European-wide spatial analysis of sewage treatment plants and the possible benefits to nature of advanced treatment to reduce pharmaceutical emissions

Pharmaceuticals are known to widely occur in the environment and to affect the health of ecosystems. Sewage treatment plants (STPs) are main emission pathways for pharmaceuticals, which are often not sufficiently removed during wastewater treatment. In Europe, STP treatment requirements are specified under the Urban WasteWater Treatment Directive (UWWTD). The introduction of advanced treatment techniques, such as ozonation and activated carbon, under the UWWTD is expected to be an important option to reduce pharmaceutical emissions. In this study, we present a European-wide analysis of STPs reported under the UWWTD, their current treatment level and potential to remove a set of 58 prioritised pharmaceuticals. Three different scenarios were analysed to show 1) UWWTD present effectiveness, 2) the effectiveness at full UWWTD compliance, and 3) the effectiveness when advanced treatment is implemented at STPs with a treatment capacity of &gt;100.000 person equivalents. Based on a literature study, the potential of individual STPs to reduce pharmaceutical emissions ranged from an average of 9% for STPs with primary treatment to 84% for STPs applying advanced treatment. Results of our calculations show that European-wide emission of pharmaceuticals can be reduced with 68% when large STPs are updated with advanced treatment, but spatial differences exist. We argue that adequate attention should also be paid with regards to preventing environmental impacts of STPs with a capacity &lt;100.000 p.e. Circa 44% of total STP effluent is emitted near Natura2000 sites (EU nature protection areas). Of all surface waters receiving STP effluent for which the ecological status has been assessed under the Water Framework Directive, 77% have a status of less than good. Relatively often only primary treatment is applied to wastewater emitted into coastal waters. This analysis can be used to further model pharmaceutical concentrations in European surface waters, to identify STPs for which more advanced treatment might be required and to protect EU aquatic biodiversity.</p

How to build an integrated neighborhood approach to support community-dwelling older people?

Background: Although the need for integrated neighborhood approaches (INAs) is widely recognized, we lack insight into strategies like INA. We describe diverse Dutch INA partners’ experiences to provide integrated person- and population-centered support to community-dwelling older people using an adapted version of Valentijn and colleagues’ integrated care model. Our main objective was to explore the experiences with INA participation. We sought to increase our understanding of the challenges facing these partners and identify factors facilitating and inhibiting integration within and among multiple levels. Methods: Twenty-one interviews with INA partners (including local health and social care organizations, older people, municipal officers, and a health insurer) were conducted and subjected to latent content analysis. Results: This study showed that integrated care and support provision through an INA is a complex, dynamic process requiring multilevel alignment of activities. The INA achieved integration at the personal, service, and professional levels only occasionally. Micro-level bottom-up initiatives were not aligned with top-down incentives, forcing community workers to establish integration despite rather than because of meso- and macro-level contexts. Conclusions: Top-down incentives should be better aligned with bottom-up initiatives. This study further demonstrated the importance of community-level engagement in integrated care and support provision

Safe and sustainable by design:A computer-based approach to redesign chemicals for reduced environmental hazards

Persistency of chemicals in the environment is seen a pressing issue as it results in accumulation of chemicals over time. Persistent chemicals can be an asset in a well-functioning circular economy where products are more durable and can be reused or recycled. This objective can however not always be fulfilled as release of chemicals from products into the environment can be inherently coupled to their use. In these situations, chemicals should be designed for degradation. In this study, a systematic and computer-aided workflow was developed to facilitate the chemical redesign for reduced persistency. The approach includes elements of Essential Use, Alternatives Assessment and Green and Circular Chemistry and ties into goals recently formulated in the context of the EU Green Deal. The organophosphate chemical triisobutylphosphate (TiBP) was used as a case study for exploration of the approach, as its emission to the environment was expected to be inevitable when used as a flame retardant. Over 6.3 million alternative structures were created in silico and filtered based on QSAR outputs to remove potentially non-readily biodegradable structures. With a multi-criteria analysis based on predicted properties and synthesizability a top 500 of most desirable structures was identified. The target structure (di-n-butyl (2-hydroxyethyl) phosphate) was manually selected and synthesized. The approach can be expanded and further verified to reach its full potential in the mitigation of chemical pollution and to help enable a safe circular economy

Coplanar waveguides on AlN for AlGaN/GaN MMIC applications

In this paper we present results on the characterization of Coplanar Waveguides (CPW) on AlN substrates. These transmission lines will be used in matching networks for high power Al- GaN/GaN ampliers. The large currents that will flow inside these ampliers require a large crosssectional conductor area resulting in CPW lines with large signal-to-ground spacings and/or large center conductor widths. The Line-Reflect-Line (LRL) algorithm was used in combination with a capacitance measurement to determine the transmission line parameters. It will be shown that the CPW lines with large dimensions show non-quasi- TEM behavior presumably related to parallel plate modes which influence decreases with sample thickness. The CPW lines show dispersion in the lowfrequency

