Stakeholder Agreement Research Articles

Convening for Consensus: Simulating Stakeholder Agreement in Collaborative Governance Processes Under Different Network Conditions

Convening for Consensus: Simulating Stakeholder Agreement in Collaborative Governance Processes Under Different Network Conditions

On approach to the agreement of diverse stakeholders’ interests and goals in the governance

The paper proposes the use of a collective cognitive map when solving governance problems as an effective means of diverse stakeholders’ interests and goals agreement. For compose such a map, an original approach is proposed that combines (1) the clarification and agreement of stakeholder representations on the governance problem using a number of criteria for improving the map quality and (2) the clusterization of similar stakeholder representations.

Land-use trade-offs in the Kapuas peat forest, Central Kalimantan, Indonesia

Forest ecosystems provide benefits to people locally and globally. Sustainable management of forest resources is required to ensure continued supply of these benefits, but complex social-ecological processes are often a constraint to the design of such forest management strategies. In this study, we developed a model of adaptive forest zonation to facilitate forest ecosystem management. We employed the ecosystem services concept and a land-use change model to identify potential areas for conservation and for economic use in the Kapuas Protected Forest Management Unit in Indonesia. Local people actively participated in this study to jointly define management zones and stakeholders’ associated rights and responsibilities. Our results show that a stakeholder agreement facilitated the reduction of threats to forest ecosystems and increased local awareness of the need for forest ecosystem conservation. Compared to current forest zonation, we show that the availability of an economic development zone in adaptive forest zonation could potentially increase ecosystem benefits for local communities by about 40% through rattan and jelutong collection and agroforestry rubber and jelutong production. Although our results are specific for the Kapuas District, the methodology of adaptive forest zonation can be applied more generally. We recommend our methods be included in guidelines for zonation and management plans to help improve sustainable forest management practices of all forest management units in Indonesia.

Understanding perceived availability and importance of tobacco control interventions to inform European adoption of a UK economic model: a cross-sectional study

BackgroundThe evidence on the extent to which stakeholders in different European countries agree with availability and importance of tobacco-control interventions is limited. This study assessed and compared stakeholders’ views from five European countries and compared the perceived ranking of interventions with evidence-based ranking using cost-effectiveness data.MethodsAn interview survey (face-to-face, by phone or Skype) was conducted between April and July 2014 with five categories of stakeholders - decision makers, service purchasers, service providers, evidence generators and health promotion advocates - from Germany, Hungary, the Netherlands, Spain, and the United Kingdom. A list of potential stakeholders drawn from the research team’s contacts and snowballing served as the sampling frame. An email invitation was sent to all stakeholders in this list and recruitment was based on positive replies. Respondents were asked to rate availability and importance of 30 tobacco control interventions. Kappa coefficients assessed agreement of stakeholders’ views. A mean importance score for each intervention was used to rank the interventions. This ranking was compared with the ranking based on cost-effectiveness data from a published review.ResultsNinety-three stakeholders (55.7% response rate) completed the survey: 18.3% were from Germany, 17.2% from Hungary, 30.1% from the Netherlands, 19.4% from Spain, and 15.1% from the UK. Of those, 31.2% were decision makers, 26.9% evidence generators, 19.4% service providers, 15.1% health-promotion advocates, and 7.5% purchasers of services/pharmaceutical products. Smoking restrictions in public areas were rated as the most important intervention (mean score = 1.89). The agreement on availability of interventions between the stakeholders was very low (kappa = 0.098; 95% CI = [0.085, 0.111] but the agreement on the importance of the interventions was fair (kappa = 0.239; 95% CI = [0.208, 0.253]). A correlation was found between availability and importance rankings for stage-based interventions. The importance ranking was not statistically concordant with the ranking based on published cost-effectiveness data (Kendall rank correlation coefficient = 0.40; p-value = 0.11; 95% CI = [− 0.09, 0.89]).ConclusionsThe intrinsic differences in stakeholder views must be addressed while transferring economic evidence Europe-wide. Strong engagement with stakeholders, focussing on better communication, has a potential to mitigate this challenge.

