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BackgroundCognitive impairment and dementia are frequently under-recognized. Health system strategies anchored in primary care are essential to address gaps in timely, comprehensive diagnosis. The goal of this paper is to describe the adaptation of a tablet-based brain health assessment (TabCAT-BHA) intervention and the study protocol to test its effectiveness in improving the detection of cognitive impairment, including dementia.MethodsThis mixed-methods, pragmatic, cluster randomized, hybrid effectiveness-implementation trial is being conducted in two 18-month waves with 26 Kaiser Permanente Southern California primary care clinics, with 13 serving as intervention clinics and 13 as usual care clinics. Patients 65 years and older with memory concerns (n ~ 180,000) receiving care at the 26 clinics will be included in the analyses. Primary care clinics are provided the following practice supports as part of the TabCAT-BHA intervention: brief education and training on neurocognitive disorders and study workflows; digital tools to assess cognitive function and support clinician decision making and documentation; and registered nurse support during the work-up and post-diagnosis periods for primary care providers, patients, and families. The intervention was adapted based on engagement with multiple levels of clinical and operational leaders in the healthcare system. Effectiveness outcomes include rates of cognitive impairment diagnosis in primary care and rates of completed standardized cognitive assessments and specialist referrals with incident diagnoses. Implementation outcomes include acceptability-appropriateness-feasibility, adoption, and fidelity.ResultsWe identified seven themes organized by system-, provider-, and patient-level domains that were used to adapt the TabCAT-BHA intervention. Accordingly, changes were made to the provider education, diagnostic work-up, and post-diagnostic support. Results will be reported in fall of 2027.ConclusionsOur engagement with multiple primary and specialty care clinical and operational leaders to adapt the TabCAT-BHA intervention to these primary care clinics has informed the protocol to evaluate the interventions effectiveness for improving the detection of cognitive impairment, including dementia, in an integrated healthcare system.Trial registationClinicaltrials.gov: NCT06090578 (registered 10/24/23).

In vitro gametogenesis (IVG), the reconstitution of germ cell development in vitro, is an emerging stem cell-based technology with profound implications for reproductive science. Despite researchers' long-term goals for future clinical applications, little is currently known about the views of IVG held by the stakeholders potentially most affected by its introduction in humans. We conducted focus groups and interviews with 80 individuals with lived experience of infertility and/or LGBTQ+ family formation in the US, two intersecting groups of potential IVG users. Respondents expressed hope that IVG would lead to higher reproductive success than current assisted reproductive technology (ART), alleviate suffering associated with ART use, and promote greater social inclusion, while expressing concerns predominantly framed in terms of equity and safety. These findings underscore the importance of sustained engagement with stakeholders with relevant experience to anticipate the implications of IVG for research and clinical translation.

Meaningful engagement with stakeholders in research demands intentional approaches. This paper describes the development of a framework to guide stakeholder engagement as research partners in a pragmatic trial proposed to evaluate behavioral interventions for dysphagia in head and neck cancer patients. We highlight the core principles of stakeholder engagement including representation of all perspectives, meaningful participation, respectful partnership with stakeholders, and accountability to stakeholders; and describe how these principles were operationalized to engage relevant stakeholders throughout the course of a large clinical trial. [ABSTRACT FROM AUTHOR]

Co‐production is a collaborative way of working which emphasises the exchange of diverse forms of knowledge in an equal partnership for equal benefits. Co‐produced research is a key strategic aim of the UK Research and Innovation (UKRI) Transforming UK Food Systems (TUKFS) Strategic Priorities Fund; this research programme brings together researchers, policymakers, industry and communities to create positive change in the way food is produced, accessed and consumed. However, more generally, there are diverse understandings of co‐production and a lack of consensus on what 'good practice' looks like. Therefore, this study aimed to identify and map examples of co‐production methods employed across the TUKFS programme. Two creative workshops (n = 15 participants), conversations with TUKFS researchers and stakeholders (n = 15), and systematic analysis of project documents were used to critically explore co‐production activities within six TUKFS projects. A range of co‐production activities were identified. Findings highlighted areas of 'messiness' and complexity, challenges associated with applying co‐production approaches and practical solutions. Four key shared principles for co‐production were identified: (1) Relationships: developing and maintaining reciprocity‐based partnerships; (2) Knowledge: recognising the contribution of diverse forms of expertise; (3) Power: considering power dynamics and addressing imbalances; and (4) Inclusivity: ensuring research is accessible to all who wish to participate. Opportunities for reflection and reflexivity were considered crucial across all these areas. Findings contribute important insights towards a shared conceptual understanding of co‐production for food system transformation research. This paper makes recommendations for researchers, practitioners, academic institutions and funders working in this area of research and practice. [ABSTRACT FROM AUTHOR]

Background: While oral health often takes a backseat to other health domains, it silently affects nearly half of the Worldwide population. The DELIVER project, funded by the EU's Horizon Europe program, seeks to develop a blueprint model for improving the quality of oral health care for everyone. Methods: Applying the Nominal Group Technique (NGT), 17 stakeholders from various backgrounds participated in identifying pressing issues for oral care quality improvement across practice, community, and policy levels. Results: The results revealed significant differences at the different levels, with accessibility emerging as a prominent issue, encompassing affordability, availability, and acceptability of oral healthcare services. Conclusions: These findings emphasizes the need for policy reforms, increased investments, and a shift towards preventive and patient-centered dental care practices. It highlights the importance of collaborative efforts with multi-stakeholders and prioritizing pressing issues on a multi-level to drive positive change in improving oral care quality. [ABSTRACT FROM AUTHOR]

