Stakeholder Support Research Articles

Two decades of One Health in action: Enabling sustainable wildlife conservation and livestock production in southern Africa

Abstract The AHEAD (Animal & Human Health for the Environment And Development) program was launched in 2003 at the IUCN World Parks Congress in Durban, South Africa. We defined our mission as serving as “a convening, facilitative mechanism, working to create enabling environments that allow different and often competing sectors to literally come to the same table and find collaborative ways forward to address challenges at the interface of wildlife health, livestock health, and human health and livelihoods.” We continue on this mission more than 20 years later, convening stakeholders, helping delineate conceptual frameworks to underpin planning, management and research, and providing technical support and resources for projects stakeholders identify as priorities. As one of the first applied One Health programs, our work is premised upon the fact that the challenge of managing transboundary animal diseases (TADs) often lies at the heart of whether transfrontier conservation areas (TFCAs) will succeed or fail in their aspirations to become the ecologically resilient land-use entities required for long-term delivery of poverty alleviation and related development as well as biodiversity conservation benefits. As the Kavango Zambezi Transfrontier Conservation Area’s (KAZA’s) remaining key wildlife corridors, needed for wildlife populations to survive and thrive for generations to come, continue to be blocked by veterinary cordon fences, the urgency of improving regional animal disease management cannot be overstated. This is especially relevant for those European donors to TFCAs whose nations set up the veterinary cordon fencing-based disease management system in the first place – starting in the 1950s when today’s KAZA partner countries were European colonies or protectorates. The prevailing veterinary fencing paradigm is rooted in the colonial era, but with impacts on KAZA’s wildlife that have persisted on up to the present. If we fail to help all countries within a given TFCA actually co-manage disease threats to the livestock sector that all value highly – culturally, economically, and politically – then how can we expect significant progress in terms of fostering habitat connectivity across international boundaries? When a given country fears diseases they believe or know are across the border, how can we lower the perceived or actual risks of the vision of restoring wildlife migrations through removal of segments of the most environmentally damaging fences? The AHEAD program continues to work on these challenges, with recent progress on sectorally integrative approaches providing reasons for cautious optimism. One Health impact statement What was arguably the first applied One Health program, AHEAD (Animal & Human Health for the Environment And Development) was launched in 2003 at the IUCN World Parks Congress in Durban – a year before one of us led the drafting of The Manhattan Principles on ‘One World, One Health’ (Cook et al ., 2004 ). As AHEAD has recently marked its 20th anniversary, some introspection certainly seems prudent. Our goal, our raison d’etre , has been to serve as ‘a convening, facilitative mechanism, working to create enabling environments that allow different and often competing sectors to literally come to the same table and find collaborative ways forward to address challenges at the interface of wildlife health, livestock health, and human health and livelihoods’ (available at: http://cornell-ahead.org ). We continue on our One Health mission to convene stakeholders, help delineate conceptual frameworks to underpin planning, management and research, and provide technical support and resources for projects stakeholders identify as priorities. AHEAD’s One Health framing recognises the need to look at health, disease, and the environment together, while always taking a given region’s socio-economic, political, and policy context into account.

Implementation of Corruption Mitigation Strategies by Public Sector Leadership in Sierra Leone

Corruption impacts the daily lives of people. In Africa, leaders share blame for persistent corruption despite various strategies used to fight it. Sierra Leone has struggled to implement corruption mitigation strategies, and few studies have been conducted there about implementing corruption mitigation strategies. This qualitative transcendental phenomenological study was conducted to identify and report on those lived experiences. Two conceptual lenses of corruption, microlevel, and macrolevel agencies helped to elucidate implementation of corruption mitigation strategies in this study. The two most endorsed challenges were allegiances and influence peddling, and the two most endorsed accomplishments were stakeholder support, policies, and programs.

