Using police crash databases for injury prevention research - a comparison of opt-out and opt-in approaches to study recruitment

Objective: The study aimed to examine the difference in response rates between opt-out and opt-in participant recruitment in a population-based study of heavy-vehicle drivers involved in a police-attended crash. Methods: Two approaches to subject recruitment were implemented in two different states over a 14-week period and response rates for the two approaches (opt-out versus opt-in recruitment) were compared. Results: Based on the eligible and contactable drivers, the response rates were 54% for the optout group and 16% for the opt-in group. Conclusions and Implications: The opt-in recruitment strategy (which was a consequence of one jurisdiction’s interpretation of the national Privacy Act at the time) resulted in an insufficient and potentially biased sample for the purposes of conducting research into risk factors for heavy-vehicle crashes. Australia’s national Privacy Act 1988 has had a long history of inconsistent practices by state and territory government departments and ethical review committees. These inconsistencies can have profound effects on the validity of research, as shown through the significantly different response rates we reported in this study. It is hoped that a more unified interpretation of the Privacy Act across the states and territories, as proposed under the soon-to-be released Australian Privacy Principles will reduce the recruitment challenges outlined in this study.

Opt-out options in new product co-development partnerships

We study three contractual arrangements—co-development, licensing, and co-development with opt-out options—for the joint development of new products between a small and financially constrained innovator firm and a large technology company, as in the case of a biotech innovator and a major pharma company. We formulate our arguments in the context of a two-stage model, characterized by technical risk and stochastically changing cost and revenue projections. The model captures the main disadvantages of traditional co-development and licensing arrangements: in co-development the small firm runs a risk of running out of capital as future costs rise, while licensing for milestone and royalty (M&R) payments, which eliminates the latter risk, introduces inefficiency, as profitable projects might be abandoned. Counter to intuition we show that the biotech's payoff in a licensing contract is not monotonically increasing in the M&R terms. We also show that an option clause in a co-development contract that gives the small firm the right but not the obligation to opt out of co-development and into a pre-agreed licensing arrangement avoids the problems associated with fully committed co-development or licensing: the probability that the small firm will run out of capital is greatly reduced or completely eliminated and profitable projects are never abandoned.

Pairing QuantiFERON gold in-tube with opt-out HIV testing in a tuberculosis contact investigation in the Southeastern United States.

Knowing one's HIV status is particularly important in the setting of recent tuberculosis (TB) exposure. Blood tests for assessment of tuberculosis infection, such as the QuantiFERON Gold in-tube test (QFT; Cellestis Limited, Carnegie, Victoria, Australia), offer the possibility of simultaneous screening for TB and HIV with a single blood draw. We performed a cross-sectional analysis of all contacts to a highly infectious TB case in a large meatpacking factory. Twenty-two percent were foreign-born and 73% were black. Contacts were tested with both tuberculin skin testing (TST) and QFT. HIV testing was offered on an opt-out basis. Persons with TST >or=10 mm, positive QFT, and/or positive HIV test were offered latent TB treatment. Three hundred twenty-six contacts were screened: TST results were available for 266 people and an additional 24 reported a prior positive TST for a total of 290 persons with any TST result (89.0%). Adequate QFT specimens were obtained for 312 (95.7%) of persons. Thirty-two persons had QFT results but did not return for TST reading. Twenty-two percent met the criteria for latent TB infection. Eighty-eight percent accepted HIV testing. Two (0.7%) were HIV seropositive; both individuals were already aware of their HIV status, but one had stopped care a year previously. None of the HIV-seropositive persons had latent TB, but all were offered latent TB treatment per standard guidelines. This demonstrates that opt-out HIV testing combined with QFT in a large TB contact investigation was feasible and useful. HIV testing was also widely accepted. Pairing QFT with opt-out HIV testing should be strongly considered when possible.

Analysis of educational materials and destruction/opt-out initiatives for storage and use of residual newborn screening samples.

