Coping with complexity, uncertainty and ambiguity in risk governance: a synthesis

Contrasting perspectives on the risks of intensive livestock farming in The Netherlands: a survey study

In the Netherlands, intensive livestock farming is a recurrent topic of societal debate with stakeholders having quite different perspectives on the benefits and harms. In particular, stakeholders appear to have different perceptions on the risks to human and animal health. This paper reports a quantitative analysis of a survey on the perceptions of risks and benefits of intensive livestock farming conducted among the general public, including people living in livestock dense municipalities (n = 808), farmers (n = 237) and other stakeholders (n = 367). Results show that farmers and citizens have contrasting views about the benefits and concerns and in particular about the risks of intensive livestock farming for human health as well as animal well-being. People living in livestock dense communities held a somewhat more positive view than the general public, yet odour hinder and air quality was perceived as a serious health problem, but not by farmers. These differences in risk perceptions may well be explained from differences in interest, experience and options for control of potential hazards. Our study reflects more than just the perceived risks related to intensive livestock farming, but also reveal the global and multidimensional legitimate concerns and views on what matter to different groups of people. We argue that these differences in risk perspectives should be taken into account when communicating about human health risks, and should also be more explicitly addressed in discussions about the risks of intensive livestock farming in order to develop more inclusive policies that are supported by stakeholders.

Knowledge, Information, and Data Readiness Levels (KaRLs) for Risk Assessment, Communication, and Governance of Nano-, New, and Other Advanced Materials

The obvious benefits derived from the increasing use of engineered nano-, new, and advanced materials and associated products have to be weighed out by a governance process against their possible risks. Differences in risk perception (beliefs about potential harm) among stakeholders, in particular nonscientists, and low transparency of the underlying decision processes can lead to a lack of support and acceptance of nano-, new, and other advanced material enabled products. To integrate scientific outcomes with stakeholders needs, this work develops a new approach comprising a nine-level, stepwise categorization and guidance system entitled "Knowledge, Information, and Data Readiness Levels" (KaRLs), analogous to the NASA Technology Readiness Levels. The KaRL system assesses the type, extent, and usability of the available data, information, and knowledge and integrates the participation of relevant and interested stakeholders in a cocreation/codesign process to improve current risk assessment, communication, and governance. The novelty of the new system is to communicate and share all available and relevant elements on material related risks in a user/stakeholder-friendly, transparent, flexible, and holistic way and so stimulate reflection, awareness, communication, and a deeper understanding that ultimately enables the discursive process that is needed for the sustainable risk governance of new materials.

Datasets of disrupted transportation networks on Canada's West Coast in a plausible M9.0 Cascadia Subduction Zone earthquake scenario

This article presents a database with geographical and demographic information characterizing the impacts to road and maritime networks, and coastal communities, of a plausible magnitude M9.0 megathrust Cascadia Subduction Zone earthquake scenario near Vancouver Island in British Columbia, Canada. The database consists of a medium and a high impact case associated with the earthquake scenario. The data include the geographical location of communities, ports, and airports/helipads/heliports, the structure of the roads network and their expected damage levels, the resilience level and population size of the communities on Vancouver Island, and the trajectories, expected delays and capacities of ferries and barges. The data originates from government and carriers' open available reports and external datasets, and several impact models. The primary purpose of this database is to support disaster management researchers working to develop and test network models that focus on road repair and restoration, and on the multi-modal distribution of relief supplies to victims. In addition, the data can be used to test heuristic and metaheuristic approaches applied to network models in the context of natural disasters.

Investigating accountability for Artificial Intelligence through risk governance: A workshop-based exploratory study

Introduction

With the growing prevalence of AI-based systems and the development of specific regulations and standardizations in response, accountability for consequences resulting from the development or use of these technologies becomes increasingly important. However, concrete strategies and approaches of solving related challenges seem to not have been suitably developed for or communicated with AI practitioners.

Methods

Studying how risk governance methods can be (re)used to administer AI accountability, we aim at contributing to closing this gap. We chose an exploratory workshop-based methodology to investigate current challenges for accountability and risk management approaches raised by AI practitioners from academia and industry.

Results and Discussion

Our interactive study design revealed various insights on which aspects do or do not work for handling risks of AI in practice. From the gathered perspectives, we derived 5 required characteristics for AI risk management methodologies (balance, extendability, representation, transparency and long-term orientation) and determined demands for clarification and action (e.g., for the definition of risk and accountabilities or standardization of risk governance and management) in the effort to move AI accountability from a conceptual stage to industry practice.

States of Uncertainty, Risk-Benefit Assessment and Early Clinical Research: A Conceptual Investigation

It can be argued that there is an ethical requirement to classify correctly what is known and what is unknown in decision situations, especially in the context of biomedicine when risks and benefits have to be assessed. This is because other methods for assessing potential harms and benefits, decision logics and/or ethical principles may apply depending on the kind or degree of uncertainty. However, it is necessary to identify and describe the various epistemic states of uncertainty relevant to such estimates in the first place. Therefore, this paper aims to develop a category system of different epistemic states of uncertainty which, although not exclusively, is primarily intended to be applied to early clinical trials. It is formed on the basis-and various combinations-of three dimensions of uncertainty that represent certain parts of incomplete knowledge: outcome (type of event), probability (of outcome) and evaluation (assessment of outcome). Furthermore, it is argued that uncertainty can arise from three different sources (the structure of the object of research, the state of the evidence, or individual handling of the research and already existing knowledge). The categories developed are applied to actual examples from gene therapy and genome editing to illustrate that they can be helpful for a more precise definition of the respective uncertainties, especially in the context of risk-benefit assessment. The categories allow a differentiated perspective of decision-making situations from the point of view of incomplete knowledge in general, but particularly, for example, in early clinical research, and may thereby support a more acceptable ethical assessment of potential harms and benefits.

