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The study of conflicts over natural resources is neither governed by a coherent set of theories nor limited by strict disciplinary boundaries. Rather, it encompasses a multitude of conceptions grounded within a wide array of disciplines and epistemological assumptions concerning the links between institutional change and conflicts, often concluding in contradictory propositions. This article aims at providing conceptual guidance for the special issue, by reviewing institutional research with a particular focus on institutional change and associated conflicts and drawing some implications from transformative settings. More specifically, the paper explores certain propositions and concepts utilised by institutional economists to explain why conflicts persist despite institutional reforms explicitly or implicitly introduced to resolve them. The author revisits diverse cases from different regions to investigate key concepts related to institutional change and its implications on environmental conflicts associated to transformations, complementing this view from a political science perspective. The paper concludes by offering an overview of factors identified as instrumental in understanding the institutional change and conflict–cooperation continuum.

Hip replacement is the most common surgical procedure among Medicare patients in the US and worldwide. The hospital length of stay (LOS) for hip replacement admissions is therefore important to be controlled, contributing to savings for hospitals. This study combined medical claims and hospital structure and service data to examine LOS fluctuations and trends, and admission distribution patterns, during weekdays, for hip replacement cases. The study furthermore examined associations of these patterns with the LOS performance. Most hospitals were found to admit hip replacement cases at the start of the week (Monday through Wednesday). There is an upward LOS trend as we approach late weekday admissions. Multiple linear regression analysis showed that LOS weekday inconsistencies, a large proportion of hip replacement admissions on Thursday and Friday, the government ownership status, the bed size, and the critical access status are associated with an increased LOS. On the other hand, the rate of hip replacement admissions over total ones, and the hospital being accredited, are associated with a lower LOS. Findings stress out the need for hospitals to maintain an effective and balanced distribution of hip replacement admissions, evenly during the week, and the need for standardized case management, to avoid practice variability and, therefore, LOS fluctuations for their hip replacement cases.

Environmental peacebuilding represents a paradigm shift from a nexus of environmental scarcity to one of environmental peace. It rests on the assumption that the biophysical environment's inherent characteristics can act as incentives for cooperation and peace, rather than violence and competition. Based on this, environmental peacebuilding presents cooperation as a win-win solution and escape from the zero-sum logic of conflict. However, there is a lack of coherent environmental peacebuilding framework and evidence corroborating the existence of this environment-peace nexus. Building on a multidisciplinary literature review, this article examines the evolution of environmental peacebuilding into an emerging framework. It unpacks the concept and explains its main building blocks (conditions, mechanisms and outcomes) to develop our understanding of when, how and why environmental cooperation can serve as a peacebuilding tool. It assembles these building blocks into three generic trajectories (technical, restorative and sustainable environmental peacebuilding), each characterised according to their own causality, drivers and prerequisites, and illustrated with concrete examples. Finally, this article draws attention to the remaining theoretical gaps in the environmental peacebuilding literature, and lays the foundations for an environmental peacebuilding research agenda that clarifies if and how environmental cooperation can spill over across borders, sectors and scales towards sustainable peace.

Environmental peacebuilding represents a paradigm shift from a nexus of environmental scarcity to one of environmental peace. It rests on the assumption that the biophysical environment's inherent characteristics can act as incentives for cooperation and peace, rather than violence and competition. Based on this, environmental peacebuilding presents cooperation as a win-win solution and escape from the zero-sum logic of conflict. However, there is a lack of coherent environmental peacebuilding framework and evidence corroborating the existence of this environment-peace nexus. Building on a multidisciplinary literature review, this article examines the evolution of environmental peacebuilding into an emerging framework. It unpacks the concept and explains its main building blocks (conditions, mechanisms and outcomes) to develop our understanding of when, how and why environmental cooperation can serve as a peacebuilding tool. It assembles these building blocks into three generic trajectories (technical, restorative and sustainable environmental peacebuilding), each characterised according to their own causality, drivers and prerequisites, and illustrated with concrete examples. Finally, this article draws attention to the remaining theoretical gaps in the environmental peacebuilding literature, and lays the foundations for an environmental peacebuilding research agenda that clarifies if and how environmental cooperation can spill over across borders, sectors and scales towards sustainable peace.

Background: Multiple studies have questioned the validity of clinical codes in hospital administrative data. We examined variability in reporting a postoperative ileus (POI). Objective: We aimed to analyse sources of coding variations to understand how clinical coding professionals arrive at POI coding decisions and to verify existing knowledge that current clinical coding practices lack standardised applications of regulatory guidelines. Method: Two medical records (cases 1 and 2) were provided to 15 clinical coders employed by a midsize nonprofit hospital in the northwest region of the United States. After coding these cases, the study participants completed a survey, reported on the application of guidelines, and participated in a focus group led by a health information management regulatory compliance expert. Results: Only 5 of the 15 clinical coders correctly indicated no POI complication in case 1 where the physician documentation did not establish a link between the POI as a complication of care and the surgery. In contrast, 13 of the 15 study participants correctly coded case 2, which included clear physician documentation and contained the clinical parameters for the coding of the POI as a complication of care. Clinical coder education, credentials, certifications, and experience did not relate to the coding performance. The clinical coders inconsistently prioritised coding rules and valued experience more than education. Conclusion and implications: The application of International Classification of Diseases, Ninth Revision, Clinical Modification; coding conventions; Centers for Medicare and Medicaid Services coding guidelines; and American Hospital Association coding clinic advice was subject to the clinical coders' interpretation; they perceived them as conflicting guidance. Their reliance on subjective experience in dealing with this conflicting guidance may limit the accuracy of reporting outcomes of clinical performance.

Unidad de excelencia María de Maeztu MdM-2015-0552 ; This paper presents a diagnostic approach to the role and capacity of governments to facilitate local collective action and alleviate environmental problems. The paper adds to a nascent scholarship aiming to conciliate theories on "governance by government" and "governance by self-organization". We adopt two premises for that purpose: (1) policy instruments shall be tailored to the strategic nature of local resource management decisions; and (2) such nature is not static and can be modified via governmental policies. We first build on the Institutional Analysis and Development (IAD) framework to characterize the decision-making situations that local resource users face and the local rules that shape said situations. Then, based on common pool resource (CPR) and policy instrument choice theory, we identify four mechanisms through which different policy instruments can facilitate local collective action (change in payoffs and their perception, reduction of transaction costs, reduction of uncertainty, and normative consonance). This analytical approach is then applied to four illustrative cases of water management in Germany, France, Greece and Spain. As shown, local resource users are embedded in not one but many overlapping decision-making situations. In this context, the promotion of collective action is rarely accomplished via a single policy instrument or mechanism but via bundles of them. Also, the paper illustrates the importance of understanding how governmental policies modify the structure of rules and incentives that affect local resource users, potentially facilitating local collective action and the solution of environmental problems.