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There has been little discussion of the way genomic research results should be returned and how to obtain informed consent for this. We systematically searched the empirical literature, identifying 63 articles exploring stakeholder perspectives on processes for obtaining informed consent about return of results and/or result delivery. Participants, patients and members of the public generally felt they should choose which results are returned to them and how, ranging from direct (face-to-face, telephone) to indirect (letters, emails, web-based delivery) communication. Professionals identified inadequacies in result delivery processes in the research context. Our findings have important implications for ensuring participants are supported in deciding which results they wish to receive or, if no choice is offered, preparing them for potential research outcomes. ispartof: Personalized Medicine vol:18 issue:3 pages:295-310 ispartof: location:England status: Published online

Any multistakeholder initiative that aims to build the basis for change in a food system, regardless of geographic scale, requires an understanding of what is important to stakeholders, how they view the boundaries of the system, and what changes they feel are needed. An assessment of stakeholder perspectives of the Phoenix Valley food system was conducted as an initial step in a process of food system coalition-building. The objectives of the research were to explore how active partici­pants in the food system visualized a “sustainable food system” and to juxtapose their perspectives on food system sustainability with those in the academic literature to create an initial picture of food sustainability. Respondents emphasized the importance of education, local food, reducing corporate power, and a strong desire to build a sense of community to better serve vulnerable communities. Nevertheless, the responses also revealed the difficulty of conceptualizing food system boundaries for intervention and the confla­tion of realist and idealist perspectives on what food systems are or could be. Stakeholders placed considerable weight on localism and the power of education and “demand constraint” on improving food system outcomes, while also attributing the root cause of Phoenix’s problems to broader-scale structural factors that were outside of their control or capacity to influence. This case study describes the potential utility of conducting such preliminary assessments in other cities, allowing stakeholders to reflect on their interests, agency, and capacities in the food system space prior to any efforts to build consensus and take collective action. We argue that this process is a crucial first step in any work on building alternative food systems, as it allows hidden areas of contestation (beliefs, values, goals) to arise. This enables participants to begin addres­sing differences and fostering trust, cooperation, and inclusiveness—thus ensuring the longevity of the coalition or group. See the press release for this article.

This paper reports on a study aimed at identifying training requirements for both staff and students in higher education to enable more widespread use of learning analytics. Opinions of staff and students were captured through ten focus groups (37 students; 40 staff) and two surveys (1,390 students; 160 staff). Participants were predominantly from two higher education institutions in Ireland. Analysis of the results informed a framework for continuous professional development in learning analytics focusing on aspects of using data, legal and ethical considerations, policy, and workload. The framework presented here differentiates between the training needs of students, academic staff and professional services staff.

Background Interventions to reduce population salt intake are feasible and cost-effective. The Victorian Salt Reduction Partnership implemented a complex, multi-faceted salt reduction intervention between 2014 and 2020 in the Australian state of Victoria. This study aimed to understand stakeholder perspectives on the effectiveness of the Victorian Salt Reduction Partnership. Methods Semi-structured interviews were conducted with Partnership and food industry stakeholders. The Consolidated Framework for Implementation Research was adapted for the Partnership intervention and used to guide the qualitative analysis. Results Fourteen Partnership and seven food industry stakeholders were interviewed. The Partnership was viewed as essential for intervention planning and decision-making and an enabler for intervention delivery. The goals of capacity building and collaborative action were perceived to have been achieved. The implementation team executed intended intervention activities and outputs, with some adaptations to strategy. Barriers and enablers to implementation were identified by interviewees, such as compatibility of individual, organisational and Partnership values and building positive relationships between the Partnership and food industry, respectively. Legal, political, social, environmental, technological and economic factors affecting intervention design, delivery and outcomes were identified. Conclusions Establishing a Partnership with diverse skills and experience facilitated collaborative action, capacity building and execution of the intervention. Monitoring and evaluating implementation informed strategy adaptations, which allowed optimisation of Partnership strategy. The importance of developing strong communication networks between strategic and implementation-levels was a key lesson.

