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BackgroundThe Global Burden of Disease (GBD) studies have transformed global understanding of health risks by producing comprehensive estimates of attributable disease burden, or the current disease that would be eliminated if a risk factor did not exist. Yet many have noted the greater policy significance of avoidable burden, or the future disease that could actually be eliminated if a risk factor were eliminated today. Avoidable risk may be considerably lower than attributable risk if baseline levels of exposure or disease are declining, or if a risk factor carries lagged effects on disease. As global efforts to deliver clean cookstoves accelerate, a temporal estimation of avoidable risk due to household air pollution (HAP) becomes increasingly important, particularly in light of the rapid uptake of modern stoves and ongoing epidemiologic transitions in regions like South and Southeast Asia.Methods and findingsWe estimate the avoidable burden associated with HAP using International Futures (IFs), an integrated forecasting system that has been used to model future global disease burdens and risk factors. Building on GBD and other estimates, we integrated a detailed HAP exposure estimation and exposure-response model into IFs. We then conducted a counterfactual experiment in which HAP exposure is reduced to theoretical minimum levels in 2015. We evaluated avoidable mortality and DALY reductions for the years 2015 to 2024 relative to a Base Case scenario in which only endogenous changes occurred. We present results by cause and region, looking at impacts on acute lower respiratory infection (ALRI) and four noncommunicable diseases (NCDs). We found that just 2.6% of global DALYs would be averted between 2015 and 2024, compared to 4.5% of global DALYs attributed to HAP in the 2010 GBD study, due in large part to the endogenous tendency towards declining traditional stove usage in the IFs base case forecast. The extent of diminished impact was comparable for ALRI and affected NCDs, though for different reasons. ALRI impacts diminish due to the declining burden of ALRI in the base case forecast, particularly apparent in South Asia and Southeast Asia. Although NCD burdens are rising in regions affected by HAP, the avoidable risk of NCD nonetheless diminishes due to lagged effects. Because the stove transition and the decline of ALRI are proceeding more slowly in Sub-Saharan Africa, avoidable impacts would also be more persistent (3.9% of total DALY due to HAP) compared to South Asia (3.6%) or Southeast Asia (2.5%).ConclusionsOur results illustrate how a temporal dynamic calculation of avoidable risk may yield different estimates, compared to a static attributable risk estimate, of the global and regional burden of disease. Our results suggest a window of rising and falling opportunity for HAP interventions that may have already closed in Southeast Asia and may be closing quickly in South Asia, but may remain open longer in Sub-Saharan Africa. A proper accounting of global health priorities should apply an avoidable risk framework that considers the role of ongoing social, economic and health transitions in constantly altering the disease and risk factor landscape.

Individual-based models (IBMs) are increasingly used in marine conservation research, making this is an ideal time to assess IBM use in marine policy. IBMs can contribute important information to marine management and policy questions, as they offer complex methods of understanding ecosystems and animal behaviour, by allowing for heterogeneity in both individuals and environments. A review of 108 international peer-review publications utilizing marine IBMs was conducted using Web of Science (WoS). It was determined that 55% of the WoS articles claimed that the IBMs were relevant or important to marine conservation policy or management. A relevant English-language policy document was located for 83% of the IBMs, but only 32% were cited, while 85% of the same policy documents cited a different, non-IBM, modelling method. A separate survey of 175 policy documents from the Government of Canada was conducted. Of the 60 that contained citations, zero documents cited an IBM, while 75% cited a different modelling method. Of 407 webpages reviewed from the National Oceanic and Atmospheric Administration, the New Zealand Department of Conservation, and the UK Government website, only 4% referenced IBMs. This research demonstrates that, despite claims of usefulness by researchers, IBMs are not used to inform policy, while other model methods are commonly cited. Modellers should not assume that their model will inherently be useful for policy and should instead ensure that they are: 1) addressing a policy need; and 2) making the information accessible to policymakers by crafting a communication plan and/or joining a relevant boundary organization. [ABSTRACT FROM AUTHOR]

