Opinions Of Key Stakeholders Research Articles

A Qualitative Exploration of Coordinators' and Carers' Perceptions of the Healthy Eating, Active Living (HEAL) Programme in Residential Care

Internationally, there are few studies that have trialled structured intervention programmes designed to prevent excessive weight gain or combat existing overweight/obesity for young people living in out‐of‐home care. The Healthy Eating, Active Living (HEAL) programme was designed to address this limitation and is, to our knowledge, the first programme that simultaneously encourages young people and their carers to engage in a healthy lifestyle. This is the second of two papers presenting the HEAL evaluation. The aim of this study was twofold: first, to explore the experiences and opinions of key stakeholders regarding the intervention programme; and second, to understand the key enablers and barriers to successful implementation of the HEAL programme in residential care. Seventeen carers and ten programme coordinators participated in semi‐structured interviews. Findings demonstrated that HEAL was considered a valuable adjunct to the residential care programme, and was successful in raising awareness about the importance of leading a healthy lifestyle. Positive behaviour change among the young people and carers' dietary, physical activity and sleeping habits, and the development of independent living skills were described. Barriers to implementation included leadership support and professional development of carers. Recommendations are made to improve implementation, particularly around the importance of increasing stakeholder ‘buy‐in’. Copyright © 2017 John Wiley & Sons, Ltd.Key Practitioner Messages There is a need to address the lifestyle habits of young people in residential care. Raising awareness is an important first step, but must be supplemented with supportive environmental change to enable lasting, healthy outcomes. Carer capabilities need to be strengthened so that they can effectively manage challenging behaviours, yet still address the lifestyle habits of young people in care. Stakeholder ‘buy‐in’ and a programme champion are critical to implementation of healthy lifestyle programmes in residential care. ‘The first programme that simultaneously encourages young people and their carers to engage in a healthy lifestyle’

Taxonomy for the Rehabilitation of Knee Conditions (TRAK), a Digital Intervention to Support the Self-Care Components of Anterior Cruciate Ligament Rehabilitation: Protocol of a Feasibility Study.

BackgroundRupture of the anterior cruciate ligament (ACL) is common, especially in the active population. In defining the problem of ACL rehabilitation, this study draws from the knowledge that improved self-care, strength, and fitness are associated with better outcomes. Traditional rehabilitation involves regular physiotherapy, but it is not clear what the optimal way for delivering rehabilitation is, and it varies widely across the world. Evidence for treatments are discussed in the literature, however standard length of rehabilitation and frequency of appointments are unknown. Additionally, current rehabilitation models in the National Health Service (NHS) struggle with catering to large volumes of patients and the lengthy time span over which rehabilitation is delivered. The use of eHealth (the Internet in health care) has been successful at delivering behavior change to a number of diverse patient groups. In physiotherapy, problems such as exercise compliance, exercise technique, and managing a broad program of rehabilitation and advice can be challenging. An eHealth intervention called Taxonomy for the Rehabilitation of Knee Conditions (TRAK) to support self-management and behavior change has been developed by patients and clinicians, and acceptability studies have yielded positive results. TRAK is not an exercise rehabilitation protocol; it is a tool to support ACL rehabilitation with personalized plans, prompts, and logs to help adherence and videos and instructions to improve quality and address queries. The patients have their own log-ins and can email their physiotherapist through the website. This novel platform is directly in line with current NHS England, National Institute for Health and Care Excellence, and NHS Improvement agendas that call for rehabilitation initiatives using both technology and supported self-management for patients. This study forms part of a research platform to identify a best practice model of ACL care from the literature and opinions of key stakeholders. Patients’ exercise programs and duration of treatment are still based on individual needs, but use of the website may offer improved self-management and function and reduced health resource use.ObjectiveThis is a feasibility study to establish recruitment, retention, sample size estimates, and practicality of collecting outcome measures to inform a future trial comparing the TRAK intervention, which has been rigorously designed to address the challenges of ACL rehabilitation, to usual care.MethodsThis is a feasibility study comparing 2 groups: standard care and standard care plus eHealth. It will use convergent parallel mixed methods where both qualitative and quantitative data are sought for a more thorough understanding of the objectives. Primary outcomes relate to feasibility, including recruitment, retention, and usage. Secondary outcomes relate to health resource use and patient-rated outcome measures.ResultsThis research expects to establish the feasibility of a full-scale randomized controlled trial to explore whether patients who use an eHealth intervention to support ACL rehabilitation have better outcomes plus improved self-efficacy and reduced health resource use than a usual care group.ConclusionsThe study will provide essential information to support the development and powering of a future clinical trial of eHealth and physiotherapy for patients with ACL reconstruction in the NHS.