While social robots bring new opportunities for education, they also come with moral challenges. Therefore, there is a need for moral guidelines for the responsible implementation of these robots. When developing such guidelines, it is important to include different stakeholder perspectives. Existing (qualitative) studies regarding these perspectives however mainly focus on single stakeholders. In this exploratory study, we examine and compare the attitudes of multiple stakeholders on the use of social robots in primary education, using a novel questionnaire that covers various aspects of moral issues mentioned in earlier studies. Furthermore, we also group the stakeholders based on similarities in attitudes and examine which socio-demographic characteristics influence these attitude types. Based on the results, we identify five distinct attitude profiles and show that the probability of belonging to a specific profile is affected by such characteristics as stakeholder type, age, education and income. Our results also indicate that social robots have the potential to be implemented in education in a morally responsible way that takes into account the attitudes of various stakeholders, although there are multiple moral issues that need to be addressed first. Finally, we present seven (practical) implications for a responsible application of social robots in education following from our results. These implications provide valuable insights into how social robots should be implemented.

Sustainable wildlife harvest is challenging due to the complexity of uncertain social-ecological systems, and diverse stakeholder perspectives of sustainability. In these systems, semi-complex stochastic simulation models can provide heuristics that bridge the gap between highly simplified theoretical models and highly context-specific case-studies. Such heuristics allow for more nuanced recommendations in low-knowledge contexts, and an improved understanding of model sensitivity and transferability to novel contexts. We develop semi-complex Management Strategy Evaluation (MSE) models capturing dynamics and variability in ecological processes, monitoring, decision-making, and harvest implementation, under a diverse range of contexts. Results reveal the fundamental challenges of achieving sustainability in wildlife harvest. Environmental contexts were important in determining optimal harvest parameters, but overall, evaluation contexts more strongly influenced perceived outcomes, optimal harvest parameters and optimal harvest strategies. Importantly, simple composite metrics popular in the theoretical literature (e.g. focusing on maximizing yield and population persistence only) often diverged from more holistic composite metrics that include a wider range of population and harvest objectives, and better reflect the trade-offs in real world applied contexts. While adaptive harvest strategies were most frequently preferred, particularly for more complex environmental contexts (e.g. high uncertainty or variability), our simulations map out cases where these heuristics may not hold. Despite not always being the optimal solution, overall adaptive harvest strategies resulted in the least value forgone, and are likely to give the best outcomes under future climatic variability and uncertainty. This demonstrates the potential value of heuristics for guiding applied management.

This mixed-methods study reports on the key stakeholders&rsquo, perspectives on the ear, nose, and throat (ENT) service redesign in remote Australia, using a participatory action research (PAR) approach. A primary health care (PHC) clinician survey was conducted to assess local needs and possible educational gaps in clinical knowledge. This was followed by an internal stakeholder forum and a follow-up survey with Torres and Cape Hospital and Health Service staff to gain their perspectives on current service delivery and table ideas for a new ENT health service model. Qualitative data were analyzed inductively and grouped in emerging themes. Quantitative data were imported into tables and analyzed descriptively. PAR allowed for input from 19 PHC clinicians, 10 face-to-face stakeholders perspectives, and 18 stakeholder follow-up survey respondents. Four themes emerged: 1. Training for health workers in ENT management, 2. Improved local service access, 3. New referral pathways to improve continuity of care, and 4. Introduction of telehealth. PAR engaged key stakeholders, identifying gaps in ENT service delivery, and guided the development of the new service model. The inclusion of stakeholders throughout the service redesign process is likely to create a more sustainable model of care which already has local &ldquo, buy-in&rdquo

Introduction: Failure to achieve accrual goals is a common problem in health-related research. Electronic health records represent a promising resource, offering the ability to identify a precisely defined cohort of patients who meet inclusion/exclusion criteria. However, challenges associated with the recruitment process remain and institutional policies vary. Methods: We interviewed researchers, institutional review board chairs, and primary care physicians in North Carolina and Tennessee. Questions focused on strategies for initiating contact with potentially eligible patients, as well as recruitment letters asking recipients to opt in versus opt out of further communication. Results: When we asked about initiating contact with prospective participants, qualitative themes included trust, credibility, and established relationships; research efficiency and validity; privacy and autonomy; the intersection between research and clinical care; and disruption to physician–researcher and physician–patient relationships. All interviewees said it was acceptable for researchers to contact patients through their physicians; most said it was acceptable for researchers to contact patients directly. Over half chose contact through physicians as more appropriate. Regarding recruitment letters, qualitative themes included the quality of the participant pool; privacy and control; research efficiency and representativeness; and patients’ opportunity to make their own decisions. All interviewees said asking recipients to opt in to further communication was acceptable; nearly all said opt out was acceptable. Similar proportions chose each approach as more appropriate. Conclusions: Comparing these results to our previous research with patients reveals potential differences in stakeholder perspectives. We offer suggestions for developing balanced approaches that respect patients and facilitate the advancement of science.

