Multi-stakeholder Process Research Articles

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.

Building sustainable capacity to adopt, adapt or develop child health guidelines, Malawi, Nigeria and South Africa.

Many national child health guidelines in Malawi, Nigeria and South Africa are outdated and score poorly on rigorous methods and stakeholder participation. In line with the World Health Organization's (WHO) emphasis on local guideline contextualization, the Global Evidence-Local Adaptation (GELA) project supported multistakeholder processes to adapt evidence-informed recommendations for child health in Malawi, Nigeria and South Africa. The GELA project team convened national steering groups, which conducted structured, iterative priority-setting exercises to identify priority topics. We identified appropriate source guidelines by systematically searching and screening available guidelines. We then matched recommendations in potential source guidelines to the relevant questions, and assessed the guidelines for timeliness and quality. Drawing on WHO's guideline process, we applied the GRADE-ADOLOPMENT process to develop contextualized recommendations from existing guidelines. If no source guideline or reviews were identified, we conducted new evidence syntheses. Malawi, Nigeria and South Africa are countries with varying health priorities and systems, all transitioning to universal health coverage. Guideline structures differ between countries, with processes largely led from national health ministries. National guideline groups, supported by GELA researchers and government-academic partners, developed five contextually-tailored child health recommendations. For most of these recommendations, additional evidence was required to inform contextually appropriate national decision-making. Formal capacity-building and on-the-job learning enhanced the competencies of national contributors and researchers in evidence-informed decision-making. Developing context-relevant recommendations requires considerable resources and time. Further investment in strengthening local capacity is needed for sustainable national guideline development.

Implementation of a Co-Design Strategy to Develop a Dashboard to Support Shared Decision Making in Advanced Cancer and Chronic Kidney Disease.

Background: Shared decision making (SDM) is the process by which patients and clinicians exchange information and preferences to come to joint healthcare decisions. Clinical dashboards can support SDM by collecting, distilling, and presenting critical information, such as patient-reported outcomes (PROs), to be shared at points of care and in between appointments. We describe the implementation strategies and outcomes of a multistakeholder collaborative process known as "co-design" to develop a PRO-informed clinical dashboard to support SDM for patients with advanced cancer or chronic kidney disease (CKD). Methods: Across 14 sessions, two multidisciplinary teams comprising patients, care partners, clinicians, and other stakeholders iteratively co-designed an SDM dashboard for either advanced cancer (N = 25) or CKD (N = 24). Eligible patients, care partners, and frontline clinicians were identified by six physician champions. The co-design process included four key steps: (1) define "the problem", (2) establish context of use, (3) build a consensus on design, and (4) define and test specifications. We also evaluated our success in implementing the co-design strategy using measures of fidelity, acceptability, adoption, feasibility, and effectiveness which were collected throughout the process. Results: Mean (M) scores across implementation measures of the co-design process were high, including observer-rated fidelity and adoption of co-design practices (M = 19.1 on a 7-21 scale, N = 36 ratings across 9 sessions), as well as acceptability based on the perceived degree of SDM that occurred during the co-design process (M = 10.4 on a 0 to 12 adapted collaboRATE scale). Capturing the feasibility and adoption of convening multistakeholder co-design teams, min-max normalized scores (ranging from 0 to 1) of stakeholder representation demonstrated that, on average, 95% of stakeholder types were represented for cancer sessions (M = 0.95) and 85% for CKD sessions (M = 0.85). The co-design process was rated as either "fully" or "partially" effective by 100% of respondents, in creating a dashboard that met its intended objective. Conclusions: A co-design process was successfully implemented to develop SDM clinical dashboards for advanced cancer and CKD care. We discuss key strategies and learnings from this process that may aid others in the development and uptake of patient-centered healthcare innovations.

