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Local perspectives provide different insights into disaster planning and response as compared to those of experts. Eliciting them, however, can be challenging, particularly for marginalised groups whose viewpoints have historically been excluded from planning processes. Fuzzy cognitive mapping (FCM) provides a semi-quantitative approach to representing the collective understanding or 'mental models' of diverse individuals and communities. This study involved 23 FCM interviews across three neighbourhoods of Saint Martin to comprehend: (i) how individuals' mental models of Hurricane Irma (2017) differ based on their context; (ii) how aligned mental models are with policy and planning documents; and (iii) the implications for the inclusiveness and representativeness of disaster response policies. It found that the residents of different neighbourhoods provided unique insights into the factors driving the social-ecological system, and that official policies aligned closely with priorities. The paper argues that the inclusion of the perspectives of different groups in disaster recovery is essential for an equitable process.

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BACKGROUND: Fuzzy cognitive mapping (FCM) is a graphic technique to describe causal understanding in a wide range of applications. This practice review summarises the experience of a group of participatory research specialists and trainees who used FCM to include stakeholder views in addressing health challenges. From a meeting of the research group, this practice review reports 25 experiences with FCM in nine countries between 2016 and 2023. RESULTS: The methods, challenges and adjustments focus on participatory research practice. FCM portrayed multiple sources of knowledge: stakeholder knowledge, systematic reviews of literature, and survey data. Methodological advances included techniques to contrast and combine maps from different sources using Bayesian procedures, protocols to enhance the quality of data collection, and tools to facilitate analysis. Summary graphs communicating FCM findings sacrificed detail but facilitated stakeholder discussion of the most important relationships. We used maps not as predictive models but to surface and share perspectives of how change could happen and to inform dialogue. Analysis included simple manual techniques and sophisticated computer-based solutions. A wide range of experience in initiating, drawing, analysing, and communicating the maps illustrates FCM flexibility for different contexts and skill bases. CONCLUSIONS: A strong core procedure can contribute to more robust applications of the technique while adapting FCM for different research settings. Decision-making often involves choices between plausible interventions in a context of uncertainty and multiple possible answers to the same question. FCM offers systematic and traceable ways to document, contrast and sometimes to combine perspectives, incorporating stakeholder experience and causal models to inform decision-making. Different depths of FCM analysis open opportunities for applying the technique in skill-limited settings.

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Floodplains provide an extraordinary quantity and quality of ecosystem services (ES) but are among the most threatened ecosystems worldwide. The uses and transformations of floodplains differ widely within and between regions. In recent decades, the diverse pressures and requirements for flood protection, drinking water resource protection, biodiversity, and adaptation to climate change have shown that multi-functional floodplain management is necessary. Such an integrative approach has been hampered by the various interests of different sectors of society, as represented by multiple stakeholders and legal principles. We present an innovative framework for integrated floodplain management building up on ES multi-functionality and stakeholder involvement, forming a scientifically based decision-support to prioritize adaptive management measures responding at the basin and local scales. To demonstrate its potential and limitations, we applied this cross-scaled approach in the world's most international and culturally diverse basin, the Danube River Basin in Europe. We conducted large-scale evaluations of anthropogenic pressures and ES capacities on the one hand and participatory modelling of the local socio-ecohydrological systems on the other hand. Based on our assessments of 14 ES and 8 pressures, we recommend conservation measures along the lower and middle Danube, restoration measures along the upper-middle Danube and Sava, and mitigation measures in wide parts of the Yantra, Tisza and upper Danube rivers. In three case study areas across the basin, stakeholder perceptions were generally in line with the large-scale evaluations on ES and pressures. The positive outcomes of jointly modelled local measures and large-scale synergistic ES relationships suggest that multi-functionality can be enhanced across scales. Trade-offs were mainly present with terrestrial provisioning ES at the basin scale and locally with recreational activities. Utilizing the commonalities between top-down prioritizations and bottom-up participatory approaches and learning from their discrepancies could make ecosystem-based management more effective and inclusive.