Introduction: Aberrant pharmacogenetic variants occur in a high proportion of people and might be relevant for the prescription of over 26 drugs in primary care. Early identification of patients who metabolize these drugs more rapidly or slowly than average could predict therapeutic effectivity and safety. Yet implementation of pharmacogenetics is progressing slowly. A high public health impact can potentially be achieved by increasing the proportion of people tested, when and where eligible according to clinical validity and utility. Methods: In this study we defined actions, roles, and responsibilities for implementation of pharmacogenetics in primary care in consultation with stakeholder groups, by using a three-step mixed-methods approach. First, to define barriers and facilitators, public pharmacists (n = 24), primary care physicians (n = 8), and patients (n = 21) participated in focus groups and face-to-face interviews. Second, a multidisciplinary expert meeting (n = 16) was organized to define desired actions, roles, and responsibilities. Third, an online Delphi Study (n = 18) was conducted to prioritize the designated actions. Results: For the integration of pharmacogenetics in primary care guidelines and practice, lack of evidence for clinical utility was mentioned as a main barrier. Furthermore, reimbursement, and facilitation of data registration and sharing were considered as key elements for future routine application of pharmacogenetic testing. Moreover, the division of roles and responsibilities, especially between general practitioners and pharmacists, is currently perceived as unclear. Sixteen actions in these four areas (clinical utility, reimbursement, data registration and sharing, and roles and responsibilities) were formulated and assigned to specific actors during the expert meeting. After ranking these 16 actions in the Delphi Study, nine actions remained pertinent, covering the four areas with at least one action. However, participants showed low agreement on the prioritization of the different actions, illustrating their different perspectives and the need to attune between them. Discussion: Stakeholders together were able to formulate required actions to achieve true integration of pharmacogenetics in primary care, but no consensus could be achieved on the prioritization of the actions. Coordination of the current independent initiatives by the different stakeholders could facilitate effective and efficient implementation of useful pharmacogenetics in primary care.

This paper examines the current state of project cultures in the German turnkey construction industry and the ideal project cultures in terms of partnering from the perspective of various key stakeholders (i.e., Investors, General Contractors, (Sub-)Contractors and Designers). To investigate the current and ideal cultures, data were gathered among the key stakeholders by means of a survey study with 72 respondents divided over 12 companies. The respondents rated the current and desired cultures by using the Organizational Culture Assessment Instrument, which belongs to the Competing Values Framework. The investigations show many similarities and differences between the stakeholder perspectives of the current and the idealized partnering project cultures. Mainly, the General Contractors desire more cooperative behaviors than the (Sub-)Contractors, and the Investors desire more pronounced flexibility than the General Contractors. All stakeholders desire a cultural change from highly competitive behaviors toward more cooperation. Changes in terms of clear procedures or more flexibility are only desired by the Designers. Defining both the current and an ideal partnering project culture enables academics and project managers to compare their actual project cultures to an ideal situation. With such an approach, academics and project managers could measure whether new tools or changes in resources affect their project cultures toward a partnering project culture.