Does public participation foster stakeholder support for policy proposals? Evidence from the European Union

Does public participation foster stakeholder support for policy proposals? Evidence from the European Union

Pengaruh Environmental, Social, and Governance Disclosure (ESGD) pada Nilai Perusahaan: Peran Ukuran Perusahaan sebagai Variabel Moderasi

This study aimed to analyze the effect of Environmental, Social, and Governance Disclosure (ESGD) on firm value by considering firm size as a moderating variable. The research method used was quantitative. The type of data in this study was secondary data, namely annual reports and sustainability reports of mining companies for the 2021–2023 period. The sampling technique was carried out through a purposive sampling method, resulting in a total of 81 company data were obtained for the sample. The data were analyzed using SPSS 26. The results of the study showed that ESGD had a negative effect on firm value due to high costs that reduced profitability, leading investors who prioritized short-term profits to consider it a negative signal and lose trust. In addition, the results also showed that firm size strengthened the relationship between ESGD and firm value because large companies have adequate financial resources, are able to handle the complexity of ESG implementation, and had high visibility to attract stakeholder support.

New evidence of unequal contribution to health burden reshaping air pollution control in waste-to-energy plants.

New evidence of unequal contribution to health burden reshaping air pollution control in waste-to-energy plants.

Same-day discharge pathway for elective total hip and knee arthroplasty patients: a quality improvement project at a Canadian community hospital

Total hip arthroplasty (THA) and total knee arthroplasty (TKA) surgeries performed annually are increasing, with over $1.26 billion in hospital costs, according to the 2021/2022 Canadian Institute of Health Information...

133 Development of a customized tracking dashboard to enhance support for NIH Funded Investigator-Initiated Clinical Trials

Objectives/Goals: Early identification and profiling of planned studies is a critical administrative challenge in providing timely support for clinical trials. Here we describe the collaborative design and development of a clinical trial tracking dashboard to enhance support and quality improvement for investigator-initiated clinical trials at our institution. Methods/Study Population: Trial-CARE organized a workgroup with key stakeholders from WashU business units that manage grants, information technology, bioinformatics, data repository stewardship, and clinical trial support. The workgroup strategized next steps in a “proof-of-concept” effort to determine whether NIH investigator-initiated clinical trial metrics would be accessible via the WashU Data Warehouse. The WashU Data Warehouse is a data repository that pulls in pre-award and post-award data from sources such as the WashU Research-Grant Management System (RMS) and the NIH Reporter Tool. The proof-of-concept findings lead to implementing a plan for Phase 1 of the design, development, and piloting of a visual dashboard to track and offer targeted and timely support to NIH investigator-initiated clinical trials at WashU. Results/Anticipated Results: WashU currently has 217 grants submitted and 114 grants awarded for NIH clinical trials. In the proof of concept, we confirmed and successfully matched over 100 awarded NIH investigator-initiated clinical trials at WashU across RMS and the NIH Reporter Tool. We determined Phase I of the dashboard would track clinical trial data from these two sources via the WashU Data Warehouse. The pilot of Phase I of the dashboard will begin in February 2025. We also identified mission critical data elements not accessible via the WashU Data Warehouse (e.g., enrollment diversity, IND, and IDE). The plan to procure this data will require continued stakeholder support in Phase II of the dashboard to (1) expand data capture in RMS and (2) ingest additional data into the WashU Data Warehouse from RMS or new systems (e.g., ClinicalTrials.gov). Discussion/Significance of Impact: Early access to robust data about NIH investigator-initiated clinical trials via our newly created Phase I dashboard will better position our centralized service cores to support trial success, compliance, and quality improvement across the lifecycle of these clinical trials. In Phase II, we plan to expand the data available in the dashboard.

Stakeholder Perceptions of the School Vaccination Program in Special Schools for Adolescents With Intellectual and Developmental Disability.

