What’s Fair – and Why? An Empirical Analysis of Distributive Fairness in the Climate Negotiations

In the climate negotiations, conceptions of fairness plays an important role. For a climate agreement to be effective and durable, it must be conceived as fair by as many of its parties as possible. Unfortunately, there is hardly a consensus in the negotiations on what a fair agreement should constitute, and diverging fairness conceptions are at the heart of the conflicts of the negotiations. This thesis is an attempt at understanding this fairness dimension. It attempts to answer two related questions: 1) what do the parties in the negotiations conceive as fair? And 2) why do parties in the negotiations have differing conceptions of what constitutes a fair agreement? The findings of this thesis indicate that there has been little progress on reaching a common understanding of fairness in the negotiations over the last five-year cycle of negotiations that concluded with the Paris agreement. Even though a significant potential for compromise exists, key actors’ positions on the fairness dimension are polarized. This might be an explanation for why a burden-sharing approach is no longer possible in the negotiations. Whether a country is listed as “developing” or “developed” in the UNFCCC is the most important explanatory factor for diverging fairness conceptions - indicating that conceptions of fairness are largely driven by self-interest

MULTI-GAS EMISSION REDUCTION FOR CLIMATE CHANGE POLICY: AN APPLICATION OF FUND

The costs of greenhouse gas emission reduction are investigated with abatement of carbon dioxide, methane, and nitrous oxide using the FUND model. The central policy scenario keeps anthropogenic radiative forcing below 4.5 Wm-2. If CO2 emission reduction were the only possibility to meet this target, the net present value of consumption losses would be $45 trillion; with abatement of the other gases added, costs fall to$33 trillion. The bulk of these costs savings can be ascribed to nitrous oxide. Because nitrous oxide is so much more important than methane, the choice of equivalence metric between the greenhouse gases does not matter much. Sensitivity analyses show that the shape of the cost curves for CH4 and N2O emission reduction matters, and that the inclusion of SO2 and sulphate aerosols make policy targets substantially harder to achieve. The costs of emission reduction vary greatly with the choice of stabilisation target. A target of 4.5 Wm-2 is not justified by our current knowledge of the damage costs of climate change.Climate change, emission reduction, carbon dioxide, methane, nitrous oxide

An Advocacy for the Use of 3D Stem Cell Culture Systems for the Development of Regenerative Medicine: An Emphasis on Photoreceptor Generation

The availability of stem cells is of great promise to study early developmental stages and to generate adequate cells for cell transfer therapies. Although many researchers using stem cells were successful in dissecting intrinsic and extrinsic mechanisms and in generating specific cell phenotypes, few of the stem cells or the differentiated cells show the capacity to repair a tissue. Advances in cell and stem cell cultivation during the last years made tremendous progress in the generation of bona fide differentiated cells able to integrate into a tissue after transplantation, opening new perspectives for developmental biology studies and for regenerative medicine. In this review, we focus on the main works attempting to create in vitro conditions mimicking the natural environment of CNS structures such as the neural tube and its development in different brain region areas including the optic cup. The use of protocols growing cells in 3D organoids is a key strategy to produce cells resembling endogenous ones. An emphasis on the generation of retina tissue and photoreceptor cells is provided to highlight the promising developments in this field. Other examples are presented and discussed, such as the formation of cortical tissue, the epithelial gut or the kidney organoids. The generation of differentiated tissues and well-defined cell phenotypes from embryonic stem (ES) cells or induced pluripotent cells (iPSCs) opens several new strategies in the field of biology and regenerative medicine. A 3D organ/tissue development in vitro derived from human cells brings a unique tool to study human cell biology and pathophysiology of an organ or a specific cell population. The perspective of tissue repair is discussed as well as the necessity of cell banking to accelerate the progress of this promising field

