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Advocacy for Post-Intensive Care Syndrome (PICS) is a critical component of supporting the recovery of survivors of critical illness. Despite its importance, a shared understanding of PICS advocacy remains underrepresented in medical literature. This chapter defines PICS advocacy as an ethical commitment to patient- and caregiver-centered care, encompassing three key dimensions: supporting individuals living with PICS, promoting awareness and prevention within medical and lay communities, and advancing the science surrounding this condition. Current advocacy efforts occur across various levels, including local communities, national organizations, and global collaborations. Central to these efforts is awareness, facilitated by a growing array of educational resources such as books, podcasts, and websites. However, PICS advocacy can further benefit from large-scale public awareness campaigns modeled after successful initiatives by organizations like the American Heart Association and the American Cancer Society. These efforts could amplify public understanding and drive systemic change. Individuals are encouraged to take an active role in PICS advocacy, and this chapter offers practical strategies for engagement. By empowering individuals to champion PICS awareness and support, the healthcare community can foster a more inclusive approach to addressing this condition. Advocacy for PICS is not just a responsibility–it is an opportunity to transform care and improve outcomes for survivors and their families.
This chapter discusses corpus applications to language teaching and learning, focusing specifically on the use of corpora and corpus linguistics research for informing coursebook and assessment development. A number of studies undertaken by the authors are discussed with a view to highlighting both the affordances of corpus linguistics for supporting such indirect applications to language education, as well as the barriers of using corpus linguistics research to inform stakeholder practices. Focusing on the use of corpora by materials writers, the use of learner corpus research and spoken corpus research for assessment refinement and design, and the use of corpus research for materials design, this chapter reflects on engagement with stakeholders in this domain over the last fifteen years. Drawing together the lessons learned from these studies, this chapter offers a critical reflection on the relative impact achieved in each study, while also proposing guidelines for those interested in working with stakeholders to co-design research and produce relevant and appliable research.
Chapter 2 defines the concept of race-conscious image construction, which occurs through disclosures, presents empirical evidence of it in action, and charts how corporations used race-conscious images to bolster their reputation between 2020 and 2024. It also demonstrates how the language and prevalence of disclosures about race changed during that time. The chapter discusses Chevron Corporation (Chevron) as representative case studies that illustrate the image construction process undertaken by thousands of companies. It also explores the role of risk management in corporations’ use of race-conscious disclosures, demonstrating that image construction is often employed as a shield from legal and reputational scrutiny.
Chapter 6 argues that a functioning federal government should assume an information enforcing role to regulate race-conscious disclosures and retraction and facilitate regulation by shareholders and stakeholders including, employees, and consumers, who can use the information provided by the federal government to establish accountability structures. The chapter makes normative suggestions for what it calls a “multi-institutional approach” to regulating business.
UK food system transformation is urgently needed, but to date, minimal research has investigated ‘blue foods’ probably because they are ethically nuanced. There exists a paradox whereby materially deprived communities should be eating more fish to meet nutritional requirements, yet there is a global ‘red flag’ around global overfishing. New collaborative and creative solutions are, therefore, needed to tackle such food system inequities. By working together, all voices can be equally heard when decisions are being made to improve the system. Similarly, innovation and disruption of established supply chains will enable better access to healthy, affordable and tasty food that will support better nutrition, health and wellbeing. This review paper will present a critique of the ‘The Plymouth Fish Finger’ as a collaborative social innovation case study. Part of the FoodSEqual research project, this exploratory pilot project championed ‘co-production’ approaches to achieve multiple (potential) impacts. This review will critically explore how this social innovation case study has exemplified the complex interplay between factors driving distortions in access to and availability of fish within the local food system. Through collaborative multi-stakeholder (transdisciplinary) processes, using participatory creative methods, new strategies and recommendations for research, practice, action and policy are informed, all of which offer great potential for progressive and transformative systemic (blue) food system change.
The European Union relies on decentralised agencies to implement important transnational regulations, such as certifying the safety of medicines. However, the authority of these agencies does not have ‘hard’ legal status and crucially depends on disseminating ideas and information effectively: what can be termed ‘political entrepreneurship’. This article provides the first comprehensive analysis of the political entrepreneurship of EU agencies by constructing a conceptual typology of entrepreneurial strategies. Drawing conceptually on transnational public administration, a new database is constructed of the ‘entrepreneurship’ of 33 EU agencies in 2014 based on their media communication activities, face‐to‐face networking in workshops and collaborations, and knowledge dissemination and ‘learning’ exercises. This is mapped against the political salience of agencies in the European Parliament and media. The mapping exercise shows four types of entrepreneurial strategies covering the population of EU agencies: technical functional, insulating, network‐seeking and politicised. The typology is validated through semi‐structured interviews in 11 EU agencies, showing the core characteristics of each type of strategy. The article concludes by arguing that this typology provides an important addition to existing categories of EU agencies based on autonomy and accountability, and advocates a future research strategy examining the interaction between agencies’ entrepreneurial strategies and the expectations and reactions of stakeholder audiences.
