Navigating uncertainty in environmental composite indicators

Composite indicators (CIs) are increasingly used to measure and track environmental systems. However, they have faced criticism for not accounting for uncertainties and their often arbitrary nature. This review highlights methodological challenges and uncertainties involved in creating CIs and provides advice on how to improve future CI development in practice. Linguistic and epistemic uncertainties enter CIs at different stages of development and may be amplified or reduced based on subjective decisions during construction. Lack of transparency about why decisions were made can risk impeding proper review and iterative development. Research on uncertainty in CIs currently focuses on how different construction decisions affect the overall results and is explored using sensitivity and uncertainty analysis. Much less attention is given to uncertainties arising from the theoretical framework underpinning the CI, and the sub-indicator selection process. This often lacks systematic rigour, repeatability and clarity. We recommend use of systems modelling as well as systematic elicitation and engagement during CI development in order to address these issues. Composite indicators make trends in complex environmental systems accessible to wider stakeholder groups, including policy makers. Without proper discussion and exposure of uncertainty, however, they risk misleading their users through false certainty or misleading interpretations. This review offers guidance for future environmental CI construction and users of existing CIs, hence supporting their iterative development and effective use in policy-making.     

Process evaluation of appreciative inquiry to translate pain management evidence into pediatric nursing practice

Background

Current healthcare systems have extended the evidence-based medicine (EBM) approach to health policy and delivery decisions, such as access-to-care, healthcare funding and health program continuance, through attempts to integrate valid and reliable evidence into the decision making process. These policy decisions have major impacts on society and have high personal and financial costs associated with those decisions. Decision models such as these function under a shared assumption of rational choice and utility maximization in the decision-making process.

Discussion

We contend that health policy decision makers are generally unable to attain the basic goals of evidence-based decision making (EBDM) and evidence-based policy making (EBPM) because humans make decisions with their naturally limited, faulty, and biased decision-making processes. A cognitive information processing framework is presented to support this argument, and subtle cognitive processing mechanisms are introduced to support the focal thesis: health policy makers' decisions are influenced by the subjective manner in which they individually process decision-relevant information rather than on the objective merits of the evidence alone. As such, subsequent health policy decisions do not necessarily achieve the goals of evidence-based policy making, such as maximizing health outcomes for society based on valid and reliable research evidence.

Summary

In this era of increasing adoption of evidence-based healthcare models, the rational choice, utility maximizing assumptions in EBDM and EBPM, must be critically evaluated to ensure effective and high-quality health policy decisions. The cognitive information processing framework presented here will aid health policy decision makers by identifying how their decisions might be subtly influenced by non-rational factors. In this paper, we identify some of the biases and potential intervention points and provide some initial suggestions about how the EBDM/EBPM process can be improved.     

Ethical Implications of Pharmacogenetics – Do Slippery Slope Arguments Matter?

Pharmacogenetics is a rapidly expanding area of research exploring the relationship between inter-individual genetic variation and drug response, with the goal of developing genetically optimised therapies. Slippery slope arguments claim that a particular action should be rejected (or supported) because it might be the first step onto a slippery slope leading to undesirable (or desirable) consequences. In this article, several slippery slope arguments relevant to the context of pharmacogenetics are evaluated under consideration of underlying reasons for their popularity. The author concludes that although the examined arguments are unconvincing as slippery slope arguments, they do matter in this context. While positive slippery slope arguments serve as a driving force to fuel the development of pharmacogenetics, their negative counterparts play an important role to sensitise policy makers and the public to potential problems.     

The policy context.

The final article in the series considers the ways in which the methods described previously are used in the formation of policy. When health authorities are making decisions about how to spend their money they have to draw on several sources of information about priorities: diktats from policy makers, opinions of consumers and of the professional bodies involved, and evidence gained from research. They must also consider the various methods of costing and select the right one for their circumstances. Some of these methods are still in the early stages of development, but more are being developed all the time and they have a valuable role in helping decision making throughout the NHS.     

Some practical suggestions for improving engagement between researchers and policy‐makers in natural resource management

Summary Policy‐makers and managers in natural resource management (NRM) often complain that researchers are out of touch. Researchers often complain that policy‐makers and managers make poorly informed decisions. In this article, we report on a meeting between researchers, policy‐makers and managers convened to identify practical solutions to improve engagement between these camps. A necessary starting point is that every researcher and policy‐maker should understand, and tap into, the motivations and reward systems of the other when seeking engagement. For example, researchers can be motivated to engage in policy development if there is a promise of outputs that align with their reward systems such as co‐authored publications. Successful research–policy partnerships are built around personal relationships. As a researcher, you cannot therefore expect your results to inform policy by only publishing in journals. As a policy‐maker, you cannot guarantee engagement from researchers by publicly inviting comment on a document. Actively building and maintaining relationships with key individuals through discussions, meetings, workshops or field days will increase the likelihood that research outcomes will inform policy decisions. We identified secondments, sabbaticals, fellowships and ‘buddies’, an annual national NRM conference and ‘contact mapping’ (a Facebook‐type network) as forums that can catalyse new relationships between researchers and policy‐makers. We challenge every researcher, policy‐maker and manager in NRM to build one new cross‐cultural relationship each year.     