Model-based scenarios have become the key method to explore uncertainties in the electricity supply transition of many countries. While retrospective scenario studies show that multi-organization, multi-model scenario ensembles increase the diversity of considered uncertainties, it remains unclear whether such ensembles align with the perspectives of transition stakeholders, including the wider public. This study compares a multi-organization, multi-model ensemble of 82 Swiss electricity supply scenarios for 2035 from a review of 19 studies between 2011 and 2018 with preferred scenarios from three samples of stakeholders: citizens from an online survey (N=61), informed citizens from participatory workshops (N=46), and energy experts from another online survey (N=60). The results show that most informed citizens and experts preferred an almost 100% domestic renewable electricity supply in Switzerland in 2035. On the contrary, most model-based scenarios relied significantly on fossil fuel-based generation and net electricity imports. Possible reasons for this misalignment include the lack of broad stakeholder participation in the development of such scenarios and the modeling choices such as cost-optimization models that are known to underrepresent renewable electricity. For both scenario developers and users, this study offers a word of caution that even a rich scenario ensemble could focus on alternatives that are not preferred by stakeholders and that diverse stakeholder and public perspectives can enrich scenario ensembles. For the Swiss electricity supply transition, the results indicate that a large-scale deployment of renewable electricity before 2035 is preferred by the expert and citizen samples and, therefore, such scenarios should be modeled more in the future. © 2020 Elsevier Ltd ISSN:1364-0321

Background: Conditional financing (CF) of hospital drugs was implemented in the Netherlands as a form of managed entry agreements between 2006 and 2012. CF was a 4-year process comprising 3 stages: initial health technology assessment of the drug (T = 0), conduct of outcomes research studies, and reassessment of the drug (T = 4). Objectives: To analyze stakeholder experiences in implementing CF in practice. Methods: Public and private stakeholders were approached for participation in stakeholder interviews through standardized email invitations. An interview guide was developed to guide discussions that covered the following topics: perceived aims of CF, functioning of CF, impact of CF, and conclusions and future perspectives. Extensive summaries were generated for each interview and subsequently used for directed content analysis. Results: Thirty stakeholders were interviewed. Differences emerged among the stakeholders on the perceived aims of CF. Conversely, there was some agreement among stakeholders on the shortcomings in the functioning of CF, the positive impact of CF on the Dutch healthcare setting, and improvement points for CF. Conclusions: Despite stakeholders' belief that CF either did not meet its aims or only partially did so, there was agreement on the need for new policy to address the same aims of CF in the future. Nevertheless, stakeholders diverged on whether CF should be improved on the basis of learnings identified and reintroduced into practice or replaced with new policy schemes.

During a participatory process in Gmunden, Austria, the organizational and responsibility-sharing arrangements for a landslide warning system proved to be contested issues. While questions on the warning system technology and the distribution of information, including the alarm for evacuation, could be resolved with the support of experts, controversies arose on the financial and legal responsibilities that ensure long-term and effective monitoring for the protection of the landslide-prone community. This paper examines how responsibilities can be shared among the residents, experts, and public authorities during the design and operation of landslide warning systems. In particular, we discuss the outcome and implications of three stakeholder workshops where participants deliberated on warning-system options that, in turn, were based on a discourse analysis of extensive stakeholder interviews. The results of the case study show that an end-user orientation requires the consideration of stakeholder worldviews, interests, and conflicts. Paradoxically, the public did not fully support their own involvement in the maintenance and control of the warning system, but the authorities promoted shared responsibility. Deliberative planning does not then necessarily lead to responsibility sharing, but it proved effective as a platform for information and for shared ownership in the warning system, Resources, 6 (4), ISSN:2079-9276

Several model-based, analytical approaches have been developed recently to deal with the deep uncertainty present in situations for which futures studies are conducted. These approaches focus on covering a wide variety of scenarios and searching for robust strategies. However, they generally do not take the multiplicity of stakeholder perspectives into account in analytic terms, which could bring in diverse opinions and views, not only on possible futures but also on values and interests. In this study, we present an approach to incorporate stakeholder perspectives into model-based scenarios for exploring the future dynamics of the Dutch gas sector. The results demonstrate that the scenario space can be demarcated according to the perspectives. This allows for a systematic comparison of the perspectives and provides a basis for identification of robust strategies. Also, the analysis shows that incompatible elements between the model and perspectives, or within perspectives can be identified. This provides insights about the problem complexity and potential barriers to the futures envisioned by the perspectives. Future research can strengthen this approach by involving stakeholders in modelling and in the model-based representation of the perspective narratives to enhance learning and credibility, and can extend the analysis to identify (socially) robust policies.