In recent years, the storage and use of residual newborn screening (NBS) samples has gained attention. To inform ongoing policy discussions, this article provides an update of previous work on new policies, educational materials, and parental options regarding the storage and use of residual NBS samples. A review of state NBS Web sites was conducted for information related to the storage and use of residual NBS samples in January 2010. In addition, a review of current statutes and bills introduced between 2005 and 2009 regarding storage and/or use of residual NBS samples was conducted. Fourteen states currently provide information about the storage and/or use of residual NBS samples. Nine states provide parents the option to request destruction of the residual NBS sample after the required storage period or the option to exclude the sample for research uses. In the coming years, it is anticipated that more states will consider policies to address parental concerns about the storage and use of residual NBS samples. Development of new policies regarding storage and use of residual NBS samples will require careful consideration of impact on NBS programs, parent and provider educational materials, and respect for parents among other issues.

Cost analysis of opt-in consent procedures for the Texas statewide immunization information system, ImmTrac

Background. Childhood immunization programs have dramatically reduced the morbidity and mortality associated with vaccine-preventable diseases. Proper documentation of immunizations that have been administered is essential to prevent duplicate immunization of children. To help improve documentation, immunization information systems (IISs) have been developed. IISs are comprehensive repositories of immunization information for children residing within a geographic region. The two models for participation in an IIS are voluntary inclusion, or "opt-in," and voluntary exclusion, or "opt-out." In an opt-in system, consent must be obtained for each participant, conversely, in an opt-out IIS, all children are included unless procedures to exclude the child are completed. Consent requirements for participation vary by state; the Texas IIS, ImmTrac, is an opt-in system.^ Objectives. The specific objectives are to: (1) Evaluate the variance among the time and costs associated with collecting ImmTrac consent at public and private birthing hospitals in the Greater Houston area; (2) Estimate the total costs associated with collecting ImmTrac consent at selected public and private birthing hospitals in the Greater Houston area; (3) Describe the alternative opt-out process for collecting ImmTrac consent at birth and discuss the associated cost savings relative to an opt-in system.^ Methods. Existing time-motion studies (n=281) conducted between October, 2006 and August, 2007 at 8 birthing hospitals in the Greater Houston area were used to assess the time and costs associated with obtaining ImmTrac consent at birth. All data analyzed are deidentified and contain no personal information. Variations in time and costs at each location were assessed and total costs per child and costs per year were estimated. The cost of an alternative opt-out system was also calculated.^ Results. The median time required by birth registrars to complete consent procedures varied from 72-285 seconds per child. The annual costs associated with obtaining consent for 388,285 newborns in ImmTrac's opt-in consent process were estimated at $702,000. The corresponding costs of the proposed opt-out system were estimated to total $194,000 per year. ^ Conclusions. Substantial variation in the time and costs associated with completion of ImmTrac consent procedures were observed. Changing to an opt-out system for participation could represent significant cost savings. ^

To be in, or to be out: reflections on the Danish referendum. EPIN Commentary No. 29, 10 December 2015

In this EPIN Commentary, Catharina Sørensen offers her reflections on Denmark’s referendum, held on December 3rd, on whether the country should change its blanket opt-out on all justice and home affairs cooperation in the EU to the more nuanced opt-in model adopted by the UK and Ireland. In her view, the outcome reflected the two separate ‘languages’ deployed in the public debate over the referendum – the emotional discussion about sovereignty, which appealed to the heart, and the technical argument about cooperation, which appealed to reason. In using these two languages, the campaigners spoke past one another, failed to understand each other and divided Denmark into two opposing camps.

Harmonisation of OH&S regulations

Policy instruments of education, regulation, fines and inspection have all been utilised by Australian jurisdictions as they attempt to improve the poor performance of occupational health and safety (OH&S) in the construction industry. However, such policy frameworks have been largely uncoordinated across Australia, resulting in differing policy systems, with differing requirements and compliance systems. Such complexity, particularly for construction firms operating across jurisdictional borders, led to various attempts to improve the consistency of OH&S regulation across Australia, four of which will be reviewed in this report. 1. The first is the Occupational Health and Safety Act 1991 (Commonwealth) which enabled certain organisations to opt out of state based regulatory regimes. 2. The second is the development of national standards, codes of practice and guidance documents by the National Occupational Health and Safety Council (NOHSC). The intent was that the OHS requirements, principles and practices contained in these documents would be adopted by state and territory governments into their legislation and policy, thereby promoting regulatory consistency across Australia. 3. The third is the attachment of conditions to special purpose payments from the Commonwealth to the States, in the form of OH&S accreditation with the Office of the Federal Safety Commissioner. 4. The fourth is the development of national voluntary codes of OHS practice for the construction industry. It is interesting to note that the tempo of change has increased significantly since 2003, with the release of the findings of the Cole Royal Commission. This paper examines and evaluates each of these attempts to promote consistency across Australia. It concludes that while there is a high level of information sharing between jurisdictions, particularly from the NOSHC standards, a fragmented OH&S policy framework still remains in place across Australia. The utility of emergent industry initiatives such as voluntary codes and guidelines for safer construction practices to enhance consistency are discussed.