Risk-layering and optimal insurance uptake under ambiguity: With an application to farmers exposed to drought risk in Austria

Many risks we face today will very likely not stay the same over time. For example, it is expected that climate change will alter future risks of natural disaster events considerably and, as a consequence, current risk management and governance strategies may not be effective anymore. Large ambiguities arise if future climate change impacts should be taken into account for analyzing risk management options today. Risk insurance, while albeit only one of many risk management actions possible, plays an important role in current societies for dealing with extremes. A natural starting point for our analysis is therefore the question of how ambiguity may be incorporated in a world with changing risks. To shed light on this question, we study how ambiguity can affect the uptake of insurance and risk mitigation within a risk-layer approach where each layer is quantified using distortion risk measures that should reflect the risk aversion of a decisionmaker toward extreme losses. Importantly, we obtain a closed-form solution for such a problem statement which allows an efficient numerical implementation. We apply this model to a case study of drought risk for Austrian farmers and address the question how ambiguity will affect the risk layers of different types of farmers and how subsidies may help to deal with current and future risks. We found that especially for small-scale farmers the consequences of increasing risk and model ambiguity are pronounced and subsidies are especially needed in this case to cover the high-risk layer.

Environmental and Resource Impacts from an Aggressive Regionalized Carbon Peak Policy

When and how to achieve a carbon peak is a concern for provincial regions within China under the context of achieving carbon neutrality in 2060. This study investigates the overall carbon peak environmental and resource impacts under current national targets and Shanghai's latest more aggressive carbon peak policy by using a dynamic multiple-region computable general equilibrium (CGE) model for the year 2030. Results show that (1) the national carbon peak and the more aggressive regional policy in Shanghai will result in energy consumption and carbon emissions decreases when compared to the business-as-usual scenario in most provinces; (2) although some cobenefits in water use reduction may occur in most provinces under the carbon policy scenarios, the results show positive and negative variations; (3) provincial level environmental and resources in transport, electricity, metal smelting and pressing, and agricultural production sectors are most influenced by Shanghai's aggressive carbon peak policy; and (4) the outsourced environmental and resource impacts from Shanghai to other provinces are very significant under Shanghai's aggressive carbon policy. These relevant results provide insights to facilitate broader governance decision-making for environmental resource nexuses while seeking an improved understanding of global sustainable development and climate governance.

Risk governance during the COVID‐19 pandemic: A quantitative content analysis of governors' narratives on twitter

The current study addresses the communication aspect of risk governance during the COVID‐19 pandemic by examining whether governors' tweets differ by political party, gender and crisis phase. Drawing on the Centers for Disease Control and Prevention's Crisis Emergency Risk Communication (CERC) model and framing literature, we examined the salience of five CERC's communication objectives, namely acknowledge crisis with empathy, promote protective actions, describe preparedness/response efforts, address rumours and misunderstanding and segment audience. Using a deductive and inductive approach, we analysed 7000 Twitter messages sent by the 50 US state governors during the period of 13 March 2020 to 17 August 2020. Our findings suggest that governors' tweets aligned with CERC's communication objectives to a varying degree. We found main and interaction effects of political party, gender and crisis phase on governors' communication objectives. New emergent communication objectives included attention to mental health, call for social influencers and promoting hope. Implications are discussed.

The Digital Transformation of the Agricultural Value Chain: Discourses on Opportunities, Challenges and Controversial Perspectives on Governance Approaches

The extent to which the digitalisation of agriculture will make a significant contribution to solving urgent sustainability challenges will depend on the design of political, legal and economic frameworks. In this context, social discourses play a central role as they not only reflect collective interpretations and systems of meaning but also reproduce power relations in “truth regimes” and prepare policy actions. While a critical scientific debate on unintended side effects of the digital transformation on agriculture has recently emerged, there is little knowledge about the discourse relations beyond academia. This article presents the results of a discourse analysis during a two-day online conference on the digital transformation of the agricultural value chain. We systematically visited and analysed sessions and presentations. The aim was to identify the main themes, concepts and ideas and different perspectives among actors from science and practice. The results show a wide range of perceived opportunities and challenges but also controversies, especially regarding governance issues such as regulation versus nonregulation, centralised versus decentralised data sharing, the appropriate design of data sovereignty models and trust and evolving inequalities. In addition, it became apparent that discourses on digitalisation are largely expert affairs. We discuss and conclude that a sustainability-oriented digital transformation requires a critical perspective, reflexivity and an adaptive governance approach where science–society collaborations play a central role.

Epidemics and pandemics risk governance: a case of post-COVID-19 in the United Kingdom

COVID-19 made significant health, economic, and social impact across the world. The situation urgently needs to strengthen disaster risk reduction strategies to reduce risks and enhance resilience. Nevertheless, many instances have evidenced disaster risk governance–related issues. This study examined the United Kingdom's present disaster risk governance system since the country has been hit significantly by the pandemic. The study evaluates the risk governance system in the United Kingdom across the key elements of the International Risk Governance Framework. The study conducted a systematic literature review following a literature review protocol. Documents were selected from the Science Direct, Emerald, and Google Scholar databases. Across the framework elements, several challenges were found within the UK's pandemic risk governance system. The study highlights the strength of the well-developed legal and policy supported the country's risk governance system. Even though the study was conducted at the early stage of the pandemic, the early findings will benefit policymakers and practitioners shaping the pandemic risk governance system in the country for a resilient society.

The Landscape of Risk Perception Research: A Scientometric Analysis

Risk perception is important in organizational and societal governance contexts. This article presents a high-level analysis of risk perception research using Web of Science core collection databases, scientometrics methods and visualization tools. The focus is on trends in outputs, geographical and temporal trends, and patterns in the associated scientific categories. Thematic clusters and temporal dynamics of focus topics are identified using keyword analysis. A co-citation analysis is performed to identify the evolution of research fronts and key documents. The results indicate that research output is growing fast, with most contributions originating from western countries. The domain is highly interdisciplinary, rooted in psychology and social sciences, but branching into domains related to environmental sciences, medicine, and engineering. Significant research themes focus on perceptions related to health, with a focus on cancer, human immunodeficiency virus, and epidemiology, natural hazards and major disasters, traffic accidents, technological and industrial risks, and customer trust. Risk perception research originated from consumer choice decisions, with subsequent research fronts focusing on understanding the risk perception concept, and on developing taxonomies and measurement methods. Applied research fronts focus on environmental hazards, traffic accidents, breast cancer and, more recently, e-commerce transactions and flood risk. Based on the results, various avenues for future research are described.

