Macro Level Research Articles

The Doctors, Their Patients, and the Symptom Checker App: Qualitative Interview Study With General Practitioners in Germany

Background Symptom checkers are designed for laypeople and promise to provide a preliminary diagnosis, a sense of urgency, and a suggested course of action. Objective We used the international symptom checker app (SCA) Ada App as an example to answer the following question: How do general practitioners (GPs) experience the SCA in relation to the macro, meso, and micro level of their daily work, and how does this interact with work-related psychosocial resources and demands? Methods We conducted 8 semistructured interviews with GPs in Germany between December 2020 and February 2022. We analyzed the data using the integrative basic method, an interpretative-reconstructive method, to identify core themes and modes of thematization. Results Although most GPs in this study were open to digitization in health care and their practice, only one was familiar with the SCA. GPs considered the SCA as part of the “unorganized stage” of patients’ searching about their conditions. Some preferred it to popular search engines. They considered it relevant to their work as soon as the SCA would influence patients’ decisions to see a doctor. Some wanted to see the results of the SCA in advance in order to decide on the patient’s next steps. GPs described the diagnostic process as guided by shared decision-making, with the GP taking the lead and the patient deciding. They saw diagnosis as an act of making sense of data, which the SCA would not be able to do, despite the huge amounts of data. Conclusions GPs took a techno-pragmatic view of SCA. They operate in a health care system of increasing scarcity. They saw the SCA as a potential work-related resource if it helped them to reduce administrative tasks and unnecessary patient contacts. The SCA was seen as a potential work-related demand if it increased workload, for example, if it increased patients’ anxiety, was too risk-averse, or made patients more insistent on their own opinions.

Health service provider views on measuring patient involvement in healthcare: an interview study with researchers, clinicians, service managers, and policymakers.

There are several strategies used to assess involvement in their healthcare across service providers. However, there is no consensus on the most appropriate measurement tool to use when evaluating patient involvement initiatives. This qualitative study aimed to explore the perspectives of stakeholders from micro, meso, and macro levels within the Danish healthcare system on measuring patient involvement in their healthcare. This descriptive, explorative study employed semi-structured interviews with open-ended questions to elicit participants' views and experiences of patient involvement and measurement tools. A purposeful sample of participants was identified, to include decision makers, researchers, and health professionals (n = 20) with experiences of measuring patient involvement in healthcare at micro, meso, and macro levels across Danish organizations. Data underwent reflexive thematic analysis. Three main themes were identified: 1) Determining the purpose of patient involvement practices and measurement alignment; 2) Reflecting on the qualities, fit, and usefulness of measures; 3) Recognizing conflicting stakeholder paradigms. Despite the interest in and positive attitudes toward patient involvement innovations, views on the meaning and value of evaluating involvement varied; in part, this was attributable to challenges in selecting criteria, methods, and measures for evaluation. The findings indicate the need to integrate the perspectives of all key stakeholders in designing the evaluation of patient involvement initiatives. The application of a multiple stakeholder approach and co-production of a multidimensional evaluation may provide some common ground for selecting evaluation criteria and measurement tools in the healthcare setting. Danish Data Protection Agency (1-16-02-400-21) 15 October 2021.

How does it end? Endpoints of boundaries lead to completion in macro-events.

While watching someone kicking a ball, missing moments of ball contact can be incorrectly identified as seen if the event is continued in a causal manner (i.e., the ball flying off). Does event completion also occur for events of a larger scale such as having breakfast (macro-event), which consists of multiple sub-steps like toasting bread (micro-event)? We conducted two experiments to measure event completion in macro-events presenting portions of multiple micro-events. In Experiment 1, video summaries were formed with or without event boundary information where a macro-end was either present or absent. Macro-end signified an overarching goal achievement that signaled the completion of previous tasks (such as leaving the kitchen with a full breakfast plate). More completion occurred for summaries with event boundary information and macro-ends. In Experiment 2, we tested two alternative hypotheses to explore the underlying process by showing the beginnings or ends of a micro-event. While the predictive processing hypothesis suggests that event completion is based more on predicting the future states of the event based on beginning information, the backward inferences hypothesis suggests that event completion relies more on deductions formed after the fact based on event endings. Results of Experiment 2 suggest that the ends of event boundaries lead to more event completion, possibly due to their role in forming causal connectivity. These results help to further understand event completion on a macro level.