Anaerobic digestion (AD), or biogas technology, is an optimal method for municipal organic waste (MOW) treatment, recovering both material and energy. This study takes a life cycle assessment perspective and examines the economic and environmental impacts of a BIO facility in Minamisanriku Town, Japan, which has utilized MOW (kitchen/food waste and surplus sludge from sewage) as local biomass resources since 2012. Stakeholder interviews were conducted to gather data on material flows and impacts. Scenario analysis considered various conditions, such as pre- and post-operation of the BIO facility, the use and non-use of digestate as liquid fertilizer, and the facility's 100% operational efficiency. The results indicate that full operation of the BIO facility and marketing of value-added products, such as branded rice grown using liquid fertilizer, could significantly reduce greenhouse gas (GHG) emissions, lower integrated environmental costs, improve the regional economy, and increase net income. In the business as usual (BAU) scenario with a 56% operation rate of the BIO facility, there is an over 10% improvement in economic and environmental impacts compared to the pre-operation baseline. This study underscores the importance of maximizing biomass utilization to develop value-added uses by enhancing, extending, and expending stakeholder collaboration. [ABSTRACT FROM AUTHOR]

Sprat are commercially valuable and are an important component of the North-East Atlantic ecosystem as major predators of zooplankton, competitors with herring, and prey for piscivorous fish, marine mammals, and seabirds. Despite this, insufficient information exists for Celtic Seas sprat, one of five North-East Atlantic stocks, to estimate stock status. To ensure the sustainable exploitation of sprat, the health of the Celtic Seas ecosystem, and the wider fisheries sector, we conduct a management strategy evaluation to stress test the current single-species advice framework. The aim is to evaluate whether ecosystem objectives can be achieved under single-species maximum sustainable yield and precautionary advice frameworks. An operating model was conditioned on life history theory and strategic information from ecosystem models. We showed that in-year advice using an empirical rule could achieve management objectives and help balance the trade-offs between fishing activities and ecosystem health. The approach allows ecosystem understanding to be incorporated within existing precautionary and maximum sustainable yield frameworks to provide a robust management framework that can meet multiple objectives despite uncertainty. [ABSTRACT FROM AUTHOR]

Background: Connecting end-users to research evidence has the power to improve patient knowledge and inform health decision-making. Differences in the culture and language of the end users may shape the effectiveness of knowledge mobilization (KMb). This scoping review set out to understand current approaches and methods when creating or adapting KMb products for culturally and linguistically diverse (CALD) audiences. Methods: We searched 3 databases (Ovid Medline, CINAHL via EBSCOhost, PsychINFO) from 2011 until August 2023. We included any literature about KMb product creation or adaptation processes serving CALD communities. A primary reviewer screened all identified publications and a second reviewer screened publications excluded by the primary. Data were extracted using a standardized form by one reviewer and verified by a second reviewer. Studies were categorized by type of adaptations ('surface' and/or 'deep' structure) and mapped based on type of stakeholder engagement used in the research approach (i2S model), and end-user involvement (content, design, evaluation and dissemination) in KMb product creation or adaptation. Results: Ten thousand two hundred ninety-nine unique titles and abstracts were reviewed, 670 full-text studies were retrieved and reviewed, and 78 studies were included in final data extraction and mapping. Twenty-four studies (31%) created or adapted exclusively text-based KMb products such as leaflets and pamphlets and 49 (63%) produced digital products such as videos (n = 16, 33%), mobile applications (n = 14, 29%), and eHealth websites (n = 7, 14%). Twenty-five studies (32%) reported following a framework or theory for their creation or adaptation efforts. Twenty-eight studies (36%) engaged stakeholders in the research approach. Nearly all (96%) involved end-users in creating or adapting the KMb products through involvement in content development (n = 64), design features (n = 52), evaluation (n = 44) and dissemination (n = 20). Thirty-two (41%) studies included reflections from the research teams on the processes for creating or adapting KMb products for CALD communities. Conclusion: Included studies cited a variety of methods to create or adapt KMb products for CALD communities. Successful uptake of created or adapted KMb products was often the result of collaboration and involvement with end-users for more applicable, accessible and meaningful products. Further research developing guidance and best practices is needed to support the creation or adaptation of KMb products with CALD communities. Registration: Protocol submitted to Open Science Framework on August 16, 2022 (https://osf.io/9jcw4/). [ABSTRACT FROM AUTHOR]

The intensive utilization of tropical inland water bodies for multiple and sometimes competing activities underlines the necessity for their integrated and holistic co-management. This paper presents our synthesis on lake and reservoir fisheries in South and Southeast Asia as social–ecological systems, based on a synopsis of our research findings from a previous EU-funded research programme in Sri Lanka, Thailand and the Philippines (FISHSTRAT project). The paper attempts to merge our results with recent developments in research, policy and practice. We explore the effects of the main external and internal control mechanisms of the trophic state and pinpoint to the high production potential of traditionally unexploited small indigenous fish species. The limitations of conventional centralized management systems highlight the importance of introducing transdisciplinary approaches which integrate limnology, fish ecology and fisheries with the interests of other resource using stakeholders and decision makers in order to develop locally appropriate co-management strategies for sustainable aquatic resource use. [ABSTRACT FROM AUTHOR]

Background: Globally, much work has been done by nonprofit, private, and academic groups to develop best practices for the care of people living with dementia (PLWD), including Alzheimer's disease. However, these best practices reside in disparate repositories and tend to focus on one phase of the patient journey or one relevant group. Objective: To fill this gap, we developed a Dementia Ideal Care Map that everyone in the dementia ecosystem can use as an actionable tool for awareness, policy development, funding, research, training, service delivery, and technology design. The intended audience includes (and not limited to) policymakers, academia, industry, technology developers, health system leaders, clinicians, social service providers, patient advocates, PLWD, their families, and communities at large. Methods: A search was conducted for published dementia care best practices and quality measures, which were then summarized in a visual diagram. The draft diagram was analyzed to identify barriers to ideal care. Then, additional processes, services, technologies, and quality measures to overcome those challenges were brainstormed. Feedback was then obtained from experts. Results: The Dementia Ideal Care Map summarizes the ecosystem of over 200 best practices, nearly 100 technology enablers, other infrastructure, and enhanced care pathways in one comprehensive diagram. It includes psychosocial interventions, care partner support, community-based organizations; awareness, risk reduction; initial detection, diagnosis, ongoing medical care; governments, payers, health systems, businesses, data, research, and training. Conclusions: Dementia Ideal Care Map is a practical tool for planning and coordinating dementia care. This visualized ecosystem approach can be applied to other conditions. [ABSTRACT FROM AUTHOR]

