Strong Stakeholders Research Articles

Review of the Paradigm on the Role of Print Media in Influencing Public Health

This paper explores important issues related to media research in the context of public health debates and emphasises the requirement of a research plan including media production based on political sciences. Consensus is that via topic selection and presentation, the media significantly impacts public health dialogues and influences public opinions. Often reflecting the interests of strong stakeholders, the way the media presents health challenges, their causes, and solutions greatly influences public health debate. But modern studies often overlook the complex processes of media production necessary for knowledge of how political economics, power, and culture impact these debates. Media production is not just the consequence of linked networks, occupational practices, technology, and institutional contexts reflecting ideological convictions; it is also the output of newsrooms, revealed by a thorough study of media production. Examining non-communicative diseases (NCDs), a major worldwide health concern affected by unsustainable commodity sectors, this viewpoint is very vital. Public health studies have not yet completely revealed the media tactics used by businesses pushing negative items such alcohol, tobacco, and processed foods. Underexplored is the impact of these sectors on public health policy discussions mediated via media coverage.

Assessing the Impact of Post-Conventional Leaders

This article provides a literature review of the state of the art in evaluating the impact of post-conventional stages of development for leaders, focusing on their impact on successful change management, on the integration of environmental concerns and practices, and on stakeholders’ relationships. A synthetic review of the general theory of adult development and of its implications to leadership is provided. Then, the empirical evidence for the impact of post-conventional leaders at work is introduced and discussed. The studies here reviewed suggests that post conventional stages of development can be a strong predictor of leadership performance, in (a) successfully leading organizational change, (b) in driving forward advanced environmentally and socially responsible initiatives, and (c) in creating strong stakeholders’ relationships. Further directions for future research are suggested.

Collaborative Governance in Mangrove Ecotourism Policy on Bintan Island Coastal Approach of Penta Helix

This study aims to explore the effectiveness of collaborative governance in implementing mangrove ecotourism policy on the Bintan Island coastal approach of penta helix. The research objectives are to identify the key stakeholders involved in the mangrove ecotourism policy formulation and implementation process, assess their roles and relationships, and analyze how collaborative governance can enhance their collaboration and coordination. Research method uses descriptive qualitative and uses NVivo-20 software analysis which is analyzed in depth. The results show that the penta-helix element in Collaborative Governance has gaps that do not involve all stakeholder actors, both from local government, academia, the private sector, community groups and the media. but in terms of policy or implementation of a Mangrove ecotourism program, scientific studies are needed to support Mangrove ecotourism in coastal areas in Islands Regions have strategic potential to be managed properly by strong stakeholders. The importance of active involvement of the local community as wide as possible with stakeholders such as central, regional and business actors in planning, implementing and making decisions in the formation and management of a Destination Management Organization (DMO). The findings also the need for further research to investigate can be integrated into the policy-making process and contexts.

Spectrum Management for Local Mobile Communication Networks

Spectrum management is a complex topic that divides stakeholders' perspectives. Recently, a major paradigm shift has taken place with the emergence of local 4G and 5G networks via local spectrum licensing models in several countries, allowing different stakeholders to establish their own mobile communication networks within specific facilities, such as a factories and ports. These local mobile communication networks can serve mobile network operators' (MNOs) end users, closed user groups, or a mix, resulting in operations under different regulatory conditions. Their emergence relies on spectrum availability in the given location, which is managed by national regulators. Local spectrum availability can be increased with spectrum sharing where two or more radio systems operate in the same band, but stakeholder views differ - some promote it while others object it. This paper analyzes the most recent spectrum management developments from the viewpoint of emerging local mobile communication networks considering the role of spectrum sharing. The analysis reveals how differently the countries have prepared for the new business opportunity arising from local mobile communication networks in their spectrum awarding decisions and quantifies current spectrum availability for establishing local 5G networks. The results show varying spectrum management approaches taken by the regulators. Especially, local spectrum licenses appear in the most recent spectrum awards. To realize a large number of local 4G/5G and future 6G networks, spectrum sharing will become critical and needs to be clearly defined and understood to mitigate currently strong stakeholders' objection.