Uncertainty analysis in integrated assessment: the users’ perspective

Integrated Assessment (IA) models aim at providing information- and decision-support to complex problems. This paper argues that uncertainty analysis in IA models should be user-driven in order to strengthen science–policy interaction. We suggest an approach to uncertainty analysis that starts with investigating model users’ demands for uncertainty information. These demands are called “uncertainty information needs”. Identifying model users’ uncertainty information needs allows focusing the analysis on those uncertainties which users consider relevant and meaningful. As an illustrative example, we discuss the case of examining users’ uncertainty information needs in the SEAMLESS Integrated Framework (SEAMLESS-IF), an IA model chain for assessing and comparing alternative agricultural and environmental policy options. The most important user group of SEAMLESS-IF are policy experts at the European and national level. Uncertainty information needs of this user group were examined in an interactive process during the development of SEAMLESS-IF and by using a questionnaire. Results indicate that users’ information requirements differed from the uncertainty categories considered most relevant by model developers. In particular, policy experts called for addressing a broader set of uncertainty sources (e.g. model structure and technical model setup). The findings highlight that investigating users’ uncertainty information needs is an essential step towards creating confidence in an IA model and its outcomes. This alone, however, may not be sufficient for effectively implementing a user-oriented uncertainty analysis in such models. As the case study illustrates, it requires to include uncertainty analysis into user participation from the outset of the IA modelling process

EXCHANGE RATES AND CLIMATE CHANGE: AN APPLICATION OF FUND

As economic and emissions scenarios assume convergence of per capita incomes, they are sensitivity to the exchange rate used for international comparison. Particularly, developing countries grow slower with a purchasing power exchange rate than with a market exchange rate. Different exchange rates may lead to scenarios with very different per capita income. However, these scenarios also assume convergence of energy intensities, which at least partly offsets the income effect, so that scenarios with different exchange rates would differ less in greenhouse gas emissions. Differences become smaller still if atmospheric concentrations and global warming is considered. However, differences become larger again if one considers the costs of meeting a certain stabilisation target, as the gap between baseline and target is more sensitive to the exchange rate used than the baseline itself. Differences also grow larger if one looks at climate change impacts, which are determined not just by climate change but also by development. The sensitivity to the exchange rate is purely due to imperfect data, imperfect statistical analysis of data, a crude spatial resolution, and imperfect models.Climate change, emissions scenarios, purchasing power parity, market exchange rate

Understanding Growing Climate Policy Differences in the EU and the United States: Scientific knowledge meets governance systems

The EU and the United States disagree deeply about the need for more stringent climate policies. Increased climate change concern in 2006-2008 created new opportunities for convergence, but ended in sharp policy differences. We explore two related explanations. First, scientific input was used to frame joint gains among stakeholders differently in the EU and US. Framing was different concerning the consequences of the problem, and particularly in the impact assessments of proposed policy. Second, different governance systems enabled distinctive responses to new opportunities in the EU and United States. Differences in how new policies were initiated and negotiated caused divergent climate policies. The paper tentatively concludes that the relationship and interaction between scientific input and governance systems resulted in distinctively different policy-making processes. This relationship reinforced a cooperative attitude to identify joint gains among EU decision- makers. In contrast, the framing of scientific knowledge reinforced a competitive attitude among US lawmakers, fueled by different stakeholder interests. Scientific knowledge was used and applied to reinforce differences in governance systems. The main lesson from this case is that the framing and application of scientific knowledge in the debate matters, but differences in governance systems are more instrumental for policy outcome

Enhanced feedback interventions to promote evidence-based blood transfusion guidance and reduce unnecessary use of blood components:The AFFINITIE research programme including two cluster factorial RCTs

