-Centered Outcomes Research Institute (PCORI) in November 2012 included patients and other stakeholders, as well as scientists. This article examines relationships among scores of the 3 reviewer types, changes in scoring after in-person discussion, and the effect of inclusion of patient and stakeholder reviewers on the review process. In the first phase, 363 scientists scored 480 applications. In the second phase, 59 scientists, 21 patients, and 31 stakeholders provided a "prediscussion" score and a final "postdiscussion" score after an in-person meeting for applications. Bland-Altman plots were used to characterize levels of agreement among and within reviewer types before and after discussion. Before discussion, there was little agreement among average scores given by the 4 lead scientific reviewers and patient and stakeholder reviewers. After discussion, the 4 primary reviewers showed mild convergence in their scores, and the 21-member panel came to a much stronger agreement. Of the 25 awards with the best (and lowest) scores after phase 2, only 13 had ranked in the top 25 after the phase 1 review by scientists. Five percent of the 480 proposals submitted were funded. The authors conclude that patient and stakeholder reviewers brought different perspectives to the review process but that in-person discussion led to closer agreement among reviewer types. It is not yet known whether these conclusions are generalizable to future rounds of peer review. Future work would benefit from additional data collection for evaluation purposes and from long-term evaluation of the effect on the funded research.
Hanken, Ingrid Maria
This article discusses obstacles that higher education institutions may need to surmount when introducing quality assurance measures such as student evaluation of teaching. It is based on a research study of how student evaluation of one-to-one instrumental tuition is perceived, experienced and practiced by instrumental teachers and their students…
Lathrop, John; Chen, Kan
This document is the final report of the Modeling Stakeholder Preferences Project. The results of the project consist of three results: 1) evaluation framework; 2) focus group non-quantitative findings/ recommendations; and, 3) performance/impact measures, their endpoints, rankings and weights, for each stakeholder group.
Franz, Nancy K.
A hallmark of Extension includes the involvement of stakeholders in research and program needs assessment, design, implementation, evaluation, and reporting. A data party can be used to enhance this stakeholder involvement specifically in data analysis. This type of event can not only increase client participation in Extension programming and…
Madsen, Henning; Ulhøi, John Parm
Regulation has been an important instrument in pushing the business community towards im-proved environmental performance. However, there has also been increasing pressure from a growing number of stakeholders, including employees, customers, neighbours and NGOs, etc. In order to improve corporate...... relationships with various stakeholders, companies need to be able to identify these stakeholders and assess their influence. The first part of this paper will discuss the relevant theory and introduce a model to analyse and identify the most significant stakeholder groups and their influence on corporate...
Full Text Available Business Intelligence (BI applications provide business information to drive decision support. Usability is one of the factors determining the optimal use and eventual benefit derived from BI applications. The documented need for more BI usability research together with the practical necessity for BI evaluation guidelines in the mining industry provides the rationale for this study. The purpose of the study was to investigate the usability evaluation of BI applications in the context of a coal mining organization. The research is guided by the question: How can existing usability criteria be customized to evaluate the usability of BI applications. The research design included user observation, heuristic evaluation and a survey. Based on observations made during user support on a BI application used at a coal mining organization a log of usability issues was compiled. The usability issues extracted from this log was compared and contrasted with general usability criteria from literature to synthesize an initial set of BI usability evaluation criteria. These criteria were used as the basis for a heuristic evaluation of the BI application used at the coal mining organization. The same BI application was also evaluated using the Software Usability Measurement Inventory (SUMI standardized questionnaire. The results from the two evaluations were triangulated and then compared with the BI user issues again to contextualize the findings and synthesize a validated and refined set of criteria. The main contribution of the study is the usability evaluation criteria for BI applications presented as guidelines. These guidelines deviate from existing evaluation guidelines in the emphasis on information architecture, learnability and operability.
Kussmann, Martin; Morine, Melissa J; Hager, Jörg
We review here the status of human type 2 diabetes studies from a genetic, epidemiological, and clinical (intervention) perspective. Most studies limit analyses to one or a few omic technologies providing data of components of physiological processes. Since all chronic diseases are multifactorial...... at different time points along this longitudinal investigation are performed with a comprehensive set of omics platforms. These data sets are generated in a biological context, rather than biochemical compound class-driven manner, which we term "systems omics."...
An Evaluation of the Generalized Intelligent Framework for Tutoring (GIFT) from a Researcher’s or Analyst’s Perspective by Robert A...Generalized Intelligent Framework for Tutoring (GIFT) from a Researcher’s or Analyst’s Perspective Robert A Sottilare and Anne M Sinatra Human...2014 4. TITLE AND SUBTITLE An Evaluation of the Generalized Intelligent Framework for Tutoring (GIFT) from a Researcher’s or Analyst’s Perspective
Boonstra, A.; Govers, M.
Implementing enterprise resource planning (ERP) systems requires significant organisational, as well as technical, changes. These will affect stakeholders with varying perspectives and interests in the system. This is particularly the case in health care, as a feature of this sector is that
On April 9--11, 1997, the Department of Energy`s Office of Worker and Community Transition convened its fifth National Stakeholder Workshop. The workshop addressed a wide range of work force restructuring and community transition issues critical to the future success of the Department. Two important elements of the meeting were: (1) reviewing progress made on the challenges identified during the March 1996f stakeholder`s meeting in Atlanta, Georgia; and (2) identifying areas that needed priority attention during the early months of the second Clinton Administration. The format of the Workshop included several plenary sessions and a number of small group discussion sessions. The small group sessions focused on topics related to labor issues, work force restructuring, work force planning, community transition, and employee concerns. The sessions provided a wide range of views on worker and community transition issues. The workshop included presentations on the following topics: Welcome and introductions; Opening remarks; Community reuse organizations: recent accomplishments; Privatization: policy, practice and potential pitfalls; Department of Energy`s integrated training initiatives; Congressional perspective on work force restructuring; and, Privatization and the Ten Year Plan.
