Justice and Surgical Innovation: The Case of Robotic Prostatectomy

Surgical innovation promises improvements in healthcare, but it also raises ethical issues including risks of harm to patients, conflicts of interest and increased injustice in access to health care. In this article, we focus on risks of injustice, and use a case study of robotic prostatectomy to identify features of surgical innovation that risk introducing or exacerbating injustices. Interpreting justice as encompassing matters of both efficiency and equity, we first examine questions relating to government decisions about whether to publicly fund access to innovative treatments. Here the case of robotic prostatectomy exemplifies the difficulty of accommodating healthcare priorities such as improving the health of marginalized groups. It also illustrates challenges with estimating the likely long‐term costs and benefits of a new intervention, the difficulty of comparing outcomes of an innovative treatment to those of established treatments, and the further complexity associated with patient and surgeon preferences. Once the decision has been made to fund a new procedure, separate issues of justice arise at the level of providing care to individual patients. Here, the case of robotic prostatectomy exemplifies how features of surgical innovation, such as surgeon learning curves and the need for an adequate volume of cases at a treatment centre, can exacerbate injustices associated with treatment cost and the logistics of travelling for treatment. Drawing on our analysis, we conclude by making a number of recommendations for the just introduction of surgical innovations.     

基于社会公平正义的城市公园绿地空间配置供需关系——以上海徐汇区为例

从社会维度的视角分析评价生态系统所提供的各种效用,必然涉及供需双方。在提供城市公共服务的过程中,城市公园绿地的空间配置会潜在地影响社会效益享用的平等与有效性,是具有显著空间属性的社会资源。研究同时关注城市公园绿地与居住人口(使用者)的空间布局特征,提出基于社会公平正义的生态系统服务供需关系的研究框架,从"地域平等"、"社会公平"与"社会正义"3个层次评估城市公园绿地的空间配置对于社会服务有效供给能力的影响,进而关联使用者需求空间特征分析供需匹配关系。研究构建基于社会公平正义的6个指标反映城市公园绿地社会服务供需状况,并选取上海徐汇区进行实证研究。研究结果表明:(1)徐汇区城市公园绿地存在供需空间不匹配状况,尤其是口袋公园层面存在较大缺口;(2)空间布局均好性较高,地域平等性较好;(3)人均享有绿地资源水平还有待提高,社会公平性不足;(4)进一步地在社会正义层面,评价结果显示过去进行城市公园绿地空间布局决策时并没有特别关注老年人、青少年群体,各个空间单元差距较大,且这两类使用人群密度较高的空间单元在这两个指标上往往低于平均水平,社会正义性亟待提高。研究为实现城市公园绿地空间的社会效益均衡、高效、可持续发展提供了有益的探索。     

我国杂粮种质资源创新研究: 现状与展望

该文系统综述了我国杂粮种质资源保存、鉴定评价、创新利用、基因资源挖掘研究现状, 以及基础研究存在的问题和挑战, 并提出杂粮研究的重点和发展方向。     

Socioeconomic and Racial Disparities in Environmental Health: Is Risk Assessment Part of the Problem or Part of the Solution?

The term “environmental justice” is a relatively recent addition to the lexicon of public health and risk-based decision making. Although it is currently a prominent public policy issue, there is no consensus-derived definition, nor is there general agreement about viable mechanisms for putting worthwhile social goals (e.g., fairness, equity, and justice) into operation. Nevertheless, the concept of environmental justice has focused attention on important questions of whether economically and politically disadvantaged communities bear a disproportionate burden of environmental pollution, and whether past environmental policies, programs and practices have been fair and equitable. Among individuals and organizations involved with issues of environmental justice there is a spectrum of strong and often contradictory convictions about the nature and role of risk assessment. Critics are convinced it is part of the problem and are inclined to see it as an ethically suspect, resource-intensive, elitist, never-ending process used to maintain the status quo. Advocates, on the other hand, contend that risk assessment is an essential policy and regulatory tool for identifying, evaluating, and resolving instances of environmental injustice, and that it provides a unifying conceptual framework and a common language for constructive dialogue on the issue. This article argues that, in practice, risk assessment has contributed to both the reality and the perception of environmental justice problems because of the overly narrow and restricted manner in which it has been applied. In principle, however, risk assessment is part of the solution to environment injustices because it provides a beneficial construct for framing key questions and fostering constructive debate about how to answer them. Well-designed research studies and high-quality risk assessments are necessary to define the dimensions of the problem, to understand the root causes, and to identify effective, efficient, and equitable solutions. Ultimately, attaining the goal of environmental justice depends on putting risk assessment principles into practice.     