Are business schools from the Global South walking their talk? Internalizing responsible management education in Africa, Asia, and Latin America

We analyzed how business schools in Latin America, Africa, and Asia internalized responsible management education. Nine hypotheses grounded in the relevant scholarly literature were tested. Data were analyzed using Multiple Correspondence Analysis. Results show that B-schools were subject to strong stakeholders' pressures: the higher those pressures, the deeper the internalization of RME. Most schools shunned a “built-in” approach, in favor of the inferior “bolt-on” alternative; RME integration in capstone courses and institutional transformation lagged. While prestigious schools did not seem keen to embrace RME, low and mid-prestige schools have made significant advances, presumably to create differentiation in a crowded market. B-schools’ transformation will require a combination of “push” (stakeholders) and “pull” (institutional actors). Society has a stake in this, as management students will eventually manage the world's most influential organizations. Future studies can investigate what is holding back the process and included stakeholders left out in this survey.

Cluster Based Pre-scaling Up of Soil Test Fertilizer Recommendation Rate for Maize in Selected Districts of Buno Bedele Zone, Southwestern Ethiopia

Ethiopia is grappling with overwhelming challenges to produce more food for a fast-growing population due to fragmented land with low soil fertility status owned by poor smallholder farmers who are unlikely to afford adequate input use. Given this, Bedele Agricultural Research Center with the support of AGP-II conducted; cluster based pre scaling up of soil test fertilizer recommendation rate for maize in selected districts of Buno Bedele zone, Southwester Ethiopia with the objectives of popularizing soil test fertilizer recommendation rate for maize through enhancing farmers’ knowledge and skill and strengthening stakeholders’ linkage in the study areas during 2019 cropping season. Bedele and Chora districts were selected purposively for being maize production potential in the zone and the conducted soil test calibration studies in which two clusters having 52 farmers (45 male and 7 female) were established in collaboration with different level agricultural stakeholders for the sustainability of technology transfer. The total land size used for cluster approach was 15 hectare in which the two maize varieties Shone and BH661 were planted with the site specific soil test based fertilizer application. For technology transfer; training and field day consisting 283 stakeholders (253 male and 30 female) were held. In general, the attained yield of Shone variety in Bedele was 7.3 tons ha^-1, whereas BH661 in Chora district was 5.2 tons ha^-1 that exceeds the attained average national maize yield 3.7 tons ha^-1 in 2019 cropping season. Therefore, scaling-up of the soil test fertilizer recommendation rate for maize should be carried out in the study areas and similar maize potential agro-ecological zones with strong stakeholders’ participation.

A view through the lens of policy formulation: the struggle to formulate Swedish moose policy

ABSTRACT Policy formulation refers to how problems identified in the agenda-setting phase transform into government programs. As the process of designing policy alternatives expresses and allocates power among different interests, policy formulation affects both implementation and outcomes. This paper examines the Swedish moose policy of 2010, revealing that the policy portrays the issue of moose as an ecological problem, while motivations for adopting policy measures are largely described in economic terms. Because of this incongruity, the policy may not achieve its goals. Furthermore, implementation principles stemming from different design strategies clash in the attempt to incorporate both local and ecosystem-based levels of management into a single system, leaving the policy implementation with many uncertainties and tensions. To deliver the policy’s goal, the government could consider clarifying the operationalization of the ecosystem-based management approach and identifying the prerequisites necessary for building capacity, dealing with strong stakeholders, and ensuring fair representation of key actors. Future research should further explore the consequences of policy imbalances in relation to intended goals, the importance of understanding the rationales and design strategies underpinning implementation principles, and the need to discuss operationalization of EBM in relation to different types of objects of management and to issues of scale.

Do Strong Stakeholders Keep Firms Out of Trouble? Evidence From Major Customer Relationships

We examine whether economic links with major customers, an important group of strong stakeholders, act as a deterrent to corporate misconduct. We show that firms with a concentrated customer base are less likely to commit misconduct and pay lower penalties. These findings hold with numerous robustness checks and different attempts to mitigate endogeneity concerns. Consistent with a risk management motive of customers, we find that the negative effect of customer concentration on misconduct is more pronounced when perceived supplier misconduct risk is higher, and that firms with major customers do not engage in more corporate goodness. Exploring underlying economic mechanisms, we find that firms with major customers exhibit improved worker safety, more employee-friendly workplace practices, and less aggressive financial and investment policies. We also provide suggestive evidence that major customers discipline supplier misconduct through both external influence and internal control.