Background Promoting awareness of rights is a value-based process that entails a different way of thinking and acting, which is at times misunderstood or deemed as aspirational. Methods Guided by the SURE framework, we undertook a secondary analysis of 26 documents identified by an earlier systematic review on promoting awareness of rights to increase use of maternity care services. We thematically analysed stakeholder experiences and implementation factors across the diverse initiatives to derive common elements to guide future efforts. Results Interventions that promote awareness of rights for maternal health varied in nature, methodological orientation, depth and quality. Materials included booklets, posters, pamphlets/ briefs and service standards/charters. Target populations included women, family members, communities, community structures, community-based and non governmental organizations, health providers and administrators, as well as elected representatives. While one initiative only focused on raising awareness, most were embedded within larger efforts to improve the accountability and responsiveness of service delivery through community monitoring and advocacy, with a few aiming to change policies and contest elections. Underlying these action oriented forms of promoting awareness of rights, was a critical consciousness and attitudinal change gained through iterative capacity-building for all stakeholders; materials and processes that supported group discussion and interaction; the formation or strengthening of community groups; situational analysis to ensure adaptation to local context; facilitation to ensure common ground and language across stakeholders; and strategic networking and alliance building across health system levels. While many positive experiences are discussed, few challenges or barriers to implementation are documented. The limited documentation and poor quality of information found indicate that while various examples of promoting awareness of rights for maternal health exists, research partnerships to systematically evaluate their processes, learning and effects are lacking. Conclusion Rather than being aspirational, several examples of promoting awareness of women’s rights for quality maternity care services exist. More than mainly disseminate information, they aim to change stakeholder mindsets and relationships across health system levels. Due to their transformatory intent they require sustained investment, with strategic planning, concrete operationalization and political adeptness to manage dynamic stakeholder expectations and reactions overtime. More investment is also required in research partnerships that support such initiatives and better elucidate their context specific variations.

This paper presents results from a survey on stakeholder attitudes towards Carbon Capture and Storage (CCS). The survey is the first to make a global comparison across three major regions; USA, Japan, and Europe. The 30-question survey targeted individuals working at stakeholder organizations that seek to shape, and will need to respond to, policy on CCS, including electric utilities, oil & gas companies, CO2-intensive industries and non-governmental organizations (NGOs). The results show generally small differences across the regions and between the different groups of stakeholders. All believed that the challenge of significant reductions in emissions using only current technologies was severe. There is a widespread belief both that renewable technologies such as solar power and CCS will achieve major market entry into the electricity sector within the next 10 to 20 years, whereas there is more skepticism about the role of hydrogen and especially nuclear fusion in the next 50 years. All groups were generally positive towards renewable energy. Yet, there were some notable areas of disagreement in the responses, for example, as expected, NGOs considered the threat of climate change to be more serious than the other groups. North Americans respondents were more likely to downplay the threat compared to those of the other regions. The Japanese were more concerned about the burden that would be placed on industry in the coming decade as a result of emissions constraints and NGOs were more likely to believe that the burden would be light or very light. NGOs believed CCS to be far more attractive than nuclear fusion power but much less than renewables. As expected, the risk for leakage from reservoirs was ranked number one of the risk options given., Alliance for Global Sustainability, National Institute of Advanced Industrial Science and Technology (Japan), Carbon Sequestration Initiative, Alliance for Global Sustainability (AGS project “Pathways to Sustainable European Energy Systems” funding)

"Contrasting social-ecological scenarios can help stakeholders envision potential futures and navigate change and uncertainty. Scenario developers integrate stakeholder perceptions into storylines to increase scenario relevance and plausibility while relying on archetypes of change from scenario literature to enrich narratives. This research examines the contributions of local perspectives and global archetypes to scenario development through a case study of a regional scenario project, Yahara 2070, in Wisconsin, USA. Interviews with 50 Yahara watershed stakeholders and 5 members of the project's scenario development team were examined to compare themes from scenario archetypes with local perspectives on how change is expected to occur. We next examined how these two sources of inspiration for trajectories of change were used in the development of the Yahara 2070 scenarios. Both global archetypes and local stakeholders emphasized social values, market forces, and policy reform as influences in determining the future, which were reflected in Yahara 2070. However, stakeholders were less likely to mention institutional breakdown, an important theme from the global scenarios literature that was included in Yahara 2070. This research offers a new approach to analyzing similarities and differences between scenarios’ narratives and local perspectives. Scenario development may involve tensions between the goals of reflecting stakeholder views and including narratives from the global scenarios literature that may be useful for creating divergent model trajectories and addressing dramatic change into the future. To improve scenario development, scenario projects should document the development process in academic and nonacademic venues, explicitly highlighting sources and constraints in storyline development."