Use of macroecology to integrate social justice and conservation

Both conservation biology and macroecology are synthetic, and macroecological research consistently has informed the theory and practice of biological conservation. Explicit integration of the macroecology of human systems and natural systems has been rare, but can advance the incorporation of social justice, environmental justice and environmental equity into conservation biology and participatory conservation (inclusion in decision‐making of those who are affected by, or can affect, that decision). The basis of this strong link is the focus of macroecology on the relations of a given biota to environmental patterns and processes, and these patterns and processes can affect humans differentially. Macroecological integration of social justice and conservation generally requires spatial and temporal representation of all variables at resolutions and extents that allow meaningful analyses. This requirement may facilitate clarity about social metrics and norms. To illustrate, we examine applications of macroecology to analysis of the effects of climate change on social justice and biological conservation; relations among climate, violence among humans and conservation; and the response of the spread of disease to social and ecological factors. We believe that macroecology is a means of providing transparent inferences that can inform conservation, health and social policies.     

Community arts: (Re)contextualizing the narrative of teaching and learning

ABSTRACT

Education in the United States is often characterized by testing and standardized outcomes, and bears little relevance to the culture and the community that surrounds both students and teachers. Conversely, community arts connect the philosophies of art and education to the larger spheres of culture and community. The community thus becomes an educational space in which both the teachers and students are motivated to learn from each other through a reciprocal relationship that changes the dynamic of both teaching and learning. Consequently, the (re)contextualization of art and education within culture and community has distinct policy implications regarding both what we teach and the way we teach it. There is an opportunity to increase the significance of art education in a democratic society if we embrace practices that empower preservice teachers to analyze how artmaking practices shape their own sensibilities and those of the communities in which they live. This article suggests a field experience model for informing cross-cultural understandings of community-based pedagogy, participation, and collaboration that challenges existing educational policy while informing the values and beliefs of the preservice teacher. It presents the opportunity to develop socially relevant programs for use in the teaching of art that include community, social justice, democracy, collective responsibility, activism, and equity—among others—that confront established perceptions of both art and education.     

Race statistics: how to get from where we are to where we should be: a rejoinder

America's race statistics are inadequate to the policy challenges of the twenty-first century, especially for social justice and immigrant incorporation policy. But inertial forces – technical and political – complicate change. Overcome technical barriers by taking advantage of an experiment fielded in 2010. To miss that opportunity would be a huge failure. Political barriers are more difficult. Start with what is familiar – more emphasis on national origin – and add flexibility and granularity, both are politically desirable. Introduce change without disrupting the existing policy practices. Phase in improvements gradually, taking advantage of generational turnover. One generation changes the statistical basis for policy. The next generation, which has grown up with the new statistics, implements the policy changes. An example of how this works is found in the multiple-race option introduced in the 2000 census but probably not put to policy use until after the 2030 census.     

LINKING INTERNATIONAL RESEARCH TO GLOBAL HEALTH EQUITY: THE LIMITED CONTRIBUTION OF BIOETHICS

Health research has been identified as a vehicle for advancing global justice in health. However, in bioethics, issues of global justice are mainly discussed within an ongoing debate on the conditions under which international clinical research is permissible. As a result, current ethical guidance predominantly links one type of international research (biomedical) to advancing one aspect of health equity (access to new treatments). International guidelines largely fail to connect international research to promoting broader aspects of health equity – namely, healthier social environments and stronger health systems. Bioethical frameworks such as the human development approach do consider how international clinical research is connected to the social determinants of health but, again, do so to address the question of when international clinical research is permissible. It is suggested that the narrow focus of this debate is shaped by high‐income countries' economic strategies. The article further argues that the debate's focus obscures a stronger imperative to consider how other types of international research might advance justice in global health. Bioethics should consider the need for non‐clinical health research and its contribution to advancing global justice.     

Honoring Our Own: Rethinking Indigenous Languages and Literacy

Today Indigenous peoples worldwide are deconstructing Western paradigms, including the classic constructs of literacy connected to alphabet systems, and articulating and constructing their own distinct paradigms based on Indigenous epistemologies and rooted in self-determination and social justice. A vital aspect of these efforts is the "rethinking of our thinking" and a reexamination of our priorities as a means for reconstituting, reproducing, and validating our own intellectual traditions and cultural knowledge and processes.     

