Bewonersparticipatie in het openbaar groenbeheer : 'State of the art' na vijf jaar zelfbeheer in de wijk EVA-Lanxmeer (Culemborg)

De wijk EVA-Lanxmeer (1997) is een duurzame woon- en werkwijk in Culemborg, op een grondwaterwingebied van Vitens. Het is een voorbeeldproject op het gebied van duurzame stedenbouw en participatief beleid. Het wordt door gemeenten en groepen burgers in binnen- en buitenland gebruikt om inspiratie, kennis en ervaring op te doen en uit te wisselen op het gebied van innovatief denken binnen de eigen gemeentelijke organisatie. Bewoners onderhouden zelf een belangrijk deel van het wijkgroen op een ecologische wijze. Zij doen dat in samenwerking en overleg met de gemeente Culemborg en Waterwinbedrijf Vitens. De meeste bewoners hebben sterk het gevoel dat het zelfbeheer de kwaliteit en diversiteit van het groen in de wijk verhoogt. De gezamenlijke werkzaamheden maken ongedwongen ontmoetingen met andere bewoners in de wijk mogelijk

Dynamics of vortex tangle without mutual friction in superfluid 4^4He

A recent experiment has shown that a tangle of quantized vortices in superfluid $^4$He decayed even at mK temperatures where the normal fluid was negligible and no mutual friction worked. Motivated by this experiment, this work studies numerically the dynamics of the vortex tangle without the mutual friction, thus showing that a self-similar cascade process, whereby large vortex loops break up to smaller ones, proceeds in the vortex tangle and is closely related with its free decay. This cascade process which may be covered with the mutual friction at higher temperatures is just the one at zero temperature Feynman proposed long ago. The full Biot-Savart calculation is made for dilute vortices, while the localized induction approximation is used for a dense tangle. The former finds the elementary scenario: the reconnection of the vortices excites vortex waves along them and makes them kinked, which could be suppressed if the mutual friction worked. The kinked parts reconnect with the vortex they belong to, dividing into small loops. The latter simulation under the localized induction approximation shows that such cascade process actually proceeds self-similarly in a dense tangle and continues to make small vortices. Considering that the vortices of the interatomic size no longer keep the picture of vortex, the cascade process leads to the decay of the vortex line density. The presence of the cascade process is supported also by investigating the classification of the reconnection type and the size distribution of vortices. The decay of the vortex line density is consistent with the solution of the Vinen's equation which was originally derived on the basis of the idea of homogeneous turbulence with the cascade process. The obtained result is compared with the recent Vinen's theory.Comment: 16 pages, 16 figures, submitted to PR

Implementation of locally adapted guidelines on type 2 diabetes

Objective. To assess the effects of a facilitator enhanced multifaceted intervention to implement a locally adapted guideline on the shared care for people with type 2 diabetes. Methods. During 1 year a cluster-randomized trial was performed in 30 general practices. In the intervention group, nurse facilitators enhanced guideline implementation by analysing barriers to change, introducing structured care, training practice staff and giving performance feedback. Targets for HbA1c%, systolic blood pressure as well as indications for angiotensin converting enzyme/angiotensin receptor blocking agent prescription differed from the national guidelines. In the control group, GPs were asked to continue the care for people with diabetes as usually. Generalized estimating equations were used to control for the clustered design of the study. Results. In the intervention group, more people were seen on a 3-monthly basis (88% versus 69%, P < 0.001) and more blood pressure and bodyweight measurements were performed every 3 months (blood pressure 83% versus 66%, P < 0.001 and bodyweight 78.9% versus 48.5%, P < 0.001). Apart from a marginal difference in mean cholesterol, differences in HbA1c%, blood pressure, body mass index and treatment satisfaction were not significant. Conclusion. Multifaceted implementation of locally adapted shared care guidelines did improve the process of diabetes care but hardly changed intermediate outcomes. In the short term, local adaptation of shared care guidelines does not improve the cardiovascular risks of people with type 2 diabetes

Randomised controlled trial of intensive multifactorial treatment for cardiovascular risk in patients with screen-detected type 2 diabetes: 1-year data from the ADDITION Netherlands study.

Background A growing body of evidence suggests that earlier diagnosis and treatment of diabetes may be benefical; however, definitive evidence is lacking. Aim To evaluate the effectiveness of an intensified multifactorial treatment on cardiovascular risk factors in patients with screen-detected type 2 diabetes. Design of study Randomised controlled trial. Setting Seventy-nine general practices in the southwestern region of the Netherlands. Method In this randomised trial, patients diagnosed with diabetes by screen-detection were assigned to intensified (n = 255) or routine treatment (n = 2,13), and followed over 1 year. Intensified treatment consisted of pharmacological treatment combined with lifestyle education to achieve haemoglobin A1c (HbA1c) Results Changes in body mass index were 0.2 (routine care) versus -1.4 kg/m(2) (intensified treatment), P Conclusion Intensified multifactorial treatment of patients with screen-detected diabetes in general practice reduces cardiovascular risk factor levels significantly without worsening HRQoL