A Realistic Process towards Korean Unification and the Harmonized Privatization of Properties in the Unified Korea: Issues, Priorities, and Opinions of Key Stakeholders

A Realistic Process towards Korean Unification and the Harmonized Privatization of Properties in the Unified Korea: Issues, Priorities, and Opinions of Key Stakeholders

Challenges to establishing successful partnerships in community health promotion programs: local experiences from the national implementation of healthy eating activity and lifestyle (HEAL™) program.

Community-based programs to address physical activity and diet are seen as a valuable strategy to reduce risk factors for chronic disease. Community partnerships are important for successful local implementation of these programs but little is published to describe the challenges of developing partnerships to implement health promotion programs. The aim of this study was to explore the experiences and opinions of key stakeholders on the development and maintenance of partnerships during their implementation of the HEAL™ program. Semi-structured interviews with key stakeholders involved in implementation of HEAL™ in four local government areas. The interviews were transcribed verbatim and analysed thematically. Partnerships were vital to the success of the local implementation. Successful partnerships occurred where the program met the needs of the partnering organisation, or could be adapted to do so. Partnerships took time to develop and were often dependent on key people. Partnering with organisations that had a strong influence in the community could strengthen existing relationships and success. In remote areas partnerships took longer to develop because of fewer opportunities to meet face to face and workforce shortages and this has implications for program funding in these areas. Partnerships are important for the successful implementation of community preventive health programs. They take time to develop, are dependent on the needs of the stakeholders and are facilitated by stable leadership. SO WHAT?: An understanding of the role of partnerships in the implementation of community health programs is important to inform several aspects of program delivery, including flexibility in funding arrangements to allow effective and mutually beneficial partnerships to develop before the implementation phase of the program. It is important that policy makers have an understanding of the time it takes for partnerships to develop and to take this into consideration when programs are funded and implemented in the community.

Stakeholders’ Perception of Istanbul's Historical Peninsula as a Sustainable Destination

ABSTRACTIstanbul, as a city of more than 13 million also hosting over 10 million tourists a year, has the challenge of managing its resources to provide tourism services within a sustainable perspective. Since the sustainability of a destination requires the long-term consciousness and appropriate behaviour of all interested parties, the opinions of key stakeholders are essential. The study analysed stakeholders' perceptions towards Istanbul's Historical Peninsula as a sustainable urban tourism destination, considering four dimensions: environmental, economic, social and cultural. The research determined that stakeholders have limited knowledge and awareness concerning the sustainability of the destination. For these interested parties, the main concern is the capability of tourism to increase profits, and other sustainability dimensions, such as environmental concerns, are mainly considered in terms of making the destination more attractive for visitors.

Trends in postgraduate medical education in Iran

Trends in postgraduate medical education in Iran Shima Tabatabai, Seyed Amir Mohsen Ziaee Background Iran is designing an evidence-based plan for promoting postgraduate medical education and efficient distribution of health professional human resources. An important part of this program is foresight studies for post graduate medical education considering the important trends affecting the future of health status and postgraduate medical education in Iran. In this article, we clarify such trends in Iran. Methods For this study, we used a systematic review of current evidence about the mega trends affecting the future of medical education. Also we gathered opinions of key stakeholders in expert panels. Results Following trends identified as affecting the health system and post graduate medical education in Iran: demographic changes; epidemiologic transition; physician work patterns changes, female specialists number growth, changes in patients’ expectations of health services; growth in information and communication technologies; new advances in diagnostic and therapeutic technolo ... BMC Health Services Research

UNIVERSAL PRIMARY EDUCATION: PERSPECTIVES FROM UGANDA

The study aimed at assessing the implementation, achievements, experiences and challenges of MDG 2 for UPEProgramme in Uganda. Opinions of key stakeholders were sought. The study revealed some significant successes inensuring access to free and compulsory education and in reducing gender disparities at the primary school level. Thegreatest challenge remains that of more girls than boys not completing the primary cycle. The lessons learnt are: politicalcommitment, government support, quality education to motivate learners to stay at school, motivation of teachers for theirhigh commitment and stakeholder involvement.