Evidence-informed policy for tackling adverse climate change effects on health: Linking regional and global assessments of science to catalyse action

Robin Fears and co-authors discuss evidence-informed regional and global policy responses to health impacts of climate change.

Summary points

• Effective policy making depends on synthesising and improving the use of existing robust scientific evidence, tackling misinformation, and identifying knowledge gaps to be filled by new research.
• A global project organised by the InterAcademy Partnership (IAP) is bringing together evidence from Africa, Asia, the Americas, and Europe to evaluate climate change effects on health and to assess policy priorities for adaptation and mitigation solutions. Project design encouraged inclusivity in assessing research from across disciplines and from diverse geographical and socioeconomic contexts encompassing issues for vulnerable groups (including Indigenous Peoples) and integrating outputs at national, regional, and global levels.
• Coordinated policy development approaches across sectors and regions and integration at national–regional–global levels are essential to understand trade-offs, avoid inadvertent consequences, and capitalise on potential synergies for multiple benefits for health, equity, and environment.
• National priorities must include integrating health actions into national climate adaptation plans and Nationally Determined Contributions (NDCs) under the Paris Agreement. Regional policy action is important to address cross-boundary issues and to build critical mass for quantifying and implementing solutions.
• A focus on human health can catalyse the strengthening of international coherence and commitment to tackling shared climate change challenges. Health must be prioritised in current global policy initiatives, including the United Nations Framework Convention on Climate Change (UNFCC) Conference of the Parties 26 (COP26), UN Convention on Biological Diversity (CBD) Conference of the Parties 15 (COP15), and the UN Food Systems Summit. The scientific and health communities have a key role to help lead efforts by engaging at the science–policy interfaces to address barriers to action.

     

生态城市与人地关系

生态城市作为当下探索人与自然协调共处、社会和谐进步、经济持续发展的实践,是实现可持续发展的重要举措。人地关系作为地理学研究的核心,是社会发展必须直面和探讨的重要问题。分别论述生态城市和人地关系相关研究的理念与框架、过程与机制、理论与方法的演变以及两者的区别。生态城市规划具备高度的综合性,在优化资源配置、调整空间布局、协调各项事业、改善城市功能等方面发挥重要作用,由单方面注重增长速度和规模转向重视城市增长容量、生态承载力、生活质量方面。人地关系研究旨在探索人地系统各要素间相互作用与系统行为及调控机制,其主旨问题随人地系统演变发生变异,准确分析人地关系面临着一系列理论、技术和数据方面的挑战。生态城市可以借助人地关系作为一个更加宏阔的系统框架,同时可为人地关系研究提供具体的工具和手段。复杂系统科学和综合集成方法是生态城市和人地关系的重点研究方向。生态城市与人地关系研究相互融合,能够更好地解决复杂问题,从而朝着共同目的—可持续发展迈进。     

Grand challenges in organismal biology

A renaissance in organismal biology has been sparked by recent conceptual, theoretical, methodological, and computational advances in the life sciences, along with an unprecedented interdisciplinary integration with Mathematics, Engineering, and the physical sciences. Despite a decades-long trend toward reductionist approaches to biological problems, it is increasingly recognized that whole organisms play a central role in organizing and interpreting information from across the biological spectrum. Organisms represent the nexus where sub- and supra-organismal processes meet, and it is the performance of organisms within the environment that provides the material for natural selection. Here, we identify five "grand challenges" for future research in organismal biology. It is intended that these challenges will spark further discussion in the broader community and identify future research priorities, opportunities, and directions, which will ultimately help to guide the allocation of support for and training in organismal biology.     

NCI's publication affiliation conundrum: Reframing innovation to incentivize an equitable path for advocate representation

Advocacy engagement has been at the forefront of National Cancer Institute (NCI) efforts to advance scientific discoveries and transform medical interventions. Nonetheless, the journey for advocates has been uneven. Case in Point: NCI publication affiliation rules of engagement pose unique equity challenges while raising questions about structural representation in biomedical research. Abiding by the core rationale that publication affiliation should be tailored to employment status, the NCI has systematically denied research advocate volunteers the opportunity to specifically list NCI as an institutional affiliation on academic publications. Unpacking advocate NCI publication affiliation restrictions and its links with advocacy heritage preservation and convergent science goals poses unique diversity, equity, and inclusion challenges and opportunities. Improving the quality of structural representation in biomedical research requires new theories of action and flexible planning to advance, promote and build capacity for strategic advocacy inclusion and equity within publication affiliation initiatives. Here we highlight several opportunities for how leadership might formulate a radically different vision for NCI's approach. This perspective interrogates the best way forward for ensuring that biomedical employee and volunteer advocate workforce publication affiliation intersections are characterized by increased creativity and representation parity. Imbuing the scientist and clinical researcher archetype with social dimensions, we join NCI critical thinkers in urging employees, funded academics, and volunteer citizen scientists to collectively assume the role as paladins of science and integrity who view the triumphs of making a difference in science alongside the social responsibility of promoting transdisciplinary professionalism and the democratization of science.     