Background : Hypertension is a highly prevalent risk factor for cardiovascular diseases in sub-Saharan Africa (SSA) that can be modified through timely and long-term treatment in primary care. Objective : We explored perspectives of primary care staff and health insurance managers on enablers and barriers for implementing high-quality hypertension care, in the context of a community-based health insurance programme in rural Nigeria. Design : Qualitative study using semi-structured individual interviews with primary care staff ( n = 11) and health insurance managers ( n =4). Data were analysed using standard qualitative techniques. Results : Both stakeholder groups perceived health insurance as an important facilitator for implementing high-quality hypertension care because it covered costs of care for patients and provided essential resources and incentives to clinics: guidelines, staff training, medications, and diagnostic equipment. Perceived inhibitors included the following: high staff workload; administrative challenges at facilities; discordance between healthcare provider and insurer on how health insurance and provider payment methods work; and insufficient fit between some guideline recommendations and tools for patient education and characteristics/needs of the local patient population. Perceived strategies to address inhibitors included the following: task-shifting; adequate provider payment benchmarking; good provider–insurer relationships; automated administration systems; and tailoring guidelines/patient education. Conclusions : By providing insights into perspectives of primary care providers and health insurance managers, this study offers information on potential strategies for implementing high-quality hypertension care for insured patients in SSA. Keywords: hypertension; primary care; community-based health insurance; sub-Saharan Africa; stakeholder perspectives; qualitative study Citation: Glob Health Action 2016, 9 : 29041 - http://dx.doi.org/10.3402/gha.v9.29041 Supplementary material : To access the supplementary material for this article, please see Supplementary files under ‘Article Tools’

Introduction: While proponents of integrated EUCSs claim that such models deliver higher quality, safety and efficiency standards without introducing spatial inequalities [1], a conflicting view is that reconfiguration is usually performed for political reasons and represents a conflict of values between different stakeholder groups [2]. A series of EUCS reconfiguration programmes have recently been implemented, albeit to varying degrees, in the Republic of Ireland. This study investigated stakeholder perspectives on the rationale of this initiative. It considered the hypothesis that individuals from different stakeholder groups will endorse different positions in relation to reconfiguration. Methods: Documentary analysis was used to identify the official justifications for change in region-specific reconfiguration planning documents. Semi-structured interviews with 175 purposively sampled stakeholders explored their perspectives on the rationale for this remodelling of care across the country. They comprised ‘internal’ (hospital staff) and ‘external’ stakeholders (general practitioners, ambulance personnel and members of the public including local politicians and hospital campaign groups). Framework analysis was used. Results: While a majority of stakeholders agreed with the need for an accessible and well-functioning health system, their understanding of what it meant and how it should be achieved in the delivery of urgent and emergency care varied considerably between the two stakeholder groups. There was some cynicism predominantly among external stakeholders as to the true motivations behind reconfiguration. They broadly perceived decision-making around service change to be influenced by political and cost-saving concerns. Discussions: Findings mirror experiences in other countries [2]. Considerable public angst has been documented over the safety issue of centralising services and associated risks potentially involved in having to travel longer distances for emergency care [3]. People have perceived service change as cuts to services [4]. Proponents of change have tended to emphasise the perceived quality and safety benefits of reconfiguration rather than focusing on cost-savings [5]. Conclusions: When it comes to reconfiguration, there are clear differences depending on stakeholder position on what a health service should look like in the delivery of EUCS care. A ‘win for all’ scenario is perceived as unattainable for there is always a trade-off of interest. Understanding what concerns the public and the trade-offs that patients and their families are prepared to make when deliberating over major service change would help those tasked with planning EUCS provision to make decisions that address the range of issues at hand. Lessons learned: Where regions have not been fully reconfigured, findings will inform those in the driving seat of change of the diversity of viewpoints on EUCSs. It will enable them to understand the concerns, misconceptions and conflicting perspectives that hinder a united effort to improving care. Limitations: This was a retrospective study. There was also discrepancy in the sum of stakeholders interviewed in each region, particularly in one region, although extensive and well documented reconfiguration had taken place there which provided a larger sample frame to recruit from. Suggestions for future research: The extent to which lessons learned from this study inform EUCS policy implementation in regions not fully reconfigured is a possible avenue for research. References: 1- Ham C, Smith J, Temple J. Hubs, spokes and policy cycles: a paper for the King’s Fund London Commission. London: King’s Fund; 1998. 2-Spurgeon P, Cooke M, Fulop N, Walters R, West P, Perri S, Barwell F, Mazelan P. Evaluating models of service delivery: reconfiguration principles. National Institute for Health Research Service Delivery and Organisation programme. London: HMSO; 2010. 3- Farrington-Douglas J, Brooks R. The future hospital: the politics of change. London: Institute for Public Policy Research; 2007. 4- Farrington-Douglas J, Brooks R. The future hospital: the progressive case for change. London: Institute for Public Policy Research; 2007. 5- Fulop N, Walters R, Spurgeon P. Implementing changes to hospital services: Factors influencing the process and ‘results’ of reconfiguration. Health Policy; 2012; 104:128-135.