Social‐ecological systems like fisheries provide food, livelihoods and recreation. However, lack of data and its integration into governance hinders their conservation and management. Stakeholders possess site‐specific knowledge crucial for confronting these challenges. There is increasing recognition that Indigenous and local knowledge (ILK) is valuable, but structural differences between ILK and quantitative archetypes have stalled the assimilation of ILK into fisheries management, despite acknowledged bias and uncertainty in scientific methods. Conducting a systematic review of fisheries‐associated ILK research (n = 397 articles), we examined how ILK is accessed, applied, distributed across space and species, and has evolved. We show that ILK has generated qualitative, semi‐quantitative and quantitative information for diverse taxa across 98 countries. Fisheries‐associated ILK research mostly targets small‐scale and artisanal fishers (70% of studies) and typically uses semi‐structured interviews (60%). We revealed large variability in sample size (n = 4–7638), predicted by the approach employed and the data generated (i.e. qualitative studies target smaller groups). Using thematic categorisation, we show that scientists are still exploring techniques, or 'validating' ILK through comparisons with quantitative scientific data (20%), and recording qualitative information of what fishers understand (40%). A few researchers are applying quantitative social science methods to derive trends in abundance, catch and effort. Such approaches facilitate recognition of local insight in fisheries management but fall short of accepting ILK as a valid complementary way of knowing about fisheries systems. This synthesis reveals that development and increased opportunities are needed to bridge ILK and quantitative scientific data. [ABSTRACT FROM AUTHOR]

Objective: To identify thoroughbred industry stakeholders' views on the yearling sales endoscopy in Australia. Design: Semi‐structured qualitative group interviews with equine veterinarians, thoroughbred breeders and yearling purchasers. Methods: Twenty‐nine experienced thoroughbred industry stakeholders participated in online focus groups: (1) equine veterinarians involved in yearling endoscopy; (2) thoroughbred breeders; and (3) yearling buyers. The focus groups were audio and video recorded and digital whiteboards were available. Data was transcribed, live‐coded and analysed thematically. Results: The main themes identified included the uncertainty surrounding the relationship between yearling laryngeal function and future performance, especially the significance of yearlings with grade 3 out of 5 laryngeal function; interobserver variability in the laryngeal function grade assigned by veterinarians to the same endoscopic exam; and the presence of intra‐horse variability in laryngeal function over different time points. Discussion: Stakeholders raised multiple concerns about the current yearling sales endoscopy process in Australia. Recommendations to address these concerns include further investigation into the race performance of yearlings identified with grade 3 laryngeal function; training of veterinarians to reduce inter‐observer variability; and the need to determine the most appropriate grading system to use in yearlings. Future research should evaluate the significance of intra‐horse variability in a yearling population. [ABSTRACT FROM AUTHOR]

Background: Perspectives of patients, parents and professional experts on personalized regenerative implants for regenerative medicine purposes are largely unknown. Method: To better understand these perspectives, we conducted four focus groups with professional experts of mixed European nationality (n = 8), Dutch patients with regular implants (n = 8), Dutch and Belgian (n = 5) and Spanish (n = 8) parents of children with cleft palate. Results: Two overarching themes were identified: 'patient-centered research and care' and 'ambivalent attitudes toward personalized regenerative implants'. Discussion: The results reveal that stakeholders should adopt a participatory rather than an impairment discourse and address the ambivalence among professional experts, patients and parents. Conclusion: Considering stakeholder perspectives facilitates ethical and responsible development and use of personalized regenerative implants. Article highlights Background It is largely unknown how patients, parents and professional experts think about personalized regenerative implants. Learning more about their perspectives is relevant because it can assist in aligning the design and implementation of these implants with the needs and desires of stakeholders such as patients, engineers and clinicians. Results The first overarching theme that emerged from the focus groups was the importance of patient-centered research and care. Three subthemes were identified: (a) support and expectation management, (b) institutional and interdisciplinary collaboration, (c) the implant's contribution to living one's life. A second theme explored in the focus groups concerned participants expressing ambivalent attitudes toward the characteristics of personalized regenerative implants, such as their regenerative capacity, the novelty of this technology and the possibility for personalization. Discussion The first overarching theme patient-centered research and care underscores the necessity for healthcare professionals to look beyond the mere technical and clinical aspects of personalized regenerative implant treatment. In medicine in general and regenerative medicine in particular, we should facilitate a shift toward participatory discourse and change the way we talk and approach the individual, their body and illness. Some of the ambivalent attitudes identified in this study were linked to characteristics of the implant itself, particularly personalization. Personalization was viewed as a potential contributor to improved care tailored to individual needs, alongside concerns about associated cost increases. During the development and use of personalized regenerative implants, researchers should address ambivalence among professional experts, patients and parents, keeping in mind that ambivalence is not inherently negative. Conclusion The obtained results provide a valuable first step for emphasizing the need for patient-centered care and research within regenerative medicine and exploring ambivalent attitudes toward personalized regenerative implants. Further evaluation of these insights and other ethically relevant aspects of personalized regenerative implants should take place in co-creation with diverse stakeholders in parallel to the technological development of these implants. [ABSTRACT FROM AUTHOR]

Abstract Meaningful engagement with stakeholders in research demands intentional approaches. This paper describes the development of a framework to guide stakeholder engagement as research partners in a pragmatic trial proposed to evaluate behavioral interventions for dysphagia in head and neck cancer patients. We highlight the core principles of stakeholder engagement including representation of all perspectives, meaningful participation, respectful partnership with stakeholders, and accountability to stakeholders; and describe how these principles were operationalized to engage relevant stakeholders throughout the course of a large clinical trial.

Abstract Background While oral health often takes a backseat to other health domains, it silently affects nearly half of the Worldwide population. The DELIVER project, funded by the EU’s Horizon Europe program, seeks to develop a blueprint model for improving the quality of oral health care for everyone. Methods Applying the Nominal Group Technique (NGT), 17 stakeholders from various backgrounds participated in identifying pressing issues for oral care quality improvement across practice, community, and policy levels. Results The results revealed significant differences at the different levels, with accessibility emerging as a prominent issue, encompassing affordability, availability, and acceptability of oral healthcare services. Conclusions These findings emphasizes the need for policy reforms, increased investments, and a shift towards preventive and patient-centered dental care practices. It highlights the importance of collaborative efforts with multi-stakeholders and prioritizing pressing issues on a multi-level to drive positive change in improving oral care quality.

