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Kenneth Mautner - One of the best experts on this subject based on the ideXlab platform.

  • highlights from the american medical society for sports medicine position statement on responsible use of regenerative medicine and orthobiologics in sports medicine
    British Journal of Sports Medicine, 2021
    Co-Authors: Shane A Shapiro, Jonathan T Finnoff, Kimberly G Harmon, Tariq M Awan, Joanne Borgstein, Daniel C Herman, Gerard A Malanga, Zubin Master, Kenneth Mautner
    Abstract:

    Musculoskeletal conditions including osteoarthritis and chronic tendinopathies are leading causes of pain and disability worldwide. The emergence of novel regenerative therapies, referred to as orthobiologics, has led to promising interventions which may reduce pain and improve function. Orthobiologics are biological substances intended to enhance healing and alter the natural course of orthopaedic disease.1 2 Despite growing experience, the field remains under-researched with inconsistent evidence; yet increasing enthusiasm has permitted overexuberant, sometimes inappropriate use with proliferation of misinformation among both providers and patients. An American Medical Society for Sports Medicine (AMSSM) position statement was developed to help sports medicine physicians make informed and responsible decisions about the role of regenerative medicine in their practice.3 The statement contains relevant terminology, review of basic and clinical Science, Ethics, regulations and best practices for considering regenerative medicine in clinical practice (figure 1). The statement seeks to educate physicians regarding a broad and emerging discipline and is not an endorsement by AMSSM of any specific product or procedure. Figure 1 Responsible use of orthobiologics and other novel regenerative therapies requires multiple considerations before translation into routine clinical practice. Regenerative medicine is rapidly growing with terms and definitions yet to be standardised. While originating with stem cell discovery and translation, regenerative therapies, of which orthobiologics is but one category, are no longer a single platform technology. Rather, they now encompass a heterogeneous collection of biological sources with varying activity that hold the potential to transform human health. Common orthobiologics employed in research and clinical practice are being conflated under the umbrella of ‘stem cell’ therapy in a …

Thomas A Kerr - One of the best experts on this subject based on the ideXlab platform.

  • Making Sustainable Decisions Using the KONVERGENCE Framework MAKING SUSTAINABLE DECISIONS USING THE KONVERGENCE FRAMEWORK
    2020
    Co-Authors: Steven J Piet, Patrick L Gibson, Jeffrey C Joe, Thomas A Kerr, Robert L Nitschke, Maxine E Dakins
    Abstract:

    ABSTRACT Hundreds of contaminated facilities and sites must be cleaned up. "Cleanup" includes decommissioning, environmental restoration, and waste management. Cleanup can be complex, expensive, risky, and time-consuming. Decisions are often controversial, can stall or be blocked, and are sometimes re-done -some before implementation, some decades later. Making and keeping decisions with long time horizons involves special difficulties and requires new approaches, including: New ways (mental model) to analyze and visualize the problem, Awareness of the option to shift strategy or reframe from a single decision to an adaptable network of decisions, and Improved tactical processes that account for several challenges. These include the following: Stakeholder values are a more fundamental basis for decision making and keeping than "meeting regulations." Late-entry players and future generations will question decisions. People may resist making "irreversible" decisions. People need "compelling reasons" to take action in the face of uncertainties. Our project goal is to make cleanup decisions easier to make, implement, keep, and sustain. By sustainability, we mean decisions that work better over the entire time-period-from when a decision is made, through implementation, to its end point. That is, alternatives that can be kept "as is" or adapted as circumstances change. Increased attention to sustainability and adaptability may decrease resistance to making and implementing decisions. Our KONVERGENCE framework addresses these challenges. The framework includes strategic improvements, i.e., expand the spectrum of alternatives to include adaptable alternatives and decision networks. It includes tactical process improvements derived from experience, values, and relevant literature. This paper includes diagnosis and medication (suggested path forward) for intractable cases. OVERVIEW Some cleanup decisions, such as cleanup of intractable contaminated sites or disposal of spent nuclear fuel, have proven difficult to make. Such decisions face high resistance to agreement from stakeholders possibly because they do not trust the decision makers, view the consequences of being wrong as too high, etc. Our project's goal is to improve Science-based cleanup decision-making. This includes diagnosing intractable situations, as a step to identifying a path toward sustainable solutions. We are two-thirds through an internally funded project to develop improved decision making approaches. Earlier papers describe the underlying philosophy of the KONVERGENCE Model for Sustainable Decisions,(1) the overall framework and process steps,(2) and diagnosis and prescription for intractable cases. guidebook for decision making,(4) containing more details, examples, and rationale than can be included here. This paper summarizes the project, emphasizing how to visualize disagreements and ways to make progress on stalled or intractable decisions. Testing of the ideas and process steps is underway; one successful test is described below. We invite your suggestions and opportunities for additional testing and exploration of these concepts. This is research and does not represent official positions of the Department of Energy or its contractors. Our framework addresses decision challenges with the following characteristics -complex and/or unusual relationships (of related decisions, among stakeholders, etc.), high likelihood for conflict, relatively high "stakes", and ramifications that extend over long time periods. We find relatively little decision Science/decision engineering work focused on this domain. Our particular field of application is cleanup of contaminated waste sites and facilities, but the framework should be applicable to other decision challenges with similar characteristics. The inadequacy of current approaches to long-term decision making is illustrated by the high degree of controversy and resultant stalling of some decisions, as well as revisiting past decisions. The National Research Council states, "Because uncertainty is inherent in many of these areas, and because DOE's preferred solutions -reliance on engineered barriers and institutional controls -are inherently failure prone, step-wise planning for DOE legacy sites must be systematic, integrative, comprehensive, and iterative in its execution through time, adaptive in the face of uncertainty, and active in the search for new and different solutions. Planning for long-term institutional management should commence while remediation is underway." One cause of difficulty in making long-lasting decisions is the way we approach them. The typical way we try to make controversial decisions is to attempt brute force to overcome resistance. Yet, in democratic societies, resistance can generally react to such brute force. We then get a force-resistance battle, stalling a decision, while the original problem remains. Perhaps it would be useful to break the single tough reaction (decision) into stages or reduce resistance by reducing the consequences of being wrong (more reversible thermodynamics). We have melded our experiences and analyses with ideas from decision Science, action Science, sociology, psychology, political Science, Ethics, history, "hard" Sciences, risk assessment, and many engineering disciplines. Our KONVERGENCE framework combines new ideas, modifications of others' ideas, and existing ideas. The framework includes (left side of We view regulations as an imperfect overlay or "snapshot" of values. An improved values component should make the decision more robust against "late entry" players. Laws & Regulations 01-GA50964-08 Fig. 2. Laws and regulations are an "overlap" of the Values universe The framework includes a generic set of 4 values and 20 principles that are a starting point for establishing "common ground" on both the process and objectives to select among alternatives. The four values are equality, democracy, trust, and reason. As an example, the generic 20 principles include two Precautionary Principles. Precautionary Principle 1-"Actions that pose a realistic threat of irreversible harm or catastrophic consequences should not be pursued unless there is some compelling countervailing need to benefit either current or future generations."(7) Precautionary Principle 2 -"Where there are threats of serious or irreversible damage, scientific uncertainty shall not be used to postpone cost-effective measures to prevent environmental degradation."(8) BASIS The theoretical ideal test would be multiple side-by-side applications of a real, messy problem with real stakeholders with their range of real concerns, time limitations, etc. -once using the framework and once without. Wait 100 years; see what happens. We have not performed such a test. To our knowledge, neither has anyone else. We have observed, analyzed, and done the following: The KONVERGENCE mental model is consistent with (and derived from) experience in many fields, including Kennedy's management of the decision to go to the moon,(1) the observation that many proposed actions have been consistent with regulations but ultimately blocked (Brent Spar (9,10) being a good example), the observation that past decisions to bury waste are now being re-examined because of changes in knowledge and priority among values, and the observation that decommissioning and cleanup of commercial reactors appears to be proceeding more smoothly than for DOE facilities. Regarding the last point, the values of the affected people are similar; the technical challenges at DOE sites may be slightly more difficult; but the confidence in provision of resources is very different because commercial reactors have trust funds and DOE facilities are subject to yearly budget battles. The strategic framing elements (emphasis on adaptability and decision networks) are consistent with the mental model, recommendations from the National Research Council (5, 11, 12) and National Academy of Public Administration,(7) common negotiation concepts (work in steps to earn confidence), the observation that decisions are often modified in practice (see for example Step 1" section below summarizes many factors that can increase or decrease resistance to making a decision. We have tested the basic ideas with diverse people, including students, colleagues, waste management/decommissioning personnel, volunteers from the INEEL Citizen's Advisory Board, and facilitation practitioners. We encourage feedback from you! We have partially tested most process parts: o Real, but simple problem, Citizen's Advisory Board volunteers, knowing that this was only a test. o Real, messy problem, ourselves, knowing we will not make the decision. o Real, messy problem, class of students, knowing that they will not actually be making a decision. They konverged without the need for weighting, utility functions, or controversy, but with variations that increase the "adaptability" of the selected alternative. (See below.) o We are looking to assist decision making; we propose to proceed in a step-wise manner starting with internal testing and proceeding cautiously. We have melded our experiences and analyses with ideas from decision Science, action Science, sociology, psychology, political Science, Ethics, history, physical Sciences, risk assessment, and many engineering disciplines. The team's experience includes a former member of the INEEL Citizen's Advisory Board (who is WM'03 Conference, February 23-27, 2003, Tucson, AZ Page 5 of 21 now a professor at the University of Idaho), an expert in the middle of the effort to site a low-level waste disposal facility in Illinois, engineers with 2 decades of experience at the INEEL, experience in commercial nuclear projects, experience in international projects (a good way to understand U.S. culture is to work and live elsewhere), experience in adjusting the direction of energy technology development to increase the chance for societal interest, and a social scientist relatively new to the INEEL