Consensus statement on the need for innovation, transition and implementation of developmental neurotoxicity (DNT) testing for regulatory purposes

This consensus statement voices the agreement of scientific stakeholders from regulatory agencies, academia and industry that a new framework needs adopting for assessment of chemicals with the potential to disrupt brain development. An increased prevalence of neurodevelopmental disorders in children has been observed that cannot solely be explained by genetics and recently pre- and postnatal exposure to environmental chemicals has been suspected as a causal factor. There is only very limited information on neurodevelopmental toxicity, leaving thousands of chemicals, that are present in the environment, with high uncertainty concerning their developmental neurotoxicity (DNT) potential. Closing this data gap with the current test guideline approach is not feasible, because the in vivo bioassays are far too resource-intensive concerning time, money and number of animals. A variety of in vitro methods are now available, that have the potential to close this data gap by permitting mode-of-action-based DNT testing employing human stem cells-derived neuronal/glial models. In vitro DNT data together with in silico approaches will in the future allow development of predictive models for DNT effects. The ultimate application goals of these new approach methods for DNT testing are their usage for different regulatory purposes.

Return-to-work success despite conflicts: an exploration of decision-making during a work rehabilitation program

Purpose: Collective decision-making by stakeholders appears important to return-to-work success, yet few studies have explored the processes involved. This study aims to explore the influence of decision-making on return-to-work for workers with musculoskeletal or common mental disorders.Method: This study is a secondary analysis using data from three earlier multiple-case studies that documented decision-making during similar and comparable work rehabilitation programs. Individual interviews were conducted at the end of the program with stakeholders, namely, the disabled workers and representatives of health care professionals, employers, unions and insurers. Verbatims were analysed inductively.Results: The 28 decision-making processes (cases) led to 115 different decisions-making instances and included the following components: subjects of the decisions, stakeholders’ concerns and powers, and types of decision-making. No differences were found in decision-making processes relative to the workers’ diagnoses or return-to-work status. However, overall analysis of decision-making revealed that stakeholder agreement on a return-to-work goal and acceptance of an intervention plan in which the task demands aligned with the worker’s capacities were essential for return-to-work success.Conclusion: These results support the possibility of return-to-work success despite conflictual decision-making processes. In addition to facilitating consensual decisions, future studies should be aimed at facilitating negotiated decisions.Implications for rehabilitationFacilitating decision-making, with the aim of obtaining agreement from all stakeholders on a return-to-work goal and their acceptance of an intervention plan that respects the worker’s capacities, is important for return-to-work success.Rehabilitation professionals should constantly be on the lookout for potential conflicts, which may either complicate the reach of an agreement between the stakeholders or constrain return-to-work possibilities.Rehabilitation professionals should also be constantly watching for workers’ and employers’ return-to-work concerns, as they may change during work rehabilitation, potentially challenging a reached agreement.

An indicator approach to capture impacts of white-tailed deer and other ungulates in the presence of multiple associated stressors.

Management of ungulates is contested ground that lacks stakeholder agreement on desirable population sizes and management approaches. Unfortunately, we often miss information about extent of local impacts, for example on plant communities, to guide management decisions. Typical vegetation impact assessments like the woody browse index do not assess herbaceous plants, and differences in browse severity can be a function of deer density, deer legacy effects, localized deer feeding preferences and/or differences in plant community composition. Furthermore, in heavily affected areas, few remnant plants may remain for assessments. We used a sentinel approach to assess impact of white-tailed deer (Odocoileus virginianus), rodent attack, invasive earthworms and three invasive plants on survival and growth of 3-month-old red oak (Quercus rubra) individuals. We planted cohorts in 2010 and 2011 into deer accessible and fenced 30 × 30 m plots at 12 forests in New York State. We found year and site-specific effects with high deer herbivory of unprotected individuals (70-90 % of oaks browsed by deer versus none in fenced areas) far exceeding importance of rodent attacks. Oaks planted at low earthworm density sites were at significantly higher risk of being browsed compared with oaks at high earthworm density sites, but there was no detectable negative effect of invasive plants. Surviving oaks grew (~2 cm per year) under forest canopy cover, but only when fenced. We consider planting of oak or other woody or herbaceous sentinels to assess deer browse pressure a promising method to provide quantifiable evidence for deer impacts and to gauge success of different management techniques. The strength of this approach is that typical problems associated with multiple stressor impacts can be avoided, areas devoid of forest floor vegetation but under heavy deer browse pressure can still be assessed and the method can be implemented by non-specialists. Implementation of regular assessments can guide ungulate management based on meaningful evidence.

