The social and environmental responsibility of informal artisanal and small-scale mining in Ghana: An Akan philosophical perspective

Informal artisanal and small-scale mining (ASM) continues to grow globally, raising both challenges and opportunities in terms of economic, social, and environmental impacts. The ASM literature explores the formalization and transfer of corporate social responsibility (CSR) practices from larger firms as the pathway to minimize negative impacts and maximize benefits. But we know very little about environmental and social responsibilities of informal mining operations (and informal economy actors in general, who are often portrayed as devoid of these responsibilities). This paper aims to theorize and empirically explore principles and practices of social and environmental responsibility in informal mining. We combine elements of relational stakeholder theory with Ghana's Akan philosophy to develop our theoretical framework. Through a qualitative research process involving thematic analysis - of field notes from field observations and 81 interviews with ASM miners, community leaders/residents and executive members of Small-Scale Mining Association-Prestea Branch in Ghana - and pattern-matching technique, we find that: a) informal ASM is culturally and relationally motivated to be socially and environmentally responsible, b) there is a model of informal social and environmental responsibility (ISER) that is characterized by commonality, solidarity, tradition, and human-nature interdependencies, and c) social and environmental responsibilities are interpreted in a distinctive, non-Western way and comply with two main informal norms: gifting for social responsibilities and taboos for environmental responsibility. We conclude by suggesting that governments should collaborate with traditional authorities to promote ISER practices as cultural norms.

Opportunity abandonment: Why are entrepreneurs vulnerable to type I and II errors?

Opportunity actualization is a critical competency attributed to entrepreneurs, which has received widespread attention in the entrepreneurship literature. However, the knowledge of Entrepreneurial Opportunity Abandonment (EOA) decisions is limited. We, therefore, explore the relatively under-studied EOA, analyzing why entrepreneurs commit decision errors, abandon potentially viable opportunities (type I error) or pursue non-opportunity spaces (type II error), and ultimately forsake them later. Through a scoping literature review, we highlight more profound psychological variables that shape entrepreneurial opportunity behavior triggering EOA decisions. We discuss entrepreneurial cognitive limitations in articulating, concretizing, and communicating the opportunity. We argue that varying construal mindsets cause reification fallacies and create perceptual blocks in enunciating an opportunity idea. Further, subjective stakeholder feedback and biased information exchange largely shape EOA decisions, which are mediated through the information processing capacity of entrepreneurs. Finally, we propose four entrepreneurial decision-limiting hypotheses which require an empirical investigation.

Provision of sexual health education in secondary schools: A multidisciplinary lens of stakeholders in southern highlands, Tanzania

Introduction

School-based sexual health education reduces risky sexual outcomes for in-school adolescents such as unintended premarital pregnancies, unsafe abortions, increased risk of contracting sexually transmitted infections (STIs) including HIV and AIDS, early parenthood, a massive dropout from schools and untimely deaths. Despite the teaching of sexual health education in secondary schools, adolescents in Iringa Region are being exposed to increasing risks of sexual behaviours such as premarital sex, multiple sexual partners, and unprotected sex. This study examines stakeholders' attitudes and beliefs toward providing sexual health education in secondary schools in Iringa Region, Tanzania.

Methods

A qualitative approach under cross-sectional design was used. A purposive sampling technique was applied in selecting the Districts and participants for the study while simple random was used in the selection of schools. The participants were purposively selected depending on their position and knowledge of the subject matter. This study had 50 participants in total, 36 of them were teachers (6 from each school) who participated in focus group discussions (FGDs). After that, in-depth interviews with 14 participants were also conducted including 6 headmasters/mistresses, 6 healthcare professionals and 2 District secondary education officers. All FGDs and in-depth interviews used standardized questions to elicit information. The collected data were audio-recorded through tape recorders, transcribed, and translated into English. An initial coding matrix was developed and refined throughout the coding process. Transcripts were coded and analyzed using the content analysis approach.

Results

Findings from this study revealed all stakeholders having positive attitudes toward the provision of sexual health education in secondary schools. Results also revealed participants in favour of adolescents being taught several topics except for homosexuality. Findings on the appropriate age to start learning sexual health education revealed participants having trouble in fixing the right age, however, they said, at least 5 through 10 years before a child initiates sexual activity.

Conclusion

The study concludes that stakeholders in the study areas have a positive attitude towards the provision of sexual health education in secondary schools and want students to be taught a wide range of topics before they initiate sexual activity. It is recommended that age-appropriate comprehensive sexuality education be given to teenagers to provide them with the knowledge they need to make informed decisions about their sexuality. This requires concerted efforts from the school, government and community involvement in the provision of sexual health education to in-school adolescents.

Identifying Core Issues for Basin Management: The Issue Generating Assessment (IGA) Methodology

Effective stakeholder engagement is essential for basin management, requiring structured approaches to foster collaboration and consensus. This paper applies the Issue Generating Assessment (IGA) method, which identifies core issues for stakeholder discussion, to basin management. Focusing on the Israeli part of the Hadera Basin, we identify the core issues that should be discussed by stakeholders using the IGA method. To this end 39 participants across 14 sectors evaluating three generic basin management strategies were asked to qualitatively explain their evaluations. By analyzing these explanations utilizing the IGA method, four core issues emerged: (1) Managing uncertainty: addressing climate change and land use impacts on stream flow; (2) Mutual impacts management: handling interactions between the stream and its surroundings; (3) Integration of uses: balancing various stream utilization priorities; (4) Defining natural system functions: determining the role of natural systems. For each core issue, we proposed questions to guide stakeholder discussions. The IGA method is thus found to be useful, and has the potential to foster meaningful dialogue in structured stakeholder meetings, thereby focusing discussions and allowing understandings among stakeholders to be reached as a basis for basin management plans. Such early understandings may contribute to the development of strategies for sustainable basin management.

Proceed with Caution: Social Acceptability of Forestry Practices in Puerto Rico among Members of Local Environmental Organizations, Academia and Professional Associations

Social acceptability of forestry practices plays a key role in defining sustainable forestry policies and strategies. In this study an online survey was distributed among members of environmental, non-governmental, professional, and academic organizations to assess the acceptability of forestry practices in Puerto Rico among members of civic society interested in environmental management issues. Participants were asked about their perception of forest uses, their preference of tree harvesting technologies, methods that may apply in small scale wood production settings, and trust in organizations providing forest information. We also inquired about attitudes towards economic activity in forests and the impact of such activity on recreation and biodiversity. The results show that even though participants do not place a high priority on economic development through forestry activities, acceptance of forest management for wood harvesting will be possible by considering adherence to particular forestry technologies and methods to safeguard current recreation activities and biodiversity conservation. Social acceptability information would be worthwhile when seeking consensus among a broader group of local stakeholders. As a next step we suggest the creation of a council constituted by diverse forestry sector stakeholders that would engage in a strategic planning exercise to delineate a clear road map that can guide short and long-term sustainable forest management, including wood industry development.

Blue-green infrastructure in view of Integrated Urban Water Management: A novel assessment of an effectiveness index

Addressing urban water management challenges requires a holistic view. Sustainable approaches such as blue-green infrastructure (BGI) provide several benefits, but assessing their effectiveness demands a systemic approach. Challenges are magnified in informal areas, leading to the combination of integrated urban water management (IUWM) with BGI as a proposed solution by this research. We employed the Urban Water Use (UWU) model to assess the effectiveness index (EI) of BGI measures in view of IUWM after stakeholder consultation. The procedure in this novel assessment includes expert meetings for scenario building and resident interviews to capture the community's vision. To assess the impact of IUWM on the effectiveness of BGI measures, we proposed a simulation with BGI only and then three simulations with improvements to the water and sewage systems. The results of the EI analysis reveal a substantial improvement in the effectiveness of BGI measures through IUWM combination. Moreover, we offer insights into developing strategies for UWU model application in informal settlements, transferrable to diverse urban areas. The findings hold relevance for policymakers and urban planners, aiding informed decisions in urban water management.