Abstract Background Connecting end-users to research evidence has the power to improve patient knowledge and inform health decision-making. Differences in the culture and language of the end users may shape the effectiveness of knowledge mobilization (KMb). This scoping review set out to understand current approaches and methods when creating or adapting KMb products for culturally and linguistically diverse (CALD) audiences. Methods We searched 3 databases (Ovid Medline, CINAHL via EBSCOhost, PsychINFO) from 2011 until August 2023. We included any literature about KMb product creation or adaptation processes serving CALD communities. A primary reviewer screened all identified publications and a second reviewer screened publications excluded by the primary. Data were extracted using a standardized form by one reviewer and verified by a second reviewer. Studies were categorized by type of adaptations (‘surface’ and/or ‘deep’ structure) and mapped based on type of stakeholder engagement used in the research approach (i2S model), and end-user involvement (content, design, evaluation and dissemination) in KMb product creation or adaptation. Results Ten thousand two hundred ninety-nine unique titles and abstracts were reviewed, 670 full-text studies were retrieved and reviewed, and 78 studies were included in final data extraction and mapping. Twenty-four studies (31%) created or adapted exclusively text-based KMb products such as leaflets and pamphlets and 49 (63%) produced digital products such as videos (n = 16, 33%), mobile applications (n = 14, 29%), and eHealth websites (n = 7, 14%). Twenty-five studies (32%) reported following a framework or theory for their creation or adaptation efforts. Twenty-eight studies (36%) engaged stakeholders in the research approach. Nearly all (96%) involved end-users in creating or adapting the KMb products through involvement in content development (n = 64), design features (n = 52), evaluation (n = 44) and dissemination (n = 20). Thirty-two (41%) studies included reflections from the research teams on the processes for creating or adapting KMb products for CALD communities. Conclusion Included studies cited a variety of methods to create or adapt KMb products for CALD communities. Successful uptake of created or adapted KMb products was often the result of collaboration and involvement with end-users for more applicable, accessible and meaningful products. Further research developing guidance and best practices is needed to support the creation or adaptation of KMb products with CALD communities. Registration Protocol submitted to Open Science Framework on August 16, 2022 ( https://osf.io/9jcw4/ ).

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Purpose: The concept of "participation" has become a buzzword in contemporary public governance models. However, despite the broad and significant interest, defining participation remains a debated topic. The aim of the current study was to explore how participants perceived and interpreted the meaning and scope of participation. Design/methodology/approach: This study is part of a four-year (2019–2022) longitudinal research project investigating stakeholder participation in the context of developing and establishing a strategic regional plan in Region Skåne in southern Sweden. The research project has a qualitative approach and uses interviews with different stakeholder groups such as municipal politicians and public officials and a survey as empirical material. Findings: The authors developed a participation spectrum including eight types of participation: to be open, to be informed, to be listened to, to discuss, to be consulted, to give and take, to collaborate and to co-create. The authors also identified four different purposes of participation: creating a joint network, creating a joint understanding, creating a joint effort and creating a joint vision. The spectrum and the purposes were related through four characteristics of participation, i.e. involvement, interaction, influence and empowerment. Research limitations/implications: The study rests on a single case, and so the results have limited transferatibility. Originality/value: Researching participation in terms of the participants' perceptions contributes a new perspective to the existing literature, which has commonly focussed on the organizers' perceptions of participation. Moreover, in order to clarify what participation meant to the participants, the study puts emphasis on untangling this from the why question of participation. [ABSTRACT FROM AUTHOR]

In urban property development projects, attention to the needs and aspirations of local communities is often neglected. Although some developers still consider local community stakeholders to be a potential threat to their developments, in many developed countries, stakeholder participation is embedded within statutory processes such as the formal planning process and is increasingly regarded as a component of sustainable development. Even though the local community is widely recognized as an important project stakeholder, little has been done to understand how to engage effectively with this stakeholder group to resolve their concerns. The purpose of this study is to investigate practitioners' perceptions and actions on local community participation in urban property development projects. The study is conducted through interviews with 12 actors in the southern part of Sweden. The findings show the importance of early involvement of local communities, the relevance of building community networks, trust and relations, the challenges to stakeholder participation and the need to formalize stakeholder participation in the organizations. [ABSTRACT FROM AUTHOR]

For long-term success, organizations and manufacturing companies must exploit the potential strengths of collective decision making in maintenance management. The maintenance strategy selection issue has been studied in a single decision-maker framework for a long time. This research is one of the first attempts at dealing with the enhancement of maintenance management through the participation of stakeholders in the decision making process. In this context, the author introduces a participatory multi criteria decision model that combines Borda count and PROMETHEE methodology to select the most appropriate maintenance strategy; in accordance with the decision makers’ preferences on a set of strategies evaluated according to conflicting criteria. Therefore, the PROMETHEE II method is used to manage the individual decisions of each stakeholder, while the Borda count is in charge of collectively selecting the best maintenance strategy, taking as a starting point stakeholder’s preferences being established thanks to PROMETHEE II. In the same context, the proposed model was applied to a real scenario: a textile company, and can be easily replicated in other industries.