  • MAKING SUSTAINABLE DECISIONS USING THE KONVERGENCE FRAMEWORK
    2020
    Co-Authors: Steven J Piet, Patrick L Gibson, Jeffrey C Joe, Thomas A Kerr, Robert L Nitschke, Maxine E Dakins
    Abstract:

    ABSTRACT Hundreds of contaminated facilities and sites must be cleaned up. "Cleanup" includes decommissioning, environmental restoration, and waste management. Cleanup can be complex, expensive, risky, and time-consuming. Decisions are often controversial, can stall or be blocked, and are sometimes re-done -some before implementation, some decades later. Making and keeping decisions with long time horizons involves special difficulties and requires new approaches, including: • New ways (mental model) to analyze and visualize the problem, • Awareness of the option to shift strategy or reframe from a single decision to an adaptable network of decisions, and • Improved tactical processes that account for several challenges. These include the following: • Stakeholder values are a more fundamental basis for decision making and keeping than "meeting regulations." • Late-entry players and future generations will question decisions. • People may resist making "irreversible" decisions. • People need "compelling reasons" to take action in the face of uncertainties. Our project goal is to make cleanup decisions easier to make, implement, keep, and sustain. By sustainability, we mean decisions that work better over the entire time-period-from when a decision is made, through implementation, to its end point. That is, alternatives that can be kept "as is" or adapted as circumstances change. Increased attention to sustainability and adaptability may decrease resistance to making and implementing decisions. Our KONVERGENCE framework addresses these challenges. The framework is based on a mental model that states: where Knowledge, Values, and Resources converge (the K, V, R in KONVERGENCE), you will find a sustainable decision. We define these areas or universes as follows: • Knowledge: what is known about the problem and possible solutions? • Values: what is important to those affected by the decision? • Resources: what is available to implement possible solutions or improve knowledge? This mental model helps analyze and visualize what is happening as decisions are made and kept. Why is there disagreement? Is there movement toward konvergence? Is a past decision drifting out of konvergence? The framework includes strategic improvements, i.e., expand the spectrum of alternatives to include adaptable alternatives and decision networks. It includes tactical process improvements derived from experience, values, and relevant literature. This paper includes diagnosis and medication (suggested path forward) for intractable cases. OVERVIEW Some cleanup decisions, such as cleanup of intractable contaminated sites or disposal of spent nuclear fuel, have proven difficult to make. Such decisions face high resistance to agreement from stakeholders possibly because they do not trust the decision makers, view the consequences of being wrong as too high, etc. Our project's goal is to improve Science-based cleanup decision-making. This includes diagnosing intractable situations, as a step to identifying a path toward sustainable solutions. We are two-thirds through an internally funded project to develop improved decision making approaches. Earlier papers describe the underlying philosophy of the KONVERGENCE Model for Sustainable Decisions,(1) the overall framework and process steps,(2) and diagnosis and prescription for intractable cases. guidebook for decision making,(4) containing more details, examples, and rationale than can be included here. This paper summarizes the project, emphasizing how to visualize disagreements and ways to make progress on stalled or intractable decisions. Testing of the ideas and process steps is underway; one successful test is described below. We invite your suggestions and opportunities for additional testing and exploration of these concepts. This is research and does not represent official positions of the Department of Energy or its contractors. Our framework addresses decision challenges with the following characteristics -complex and/or unusual relationships (of related decisions, among stakeholders, etc.), high likelihood for conflict, relatively high "stakes", and ramifications that extend over long time periods. We find relatively little decision Science/decision engineering work focused on this domain. Our particular field of application is cleanup of contaminated waste sites and facilities, but the framework should be applicable to other decision challenges with similar characteristics. The inadequacy of current approaches to long-term decision making is illustrated by the high degree of controversy and resultant stalling of some decisions, as well as revisiting past decisions. The National Research Council states, "Because uncertainty is inherent in many of these areas, and because DOE's preferred solutions -reliance on engineered barriers and institutional controls -are inherently failure prone, step-wise planning for DOE legacy sites must be systematic, integrative, comprehensive, and iterative in its execution through time, adaptive in the face of uncertainty, and active in the search for new and different solutions. Planning for long-term institutional management should commence while remediation is underway." One cause of difficulty in making long-lasting decisions is the way we approach them. The typical way we try to make controversial decisions is to attempt brute force to overcome resistance. Yet, in democratic societies, resistance can generally react to such brute force. We then get a force-resistance battle, stalling a decision, while the original problem remains. Perhaps it would be useful to