Regulatory impact analyses (RIAs), required for new major federal regulations, are often criticized for not incorporating epistemic uncertainties into their quantitative estimates of benefits and costs. “Integrated uncertainty analysis,” which relies on subjective judgments about epistemic uncertainty to quantitatively combine epistemic and statistical uncertainties, is often prescribed. This article identifies an additional source for subjective judgment regarding a key epistemic uncertainty in RIAs for National Ambient Air Quality Standards (NAAQS)—the regulator's degree of confidence in continuation of the relationship between pollutant concentration and health effects at varying concentration levels. An illustrative example is provided based on the 2013 decision on the NAAQS for fine particulate matter (PM2.5). It shows how the regulator's justification for setting that NAAQS was structured around the regulator's subjective confidence in the continuation of health risks at different concentration levels, and it illustrates how such expressions of uncertainty might be directly incorporated into the risk reduction calculations used in the rule's RIA. The resulting confidence-weighted quantitative risk estimates are found to be substantially different from those in the RIA for that rule. This approach for accounting for an important source of subjective uncertainty also offers the advantage of establishing consistency between the scientific assumptions underlying RIA risk and benefit estimates and the science-based judgments developed when deciding on the relevant standards for important air pollutants such as PM2.5. 相似文献
Abstract This paper describes a longitudinally based discharge planning and treatment model. The model proposes to develop linkages between inpatient and community mental health providers during the early stages of hospitalization. The goal is to put the client's need first to ensure a smooth transition from the structure of the inpatient ward to the community, while maintaining continuity of care and reducing potential re-admissions to the hospital. The barriers that prevent such an adoption and implementation of such a system are discussed. Both clinical and policy issues are examined. Part 1 focuses on the background of case management and discharge planning and provides a critique of case management models (Belcher &; DeForge, 2005). Part 2 presents and describes the components of the longitudinally based discharge planning and treatment model (LDPTM) (DeForge &; Belcher, 2005). 相似文献
Data from surveys on local quality of life (QOL) in Switzerland amongthree age cohorts of a combined 87 000 recruits doing their basicmilitary training in 1978, 1987 and 1996 are used in this study in orderto answer the following questions: How stable was the QOLprofile of the whole country since 1978, and how much QOLprofiles changed since then at the four disaggregationlevels of the 26 cantons, 106 regions, 169 urban communities and 91neighborhoods or suburbs of the 7 largest urban agglomerations ofSwitzerland? At the first three disaggregation levels, most of theone-item measures used seem to be rather valid, i.e., they tended infact to generate stable as well as plausible results in unchangingsituations, or to react sensitively to “objectively” changingconditions of life. Where in public discourse QOL attributes arediffuse, i.e. where they are only loosely coupled to acertain village, town, region etc., or where the QOL profiles of smallerterritories are only based on answers of a few respondents, the strongerimpact that unknown measurement errors have under these conditions makesinterpreting the results of some single variables moredifficult. Especially at the level of cantons and regions, however, QOLprofiles defined by spatially well-focused sets of subjectiveindicators are easily interpretable and very stable. Through all threesurveys, they depict and preserve the distinctive characteristics of acanton or region remarkably well. In general, interpreting these surveyresults from the perspective of discursive social psychology proves tobe advantageous.