Participants represented four distinct stakeholder groups and were from 14 different countries.
31 33 To increase the reliability of the results, a large heterogeneous panel of 'experts', consisting of distinct stakeholder groups was recruited.
The strengths of this study included a randomized study design; an intervention targeted at high-risk patients; the successful partnership between numerous distinct community stakeholders; and that we were able to 'replicate' the intervention's effects 6 months later in the DP group.
Although it's easy to conclude that REBs could be faulty for any variability and inconsistency observed in the process or final approved ethics documents, it is worth reiterating that research ethics and ethics review are shared responsibilities and that ethics governance systems are comprised of distinct key stakeholders such as researchers, REBs, funding bodies, and academic institutions.
These loops involve shifting rationalities, historically formed path dependencies and distinct constellations of stakeholders, all of which affect the means of their implementation within national and regional socio-spatial environments.
The ranking of these messages was organized in 4 groups corresponding to distinct categories of stakeholders: national and international health authorities and policy makers, the medical and veterinary communities, the general public, and Industry.
This is acknowledged by the 'Accountability for Reasonableness' (A4R) framework [ 2, 3] which is based on the believe that any consensus on priority setting weights and subsequent results may be difficult to achieve because of these distinct perspectives of stakeholders.
Sasson et al. [ 15] identified three distinct groups of stakeholders whose current policies may impede efforts to adopt TOR rules: payers who incentivize transport, legislators who create state mandates for transport and allow only narrow use of do-not-resuscitate orders and communities in which cultural norms are perceived to impede TOR.
The responses were distinct for each stakeholder group.
In this respect, the authors acknowledge that stakeholder-specific data acquisition is needed not only when local authorities want to adopt distinct policy instruments for different stakeholders or stakeholders types, but also when homogeneous policies impacting the various stakeholders are considered.
From the Dutch Heat Vision [3] of the Dutch Ministry of Economic Affairs, it becomes clear that the central Dutch government is considering specific constitutional level interventions towards a more distinct positioning of certain stakeholders, to further effective orchestration within the regulated heat market.