Implementing a Treatment for People with Serious Mental Illness in Jail: A Mixed-Methods Study of Stakeholder Perspectives on Feasibility and Acceptability

People with mental illness are over-represented in the U.S. criminal legal system. Jail presents an optimal opportunity to provide needed mental health care as the entry point to corrections. However, there is a lack of programming available in jails, which may be partly due to limited understanding of how to successfully implement interventions in this complex setting. We implemented a nine-session psychotherapeutic intervention for people with serious mental illness in a county jail. As part of a larger implementation-effectiveness hybrid study, we gathered mixed-methods data from stakeholders (treatment recipients and jail administrators) on the feasibility and acceptability of the intervention's implementation. In focus group discussions and qualitative interviews, treatment recipients (n = 29) provided qualitative and quantitative data on their perceptions of the implementation's feasibility and acceptability. Jail administrators (n = 6) completed two quantitative self-report measures on their perceptions of the treatment's feasibility and acceptability. Qualitative analyses were conducted by two coders using inductive thematic template analysis; seven global themes relating to treatment recipients' perceptions of the assets and hindrances to feasibility and acceptability were developed and are presented with supporting quotations. Quantitatively, all treatment recipients endorsed the intervention's feasibility (100%), and nearly all (97%) endorsed its acceptability. On both self-report measures, jail administrators' mean scores fell above a-priori thresholds indicating feasibility and acceptability. We found qualitative and quantitative support for the use of this intervention in jail from both sets of stakeholders. These results have implications for clinical service and policy in jail, where service providers struggle to meet the considerable demand for mental health services.

New dockside eDNA based protocol to detect the seaweed Asparagopsis armata evaluated by stakeholders

Early detection of invasive species is crucial to deal effectively with biological invasions in ports, which are hotspots of species introductions. In this study, a simplified end-time PCR methodology conducted on eDNA from water samples was developed for rapid detection of the invasive seaweed Asparagopsis armata (four hours from water collection to result visualization). It was tested dockside in four international Spanish ports in presence of stakeholders, whose feedback was obtained to explore the real applicability of this biotechnology. Although biological invasions were not a main concern for them, results indicate a unanimous approval of the methodology by the stakeholders, having detected the presence of A. armata in three of the ports. Stakeholders suggested further developments for easier application of the tool and multiple species detection, to be adopted for the control of invasive species in ports.

Critical success factors and collaborative governance mechanism for the transformation of existing residential buildings in urban renewal: From a social network perspective

The renovation of urban residential buildings in the context of urban renewal presents social challenges due to the involvement of diverse stakeholders and complex interest relations. This study identifies 28 critical success factors (CSFs) and 9 stakeholders, drawing insights from literature and on-site research of 45 old residential renewal projects in Jiangsu Province, China. Employing social network analysis, the intricate interplay between CSFs and stakeholders is explored, emphasizing the imperative for collaborative governance and elucidating governance mechanism principles. Focusing on stakeholders' resource contributions to transformation projects, the study devises a collaborative governance mechanism based on the specific types of resources required to support each CSF. This approach ensures that CSFs receive the necessary resources, enhancing project success. The paper concludes by outlining nine governance mechanisms and their implementation paths, anchored in the relationships between 13 CSFs and their respective stakeholders.

Spatiotemporal assessment of sustainable groundwater management using process-based and remote sensing indices: A novel approach

This study aims to develop a process-based method for evaluating groundwater sustainability and use the results in an archetypal analysis to fundamentally frame and understand sustainable development interactions in a river basin scale and sub-basin resolution. This method was applied in the Tashk-Bakhtegan-Maharloo (TBM) basin of Iran between 2003 and 2018; anthropogenic and natural factors were considered. With its 31 aquifers in 27 sub-basins, the TBM basin has repeatedly suffered severe droughts and water shortages over the past half a century, highlighting the importance of sustainable groundwater management. This study quantified anthropogenic and natural factors affecting groundwater dynamics to address sustainability and defined representative and relative indices, including climatological and drought conditions, vegetation cover, land cover, and population, to assess groundwater sustainability (GWS). Relative indices, prepared using measured data and remote sensing analysis, were chosen to explain groundwater-related situations, whereas representative indices, such as groundwater level and total dissolved solids, were used to explain the groundwater situation. GWS was spatially monitored using a couple-indicator trend-line slope comparison method to analyze process-based indices. Then, archetypal interaction patterns and their drivers in the groundwater system were investigated using results from process-based indices analyses results. The results showed that the TBM basin has moved towards unsustainable levels because of drought, increased irrigated croplands, unbalanced development of the sub-basins up- and downstream in the river's path, and over-exploitation of groundwater. These findings indicate that a deeper understanding of groundwater problems and stakeholder associations is required in order to adapt to the changing groundwater conditions.

An online survey capturing the views of stakeholders on primary school food systems across the four UK nations

BACKGROUND

In 2020, the Generating Excellent Nutrition in UK Schools (GENIUS) Network was established to develop an understanding of the school food system across the four UK nations. This study explores stakeholders' views (headteachers, teachers, parents and pupils) on what works well, the challenges, and what an ideal primary school food system includes.

METHODS

An online 'School Food Survey' was created in Qualtrics XM including closed and open-ended questions about the primary school food system. The Qualtrics link was distributed to stakeholders with an interest in school food through key contacts and networks across the four UK nations (21st June to 21st July and September 2021). Responses from the open-ended questions were exported from Qualtrics into Excel and analysed using SPSS. Aspects of qualitative content analysis were applied to summarise, code and quantify responses. Identified codes were entered by stakeholder, for example, parents and their response to the question into a Matrix table to allow identification of categories, themes and interpretation.

RESULTS

A total of 509 participants completed the survey: most participants were from Scotland (n = 281; 55%) and England (n = 213; 42%) and were parents (n = 394). There were some consistent views across stakeholder responses, for example, the range of healthy options, costs, and portion sizes offered to pupils. Parents views varied, with some expressing the range of healthy options worked well and others reporting too many unhealthy choices. The cost of school food and school food funding presented challenges for both parents and schools. For parents, an ideal school food system would include a wide variety of fresh healthy food choices that were made on site, use quality produce, be inclusive for all cultures and diets, and provide food portion sizes appropriate for pupils ages.

CONCLUSIONS

The findings iterate the diversity and some inconsistencies between stakeholders, emphasising the complexity and competing tensions school food systems encounter. Parental involvement and consideration of school-level and national factors are important when identifying challenges, what works well and describing an ideal primary school food system.

Scelte gestionali per sostenere e migliorare i programmi di screening oncologico

Improving screening programmes in terms of increasing screening participation and providing appropriate follow-up is a major challenge requiring great planning. This contribution discusses the effect of a major intra-organizational intervention on three population-based oncological screening programs (i.e., breast, cervical, and colorectal cancers) active in a large Italian Screening Centre. A review of the literature data on the key elements for high-quality healthcare was conducted. The PRECEDE-PROCEED model was retrospectively used as a theoretical frame for the improvement strategies adopted in the Centre. Classification of interventions to increase participation was performed according by target: individual, population, health workers, tests, and health service management. To assess the impact of the reorganization on the three screening programmes, the 'participation rate in the first-level screening tests' indicator was considered; the years 2018, 2019, and 2022 were analyzed.The main factors driven by the change were optimization of resources (human and financial), a stronger leadership, a higher collaboration level, stakeholders' engagement, positive work culture, and continuous staff learning. Reminders to non-responders (mobile phone text-message and letter), delivery of publicity by media, offering the self-sampling method for HPV testing, and increasing accessibility were implemented.A significant increase in screening participation was observed for all screening programmes when comparing the participation rates in 2022 to those in 2018 and 2019. In particular, focusing on 2019 (the last standard activity year before the COVID-19 emergency), an increase in participation rate of 3% for breast, 8.5% for cervical, and 4.6% for colorectal cancer screening was observed. This increase can plausibly be an effect of the improvement strategies implemented in the Centre.Performance measurements and internal and external feedback are regularly conducted to ensure ongoing improvement.

Co-producing knowledge on the use of urban natural space: Participatory system dynamics modelling to understand a complex urban system

Decision-makers are increasingly asked to act differently in how they respond to complex urban challenges, recognising the value in bringing together and integrating cross-disciplinary, cross-sectoral knowledge to generate effective solutions. Participatory modelling allows to bring stakeholders together, enhance knowledge and understanding of a system, and identify the impacts of interventions to a given problem. This paper uses an interdisciplinary and systems approach to investigate a complex urban problem, using a participatory System Dynamics modelling process as an approach to facilitate learning and co-produce knowledge on the factors influencing the use of urban natural space. Stakeholders used a Systems Dynamics model and interface, as a tool to collectively identify pathways for improving the use of space and simulating their impacts. Under the lens of knowledge co-production, the paper reflects how such mechanisms can lead to the co-production of knowledge and social learning. The findings also contribute to identify ways of increasing the value of urban natural space focusing on urban areas undergoing physical and social transformation, such as the Thamesmead case study, London, UK.

Exploring stakeholders' perceived problems associated with the care and support of children and youth with mental ill health in Sweden: a qualitative study

BACKGROUND

Care and support for children and youth with mental ill health have become more specialized and are provided by an increasing number of stakeholders. As a result, services are often fragmented, inefficient and unco-ordinated, with negative consequences for the service user and their family. Enhanced collaboration could lead to improved care and support but requires a shared understanding and a joint problem formulation between involved stakeholders to commence. The aim of this study was to explore different stakeholders' perceived problems associated with delivering care and support to children and youth with mental ill health and to discuss how the perceived problems relate to collaboration.