International nongovernmental organizations (INGOs) are frequently criticized for failing to adequately represent or engage with grassroots stakeholders. Yet most explanations of this shortcoming have focused on factors external to the organizations, e.g., economic pressures that privilege donor interests. What has been largely lacking is an examination of the role of internal INGO characteristics. We address this by examining INGOs’ legitimacy standards: how INGOs understand themselves to be doing the right thing and seek to convey that righteousness to others. Drawing on the literature from business ethics and organizational behavior, we show that organizations’ self-selected standards of legitimacy are key drivers of behavior. Using an analysis of 57 American INGO websites, we identify 11 legitimacy types and examine their usage. We find that while most INGOs make a series of technical legitimacy claims that seem designed to attract donors, they simultaneously employ additional legitimacy standards that do not seem to be externally dictated. These additional standards generally prioritize adherence to a cause rather than stakeholder input. The findings suggest that challenges to INGO representivity or responsiveness result not only from external pressures, but also from INGOs’ own choice of values.
Non-governmental organizations (NGOs) play a critical role in the response to human displacement yet face competing pressures. One ongoing site of displacement is among the 1.1 million Rohingya persons living in refugee camps in Bangladesh. NGOs are party to the ongoing humanitarian response yet operate under competing demands by multiple stakeholders. To what extent do NGOs meet the various expectations among different groups of Rohingya refugee beneficiary stakeholders? We used UNHCR survey data from 31 refugee sites in Cox’s Bazar to empirically examine the relationship between demographic and socioeconomic indicators with satisfaction levels of service provision. We find that female refugees and head of household disability (difficulty seeing, hearing, walking, remembering, or communicating) are indicators that present the most significant differences; NGO responses more often overlook the priority needs of females and persons with disabilities when compared to other refugees, a response gap that reduces their satisfaction and potentially heightens these groups’ vulnerabilities. Although UNHCR and NGOs face pressures from competing demands within beneficiary populations, they also have opportunities to develop refugee-centered policies and practices that are more responsive to vulnerable groups. Overall, this paper adds dimension to understanding of various refugee stakeholder perspectives within a camp setting.
The governance of civil society organizations (CSOs) is a crucial determinant of organizational legitimacy, accountability, and performance. International nongovernmental organizations (INGOs) are a subtype of CSOs and have received a lot of attention as actors in global governance. Research suggests that INGOs can follow a membership model, where the board is elected by the membership, or a board-managed model, where the board is appointed to represent major stakeholders. Following resource dependency theory, we argue that the choice between these two models depends on the INGOs different sources of funding and the degree of volunteer involvement: As donors and volunteers provide important resources, they are in turn granted the right to nominate board members or to sit on the board. In our quantitative study we show that individual members, regional member organizations, and governmental donors hold a stronger position in the governance of INGOs than philanthropists, foundations and volunteers. Our results inform research on CSO governance by highlighting the relevance of board nomination modes and by showing how CSOs can incorporate stakeholders into their governance mechanisms.
The long-term performance of NPOs is based on their ability to link and maximize social value as defined in their mission. This involves legitimacy obtained from stakeholders influenced by and influencing NPO activities, and their operational capacity or economic efficiency. Thus, NPOs have to utilize multiple level accountability systems which should be compatible with their multiple objectives and stakeholders’ claims. The accountability system of an NPO should focus on its operational capacity, because in order to maximize its efficiency, an NPO has to measure its resource use, cost structure, and financial structure. Legitimacy obtained from stakeholders is also integral. If an organization is considered a social contract between multiple stakeholders, it has to consider the social economic effects of its activities and it has the duty to account for them. However, since the mission of an NPO is to create and distribute social value to a certain specific group, its social value creation has the most important role and an NPO should measure the social value it has created. This article analyzes the accountability system of a specific type of Italian NPO called Centri di Servizio per il Volontariato (CSVs)—namely centers which provide services for voluntary associations. The aim of the research is to verify if the accountability system adopted by CSVs satisfies their need for multiple level information (operational, legitimacy, and social value) and accomplishes their stakeholder claims, and to determine its impact on the definition and implementation of their strategy and on their long-term performance. The research was carried out using the action research model, and the findings are based on the analysis of a sample of 64 CSVs situated throughout Italy.