Plenary Session 1 Moderated by Edgar de León Izeppi This presentation was held at the Pavement Evaluation 2014 Conference, which took place from September 15-18, 2014 in Blacksburg, Virginia. Presentation only
DeMuro, Paul R; Ash, Joan; Middleton, Blackford; Fletcher, Justin; Madison, Cecelia J
evaluated the framework and found it useful. Positives and negatives associated with e-prescribing in the areas of quality, benefits, costs, and financial considerations can be rank ordered from the perspective of each stakeholder. The experts agreed on some points but disagreed on others. For example, they agreed that the main negative of e-prescribing from the perspective of pharmacists and pharmacies was its implementation costs but differed on the importance of providing faster information transfer. A framework was created that could be successfully used by payers, integrated delivery systems, policymakers and legislators, and those who influence public policy for the development of incentives and payment mechanisms. This research was supported by the National Library of Medicine of the National Institutes of Health under Award Number T15LM007088. The authors declare no conflicts of interest in the research. Study concept and design were contributed by DeMuro, Ash, Middleton, and Fletcher. DeMuro took the lead in data collection, along with Ash, and data interpretation was performed by DeMuro, Ash, Madison, Middleton, and Fletcher. The manuscript was written primarily by DeMuro, along with Ash and Middleton, and revised by DeMuro, Madison, and Ash, along with Middleton and Fletcher.
Hörstedt, Maria; Linjamaa, Johanna
As a result from the latest financial crisis, the banking industry has undergone major modifications during the last years in order to limit banks’ risks. A vast majority of existing literature tends to focus upon credit risk evaluation methods and techniques mainly concerning quantitative measures and large companies. Thus, the lack of research regarding credit risk evaluation of SMEs is profound, especially considering Sweden. With the dominant market share of SMEs compared to large corpora...
Ekirapa-Kiracho, Elizabeth; Ghosh, Upasona; Brahmachari, Rittika; Paina, Ligia
research project. PIPA also allowed participatory evaluation of the project from the perspective of the community. This paper provides lessons about the use of these participatory tools.
Wong, Hartanto; Eyers, Daniel
In this paper we present a formal approach to evaluate the value of enhanced customisation. The suggested approach is based on a new perspective addressing the important alignment between the operations and marketing functions, under which we are able to obtain a more holistic understanding...
Kenyon, James J., Jr.
This evaluation assesses the Alternative Route to Licensure (ARL) program of the Clark County School District (CCSD), in Clark County, Nevada from the program participants' perspectives. The program was implemented to reduce teacher shortages in the school district and allow persons with non-education-related Bachelor's Degrees to obtain teaching…
Hogan, Niamh M
To date, associations between the number of lymph nodes evaluated, staging, and survival have been examined in the context of large population-based studies conducted by a small number of investigators. Therefore, although high-quality data are available, perspective is lacking.
Memery, Juliet; Birch, Dawn
This study explores attitudes towards aquaculture development as a way of providing a sustainable source of seafood through a consultative stakeholder approach. Given aquaculture is a less familiar concept within South West England, gaining insight of the views and perspectives of such a development in the region is required to facilitate stakeholder engagement. In-depth qualitative interviews investigate attitudes across five stakeholder sectors: government, fishing/marine, business/catering...
This paper analyses the expectations of particular stakeholder groups’ impact on corporate financial accounting policy-making in Lithuanian enterprises from Stakeholder theory perspective. Companies should seek to present a true and fair view of their financial performance and results while making financial accounting policy because stakeholders need informative and truthful accounting data for making right decisions. On the basis of empirical results it could be stated that the impact of dif...
Irwin, Elise R.; Kathryn, D.; Kennedy, Mickett
Adaptive management is different from other types of management in that it includes all stakeholders (versus only policy makers) in the process, uses resource optimization techniques to evaluate competing objectives, and recognizes and attempts to reduce uncertainty inherent in natural resource systems. Management actions are negotiated by stakeholders, monitored results are compared to predictions of how the system should respond, and management strategies are adjusted in a “monitor-compare-adjust” iterative routine. Many adaptive management projects fail because of the lack of stakeholder identification, engagement, and continued involvement. Primary reasons for this vary but are usually related to either stakeholders not having ownership (or representation) in decision processes or disenfranchisement of stakeholders after adaptive management begins. We present an example in which stakeholders participated fully in adaptive management of a southeastern regulated river. Structured decision analysis was used to define management objectives and stakeholder values and to determine initial flow prescriptions. The process was transparent, and the visual nature of the modeling software allowed stakeholders to see how their interests and values were represented in the decision process. The development of a stakeholder governance structure and communication mechanism has been critical to the success of the project.
Geil, Hans Olav
Evaluation codes (also called order domain codes) are traditionally introduced as generalized one-point geometric Goppa codes. In the present paper we will give a new point of view on evaluation codes by introducing them instead as particular nice examples of affine variety codes. Our study...... includes a reformulation of the usual methods to estimate the minimum distances of evaluation codes into the setting of affine variety codes. Finally we describe the connection to the theory of one-pointgeometric Goppa codes. Contents 4.1 Introduction...... . . . . . . . . . . . . . . . . . . . . . . . 171 4.9 Codes form order domains . . . . . . . . . . . . . . . . . . . . . . . . . . . . 173 4.10 One-point geometric Goppa codes . . . . . . . . . . . . . . . . . . . . . . . . 176 4.11 Bibliographical Notes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 178 References...
