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Recent years have witnessed a growing volume in Chinese interregional trade, along with the increasing disparities in environmental pressures. This has prompted an increased attention on where the responsibilities for environmental impacts should be placed. In this paper, we quantify the environmental responsibility of SO2 emissions and biodiversity impacts due to terrestrial acidification at the provincial level for the first time. We examine the environmental responsibility from the perspectives of production, consumption, and income generation by employing a Multi-Regional Input-Output (MRIO) model for 2007, 2010, and 2012. The results indicate that ?40% of SO2 emissions were driven by the consumption in provinces other than where the emissions discharged. In particular, those developed provinces were net importers of SO2 emissions and mainly outsourced their emissions to nearby developing provinces. Over the period of analysis, environmental inequality among 30 provinces was larger than GDP inequality. Furthermore, environmental inequality continued to increase while GDP inequality decreased over the time period. The results of a shared income- and consumption-based responsibility approach suggest that the environmental responsibility of SO2 emissions and biodiversity impacts for developed provinces can reach up to ?4- to 93-fold the environmental pressure occurred within those provinces. This indicates that under these accounting principles the developed northern provinces in China would bear a much larger share of the environmental responsibility. © 2018 Elsevier LtdWe calculate the shared responsibilities for SO2 emissions in China and find them to differ significantly from the production-based reduction targets set by governments. © 2018 Elsevier Ltd

Health, safety, and well-being (HSW) at work represent important values in themselves. It seems, however, that other values can contribute to HSW. This is to some extent reflected in the scientific literature in the attention paid to values like trust or justice. However, an overview of what values are important for HSW was not available. Our central research question was: what organizational values are supportive of health, safety, and well-being at work? Methods: The literature was explored via the snowball approach to identify values and value-laden factors that support HSW. Twenty-nine factors were identified as relevant, including synonyms. In the next step, these were clustered around seven core values. Finally, these core values were structured into three main clusters. Results: The first value cluster is characterized by a positive attitude toward people and their “being”; it comprises the core values of interconnectedness, participation, and trust. The second value cluster is relevant for the organizational and individual “doing”, for actions planned or undertaken, and comprises justice and responsibility. The third value cluster is relevant for “becoming” and is characterized by the alignment of personal and organizational development; it comprises the values of growth and resilience. Conclusion: The three clusters of core values identified can be regarded as “basic value assumptions” that underlie both organizational culture and prevention culture. The core values identified form a natural and perhaps necessary aspect of a prevention culture, complementary to the focus on rational and informed behavior when dealing with HSW risks.

At the start of the 21st century, Corporate Social Responsibility (CSR) seems to have great potential for innovating business practices with a positive impact on People, Planet and Profit. In this article the differences between the management systems approach of the nineties, and Corporate Social Responsibility are analysed. An analysis is structured around three business principles that are relevant for CSR and management systems: (1) doing things right the first time, (2) doing the right things, and (3) continuous improvement and innovation. Basically CSR is focussing on the second principle, and management systems focus on the first. However, CSR is very likely to build on the management systems as well. From a CSR point of view, the existing generation of management systems with their focus on rational control (= doing things right) can only be of limited use in the development of CSR. However, the preventive rationalities of management systems are important. Values and the principle doing the right things is extremely relevant for CSR. This goes far beyond the present generation of ISO type management systems; opportunities stem from building on TQM approaches like the EFQM Business Excellence model. Continuous improvement and innovation is a permanent challenge underlying the two other business principles, and requires both individual and organisational learning processes. In the present generation of management systems, continuous improvement mainly addresses rational prevention, barely the value aspects of business. For the further development and implementation of CSR, each of the three business management principles are vital. There is a need for a new generation of management systems that addresses the values at stake in strategic decision-making, both at company level and in the behaviour of individuals, while the rationalities of prevention and anticipation are still relevant. In both directions more emphasis for continuous learning and innovation will be needed. CSR is likely to trigger the development of management systems in the directions mentioned. This will support companies to be credible and transparent in improving the performance with respect to people, planet and profit.