Introduction: Patient and public involvement is vital for high‐quality research. Integrating patients' and providers' perspectives early in research enhances the feasibility and relevance of study results. Within our family practice‐based research network ForN, we established a standing patient advisory board (PAB) to include patients with diverse conditions and experiences. In this paper, we aim to describe the establishment and functioning of a standing PAB in family medicine research from patients' and researchers' perspectives. Methods: After each PAB meeting, patients and researchers were asked to name anonymously positive and challenging moments in a feedback form with open questions. Researchers were also asked to reflect on how they implemented the discussion content in their research projects. The responses from both groups were transferred to MAXQDA 2018 and analyzed separately using thematic analysis. Results: We analyzed 40 feedback forms from patients and 14 feedback forms from researchers. The dominant theme in the patients' feedback was 'exchange': They positively emphasized the 'exciting and open discussions' and the exchange of perspectives with one another and researchers. The clarity of the researchers' presentations and the research topics were appreciated. Researchers also positively highlighted the open atmosphere of the discussions. Presenting their research to the PAB helped most researchers reflect on their research topics from patients' perspectives and implement changes. However, researchers also mentioned several barriers to the implementation of PAB members' feedback. Conclusion: The establishment of a standing PAB in family practice research is feasible and productive both from patients' and researchers' perspectives. Patient or Public Contribution: This study reports the evaluation of the establishment of a standing PAB in family practice research. Board members are involved in the design of studies, the co‐production of interventions and information material, and the interpretation of data. [ABSTRACT FROM AUTHOR]

Sustainability has become more than just an aspiration in business. It has become an integral part of business strategy and decision‐making. Organizations have realized that adhering to sustainability with its impact on multi‐facets can drive business success. Long‐term growth requires an understanding of the relationships between people and their surroundings. Engagement of stakeholders is essential for planning, designing, implementing, and ensuring the efficacy of programmes. Due to the requirement for sustainability and the engagement of a greater stakeholder range in project planning, the project plan complexity is growing. The lack of or insufficient engagement of stakeholders throughout the project life cycle, particularly in the early phases of implementation and planning, frequently has a detrimental effect on the intended project performance. Effective stakeholder engagement is essential to counterbalance the combined effects of a lack of contextual knowledge by stakeholders and a lack of support in the field. However, this integration encounters difficulties such as resource restrictions and competing stakeholder interests. To encourage stakeholder engagement with the initiatives, project resources may be allocated based on the relative importance of competing areas. This study intends to establish a Stakeholder Engagement Framework (SEF) to increase the effectiveness of stakeholder engagement in projects by systematically evaluating potential conflicts and integrating the perspectives of stakeholders and the project management team. To do this, we use fuzzy logic inputs to account for ambiguities throughout the project life cycle, as well as stakeholder theory, value‐based management, matrix‐based dependency modeling, and total quality management to provide a framework for stakeholder participation. Then we implement the suggested SEF methodology to organize stakeholder participation for a green building project. The suggested framework will promote stakeholder participation under long‐term goals for project managers by identifying potential conflicts of interest. [ABSTRACT FROM AUTHOR]

Achieving water security requires action at all levels of governance, and cooperation among state and non-state actors, including civil society. However, in many places, participatory arrangements to enable cooperation, such as river basin committees or water user groups, have not been created, due to resource constraints or scepticism regarding their effectiveness. Here, we develop a typology of five key 'governance actions' that non-state actors may undertake to address environmental problems. We apply this typology to empirical findings from a water scarcity situation in Johor, Malaysia, where subnational civil society actors undertook a range of responses. The analysis reveals that, despite the absence of formal engagement mechanisms, civil society positively contributed to the governance of water security through 'defining issues', 'creating and sharing knowledge' and 'taking independent action' that could potentially inform wider practice, but faced challenges in 'monitoring and evaluating' or otherwise providing a critical perspective on impacts of water insecurity. The findings indicate possibilities for place-based and interest-based partnerships between government and civil society, and for supporting vertical relationships among civil society actors operating at different levels of governance. The study contributes to debates around power relations, knowledge sharing, and decision making across multilevel environmental governance. [ABSTRACT FROM AUTHOR]

Issue Addressed: Outdoor adventure education (OAE) (programs involving outdoor activities such as rock climbing or white‐water canoeing) that participants perceive as risky, conducted in a social support setting, can be utilised by practitioners to elicit changes in educational and psychosocial outcomes to support participant adolescent wellbeing. Methods: This study garnered the opinions of an expert OAE panel on the content of future programs aiming to impact adolescent wellbeing. The panel consisted of local (Western Australia, n = 7), national (Australia, n = 4), and international (Canada, Germany, New Zealand, United Kingdom, United States, n = 7) experts. A two‐round, mixed‐methods Delphi approach was employed. Extensive formative work led to the development of a series of open‐ended questions requiring qualitative responses for round one. Panellists were also asked to respond to 17 statements using Likert scales in the second round. Results: After analysis, a consensus was reached for all statements, with five statements having high consensus and being considered important by panellists. Conclusions: The statement 'Equity for all participants requires flexible delivery and facilitation' had the highest level of agreement amongst panellists. Connections, authentic experiences, and equitable experiences developed as key themes. So What?: Future OAE interventions focused on wellbeing impact could use the findings of this research as a basis for program design. [ABSTRACT FROM AUTHOR]

Issue Addressed: Social support is positively correlated with physical activity (PA), especially amongst girls, but is underexplored in male‐dominated action sports (e.g., mountain biking, skateboarding and surfing). This study explored family level social support needs and experiences of girls and boys in three action sports. Method: Aspiring, current or former Australian adolescent (12–18 years; girls n = 25; boys n = 17) mountain bikers, skateboarders and/or surfers were individually interviewed (telephone/Skype) in 2018/2020. A socio‐ecological framework guided the semi‐structured interview schedule. Audio‐recordings were transcribed verbatim and data analysed thematically using a constant comparative approach. Results: Family level social support was highly influential in young people's participation in action sports, with its absence a common reason for no or discontinued engagement amongst girls. Parents and siblings were the main social support providers with extended family (e.g., grandparents, aunts/uncles, cousins) also notable. Participation (current/past/co‐) was the main social support type followed by emotional (e.g., encouragement), instrumental (e.g., transport, equipment/funding) and informational (e.g., coaching) support. Girls were inspired/encouraged by brothers but boys were not inspired/encouraged by sisters; boys and girls co‐participated with both parents but co‐participating and being inspired by fathers was most common, especially amongst girls; fathers were more commonly the main transport provider if they co‐participated with their child; fathers mostly provided initial coaching; only boys were taught equipment maintenance by parents. Conclusions and So What: Sport‐related organisations/groups have numerous opportunities to improve girls' representation in action sports by fostering family level social support through various means. Intervention strategies should be tailored to account for gendered participation differences. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Community engagement is increasingly recognized as a critical component of research, but few studies provide details on how to successfully incorporate community perspectives in urological research. This manuscript describes the community engagement strategy used by the Prevention of Lower Urinary Tract Symptoms Research Consortium (PLUS) to design RISE FOR HEALTH (RISE), a multicenter, population-based, prospective cohort study to promote bladder health. METHODS AND RESULTS: The PLUS Community Engagement Subcommittee, guided by a set of antiracist community engagement principles and practices, organized, implemented, and communicated findings for all RISE community engagement activities. Community engagement was conducted through a diverse network of community partners at PLUS clinical research centers called Rapid Assessment Partners (RAPs). Via online surveys (4), virtual discussion groups (14), and one-on-one interviews (12), RAPs provided input on RISE processes and materials, including in-person visit procedures, specimen collection instructions, survey data collection instruments, recruitment materials, the study website, and the study name. This process resulted in significant changes to these aspects of the study design with reciprocal benefits for the community partners. DISCUSSION: Meaningful community engagement improved the design and implementation of RISE. PLUS will continue to engage community partners to interpret the RISE study results, disseminate RISE findings, and inform other PLUS studies toward the development of interventions to promote bladder health. Future urological studies would also benefit from community participation in determining priority research questions to address.