break the single tough reaction (decision) into stages or reduce resistance by reducing the consequences of being wrong (more reversible thermodynamics). We have melded our experiences and analyses with ideas from decision Science, action Science, sociology, psychology, political Science, Ethics, history, "hard" Sciences, risk assessment, and many engineering disciplines. Our KONVERGENCE framework combines new ideas, modifications of others' ideas, and existing ideas. The framework is based on a mental model that states: where Knowledge, Values, and Resources konverge (the K, V, R in KONVERGENCE), you will find a sustainable decision -a decision that works over time. • Knowledge: what is known about the problem and possible solutions? • Values: what is important to those affected by the decision? • Resources: what is available to implement possible solutions or improve knowledge? The framework includes (left side of • A mental model, KONVERGENCE, that describes some of the underlying decision dynamics that require cleanup alternatives to be (and to remain) konvergent with knowledge, values, and resources so the decision works over time (right side of We view regulations as an imperfect overlay or "snapshot" of values. Laws & Regulations 01-GA50964-08 Fig. 2. Laws and regulations are an "overlap" of the Values universe The framework includes a generic set of 4 values and 20 principles that are a starting point for establishing "common ground" on both the process and objectives to select among alternatives. The four values are equality, democracy, trust, and reason. As an example, the generic 20 principles include two Precautionary Principles. • Precautionary Principle 1-"Actions that pose a realistic threat of irreversible harm or catastrophic consequences should not be pursued unless there is some compelling countervailing need to benefit either current or future generations."(7) • Precautionary Principle 2 -"Where there are threats of serious or irreversible damage, scientific uncertainty shall not be used to postpone cost-effective measures to prevent environmental degradation."(8) BASIS The theoretical ideal test would be multiple side-by-side applications of a real, messy problem with real stakeholders with their range of real concerns, time limitations, etc. -once using the framework and once without. Wait 100 years; see what happens. We have not performed such a test. To our knowledge, neither has anyone else. We have observed, analyzed, and done the following: • The KONVERGENCE mental model is consistent with (and derived from) experience in many fields, including Kennedy's management of the decision to go to the moon,(1) the observation that many proposed actions have been consistent with regulations but ultimately blocked (Brent Spar (9,10) being a good example), the observation that past decisions to bury waste are now being re-examined because of changes in knowledge and priority among values, and the observation that decommissioning and cleanup of commercial reactors appears to be proceeding more smoothly than for DOE facilities. Regarding the last point, the values of the affected people are similar; the technical challenges at DOE sites may be slightly more difficult; but the confidence in provision of resources is very different because commercial reactors have trust funds and DOE facilities are subject to yearly budget battles. • The strategic framing elements (emphasis on adaptability and decision networks) are consistent with the mental model, recommendations from the National Research Council (5, 11, 12) and National Academy of Public Administration,(7) common negotiation concepts (work in steps to earn confidence), the observation that decisions are often modified in practice (see for example • The tactical process elements, especially the emphasis on understanding the broad range of values/principles, the search for common ground, and building process steps on principles are consistent with the best recommendations of facilitation/negotiation practitioners, and a range of social Science studies. The " Step 1" section below summarizes many factors that can increase or decrease resistance to making a decision. • We have tested the basic ideas with diverse people, including students, colleagues, waste management/decommissioning personnel, volunteers from the INEEL Citizen's Advisory Board, and facilitation practitioners. We encourage feedback from you! • We have partially tested most process parts: o Real, but simple problem, Citizen's Advisory Board volunteers, knowing that this was only a test. o Real, messy problem, ourselves, knowing we will not make the decision. o Real, messy problem, class of students, knowing that they will not actually be making a decision. They konverged without the need for weighting, utility functions, or controversy, but with variations that increase the "adaptability" of the selected alternative. (See below.) o We are looking to assist decision making; we propose to proceed in a step-wise manner starting with internal testing and proceeding cautiously. • We have melded our experiences and analyses with ideas from decision Science, action Science, sociology, psychology, political Science, Ethics, history, physical Sciences, risk assessment, and many engineering disciplines now a professor at the University of Idaho), an expert in the middle of the effort to site a low-level waste disposal facility in Illinois, engineers with 2 decades of experience at the INEEL, experience in commercial nuclear projects, experience in international projects (a good way to understand U.S. culture is to work and live elsewhere), experience in adjusting the direction of energy technology development to increase the chance for societal interest, and a social scientist relatively new to the INEEL

