Local Action Research Articles

Protein kinase A and local signaling in cancer.

Protein kinase A (PKA) is a basophilic kinase implicated in the modulation of many cell-signaling and physiological processes. PKA also contributes to cancer-relevant events such as growth factor action, cell cycle control, cell migration and tumor metabolism. Germline and somatic mutations in PKA, gene amplifications, and chromosome rearrangements that encode kinase fusions, are linked to a growing number of malignant neoplasms. Mislocalization of PKA by exclusion from A-Kinase Anchoring Protein (AKAP) signaling islands further underlies cancer progression. This article highlights the influence of AKAP signaling and local kinase action in selected hallmarks of cancer. We also feature the utility of kinase inhibitor drugs as frontline and future anti-cancer therapies.

Environmental public health research at the U.S. Environmental Protection Agency: A blueprint for exposure science in a connected world.

Exposure science plays an essential role in the U.S. Environmental Protection Agency's (U.S. EPA) mission to protect human health and the environment. The U.S. EPA's Center for Public Health and Environmental Assessment (CPHEA) within the Office of Research and Development (ORD) provides the exposure science needed to characterize the multifaceted relationships between people and their surroundings in support of national, regional, local and individual-level actions. Furthermore, exposure science research must position its enterprise to tackle the most pressing public health challenges in an ever-changing environment. These challenges include understanding and confronting complex human disease etiologies, disparities in the social environment, and system-level changes in the physical environment. Solutions will sustainably balance and optimize the health of people, animals, and ecosystems. Our objectives for this paper are to review the role of CPHEA exposure science research in various recent decision-making contexts, to present current challenges facing U.S. EPA and the larger exposure science field, and to provide illustrative case examples where CPHEA exposure science is demonstrating the latest methodologies at the intersection of these two motivations. This blueprint provides a foundation for applying exposomic tools and approaches to holistically understand real-world exposures so optimal environmental public health protective actions can be realized within the broader context of a One Health framework. IMPACT STATEMENT: The U.S. EPA's Center for Public Health and Environmental Assessment exposure research priorities reside at the intersection of environmental decision contexts and broad public health challenges. The blueprint provides a foundation for advancing the tools and approaches to holistically understand real-world exposures so optimal environmental protection actions can be realized. A One Health lens can help shape exposure research for maximum impact to support solutions that are transdisciplinary and must engage multiple sectors.

Axonal sensitivity and block dynamics

The role of differential nerve block in the development of analgesia after erector spinae plane block has been questioned. While highly myelinated nerves are more sensitive to local anesthetics than unmyelinated ones in vitro, factors influencing drug diffusion, particularly pKa, are more relevant in the clinical setting. Bupivacaine (the drug most used for an ‘analgesic’ effect) has a relatively high pKa (8.1), and only 15% of it is present in the lipid permeant, unionized form at pH 7.4 so it will penetrate unmyelinated C fibers relatively easily, but the myelin sheaths around other fiber types are a significant barrier to drug diffusion. The greater sensitivity of myelinated axons to local anesthetic action will only be apparent if the drug can reach their membranes in significant concentrations. In the very dynamic situation pertaining to a local anesthetic injection (no matter the site), diffusion factors mean that the concentration of the drug around the axons is likely to be very low and may result in an effect on unmyelinated fibers only.

Shaping global strategy, mobilising for local action: reflections from the World Conference on Drowning Prevention 2023

Drowning is a significant cause of preventable mortality and morbidity and has been described as a serious, preventable and neglected public health challenge. Amid building momentum for drowning prevention, most...

James (Carrick) Moore (1763-1860): Another (Scottish) Local Anaesthetic Hero.

Modern technology has provided the author with access to a previously unobtainable publication, John Moore's 1784 work, 'A Method of Preventing or diminishing Pain in Several Operations of Surgery'. Not only did this allow direct consideration of his technique of nerve compression (which has been described briefly by many others since), but also showed that Moore had very advanced humane views on the need to try and produce pain relief for surgery. It also became possible to obtain far more information on the author, notably that although he worked in London he was born and educated in Glasgow, and did his initial medical training in Edinburgh. He thus is one of a group, all of whom were Scots, who did preliminary work on local anaesthesia before the recognition of the local action of cocaine. His technique was tried, apparently successfully, for a below-knee amputation by John Hunter, and while both the technique and his humane approach were noted by others, the method does not seem to have found wider favour. He continued working as a surgeon in London until he inherited an estate in south-west Scotland, this allowing him to give up clinical practice and focus on writing and campaigning. He wrote the definitive biography of his brother (Sir John Moore of Corunna fame) and was a leading advocate of vaccination, leading the organisation after Jenner's death. These activities meant that he was well known in his lifetime, but he deserves to be better known today as being the first person to promote the need for pain relief during surgery.