A Review of the Multi-Stakeholder Process for Salmon Recovery and Scenario Mapping onto Stability Landscapes

A Review of the Multi-Stakeholder Process for Salmon Recovery and Scenario Mapping onto Stability Landscapes

Excluding through inclusion: managerial practices in the era of multistakeholder governance

Managerial practices underpin most global policy agendas. Existing research shows how these practices have reshaped the public sector, facilitated the marketization of problems, and altered organizational structures. This article highlights that managerial practices are also a central driver of political marginalization. When incorporated into multistakeholder processes, managerial practices engender two exclusionary processes: the accommodation of dissent and the uniformization of political subjects. They do so by making consensus an organizational goal and by treating politics as a marketplace. Through an examination of the United Nations Food Systems Summit, the article shows how, within multistakeholder models, managerialism sidelines critical voices by invoking ideals of openness, spontaneity, and the absence of rule, rather than traditional principles of ‘command and control’. Additionally, it unpacks the novel roles assumed by private consultancy firms, which are nowadays not only tasked with implementing weighty bureaucratic reforms but are also increasingly involved in ‘optimizing’ political struggles and shaping debates on how societies ought to be governed.

Philanthropy, the 2030 Agenda and UN Diplomacy

Abstract An increasing number of philanthropic organizations (inter alias, POs) are contributing to the implementation of the 2030 Agenda and its 17 SDGs and are involved with the multi-stakeholder process at the UN and other international Organisations. POs’ interest in participating in the SDG process has over the years increased due to the multiple crises that the world has to face caused by pandemics, war, food insecurity, poverty, and climate change. The interventions of POs are in general greatly appreciated but also questioned by some Civil Society Organisations (CSOs) who have some reservations about the intentions of POs. Within the family of UN agencies, several International Organizations (IOs) welcome POs and provide mechanisms of engagement (UN, UNDESA, UNDP, WHO). Some POs are taking part in the implementation of the SDGs and the related UN processes and are creating intermediary actors or organizations and platforms for greater scale and impact. Some POs are interested in creating a joint representation at the UN in the High-Level Political Forum (HLPF). This new development is the subject matter of this short commentary.

Countering social exclusion through inclusive homecare provision: Utilising a participatory life-course approach to influence policy

Homecare models can be effective mechanisms in securing wellbeing and ageing-in-place goals prevalent in health policy agendas. However, the relevance and utility of these models for those living in socially and environmentally insecure conditions has rarely been considered. This is marked by an assumption of in-situ care delivery in private dwellings, and the absence of such groups from homecare development processes. This study aims to harnesses the experiences and preferences of older people in homelessness (OH), older Irish Travellers (OT), and professional stakeholders in an evidence-based co-production of policy recommendations for inclusive homecare provision. The study employed a participatory approach involving the integration of lived experience evidence in a multistakeholder co-production process. Methods comprised: five separate focus groups with OH, OT and service providers (n = 30); two consultative forums involving focus group participants together; and 49 life-course interviews with OH (n = 27) and OT (n = 22) and adults. Findings demonstrate that sizeable gaps in care remain for these groups, and that resource constraints and legislative restrictions prevail for professional stakeholders. Co-produced policy recommendations for inclusive homecare provision based on these experiences and group preferences are presented and discussed.

A Master Protocol Template for Pediatric ARDS Studies.

Pediatric ARDS is associated with significant morbidity and mortality. High-quality data from clinical trials in children are limited due to numerous barriers to their design and execution. Here we describe the collaborative development of a master protocol as a tool to address some of these barriers and support the conduct of pediatric ARDS studies. Using PubMed, we performed a literature search of randomized controlled trials (RCTs) in pediatric ARDS to characterize the current state and evaluate potential benefit of harmonized master protocols. We used a multi-stakeholder, collaborative, and team science-oriented process to develop a master protocol template with links to common data elements (CDEs) for pediatric ARDS trials. We identified 11 RCTs that enrolled between 14-200 total subjects per trial. Interventions included mechanical ventilation, prone positioning, corticosteroids, and surfactant. Studies displayed significant heterogeneity in ARDS definition, design, inclusion and exclusion criteria, and reported outcomes. Mortality was reported in 91% of trials and ventilator-free days in 73%. The trial heterogeneity made pooled analysis unfeasible. These findings underscore the need for a method to facilitate combined analysis of future trials through standardization of trial elements. As a potential solution, we developed a master protocol, iteratively revised with input from a multidisciplinary panel of experts and organized into 3 categories: instructions and general information, templated language, and a series of text options of common pediatric ARDS trial scenarios. Finally, we linked master protocol sections to relevant CDEs previously defined for pediatric ARDS and captured in a series of electronic case report forms. The majority of pediatric ARDS trials identified were small and heterogeneous in study design and outcome reporting. Using a master protocol template for pediatric ARDS trials with CDEs would support combining and comparing pediatric ARDS trial findings and increase the knowledge base.