IntroductionThe Alzheimer's Disease Neuroimaging Initiative (ADNI) aims to validate biomarkers for Alzheimer's disease (AD) clinical trials. To improve generalizability, ADNI4 aims to enroll 50-60% of its new participants from underrepresented populations (URPs) using new biofluid and digital technologies. ADNI4 has received funding from the National Institute on Aging beginning September 2022.MethodsADNI4 will recruit URPs using community-engaged approaches. An online portal will screen 20,000 participants, 4000 of whom (50-60% URPs) will be tested for plasma biomarkers and APOE. From this, 500 new participants will undergo in-clinic assessment joining 500 ADNI3 rollover participants. Remaining participants (∼3500) will undergo longitudinal plasma and digital cognitive testing. ADNI4 will add MRI sequences and new PET tracers. Project 1 will optimize biomarkers in AD clinical trials.Results and discussionADNI4 will improve generalizability of results, use remote digital and blood screening, and continue providing longitudinal clinical, biomarker, and autopsy data to investigators.

Throughout COVID-19, health officials have relied on data visualizations to communicate urgent messages about the spread of the virus and preventative measures. Relatively few efforts have employed participatory engagement with communities who have experienced a disproportionate burden of COVID-19 illness to shape these communications. Sociologist W.E.B. Du Bois viewed data visualization as an approach to changing the way people think about themselves. This paper describes a community-engaged approach to data literacy skill-building with bilingual Latina learners in an adult English program in Northern California, Bay Area. The curriculum combines data visualization activities with language instruction and preventive health themes. Early work on COVID-19 in 2020-21 emphasized improving health knowledge and message interpretation but later shifted to a critical data literacy perspective, focusing on myth-busting, improving risk messaging in their own social networks, and supporting learners to see the power of their own experiences in data story-telling processes. This pedagogical approach, guided by Charles Brigg's idea of communicative justice priorities, locates adult learners' data visualization work as part of a broader effort to be included in the perspectives that shape knowledge production in today's healthcare system. This approach can be used to examine disparities in information access in linguistically minoritized communities and guide future education interventions.

By addressing the question “Are the roles and values of stakeholder participation qualitatively different for non-governmental organizations (NGOs) and national human rights institutions (NHRIs), and if so, how?” this article dissects stakeholder participation in UN human rights treaty body activities. First, it normatively posits that stakeholder participation in treaty body activities carries three values, which weigh differently based on the actor and the treaty body activity concerned: facilitating “bounded” national deliberations, promoting international deliberations on human rights treaty standards, and supplementing the treaty bodies’ fact-finding capacity. It offers concrete normative guidance for treaty bodies on their engagement with NGO and NHRI participation to maximize the benefits of these values. It then empirically analyzes their current practice in light of the above-mentioned normative guidance. This article contributes, first, to the theorization of stakeholder participation in treaty body activities, which has been discussed but only in generalized or fragmented ways in previous studies. Second, it supports the effectiveness and legitimacy of treaty bodies by endorsing their practice that is consistent with the guidance and finding space for improvement. Finally, it provides a rationale for establishing and strengthening NHRIs by showing that NHRI participation has unique roles distinct from those of NGOs.

Abstract Solving complex post-disaster reconstruction challenges requires the altruistic involvement of heterogeneous stakeholder groups. However, small, more organized groups, such as government parastatals, private developers, and contractors often exploit large, unorganized groups, such as affected communities, leaving them more vulnerable to future disasters. Based on data collected from a case study in Pakistan, this study proposed a framework to assess, anticipate, and mitigate the exploitation of vulnerable stakeholders in post-disaster reconstruction projects. The framework draws on influential management theories and utilizes reciprocal relationships between stakeholder attributes (power, legitimacy, and urgency), participation, and exploitation. The study also argued for non-binary treatment of stakeholder attributes. The framework will allow practitioners to address issues around the exploitation of stakeholder interests in future post-disaster reconstruction projects.