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BACKGROUND: The Students Training in Academia, Health, and Research (STAHR) Program at the University of Missouri-Kansas City (UMKC) strives to help students from low-income families that have experienced educational challenges due to poverty and prepare them to enter, persist, and graduate from a health sciences degree program at UMKC. Students in the program participated in fuzzy cognitive mapping (FCM) sessions to ensure that all voices of the program were heard to improve program implementation, and student success, and contribute to an equitable educational environment. METHODS: Fuzzy Cognitive Mapping sessions for the 2020-2021 cohort of students (n = 52) were conducted to assess the strengths and weaknesses in program implementation, especially through the beginning of the COVID-19 pandemic. Students' maps were coded by a team of researchers and then confirmed using confirmatory factor analysis. RESULTS: Statistical analyses reveal that mentorship, workshops, and social support helped students to work toward their goal of obtaining a professional health sciences degree, while a lack of time, remote learning, and outside stressors inhibited their opportunities for success. CONCLUSIONS: The findings from a multipronged analysis of mapping data demonstrate the value of this innovative approach to the field, especially when looking to incorporate student voices.

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The present study aimed to perform a dynamic risk assessment of liquefied petroleum gas (LPG) in spherical storage tanks using the Hazard and Operability (HAZOP) method. The "LPG release from spherical storage tank" scenario was determined to be a top event based on the risk level. The causes and consequences of this scenario were then specified using the Bow-Tie method. Additionally, fuzzy cognitive mapping (FCM) was utilized to identify the most critical threats, consequences, and effective barriers in a dynamic approach. Results showed that fracture/rupture in pipelines/a storage tank due to fire had the highest output degree and was identified as the most influential threat in the occurrence of the LPG release. Fatality/injury due to fire and explosion had the highest input degree and was more influenced by the release of LPG as the main consequence in the selected scenario. The findings of this study enabled us to make a logical decision about effective barriers for avoiding and minimizing the release of LPG and its threats and consequences based on the fuzzy cognitive map. Moreover, the results of this study showed that the FCM method could determine the most critical nodes with a higher degree and represent their relationships.

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We present a collaboratively developed social-ecological model of the Kenai River Fishery. We developed the model through iterative interviews with stakeholders throughout the Kenai Peninsula using a novel participatory Fuzzy Cognitive Mapping process grounded in Ostrom's social-ecological systems framework. Individual social-ecological models, developed one-on-one with stakeholders, were combined into a single aggregated model representing the system's structure and function. We validated this aggregated model through subsequent interviews with stakeholders and focused literature reviews. The result is a model that can: 1) illustrate the breadth and interconnectedness of the Kenai River Fishery's social-ecological system; 2) be used to facilitate discussions around management of the fishery; and 3) be used to explore the components and interactions that move the system toward or away from sustainability. Using the model, we identify how the nature of salmon (migratory) and their habitat (large and unpredictable) leads to uncertainty about effective management strategies. This uncertainty, in addition to a large and diverse set of resource users, creates conflicting management goals that ultimately limit the governance system in making decisions that might increase the sustainability of the fishery.

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Mixed methods research is well-suited to grapple with questions of what counts as valid knowledge across different contexts and perspectives. This article introduces Weight of Evidence as a transformative procedure for stakeholders to interpret, expand on and prioritize evidence from evidence syntheses, with a focus on engaging populations historically excluded from planning and decision making. This article presents the procedure's five steps using pilot data on perinatal care of immigrant women in Canada, engaging family physicians and birth companions. Fuzzy cognitive mapping offers an accessible and systematic way to generate priors to update published literature with stakeholder priorities. Weight of Evidence is a transparent procedure to broaden what counts as expertise, contributing to a more comprehensive, context-specific, and actionable understanding.

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Improving flood resilience of communities requires a holistic understanding of risks and resilience options as well as the preferences and priorities of different stakeholders. Innovations in risk and resilience assessment have helped communities to identify gaps in their flood risk management strategy but selecting and implementing resilience solutions remains a big challenge for many decision-makers. In addition to traditional appraisals and cost-benefit assessments this also calls for a participatory process in which various stakeholders are encouraged to adopt a system-level approach in identifying interventions that can maximise a range of benefits and co-benefits. In this study, we investigate how a combination of modelling and measurement methods can help decision-makers with their flood resilience strategies. We apply a participatory system thinking approach combining Fuzzy Cognitive Mapping (FCM) with a flood resilience measurement framework called Flood Resilience Measurement for Communities (FRMC). We first investigate stakeholders' biases on flood resilience interventions, and then lead them through a system thinking exercise using FCM and FRMC to elicit mental models representing important aspects of flood resilience and their interrelation. These are then aggregated, representing the collective perceptions and knowledge of stakeholders, and used to identify the most beneficial resilience actions in terms of direct and indirect impacts on flood resilience. We apply this approach to the case of Lowestoft, a coastal town in England exposed to significant flood risk. Developed in close collaboration with the local authorities, the ambition is to support decision-making on flood resilience interventions. We find that this combination of methods enables system-level thinking and inclusive decision-making about flood resilience which can ultimately encourage transformative decisions on prioritization of actions and investments.