David C J Main - One of the best experts on this subject based on the ideXlab platform.

  • evolution of animal welfare education for veterinary students
    Journal of Veterinary Medical Education, 2010
    Co-Authors: David C J Main
    Abstract:

    Animal-welfare education is an evolving component of the veterinary curriculum. Although different veterinary schools may cover different elements of the subject and teach it in many different ways, it is important to recognize that this multidisciplinary subject is evolving rapidly. For example, welfare Science is beginning to examine the quantification of positive welfare or a good life in addition to evaluating harms associated with different husbandry systems. Although the curriculum is under continual pressure, the drivers (policy makers, student expectations, and trade requirements) for including animal welfare in the course are likely to increase. Some core components of an animal-welfare course are important to include in all veterinary curriculums. This would include an appreciation of the difference between welfare Science, Ethics, and standards.

  • teaching animal welfare Science Ethics and law to veterinary students in the united kingdom
    Journal of Veterinary Medical Education, 2005
    Co-Authors: David C J Main, P Thornton, K Kerr
    Abstract:

    Teaching veterinary students about animal welfare Science, Ethics, and law has been identified as a priority of the veterinary curriculum. Suggested content for such a course, the stage at which it should be taught, and possible methods of teaching and assessing the subject have been outlined. Critically, such a course needs to address the quantification of the impact of humans on animals (welfare Science), the analysis of our moral obligations (welfare Ethics), and knowledge of minimum welfare standards (welfare legislation). A mixture of both teaching methods and assessment techniques is needed to ensure that sufficient skills and knowledge and a deeper understanding are achieved.

Shane A Shapiro - One of the best experts on this subject based on the ideXlab platform.

  • highlights from the american medical society for sports medicine position statement on responsible use of regenerative medicine and orthobiologics in sports medicine
    British Journal of Sports Medicine, 2021
    Co-Authors: Shane A Shapiro, Jonathan T Finnoff, Kimberly G Harmon, Tariq M Awan, Joanne Borgstein, Daniel C Herman, Gerard A Malanga, Zubin Master, Kenneth Mautner
    Abstract:

    Musculoskeletal conditions including osteoarthritis and chronic tendinopathies are leading causes of pain and disability worldwide. The emergence of novel regenerative therapies, referred to as orthobiologics, has led to promising interventions which may reduce pain and improve function. Orthobiologics are biological substances intended to enhance healing and alter the natural course of orthopaedic disease.1 2 Despite growing experience, the field remains under-researched with inconsistent evidence; yet increasing enthusiasm has permitted overexuberant, sometimes inappropriate use with proliferation of misinformation among both providers and patients. An American Medical Society for Sports Medicine (AMSSM) position statement was developed to help sports medicine physicians make informed and responsible decisions about the role of regenerative medicine in their practice.3 The statement contains relevant terminology, review of basic and clinical Science, Ethics, regulations and best practices for considering regenerative medicine in clinical practice (figure 1). The statement seeks to educate physicians regarding a broad and emerging discipline and is not an endorsement by AMSSM of any specific product or procedure. Figure 1 Responsible use of orthobiologics and other novel regenerative therapies requires multiple considerations before translation into routine clinical practice. Regenerative medicine is rapidly growing with terms and definitions yet to be standardised. While originating with stem cell discovery and translation, regenerative therapies, of which orthobiologics is but one category, are no longer a single platform technology. Rather, they now encompass a heterogeneous collection of biological sources with varying activity that hold the potential to transform human health. Common orthobiologics employed in research and clinical practice are being conflated under the umbrella of ‘stem cell’ therapy in a …

Steven J Piet - One of the best experts on this subject based on the ideXlab platform.

  • Making Sustainable Decisions Using the KONVERGENCE Framework MAKING SUSTAINABLE DECISIONS USING THE KONVERGENCE FRAMEWORK
    2020
    Co-Authors: Steven J Piet, Patrick L Gibson, Jeffrey C Joe, Thomas A Kerr, Robert L Nitschke, Maxine E Dakins
    Abstract:

    ABSTRACT Hundreds of contaminated facilities and sites must be cleaned up. "Cleanup" includes decommissioning, environmental restoration, and waste management. Cleanup can be complex, expensive, risky, and time-consuming. Decisions are often controversial, can stall or be blocked, and are sometimes re-done -some before implementation, some decades later. Making and keeping decisions with long time horizons involves special difficulties and requires new approaches, including: New ways (mental model) to analyze and visualize the problem, Awareness of the option to shift strategy or reframe from a single decision to an adaptable network of decisions, and Improved tactical processes that account for several challenges. These include the following: Stakeholder values are a more fundamental basis for decision making and keeping than "meeting regulations." Late-entry players and future generations will question decisions. People may resist making "irreversible" decisions. People need "compelling reasons" to take action in the face of uncertainties. Our project goal is to make cleanup decisions easier to make, implement, keep, and sustain. By sustainability, we mean decisions that work better over the entire time-period-from when a decision is made, through implementation, to its end point. That is, alternatives that can be kept "as is" or adapted as circumstances change. Increased attention to sustainability and adaptability may decrease resistance to making and implementing decisions. Our KONVERGENCE framework addresses these challenges. The framework includes strategic improvements, i.e., expand the spectrum of alternatives to include adaptable alternatives and decision networks. It includes tactical process improvements derived from experience, values, and relevant literature. This paper includes diagnosis and medication (suggested path forward) for intractable cases. OVERVIEW Some cleanup decisions, such as cleanup of intractable contaminated sites or disposal of spent nuclear fuel, have proven difficult to make. Such decisions face high resistance to agreement from stakeholders possibly because they do not trust the decision makers, view the consequences of being wrong as too high, etc. Our project's goal is to improve Science-based cleanup decision-making. This includes diagnosing intractable situations, as a step to identifying a path toward sustainable solutions. We are two-thirds through an internally funded project to develop improved decision making approaches. Earlier papers describe the underlying philosophy of the KONVERGENCE Model for Sustainable Decisions,(1) the overall framework and process steps,(2) and diagnosis and prescription for intractable cases. guidebook for decision making,(4) containing more details, examples, and rationale than can be included here. This paper summarizes the project, emphasizing how to visualize disagreements and ways to make progress on stalled or intractable decisions. Testing of the ideas and process steps is underway; one successful test is described below. We invite your suggestions and opportunities for additional testing and exploration of these concepts. This is research and does not represent official positions of the Department of Energy or its contractors. Our framework addresses decision challenges with the following characteristics -complex and/or unusual relationships (of related decisions, among stakeholders, etc.), high likelihood for conflict, relatively high "stakes", and ramifications that extend over long time periods. We find relatively little decision Science/decision engineering work focused on this domain. Our particular field of application is cleanup of contaminated waste sites and facilities, but the framework should be applicable to other decision challenges with similar characteristics. The inadequacy of current approaches to long-term decision making is illustrated by the high degree of controversy and resultant stalling of some decisions, as well as revisiting past decisions. The National Research Council states, "Because uncertainty is inherent in many of these areas, and because DOE's preferred solutions -reliance on engineered barriers and institutional controls -are inherently failure prone, step-wise planning for DOE legacy sites must be systematic, integrative, comprehensive, and iterative in its execution through time, adaptive in the face of uncertainty, and active in the search for new and different solutions. Planning for long-term institutional management should commence while remediation is underway." One cause of difficulty in making long-lasting decisions is the way we approach them. The typical way we try to make controversial decisions is to attempt brute force to overcome resistance. Yet, in democratic societies, resistance can generally react to such brute force. We then get a force-resistance battle, stalling a decision, while the original problem remains. Perhaps it would be useful to break the single tough reaction (decision) into stages or reduce resistance by reducing the consequences of being wrong (more reversible thermodynamics). We have melded our experiences and analyses with ideas from decision Science, action Science, sociology, psychology, political Science, Ethics, history, "hard" Sciences, risk assessment, and many engineering disciplines. Our KONVERGENCE framework combines new ideas, modifications of others' ideas, and existing ideas. The framework includes (left side of We view regulations as an imperfect overlay or "snapshot" of values. An improved values component should make the decision more robust against "late entry" players. Laws & Regulations 01-GA50964-08 Fig. 2. Laws and regulations are an "overlap" of the Values universe The framework includes a generic set of 4 values and 20 principles that are a starting point for establishing "common ground" on both the process and objectives to select among alternatives. The four values are equality, democracy, trust, and reason. As an example, the generic 20 principles include two Precautionary Principles. Precautionary Principle 1-"Actions that pose a realistic threat of irreversible harm or catastrophic consequences should not be pursued unless there is some compelling countervailing need to benefit either current or future generations."(7) Precautionary Principle 2 -"Where there are threats of serious or irreversible damage, scientific uncertainty shall not be used to postpone cost-effective measures to prevent environmental degradation."(8) BASIS The theoretical ideal test would be multiple side-by-side applications of a real, messy problem with real stakeholders with their range of real concerns, time limitations, etc. -once using the framework and once without. Wait 100 years; see what happens. We have not performed such a test. To our knowledge, neither has anyone else. We have observed, analyzed, and done the following: The KONVERGENCE mental model is consistent with (and derived from) experience in many fields, including Kennedy's management of the decision to go to the moon,(1) the observation that many proposed actions have been consistent with regulations but ultimately blocked (Brent Spar (9,10) being a good example), the observation that past decisions to bury waste are now being re-examined because of changes in knowledge and priority among values, and the observation that decommissioning and cleanup of commercial reactors appears to be proceeding more smoothly than for DOE facilities. Regarding the last point, the values of the affected people are similar; the technical challenges at DOE sites may be slightly more difficult; but the confidence in provision of resources is very different because commercial reactors have trust funds and DOE facilities are subject to yearly budget battles. The strategic framing elements (emphasis on adaptability and decision networks) are consistent with the mental model, recommendations from the National Research Council (5, 11, 12) and National Academy of Public Administration,(7) common negotiation concepts (work in steps to earn confidence), the observation that decisions are often modified in practice (see for example Step 1" section below summarizes many factors that can increase or decrease resistance to making a decision. We have tested the basic ideas with diverse people, including students, colleagues, waste management/decommissioning personnel, volunteers from the INEEL Citizen's Advisory Board, and facilitation practitioners. We encourage feedback from you! We have partially tested most process parts: o Real, but simple problem, Citizen's Advisory Board volunteers, knowing that this was only a test. o Real, messy problem, ourselves, knowing we will not make the decision. o Real, messy problem, class of students, knowing that they will not actually be making a decision. They konverged without the need for weighting, utility functions, or controversy, but with variations that increase the "adaptability" of the selected alternative. (See below.) o We are looking to assist decision making; we propose to proceed in a step-wise manner starting with internal testing and proceeding cautiously. We have melded our experiences and analyses with ideas from decision Science, action Science, sociology, psychology, political Science, Ethics, history, physical Sciences, risk assessment, and many engineering disciplines. The team's experience includes a former member of the INEEL Citizen's Advisory Board (who is WM'03 Conference, February 23-27, 2003, Tucson, AZ Page 5 of 21 now a professor at the University of Idaho), an expert in the middle of the effort to site a low-level waste disposal facility in Illinois, engineers with 2 decades of experience at the INEEL, experience in commercial nuclear projects, experience in international projects (a good way to understand U.S. culture is to work and live elsewhere), experience in adjusting the direction of energy technology development to increase the chance for societal interest, and a social scientist relatively new to the INEEL