Abstract Background Involving patient and community stakeholders in clinical trials adds value by ensuring research prioritizes patient goals both in conduct of the study and application of the research. The use of stakeholder committees and their impact on the conduct of a multicenter clinical trial have been underreported clinically and academically. The aim of this study is to describe how Study Advisory Committee (SAC) recommendations were implemented throughout the Emergency Medicine Palliative Care Access (EMPallA) trial. EMPallA is a multi-center, pragmatic two-arm randomized controlled trial (RCT) comparing the effectiveness of nurse-led telephonic case management and specialty, outpatient palliative care of older adults with advanced illness. Methods A SAC consisting of 18 individuals, including patients with palliative care experience, members of healthcare organizations, and payers was convened for the EMPallA trial. The SAC engaged in community-based participatory research and assisted in all aspects from study design to dissemination. The SAC met with the research team quarterly and annually from project inception to dissemination. Using meeting notes and recordings we completed a qualitative thematic analysis using an iterative process to develop themes and subthemes to summarize SAC recommendations throughout the project’s duration. Results The SAC convened 16 times between 2017 and 2020. Over the course of the project, the SAC provided 41 unique recommendations. Twenty-six of the 41 (63%) recommendations were adapted into formal Institutional Review Board (IRB) study modifications. Recommendations were coded into four major themes: Scientific, Pragmatic, Resource and Dissemination. A majority of the recommendations were related to either the Scientific (46%) or Pragmatic (29%) themes. Recommendations were not mutually exclusive across three study phases: Preparatory, execution and translational. A vast majority (94%) of the recommendations made were related to the execution phase. Major IRB study modifications were made based on their recommendations including data collection of novel dependent variables and expanding recruitment to Spanish-speaking patients. Conclusions Our study provides an example of successful integration of a SAC in the conduct of a pragmatic, multi-center RCT. Future trials should engage with SACs in all study phases to ensure trials are relevant, inclusive, patient-focused, and attentive to gaps between health care and patient and family needs. Trial Registration: Clinicaltrials.gov Identifier: NCT03325985, 10/30/2017.

Introduction: Health systems have obtained valuable experience in dealing with various epidemics. The present study, by systematically reviewing the successful experiences of countries, presents a model for a coordinated response to pandemics by various actors in the primary healthcare system. Methods: Thirty-eight articles were obtained from Magiran, SID, PubMed, Scopus, Web of Science, and Google Scholar databases after applying the search strategy, inclusion and exclusion criteria, time-bound of 2005 to 2022, and quality assessment by Strobe checklist. The articles were assessed in terms of title, abstract, and text, and after removing duplicate and irrelevant ones, the final articles were selected.Results: This study assumed the PHC system as a leafy tree, which requires 25 background factors to strengthen its roots. Three groups of health policymakers, healthcare providers, and society must carry out the necessary measures in a coordinated and synergistic program in the four phases of crisis management, including prevention, preparedness, response, and recovery.Conclusion: Strengthening PHC in prevention, screening, testing, and outpatient treatment and mobilizing the community to take care of itself are the most successful experiences dealing with epidemics compared to treating patients in hospitals and spending significant financial and life costs.

The evolution of urban morphology and urban mobility reveals a complex and multidimensional relation that has been historically linked to the evolution of technology and its influence on people's behaviour, desires, and needs. The increasing level of digitalization of human interactions in both social and work environments has created a new paradigm for urban mobility. Alongside, sustainability concerns are also accelerating the design of new policies for improving citizens’ quality of life in urban areas. To address this new paradigm, municipalities need to consider new methodologies encompassing the different dimensions of the urban environment. This can be achieved if key stakeholders participate in co-creating and co-designing new solutions for urban mobility. In this paper we propose a multidisciplinary approach to these problems, supported by service-dominant logic concepts. The approach was used to design the CoDUMIS framework that brings together four dimensions of urban areas (social, urban, technological, and organizational). The application of the framework to four distinct cases, in Portuguese municipalities, resulted in a set of guidelines that help municipalities to improve their services and policies in a participatory environment, involving all the stakeholders.

ABSTRACTThe study assessed the satisfaction level of stakeholders with Public-Private Partnership (PPP) in Solid Waste Management (SWM) in Ghana. The study was underpinned by the pragmatist paradigm and mixed-methods design. Purposive and stratified random sampling techniques were used to engage 777 respondents for the data. Narrative inquiry, descriptive statistics and ANOVA were used to analyse the data. The study found that even though there was low participation of service users in the contractual arrangement regarding PPP in SWM, the service agreement was highly responsive to their (73%) SWM needs, as they (51.6%) were generally satisfied with the service provided through the agreement. This finding was at variance with the general participation-satisfaction nexus that greater participation leads to stakeholder satisfaction and vice-versa. The implication is that a high level of responsiveness of a service to the needs of stakeholders could sometimes offset the need for greater participation to enhance satisfaction. The result further suggests that the responsiveness-satisfaction nexus is stronger than the participation-satisfaction nexus in the PPP arrangement for SWM in Ghana. The study recommends that PPP arrangements in SWM in Ghana should focus more on adopting innovative ways to deliver services under the agreement to continuously address the immediate needs of service users and sustain their relevance in public service management. It also recommends that Assembly persons should utilise town hall meetings to increase the participation of service users in the contractual and implementation issues regarding PPP in SWM.

This study aims to provide an overview of the service system view (SSV), and the current status of its adoption for the development and implementation of assistive technology (AT). The role of ATs in the global aging scenario is anticipated; however, their diffusion is cumbersome. The SSV captures stakeholders, technologies, and their interactions as integrated systems. Based on this perspective, several approaches for designing long‐term care services have been proposed that would be helpful for the successful implementation of ATs. However, the existing geriatrics and gerontology literature seldom addresses these topics. Based on a literature review, this study first illustrates the challenges of using ATs in the real world. The existing literature highlights the sociotechnical challenges of utilizing ATs, such as the changes required in care work and resistance to them. To overcome the challenges, three approaches associated with the SSV have been introduced: service design, service engineering and living labs. This paper also introduces recent national projects in Japan that have adopted these approaches. As the importance of the SSV is growing for the successful implementation of ATs, the ability to adopt the SSV and its approaches is anticipated. In relation to geriatrics and gerontology studies, the impact on older adults' quality of life, as well as the economic effect, needs to be analyzed in future research. Geriatr Gerontol Int 2024; 24: 74–80. [ABSTRACT FROM AUTHOR]

Background: Using community-engaged research may result in interventions that reduce infant oral health disparities in underserved populations. Objective: Develop community partnerships to create a sustainable infant oral health program that meets specific community-identified needs and provides an interprofessional education experience. Methods: Partnering with the Homewood Community Engagement Center, researchers engaged and surveyed key community partners to assess the need for an infant oral health invention. Lessons Learned: Community-identified organizing principles and barriers became the framework for, "Healthy Teeth, Healthy Me," a community-driven infant oral health program. Barriers, like access to care, were addressed with community-specific solutions like agreements with local dental clinical for referrals. Conclusions: Community partnerships can be leveraged to develop oral health programs that fit specific community needs and provide resources to families at greatest risk for child dental caries. Community engagement can be used to modify the intervention to meet oral health needs of other vulnerable communities. [ABSTRACT FROM AUTHOR]

