The importance of being nimby; Een essay over burgerverzet en erfgoed

Dit essay is geschreven als statement naast alle feitelijke en verhelderende studies over burgerinitiatieven die eerder in deze reeks verschenen en nog zullen verschijnen. In een dialoog aan het einde van het essay maken we de (beleids)dilemma’s helder waar soms wel en soms nog geen oplossingen voor zij

General practitioners' accounts of negotiating antibiotic prescribing decisions with patients: a qualitative study on what influences antibiotic prescribing in low, medium and high prescribing practices

Background Antimicrobial resistance (AMR) is high on the UK public health policy agenda, and poses challenges to patient safety and the provision of health services. Widespread prescribing of antibiotics is thought to increase AMR, and mostly takes place in primary medical care. However, prescribing rates vary substantially between general practices. The aim of this study was to understand contextual factors related to general practitioners’ (GPs) antibiotic prescribing behaviour in low, high, and around the mean (medium) prescribing primary care practices. Methods Qualitative semi-structured interviews were conducted with 41 GPs working in North-West England. Participants were purposively sampled from practices with low, medium, and high antibiotic prescribing rates adjusted for the number and characteristics of patients registered in a practice. The interviews were analysed thematically. Results This study found that optimizing antibiotic prescribing creates tensions for GPs, particularly in doctor-patient communication during a consultation. GPs balanced patient expectations and their own decision-making in their communication. When not prescribing antibiotics, GPs reported the need for supportive mechanisms, such as regular practice meetings, within the practice, and in the wider healthcare system (e.g. longer consultation times). In low prescribing practices, GPs reported that increasing dialogue with colleagues, having consistent patterns of prescribing within the practice, supportive practice policies, and enough resources such as consultation time were important supports when not prescribing antibiotics. Conclusions Insight into GPs’ negotiations with patient and public health demands, and consistent and supportive practice-level policies can help support prudent antibiotic prescribing among primary care practices

Structural phase transition and material properties of few-layer monochalcogenides

GeSe and SnSe monochalcogenide monolayers and bilayers undergo a two-dimensional phase transition from a rectangular unit cell to a square unit cell at a temperature $T_c$ well below the melting point. Its consequences on material properties are studied within the framework of Car-Parrinello molecular dynamics and density-functional theory. No in-gap states develop as the structural transition takes place, so that these phase-change materials remain semiconducting below and above $T_c$. As the in-plane lattice transforms from a rectangle onto a square at $T_c$, the electronic, spin, optical, and piezo-electric properties dramatically depart from earlier predictions. Indeed, the $Y-$ and $X-$points in the Brillouin zone become effectively equivalent at $T_c$, leading to a symmetric electronic structure. The spin polarization at the conduction valley edge vanishes, and the hole conductivity must display an anomalous thermal increase at $T_c$. The linear optical absorption band edge must change its polarization as well, making this structural and electronic evolution verifiable by optical means. Much excitement has been drawn by theoretical predictions of giant piezo-electricity and ferroelectricity in these materials, and we estimate a pyroelectric response of about $3\times 10^{-12}$ $C/K m$ here. These results uncover the fundamental role of temperature as a control knob for the physical properties of few-layer group-IV monochalcogenidesComment: Supplementary information included. Published versio

Методические подходы к оценке возможности реализации инновационных стратегий

Целью данной статьи является рассмотрение методических подходов к оценке возможности реализации инновационных стратегий

Patterns of recurring dispensing of guideline antibiotics for uncomplicated urinary tract infection in women over a 5-year period: longitudinal patterns of recurring dispensings of Dutch guideline UTI antibiotics

Background. Urinary tract infection (UTI) is one of the most prevalent medical conditions among women seeking primary care. About 20-40% of the women have a UTI recurrence during their lifetime.Objective. To provide insight in the patterns of recurring annual dispensing for antibiotics commonly used for UTI treatment in women, aged 18 years or older, during a 5-year follow-up period in the Netherlands.Methods. The Dutch Foundation of Pharmaceutical statistics collects dispensing data from more than 90% of all community pharmacies. Pharmacies with complete data between years 2011 and 2017 were included. Women of age 18 years or older with a first dispensing of nitrofurantoin, fosfomycin, or trimethoprim in 2012 and a dispensing of any medication in 2017 were selected. For each year between 2013 and 2017, the proportions of women with recurring dispensing of nitrofurantoin, fosfomycin or trimethoprim were calculated and stratified for age categories.Results. Within 1517 eligible community pharmacies, 463 821 women, aged 18 years or older, were dispensed one of the antibiotics in 2012, and 239 292 women still visited the same pharmacy in 2017. About 56% of them received at least one recurring dispensing during 5 years of follow-up. Each year, similar to 20% of the source population had at least one recurring dispensing. Approximately 2% of the source population had at least one recurring dispensing in each year of follow-up.Conclusions. Over the 5-year study period, more than 50% of the source population had at least one recurring dispensing for uncomplicated UTI, most of them with at least 1 year without UTI dispensing in between.Clinical Pharmacy and Toxicolog