Here Comes the Flood, but Not Failure? Lessons to Learn after the Heavy Rain and Pluvial Floods in Germany 2021

Floods are a known natural hazard in Germany, but the amount of precipitation and ensuing high death toll and damages after the events especially from 14 to 15 July 2021 came as a surprise. Almost immediately questions about failure in the early warning chains and the effectiveness of the German response emerged, also internationally. This article presents lessons to learn and argues against a blame culture. The findings are based on comparisons with findings from previous research projects carried out in the Rhein-Erft Kreis and the city of Cologne, as well as on discussions with operational relief forces after the 2021 events. The main disaster aspects of the 2021 flood are related to issuing and understanding warnings, a lack of information and data exchange, unfolding upon a situation of an ongoing pandemic and aggravated further by critical infrastructure failure. Increasing frequencies of flash floods and other extremes due to climate change are just one side of the transformation and challenge, Germany and neighbouring countries are facing. The vulnerability paradox also heavily contributes to it; German society became increasingly vulnerable to failure due to an increased dependency on its infrastructure and emergency system, and the ensuing expectations of the public for a perfect system.

Finding shared solutions in landscape or natural resource management through social learning: A quasi-experimental evaluation in an Alpine region

Context

The implementation of landscape-management decisions is often blocked because actors disagree in their perception of the problem at hand. These conflicts can be explained with the concept of problem framing, which argues that actors' problem perspectives are shaped by their interests. Recent literature suggests that social learning through deliberative processes among actors enables shared solutions to complex landscape-management conflicts.

Methods

To examine these assumptions, a participatory process on integrated water-resource-management in a Swiss Alpine region was systematically evaluated using a quasi-experimental intervention-research design. The involved actors' problem perspectives were elicited before and after the participatory processes using qualitative interviews and standardized questionnaires. Furthermore, a standardized survey was sent to a sample of regional residents (N = 2000) after the participatory process to measure the diffusion of actors' social learning to the wider public.

Results

The data analysis provided systematic evidence that a convergence of involved actors' problem perspectives, which were found to differ considerably before the intervention, had taken place during the participatory process. Furthermore, it determined diffusion effects of actors' social learning to the wider public in terms of its attitude towards participatory regional planning.

Conclusions

The findings confirm the expected mechanism of social learning through deliberative processes and demonstrate it as a promising approach to implementing landscape-management decisions successfully. The catalyzing role of shared interests among actors suggests that landscape-management decisions should be implemented by participatory integrated planning on the regional level, which would require a new, strategic role of regional institutions.

Understanding systemic risk induced by climate change

The systemic risk induced by climate change represents one of the most prominent threats facing humanity and has attracted increasing attention since the outbreak of the COVID-19 pandemic at the end of 2019. The existing literature highlights the importance of systemic risk induced by climate change, but there are still deficiencies in understanding its dynamics and assessing the risk. Aiming to bridge this gap, this study develops a theoretical framework and employs two cases to illustrate the concept, origin, occurrence, propagation, evolution, and assessment framework of systemic risk induced by climate change. The key findings include: 1) systemic risk induced by climate change derives from the rapid growth of greenhouse gas emissions, increasingly complex connections among different socioeconomic systems, and continuous changes in exposure and vulnerability; 2) systemic risk induced by climate change is a holistic risk generated by the interconnection, interaction, and dynamic evolution of different types of single risks, and its fundamental, defining feature is cascading effects. The extent of risk propagation and its duration depend on the characteristics of the various discrete risks that are connected to make up the systemic risk; 3) impact domains, severity of impact, and probability of occurrences are three core indicators in systemic risk assessment, and the impact domains should include the economy, society, homeland security, human health, and living conditions. We propose to deepen systemic risk research from three aspects: to develop theories to understand the mechanism of systemic risk; to conduct empirical research to assess future risks; and to develop countermeasures to mitigate the risk.

The Coming of Age of Risk Governance

Proposed as an advanced conceptualization of how to handle risk, risk governance begins with the critique and expansion of the traditional idea and standard practices of risk analysis. In developments over the last two decades, proponents of a more integrative approach on governing risks have moved further away from distinct conceptions of risk assessment, risk management, and risk communication and toward the processes and institutions that guide, restrain, and integrate collective activities of handling risk. In early formulations of what risk governance entails, the superiority of the interplay between risk evaluation and risk management over linear and simple deductions from risk assessment to risk management was established precisely by developing a distinctive rationality of how to proceed. Later, the International Risk Governance Council recaptured this distinctive rationality that institutionalized processes should embody the interplay of the assessment of risks and related concerns, their sociopolitical appraisal, and the logical inference for risk management. Recently, this approach has been refined and augmented toward an integrative and adaptive concept of risk governance and toward a postnormal conception of risk governance. Main characteristics are a new concept of differentiated responsibility and deliberation in which expertise, experience, and tacit knowledge are integrated, forming the core of legitimate political risk decision making.

Playing God and tampering with nature: popular labels for real concerns in synthetic biology

Public engagement in science with diverse cross-sections of the community is considered a critical aspect of responsible biotechnological innovation. While the research community shows willingness to engage with both ambivalent and supportive audiences about potentially disruptive technological advances, there is less enthusiasm for engaging with groups who hold deeply opposing views to such advances. 'Playing God' and 'tampering with nature' are popular examples of intrinsic objections often made in opposition to the development or use of novel genetic technologies. Historically appearing in arguments against the pursuit of genetically modified organisms in agriculture and food industries, intrinsic objections have previously been labelled by the science community as inconsistent, non-scientific, and vague. Now found in a range of innovation contexts, the domain of synthetic biology appears to attract such objections consistently. We present the findings from a large Australian study (N = 4593) which suggests 'playing God' objections and their variants can be multilayered and, at times, accompanied by meaningful information about risk perceptions. We use qualitative analysis of open-ended responses from an online survey to show how these objections are articulated in response to selected synthetic biology applications across environmental and health domains. Our research invites a rethink of how the synthetic biology community perceives, and engages with, people who express intrinsic objections. These people may additionally hold extrinsic concerns that may be potentially addressed, or at least reasonably considered, through dialogue. We offer some concluding remarks for engaging with publics who employ these types of arguments to communicate unease with aspects of technology development and use.

Risk Governance of Emerging Technologies Demonstrated in Terms of its Applicability to Nanomaterials

Nanotechnologies have reached maturity and market penetration that require nano-specific changes in legislation and harmonization among legislation domains, such as the amendments to REACH for nanomaterials (NMs) which came into force in 2020. Thus, an assessment of the components and regulatory boundaries of NMs risk governance is timely, alongside related methods and tools, as part of the global efforts to optimise nanosafety and integrate it into product design processes, via Safe(r)-by-Design (SbD) concepts. This paper provides an overview of the state-of-the-art regarding risk governance of NMs and lays out the theoretical basis for the development and implementation of an effective, trustworthy and transparent risk governance framework for NMs. The proposed framework enables continuous integration of the evolving state of the science, leverages best practice from contiguous disciplines and facilitates responsive re-thinking of nanosafety governance to meet future needs. To achieve and operationalise such framework, a science-based Risk Governance Council (RGC) for NMs is being developed. The framework will provide a toolkit for independent NMs' risk governance and integrates needs and views of stakeholders. An extension of this framework to relevant advanced materials and emerging technologies is also envisaged, in view of future foundations of risk research in Europe and globally.