The Emperor and the New Clothes: Engaging the Frivolity of Ethical and Moral Leadership as Espoused Values Against the Values of use

University Education in South Africa has been a subject of transformation in systematic ways and over time. This has had to call upon the multi-dimensional approaches (about MLG Systems and Practices) due to the complexity of the subject. While remarkable progress has been made, and can be evidenced by empirical data, such developments remain elusive for some universities within the sector. Strangely, even the considerable highly ranked universities have not been spared from what can be argued as the complexity of power relations in the politics of knowledge and of being and becoming. This article is based on this issue about complexity in university education, which can play out more as the continuities than what should be the discontinuities from the old regimes of power and of truth. A Case study approach was applied as a methodology, with the actual methods about data management including organisational records, content analysis and critical discourse analysis, over time. Informing such an approach was the ideal of ensuring the theory-methodology-practical program aspects of a potentially credible scholarship project. As such the social realist theory, informed by the critical realist philosophy, served as the anchor of the study that this article is reporting on. The findings relate to what can become the enduring management, leadership and governance crisis in the case of university education, thus constituting the micro politics of being and becoming, despite what can be reported about the same case at macro level. Such cases call upon scholarly critiques if the practical alternatives might constitute the realms of new possibilities. The potential value of the study can be the enhanced dialogue and sustained conversations about the role of management, leadership and governance systems in university education, which have to be maintained and sustained by the idea of ethical and moral practices in pursuit of what ought to be the public and common good.

The impact of digital technology and technological innovation on environmental attitudes——insights from a cross-country survey

ABSTRACT The evolving landscape of digital technologies and technological innovations is reshaping our relationship with the environment. While empirical studies at the micro level have extensively examined the separate impacts of these advancements on environmental attitudes, a significant gap persists in understanding their collective influence at the macro level. To address this gap, our study investigates the impact of digital technology and technological innovation on environmental attitudes using data from 44,622 surveys across 28 countries, sourced from the International Social Survey Program. Our analysis reveals that country-level digital technology and technological innovation significantly influence individuals’ environmental attitudes. At the individual level, factors such as air pollution, the quality of the individual’s living environment, and education level play crucial roles in shaping these attitudes. Additionally, public trust in the media plays a significant moderating role in the relationship between digital technology and environmental attitudes. Our research contributes to the literature by simultaneously examining these factors at both individual and national levels. To gain citizens’ attitudes toward environmental protection, there is a need to strengthen the integration of technological innovation and environmental protection and to improve the authenticity of mass media materials while focusing on environmental governance.

Responsible Leadership - Knowledge Status and Future Research Agenda

The present review article deals with the highly relevant and rich research field of responsible leadership (RL). It summarizes existing literature using a wide scope of 96 peer-reviewed journal articles and subsequently provides recommendations for future research paths. The current state of knowledge is depicted in relation to five knowledge areas: In the first area, the conceptualisation of RL, works addressing fundamental views on RL, the development of frameworks and the application of specific philosophies or theories are introduced. In the second area, the operationalisation of RL, results of studies dealing with the development of measurement instruments or applying quantitative empirical study designs in order to test specific research questions are presented. The third area, RL antecedents, covers the depiction of empirically investigated antecedent variables pertaining to either a personal or a contextual level. In the fourth area, RL consequences, empirically examined impacts of RL at a micro, meso and macro level are summarised and further works dealing with effects of RL on relationships between other variables discussed. Finally, the fifth area of RL promotion presents works that are empirically testing RL development interventions that take place either in the context of higher education or work. Derived potential lines of research relate to these five areas of knowledge and address identified research gaps of content-related, empirical and methodological nature.

Social protection comparison across the world: a study of fiscal, structural and institutional performance discrepancies