Sustainability Impact Assessment (SIA) in fisheries: Implementation in EU fishing regions

An Impact Assessment (IA) is a process aimed at structuring and supporting the development of policies. Besides the fact that IA assumes different features when applied to different sectors, really it should help policy makers in evaluating the contribution to the fisheries sustainability of new regulations. The recent improvements and development around the IA methodologies go more and more toward the concept of a Sustainability Impact Assessment (SIA). The evolution of IA in the fishery sector has followed the general and increasing need in having a more and more integrated type of analysis, focusing on the three dimensions of sustainability (environmental, economic and social). This paper synthesizes the methodology developed under the EU FP7 SOCIOEC project,11Socio economic effects of management measures of the future CFP (grant agreement 289192), financed by the FP7. whose main objective was the application of the most recent EU guidelines on IA to the current (and future) EU fishery management. The result is an integrated approach taking into account the main pillars of sustainability and a strong stakeholders’ involvement. A clear step-by-step procedure based on both qualitative and quantitative type of analyses has been defined, the last step being the “rating” phase, an essential step in a SIA, that provides the possibility to assess the results of different policy options (allowing policy makers to select the most appropriate one) in terms of acceptability, effectiveness, coherence and efficiency. The overall methodology has been tested on different EU regions, fisheries and management measures.

Sharing the Caring - Reinvigorating GP Ante-natal Share Care on the Central Coast

Introduction – context and problem statement: An examination of the causes of a substantial decline in GP Antenatal Share Care (GPANSC) on the Central Coast over the last 15 years, and solutions to re-invigorate the GPANSC. Aim and theory of change: GPANSC can provide women centred care and continuity of care close to the woman’s home. A survey of Central Coast women showed 9% want GPANSC however only 3% were participating. Goal: Improve women’s access to antenatal care of their choice, by increasing GPANSC. Objectives: 1. Increase the number of women receiving GPANSC from 3% to 9% and the number of GPs who provide ANSC from 71 to 81 by January 2018. 2. Ensure that all pregnant women accessing pregnancy care with the LHD are aware of GPANSC as an option. The Agency for Clinical Innovation (ACI) Clinical Redesign Framework and Accelerating Implementation Methodology (AIM) principles were followed. Targeted population and stakeholders: Women presenting for pregnancy care GPs Local Health District & Primary Health Network staff Timeline: Jan 2016-2018 Description of practice change implemented: ACI Clinical Redesign methodology with strong stakeholder involvement in all stages. Solutions are being implemented to address the key issues identified: Increase Women’s knowledge of options of care Remove Registration list for GPs Improve Communication between key stakeholders Regular Antenatal Education Events Central Contact Person Pilot Midwife position providing GP Practice Visits Increase Use of HealthPathways Highlights – innovation, impact, outcomes: This project is currently in implementation phase and early results are promising: Patient surveys showed patient understanding of GPANSC increased from 67% (April 2016) to 81% (December 2016). 18 new GPs commencing GPANSC. Sustained increase in the number of views of relevant pages on HealthPathways since June 2016. Percentage of women enrolled in GPANSC has risen to 5.6% (at September 2017). 38 GP Practice visits from pilot Midwife position. Sustainability: Greater collaborative community based Antenatal Care not only increases patient satisfaction but has positive fiscal benefits for LHDs as GP ANSC is partially or fully funded via Medicare. Low- risk pregnancy care in the community with GPs also results in an increased capacity in the hospital setting for High Risk Clinics. Transferability: There is generality of the diagnostics and solutions generated in this clinical redesign intervention for other LHDs looking to provide woman centred care in a collaborative model, and sustainable maternity services in a time of medical and midwifery workforce shortages and increasing birth rates. Conclusion & Key Findings: This initiative demonstrates collaboration between a Local Health District and GPs to connect health care for the benefit of pregnant women. Following a structured framework for clinical redesign is important to ensure strong stakeholders engagement. Discussions: Addressing long standing communication issues and declining interest in GPANSC requires extended timeframes and a commitment to maintaining relationships between stakeholders. Lessons Learned: Patient experience measures are useful to feedback to clinicians, and are powerful drivers for change. Implementing a clinical redesign project during an organisational restructure and redevelopment maybe challenging due to change fatigue among staff.

