The 2014 EU Directive on Maritime Spatial Planning (MSP) lays down obligations for the EU Member States to establish a maritime planning process, resulting in a maritime spatial plan by 2020. Consultation should be carried out with local, national and transnational stakeholders. Stakeholder engagement in MSP is complex because of the great number and diversity of maritime stakeholders and the unfamiliarity of some of these stakeholders with MSP and its potential impact. To facilitate stakeholder engagement in MSP, the 'MSP Challenge' table top strategy game was designed and played as part of several stakeholder events in different European countries. The authors study the efficacy of the game for stakeholder engagement. Background and evaluation data of nineteen game sessions with a total of 310 stakeholders with different backgrounds were collected through post-game surveys. Furthermore, the efficacy of the game for stakeholder engagement processes, organised by competent MSP authorities in Scotland and Belgium, is studied in more detail. The results show that the board game, overall, has been a very efficient and effective way of familiarising a great diversity of stakeholders with MSP and to create meaningful interaction and learning among stakeholders in formal planning processes. However, the case studies also show that contextual factors-the level of familiarity with MSP and participants' perception to sustainability-influences the efficacy of the game.
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Background: Previous systematic reviews revealed poor reliability and validity for sacroiliac joint (SIJ) mobility tests. However, these reviews were published nearly 20 years ago and recent evidence has not yet been summarised. Objectives: To conduct an up-to-date systematic review to verify whether recommendations regarding the clinical use of SIJ mobility tests should be revised. Study design: Systematic review. Method: The literature was searched for relevant articles via 5 electronic databases. The review was conducted according to the PRISMA guidelines. COSMIN checklists were used to appraise the methodological quality. Studies were included if they had at least fair methodology and reported clinimetric properties of SIJ mobility tests performed in adult patients with non-specific low back pain, pelvic (girdle) pain and/or SIJ pain. Only tests that can be performed in a clinical setting were considered. Results: Twelve relevant articles were identified, of which three were of sufficient methodological quality. These three studies evaluated the reliability of eight SIJ mobility tests and one test cluster. For the majority of individual tests, the intertester reliability showed slight to fair agreement. Although some tests and one test cluster had higher reliability, the confidence intervals around most reliability estimates were large. Furthermore, there were no validity studies of sufficient methodological quality. Conclusion: Considering the low and/or imprecise reliability estimates, the absence of high-quality diagnostic accuracy studies, and the uncertainty regarding the construct these tests aim to measure, this review supports the previous recommendations that the use of SIJ mobility tests in clinical practice is problematic.
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