Ultra-tuning of nonlinear drumhead MEMS resonators by electro-thermoelastic buckling

Nonlinear micro-electro-mechanical systems (MEMS) resonators open new opportunities in sensing and signal manipulation compared to their linear counterparts by enabling frequency tuning and increased bandwidth. Here, we design, fabricate and study drumhead resonators exhibiting strongly nonlinear dynamics and develop a reduced order model (ROM) to capture their response accurately. The resonators undergo electrostatically-mediated thermoelastic buckling which tunes their natural frequency from 4.7 to 11.3 MHz, a factor of 2.4x tunability. Moreover, the imposed buckling switches the nonlinearity of the resonators between purely stiffening, purely softening, and even softening-to-stiffening. Accessing these exotic dynamics requires precise control of the temperature and the DC electrostatic forces near the resonator's critical-buckling point. To explain the observed tunability, we develop a one-dimensional physics-based ROM that predicts the linear and nonlinear response of the fundamental bending mode of these drumhead resonators. The ROM captures the dynamic effects of the internal stresses resulting from three sources: The residual stresses from the fabrication process, the mismatch in thermal expansion between the constituent layers, and lastly, the applied electrostatic forces. The ROM replicates the observed tunability of linear (within 5.5% error) and nonlinear responses even near the states of critical buckling. These remarkable nonlinear and large tunability of the natural frequency are valuable features for on-chip acoustic devices in broad applications such as signal manipulation, filtering, and MEMS waveguides

Inventarisatie van uitzetmethoden van biologische bestrijders in kassen Gezonde Kas: Product 23: Doelgericht uitzetten van biologische bestrijders en evaluatie van toedieningstechnieken voor biologische bestrijders

Dit rapport geeft een overzicht van toedieningsmethoden van biologische bestrijders met daaraan gekoppeld de voor- en nadelen per methode. Roofmijten, roofwantsen, sluipwesppoppen (wittevlieg en mineervlieg), galmugpoppen en sluipwespen, galmuggen worden allemaal handmatig uitgezet. Handmatig uitzetten kost veel tijd en is daarom duur. Een vorm van mechanisatie van het uitzetten is op gang gekomen, met name voor roofmijten en galmugpoppen. Per bestrijder is objectief gezien onbekend of voldoende, te weinig of te veel wordt gedoseerd. Aangezien de bestrijders lopen (roofmijten) of vliegen (sluipwespen, galmuggen, roofwantsen) en actief op zoek gaan naar prooien wordt door telers en leveranciers alleen naar de effectieve plaagbestrijding gekeken. Sluipwesppoppen kunnen eventueel nog worden verblazen (mechanisatie van uitzetten); voor de vliegende bestrijders lijkt dit minder zinvol, hoewel het effect onbekend is

Ruimtelijke verdeling van gewasbeschermingsmiddelen in de kas: Hoe komt een middel via een gewasbehandeling in het recirculatiewater terecht?

Gewasbeschermingsmiddelen vormen een probleem in het oppervlaktewater om een goede ecologische kwaliteit te bereiken (Teunissen, 2005; Kruger, 2008; Van der Staaij, 2009). In 2015 moet het oppervlaktewater een goede kwaliteit hebben en lozen van middelen is dan niet meer toegestaan. Het is daarom belangrijk te weten hoe middelen in het oppervlaktewater terecht komen. In deze notitie wordt verslag gedaan van een inventariserend onderzoek naar de route die het spuitmiddel in de kas aflegt. Komt er via de standaard spuitmethode spuitmiddel in het recirculatiewater en is dit te voorkomen of te verminderen? Telen met toekomst heeft de taak vragen en knelpunten bij geïntegreerde teelt en emissie van gewasbeschermingsmiddelen naar het onderzoek terug te koppelen. Dit onderzoek is dan ook op verzoek van Telen met toekomst uitgevoerd in het project ‘Knelpunten bij de implementatie van Best Practices’, onderdeel van het LNV programma Plantgezondhei