Activist groups increasingly use computer-mediated communication (CMC) channels to mobilize large groups of consumers to persuade incumbent firms to change their contested strategies or practices. The attributes of CMC channels change the effectiveness of persuasion processes in organizations. Similarly, attributes may change the effectiveness of protest mobilization. Yet, organizational research to date has mostly neglected this potential effect. This paper systematically reviews the effect of CMC attributes on the antecedents of protest participation. We construct a conceptual framework based on social movement and media choice theory, which guides the systematic collation of online activism research. Threemain themes emerge from the literature. First, we find that the interactivity of online activism decreases the need for formal mobilizing structures, while increasing the importance of informal mobilizing structures for protest diffusion and global cooperation between activist groups. Second, increased interactivity and user control provide an alternative media channel for consumers and resource-poor activist groups to express and bundle their grievances. Third, the degree of publicness and interactivity seems to stimulate the formation of multiple, online collective identities that are rather interest-based than identity-based. We conclude this paper with a conceptual model that highlights the most prominent relations found in literature and discuss the implications for future research and practitioners

The research presented in this document analyzes how safety values are defined and used in practice, in particular by managers, and how they affect employers’ and employees’ decisions and behaviour at work. The work comprises three complementary activities: a literature review on the value of safety and safety as a value, focusing on the moral, social and business dimensions that strengthen safety values; a set of semi-structured interviews with CEOs in several European countries, which collected their perception of safety as a value and its impact in company strategy and in the workplace; a Delphi survey (N=111), which collected consensus statements on the value of safety, on values that support safety, and the mechanisms that form and reinforce values that are perceived to support safety values in practice.

The use of health targets as a tool in health policy is receiving more attention. Beyond political will and daring, there awaits the challenge of the fruitful use of health targets. This means an adequate response to the complexity of population health in a target structure that is transparent, controllable, and adaptable in changing circumstances. In this article, we will review the health policy development cycle in relation to health target setting. First, there should be understanding of the problem, and a clear picture of the health status of the population. Then a solution can be chosen. This part is not restricted to the technical side of the solution, i.e. the target setting and action planning. It also has a political side in which responsibility is taken for the choices made. In the next step, the chosen solutions are implemented by government and stakeholders. This will be followed by a monitoring and evaluation phase, which will in turn provide us with an insight into the health status of the population. At every stage of the health policy cycle, questions which should be addressed when using health targets in health policy will be discussed. (C) 2000 Elsevier Science Ireland Ltd.

Promoting unstructured outside play is a promising vehicle to increase children's physical activity (PA). This study investigates if factors of the social environment moderate the relationship between the perceived physical environment and outside play. Study design: 1875 parents from the KOALA Birth Cohort Study reported on their child's outside play around age five years, and 1516 parents around age seven years. Linear mixed model analyses were performed to evaluate (moderating) relationships among factors of the social environment (parenting influences and social capital), the perceived physical environment, and outside play at age five and seven. Season was entered as a random factor in these analyses. Results: Accessibility of PA facilities, positive parental attitude towards PA and social capital were associated with more outside play, while parental concern and restriction of screen time were related with less outside play. We found two significant interactions; both involving parent perceived responsibility towards child PA participation. Conclusion: Although we found a limited number of interactions, this study demonstrated that the impact of the perceived physical environment may differ across levels of parent responsibility. © Remmers et al.; licensee BioMed Central Ltd.

Aims Educating physicians in the procedural as well as cognitive skills of information technology (IT)-mediated medication management could be one of the missing links for the improvement of patient safety. We aimed to compose a framework of tasks that need to be addressed to optimize medication management in outpatient care. Methods Formal task analysis: decomposition of a complex task into a set of subtasks. First, we obtained a general description of the medication management process from exploratory interviews. Secondly, we interviewed experts in-depth to further define tasks and subtasks. Setting: Outpatient care in different fields of medicine in six teaching and academic medical centres in the Netherlands and the United States. Participants: 20 experts. Tasks were divided up into procedural, cognitive and macrocognitive tasks and categorized into the three components of dynamic decision making. Results The medication management process consists of three components: (i) reviewing the medication situation; (ii) composing a treatment plan; and (iii) accomplishing and communicating a treatment and surveillance plan. Subtasks include multiple cognitive tasks such as composing a list of current medications and evaluating the reliability of sources, and procedural tasks such as documenting current medication. The identified macrocognitive tasks were: planning, integration of IT in workflow, managing uncertainties and responsibilities, and problem detection. Conclusions All identified procedural, cognitive and macrocognitive skills should be included when designing education for IT-mediated medication management. The resulting framework supports the design of educational interventions to improve IT-mediated medication management in outpatient care. © 2015 The Authors. British Journal of Clinical Pharmacology published by John Wiley and Sons Ltd on behalf of The British Pharmacological Society.