Gandjbakhch, Frédérique; Terslev, Lene; Joshua, Fredrick
to support face, content validity and reliability for the evaluation of enthesitis, though there is a lack of well-reported methodology in most of the studies. Consensus on elementary lesions and standardization of exam is needed to determine the ultrasound definition of enthesitis in grey......%). Only 46% of studies reported the use of Doppler. High discrepancies were observed on frequency, type of probe and Doppler mode used. Face and content validity were the most frequently evaluated criteria (43%) followed by reliability (29%) and responsiveness (19%). CONCLUSIONS: Ultrasound has evidence......ABSTRACT: INTRODUCTION: An increasing number of studies have applied ultrasound to the evaluation of entheses in spondyloarthritis patients. However, no clear agreement exists on the definition of enthesitis, on the number and choice of entheses to examine and on ultrasound technique, which may all...
Vos, Leti; Groothuis, Siebren; van Merode, Godefridus G
This paper describes an evaluation method for the assessment of hospital building design from the viewpoint of operations management to assure that the building design supports the efficient and effective operating of care processes now and in the future. The different steps of the method are illustrated by a case study. In the case study an experimental design is applied to assess the effect of used logistical concepts, patient mix and technologies. The study shows that the evaluation method provides a valuable tool for the assessment of both functionality and the ability to meet future developments in operational control of a building design.
An increasing number of studies have applied ultrasound to the evaluation of entheses in spondyloarthritis patients. However, no clear agreement exists on the definition of enthesitis, on the number and choice of entheses to examine and on ultrasound technique, which may all affect the results of the examination. The objectives of this study were to first determine the level of homogeneity in the ultrasound definitions for the principal lesions of enthesitis in the published literature and second, to evaluate the metric properties of ultrasound for detecting enthesitis according to the OMERACT filter.
Stavrogiannis, Lampros C.; Mitkas, Pericles A.
The annual Trading Agent Competition for Market Design, CAT, provides a testbed to study the mechanisms that modern stock exchanges use in their effort to attract potential traders while maximizing their profit. This paper presents an evaluation of the agents that participated in the 2008 competition. The evaluation is based on the analysis of the CAT finals as well as on the results obtained from post-tournament experiments. We present Mertacor, our entrant for 2008, and compare it with the other available agents. In addition, we introduce a simple yet effective way of computing the global competitive equilibrium that Mertacor utilizes and discuss its importance for the game.
Appert, O. [Institut Francais du Petrole (IFP), 92 - Rueil-Malmaison (France); Maillard, D. [Energy and Raw Materials, 75 - Paris (France); Pumphrey, D. [Energy Cooperation, US Dept. of Energy (United States); Sverdrup, G.; Valdez, B. [National Renewable Energy Laboratory, Golden, CO (United States); Schindler, J. [LB-Systemtechnik (LBST), GmbH, Ottobrunn (Germany); His, St.; Rozakis, St. [Centre International de Recherche sur Environnement Developpement (CIRED), 94 - Nogent sur Marne (France); Sagisaka, M. [LCA Research Centre (Japan); Bjornstad, D. [Oak Ridge National Laboratory, Oak Ridge, Tennessee (United States); Madre, J.L. [Institut National de Recherche sur les Transports et leur Securite, 94 - Arcueil (France); Hourcade, J.Ch. [Centre International de Recherche sur l' Environnement le Developpement (CIRED), 94 - Nogent sur Marne (France); Ricci, A.; Criqui, P.; Chateau, B.; Bunger, U.; Jeeninga, H. [EU/DG-R (Italy); Chan, A. [National Research Council (Canada); Gielen, D. [IEA-International Energy Associates Ltd., Fairfax, VA (United States); Tosato, G.C. [Energy Technology Systems Analysis Programme (ETSAP), 75 - Paris (France); Akai, M. [Agency of Industrial Science and technology (Japan); Ziesing, H.J. [Deutsches Institut fur Wirtschaftsforschung, DIW Berlin (Germany); Leban, R. [Conservatoire National des Arts et Metiers (CNAM), 75 - Paris (France)
The aims of this workshop is to better characterize the future in integrating all the dynamic interaction between the economy, the environment and the society. It offers presentations on the Hydrogen chains evaluation, the micro-economic modelling for evaluation of bio-fuel options, life cycle assessment evolution and potentialities, the consumer valuation of energy technologies attributes, the perspectives for evaluation of changing behavior, the incentive systems and barriers to social acceptability, the internalization of external costs, the endogenous technical change in long-tem energy models, ETSAP/technology dynamics in partial equilibrium energy models, very long-term energy environment modelling, ultra long-term energy technology perspectives, the socio-economic toolbox of the EU hydrogen road-map, the combined approach using technology oriented optimization and evaluation of impacts of individual policy measures and the application of a suite of basic research portfolio management tools. (A.L.B.)
Jordan, Matt; Chrislip, David; Workman, Emily
Stakeholder engagement and collaboration are essential to the development of an effective state plan. Engaging a diverse group of stakeholders tasked with working together to create education policies that will have a positive, lasting impact on students is not as easy as it sounds. Experts in the field argue that the traditional stakeholder…
Scholtens, B.; Zhou, Y.