Promotion and succession management and associated retention issues in Australian law firms

The focus of this research was promotion and succession management in Australian law firms. Two staff retention issues currently faced by the Australian legal industry were identified as suggesting possible failures in this area: 1) Practitioners are leaving law firms early in their careers, 2) Female representation is disproportionally low at partnership level. The research described current Australian law firm promotion and succession practices and then explained their possible relevance to the two retention issues. The overall aim of the research was to uncover key findings and present practical recommendations to law firm managers and partners ready for incorporation into their future promotion and succession planning practice. In so doing the research aimed to benefit the Australian legal community as a whole. Four areas of literature relevant to the topic were reviewed, 1) law firm governance concluding that the fundamental values of the P²-Form remained constant (Cooper, Hinings, Greenwood & Brown, 1996; Morris & Pinnington, 1998) with ownership and strategic control of law firms remaining in the hands of partners; 2) the importance of individual practitioners to law firms concluding that the actual and opportunity costs relating to practitioner turnover were significant due to the transient nature of knowledge as a key asset of law firms (Gottschalk & Khandelwal, 2004; Rebitzer & Taylor, 2007); 3) generational differences concluding with support for the work of Finegold, Mohrman and Spreitzer (2002), Davis, Pawlowski and Houston (2006), Kuhnreuther (2003), and Avery, McKay, and Wilson (2007) which indicated that generational cohort differences were of little utility in human resources management practice; and 4) previous research relating to law firm promotion and succession practices indicating that five practices were relevant in law firm promotion outcomes; 1) firm billing requirements (Gorman & Kmec, 2009; Phillips, 2001; Noonan & Corcoran, 2004; Webley & Duff, 2007); 2) mentoring programs (Phillips, 2001; Noonan & Corcoran, 2004); 3) the existence of female partners (Gorman & Kmec, 2009; Beckman & Phillips, 2005); 4) non-partner career paths (Phillips, 2001; Corcoran & Noonan, 2004); and 5) the existence of family friendly policies (Gorman & Kmec, 2009; Phillips, 2001; Noonan & Corcoran, 2004; Webley & Duff, 2007.) The research was carried out via a sequential mixed method approach. The initial quantitative study was based upon a theoretical framework grounded in the literature and provided baseline information describing Australian law firm promotion and succession practices. The study was carried out via an on-line survey of Australian law firm practitioners. The results of the study provided the basis for the second qualitative study. The qualitative study further explained the statistically generated results and focused specifically on the two identified retention issues. The study was conducted via one-on-one interviews with Australian law firm partners and experienced law firm managers. The results of both studies were combined within the context of relevant literature resulting in eight key findings: Key findings 1) Organisational commitment levels across generational cohorts are more homogenous than different. 2) Law firm practitioners are leaving law firms early in their careers due to the heavy time commitment behaviour demanded of them, particularly by clients. 3) Law firm promotion and succession practices reinforce practitioner time commitment behaviour marking it as an indicator of practitioner success. 4) Law firm practitioners believe that they have many career options outside law firms and are considering these options. 5) Female practitioners are considering opting out of law firms due to time commitment demands related to partnership conflicting with family commitment demands. 6) A masculine, high time commitment culture in law firms is related to the decision by female practitioners to leave law firms. 7) The uptake of alternative work arrangements by female practitioners is not fatal to their partnership prospects particularly in firms with supportive policies, processes and organisational culture. 8) Female practitioners are less inclined than their male counterparts to seek partnership as an ultimate goal and are more likely to opt out of law firms exhibiting highly competitive, masculine cultures. Practical recommendations Further review of the data collected in relation to the key findings provided the basis for nine practical recommendations specifically geared towards implementation by law firm managers and partners. The first recommendation relates to the use of generational differences in practitioner management. The next six relate to recommended actions to reduce the time commitment demands on practitioners. The final two recommendations relate to the practical implementation of these actions both at an individual and organisational level. The recommendations are as follows: 1) "Generationally driven," age based generalisations should not be utilised in law firm promotion and succession management practice. 2) Expected levels of client access to practitioners be negotiated on a client by client basis and be included in client retention agreements. 3) Appropriate alternative working arrangements such as working off-site, flexible working hours or part-time work be offered to practitioners in situations where doing so will not compromise client serviceability. 4) The copying of long working hour behaviours of senior practitioners should be discouraged particularly where information technology can facilitate remote client serviceability. 5) Refocus the use of timesheets from an employer monitoring tool to an employee empowerment tool. 6) Policies and processes relating to the offer of alternative working arrangements be supported and reinforced by law firm organisational culture. 7) Requests for alternative working arrangements be determined without regard to gender. 8) Incentives and employment conditions offered to practitioners to be individualised based on the subjective need of the individual and negotiated as a part of the current employee performance review process. 9) Individually negotiated employment conditions be negotiated within the context of the firm’s overall strategic planning process. Through the conduct of the descripto-explanatory study, a detailed discussion of current law firm promotion and succession practices was enabled. From this discussion, 7 eight key findings and nine associated recommendations were generated as well as an insight into the future of the profession being given. The key findings and recommendations provide practical advice to law firm managers and partners in relation to their everyday promotion and succession practice. The need to negotiate individual employee workplace conditions and their integration into overall law firm business planning was put forward. By doing so, it was suggested that both the individual employee and the employing law firm would mutually benefit from the arrangement. The study therefore broadened its practical contribution from human resources management to a contribution to the overall management practice of Australian law firms. In so doing, the research has provided an encompassing contribution to the Australian legal industry both in terms of employee welfare as well as firm and industry level success.

