Key Stakeholders Research Articles

COVID-19 pandemic and food security: Strategic agricultural budget allocation in Indonesia

The COVID-19 pandemic has exposed significant vulnerabilities in Indonesia's food security, highlighting the need for more strategic agricultural budget allocation. This study addresses the issue of inadequate budgeting techniques that fail to effectively support food production and distribution during crises. The primary objective is to develop a tailored framework that optimises budget allocations to strengthen Indonesia's food security in the face of socio-economic and geographical challenges. Using a multi-dimensional research approach, the study involves key stakeholders from the Ministry of Agriculture, the Ministry of Finance, and the Ministry of National Development Planning, employing methods such as in-depth interviews, focus group discussions, and data collection from primary and secondary sources. The research utilises the Analytical Hierarchy Process (AHP) with the Expert Choice 2000 program to systematically evaluate decision-making options. Findings reveal the necessity of a resilient framework that balances short-term emergency responses with long-term strategies, focusing on increasing production capacity, improving seed quality, expanding land availability, and adopting advanced agricultural technologies. The study contributes to the policy landscape by offering a structured agricultural budgeting framework and policy recommendations aimed at mitigating disruptions, enhancing productivity, and supporting sustainable agricultural practices. It also emphasizes the importance of sensitivity analysis in budget planning to inform strategic decisions. The study recommended targeted investments in production capacity, a reevaluation of rice import regulations, and the adoption of innovative technologies to ensure a resilient and sustainable food system in Indonesia.

What can be done to ease the transition to becoming a new paediatric registrar?

BackgroundThe transition period of becoming a new paediatric registrar has limited study. Consequently, the learning needs of such trainees are unclear including educational interventions that may improve the process. This qualitative study examined the negative and positive experiences of transitioning paediatric trainees to identify learning needs and subsequently derive educational interventions that are perceived to ease transition.MethodsThis was a qualitative study of semi-structured interviews with Wales deanery paediatric speciality trainees 3 and 4 (ST3 and ST4) undergoing transition to registrar. Participants were asked to recall one positive and one negative experience during transition using the critical incident technique (CIT). Transcribed responses were coded and thematically analysed and categorised into higher and lower order themes.ResultsSix paediatric trainees were interviewed for the study. A total of eighteen codes relating to learning needs were identified and dichotomised into two higher order themes; clinical skills, and leadership and management skills, with further exploration into lower order themes. Clinical skills included child protection procedures, difficult communication with relatives, emergencies, childhood death, difficult procedures, tertiary level neonatal care, managing family anxiety and expectations, dealing with uncertainty and running clinics. Leadership and management skills involved clinical decision making by new registrars, leading ward rounds, managing workload, leading a team and supervising junior colleagues. For educational interventions, sixty-seven initial codes were recorded and combined to form thirty-two lower order themes under six higher order themes. This outlined six educational interventions perceived to ease the transition to the registrar grade including; acting up whilst a senior house officer, seniors providing feedback, seniors providing support, staff providing support, trainee familiarisation with the new registrar placement and trainees maximising SHO learning opportunities.ConclusionsThis study provided a grounding upon which further research can be based, by identifying learning needs within the themes of clinical skills and leadership and management skills, as well as providing further descriptions of perceived beneficial educational interventions that ease transition to paediatric registrar. Furthermore, this study proposes evidence-based recommendations involving five key stakeholders to improve the experience of transition for future trainees. These stakeholders include; trainees, seniors, educators, nursing staff and rota coordinators.