Adolescents with intellectual and developmental disability (IDD) are reported to have lower uptake of routine vaccines than their peers. Little research has explored stakeholders' perceptions and support of school-based vaccinations for this population in NSW, Australia. Focus groups and interviews were conducted with four stakeholder groups involved in the vaccination program in special education schools in New South Wales, Australia: students with IDD, parents, education staff, and health professionals. Stakeholders mostly supported vaccinating adolescents with IDD in school settings. Students valued the familiar environment and emotional support from teachers. Parents appreciated the convenience and accessibility of the program. Education staff regarded vaccinations as vital for student health and mostly supported school-based delivery but faced practical and ethical challenges, such as insufficient resourcing, confusion around holding students for safety and emotional support, and concerns about losing students' trust in the school as a safe environment if vaccination was experienced as traumatic. Health staff identified a need for better prevaccination communication with families and schools to improve vaccine uptake and student preparation. Findings highlight a need for increased support for special schools that act as key program facilitators between those who deliver and those who receive this vital health service.

Challenges and Opportunities of Ultrasound in Pregnancy at Primary Care in Low-Middle Income Countries

The use of ultrasound in pregnancy was becoming more popular in LMICs as a routine antenatal care to detect early pregnancy complications. However, the challenges and opportunities of ultrasound in LMICs were not completely understood. This study aims to explore the challenges and opportunities of utilizing ultrasound in pregnancy at primary care in low-middle income countries. Method: The electronic databases from Springer, PubMed, and Science Direct through keywords “challenges AND opportunities AND ultrasound OR ultrasonography AND pregnancy OR pregnant AND primary care AND low middle income countries” were searched from 2014 to 2024 for studies available in English, qualitative or quantitative research, and free full text. A total of 8 articles from Australian rural/remote area, Kenya, Ethiopia, Rwanda, Vietnam, South Africa, and cross countries studies consist of Asia, Africa, and South America were included in this scoping review. Ultrasound training, availability of ultrasound equipment, and patient access to ultrasound service were the challenges of utilizing ultrasound. Stakeholder support and health systems became the opportunities to improve the utilizing and quality of ultrasound.Ultrasound examinations in LMICs still face several challenges. Opportunities that could overcome these obstacles would arise from the collaboration of multiple stakeholders.

The Challenges Of Integrating Sustainable Practices In Hotels And Lodges: A Case Study Of Victoria Falls

This study investigates the challenges associated with integrating sustainable practices in the accommodation sector of Victoria Falls, Zimbabwe. Despite the growing recognition of green tourism as vital for all tourist destinations, hotels in developing countries, including Zimbabwe, often struggle to implement effective environmental measures. This research examines the barriers to adopting sustainable operating strategies within the hotels and lodges of Victoria Falls. Using a mixed methods approach, data were gathered from hotel employees and managers. Qualitative insights were obtained through interviews with fifteen purposively selected key informants, while quantitative data were collected via questionnaires distributed to 150 participants using stratified random sampling. Thematic analysis was employed to interpret the qualitative data, and quantitative results were analyzed using Excel and manual calculations. Findings indicate that the hotel sector primarily adopts simple and cost-effective green practices focused on energy management, water conservation, and waste management. However, significant challenges hinder the effective implementation of these initiatives, including the high costs of acquiring green technology, insufficient stakeholder support, and limited financial resources. Additional barriers identified include a lack of awareness, inadequate infrastructure, and weak regulatory frameworks. This research highlights the intricate relationship between internal and external factors that influence the adoption of green strategies. It emphasizes the importance of organizational culture, leadership commitment, stakeholder engagement, and industry collaboration in overcoming these challenges. The study concludes by recommending the development of a stronger green tourism policy, enhanced guest education, and active stakeholder engagement to promote the implementation of sustainable practices in Zimbabwe's hotel sector.

Use of Transportation Utility Fee to Fund Non-auto Transportation Modes

This research examines the extent to which transportation utility (TUF) funds non-auto transportation modes in the US, factors that enable jurisdictions to use TUF to fund these modes, and specific ways in which TUF-levying jurisdictions support these modes. The paper finds that while the use of TUF is growing, it rarely funds non-auto transportation modes. Second, several factors enable jurisdictions to use TUF to fund non-auto transportation modes, including, strong local stakeholder support, broad powers provided by the states to the local jurisdictions to levy fees and taxes, and the local jurisdiction-level authorizing ordinances and policies explicitly allowing the use of TUF revenues for non-auto transportation modes. Third, the case study jurisdictions support non-auto modes in ways that are influenced by three, often interrelated, factors—the amount of fee revenue, whether a portion of the fee revenue is earmarked for non-auto uses, and whether the jurisdiction provides transit service.