A text analytics study on the alignment of an Indonesian Muslim community’s municipal corporation policy with Sustainable Development Goals

PurposeThis study analyses the supervision policy of Municipal Corporations (MCs) in the Indonesian Muslim community regarding its alignment with the United Nations Sustainable Development Goals (SDGs).Design/methodology/approachAs a single case study, purposive sampling was adopted to select a municipal corporation policy issued by Ciamis Regency, West Java, Indonesia. A novel mixed methods approach, combining computer analytics and human intelligence, was introduced to perform text analytics.FindingsText mining identified the most frequently occurring words — e.g., ‘perumda’ (municipal corporation), ‘daerah’ (regional), ‘pengawas’ (supervisor), ‘peraturan’ (regulation) — from the sample but found no single word indicating business alignment with SDGs. Further qualitative inductive analysis was conducted, revealing the critical role of MCs’ supervisory boards in business planning, execution, and reporting to align the MC businesses with local SDG initiatives.Originality/valueAligning MC business activities with local SDG actions is entirely within the authority of supervisory boards which demands transformational leadership. This research pioneered an innovative blend of computer-assisted techniques and human reasoning to investigate the supervision policies of MCs concerning local SDG actions, with evidence from a Muslim community in Indonesia.

Reimagining early childhood education and school readiness through the perspectives of historically marginalized families living in a rural community

Given opportunities for early childhood education (ECE) expansion in the US, we seek to explore and elevate the perspectives of historically marginalized families, from an understudied rural community, to inform future local and state action involving public pre-kindergarten (pre-K) and kindergarten (K) provision. In partnership with a state Department of Education (DOE) and local district, we conducted two culturally responsive focus groups to investigate how such caregivers conceptualize ECE and school readiness, identify barriers with the current system, and pinpoint potential solutions to improve public pre-K and K. Participants included eight female caregivers, three of whom identified as Black, two as Hispanic, and three as White. All families met the DOE's eligibility requirements to attend public preschool. Through two 90-minute focus groups, we found families conceptualized ECE as a time for humanizing and hands-on classroom practices. They questioned the concept of school readiness, instead advocating for ways that schools can be ready for their children. Furthermore, families identified accountability culture (testing, standardization of curricula, narrow focus on core academic content, etc.), as a problem, particularly upon kindergarten entry. Solutions to improve pre-K and K included representative curricula, more equitable funding, and opportunities for collaboration across education interest-holders (e.g., teachers, families, administration, etc.) at school, district, and state levels.

Geomatics Technology Education – Assessment of Learning Pedagogy

Abstract. The paper investigates multidisciplinary education and specialization at the master's level, analyzes assessment methods, and proposes a technique for evaluating geospatial technology education. It emphasises is on pedagogical approaches, and highlights the importance of capacity building to meet the growing demand for skilled professionals in spatial information management. The research provides guidelines for improving course content, structure, and teaching methodologies, aiming to enhance the quality and relevance of geospatial education for both students and stakeholders. This paper is based on online data gathered from 115 universities across the globe, who are imparting geospatial education, campus-based and e-learning, also a survey was conducted of two thousand students. It supported in analysis and suggestion to develop a specific robust technique for assessment of the geospatial technology education and provides the corrective measures to the users of the technique. It proposed a framework aimed at enhancing the course content, organization, and teaching methods substantially. Further an attempt was made to adopt AHP model for investigating the statistical approach. It was aimed to know the actual values and significance of each parameter used for analysis of the study. In order to prepare a common guideline for improving the course structure, course content and teaching methodology, ANFIS architecture (Artificial Neural Fuzzy-Inference System) was adopted. Spatial information represented in the form of thematic maps in relation with the respective attribute data in Geographical Information System (GIS) environment is now used by all spectrum of the society, be it government organizations, industry, and academia. The result of the study has designed the criteria and common guidelines, which may be implemented, would able to help and curtail the challenges of the geospatial education as global vision for Local Action.

Creating an inclusive workforce in 2024: Are pharmacy teams across England committed to embedding equality, diversity, and inclusion?