PurposeSocial protection states the public-mandated (strategies and programmes) to address the vulnerability and risk among poor and near-poor households. Social protection must not only help people meet their basic needs but also contribute to the long-term well-being and broader societal goals of equity, social justice and empowerment. The role of social protection in achieving these goals has not been adequately documented. This paper examines the performance of the social protection mechanism from the perspective of the regional structural and institutional performance indicators. Social protection outlay dynamics are synthesized in the structural and institutional conducts.Design/methodology/approachA world regional comparability is made by considering the panel dataset for the time interval 1995–2020. In empirics, the unconditional and conditional ranks are constructed, and regression analyses are made subject to (1) the fiscal constraint of social protection, (2) structural performance indicators and (3) the institutional performance indicators of the targeted regions across the globe. The fully modified-ordinary least square (FM-OLS) method is used to construct the ranks.FindingsThe rank analysis demonstrates that the developed regions (i.e. Europe, Central Asia and North America) have relatively good welfare standards and fiscal capacity for social protection drives compared to the developing/underdeveloped regions (i.e. Sub-Saharan Africa and South Asia). The structural/institutional performance indicators have shown their significance in determining/utilizing their budget for social protection and maintaining welfare standards. Interestingly, most developed regions are relatively reluctant to maintain the structural/institutional performance for the determination/execution of the funds for social protection as compared to the developing and underdeveloped regions.Practical implicationsIn policy discourse, this research suggests that governments must make some market operations to enhance their regions’ structural and institutional performance to get better outcomes of social protection spending in the form of attractive welfare standards.Originality/valueMultiple studies have been done considering the social protection dynamics at nano, micro and macro levels, while this study considered the mega dataset across the globe to analyse the social protection dynamics in consideration of structural and institutional performances.

Addressing the Sense of School Belonging Among All Students? A Systematic Literature Review

The sense of school belonging plays an important role in students’ academic, behavioural, and psychological outcomes. Based on a systematic review, following the PRISMA 2020 guidelines and examining 86 studies conducted between 1990 and February 2023, the article addresses two research questions: (a) what are the predictors of the sense of school belonging at the individual, micro, meso, exo, macro, and chrono levels of the bioecological model of human development; (b) do these predictors differ based on students’ individual characteristics, and if so, how. The findings reveal individual factors as important predictors of school belonging and indicate the lack of studies that take into consideration the interplay of different (micro, meso, exo, macro, chrono) levels in addressing the sense of school belonging. Considering the complexity and multi-factorial nature of the sense of school belonging, it calls upon further research, which would support the development of evidence-based interventions for fostering school belonging among different groups of students, particularly those who are at risk of feeling alienated from school, and thus promote equity in education.

Sustainable Development of the Cultural and Creative Industries in the Post-Pandemic Era: A Case Study of the Animation Industry in China

As a novel development concept and model, the cultural and creative industries have become an important sector of the global economy owing to their diverse development pathways. In particular, the animation industry surpasses traditional sectors in scale. This industry demonstrated unprecedented resilience during the COVID-19 pandemic, highlighting its critical significance in the global economy. In this study, the SWOT (strength, weakness, opportunity, and threat)-PEST (political, economic, social, and technological factor) analytical model was employed to systematically assess various properties of the animation industry in China. Through an in-depth analysis of both internal and external factors affecting the industry and in consideration of conditions in the post-pandemic era, industrial development strategies across macro, meso, and micro levels were proposed to improve the existing development system. It was found that policy guidance at the macro level, improving the industry chain, integrating technologies at the meso level, and expanding target markets and financial channels at the micro level are key strategies for the continued development of the industry. This study offers new insights and directions for the sustainable development of the animation industry in China.

‘The Patriarchy Is Finished’: Broadcasting Women’s Emancipation on RIAS Berlin

Abstract This article examines a sudden shift in women’s radio programming in the late 1950s at RIAS Berlin (Radio in the American Sector Berlin). The American-led propaganda radio station had been established in 1946 to support democracy in West Berlin and then also to combat Communism in East Germany. From its initial broadcast day, RIAS targeted female audiences with a mix of household tips and political analysis that highlighted the ways the Communist regime worked against women. However, in 1957 the women’s division began to critique conservative gender norms in arguing for female equality in West Germany. RIAS introduced a new program, the soap opera Gaby and Franz, that modelled a more companionate form of marriage. At the same time, its established women’s programs, including Can You Spare 5 Minutes?, highlighted obstacles to the full realization of legal reforms such as the Law for the Protection of Mothers of 1952 and the Equal Rights Law of 1957. To promote women’s rights in the Federal Republic, the women’s division adapted the presentation style designed to fight East German Communism. Drawing upon scripts held by Deutschlandfunk Kultur, the successor station to RIAS, the article argues that radio offered an ideal medium for women to press for gender equality at the micro level of the home and the macro level of policy well before the women’s rights movement of the late 1960s.