Navigating conflicts of justice in the use of race and ethnicity in precision medicine

Given the sordid history of injustices linking genetics to race and ethnicity, considerations of justice are central to ensuring the responsible development of precision medicine programmes around the world. While considerations of justice may be in tension with other areas of concern, such as scientific value or privacy, there are also tensions between different aspects of justice. This paper focuses on three particular aspects of justice relevant to this precision medicine: social justice, distributive justice and human rights. We describe the implications of each for the use of race and ethnicity in precision medicine, and also how they intersect and potentially conflict with each another. By attending to these intersections, we aim to enrich and add nuance to debates over how best to proceed with precision medicine initiatives.     

中国可持续发展政策试点文献计量研究——以可持续发展实验区和可持续发展议程创新示范区为例

可持续发展实验区（以下简称"实验区"）是一项地方试点示范工作，倡导实验区基于自身特点设计实验主题，自行探索可持续发展的典型做法，依靠科技创新解决制约可持续发展的问题。作为可持续发展领域建设时间最长、覆盖规模最广、实验主题最为多样的政策试点，实验区已经积累了一定的研究，现有文献多集中于对发展理念的概念和框架探讨、可持续发展水平综合评估、区域发展耦合度和协调度计算、以及可持续发展投入产出效率差异等，为实验区理论研究和政策实践打下基础。为了系统梳理实验区研究的整体演进情况，为未来研究提供一个较为全面的参考，从文献计量的视角，对实验区和可持续发展议程创新示范区（以下简称"创新示范区"）为主题的研究进行科学知识图谱分析，厘清实验区研究的阶段性特点、研究领域、核心问题、前沿热点和科学合作网络结构，基于此提出未来可能的研究方向。研究结果表明实验区主题的发文量总体上呈波动趋势，研究者和研究机构的局部性合作较强；研究的核心问题始终围绕可持续发展在实验区的政策实践；研究前沿与宏观经济社会发展背景相呼应，其中可持续发展战略实施一直都是热点问题；经历了从可持续发展理念普及到可持续发展实践模式的历程。在可持续发展目标（SDGs）这一全球新形势下，为了更好地发挥实验区和创新示范区作为政策试点的作用，提出未来的研究方向：一是加强与SDGs研究的衔接；二是增加科技创新驱动可持续发展的研究；三是推进可持续发展典型问题和解决方案的系统研究。     

The Park is Ruining our Livelihoods. We Support the Park! Unravelling the Paradox of Attitudes to Protected Areas

Despite considerable field-based innovation and academic scrutiny, the nexus between conservation approaches, local support for parks and park effectiveness remains quite puzzling. Common approaches to understanding notions of environmental justice are to understand distributional and procedural issues, representation in decision making, and recognition of authorities and claims. We took a different approach and analysed environmental justice claims through institutional, ideational and psychological lenses. We sought to understand how the national park could have such broad support from local communities despite their acknowledgement that it severely curtailed their livelihoods. We conducted 100 household interviews in three villages that border Nam Et-Phou Louey National Protected Area. Our study found that villagers 1) hold on to broken promises by the State for agricultural activities and alternative revenues without fully changing forest use behaviours; 2) were influenced heavily by the ‘educational’ programmes by the State; 3) accepted the authority of the State and lack of participation in decision-making based on historical experiences and values; 4) justified their burdens by over-emphasising the positive aspects of the park. Our findings present a complementary framework to explain environmental justice claims, allowing for a nuanced analysis of how people respond to justices and injustices, and specifically how injustices can be identified through proven social science concepts.     