METHODS

A qualitative descriptive study was conducted, using short statements of perceived problems written by stakeholders involved in the care and support of children and youth with mental ill health during an inter-organizational workshop. The 26 stakeholders represented school and student health, primary health care, specialist care, social services, and different service user organizations. Data were collected during February 2020. Inductive content analysis with a summative approach was used when analysing the data.

RESULTS

The perceived problems were summarized in a model consisting of four main categories: Resources and governance; Collaboration and co-ordination; Knowledge and competence; and Stigma and confidence, containing 24 subcategories. These categories and subcategories were distributed over three levels: Societal level, Organizational level and Individual level. The perceived problems were shared on the category level but to some extent varied between stakeholder groups on the subcategory level. The perceived problems were either directly or indirectly related to collaboration.

CONCLUSIONS

The perceived problems often acted as barriers to achieving successful collaboration. The problems were distributed on all three levels in the developed model, indicating a complex problem. Even though the perceived problems were shared by stakeholders on an overall level, the findings indicate that the stakeholders did not have a completely shared understanding of the perceived problems, as they tended to focus on aspects most relevant to their own organization or perceptions. The challenge is to find which perceived problems are appropriate for inter-organization problem-solving and which can be solved within individual organizations.

People's Perception and Awareness towards Plant Invasion, Its Impacts on Forest Ecosystem Services and Livelihood: A Tale of Central Himalayas

Plant invasion is a leading threat to biodiversity, ecosystem services and human wellbeing worldwide. In the central Himalayas intentionally or accidentally introduced invasive alien plant species (IAPS) facilitate their own establishment and spread, which is altering forest structure, vegetation composition, species diversity and livelihood. To understand the perception and awareness amongst local communities about invasive alien and native plants and its effect on local livelihood, a questionnaire-based study was conducted in 10 villages of Nainital district, Uttarakhand, India. Household data of 179 respondents were triangulated with key informants such as community leaders, teachers and older people. A majority of the respondents were found to be more familiar with the native species (Berberis asiatica, Pyracantha crenulata and Rubus ellipticus) than IAPS (Ageratina adenophora and Lantana camara). Both the IAPS negative impacts on native biodiversity, ecosystem services and livelihood. During the last two decades IAPS have encroached on various forests and caused a decrease in native species in the study area. According to the local perception, deforestation, forest fire, climate change, increased transport, light weight seed, no use and grazing etc. have been the main factors behind the spread of IAPS. A. adenophora invaded both chir pine (Pinus roxburghii) and banj oak (Quercus leucotrichophora) forests while L. camara remained more prominent in low elevation open canopy chir pine forest. Uprooting is the primary method used to control IAPS in crop fields and forests. The studied villages have not reported awareness and education programs about the IAPS. Our study demonstrates the wide range of perspectives on the threat posed by IAPS to forest ecosystems and natural resources. Education could help to raise awareness about the issue and could be beneficial in managing and controlling invasion in the Himalayan region.

Organizations and stakeholders' roles and influence on implementing sustainability requirements in construction projects

Construction projects significantly affect a country's development, consume many resources, and impact many stakeholders. Project sustainability requirements are essential to overcome the current social and environmental challenges, yet entrepreneurs, decision-makers, and technical professionals still ignore them. This research aims to reveal the leading players that can influence implementing sustainability requirements in construction project development, the barriers, and possible solutions. The results show that organizational strategies, maturity level in sustainability, and the ability to change corporate values and beliefs play a significant role in this pivotal movement. At the same time, a set of external stakeholders, such as investors, banks, communities, suppliers, regulatory agencies, and insurance companies, may push a specific behavior to the market and influence change. On top of this, organizations shall build their strategy toward sustainability and implement sustainable project management. This study employs the Complex Holographic Assessment of Paradoxical Problems (CHAP2) to investigate the current situation in Brazil related to the integration of construction project development and sustainability requirements.

Stakeholders' Response to IFRS adoption/ convergence on accounting quality and disclosures: A bibliometric review of Scopus database

This study characterises the results of behavioral accounting research on International Financial Reporting Standards (IFRS) adoption published in various journals. It: (a) provides an integrated overview of the extant literature available on the Scopus database, (b) locates their contributions, (c) identifies knowledge gaps and (d) derives a unique hypothesis for future investigation. This review presents an analysis of the studies on IFRS adoption/convergence considering the response of various stakeholders to IFRS adoption on issues including accounting quality and disclosure requirements. The present paper analyses 106 articles published between 2005 and 2021. Preparers (accountants) and users including academicians, researchers, policymakers, and regulatory and standard-setting bodies such as IASB may use this examination as a guideline to conduct further inspections into the standard-setting processes and the related issues.

Identifying policy options to regulate high potency cannabis: A multiple stakeholder concept mapping study in Washington State, USA

BACKGROUND

Cannabis legalization in some U.S.A. states has catapulted the mass production of concentrates, with tetrahydrocannabinol (THC) concentrations ranging from 50-90%. A major public health concern is that these products will increase cannabis-related harms such as use disorders, psychotic symptoms, and accidental poisonings. This paper describes and contextualizes the results of a study requested by the WA State Legislature to understand perspectives of WA stakeholders on the topic.

METHODS

Concept Mapping (CM), a mixed-methods research approach that supports people-centered policy decisions was utilized. The goal of the study was to explore stakeholders' concern levels and support of policies to address the availability of high THC cannabis products. For analysis purposes, stakeholders were categorized into three groups: community, professionals, and cannabis advocates.

RESULTS

CM generated an inventory of policy ideas for regulating high-potency cannabis from a variety of stakeholders. Notably, stakeholders from community and professional groups supported environmental policy changes such as such as taxation, increasing minimum age for high concentration cannabis products, and advertising prohibition. Meanwhile, cannabis advocates (mostly industry actors) opposed taxation per THC content, proposed lowering taxes, and supported policies with low population impact such as educating parents, teachers, and youth.

CONCLUSION

Support for regulating high concentration THC products varied by stakeholder group. Consistent with how other health compromising industries have historically acted, cannabis industry stakeholders rejected regulation of their products. Future studies should explore non-cannabis industry stakeholders' willingness to work towards minimizing the influence of the cannabis industry in policy development processes to assure public health regulations prevail.

To sample or not to sample: A governance-focused decision tree for wastewater service providers considering participation in wastewater-based epidemiology (WBE) in support of public health programs

Wastewater-based epidemiology (WBE) provides value to public health monitoring and protection. Participation of public and private wastewater system operators in WBE efforts is critical to public health surveillance program success and sustainability. However, given the number of WBE solicitations wastewater service providers receive, the limitation of service provider resources, the concerns around privacy, ethics, and equity, and the fatigue associated with responding to COVID-19, operators are becoming more hesitant to participate in WBE efforts. While various ethical concerns and sustainability challenges associated with WBE have been documented, no efforts to date have investigated what factors should systematically influence the decision to provide samples to a WBE effort. Therefore, this study develops a decision-making tool for WBE teams to proactively monitor, manage, and avoid wastewater system operators' operational risks and potential liabilities. Ultimately, using this tool allows WBE program partners in academia, government, and industry to better understand wastewater system operators' needs and challenges surrounding data quality and use, public health ethics, and daily wastewater infrastructure operation.

The revitalization of endangered heritage buildings: A decision-making framework for investment and determining the highest and best use in Egypt

Background

Egypt's major cities have been losing heritage and historical buildings due to neglect and misuse, prompting non-governmental organizations, academic institutions, and researchers to advocate for adaptive reuse strategies to preserve the cities' heritage and identity. Adaptive reuse involves changing, modifying, or reusing a space based on community needs, business model, location, and proximity to facilities and services. Heritage buildings offer many tangible and intangible benefits that enhance financial returns, making them challenging but feasible and attractive for investors who value authenticity, uniqueness, and sustainability.

Methods

This study examines how market value, acquisition opportunities, target clients, age groups, and socioeconomic status affect decision-making. A comparative analysis of three buildings in the Egyptian cities of Alexandria and Cairo is utilized to establish development guidelines and decision-making parameters that significantly impact project design and building functions to determine the highest and best use. In order to complete this study, AutoCAD by Autodesk was used for 2D drawings, SketchUp by Trimble for 3D models, Adobe Photoshop for diagram presentation, and Microsoft Office for tables and diagrams.

