Drought management: a multi-level governance approach in rural China

Drought has always been a serious problem in many parts of the world, and climate change may further exacerbate this problem. Much literature is available on providing information on drought instruments in rural China covering establishing national drought relief (Zhang et al., 2005) and water scarcity management systems (Qu et al., 2010), promoting water saving and agricultural technology (Huang et al., 2009; Blanke, et al., 2007), analyzing Water Users Association (WUA) (Wang et al., 2010), initiating water pricing measures (Yang et al., 2003; Zhong and Mol, 2010), popularizing agricultural subsidies (Du et al., 2011), and experimenting with policy-oriented microfinance and agricultural insurance (Du, 2003; Zeng and Mu, 2010). But very few has addressed the issues on multi-level governance in this area in general, and in China in particular. This paper focuses on the question: How can an examination of institutional and non-institutional causes of drought and the performance of existing instruments at multiple levels of governance help us to develop more appropriate policy instruments for drought management in China

Trees and Regeneration in Rubber Agroforests and Other Forest-derived Vegetation in Jambi (Sumatra, Indonesia)

The rubber agroforests (RAF) of Indonesia provide a dynamic interface between natural processes of forest regeneration and human's management targeting the harvesting of latex with minimum investment of time and financial resources. The composition and species richness of higher plants across an intensification gradient from forest to monocultures of tree crops have been investigated in six land use types (viz. secondary forest, RAF, rubber monoculture, oil palm plantation, cassava field and Imperata grassland) in Bungo, Jambi Province, Indonesia. We emphasize comparison of four different strata (understory, seedling, sapling and tree) of vegetation between forest and RAF, with specific interest in plant dependence on ectomycorrhiza fungi. Species richness and species accumulation curves for seedling and sapling stages were similar between forest and RAF, but in the tree stratum (trees > 10 cm dbh) selective thinning by farmers was evident in a reduction of species diversity and an increase in the proportion of trees with edible parts. Very few trees dependent on ectomycorrhiza fungi were encountered in the RAF. However, the relative distribution of early and late successional species as evident from the wood density distribution showed no difference between RAF and forest

Patient-reported causes of heart failure in a large European sample

Background:  Patients diagnosed with chronic diseases develop perceptions about their disease and its causes, which may influence health behavior and emotional well-being. This is the first study to examine patient-reported causes and their correlates in patients with heart failure. Methods:  European heart failure patients (N = 595) completed questionnaires, including the Brief Illness Perceptions Questionnaire. Using deductive thematic analysis, patient-reported causes were categorized into physical, natural, behavioral, psychosocial, supernatural and other. Clinical data were collected from medical records. Results:  Patients who did not report any cause (11%) were on average lower educated and participated less often in cardiac rehabilitation. The majority of the remaining patients reported physical causes (46%, mainly comorbidities), followed by behavioral (38%, mainly smoking), psychosocial (35%, mainly (work-related) stress), and natural causes (32%, mainly heredity). There were socio-demographic, clinical and psychological group differences between the various categories, and large discrepancies between prevalence of physical risk factors according to medical records and patient-reported causes; e.g. 58% had hypertension, while only 5% reported this as a cause. Multivariable analyses indicated trends towards associations between physical causes and poor health status (Odds ratio (OR) = 1.41, 95% confidence interval (95% CI) = 0.95-2.09, p = 0.09), psychosocial causes and psychological distress (OR = 1.54, 95% CI = 0.94-2.51, p = 0.09), and behavioral causes and a less threatening view of heart failure (OR = 0.64, 95% CI = 0.40-1.01, p = 0.06). Conclusion:  European patients most frequently reported comorbidities, smoking, stress, and heredity as heart failure causes, but their causal understanding may be limited. There were trends towards associations between patient-reported causes and health status, psychological distress, and illness perceptions

Distinct trajectories of disease-specific health status in heart failure patients undergoing cardiac resynchronization therapy