We analyze how shareholder performance can be associated with stakeholder relations. As such, we try to find out whether there is an association between financial performance and stakeholder relations with respect to different theoretical notions about the firm. Financial performance is
management in listed firms and other traditional remedies. The theoretical insightsare applied on a case from the Danish Supreme Court (Louis Poulsen A/S) where theinterests of the stakeholders were decisive. However, it is shown that the verdict mayinstead harm the relevant stakeholders illustrating how...
Al Harbi, Abdullah Abdul Muhsen
This study aimed at evaluating EFL textbook for secondary stage in Saudi Public schools. Participants consisted of (100) male teachers and (73) female teachers teaching secondary stage students in two cities: Madinah and Dowadmi. The tool of the study designed to cover five dimensions: layout and design, the objectives of the textbook, teaching…
This study constructs indicators and weights that can be used in the professional development evaluation (PDE) of elementary school teachers. The indicators were constructed using data collected from literature reviews, interviews with experts, and questionnaire surveys. The Fuzzy Analytic Hierarchy Process (FAPH) was used to analyze the collected…
Spuls, Phyllis I.; Nast, Alexander
Tan et al. critically appraised the quality of eight guidelines for the treatment of psoriasis published by five working groups between 2006 and 2009, using the Appraisal of Guidelines Research and Evaluation ( AGREE) instrument. Four groups used the standards established by the AGREE instrument.
Walstad, William; Urban, Carly; Asarta, Carlos J.; Breitbach, Elizabeth; Bosshardt, William; Heath, Julie; O'Neill, Barbara; Wagner, Jamie; Xiao, Jing Jian
This review discusses the heterogeneity in the effectiveness of financial education programs that occurs because of the unique conditions for programs and methods to evaluate them. The authors define six groups served by financial education: children, youth, college students and young adults, working adults, military personnel, and low-income…
Describes how evaluation strategies can be implemented to increase the effectiveness of English in the Work Place programs. Discusses the design and implementation of the strategy, how to analyze its results and produce a final report, and ways to get the results used. (SED)
Gates, Karol; Hansen, Deb; Tuttle, Lynn
The purpose of this report is to provide insight into how state departments are implementing legislative requirements for educator evaluation, particularly the specific circumstances states encounter around arts education. Spotlights on Delaware, a first-round recipient of Race to the Top funding, and Colorado and Arizona, third-round recipients,…
Marsden, David; Oakley, Peter
An instrumental/technocratic approach to evaluation of social development relies on primarily quantitative methods. An interpretive approach resists claims to legitimacy and authority of "experts" and questions existing interpretations. The latter approach is characterized by cultural relativism and subjectivity. (SK)
Smith, Gareth; Smith, Alison; Clarke, Alison
Purpose: The purpose of the study is to report on an in-depth exploration of service quality in an Information Technology service department in a Higher Education Institute (HEI) and to evaluate the instrument used. Design/methodology/approach: The study surveys customers using the SERVQUAL instrument, which is one of the most widely used and…
Smith, Michael E.; Zsidisin, George A.; Adams, Laural L.
The emphasis in recent research on the responsibility of college and university business instructors to prepare students for future employment underscores a need to refine the evaluation of student performance. In this article, an agency theory framework is used to understand the trade-offs that may be involved in the selection of various…
Robert Wayne Gould
Full Text Available The paradox of open innovation lies in the conflict between the practical desire to reap the benefits of open innovation and concern over the risk that others will misappropriate those benefits. Stakeholder theory and recent developments in value creation through stakeholder engagement can assist with reconciliation of this inherent structural risk. The limitations of existing open innovation typologies are identified, and a process-based model of open innovation is proposed. The model is then expanded to include stakeholder engagement. When integrated with stakeholder engagement, open innovation processes can be understood to generate benefits beyond the acquisition of specific information sought from external experts. The addition of stakeholder engagement to the open innovation model allows for greater understanding and easier acceptance of the risks inherent in the open innovation process.
Gjerdrum Pedersen, Esben Rahbek; Hove Henriksen, Morten; Frier, Claus
Purpose – The objective of the paper is to describe and discuss how the biotech company Novozymes integrates stakeholder thinking into everyday sustainability practices. Design/methodology/approach – The paper is based on first-hand experiences as well as secondary information from Novozymes' sta...... to make sense of stakeholder thinking. Originality/value – The contribution of this paper is to provide a detailed analysis of how various stakeholder relations management methods can be used in practice to integrate sustainability in an organisation.......' stakeholder-oriented sustainability activities. Findings – The paper illustrates how a company is striving to transform the general stakeholder principles into concrete, manageable actions. Moreover, the paper describes some of the needs, challenges, and paradoxes experienced by an organisation that is trying...
Eriksen, Rikke Augustinus; Morsing, Mette
Based on a systematic data collection we study one of the first pioneering company-stakeholder communication campaigns in social media: the case of energy company Vattenfall A/S’s pan-European campaign ‘The Climate Manifesto’. Our findings challenge the general assumption, that stakeholder...... lacked between the company and stakeholders. Vattenfall was accused of green-washing, resulting in a communications crisis. Negative stakeholder reactions consisted of prejudiced and non-negotiable argumentation indicating that social media imposes new managerial challenges since communication processes...... technologies and we question to what extent social media serve the enhancement of improved understandings across corporate and civil society on CSR issues. This paper suggests that managers face a risk of the “double-edge of stakeholder communication” when incorporating social media into their CSR strategies...