Abstract Introduction The Pharmacy Workforce Race Equality Standard (PWRES) published in 2023 provided evidence of the varied experiences that registered pharmacy professionals in NHS trusts face, particularly in relation to gender and ethnicity.1 Following this, the Inclusive Pharmacy Practice delivery group at NHS England set out to raise awareness of the data and to support regions in developing action plans to drive improvements in equality, diversity and inclusion (EDI) within pharmacy teams. Aim The aim of this study was to identify current initiatives within NHS providers that promote EDI within the pharmacy workforce with a view to enabling the sharing of good practice, and identifying implementation barriers. Methods A questionnaire was created by the Chief Pharmaceutical Officer’s Clinical Fellows and distributed by the 6 regional chief pharmacists within NHS England to their networks. The questionnaire was also promoted in regional pharmacy leadership meetings. Responses were collected between 1st February and 31st May 2024. Data was collected on an Excel spreadsheet. London was excluded from data collection as a similar questionnaire was distributed in 2023. No ethical approval was needed for non-sensitive anonymised data. Results There were 77 responses: 75% (n = 58) from hospital trusts, 13% (n = 10) from integrated care boards and the remaining 9 responses included the Local Pharmaceutical Committee, Hospice and Mental Health Trust. 86% of respondents (n = 66) indicated that their organisation has EDI initiatives in place. These have been summarised into six key themes: 1) EDI network/steering group (n = 44), 2) action plan (n = 14), 3) EDI training/accreditation (n =14), 4) reverse/reciprocal mentoring (n = 11), 5) awareness days (n = 10) and 6) inclusive recruitment practices (n = 10). In contrast, only half of respondents indicated that their team had EDI initiatives. The impact of any initiatives was measured by feedback from staff (e.g. Internal staff survey, NHS staff survey, focus groups, open staff forums) and regular staff demographic data collection. 55% of respondents (n = 36) indicated that recruitment panel members received compulsory EDI training for interviews and 54% of respondents (n = 35) received mandatory recruitment training. Barriers and challenges identified with implementing EDI initiatives included organisational change, workforce capacity, competing priorities and staff apathy. Discussion The survey results highlight a strong commitment to EDI initiatives at an organisational level, with most organisations having established EDI frameworks. However, the lower prevalence of EDI initiatives within individual pharmacy teams suggests a gap in implementation. This discrepancy indicates a need for better dissemination and integration of EDI practices within pharmacy team settings. There is evidence of varied practice in terms of EDI training requirements of interview panellists, and these variations are opportunities where improvements can be made in terms of IPP. The survey was only sent to the managed NHS sector and is not reflective of primary care or community pharmacy. One of the next steps is for regions to use the results of the questionnaire in combination with the PWRES data to develop and implement local action plans to address these issues. Reference 1. NHS England. Pharmacy Workforce Race Equality Standard Report 2023. [Accessed 4th June 2024]. Available from https://www.england.nhs.uk/long-read/pharmacy-workforce-race-equality-standard-report/

Term limits and accountability incentives to perform: performative signalling of local governmental action

ABSTRACT Research exploring term-limits’ influence on politicians’ behaviour has mainly focused on financial measures of government performance. However, other dimensions of performance which can be used by politicians to claim credit and boost their political careers have seldom been explored in this research agenda. Leveraging the lift of the reelection ban for Mexican mayors after 2014, we study the electoral incentives of term limits on local government performance. We use a difference-in-difference design and compare first-term mayors, thus discarding alternative mechanisms such as differences in competence due to longer tenure. Municipalities where reelection is allowed report more municipal council meetings. Yet, term limits fail to affect the initiatives presented per meeting, administrative procedures on behalf of citizens, nor water provision. Thus, while term limits affect performance incentives for local politicians via accountability and electoral incentives, these focus on more visible and performative actions that serve as inexpensive signals of governmental activity.