More Democratic Sustainability Governance through Participatory Knowledge Production? A Framework and Systematic Analysis

This paper investigates how participatory knowledge production may contribute to more democratic sustainability governance. It develops an analytical framework in order to perform a systematic analysis of the GammaSense project in the Netherlands, on the measurement of gamma radiation by citizens. The paper first of all concludes that the way in which participation takes place throughout each and every stage of the knowledge production process, including technically complex issues such as the design of the measurement system and analytical toolset, has consequences for (a) which aspects of the gamma radiation decision-making process can potentially be democratized; (b) who gains a voice on the issue; (c) which form of democratization process is potentially facilitated. Secondly, the democratizing effects of setting the purpose of knowledge production, defining the research object and developing the methodological toolset are closely intertwined. Finally, providing space for multiple epistemologies and being attentive towards the role of material objects—the issue at hand and the methodological devices—are of crucial importance to realize the democratizing ambitions that the GammaSense project aimed to contribute towards.

Design for Societal Resilience: The Risk Evaluation Diversity-Aiding Approach (RED-A)

The global impacts of disaster risks are on the rise. Moreover, evidence shows that the severity of damage will increase exponentially. In 2019, there were 395 natural disasters that caused 11,755 deaths. Literature and practice indicate that diversification of disaster risk management (DRM) approaches can make communities more resilient. One notable bottleneck in adopting diverse DRM approaches is the historical dominance of natural and technological sciences with little contribution from social sciences. Thus, a heterogeneous social-technical approach to DRM is rare and risk governance challenges are hardly understood. We conducted a systematic literature and practice review and extracted data to develop and answer five sub-questions. After that, we reviewed relevant information and selected eight risk evaluation approaches. We made comparisons and used the input to design the Risk Evaluation Diversity-aiding Approach (RED-A). The approach consists of 12 criteria and a checklist with 22 items. RED-A provides guidance to DRM researchers and practitioners when conducting socio-technical risk evaluations. It helps identify cognitive biases in the ongoing DRM process that may largely impact the quality of risk evaluation procedures. The goal of the 22-item checklist is to ensure that the 12 RED-A criteria are incorporated as much as possible to support the progressive transition towards a heterogeneous social-technical DRM approach. Finally, the RED-A criteria and checklist are applied in the Solotvyno municipality context (in Ukraine), to illustrate the use of the approach.

Risk, uncertainty, ignorance and myopia: Their managerial implications for B2B firms

Rare events are common: Even though any particular type of ‘rare event’ - a world war, global economic collapse, or pandemic for that matter - should only occur once every 100 years, there are enough of those types of ‘rare events’ that overall, they commonly occur about once every 10 years. As we are currently experiencing with the COVID-19 pandemic, we do not sufficiently leverage the rich toolset that risk management offers to prepare for and mitigate the resulting uncertainty. This article highlights four aspects of risk management, and their practical and theorical implications. They are: 1) Risk (in the narrower sense), where possible future outcomes can be captured through probability distributions. 2) A situation of uncertainty, where there is transparency regarding what is not known, but probability distributions are unknown, as well as causal relationships influencing the outcome in question. 3) A situation of ignorance, where there is no understanding that certain possible future developments are even relevant. And finally: 4) The emergence of organizational and inter-organizational myopia as an effect of risk, uncertainty and ignorance on collective human behaviour.

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Discusses four conditions of decreasing knowledge and their effect: risk, uncertainty, ignorance, and myopia.

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Introduces four corresponding management responses: risk management, robust decision making, resilience, and mindfulness.

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Highlights inter-organizational challenges using UK National Health Service challenges during COVID-19 pandemic.

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Summarizes open challenges, e.g. reconciliation of risk definitions and tailoring of response to specific context.

Strengths and Weaknesses of a Hybrid Post-disaster Management Approach: the Doce River (Brazil) Mine-Tailing Dam Burst

Mine-tailing dam bursts occur frequently with attendant implications for the environment and human populations. Institutional preparedness for such events plays an important role in their lasting impact. This study analyzes the stakeholder engagement in the new governance framework created to recover the Doce River ecosystem following the 2015 disaster, where 34 million m³ of tailings were released, killing 19 people and causing massive impacts on riverine life. Following the disaster, poorly conceived political and management decisions impeded and continue to impede the progress of ecosystem recovery. The post-event management structure shows a centralized and poorly diverse stakeholder pool. We conclude that poor governance structure, and weak law enforcement, are among the main reasons preventing the Doce River post-disaster watershed recovery. A watershed vulnerability analysis combining dam stability and socioeconomic data, concluded that low ratings of socioeconomic performance substantially increase basin vulnerability. We recommend that the watershed committee should be fully involved in the implementation of the program and take a central role so that the most vulnerable communities (including indigenous people) take ownership of ecosystem recovery.

Climatic changes and their role in emergence and re-emergence of diseases

Global warming and the associated climate changes are predictable. They are enhanced by burning of fossil fuels and the emission of huge amounts of CO2 gas which resulted in greenhouse effect. It is expected that the average global temperature will increase with 2-5 °C in the next decades. As a result, the earth will exhibit marked climatic changes characterized by extremer weather events in the coming decades, such as the increase in temperature, rainfall, summertime, droughts, more frequent and stronger tornadoes and hurricanes. Epidemiological disease cycle includes host, pathogen and in certain cases intermediate host/vector. A complex mixture of various environmental conditions (e.g. temperature and humidity) determines the suitable habitat/ecological niche for every vector host. The availability of suitable vectors is a precondition for the emergence of vector-borne pathogens. Climate changes and global warming will have catastrophic effects on human, animal and environmental ecosystems. Pathogens, especially neglected tropical disease agents, are expected to emerge and re-emerge in several countries including Europe and North America. The lives of millions of people especially in developing countries will be at risk in direct and indirect ways. In the present review, the role of climate changes in the spread of infectious agents and their vectors is discussed. Examples of the major emerging viral, bacterial and parasitic diseases are also summarized.