A finite element model of seat cushion indentation with a soft tissue human occupant model

Effective digital human model (DHM) simulation of automotive driver packaging ergonomics, safety and comfort depends on accurate modelling of occupant posture, which is strongly related to the mechanical interaction between human body soft tissue and flexible seat components. This paper presents a finite-element study simulating the deflection of seat cushion foam and supportive seat structures, as well as human buttock and thigh soft tissue when seated. The three-dimensional data used for modelling thigh and buttock geometry were taken on one 95th percentile male subject, representing the bivariate percentiles of the combined hip breadth (seated) and buttock-to-knee length distributions of a selected Australian and US population. A thigh-buttock surface shell based on this data was generated for the analytic model. A 6mm neoprene layer was offset from the shell to account for the compression of body tissue expected through sitting in a seat. The thigh-buttock model is therefore made of two layers, covering thin to moderate thigh and buttock proportions, but not more fleshy sizes. To replicate the effects of skin and fat, the neoprene rubber layer was modelled as a hyperelastic material with viscoelastic behaviour in a Neo-Hookean material model. Finite element (FE) analysis was performed in ANSYS V13 WB (Canonsburg, USA). It is hypothesized that the presented FE simulation delivers a valid result, compared to a standard SAE physical test and the real phenomenon of human-seat indentation. The analytical model is based on the CAD assembly of a Ford Territory seat. The optimized seat frame, suspension and foam pad CAD data were transformed and meshed into FE models and indented by the two layer, soft surface human FE model. Converging results with the least computational effort were achieved for a bonded connection between cushion and seat base as well as cushion and suspension, no separation between neoprene and indenter shell and a frictional connection between cushion pad and neoprene. The result is compared to a previous simulation of an indentation with a hard shell human finite-element model of equal geometry, and to the physical indentation result, which is approached with very high fidelity. We conclude that (a) SAE composite buttock form indentation of a suspended seat cushion can be validly simulated in a FE model of merely similar geometry, but using a two-layer hard/soft structure. (b) Human-seat indentation of a suspended seat cushion can be validly simulated with a simplified human buttock-thigh model for a selected anthropomorphism.

Virtual worlds in Australian and New Zealand higher education : remembering the past, understanding the present and imagining the future

3D virtual reality, including the current generation of multi-user virtual worlds, has had a long history of use in education and training, and it experienced a surge of renewed interest with the advent of Second Life in 2003. What followed shortly after were several years marked by considerable hype around the use of virtual worlds for teaching, learning and research in higher education. For the moment, uptake of the technology seems to have plateaued, with academics either maintaining the status quo and continuing to use virtual worlds as they have previously done or choosing to opt out altogether. This paper presents a brief review of the use of virtual worlds in the Australian and New Zealand higher education sector in the past and reports on its use in the sector at the present time, based on input from members of the Australian and New Zealand Virtual Worlds Working Group. It then adopts a forward-looking perspective amid the current climate of uncertainty, musing on future directions and offering suggestions for potential new applications in light of recent technological developments and innovations in the area.