Results

The comparative analysis provided valuable insights into the adaptive reuse of heritage buildings in developing countries. Findings highlighted how cultural heritage preservation could foster socioeconomic development. Key success factors included stakeholder and community engagement, financial viability, and architectural compatibility. The decision-making framework provides a practical tool for evaluating heritage building reuse.

Conclusions

The analysis illustrates successful reuse strategies and considerations. Decision-making frameworks and tools offer practical guidance for future investments and decisions. These findings affect heritage conservation and urban development policymakers, planners, and investors. Stakeholders can make informed decisions and implement strategies to preserve cultural and environmental value by realizing challenges and opportunities. This study hopes to inspire more research and help preserve and revitalize heritage buildings in developing countries, preserving their cultural and socioeconomic value.

What is the functional reach of wastewater surveillance for respiratory viruses, pathogenic viruses of concern, and bacterial antibiotic resistance genes of interest?

BACKGROUND

Despite a clear appreciation of the impact of human pathogens on community health, efforts to understand pathogen dynamics within populations often follow a narrow-targeted approach and rely on the deployment of specific molecular probes for quantitative detection or rely on clinical detection and reporting.

MAIN TEXT

Genomic analysis of wastewater samples for the broad detection of viruses, bacteria, fungi, and antibiotic resistance genes of interest/concern is inherently difficult, and while deep sequencing of wastewater provides a wealth of information, a robust and cooperative foundation is needed to support healthier communities. In addition to furthering the capacity of high-throughput sequencing wastewater-based epidemiology to detect human pathogens in an unbiased and agnostic manner, it is critical that collaborative networks among public health agencies, researchers, and community stakeholders be fostered to prepare communities for future public health emergencies or for the next pandemic. A more inclusive public health infrastructure must be built for better data reporting where there is a global human health risk burden.

CONCLUSIONS

As wastewater platforms continue to be developed and refined, high-throughput sequencing of human pathogens in wastewater samples will emerge as a gold standard for understanding community health.

Policies and practices in Nigeria's pharmaceutical sector: A mixed methods exploration of stakeholders' perspectives on strategic reforms

Background

Policies and practices are key factors that determine development in any sector. In the Nigerian setting however, there is lack of evidence that the pharmaceutical sector is embedded with contextual policies and practices that can expedite development in the system. This inadvertently has an impact as regards access to medicines for the citizenry. This study therefore aimed at adopting a bottom-up approach in gathering insights into stakeholders' perspectives on policies and practices in Nigeria's pharmaceutical sector, and how they influence Medicines' Security and consequent access to healthcare.

Methods

Data were collected using a self completion questionnaire which was administered to stakeholders present during an event held in Abuja, the capital of Nigeria, which focused on improving the Nigerian pharmaceutical sector. A total number of 82 questionnaires were administered to participants. Following retrieval of questionnaires, quantitative data were subjected to descriptive and inferential analyses, whilst textual data were analysed using thematic analysis approach.

Results

Of the 82 questionnaires administered, response rate was 92.68%. Two-thirds of the participants were males (69.7%). A quarter of the study participants were between the ages of 41 and 50 years, whilst those above 50 years represented the most populous proportion of the sample (38.2%). A considerable proportion (48%) of the study participants indicated that current policy ecosystem was hostile for pharmaceutical sector growth and development. Also, majority (97.3%) of the study participants indicated that increased investment in health research could stimulate the development of the pharmaceutical sector. Majority of the study participants indicated the need for collaboration between pharmaceutical companies, research institutes and the petrochemical industry.

Conclusion

This study consequently identified several critical factors that could stimulate development in the sector, including increased funding of research; stringent implementation of existing policies; and prioritisation of pharmaceutical sector by government and other key stakeholders.

Speaking and listening: The importance of stakeholder engagement in quality improvement in pediatric urology

To improve health care, we as clinicians must work to change processes that make it easier to do our job well and reliably every day. Before improving a process, we must understand it and this often requires employing the expertise of others. Indeed, quality improvement work is often done in teams. The key is identifying and engaging the right stakeholders for each improvement initiative. The goal of this review is to provide health care professionals with the basis for how to do this. We describe four essential stakeholder steps that aid in the success of a quality improvement initiative. The steps of 1.) identifying and 2.) categorizing stakeholders involve spending the time to think about who the necessary stakeholders are and how to organize them. It is essential to consider stakeholders who are balanced for expertise, skills, experience, perspective, gender, race, and ethnicity. The process then moves on to 3.) analyzing stakeholders, which supports efforts that are focused on the stakeholder relationships that will most impact project success. The final step is 4.) stakeholder engagement. This represents a critical opportunity, not only upfront, but also to maintain a high level of stakeholder engagement throughout the quality improvement project. As the improvement work evolves, it is important to return to the earlier steps and reflect on the stakeholder group; the process is iterative. Devoting sufficient energy and time to these stakeholder steps will provide ample returns. This review should assist health care professionals in establishing an improvement team for each quality improvement initiative, which is foundational to initiating change efforts that better system performance, enhance the quality of care, and ensure patient safety.

Feasibility of introducing effective alcohol harms reduction strategies in a low regulation region: A qualitative study from Hong Kong

To counter the harms of excessive alcohol use, the World Health Organization (WHO) outlined a series of alcohol policy recommendations, including the most cost-effective "Best Buys". This study aims to obtain key stakeholder views on feasibility of implementing various publicly endorsed alcohol policies in Hong Kong, a relatively low alcohol consumption region with few extant alcohol regulations. Between 2019 and 2021, we conducted semi-structured interviews with stakeholders involved in alcohol policy adoption and implementation. Interviewees included hospitality/alcohol sales workers (n = 13) and government officers (n = 4). The stakeholders noted that although WHO advocacy facilitated local policy considerations, the adoption of stringent measures was challenged by low political priority due to the low visibility of harms. For implementing strategies, the stakeholders cited alignment with social norms as a major facilitator, whereas law enforcement difficulties and resistance from industry/business sectors were viewed as major obstacles. There was a general belief that population-level alcohol policies would be effective for certain groups of drinkers but would also harm the local economy and detract from Hong Kong's image as a "world city". Hong Kong may not be ready to adopt a wide range of highly restrictive population-level alcohol policies. Local governments should carefully consider contextual factors when following international recommendations.

Increased bicycle helmet use in the absence of mandatory bicycle helmet legislation: Prevalence and trends from longitudinal observational studies on the use of bicycle helmets among cyclists in Denmark 2004-2022

INTRODUCTION

Using a bicycle helmet reduces the risk of serious head injuries among cyclists substantially. This makes it highly relevant to increase the use of helmets and to measure the prevalence of bicycle helmet use over time and across different groups.

METHOD

Since 2004, the use of bicycle helmets in Denmark has been measured observationally in two nationwide time series: one among cyclists in city traffic across all age groups, and one among cycling school children (aged 6-16) around schools. The observations have been conducted on a regular basis in different parts of the country following the same methodology over the years.

RESULTS

Bicycle helmet use among cyclists in city traffic in Denmark has increased from 6% in 2004 to 50% in 2022. Among cycling school children, helmet use has increased from 33% in 2004 to 79% in 2022. Throughout the years, helmet wearing rates have been highest among young children and lowest among young adults. Since 2015, female cyclists in city traffic have had a slightly higher helmet use than male cyclists.

DISCUSSION

Several factors might have affected bicycle helmet use in Denmark. One possible factor is a nationwide focus on traffic safety education and behavior change campaigns to encourage helmet wearing. Furthermore, among stakeholders on cycling safety there has been consensus on recommending bicycle helmet use and supporting the promotion of helmets while not recommending or promoting helmet legislation. Finally, more safety-oriented behavior in road traffic in general, and self-reinforcing effects of increased helmet use have plausibly been important factors.

PRACTICAL APPLICATIONS

Increasing bicycle helmet use in a country where cycling is popular is possible in the absence of mandatory bicycle helmet legislation. Persistent behavior change campaigning and education, stakeholder consensus, higher levels of road safety-oriented behaviors, and self-reinforcing processes could potentially be important factors.

Prioritization of research engaged with rare disease stakeholders: a systematic review and thematic analysis

BACKGROUND

Although rare diseases (RD) are increasingly becoming a priority for healthcare activities and services around the world, developing research policy for investigating RD in public settings proves challenging due to the limited nature of existing evidence. Rare conditions require the involvement of a wide range of stakeholders in order to promote general awareness and garner political support. Consequently, it is critically important to identify trends in the various types of research focusing on rare disease stakeholders, including the specific topics or issues to be included in surveys and studies focused on RD stakeholders. This systematic review and thematic analysis analyses the existing literature based on RD surveys, including the stakeholders involved, and proposes potential research priorities and initiatives for policy-making related to RD.