Human capital development programme for mid-career agricultural extension workers: The case of Sokoine University of Agriculture BSc. agricultural extension and education training programme

Of recent, there is changing work environment for agricultural extension workers as they operate under the multi-stakeholders’ phenomenon. This increasingly poses a challenge to frontline extension workers trained on linear model (extension-researcher-farmer linkage) in extension services delivery. This is because, facilitating the multi-stakeholder processes requires competent agricultural extension workers well-versed in human relations. In recognizing the importance of human capital development for agricultural extension service delivery in Tanzania, Sokoine University of Agriculture established a mid-career agricultural extension training programme in 1998. Informed by the human capital theory, this study employed an evaluative study design to assess the impact of the Sokoine University of Agriculture (SUA) mid-career BSc. Agricultural Extension and Education training programme on human capital development. The study was conducted in five agro-ecological zones, that is, Eastern, Western, Central, Southern Highlands and Lake zones in Tanzania. The development of the sampling frame was done in collaboration with the Ministry of Agriculture (MoA), Ministry of Livestock and Fisheries (MLF) and President’s Office-Regional Administration and Local Government (PO-RALG). A total of 200 respondents-100 alumni and 100 farmers were sampled proportionately. A snowball sampling technique was used to replace the respondents who were selected randomly but could not be reached for interview. Data were collected from respondents through a questionnaire that covered a set of competences through analysis of the mid-career agricultural extension curriculum and consultations with public and private employers. In addition, literature review and observations were also used to supplement the collected information. The findings indicate that the agricultural training programme at Sokoine University of Agriculture (SUA) equipped graduates with appropriate knowledge, competencies and skills that improved their job performance and productive capacities that enabled them to interact with various stakeholders and facilitate multi-stakeholders’ processes. This is in line with the purpose of establishing the programme. Hence, this points to the need for continuous human capital building and motivations of agricultural extension workers for the improvement of their performance. Key words: Mid-career, Agricultural extension workers, Curriculum, Human capital, Multi-stakeholder processes

90 Novel approach for childhood Sjögren’s Disease therapies: multistakeholder design of a series of N-of-1 trials

OBJECTIVES/GOALS: Childhood Sjögren’s disease (cSD) is a rare autoimmune disease. Despite the profound impact on children and their families, pediatric-specific clinical trials to inform therapeutic strategies in cSD are lacking. In 2022 we participated in the Trial Innovation Network (TIN) Design Lab with the purpose of designing a series of N-of-1 trials for cSD. METHODS/STUDY POPULATION: New medications have the potential to be safe/effective treatments for cSD but must be evaluated in randomized trials. To overcome limitations of traditional parallel-group designs given the rarity of cSD, we developed an N-of-1 trial approach. Our proposal was selected by the Tufts TIN Design Lab. The Design Lab multi-stakeholder process involved parents of and patients with cSD, pediatric and adult rheumatologists, and experts in clinical trial design and outcomes. We engaged all stakeholders in protocol development to maximize the impact of the proposed approach on clinical care, ensure a successful recruitment plan, and inform the choice of endpoints as there are no widely accepted cSD outcome measures to determine treatment efficacy. RESULTS/ANTICIPATED RESULTS: Using the Design Lab methodology, we clarified the N-of-1 study goals and engaged in an iterative process to develop a “briefing book” that ensured a sound premise for our study. We reviewed and accumulated published literature to support our focus on mucosal/glandular manifestations, identified potential interventions to be used in the N-of-1 trials, and enumerated possible outcomes, including outcomes important to patient/parents. This work culminated in a full-day Design Lab event that included multiple stakeholders who provided expertise from different perspectives on the full drug development pathway. Study design feedback focused on three specific areas. 1) Inclusion and exclusion criteria; 2) Identification of outcome measures; 3) Treatment and washout periods. DISCUSSION/SIGNIFICANCE: To address the critical need and move treatment of cSD forward, we are designing a prototype N-of-1 trial in children with rheumatic disease. We will continue to engage stakeholders by using a series of Delphi surveys and an in-person meeting to create composite outcome measures to test cSD therapies in personalized trials.