Crisis resolution and home treatment: stakeholders\u2019 views on critical ingredients and implementation in England

BackgroundCrisis resolution teams (CRTs) can provide effective home-based treatment for acute mental health crises, although critical ingredients of the model have not been clearly identified, and implementation has been inconsistent. In order to inform development of a more highly specified CRT model that meets service users’ needs, this study used qualitative methods to investigate stakeholders’ experiences and views of CRTs, and what is important in good quality home-based crisis care.MethodSemi-structured interviews and focus groups were conducted with service users (n = 41), carers (n = 20) and practitioners (CRT staff, managers and referrers; n = 147, 26 focus groups, 9 interviews) in 10 mental health catchment areas in England, and with international CRT developers (n = 11). Data were analysed using thematic analysis.ResultsThree domains salient to views about optimal care were identified. 1. The organisation of CRT care: Providing a rapid initial responses, and frequent home visits from the same staff were seen as central to good care, particularly by service users and carers. Being accessible, reliable, and having some flexibility were also valued. Negative experiences of some referral pathways, and particularly lack of staff continuity were identified as problematic. 2. The content of CRT work: Emotional support was at the centre of service users’ experiences. All stakeholder groups thought CRTs should involve the whole family, and offer a range of interventions. However, carers often feel excluded, and medication is often prioritised over other forms of support. 3. The role of CRTs within the care system: Gate-keeping admissions is seen as a key role for CRTs within the acute care system. Service users and carers report that recovery is quicker compared to in-patient care. Lack of knowledge and misunderstandings about CRTs among referrers are common. Overall, levels of stakeholder agreement about the critical ingredients of good crisis care were high, although aspects of this were not always seen as achievable.ConclusionsStakeholders’ views about optimal CRT care suggest that staff continuity, carer involvement, and emotional and practical support should be prioritised in service improvements and more clearly specified CRT models.

An exploratory quality assessment of orthodontic clinical guidelines using the AGREE II instrument.

Clinical guidelines act as a means of assisting clinicians in improving the quality of healthcare provided. We aim to assess the quality of currently available international orthodontic guidelines. A cross-sectional systematic assessment of orthodontic clinical guidelines was undertaken. A Medline search using the keywords 'guideline', 'orthodontics', and 'dent', and search of specific dental and orthodontic organization websites for orthodontic-related clinical guidelines. Relevant guidelines published between 1999 and 2012 in English were identified. Draft guidelines and endorsements were excluded. The quality of each guideline was evaluated by a single calibrated assessor using the AGREE II instrument. Variation in the quality of guidelines produced by different organizations was also assessed. Seventeen guidelines were included in this study. Overall, the reporting of scope and purpose (84.31, 95% CI: 70.91-97.72) and clarity of presentation (75.49, 95% CI: 61.68-89.3) domains of the AGREE II instrument were deemed of high quality. Lower scores were obtained for the following domains: rigour of development (52.08, 95% CI: 37.59-66.57), editorial independence (47.06, 95% CI: 20.6-73.51), stakeholder agreement (46.41, 95% CI: 29.66-63.15), and applicability (27.45, 95% CI: 8.26-46.64). There was a noted difference in the individual domain scores of orthodontic guidelines produced by the different organizations. In relation to the AGREE II instrument, the quality of orthodontic guidelines for use in clinical practice are deemed sub-optimal. Variation in the quality of guidelines produced different organizations is evident.

Stakeholder perspectives on the use of telehealth to improve ambulatory care for chemotherapy patients in a large urban cancer centre.

86 Background: Chemotherapy outpatients are often left in vulnerable positions without direct access to their providers between appointments, which can lead to Emergency Department (ED) visits to address side effects. Improved use of telehealth has been postulated in the literature as a potential low-cost tool to manage this problem. Our objective was to explore, as a case study, how telehealth can be optimized to provide better care to ambulatory chemotherapy patients. Methods: This study was done at Princess Margaret Cancer Centre in Toronto. Semi-structured interviews (n = 21) were conducted to elicit a broad set of perspectives on the feasibility and constraints of implementing new telehealth measures in the breast cancer (BC) clinic. Interviewees included hospital administrators (n = 3), nurse managers (n = 4), BC nurses (n = 3), BC physicians (n = 2), one non-BC nurse, one pharmacist, BC patients (n = 4), and telehealth and technology experts (n = 3). Transcripts were reviewed separately by each author and themes were extracted using content analysis. Key learnings were established based on stakeholder agreement and theme novelty. Results: Provider-initiated proactive calling of chemotherapy patients was felt to bethe most valuable and feasible potential change according to all stakeholders. A number of key considerations emerged regarding the creation of a successful proactive calling system: 1) calls should address symptoms that are predictable, regimen-specific, and most likely to result in ED visits; 2) patients most likely to benefit are those beginning chemotherapy, starting new drugs, or fitting certain high-needs criteria; 3) structured call questionnaires can be valuable, but must be flexible to best meet patient needs; 4) the caller’s expertise is more important than his or her familiarity with the patient; and 5) basic IT support systems are necessary for operationalization. Conclusions: Simple telehealth initiatives such as proactive calls can improve outpatient care for chemotherapy patients, and may reduce ED burden. This study provides key principles that should guide development and implementation of proactive calling programs at cancer care institutions.