Decoupling by Local Random Unitaries without Simultaneous Smoothing, and Applications to Multi-user Quantum Information Tasks

We show that a simple telescoping sum trick, together with the triangle inequality and a tensorisation property of expected-contractive coefficients of random channels, allow us to achieve general simultaneous decoupling for multiple users via local actions. Employing both old (Dupuis et al. in Commun Math Phys 328:251–284, 2014) and new methods (Dupuis in IEEE Trans Inf Theory 69:7784–7792, 2023), we obtain bounds on the expected deviation from ideal decoupling either in the one-shot setting in terms of smooth min-entropies, or the finite block length setting in terms of Rényi entropies. These bounds are essentially optimal without the need to address the simultaneous smoothing conjecture, which remains unresolved. This leads to one-shot, finite block length, and asymptotic achievability results for several tasks in quantum Shannon theory, including local randomness extraction of multiple parties, multi-party assisted entanglement concentration, multi-party quantum state merging, and quantum coding for the quantum multiple access channel. Because of the one-shot nature of our protocols, we obtain achievability results without the need for time-sharing, which at the same time leads to easy proofs of the asymptotic coding theorems. We show that our one-shot decoupling bounds furthermore yield achievable rates (so far only conjectured) for all four tasks in compound settings, which are additionally optimal for entanglement of assistance and state merging.

Evolution of amplitude and longitude phase of tachocline Rossby waves diffusing to the photosphere

ABSTRACT Physics of magnetohydrodynamic (MHD) Rossby waves in the tachocline-layer were studied by Dikpati et al., using a fluid-particle-trajectory approach along with solving vorticity and induction equations. By extending that model to include a hydrodynamic turbulent convection zone (CZ), we examine how MHD Rossby waves generated in the tachocline might diffuse upward through the CZ to solar surface. We find that pure hydrodynamic Rossby wave amplitudes decline with height due to viscous diffusion at a rate that is independent of viscosity and increases with longitude wavenumber. Fast MHD Rossby waves amplitude declines faster with height for increasing toroidal field, due to their longitude-phase shifting with height, which increases dissipation of kinetic energy in the wave velocities. Slow MHD Rossby waves decline even faster with height because their longitude-phase shifts more rapidly with height, due to their slow phase speed. We conclude that low wavenumber HD and fast MHD Rossby waves, originating in the tachocline, might be detected at the photosphere, but slow MHD Rossby waves should be virtually impossible to detect. We infer from fluid particle trajectories that wave amplitudes declining with height and longitude phase shifting with height associated with decline, implies a powerful mechanism for tangling of magnetic fields, distinct from convective turbulence effects. This could cause a sustained or dissipative local dynamo action triggered by Rossby waves.

NHS action on social and economic development in England: Vague national policy expectations

Under recent reforms to the National Health Service (NHS) in England, NHS organizations have been given new objectives to contribute to social and economic development. Health systems in other high-income countries are pursuing related approaches. This paper analyses national policy documents to understand the framing of the NHS's new policy priorities on social and economic development. We focus on the role of NHS integrated care systems—area-based planning bodies responsible for managing NHS resources and coordinating local services. National policy is vague about what social and economic development means in practice. There is limited guidance on which approaches local organizations should prioritize, and which organisations are responsible for implementation. Greater clarity from national policymakers and an overarching framework to guide local action is needed to reduce the risk of inaction, poorly targeted interventions, and missed opportunities for learning and evaluation. Policymakers and health system leaders also need to be realistic about the limits of local action given the importance of national public policy choices in shaping the social determinants of health. Coordinated policy action and investment across government is needed to address underlying social and economic conditions.

Magnetic assembly of microwires on a flexible substrate for minimally invasive electrophysiological recording

Understanding the neural system in the brain requires the detection of signals from the tissue. Microscale electrodes enable high spatiotemporal neural recording, whereas traditional microelectrodes cause material and geometry mismatches between the electrode and the tissue, leading to injury and signal loss during recording. In this study, we propose a fabrication technique that uses magnetic force to facilitate assembly of vertical microscale wire-electrodes on a flexible substrate. Two-channel 15-μm-diameter and 400-μm-length nickel-microwire electrodes on a 5-μm-thick flexible parylene film are designed and fabricated. Impedance characteristics of these electrodes are <500 kΩ at 1 kHz, with output/input signal amplitude ratios of over 90%. In vivo acute neural recording in mice demonstrates that both local field potentials and action potentials are detected through each wire electrode, confirming the minimal invasiveness during the electrode penetration and through immunohistochemical tissue analysis.