Infection Prevention and Control Response and Escalation Framework – evaluation and application beyond a pandemic

BackgroundThe COVID-19 pandemic brought rapid and frequent changes to Infection Prevention and Control (IPAC) recommendations making it difficult for clinicians to stay informed of the most recent requirements and guidelines. The COVID-19 IPAC Response and Escalation Framework (IPAC Framework) was developed to provide scalable IPAC guidance during the pandemic to healthcare in New South Wales, Australia. The use of such frameworks during or outside of a pandemic has rarely been reported and evaluated here. MethodsUsing a thematic analysis approach, a qualitative study using an online, cross-sectional survey comprising 27 questions was sent to 248 key stakeholders. Participants were health workers with broad clinical and system representation with responsibilities for risk assessment, communicating, implementing and/or monitoring the IPAC Framework. ResultsThe IPAC Framework provided a useful IPAC tool for the management of COVID-19 as perceived by 93% of respondents. The overwhelming majority (91%) reported the Framework provided enough information on IPAC strategies needed for COVID-19 that were aligned with transmission risk. Resources supporting the IPAC Framework were reported by most respondents (84%) as being widely accepted as the authoritative guidance. ConclusionAn IPAC response and escalation framework is perceived as highly useful by clinicians and administrators to manage IPAC requirements in health care during a pandemic. The IPAC Framework can be applied more generally to support ongoing IPAC requirements.

A rapid response process for evaluating causes of extreme temperature events in the United States: The 2023 Texas/Louisiana heat wave as a prototype

Abstract As climate attribution studies have become more common, routine processes are now being established for attribution analysis following extreme events. This study describes the prototype process being developed through a collaboration across National Oceanic and Atmospheric Administration (NOAA), including monitoring tools as well as observational and model-based analysis of causal factors. The prolonged period of extreme heat in summer 2023 over Texas, Louisiana and adjacent areas provided a proving ground for this emerging capability. This event posed unique challenges to the initial process. The extreme heat lasted for most of the summer while most heat wave metrics have been designed for 3–7 d events. The eastern portion of the affected area also occurred within the so-called summer-time daytime warming hole where the warming trend in maximum temperatures has been mitigated wholly or in part by increased precipitation. The extreme temperature coincided with a strong—but not record—precipitation deficit over the region. Both observations and climate model simulations illustrate that the temperatures for a given precipitation deficit have warmed in recent decades. In other words, meteorological droughts today are hotter than their historical analogs providing a stronger attribution to anthropogenic forcing than for temperature alone. These findings were summarized in a prototype plain language report that was distributed to key stakeholders. Based on their feedback, the monitoring and assessment tools will continue to be refined, and the project is exploring other climate model large ensembles to increase the robustness of attribution for future events.

Consensus definition of a radiologically healed fistula on magnetic resonance imaging in perianal Crohn’s disease: an international Delphi study

IntroductionPerianal fistulising Crohn’s disease (pfCD) is a distinct and debilitating phenotype seen in around one-third of patients with CD. Clinical trials in pfCD are increasingly using magnetic resonance imaging (MRI) criteria as a primary endpoint, but there is heterogeneity in the radiological definition of a healed perianal fistula that currently limits our ability to perform meaningful meta-analyses of studies. Our aim is to standardise outcomes through the generation of an international consensus definition of a radiologically healed fistula.Methods and analysisThis international Delphi consensus study employs a two-part strategy.The first is a systematic review to identify a longlist of variables used to define radiological healing in pfCD. MRI-based indices used to score fistula severity and healing will be assessed for their methodological quality using Consensus-based Standards for the selection of health Measurement Instruments (COSMIN). The systematic review protocol will be conducted using COSMIN methodology and reported using Preferred Reporting Items for Systematic Reviews and Meta-Analyses.The second part will be an online Delphi consensus, guided by the results of the systematic review. Radiologists, gastroenterologists and colorectal surgeons with expertise in the management of pfCD will be invited to take part in two to three rounds of online surveys. Once an a priori threshold of >80% agreement is reached on individual radiological components used to define ‘healing’ and ‘healed’, a final meeting of key stakeholders will be organised to generate a consensus definition of a healed fistula.Ethics and disseminationThe study has been deemed exempt from a formal Research Ethics Committee review as no patients will participate directly in the consensus process, given the technical nature of the research question. The study is registered with the local R&D department (Reference RD24/007). Publication of this study will help standardise radiological endpoint measurement in clinical trials of pfCD and improve the synthesis and meta-analysis of comparative studies.PROSPERO registration numberCRD42024504334.