An Integrated Health Collaboration – A Localized Solution

Introduction : Operating under confirmed Terms of Reference and supported by a signed Statement of Intent, an Integrated Health Committee (IHC) was established between a Local Health District and Primary Health Network to oversee improved integration of services and information between them and other health providers. Under this stewardship, great progress has been made in developing initiatives for a population of 950,000 where locally tailored solutions are delivered balanced with a remit to scale these across this population base. This paper will address the opportunities and barrier of this large-scale and fast-paced health reform and to identify lessons to be learned. Short description of practice change implemented : The Service Model from the IHC has designed around community needs, maximises community participation, harnesses emerging technologies and optimises interagency coordination to address targeted health issues and to facilitate access to a wide range of services and assistance. Aim and theory of change : The aim of the IHC is to strive for a health neighbourhood model in which services are designed to envelope their users, where data is collected and analysed, and technology and shared real-time patient information is available to health care providers to facilitate more integrated and continuous care. Targeted population and stakeholders : The IHC established comprise a range of stakeholders from the Local Health District, Primary Health Network, General Practitioners (GP), senior clinicians, consumers and indirectly with Non-Government Organisations and Local Government. It aims to change the way local residents use traditional health services. The framework conceptualise the governance and support structure to achieve this vision include a strong stakeholders engagement from consumers, health service staff and primary health care workers inclusive of the GP. Timeline : The groups reflect the core integrated care elements and are tasked with identifying and scoping priority models of care and resources required for implementation in order to select suggested areas for action. The partners have acknowledged the importance of articulating a clear vision, provide dedicated resources and the value of working in true partnership with stakeholders. Highlights : The initiatives implemented, under the leadership of the IHC include: - ORAN Park Family Centre - infrastructure - Wollondilly Health Alliance – population and system - Health Pathway – system and infrastructure - Research & Evaluation in integrated care – system These initiatives have been evidenced in filling some of the gaps and issues identified in the region such as improved access to GPs, health service planning in align to population projections and health priorities and connectedness between providers and sharing of clinical information. Conclusions : Integrated care can be implemented successfully in any type of health system and it does not depend on the presence of a single point of control. However, implementation is difficult, and success cannot be achieved quickly. But if the elements and enablers are in place, particularly led by champions, integrated care can work almost anywhere. Discussions : As part of broadening the reach of this endeavour, the IHC has re-engerzing to become an Integrated Care Collaboration operating under a well-defined Governance Framework and Strategy.

The Magnitude of Nutritional Underweight and Associated Factors Among Children Aged 6-59 Months in Wonsho Woreda, Sidama Zone Southern Ethiopia

Background: Childhood under-nutrition is a major global health problem. Although the rate of under-nutrition in southern Ethiopia has substantially declined in the last decade, but it still remains the major causes of morbidity and mortality of children under-five years. Unfortunately, there was no study in this study area with respect to this topic of interest and therefore, this study was carried out to assess the magnitude of underweight and associated factors among children aged 6-59 months. Methods: A community based cross sectional study was conducted in Wonsho Woreda, Southern Ethiopia. A total of 595 randomly selected child mother pairs were selected using cluster sampling method. Data were collected using a face-to-face interview and children anthropometric measurements. Child Dietary Diversity Score (DDS) was determined. World Health Organization Anthro software was used to convert anthropometric measurements into Z-scores. The data was analyzed using Epidata version 3.1 and SPSS version 20. Bivariate and multivariable logistic regression model was used. A statistical significance was declared at p-value less than 0.05. Result: The overall prevalence of underweight was 122(20.5%) (95% CI, 17.3-23.8%), meanwhile, the prevalence of severe and moderate underweight was 7.1% and 13.4% respectively. Male children were 1.78 times more likely to be underweight than female children (AOR=1.78; 95%CI=1.17, 2.70). Unimmunized, children were 2.45 times more likely to be underweight (AOR=2.45; 95%CI=1.41, 4.24). Conclusion: Prevalence of nutritional underweight was high in the study area. Driving factors of underweight were investigated and therefore, strong stakeholders’ collaboration is compulsory to address the future public health burden.