Background: Blood transfusion is a common but costly treatment. Repeated national audits in the UK suggest that up to one-fifth of transfusions are unnecessary when judged against recommendations for good clinical practice. Audit and feedback seeks to improve patient care and outcomes by comparing clinical care against explicit standards. It is widely used internationally in quality improvement. Audit and feedback generally has modest but variable effects on patient care. A considerable scope exists to improve the impact that audit and feedback has, particularly through head-to-head trials comparing different ways of delivering feedback. Objectives: The AFFINITIE (Development & Evaluation of Audit and Feedback INterventions to Increase evidence-based Transfusion practIcE) programme aimed to design and evaluate enhanced feedback interventions, within a national blood transfusion audit programme, to promote evidence-based guidance and reduce the unnecessary use of blood components. We developed, piloted and refined two feedback interventions, ‘enhanced content’ and ‘enhanced follow-on’ (workstream 1), evaluated the effectiveness and cost-effectiveness of the two feedback interventions compared with standard feedback practice (workstream 2), examined intervention fidelity and contextual influences (workstream 3) and developed general implementation recommendations and tools for other audit and feedback programmes (workstream 4). Design: Interviews, observations and documentary analysis in four purposively sampled hospitals explored contemporary practice and opportunities for strengthening feedback. We developed two interventions: ‘enhanced content’, to improve the clarity and utility of feedback reports, and ‘enhanced follow-on’, to help hospital staff with action-planning (workstream 1). We conducted two linked 2 × 2 factorial cross-sectional cluster-randomised trials within transfusion audits for major surgery and haematological oncology, respectively (workstream 2). We randomised hospital clusters (the organisational level at which hospital transfusion teams operate) to enhanced or standard content or enhanced or standard follow-on. Outcome assessment was masked to assignment. Decision-analytic modelling evaluated the costs, benefits and cost-effectiveness of the feedback interventions in both trials from the perspective of the NHS. A parallel process evaluation used semistructured interviews, documentary analyses and web analytics to assess the fidelity of delivery, receipt and enactment and to identify contextual influences (workstream 3). We explored ways of improving the impact of national audits with their representatives (workstream 4). Setting and participants: All NHS hospital trusts and health boards participating in the National Comparative Audit of Blood Transfusions were invited to take part. Among 189 hospital trusts and health boards screened, 152 hospital clusters participated in the surgical audit. Among 187 hospital trusts and health boards screened, 141 hospital clusters participated in the haematology audit. Interventions: ‘Enhanced content’ aimed to ensure that the content and format of feedback reports were consistent with behaviour change theory and evidence. ‘Enhanced follow-on’ comprised a web-based toolkit and telephone support to facilitate local dissemination, planning and response to feedback. Main outcome measures: Proportions of acceptable transfusions, based on existing evidence and guidance and algorithmically derived from national audit data. Data sources: Trial primary outcomes were derived from manually collected, patient-level audit data. Secondary outcomes included routinely collected data for blood transfusion. Results: With regard to the transfusions in the major surgery audit, 135 (89%) hospital clusters participated from 152 invited. We randomised 69 and 66 clusters to enhanced and standard content, respectively, and 68 and 67 clusters to enhanced and standard follow-on, respectively. We analysed a total of 2222 patient outcomes at 12 months in 54 and 58 (enhanced and standard content, respectively) and 54 and 58 (enhanced and standard follow-on, respectively) hospital clusters. With regard to the haematology audit, 134 hospital clusters (95%) participated from 141 invited. We randomised 66 and 68 clusters to enhanced and standard content, respectively, and 67 clusters to both enhanced and standard follow-on. We analysed a total of 3859 patient outcomes at 12 months in 61 and 61 (enhanced and standard content, respectively) and 63 and 59 (enhanced and standard follow-on) hospital clusters. We found no effect of either of the enhanced feedback interventions in either trial across all outcomes. Incremental enhanced intervention costs ranged from £18 to £248 per site. The enhanced feedback interventions were dominated by the standard intervention in cost-effectiveness analyses. The interventions were delivered as designed and intended, but subsequent local engagement was low. Although the enhancements were generally acceptable, doubts about the credibility of the blood transfusion audits undermined the case for change. Limitations: Limitations included the number of participating clusters; loss to follow-up of trial clusters, reducing statistical power and validity; incomplete audit and cost data contributing to outcome measures; participant self-selection; reporting; missing data related to additional staff activity generated in response to receiving feedback; and recall biases in the process evaluation interviews. Conclusions: The enhanced feedback interventions were acceptable to recipients but were more costly and no more effective than standard feedback in reducing unnecessary use of blood components, and, therefore, should not be recommended on economic grounds. Future work: We have demonstrated the feasibility of embedding ambitious large-scale rigorous research within national audit programmes. Further head-to-head comparisons of different feedback interventions are needed in these programmes to identify cost-effective ways of increasing the impact of the interventions

Let the Buyer Be Well Informed? - Doubting the Demise of Caveat Emptor

Returning home from grocery shopping one evening last spring, a forty-two-year-old architect was killed in the presence of his wife and children on the street outside his St. Louis townhouse by a gunshot to the neck during an attempted carjacking.2 By the next morning, police had arrested and obtained a confession from a recently released parolee wearing an electronic ankle bracelet.3 Several homes in the neighborhood, previously considered to be generally free of serious crime, were listed for sale at the time of this incident. Human experience teaches that other homes are likely to be offered for sale in the aftermath of this incident. Private morality and conscience will inform each seller\u27s decision whether to volunteer information about this notorious crime to potential purchasers from outside the community, or to respond expansively if asked about security. Some of these sellers may also seek the advice of counsel