By addressing the question "Are the roles and values of stakeholder participation qualitatively different for non-governmental organizations (NGOs) and national human rights institutions (NHRIs), and if so, how?" this article dissects stakeholder participation in UN human rights treaty body activities. First, it normatively posits that stakeholder participation in treaty body activities carries three values, which weigh differently based on the actor and the treaty body activity concerned: facilitating "bounded" national deliberations, promoting international deliberations on human rights treaty standards, and supplementing the treaty bodies' fact-finding capacity. It offers concrete normative guidance for treaty bodies on their engagement with NGO and NHRI participation to maximize the benefits of these values. It then empirically analyzes their current practice in light of the above-mentioned normative guidance. This article contributes, first, to the theorization of stakeholder participation in treaty body activities, which has been discussed but only in generalized or fragmented ways in previous studies. Second, it supports the effectiveness and legitimacy of treaty bodies by endorsing their practice that is consistent with the guidance and finding space for improvement. Finally, it provides a rationale for establishing and strengthening NHRIs by showing that NHRI participation has unique roles distinct from those of NGOs. [ABSTRACT FROM AUTHOR]

Urban resilience must consider the ability of cities to cope with the effects of climate change. Community awareness raising and sustainable urban drainage systems (SUDs) are often mentioned in the literature as effective adaptation actions while the success of these solutions is highly context-dependent and improved planning procedures are urgently needed. In this framework, the URCA! project represents a good practice aiming to strengthen the resilience of urban areas by promoting the implementation of SUDs in territorial planning. The main objective of the present research deals with the role of participation in promoting the use of SUDs and their uptake in town planning and land management involving local communities, students, experts, local authorities, and enterprises. To this end, the research adopts a participatory approach to SUDs urban planning for three case studies in Italy selected under the criterion of maximum variation (Brescia, Genoa, and Matera). For the three case studies, participatory approaches are at different stages of development thus requiring appropriate ways of interacting and resulting in different impacts on decisions. Preliminary results, drivers, and barriers in the application of the participatory approach are discussed and compared in order to bring innovation into planning practices, stimulating a revision of typical governance mechanisms. [ABSTRACT FROM AUTHOR]

Planning for resilient cities requires an evidence-based understanding of flood risk and the involvement of stakeholders and local actors. The paper addresses research developed within the URCA!—Urban Resilience to Climate Change: to activate the participatory mapping and decision support tool for enhancing sustainable urban drainage—project. A top-down/bottom-up participatory and flexible methodology for the conception of participatory mapping aimed at the planning and installation of sustainable urban drainage systems (SUDS) on the territory is then developed. The innovative methodology is applied and tested in the case study of the Sampierdarena district in Genoa, northern Italy. This research paper illustrates the development of a participatory map (Pmap) that can support the implementation of SUDS as mitigation/adaptation strategies, integrating technical assessment and containing community visions and expectations. Findings concerning the connections between proposed SUDS locations and their frequencies confirm the relevance of the commercial area and the main traffic lanes along, confirming that all zones characterized by intense vehicular and pedestrian flow are suitable for SUDS as a solution to contribute to urban flood resilience. The georeferenced and intergenerational Pmap may be integrated into a decision support system to be developed as a guidance tool for the public administration. [ABSTRACT FROM AUTHOR]

Family involvement in mental health treatment has been shown to improve outcomes for service users. This project used a whole system‐focused action research framework and involved service users, family members and healthcare professionals to develop ways to improve family engagement in an adult inpatient mental health service. Focus groups were conducted with two service users, two family members and four healthcare professionals to discuss their experiences of family involvement and develop initial ideas. A problem‐solving group, involving service users, family members and professionals, was used to develop the solutions. The project identified context‐specific solutions to improve family engagement, which included specific training for professionals working on the inpatient wards, questionnaires to facilitate conversations with families, and sharing information about mental health and the inpatient mental health service with families. These may be helpful for other adult inpatient services. [ABSTRACT FROM AUTHOR]

The study sought to develop and validate an innovative leadership model for improving service delivery in urban local authorities. The prevalence of poor service delivery in urban local authorities motivated this study. The selected constructs of innovative leadership are innovative and creative thinking behaviour, risk taking and change oriented leadership, stakeholder participation, public administration core values, and service leadership. Data was collected using a survey approach from residents of Harare City Council, Zimbabwe. A structured questionnaire was used to collect 415 validated responses which were analysed using AMOS structural equation modelling (SEM) application. The innovative leadership model was confirmed and the study concluded that innovative and creative thinking behaviour, risk taking and change oriented leadership stakeholder participation, service leadership, and public administration core values, as constructs of innovative leadership, can go a long way on improving service delivery challenges in urban local authorities. As a result, the study validated and concluded the role of the constructs on service delivery challenges in urban local authorities. The study therefore recommends the adoption of the tested model as a plausible solution to service delivery challenges being faced by urban local authorities. [ABSTRACT FROM AUTHOR]

Solving complex post-disaster reconstruction challenges requires the altruistic involvement of heterogeneous stakeholder groups. However, small, more organized groups, such as government parastatals, private developers, and contractors often exploit large, unorganized groups, such as affected communities, leaving them more vulnerable to future disasters. Based on data collected from a case study in Pakistan, this study proposed a framework to assess, anticipate, and mitigate the exploitation of vulnerable stakeholders in post-disaster reconstruction projects. The framework draws on influential management theories and utilizes reciprocal relationships between stakeholder attributes (power, legitimacy, and urgency), participation, and exploitation. The study also argued for non-binary treatment of stakeholder attributes. The framework will allow practitioners to address issues around the exploitation of stakeholder interests in future post-disaster reconstruction projects. [ABSTRACT FROM AUTHOR]