The EU Maritime Spatial Planning Directive (MSPD) requires the member states (MS) to pursue Blue Growth while ensuring good environmental status (GES) of sea areas. An ecosystem-based approach (EBA) should be used for the integration of the aims. However, the MSPD does not specify how the MS should arrange their MSP governance, which has led to a variety of governance arrangements and solutions in addressing the aims. We analysed the implementation of the MSPD in Finland, to identify conditions that may enable or constrain the integration of Blue Growth and GES in the framework of EBA. MSP in Finland is an expert-driven regionalized approach with a legally non-binding status. The results suggest that this MSP framework supports the implementation of EBA in MSP. Yet, unpredictability induced by the non-binding status of MSP, ambiguity of the aims of MSP and of the concept of EBA, and the need to pursue economic viability in the coastal municipalities may threaten the consistency of MSP in both spatial and temporal terms. Developing MSP towards a future-oriented adaptive and collaborative approach striving for social learning could improve the legitimacy of MSP and its capacity to combine Blue Growth and GES. The analysis indicates, that in the delivery of successful MSP adhering to the principles of EBA should permeate all levels of governance. The study turns attention to the legal status of MSP as a binding or non-binding planning instrument and the role the legal status plays in facilitating or constraining predictability and adaptability required in MSP.
MULTIFILE
The EU Maritime Spatial Planning Directive (MSPD) requires the member states (MS) to pursue Blue Growth while ensuring good environmental status (GES) of sea areas. An ecosystem-based approach (EBA) should be used for the integration of the aims. However, the MSPD does not specify how the MS should arrange their MSP governance, which has led to a variety of governance arrangements and solutions in addressing the aims. We analysed the implementation of the MSPD in Finland, to identify conditions that may enable or constrain the integration of Blue Growth and GES in the framework of EBA. MSP in Finland is an expert-driven regionalized approach with a legally non-binding status. The results suggest that this MSP framework supports the implementation of EBA in MSP. Yet, unpredictability induced by the non-binding status of MSP, ambiguity of the aims of MSP and of the concept of EBA, and the need to pursue economic viability in the coastal municipalities may threaten the consistency of MSP in both spatial and temporal terms. Developing MSP towards a future-oriented adaptive and collaborative approach striving for social learning could improve the legitimacy of MSP and its capacity to combine Blue Growth and GES. The analysis indicates, that in the delivery of successful MSP adhering to the principles of EBA should permeate all levels of governance. The study turns attention to the legal status of MSP as a binding or non-binding planning instrument and the role the legal status plays in facilitating or constraining predictability and adaptability required in MSP.
MULTIFILE
Background: Despite the wide range of available treatment modalities a delay between the first outbreak of acne vulgaris and an effective treatment outcome is experienced by many patients. Considering the growing incentives to improve patient satisfaction and quality of care while reducing healthcare costs, insights into the structure, quality and accessibility of acne healthcare services beyond guidelines are therefore needed. Objective: To provide insights into the structure, quality and accessibility of acne healthcare services. Methods: A qualitative study was conducted according to the principles of ‘situational analysis’. The Dutch acne healthcare system was taken as an illustrative example. Twenty-four semi-structured interviews were conducted among representatives of the 4 main Dutch professions providing acne care. All interviews were audiotaped, transcribed verbatim and analyzed. Results: Multiple facilitators and barriers emerged from the interviews. Identified facilitators were care providers delivering personalized patient care and having a positive attitude toward formalized multidisciplinary care delivery. A lack of streamlined referral pathways and standardization in acne severityassessment, financial aspects and unfamiliarity with the content and added value of other acne care professionals were identified as barriers. Further research is recommended to investigate how demedicalisation, the gatekeepers role, and the impact of location and work setting influence the quality of and accessibility to care. Conclusions: Identified facilitators and barriers and an overall positive attitude of care providers toward multidisciplinary care provision provides opportunities for the utilization of future guidelines involving streamlined referral pathways and good working arrangements between all acne care providing professions.
LINK
