Boundary spanning at the science-policy interface: the practitioners' perspectives.

Cultivating a more dynamic relationship between science and policy is essential for responding to complex social challenges such as sustainability. One approach to doing so is to "span the boundaries" between science and decision making and create a more comprehensive and inclusive knowledge exchange process. The exact definition and role of boundary spanning, however, can be nebulous. Indeed, boundary spanning often gets conflated and confused with other approaches to connecting science and policy, such as science communication, applied science, and advocacy, which can hinder progress in the field of boundary spanning. To help overcome this, in this perspective, we present the outcomes from a recent workshop of boundary-spanning practitioners gathered to (1) articulate a definition of what it means to work at this interface ("boundary spanning") and the types of activities it encompasses; (2) present a value proposition of these efforts to build better relationships between science and policy; and (3) identify opportunities to more effectively mainstream boundary-spanning activities. Drawing on our collective experiences, we suggest that boundary spanning has the potential to increase the efficiency by which useful research is produced, foster the capacity to absorb new evidence and perspectives into sustainability decision-making, enhance research relevance for societal challenges, and open new policy windows. We provide examples from our work that illustrate this potential. By offering these propositions for the value of boundary spanning, we hope to encourage a more robust discussion of how to achieve evidence-informed decision-making for sustainability.

Hyperparathyroidism in the elderly.

Primary hyperparathyroidism seems to be increasing in incidence in elderly patients. Their symptoms are somewhat different from those encountered in younger patients, the most striking difference being the increase in the number of patients with mental changes. Twenty-nine patients, 23 women and 6 men, were treated at two community hospitals. Surgery was successful in all instances with no postoperative mortality and a low rate of complications. When properly evaluated, elderly patients tolerate parathyroid exploration very satisfactorily.

Primary retroperitoneal extraosseous osteogenic sarcoma: A case report and review of the literature.

A case of retroperitoneal extra-osseous osteogenic sarcoma is reviewed, as well as the criteria necessary for the diagnosis. The general characteristics and the differential diagnosis of the tumor are also presented.

Abdominal aortic aneurysm and horseshoe kidney in a 91-year-old man.

A 91-year-old man had a symptomatic, enlarging abdominal aortic aneurysm in association with horseshoe kidney. He underwent successful surgical resection. Difficulties, secondary to the inter-relationship of the renal artery supply and the aneurysm, are discussed. This patient is 15 years older than the previously oldest reported patient with these two associated anomalies.

Idiopathic rupture of the iliac vein.

Idiopathic rupture of large veins is very rare. There has been one report in the Portugese literature of such an instance involving the iliac vein. Our patient was an elderly woman in whom evidence of intra-abdominal hemorrhage developed. There was no clinical evidence of trauma. At laparotomy a large retroperitoneal hematoma secondary to an 8-mm tear in the left common iliac vein was found. The tear occurred adjacent to where the right common iliac artery passes over the vein. Repair was followed by uneventful recovery. Results of the pathological examination showed nonspecific information.

Primary hyperparathyroidism in children.

Three cases of primary hyperparathyroidism in children are presented and the literature reviewed. Symptoms of nausea, weight loss, and personality changes are more common in children than in adults with this disease. Children may have the diagnosis delayed because of failure to consider hyperparathyroidism. Surgery has been demonstrated to be most effective in treating this condition.