Runaway Costs in Medi-Cal—A Myth

An analysis of increases in Medi-Cal expenditures to their present level, more than $4 billion a year, shows them to be attributable largely to changes in eligibility and scope of benefits. The actual costs of providing care have risen at a relatively modest rate. If in fact costs are to be lowered from present levels, public policy makers must make important decisions concerning program changes which transcend merely altering payment and delivery methods.     

The nitrogen cycle, scientific uncertainty and policy relevant science

Much of the research on the nitrogen cycle aims to improving scientific understanding but is not focused specifically on removing or reducing the scientific uncertainties that constrain policy makers in the formulation of appropriate responses to old or emerging environmental problems. Policy makers, for example, commonly find it difficult to assess the spatial or temporal importance of the various risks to human and ecosystem health that stem from man's interference with the natural N cycle. This paper will justify this conclusion by reference to the findings of a recent study on non-point pollution from crop production in China. The findings concern the perceived risks of groundwater nitrate to human health; uncertainties about critical NOx levels and their interactions with other pollutants; various other dimensions of man's impact on the N cycle. The paper will go on to suggest a more systematic process or pathway by which scientists can select and design their research in a manner that could give more effective support to policy makers.     

Ecological benefits assessment: A policy‐oriented alternative to regional ecological risk assessment

As the focus of many environmental and resource management decisions shifts to larger ecological units such as watersheds and ecoregions, the respective roles of ecological risk and ecological benefits must be reassessed. At larger ecological scales, risk becomes much more difficult to characterize because of the focus on the system rather than individual species. However, quantifying the monetary value of many ecological benefits is also difficult because no direct measures of their value exist, and the indirect techniques used by economists are not fully accepted in some policy‐making settings. This dilemma may be resolved by considering ecological resource/service flows, which are ecological benefits in physical rather than monetary units. By assessing the whole range of resource/service flows and the changes to each that would result from different management/control alternatives, scientists would be able to provide policy‐makers a much better basis for their decisions, and the resulting assessment would characterize changes in ecological features that are more familiar to both policy‐makers and the public.     

The nitrogen cycle, scientific uncertainty and policy relevant science

Much of the research on the nitrogen cycle aims to improving scientific understanding but is not focused specifically on removing or reducing the scientific uncertainties that constrain policy makers in the formulation of appropriate responses to old or emerging environmental problems. Policy makers, for example, commonly find it difficult to assess the spatial or temporal importance of the various risks to human and ecosystem health that stem from man's interference with the natural N cycle. This paper will justify this conclusion by reference to the findings of a recent study on non-point pollution from crop production in China. The findings concern the perceived risks of groundwater nitrate to human health; uncertainties about critical NOX levels and their interactions with other pollutants; various other dimensions of man's impact on the N cycle. The paper will go on to suggest a more systematic process or pathway by which scientists can select and design their research in a manner that could give more effective support to policy makers.     

The nitrogen cycle,scientific uncertainty and policy relevant science

Much of the research on the nitrogen cycle aims to improving scientific understanding but is not focused specifically on removing or reducing the scientific uncertainties that constrain policy makers in the formulation of appropriate responses to old or emerging environmental problems. Policy makers, for example, commonly find it difficult to assess the spatial or temporal importance of the various risks to human and ecosystem health that stem from man’s interference with the natural N cycle. This paper will justify this conclusion by reference to the findings of a recent study on non-point pollution from crop production in China. The findings concern the perceived risks of groundwater nitrate to human health; uncertainties about critical NO_x levels and their interactions with other pollutants; various other dimensions of man’s impact on the N cycle. The paper will go on to suggest a more systematic process or pathway by which scientists can select and design their research in a manner that could give more effective support to policy makers.

