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This article discusses the impact of the Norwegian government's administrative reform on the management of the Norwegian aquaculture industry and coastal areas. The 2010 reform of government administration strengthened the County Councils’ role in issues of aquaculture at the expense of the regional offices of the Directorate of Fisheries. The aim of the reform was to increase self-governance through decentralization. However, international trends in coastal zone and marine resource management are moving in the opposite direction, aiming at more integrated and ecosystem-based approaches involving the management of larger, rather than smaller, geographic regions. This article examines the possible effects of this reform in light of the move from government to governance, and in the context of a broad policy shift toward a more integrated, ecosystem-based management (EBM) of the coastal zone. Based on insights from multi-level and coastal zone governance debates, we argue that an unintended consequence of the Norwegian administrative reform could be increased fragmentation of the aquaculture governance system, as well as a reduced capacity to implement EBM-related measures. At the same time, the reform might improve coastal zone planning, although a further step toward integrated coastal zone management (ICZM) would require a greater delegation of authority to the County Councils. [ABSTRACT FROM AUTHOR]

To explore, from a philosophy of knowledge perspective, the contribution of the guideline development process to reducing epistemic uncertainty in clinical decision-making – defined as the challenge of applying evidence to patients, dealing with conflicting information and determining the level of confidence in a medical conclusion. Longitudinal ethnographic study of national guideline development panels. Fieldnotes were collected from 19 panel meetings in UK, Netherlands and Norway (~120 h of observation) between September 2016 and February 2019. Draft guidelines, review protocols and background material were collated (~200 documents). Data were analyzed thematically to gain familiarity and then theorized using concepts of knowledge development and use and clinical decision-making. Guideline development panels in all three countries wrestled with epistemic tensions – notably between the desire to "purify" an assumed external truth (for example by limiting included evidence to high-quality randomized controlled trials) and a more pragmatic and pluralist approach that drew on a wider range of evidence including qualitative research, real-world data, clinical experience and patient testimony. Detailed analysis of the process by which particular guideline recommendations were constructed allowed us to draw out the implications of these tensions for guideline users in clinical practice. Guideline development panels apply multiple – often conflicting – understandings of knowledge, inference and truth in an attempt to reduce epistemic uncertainty. Guidelines makers, clinicians, scientists and students should engage critically and reflexively with the philosophical assumptions that underpin guideline development and inductive inference to build capability to deal with clinical complexity. • Ethnographic study of guideline development panels. • Informed by philosophical notions of the nature of knowledge, inference and truth. • Panel discussions included clinical experience and a broad range of knowledge. • Panels wrestled with tensions between purist and pluralist approaches of EBM. • Our findings question the philosophical assumptions of guideline development panels. [ABSTRACT FROM AUTHOR]