Even Buurten: Een wijkgerichte aanpak voor thuiswonende ouderen in Rotterdam

__Abstract__ Door de dubbele vergrijzing en noodzaak van kostenbesparing in de zorg wordt steeds meer een appèl gedaan op ondersteuning van ouderen door informele netwerken. Vrijwel alle ouderen willen zo lang mogelijk zelfstandig blijven leven in hun eigen buurt. Een sterk ondersteunend netwerk is een belangrijke voorwaarde om dat doel te bereiken. In Rotterdam is sinds mei 2011 het project ‘Even Buurten’ actief waarin professionals uit zorg en welzijn via een integrale wijkaanpak proberen de sociale netwerken rondom thuiswonende ouderen te versterken. Dit met als doel om (vroeg)signalering mogelijk te maken en concrete hulp en ondersteuning te bieden aan kwetsbare ouderen. Uitgangspunt hierbij is de wens van de oudere zelf, wat hij of zij zelf nog kan doen, zonodig met ondersteuning uit het informele netwerk en –pas als dat niet voldoende blijkt te zijn– professionele ondersteuning. Onderzoekers van de Erasmus Universiteit Rotterdam (EUR), instituut Beleid en Management Gezondheidszorg (iBMG) evalueren het Even Buurten project onder leiding van Professor Anna Nieboer. Doel van deze rapportage over de tussentijdse bevindingen van de evaluatie is i) inzicht geven in de relaties tussen kenmerken van ouderen zoals, geslacht, opleidingsniveau, etnische achtergrond, kwetsbaarheid en welzijn en buurtkenmerken zoals sociale cohesie, veiligheid en kwaliteit van de buurt, ii) de behoeften van (kwetsbare) ouderen beschrijven als het gaat om hun fysieke en sociale omgeving, iii) inventariseren in hoeverre een integrale wijkaanpak als Even Buurten bijdraagt aan de kwaliteit van leven van kwetsbare ouderen, iv) nagaan wat de kosten en baten zijn van de inzet van spillen in de buurt, v) beschrijven wat de ervaringen van de spillen zijn in het Even Buurten project en vi) rapporteren welke barrières er zijn bij deze wijkgerichte aanpak

Effects of an integrated neighborhood approach on older people's (health-related) quality of life and well-being

Background: Integrated neighborhood approaches (INAs) are increasingly advocated to reinforce formal and informal community networks and support community-dwelling older people. They aim to augment older people's self-management abilities and engage informal networks before seeking professional support. INAs' effectiveness however remains unknown. We evaluated an INA's effects on older people's (health-related) quality of life (HRQoL) and well-being in Rotterdam. Methods: We used a matched quasi-experimental design comparing INA with "usual" care and support. Community-dwelling frail older (70+ years) people and frailty- and gender-matched control subjects (n = 186 each) were followed over a 1-year period (measurements at baseline and 6 and 12 months). Primary outcomes were HRQoL (EQ-5D-3L, SF-20) and well-being [social production function instrument for the level of well-being (SPF-IL)]. The effect of INA was analysed using an "intention to treat" and an "as treated" approach. Results: The results indicated that pre-intervention participants had lower incomes and were significantly older, more often single, less educated and more likely to have ≥1 disease than control subjects; they had lower well-being, physical functioning, role functioning, and mental health. Generalized linear mixed modelling of repeated measurements revealed no substantial difference in well-being or HRQoL between the intervention and control group after 1 year. The small differences we did find in the intention to treat group though were in favour of the control subjects (SF-20 = 6.98, 95 % confidence interval [CI] = 2.45-11.52; SPF-IL =.09, 95 % CI =.01-.17). However, the difference in well-being (SPF-IL) disappeared in the as treated analysis. Conclusions: The lack of effects of INA highlights the complexity of integrated care and support initiatives. Barriers associated with meeting the complex, varied needs of frail older people, and those related to dynamic political and social climates challenge initiative effectiveness. Trial registration The research was supported with a grant provided by the Netherlands Organisation for Health Research and Development (ZonMw, project number 314030201) as part of the National Care for the Elderly Programme

Even Buurten: De complexiteit van een wijkgerichte aanpak

De inzet van een integrale wijkaanpak wordt steeds vaker aanbevolen als middel om een ondersteunend klimaat te bieden aan het groeiend aantal zelfstandig wonende ouderen met een (complexe) hulpvraag. Binnen een integrale wijkaanpak werken de gemeente(n), zorg- en welzijnsorganisaties en informele zorgverleners samen om de beschikbare zorg in de wijk te coördineren zodat beter kan worden ingespeeld op de specifieke behoeften van de kwetsbare ouderen. Hoewel een integrale wijkaanpak steeds vaker wordt aangeprezen als middel om zelfstandigwonende ouderen te onde

Technische resultaten wisselbouw mais-gras

Uit onderzoek op Proefbedrijf Cranendonck blijkt dat de opbrengststijging van snijmaos bij wisselbouw met grasland maximaal 7% bedraagt