The Role of Partnerships in U.S. Food Policy Council Policy Activities

Food Policy Councils (FPC) help to identify and address the priorities of local, state, and regional food systems with the goal of improving food systems through policy. There is limited research describing FPCs’ strategies for accomplishing this goal. As part of a larger study examining FPC policy efforts, this paper investigates the role of partnerships in food systems policy change. We conducted interviews with representatives from 12 purposefully selected FPCs in the United States and 6 policy experts identified by the selected FPC representatives to document and describe their policy work. One theme that emerged from those interviews was the role of partners. Interviewees described a range of partners (e.g., stakeholders from government, business, and education) and credited FPC partnerships with advancing their policy goals by increasing the visibility and credibility of FPCs, focusing their policy agenda, connecting FPCs to key policy inputs (e.g., local food community knowledge and priorities), and obtaining stakeholder buy-in for policy initiatives. Partnerships were also described as barriers to policy progress when partners were less engaged or had either disproportionate or little influence in a given food sector. Despite these challenges, partnerships were found to be valuable for FPCs efforts to effectively engage in the food policy arena.     

Navigating Contradictory Communities of Practice in Learning to Teach for Social Justice

In this article, I explore the contradictions that four new teachers experienced as their commitments to social justice collide with urban school culture. Framed within Jean Lave and Etienne Wenger's (1999) theory of situated learning and development concepts of identity, practice, and relationships illustrate how teachers' ideals are challenged as socializing features of two communities of practice—the universities and schools—intersect in new teachers' development. This research contributes empirical evidence of the application of critical multicultural teacher preparation into practice, a cultural representation of how educational inequities are reproduced or disrupted in the situated contexts of urban schools, an application of Lave and Wenger's theory of Legitimate Peripheral Participation that incorporates formal and informal education across multiple activity settings, and a call for collaborative communities of practice that support teachers' situated learning in creating transformative practices.     

Biomedical Data Sharing and Reuse: Attitudes and Practices of Clinical and Scientific Research Staff

Background

Significant efforts are underway within the biomedical research community to encourage sharing and reuse of research data in order to enhance research reproducibility and enable scientific discovery. While some technological challenges do exist, many of the barriers to sharing and reuse are social in nature, arising from researchers’ concerns about and attitudes toward sharing their data. In addition, clinical and basic science researchers face their own unique sets of challenges to sharing data within their communities. This study investigates these differences in experiences with and perceptions about sharing data, as well as barriers to sharing among clinical and basic science researchers.

Methods

Clinical and basic science researchers in the Intramural Research Program at the National Institutes of Health were surveyed about their attitudes toward and experiences with sharing and reusing research data. Of 190 respondents to the survey, the 135 respondents who identified themselves as clinical or basic science researchers were included in this analysis. Odds ratio and Fisher’s exact tests were the primary methods to examine potential relationships between variables. Worst-case scenario sensitivity tests were conducted when necessary.

Results and Discussion

While most respondents considered data sharing and reuse important to their work, they generally rated their expertise as low. Sharing data directly with other researchers was common, but most respondents did not have experience with uploading data to a repository. A number of significant differences exist between the attitudes and practices of clinical and basic science researchers, including their motivations for sharing, their reasons for not sharing, and the amount of work required to prepare their data.

Conclusions

Even within the scope of biomedical research, addressing the unique concerns of diverse research communities is important to encouraging researchers to share and reuse data. Efforts at promoting data sharing and reuse should be aimed at solving not only technological problems, but also addressing researchers’ concerns about sharing their data. Given the varied practices of individual researchers and research communities, standardizing data practices like data citation and repository upload could make sharing and reuse easier.     

The current and potential role of urban metabolism studies to analyze the role of food in urban sustainability

Food supply chains are essential for urban sustainability. To reflect on the state of knowledge on urban food flows in urban metabolism research, and the actual and potential role of urban metabolism studies to tackle food sustainability in cities, we systematically review scientific research on food from an urban metabolism perspective and apply statistical and thematic analyses. The analysis of 89 studies provides insights as to the relation between food supply and (environmental and social dimensions of) urban sustainability. First, food is an important contributor to urban environmental impacts, if a consumption-based approach is adopted. Secondly, the social impacts of urban food supply remain scarcely studied in urban metabolism research, but emerging results on public health, malnutrition, and food waste appear promising. In parallel, we find that the findings of the studies fail to engage with debates present in the broader literature, such as that of food justice. Our analysis shows that most studies focus on large cities in high-income, data-rich countries. This limits our understanding of global urban food supply. Existing studies use innovative mixed-methods to produce robust accounts of urban food flows in data-scarce contexts; expanding these accounts is necessary to get a better understanding of how urban food supply and its diverse impacts in terms of environmental and social sustainability may vary across cities, a necessary step for the urban metabolism literature to contribute to current debates around food sustainability and justice.