Reframing water: Contesting H2O within the European Union

AbstractWater fulfills multiple functions and is instilled with numerous meanings: it is concurrently an economic input, an aesthetic reference, a religious symbol, a public good, a fundamental resource for public health, and a biophysical need for humans and ecosystems. Hence, water has multiple ontologies embedded within diverse social, cultural, spiritual, and political domains. For this paper, we reviewed 78 pieces of water legislation across the European Union, critically analysing the different ways in which water has been defined; subsequently we contrasted these definitions against the European Union Water Framework Directive (WFD). We argue that the act of defining water is not only a deeply social and political process, but that it often privileges specific worldviews; and that the impetus of the WFD reveals a neoliberal approach to water governance: an emphasis on water as a commercial product that should be subjected to market influences. Subsequently, we conclude that the emerging concept of the ’hydrosocial cycle,’ which emphasises the inherent links between water and society, could be a useful heuristic tool to promote a broader conception of water based on diverse understandings, that challenge hegemonic definitions of water

Vertical integration and firm boundaries : the evidence

Since Ronald H. Coase's (1937) seminal paper, a rich set of theories has been developed that deal with firm boundaries in vertical or input–output structures. In the last twenty-five years, empirical evidence that can shed light on those theories also has been accumulating. We review the findings of empirical studies that have addressed two main interrelated questions: First, what types of transactions are best brought within the firm and, second, what are the consequences of vertical integration decisions for economic outcomes such as prices, quantities, investment, and profits. Throughout, we highlight areas of potential cross-fertilization and promising areas for future work

Use of Quality Improvement Strategies Among Small to Medium-Size US Primary Care Practices

PURPOSE Improving primary care quality is a national priority, but little is known about the extent to which small to medium-size practices use quality improvement (QI) strategies to improve care. We examined variations in use of QI strategies among 1,181 small to medium-size primary care practices engaged in a national initiative spanning 12 US states to improve quality of care for heart health and assessed factors associated with those variations. METHODS In this cross-sectional study, practice characteristics were assessed by surveying practice leaders. Practice use of QI strategies was measured by the validated Change Process Capability Questionnaire (CPCQ) Strategies Scale (scores range from −28 to 28, with higher scores indicating more use of QI strategies). Multivariable linear regression was used to examine the association between practice characteristics and the CPCQ strategies score. RESULTS The mean CPCQ strategies score was 9.1 (SD = 12.2). Practices that participated in accountable care organizations and those that had someone in the practice to configure clinical quality reports from electronic health records (EHRs), had produced quality reports, or had discussed clinical quality data during meetings had higher CPCQ strategies scores. Health system–owned practices and those experiencing major disruptive changes, such as implementing a new EHR system or clinician turnover, had lower CPCQ strategies scores. CONCLUSION There is substantial variation in the use of QI strategies among small to medium-size primary care practices across 12 US states. Findings suggest that practices may need external support to strengthen their ability to do QI and to be prepared for new payment and delivery models

Pharmacokinetic/pharmacodynamic modelling approaches in paediatric infectious diseases and immunology.

Pharmacokinetic/pharmacodynamic (PKPD) modelling is used to describe and quantify dose-concentration-effect relationships. Within paediatric studies in infectious diseases and immunology these methods are often applied to developing guidance on appropriate dosing. In this paper, an introduction to the field of PKPD modelling is given, followed by a review of the PKPD studies that have been undertaken in paediatric infectious diseases and immunology. The main focus is on identifying the methodological approaches used to define the PKPD relationship in these studies. The major findings were that most studies of infectious diseases have developed a PK model and then used simulations to define a dose recommendation based on a pre-defined PD target, which may have been defined in adults or in vitro. For immunological studies much of the modelling has focused on either PK or PD, and since multiple drugs are usually used, delineating the relative contributions of each is challenging. The use of dynamical modelling of in vitro antibacterial studies, and paediatric HIV mechanistic PD models linked with the PK of all drugs, are emerging methods that should enhance PKPD-based recommendations in the future

Enhancing the relevance of Shared Socioeconomic Pathways for climate change impacts, adaptation and vulnerability research

This paper discusses the role and relevance of the shared socioeconomic pathways (SSPs) and the new scenarios that combine SSPs with representative concentration pathways (RCPs) for climate change impacts, adaptation, and vulnerability (IAV) research. It first provides an overview of uses of social–environmental scenarios in IAV studies and identifies the main shortcomings of earlier such scenarios. Second, the paper elaborates on two aspects of the SSPs and new scenarios that would improve their usefulness for IAV studies compared to earlier scenario sets: (i) enhancing their applicability while retaining coherence across spatial scales, and (ii) adding indicators of importance for projecting vulnerability. The paper therefore presents an agenda for future research, recommending that SSPs incorporate not only the standard variables of population and gross domestic product, but also indicators such as income distribution, spatial population, human health and governance

