Improving patient involvement in the lifecycle of medicines : insights from the EUPATI BE survey

EUPATI Belgium (EUPATI.be) is an informal gathering of local partners who are interested in improving patient involvement in healthcare innovation and medicines research and development. EUPATI.be brings together various stakeholders from different areas related to healthcare including patients, academia and industry. In doing so, we create an innovative collaborative approach where actors from different backgrounds work toward improving patient involvement in medical research, and putting the patient at the center of the Belgian healthcare system. Previously, we performed in-depth interviews with a small group of stakeholders on patient involvement. Here, we elaborate on our previous findings by using a nation-wide survey to inquire into Belgian stakeholders' perception on patient involvement. To this end, an electronic survey was available in French, Dutch and English, and accessible for 11 months. Twelve questions were asked, including 11 multiple choice questions and 1 open question. The latter was thematically analyzed according to the framework method. A total of 117 responses were registered and descriptive statistics were performed. The majority of respondents could be categorized into patient, academia and industry, whereas policy makers, payers, and healthcare professionals were underrepresented. We identified several barriers that hamper patient involvement, which were sometimes more reported by specific stakeholder groups. Next, we found that various stakeholders still consider patient involvement as a passive role, i.e., medical subject in a clinical trial. Respondents also reported that the role of the various stakeholders needed more clarification; this was also confirmed by the level of trust amongst the various stakeholders. Existing and the wish for more collaboration with the various stakeholders was reported by almost all respondents. Based on this survey, we can define the potential of involving patients in the medical research and development in the Belgian landscape. Our results will help to understand and tackle the various barriers that currently hamper patient involvement, whilst highlighting the need for a collaborative landscape from the multi-stakeholder perspective

Causes, Consequences, and Policy Responses to the Migration of Health Workers: Key Findings from India

Background: This study sought to better understand the drivers of skilled health professional migration, its consequences, and the various strategies countries have employed to mitigate its negative impacts. The study was conducted in four countries—Jamaica, India, the Philippines, and South Africa—that have historically been “sources” of health workers migrating to other countries. The aim of this paper is to present the findings from the Indian portion of the study. Methods: Data were collected using surveys of Indian generalist and specialist physicians, nurses, midwives, dentists, pharmacists, dieticians, and other allied health therapists. We also conducted structured interviews with key stakeholders representing government ministries, professional associations, regional health authorities, health care facilities, and educational institutions. Quantitative data were analyzed using descriptive statistics and regression models. Qualitative data were analyzed thematically. Results: Shortages of health workers are evident in certain parts of India and in certain specialty areas, but the degree and nature of such shortages are difficult to determine due to the lack of evidence and health information. The relationship of such shortages to international migration is not clear. Policy responses to health worker migration are also similarly embedded in wider processes aimed at health workforce management, but overall, there is no clear policy agenda to manage health worker migration. Decision-makers in India present conflicting options about the need or desirability of curtailing migration. Conclusions: Consequences of health work migration on the Indian health care system are not easily discernable from other compounding factors. Research suggests that shortages of skilled health workers in India must be examined in relation to domestic policies on training, recruitment, and retention rather than viewed as a direct consequence of the international migration of health workers

An Assessment of the Impact Investing and Social Enterprise Ecosystem in Virginia

In a study that spanned more than four months from April through August of 2016, the Virginia Impact Investing Forum surveyed nearly 200 stakeholders and held dozens of personal interviews and focus groups with thought leaders across the state. The goal was to map Virginia’s Impact Investing and Social Enterprise ecosystem and to determine the next steps necessary to the continued growth and prosperity of this emerging field. Results show that there is strong interest in seeing Impact Investing and Social Enterprise development flourish throughout Virginia, as evidenced by concerted efforts from across all three sectors to promote this ecosystem, including bi-partisan government actors, private equity firms, foundations, and entrepreneurs. One general theme that has emerged in conversations and survey responses around Impact Investing is the tension that often exists between prospective Impact Investors and Social Entrepreneurs, and while this research does not seek to solidify answers to some of the most pressing questions that create these tensions, it does make a key point: Impact Investing has the potential to be something entirely different from philanthropy and investing, something that has the power to reshape longstanding economic barriers between one’s wallet and one’s heart, by fueling the creative fire behind social innovation and breaking down the walls between the traditional public, nonprofit, and private sectors - And that is something worth celebrating, and worth continuing to fight for