Floating offshore wind – an overview of marine spatial planning and the needs of the industry

Abstract The International Energy Agency (IEA) Wind Task 49 aims to accelerate the commercialisation of floating wind. Work package 4 of the task analyses and incorporates the views of key stakeholders to ensure the Task is aligned with industrial needs. Work package 4 is broadly split into innovation management and marine spatial planning (MSP). The innovation management section evaluates the potential social, environmental and economic impact of floating wind innovations by surveying a multidisciplinary group of stakeholders to ask them to compare the potential impact of identified innovations. The survey results will inform a scored ranking of floating wind innovations, and the future research directions for the Task. In the MSP section representatives from partner countries are interviewed to assess their domestic offshore wind sector and discuss the approach the country has taken to MSP, with a focus on floating wind. The other explored parameters include MSP regulations, offshore wind policy and targets, supply chain capabilities, and environmental and fisheries impact assessments. A synthesis of what stakeholders perceive as impactful innovation, and an understanding of the direction of the industry and policy can be built from the two parts. This paper describes the methodology used to create this synthesis and findings from the first year of work are shared.

Integrating the Airway Lead structure into a large healthcare system to appraise the landscape of airway management resources

Airway Leads are clinicians who guide safe airway management institutionally and act as liaisons between the evolving airway management landscape and bedside clinicians. Internationally, resources produced by Airway Leads Networks aid clinicians in establishing emergency airway management protocols and making difficult airway equipment decisions. The creation of an Airway Leads Network within the United States' multi-payer healthcare system is ongoing, spearheaded nationally by groups such as the Society for Airway Management. We aimed to build a committee of airway leaders across the Yale New Haven Health system and to leverage this committee to appraise the airway equipment and personnel resources throughout the system. We identified key stakeholders in airway management across the healthcare system and administered a quality improvement survey to members of the assembled committee querying their knowledge of the availability of airway management devices. The dataset was gathered from 14 airway management leaders identified across 4 surgical facilities, 6 emergency departments and 5 medical intensive care units at 8 hospitals and hospital campuses within the Yale New Haven Health system. Equipment available in greater than 75 % of locations included hyperangulated and standard geometry videolaryngoscopes, rigid tracheal tube stylets, tracheal tube introducers, flexible intubation scopes, scalpels and waveform capnography. Equipment available in 25 % to <75 % of locations included emergency invasive airway kits, wheeled airway towers or airway boxes, intubating oral airways, airway exchange and Aintree catheters, intubation-capable supraglottic airways, and awake intubation supplies. Glidescope (Verathon) was the most common videolaryngoscope and flexible intubation scope, and Aura (Teleflex) was the most common intubation-capable supraglottic airway available. The initiative illustrated the feasibility and utility of developing a committee of airway leaders in a large health system. While all locations had access to a requisite array of airway management devices, there was variation in the availability and brand of individual airway equipment.

Implementing Screening for Neonatal Delirium in the Neonatal Intensive Care Unit: A Quality Improvement Initiative.

Delirium is not commonly diagnosed in neonatal intensive care units and can adversely impact patient outcomes in the ICU setting. Recognition of delirium in the NICU is a necessary first step to address the potential impact on neonatal outcomes. We conducted a quality improvement initiative implementing screening for neonatal delirium. We aimed to increase screening in NICU patients from 0% to 85% by March 2022. Interdisciplinary meetings were held with key stakeholders to develop a clinical algorithm. We used standardized tools for delirium screening. Our process measures included weekly nursing compliance with Richmond Agitation Sedation Scale/Cornell Assessment of Pediatric Delirium/ scoring documentation (Fig. 1) and patients referred to psychiatry. Outcome measures included the percentage of patients screened for delirium before discharge. We conducted Plan-Do-Study Act cycles to optimize the screening process in the electronic medical record (EMR). This included creating an order set, documentation flowsheets, and prompts in the EMR for patients. After initial implementation, we achieved an average weekly screening compliance of 76% (Fig. 1). Inclusion criteria expansion resulted in a downward compliance shift to 59%. Subsequently, the addition of the EMR checklist resulted in a center-line shift to a sustained average weekly screening compliance of 77%. An average of 82% of all eligible NICU patients received delirium screening before discharge (Fig. 2). Using quality improvement methodology, there was increased screening and recognition of delirium in our NICU. Future research efforts could focus on assessing preventive measures and the impact of neonatal delirium on patient outcomes.