The development feasibility of canal oriented development in the arid southwest: Opinions of key stakeholders

Phoenix Arizona is the quintessential polycentric desert city. Built for the car in an extreme climate, the city both lacks walkability and substantial density within the built form that is often found in cities of similar size. Yet within the boundaries of the metropolitan area, 181 miles of canals traverse the built environment, providing an opportunity for walkable nodal development at strategic locations. This unrealized potential offers the city a unique opportunity for mixed-use development within an already-constructed infrastructure, but challenges remain. This paper explores the feasibility of canal oriented development (COD) in Phoenix by analyzing: (1) opinions of key stakeholders, (2) the possibility of place based mixed-use walkable developments along the canals, and (3) the ability to create pockets of density. Results indicate that COD in Phoenix will be driven by commercial development, which entails that municipal investment will be a greater catalyst for eventual success than the regional utility that maintains the canal.

Mobile Number Portability in South Asia

Mobile Number portability (MNP), a feature present in most developed telecom markets around the world, is now making its way into the developing telecom markets of South Asia. Unlike the conditions that exist in the mature environments of the western world, however, market structures, pricing mechanisms and even customer phone use behaviours are vastly different in the emerging South Asian markets. As such, the preconditions necessary for the success of this service and its potential implications will be largely different in this region.The paper explores Pakistan’s experience in introducing MNP and will investigate the suitability of introducing the same in India and other emerging South Asian microstates such as the Maldives. The paper will also consider how phone subscribers at the Bottom of the Pyramid (BOP) and the impact of the low-cost, low-ARPU pricing model implemented in South Asia will affect porting rates. The study will be mainly based on secondary data collection (existing reports, market trends and opinions of key stakeholders) while the BOP data will be sourced from LIRNEasia’s large sample study, carried out in six-countries in 2008.

Bosnia and Herzegovina - Meeting Copenhagen Economic Criteria for Accession to the EU

Delegation of the European Commission based in Sarajevo, Bosnia and Herzegovina (BH) granted the consortium represented by ECORYS a contract for EU support to the Economic Policy Research Unit, a subdivision of the Economic Policy Planning Unit of the Council of Ministers of Bosnia and Herzegovina. As part of this project activities a subproject was designed trying to assess the position of BH against the benchmarks of the Copenhagen economic criteria and to identify policy measures for meeting the criteria. The issues of particular relevance to the project included: presentation of the Copenhagen economic criteria, analysis of the existing situation in the country, strategic and policy documents addressing the subject, identification of gaps to be filled in order to achieve the benchmark, and policy recommendations. In July, 2006 ECORYS appointed the Center for Social and Economic Research (CASE), an international, non-profit research and advisory institution, to research on the subject. The research project team comprised experts: Messrs. Rafal Antczak (team leader), Wojciech Paczynski, and Ranko Markus, Mmes. Malgorzata Antczak and Karina Kostrzewa, assisted by Mr. Erol Mujanovic.The report was based on available national account and microeconomic data, strategic and policy documents of the BH governmental bodies, relevant reports by international organisations, EU institutions, academic and research centres and opinions of key stakeholders. The analytical research on the economic developments in BH by international financial institutions, especially the IMF and World Bank, as well as domestic bodies, especially the Economic Policy Research Unit, was extensively exploited in the research. However, the primary focus of the research was on structural and institutional aspects facilitating or impeding functioning of a market economy in the BH and country's capacity to cope with competitive pressure and market forces within the EU. Therefore, the report focuses on background analysis of economic factors influencing the functioning of market economy and the capacity to withstand the competition in the EU market.The research consists of four main parts. In Part 1, the Copenhagen economic criteria are presented in a comparative perspective of the recent experiences of the new member states and acceding countries to allow diagnosing of the most important gaps to be filled by BH. Part 2 analyses macroeconomic developments in BH, presenting them in a comparative perspective relative to EU candidate countries. The special focus is on two fields where BH faces particularly difficult challenges: labour market and foreign trade. Also, the three scenarios of BH catching-up with the EU are presented. Privatisation process which is one of the most important institutional and structural features of every transition economy and especially relevant from the perspective of meeting the Copenhagen criteria is analysed in Part 3. Part 4 comprises analysis of microeconomic developments in BH with the elements of the financial analysis of enterprises, both state and private. The financial analysis of enterprises concentrates on current situation and identification of trends in microeconomic developments to identify comparative advantages, assess productivity, and to position the BH enterprise sector towards the potential competition on the EU markets. Finally, Part 5 includes policy recommendations for decision makers both from the BH government and the EC. The research is supplemented by the Annexes providing background pieces of information on the analysed topics.The project team established contacts with representatives of international organizations, the BH governmental bodies, and research community in BH to collect pieces of information and consult on research topics. However, the authors of the researchers bear the sole responsibility for the pieces of information and opinions presented in the report.