Spam – Spim – Spit. En marknadsrättslig undersökning av marknadsföring via nya kommunikationstekniker

I boken behandlas nya kommunikationstekniker och olika marknadsföringsmetoder som har uppkommit till följd av den tekniska utvecklingen. Marknadsföring via de nya kommunikationskanalerna har givit upphov till vissa olägenheter för mottagarna. Olägenheterna som mottagarna förorsakas vid marknadsföring via de nya teknikerna kan delas in i tre kategorier; 1) meddelandet förorsakar kostnader för mottagaren, 2) meddelandet hindrar mottagaren samt 3) meddelandet upplevs vara påträngande och utgöra ett intrång i mottagarens privatliv. Under de senaste åren har det förekommit hektiska lagstiftningsåtgärder på många håll i världen. Såväl enskilda stater, nationella myndigheter samt internationella organisationer har utarbetat regler om marknadsföring via de nya teknikerna. En av kärnfrågorna i regleringen är huruvida man skall ha ett system med ”opt-in” eller ”opt-out”. En opt-in-lösning innebär att marknadsföraren måste inhämta mottagarens samtycke på förhand, medan en opt-out-lösning innebär att det är tillåtet att sända marknadsföring om inte mottagaren motsatt sig detta. Enligt gällande lagstiftning faller marknadsföring via följande tre tekniker under opt-in: automatiserade uppringningssystem, telefax samt e-post. Det huvudsakliga syftet med avhandlingen är att utreda om nuvarande opt-in-lista är tillräckligt omfattande med beaktande av de olägenheter som marknadsföring via de nya teknikerna förorsakar, eller om den bör utvidgas. I genomgången av marknadsföring via nya tekniker har marknadsföring via bl.a. följande tekniker undersökts: Internet (www-sidor), reklamfönster, reklambanner, e-post, mobiltelefon, telefax, bloggar, RSS, Instant Messaging samt Internettelefoni. Vid sidan av nya tekniker har även vissa ”traditionella” marknadsföringsmetoder undersökts, i syfte att utreda huruvida även de bör falla in under en opt-in-lösning. De traditionella marknadsföringsmetoder som ingår i avhandlingen är hemförsäljning, telemarketing, TV- och radioreklam samt adresserad och oadresserad direktreklam. En annan central del i avhandlingen är frågan hur påföljdssystemet vid överträdelser av opt-in-bestämmelserna bör utformas. Hur skall de enskilda mottagarna få ersättning för de kostnader de åsamkats av marknadsföringen? Är det dags att införa straffskadestånd i Finland? Hög tid att även Finland får grupptalan? Kan tvisterna avgöras virtuellt via domstolar on-line eller ODR?

Surveillance during pregnancy: methods and response rates from a hospital based pilot study of the Pregnancy Risk Assessment Monitoring System in Ireland

Background: Many European countries including Ireland lack high quality, on-going, population based estimates of maternal behaviours and experiences during pregnancy. PRAMS is a CDC surveillance program which was established in the United States in 1987 to generate high quality, population based data to reduce infant mortality rates and improve maternal and infant health. PRAMS is the only on-going population based surveillance system of maternal behaviours and experiences that occur before, during and after pregnancy worldwide.Methods: The objective of this study was to adapt, test and evaluate a modified CDC PRAMS methodology in Ireland. The birth certificate file which is the standard approach to sampling for PRAMS in the United States was not available for the PRAMS Ireland study. Consequently, delivery record books for the period between 3 and 5 months before the study start date at a large urban obstetric hospital [8,900 births per year] were used to randomly sample 124 women. Name, address, maternal age, infant sex, gestational age at delivery, delivery method, APGAR score and birth weight were manually extracted from records. Stillbirths and early neonatal deaths were excluded using APGAR scores and hospital records. Women were sent a letter of invitation to participate including option to opt out, followed by a modified PRAMS survey, a reminder letter and a final survey.Results: The response rate for the pilot was 67%. Two per cent of women refused the survey, 7% opted out of the study and 24% did not respond. Survey items were at least 88% complete for all 82 respondents. Prevalence estimates of socially undesirable behaviours such as alcohol consumption during pregnancy were high [>50%] and comparable with international estimates.Conclusion: PRAMS is a feasible and valid method of collecting information on maternal experiences and behaviours during pregnancy in Ireland. PRAMS may offer a potential solution to data deficits in maternal health behaviour indicators in Ireland with further work. This study is important to researchers in Europe and elsewhere who may be interested in new ways of tailoring an established CDC methodology to their unique settings to resolve data deficits in maternal health.