The Benefits of Streamlined Hip Fracture Management in a Regional Hospital.

Introduction:Hip fracture is an increasingly common injury in the growing elderly population. The morbidity and mortality associated with this injury can be reduced by minimizing delays to surgical treatment. We describe the impact of a regional hospital service redesign project that utilized the principles of smart simplicity, a management strategy that lays emphasis on collaboration to achieve desired goals.Methods:Prior to the redesign, patients with hip fractures were taking an average of 72 hours for surgical treatment. A hip fracture working group was created to examine closely the process of hip fracture care, and a single key performance indicator (KPI) of “surgery within 48 hours” was adopted. This allowed identification of processes that could be clarified and streamlined, with the agreement of relevant stakeholders, in the creation of a new hip fracture pathway.Results:In the first 3 months of the pathway’s implementation, 16 of 18 patients had surgery within 48 hours of presentation. In a 6-month follow-up audit after 2 years of implementation, 36 of 39 patients were treated within 48 hours. This was significantly different to the time to surgery seen in the 12 months prior to the redesign (P < .001, Student t test). The mean time to surgery was reduced from 72 hours to 36 hours, a saving in an annual acute bed stay cost of A$152 000.Discussion:Decreased time to the operating room, the cost savings inherent to this, can be achieved with the introduction of the best standard of care. A redesign that mandates collaboration in achieving a single KPI has allowed a significant culture shift in the treatment of hip fractures in our institution in the months following its institution.Conclusion:Collaborative, multidisciplinary collaboration has facilitated a higher standard of care and demonstrated significant cost benefit.

Gender Incongruence of Childhood: Clinical Utility and Stakeholder Agreement with the World Health Organization's Proposed ICD-11 Criteria.

The World Health Organization (WHO) is revising the tenth version of the International Classification of Diseases and Related Health Problems (ICD-10). This includes a reconceptualization of the definition and positioning of Gender Incongruence of Childhood (GIC). This study aimed to: 1) collect the views of transgender individuals and professionals regarding the retention of the diagnosis; 2) see if the proposed GIC criteria were acceptable to transgender individuals and health care providers; 3) compare results between two countries with two different healthcare systems to see if these differences influence opinions regarding the GIC diagnosis; and 4) determine whether healthcare providers from high-income countries feel that the proposed criteria are clinically useful and easy to use. A total of 628 participants were included in the study: 284 from the Netherlands (NL; 45.2%), 8 from Flanders (Belgium; 1.3%), and 336 (53.5%) from the United Kingdom (UK). Most participants were transgender people (or their partners/relatives; TG) (n = 522), 89 participants were healthcare providers (HCPs) and 17 were both HCP and TG individuals. Participants completed an online survey developed for this study. Overall, the majority response from transgender participants (42.9%) was that if the diagnosis would be removed from the mental health chapter it should also be removed from the ICD-11 completely, while 33.6% thought it should remain in the ICD-11. Participants were generally satisfied with other aspects of the proposed ICD-11 GIC diagnosis: most TG participants (58.4%) thought the term Gender Identity Disorder should change, and most thought Gender Incongruence was an improvement (63.0%). Furthermore, most participants (76.1%) did not consider GIC to be a psychiatric disorder and placement in a separate chapter dealing with Gender and Sexual Health (the majority response in the NL and selected by 37.5% of the TG participants overall) or as a Z-code (the majority response in the UK and selected by 26.7% of the TG participants overall) would be preferable. In the UK, the majority response (35.8%) was that narrowing the GIC diagnosis was an improvement, while the NL majority response (49.5%) was that this was not an improvement. Although generally the results from HCPs were in line with the results from TG participants some differences were found. This study suggests that, although in an ideal world a diagnosis is not welcomed, several participants felt the diagnosis should not be removed. This is likely due to concerns about restricting access to reimbursed healthcare. The choice for positioning of a diagnosis of GIC within the ICD-11 was as a separate chapter dealing with symptoms and/or disorders regarding sexual and gender health. This was the overall first choice for NL participants and second choice for UK participants, after the use of a Z-code. The difference reflects that in the UK, Z-codes carry no negative implications for reimbursement of treatment costs. These findings highlight the challenges faced by the WHO in their attempt to integrate research findings from different countries, with different cultures and healthcare systems in their quest to create a manual that is globally applicable.