Dang, Amit; Likhar, Nishkarsh; Alok, Utkarsh
Health economic studies provide information to decision makers for efficient use of available resources for maximizing health benefits. Economic evaluation is one part of health economics, and it is a tool for comparing costs and consequences of different interventions. Health technology assessment is a technique for economic evaluation that is well adapted by developed countries. The traditional classification of economic evaluation includes cost-minimization, cost-effectiveness analysis, cost-utility analysis, and cost-benefit analysis. There has been uncertainty in the conduct of such economic evaluations in India, due to some hesitancy with respect to the adoption of their guidelines. The biggest challenge in this evolutionary method is lack of understanding of methods in current use by all those involved in the provision and purchasing of health care. In some countries, different methods of economic evaluation have been adopted for decision making, most commonly to address the question of public subsidies for the purchase of medicines. There is limited evidence on the impact of health insurance on the health and economic well-being of beneficiaries in developing countries. India is currently pursuing several strategies to improve health services for its population, including investing in government-provided services as well as purchasing services from public and private providers through various schemes. Prospects for future growth and development in this field are required in India because rapid health care inflation, increasing rates of chronic conditions, aging population, and increasing technology diffusion will require greater economic efficiency into health care systems. Copyright Â© 2016 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.
Sperling, Karl; Hvelplund, Frede; Mathiesen, Brian Vad
Wind power is a maturing technology that may form an essential element of fully renewable energy systems in a number of countries. Denmark has a long history of wind power development and is planning to expand its existing capacity. If large-scale penetration of wind power is to be achieved......, an integrated framework is needed that can respond to the associated challenges. This paper argues for adopting an integrated macro perspective when evaluating and building frameworks to support wind power development. This macro perspective is applied to the case of Denmark, and more specifically to concrete...
Melia, J.; Pendry, L.; Eiser, J.R.; Harland, C.; Moss, S.
Good quality research to study behaviour in the sun is needed in the UK to ensure that we can develop the most effective methods for ultimately reducing the incidence of skin cancer. Many initiatives have taken place during the past two decades to reduce the level of sun exposure. However, there have been relatively few studies to evaluate the impact of these initiatives on behaviour and health. This review summarises outcome measures of knowledge, attitudes, and behaviour and of clinical signs of sun damage. The results of evaluation studies show that adolescents are a group resistant to change. Initiatives should focus on families with young children. Targeting holiday makers at the time of departure also proved to be ineffective. Future research should aim to monitor changes in behaviour in the general population, and to study changes among target groups using standardised methods. The costs of different interventions should be compared. (author)
Gandjbakhch, Frédérique; Terslev, Lene; Joshua, Fredrick; Wakefield, Richard J; Naredo, Esperanza; D'Agostino, Maria Antonietta
An increasing number of studies have applied ultrasound to the evaluation of entheses in spondyloarthritis patients. However, no clear agreement exists on the definition of enthesitis, on the number and choice of entheses to examine and on ultrasound technique, which may all affect the results of the examination. The objectives of this study were to first determine the level of homogeneity in the ultrasound definitions for the principal lesions of enthesitis in the published literature and second, to evaluate the metric properties of ultrasound for detecting enthesitis according to the OMERACT filter. Search was performed in PUBMED and EMBASE. Both grey-scale and Doppler definitions of enthesitis, including describing features of enthesitis, were collected and metrological qualities of studies were assessed. After selection, 48 articles were analyzed. The definition of ultrasound enthesitis and elementary features varied among authors. Grey-scale enthesitis was characterized by increasing thickness (94% of studies), hypoechogenicity (83%), enthesophytes (69%), erosions (67%), calcifications (52%), associated bursitis (46%) and cortical irregularities (29%). Only 46% of studies reported the use of Doppler. High discrepancies were observed on frequency, type of probe and Doppler mode used. Face and content validity were the most frequently evaluated criteria (43%) followed by reliability (29%) and responsiveness (19%). Ultrasound has evidence to support face, content validity and reliability for the evaluation of enthesitis, though there is a lack of well-reported methodology in most of the studies. Consensus on elementary lesions and standardization of exam is needed to determine the ultrasound definition of enthesitis in grey-scale and in Doppler for future applications.
Gandjbakhch, Frédérique; Terslev, Lene; Joshua, Fredrick; Wakefield, Richard J; Naredo, Esperanza; D'Agostino, Maria Antonietta
Introduction An increasing number of studies have applied ultrasound to the evaluation of entheses in spondyloarthritis patients. However, no clear agreement exists on the definition of enthesitis, on the number and choice of entheses to examine and on ultrasound technique, which may all affect the results of the examination. The objectives of this study were to first determine the level of homogeneity in the ultrasound definitions for the principal lesions of enthesitis in the published lite...
Full Text Available Purpose: This paper conceptualises a firm’s business model employing stakeholder theory as a central organising element to help inform the purpose and objective(s of business model financial reporting and disclosure. Framework: Firms interact with a complex network of primary and secondary stakeholders to secure the value proposition of a firm’s business model. This value proposition is itself a complex amalgam of value creating, value capturing and value manipulating arrangements with stakeholders. From a financial accounting perspective the purpose of the value proposition for a firm’s business model is to sustain liquidity and solvency as a going concern. Findings: This article argues that stakeholder relations impact upon the financial viability of a firm’s business model value proposition. However current financial reporting by function of expenses and the central organising objectives of the accounting conceptual framework conceal firm-stakeholder relations and their impact on reported financials. Practical implications: The practical implication of our paper is that ‘Business Model’ financial reporting would require a reorientation in the accounting conceptual framework that defines the objectives and purpose of financial reporting. This reorientation would involve reporting about stakeholder relations and their impact on a firms financials not simply reporting financial information to ‘investors’. Social Implications: Business model financial reporting has the potential to be stakeholder inclusive because the numbers and narratives reported by firms in their annual financial statements will increase the visibility of stakeholder relations and how these are being managed. What is original/value of paper: This paper’s original perspective is that it argues that a firm’s business model is structured out of stakeholder relations. It presents the firm’s value proposition as the product of value creating, capturing and
Time to shift from systems thinking-talking to systems thinking-action: Comment on "Constraints to applying systems thinking concepts in health systems: A regional perspective from surveying stakeholders in Eastern Mediterranean countries".