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In the totally unprecedented context of the COVID-19 health crisis, the widespread adoption of Industry 4.0 technologies, and the great interest in resilience, have been stronger than ever. Within this framework, the present paper outlines the involvement of technologies emerging from the fourth industrial revolution in the fight against the epidemic expansion, and the results of this implication in terms of strengthening and achieving resilience in diverse fields. In order to gain a fuller understanding of these points, fourteen resilience domains related to the COVID-19 pandemic are defined. On the other hand, the third section of this paper digs into the literature to expose a variety of Industry 4.0 solutions developed to cope with the sanitary crisis. Afterwards, a fuzzy cognitive map is elaborated, using mental modeler, in order to emphasize the causal links between Industry 4.0 technologies and resilience domains. Subsequently, a simulation of this model is performed to evaluate the contribution of an optimized joint use of Industry 4.0 core technologies in the achievement of resilience in its different dimensions during the COVID-19 pandemic, and to discuss how the identified gaps or weaknesses can be addressed.

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BACKGROUND: Short birth intervals, defined by the World Health Organization as less than 33 months, may damage the health and wellbeing of children, mothers, and their families. People in northern Nigeria recognise many adverse effects of short birth interval (kunika in the Hausa language) but it remains common. We used fuzzy cognitive mapping to systematize local knowledge of causes of kunika to inform the co-design of culturally safe strategies to address it. METHODS: Male and female groups in twelve communities built 48 maps of causes and protective factors for kunika, and government officers from the Local Government Area (LGA) and State made four maps. Each map showed causes of kunika or no-kunika, with arrows showing relationships with the outcome and between causes. Participants assigned weights for the perceived strength of relationships between 5 (strongest) and 1 (weakest). We combined maps for each group: men, women, and government officers. Fuzzy transitive closure calculated the maximum influence of each factor on the outcome, taking account of all relationships in the map. To condense the maps, we grouped individual factors into broader categories and calculated the cumulative net influence of each category. We made further summarised maps and presented these to the community mapping groups to review. RESULTS: The community maps identified frequent sex, not using modern or traditional contraception, and family dynamics (such as competition between wives) as the most influential causes of kunika. Women identified forced sex and men highlighted lack of awareness about contraception and fear of side effects as important causes of kunika. Lack of male involvement featured in women's maps of causes and in the maps from LGA and State levels. Maps of protective factors largely mirrored those of the causes. Community groups readily appreciated and approved the summary maps resulting from the analysis. CONCLUSIONS: The maps showed how kunika results from a complex network of interacting factors, with culture-specific dynamics. Simply promoting contraception alone is unlikely to be enough to reduce kunika. Outputs from transitive closure analysis can be made accessible to ordinary stakeholders, allowing their meaningful participation in interpretation and use of the findings. For people in Bauchi State, northern Nigeria, kunika describes a short interval between successive births, understood as becoming pregnant again before the previous child is weaned. They recognise it is bad for children, mothers and households. We worked with 12 communities in Bauchi to map their knowledge of the causes and protective factors for kunika. Separate groups of men and women built 48 maps, and government officers at local and state level built four maps. Each group drew two maps showing causes of kunika or of no-kunika with arrows showing the links between causes and the outcome. Participants marked the strength of each link with a number (between 5 for the strongest and 1 for the weakest). We combined maps for women, men and government officers. We grouped similar causes together into broader categories. We calculated the overall influence of each category on kunika or no-kunika and produced summary maps to communicate findings. The maps identified the strongest causes of kunika as frequent sex, not using modern or traditional contraception, and family dynamics. Women indicated forced sex as an important cause, but men focused on lack of awareness about contraception and fear of side effects. The maps of protective factors mirrored those of the causes. The groups who created the maps approved the summary maps. The maps showed the complex causes of kunika in Bauchi. Promoting contraception is unlikely to be enough on its own to reduce kunika. The summary maps will help local stakeholders to co-design culturally safe ways of reducing kunika.

