Knowledge uncertainties in environmental conflicts:How the mussel fishery controversy in the Dutch Wadden Sea became depoliticised

<p>Policy-makers and scientists often expect that controversies in public policy can be solved by gathering more knowledge, even though this linear model of expertise is widely criticised in social studies of science. To shed more light on this expectation, the role of scientific uncertainties in controversies on mussel fishery in the Dutch Wadden Sea (1990–2016) is investigated. The analysis shows that mussel fishery regulation decisions were primarily based on government authority, not on scientific knowledge. Expectations of policy-makers and scientists on conflict resolution by more research were not met, because the knowledge debate was politicised over ambiguous knowledge claims. The controversy was depoliticised by a political covenant between the conflicting parties. The case study confirms that science-based knowledge fails to guide policy-making as expected in the linear model, and demonstrates how science plays important strategic, procedural and instrumental roles in structuring interactions between stakeholders in nature protection conflicts.</p

Is methotrexate safe for men with an immune-mediated inflammatory disease and an active desire to become a father? Results of a prospective cohort study (iFAME-MTX)

Introduction Current scientific evidence guiding the decision whether men with an active desire to become a father should be treated with methotrexate (MTX) remains controversial. We aimed to prospectively evaluate the testicular toxicity profile of MTX focusing on several markers of male fertility, including semen parameters and sperm DNA fragmentation index (sDFI). As a secondary outcome, we aimed to evaluate whether MTX-polyglutamates can be detected in spermatozoa and seminal plasma and to evaluate the enzymatic activity in spermatozoa of folylpolyglutamate synthetase (FPGS). Methods In a prospective cohort study, men ≥18 years who started therapy with MTX were invited to participate (MTX-starters). Participants were instructed to produce two semen samples (a pre-exposure and a post-exposure sample after 13 weeks). Healthy men ≥18 years were invited to participate as controls. Conventional semen analyses, male reproductive endocrine axis and sDFI were compared between groups. FPGS enzymatic activity and MTX-PG1-5 concentrations were determined by mass spectrometry analytical methods. Results In total, 20 MTX-starters and 25 controls were included. The pre-exposure and postexposure semen parameters of MTX-starters were not statistically significant different. Compared with healthy controls, the conventional semen parameters and the sDFI of MTX-starters were not statistically significant different. These data were corroborated by the marginal accumulation of MTX-PGs in spermatozoa, consistent with the very low FPGS enzymatic activity associated with the expression of an alternative FPGS splice-variant. Discussion Treatment with MTX is not associated with testicular toxicity, consistent with the very low concentration of intracellular MTX-PG. Therefore, therapy with MTX can be safely started or continued in men and with a wish to become a father.</p

Effect of Hydrocortisone on Mortality and Organ Support in Patients With Severe COVID-19: The REMAP-CAP COVID-19 Corticosteroid Domain Randomized Clinical Trial.

Importance: Evidence regarding corticosteroid use for severe coronavirus disease 2019 (COVID-19) is limited. Objective: To determine whether hydrocortisone improves outcome for patients with severe COVID-19. Design, Setting, and Participants: An ongoing adaptive platform trial testing multiple interventions within multiple therapeutic domains, for example, antiviral agents, corticosteroids, or immunoglobulin. Between March 9 and June 17, 2020, 614 adult patients with suspected or confirmed COVID-19 were enrolled and randomized within at least 1 domain following admission to an intensive care unit (ICU) for respiratory or cardiovascular organ support at 121 sites in 8 countries. Of these, 403 were randomized to open-label interventions within the corticosteroid domain. The domain was halted after results from another trial were released. Follow-up ended August 12, 2020. Interventions: The corticosteroid domain randomized participants to a fixed 7-day course of intravenous hydrocortisone (50 mg or 100 mg every 6 hours) (n = 143), a shock-dependent course (50 mg every 6 hours when shock was clinically evident) (n = 152), or no hydrocortisone (n = 108). Main Outcomes and Measures: The primary end point was organ support-free days (days alive and free of ICU-based respiratory or cardiovascular support) within 21 days, where patients who died were assigned -1 day. The primary analysis was a bayesian cumulative logistic model that included all patients enrolled with severe COVID-19, adjusting for age, sex, site, region, time, assignment to interventions within other domains, and domain and intervention eligibility. Superiority was defined as the posterior probability of an odds ratio greater than 1 (threshold for trial conclusion of superiority >99%). Results: After excluding 19 participants who withdrew consent, there were 384 patients (mean age, 60 years; 29% female) randomized to the fixed-dose (n = 137), shock-dependent (n = 146), and no (n = 101) hydrocortisone groups; 379 (99%) completed the study and were included in the analysis. The mean age for the 3 groups ranged between 59.5 and 60.4 years; most patients were male (range, 70.6%-71.5%); mean body mass index ranged between 29.7 and 30.9; and patients receiving mechanical ventilation ranged between 50.0% and 63.5%. For the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively, the median organ support-free days were 0 (IQR, -1 to 15), 0 (IQR, -1 to 13), and 0 (-1 to 11) days (composed of 30%, 26%, and 33% mortality rates and 11.5, 9.5, and 6 median organ support-free days among survivors). The median adjusted odds ratio and bayesian probability of superiority were 1.43 (95% credible interval, 0.91-2.27) and 93% for fixed-dose hydrocortisone, respectively, and were 1.22 (95% credible interval, 0.76-1.94) and 80% for shock-dependent hydrocortisone compared with no hydrocortisone. Serious adverse events were reported in 4 (3%), 5 (3%), and 1 (1%) patients in the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively. Conclusions and Relevance: Among patients with severe COVID-19, treatment with a 7-day fixed-dose course of hydrocortisone or shock-dependent dosing of hydrocortisone, compared with no hydrocortisone, resulted in 93% and 80% probabilities of superiority with regard to the odds of improvement in organ support-free days within 21 days. However, the trial was stopped early and no treatment strategy met prespecified criteria for statistical superiority, precluding definitive conclusions. Trial Registration: ClinicalTrials.gov Identifier: NCT02735707