A stakeholder-based EU territorial cooperation: the example of European macro-regions

ABSTRACTIn the last decade, European regional policy has faced considerable changes typified by the introduction of the place-based approach with the Barca Report. One of the most prominent changes in European territorial cooperation (ETC), supposedly reflecting this shift, is the development of macro-regions, the dynamic of which are only just beginning to influence policy-making. This paper aims to analyse contemporary styles of ETC under the place-based narrative by identifying characteristics of macro-regional cooperation. Drawing on empirical studies in the Danube, Alpine and North Sea regions, the paper shows that stakeholders’ primary rationale for getting involved is the opportunity for agenda-setting, and the intention to evoke changes in debates and in other stakeholders’ influence. The main argument the paper follows is that macro-regional experiences reveal a crucial dependence on relatively strong stakeholders. With the term ‘stakeholder-based’, the paper draws attention to the importance of stakeholder settings in these new forms of ETC. The paper concludes that conceptualizations of approaches to European regional policies would need to acknowledge the regional differences of stakeholder settings more explicitly, and highlights the need to better acknowledge the implications for political transparency and relative power in agenda-setting.

Stakeholder responses to government austerity: what happens when strong stakeholders fail to react?

Using stakeholder theory and a historical case study, I examine how key stakeholders failed to challenge the Alberta provincial government’s fiscal reforms, leading to the emergence of an unlikely champion in the Calgary hospital laundry workers. Notwithstanding that several prominent and powerful professional groups had the opportunity to oppose the government’s reforms, these groups either acquiesced or sought compromise individually with the government. This case calls into question the professions’ ability to protect public institutions under their domain. Points for practitioners In terms of potential implications for public administrators, this case provides an example of professional failure to intercede in the public interest, despite having the power and legitimacy to act according to stakeholder theory. This raises questions as to the circumstances under which professional groups will exercise their advocacy role. Unaddressed are the conditions under which relatively powerless demanding stakeholders can acquire power and legitimacy. Accordingly, administrators ‘relying’ upon established stakeholders as barometers of public opinion may misread public sentiment.

Dwelling in Possibility

Challenges to historic house museums are often mired in the rhetoric of crisis. Toward countering that rhetoric, this essay attempts to draw attention to it and to the complicated history of narrative (and storytelling) in interpretation and the academy. It argues that literary house museums are sites of innovation within the house museum sector with lessons for us all. These lessons include a willingness to leverage “the old, bad history” toward reflective practice and continuity for multigenerational audiences; creating inventive university and school partnerships toward insuring strong community stakeholders; embracing the history of race, gender, and sexuality; and perhaps most importantly, making the most of fiction toward embracing multiple points of view about the past.

124IN - Phase I Cancer Drug Development in Europe

ABSTRACT Early drug development (EDD) in Europe is today very much in line with EDD in the USA in terms of regulatory process, timelines, and methodological approaches. However in Europe, approval for clinical trials of new agents is the responsibility of each member state, with each country providing its own regulatory authority. In that same direction the EU Clinical Trials Directive (CTD) provides the principles (derived from ICH-GCP), which are however interpreted and converted to law separately by each member state (1). While historically cooperative groups used to be strong stakeholders of EDD in the EU (ie, the Early Clinical Trials Group of the EORTC, SENDO, the Experimental Cancer Medicine Network of Cancer Research UK, CESAR), there is a clear trend towards the emergence of individual phase I centers where the expertise and the reputation for the conduct of these studies has been firmly established. Among those centers, the largest ones (by number of new patients enrolled in phase I/year) encompass: the Drug Development Unit at The Royal Marsden in London, the Vall D'Hebron Institute of Oncology in Barcelona, and the Drug Development Department (DITEP) at Gustave Roussy in Paris. Recently a retrospective analysis of phase I data from 14 European Institutions has demonstrated that phase I trials are characterized by a 50% likelihood of patient benefit (ie PR, SD) and a very low risk of toxic death (0.5%) (2). In collaboration with pharmaceutical companies and academia, an EORTC-led initiative, DLT-TARGETT, collected data encompassing 24 918 adverse events from 2084 patients included in 54 completed phase 1 trials. This initiative concluded that a) dose-increment recommendation need to take into account all available information, notably DLTs observed beyond cycle 1 in prior (and current, if feasible) dose levels b) any toxicity – whatever the grade - leading to a significant decrease in RDI should deserve particular attention c) the Recommended Dose for further studies should incorporate all available information - notably toxicities observed after C1 and intolerable clinical G2 toxicities - and be based on achieving > 75% RDI (3)

