Drivers and Barriers for Biochar Deployment in Swedish Agriculture

There are several sustainability challenges (e.g., environmental degradation, biodiversity loss, and food insecurity) that agro-food systems face. Simultaneously, agriculture is a major contributor to greenhouse gas emissions. Addressing these challenges requires socio-technical transformations in the agro-food system. Biochar can play a part in the solution because it is a carbon removal method with co-benefits for agriculture. Despite the goal of the Swedish government to achieve net-zero emissions by 2045, biochar has not been adopted widely in Swedish agriculture. Therefore, this study aims to investigate the drivers and barriers that facilitate or hinder biochar deployment in Swedish agriculture, and under what prerequisites an accelerated adoption can take place. The study used a qualitative case study method. The data was collected through 9 semi-structured interviews and participation in a webinar. The data was analyzed with the use of thematic analysis. The multi-level perspective framework on sustainability transitions has been applied to interpret the empirical findings. The results suggest that biochar holds promise to contribute to sustainable agriculture in Sweden, but that there are certain barriers that need to be overcome. Regarding drivers, biochar offers various agricultural and environmental benefits. The Swedish government’s goal to reduce greenhouse gas emissions from agriculture further supports its deployment. However, there are barriers that hinder the widespread adoption of biochar. The high cost of biochar, along with volatility in biochar and carbon credit price makes it risky for farmers to invest in biochar technology. Financial incentives are essential to make biochar more affordable and attractive for on-farm use. The creation of a stable and farmer-friendly carbon market is crucial to reduce fluctuations in price and ensure economic viability for farmers. Knowledge gaps also exist, highlighting the need for research funding, knowledge sharing, and collaboration among stakeholders and countries. Farmers and researchers should work together to bridge the gap between scientific findings and practical on-farm use of biochar to find its ultimate applications in agriculture. Competition with other carbon removal technologies poses additional barriers as well as perceived resistance from fertilizer companies expressed by a few stakeholders. Lack of supportive legislation for using waste materials and side streams as biomass sources and inadequate financial support for production plant investments also hinder the diffusion of biochar technology. Overcoming these barriers requires learning processes and collective efforts to establish a sustainable and economically viable biochar market that benefits Swedish agriculture and contributes to the government’s environmental goals. The results of this study can be utilized to guide policy-makers and biochar stakeholders on how to enable increased biochar adoption in Swedish agriculture

Paediatric Care in The Netherlands:State of Affairs, Challenges and Prospects

There are many societal developments in The Netherlands, such as a rising and changing demand for care and support and a paradigm shift from curation to prevention, that currently—and in the near future—will have an impact on paediatric care. These developments both reveal potential risks in paediatric care and affect practices that require future improvement. In this viewpoint, we first present the most pressing developments for paediatrics, and we demonstrate why and how Dutch paediatricians have renewed their vision on paediatric care in order to cope with a changing society. It is a vision towards the year 2030 that gives children and paediatric care the right place in the Dutch healthcare landscape to guarantee accessible, high-quality, and effective care for every child at the right time. Realising this renewed vision requires however not only an adjustment from paediatricians and paediatricians in training, but also from professionals who work with them and from the Government that can facilitate or accelerate the implementation of the renewed vision in various ways

Shared decision-making about cardiovascular disease medication in older people: A qualitative study of patient experiences in general practice

Objectives To explore older people's perspectives and experiences with shared decision-making (SDM) about medication for cardiovascular disease (CVD) prevention. Design, setting and participants Semi-structured interviews with 30 general practice patients aged 75 years and older in New South Wales, Australia, who had elevated CVD risk factors (blood pressure, cholesterol) or had received CVD-related lifestyle advice. Data were analysed by multiple researchers using Framework analysis. Results Twenty eight participants out of 30 were on CVD prevention medication, half with established CVD. We outlined patient experiences using the four steps of the SDM process, identifying key barriers and challenges: Step 1. Choice awareness: taking medication for CVD prevention was generally not recognised as a decision requiring patient input; Step 2. Discuss benefits/harms options: CVD prevention poorly understood with emphasis on benefits; Step 3. Explore preferences: goals, values and preferences (eg, length of life vs quality of life, reducing disease burden vs risk reduction) varied widely but generally not discussed with the general practitioner; Step 4. Making the decision: overall preference for directive approach, but some patients wanted more active involvement. Themes were similar across primary and secondary CVD prevention, different levels of self-reported health and people on and off medication. Conclusions Results demonstrate how older participants vary widely in their health goals and preferences for treatment outcomes, suggesting that CVD prevention decisions are preference sensitive. Combined with the fact that the vast majority of participants were taking medications, and few understood the aims and potential benefits and harms of CVD prevention, it seems that older patients are not always making an informed decision. Our findings highlight potentially modifiable barriers to greater participation of older people in SDM about CVD prevention medication and prevention in general

The Need for a Data Ecosystem for Youth Mental Health in The Netherlands

The Netherlands is missing nationally representative data on child and adolescent mental health, e.g., on prevalence, course, and consequences of psychological disorders and mental health care utilization. Researchers and policy makers also lack a basic data infrastructure that is necessary to provide timely and reliable data crucial for benchmarking and informed decision making. In this article, we describe the necessity for a clear and well-organized overview of data on youth mental health and mental health care. We look back on three key moments in time to illustrate the breadth of the desire for data. Barriers in collecting structured, national data on a frequent basis are discussed, and several recommendations are provided of what is needed to move towards a data ecosystem that can help us to track the development and mental well-being of all children and youth and the impact of the care they receive.</p

The Need for a Data Ecosystem for Youth Mental Health in The Netherlands

The Netherlands is missing nationally representative data on child and adolescent mental health, e.g., on prevalence, course, and consequences of psychological disorders and mental health care utilization. Researchers and policy makers also lack a basic data infrastructure that is necessary to provide timely and reliable data crucial for benchmarking and informed decision making. In this article, we describe the necessity for a clear and well-organized overview of data on youth mental health and mental health care. We look back on three key moments in time to illustrate the breadth of the desire for data. Barriers in collecting structured, national data on a frequent basis are discussed, and several recommendations are provided of what is needed to move towards a data ecosystem that can help us to track the development and mental well-being of all children and youth and the impact of the care they receive

Stepping Stones Triple P:The importance of putting the findings into context - a response to Tellegen and Sofronoff

Recently, we reported the findings of a randomized controlled trial on the effectiveness of Stepping Stones Triple P (SSTP) compared to Care as Usual (CAU), in BMC Medicine. The study involved parents of 209 children with Borderline to Mild Intellectual Disability (BMID), included following a school-based assessment of psychosocial problems. We found that SSTP had some short-term advantages over CAU, i.e., a reduction of parenting stress and of teacher-reported psychosocial problems, but no long-term advantages, at 6 months after the intervention. Tellegen and Sofronoff criticized that we included a limited amount of studies on the effectiveness of SSTP, and that the interpretation of our findings was inadequate. Regarding available evidence, we confined our summary to published high-quality RCTs regarding individual SSTP on level 4 - our RCT concerned that type of SSTP. Consequently, many studies were excluded but in a very adequate way. Regarding interpretation, Tellegen and Sofronoff criticized that we compared SSTP with CAU, but seem to be unware that this is consonant with current guidelines. Moreover, they noted that 49% of the parents who started SSTP followed less than half of the intended number of sessions. However, our findings on those who completed SSTP showed no more advantages of SSTP in the long term than CAU. We therefore stick to our conclusion that SSTP has some advantages in the short term compared to CAU, but not in the long term. The major burden of psychosocial problems in children with BMID prompts for further improvements.</p