Coordinating multi-agent reinforcement learning via dual collaborative constraints

Many real-world multi-agent tasks exhibit a nearly decomposable structure, where interactions among agents within the same interaction set are strong while interactions between different sets are relatively weak. Efficiently modeling the nearly decomposable structure and leveraging it to coordinate agents can enhance the learning efficiency of multi-agent reinforcement learning algorithms for cooperative tasks, while existing works typically fail. To overcome this limitation, this paper proposes a novel algorithm named Dual Collaborative Constraints (DCC) that identifies the interaction sets as subtasks and achieves both intra-subtask and inter-subtask coordination. Specifically, DCC employs a bi-level structure to periodically distribute agents into multiple subtasks, and proposes both local and global collaborative constraints based on mutual information to facilitate both intra-subtask and inter-subtask coordination among agents. These two constraints ensure that agents within the same subtask reach a consensus on their local action selections and all of them select superior joint actions that maximize the overall task performance. Experimentally, we evaluate DCC on various cooperative multi-agent tasks, and its superior performance against multiple state-of-the-art baselines demonstrates its effectiveness.

Exploring the perceived dynamic system driving inequities in the community obesogenic environment

Abstract Introduction Persons in socioeconomically disadvantaged situations (PSEDS) are more susceptible and disproportionally exposed to obesogenic environments, resulting in poorer dietary outcomes and lower levels of physical activity. This study aimed to map the complex dynamic system within the community obesogenic environment driving unhealthy eating and insufficient physical activity among PSEDS in Flanders, and to identify potential local actions. Methods Participatory group model building (GMB), a qualitative system dynamics method, was used to engage PSEDS (n = 7), local decision makers (n = 7) and local stakeholders (n = 5) in two Flemish municipalities. A two-day GMB session was held in each municipality during which a causal loop diagram (CLD) was created and potential local actions were identified by considering causal pathways and reinforcing loops in the system. Results The CLD was designed around two main variables (i) healthy eating and (ii) physical activity among PSEDS. Seven sub-systems could be identified: 1) social environment, 2) facilities and activities, 3) mobility options, 4) information, 5) affordability, 6) safety (specifically for physical activity), and 7) industry and advertisement (specifically for eating behaviour). Several actions to improve the local environment to promote eating behaviour and physical activity among PSEDS were identified. Conclusions The CLD illustrates the complex interactions between individual and environmental determinants contributing to inequalities in eating behaviour and physical activity by including multiple perspectives of community members in socioeconomically disadvantaged situations, local decision makers and local stakeholders. Both the participatory GMB approach and the final CLD visualization can provide the basis for planning local actions for promoting healthy eating behaviour and physical activity among PSEDS. Key messages • Group model building is an effective approach to explore and understand a dynamic complex system through a shared understanding among diverse stakeholders. • A systems approach is valuable to provide a more comprehensive and context-specific understanding of the perceived factors contributing to inequities in the obesogenic environment.

Co-planning as a public health tool: the Milan Health Protection Agencies’s Local Gambling Plan

Abstract Issue/problem Gambling represents a public health, social, and economic problem. Lombardy Region, according with national and regional law, has approved the Regional Plan for the prevention and contrast of Pathological Gambling. The Health Protection Agencies (HPA) of the Metropolitan City of Milan, as the other HPAs, implemented the Local Gambling Plan, based on a context analysis and in synergy with all the actors involved. Description of the problem Since 2019, the Milan HPA’s Local Gambling Plan has been implemented through collaboration with non-profit entities (TSEs), which are involved via public tendering. The implementation of the new Italian ‘Code of the Third Sector’ changed the TSEs engagement modalities. For this reason, a complex co-planning process has been initiated in order to increase the level of active citizenship and to enhance public health, in line with horizontal subsidiarity principle. Results The Co-planning procedure promoted the integration among local health services, non-profit entities and municipalities with the aim of gambling prevention and contrast, ensuring the continuity of prevention programs and the involvement of local stakeholders in addressing a public health issue. During the co-planning, 9 working groups were established to define objectives, project actions, monitoring and evaluation methods, ensuring the common interest of all actors involved. Lessons For the health and social system, the co-planning procedure becomes an opportunity to translate what is foreseen by the regulations into local actions. It allow the active participation of local stakeholders involved into the co-construction and achievement of public health objectives and the promotion of communities’ empowerment. Key messages • Co-planning is both a process and a tool for local welfare. • Co-planning involved multiple actors, among which the public institution that ensures satisfaction of health needs through governance actions.