Robots in Agriculture – A case-based discussion of ethical concerns on job loss, responsibility, and data control

There is a growing interest in using robots in agriculture due to increasing challenges of labour scarcity and cost. Field robots are expected to help overcome these challenges and to contribute to financial, environmental and social sustainability. However, socially responsible introduction of field crop robots will require awareness and consideration of ethical trade-offs by stakeholders including farmers, regulators, and manufacturers. In this article we discuss the ethical themes of job loss, moral responsibility, and data control in light of the results of sixteen interviews with key stakeholders conducted in 2022 under a European research project named Robs4crops.

What does flexible work for men really mean?: a qualitative content analysis of key stakeholder accounts

ABSTRACT This article explores definitions and practice of flexible work and is part of a larger project about men’s flexible work. Flexible work is prevalent in workplace research, but evidence is lacking regarding how flexible work for men is interpreted and applied in practice. Gendered patterns of work and care more often position men in paid employment and less often in care and domestic responsibilities. Men’s use of flexible work could assist in balancing paid employment with unpaid domestic and care tasks. Qualitative content analysis (QCA) was undertaken to summarise participants’ descriptions of two key aspects of flexible work – forms of flexible work, and the reasons for flexible work. QCA was applied to 30 interviews about men’s flexible work with organisational leaders (n = 12, 3 women and 9 men) and men who use flexible work arrangements (n = 18). Participants typically discussed flexible work in their white-collar employment situations, most often in the form of part-time work and for the reason of caring for children. Participants’ descriptions of flexible work differed from how flexible work is commonly defined in policy and legislation, demonstrating that men use flexible work in ways not described in policy or legislation.

The repercussions of enacting the IMO 2020 regulation for mitigating ship emissions in Malaysian waters

ABSTRACT The IMO 2020 regulations, introduced by the International Maritime Organization (IMO), came into effect on January 1, 2020, with the primary goal of reducing sulphur oxide emissions from ships by capping the allowable sulphur content in marine fuels at 0.50%. This measure aims to minimize the harmful environmental and health impacts of sulphur emissions, which contribute to air pollution and acid rain. However, the implementation of these regulations has posed considerable challenges for Malaysia’s maritime sector, particularly due to increased operational costs and difficulties in complying with the stringent requirements. This study critically analyses the challenges associated with the enforcement of IMO 2020 regulations in Malaysia, focusing on regulatory compliance. By conducting a comprehensive review of existing literature and integrating insights from key stakeholders and regulatory authorities, this research evaluates the current state of implementation. The findings reveal that the enforcement of IMO 2020 in Malaysia has been suboptimal, largely due to gaps in regulatory execution and industry preparedness. For Malaysia to fully align with international standards and contribute to the preservation of a sustainable maritime ecosystem, concerted efforts are essential to enhance enforcement mechanisms and ensure compliance with global emission reduction targets.

STAKEHOLDERS ANALYSIS OF MANGROVE ECOSYSTEM MANAGEMENT IN SEGARA ANAKAN LAGOON, CILACAP

The mangrove ecosystems are one type of coastal ecosystem found along coastlines and river estuaries that are influenced by tides and inundation. Segara Anakan Lagoon, Cilacap as one type of coastal ecosystem has a protection function, coastal area buffer, and cultivation area function that must be supported from the aspects of policy and institutions, communication, and coordination. This study aims to identify the role of stakeholders and the relationship between stakeholders in mangrove ecosystem management in Segara Anakan Lagoon, Cilacap. The research method used was a survey and interview method analyzed with MACTOR software. The results showed that there were 18 stakeholders who involved in mangrove ecosystem management in Segara Anakan Lagoon, Cilacap. The stakeholders are classified into main stakeholders, key stakeholders, and supporting stakeholders using the objective of mangrove management as key activities such as silvofishery, mangrove conservation, fishing activity, industry activity, etc. The level of convergence between stakeholders was 96.1% and the level of divergence was 3.9%. These results indicate a relatively low potential for conflict between stakeholders. The research can be used as a model relation between stakeholders to support the management activity of Segara Anakan Lagoon.