ANTECEDENTES: Los intervalos intergenésicos cortos (menores de 33 meses, según la OMS) afectan la salud y el bienestar de la madre, el niño y la familia. Aunque los habitantes del norte de Nigeria reconocen muchos efectos adversos de un intervalo intergenésico corto (kunika en lengua hausa), éstos aún son frecuentes. Nosotros usamos cartografía cognitiva para sintetizar el conocimiento local sobre causas de kunika y guiar el codiseño de estrategias culturalmente seguras que permitan su disminución. MéTODO: Grupos de hombres y mujeres en doce comunidades hicieron 48 mapas, mientras funcionarios del Estado de Bauchi y del Área Local de Gobierno (LGA) hicieron otros cuatro. Cada mapa mostraba causas de kunika o de no-kunika con flechas indicando la influencia entre ellas. Los participantes ponderaron la influencia entre 1 (la más débil) y 5 (la más fuerte). Nosotros combinamos los mapas por grupos de mujeres, hombres y funcionarios. Con fuzzy transitive closure calculamos la máxima influencia entre factores cuando todas las relaciones en el mapa son consideraras. Condensamos los mapas agrupando factores individuales en categorías y calculamos la influencia neta acumulativa para cada una. Estos mapas los sintetizamos aún más para revisarlos con sus autores. RESULTADOS: Los mapas de los grupos comunitarios identificaron el sexo frecuente y factores relacionados, no usar anticonceptivos modernos o tradicionales y las dinámicas familiares (como el deseo de tener más hijos o la competencia entre esposas) como las causas más importantes de kunika. Los mapas de las mujeres identificaron el sexo forzado como causa importante y los mapas de los hombres destacaron la falta de conocimiento sobre anticoncepción y el temor a los efectos secundarios. La falta de participación masculina apareció en los mapas de las mujeres, del LGA y del Estado. Los mapas de los factores protectores reflejaron en gran medida los de las causas. Los grupos comunitarios aprobaron y apreciaron los mapas que sintetizaban el análisis. CONCLUSIONES: Los mapas comunitarios mostraron que kunika es el resultado de una compleja red de factores con dinámicas culturales específicas. Es poco probable que enfocarse solo en promover anticoncepción reduzca kunika. Los resultados del transitive closure pueden comunicarse al público en general para una mayor participación en la interpretación y uso de los resultados.

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OBJECTIVE: To describe and determine the barriers and facilitators to food-related health behaviors of residents in a rural Mississippi Delta community. STUDY DESIGN: Descriptive study of qualitative interviews. METHODS: A non-random sample of 34 low-income, food-insecure adults residing in a rural Mississippi Delta community were interviewed using fuzzy cognitive mapping, a mixed methods approach. RESULTS: Participants strongly emphasized the time restraints they faced in both procuring and preparing foods, due to substantial travel time required to procure groceries. Participants also identified key facilitators to healthy eating behaviors, including seasonal produce stands, foraging, fishing, home provisioning, and access to the local food pantry. These barriers and facilitators are highly interconnected with other influential factors including poverty, lack of health care, unemployment, and faith-based support systems. CONCLUSIONS: While the connection between low food access and poor eating habits is well researched, this novel mixed-method approach details two important elements missing from the literature: (1) other factors often overlooked that mitigate or exacerbate this relationship and (2) the dynamic nature of the relationships between these factors, poor eating habits, and health. Additionally, this research examines these relationships in an underrepresented rural minority population where resources needed to mitigate poor health are often much more limited. Findings from this study are critical to health and food policy in Mississippi and more generally, rural communities.