What characterizes the eldercare debut? A registry-based study of pre-entry health care use

Abstract Introduction Timely identification of needs due to functional loss in old age is important. Policy guidelines requires local collaborative care action. Eldercare debut circumstances are poorly investigated from a collaborative perspective. This study explored the socio-demographic characteristics, functional status and patterns of health care use leading up to the first application for eldercare, and how older people’s intensity of primary care use was associated with their intensity of granted eldercare at debut. Methods Data on socio-demographics, functional status, and informal care in people ≥65 years (July ‘21 to June ‘22; n = 3,649) were combined with data on inpatient and outpatient care six months preceding debut in Stockholm, Sweden. Descriptive and regression statistics were used. Results Every second person debuted following a hospital stay and one in four had extensive functional limitations. The majority made one or two visits in primary care, but 13% had a high intensity of use and 20% made no visits at all. More than half received informal care weekly or daily. Non-use and high use of primary care were both significantly associated with increased probability of receiving high intensity of eldercare. Conclusions and implications The intensity of primary care use can provide an indication of people’s intensity of eldercare at debut, which is important for resource allocation. Deeper collaboration between eldercare and primary care actors can facilitate early identification of people in need of support, thereby alleviating individual suffering, enabling secondary and tertiary prevention, and optimizing the management of welfare resources. Key messages • The intensity of primary care use can provide an indication of people’s intensity of eldercare at debut. • Deeper collaboration between eldercare and primary care actors can facilitate early identification of older people with social support needs.

Mobile street clinics and harm reduction: pathways to provide care to homeless people in Brazil

Abstract Homeless people (HP) are defined as a heterogeneous group that lives in extreme poverty, with weakened or severed family ties, lacking access to conventional housing, and using public spaces as residence. In terms of health, mental health conditions are prominent as a primary treatment demand, with care aimed at addressing needs arising from the use of alcohol and other drugs being a priority in serving HP. In this context, mobile street clinics (MSC) provide health services directly in street environments, focusing on individuals who use alcohol and other substances through harm reduction approaches. Harm reduction is defined as a set of practices aimed at minimizing the adverse health effects of alcohol and drug use without necessarily eliminating usage. Moreover, it represents an ethical and political direction in care, confronting the logic of criminalization and compulsory abstinence, enhancing access to health care for alcohol and other drug users through strategies that foster autonomy development. In the current study, we conducted an integrative review assessing the facilitators and barriers for HP access to mental health services. Preliminary results indicated that MSC, the connection between healthcare workers and the HP they serve, and the implementation of local street-based actions were the main facilitators of access for individuals who engage in harmful use of alcohol and other drugs to mental health services. Conversely, stigma, services’ lack of adjustment to the lifestyles of homeless people, and excessive bureaucracy were identified as the principal barriers of access. MSC, through their harm reduction activities, have emerged as a potential care technology to facilitate access to health services for homeless people. This research aims to present harm reduction as an ethical and political direction of care through the actions of mobile street clinics, as a way to facilitate access to health services for the homeless people. Key messages • Homeless people require mental health care tailored to the use of alcohol and other drugs, and harm reduction strategies implemented through mobile street clinics prove to be an effective form of care. • Mobile street clinics and harm reduction are important care technologies that enhance access to health services for the homeless population.

Customised Methodology to Assess and Measure Effectiveness of Integrated Landscape Management Relevant Multi-Stakeholder Transformative Governance, Incorporating Rights-Based Planning and Tenure Aspects, Applied in Kenya, Nigeria, and Viet Nam

Different thinking and strategies are needed to transform our food systems at different scales. Food systems can be changed towards a more sustainable path through multi-stakeholder transformative governance at the landscape level because that is where national-level visions, objectives, and policies meet with local practice, priorities, and actions. Concrete and practical guidance on how to effectively put a multi-stakeholder transformative governance process into practice is missing. Through the Global Environment Facility (GEF) funded ‘Food Systems, Land Use and Restoration Impact Programme’, led by the World Bank, countries are supported in integrated landscape management (ILM) to ensure that production systems are embedded within wider landscapes to safeguard the natural capital and ecosystem services on which they depend. A customised methodology to assess and measure the effectiveness of ILM-relevant multi-stakeholder transformative governance, incorporating rights-based planning and tenure aspects, has been developed that makes governance explicit in the ILM process. This methodology aims to improve landscape-level institutional coordination, coherence, and collaboration through enhanced horizontal and vertical coordination and network dynamics. The conceptual framework of the customised methodology and how to operationalise it are explained and illustrated with the application in the country projects in Kenya, Nigeria, and Viet Nam. Making transformative governance explicit within the ILM process at the landscape level will require investments in time and capabilities, but allows governance to act as a catalyst towards more sustainable pathways.