PENERAPAN MEDIA SOSIAL UNTUK PENINGKATAN PEMASARAN PRODUK UMKM MAKANAN RINGAN

This study examines the implementation of digital marketing for MSME products, especially snacks in Sidosari Village, Salaman Sub-district, Magelang District. This research uses a qualitative approach through interviews and observations with 15 MSME players. This study aims to identify barriers to the use of digital marketing, analyze the potential of digital markets, and formulate effective marketing strategies. The results revealed that digital marketing expands market reach, marketing cost efficiency, and increased interaction with consumers. However, MSMEs in Sidosari Village face several challenges such as limited digital skills, difficulty accessing the internet, limited capital, and high competition among sellers. Further analysis shows that almost all MSME players in Sidosari Village still rely on conventional marketing methods. Based on these findings, this study recommends a digital marketing strategy that suits the needs of MSMEs, including digital skills training and social media. The research emphasizes the importance of government and stakeholder support in building a good digital ecosystem, including the provision of internet infrastructure and digital empowerment programs.

Intervensi Pengendalian Hipertensi Melalui Program Konselor di Dusun Pabuaran Desa Karyamukti Kecamtan Pataruman Kota Banjar Tahun 2025

Hypertension is a non-communicable disease whose prevalence continues to increase in Indonesia, including in Pabuaran Hamlet, Karyamukti Village, Pataruman Sub-district, Banjar City. This disease is known as the silent killer because it often does not show clear symptoms but can cause serious complications such as stroke and cardiovascular disease. Based on the results of community diagnosis in Pabuaran Hamlet, it was found that the prevalence of hypertension in this area reached 87.8% with high salt food consumption as the main risk factor. To overcome this problem, an intervention was conducted through the Konselor (Hypertension Control with Moringa Leaves) program, which aims to prevent and control hypertension by utilizing moringa leaves to reduce the effects of consuming high-salt foods. This program collaborates with Pataruman 2 Puskesmas through the Sakalor (Saimah Sakelor) program and involves various parties such as PKK cadres, especially Pokja IV, Field Agricultural Extension Workers (PPL), Women Farmers Group (KWT), and village government. The counselor's intervention activities include health education through counseling on healthy eating patterns, demonstrations on processing moringa leaves into herbal tea and procedures for planting moringa plants, as well as distribution of moringa plant seeds and leaflets to the community. The method used in developing the program uses SWOT analysis to identify internal and external factors, and the preparation of a Plan of Action (POA) as an implementation guide. The evaluation results showed that the Counselor program increased community awareness about the importance of hypertension control and how to use moringa leaves. However, several obstacles were faced, such as unoptimal community participation, uneven distribution of leaflets, and limited supporting facilities. Nevertheless, the program succeeded in initiating changes in community behavior in healthy consumption patterns. In conclusion, the Counselor Program can be an effective intervention model in community-based hypertension control. It is hoped that this program can be sustainable with the support of various stakeholders and increased community participation in implementing a healthy lifestyle, so that the incidence of hypertension in Pabuaran Hamlet can be significantly reduced in the long term.