To Study the Effectiveness of Youtube and TV Advertisements on Consumer Purchasing Intention of Mobile Product in Ahmedabad

HR Solutions LLP, a reputable Ahmedabad-based HR consulting firm, is provided in this report. The study's objectives are to examine the range of services offered, the technology employed, and the effectiveness of these services in enhancing organizational performance. Using a mixed-methods approach, this study integrates qualitative data from semi-structured interviews with key stakeholders with quantitative data from structured customer surveys. Research indicates that Head Quest HR Solutions LLP employs several strategies that are tailored to meet the unique requirements of its customers. These methods improve organizational development, talent management, and employee engagement despite obstacles like assessing long-term effects and integrating advice with customer culture

ANALYSIS OF THE IMPACT OF THE POLISH-UKRAINIAN BORDER CONFLICT ON THE EXPORT AND IMPORT ACTIVITIES OF ENTERPRISES

The article focuses on the Polish-Ukrainian border conflict, which has become a focal point of geopolitical tension. The consequences of this conflict extend beyond the political realm and impact the export-import activities of enterprises. The blockades are being implemented in six of the nine directions along the border between Poland and Ukraine, which is a key factor in deepening the crisis. This study aims to comprehensively analyse the multifaceted impact of the conflict on trade dynamics, regulatory changes, operational challenges faced by businesses, and potential strategies adopted to overcome these difficulties. This study uses a mix of methods, such as in-depth interviews with key stakeholders and statistical analysis of trade data from the State Statistics Service of Ukraine, to find out how geopolitical factors, trade policy, and business operations are all connected in complex ways. By shedding light on the complex relationship between border conflict and export-import activity, this study provides valuable insights for policymakers, businesses, and researchers grappling with the effects of geopolitical tensions on international trade.

Unpacking Forest Stewardship Council certification in Chile: The scope and limitations of neoliberal market‐driven governance for achieving sustainable development

AbstractThe Forest Stewardship Council (FSC) is an international NGO promoting sustainable forest management by setting standards and certifying timber as eco‐friendly. After facing significant resistance from the Chilean forestry sector, which is plagued by environmental and territorial conflicts, FSC began certifying Chile's main forestry corporations in 2010. This article examines the implementation of FSC's standards by addressing two questions. First, how does FSC function in practice, including the roles of consultants, chambers, and instruments in the certification process? Second, what are the scope and limitations of FSC in achieving sustainable development and managing forestry industry conflicts? Elaborating on 24 interviews with key forestry stakeholders, ethnographic fieldwork, and documentary analysis, the findings indicate that FSC enhances management practices in the forestry industry by promoting legal compliance, rational production management, and improved relations between firms and local communities. FSC provides a green imaginary that ‘cleans up’ timber production as conflict‐free, facilitating its free circulation in the international market. However, as a private governance system, FSC is based on an artificial consensus that has limitations such as power imbalances between firms and communities, limited sanctioning power, and close ties with large industry actors. This neoliberal form of governance fails to resolve structural problems between industry and indigenous communities, yet it creates strategic opportunities for mediating the relationships between actors. In Chile, FSC enables incomplete citizenship for communities and serves as a ‘soft regulation’ for firms, reducing the likelihood of increased State regulation in the forestry sector.