Designing the Tokyo Motor Show 2.0 using System engineering

AbstractIn this paper, we apply a systems engineering approach to redesign the Tokyo Motor Show. Our results suggest two improvements. The first is to strengthen international publicity. The second is a change in the focus of the exhibitors to focus on automobile developments and inter‐industry cooperation, by developing relationships with companies from related industries. We must be able to demonstrate the clear re‐examinable steps that led to our conclusions, to convince the stakeholders and move everyone in the same direction. There is nothing that can contribute to this better than systems engineering. Systems engineering has not been previously applied to the Tokyo Motor Show, and we believe that it was successful in encouraging stakeholder participation and agreement, and even led to voluntary actions. The validity of our system design method was demonstrated by the success of the most recent Tokyo Motor Show, which was the biggest exhibition in Japan.

Perspectives from Employers, Insurers, Lawyers and Healthcare Providers on Factors that Influence Workers' Return-to-Work Following Surgery for Non-Traumatic Upper Extremity Conditions.

Return-to-work (RTW) stakeholders have varied roles and may therefore hold their own perspectives regarding factors that may influence outcomes. This study aimed to determine stakeholders' perspectives on factors influencing RTW following surgery for non-traumatic upper extremity conditions. A questionnaire was distributed to RTW stakeholders via gatekeeper organizations. Stakeholders rated 50 potential prognostic factors from 'not' to 'extremely' influential. Data were dichotomized to establish stakeholders' level of agreement. Disagreements between stakeholder groups were analyzed using χ 2. The relationship between stakeholder demographic variables and rating of a factor was determined via regression analysis. One thousand and eleven stakeholders completed the survey: healthcare providers (77.8%); employer representatives (12.2%); insurer representatives (6.8%); and lawyers (3.2%). Factors with the highest stakeholder agreement for influencing RTW were: self-efficacy (92.2%); post-operative psychological status (91.8%); supportive employer/supervisor (91.4%); employer's willingness to accommodate job modifications (90.7%); worker's recovery expectations (88.3%); mood disorder diagnosis (86.6%); post-operative pain level (86.4%); and whether the job can be modified (86.3%). Disagreements between stakeholder groups were found for 19 (36%) factors. The strongest disagreements were for: age; gender; obesity; doctor's RTW recommendation; and presence of a RTW coordinator. Respondents' characteristics (e.g., age, workers' compensation jurisdiction, work experience, stakeholder group) were associated with factor rating. The factors stakeholders rated as having the greatest influence on RTW were predominately psychosocial and modifiable. These variables should be the focus of future research to determine prognostic factors for RTW for workers with upper extremity conditions, and to develop effective RTW interventions.

Toward shared understandings of ecosystem-based fisheries management among fishery management councils and stakeholders in the U.S. Mid-Atlantic and New England regions