  • MAKING SUSTAINABLE DECISIONS USING THE KONVERGENCE FRAMEWORK
    2020
    Co-Authors: Steven J Piet, Patrick L Gibson, Jeffrey C Joe, Thomas A Kerr, Robert L Nitschke, Maxine E Dakins
    Abstract:

    ABSTRACT Hundreds of contaminated facilities and sites must be cleaned up. "Cleanup" includes decommissioning, environmental restoration, and waste management. Cleanup can be complex, expensive, risky, and time-consuming. Decisions are often controversial, can stall or be blocked, and are sometimes re-done -some before implementation, some decades later. Making and keeping decisions with long time horizons involves special difficulties and requires new approaches, including: • New ways (mental model) to analyze and visualize the problem, • Awareness of the option to shift strategy or reframe from a single decision to an adaptable network of decisions, and • Improved tactical processes that account for several challenges. These include the following: • Stakeholder values are a more fundamental basis for decision making and keeping than "meeting regulations." • Late-entry players and future generations will question decisions. • People may resist making "irreversible" decisions. • People need "compelling reasons" to take action in the face of uncertainties. Our project goal is to make cleanup decisions easier to make, implement, keep, and sustain. By sustainability, we mean decisions that work better over the entire time-period-from when a decision is made, through implementation, to its end point. That is, alternatives that can be kept "as is" or adapted as circumstances change. Increased attention to sustainability and adaptability may decrease resistance to making and implementing decisions. Our KONVERGENCE framework addresses these challenges. The framework is based on a mental model that states: where Knowledge, Values, and Resources converge (the K, V, R in KONVERGENCE), you will find a sustainable decision. We define these areas or universes as follows: • Knowledge: what is known about the problem and possible solutions? • Values: what is important to those affected by the decision? • Resources: what is available to implement possible solutions or improve knowledge? This mental model helps analyze and visualize what is happening as decisions are made and kept. Why is there disagreement? Is there movement toward konvergence? Is a past decision drifting out of konvergence? The framework includes strategic improvements, i.e., expand the spectrum of alternatives to include adaptable alternatives and decision networks. It includes tactical process improvements derived from experience, values, and relevant literature. This paper includes diagnosis and medication (suggested path forward) for intractable cases. OVERVIEW Some cleanup decisions, such as cleanup of intractable contaminated sites or disposal of spent nuclear fuel, have proven difficult to make. Such decisions face high resistance to agreement from stakeholders possibly because they do not trust the decision makers, view the consequences of being wrong as too high, etc. Our project's goal is to improve Science-based cleanup decision-making. This includes diagnosing intractable situations, as a step to identifying a path toward sustainable solutions. We are two-thirds through an internally funded project to develop improved decision making approaches. Earlier papers describe the underlying philosophy of the KONVERGENCE Model for Sustainable Decisions,(1) the overall framework and process steps,(2) and diagnosis and prescription for intractable cases. guidebook for decision making,(4) containing more details, examples, and rationale than can be included here. This paper summarizes the project, emphasizing how to visualize disagreements and ways to make progress on stalled or intractable decisions. Testing of the ideas and process steps is underway; one successful test is described below. We invite your suggestions and opportunities for additional testing and exploration of these concepts. This is research and does not represent official positions of the Department of Energy or its contractors. Our framework addresses decision challenges with the following characteristics -complex and/or unusual relationships (of related decisions, among stakeholders, etc.), high likelihood for conflict, relatively high "stakes", and ramifications that extend over long time periods. We find relatively little decision Science/decision engineering work focused on this domain. Our particular field of application is cleanup of contaminated waste sites and facilities, but the framework should be applicable to other decision challenges with similar characteristics. The inadequacy of current approaches to long-term decision making is illustrated by the high degree of controversy and resultant stalling of some decisions, as well as revisiting past decisions. The National Research Council states, "Because uncertainty is inherent in many of these areas, and because DOE's preferred solutions -reliance on engineered barriers and institutional controls -are inherently failure prone, step-wise planning for DOE legacy sites must be systematic, integrative, comprehensive, and iterative in its execution through time, adaptive in the face of uncertainty, and active in the search for new and different solutions. Planning for long-term institutional management should commence while remediation is underway." One cause of difficulty in making long-lasting decisions is the way we approach them. The typical way we try to make controversial decisions is to attempt brute force to overcome resistance. Yet, in democratic societies, resistance can generally react to such brute force. We then get a force-resistance battle, stalling a decision, while the original problem remains. Perhaps it would be useful to