Holmes, Bev J; Noel, Kevin
A recent International Journal of Health Policy and Management (IJHPM) article by Fadi El-Jardali and colleagues makes an important contribution to the literature on health system strengthening by reporting on a survey of healthcare stakeholders in Low- and Middle-Income Countries (LMICs) about Systems Thinking (ST). The study's main contributions are its confirmation that healthcare stakeholders understand the importance of ST but do not know how to act on that understanding, and the call for collective action by the global community of systems thinkers committed to healthcare improvement. We offer three basic considerations for next steps by this community, derived from our recent work in ST and the related field of Knowledge Translation (KT): resist the temptation to adopt a reductionist approach; recognize not everyone needs to understand ST; and do not wait for everything to be in place before getting started.
Alonso Abad, Ariel; Molenberghs, Geert
The last 20 years have seen lots of work in the area of surrogate marker validation, partly devoted to frame the evaluation in a multitrial framework, leading to definitions in terms of the quality of trial- and individual-level association between a potential surrogate and a true endpoint (Buyse et al., 2000, Biostatistics 1, 49–67). A drawback is that different settings have led to different measures at the individual level. Here, we use information theory to create a unified framework, lea...
Ahsan, Dewan; Pedersen, Søren
One of the prime challenges in offshore wind is to manage and coordinate with the various stakeholders involved in the operation and maintenance (O&M) phase. Therefore the aims of this paper are: i) to map the stakeholder groups involved in O&M of Offshore Wind Farm (OWF), ii) to assess...... the identified stakeholder group's interest and power to influence O&M, iii) to evaluate the relationship between different stakeholder groups and iv) to highlight potential strategies to manage the stakeholder groups. In this article, the stakeholder analysis approach is used. The results reveal that eleven key...
Marco Antonio Viana Borges
Full Text Available Thecharacteristics and challenges of the integrated market, along with the risinginternational cooperation and vertical disintegration, have led to the notionthat firms are linked in a global supply chain. This study is focused onconcepts and models organized for the development of a theoretical essay inGlobal Supply Chain Management to evaluate characteristics and opportunities inthis field. It was used references that cover the global market factorsinvolving economic, cultural, political and demographic issues that representopportunities and barriers for going global. It was indentified that the challenge relatedto the international operations is to develop a global strategy considering theinfluence of political and economic factors in the trade, culturalcharacteristics, supply chain costs, infrastructure, technology, market andcompetitive rules. From the elements raised from theory for the configurationof a global supply chain approach, this study also identified gaps andquestions for future research agenda in the area.
Alonso, Ariel; Molenberghs, Geert
The last 20 years have seen lots of work in the area of surrogate marker validation, partly devoted to frame the evaluation in a multitrial framework, leading to definitions in terms of the quality of trial- and individual-level association between a potential surrogate and a true endpoint (Buyse et al., 2000, Biostatistics 1, 49-67). A drawback is that different settings have led to different measures at the individual level. Here, we use information theory to create a unified framework, leading to a definition of surrogacy with an intuitive interpretation, offering interpretational advantages, and applicable in a wide range of situations. Our method provides a better insight into the chances of finding a good surrogate endpoint in a given situation. We further show that some of the previous proposals follow as special cases of our method. We illustrate our methodology using data from a clinical study in psychiatry.