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BACKGROUND: Effective health care requires services that are responsive to local needs and contexts. Achieving this in indigenous settings implies communication between traditional and conventional medicine perspectives. Adequate interaction is especially relevant for maternal health because cultural practices have a notable role during pregnancy, childbirth and the postpartum period. Our work with indigenous communities in the Mexican state of Guerrero used fuzzy cognitive mapping to identify actionable factors for maternal health from the perspective of traditional midwives. METHODS: We worked with twenty-nine indigenous women and men whose communities recognized them as traditional midwives. A group session for each ethnicity explored risks and protective factors for maternal health among the Me'phaa and Nancue ñomndaa midwives. Participants mapped factors associated with maternal health and weighted the influence of each factor on others. Transitive closure summarized the overall influence of each node with all other factors in the map. Using categories set in discussions with the midwives, the authors condensed the relationships with thematic analysis. The composite map combined categories in the Me'phaa and the Nancue ñomndaa maps. RESULTS: Traditional midwives in this setting attend to pregnant women's physical, mental, and spiritual conditions and the corresponding conditions of their offspring and family. The maps described a complex web of cultural interpretations of disease - "frío" (cold or coldness of the womb), "espanto" (fright), and "coraje" (anger) - abandonment of traditional practices of self-care, women's mental health, and gender violence as influential risk factors. Protective factors included increased male involvement in maternal health (having a caring, working, and loving husband), receiving support from traditional healers, following protective rituals, and better nutrition. CONCLUSIONS: The maps offer a visual language to present and to discuss indigenous knowledge and to incorporate participant voices into research and decision making. Factors with higher perceived influence in the eyes of the indigenous groups could be a starting point for additional research. Contrasting these maps with other stakeholder views can inform theories of change and support co-design of culturally appropriate interventions.

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Coral reefs are among the most fragile ecosystems that provide essential services to local Small Island Developing States (SIDS) communities. As such, exploring the characteristics and interactions shaping regime shifts of coral reefs is of paramount importance in managing system pressures; enhancing resilience; aiding their regeneration and recovery process; and restoring habitat complexity. However, understanding the dynamics of coral reef ecosystems regime shift requires employing an approach capable of dealing with systems being affected by multiple climatic and socio-economic non-climatic pressures as well as an effective treatment of systemic embedded uncertainties. This study applies Fuzzy Cognitive Mapping (FCM) in a participatory stepwise and systematic procedure to reflect dynamic casualties and temporal changes of coral reef ecosystem regime change over a long-time perspective. This mapping technique allows conceptualising dynamic models to represent causalities and modelling input values to simulate fluctuations within a complex temporal system. Port Resolution on Tanna Island in Vanuatu was selected as the case study region representative of Pacific-SIDS geography and human communities. As an initial outcome and an indicator of multidisciplinary of this study, twenty-seven principal influential factors and their corresponding causal relationships were identified. Subsequently, the coral reef regime shift was analysed under four main plausible scenarios representing major climatic and non-climatic trajectories. The results indicate that climate change factors play pivotal roles in the regime shift of the coral reef ecosystem globally. At the focal scale of this study, the tourism industry and coral fisheries are the most vulnerable services provided by coral reefs. As such, coupled local management interventions and global efforts in mitigating the adverse impacts of climate change is likely to yield better coral reef ecosystem services at a local community level.

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Policy making for complex Social-Ecological Systems (SESs) is a multi-factorial and multi-stakeholder decision making process. Therefore, proper policy simulation in a SES should consider both the complex behavior of the system and the multi-stakeholders' interventions into the system, which requires integrated methodological approaches. In this study, we simulate impacts of policy options on a farming community facing water scarcity in Rafsanjan, Iran, using an integrated modeling methodology combining an Agent Based Model (ABM) with Fuzzy Cognitive Mapping (FCM). First, the behavioral rules of farmers and the causal relations among environmental variables are captured with FCMs that are developed with both qualitative and quantitative data, i.e. farmers' knowledge and empirical data from studies. Then, an ABM is developed to model decisions and actions of farmers and simulate their impacts on overall groundwater use and emigration of farmers in this case study. Finally, the impacts of different policy options are simulated and compared with a baseline scenario. The results suggest that a policy of facilitating farmers' participation in management and control of their groundwater use leads to the highest reduction of groundwater use and would help to secure farmers' activities in Rafsanjan. Our approach covers four main aspects that are crucial for policy simulation in SESs: 1) causal relationships, 2) feedback mechanisms, 3) social-spatial heterogeneity and 4) temporal dynamics. This approach is particularly useful for ex-ante policy options analysis.