Systematic development of a complex intervention: a theory and evidence-based physiotherapist led group intervention to increase physical activity and reduce sedentary behaviour following bariatric surgery (PARIS)

ObjectivesTo describe the systematic development of a physiotherapist led group behaviour change intervention targeting physical activity and sedentary behaviour in individuals who have undergone bariatric surgery. Study designIntervention development including evidence synthesis, qualitative research and mapping of intervention components, using the 2008 MRC framework for complex interventions. MethodsWe conducted a systematic review to identify the evidence for promising interventions and components to increase physical activity and reduce sedentary behaviour following bariatric surgery. We also conducted primary qualitative research exploring these behaviours with three key stakeholder groups: patients, clinicians and commissioners. We selected two contemporary behaviour change frameworks to inform intervention development and developed a conceptual matrix in which intervention objectives were defined to inform selection of appropriate behaviour change techniques, proposed mechanisms of action(s), and mode of delivery. We also developed two intervention handbooks for participants and facilitators to support delivery and receipt of the intervention. ResultsWe have developed a behaviour change intervention targeting physical activity and sedentary behaviour in patients following bariatric surgery. Eight intervention objectives were defined and mapped to the Behaviour Change Wheel and Theoretical Domains Framework. We identified what the intervention must be able to do (intervention functions), behaviour change techniques that could be used to achieve this, the proposed mechanism of action, and mode of delivery. This intervention will be subject to a feasibility study, with the intervention delivered online over a six-week period to participants who have had bariatric surgery within the previous five years. Contribution of the Paper•This paper clearly explains the process involved in developing a theory and evidence-based physiotherapy-led complex behaviour change intervention.•The full specification of the intervention including proposed mechanism of effect has been provided, which should facilitate faithful intervention delivery and allow it to be comprehensively evaluated in a planned feasibility study.•This paper aims to enable physiotherapists to develop their own complex interventions, targeting behaviours that are relevant to their patients in their own areas of clinical practice.

Explaining the stakeholders’ perspectives about urban regeneration policy: a grounded theory study in downtown Tabriz city, Iran

ABSTRACT In recent decades, urban regeneration has become increasingly important as a policy focusing on inner cities and deteriorated urban areas in the Global South. This policy consists of multiple stakeholders involved in its process, which requires profound research to solve acute problems and modify inefficient practices. Therefore, the current paper’s primary purpose is to explain stakeholders’ attitudes about urban regeneration in downtown Tabriz (Iran) as a second-tier middle eastern city based on grounded theory. Data collection was conducted through semi-structural interviews with 32 key stakeholders in the study area. The coding steps were also categorized using Atlas.ti software. Results indicate that the main forces, sub-factors and contextual conditions have been behind urban regeneration. Furthermore, gentrification and technocracy were recognized as the dominant approach in downtown Tabriz city. Consequently, by interpreting and reflecting on conceptual categories, “rent-oriented, growth-based and unbalanced regeneration” was called a core phenomenon.

Planning and evaluating an integrated clinical exercise oncology service: an exploratory mixed-methods study

BackgroundThis project aimed to design and evaluate the potential to integrate an exercise oncology service into clinical care in a local healthcare system. The goal was to inform the design of an implementation strategy to promote its sustainable use in standard care.MethodsThis two-phase, exploratory study used a mixed-methods approach. First, qualitative measures were used to understand the context for exercise integration into oncology care by clinicians and administrators in the healthcare system. Next, the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework guided a comprehensive evaluation of the exercise service. Reach and Adoption were measured via number of patients enrolled in the program relative to those treated. Adoption was measured via referrals from stakeholders. Implementation was described using the program structure and delivery. Maintenance was described using hospital funding decisions. Effectiveness was assessed using the Bellarmine Norton Assessment Tool (BNAT) and Functional Assessment of Cancer Therapy – Fatigue Scale.ResultsPhase 1 context analysis suggested critical elements to guide program delivery, including limiting participants to post-primary treatment (surgery, chemotherapy and radiation) and streamlining referral process. The Phase 2 evaluation demonstrated suboptimal program reach (2%); significant program effectiveness (improved physical function (BNAT; p = 0.05 ) and decreased fatigue (p < 0.05)); receptiveness to program adoption (75%); and strong potential for program maintenance.ConclusionsTraditional approaches to exercise oncology research trials are not easily integrated into healthcare systems. Designing an exercise program for meaningful integration and sustainment requires understanding the context where the program will be delivered, followed by intentional and continuous engagement with key stakeholders to ensure the program continues to meet the needs of the system. Initial exploration of the settings is critical to inform a comprehensive implementation strategy.Trial registrationclinicaltrials.gov: NCT06039488. Prospectively Registered Sept 15th, 2023.