METHODS

Articles were downloaded and analyzed from across five electronic databases (PubMed, EMBASE, Cochrane Central, Web of Science, and CINHAL) and 115 studies were included.

RESULTS

Across 115 studies, the main research participants were patients and/or caregivers (n = 77, 67.0%), health professionals (n = 18, 15.7%), and the public (n = 7, 6.1%). The studies discussed RDs in general (n = 46, 40.0%), endocrine, nutritional, and metabolic diseases (n = 20, 17.4%) and other RDs. Experiences with RD were examined by more than half of the selected studies (n = 74, 64.3%), followed by the opinions of stakeholders (n = 24, 20.9%). Most of the studies used surveys in order to collect relevant data (n = 114, 99.1%). Additionally, the majority of the studies were conducted in high-income countries (n = 92, 80.0%) and rarely in middle and low-income countries (n = 12, 13.8%).

CONCLUSION

Stakeholder research on RD reveals that there are significant instances of unmet needs and various challenges faced by the medical system in dealing with RDs. Furthermore, public awareness and support is critical to ensuring political feasibility of increasing national-level investments for RDs and development of medical products and treatment.

Actions and perceived impact of African swine fever control measures along the smallholder pig value chain in Uganda

Pig production in Uganda is constrained by African swine fever (ASF) which is endemic in the country. Current measures taken by the Government of Uganda in controlling ASF outbreaks include trade and livestock movement restrictions, called "quarantine." Little is known about the actions of, and impact of value chain actors in response to ASF quarantines. This study describes actions that different stakeholders in the smallholder pig value chain took, and the perceived economic impact, during ASF quarantines. Data was collected in ten focus group discussions (FGD) using participatory epidemiology tools and two key informants' (KIs) interviews with District Veterinary Officers (DVOs) of Kisoro and Moyo districts in Uganda. The results show that during ASF quarantine, pig value chain actors shifted their activities from formal places such as livestock markets, slaughter slabs, pork butcheries and pork joints to informal places such as farmers' homesteads. Farmers were perceived the most economically affected stakeholder group with forgone income due to unsold pigs, costs for implementing biosecurity measures and extra costs for feeding unsold pigs being the major perceived causes of the losses. The continued trade in pigs and pig products in informal marketplaces suggests that quarantine might not be effective for hindering activities that might spread ASF in these settings. The perceived economic losses provide an insight into the negative economic impact of the quarantine for the different stakeholders.

The Importance of Social Engagement in the Development of an HIV Cure: A Systematic Review of Stakeholder Perspectives

As research into the development of an HIV cure gains prominence, assessing the perspectives of stakeholders becomes imperative. It empowers stakeholders to determine priorities and influence research processes. We conducted a systematic review of the empirical literature on stakeholder perspectives. PubMed, Embase, Web of Science, and Scopus were searched for empirical, peer-reviewed articles, published before September 2022. Our analysis of 78 papers showed that stakeholders could be divided into three categories: people with HIV, key populations, and professionals. Following thematic synthesis, two main themes were distinguished: stakeholders' perspectives on HIV cure research and stakeholders' perspectives on HIV cure. Research on perspectives on HIV cure research showed that stakeholders' hypothetical willingness to participate (WTP) in HIV cure research was relatively high, while actual WTP was found to be lower. Studies also identified associated (individual) characteristics of hypothetical WTP, as well as facilitators and barriers to hypothetical participation. Additionally, we reported research on experiences of actual HIV cure research participation. Our analysis of stakeholder perceptions of HIV cure showed that most stakeholders preferred a cure that could eliminate HIV and outlined positive associated impacts. Furthermore, we observed that most included studies were conducted among PWHIV, and in the Global North. To empower stakeholders, we recommend that future research include an even greater diversity of stakeholders and incorporate theories of behavior to further explore how stakeholders decide to meaningfully engage in every stage of HIV cure research.

Improving communication access in psychoeducational interventions for people with complex communication needs: a scoping review and stakeholder consultation

PURPOSE

Psychoeducational interventions are commonly used to improve mental health among the general population; however, their application among people with complex communication needs is under explored. This scoping review aims to identify the psychoeducational interventions utilised with people with complex communication needs, any adaptations to improve communication access, and outcomes for this population.

MATERIALS AND METHODS

The scoping review was conducted using the Arksey and O'Malley guidelines and included stakeholder consultations. A systematic search of the literature was conducted. Stakeholder consultations were conducted via semi-structured interviews with informants from three populations: people with complex communication needs, everyday communication partners and mental health workers.

RESULTS

The search yielded 2112 articles. Twenty-four articles were retained for data extraction. Numerical analysis provided an overview of the existing literature. Thematic analysis highlighted the range of communication access strategies applied within psychoeducational interventions. Common aims and outcomes of interventions occurred across three interrelated themes: education, symptom reduction, and improved coping and wellbeing. Stakeholder consultations enabled contextualisation of literature.

CONCLUSIONS

People with complex communication needs may benefit from psychoeducational interventions when effective, personalised communication access strategies are employed. Future research should include lived-experience perspectives to ensure the relevance of communication access strategies in mental health support.Implications for rehabilitationThis scoping review adds to the evidence base supporting equitable access to mental health support for people with complex communication needs.A range of specific strategies are presented for mental health workers to consider when working with people with complex communication needs.Positive behaviour support (PBS) practitioners must be equipped to address the psychoeducational and mental health support requirements of people with complex communication needs.

Methods for a composite ecological suitability measure to inform cumulative restoration assessments in Gulf of Mexico estuaries

Ecosystem management requires a systematic, holistic approach that considers ecological and social outcomes. Effective restoration practices promote a balance of ecological and social goals by addressing ecological integrity, efficiently maximizing benefits while minimizing investment, and encompassing collaborative stakeholder engagement. Socio-ecological assessments can inform adaptive management and be utilized to prioritize restoration activities and monitor restoration effectiveness. In estuarine systems, socio-ecological assessments should evaluate the ability of habitats to support both ecologically and locally important species. The composite measure presented utilizes a combination of ecological and social measures to characterize ecological suitability for individual and multiple Gulf of Mexico estuarine species. The ecological suitability value (ES) for a given spatial unit is based on a suite of biophysical measures of the quality and extent of suitable habitat for each species, the species' trophic importance in a food web context, and the importance of each species in relation to stakeholder values and benefits. ES values for individual spatial units can be aggregated to estimate the distribution of ecological suitability at the estuarine scale. The ES values are calculated using examples for each step in the process. The information provided by ecological suitability characterizations can support restoration prioritization decisions for Gulf of Mexico estuaries and can provide a baseline measure to gauge restoration effectiveness over time to inform cumulative restoration assessments.

Recognition During the Return-to-Work Process in Workers with Common Mental Disorders

Purpose Considering worker's perspective, the purpose of this study was twofold: (1) to document the meaning of the experience of recognition in the return to work (RTW) process of work after a sick leave due to a common mental disorder (CMD) and (2) to investigate the phenomenon of recognition for workers in the process of RTW after a sick leave due to a CMD, by evaluating the presence or absence of marks of recognition from salient RTW stakeholders stemming from different systems. Methods The Relational Caring Inquiry phenomenological method was used to explore the meaning of recognition during the return-to-work process and marks of recognition in a group of 20 workers who returned to their employment after a sick leave due to a CMD. In depth individual interviews were conducted with each participant. Results The definition of recognition that emerged from workers experiencing the RTW process is related to the behaviours and attitudes of various stakeholders, stemming from the work, health, insurance and social systems that allow them to feel appreciated, valued and respected, throughout the RTW process. Recognition was most often described as showing support, trust, respect for recovery and pace, and providing positive feedback. Conclusion The findings from this study could serve as guidelines in organizations regarding the RTW process, and in particular clarifying the roles and actions that different stakeholders could take in the workplace to stimulate expressions of meaningful recognition.

Ca-HELP: Adaptation of a Communication Tool to Help Geriatric Cancer Patients in Rural Settings Talk to Their Doctors About Pain

Background and Objectives

Among the older adult population living in the rural United States, undertreated cancer pain is very common. The need for interventions targeting pain management communication between older adults with cancer in rural communities and their doctors outpaces the current evidence base. Adaptation of existing pain interventions may improve the speed at which clinicians can respond to pain in this vulnerable population.

Research Design and Methods

The Cancer Health Empowerment for Living without Pain (Ca-HELP) is an evidence-based communication tool that coaches patients to communicate about pain by asking questions, making requests, and signaling distress to their physicians in order to achieve improved pain control. Guided by the Method for Program Adaptation through Community Engagement (M-PACE) model, which utilizes detailed stakeholder feedback to guide the adaptation of an intervention for an appropriate target audience, we proactively adapted the Ca-HELP and its delivery for use among geriatric cancer patients living in rural settings using qualitative feedback from patients, informal caregivers, and providers as a planned step in a multiphase pilot study.