Uncertain Risk Assessment and Management: Case Studies of the Application of the Precautionary Principle in Portugal

This study intends to clarify how the precautionary principle (PP) has been interpreted and applied by the courts in Portugal in the analysis of conflicts associated with uncertain and serious potential risks to human health and the environment. It also aims to contribute to the debate of when and how to apply precautionary measures. To this end, recent court cases in the areas of waste incineration, high-voltage power lines, as well as dam and wind farm construction were considered. The degree of consistency in the courts' decisions and their reasons in the different judicial bodies was analyzed with the support of a theoretical framework based on three attributes: the level of seriousness of potential hazards, level of evidence required, and the severity of precautionary actions taken. Different positions among courts were observed, with contradictory arguments in the same case or in similar cases. A greater propensity for favorable decisions in the acceptance of restraining orders was verified in the courts of lower instances, where human health could be threatened. However, the decisions of the Supreme Administrative Court, which were always unfavorable to the restraining orders, seem to reflect the priority given to national economic and political interests over local or regional environmental interests. They may also reflect the Supreme Court's reluctancy to apply the PP in the absence of a firm legally binding PP in national legislation. To address this situation, more explicit legal requirements and criteria for the analysis of uncertain risks and the weighting of interests by area of activity are needed.

Review and analysis of current responses to COVID-19 in Indonesia: Period of January to March 2020

The world is under pressure from the novel COVID-19 pandemic. Indonesia is the fourth most populous country in the world and predicted to be affected significantly over a longer time period. Our paper aims to provide detailed reporting and analyses of the present rapid responses to COVID-19, between January and March 2020, in Indonesia. We particularly highlight responses taken by the governments, non-government organisations and the community. We outline gaps and limitations in the responses, based on our rapid analysis of media contents, from government speeches and reports, social and mass media platforms. We present five recommendations toward more rapid, effective, and comprehensive responses.

A comparative analysis of Chinese regional climate regulation policy: ETS as an example

An effective and powerful regulation is indispensable for the development and smooth operation of a cap-and-trade emission trading scheme (ETS). Seven regional pilot ETSs have been established and gradually improved in China, from which the experiences and lessons learned may provide useful references to facilitate China's national ETS regulation. This article systematically reviews and compares the practices and policies of carbon trading regulation in China's seven pilot schemes from three major aspects of regulatory institutions and subjects, regulatory objects and content, and regulatory means and techniques, and covering both internal and external regulatory architectures. The comparative analysis has demonstrated that the regional pilot schemes have made notable achievements in developing ETS regulatory systems with Chinese characteristics, but they still have considerable deficiencies. Referencing both international and domestic pilot experiences, this study recommends that China's national ETS improve regulatory institutional basis, foster an extensive participation of pluralistic regulatory subjects with a clear division of powers and responsibilities, establish effective regulatory systems on carbon finance, and continuously enrich regulatory techniques and platforms.

Unmanned Remotely Operated Search and Rescue Ships in the Canadian Arctic: Exploring the Opportunities, Risk Dimensions and Governance Implications

This chapter is a proactive risk exploration of hypothetical remotely operated search and rescue (SAR) ships in the Canadian Arctic. The harsh and remote environment in the region, combined with complicated coastlines and many uncharted or poorly charted traffic routes, makes it one of the most challenging SAR areas. Canada has committed itself to safety, environmental protection and sovereign presence in the area by maintaining joint SAR centres of federal government departments and mobilizing private volunteers. The characteristics of Canadian SAR response in the Arctic rest with its high dependency on heavy equipment such as aircraft, helicopters and icebreakers, entailing prolonged hours of response time. As recent climate change impacts and maritime traffic increase in the northern waters disclose safety gaps, innovation in SAR assets is anticipated. The safety gaps may be filled by state-of-the-art remote control technology. This chapter discusses remotely operated unmanned ships for SAR response, exploring their opportunities, risk dimensions and governance implications.

Who is afraid of ticks and tick-borne diseases? Results from a cross-sectional survey in Scandinavia

Background

In Scandinavia, the distribution of ticks is expanding and tick-borne diseases constitute growing health risks. While the probability of getting a tick-borne disease after a tick bite is low, the health impacts can be large. This, as well as other characteristics of these diseases make tick-related risks difficult for laypeople to assess and perceived risk may differ substantially from actual risk. Understanding risk perceptions is important since it is the perceived risk, rather than actual risk, that determine behaviour and even more so for new and emerging risks. The aim of this study is to investigate knowledge and risk perceptions related to tick bites and the tick-borne diseases Lyme borreliosis (LB) and tick-borne encephalitis (TBE). By analysing risk perceptions and knowledge, the study helps inform the development of public health strategies in response to the increasing incidence of these diseases in Scandinavia.

Methods

Two thousand, six hundred sixty-eight respondents in Denmark, Norway and Sweden answered an online questionnaire with 48 questions, including 7 questions on risk perceptions and 9 knowledge questions. Chi-squared tests were used to analyse statistical differences between country sub-samples, gender and age groups. A multivariate regression model was used to analyse factors associated with risk perceptions.

Results

Risk perceptions were on average high in comparison with scientific estimates, with respondents grossly overrating the probability of contracting LB or TBE if bitten by a tick. Also, the average perceived seriousness of a single tick bite and of getting LB or TBE was high. Knowledge on the other hand was low, especially among men and the youngest age group (18–29 years). Higher levels of knowledge about tick-borne diseases were associated with lower perceived seriousness of tick bites and LB and higher perceived seriousness of TBE. Also, having been diagnosed with LB was negatively associated with the perceived seriousness of LB.

Conclusions

Our results indicate that informing about ticks and tick-borne diseases would be a relevant public health strategy as it could make risk perceptions better aligned with actual risk.

Should the TBE virus spread further in Denmark and Norway, increasing knowledge about TBE vaccination would be especially important.

'Engagement' of patients and healthcare professionals in regulatory pharmacovigilance: establishing a conceptual and methodological framework

BACKGROUND

Engagement of patients and healthcare professionals is increasingly considered as fundamental to pharmacovigilance and risk minimisation activities. Few empirical studies of engagement exist and a lack of explicit conceptualisations impedes effective measurement, research and the development of evidence-based engagement interventions.

AIMS

This article (1) develops a widely applicable conceptualisation, (2) considers various methodological challenges to researching engagement, proposing some solutions, and (3) outlines a basis for converting the conceptualisation into specific measures and indicators of engagement among stakeholders.