Introduction Long-term forecasts of mortality and disease burden are essential for setting current and future health system priorities, yet few forecasts cover a wide range of nations over a long [...], Objective To develop an integrated health forecasting model as part of the International Futures (IFs) modelling system. Methods The IFs model begins with the historical relationships between economic and social development and cause- specific mortality used by the Global Burden of Disease project but builds forecasts from endogenous projections of these drivers by incorporating forward linkages from health outcomes back to inputs like population and economic growth. The hybrid IFs system adds alternative structural formulations for causes not well served by regression models and accounts for changes in proximate health risk factors. Forecasts are made to 2100 but findings are reported to 2060. Findings The base model projects that deaths from communicable diseases (CDs) will decline by 50%, whereas deaths from both non-communicable diseases (NCDs) and injuries will more than double. Considerable cross-national convergence in life expectancy will occur. Climate-induced fluctuations in agricultural yield will cause little excess childhood mortality from CDs, although other climate--health pathways were not explored. An optimistic scenario will produce 39 million fewer deaths in 2060 than a pessimistic one. Our forward linkage model suggests that an optimistic scenario would result in a 20% per cent increase in gross domestic product (GDP) per capita, despite one billion additional people. Southern Asia would experience the greatest relative mortality reduction and the largest resulting benefit in per capita GDP. Conclusion Long-term, integrated health forecasting helps us understand the links between health and other markers of human progress and offers powerful insight into key points of leverage for future improvements. Objectif Developper un modele integre de prevision sanitaire s'integrant dans le systeme de modelisation International Futures (IFs). Methodes Le modele IFs commence avec les relations historiques entre le developpement economique et social et la mortalite par cause utilisees par le projet Charge globale de la morbidite, mais il elabore des previsions a partir de projections endogenes de ces agents en reintegrant des donnees, comme la population et la croissance economique, aux correlations aval des resultats sanitaires. Le systeme hybride IFs ajoute des formulations structurelles alternatives pour des causes mal prises en compre par les modeles de regression et rend compte de modifications dans des facteurs proches de risque sanitaire. Les previsions sont faites pour 2100 mais les resultats sont exprimes pour 2060. Resultats Le modele de base prevoit que les morts par maladies contagieuses (MC) baisseront de 50%, tandis que les morts par maladies non contagieuses (MNC) et par blessures feront plus que doubler. Une forte convergence dans l'esperance de vie se produira entre les differents pays. Les fluctuations de la production agricole dues au climat entraineront un Ieger exces de mortalite infantile par MC, bien que d'autres approches climat-sante n'aient pas ete explorees. Un scenario optimiste produira 39 millions de morts de moins en 2060 qu'un scenario pessimiste. Notre modele de correlation en aval suggere qu'un scenario optimiste entranerait une augmentation du produit interieur brut (PIB) par tete de 20%, malgre le milliard de personnes supplementaires. L'Asie du Sud jouirait .de la plus forte reduction relative de mortalite et de la plus importante croissance du PIB par tete qui en resultera. Conclusion La prevision sanitaire integree a Iong terme nous aide a comprendre les liens entre la sante et les autres marqueurs de progres humain et met en evidence des points d'action cles pour des ameliorations futures. Objetivo Desarrollar un modelo de prediccion de salud integrado como parte del sistema de modelos International Futures (IF). Metodos El modelo IF comienza con las relaciones historicas entre desarrollo economico y social y mortalidad por causas especificas, utilizado por el proyecto Global Burden of Disease, pero genera predicciones a partir de proyecciones endogenas de estos causantes, incorporando asociaciones prospectivas de los resultados de salud que se remontan a aportaciones como la poblacion y el crecimiento economico. El sistema hibrido IF anade formulaciones estructurales alternativas para causas no muy bien tratadas en modelos de regresion y tiene en cuenta cambios en factores de riesgo proximos para la salud. Se hacen pronosticos hasta el 2100, pero se informa de los resultados hasta el 2060. Resultados El modelo de base proyecta que las muertes por enfermedades transmisibles (ET) disminuiran en un 50%, mientras que las muertes, tanto por enfermedades no transmisibles (ENT) como por lesiones, superaran el doble de lo actual. Se dara una convergencia transnacional apreciable en la esperanza de vida. Las fluctuaciones causadas por el clima en el rendimiento agricola causaran poco aumento de la mortalidad infantil causada por las ET, aunque no se investigaron otros patrones clima-salud. Una prediccion optimista dara 39 millones de muertes menos en el 2060 que una prediccion pesimista. Nuestro modelo de asociacion prospectiva sugiere que una prediccion optimista resultara en un aumento del 20% en el producto interior bruto (PIB) per capita, a pesar de los mil millones mas de personas. El Sur de Asia experimentara la mayor reduccion de la mortalidad relativa y el mayor beneficio resultante en el PIB per capita. Conclusion La prediccion de salud a largo plazo e integrada nos ayuda a entender las relaciones entre la salud y otros marcadores dei progreso humano y ofrece una ilustrativa perspectiva en puntos clave de influencia para mejoras futuras.