The views of stakeholders on controlled access schemes for high-cost antirheumatic biological medicines in Australia

BackgroundIn Australia, government-subsidised access to high-cost medicines is "targeted" to particular sub-sets of patients under the Pharmaceutical Benefits Scheme to achieve cost-effective use. In order to determine how this access system could be improved, the opinions of key stakeholders on access to biological agents for rheumatoid arthritis were explored.MethodsThirty-six semi-structured interviews were conducted with persons from relevant stakeholder groups. These were transcribed verbatim, and analysed thematically.ResultsControlled access to expensive medicines was considered to be equitable and practical; however, there was disagreement as to the method of defining the target patient populations. Other concerns included timeliness of access, excessive bureaucracy, and the need for additional resources to facilitate the scheme. Collaboration between stakeholders was deemed important because it allows more equitable distribution of limited resources. The majority considered that stakeholder consultation should have been broader. Most wanted increased transparency of the decision-making process, ongoing and timely review of access criteria, and an increased provision of information for patients. More structured communication between stakeholders was proposed.ConclusionThe Pharmaceutical Benefit Scheme is adapting to meet the changing needs of patients. Provision of subsidised access to high-cost medicines in a manner that is affordable for individuals and society, and that is equitable and efficiently managed is challenging. The views of stakeholders on targeted access to anti-rheumatic biological medicines in Australia acknowledged this challenge and provided a number of suggestions for modifications. These could serve as a basis to inform the debate on how to change the processes and policies so as to improve the scheme.

Branding on ambiguity? Place branding without a national identity: Marketing Northern Ireland as a post-conflict society in the USA

This study focuses on place branding as a method of promoting a positive image of Northern Ireland as a post conflict society in the United States of America in the absence of an agreed single national identity on which to build. Qualitative methods were used to collect data on the views and opinions of key stakeholders in both Northern Ireland and the USA. The results show that Northern Ireland has adopted a ‘Janus’ strategy when marketing Northern Ireland internationally, marketing Northern Ireland as ‘Irish’ in Irish-friendly markets and as ‘British’ in British-friendly markets.

Implications of tariff laws on private investment: Tanzanian power sector

This study investigates the tariff provisions in the Electricity Ordinance of Tanganyika and infers their implications for attraction or repulsion of private investment. There were three main strands to the analytical methodology: textual analysis of the Electricity Ordinance, investigation of what is actually taking place on the ground and investigation of opinions of key stakeholders. Furthermore, the act governing telecommunications, a sector that has made significant reforms, was examined in order to discover lessons for power sector legislation reform. The findings show that: (1) tariff is a function of time lapse rather than cost and other market factors; (2) the existing ordinance does not provide mechanisms for tariffs to reflect actual costs; (3) the ordinance has no provisions for meaningful encouragement of mobilisation of financial resources for growth through tariff; and (4) there is too much direct involvement of the political machinery in tariff-setting; this tends to push tariffs down below cost. These findings suggest the following policy options: the 1931 Electricity Ordinance, enacted during colonial times, is so outdated that it is not fit for amendment; instead, its revocation should be considered and a new one enacted. The new law should: (1) reduce direct involvement of the political machinery in tariff-setting by introducing separation between policy formulation (ministry) and policy implementation (regulator); (2) introduce a tariff formula to track movement in costs that are critical to electricity generation in order to maintain the tariff level in real terms; and (3) contain legal provisions granting, through the tariff mechanism, a meaningful encouragement of mobilisation of financial resources for growth. The proposed multi-sector regulator for utilities and a mechanism of appeal and scrutiny by a parliamentary committee is a step in the right direction for it reduces the chances for regulatory capture.

Measuring destination competitiveness: an empirical study of Canadian ski resorts

This article focuses on a recently developed model of tourism destination competitiveness, adapts this general model to ski resorts and subsequently develops operational measures for each of the components of the model in order to provide an index of destination competitiveness for ski areas in Canada. Using this index, thirteen ski areas were surveyed using a detailed stakeholder questionnaire. The results highlight the various strengths and weaknesses for each destination, and show that the opinions of key stakeholders can be very useful for indicative purposes. The research provides a foundation for developing a comprehensive and standardized model for measuring the competitiveness of tourism resorts worldwide. The model may be a very useful vehicle for the planning and development of resorts that operate in highly competitive markets.