Designing a precision-medicine platform trial to improve the nutritional care and intestinal health of very preterm babies: the COLLABORATE study

Background Nutrition is essential for preterm brain development. Optimal nutrition is dependent upon gastrointestinal health. Primary objective To form a multiprofessional collaboration to design the world’s first neonatal precision-medicine platform trial to test new and existing nutritional interventions for very preterm infants, to prevent and treat the serious gastrointestinal inflammatory disease necrotising enterocolitis and improve brain health and development. Participants Infants born very preterm (< 32 weeks gestation). Data sources Published literature; United Kingdom National Neonatal Research Database. Methods Engagement with parents, patients, clinical teams, and industry; literature reviews; simulation studies; mechanistic study design; collaborative study development. Results There was strong stakeholder support for the platform; seven interventions were selected from those proposed, four for immediate evaluation (pasteurised human donor milk; cow milk- and human milk-derived macronutrient fortifiers; probiotic), and three for subsequent incorporation (enteral arginine; enteral insulin; fluorescence image-guided surgery). We involved Australia/New Zealand neonatal units to shorten recruitment time, designed a precision-medicine platform trial, specified operational requirements and costs, developed engagement materials, and established parent–patient, independent scientific advisory and emerging investigator groups. Limitations National Institute for Health and Care Research processes required stage 1 application submission 8 months into the Accelerated Development Award. This was unsuccessful and did not include an opportunity to respond to feedback. Conclusions Stakeholders consider a neonatal precision-medicine platform trial a high priority, providing an efficient approach to establish the efficacy of treatments and the gestational age range of infants most likely to benefit, and to speed the pace of evidence generation to improve clinical care. Future work Reapplication, requiring a further stage 1 application. Funding This article presents independent research funded by the National Institute for Health and Care Research (NIHR) Efficacy and Mechanism Evaluation programme as award number NIHR153935.

MyAURA: a personalized health library for epilepsy management via knowledge graph sparsification and visualization.

myAURA: a personalized health library for epilepsy management via knowledge graph sparsification and visualization.

Effectiveness of Digital Interventions in Improving Knowledge and Attitudes of Adolescent Mental Health: A scoping review

Adolescent mental health is a critical issue that affects their quality of life and development. Digital interventions offer an innovative solution to enhance mental health literacy among adolescents. This article to identify the effectiveness of digital educational interventions in improving adolescents' knowledge and attitudes toward early detection of mental health issues. A scoping review was conducted using the PEOS framework. Literature searches were performed in PubMed and ScienceDirect databases for articles published between 2019 and 2024. A total of 15 articles were selected based on inclusion and exclusion criteria. Digital interventions, such as school-based applications and social media campaigns, enhanced mental health literacy and reduced stigma related to mental health. Several interventions also improved adolescents' abilities to recognize mental health symptoms and encouraged help-seeking behaviors. However, challenges such as low digital literacy and limited access remain significant barriers to implementation. Digital education effectively improves adolescents' knowledge and attitudes toward early detection of mental health issues. Culturally relevant approaches and stakeholder support are crucial for the program's sustainability.

Stakeholder analysis of construction liquid waste management in Victoria, Australia

Construction sites generate liquid waste, and improper management can cause significant environmental and human impacts. Recent research in Australia revealed that multiple stakeholders with diverse interest and their lack of coordination impact the management of liquid waste. Thus, the study aimed to analyze the stakeholders in the construction liquid waste management process in Victoria, Australia, to understand the communication and coordination mechanisms present among them. The study used a questionnaire survey to identify stakeholder power, awareness, interest, support, and stakeholder networks in construction liquid waste management. Focus group was used to validate the findings from the survey. The findings show that public authorities, water corporations, local councils, building authorities, and construction companies are the key parties involved in the construction liquid waste management process. It was identified that lack of relationship between key stakeholders; lack of education, knowledge, and awareness; lack of liquid waste management requirements in building codes; and lack of strategic involvement of water corporations as four key limitations. Five strategies were identified to improve the liquid waste management process and foster the relationship among stakeholders. The findings will help as an initial step to streamline construction liquid waste management processes by clearly defining the responsibilities among key stakeholders.