Results

All stakeholders agreed that the Ca-HELP was a promising candidate intervention to improve pain among older adults with cancer. They suggested modifications to the delivery, context, and content of the intervention. A multidisciplinary team of nurse leaders and researchers evaluated stakeholder feedback and recommendations before determining which adaptations were made. Adaptations were cataloged and reported using the Framework for Reporting Adaptations and Modifications-Enhanced model.

Discussion and Implications

Our multistakeholder team proactively modified the Ca-HELP intervention tool using end-user feedback with a goal to optimize fit for use by older adults with cancer in rural settings without compromising the active ingredients. Documenting and reporting modifications to interventions are critical to their implementation and will lay the groundwork for further testing of the efficacy of the adapted Ca-HELP intervention.

Caring in an Algorithmic World: Ethical Perspectives for Designers and Developers in Building AI Algorithms to Fight Fake News

This article suggests several design principles intended to assist in the development of ethical algorithms exemplified by the task of fighting fake news. Although numerous algorithmic solutions have been proposed, fake news still remains a wicked socio-technical problem that begs not only engineering but also ethical considerations. We suggest employing insights from ethics of care while maintaining its speculative stance to ask how algorithms and design processes would be different if they generated care and fight fake news. After reviewing the major characteristics of ethics of care and the phases of care, we offer four algorithmic design principles. The first principle highlights the need to develop a strategy to deal with fake news on the part of the software designers. The second principle calls for the involvement of various stakeholders in the design processes in order to increase the chances of successfully fighting fake news. The third principle suggests allowing end-users to report on fake news. Finally, the last principle proposes keeping the end-user updated on the treatment in the suspected news items. Implementing these principles as care practices can render the developmental process more ethically oriented as well as improve the ability to fight fake news.

Emergence of National Nutrition Policy in the Lao People's Democratic Republic: an analysis of collaborations between governmental and external actors

BACKGROUND

In most developing countries, addressing malnutrition involves a coalition of stakeholders that includes the government and international development partners. This study explores the evolution of the malnutrition actor coalition landscape before and after the emergence of the National Nutrition Policy in the Lao People's Democratic Republic (Lao PDR) in 2008.

METHODS

A qualitative study was conducted based on the theory of coalition structuring. Twenty semi-structured interviews were performed with representatives of national and international organisations involved in addressing malnutrition in Lao PDR. The information obtained from the interviews was complemented by an analysis of relevant documents dating back to 1990. Interviews were recorded and transcribed verbatim. A thematic analysis was performed using NVivo 11 software and the diagrams of collaboration drawn by the participants were turned into a visual collaboration map using SocNetV software. We relied on various types of triangulation to increase the analysis's credibility, reliability, and confirmability.

RESULTS

The results showed that before the emergence of the National Nutrition Policy, three coalitions representing the health, agriculture, and education sectors coexisted. These colalitions worked largely in silos, although with some interactions when deemed necessary mainly by United Nations agencies. The emergence of the National Nutrition Policy provided the government with an effective political tool for coalescing the three coalitions into a unique coalition involving all major stakeholders in the nutrition field. All three forces that incite actors to collaborate inside a coalition according to the theory of coalition structuring (transactions, control, intangible factors) were mobilised in the creation of the single coalition.

CONCLUSIONS

Combating malnutrition is a government priority in the Lao PDR. The current study showed that the National Nutrition Policy in Lao PDR has led to a significant evolution in the malnutrition coalition landscape, resulting in improved collaboration among stakeholders. This finding highlights the effectiveness of public policies in facilitating intersectoral activities to tackle complex problems, such as malnutrition.

Vaginal birth core information set: study protocol for a Delphi study to achieve a consensus on a 'core information set' for vaginal birth

INTRODUCTION

Studies have shown that women are often underinformed about potential benefits and risks of vaginal birth. This is in contrast to other modes of birth, such as caesarean birth, for which the risks/benefits are often conveyed prior to undergoing the procedure. A core information set (CIS) is an agreed set of information points that should be discussed with all patients prior to undergoing a procedure or intervention. This CIS could improve the quality of information given regarding mode of birth options, as women will be given information prioritised by patients and stakeholders regarding vaginal birth, empowering them to make informed decisions about their birth. We aim to describe the protocol for the development of this vaginal birth CIS.

METHODS AND ANALYSIS

We will develop the CIS by: (1) Compiling a 'long-list' of information points about vaginal birth by: undertaking a scoping review of studies and patient information leaflets; interviews with antenatal/postnatal women, an online survey of stakeholders. (2) Collating the 'long-list' of information points and developing the Delphi survey. Think-aloud interviews will refine the survey. (3) Conducting a two-round Delphi survey. 200 stakeholder participants will be recruited. Items rated critically important by ≥80% of participants in one stakeholder group, or with no consensus, will be carried through to a stakeholder consensus meeting to decide the final CIS. Planned start date is 1 June 2022. Planned end date is 31 August 2023.

ETHICS AND DISSEMINATION

This project has been given a favourable ethics opinion by the University of Bristol Research Ethics Committee (Ref: 10530). Approval from the ethics committee will be sought for any protocol amendments, and the principal investigator will be responsible for these changes. Findings will be presented at relevant conferences and published in a high-impact journal. We will disseminate the CIS, via Policy Bristol, to clinical policy and guideline developers.

Listening to stakeholders in the prevention of gender-based violence among young people in Spain: a qualitative study from the positivMasc project

OBJECTIVE

This study seeks to deepen current knowledge of the phenomenon of gender-based violence (GVB) among young people in Spain, identifying the main challenges in terms of prevention from the perspective of key stakeholders in the field.

METHODS

23 semi-structured qualitative interviews were performed with professionals whose work involves youth and comes from different areas: social work, policy making, youth education, feminist and LGBTQ activism and anti-violence masculinities engagement (13 women and 10 men).

RESULTS

Among the main challenges identified by stakeholders in relation to GBV preventive strategies in young populations there is a need to focus on transformative programmes within educational settings. The findings indicate that specific programs and interventions in this area may not be yielding the expected effectiveness. This outcome could be attributed less to a lack of resources and more to a failure to address the core issues and challenges adequately. Thus, the results underline that intervention programmes should emphasise equitable gender norms and gender relations and incorporate content on anti-violence masculinities. Finally, a pivotal aspect seen by professionals to facilitate GBV prevention is the design and development of interventions based on participatory and active approaches, close to young people's everyday situations. The results also draw attention to the need to analyse the impact of new forms of violence in greater depth, especially those that occur through information and communication technologies.

CONCLUSION

Among other implications for policy and practice, the study points to the need to articulate interventions designed to work simultaneously at different levels of influence acting on people.

Innovation in healthcare: leadership perceptions about the innovation characteristics of artificial intelligence-a qualitative interview study with healthcare leaders in Sweden

BACKGROUND

Despite the extensive hopes and expectations for value creation resulting from the implementation of artificial intelligence (AI) applications in healthcare, research has predominantly been technology-centric rather than focused on the many changes that are required in clinical practice for the technology to be successfully implemented. The importance of leaders in the successful implementation of innovations in healthcare is well recognised, yet their perspectives on the specific innovation characteristics of AI are still unknown. The aim of this study was therefore to explore the perceptions of leaders in healthcare concerning the innovation characteristics of AI intended to be implemented into their organisation.

METHODS

The study had a deductive qualitative design, using constructs from the innovation domain in the Consolidated Framework for Implementation Research (CFIR). Interviews were conducted with 26 leaders in healthcare.

RESULTS

Participants perceived that AI could provide relative advantages when it came to care management, supporting clinical decisions, and the early detection of disease and risk of disease. The development of AI in the organisation itself was perceived as the main current innovation source. The evidence base behind AI technology was questioned, in relation to its transparency, potential quality improvement, and safety risks. Although the participants acknowledged AI to be superior to human action in terms of effectiveness and precision in some situations, they also expressed uncertainty about the adaptability and trialability of AI. Complexities such as the characteristics of the technology, the lack of conceptual consensus about AI, and the need for a variety of implementation strategies to accomplish transformative change in practice were identified, as were uncertainties about the costs involved in AI implementation.

CONCLUSION

Healthcare leaders not only saw potential in the technology and its use in practice, but also felt that AI's opacity limits its evidence strength and that complexities in relation to AI itself and its implementation influence its current use in healthcare practice. More research is needed based on actual experiences using AI applications in real-world situations and their impact on clinical practice. New theories, models, and frameworks may need to be developed to meet challenges related to the implementation of AI in healthcare.