City Open Data Policies

The capture and analysis of data is transforming the 21st Century. As society becomes more data driven, data has the ability to drive the bottom line for private companies and help the public sector to define where and how services can best be delivered. In City Open Data Policies: Learning by Doing, the National League of Cities identifies how cities can take advantage of the opportunities presented by open data initiatives.SUMMARY OF RECOMMENDATIONSLeadership: Political support stands out as one of the key requirements to implementing a successful open data project.Appropriate Legislation: Enacting legislation or formal policies is a crucial step toward ensuring the growth and sustainability of open data portals. Funding: Open data initiatives do not require high levels of funding. It is, however, important that the programs have their own budget line items where resources are specifically allocated. Technical Approach: Leading U.S. cities rely on commercial platforms that facilitate the implementation of open data initiatives, provide technical expertise, and ensure 24/7 customer support, often at a lower cost than providing these services in-house. Stakeholder Involvement: Open data is a two-way process. It is, therefore, essential to encourage participation and engagement among multiple stakeholders including: community members; non-profits; universities; the press; businesses; city departments; and other levels of government. Many cities adopt a flexible, and usually informal, approach to interact with the stakeholders. Measuring Success: Developing evaluation tools should be an integral part of any future open data policies

Trade-offs and synergies in the ecosystem service demand of urban brownfield stakeholders

Brownfield site redevelopment presents an opportunity to create urban green spaces that provide a wide range of ecosystem services. It is important, therefore, to understand which ecosystem services are demanded by stakeholders and whether there are trade-offs or synergies in this demand. We performed a quantitative survey of ecosystem service demand from brownfield sites that included all major stakeholder groups. Results showed that there was a strong trade-off between demand for services related to property development (e.g. ground strength and low flood risk) and all other services, which were linked to vegetated sites. There was a secondary, but weak, trade-off between demand for services of more ‘natural’ vegetated sites (e.g. with a biodiversity protection role) and those linked to aesthetics and recreation. Stakeholders with a strong preference for biodiversity protection formed a distinct group in their ecosystem service demands. While a ‘development’ vs ‘green space’ trade-off may be unavoidable, the general lack of strong trade-offs in demand for other services indicated that the creation of multifunctional greenspaces from former brownfield sites would be desirable to most stakeholders, as long as these are biophysically possible

Developing a framework for the analysis of power through depotentia

Stakeholder participation in tourism policy-making is usually perceived as providing a means of empowerment. However participatory processes drawing upon stakeholders from traditionally empowered backgrounds may provide the means of removing empowerment from stakeholders. Such an outcome would be in contradiction to the claims that participatory processes improve both inclusivity and sustainability. In order to form an understanding of the sources through which empowerment may be removed, an analytical perspective has been developed deriving from Lukes�s views of power dating from 1974. This perspective considers the concept of depotentia as the removal of �power to� without speculating upon the underlying intent and also provides for the multidimensionality of power to be examined within a single study. The application of this analytical perspective has been tested upon findings of the government-commissioned report of the Countryside and Community Research Unit in 2005. The survey and report investigated the progress of Local Access Forums in England created in response to the Countryside and Rights of Way Act 2000. Consideration of the data from this perspective permits the classification of individual sources of depotentia which can each be addressed and potentially enable stakeholder groups to reverse loss of empowerment where it has occurred

The National Dialogue on the Quadrennial Homeland Security Review

Six years after its creation, the Department of Homeland Security (DHS) undertook the first Quadrennial Homeland Security Review (QHSR) to inform the design and implementation of actions to ensure the safety of the United States and its citizens. This review, mandated by the Implementing the 9/11 Commission Recommendations Act of 2007, represents the first comprehensive examination of the homeland security strategy of the nation. The QHSR includes recommendations addressing the long-term strategy and priorities of the nation for homeland security and guidance on the programs, assets, capabilities, budget, policies, and authorities of the department.Rather than set policy internally and implement it in a top-down fashion, DHS undertook the QHSR in a new and innovative way by engaging tens of thousands of stakeholders and soliciting their ideas and comments at the outset of the process. Through a series of three-week-long, web-based discussions, stakeholders reviewed materials developed by DHS study groups, submitted and discussed their own ideas and priorities, and rated or "tagged" others' feedback to surface the most relevant ideas and important themes deserving further consideration.Key FindingsThe recommendations included: (1) DHS should enhance its capacity for coordinating stakeholder engagement and consultation efforts across its component agencies, (2) DHS and other agencies should create special procurement and contracting guidance for acquisitions that involve creating or hosting such web-based engagement platforms as the National Dialogue, and (3) DHS should begin future stakeholder engagements by crafting quantitative metrics or indicators to measure such outcomes as transparency, community-building, and capacity