     

The nitrogen cycle,scientific uncertainty and policy relevant science

Much of the research on the nitrogen cycle aims to improving scientific understanding but is not focused specifically on removing or reducing the scientific uncertainties that constrain policy makers in the formulation of appropriate responses to old or emerging environmental problems. Policy makers, for example, commonly find it difficult to assess the spatial or temporal importance of the various risks to human and ecosystem health that stem from man’s interference with the natural N cycle. This paper will justify this conclusion by reference to the findings of a recent study on non-point pollution from crop production in China. The findings concern the perceived risks of groundwater nitrate to human health; uncertainties about critical NO_x levels and their interactions with other pollutants; various other dimensions of man’s impact on the N cycle. The paper will go on to suggest a more systematic process or pathway by which scientists can select and design their research in a manner that could give more effective support to policy makers.     

Should I stay or should I go? How the human brain manages the trade-off between exploitation and exploration

Many large and small decisions we make in our daily lives-which ice cream to choose, what research projects to pursue, which partner to marry-require an exploration of alternatives before committing to and exploiting the benefits of a particular choice. Furthermore, many decisions require re-evaluation, and further exploration of alternatives, in the face of changing needs or circumstances. That is, often our decisions depend on a higher level choice: whether to exploit well known but possibly suboptimal alternatives or to explore risky but potentially more profitable ones. How adaptive agents choose between exploitation and exploration remains an important and open question that has received relatively limited attention in the behavioural and brain sciences. The choice could depend on a number of factors, including the familiarity of the environment, how quickly the environment is likely to change and the relative value of exploiting known sources of reward versus the cost of reducing uncertainty through exploration. There is no known generally optimal solution to the exploration versus exploitation problem, and a solution to the general case may indeed not be possible. However, there have been formal analyses of the optimal policy under constrained circumstances. There have also been specific suggestions of how humans and animals may respond to this problem under particular experimental conditions as well as proposals about the brain mechanisms involved. Here, we provide a brief review of this work, discuss how exploration and exploitation may be mediated in the brain and highlight some promising future directions for research.     

Communicating useful results from restoration ecology research

Interactions between restoration ecologists and stakeholders (policy makers and decision makers, volunteers, public supporters) benefit from clear communication of research findings. Given that adaptive management (e.g. learning while restoring) already stresses frequent and effective discourse among researchers and stakeholders, it seems that a new specialty under a new term, “translational ecology,” adds more confusion than clarity. Communicating technical information to nontechnical audiences benefits from simple rules—be clear and concise, retain familiar terms that serve well, and use fewer words.     

Decision-making under great uncertainty: environmental management in an era of global change

Global change issues are complex and the consequences of decisions are often highly uncertain. The large spatial and temporal scales and stakes involved make it important to take account of present and potential consequences in decision-making. Standard approaches to decision-making under uncertainty require information about the likelihood of alternative states, how states and actions combine to form outcomes and the net benefits of different outcomes. For global change issues, however, the set of potential states is often unknown, much less the probabilities, effect of actions or their net benefits. Decision theory, thresholds, scenarios and resilience thinking can expand awareness of the potential states and outcomes, as well as of the probabilities and consequences of outcomes under alternative decisions.     

A collaboratively-derived science-policy research agenda

The need for policy makers to understand science and for scientists to understand policy processes is widely recognised. However, the science-policy relationship is sometimes difficult and occasionally dysfunctional; it is also increasingly visible, because it must deal with contentious issues, or itself becomes a matter of public controversy, or both. We suggest that identifying key unanswered questions on the relationship between science and policy will catalyse and focus research in this field. To identify these questions, a collaborative procedure was employed with 52 participants selected to cover a wide range of experience in both science and policy, including people from government, non-governmental organisations, academia and industry. These participants consulted with colleagues and submitted 239 questions. An initial round of voting was followed by a workshop in which 40 of the most important questions were identified by further discussion and voting. The resulting list includes questions about the effectiveness of science-based decision-making structures; the nature and legitimacy of expertise; the consequences of changes such as increasing transparency; choices among different sources of evidence; the implications of new means of characterising and representing uncertainties; and ways in which policy and political processes affect what counts as authoritative evidence. We expect this exercise to identify important theoretical questions and to help improve the mutual understanding and effectiveness of those working at the interface of science and policy.     

Medical decision making and medical education: challenges and opportunities

The Flexner Report highlighted the importance of teaching medical students to reason about uncertainty. The science of medical decision making seeks to explain how medical judgments and decisions ought ideally to be made, how they are actually made in practice, and how they can be improved, given the constraints of medical practice. The field considers both clinical decisions by or for individual patients and societal decisions designed to benefit the public. Despite the relevance of decision making to medical practice, it currently receives little formal attention in the U.S. medical school curriculum. This article suggests three roles for medical decision making in medical education. First, basic decision science would be a valuable prerequisite to medical training. Second, several decision-related competencies would be important outcomes of medical education; these include the physician's own decision skills, the ability to guide patients in shared decisions, and knowledge of health policy decisions at the societal level. Finally, decision making could serve as a unifying principle in the design of the medical curriculum, integrating other curricular content around the need to create physicians who are competent and caring decision makers.     