Climate stress tests as a climate adaptation information tool in Dutch municipalities

Climate information plays a key role in adaptation to climate change, but providing and using it in effective ways is a challenge. Climate information often remains underutilized and even when used, its influence on policy making is far from clear. In the Netherlands, climate stress tests were introduced to inform and stimulate climate adaptation policy on a municipal level. In the stress tests, risks and vulnerabilities were estimated for scenarios of extreme precipitation, heat stress, drought, and flooding. This article examines whether and how this new tool has effectuated mainstreaming of climate adaptation information into municipal policy. Based on interviews with municipal officials and document analysis we show that the stress tests did so along two general pathways. In the ‘applied’ pathway, the stress tests were used in an instrumental way to influence policy goals and measures. In the ‘configuring’ pathway, stress tests were primarily used for learning and persuasion, and mostly influenced problem perceptions and actor involvement. In the ‘applied’ pathway, the accuracy and resolution of the information were key factors; in the ‘configuring’ pathway, its influence depended on the accessibility of information and the kind of interaction during policy formulation. Which of the pathways predominated depended on how an adaptation problem fitted with existing policy arrangements. The findings show that stress tests are a promising tool for policy mainstreaming and for promoting local climate adaptation. They also highlight the importance of identifying the pathways of information use, in order to increase the impact of climate information

Environmental reform of West and Central Africa ports : the influence of colonial legacies

West and Central Africa ports have historically not paid much attention to environmental issues. In the past decade, however, environmental concerns are beginning to emerge with pockets of innovative responses to environmental risks as the ports undergo institutional and infrastructural reform – most notably, with concessions to multinational terminal operators. In this article, environmental management processes in the ports of Abidjan (Ivory Coast), Douala (Cameroon), Lagos (Nigeria) and Tema (Ghana) are compared. Three aspects of ecological modernization theory: changing role of the state, growing involvement of economic actors and economic incentives, and shifting roles for civil society organizations are focused on to analyse the dynamics of their environmental reform. Findings suggest that globalization processes are a common major trigger in enhancing a gradual but still fragmented and limited process of environmental reform in West and Central Africa ports, but paces and pathways of the reform are influenced by national politico-administrative arrangements rooted in colonial legacies. Consequently, understanding and advancing environmental reform processes of West and Central Africa ports requires following trends and significant developments but also taking into account national historical trajectories

A social practice approach to nature-based tours : the case of the Marble Caves in Northern Patagonia, Chile

Chile’s Northern Patagonia attracts thousands of tourists, who every summer venture to undertake a range of outdoor activities. In this article, we explore the local production of outdoor activities, by conceptualizing small-scale nature-based tours as a social practice. The study is based on empirical research, taking as a case study the development of the Marble Caves tour, an iconic destination in Northern Patagonia, Chile. The touring practice is analyzed based on the interplay of its material components, required competences and symbolic meanings. Our findings demonstrate that the persistence of the practice is particularly reliant on the competences of the tour operators, and on the abiotic nature of the tourist attraction. Fostering tour guide competences therefore contributes to the sustainability and performance of the practice. We contend that tourism policy interventions that aim to harmonize local development and environmental protection need to carefully analyze and take into account existing social practices

Greening international shipping through private governance: A case study of the Clean Shipping Project

This article aims to generate insights into both private governance and partnerships within the shipping industry, but also tries to improve understanding of the complex process of institutionalisation. This is achieved through a case study of the Clean Shipping Project, a public/private partnership that aims to promote sustainability in the shipping industry. A set of enabling and constraining factors are examined that shape the institutionalisation process and determine to what extent the Clean Shipping Project can establish and expand authority as an industry norm. Overall, the Clean Shipping Project cannot yet be considered a full-fledged private governance institution, because of an insufficient level of collaborative advantage mainly due to weak system robustness and unfavourable market characteristics and conditions. However, institutionalisation is an ongoing process and the future outlook for the Clean Shipping Project remains promising. The Clean Shipping Project is certainly a relevant supplement to existing regulations and there is a basic level of commitment and cohesion within the partnership, so it is not unlikely that in the future this initiative may help to uncouple growth in shipping activities from environmental harm.Clean Shipping Project Private governance Partnerships Institutionalisation Shipping

Protecting wilderness or cultural and natural heritage? : Insights from northern Patagonia, Chile

Protecting 30% of the planet’s terrestrial and marine ecosystems by 2030 (30x30) is the most recent call for global conservation action. Toward this end, the creation of protected areas is a central strategy. The various parties to the Convention on Biological Diversity (CBD) have committed to this global goal, including Chile. Against this backdrop, this article explores current narratives and practices around five protected areas in northern Patagonia, Chile. We argue that environmental discourses are key to understanding these narratives and practices. Environmental discourses influence the values central to the creation and development of protected areas, as well as the prevailing management approaches for these areas. Our findings show that two discourses are of particular importance: the ‘Patagonian wilderness’ discourse and the ‘cultural and natural heritage’ discourse. Based on our findings, we also discuss three emerging topics: the rewilding and rebranding of Patagonia, optimism around nature-based tourism, and implementation of global conservation goals within the national context. We reflect on the implications of our findings for further developments in Patagonia and for the global conservation debate. We contend that the future of protected-area management in northern Patagonia will depend on how community-based management initiatives are fostered and argue that aligning with such inclusive conservation approaches will be a critical requirement for the implementation of the 30x30 goal moving forward