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Severe hemorrhage is the leading cause of early preventable death in severe trauma patients. Delayed diagnosis is a poor prognostic factor, and severe hemorrhage prediction is essential. The aim of our study was to investigate if there was an association between the detection of peritoneal or pleural fluid on prehospital sonography for trauma and posttraumatic severe hemorrhage. We retrospectively studied data from records of thoracic or abdominal trauma patients managed in mobile intensive care units from January 2017 to December 2021 in four centers in France. Severe hemorrhage was defined as a condition necessitating transfusion of at least four packed red blood cells or surgical intervention/radioembolization for hemostasis within the first 24 h. Using a multivariate analysis, we investigated the predictive performance of focused assessment with sonography for trauma (FAST) alone or in combination with the five Red Flags criteria validated by Hamada et al. Among the 527 patients analyzed, 371 (71%) were men, the mean age was 41 ± 19 years, and the Injury Severity Score was 11 (Interquartile range = [5; 22]). Seventy-three (14%) patients had severe hemorrhage - of whom 28 (38%) had a positive FAST, compared to 61 (13%) without severe hemorrhage (p < 0.01). For severe hemorrhage prediction, FAST had a sensitivity of 38% (95%CI = [27%; 50%]) and a specificity of 87% (95%CI = [83%; 90%]) (AUC = 0.62, 95%CI = [0.57; 0.68]). The comparison of the other outcomes between positive and negative FAST was: hemostatic procedure, 22 (25%) vs 28 (6%), p < 0.01; intensive care unit admission 71 (80%) vs 190 (43%), p < 0.01; mean length of hospital stay 11 [4; 27] vs 4 [0; 14] days, p = 0.02; 30-day mortality 13 (15%) vs 22 (5%), p < 0.01. A positive FAST performed in the prehospital setting is associated with severe hemorrhage and all prognostic criteria we studied. [ABSTRACT FROM AUTHOR]

Agencies consult extensively with stakeholders such as industry associations, nongovernmental organizations, and trade unions. One rationale for consultations is that these improve procedural legitimacy and lead to greater acceptance of regulatory outcomes by citizens and the regulated industry. While this presumption of a positive relation between stakeholder consultations and the legitimacy of agencies is widespread, research analyzing this relationship remains scarce. Using a survey experiment, we examine the effect of open and closed consultations on the acceptance of procedures and regulatory outcomes in the field of environmental politics. The results demonstrate that consultation arrangements positively affect the acceptance of decision‐making procedures, especially when regulators grant access to different types of stakeholders. However, although the consultation arrangement itself does not directly affect acceptance of the regulatory outcome, procedural legitimacy matters, as it increases decision acceptance among individuals who are negatively disposed toward government regulation. [ABSTRACT FROM AUTHOR]

To design regulatory policies, agencies depend on information from the industries they are tasked to regulate. Therefore, agencies can organise consultations with the aim of obtaining information from different perspectives. This article focuses on stakeholder diversity in agency public consultations. We ask to what extent is information provided by stakeholders other than the regulated sector, such as other business interests, experts or nonbusiness interests? Stakeholder diversity is relevant as it may prevent agencies to become exposed to one-sided information and capture by specialised interests. Are there consultation design factors that foster consultation diversity? Or, is (a lack of) consultation diversity structurally shaped by the context in which an agency operates? Analysing a wide range of public consultations organised by European Union regulatory agencies indicates that most information agencies receive via consultations comes from regulated interests and that the limited participation of nonregulated interests is highly tenacious. [ABSTRACT FROM AUTHOR]

To facilitate stakeholder representation, European Union (EU) agencies use a range of procedures, including closed consultation or advisory committees and open or public consultations. For analysing what kind of stakeholders gain access to advisory committees, we compare these two particular procedures. Two theoretical perspectives guide this analysis. The first is a resource‐based account, which emphasizes informational needs and leads to the expectation that not only regulated interests but also EU‐level associations and European Commission expert group members will gain representation through closed consultations. The second is a norm‐based perspective that stresses the importance for agencies to establish a credible reputation, leading them to balance interest representation. A systematic comparison of stakeholders represented in agency committee with those participating in open consultations demonstrates that regulated interests have no systematic advantage in gaining access to closed consultations. Instead, closed consultations may diversify interest representation and facilitate the involvement of non‐business interests. [ABSTRACT FROM AUTHOR]

This article examines why and how European Union agencies involve non-state stakeholders - such as non-governmental organizations (NGOs), business associations or trade unions - via three access instruments: public consultations; stakeholder bodies; and representation in management boards. We assess how the use of these instruments varies across agencies, and how they are linked to different motivations driving the demand for stakeholder participation. We present two alternative sets of hypotheses, first focusing on agencies’ need for information, organizational capacity and reputation, and second, considering stakeholder involvement as an instrument of legislative control. We draw on a new dataset of stakeholder involvement practices of the full population of EU agencies, compiled via document analysis and interviews. Our findings indicate that stakeholder involvement is a double-edged sword, contributing to agency accountability and control, but with an inevitable risk of dependence on the regulated industry. [ABSTRACT FROM AUTHOR]