Purpose: It is well known that a significant proportion of heart failure patients (10–44 %) do not show improvement in symptoms or functioning from cardiac resynchronization therapy (CRT), yet no study has examined patient-reported health status trajectories after implantation. Methods: A cohort of 139 patients with a CRT-defibrillator (70 % men; age 65.7 ± 10.1 years) completed the Kansas City Cardiomyopathy Questionnaire (KCCQ) prior to implantation (baseline) and at 2, 6, and 12–14 months post-implantation. Latent class analyses were used to identify trajectories and associates of disease-specific health status over time. Results: All health status trajectories showed an initial small to large improvement from baseline to 2-month follow-up, whereafter most trajectories displayed a stable pattern between short- and long-term follow-up. Low educational level, NYHA class III/IV, smoking, no use of beta-blockers, use of psychotropic medication, anxiety, depression, and type D personality were found to be associated with poorer health status in unadjusted analyses. Interestingly, subgroups of patients (12–20 %) who experienced poor health status at baseline improved to stable good health status levels after implantation. Conclusions: Levels of disease-specific health status vary considerably across subgroups of CRT-D patients. Classification into poorer disease-specific health status trajectories was particularly associated with patients’ psychological profile and NYHA classification. The timely identification of CRT-D patients who present with poor disease-specific health status (i.e., KCCQ score < 50) and a distressed psychological profile (i.e., anxiety, depression, and/or type D personality) is paramount, as they may benefit from cardiac rehabilitation in combination with psychological intervention

Sandalwood as a Component of Agroforestry: Exploration of Parasitism and Competition with the Wanulcas Model

Sandalwood is an important component of agroforestry systems in the drier Eastern parts of Indonesia, although its value to farmers is still limited by existing policies and regulation of marketing. As a relatively slow growing root parasite, sandalwood will interact with other components in a complex pattern of competition and host-parasite relationships, depending on root distribution and rooting depth of potential hosts. We describe a number of modifications to the generic tree-soil-crop simulation model WaNuLCAS, that allow exploration of the transition between parasitism and competition. The key variable in this transition is the effectiveness of formation of the parasitic link for all situations where roots of the host and parasite occur in the same volume of soil. At low values of this effectiveness competition dominates, at higher values sandalwood will weaken the host, until it effectively kills it, leading to an optimum response of sandalwood to the effectiveness parameter. Unresolved questions in the formulation of the model are the lifespan of parasitized roots and the question whether or not sandalwood will allocate energy resources for maintenance respiration of host roots after the formation of haustoria. The'desk study' reported here was intended to focus subsequent field studies on these unresolved issues

Substance use disorders and sexual behavior:the effects of alcohol and drugs on patients' sexual thoughts, feelings and behavior

Introduction: Hardly any research exists on the relationship between substance use and sexual behaviors in patients with a substance use disorder. This study aimed to examine this relation by looking into perceived positive effects on sexual behavior, perceived negative effects and risky sexual behavior due to substance use in patient groups of users of alcohol, stimulants, sedatives and Gamma hydroxybutyrate (GHB). In addition, the current study aimed to address the question whether sexual behavior (e.g. number of sexual partners, sexual activity) differs between these patient groups. Method: A total of 180 patients with a substance use disorder (i.e. alcohol, amphetamine, cannabis, cocaine, GHB and opiates) participated. A self-report questionnaire was administered with questions on substance use, sexual behaviors (e.g. sexual activity, masturbation, use of pornography) and statements about the perceived changes in sexual functioning and behavior under influence of the primary substance of abuse. Results: All four groups reported changes in sexual thoughts, feelings and behavior due to the use of their primary substance. More than half of the patients reported enhancements in sexual domains (i.e. sexual pleasure, sexual arousal, sexual behavior), but also decrements or risky behaviors and about a quarter stated that their sexual thoughts, feelings and behaviors were often associated with the use of their primary substance of abuse. Patients with a GHB use disorder reported the strongest relation between drug use and sexual behavior. Users of HB not only reported more enhancement in several sexual domains, but also less decline in sexual domains compared to the other patient groups and more risky behavior or more sexual activity than some of the other groups of patients. Conclusions: The results underline the importance of addressing the relationship between substance use and sexual behavior in treatment programs, as patients may be hesitant to stop their use of substances when they experience many positive effects in their sexual behavior. Future research directions are suggested

Voluntary agreements to achieve energy efficiency, a comparison between China and The Netherlands

China has gained experience with voluntary agreements. In this paper the experiences in China will be analysed and compared to the factors contributing to the success of this model in the Netherlands. Are voluntary agreements an alternative for the Chinese command and control system? We distinguish different types of voluntary agreements and compare those in China and the Netherlands on a number of dimensions. The hypothesis is tested that voluntary agreements are more effective in achieving pollution control than the traditional command and control approach. It is found that indeed most voluntary agreements score good in China as well as in the Netherlands on a number of chosen indicators. Voluntary agreements are effective in achieving ambitious energy saving targets in a flexible and cost-effective way. Voluntary agreements have the function to mobilise support for energy saving, which is not easily mobilised through the traditional command-and-control approaches. There are however some important differences between the functioning of the system in China and in the Netherlands, where a more bottom-up approach is common. The Netherlands has a tradition of stakeholders' involvement and experience over a longer time of monitoring the effectiveness of the project and adjusting them if necessary