Full Text Available Introduction: The evaluation of received medical service is seen by the patient as the final stage in the comparison between expectations and reality. Especially when a hospitalised patient has the opportunity to pay closer attention to such elements associated with medical staff as their behaviour, availability, responses to difficult situations, empathy, and support. The evaluation of medical service quality by the patient is, undoubtedly, of great importance to medical entities. The quality of medical services usually constitutes the most vital criterion in selecting a medical facility by the patient. Therefore medical entities have to keep track of the patient’s needs in order to remain competitive. It is the quality of services provided by medical facilities that ensures the patient’s safety and satisfaction, as well as a particular entity’s high position on the medical service market. Aim: This paper aims at illustrating the quality of nursing care as assessed by hospitalised patients. The study was to show the nursing care quality according to the criteria of the evaluation of the medical staff’s work and the attitude towards the provided services. These criteria include kindness, politeness, availability, empathy, gentleness in conducting particular procedures, approach and means of communication. Material and Methods: The study was conducted in a group of 150 patients attending the Independent Public Healthcare Institution in Kraśnik. The public inquiry utilised the diagnostic survey method and the research technique in the form of a poll. The study was performed using author’s questionnaire which included 28 open and closed questions, of which 8 were sociometric in nature and the remaining 20 concerned the evaluation of nurses’ and midwives’ care. The study was performed in the period from January to May 2013. The results and conclusions: The results indicated that the level of nursing care quality provided by
Full Text Available At the Supreme Court of Victoria, Australia, concepts of judicial performance and evaluation are relatively new. Responding to modern expectations for increased judicial accountability for their performance, Victorian judges have engaged a number of court–led evaluation and measurement tools aimed at improving judicial performance both inside and outside the courtroom. These include the Court Craft judicial education programme, the Report on Government Services performance indicators and the International Framework for Court Excellence. This article discusses how the Supreme Court of Victoria obtained judicial acceptance of the value of these tools in the Australian constitutional and institutional context. It highlights programme design aspects, including the importance of judicial involvement in programme development. En la Corte Suprema de Victoria, Australia, los conceptos de rendimiento y evaluación judicial son relativamente nuevos. En respuesta a las expectativas modernas de una mayor responsabilidad judicial por el desempeño de sus funciones, los jueces de Victoria han integrado un número de herramientas de evaluación y medición dirigidas a mejorar el desempeño judicial, tanto dentro como fuera de la sala. Estas herramientas incluyen el programa de educación judicial Court Craft, los indicadores de rendimiento del Informe sobre Servicios del Gobierno y el Sistema Internacional para la Excelencia de los Tribunales. Este artículo analiza cómo obtuvo la Corte Suprema de Victoria la aceptación judicial del valor de estas herramientas, en el contexto constitucional e institucional de Australia. Se destacan aspectos como el diseño del programa, incluyendo la importancia de la intervención judicial en el desarrollo del programa. DOWNLOAD THIS PAPER FROM SSRN: http://ssrn.com/abstract=2536304
Arnold, Corey W; Oh, Andrea; Chen, Shawn; Speier, William
Probabilistic topic models provide an unsupervised method for analyzing unstructured text. These models discover semantically coherent combinations of words (topics) that could be integrated in a clinical automatic summarization system for primary care physicians performing chart review. However, the human interpretability of topics discovered from clinical reports is unknown. Our objective is to assess the coherence of topics and their ability to represent the contents of clinical reports from a primary care physician's point of view. Three latent Dirichlet allocation models (50 topics, 100 topics, and 150 topics) were fit to a large collection of clinical reports. Topics were manually evaluated by primary care physicians and graduate students. Wilcoxon Signed-Rank Tests for Paired Samples were used to evaluate differences between different topic models, while differences in performance between students and primary care physicians (PCPs) were tested using Mann-Whitney U tests for each of the tasks. While the 150-topic model produced the best log likelihood, participants were most accurate at identifying words that did not belong in topics learned by the 100-topic model, suggesting that 100 topics provides better relative granularity of discovered semantic themes for the data set used in this study. Models were comparable in their ability to represent the contents of documents. Primary care physicians significantly outperformed students in both tasks. This work establishes a baseline of interpretability for topic models trained with clinical reports, and provides insights on the appropriateness of using topic models for informatics applications. Our results indicate that PCPs find discovered topics more coherent and representative of clinical reports relative to students, warranting further research into their use for automatic summarization. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
Shang, Qian; Pei, Guanxiong; Dai, Shenyi; Wang, Xiaoyi
Brand extension typically has two strategies: brand name extension (BN) and brand logo extension (BL). The current study explored which strategy (BN or BL) better enhanced the success of dissimilar brand extension and product promotion in enterprises. Event-related potentials (ERPs) were used to investigate electrophysiological processes when subjects evaluated their acceptance of the brand extension using a combined picture of S1 and S2. S1 was a famous brand presented by two identity signs (brand name and brand logo). S2 was a picture of an extension product that belonged to a dissimilar product category than S1. The behavior data showed that BL was more acceptable than BN in the dissimilar brand extension. The neurophysiology process was reflected by a less negative N2 component and a larger P300 component in the BL than in the BN. We suggested that N2 reflected a whole conflict between the brand-product combination and the long-term memory and that P300 could be regarded as the reflection of the categorization process in the working memory.
Liang, Long; Chen, Yuan-Quan; Gao, Wang-Sheng
For the point of view that recycling economy system is one of ways to achieve the low-carbon economy, we have made an evaluation on a typical circular agriculture duck industry in Hunan Province, China, through improving the framework of life cycle assessment (LCA). The analysis indicated that the consumption of non-renewable resources, land and water were 48.629 MJ, 2.36 m2 and 1 321.41 kg, while the potential greenhouse gas (GHGs), acidification, eutrophication, human toxicity, freshwater ecotoxicity and terrestrial ecotoxicity were 11 543.26 g (CO2 eq), 52.36g (SO2eq), 25.83g (PO4eq), 1.26, 60.74 and 24.65 g (1,4-DCBeq), respectively. The potential damage of aquatic eutrophication, freshwater ecotoxicity and terrestrial ecotoxicity was more serious than that of GHGs. Main results were following: i. the circular agricultural chain promoted the principle of "moderate circulation", which based on the traditional production methods; ii. circular agriculture could not blindly pursue low carbon development. Instead, soil and biological carbon sequestration should be considered, in addition to reducing carbon emissions; iii. circular economy and circular agriculture should take other potential environmental impacts into account such as acidification, eutrophication and ecotoxicity,with the exception to carbon emissions,to developed integrated system assessment; iv. LCA could provide a comprehensive assessment of circular agriculture, and it was worth of further study.
