A framework for analyzing institutional gaps in natural resource governance

In this paper we present the Inter-Institutional Gap(IIG) Framework as a novel approach to conceptualizing the often-overlooked interconnectivity of different rule-levels between formal and informal institutions in a resource system. This framework goes beyond the existing concepts of legal pluralism, institutional void, structural hole, and cultural mismatch, each of which offer valuable insights to particular gaps between formal and informal institutions, but do not sufficiently address the interaction at every rule level (i.e. constitutional choice, collective choice and operational choice rules). In order to demonstrate the potential of our framework for better understanding the underlying causes of inter-institutional gaps, we apply it to four case studies that encompass diverse geographical locations, governance scales, and social-ecological systems. Results reveal inter-institutional gaps can be created when there are unintended, unforeseen or hidden gaps between different rule hierarchies in two or more simultaneously operating institutions. More specifically we observe that: i) inter-institutional gaps are co-existing, therefore if a certain gap is identified, other gaps may be expected; ii) certain gaps may reveal latent gaps; and iii) intermediaries may be key to addressing inter-institutional gaps. In many cases, sustainable natural resource management and regulation cannot be achieved without directly addressing the inter-institutional gaps that exist between formal and informal institutions operating in the same resource system. The Framework facilitates analysis and understanding of multi-level governance structures in pursuit of addressing complex natural resource management issues

Assessing dysphagia via telerehabilitation: patient perceptions and satisfaction

To gain insight into factors which may infl uence future acceptance of dysphagia management via telerehabilitation, patients’ perceptions were examined before and after a telerehabilitation assessment session. Forty adult patients with dysphagia(M = 66 years, SD = 16.25) completed pre- and post-session questionnaires which consisted of 14 matched questions worded to suit pre- and post-conditions. Questions explored comfort with the use of telerehabilitation, satisfaction with audio and video quality, benefi ts of telerehabilitation assessments and patients’ preferred assessment modality. Questions were rated on a 5-point scale (1 = strongly disagree, 3 = unsure, 5 = strongly agree). Patients’ comfort with assessment via telerehabilitation was high in over 80% of the group both pre- and post-assessment. Pre-assessment, patients were unsure what to expect with the auditory and visual aspects of the videoconference, however there were signifi cant positive changes reported post-experience. In relation to perceived benefits of telerehabilitation services in general, most patients believed in the value of telerehabilitation and post-assessment this increased to 90 – 100% agreement. Although 92% felt they would be comfortable receiving services via telerehabilitation, 45% of patients indicated ultimate preference for a traditional faceto-face assessment. The data highlight that patients are interested in and willing to receive services via telerehabilitation; however, any concerns should be addressed pre-assessment

Broadening the knowledge base of small-scale fisheries through a food systems framework: A case study of the Lake Superior region

Lake Superior is the largest and northernmost of the Great Lakes of North America. It supports a diversity of wildlife and fish species, along with commercial, recreational, and Indigenous fisheries that make vital contributions to nutrition, livelihoods, cultures, and food systems. However, this diversity of social and cultural values is not fully reflected in management practices that tend towards a ‘resourcist’ approach. This chapter seeks to ‘broaden the scope’, proposing a food systems framework as a way of grappling with the wicked problem of Lake Superior fisheries governance. Using a food systems framework, we look at the different values associated with fisheries, including the objective, subjective, and relational contributions they make to Lake Superior food systems. We explore these food-related values attached to fisheries by presenting three illustrative examples: The fisheries of Batchewana First Nation; Eat the Fish, a small business marketing local fish through alternative food networks in Northwestern Ontario; and Bodin’s Fisheries in Wisconsin, a regional fish processor and retail outlet. We conclude by identifying ways of strengthening fisheries contributions to regional food systems and offer a set of transdisciplinary questions on fishery-food system linkages that may assist others in ‘broadening the scope’ of fisheries governance

Science or art: risk and project management in healthcare

Despite its rapid growth in recent literature, risks in project management have received limited critical attention when compared to Lean principles and total quality management. The aim of this article is to examine the ongoing dialogue within health services funders and providers concerning the relationship between project management and its relationship to hard and soft environmental risk factors. The failure of high profile projects and cost to the taxpayer is on the increase. This article argues that the lack of understanding in relation to a holistic assessment of project success factors contributes to increased risk of failure. It argues that greater emphasis is needed on placing risk relative to both operational and cultural factors, as opposed to the frequent use of prescriptive mechanistic methodologies. These changes have the potential not merely to improve the success rates of healthcare management projects, but health outcomes too

What are the implications of implementation science for medical education?

© 2015 David W. Price et al. Background: Derived from multiple disciplines and established in industries outside of medicine, Implementation Science (IS) seeks to move evidence-based approaches into widespread use to enable improved outcomes to be realized as quickly as possible by as many as possible. Methods: This review highlights selected IS theories and models, chosen based on the experience of the authors, that could be used to plan and deliver medical education activities to help learners better implement and sustain new knowledge and skills in their work settings. Results: IS models, theories and approaches can help medical educators promote and determine their success in achieving desired learner outcomes. We discuss the importance of incorporating IS into the training of individuals, teams, and organizations, and employing IS across the medical education continuum. Challenges and specific strategies for the application of IS in educational settings are also discussed. Conclusions: Utilizing IS in medical education can help us better achieve changes in competence, performance, and patient outcomes. IS should be incorporated into curricula across disciplines and across the continuum of medical education to facilitate implementation of learning. Educators should start by selecting, applying, and evaluating the teaching and patient care impact one or two IS strategies in their work