METHOD

We synthesise social science work on risk governance and public understandings of science with insights from studies in the pharmacovigilance field.

FINDINGS

This leads us to define engagement as an ongoing process of knowledge exchange among stakeholders, with the adoption of this knowledge as the outcome which may feed back into engagement processes over time. We conceptualise this process via three dimensions; breadth, depth and texture. In addressing challenges to capturing each dimension, we emphasise the importance of combining survey approaches with qualitative studies and secondary data on medicines use, prescribing, adverse reaction reporting and health outcomes. A framework for evaluating engagement intervention processes and outcomes is proposed. Alongside measuring engagement via breadth and depth, we highlight the need to research the engagement process through attentiveness to texture-what engagement feels like, what it means to people, and how this shapes motivations based on values, emotions, trust and rationales.

CONCLUSION

Capturing all three dimensions of engagement is vital to develop valid understandings of what works and why, thus informing engagement interventions of patients and healthcare professionals to given regulatory pharmacovigilance scenarios.

Effects of Rank-Ordered Feature Perceptions of Energy Sources on the Choice of the Most Acceptable Power Plant for a Neighborhood: An Investigation Using a South Korean Nationwide Sample

The present study incorporates a competitive context into an individual’s response to the construction of a power plant in his/her neighborhood and the determinants of this response. The study adopts an individual’s rank-ordered feature perceptions of competing energy sources to reflect the individual’s comparative perceptions of the sources regarding the features, and it investigates the effects of these perceptions on his/her choice of the most acceptable power plant in the area where he/she lives. Our mixed conditional logit analysis of nationwide survey data from South Korea demonstrated the following: among the rank-ordered feature perceptions, the perceptions regarding safety and eco-friendliness significantly predict an individual’s choice of the most acceptable power plant for his/her neighborhood, while those regarding affordability, contribution to economic development, and job creation do not. In addition, among those significant features, safety was found to be a stricter criterion than eco-friendliness. The selective significance of the feature perceptions and the differentiated criteria between the significant features provide practical implications for professionals in energy industries, as well as theoretical implications for researchers.

Assessing Transboundary Wildfire Exposure in the Southwestern United States

We assessed transboundary wildfire exposure among federal, state, and private lands and 447 communities in the state of Arizona, southwestern United States. The study quantified the relative magnitude of transboundary (incoming, outgoing) versus nontransboundary (i.e., self-burning) wildfire exposure based on land tenure or community of the simulated ignition and the resulting fire perimeter. We developed and described several new metrics to quantify and map transboundary exposure. We found that incoming transboundary fire accounted for 37% of the total area burned on large parcels of federal and state lands, whereas 63% of the area burned was burned by ignitions within the parcel. However, substantial parcel to parcel variation was observed for all land tenures for all metrics. We found that incoming transboundary fire accounted for 66% of the total area burned within communities versus 34% of the area burned by self-burning ignitions. Of the total area burned within communities, private lands contributed the largest proportion (36.7%), followed by national forests (19.5%), and state lands (15.4%). On average seven land tenures contributed wildfire to individual communities. Annual wildfire exposure to structures was highest for wildfires ignited on state and national forest land, followed by tribal, private, and BLM. We mapped community firesheds, that is, the area where ignitions can spawn fires that can burn into communities, and estimated that they covered 7.7 million ha, or 26% of the state of Arizona. Our methods address gaps in existing wildfire risk assessments, and their implementation can help reduce fragmentation in governance systems and inefficiencies in risk planning.

Impacts of the water framework directive on learning and knowledge practices in a Swedish catchment

Catchments are complex social-ecological systems involving multiple, and often competing, interests. Water governance and management regimes are increasingly embracing pluralistic, participatory, and holistic norms as a means to engage with issues of complexity, uncertainty, and value-conflicts. Integrated, participatory approaches are theoretically linked to improved learning amongst stakeholders across sectors and decision-making that is grounded in shared knowledge, experiences and scientific evidence. However, few studies have empirically examined the impacts of an integrated approach to learning and knowledge practices related to water resources. Here, a Swedish sub-catchment that has adopted such an approach in association with implementation of the European Water Framework Directive (WFD) is examined. Interview-based analyses show that WFD implementation has both helped and hindered learning and knowledge practices surrounding both water planning and spatial planning. Whilst communities of practice have developed in the study area, a number of important challenges remain. These include the rigid goal-orientation of the WFD, the fragmentation of knowledge caused by an over-reliance on external consultants, as well as a lack of resources to synthesise information from multiple sources. Present results raise questions regarding the efficacy of the WFD to sufficiently enable the development of learning and knowledge practices capable of handling the complexity, uncertainties and value-conflicts facing catchments in Sweden and elsewhere.

Integrating Resilience Assessment in Environmental Impact Assessment

It has become important in the fields of environmental impact assessment (EIA) and resilience assessment that both disciplines begin to be considered together as complementary approaches aimed at achieving the same goals. There is a great advantage to combining the EIA methodology with a synergetic concept such as resilience, and thereby contributing to a more insightful and effective EIA process. A comprehensive approach is vital for effective assessment and management of environmental impacts and to support better decision making with regard to different planned interventions and socioecological systems. In this paper, we advocate for a hybrid environmental assessment model that combines EIA and resilience assessment. This proposed assessment approach expands the capacity of EIA to evaluate and manage the uncertainties and unexpected outcomes associated with human and natural environmental impacts. Integr Environ Assess Manag 2018;14:567-570. © 2018 SETAC.

Transnational pharmacogovernance: emergent patterns in the jazz of pharmaceutical policy convergence

BACKGROUND

As a transnational policy network, the International Council for Harmonization of Technical Requirements for Registration of Pharmaceuticals for Human Use (ICH) aligns international regulatory standards to address the pressures of globalization on the pharmaceutical industry and increase access to new medicines. Founding ICH members include regulators and pharmaceutical industry trade associations in the European Union, the United States and Japan. In this paper we explore the manner in which state interdependence fosters the conditions for regulatory harmonization by tracing the underlying parallels between ICH and member state pharmacogovernance to clarify emergent patterns in regulatory policy convergence.