Acculturation and religion in schools: the views of young people from minority belief backgrounds

This paper aims to explore the relationship between religious identity, acculturation strategies and perceptions of acculturation orientation in the school context amongst young people from minority
belief backgrounds. Based on a qualitative study including interviews with 26 young people from religious minority belief backgrounds in Northern Ireland, it is argued that acculturation theory provides a useful lens for understanding how young people from religious minority belief backgrounds navigate majority religious school contexts. Using a qualitative approach to explore acculturation theory enables an in-depth understanding of the inter-relationship between minority belief youth’s acculturation strategies and their respective school contexts. Similar to previous research, integrationist attitudes generally prevailed amongst minority belief young people in this study. The findings highlight how young people negotiate their religious identities in a complex web of inter-relationships between their minority religious belief community and the mainstream school culture as represented through peer and staff attitudes, school ethos and practices and religious education. Young people demonstrated differentiated understandings of acculturation orientations within the school context, which they evaluated on the basis of complex perceptions of educational policy, interpersonal relationships and individuals’ motivations. Findings are discussed in view of acculturation tensions, which arose particularly in relation to the religious education curriculum and their implications for opt-out provision as stipulated by human rights law.

Access to medical records for research purposes:Varying perceptions across research ethics boards

Introduction: Variation across research ethics boards (REBs) in conditions placed on access to medical records for research purposes raises concerns around negative impacts on research quality and on human subject protection, including privacy. Aim: To study variation in REB consent requirements for retrospective chart review and who may have access to the medical record for data abstraction. Methods: Thirty 90-min face-to-face interviews were conducted with REB chairs and administrators affiliated with faculties of medicine in Canadian universities, using structured questions around a case study with open-ended responses. Interviews were recorded, transcribed and coded manually. Results: Fourteen sites (47%) required individual patient consent for the study to proceed as proposed. Three (10%) indicated that their response would depend on how potentially identifying variables would be managed. Eleven sites (38%) did not require consent. Two (7%) suggested a notification and opt-out process. Most stated that consent would be required if identifiable information was being abstracted from the record. Among those not requiring consent, there was substantial variation in recognising that the abstracted information could potentially indirectly re-identify individuals. Concern over access to medical records by an outside individual was also associated with requirement for consent. Eighteen sites (60%) required full committee review. Sixteen (53%) allowed an external research assistant to abstract information from the health record. Conclusions: Large variation was found across sites in the requirement for consent for research involving access to medical records. REBs need training in best practices for protecting privacy and confidentiality in health research. A forum for REB chairs to confidentially share concerns and decisions about specific studies could also reduce variation in decisions.

Political Posturing or Real Powers: Control of Genetically Modified Crops by the Member States and their Regions

The cultivation of genetically modified (GM) crops in the EU is highly harmonised, involving a central authorisation procedure that aims to ensure a high level of environmental and human health protection. However conflicts over authority persist and the Commission has responded to a combination of internal and external pressures with a more flexible approach to coexistence, a proposed opt-out clause and recently a promise by the head of the Commission to review the existing EU GM legislative regime, providing an opportunity to consider and suggest paths of development. In light of the significance of multilevel governance and subsidiarity for GM cultivation, this paper considers the policy-making powers of the Member States and subnational regions in this regime, focussing upon post-authorisation options in particular. A number of core mechanisms exist, including voluntary measures, safeguard clauses, coexistence measures, a proposed express opt-out and Article 4(2) TEU on ‘national identity. These mechanisms are examined in light of the goals and challenges of multilevel governance, in order to consider whether the relevant powers are located at the appropriate level. Overall, it is apparent that the developments occurring at the EU level are strengthening multilevel governance, but with significant opportunities to improve it further through focussing on the supporting roles and the regional levels in particular.