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National and local policy supports the involvement of patients at all levels in the design, delivery and improvement of health services. Whilst existing approaches to support involvement have been described and disseminated, including the 4Pi National Involvement Standards, their application in quality improvement is rarely reported. The paper aims to discuss this issue.

A quality improvement initiative within a mental health trust was developed with a multi-disciplinary team, including those with professional experience of delivering or improving care and those with lived experience. The aim of the initiative was to improve the physical health of inpatients within an acute mental health unit. This case study aims to describe how the integration of concepts from the 4Pi National Involvement Standards (Principles, Purpose, Presence, Process and Impact) provided a framework for engaging and involving service users. The case study also aims to describe how co-design was included within the 4Pi approach and supported the development of a tool to aid improving physical healthcare.

The 4Pi National Involvement Standards provided a guiding framework for the involvement of service users within a quality improvement initiative. Value of the approach was realised through the co-design of a tool developed by service users, along with healthcare professionals, to facilitate discussion and support shared-decision making about inpatients’ physical health.

Identifying “ways that work” for service user involvement is crucial to move beyond the policy rhetoric or tokenistic involvement. Involvement in quality improvement initiatives can bring benefits both to services and the service users themselves.

Whilst the 4PI approach is recognised as a useful framework for involvement, few examples exist of its practical applications within a quality improvement setting.

Increasing environmental pollution and destruction have damaged sustainability in polluting societies and organizations. For this reason, various environmental management programs have recently been developed by governments and the environmental protection agencies (EPAs) to control and reduce environmental pollution. One of these programs is environmental audit (EA), which has not been fully implemented yet in developing countries and it has many disadvantages. It seems that one of the reasons for the lack of perfect implementation of EA in these countries is the lack of adequate review of the factors affecting its implementation. The purpose of this paper is to identify the factors affecting EA implementation and then analysis of causal relationships between them.

Decision-making trial and evaluation laboratory (DEMATEL) technique was used to identify causal relationships of factors affecting EA implementation. Based on the literature review and interviewing nine experts in EA, 17 factors were identified to influence EA implementation. Six experts were selected for the evaluation using snowball sampling method. Using the DEMATEL approach, a cause and effect relationship diagram was generated through which the effect of factors was analyzed.

Seventeen factors were categorized in terms of cause and effect, and the interrelationships of factors were also analyzed. “Reducing environmental impacts and improving environmental performance,” “obtaining environmental management system certificates” and “contributing to the environmental goals of investment projects” are the most prominent factors on the basis of their prominent score.

Analysis in the research is highly dependent on expert judgments and opinions may be biased. However, the initial matrix obtained from the experts is hindered by the ambiguity about some relationships. But this can be improved by using fuzzy and gray set theories. The factors used for the analysis may not be comprehensive and other researchers may find other factors.

Identifying the factors affecting EA implementation and analyzing causal relationships between them can be a guide and help governments to improve the implementation of EA or even develop this policy by being aware of the effect of the factors analyzed.

To the best of the authors’ knowledge, no comprehensive study of factors affecting EA implementation has been undertaken; this study is the first to identify these factors and analyze them using DEMATEL. Therefore, it is suggested that governments and EPAs in the policies focus on the significant factors.

The shift toward a circular economy (CE) represents a collaborative endeavor necessitating the presence of efficient frameworks, conducive contexts and a common comprehension. This research serves as a pivotal stride towards this goal, presenting an exclusive prospect for the investigation and fusion of these frameworks, with particular emphasis on the Quintuple Helix Model (5HM), into a unified theoretical framework that underscores the core principles of the CE. This study is centered on three pivotal questions aimed at decoding the CE transition in specific regional settings.

Adopting an abductive approach firmly anchored in a two-stage qualitative process, this study specifically merges the foundational principles from institutional theory, entrepreneurship literature and CE frameworks to provide insights into the dynamics of circular ecosystems, with a specific focus on the Huelva region in Spain.

The findings demonstrate significant potential in the CE, ranging from the integration of product and service systems to innovations in eco-industrial practices. Yet, a notable deficiency exists: the absence of institutional entrepreneurs, highlighting the essential role that universities can play. As recognized centers of innovation, universities are suggested to be key contributors to the transformation toward a CE, aligning with their societal and economic responsibilities.

This study highlights the importance of managing relationships with entities like SMEs and policymakers or academia for effective CE adoption. Policymakers can refine strategies based on the research’s insights, while the impact of university-driven circular ecosystems on sustainable societies is another crucial area for research.

The sustainability models cited in CE literature may not be comprehensive enough to prevent problem shifting, and it can be argued that they lack a sound theoretical and conceptual basis. Furthermore, the connections between sustainability objectives and the three levels of the CE operating system remain vague. Additionally, there is insufficient information on how regions foster the involvement of the environment in fivefold helix cooperation and how this impacts the CE.

The Baduy tribe has its own uniqueness and values regarding the forest; it manages the forest using customary law to keep it sustainable. This research aims to describe the position of customary law used by the Baduy tribe to conserve forest areas.

This research is a qualitative research conducted in September 2019 and 2020 at Baduy. The data were collected through a literature study and in-depth interviews with informants related to the Baduy tribe. The collected data included documentation and interview transcripts that were translated into English. Data analysis was conducted in a descriptive manner, equipped with related evidence.

The Baduy community holds firm to its customs and culture called pikukuh. The Baduy community applies the concept of sustainable forest management in that local communities are directly involved in forest management activities to improve welfare and implement sustainable forests.

The implication of this research is that it is beneficial for forest conservation based on customary law, using the conservation approach of the Baduy tribe as a local community in protecting the sustainability of forest resources and their sustainability for the next generation. This study contributes as a guide for the government to formulate policies that will include local communities into conservation programs and government policies. It may apply to a study of coordination with related institutions such as the Ministry of Environment and Forestry in implementing forest conservation.

This study uses primary data from the Baduy tribe, which has unique local traditional values regarding the territory and the important role of the forest. The originality of the findings from the excavation of each activity was based on the procedures and beliefs regulated in customary law regarding forest management. Preservation of traditional knowledge in customary law has contributed to the urgency of sustainable forest conservation and biodiversity conservation, which is part of the traditional knowledge of the Baduy tribe.