The role of experts in policy making

As public policy issues increasingly have a technical aspect to them an interactive relationship has developed between science and policy. The aim of this thesis is to investigate the two aspects of this relationship: the influence of science on policy and the influence of policy implications on science. Most existing studies in this area treat only one or other of these aspects. Furthermore, they tend to provide interesting case study material but very little theoretical analysis. This thesis attempts to overcome these problems by dealing with both aspects of the interaction between science and policy and by providing theoretical models of this relationship. The thesis combines the theoretical development of these models with the analysis of three empirical case studies: the controversy in Britain over smoking and health; the application of educational psychology to the development of education policy in Britain; the controversy over the health effect of lead in the environment. The theoretical models are developed in Part 1. In Part 2 the empirical case studies are presented and in Part 3 the theoretical material is assessed in the light of these case studies. The main thesis of this study is that there is a fundamental mismatch between science and policy-making. Criticism is always essential in science. However, when science is involved in the policy process, either scientific claims are not subjected to a significant level of criticism or they are scrutinized so closely that no view achieves general consensus and conflicting advice results. In this situation, contrary to the traditional view, science can generate uncertainty. The role which science plays in the policy process is influenced by this level of criticism, by the context of political power and by the progress of an issue through the various stages of the policy process.

Retinal and systemic vascular function in health and disease: the effect of smoking and coronary artery disease

The purpose of the following studies was to explore the effect of systemic vascular and endothelial dysfunction upon the ocular circulation and functionality of the retina. There are 6 principal sections to the present work. Retinal vessel activity in smokers and non-smokers: the principal findings of this work were: chronic smoking affects retinal vessel motion at baseline and during stimulation with flickering light; chronic smoking leads to a vaso-constrictory shift in retinal arteriolar reactivity to flicker; retinal arteriolar elasticity is decreased in chronic smokers. The effect of acute smoking on retinal vessel dynamics in smokers and non-smokers: the principal finding of this work was that retinal reactivity in chronic smokers is blunted when exposed to clicker light provocation immediately after smoking one cigarette. Ocular blood flow in coronary artery disease: The principal findings of this work were: retrobulbar and retinal blood flow is preserved in CAD patients, despite a change pulse wave transmission; arterial retinal response to flickering light provocation is significantly delayed in CAD patients; retinal venular diameters are significantly dilated in CAD patients. Autonomic nervous system function and peripheral circulation in CAD: The principal findings in this work were: CAD patients demonstrate a sympathetic overdrive during a 24 period; a delay in peripheral vascular reactivity (nail-fold capillaries) as observed in patients suffering from CAD could be caused by either arteriosclerotic changes of the vascular walls or due to systemic haemodynamic changes. Visual function in CAD: The principal findings in this work were: overall visual function in CAD patients is preserved, despite a decrease in contrast sensitivity; applying a filtering technique selecting those with greater coefficient of variance which in turn represents a decrease in reliability, some patients appear to have an impaired visual function as assessed using FDT visual field evaluation. Multiple functional, structural and biochemical vascular endothelial dysfunctions in patients suffering from CAD: relationships and possible implications: The principal findings of this work were: BMI significantly correlated with vWF (a marker of endothelial function) in CAD patients. Retinal vascular reactivity showed a significant correlation with peripheral reactivity parameters in controls which lacked in the CAD group and could reflect a loss in vascular endothelial integrity; visual field parameters as assessed by frequency doubling technology were strongly related with systemic vascular elasticity (ambulatory arterial stiffness index) in controls but not CAD patients.