The challenge of policy coordination for sustainable sociotechnical transitions: the case of the zero-carbon homes agenda in England

Emerging in recent research on sociotechnical transitions towards a low-carbon economy is the question of the extent to which such transitions require centralised, intentional coordination by government. Drawing from Hayek's conceptualisation of coordination, I evaluate the effectiveness of policy for low-carbon and zero-carbon homes in England. A detailed analysis is presented of how policy makers address complex choices and trade-offs as well as significant uncertainty. Particular attention is given to those policy decisions which are widely agreed by stakeholders to cause distortive effects. The focus here on the impacts of policy definition and delivery in terms of multiple evaluative criteria can complement and enrich the more process-orientated cross-sector and multilevel analyses that predominate in existing research on policy coordination. Furthermore, the coordination problems identified yield further insights into the actual and potential effectiveness of policy processes in shaping complex sociotechnical transitions

Fontes cotidianas de estresse entre mulheres portadoras de HIV Daily sources of stress among HIV-positive women

OBJETIVO: Categorizar e descrever as fontes de estresse cotidianas de mulheres portadoras do vírus da imunodeficiência humana (HIV). MÉTODOS: Foram realizadas entrevistas individuais, por meio de um questionário semi-estruturado, com uma amostra consecutiva de 150 mulheres portadoras do HIV, de julho a dezembro de 1997, no Centro de Referência e Tratamento de Doenças Sexualmente Transmissíveis e Aids (CRT DST/Aids) (Secretaria de Estado da Saúde, SP). As variáveis investigadas foram: dados demográficos, estrutura familiar, percepção de risco, sexualidade, acesso ao sistema de saúde, adesão ao tratamento, uso de álcool e drogas, evento significativo e evento estressante, sendo este o foco de discussão do artigo. RESULTADOS: Apenas 14% dos eventos estressantes são diretamente resultados do tratamento ou do adoecimento. Os relatos das fontes de estresse foram distribuídos nos seguintes assuntos: familiares (17%); relacionamento com o parceiro (12%); filhos (14%); enfermidade (14%); relacionamento com outras pessoas (9%); problemas financeiros (8%) e profissionais (7%); vivências de discriminação (7%); outros (4%); e não responderam (8%). CONCLUSÕES: As fontes de estresse apresentam principalmente um conteúdo afetivo-relacional, derivadas muitas vezes do estigma associado ao HIV e, na maioria das vezes, a temas comuns a todas as mulheres. Os profissionais de saúde deveriam oferecer cuidado integral às mulheres portadoras do HIV.<br>OBJECTIVE: To categorize and describe the daily sources of stress encountered by HIV-infected women. METHODS: Using a semi-structured questionnaire, 150 interviews were conducted among HIV-infected women who attended the Reference and Treatment Center for Sexually Transmitted Diseases and Aids in the state of São Paulo, Brazil, between July and December 1997. The studied variables were: demographics, family structure, risk perception, sexuality, access to health system, treatment compliance, drug use, and significant and stressful events. Stressful events are further discussed here. RESULTS: Only 14% of the stressful events are directly related to the treatment and illness itself. Sources of stress were categorized as follows: family relations (17%); partner relationship (12%); children (14%); illness (14%); non-family relationship (9%); financial (8%); professional (7%); discrimination issues (7%); others (4%); and no response (8%). CONCLUSIONS: Stressful events are mainly related to affective/relationship sources, most often associated to the HIV stigma and mostly to women-related subjects. Health care professionals should provide integral care to HIV-infected women

Human Health and the Biological Effects of Tritium in Drinking Water: Prudent Policy Through Science – Addressing the ODWAC New Recommendation

Tritium is a radioactive form of hydrogen and is a by-product of energy production in Canadian Deuterium Uranium (CANDU) reactors. The release of this radioisotope into the environment is carefully managed at CANDU facilities in order to minimize radiation exposure to the public. However, under some circumstances, small accidental releases to the environment can occur. The radiation doses to humans and non-human biota from these releases are low and orders of magnitude less than doses received from naturally occurring radioisotopes or from manmade activities, such as medical imaging and air travel. There is however a renewed interest in the biological consequences of low dose tritium exposures and a new limit for tritium levels in Ontario drinking water has been proposed. The Ontario Drinking Water Advisory Council (ODWAC) issued a formal report in May 2009 in response to a request by the Minister of the Environment, concluding that the Ontario Drinking Water Quality Standard for tritium should be revised from the current 7,000 Bq/L level to a new, lower 20 Bq/L level. In response to this recommendation, an international scientific symposium was held at McMaster University to address the issues surrounding this change in direction and the validity of a new policy. Scientists, regulators, government officials, and industrial stakeholders were present to discuss the potential health risks associated with low level radiation exposure from tritium. The regulatory, economic, and social implications of the new proposed limit were also considered