Exploring the barriers to the development of organizational health literacy in health institutions to meet the needs of older patients from multiple perspectives: a mixed-methods study

BackgroundThe latest evidence on health literacy in China revealed that only 8% of individuals aged 65–69 years, a segment of the geriatric population, possess adequate health literacy levels, indicating a low level in China. Studies have demonstrated that improving the organizational health literacy of healthcare institutions is a crucial approach to addressing low health literacy among older patients.ObjectiveTo explore the obstacles hindering the advancement of organizational health literacy in healthcare institutions in meeting the needs of older patients.DesignA mixed-methods approach was employed to investigate both the status and barriers to the establishment of organizational health literacy within two healthcare institutions.ParticipantsParticipants included older individuals aged over 60, clinical staff, and managerial personnel from these two health institutions.MethodsThis research utilized the social-ecological model as its theoretical foundation and utilized a mixed-methods approach to examine the current status and challenges in developing organizational health literacy within healthcare institutions. Initially, a survey using a questionnaire (n = 178) was conducted among older patients to evaluate the establishment of organizational health literacy from their perspective. Following this, interviews (n = 22) were carried out with administrators, clinical personnel, and elderly patients to identify the barriers hindering the development of organizational health literacy within healthcare institutions.ResultsQuantitative research indicates that health institutions have been less accommodating to the requirements of older patients, with health information dissemination and communication emerging as the weakest areas. Qualitative investigations revealed three key influencing factors: patient-related factors, including physiological and cognitive decline, as well as low educational attainment among older patients; organizational factors, including inadequate clinical staff numbers, deficient long-term systematic training, and a digital divide resulting from health institutions’ digital advancements; and policy-related factors indicating a lack of regulations governing the establishment of organizational health literacy within healthcare institutions.ConclusionThe two most vulnerable aspects of OHL in medical institutions regarding the needs of older patients are health information and communication. The factors influencing the construction of OHL in medical institutions are multifaceted, encompassing micro, meso, and macro levels. At the macro level, it is essential for medical institutions to enhance leadership awareness of OHL and to incorporate its development into institutional strategic plans. At the meso-level, medical institutions should be made to optimize the medical environment for elderly patients and to prioritize health literacy training for medical staff. At the micro level, attention must be given to the characteristics and needs of elderly patients. Ultimately, by implementing a comprehensive construction of intervention strategies, the response ability of medical institutions to the needs of elderly patients can be enhanced.

The Context of the Emergency Department as a Location for a Smoking Cessation Intervention-Process Evaluation Findings From the Cessation of Smoking Trial in the Emergency Department Trial.

Hospital emergency departments (ED) offer an opportunity to engage with large numbers of people who smoke to prompt cessation, although the acceptability of opportunistic intervention in this context has been questioned. This process evaluation study was embedded into the Cessation of Smoking Trial in the Emergency Department (COSTED) randomized controlled trial and sought to explore the context of intervention delivery within the ED. Qualitative interviews were conducted with participants and staff across six EDs participating in the COSTED randomized controlled trial. Interview data were thematically analyzed specifically exploring contextual influences. Data were triangulated with ethnographic observations. In participant interviews (N = 34), it was acceptable overall to receive a brief opportunistic smoking cessation intervention in the ED. Contextual factors are impacted at a range of levels. At the micro level participant views and experiences combined with staff tailoring were important. Being given an e-cigarette starter kit by a "credible source" helped to legitimize vaping for smoking cessation and gave confidence in personal ability to switch away from tobacco. At the meso level, adaptations to intervention delivery were made in response to the context of the ED. Stop smoking advisors (N = 11) had to adapt and deliver the intervention flexibly depending on space and clinical need. At the macro level, hospital policies supportive of vaping legitimized the approach. Smoking cessation outcomes reported in the main trial across sites were very similar because of the high credibility, acceptability, and flexible approach to delivering the COSTED intervention in the ED. Attending a hospital ED is the right time and place to receive smoking cessation intervention, even for those not motivated to quit. People are willing to receive intervention, and clinical staff are willing to support intervention delivery. Despite challenges, overall the context is helpful in supporting people to switch away from tobacco. The intervention, with flexible and tailored implementation, is adaptable to different ED contexts. This suggests that wider implementation across NHS Trusts of the effective COSTED intervention is feasible and will ultimately support smoking cessation for people attending EDs, who may not otherwise have sought support.