Co-Production Boundaries of Nature-Based Solutions for Urban Regeneration: The Case of a Healthy Corridor

Co-production, rooted in public collaborative management (Ostrom, 1996) or science and technology (Jasanoff, 2013) evolution, has demonstrated its innovative and transformative character within participatory processes. However, there is little empirical evidence that scrutinises these contexts of interaction. Equality of partnership in many cases is used as a discursive rhetoric that seeks to prescribe co-production above any difficulty, uncertainty, conflict, or unwanted situation. As a starting point, our proposal considers co-production as a social practice, composed of multiple layers and different participatory processes, activities, and strategies. Grounded in co-production approaches, the study draws upon the ongoing evaluation findings of the European project URBiNAT, which focuses on inclusive urban regeneration through nature-based solutions. The qualitative methods of evaluation (interviews and participant observation), applied during the co-production activities in the city of Porto (Portugal), provide evidence of how the various stakeholders—elected politicians, citizens, technicians, and researchers—participate in the co-production dynamic. The boundaries of a multi-stakeholder process are revealed with the goal of implementing healthy corridors in peripheral neighbourhoods. The intended evaluation analysis lies in the techniques, the agents, the dynamics, the knowledge, and the degrees of co-production. This analysis will contribute to the lack of explicit consideration of the impacts of nature-based solutions in urban regeneration pathways, especially those related to the social fabric underlined in Dumitru et al. (2020).

Data-driven decision making: Informed healthcare supply chain management

With the evolution and incorporation of artificial intelligence (AI) and machine learning (ML) into so many business models and enterprises, data-driven decision making is assuming an ascendant role among organisational operations. While this work is not intended to negate experiential or intuitive decision making, leaders are encouraged to examine operational decision making through a lens of how experience can be supported by organisationally derived information yielding more effective operational decisions. While experiential learning is beneficial in determining how organisational decisions are being made, data presents why such decisions are made in the first place. More important still, what impact might decisions have on healthcare operations if grounded in ill-informed, ill-defined decision-making processes? Especially within healthcare supply chain operations, decision making should be a collaborative, multidiscipline, multistakeholder process that is best grounded in data-driven approaches. Healthcare supply chain data and analytics can and do provide a valuable framework within which operational decisions should be viewed. Potentially gleaned from this paper will be a perspective relatable to evidence-based analyses permitting the evolution of better-informed leadership decision criteria contributing to tangible organisational resilience, agility and flexibility.

Which Technologies Make Australian Farm Machinery Safer? A Decision Support Tool for Agricultural Safety Effectiveness

This project combined systems engineers, farm safety researchers, work health and safety inspectorate and policymakers with the aim of designing a way in which to reduce fatal farm injury caused by run-overs and roll-overs by tractors and side-by-side vehicles. The team made comparisons between farm machinery and powered mobile plant that is used in the industrial manufacturing, warehousing and logistics, mining, and construction sectors. Current and emerging safety technologies and engineering solutions were collated. Safety standards, legislated engineering controls, retrofit designs, and known ways in which farmers’ workaround safety features were considered. These elements were used as criteria to propose a way to resolve which safety technologies or engineering controls should be recommended for aftermarket retrofitting or incorporated at the original equipment manufacturer design stage. The concept of measuring safety effectiveness to prevent fatal farm injury emerged. This developed into a score sheet and a corresponding matrix to highlight engineering strength and industry acceptance. The project resulted in the conceptual design of the agricultural safety effectiveness score (ASES). The next phase is a multi-stakeholder validation process and a protocol for the scoring system. It requires a hypothesis to test the theory that when safety technologies and engineering solutions are mature in other industries or if they are associated with agricultural productivity gains, their adoption into the agricultural sector is more likely, which in turn will reduce the incidence of tractor and side-by-side run-overs and roll-overs on farms.