Full Text Available The popularity of the index funds as an investment option has increased manifolds ever since they were introduced. This is primarily because of the merits that the investor enjoys through passive style of funds management. This includes the low cost involved in managing such funds and the significant tax savings. Most of the researchers have compared the performance of the actively managed funds with that of index funds. However the index funds of US and for that reason other parts of the world are different from that of India. Unlike other countries in India the benchmark indices comprise of very less number of securities and thus are unable to represent the entire economy. So in Indian context comparison of performance of actively managed funds with index funds is not logical. Therefore this paper attempts to make an intra-class performance evaluation of some Indian index funds based on some statistics. The study includes the use of graphical interpretations coupled with statistical tools like R-square and tracking error values. Two models of tracking error have been employed to test empirically the performance of the selected index funds. The study is useful for those interested in mutual funds, which includes researchers, academicians, and financial advisors. The paper suits the requirement and the situations prevalent in Indian economy during the period under study.
Hietbrink, M.; Hartmann, Andreas; Dewulf, Geert P.M.R.
Understanding the process of stakeholder satisfaction is a prerequisite for successful stakeholder management. The expectancy disconfirmation model describes the process of stakeholder satisfaction by relating customers’ satisfaction with a product or service to discrepancy between the perceived
A survey was conducted among members of the Ontario Energy Board's (OEB) various stakeholder groups in order to measure the Board's performance and to help the Board identify areas for improvement in the way it operates. The survey included telephone interviews with consumer groups, advocacy groups, the energy sector, electricity and gas distributors, financial organizations as well as other stakeholders. The topics addressed in the survey were key energy issues and priority issues; the perceived role of the OEB; the OEB strengths and weaknesses; the importance of various OEB functions; the overall performance of the OEB; an evaluation of OEB communication with industry and consumers; an evaluation of service quality; and, awareness and participation in regulatory policy initiatives. Respondents used a 10-point scale in their evaluation. This report presented the main findings and their interpretations. Major stakeholders identified electricity supply issues and the price of electricity as being the most important energy issues facing Ontario. This report also presented the detailed findings for questions regarding the lack of generator capacity, policy stability, the coal phase out program, electricity blackouts, conservation, electricity restructuring and investment. The major finding of the survey was an overall increase in satisfaction with the OEB's performance. It was suggested that the OEB can improve in timeliness and providing consumer information. The major areas of strength were found to be its professionalism in conducting hearings and the fairness of the Board's decisions and regulations. tabs
Madsen, Henning; Ulhøi, John Parm
is to discuss how the influence from an increasing number of stakeholders may influence the companies to adopt a more proactive attitude towards environmentally related initiatives. The first part of the paper will discuss the relevant theory and introduce a model to analyse and identify the most relevant......Regulation has been an important instrument in pushing the business community towards a more sustainable way of conduct. But recently an increasing pressure from a growing number of stakeholders including employees, customers, neighbours, NGO's etc has been observed. The purpose of this paper...... stakeholder groups and their influence. Based on a recent survey among Danish companies the second part of the paper will report on the actual perceived influence from a variety of stakeholders to force companies to introduce environmentally-related initiatives. The results will then be discussed in light...
EPA's National Port Stakeholders Summit, Advancing More Sustainable Ports, focused on actions to protect air quality while reducing climate risk and supporting economic growth, making ports more environmentally sustainable.
MacLean, Samantha; Burgess, Michael M
Providing technical and experiential information without overwhelming participants' perspectives presents a major challenge to public involvement in policy decisions. This article reports the design and analysis of a case study on incorporating expert and stakeholder knowledge without including them as deliberators, while supporting deliberative participants' ability to introduce and critically assess different perspectives. Analysis of audio-recorded deliberations illustrates how expert and stakeholder knowledge was cited, criticized and incorporated into deliberations. In conclusion, separating experts and stakeholders from deliberations may be an important prima facie principle when the goal is to enhance citizen representation on technical issues and related policy.
Aas, C.; Ladkin, Adele; Fletcher, John
This article examines a collaborative approach to the relationship between heritage management and tourism development in Luang Prabang, Laos. The purpose is to examine stakeholder collaboration and management roles, heritage tourism development, as well as the interdependence of the heritage conservation and tourism relationship. The research examines a UNESCO/Norwegian government project, which aiming to promote collaboration between heritage conservation and tourism through stakeholder inv...
Bøhren, Øyvind; Josefsen, Morten G.; Steen, Pål E.
This is the authors’ final, accepted and refereed manuscript to the article This paper compares the dividend policy of owner-controlled firms with that of firms where the owners are a minority relative to non-owner employees, customers, and community citizens. We find that regardless of whether owners or non-owners control the firm, the strong stakeholder uses the dividend payout decision to mitigate rather than to intensify the conflict of interest with the weak stakeholder. H...
Mainardes, Emerson; Alves, Helena; Raposo, Mario
In accordance with the importance of the student stakeholder to universities, the objective of this research project was to evaluate student satisfaction at Portuguese public universities as regards their self-expressed core expectations. The research was based both on stakeholder theory itself and on previous studies of university stakeholders.…
Full Text Available Corporate communications represent a modern communications discipline used by businesses across the globe to communicate with key stakeholders. Chief executive officers and executive management teams strive to create, protect and advance corporate reputation through corporate communications. Further, by communicating with key stakeholders the company adequately prepares for good news and future problems. With the benefit of technology and greater transparency, corporations of the future will continue to use corporate communications approaches to advance their business. Company's reputation derives from the way stakeholders perceive the organization, how they think, feel or act towards it. It is therefore vital that organizations interested in developing and building their reputational capital; pay careful attention to the way they are perceived and that they manage the relationships with their various stakeholders like a strategic resource. Stakeholders represent both opportunity and threat for the organizations. For instance, if an institution has a good reputation with stakeholders they may provide the organization more latitude to operate. On the other hand a poor reputation may result in creating the legislative that can make it more difficult for an institution to operate.