Increasingly, workers have psychological work-related complaints, endangering their work ability and causing considerable economic losses. Many employees consult their general practitioner (GP). He, however, often pays insufficient attention to work-relatedness or to coordination with occupational physicians (OPs). Appropriate guidelines are missing. Consequently, we developed a GP guideline to handle these problems in coordination with OPs, and tested it in a pilot, using an explorative, evaluative study design. 23 GPs were trained to include employed patients and to test the guideline. Patients received questionnaires after 0, 4, 10 and 30 wk, GPs after 4 and 30 wk. The result was a new guideline, regarding problem orientation, diagnosis and advice, meant to avoid contradictory GP-OP advice and to activate patient responsibility. It included a GP-OP-patient communication form concerning information exchange and harmonization of insight/advice. Implementing GPs concluded that the guideline promotes recovery and work resumption and OP-GP contact benefits patients, prevents conflicting advice and promotes agreement on task division. They judged guideline efficiency and OP commitment less positively. Patients were positive, especially about GP-OP contact. Accordingly, an improved guideline, when tested for its effectiveness in a Randomized Controlled Trial, can help GPs to cope with a growing, complex problem, in collaboration with their occupational colleagues.

Background This study aims to give insight into the opinions of maternity care professionals and other stakeholders on the integration of midwife-led care and obstetrician-led care and on the facilitating and inhibiting factors for integrating maternity care. Methods Qualitative study using interviews and focus groups from November 2012 to February 2013 in the Netherlands. Seventeen purposively selected stakeholder representatives participated in individual semi-structured interviews and 21 in focus groups. One face-to-face focus group included a combined group of midwives, obstetricians and a paediatrician involved in maternity care. Two online focus groups included a group of primary care midwives and a group of clinical midwives respectively. Thematic analysis was performed using Atlas.ti. Two researchers independently coded the interview and focus group transcripts by means of a mind map and themes and relations between them were described. Results Three main themes were identified with regard to integrating maternity care: client-centred care, continuity of care and task shifting between professionals. Opinions differed regarding the optimal maternity care organisation model. Participants considered the current payment structure an inhibiting factor, whereas a new modified payment structure based on the actual amount of work performed was seen as a facilitating factor. Both midwives and obstetricians indicated that they were afraid to loose autonomy. Conclusions An integrated maternity care system may improve client-centred care, provide continuity of care for women during labour and birth and include a shift of responsibilities between health care providers. However, differences of opinion among professionals and other stakeholders with regard to the optimal maternity care organisation model may complicate the implementation of integrated care. Important factors for a successful implementation of integrated maternity care are an appropriate payment structure and maintenance of the autonomy of professionals.

Background: During the last decade, a rapid increase of birth locations for low-risk births, other than conventional obstetric units, has been seen in the Netherlands. Internationally some of such locations are called birth centres. The varying international definitions for birth centres are not directly applicable for use within the Dutch obstetric system. A standard definition for a birth centre in the Netherlands is lacking. This study aimed to develop a definition of birth centres for use in the Netherlands, to identify these centres and to describe their characteristics. Methods: International definitions of birth centres were analysed to find common descriptions. In July 2013 the Dutch Birth Centre Questionnaire was sent to 46 selected Dutch birth locations that might qualify as birth centre. Questions included: location, reason for establishment, women served, philosophies, facilities that support physiological birth, hotel-facilities, management, environment and transfer procedures in case of referral. Birth centres were visited to confirm the findings from the Dutch Birth Centre Questionnaire and to measure distance and time in case of referral to obstetric care. Results: From all 46 birth locations the questionnaires were received. Based on this information a Dutch definition of a birth centre was constructed. This definition reads: "Birth centres are midwifery-managed locations that offer care to low risk women during labour and birth. They have a homelike environment and provide facilities to support physiological birth. Community midwives take primary professional responsibility for care. In case of referral the obstetric caregiver takes over the professional responsibility of care." Of the 46 selected birth locations 23 fulfilled this definition. Three types of birth centres were distinguished based on their location in relation to the nearest obstetric unit: freestanding (n = 3), alongside (n = 14) and on-site (n = 6). Transfer in case of referral was necessary for all freestanding and alongside birth centres. Birth centres varied in their reason for establishment and their characteristics.

Health technology assessment (HTA) consists of the systematic study of the consequences of the introduction or continued use of the technology in a particular context, with the explicit objective to arrive at a judgment of the value or merit of the technology. Ideally, it is aimed at assessing all aspects of a given technology or group of technologies, including non-technical, e.g. socio-ethical, aspects. However, methods for assessing socio-ethical implications of health technology are relatively undeveloped and few mechanisms exist to take action based on the results of such evaluations. Still, the examples of cochlear inplants (CI) and other cases illustrate that HTA is not a matter of merely collecting the facts about a technology. The facts must be plausible and relevant from a particular framework, which is not always shared by different groups. It is here that socio-ethical aspects are encountered. If health technology assessment aims to enhance the accountability of the decision making process regarding funding and use of health technology, it is a major challenge to assessor of health technologies to deal adequately with existing value pluralism. In this respect interactive evaluation may have something to offer.