Multi-stakeholder Engagement and Development of a Virtual Care Toolkit for Integrated Guideline-Based Low Back Pain Management

Introduction: The abrupt COVID-19 related healthcare closures across Ontario, Canada resulted in a rapidly growing backlog of patients referred to the Provincial Rapid Access Clinics (RACs) Program, designed to manage patients suffering from unmanageable low back pain (LBP). Left untreated or poorly treated, LBP can lead to a significant burden on patients and the health system. Expeditious implementation of virtual care (VC) became a necessity, however, frontline clinicians identified lack of confidence and experience with LBP-VC. To ensure continuity in patient-centered care, a Toolkit was developed to enable delivery of a standardized guideline-based integrated LBP pathway through VC.
 Aims, Objectives, Theory or Methods: A coordinated in-depth multi-stakeholder engagement process was utilized to address clinicians’ concerns to promote confident adoption of VC. A system-level rapid response approach led through a centralized clinical and digital provincial infrastructure was used for Toolkit development. Toolkit structure, content and refinement was determined through an iterative mix-methods approach undertaken with provincial LBP stakeholders on how best to implement an established evidence-based shared-care LBP clinical pathway through VC. This approach facilitated acceptable strategies for barrier mitigation and enabled optimization to be rapidly developed on a provincial level with necessary resources and guidelines to deliver standardized LBP-VC across Ontario.
 Highlights or Results or Key Findings: Toolkit resources have been adopted across 16 urban and rural regions in Ontario. Engaging front-line clinicians, (including spine surgeons), was critical for active implementation of VC that was safe, effective, and met professional requirements. Stakeholders for operational oversight included government, hospital and regional administrators, and professional colleges and associations. With collaborative provincial leadership, barriers and enablers to LBP-VC were systematically identified. Extensive multi-stakeholder consultation which included patient feedback, provided pragmatic information related to privacy; informed consent; professional standards; regional variations, and clinical and patient barriers and enablers. Emergent themes included technology requirements, administrative processes, educational needs, and professional standards. Four hundred and forty LBP-VC patient satisfaction questionnaires were completed (June 2020-May 2021). Based on a 5-point Likert scale, (5 most positive), overall satisfaction and likelihood of participating again was 4.7/5. Qualitative analysis revealed three themes with VC, importance of human connection, patient-perceived virtual physical examination limitations and VC efficiencies.
 
 Conclusions: A Toolkit enabled a standardized province-wide approach to LBP-VC. Multi-stakeholder engagement was utilized to understand barriers, identify enablers, and ultimately promote patient and provider adoption and confidence with LBP-VC. With collaborative leadership, and extensive engagement, clinical resources and guidelines were developed and implemented province-wide with excellent face-validity based on patient and provider feedback and uptake. 
 Implications for applicability/transferability, sustainability and limitations: There is a need to further assess patient preference for care delivery during normal and non-emergency circumstances (COVID-19). Future directions include validating LBP-VC physical examination findings compared to hands-on assessment. There is also a need to explore cost-effectiveness of LBP-VC at scale; patient-related factors including demographics, satisfaction, preference, and acceptance with LBP-VC; treatment outcomes, including surgical; safety considerations such as security of online platforms, physical patient safety during the assessment; and comparing rate of escalation to surgeon with in-person and virtual assessment.
 

Integrating Irish health care: How can we use the United Nations Convention on the Rights of Persons with Disabilities and Nine Pillars of Integrated Care?

