Brownfield regeneration and the shifting of financial risk: Between plans and reality in public-private partnerships

Internationally, brownfield regeneration projects are deliveredthrough public-private partnerships that form complex legal andstructural delivery mechanisms. Utilizing private-sector finance andskills is an accepted practice to reduce financial risk for the publicsector while delivering profits for the private sector. This articleexplores three international brownfield regeneration schemes. Ithighlights how and why financial risk remains within the publicsector from the outset or returns to the public sector over time,despite the initial rhetoric for this burden to be carried mainly bythe private sector. The analysis improves the empirical understandingof financial risk dynamics in brownfield regeneration

The PRO-RCC study:a long-term PROspective Renal Cell Carcinoma cohort in the Netherlands, providing an infrastructure for ‘Trial within Cohorts’ study designs

BACKGROUND: Ongoing research in the field of both localized, locally advanced and metastatic renal cell carcinoma has resulted in the availability of multiple treatment options. Hence, many questions are still unanswered and await further research. A nationwide collaborative registry allows to collect corresponding data. For this purpose, the Dutch PROspective Renal Cell Carcinoma cohort (PRO-RCC) has been founded, for the prospective collection of long-term clinical data, patient reported outcome measures (PROMs) and patient reported experience measures (PREMs).METHODS: PRO-RCC is designed as a multicenter cohort for all Dutch patients with renal cell carcinoma (RCC). Recruitment will start in the Netherlands in 2023. Importantly, participants may also consent to participation in a 'Trial within cohorts' studies (TwiCs). The TwiCs design provides a method to perform (randomized) interventional studies within the registry. The clinical data collection is embedded in the Netherlands Cancer Registry (NCR). Next to the standardly available data on RCC, additional clinical data will be collected. PROMS entail Health-Related Quality of Life (HRQoL), symptom monitoring with optional ecological momentary assessment (EMA) of pain and fatigue, and optional return to work- and/or nutrition questionnaires. PREMS entail satisfaction with care. Both PROMS and PREMS are collected through the PROFILES registry and are accessible for the patient and the treating physician.TRIAL REGISTRATION: Ethical board approval has been obtained (2021_218) and the study has been registered at ClinicalTrials.gov (NCT05326620).DISCUSSION: PRO-RCC is a nationwide long-term cohort for the collection of real-world clinical data, PROMS and PREMS. By facilitating an infrastructure for the collection of prospective data on RCC, PRO-RCC will contribute to observational research in a real-world study population and prove effectiveness in daily clinical practice. The infrastructure of this cohort also enables that interventional studies can be conducted with the TwiCs design, without the disadvantages of classic RCTs such as slow patient accrual and risk of dropping out after randomization.</p

Co-creation in public utilities: The case of district heating networks

International audiencePublic authorities are committing to the decarbonization of economies. Public utilities especially district heating networkscould serve as critical levers for cutting carbon emissions. Heat production accounts for about fifty percent of the global energy consumption and is still heavily carbonized. Fossil-free and locally-based district heating systems are being promoted and implemented with the support of public authorities. These innovative systems raise challenges as they integrate a greater variety of stakeholders than conventional ones. To maximize the creation of public value, public authorities have been setting up co-creation processes with these stakeholders. This paper analyzes how co-creation processes are used in district heating projects, using a framework that revolves around three co-creation activities: setting up a collaborative network, defining the collaborative governance and assessing and learning from project outcomes. These activities are studied throughout the lifecycle of five projects: three innovative district heating networks and two conventional ones. Innovative projects are expected to demonstrate more articulated and elaborate forms of co-creation compared to conventional counterparts, including more activities and a greater diversity of stakeholders involved. The data comes from twenty-seven semi-structured interviews, informal discussions with project stakeholders, and an analysis of project documentspartly publicly available, partly confidential. The research findings focus on (1) demonstrating and explaining the use of co-creation within the selected cases and (2) discussing the critical limitations of and barriers to the integration of co-creation in the utility sector