Meta4CBC: Metamodel for Competency-Based Curriculum Design in Higher Education

Meta4CBC is proposed as an innovative metamodel for competency-based curriculum design in higher education, addressing the critical need to adapt curricula to contemporary challenges driven by globalization, technological advancement, and climate change. Inspired by the Business Motivation Model and Semantics of Business Vocabulary and Business Rules metamodels, Meta4CBC seeks to overcome the limitations of current CBCD models by providing a coherent structure that integrates curriculum components at supra, macro, meso, micro, and nano levels and establishes a common language that facilitates interdisciplinary collaboration. The proposal promotes curriculum alignment and coherence while supporting the development of software tools to assist in curriculum design, automate repetitive tasks, and provide data analysis for informed decision-making. The validation of Meta4CBC was conducted through a multi-step methodology involving proof of concept, expert judgment, and practical application. After defining the components through a systematic literature review, the metamodel was tested in the Computer Engineering program at the University of La Frontera. This testing verified its adaptability and alignment across curriculum levels. Experts from various Chilean universities reviewed the model, providing feedback for refinement.

Tekstmarkering, kommentarar og metaspråk

How do students in the second year of upper secondary school (vg2) comment on each other’s texts, which text aspects are emphasized and what meta-language do they use in such comments? The article presents a study of first drafts of academic articles in two vg2 classes, where students provide each other with feedback in the form of markings and comments. The texts are part of a text exchange project between two different classes from different parts of the country, where students provide anonymous feedback to the students in the other class. In addition to a classification of the comments with regard to text aspect and the functions of the comments, the specific meta-language the students use is examined more closely. The analysis shows that the students have a good balance between form and content and between micro and macro level in their text comments. At the same time, both praising and directive comments are largely general, which can make them less suitable as a basis for revision. All in all, it seems that the students have stronger and more explicit competence in the overall content and text organization aspects of the texts than is the case for form aspects and language systemic aspects. It is also related to the overall organization of the texts that they to the greatest extent display the use of an expanded meta-language.

Joint Learning of Volume Scheduling and Order Placement Policies for Optimal Order Execution

Order execution is an extremely important problem in the financial domain, and recently, more and more researchers have tried to employ reinforcement learning (RL) techniques to solve this challenging problem. There are a lot of difficulties for conventional RL methods to tackle the order execution problem, such as the large action space including price and quantity, and the long-horizon property. As naturally order execution is composed of a low-frequency volume scheduling stage and a high-frequency order placement stage, most existing RL-based order execution methods treat these stages as two distinct tasks and offer a partial solution by addressing either one individually. However, the current literature fails to model the non-negligible mutual influence between these two tasks, leading to impractical order execution solutions. To address these limitations, we propose a novel automatic order execution approach based on the hierarchical RL framework (OEHRL), which jointly learns the policies for volume scheduling and order placement. OEHRL first extracts the state embeddings at both the macro and micro levels with a sequential variational auto-encoder model. Based on the effective embeddings, OEHRL generates a hindsight expert dataset, which is used to train a hierarchical order execution policy. In the hierarchical structure, the high-level policy is in charge of the target volume and the low-level learns to determine the prices for a series of the allocated sub-orders from the high level. These two levels collaborate seamlessly and contribute to the optimal order execution policy. Extensive experiment results on 200 stocks across the US and China A-share markets validate the effectiveness of the proposed approach.

You play the bad guy: how foreign direct investment affects zombie firms in China

This paper investigates the impact of foreign direct investment (FDI) on zombie firms at both the macro and micro levels, revealing a significant negative effect on their prevalence at the city level. Our results show that FDI accelerates zombie firm exits as local governments cease subsidies, recognizing that foreign firms can sustain local economic growth. This result is robust to alternative methods of identifying zombies, alternative measures for FDI, and diverse regression methodologies. This shift is predicated on the recognition that foreign firms can sustain local economic growth. Consequently, financial constraints and profitability among zombie firms deteriorate significantly, while healthy firms remain unaffected. These results support the crowding-out effect but find no evidence for technology spillover, challenging some conventional expectations about the benefits of FDI. Our findings contribute to a nuanced understanding of FDI spillover effects and its role in the targeted disposal of non-viable firms.