break the single tough reaction (decision) into stages or reduce resistance by reducing the consequences of being wrong (more reversible thermodynamics). We have melded our experiences and analyses with ideas from decision Science, action Science, sociology, psychology, political Science, Ethics, history, "hard" Sciences, risk assessment, and many engineering disciplines. Our KONVERGENCE framework combines new ideas, modifications of others' ideas, and existing ideas. The framework is based on a mental model that states: where Knowledge, Values, and Resources konverge (the K, V, R in KONVERGENCE), you will find a sustainable decision -a decision that works over time. • Knowledge: what is known about the problem and possible solutions? • Values: what is important to those affected by the decision? • Resources: what is available to implement possible solutions or improve knowledge? The framework includes (left side of • A mental model, KONVERGENCE, that describes some of the underlying decision dynamics that require cleanup alternatives to be (and to remain) konvergent with knowledge, values, and resources so the decision works over time (right side of We view regulations as an imperfect overlay or "snapshot" of values. Laws & Regulations 01-GA50964-08 Fig. 2. Laws and regulations are an "overlap" of the Values universe The framework includes a generic set of 4 values and 20 principles that are a starting point for establishing "common ground" on both the process and objectives to select among alternatives. The four values are equality, democracy, trust, and reason. As an example, the generic 20 principles include two Precautionary Principles. • Precautionary Principle 1-"Actions that pose a realistic threat of irreversible harm or catastrophic consequences should not be pursued unless there is some compelling countervailing need to benefit either current or future generations."(7) • Precautionary Principle 2 -"Where there are threats of serious or irreversible damage, scientific uncertainty shall not be used to postpone cost-effective measures to prevent environmental degradation."(8) BASIS The theoretical ideal test would be multiple side-by-side applications of a real, messy problem with real stakeholders with their range of real concerns, time limitations, etc. -once using the framework and once without. Wait 100 years; see what happens. We have not performed such a test. To our knowledge, neither has anyone else. We have observed, analyzed, and done the following: • The KONVERGENCE mental model is consistent with (and derived from) experience in many fields, including Kennedy's management of the decision to go to the moon,(1) the observation that many proposed actions have been consistent with regulations but ultimately blocked (Brent Spar (9,10) being a good example), the observation that past decisions to bury waste are now being re-examined because of changes in knowledge and priority among values, and the observation that decommissioning and cleanup of commercial reactors appears to be proceeding more smoothly than for DOE facilities. Regarding the last point, the values of the affected people are similar; the technical challenges at DOE sites may be slightly more difficult; but the confidence in provision of resources is very different because commercial reactors have trust funds and DOE facilities are subject to yearly budget battles. • The strategic framing elements (emphasis on adaptability and decision networks) are consistent with the mental model, recommendations from the National Research Council (5, 11, 12) and National Academy of Public Administration,(7) common negotiation concepts (work in steps to earn confidence), the observation that decisions are often modified in practice (see for example • The tactical process elements, especially the emphasis on understanding the broad range of values/principles, the search for common ground, and building process steps on principles are consistent with the best recommendations of facilitation/negotiation practitioners, and a range of social Science studies. The " Step 1" section below summarizes many factors that can increase or decrease resistance to making a decision. • We have tested the basic ideas with diverse people, including students, colleagues, waste management/decommissioning personnel, volunteers from the INEEL Citizen's Advisory Board, and facilitation practitioners. We encourage feedback from you! • We have partially tested most process parts: o Real, but simple problem, Citizen's Advisory Board volunteers, knowing that this was only a test. o Real, messy problem, ourselves, knowing we will not make the decision. o Real, messy problem, class of students, knowing that they will not actually be making a decision. They konverged without the need for weighting, utility functions, or controversy, but with variations that increase the "adaptability" of the selected alternative. (See below.) o We are looking to assist decision making; we propose to proceed in a step-wise manner starting with internal testing and proceeding cautiously. • We have melded our experiences and analyses with ideas from decision Science, action Science, sociology, psychology, political Science, Ethics, history, physical Sciences, risk assessment, and many engineering disciplines now a professor at the University of Idaho), an expert in the middle of the effort to site a low-level waste disposal facility in Illinois, engineers with 2 decades of experience at the INEEL, experience in commercial nuclear projects, experience in international projects (a good way to understand U.S. culture is to work and live elsewhere), experience in adjusting the direction of energy technology development to increase the chance for societal interest, and a social scientist relatively new to the INEEL