Realizing the value of complex medical technology: Demonstrating cost-effectiveness is not enough

The main factors driving the value of medical treatments are proven effectiveness and cost-effectiveness. This is different for complex medical technologies that combine scientific disciplines, functions or tools in a single solution-oriented method. This short communication provides three recommendations to realize the value of complex medical technologies. It is important to engage stakeholders before technology implementation to promote its relevance from multiple perspectives, to explore opportunities for professional development and collaboration, and to demonstrate the societal effects over the entire life-cycle.

[Mapping, profile and training of immunization stakeholders, Benin, 2020]

Introduction

The Benin Immunization and Logistic Directorate commissioned this study to provide evidence-based data to improve the performance of the Expanded Programme on Immunization. The objectives were to identify immunization stakeholders, describe their profile, their geographical distribution and determine their training needs.

Methods

In December 2020, we conducted a census of Benin's immunization stakeholders via their administrative files and telephone interviews. The data were collected in each departmental directorate and health zone by focal points using an Excel^® grid. The authorizations of the ethics and personal data protection committees were obtained.

Results

We identified 3, 893 immunization workers, 39 years old on average, 66% of whom were women, 53% were health care assistants, 77% were vaccinators, and 56% were government contract workers. About 96% of them worked in peripheral centers. Approximately 56% were untrained and 14% had been untrained for more than 5 years. More than half of the actors were not trained for their function. The proportion of actors needing training was estimated at 70%. The training needs were at least 72% in the departmental hospitals, zone hospitals and health centers. 98% of actors reported a need for training, including immunization (74%), vaccine management (69%), cold chain (61%), monitoring (61%), and maintenance (47%).

Conclusion

The predominance of nurses' aides and women and the low proportion of trained personnel among immunization workers were also observed in other sub-Saharan African countries. Benin's Immunization and Logistics Directorate should mobilize sufficient resources to strengthen the technical capacities of the majority of immunization stakeholders.

Multicriteria analysis of critical areas for restoration in a semiarid landscape: A comparison between stakeholder groups

In landscape-scale ecological restoration, there is an urgent need to develop participatory systematic planning strategies and prioritization schemes that are operational under current technical and legal constraints. Different stakeholder groups may differ in their choice of criteria to define critical areas for restoration. Analyzing the correspondence between stakeholder characteristics and their expressed preferences is key to understand their values and facilitate consensus among the different groups. We analyzed the participatory identification of critical areas for restoration in a Mediterranean semiarid landscape of southeastern Spain by means of two Spatial Multicriteria Analyses. The first one included 33 ecological and socioeconomic prioritization criteria. The second included 24 ecosystem services. Prioritization criteria and services and their weights were based on the preferences of 46 stakeholders. We distinguished three stakeholder groups, according to their approach to ecological restoration. Stakeholders showed similarities regarding the most important criteria and services assessed. Yet, we found contrasted opinions between the group labeled as Biodiversity, who showed preference for Regulating Services and Ecosystem Functions, and the two groups labeled as Environment, and Agriculture & other occupations who assigned the highest importance to Provisioning and Cultural Services, along with highly Anthropized Environments. Maps integrating criteria and services weighted by the different groups of stakeholders were largely coincident, because of their overall agreement and the high number of criteria and services included in the analysis. Our approach allowed the identification of consensual critical areas for restoration, which were mainly covered by shrublands and rainfed crops, and mostly characterized by low to medium supply of ecosystem services. Our study emphasizes the need to recognize and integrate different social perspectives when identifying critical areas for restoration and highlights the importance of using complementary approaches as decision-making support tools to define these areas.

Identifying most important contextual factors for the implementation of self-management interventions: A Delphi study

OBJECTIVE

To reach consensus amongst stakeholders about the most important contextual factors (CFs) that may influence the successful implementation of (components of) self-management interventions (SMIs) for type 2 diabetes, obesity, COPD and heart failure.

METHODS

Building on our literature review that identified 31 CFs on different levels we conducted a Delphi with 44 stakeholders to identify which of these CFs, or additional ones, contribute most to successful implementation of SMIs. The Delphi consisted of three rounds in which the CFs were scored, prioritized and discussed.

RESULTS

The most important CFs overlapped to a great extent across components of SMIs and diseases. Overall, stakeholders identified 'HCP's ability to adapt the advice, communication or intervention to patients' situation and level of knowledge' as most important CF.

CONCLUSION

CFs need to be taken into account when implementing promising SMIs. According to stakeholders, the most important CFs are patient-, HCP- or interaction related. 'Tailoring' was selected as the most crucial aspect for HCPs.

PRACTICE IMPLICATIONS

Stakeholders can make informed decisions on the adoption of the most suitable SMIs in a given context. These CFs are available through a self-management platform. Suggestions to implement self-management behaviour and to close the research-to-practice gap are made.

International stakeholder perspectives on One Health training and empowerment: a needs assessment for a One Health Workforce Academy

BACKGROUND

One Health is defined as an integrated, unifying approach that aims to sustainably balance and optimize the health of people, animals and ecosystems; this approach attracts stakeholders from multiple sectors, academic disciplines, and professional practices. The diversity of expertise and interest groups is frequently and simultaneously framed as (1) a strength of the One Health approach in the process of understanding and solving complex problems associated with health challenges such as pathogen spillovers and pandemics and (2) a challenge regarding consensus on essential functions of One Health and the sets of knowledge, skills, and perspectives unique to a workforce adopting this approach. Progress in developing competency-based training in One Health has revealed coverage of various topics across fundamental, technical, functional, and integrative domains. Ensuring that employers value the unique characteristics of personnel trained in One Health will likely require demonstration of its usefulness, accreditation, and continuing professional development. These needs led to the conceptual framework of a One Health Workforce Academy (OHWA) for use as a platform to deliver competency-based training and assessment for an accreditable credential in One Health and opportunities for continuing professional development.

METHODS

To gather information about the desirability of an OHWA, we conducted a survey of One Health stakeholders. The IRB-approved research protocol used an online tool to collect individual responses to the survey questions. Potential respondents were recruited from partners of One Health University Networks in Africa and Southeast Asia and international respondents outside of these networks. Survey questions collected demographic information, measured existing or projected demand and the relative importance of One Health competencies, and determined the potential benefits and barriers of earning a credential. Respondents were not compensated for participation.

RESULTS

Respondents (N = 231) from 24 countries reported differences in their perspectives on the relative importance of competency domains of the One Health approach. More than 90% of the respondents would seek to acquire a competency-based certificate in One Health, and 60% of respondents expected that earning such a credential would be rewarded by employers. Among potential barriers, time and funding were the most cited.

CONCLUSION

This study showed strong support from potential stakeholders for a OHWA that hosts competency-based training with opportunities for certification and continuing professional development.

A Contribution to Sustainable Human Resource Development in the Era of the COVID-19 Pandemic

This examines the six drivers and twelve detailed practices of sustainable human resource development (S-HRD) before and during the COVID-19 pandemic across different organizations in Poland. The empirical strategy is based on explorative research conducted using surveys in Poland between 2020 and 2021. The results confirm that the surveyed organizations implemented S-HRD practices driven mainly by the expectations of external stakeholders. They neglected the areas of caring for employees' well-being and developing environmental awareness before the COVID-19 pandemic. During the pandemic, most companies maintained their approach to S-HRD. This research is unique because it adds to the body of literature advocating the significance of S-HRD for organizational resilience before, during, and after extreme events. Generalizing the results is challenging because the snowball sample has significant restrictions. However, future research may overcome these shortcomings by using larger samples based on probability or random sampling techniques.

How to acquire and use information about pupils to improve the transition from primary to secondary school?

The transition from primary to secondary school can affect children's school and work careers. Mentors at secondary school guide the children through the transition process. For this, they need support from the children, their parents, and the primary schoolteachers. We interviewed 17 mentors from secondary schools in the Netherlands to investigate whether they acquire the information they need and how they value that information. The results show that mentors play an autonomous role, are insufficiently aware of the experiences of primary schoolteachers and dissatisfied with the overall educational report by the primary school. Direct contact with primary education teachers is greatly appreciated but often does not happen.

How has the COVID-19 pandemic impacted wastewater-based epidemiology?