This article focuses on the nexus between the governance of U.S. nonprofit organizations and their ability to secure the resources necessary to effectively execute their missions. Different sources of nonprofit income are associated with alternative stakeholders. Viewing these constituencies as beneficiary groups, we consider how the particular mix of income sources influences the capacity of nonprofits to generate resources, especially if there is competition among stakeholder groups for control of the organization’s policies and practices. We then ask how nonprofit governance might be modified to improve the ability of the organization to generate resources through a regime of economic stakeholder governance.
Why do nonprofit organizations exist? From an economic perspective, a number of major theories have been proposed to explain their existence. However, when exploring determinants of nonprofit sector density, one needs to take into account that demand and supply factors operate simultaneously and that it is difficult to separate them. By using a stakeholder approach, we develop a more integrative framework for understanding variations in nonprofit sector density. We test this framework by investigating determinants of nonprofit sector density in Texas at the county level.
Efforts to reduce restrictive practices (RPs) in mental health care are growing internationally. Yet, inconsistent definitions and perspectives often challenge the consistent implementation and evaluation of reduction strategies. This study explored which scenarios different mental health stakeholders classify as RPs, examined the contextual factors influencing these classifications and compared classification patterns across clinicians, researchers, service users and family caregivers.
Methods
An international cross-sectional survey was conducted using a multilingual online questionnaire hosted on the Qualtrics platform. A total of 851 stakeholders participated, including clinicians (n = 517), service users (n = 80), family caregivers (n = 89) and researchers (n = 165). Participants were presented with 44 potential RP case scenarios and asked to rate whether each scenario should be classified as an RP using a four-point Likert scale (Definitely yes, Probably yes, Probably no, Definitely no). The scenarios were organized into 22 paired comparisons, each sharing the same core context but differing in specific details. Paired comparisons were analyzed one pair at a time, allowing us to identify classification patterns between the scenarios and isolate the effects of particular contextual factors using ordered logistic regression. Interaction analyses were then conducted to assess how classification patterns varied across stakeholder groups.
Results
Substantial discrepancies exist both within and between stakeholder groups regarding whether a given action should be considered an RP or not. Physically visible actions were often identified as RPs across all groups, while less visible forms often went unrecognized. Contextual differences, such as the healthcare professional’s intention, duration of the action, methods used, presence or absence of consent, door-locking status, and the severity of anticipated harm to be prevented influenced whether a given action was classified as an RP. Service users classified more scenarios as RPs than other groups; however, their decisions were more context-sensitive, shifting notably even with minor changes in scenario details. Among the 22 paired scenarios compared, 13 (59.09%) showed significant differences (p < 0.01) within at least one stakeholder group and eight demonstrated differences between groups.
Conclusions
Mental health stakeholders’ interpretations of RPs were often shaped not only by the inherent coercive nature of actions but also by the context in which they occurred and the professional role of the assessors. This underscores the need for harmonized definitions and classification frameworks for RPs, co-designed with diverse stakeholders. Addressing less visible forms of RPs in policy and clinical practice is also essential.
Dealing with cumulative environmental problems unavoidably requires repeated interactions (coordination) among multiple and often many actors relevant to the other three CIRCle functions (conceptualization, information, and regulatory intervention). Coordination can promote effective approaches, avoid policy drift, and resolve disputes. Key actors may include multiple agencies and levels of government, quasi-governmental organizations, supranational and international institutions, and nongovernmental organizations representing stakeholders of different kinds. Rules can help overcome significant cost, time, and political disincentives to establishing and maintaining coordination. Two broad types of formal rules for coordination emerge in mechanisms for coordinating conceptualization, information, and intervention: those that establish an institution, and those that provide for interaction in other ways, such as duties to notify or cooperate or undertake joint planning. Legal mechanisms can also expressly provide for dealing with policy drift and resolving disputes between regulatory actors. Real-world examples are provided of legal mechanisms to support these forms of coordination.
Directors’ duties can be classified into two themes: duties in relation to care and skill, and duties in relation to loyalty and good faith. This chapter is the first of two chapters addressing the duties of loyalty and good faith. These duties fall into two categories: those concerned with the way in which directors exercise the powers and discretions vested in them, and those concerned with the standard of conduct expected from directors. This chapter will focus on the first category, which includes the duty to act bona fide in the best interests of the company and for proper purposes, its counterpart in s 181 of the Corporations Act, and the limitations on directors not to fetter the future exercise of their discretions.