An adaptive bionic sensor: enhancing ankle joint tracking with high sensitivity and superior cushioning performance

Flexible sensors are renowned for their rapid responsiveness, high flexibility, and outstanding mechanical properties, making them ideal for applications in wearable devices, sports and health monitoring, and human-machine interfaces. To enhance the sensing performance of these flexible sensors, researchers have drawn inspiration from nature, creating various bionic microstructures. However, these structures often manifest in the macroscopic form of thin films, which do little to improve impact resistance and joint protection. In response, this work achieves a highly sensitive and impact-resistant pressure sensor by integrating bionic principles at both micro and macro levels. Specifically, at the micro level, a muscle-like hydrogel system consisting of MXene nanosheets incorporated into the double network of polyvinyl alcohol and sodium alginate matrix is selected. At the macro level, the bionic prototypes of mimosa leaves and durian spikes with good energy absorption structure, together with octopus’ sucker with good adsorption capacity are selected, and the synergistic construction of the three structures is realized through 3D printing methods. The obtained sensor has an appropriate response range, sensitivity and stability. More importantly, the displacement deformation of the hydrogel can be reduced by 91.22%, while its adhesion strength can be increased by 57.5% compared to the unstructured hydrogel. As a proof-of-concept, the proposed bionic flexible sensor can be used to monitor the motion status of the human ankle joint in real-time, thereby assisting users in making real-time judgments on gait health.

Barriers and Facilitators in Lactation Support for the Preterm Mother-Infant Dyad: An Integrated Approach.

Breastfeeding offers significant health benefits for both mothers and infants, particularly preterm infants, where it serves as a therapeutic strategy to reduce mortality and morbidities. However, breastfeeding practices are threatened globally by societal norms and systemic barriers at both micro and macro levels. This paper explores the complex interplay of these barriers and facilitators, focusing on the Neonatal Intensive Care Unit (NICU) setting. Preterm infants face specific feeding challenges due to immature physiological functions, yet evidence supports that strategies like cue-based feeding and individualized care can enhance feeding success and health outcomes. For mothers, initiating and maintaining lactation after preterm birth is critical but challenging, with early lactation support and achieving sufficient milk volume being key predictors of success. Partner support significantly influences lactation outcomes, although more inclusive research is needed for diverse family structures. In the NICU, a multidisciplinary approach to lactation care is vital, emphasizing the need for experienced staff and family-centered practices. NICU design, policies promoting parental presence, and adherence to Baby-friendly Hospital Initiative guidelines further support breastfeeding. This paper aims to provide directives for local breastfeeding policies through an integrated approach, considering societal attitudes and healthcare practices. The findings advocate for improved lactation support in NICUs, inclusive language and policies, and further research into diverse familial and gender roles in breastfeeding.

Making the state care: the role of political willingness and brokerage in Bogota’s new feminist care policy

This article examines the crucial role of political willingness and brokerage in the implementation of Bogotá's new feminist care policy, the ‘System of Care', which aims to address gender and class inequalities and alleviate care burdens on women. Through a combination of ethnographic data and stakeholder interviews, we analyze the intricate political and social processes that underpin the policy's effectiveness. Drawing on academic literature about care work, policy implementation in weak states, and brokerage, we provide a comprehensive understanding of the policy's development and operation, from the inception of the System of Care to its day-to-day functionality within the local Care Blocks. Our findings underscore the significance of political willingness and brokerage at the macro level, along with the importance of debureaucratization and trust-building at the micro level, as key factors contributing to the policy’s success. Yet, the policy innovation also faces several challenges, primarily political uncertainties and the risk of burnout among local Care Block coordinators.

Risks impeding sustainable energy transition related to metals mining

Sustainable energy transition is essential for global climate change mitigation, requiring substantial amounts of metals to support clean energy technologies. However, a key challenge is ensuring the stable metals mining operations while achieving economic viability, social benefits, and environmental responsibilities. Through a comprehensive literature review, this study identifies 30 risks impeding sustainable energy transition related to metals mining at two levels: the micro level risk and the macro level risk. A cross-evaluation method, by considering literature analysis and expert assessments, is proposed to develop a framework of 15 key risks. The findings reveal inappropriate classification in current literature, as the causes, consequences, and certain objective facts of risk events have been categorized as risks by academics. Additionally, there exist conflicting opinions between academics and practitioners on the key risks. Based on the findings, a multi-stakeholder governance approach is proposed to effectively mitigate these key risks and ensure the sustainable energy transition.