Introduction: Over 1 billion (15%) of the world’s population are estimated to experience some form of disability, of whom up to 190 million people live with significant difficulties in functioning, often requiring health care services.
 Despite a myriad of policies and research, disabled people globally continue to be denied their human rights and face enduring barriers to full participation in society.
 The United Nations Convention on the Rights of Persons with Disabilities (UN CRPD) is an International Treaty setting out legal obligations on States to promote and protect the rights of persons with disabilities. It provides a unique opportunity to improve the quality of life of all disabled people. The convention identifies that disability arises as a result of barriers in society, including negative attitudes, inappropriate or inaccessible services that result in discrimination against persons with disabilities. The convention includes persons who are or will require Integrated Care. A number of the fifty Articles of the Convention are relevant as a framework to guide the implementation of Integrated Care for and with persons with disabilities. The aim of this workshop was to seek to understand how UNCRPD articles and the IFIC 9 pillars might inform priorities for integrated care.
 Methods: Led and co-designed by people with disabilities, a workshop was held to seek to understand from a broad audience how to use the UNCRPD to frame integrated health care in Ireland in parallel with the IFIC 9 pillars of integrated care.
 The workshop used a World Café methodology, a participatory multi-stakeholder action research process that takes place in a cafe style setting and supports the development of collective knowledge among individuals and communities to address shared problems.
 Participants were allocated into four groups to discuss the following four questions under the guidance of facilitators -
 1.In the context of the UNCRPD and the IFIC 9 pillars of integrated care what are the top 3 priorities to be addressed for people with disabilities across Ireland?
 2.What is currently happening in advancing integrated care for people with disabilities in Ireland?
 3.What would a successful, innovative integrated care system for people with disabilities in Ireland look like?
 4.What are the top 3 solutions you would like to see and work to see implemented immediately?
 Feedback and perspectives were captured on post-it notes and flipcharts and subsequently collated by facilitators. Data were reviewed, and a thematic analysis was conducted.
 Results: There were 20 participants from diverse backgrounds, including experts by experience, disabled persons organisations, academia and health services. Four key themes were generated through inductive thematic analysis: 1) the importance of co-production, 2) the need for equity as opposed to equality, 3) the need for data collection, sharing and knowledge mobilisation and 4) the need for a socioecological integrated care system for people with disabilities.
 Conclusions: Having policies and conventions, and models for the rights of persons with disabilities is not sufficient to ensure implementation. Successful implementation of integrated care needs enablers, including co-production of initiatives with persons with disabilities.

Multiphase and Multistakeholder English Translation Processes Behind Subtitling Chinese Auteur Films

The professional translation processes involved in subtitling Chinese auteur films are under-reported in audiovisual translation literature. The present study investigates the translation processes employed for Chinese films destined for an international audience with a focus on fifth- and sixth-generation directors’ films. These film auteurs depict China’s diverse cultural elements and contemporary social reality, for which English subtitles provide an essential bridge to connect to an international audience. Interview data collected from ten established Chinese-to-English translators/subtitlers, whose names are credited in the selected films, identify two remarkable features of subtitling these contemporary Chinese auteur films: Multiple phases of the translation processes employed across the filmmaking lifespan and multiple stakeholders involved in the wider translation processes beyond translators/subtitlers. Actor-Network Theory is used to elicit interwoven relationships among the various human and non-human actors connected to translating/subtitling activities across different stages of filmmaking. These findings confirm that translating/subtitling is not an isolated post-production task but rather permeates all filmmaking phases. This can be a key factor in contributing to overall quality, which is critical in disseminating subtitled films by some of China’s most celebrated auteurs. Lay summary The international film market has increasingly featured Chinese films, especially the works by established Chinese directors, such as Zhang Yimou, Chen Kaige, Jia Zhangke and Jia Zhangke. Their films reflect China’s cultural conventions and contemporary social reality. English subtitling is the most popular mode of translation to distribute Chinese films among the English-speaking audience. However, little is known about the agents involved in translating the Chinese high-profile films and the translation processes. To fill this knowledge gap, we interviewed ten translators or subtitlers contributing to the translation of the four aforementioned directors. The collected interview data inform us that many other stakeholders (e.g. directors, producers, screenwriters, distributors and subtitle editors) play a role in the shaping of the final English subtitles shown on the screen, and translation of Chinese films takes place throughout the whole filmmaking process (i.e. film development, pre-production, post-production, distribution and exhibition). A sociological framework is adopted to demonstrate the interwoven relationships among the various human (i.e. translators/subtitlers and other stakeholders) and non-human actors (i.e. accompanying materials and translation products) connected to translating/subtitling activities across different stages of filmmaking. It is argued that such a multiphase and multistakeholder process helps to improve the overall quality of Chinese film subtitling.

Towards the Aim of the EU Circular Economy in a Multi-Stakeholder Process: From Policy to Industry and Back

Towards the Aim of the EU Circular Economy in a Multi-Stakeholder Process: From Policy to Industry and Back

Using a multi-stakeholder co-design process to develop a health service organisation-wide patient reported outcome measure collection system.