Wastewater-based epidemiology (WBE) was one of the areas of scientific knowledge that developed significantly with the COVID-19 pandemic, with robust worldwide application to monitor the circulation of the SARS-CoV-2 virus in urban communities at different scales and levels. This mini-review assesses how the COVID-19 pandemic may have influenced the WBE based on the investigation of 1305 scientific reports published (research, review, and conference papers) up to the end of 2022, considering the research objects, funding sources, actors, and countries involved. As a result, 71 % of all WBE-based publications occurred since the beginning of the pandemic, with 62 % addressing SARS-CoV-2, demonstrating the migration of WBE's relative importance in studies on drug abuse, pharmaceuticals consumption, and other disease-causing organisms to the constitution of a tool to support the monitoring of the coronavirus. Before the pandemic, WBE was a tool used for epidemiological surveillance of several diseases (54 % of studies), drug abuse (30 %), and pharmaceutical consumption (9 %). With the pandemic, these research topics lost to space, constituting only 37 % of the area's studies, and SARS-CoV-2 became the central object of studies. In addition, there has been a 4.7 % expansion of developing country participation in sewage surveillance publications and greater diversification of collaborators and funders, especially from government, businesses, and the water industry. International research partnerships had a reduction of 8 %, consequently, there was an increase in local and regional partnerships. With the COVID-19 pandemic, funding for research in WBE became approximately 6.5 % less dependent on traditional research funds. The future of WBE involves different approaches, including different focuses of research and technological advancements to improve the sensitivity, precision, and applicability of these investigations. The new WBE research arrangements are promising, although the post-pandemic challenges are likely to be in maintaining them and overcoming the trend toward a lack of diversity in study subjects.

Routine health check-ups for adolescents in Mwanza City, Tanzania: stakeholders' recommendations on its content, venue, and mode of delivery

BACKGROUND

Routine adolescent health screening aiming at the detection of unnoticed medical problems may increase awareness among policy makers and contribute to improved health in this population. Research is needed to inform the World Health Organization (WHO) and national health programs to provide evidence-based guidance on whether public health systems should offer comprehensive adolescent health screening, what should be included in different contexts, and how it should be delivered. We conducted formative research to define the content and delivery strategies for health check-ups to be performed in young (10-14 years) and older (15-19 years) adolescents, and to assess whether such services are likely to be acceptable and feasible in Tanzania.

METHODS

As part of a collaborative research program coordinated by WHO in Chitungwiza, Zimbabwe; Mwanza City, Tanzania; and Cape Coast, Ghana a series of key informant interviews were conducted from April to July 2020, using a semi-structured guide with purposively selected stakeholders from government departments, non-governmental and community-based organisations, schools and health facilities. Data transcripts were coded using NVivo 12 software and thematic analysis was performed.

RESULTS

We report results from 31 key informant interviews to address four main domains: proposed health conditions for routine health check-ups, health interventions to be combined with such check-ups, preferable venues, and the mode for delivering such screening activities. Stakeholders were supportive of introducing routine health check-ups among adolescents. They recommended focusing on non-communicable diseases, physical disabilities, common mental health problems, reproductive health problems, specific communicable diseases, and hygiene-related problems. They also recommended combining counselling and family planning information with these check-ups. Three venues were proposed: schools, community settings (to reach out-of-school adolescents), and youth-friendly health facilities (for conditions requiring a high level of confidentiality).

CONCLUSIONS

Stakeholders were supportive of the proposed routine health check-ups for adolescents, recommending specific health conditions to be screened for in both community and school settings. Based on the above, we plan to conduct implementation research to determine the number of new treatable conditions detected, and the costs of offering such services. In the longer term, evaluation of their health impact and cost-effectiveness will be required to guide policy.

Talking Ethics Early in Health Data Public Private Partnerships

Data access and data sharing are vital to advance medicine. A growing number of public private partnerships are set up to facilitate data access and sharing, as private and public actors possess highly complementary health data sets and treatment development resources. However, the priorities and incentives of public and private organizations are frequently in conflict. This has complicated partnerships and sparked public concerns around ethical issues such as trust, justice or privacy-in turn raising an important problem in business and data ethics: how can ethical theory inform the practice of public and private partners to mitigate misaligned incentives, and ensure that they can deliver societally beneficial innovation? In this paper, we report on the development of the Swiss Personalized Health Network's ethical guidelines for health data sharing in public private partnerships. We describe the process of identifying ethical issues and engaging core stakeholders to incorporate their practical reality on these issues. Our report highlights core ethical issues in health data public private partnerships and provides strategies for how to overcome these in the Swiss health data context. By agreeing on and formalizing ethical principles and practices at the beginning of a partnership, partners and society can benefit from a relationship built around a mutual commitment to ethical principles. We present this summary in the hope that it will contribute to the global data sharing dialogue.

Landscape assessment of the cities in the state of Maharashtra: first step towards air quality management (AQM) and strategic implementation of mitigation plans

OBJECTIVE OF THE STUDY

This study aims to understand the need for landscape assessment of the 18 non-attainment cities in the state of Maharashtra, to understand and rank the cities according to the need and necessity for strategic implementation of air quality management. This air quality management is a National Clean Air Programme initiative to curb the air pollution level in all the highly polluted Indian cities by 20-30% till 2024.

METHODOLOGY

The ranking and selection of the cities consisted of a two-phase approach including (a) desk research and (b) field interventions and stakeholders' consultations. The first phase included (a_i) review of 18 non-attainment cities in Maharashtra, (a_ii) identification of suitable indicators to inform prioritisation during the ranking process, (a_iii) data collection and analysis of the indicators and (a_iv) the ranking of the 18 non-attainment cities in Maharashtra. The second phase, i.e. field interventions included (b_i) Mapping of stakeholders and field visits, (b_ii) the consultations with the stakeholders, (b_iii) information and data collection and (b_iv) ranking and selection of cities. On analysing the score obtained from both the approaches a ranking of all the cities is done accordingly.

RESULTS AND DISCUSSION

The screening of cities from the first phase gave a possible list of 8 cities-Aurangabad, Kolhapur, Mumbai, Nagpur, Nashik, Navi Mumbai, Pune, Solapur. Further, the second round of analysis involving field interventions and stakeholder consultations was done within the 8 cities to find out the most suitable list of two to 5 cities. The second research analysis gave Aurangabad, Kolhapur, Mumbai, Navi Mumbai and Pune. A more granular stakeholder consultation resulted in the selection of cities like Navi Mumbai and Pune as the cities where implementation of new strategies seemed feasible.

INTERVENTION AND ACTIVITIES

New strategic interventions like (a) strengthen the clean air ecosystem/institutions, (b) air quality monitoring and health impact assessment, and (c) skill development to ensure the long-term sustainability of initiatives planned for the cities.

A citizen science approach to investigate the distribution, abundance, and pathogen infection of vector ticks through active surveillance

Tick-borne disease poses a growing public health burden in the United States and understanding the patterns of presence and density of infected vector ticks is key to developing and implementing effective public health management strategies. Citizen science has emerged as a highly effective means to generate data sets on the geographical distribution of tick species. But to date, nearly all citizen science studies of ticks are 'passive surveillance' programs in which researchers accept reports of ticks, together with either physical specimens or digital images, found opportunistically on people, pets, and livestock from community members for species identification and in some cases also tick-borne pathogen detection. These studies are limited because data are not collected systematically, making comparisons among locations and over time challenging, and introducing considerable reporting bias. In this study, we engaged citizen scientists in 'active surveillance' of host-seeking ticks, training volunteers to actively collect ticks on their woodland properties in an emergent region of tick-borne disease in the state of Maine, USA. We developed volunteer recruitment strategies, materials to train volunteers in data collection methods, field data collection protocols based on techniques used by professional scientists, and a variety of incentives to promote volunteer retention and satisfaction with their experiences, and we communicated research findings to participants. A total of 125 volunteers in 2020 and 181 volunteers in 2021 collected 7,246 ticks in southern and coastal Maine, including the American dog tick (Dermacentor variabilis, 4,023 specimens), the blacklegged tick (Ixodes scapularis, 3,092 specimens), and the rabbit tick (Haemaphysalis leporispalustris, 102 specimens). We demonstrated the feasibility of citizen scientists collecting ticks using active surveillance methods and found that volunteers were motivated to participate largely by their interest in the scientific problem and a desire to learn about ticks on their properties.

Questions worth asking for futures worth making: an effectual approach

It is not unusual in the psychology and economics of entrepreneurship to focus on decision models based on predictive reasoning that explain outcomes such as venture creation (at the micro level), firm performance (meso level), or job creation (macro level). However, in this article, derived from the literature on entrepreneurial expertise, I argue for an embrace of uncertainty, where outcomes are not only unknown, but unknowable, hence undermining predictive criteria for actions and decisions. By focusing on principles and processes that do not entail predictive reasoning, effectuation offers both practical guidance for acting in the face of multiple uncertainties and novel research questions not yet examined through the lens of the entrepreneurial method. Specifically, I offer five possible new ventures for future research built on the five principles of effectuation. These pertain to new futures worth making, without prescribing or predicting what those would, could, or should be.