Ecosystem-based fisheries management (EBFM) is often discussed by fisheries managers and stakeholders as a potential goal. EBFM is based on a multi-species approach, which varies significantly from the single species fisheries management (SSFM) approach currently practiced under the U.S. Magnuson-Stevens Fishery Conservation and Management Act (MSFCMA). EBFM is “holistic” and considers “all factors,” but it is impossible for management to incorporate all factors into EBFM. This study sought to improve understanding of factors contributing to or preventing progress toward EBFM implementation in the Mid-Atlantic Fishery Management Council (MAFMC) and New England Fishery Management Council (NEFMC), focusing on Council member and stakeholder beliefs, attitudes, and mutual understanding. Objectives included determining mutual understanding between MAFMC and NEFMC members and stakeholders about EBFM and identifying MAFMC and NEFMC member and stakeholder preferences for EBFM definitions, practices, and outcomes, and prioritizing which aspects of EBFM managers and stakeholders find most important. Stakeholders included commercial fishermen, recreational anglers, nongovernmental organization (NGO) leaders, and Scientific and Statistical Committee (SSC) members. Over 1000 survey responses about EBFM from council members and stakeholders in the Mid-Atlantic (MA) and New England (NE) regions were analyzed. The Coorientation Model was used to characterize understanding between the Council and fisheries-related stakeholder groups. For the MA and NE regions, most stakeholders agreed on definitions, practices, and possible outcomes for EBFM. Results suggest that most Council members and stakeholders in the MA and NE regions support a change from SSFM to EBFM at an incremental, intermediate, or complete, gradual (5–10 years) pace. The application of the Coorientation Model to EBFM and the fishery management councils provided insights into how an improved understanding of the attitudes, beliefs, and mutual comprehension of Council members and stakeholder groups could potentially facilitate the implementation of EBFM. Council members and stakeholders responded similarly to, and Council members correctly predicted stakeholder responses about, EBFM definitions, practices, and outcomes. These findings suggest that Council member and stakeholder agreement and understanding are not barriers to MAFMC and NEFMC adoption of EBFM.

Up the Chute, Down the Ladder: Shifting Priorities Through Structured Dismissals in Bankruptcy

In a “structured dismissal” of a chapter 11 bankruptcy case, a bankruptcy court approves case dismissal alongside a stakeholder agreement as to the manner in which the estate is to be dealt with once the case has been dismissed. Such orders are controversial in that they are not explicitly authorized through the United States Bankruptcy Code, but are especially controversial where the accompanying agreement seeks to distribute estate property in contravention of the priority scheme laid out in Section 507 of the Code. Where the agreement violates this “waterfall” payment method, bankruptcy courts are faced with difficult questions: should structured dismissals be strictly governed by the Code’s priority regime? Should they ever be approved where they deviate from priorities? If so, what standard should a bankruptcy court apply in deciding whether deviation is proper? This Note explores a recent decision by the Third Circuit, In re Jevic Holding Corp., in which the Court affirmed a bankruptcy court’s approval of a structured dismissal that cut against priorities, relying heavily on the importance of economic efficiency and stakeholder compromise in reaching its holding. This Note argues that while priority deviation is sometimes proper, the standard applied by the Third Circuit for approval of priority-noncompliant structured dismissals does not go far enough to ensure that the procedural safeguards of chapter 11 are upheld. This Note therefore proposes a multifactor analysis that would provide a more transparent system for approval of structured dismissals that do not comply with priorities.

Freight corridor performance measurement system: A framework for South Africa

Background: On a national level, South Africa’s freight logistics industry is inefficient. The country ranks 36th out of 40 countries in terms of transport productivity (tonne kilometres as a ratio of gross domestic product, or GDP); the ratio of freight logistics costs to GDP measured 11.1% in 2013, compared to that of developed regions which measures in the order of 9%; and rail tonne-km market share on the two most dense long-distance corridors, namely, GautengDurban and Gauteng-Cape Town, is only 12.8% and 4.4%, respectively, whereas rail is globally acknowledged as a more efficient provider of long-distance freight solutions, given appropriate investments and service commitments.Objectives: A cornerstone of improved national freight logistics performance is the availability of reliable indicators to quantify the efficiency and capacity of the logistics network over the intermediate and long term, thereby enabling an evidence-based policy and investment environment. The objective of this article is to describe the foundation framework (i.e. phase 1) for South Africa’s freight corridor performance measurement system (CPMS). Once populated, the CPMS will be a key generator of indicators to facilitate the systemic management of corridors as a national production factor and thereby contributing to South Africa’s competitiveness.Method: The design of South Africa’s CPMS was informed by desktop research and refined through an extensive stakeholder consultation process. A distinction was made between South Africa’s dedicated bulk corridors and the multi-modal corridors.Results: Facilitating both stakeholder involvement and agreement on key indicators, as well as the eventual development of a system supporting the population, aggregation and dissemination of the CPMS are critical outcomes for the management of corridors as a national production factor. Three overarching corridor indicators were defined, relating to increased throughput, lower costs and optimal modal application – the key rationale to improve the competitiveness of South African industry. This is supported by three corridor measurement perspectives, that is, a policy, customer service and infrastructure perspective. The purpose of the policy perspective is to support the role of national government in facilitating logistics competitiveness and equitable access through appropriate policy instruments. The customer service perspective should track service reliability and efficiency as contracted, at costs and cycle times that facilitate the competitiveness of the freight owner. The infrastructure perspective indicates whether sufficient capacity is provided, and whether this capacity is both available when required and utilised optimally.Conclusion: Elevation of logistics to the macroeconomic realm through the development of appropriate indicators will enable the management of logistics as a national production factor, thereby contributing to reducing national freight logistics costs and improving industry competitiveness.