Listening to children with lower limb loss: Rationale, design, and protocol for delivery of a novel globally applicable research toolkit-Prosthetic user needs, quality of life, pain, and physical function.

Rehabilitation after childhood lower limb loss is complex and dependent on multiple stakeholders and environmental factors. While research with adults underscores the importance of involving prosthetic limb users and caregivers in discussions to drive innovation, children are often excluded or not effectively engaged. This protocol lays out the development and implementation protocol for an internationally applicable research toolkit which has been designed and evaluated around the essential presence of the child. Research domains span their unique prosthetic needs, quality of life, pain, and mobility. Cohorts of children in contrasting environments were identified (Cambodia, Gaza Strip, and the UK) to provide a comprehensive global understanding of the child with lower limb loss. A literature review revealed a lack of appropriate tools for identifying paediatric prosthetic user requirements leading to the development of novel interview guides for each key stakeholder: child, caregiver, and prosthetist. The child's guide centred around enjoyment and engagement using card games and activities. A panel of experts in paediatric limb loss and mental health rigorously reviewed the guides. Guides were integrated with existing validated measures for quality of life, pain, and mobility to form a comprehensive toolkit. The toolkit was successfully piloted with 5 children, their families, and 2 prosthetists. This protocol lays out the toolkit rationale and implementation plan (Jan 2023 to Dec 2025). This work offers the opportunity for this cohort to enjoyably engage with research that seeks to radically improve prospects for all children living with limb loss. The outlined best practices ensure ethical considerations when working with vulnerable cohorts. This study is approved to cover implementation at all geographical locations as well as the researcher institutions. Results will be disseminated through national and international conferences, as well as through manuscripts in leading peer-reviewed journals.

Multi-stakeholder Governance Toward Mitigating Marine Plastic Waste in Hoi An Coastal City, Vietnam

Background and objective: Marine plastic waste is a pressing environmental issue that requires coordinated efforts across various stakeholders to mitigate its impacts effectively. This research examines the multi-stakeholder governance approach towards reducing marine plastic waste in Hoi An coastal city, Vietnam. The study explores the roles and interactions of key stakeholders, including government agencies, local communities, businessmen, scientists, and international agencies, in addressing marine plastic pollution.Methods: Through a combination of interviews, policy analysis, and field observations, this research identifies the challenges and opportunities in implementing sustainable waste management practices. A mixed-methods approach study was conducted and collected data from August 2022 to February 2023, June 2023 to September 2023 and July-August 2024. Two hundred and three random online survey samples were collected. Additionally, forty in-depth interviews were conducted with government officers, businesspeople, researchers, and international agency representatives and each interview lasted for about one hour. The research used both purposive and snowball sampling to maximise the breadth of actors’ perspectives.Results: The research found that effective mechanisms and collaborative governance among diverse stakeholders such as government officials, businesses, communities, international organizations, and scientists are crucial for significantly reducing marine plastic waste. It also underscores the importance of community engagement in preventing plastic waste from entering the ocean and highlights the role of market-driven forces in plastic waste mitigation. Furthermore, the findings emphasize the need to expand scientific and international support to achieve the ultimate goal of reducing marine plastic waste.Conclusion: This study offers insights into best practices and policy recommendations that can be applied to other coastal regions facing similar environmental challenges. By fostering a collective responsibility approach, Hoi An can serve as a model for other coastal cities in Vietnam and beyond in their efforts to combat marine plastic pollution.