RESULTS

A shift to the life cycle approach to pharmaceutical regulation corresponded with international convergence in pre-market standards as emphasis shifted to post-market standards where convergence remains unresolved. Transnational pharmacogovernance was found to concentrate regulatory authority within a co-regulatory model of bilateral negotiation with pharmaceutical trade associations in defining safety and efficacy standards. Given a context of state interdependence, parallels were found between transnational and ICH member pharmacogovernance modes that guide policy development. Divergent modes of state regulatory governance that re-calibrate perceptions of risk and risk mitigation were found to coincide with post-market policy dissonance.

CONCLUSION

Although interdependence fostered harmonization in pre-market standards and aligned with increased focus on post-market approaches, the confluence of divergent state governance modes and perceptions of risk may inspire improvisation in post-market standards. As the ICH expands to an ensemble with a greater global reach, further research is needed to clarify the manner in which interdependence shapes transnational pharmacogovernance and the conditions that foster policy convergence in the public interest.

Induced Earthquakes from Long-Term Gas Extraction in Groningen, the Netherlands: Statistical Analysis and Prognosis for Acceptable-Risk Regulation

Recently, growing earthquake activity in the northeastern Netherlands has aroused considerable concern among the 600,000 provincial inhabitants. There, at 3 km deep, the rich Groningen gas field extends over 900 km² and still contains about 600 of the original 2,800 billion cubic meters (bcm). Particularly after 2001, earthquakes have increased in number, magnitude (M, on the logarithmic Richter scale), and damage to numerous buildings. The man-made nature of extraction-induced earthquakes challenges static notions of risk, complicates formal risk assessment, and questions familiar conceptions of acceptable risk. Here, a 26-year set of 294 earthquakes with M ≥ 1.5 is statistically analyzed in relation to increasing cumulative gas extraction since 1963. Extrapolations from a fast-rising trend over 2001-2013 indicate that-under "business as usual"-around 2021 some 35 earthquakes with M ≥ 1.5 might occur annually, including four with M ≥ 2.5 (ten-fold stronger), and one with M ≥ 3.5 every 2.5 years. Given this uneasy prospect, annual gas extraction has been reduced from 54 bcm in 2013 to 24 bcm in 2017. This has significantly reduced earthquake activity, so far. However, when extraction is stabilized at 24 bcm per year for 2017-2021 (or 21.6 bcm, as judicially established in Nov. 2017), the annual number of earthquakes would gradually increase again, with an expected all-time maximum M ≈ 4.5. Further safety management may best follow distinct stages of seismic risk generation, with moderation of gas extraction and massive (but late and slow) building reinforcement as outstanding strategies. Officially, "acceptable risk" is mainly approached by quantification of risk (e.g., of fatal building collapse) for testing against national safety standards, but actual (local) risk estimation remains problematic. Additionally important are societal cost-benefit analysis, equity considerations, and precautionary restraint. Socially and psychologically, deliberate attempts are made to improve risk communication, reduce public anxiety, and restore people's confidence in responsible experts and policymakers.

Comparative, collaborative, and integrative risk governance for emerging technologies

Various emerging technologies challenge existing governance processes to identify, assess, and manage risk. Though the existing risk-based paradigm has been essential for assessment of many chemical, biological, radiological, and nuclear technologies, a complementary approach may be warranted for the early-stage assessment and management challenges of high uncertainty technologies ranging from nanotechnology to synthetic biology to artificial intelligence, among many others. This paper argues for a risk governance approach that integrates quantitative experimental information alongside qualitative expert insight to characterize and balance the risks, benefits, costs, and societal implications of emerging technologies. Various articles in scholarly literature have highlighted differing points of how to address technological uncertainty, and this article builds upon such knowledge to explain how an emerging technology risk governance process should be driven by a multi-stakeholder effort, incorporate various disparate sources of information, review various endpoints and outcomes, and comparatively assess emerging technology performance against existing conventional products in a given application area. At least in the early stages of development when quantitative data for risk assessment remain incomplete or limited, such an approach can be valuable for policymakers and decision makers to evaluate the impact that such technologies may have upon human and environmental health.

Rapid Assessment of Stakeholder Concerns about Public Health. An Introduction to a Fast and Inexpensive Approach Applied on Health Concerns about Intensive Animal Production Systems

To effectively manage environmental health risks, stakeholders often need to act collectively. Stakeholders vary in their desire to act due to many factors, such as knowledge, risk perception, interests, and worldviews. Understanding their perceptions of the issues at stake is crucial to support the risk governance process. Even though concern assessment is a pivotal element of risk governance, few tools for rapid assessment are reported in the literature. We tested a rapid and relatively cheap approach, taking the Dutch debate on Intensive Animal Production Systems (IAPS) and health as an example. Dutch policy-oriented publications on IAPS and health and ten semi-structured in-depth interviews with a variety of stakeholders were analyzed to identify stakeholders and concerns involved in the Dutch debate about IAPS and health. Concerns were mapped and a stakeholder network was derived. Three classes of concerns were recognized in the discussions about IAPS and health: concerns related to health risks, concerns regarding the activity causing the risks (IAPS), and concerns about the process to control the risks. The notions of 'trust' and 'scientific uncertainty' appeared as important themes in the discussions. Argumentation based on concerns directly related to health risks, the activity causing the risk (IAPS), and its risk management can easily become muddled up in a societal debate, limiting the development of effective action perspectives. Acknowledging these multiple stakeholder concerns can clarify the positions taken by stakeholders and allow for more and other action perspectives to develop.

Emergency Preparedness in Elderly Care in Sweden: A Study of Staff Perspectives

OBJECTIVE

The aim was to investigate the interface between elderly care and emergency preparedness from the elderly care staff's perspective.

METHODS

A web-based questionnaire was sent to elderly care staff in 4 Swedish municipalities. The questions involved experiences of extraordinary events, education and exercises, and risk and vulnerability analyses, evaluations of main risks and emergency preparedness, and familiarity with preparedness plans. In total, 568 elderly care staff responded.

RESULTS

Between 15% and 25% of the respondents claimed experiences of extraordinary events, exercises and education, and risk and vulnerability analyses. The same number claimed familiarity with the organization's preparedness plan, whereas ~85% answered that they need more education and exercises. Emergency preparedness was evaluated as important. The experiences and risks referred to pertained to both official categories used within emergency preparedness and issues such as work conditions, seniors' fall accidents.

CONCLUSION

Elderly care staff, though highly motivated, do not seem to be involved in emergency preparedness and are not targeted to a large extent when education and training are organized. A development of the interface between emergency preparedness and elderly care could require a clarification of the scope and context of emergency preparedness and of differing understandings of central concepts. (Disaster Med Public Health Preparedness. 2018;12:86-93).