Impacts of climate change on agro-ecological landscapes in the coastal area of the Thai Binh province (Vietnam) using the Delphi technique

Purpose– This paper aims to facilitate the joint assessment of issues related to the agricultural systems, i.e. agriculture, aquaculture and climate change (CC) response strategies, in the coastal districts with a panel of stakeholders; and to evaluate the level of agreement on the topics under consideration and potentially identify the most promising approaches to assessing CC affecting agricultural systems in the area and identify relevant and adequate response strategies.Design/methodology/approach– Stakeholder Delphi technique – its assessment is an interactive method of qualitative research used to facilitate the interactive participation of varied and conceivably hierarchical and antagonistic stakeholder groups.Findings– The most important result for the province is that the impact of climate change on agro-ecological landscapes (poverty and near river areas) is the duration of cold weather, more frequent and extreme. Moreover, Kendall’s W test gave a score of 0.547, which indicates a “strong” stakeholder agreement and the “confidence in ranks” being “high” in Thai Binh (Vietnam).Originality/value– The scientific results in this study are intended to serve as relevant knowledge-inputs and direct contributions to capacity-building for the local partners (stakeholders and local authorities). These local partners are engaged in policy-making and effective planning and implementation of climate response measures in the districts in the province of Thai Binh.

Identifying public land stakeholder perspectives for implementing place-based land management

Public lands provide significant environmental, economic, and social values to society across a range of classifications and tenures. Stakeholders representing multiple interests are presumed to hold different management preferences for these lands. The purpose of this study was to demonstrate how stakeholder perspectives can influence place-based management preferences for public lands. We developed a multi-dimensional public land preference scale and used cluster analysis of responses to classify individuals (n=1507) into stakeholder groups using data collected from a large public participation GIS (PPGIS) survey in Victoria, Australia. We analyzed the results of the two largest stakeholder groups (identified as “Preservation” and “Recreation”) to assess their spatial preferences for public land conservation, access, and development. We developed a method to assess the level of spatial stakeholder agreement, with the results identifying geographic areas of both agreement and disagreement between stakeholder groups. To determine the effects of unequal stakeholder participation in mapping, we performed sensitivity analysis by weighting the responses of the Recreation stakeholder group to approximate the mapping effort of the Preservation stakeholder group. The place-based management preferences changed significantly for conservation/development and improving/limiting public land access, while preferences for increasing/limiting facility development were less sensitive to stakeholder weighting. The spatial mapping of stakeholder preferences appears effective for identifying locations with high potential for conflict as well as areas of agreement, but would benefit from further research in a range of land management applications to provide further guidance on the analysis of stakeholder group responses that result from diverse stakeholder group participation.

Perceptions of practice guidelines for people with spinal cord injury.

The Consortium for Spinal Cord Medicine published clinical practice guidelines (CPG) related to upper limb (UL) preservation in people with spinal cord injury (SCI) in 2005. The purpose of this qualitative research was to identify stakeholder agreement with recommendations, performance gaps, and barriers and facilitators to CPG implementation. This 6-month study focused on the perspectives of healthcare providers, veterans, and key informants. The Promoting Action on Research Implementation in Health Services (PARiHS) was used to frame the interview questions, analyze data from focus groups and interviews, and develop conclusions and recommendations. SCI Centers at the Tampa, Seattle, and Hines Veterans' hospitals participated. The purposeful sample for the focus groups included 32 healthcare providers, 21 veterans with SCI, and 3 key informants. Analysis of qualitative data netted the percent of agreement with recommendations, performance gaps, and strategies for CPG implementation. Content analysis of focus group data revealed that healthcare providers agreed or partially agreed with 20 (57%) of the 35 CSCM CPG on UL preservation of function. Agreement ranged from 100% for assessment to 28% for equipment use. Barriers for implementation related to administrative and system issues. Consideration of gaps, barriers, and facilitators to implementation will assist clinicians to target interventions to preserve UL function.