Looking to the Future of Ecosystem Services

Ecosystem services—the benefits that people obtain from ecosystems—are essential to human existence, but demands for services often surpass the capacity of ecosystems to provide them. Lack of ecological information often precludes informed decision making about ecosystem services. The Millennium Ecosystem Assessment (MA) was conceived in part to provide the necessary ecological information to decision makers. To this end, the MA set out to address the stated needs and concerns of decision makers and examine the ecological dynamics and uncertainties underlying these concerns. To improve our understanding of their information needs and concerns, we interviewed 59 decision makers from five continents. The respondents indicated that although most people generally agree about the ideal state of the planet—free of poverty and extreme inequality, replete with cultural and biological diversity—they often disagree about the best way to achieve these goals. Further, although nonspecialists are generally concerned about the environment and may have a good understanding of some of issues, they often have a more limited grasp of the ecological dynamics that drive the issues of concern. We identify some of the principal uncertainties about ecosystem dynamics and feedbacks that underlie the concerns of decision makers. Each of the papers in this special feature addresses these ecological feedbacks from the perspective of a specific discipline, suggesting ways in which knowledge of ecological dynamics can be incorporated into the MA’s assessment and scenario-building process.     

The statistical basis of public policy: a paradigm shift is overdue.

The recent controversy over the increased risk of venous thrombosis with third generation oral contraceptives illustrates the public policy dilemma that can be created by relying on conventional statistical tests and estimates: case-control studies showed a significant increase in risk and forced a decision either to warn or not to warn. Conventional statistical tests are an improper basis for such decisions because they dichotomise results according to whether they are or are not significant and do not allow decision makers to take explicit account of additional evidence--for example, of biological plausibility or of biases in the studies. A Bayesian approach overcomes both these problems. A Bayesian analysis starts with a "prior" probability distribution for the value of interest (for example, a true relative risk)--based on previous knowledge--and adds the new evidence (via a model) to produce a "posterior" probability distribution. Because different experts will have different prior beliefs sensitivity analyses are important to assess the effects on the posterior distributions of these differences. Sensitivity analyses should also examine the effects of different assumptions about biases and about the model which links the data with the value of interest. One advantage of this method is that it allows such assumptions to be handled openly and explicitly. Data presented as a series of posterior probability distributions would be a much better guide to policy, reflecting the reality that degrees of belief are often continuous, not dichotomous, and often vary from one person to another in the face of inconclusive evidence.     

模糊两阶段优化方法应用于东营市生态系统规划

东营市经济主要以石油化工产业为主,其占据大量的土地资源,产生大量污染物,对于当地的生态系统可持续发展产生了极大的负面影响。土地交易机制是一种有效的规划方法,其可促进土地的使用价值从低向高转变。在实际的生态系统管理规划中,由于不可避免的误差、数据缺失而使输入参数具有不确定性,这将使确定的优化方法受到限制。将采用模糊两阶段优化方法处理系统中的模糊和随机不确定信息;同时将交易机制引入到区域生态系统规划中,通过对交易模式和不交易模式的对比,得到两种模式下的土地交易量、生态服务价值以及工业污染物排放量等。结果表明交易模式适合当前东营市生态系统的可持续发展战略;方法的提出可作为分析和处理系统中不确定性的一种有效的工具。此外,定量分析能够帮助决策者更深入的分析生态服务价值和经济效益之间的关系。本研究通过区域生态系统的土地交易机制,探索可持续发展途径,为当地的经济、生态发展提供可行性建议。     

Representing infant feeding: content analysis of British media portrayals of bottle feeding and breast feeding

ObjectiveTo examine how breast feeding and bottle feeding are represented by the British media.DesignContent analysis.Subjects Television programmes and newspaper articles that made reference to infant feeding during March 1999.SettingUK mass media.ResultsOverall, 235 references to infant feeding were identified in the television sample and 38 in the newspaper sample. Bottle feeding was shown more often than breast feeding and was presented as less problematic. Bottle feeding was associated with “ordinary” families whereas breast feeding was associated with middle class or celebrity women. The health risks of formula milk and the health benefits of breast feeding were rarely mentioned.ConclusionsThe media rarely present positive information on breast feeding, even though this feeding practice is associated with the most health benefits. Health professionals and policy makers should be aware of patterns in media coverage and the cultural background within which women make decisions about infant feeding.