Climate change litigation: a review of research on courts and litigants in climate government

Studies of climate change litigation have proliferated over the past two decades, as lawsuits across the world increasingly bring policy debates about climate change mitigation and adaptation, as well as climate change‐related loss and damage to the attention of courts. We systematically identify 130 articles on climate change litigation published in English in the law and social sciences between 2000 and 2018 to identify research trajectories. In addition to a budding interdisciplinarity in scholarly interest in climate change litigation we also document a growing understanding of the full spectrum of actors involved and implicated in climate lawsuits and the range of motivations and/or strategic imperatives underpinning their engagement with the law. Situating this within the broader academic literature on the topic we then highlight a number of cutting edge trends and opportunities for future research. Four emerging themes are explored in detail: the relationship between litigation and governance; how time and scale feature in climate litigation; the role of science; and what has been coined the “human rights turn” in climate change litigation. We highlight the limits of existing work and the need for future research—not limited to legal scholarship—to evaluate the impact of both regulatory and anti‐regulatory climate‐related lawsuits, and to explore a wider set of jurisdictions, actors and themes. Addressing these issues and questions will help to develop a deeper understanding of the conditions under which litigation will strengthen or undermine climate governance. This article is categorized under: Policy and Governance > Multilevel and Transnational Climate Change Governanc

Decadal-scale litter manipulation alters the biochemical and physical character of tropical forest soil carbon

© 2018 Elsevier Ltd Climate change and rising atmospheric carbon dioxide (CO2) concentrations are likely to alter tropical forest net primary productivity (NPP), potentially affecting soil C storage. We examined biochemical and physical changes in soil C fractions in a humid tropical forest where experimental litter manipulation changed total soil C stocks. We hypothesized that: (1.) low-density soil organic C (SOC) fractions are more responsive to altered litter inputs than mineral-associated SOC, because they cycle relatively rapidly. (2.) Any accumulation of mineral-associated SOC with litter addition is relatively stable (i.e. low leaching potential). (3.) Certain biomolecules, such as waxes (alkyl) and proteins (N-alkyl), form more stable mineral-associations than other biomolecules in strongly weathered soils. A decade of litter addition and removal affected bulk soil C content in the upper 5 cm by +32% and −31%, respectively. Most notably, C concentration in the mineral-associated SOC fraction was greater in litter addition plots relative to controls by 18% and 28% in the dry and wet seasons, respectively, accounting for the majority of greater bulk soil C stock. Radiocarbon and leaching analyses demonstrated that the greater mineral-associated SOC in litter addition plots consisted of new and relatively stable C, with only 3% of mineral-associated SOC leachable in salt solution. Solid-state13C NMR spectroscopy indicated that waxes (alkyl C) and microbial biomass compounds (O-alkyl and N-alkyl C) in mineral-associated SOC are relatively stable, whereas plant-derived compounds (aromatic and phenolic C) are lost from mineral associations on decadal timescales. We conclude that changes in tropical forest NPP will alter the quantity, biochemistry, and stability of C stored in strongly weathered tropical soils

Can cognitive insight predict symptom remission in a first episode psychosis cohort?

BACKGROUND: The outcome of first episode psychosis (FEP) is highly variable and difficult to predict. Cognitive insight measured at illness onset has previously been found to predict psychopathology 12-months later. The aims of this study were to examine whether the prospective relationship between cognitive insight and symptom severity is evident at four-years following FEP and to examine some psychological correlates of cognitive insight. METHODS: FEP participants (n = 90) completed the Beck Cognitive Insight Scale (BCIS) at illness onset, and associations between BCIS scores with symptom severity outcomes (4-years after FEP) were assessed. The BCIS scales (self-reflectiveness and self-certainty) were examined as a composite score, and individually compared to other cognitive measures (IQ and jumping to conclusions (JTC) bias). RESULTS: Regression analyses revealed that the cognitive insight composite did not predict 4-year symptom remission in this study while the self-reflection subscale of the BCIS predicted severity of symptoms at 4-years. Self-certainty items of the BCIS were not associated with symptom severity. Significant correlations between the JTC bias, self-certainty and IQ were found, but self-reflection did not correlate with these other cognitive measures. CONCLUSIONS: Self-reflective capacity is a more relevant and independent cognitive construct than self-certainty for predicting prospective symptom severity in psychosis. Improving self-reflection may be a useful target for early intervention research