Is One Health delivering results? Introduction.

The One Health concept is responsible for a shift towards practices, policies and partnerships that better link the health of people, animals and our shared environments. The papers in this issue of the World Organisation for Animal Health Scientific and Technical Review illustrate a myriad of ways in which a One Health approach could advance or has already advanced human and animal well-being. Independently, the authors conducted their own thematic analysis of One Health activities and found strong support for the notion that One Health has inspired a renaissance in veterinary public health, increased our basic knowledge of the mechanisms and natural history of many animal diseases, promoted systems approaches to health issues and encouraged stronger cross-sectoral collaboration. Unfortunately, many collaborations often end when funding ends and many remain distinct partnerships. One Health still suffers from a lack of strong environmental stakeholders and has mostly worked on infectious disease rather than addressing many of the pressing determinants of health that will confront us in the next century. There is no shared conception of health across veterinary, medical and environment sectors, and this is an issue that must be confronted if there are to be programmes that are truly integrated across people, animals and the environment.

Strategic use of scope in multi-business healthcare firms

This paper examines how executives in multi-business healthcare firms strategically use scope and the extent of centralisation to compete in the dynamic and complex healthcare environment. Scope is defined as the breadth and type of businesses comprising the corporate firm. Results suggest executives tend to take a decentralised approach attributed to the dynamic nature of healthcare and strong institutional stakeholders. Also, two distinct strategic groups based on different scope of businesses are observed. One group provides health plans and emphasises its ambulatory care services, while the other group does not provide health plans and focuses on its acute hospital and sub-acute long-term care businesses. Finally, executives are engaging in new ways of competing by increasingly purchasing different types of related non-patient care for-profit businesses and engaging in multiple collaborations in order to increase profitability.

Crisis Management: Lessons Learnt from the BP Deepwater Horizon Spill Oil

The present paper studies the BP crisis management of the Deepwater Horizon Disaster which occurred on April 20th, 2010. The authors content-analysed a large amount of secondary data from various sources, used the three-phase crisis management model and found that BP management of this crisis failed at many levels. The authors mainly highlighted four lessons relating to the connection between the Corporate Social Responsibility and the crisis management, the importance of the initial response when a crisis occurs, the need for strong stakeholders’ relationship before, during and after the crisis; and the opportunity to learn from a crisis.

Social responsibility, activism and boycotting in a firm–stakeholders network of games with players’ conformist preferences

This paper focuses on the relationships between firms and stakeholders and provides a theoretical explanation for the emergence of phenomena such as stakeholder activism and socially responsible behaviors by firms. We start by drawing an original distinction between weak and strong stakeholders where, as long as only material payoffs are considered, firms are interested in cooperating only with the latter. Then, arguing that the motivations and preference systems of economic agents are complex and irreducible to mere rational self-interest, we consider agents endowed with conformist preferences: that is, agents that obtain positive ideal utility by conforming with some ideal principles that they are willing to fulfill conditionally on the expected behavior of others. Given conformist preferences, we show that: (a) strong stakeholders may have incentives to punish firms who do not cooperate with the weak ones; (b) both strong stakeholders and firms may have incentives to cooperate in the long term and to ensure that weak stakeholders receive a fair proportion of the surplus generated by the firm's activity.