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.futures.2005.07.006 Byline: Kasper Kok (a)(b), Mita Patel (b), Dale S. Rothman (c), Giovanni Quaranta (d) Abstract: This paper builds on Part I, where three European and Mediterranean scenarios were introduced. Theses scenarios can be typified as qualitative, integrated narrative storylines that describe three possible directions of future change until 2030. The main purpose of the paper is to summarise the methods and results of a series of stakeholder workshops held in the Guadalentin (Spain) and the Val d'Agri (Italy) to develop local scenarios, using the Mediterranean scenarios as boundary conditions. Two workshops were organised in both watersheds, employing different methods to develop short-term and long-term future outlooks. During the first workshop an exploratory forecasting methodology was employed. By means of a collage of images, stakeholders constructed three future images linked to three Mediterranean scenarios. In the second workshop, a discussion on the short-term outlook based on current trends was followed by a backcasting exercise. The various methods yielded highly complementary results, with detailed short-term developments, rather general yet highly creative visions of the long-term future, and a set of desirable futures. It is argued that such a mix of methods has increased the quality and comprehensiveness of the results. In any case, these efforts should be but the onset of long-term stakeholder participation. Author Affiliation: (a) Laboratory of Soil Science and Geology, Wageningen University, P.O. Box 37, 6700 AA Wageningen, The Netherlands (b) International Centre for Integrative Studies, Maastricht, The Netherlands (c) The Macaulay Institute, Aberdeen, Scotland (d) Dipartimento Tecnico-Economico, Universita degli Studi della Basilicata, Potenza, Italia

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.futures.2005.07.001 Byline: Kasper Kok (a)(b), Dale S. Rothman (c), Mita Patel (b) Abstract: Desertification in the Northern Mediterranean region can be effectively managed only through an understanding of the principal ecological, socio-cultural and economic drivers. Scenarios can play an important role in the understanding of such a complex system. Following the fundamentals of Integrated Assessment, narrative storylines were developed that are qualitative, participatory, and highly integrated. Multi-scale long-term (2030) storylines were developed for Europe, the Northern Mediterranean, and for four local cases. This paper discusses the methodology and results of the process of developing European and Mediterranean scenarios. In Part II, the local scenario development by means of scenario workshops is elaborated upon. European and Mediterranean scenarios were based on a set of three existing European scenarios, that were adapted to fit the specific issues in the Mediterranean region, using the so-called Factor-Actor-Sector (FAS) framework. Resulting scenarios were Convulsive Change (disruptive climate change); Big is Beautiful (oversized EU and powerful multinationals); and Knowledge is King (technological development and mass migration). It proved possible to use and enrich a set of existing European scenarios and to translate them to fit the Mediterranean region. A possible use of this type of narrative storylines is further illustrated in Part II. Author Affiliation: (a) Laboratory of Soil Science and Geology, Wageningen University, P.O. Box 37, 6700 AA, Wageningen, The Netherlands (b) International Centre for Integrative Studies, Maastricht, The Netherlands (c) The Macaulay Institute, Aberdeen, Scotland

INTRODUCTION Energy demand is at the very heart of many economic and environmental issues. Energy has always played a key role in driving the economy, and it is recognized that [...]

After more than a decade of scientific warning, the policy community has begun to take up the challenge of global climate change. This paper considers recent efforts to analyze policymaking in this area. Shortcomings in present policy research include: (i) inconsistencies in data and methods, (ii) myopic vision of available options, (iii) overly anthropocentric cost/benefit assessments, (iv) inadequate treatment of uncertainly and irreversibility, (v) lack of recognition of developing and developed countries' differential motives, (vi) unsatisfactory presentation and interpretation of results, and (vii) limited peer review.