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IntroductionEngaging public and patients in the decision-making processes is on the agenda of many healthcare systems towards sustainable healthcare delivery. While many engagement initiatives are performed face-to-face, an increasing number is conducted online. An example of the latter is the Dutch digital platform Gezonde Mening that engages patients, healthcare professionals and other stakeholders in the co-creation of healthcare innovations. This study aimed to evaluate the effectiveness of stakeholder engagement performed on Gezonde Mening by focusing on the process of planning, execution and transition of engagement activities.MethodsA mixed-methods study was performed by conducting eight semi-structured interviews with developers and funders of Gezonde Mening and an assessment of the psychometric properties of two questionnaires administrated via Gezonde Mening to seek stakeholders’ inputs. While the interviews were analysed deductively and inductively, data from the assessment of psychometric properties were analysed in a descriptive quantitative manner. Data were interpreted through triangulation.ResultsAssessment of the planning of stakeholder engagement identified needs for having more stakeholders on the platform to enable subgroup analysis and robust insights. Moreover, questionnaires administered by Gezonde Mening showed low validity and reliability. Assessment of the execution of stakeholder engagement indicated that stakeholders are sufficiently informed about engagement. Assessment of the transition of engagement activities showed needs to provide direct results to stakeholders and allow their evaluation of the platform.ConclusionGezonde Mening digital platform facilitates communication between innovators and stakeholders during engagement activities. However, the study identified room for improvement regarding the planning and transition activities.

Current research and innovation (R&amp, I) systems are not equipped to fully serve as catalysts for the urgently needed transformation of food systems. Though research on food systems transformation (first order: &lsquo, what?&rsquo, ) and transformative research (second order: &lsquo, how to&rsquo, ) are rapidly gaining traction in academic and policy environments, current efforts fail to explicitly recognize the systemic nature of the challenges associated with performing transformative second-order research. To recognize these manifold and interlinked challenges embedded in R&amp, I systems, there is a need for a coupled-systems perspective. Transformations are needed in food systems as well as R&amp, I systems (&lsquo, how to do the &ldquo, how to&rdquo, &rsquo, ). We set out to conceptualize an approach that aims to trigger double transformations by nurturing innovations at the boundaries of R&amp, I systems and food systems that act upon systemic leverage points, so that their multisystem interactions can better support food system transformations. We exemplify this coupled-systems approach by introducing the FIT4FOOD2030 project with its 25 living labs as a promising multilevel boundary innovation at the cross-section of R&amp, I and food systems. We illustrate how this approach paves the way for double systems transformations, and therefore for an R&amp, I system that is fit for future-proofing food systems.

Purpose Work participation after breast cancer treatment is generally negatively affected. Occupational health professionals might improve work-related outcomes by bridging the gap between sick-listed employees’ levels of functioning and work demands. To aid them in this task, this review explored the association between functional impairments and work-related outcomes in breast cancer survivors. Methods Publications from January 2000–March 2016 were identified through five online databases (i.e. Pubmed, EMBASE, PsycINFO, CINAHL and the Cochrane Library). Quantitative and qualitative studies were included if they focused on functional impairments and work-related outcomes in breast cancer survivors. Two reviewers independently selected studies, extracted data and performed quality assessment. Results The search identified 998 studies, of which 20 studies met eligibility criteria. Impairments in physical functioning negatively affected return to work (RTW) and work ability in quantitative and qualitative studies. Studies measuring cognitive functioning with tests found no association with work-related outcomes, whereas the results of studies using self-reported measures were ambiguous. Social functioning was less commonly investigated and findings differed across work-related outcomes. Emotional functioning was not associated with work-related outcomes in quantitative studies, while in qualitative studies feelings such as insecurity were described as influencing RTW. Conclusions Functional impairments can severely hamper work participation in breast cancer survivors. This provides important opportunities for occupational health professionals to enhance RTW in breast cancer survivors, such as adequately addressing illness perceptions and work expectations. Ongoing research is warranted to aid occupational health professionals in providing effective vocational guidance and improve work-related outcomes in breast cancer survivors.

While evaluation is seen as a mechanism for both accountability and learning, it is not self-evident that the evaluation of niche experiments focuses on both accountability and learning at the same time. Tensions exist between the accountability-oriented needs of funders and the learning needs of managers of niche experiments. This article explores the differences in needs and expectations of funders and managers in terms of upwards, downwards and internal accountability. The article shows that as the multi-stakeholder contexts in which niche experiments take place give rise to various requirements, tensions in evaluation are essentially a specific manifestation of tensions between niche experiments and their multiple contexts. Based on our findings, an adjusted accountability framework is proposed, including several strategies that can reconcile a learning approach with accountability needs in niche experiments aiming to change current practices in a more sustainable direction.

Diagnose en behandeling van borstkanker hebben vaak een nadelig effect op arbeidsparticipatie.1-3 Onderzoek wijst uit dat werkhervatting samenhangt met factoren zoals leeftijd, sociaal-economische status, stadium van de kanker, en behandeling of daaruit voortvloeiende klachten.4,5 Daarnaast wordt gesuggereerd dat het niet aansluiten van functionele mogelijkheden na borstkanker op de functie-eisen van werk, succesvolle arbeidsre-integratie kan belemmeren.6Bedrijfsartsen kunnen hulp bieden bij arbeidsre-integratie door de brug te slaan tussen functionele mogelijkheden van de cliënt en functie-eisen van het werk. Dit literatuuronderzoek geeft een overzicht van de relatie tussen functionele mogelijkheden en werkgerelateerde uitkomsten bij mensen die borstkanker hebben gehad.