This chapter starts with a discussion of the general law in relation to the duty to act bona fide in the best interests of the company and for proper purposes. The discussion examines how the law developed historically and how it exists today. It then considers s 181 of the Corporations Act, before moving to consider alternative approaches to this area of law, which demonstrate a development of the stakeholder approach to corporate theory.
This chapter outlines the importance of partnering with stakeholders for quality health service management and delivery, and highlights common patterns driving partnership-based public policy. It introduces concepts associated with partnering in health services, defines key terms and discusses necessary managerial skills or competencies needed to engage with stakeholders and implement partnership-based policy. The interests of key health-sector stakeholders are discussed and important steps are outlined for managers undertaking stakeholder analyses. Finally, the chapter explores essential factors for successful partnerships and the competencies managers need to successfully develop and maintain stakeholder partnerships.
While prototype testing with stakeholders is key for valuable feedback in iterative design, there is limited research on how novice designers, who lack the relevant experience, solicit meaningful feedback. This paper analyzes 30 prototype testing sessions from five student design teams to understand how novices structure their testing time by identifying and reporting the instances of testing interactions and types of questions within different contexts. Initial findings show that novices effectively set up testing, engage in active listening, and ask more close-ended follow-up questions. However, they rarely conclude sessions, seek stakeholder questions, and use fewer leading questions in later testing sessions. This preliminary understanding highlights opportunities to strengthen novices’ skills in prototype testing and how testing approaches affect stakeholder feedback quality.
The rise in the use of AI in most key areas of business, from sales to compliance to financial analysis, means that even the highest levels of corporate governance will be impacted, and that corporate leaders are duty-bound to manage both the responsible development and the legal and ethical use of AI. This transformation will directly impact the legal and ethical duties and best practices of those tasked with setting the ‘tone at the top’ and who are accountable for the firm’s success. Directors and officers will have to ask themselves to what extent should, or must, AI tools be used in both strategic business decision-making, as well as monitoring processes. Here we look at a number of issues that we believe are going to arise due to the greater use of generative AI. We consider what top management should be doing to ensure that all such AI tools used by the firm are safe and fit for purpose, especially considering avoidance of potential negative externalities. In the end, due to the challenges of AI use, the human component of top corporate decision-making will be put to the test, to prudentially thread the needle of AI use and to ensure the technology serves corporations and their human stakeholders instead of the other way around.
Partnerships between public, private and civil society actors can potentially address food systems challenges. However, such cross-sector partnerships may require the management of potential tensions and conflicts of interest. This article presents the development and content of a framework for engagement between food systems actors involved in NewTools, a cross-sector research partnership involving twenty-eight partners from research institutions, government, food industry and civil society. The purpose of the framework is to facilitate engagement of partners and maintain research integrity.
Design:
This two-phased, iterative study was conducted in 2022. It was guided by recommendations for methodological framework development and was informed by existing frameworks and recommendations as well as two rounds of consultations with partners.
Setting:
The Norwegian cross-sector research partnership NewTools that aims to develop two food profiling models: one for dietary quality and one for environmental and social impact.
Participants:
Food systems actors involved in the NewTools project.
Results:
The NewTools framework consists of four main parts: (1) definition of overarching principles for collaboration (transparency, regular information, adhering to defined roles and responsibilities), (2) descriptions of roles and responsibilities of the partners involved, (3) procedures to ensure involvement and transparency and (4) identification and mediation of potential conflict areas.
Conclusions:
This article provides an example of how a cross-sector research partnership developed a framework to facilitate engagement between partners with different interest within a food system. Future studies are needed to assess the potential value of frameworks for cross-sector research partnerships towards healthier and more sustainable food systems.
Observation medicine and its dedicated units provide hospitals with a high quality, safe, and efficient space to provide care while avoiding increased costs. Observation units (OUs) positively impact inpatient capacity, reduce audits, and improve revenue capture making them a value-added asset for hospitals and their administrators. OUs can turn unprofitable admissions into profitable observation stays. Private and government insurance companies benefit from the structure and efficiency of OUs which provide care at an outpatient payment level that is far less than the payments for inpatient care. Furthermore, by freeing up acute care beds for undifferentiated patients within the waiting room, OUs alleviate strains on emergency department resources – a benefit to both physicians and patients. The medical and financial benefits of OUs, and their viability, ultimately requires the support of several key stakeholders including physicians, advanced practice providers, nurses, hospital administrators, payers and patients.