Limited examples exist of successful Patient Reported Outcome Measure (PROM) implementation across an entire healthcare organisation. The aim of this study was to use a multi-stakeholder co-design process to develop a PROM collection system, which will inform implementation of routine collection of PROMs across an entire healthcare organisation. Co-design comprised semi-structured interviews with clinicians (n = 11) and workshops/surveys with consumers (n = 320). The interview guide with clinicians focused on their experience using PROMs, preferences for using PROMs, and facilitators/barriers to using PROMs. Co-design activities specific to consumers focused on: (1) how PROMs will be administered (mode), (2) when PROMs will be administered (timing), (3) who will assist with PROMs collection, and (4) how long a PROM will take to complete. Data were analysed using a manifest qualitative content analysis approach. Core elements identified during the co-design process included: PROMs collection should be consumer-led and administered by someone other than a clinician; collection at discharge from the healthcare organisation and at 3-6months post discharge would be most suitable for supporting comprehensive assessment; PROMs should be administered using a variety of modes to accommodate the diversity of consumer preferences, with electronic as the default; and the time taken to complete PROMs should be no longer than 5-10min. This study provides new information on the co-design of a healthcare organisation-wide PROM collection system. Implementing a clinician and patient informed strategy for PROMs collection, that meets their preferences across multiple domains, should address known barriers to routine collection.

Access, health, re‐conhecimento: Co‐crafted Brazilian discourses on sustainable food

AbstractAcademic discourse on food justice and sustainable food consumption needs to be informed by empirical contributions and heterogenous conceptualisations from diverse parts of the world. This paper broadens the dialogue with a variety of voices and knowledges, rooting itself not only in the specific political and social context, but also the discursive and epistemic traditions of Brazil, which stand in dialogue with international discourses. Firstly, an analysis is offered of the multi‐stakeholder process that since the mid‐1990s shaped the discourse, theorisation and policy making on food justice and sustainable food consumption in Brazil. Emerging from this process were globally leading Brazilian policy initiatives such as Zero Hunger, the School Feeding Program, the progressive Food Guide, and co‐crafted concepts such as comida de verdade. The institutional architecture for this discourse, the National Food Council and regular conferences, were dismantled in 2019 after a change in government. Secondly, the paper presents data from 30 interviews with key stakeholders from civil society, policy, business, media and celebrity influencers, conducted at the time of the dissolution. Three key subdiscourses on sustainable food consumption emerge: access, with an emphasis on right to food; health; and re‐conhecimento, a term we use to articulate the confluence of multiple knowledges and consciousnesses, including an insistence on the cultural role of food. Throughout the interviews, co‐crafted concepts and phrases emerging from the multistakeholder process reverberated. The paper argues that the multi‐stakeholder process resulted not just in a coherent shared discourse, concepts and policy during a period of conducive policy environment, but also in collective resilience. The invisible edifice of shared ideas and commitments around this public issue is still intact and may be reactivated in future. In times of increased political polarisation, not just in Brazil, this is an important argument for investing in such long‐term multi‐stakeholder dialogue processes.

Building Human Values into Recommender Systems: An Interdisciplinary Synthesis

Recommender systems are the algorithms which select, filter, and personalize content across many of the world's largest platforms and apps. As such, their positive and negative effects on individuals and on societies have been extensively theorized and studied. Our overarching question is how to ensure that recommender systems enact the values of the individuals and societies that they serve. Addressing this question in a principled fashion requires technical knowledge of recommender design and operation, and also critically depends on insights from diverse fields including social science, ethics, economics, psychology, policy and law. This paper is a multidisciplinary effort to synthesize theory and practice from different perspectives, with the goal of providing a shared language, articulating current design approaches, and identifying open problems. We collect a set of values that seem most relevant to recommender systems operating across different domains, then examine them from the perspectives of current industry practice, measurement, product design, and policy approaches. Important open problems include multi-stakeholder processes for defining values and resolving trade-offs, better values-driven measurements, recommender controls that people use, non-behavioral algorithmic feedback, optimization for long-term outcomes, causal inference of recommender effects, academic-industry research collaborations, and interdisciplinary policy-making.