Peran Manajemen Pendidikan dalam Mewujudkan Pendidikan Berkualitas

Educational management has a very important role in realizing quality education, which aims to improve the quality, effectiveness, and efficiency of the education process. The purpose of this study is to examine more deeply the role of educational management in realizing quality education. The research method that will be used in this study is a literature study approach, where data and information will be collected from various academic sources, such as books, journals, and relevant articles on educational management and realizing quality education. The results of this study indicate that quality management plays a key role in creating quality education through main components such as curriculum, human resources, financial management, facilities and infrastructure, and cooperation with external parties. Each of these components works synergistically to support an optimal learning process, although it often faces challenges, such as limited resources, resistance to change, and lack of stakeholder support. Through collaboration from various parties, including the government, community, and parents, schools can overcome these challenges. The role of educational management equipped with Educational Quality helps improve the professional quality of teachers, curriculum, and school management, as well as build cooperation with external parties. This synergy produces schools that are quality, adaptive, and able to answer the demands of today's education.

How Effectiveness of Posyandu Child Visits 6-59 Months Frequency Prevent Stunting?

Research in Jambi Province at 2013 showed a high prevalence of stunting by 37.9%. This may indicate the risk of low quality of human resources. On the other hand, the visit of posyandu in Jambi Province was very low at 25%. Posyandu activities should be a monitoring activity of child growth, health promotion activities, early prevention of infectious diseases such as immunization, and supplementation of vitamin A. This study aims to determine the association of posyandu child visits 6-59 months frequency with stunting in Jambi Province. A total of 2502 children from 6 to 59 months eligible were sampled from nutritional status monitoring. To know the reason for the low of posyandu visit, qualitative research was conducted in 2 districts. The results showed one of four (27.5%) children 6-59 months was stunting. The result of binary logistic analysis shows that the frequency of posyandu visit is not associated with stunting. Its indicates that programs run by posyandu have not been effective in preventing stunting. Attention to cadre knowledge, cadre skills, mother knowledge, facilities and infrastructure, stakeholder support is a priority to improve the function of growth monitoring, promotion and referral in posyandu so as to effectively prevent stunting.

P-1769. Improving Surgical Prophylaxis for Patients with Penicillin Allergy Label

Abstract Background Patients with a penicillin allergy label (PAL) have an increased risk of surgical site infection when receiving a β-lactam alternative for surgical prophylaxis. The updated 2022 Drug Allergy Parameters support the use of cefazolin for patients with a penicillin allergy history including anaphylaxis. We evaluated antibiotic use for surgical prophylaxis in a large academic center. Methods We performed a quality improvement intervention to decrease inappropriate use of non-β-lactam antibiotic surgical prophylaxis in patients with PAL at a 1091-bed tertiary hospital. Beginning in 10/2018, we provided education at anesthesia grand rounds and surgical safety meetings regarding preferential use of cefazolin in patients without severe PAL. In 12/2023, we updated institutional guidelines to recommend cefazolin use in all patients except those with history of anaphylaxis to cephalosporins, isolated hives to cefazolin, and β-lactam-associated severe cutaneous drug reactions. This was communicated to anesthesia and surgery stakeholders. Peri-operative antibiotic prophylaxis alert cards were hung in the operating rooms (Figure 1) and clindamycin and gentamicin were removed from OR medication-dispensing machines (ORMD). Results There was a significant decrease in clindamycin use from 11.2% in the pre-education period to 6.2% after education, further reduced to 1.7% since updating institutional guidelines and removing clindamycin and gentamicin from ORMD. Concurrently, cefazolin use increased from 9.0% to 26.0% to 39.5% in the same periods (Figure 2). This was seen across surgical services (Figure 3). Decreases were also seen in gentamicin use. There was no significant change IV vancomycin use as an alternative for patient with PAL. There was no increase in episodes of perioperative anaphylaxis related to these interventions. Conclusion There remains significant opportunity to optimize surgical prophylaxis for patients with PAL. QI efforts such as acquiring stakeholder support and development and dissemination of teaching materials were effective in reducing suboptimal perioperative antibiotic prophylaxis. Informative posters at point of care and removal of clindamycin and gentamicin from OMRD further reduced inappropriate surgical prophylaxis in patients with PAL. Disclosures All Authors: No reported disclosures