Discursive junctions in flood risk governance - A comparative understanding in six European countries

Flood risks are managed differently across Europe. While a number of research studies aim to understand these differences, they tend to pay little attention to the social constructionist aspects of flood risk governance, i.e. the meaning that societies give to flood risk and governance. This paper aims to address this gap by understanding differences in flood risk management approaches (FRMA) from a discursive-institutional perspective. Based on this perspective, an analytical framework was developed to systematically analyse and compare discourses pertaining to flood risk and its governance in six European member states (England (the United Kingdom), Flanders (Belgium), France, the Netherlands, Poland and Sweden). Correspondingly, this paper demonstrates how the hegemonic discursive-institutional patterns of flood risk governance differ between the six European countries. These differences may influence the capability of countries to learn from each other, adopt new FRMAs or cooperate with each other. Moreover, the paper argues that differences in discourses partially account for the differences in FRMAs between countries, combined with other factors. Additionally, broader implications are discussed. For example, the research findings imply that some discourses tend to favour or disfavour other discourses, and that they additionally also tend to favour particular FRMAs; e.g. the flood risk discourse pertaining to high manageability of risks seems to favour a governance discourse of collectivity and central governance. The different insights imply that further research is necessary to understand the complex interaction of discourses and institutional arrangements.

Transcranial Electrical Stimulation to Enhance Cognitive Performance of Healthy Minors: A Complex Governance Challenge

An increasing number of healthy adolescents are consuming products that can enhance their cognitive performance in educational settings. Currently, the use of pharmaceuticals is the most widely discussed enhancement method in the literature, but new evidence suggests that other methods based on Transcranial Electrical Stimulation (tES) also have potential as cognitive enhancer. Just like pharmaceutical enhancers, the availability and education-related use of tES-devices raise a broad range of ethical, legal, and societal issues that need to be addressed by policy-makers. Few studies, however, have specifically explored these issues in relation to child wellbeing. In this narrative review with systematic search, we describe the issues for child wellbeing that could arise from the availability and education-related use of tES-based enhancers by healthy minors. We demonstrate that the issues form a complex web of uncertainties and concerns, which are mainly incited by two factors. First is the high level of factual uncertainty due to gaps in empirical evidence about the exact working mechanisms and efficacy of tES. Moreover, a lack of insight into the technique’s (long-term) effects on healthy developing brains, and uncertainties about potential cognitive trade-offs have fueled concerns about the technique’s safety and impact. The second factor that contributes to the complexity of issues is the presence of moral diversity in our society. Different opinions exist on whether a certain enhancement effect would be desirable and whether potential risks would be acceptable. These opinions depend on one’s moral perspective, and the way one interprets and weights values such as the child’s autonomy and authenticity. The challenge for proper governance resides in the design of an appropriate framework that is capable of balancing the different moral perspectives in society, while recognizing the uncertainties that still exist. We therefore argue for a responsible innovation approach, which encourages an adaptive attitude toward emerging knowledge and dynamic societal values, to deal with the identified issues regarding tES-based enhancement appropriately.

Matching safety to access: global actors and pharmacogovernance in Kenya- a case study

Background

The Kenyan government has sought to address inadequacies in its National Pharmaceutical Policy and the Pharmacy and Poisons Board’s (PPB) medicines governance by engaging with global actors (e.g. the World Health Organization). Policy actors have influenced the way pharmacovigilance is defined, how challenges are understood and which norms are requisite to address drug safety issues. In this paper, we investigate the relationship between specific modes of engagement among global (exogenous) and domestic actors at the national and sub-national level to identify the positive or negative effect on pharmacovigilance and pharmacogovernance in Kenya. Pharmacogovernance is defined as the manner in which governing structures; policy instruments; institutional authority (e.g., ability to act, implement and enforce norms, policies and processes) and resources are managed to promote societal interests for patient safety and protection from adverse drug reactions (ADRs). Qualitative research methods that included key informant interviews and document analysis, were employed to investigate the relationship between global actors’ patterns of engagement with national actors and pharmacogovernance in Kenya.

Results

Global actors’ influence on pharmacogovernance and pharmacovigilance priorities in Kenya (e.g., legislation and adverse drug reaction surveillance) was positively perceived by key informants. We found that global actors’ engagement with state actors produced positive and negative outcomes. Engagement with the PPB and Ministry of Health (MOH) that was characterized as dependent (advocacy, empowerment, delegated) or interdependent (collaborative, cooperative, consultative) was mostly associated with positive outcomes e.g., capacity building; strengthening legislation and stakeholder coordination. Fragmentation (independent engagement) hindered risk communication between public, private, and NGO health programs.

Conclusion

A framework for assessing pharmacogovernance would support policy makers’ evidence-based decision making regarding investments to strengthen capacity for pharmacovigilance and guide policies regarding the state and exogenous actor relationship pertaining to pharmacogovernance. Ideally, dependency on exogenous actors should be reduced while retaining consultative, collaborative, and cooperative engagement when inter-dependency is appropriate. The use of global actors to address Kenya’s pharmacovigilance inadequacies leaves the country vulnerable to 1) ad hoc drug surveillance; 2) pharmacovigilance fragmentation; 3) shifting priorities; and 4) cross purpose interests.

Still Elegantly Muddling Through? NICE and Uncertainty in Decision Making About the Rationing of Expensive Medicines in England

This article examines the "technological appraisals" carried out by the National Institute for Health and Care Excellence as it regulates the provision of expensive new drugs within the English National Health Service on cost-effectiveness grounds. Ostensibly this is a highly rational process by which the regulatory mechanisms absorb uncertainty, but in practice, decision making remains highly complex and uncertain. This article draws on ethnographic data-interviews with a range of stakeholders and decision makers (n = 41), observations of public and closed appraisal meetings, and documentary analysis-regarding the decision-making processes involving three pharmaceutical products. The study explores the various ways in which different forms of uncertainty are perceived and tackled within these Single Technology Appraisals. Difficulties of dealing with the various levels of uncertainty were manifest and often rendered straightforward decision making problematic. Uncertainties associated with epistemology, procedures, interpersonal relations, and technicality were particularly evident. The need to exercise discretion within a more formal institutional framework shaped a pragmatic combining of strategies tactics-explicit and informal, collective and individual-to navigate through the layers of complexity and uncertainty in making decisions.