"Theoretically, co-management provides a fruitful way to engage local residents in efforts to conserve and manage particular spaces of ecological value. However, natural resource management, and biodiversity conservation in particular, are faced with novel sets of complexities in the rapidly urbanizing areas of Cape Town, South Africa, and in the nexus between an apartheid past, informal settlements, remnant biodiversity patches, and urban poverty. Departing from such a dynamic social and ecological context, this article first provides an historical account of the decade-long comanagement process at Macassar Dunes, and then considers, through stakeholder perceptions, what are the successes and failures of the contested process. We find that comanagement at Macassar Dunes faces serious legitimacy, trust, and commitment issues, but also that stakeholders find common ground on education and awareness-raising activities. In conclusion we argue that the knowledge generated from case studies like this is useful in challenging and rethinking natural resource management theory generally, but specifically it is useful for the growing cities of the Global South. More case studies and a deeper engagement are needed with geographical theories on the 'urban fringe' as 'possibility space', to help build a firm empirical base for theorizing comanagement 'at the fringes', i.e., at the intersection of poverty, socioeconomic inequality, and high biodiversity and ecological values."

Multifunctionality in agriculture has received a lot of attention the last decade from researchers and policy-makers alike, perhaps most notably evidenced by the important changes made to the EU's Common Agricultural Policy. While the concept has been embraced by environmentalists envisioning positive impulses for decoupling and a range of local stakeholders recognizing implicit marketing opportunities involved, it has also been criticized as a mere argument in favour of disguised protectionism. Problematic in this discussion is the lack of an operationalising framework for the assessment of multiple functions. In this paper, we discuss such a framework and the role it can play in the decision-making process. Focusing on a case study about olive farming on sloping and mountainous land in northeastern Portugal, the contribution discusses methods for studying multiple functions of agro-ecosystems. While function assessment is presented from a research perspective, its relevance for stakeholders is also stressed here. By using the metaphor of a house, the method could appeal to a wide range of actors. In the case study, we conclude that olive groves on sloping and mountainous land particularly fall short in supplying ecological functions. They do however contribute significantly to the local economy, generate employment and perform an important role in maintaining the cultural landscape and identity, and are thus vital to regional development and to stop outmigration of the population. Policy-makers could use the function assessment tool to design effective cross-compliance rules and relevant agro-environmental measures to reinforce ecological and social functions, and to communicate ideas to other stakeholders. As such, it provides an extension of public debate and can reinforce decision-making by visualizing trends, development alternatives or scenarios. The role of research in this method is to facilitate dialogue between stakeholder groups and to feed the process with relevant indicators.

International audience; Anchoring our research in stakeholder theory and using secondary data from 100 countries, we examine the role of 'Information Technology (IT) readiness' of primary national stakeholder groups in a nation (i.e., citizens, businesses and governments), in facilitating both ''e-government and e-Commerce development'' in a nation. Furthermore, using the IT impact perspective, we examine the impact of e-government and e-Commerce development on the 'IT usage patterns' of the three identified national stakeholder groups. This study also examines the relationships between e-government and e-commerce in a nation so as to identify the important interdependencies between the two.