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BACKGROUND CONTEXT: Low back pain (LBP) is a multifactorial problem with complex interactions among many biological, psychological and social factors. It is difficult to fully appreciate this complexity because the knowledge necessary to do so is distributed over many areas of expertise that span the biopsychosocial domains. PURPOSE: This study describes the collaborative modeling process, undertaken among a group of participants with diverse expertise in LBP, to build a model to enhance understanding and communicate the complexity of the LBP problem. STUDY DESIGN: The study involved generating individual models that represented participants' understanding of the LBP problem using fuzzy cognitive mapping (FCM), and 4 subsequent phases of consultation and consensus with the participants to characterize and refine the interpretation of the FCMs. METHODS: The phases consisted of: proposal of Categories for clustering of model Components; preliminary evaluation of structure, composition and focal areas of participant's FCMs; refinement of Categories and Components with consensus meeting; generation of final structure and composition of individual participant's FCMs. Descriptive statistics were applied to the structural and composition metrics of individual FCMs to aid interpretation. RESULTS: From 38 invited contributors, 29 (76%) agreed to participate. They represented 9 disciplines and 8 countries. Participants' models included 729 Components, with an average of 25 (SD = 7) per model. After the final FCM refinement process (Components from separate FCMs that used similar terms were combined, and Components from an FCM that included multiple terms were separated), there were 147 Components allocated to ten Categories. Although individual models varied in their structure and composition, a common opinion emerged that psychological factors are particularly important in the presentation of LBP. Collectively, Components allocated to the "Psychology" Category were the most central in almost half (14/29) of the individual models. CONCLUSIONS: The collaborative modeling process outlined in this paper provides a foundation upon which to build a greater understanding and to communicate the complexity of the LBP problem. The next step is to aggregate individual FCMs into a metamodel and begin disentangling the interactions among its Components. This will lead to an improved understanding of the complexity of LBP, and hopefully to improved outcomes for those suffering from this condition.

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Including stakeholders in environmental model building and analysis is an increasingly popular approach to understanding ecological change. This is because stakeholders often hold valuable knowledge about socio-environmental dynamics and collaborative forms of modeling produce important boundary objects used to collectively reason about environmental problems. Although the number of participatory modeling (PM) case studies and the number of researchers adopting these approaches has grown in recent years, the lack of standardized reporting and limited reproducibility have prevented PM's establishment and advancement as a cohesive field of study. We suggest a four-dimensional framework (4P) that includes reporting on dimensions of (1) the Purpose for selecting a PM approach (the why); (2) the Process by which the public was involved in model building or evaluation (the how); (3) the Partnerships formed (the who); and (4) the Products that resulted from these efforts (the what). We highlight four case studies that use common PM software-based approaches (fuzzy cognitive mapping, agent-based modeling, system dynamics, and participatory geospatial modeling) to understand human-environment interactions and the consequences of ecological changes, including bushmeat hunting in Tanzania and Cameroon, agricultural production and deforestation in Zambia, and groundwater management in India. We demonstrate how standardizing communication about PM case studies can lead to innovation and new insights about model-based reasoning in support of ecological policy development. We suggest that our 4P framework and reporting approach provides a way for new hypotheses to be identified and tested in the growing field of PM.

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In this study we demonstrate how to support policy option analysis for a problematic Social-Ecological System (SES) with the help of stakeholder participation. SES sustainability problems 1) are highly complex, 2) may lack reliable data, 3) encompass conflicting interests and 4) may require contradictory management interventions. Our approach uses a structured participatory method combining the Driver-Pressure-State-Impact-Response (DPSIR) model together with Fuzzy Cognitive Mapping (FCM) to capture the complexity of the system and simplify its representation for simulation and policy option analysis. Using this novel mixed-method was useful in dealing with above-mentioned characteristics of the complex SES problems. The method was applied in a case study of water scarcity in Rafsanjan, Iran. FCMs were produced for 60 individual farmers and 40 individual researchers and policy makers. Our mixed-method analysis reveals similarities and differences of stakeholder knowledge and problem perception, and simulates the impacts of alternative policy options according to each group's perception. The final result of our case study indicates that farmers in Rafsanjan strongly believe in the impact of economic diversification on reducing water shortage, but they have a low level of trust in the ability of the government to regulate and control water usage, whereas the policy makers and researchers still believe in the role of government control and monitoring policies to deal with water scarcity in Rafsanjan.

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